Objective:To analyze the immune microenvironment characteristics of human dental follicle tissues from the third molars and to explore the mutual communication and the effects of innate immune cells and adaptive immune cells within the dental follicle.Methods:Sequencing data(GSA-Human:HRA008022)in the GSA database were analyzed.Bioinformatics tools were employed for gene identification and GO enrichment analysis was performed to define the biological function of innate and adaptive immune cells.CellChat analysis was used for explaining intercellular communication among immune cell populations.Results:Using t-SNE dimen-sionality reduction analysis for immune cell populations,innate immune cell populations were obtained,including innate lymphoid cells,dendritic cells,mast cells and macrophages,and adaptive immune cell populations including T cells and B cells.Pearson corre-lation analysis showed that innate immune cells,specifically innate lymphoid cells and macrophages,had a strong correlation with adap-tive immune cell populations.GO enrichment analysis revealed mutual coordination among innate immune cell populations and regulato-ry effects on adaptive immune cell populations.Further CellChat analysis indicated biological signal transmission between innate and a-daptive immune cell populations,with CLEC,MIF,ADGRE5,COLLAGEN and MIF signaling pathways is the most significant.Con-clusion:Dental follicle tissues are rich in immune cells and innate immune cell populations interact with adaptive immune cells to regulate immune responses and participate in maintaining the homeostasis of dental follicle.

Objective:Explore the characteristics of injury current changes in ventricular septal myocardium during left bundle branch area pacing (LBBAP) surgery.Methods:Retrospective analysis of clinical data of patients who underwent permanent pacemaker implantation at The Second People's Hospital of Wuxi in Jiangsu Province from January 2020 to November 2022. Among them, 42 patients were treated with LBBAP (LBBAP group) and 56 patients with Right ventricle septum pacing (RVSP group). Compare the conventional parameters such as threshold, perception, impedance during electrode implantation, damage current values at 0, 5, and 10 minutes before and after electrode rotation, and the correlation between damage current and conventional parameters. The measurement data is represented by xˉ± s, analysis of variance is used for comparison between multiple groups, t-test is used for comparison between two groups, and repeated measurement analysis of variance is used for comparison between two groups at multiple time points; Counting data is represented as an example (%), and inter group comparisons are made using χ 2 Inspection; Pearson correlation analysis was used to analyze the correlation between the two variables. Results:There was no statistically significant difference in pacing threshold, perception, and impedance between the two groups of electrode implantation surgery (all P>0.05). The damage current values at 0, 5, and 10 minutes before and after electrode rotation in the LBBAP group were higher than those in the RVSP group [(7.19±1.26) mV compared to (5.33±0.79) mV, (22.50±3.06) mV compared to (10.85±1.70) mV, (15.75±2.63) mV compared to (8.01±1.09) mV, (9.24±2.00) mV compared to (5.51±0.98) mV]. The damage current values at 0 minutes after electrode rotation in both groups were higher than before electrode rotation, and gradually decreased thereafter, After 10 minutes of electrode placement, the damage current value of the LBBAP group was still higher than the level before electrode rotation (all P<0.05), while there was no statistically significant difference between the RVSP group and the level before electrode rotation ( P>0.05). The damage current value at 0 minutes after the LBBAP group electrode was in place was positively correlated with ventricular septal thickness and left ventricular posterior wall thickness ( r values 0.45 and 0.46, P values 0.003 and 0.002, respectively), and negatively correlated with conventional pacing parameter impedance ( r=-0.32, P=0.037). There was no correlation with threshold and perception ( r values 0.08 and 0.01, P values 0.604 and 0.968, respectively). The damage current value at 0 minutes after the RVSP group electrode was in place was negatively correlated with the threshold ( r=-0.28, P=0.036). Conclusions:The COI value of LBBAP interventricular septum myocardium increased significantly after the electrode was rotated out. The COI value at 0 min after the electrode put in place was positively correlated with the interventricular septum thickness and left ventricular posterior wall thickness, and negatively correlated with the electrode impedance, but there was no correlation with threshold and perception.

