The resistance and dose limitation of tumors is a serious obstacle to cytotoxic drug therapy in the field of medical oncology. Nitric oxide (NO) is a powerful adjuvant for tumor hypersensitivity for traditional chemotherapy and radiation therapy. The concentration of NO plays an important role in affecting its anti-tumor effect. This review summarizes the mechanism of concentration-dependent effects of NO on tumor cells and the mechanism of chemotherapy sensitization. It provides evidence for rational use of NO to exert anti-tumor effects, and overcoming multidrug resistance and anti-tumor drug development.

Identifying the ideal implantation site is important for the long-term stability and effectiveness of follow-up restorations. Implant surgical guide and navigation are used to determine the implantation site in clinic and improve the precision of implantation. However, due to difficulties in digital methods, such as multiple procedures, high cost, and actual accuracy of more than 1 mm, many physicians still prefer to operate with free hand. In preoperative, intraoperative, and postoperative procedures, time-saving and practical methods for implant site evaluation are lacking. In many cases, oral physicians found that the position deviates only by cone beam CT, which was costly to modify the position. In this article, we presented a precise implantation insertion technology that is guided by a measurable technique throughout the implantation application for all implant systems. This method was guided by a dynamic control measuring ruler, which functions together with the measuring and intraoperative locating rulers. The 3D space of the operative area was measured by a measuring ruler prior to operation, and the implant plan and quantitative guidance design were conducted according to the measured and cone beam CT data. The whole implantation process was guided by the dynamic control measuring ruler, and measuring verification results were also considered. This method can realize the quantification of the entire preoperative space analysis, intraoperative precise implantation guidance, and postoperative site measurement and evaluation. This practical technique also helps to adjust the position, improve the implantation accuracy and is suitable in generalizing dental implantation.
Computer-Aided Design ; Cone-Beam Computed Tomography ; Dental Implantation, Endosseous ; Dental Implants ; Imaging, Three-Dimensional ; Patient Care Planning ; Surgery, Computer-Assisted

OBJECTIVE: To compare the clinical effect on the joint attention and social communication in children with autism spectrum disorder (ASD) between the combined treatment of acupoint catgut embedding therapy with rehabilitation training and the simple application of rehabilitation training. METHODS: A total of 60 children with ASD were randomized into an observation group and a control group, 30 cases in each one. In the control group, the routine ASD rehabilitation training was adopted, including conductive education, speech training and music therapy, once a day. In the observation group, on the base of the treatment as the control group, the catgut embedding therapy was applied to Shenting (GV 24), Baihui (GV 20), Shenmen (HT 7) and the optic area (the point of scalp acupuncture), once a week. In the two groups, the treatment for 4 weeks was as one course, at the interval of 1 week between the courses. A total of 3 courses of treatment were required. The social domain of the autism treatment evaluation checklist (ATEC) and the autism behavior checklist (ABC) were adopted to assess the therapeutic effect of the two groups. RESULTS: After treatment, the scores of each item of the social domain in ATEC and the scores of ABC (feeling, communication, physical movement, language and healthy behavior) were all lower than those before treatment in the two groups (<0.01). The scores of each item in the observation group were lower than those in the control group after treatment (<0.05). CONCLUSION The combined treatment of acupoint catgut embedding therapy with the rehabilitation training effectively improves in the joint attention and social communication. The therapeutic effect of this combined treatment is better than the simple application of rehabilitation training.

Objective To discuss the controversial role of breast milk in late-onset group B Streptococcus (GBS) infections.Methods This study reported a case of recurrent late-onset GBS sepsis with the suspicion of breast milk transmission in an extremely preterm infant born at 22+6 weeks who was treated at the University of Hong Kong-Shenzhen Hospital in September 2016.Literatures about late-onset GBS cases associated with contaminated breast milk were reviewed to investigate whether GBS could be transmitted through breast milk.Results (1) Case report:A breast-fed extremely preterm infant born at 22+6 gestational weeks suffered from GBS sepsis along with meningitis for the first time on 100 d.The mother was negative for rectovaginal GBS screening.Breast milk wasn't tested as no signs of mastitis were found.The neonate recovered from the first GBS sepsis after 14 days of antibiotic treatment,then returned to breastfeeding.On 126 d,GBS sepsis reoccurred in this baby.Fresh breast milk culture yielded GBS which was identical with the GBS strains isolated from the neonatal blood in antimicrobial susceptibility.After recovery from the second episode,the baby was partially breastfed again without further relapses of late-onset GBS sepsis.(2) Literature review:64 cases of late-onset GBS infections that transmitted via breast milk were retrieved from PubMed,while no Chinese cases had been reported.Clinical data of the 65 cases (including this case) were reviewed and the results revealed that contaminated breast milk was associated with late-onset GBS infections.The reported relapse rate of GBS infections transmitted via breast milk was 25％ for two episodes and 7％ for three episodes.Conclusions GBS contaminated breast milk could potentially cause late-onset GBS sepsis in infants and further studies are required to identify the underlying mechanisms.

