OBJECTIVE To investigate the serum toll-like receptor 4(TLR4),matrix metalloproteinase-3(MMP-3),in-terleukin-1β(IL-1β)and peripheral blood helper T-cell 17/regulatory T-cell(Th17/Treg)levels in patients with chronic periodontitis infected with porphyromonas gingivalis(Pg),as well as their diagnostic value of Pg infection in patients with chronic periodontitis.METHODS Totally 390 cases of patients with chronic periodontitis who at-tended Tianjin Stomatological Hospital from Jan.2022 to Jan.2024 were selected as the study subjects,and were divided into the infected group(113 cases)and the uninfected group(277 cases)according to Pg infection,and those patients in the infected group were further classified into the mild group(31 cases),the moderate group(45 cases),and the severe group(37 cases)according to the condition of the disease.Serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg levels were compared between the infected and uninfected groups and patients with different conditions of chronic periodontitis Pg infection,and the infected group was included in the positive and the uninfected group was included in the negative,and the receiver's operating characteristics(ROC)curves were plotted to obtain the area under the curve(AUC)to analyze the diagnostic value of single and combined de-tection of serum TLR4,MMP-3,and IL-1β,Peripheral blood Th17/Treg for Pg infection in patients with chronic periodontitis.RESULTS Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the infected group were(20.41±5.12)ng/ml,(6.12±2.03)μg/L,(10.24±2.19)μg/L and(0.32±0.10),higher than those in the uninfected group(P＜0.05).Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the se-vere group were(22.58±6.10)ng/ml,(8.12±2.67)μg/L,(12.49±3.10)μg/L and(0.52±0.15),higher than those in the moderate group[(14.78±3.44)ng/ml,(6.15±2.07)μg/L,(7.23±1.99)μg/L and(0.22±0.07)]and mild group(P＜0.05),which in the moderate group was higher than those in the mild group(P＜0.05).The results of ROC analysis showed that the AUC of serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg combined test for diagnosing Pg infection in patients with chronic periodontitis was 0.937,which was higher than that of the four single tests(P＜0.05).CONCLUSION Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg were highly expressed in chronic periodontitis patients infected with Pg,and all four indicators can participate in the progression of the disease,and the combined detection of these four indicators has a higher diagnostic value for Pg infection in patients with chronic periodontitis.

OBJECTIVE To investigate the serum toll-like receptor 4(TLR4),matrix metalloproteinase-3(MMP-3),in-terleukin-1β(IL-1β)and peripheral blood helper T-cell 17/regulatory T-cell(Th17/Treg)levels in patients with chronic periodontitis infected with porphyromonas gingivalis(Pg),as well as their diagnostic value of Pg infection in patients with chronic periodontitis.METHODS Totally 390 cases of patients with chronic periodontitis who at-tended Tianjin Stomatological Hospital from Jan.2022 to Jan.2024 were selected as the study subjects,and were divided into the infected group(113 cases)and the uninfected group(277 cases)according to Pg infection,and those patients in the infected group were further classified into the mild group(31 cases),the moderate group(45 cases),and the severe group(37 cases)according to the condition of the disease.Serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg levels were compared between the infected and uninfected groups and patients with different conditions of chronic periodontitis Pg infection,and the infected group was included in the positive and the uninfected group was included in the negative,and the receiver's operating characteristics(ROC)curves were plotted to obtain the area under the curve(AUC)to analyze the diagnostic value of single and combined de-tection of serum TLR4,MMP-3,and IL-1β,Peripheral blood Th17/Treg for Pg infection in patients with chronic periodontitis.RESULTS Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the infected group were(20.41±5.12)ng/ml,(6.12±2.03)μg/L,(10.24±2.19)μg/L and(0.32±0.10),higher than those in the uninfected group(P＜0.05).Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the se-vere group were(22.58±6.10)ng/ml,(8.12±2.67)μg/L,(12.49±3.10)μg/L and(0.52±0.15),higher than those in the moderate group[(14.78±3.44)ng/ml,(6.15±2.07)μg/L,(7.23±1.99)μg/L and(0.22±0.07)]and mild group(P＜0.05),which in the moderate group was higher than those in the mild group(P＜0.05).The results of ROC analysis showed that the AUC of serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg combined test for diagnosing Pg infection in patients with chronic periodontitis was 0.937,which was higher than that of the four single tests(P＜0.05).CONCLUSION Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg were highly expressed in chronic periodontitis patients infected with Pg,and all four indicators can participate in the progression of the disease,and the combined detection of these four indicators has a higher diagnostic value for Pg infection in patients with chronic periodontitis.