Objective:To investigate the value of radiotherapy in patients with stage Ⅳ B thoracic esophageal squamous cell carcinoma (ESCC) at initial diagnosis. Methods:A total of 199 patients with stage Ⅳ B thoracic ESCC at initial diagnosis (according to UICC/AJCC Eighth Edition Esophageal and Esophagogastric Junction Cancer TNM Staging) who were treated in the Fourth Hospital of Hebei Medical University between January 2010 to December 2016 were recruited. Winthin the whole group, 130 patients (65.3%) had distant lymph node metastases alone, 51 cases (25.6%) of solid organ metastases alone and 18 cases (9.0%) of solid organ complicated with distant lymph node metastases. Among them, 16 patients (8.0%) were treated with chemotherapy alone, 50 cases (25.1%) of radiotherapy alone, 133 cases (66.8%) of radiochemotherapy (81 patients treated with concurrent radiochemotherapy and 52 patients treated with sequential radiochemotherapy). The survival rate was calculated by Kaplan-Meier method and the difference was analyzed by log-rank test. Clinical prognosis was assessed by multivariate Cox regression model. Results:The median overall survival (OS) of the entire cohort was 12.3 months (95% CI: 10.6-15.4m), and the 1-, 2-, 3-and 5-year OS rates were 52.1%, 25.2%, 19.1%, and 11.5%, respectively. Multivariate analysis showed that tumor length, the number of metastatic organs, and treatment modalities were the independent prognostic factors for OS. There was no significant difference in OS between concurrent radiochemotherapy and sequential radiochemotherapy ( P=0.955). The OS of patients in the radiotherapy dose of ≥6000 cGy group was significantly longer than that of their counterparts in the 4500-5039 cGy and 5040-6000 cGy groups (both P<0.001). Conclusions:For stage Ⅳ B thoracic ESCC patients at initial diagnosis, tumor length ≤3cm, single organ metastasis, and radiochemotherapy strategy are significantly correlated with longer OS. For stage Ⅳ ESCC patients with good physical status, radiotherapy can be supplemented on the basis of systemic chemotherapy. Concurrent or sequential radiochemotherapy needs to be individualized. If patients are tolerable, radiochemotherapy is recommended to the primary tumor or non-regional metastatic lymph nodes, aiming to prolong the OS of patients.

Objective:To explore the influence of mindfulness on perceived stress in psychiatric nurses and the mediating effect of resilience.Methods:A total of 427 psychiatric nurses from a psychiatric hospital in Beijing were selected.Five-facet mindfulness questionnaire(FFMQ), Chinese-version perceived stress scale (CPSS) and Connor-Davidson resilience scale (CD-RISC) were used in this survey.Pearson correlation analysis and multiple stepwise regression analysis were performed using SPSS 24.0.And mediating effect was performed using AMOS 24.0.Results:The total score of psychiatric nurses' perceived stress was (37.89±7.16). Among all psychiatric nurses, 66.74% were under high pressure and 20.84% were under great pressure.The perceived stress was negatively correlated with mindfulness(123.69±10.82, r=-0.65, P<0.01) and resilience(85.40±17.87, r=-0.67, P<0.01), and mindfulness was positively correlated with resilience ( r=0.50, P<0.01). The direct effect of mindfulness on perceived stress was -0.15, the indirect effect was -0.34, and the total effect was -0.49. Conclusion:Resilience plays a partial mediating role between mindfulness and perceived stress psychiatric nurses.

OBJECTIVE：To establish the fingerprint of raw produc ts and different processed products of Pinellia pedatisecta ， to determine the contents of 5 kinds of nucleosides ，and to compare the differences of components between the raw products and processed products. METHODS ：P. pedatisecta raw products ，processed products by Processing Standard of Chinese Medicine in Henan Province （called“Standard processed product ”for short ）and processed products by new integrated processing technology in the production area （called“new integrated processed product ”for short ）were collected as investigation objects （12 batches of each）. The determination was performed on SymmetryShield RP 18 column with mobile phase consisted of acetonitrile （A）-0.1％ acetic acid aqueous water solution （B）（gradient elution ）at the flow rate of 0.8 mL/min，with the column temperature of 30 ℃， the detection wavelength of 270 nm，and the injection volume of 15 µL. HPLC fingerprints of 3 kinds of P. pedatisecta samples were established by using Similarity Evaluation System of TCM Chromatographic Fingerprints （2004 A version ） ，and the similarity of fingerprints was evaluated. The chromatographic peaks were identified by comparing with the reference chromatogram. Five nucleosides （adenine，hypoxanthine，uridine，xanthine，inosine）were quantitatively analyzed. SPSS 21.0 software was used for cluster analysis of 36 batches of samples. RESULTS ：The results of fingerprint and content determination met the relevant requirements. The similarity of 3 kinds of sample with their control fingerprint were all greater than 0.990. There were 22 common peaks in the raw products of P. pedatisecta ，and 16 common peaks were identified in the 2 kinds of processed products （the same 6 peaks disappeared from 2 kinds of processed products ）. Fivecomponents were identified in 3 kinds of samples ，such as adenine（peak 3），hypoxanthine（peak 7），uridine（peak 8）， 1064056472@qq.com xanthine（peak 9）and inosine （peak 11）. Results of content determination showed that total contents of 5 kinds of nucleosides in 2 kinds of proc essed products were all· decreased；the contents of them in descending order w as raw product ＞new i ntegrated processed products ＞Standard processed products. Results of cluster analysis showed that 36 batches of samples could be clustered into 2 categories，i.e. raw product was clustered into one category and 2 kinds of processed products into other one . CONCLUSIONS ：Established method is stable ， feasible and suitable for the quality evaluation of raw products and different processed products of P. pedatisecta . Fingerprints have changed significantly and the total content of 5 kinds of nucleosides in P. pedatisecta are all decreased after processing ，but that of new integrated processed products is slightly higher than that of Standard processed products .