Objective To investigate the therapeutic effect of acupuncture and moxibustion on allergic rhinitis and its influence on the patients' quality of life. Method Seventy-two patients with allergic rhinitis were allocated, according to different protocols, to control and observation groups, 36 cases each. The control group received conventional Western drug treatment and the observation group, acupuncture and moxibustion. Both groups were treated for three consecutive months. The effects were evaluated after the completion of treatment. VCAM-1, interleukin-4 (IL-4), interleukin-6 (IL-6) and interleukin-10 (IL-10) levels were measured using enzyme linked immunosorbent assay. The quality of life was assessed using the WHOQOL-BREF. The clinical therapeutic effects and the influences on the patients' quality of life were compared between the two groups. Result The total efficacy rate was 97.2％ in the observation group, which was higher than 86.1％ in the control group (P<0.05). There were no statistically significant pre-treatment differences in VCAM-1, IL-4, IL-6 and IL-10 levels between the two groups (P>0.05). After treatment, VCAM-1, IL-4, IL-6 and IL-10 levels decreased in both observation and control groups compared with before (P<0.05) and were lower in the observation group than in the control group (P<0.05). After treatment, the physical health, psychological health, social relationships, environment and independent ability scores increased in both observation and control groups compared with before (P<0.05) and were higher in the observation group than in the control group (P<0.05). Conclusion Acupuncture and moxibustion has a definite therapeutic effect on allergic rhinitis. It can reduce the levels of inflammatory factors and improve the patients' quality of life.

BACKGROUND: Particulated juvenile cartilage allograft is simple and easy to obtain, and relevant clinical studies are underway in the USA. However, how the transplanted juvenile cartilage fragments exert biological effects through biochemical mechanisms and genetic signal transduction is still unclear. There is as yet no report on this technology in China. OBJECTIVE: To explore the feasibility of articular cartilage defects repaired with particulated juvenile cartilage allograft. METHODS: The cartilage fragments were obtained from juvenile Pitman-Moore strains (provided by the Laboratory Animal Center of the Army Medical University in China) and cultured in vitro. Brdu immunofluorescence assay was performed at 1, 3, and 7 days of culture. The particulated juvenile cartilage allograft/fibrin gel composites were subcutaneously transplanted into the SCID rats (provided by the Laboratory Animal Center of the Army Medical University). The specimens were taken for hematoxylin-eosin staining, safranin O staining and immunohistochemistry after 1 month. Cartilage defects of 8 mm in diameter were made in the knee joint of 10 adult Pitman-Moore strains (Laboratory Animal Center of the Army Medical University), and were randomized into two groups, which were then transplanted with the particulated juvenile cartilage allograft/fibrin gel composites (experimental group) or nothing (control group). The specimens were taken for hematoxylin-eosin staining, safranin O fast green staining, toluidine blue and immunohistochemistry at 3 months after transplantation. RESULTS AND CONCLUSION: Little Brdu incorporation was detected in juvenile cartilage fragments at 1 day of culture, some Brdu incorporation was defected at 3 days of culture. At 7 days of culture, a progressive increase in the Brdu signal was detected in chondrocytes within the cultured cartilage fragments, which seemed to localize along the tissue edge. At 1 month after subcutaneous transplantation, the particulated juvenile cartilage allograft still survived and were surrounded by few proliferative chondrocytes. There was no obvious tissue repair in the control group at 3 months after transplantation. In the experimental group, there was obvious tissue repair, the color of the newly formed tissues was similar to the normal cartilage tissue, which integrated well with the surrounding normal cartilage tissue, and the cells distributed evenly. These results imply that particulated juvenile cartilage allograft can achieve good results in repairing articular cartilage defects.

AIM:To investigate the effect of proline-spirooxindole on the viability and apoptosis of human nonsmall-cell lung cancer A549 cells.METHODS:The effect of proline-spirooxindole on the viability of A549 cells was determined by CCK-8 assay.The apoptosis was analyzed by flow cytometry.The effects of proline-spirooxindole on the expression of PARP and p53 and the phosphorylation of m TOR were determined by Western blot.RESULTS:After A549 cells were treated with proline-spirooxindole (25, 50 and 100 mg/L) , the cell viability was decreased (P<0.01) compared with DMSO control group.The apoptotic rate was increased compared with DMSO control group (P<0.01).The protein expression of p53 was up-regulated, the increased apoptotic protein cleaved PARP was observed, and the phosphorylation of m TOR was inhibited (P<0.01).CONCLUSION:Proline-spirooxindole inhibits the viability of A549 cells and induces apoptosis, which may be related to the phosphorylation of m TOR.