Objective:To investigate the incidence of venous thromboembolism (VTE) in patients with esophageal cancer (EC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 8 458 EC patients who were admitted to Sichuan Cancer Hospital from January 2017 to December 2021 were collected. There were 6 923 males and 1 535 females, aged (64±9)years. There were 3 187 patients undergoing surgical treatment, and 5 271 cases undergoing non-surgical treatment. Observation indicators: (1) incidence of VTE in EC patients; (2) treatment and outcomes of patients with VTE. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the nonparameter rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparameter rank sum test. Results:(1) Incidence of VTE in EC patients. Of 8 458 EC patients, 175 cases developed VTE, with an incidence rate of 2.069%(175/8 458). Among 175 VTE patients, there were 164 cases of deep venous thrombosis (DVT), 4 cases of pulmonary embolism (PE), 7 cases of DVT and PE. There were 59 surgical patients and 116 non-surgical patients. There was no significant difference in thrombus type between surgical and non-surgical EC patients with VTE ( χ2=1.95, P>0.05). Of 3 187 surgical patients, the incidence of VTE was 1.851%(59/3 187), including an incidence of 0.157%(5/3 187) of PE. PE accounted for 8.475%(5/59) of surgical patients with VTE. Of 5 271 non-surgical patients, the incidence of VTE was 2.201%(116/5 271), including an incidence of 0.114%(6/5 271) of PE. PE accounted for 5.172%(6/116) of non-surgical patients with VTE. There was no significant difference in the incidence of VTE or PE between surgical patients and non-surgical patients ( χ2=1.20, 0.05, P>0.05). (2) Treatment and outcomes of patients with VTE. Among 175 EC patients with VTE, 163 cases underwent drug treatment, and 12 cases did not receive treatment. Among 163 cases with drug therapy, 158 cases underwent anticoagulant therapy, 5 cases were treated with thrombolysis. All the 163 patients were improved and discharged from hospital. Conclusions:The incidence of VTE in patients with EC is relatively low, as 2.069%. There is no significant difference in the incidence of VTE or thrombus type between surgical EC patients and non-surgical EC patients.

Objective:To investigate the clinical efficacy and prognostic influencing factors of open abdomen technique for acute pancreatitis with abdominal compartment syndrome (ACS).Methods:The retrospective cohort study was conducted. The clinical data of 186 patients of acute pancreatitis with ACS who were admitted to 6 hospitals, including 65 cases in the 910th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army, 46 cases in the First Affiliated Hospital of Wenzhou Medical University, 33 cases in the Fujian Provincial Hospital, 31 cases in the Second Affiliated Hospital of Fujian Medical University, 7 cases in the People′s Hospital Affiliated to Quanzhou Medical College, 4 cases in the Shishi General Hospital, from January 2013 to December 2020 were collected. There were 142 males and 44 females, aged (43±8)years. Observation indica-tors: (1) patients conditions after being treatment with open abdomen technique; (2) analysis of clinical characteristics in patients with different treatment outcomes; (3) changing trend of the volume of urine output, levels of lactic acid, levels of enteral nutrient intake and the sequential organ failure score in patients with different treatment outcomes; (4) influencing factors for prognosis of patients. Measurement data with normal distribution were represented as Mean± SD, and compari-son between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test or the continuity correction chi-square test. Repeated measurement data were analyzed using the repeated ANOVA. Spearman correlation analysis was used for correlation analyses. The COX regression model was used for univariate analysis and COX regression model with forward regression was used for multivariate analysis. Results:(1) Patients conditions after being treatment with open abdomen technique. Intra-abdominal pressure, oxygena-tion index, levels of lactic acid and sequential organ failure score of the 186 patients were (23.3±1.9)mmHg (1 mmHg=0.133 kPa), (121±24)mmHg, (5.0±3.4)mmol/L and 10.4±3.6 before the treatment with open abdomen technique and (11.2±2.9)mmHg, (222±38)mmHg, (3.2±2.1)mmol/L and 4.4±2.3 at postoperative 168 hours, showing significant differences in time effects before and after the treatment ( Ftime=855.26,208.50, 174.91,208.47, P<0.05). (2) Analysis of clinical characteristics in patients with different treatment