OBJECTIVE：To establis h HPLC fingerprint of Chinese gall leaven ，simultaneous determination of 5 components and optimization of distillers ’grains. METHODS ：HPLC method was adopted. The determination was carried out on Waters Symmetry Shield TM RP18 column with mobile phase consisted of acetonitrile- 0.1％ trifluoroacetic acid aqueous （gradient elution ）at the flow rate of 0.8 mL/min. The column temperature was 30 ℃，and detection wavelength was set at 280 nm. The sample size was 5 µL. Using gallic acid as reference ，HPLC fingerprints of 14 batches of sample were drawn. The similarity evaluation was performed by using Similarity Evaluation System of Chromatogram Fingerprint of TCM （2012 edition）to determine common peaks；SPSS 20.0 software was used for cluster analysis. RESULTS ：There were 11 common peaks in 14 batches of samples ，and the similarity range of 14 batches of samples was 0.424-0.998，A1-A5 was less than 0.850；5 components were identified in B 1-B9 sample，i.e. gallic acid ，（－）-epigallocatechin，methyl gallate ，2，4，6-tri-O-galloyl-α-D-glucose and 2，4，6-tri-O-galloyl- β-D-glucose. The results of cluster analysis showed that 14 batches of samples could be grouped into 3 categories，i.e. A1-A5 into one category，B1 and B 6 into one category ，B2-B5 and B 7-B9 into one category. The linear ranges of above 5 components were 29.96-599.2 μg/mL（r＝0.999 6），0.832-416 μg/mL（r＝0.999 6），0.102-51 μg/mL（r＝0.999 8），0.286 4-143.2 μg/mL（r＝0.999 8）， 0.286 4- 143.2 μg/mL（r＝0.999 8），respectively. The limits of quantitation were 0.060，0.104，0.017，0.029，0.057 μg/mL；the limits of detection were 0.018，0.031，0.005，0.009，0.017 μg/mL，respectively. RSDs of precision ，stability，reproducibility and durability tests were all lower than 3％. The recoveries were 97.16％-101.88％（RSD＝1.60％，n＝6），96.98％-99.24％（RSD＝ 0.85％，n＝6），97.7％-101.64％（RSD＝1.54％，n＝6），97.77％-103.08％（RSD＝1.82％，n＝6），98.16％-101.88％（RSD＝1.24％， n＝6），respectively. CONCLUSIONS：The established HPLC fingerprint and cluster analysis can be used to evaluate the quality of Chinese gall leaven. The established method is simple to Δ 基金项目：国家重点研发计划项目（No.2018YFC1707200）；公 operate and can be used to determine the contents of 5 益性行业科研专项项目（No.201507004-03）；河南中医药大学研究生 components simultaneously ；rice husk distillers ’grains were 科研创新基金项目（No.YJS2018B14） ＊硕士研究生 。研究方向 ：中药饮片及新药研究 。E-mail： not suitable for fermented Chinese gall leaven . 401327039@qq.com

Objective: To investigate the incidence and rank of chronic obstructive pulmonary disease and pneumoconiosis to the workers in different occupational positions in Jinchang Cohort. Methods: In January 2014, a cohort of follow-up population in jinchang city was taken as the research object, 17843 individuals among follow-up populations in Jinchang Cohort Study, removed the individuals with chronic obstructive pulmonary disease and pneumoconiosis before 2013, and counted the new incidence individuals diagnosed by the A-Class hospital in Grade III in Jinchang City, Gansu Province, as the investigation objects to investigate the incidence rate & rank of chronic obstructive pulmonary disease and pneumoconiosis. The statistical significance was tested by chi-square test. Results: The 2-year incidence rate of Chronic Obstructive Pulmonary Disease and Pneumoconiosis in the population of Jinchang Cohort Study were 11.60‰, 13.51‰ for male and 8.46‰ for female. the ranks of 2-year incidence rates of chronic bronchitis, emphysema, pneumoconiosis and other phenotypes of chronic obstructive pulmonary disease were 7.06‰、3.42‰、0.84‰、0.34‰, respectively. Incidence rate of chronic bronchitis among administrators and executive staffs were 10.45‰; incidence rate of chronic bronchitis among service staffs were 10.45‰; incidence rate of pneumoconiosis among mining staffs were 3.44‰. Conclusion The first incidence rank of chronic obstructive pulmonary disease and pneumoconiosis in Jinchang cohort is chronic bronchitis, and the risk factors are smoking and occupational exposure.