AIM:To investigate the stemness of mouse triple-negative breast cancer (TNBC) 4T1 cells induced by doxorubicin (DOX) and the underlying mechanism.METHODS:The 4T1 cells and MDA-MB-468 cells were treated with DOX at different concentrations (0, 0.05, 0.1 and 0.5μmol/L) for 24 h, and the shape and viability of the cells were observed.The concentration of DOX at 0.1μmol/L was chosen as the optimal concentration for the following experiments.The 4T1 cells and MDA-MB-468 cells resistant to DOX were established by continuous stimulation with DOX for 4 weeks, and named as 4T1-DOX and MDA-MB-468-DOX.Sphere formation assay was used to detect the stemness of 4T1cells and MDA-MB-468 cells.The expression of CD133 was observed by immunofluorescence staining.The expression of CD44 was analyzed by flow cytometry.The protein levels of Stat3, phosphorylated Stat3 (p-Stat3) and Oct-4 were determined by Western blot.RESULTS:The sphere formation ability of the 4T1-DOX cells was stronger than that of the 4T1control cells.The 4T1-DOX cells expressed high levels of the stemness markers CD133 and CD44 as compared with the 4 T1 cells (P<0.05).Furthermore, the 4T1-DOX cells exhibited enhanced activation of Stat3 (p-Stat3) and increased expression of Oct-4 (P<0.05) , while the expression of total Stat3 had no obvious variation.In addition, when activation of Stat3 was inhibited by WP1066, the protein levels of p-Stat3, Oct-4 and CD44 were down-regulated (P<0.05).Furthermore, inhibition of Stat3 phosphorylation reduced the sphere formation ability of the 4T1-DOX cells (P<0.05).CONCLUSION:DOX induces the stemness of mouse TNBC 4T1 cells through Stat3-Oct-4 signaling pathway.

Objective To compare the consistency and detection rate of early gastric cancer (EGC) of three different methods including anti-Helicobacter pylori (Hp) antibody combined with pepsinogen (PG) (ABC method),serum PG combined with gastrin-17 (G-17) (new ABC method) and the new scoring system.Methods Serological tests were performed in Zhejiang population,which divided the subjects into low risk,intermediate risk and high risk groups.High risk subjects were examined by endoscopic and pathological examination.SPSS19.0 were used to evaluate the consistency of three methods.According to the receiver operating characteristic (ROC) curve,the ratio of G-17 to PG (PGR) was calculated for the optimal diagnostic cut-off value of EGC.Results A total of 30 126 subjects were recruited.Based on the data of ABC method,the proportions of low risk,intermediate risk and high risk group were 15 368 (51.01％),13 246 (43.97％),and 1 512 (5.02％),respectively.These proportions by the new ABC method were 20 584 (68.32％),8 990 (29.84％),552 cases (1.83％),respectively.By new scoring system,these were 20 810 (69.08％),8 059 (26.75％),and 1 257 (4.17％),respectively.Among them,1 263 subjects underwent endoscopy and 22 cases (1.74％) were finally diagnosed as gastric cancer including 19 EGC (86.4％).There were 1 case (0.35％),14 cases (1.84％),and 7 cases (3.21％) with gastric cancer in low risk,intermediate risk,and high risk groups by ABC methods,respectively.Gastric cancer patients were 7 (1.68％),10 (1.38％),and 5 (4.10％) in three groups respectively by new ABC methods.Via new scoring system,gastric cancer were detected in 5 (0.66％),9 (2.22％),and 8 (7.84％) patients of three risk groups respectively.The consistency of three screening methods was poor.The detection rate of gastric cancer in high risk group was higher than that in the other two (P＜0.05).The area under the curve (AUC) for diagnosis of gastric cancer by G-17 and PGR was 0.588 and 0.729,respectively.According to the PGR cut-off value determined by the fitted model,the incidence of gastric cancer in the low,intermediate and high risk groups was 0.94％,1.97％,and 6.31％,respectively.When the cut-off value is PGR＜4.135,the sensitivity is 0.855 and the specificity is 0.545.Conclusion The new scoring system has a better predictive value in EGC screening.The detection rate of EGC in high risk group is higher than that in low and intermediate risk groups.

Simulation-based medical education can ensure medical safety, reduce medical errors and improve students' clinical skills. At present, the main problems in medical teaching are the conflict between doctors and patients, the contradiction between medical teaching and ethics, the shortage of teaching resources and the lack of a universal assessment standard. The advantages of simulation-based medical education are its safety, repeatability, standardization, controllability, relative authenticity, and the cultivation of humanistic spirit and teamwork for students. Simulation-based medical education has two major limits. First, its teaching effect relies on the function and quality of each model. Second, simulation cannot replace clinical practice. This article proposes the following ways and means for promoting the simulation-based medical education: training of faculty is the core, establishment of courses is the focus, cooperation and communication is an important way to promote development, and phased and refined development is the future direction.