outcomes. Of the 186 patients, 166 cases survived and were discharged, and 20 cases died during hospitalization. Age, sequential organ failure score, duration of ACS and levels of lactic acid during hospitalization before the treatment with open abdomen technique were (41±7)years, 9.4±3.4, 13(10,21)hours and (4.2±0.6)mmol/L in surviving patients, versus (45±6)years, 11.5±2.4, 65(39,84)hours and (5.2±0.5)mmol/L in dead patients, respectively, showing significant differences between them ( t=-2.10, -2.71, Z=-5.36, t=-7.16, P<0.05). Duration of postoperative acute gastro-intestinal injury, duration of continuous renal replacement therapy, time to liberation from mech-anical ventilation, duration of vasoactive drugs therapy, cases undergoing early abdominal closure, cases without intestinal fistula or with postoperative high-order intestinal fistula and low-order intestinal fistula during hospitalization after the treatment with open abdomen technique were 4(2,6)days, 4(3,7)days, 34(21,41)days, 3(2,6)days, 126, 131, 23, 12 in surviving patients, versus 13(10,17)days, 10(8,18)days, 0(0,3)days, 8(6,12)days, 1, 2, 15, 3 in dead patients, respectively, showing significant differences between them ( Z=-5.60, -3.75, -3.64, -3.06, χ2=41.43, 45.86, P<0.05). (3) Changing trend of the volume of urine output, levels of lactic acid, levels of enteral nutrient intake and the sequential organ failure score in patients with different treatment outcomes. The volume of urine output, levels of lactic acid, levels of enteral nutrient intake and the sequential organ failure score in surviving patients during hospitalization were (0.29±0.10)mL/(kg·h), (4.2±0.6)mmol/L, 0.0 kcal/(kg·d) and 9.4±3.4 before the treatment with open abdomen technique and (2.22±0.15)mL/(kg·h), (1.9±0.7)mmol/L, (20.7±2.9)kcal/(kg·d) and 3.7±2.2 at postoperative 168 hours. The above indicators in dead patients during hospitalization were (0.28±0.08)mL/(kg·h), (5.2±0.5)mmol/L, 0.0kcal/(kg·d) and 11.5±2.4 before the treatment with open abdomen technique and (0.28±0.09)mL/(kg·h), (7.7±0.8)mmol/L, (4.6±1.8)kcal/(kg·d) and 12.4±2.1 at postoperative 168 hours. There were significant differences in time effects in the above indicators in surviving patients and dead patients before and after the treatment with open abdomen technique ( Ftime=425.57, 188.59, 394.84, 37.52, P<0.05). There were interactive effects between the above indicators and the treatment outcome at different time points ( Finteraction=383.14, 233.04, 169.83, 36.61, P<0.05). There were signifi-cant differences in the change trends of the above indicators between the surviving patients and the dead patients during hospitalization ( Fgouprs=2 739.56, 877.98, 542.05, 240.85, P<0.05). (4) Influen-cing factors for prognosis of patients. Results of univariate analysis showed that age, sequential organ failure score, duration of ACS before surgery, procalcitonin, lactic acid, postoperative high-order intestinal fistula, abdominal hemorrhage, duration of postoperative acute gastrointestinal injury, duration of continuous renal replacement therapy, duration of vasoactive drugs therapy, early abdominal closure were related factors influencing prognosis of patients under-going treatment with open abdomen technique ( hazard ratio=1.07, 1.18, 1.39, 1.16, 8.25, 12.26, 2.83, 1.29, 1.56, 1.41, 0.02, 95% confidence interval as 1.00-1.15, 1.45-2.27, 1.22-1.57, 1.02-1.32, 1.75-38.90, 7.37-41.23, 1.16-6.93, 1.22-1.37, 1.23-1.99, 1.08-1.84, 0.00-0.16, P<0.05). Results of multivariate analysis showed that extended duration of ACS before surgery, postoperative high-order intestinal fistula and extended duration of postoperative acute gastrointestinal injury were independent risk factors influencing prognosis of patients undergoing treatment with open abdomen technique ( hazard ratio=1.05, 7.95, 1.17, 95% confidence interval as 1.01-1.32, 2.05-30.87, 1.13-1.95, P<0.05) and early abdominal closure was an independent protective factor ( hazard ratio=0.10, 95% confidence interval as 0.01-0.89, P<0.05). Results of Spearman correlation analysis showed that duration of ACS was positively correlated with sequential organ failure score before surgery ( r=0.71, P<0.05). Conclusions:Open abdomen technique is effective for acute pancreatitis with ACS. Extended duration of ACS before surgery, postoperative high-order intestinal fistula and extended duration of postoperative acute gastrointestinal injury are independent risk factors for prognosis of patients during hospitalization and early abdominal closure is an independent protective factor.