Objective To evaluate the efficacy of Sacubitril/Valsartan in the treatment of chronic heart failure in elderly patients with dilated cardiomyopathy.Methods A total of 126 elderly patients with dilated cardiomyopathy induced chronic heart failure who were treated in Beijing Anzhen Hospital from January 2017 to December 2017 were enrolled and randomly divided into the experimental group(n=62)and the control group(n=64).All patients were given a standard heart failure treatment,and the experimental group underwent sacubitril/valsartan(100 mg Bid)and the control group received benazepril (10 mg Qd)additionally for 12 months.Left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP),six-minute walk test(6MWT) and major adverse cardiovascular events(mortality and readmission for heart failure)were compared between the two groups.Results Of 126 elderly patients,73 patients(57.9％)were male,and 53were female,with a mean ± SD age of (67.2 ± 5.8) years.Basic characteristics,including age,gender,clinical history of hypertension and diabetes,LVEF,NT-proBNP and 6MWT,showed no significant difference between two groups (P ＜ 0.05).After 12 months of treatment,symptomatic hypotension occurred in one cases in each group.In the control group,NT-proBNP level was decreased after treatment as compared with before treatment[(983.3± 326.1) ng/L vs.(1 779.1 ± 478.1) ng/L,P ＜0.05],and no significant difference was found in LVEF and 6MWT at post-treatment versus pretreatment(P ＞ 0.05).In the experimental group,LVEF,NT-proBNP level and 6MWT were significantly improved in post-treatment versus pre-treatment (P ＞ 0.05).And LVEF,NT-proBNP level and 6MWT were significantly better in the experimental group than in the control group[(38.5 ±3.1)％ vs.(36.9±3.0)％,(744.5±246.7) ng/L vs.(983.3±326.1) ng/L,(323.4±60.5) m vs.(283.5±45.9)m,P＜0.05].The readmission rate for heart failure was lower in the experimental group than in the control group(26.6％ or 19 cases vs.46.8％ or 30 cases,P＜0.05),while no significant difference was found in mortality between the two groups (P ＞ 0.05).Conclusions Compared with benazepril,sacubitril/valsartan can improve the left ventricular function and exercise tolerance,and reduce the readmission rate due to chronic heart failure in patients with dilated cardiomyopathy.However,more studies are needed to assess the effects of sacubitril/valsartanthe on the prognosis of advanced elderly patients(＞88 years old)who have a preserved LVEF and a chronic end-stage heart failure(NYHA Ⅳ),and start the drug administration at different time points(before or after discharge).

Objective To evaluate the predictive value of IABP SHOCK Ⅱ risk score in in-hospital mortality of patients with ST segment elevation myocardial infarction complicated with cardiogenic shock (CS). Methods From August 2011 to August 2013, the clinical data of 89 patients with cardiogenic shock after STEMI treated with primary PCI and then supported by using IABP were retrospectively analyzed. The IABP SHOCK Ⅱ risk score were calculated from the data at admission and primary PCI. Comparisons of general information, medication and intervention, pre/post IABP vital life signs and in-hospital death were carried out among patients with different risk stratifications. Results The area under ROC curve of risk stratification was 0.723. The patients were categorized into low risk group (score 0-2, n=71) and intermediate-high risk group (score 3-9, n=18).The patients in intermediate-high risk group were with advanced age, high rate of diabetes mellitus, history of stroke, renal insufficiency, higher serum lactate and glucose at admission compared with low risk group. And more patients in intermediate-high risk group had impaired post-PCI coronary flow (TIMI flow grade<3). Conclusions The IABP SHOCK Ⅱ risk score is a simple and useful risk score for predicting in-hospital mortality of STEMIpatients complicated with CS. Though the patietns are treated with primary PCI and then supported by IABP, the in-hospital mortality of patients with IABP SHOCK Ⅱ risk score ≥ 3 increases significantly.