Objective To investigate the prevalence and correlates of depression in residents aged 15 and older in Hainan province.Methods Stratified multistage random sampling methods were utilized to identify 12 117 individuals (≥15 years old) from 59 villages (neighborhoods) in 24 towns (streets) within 6 counties (cities) in Hainan Province from September 2010 to November 2011.The subjects were screened with an expanded version of the General Health Questionnaire (GHQ-12) and the respondents were divided into three groups by high risk,moderate risk and low risk of mental disorder,followed by formal diagnosis according to the Structured Clinical Interview for DSM-IV-TR (SCID-I/P) by psychiatrists among 100％ subjects in group with high risk,40％ subjects in group with moderate risk and 10％ subjects in group with low risk.The adjusted rate,standardized rate,and 95％ confidence interval (95％CI) of the one-month and lifetime prevalence were also calculated among the 3 groups of individuals who were diagnosed with depressive disorder.The difference in whether they suffered depression was determined by the chi-squared test.Correlations to depressive disorder and the odds ratio (OR) were explored with multiple regression analysis.Results There were 97 cases of depressive disorders (1-month) and 166 cases of lifetime depressive disorders finally confirmed.The adjusted rate of 1-month prevalence was 1.38％ (95％CI:1.12-1.59) and the life-time adjusted prevalence rate was 2.80％ (95％CI:2.51-3.09).Female (OR=1.55,95％CI:1.12-2.14),mid-age(50-64 y,OR=1.84,95％CI:1.13-2.99),being divorced or living separated (OR=4.87,95％CI:1.86-12.73),suffering chronic diseases (OR=2.19,95％CI:1.56-3.07),and low family income were significantly associated with suffering depressive disorder.Conclusions The prevalence of the depressive disorder among residents aged 15 and older in Hainan province is lower than the nationwide prevalence.People who are female,mid-age,being divorced or not living with the partner,earning a low income,and suffering chronic diseases have more predisposition to develop the depressive disorder in Hainan province.

Objective To investigate the prevalence and correlates of depression in residents aged 15 and older in Hainan province.Methods Stratified multistage random sampling methods were utilized to identify 12 117 individuals (≥15 years old) from 59 villages (neighborhoods) in 24 towns (streets) within 6 counties (cities) in Hainan Province from September 2010 to November 2011.The subjects were screened with an expanded version of the General Health Questionnaire (GHQ-12) and the respondents were divided into three groups by high risk,moderate risk and low risk of mental disorder,followed by formal diagnosis according to the Structured Clinical Interview for DSM-IV-TR (SCID-I/P) by psychiatrists among 100％ subjects in group with high risk,40％ subjects in group with moderate risk and 10％ subjects in group with low risk.The adjusted rate,standardized rate,and 95％ confidence interval (95％CI) of the one-month and lifetime prevalence were also calculated among the 3 groups of individuals who were diagnosed with depressive disorder.The difference in whether they suffered depression was determined by the chi-squared test.Correlations to depressive disorder and the odds ratio (OR) were explored with multiple regression analysis.Results There were 97 cases of depressive disorders (1-month) and 166 cases of lifetime depressive disorders finally confirmed.The adjusted rate of 1-month prevalence was 1.38％ (95％CI:1.12-1.59) and the life-time adjusted prevalence rate was 2.80％ (95％CI:2.51-3.09).Female (OR=1.55,95％CI:1.12-2.14),mid-age(50-64 y,OR=1.84,95％CI:1.13-2.99),being divorced or living separated (OR=4.87,95％CI:1.86-12.73),suffering chronic diseases (OR=2.19,95％CI:1.56-3.07),and low family income were significantly associated with suffering depressive disorder.Conclusions The prevalence of the depressive disorder among residents aged 15 and older in Hainan province is lower than the nationwide prevalence.People who are female,mid-age,being divorced or not living with the partner,earning a low income,and suffering chronic diseases have more predisposition to develop the depressive disorder in Hainan province.

Objective:To investigate the competency of informed consent in new admitted schizophrenia pa-tients.Methods:Fifty-three patients who were consecutively admitted to the hospital and diagnosed as schizophrenia according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10)were recruited and assessed in seventy-two hours.The competence of informed consent was assessed by the MacArthur Competence Assessment Tool-Treatment (MacCAT-T).The insight was assessed by the Insight and Treatment Attitude Questionnaire.The severity of illness was assessed by the Brief Psychiatric Rating Scale (BPRS).Correlations between the competence of informed consent and the factors mentioned above were discussed.Results:Forty-five (84.9%)patients had lower MacCAT-T scores,especially the scores of understand-ing dimension (1.58 ±1.85)and appreciation dimension (2.40 ±1.47).The competence of informed consent was significantly correlated with insight (r =0.73,P <0.01)but not correlated with age,education,duration of illness and BPRS scores.Logistic regression demonstrated that insight (OR =0.69)was a protective factor of competence of informed consent while thought disturbance (OR =1.39)was a risk factor.As to the involuntary admitted pa-tients,34.1% of them had competence of informed consent.Conclusion:The competence of informed consent in new admitted schizophrenia patients is widely impaired especially in understanding and appreciation dimension.The competence of informed consent is correlated with insight and thought disturbance.Voluntary or involuntary hospi-talization does not reflect the level of competence of informed consent.

Objective To investigate the easier and more effective moduses of artificial respiration to the neonatal continuous chest compression eardiopulmonary resuscitation. Methods The experience of the treatment on 66 inpatient neonates(with 84 vices cardiac arrest) by continuous chest compression cardiopulmonary resuscitation was summarized. Based on different moduses of artificial respiration matched with mask-gasbag pressure breathing or tracheal intubation pressure breathing to cardiopulmonary resuscitation(CPR), and according to the principles of therandomized block design,sixty-six neonates in cardiac arrest were randomly divided into two groups of A and B. Fun-damental therapeutics in these two groups were alike. A group(38 cases with 53 vices cardiac arrest) was with mask-gasbag pressure breathing. B group(28 cases with 31 vices cardiac arrest) was with tracheal intubation gasbag pres-sure breathing. Time of cardiac arrest (Tca), time of cardiac restore independent rhythm(Tr), Time of cardiopul-monary resuscitation completed(Tc), achievement ratio of cardiopulmonary resuscitation, and 24 hours survival rateof these two groups were compared. Results Compared with B group, there was no significant deviation of Pca, Tr,Tc, the successful rate of CPR and 24 hours survival rate in A group. Comparing A group to B group, the Tea[ (0.99±0.75)rain vs (0.92±0.69)min, P = 0.69];Tr[(3.58±2.15)rain vs (3.66±2.01)min, P = 0.87];Tc [(23.28±9.26)min vs (23.73±9.51)min,P=0.84];suecessful rate of CPR [88.68% vs 83.87% ,P>0.05];24h survival rate [84.21% vs 82.14 %, P > 0.05 ]. Conclusion The mask-gasbag pressure breathing was an easy,safe and effective artificial respiration method for the neonatal continuous chest compression cardiopulmonary resusci-tation. Only in a few eases with airway resistance heightening was the modus of tracheal intubation gasbag pressure breathing applied.