Objective To investigate the prognostic value of thrombin-antithrombin III complex(TAT),plasmin-α2-plasmin inhibitor complex(PIC),thrombomodulin(TM)and tissue plasminogen activator-inhibitor complex(t-PAIC)in patients with myelodysplastic syndrome(MDS).Methods Selected 88 primary MDS patients diagnosed at the 521 Hospital of Ordnance Industry from January 2018 to January 2021.Plasma levels of TAT,PIC,TM,t-PAIC,fibrin degradation products(FDP)and D-dimer(D-D)were measured.A multivariate approach was used to analyze the association between overall survival(OS)and the levels of each coagulation marker.Coagulation markers significantly associated with OS were used to construct a coagulation prognostic scoring system.Based on the median coagulation marker score,MDS patients were divided into high and low score groups.Kaplan-Meier analysis was used to plot survival curves.Results TAT(OR=1.667),PIC(OR=0.734),TM(OR=1.294)and t-PAIC(OR=1.523)were independent factors influencing OS in MDS patients(Wald χ2=0.671～10.751,all P<0.05).The β-values were integrated as statistical weights to construct a coagulation marker score,calculated as follows:[TAT]×0.502-[PIC]×1.013+[TM]×0.181+[t-PAIC]×0.381.The OS(median 14.6 months)and leukemia free survival(LFS)(median 10.3 months)of patients in the high coagulation marker score group were significantly lower than those in the low score group(33.6 months,35.2 months)(Log rank=20.57,26.84,all P<0.001).Subgroup analysis indicated that in both the low-risk IPSS-R subgroup(very low,low,and intermediate risk)and the high-risk IPSS-R subgroup(high and very high risk),the OS(Log rank=9.12,4.30)and LFS(Log rank=4.54,8.51)of the high coagulation marker score group were lower than those of the low score group(all P<0.05).Bivariate analysis showed a moderate correlation between the coagulation marker score and Revise International Prognostic Scoring System(IPSS-R)(PCC=0.536,P<0.001).Multivariate analysis indicated that IPSS-R and high coagulation marker scores were independent risk factors for OS and LFS in MDS patients(P<0.05).Conclusion The coagulation marker score,based on TAT,PIC,TM and t-PAIC,can serve as an independent prognostic factor for OS and LFS in MDS patients.

Irritable bowel syndrome(IBS)is a kind of gastrointestinal dysfunction disease characterized by abdominal pain and abnormal defecation accompanied by changes in frequency or fecal character as the main clinical symptoms,and diarrhea-type irritable bowel syndrome(IBS-D)is the most common.It has been found that Chinese medicine therapy has achieved good results in the treatment of IBS-D through multi-component,multi-target and multi-pathway targeted regulation of intestinal flora.Therefore,based on intestinal flora,this paper reviews the relationship between intestinal flora and IBS-D,the understanding of Chinese medicine on IBS-D and intestinal flora,and the role of Chinese medicine therapy on intestinal flora.

Objective To explore the application value of serum Syndecan-1 and endocan-1 combined with rapid sequential organ failure(qSOFA)score in the diagnosis and prognosis of sepsis.Methods The severity of 118 patients with sepsis was divided into the general sepsis group(48 cases),the severe sepsis group(42 cases)and the septic shock group(28 cases).According to the prognosis,patients were divided into the death group(n=32)and the survival group(n=86).A total of 118 healthy volunteers were selected as the control group.Serum Syndecan-1 and endocan-1 levels were detected by enzyme-linked immunosorbent assay(ELISA).The value of serum Syndecan-1,endocan-1 and qSOFA scores in the early diagnosis and prognosis of sepsis was analyzed by receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was compared.Results Compared with the control group,levels of Syndecan-1,endocan-1 and qSOFA scores were increased in the study group(P＜0.05).The serum Syndecan-1,endocan-1 and qSOFA score in the general sepsis group,the severe sepsis group and the septic shock group were significantly increased in sequence(P＜0.05).ROC curve analysis showed that the AUC of serum Syndecan-1,endocan-1 and qSOFA score in the diagnosis of sepsis(0.967)were higher than that of Syndecan-1(AUC=0.868),endocan-1(AUC=0.798)and qSOFA score(AUC=0.873)alone(Z=6.541,5.495 and 6.395,P＜0.001).Compared with the survival group,the levels of Syndecan-1,endocan-1 and qSOFA scores were significantly increased in the death group(P＜0.05).The combined prediction of AUC(0.983)was higher than that of Syndecan-1(AUC=0.814),endocan-1(AUC=0.834)and qSOFA score(AUC=0.924)alone(Z=6.596,9.268 and 6.904,P＜0.001).Conclusion Serum levels of Syndecan-1,endocan-1 and qSOFA are increased in patients with sepsis,and the combination of the three has higher clinical value in the diagnosis and prognosis evaluation of sepsis.

Objective To investigate the prognostic value of thrombin-antithrombin III complex(TAT),plasmin-α2-plasmin inhibitor complex(PIC),thrombomodulin(TM)and tissue plasminogen activator-inhibitor complex(t-PAIC)in patients with myelodysplastic syndrome(MDS).Methods Selected 88 primary MDS patients diagnosed at the 521 Hospital of Ordnance Industry from January 2018 to January 2021.Plasma levels of TAT,PIC,TM,t-PAIC,fibrin degradation products(FDP)and D-dimer(D-D)were measured.A multivariate approach was used to analyze the association between overall survival(OS)and the levels of each coagulation marker.Coagulation markers significantly associated with OS were used to construct a coagulation prognostic scoring system.Based on the median coagulation marker score,MDS patients were divided into high and low score groups.Kaplan-Meier analysis was used to plot survival curves.Results TAT(OR=1.667),PIC(OR=0.734),TM(OR=1.294)and t-PAIC(OR=1.523)were independent factors influencing OS in MDS patients(Wald χ2=0.671～10.751,all P<0.05).The β-values were integrated as statistical weights to construct a coagulation marker score,calculated as follows:[TAT]×0.502-[PIC]×1.013+[TM]×0.181+[t-PAIC]×0.381.The OS(median 14.6 months)and leukemia free survival(LFS)(median 10.3 months)of patients in the high coagulation marker score group were significantly lower than those in the low score group(33.6 months,35.2 months)(Log rank=20.57,26.84,all P<0.001).Subgroup analysis indicated that in both the low-risk IPSS-R subgroup(very low,low,and intermediate risk)and the high-risk IPSS-R subgroup(high and very high risk),the OS(Log rank=9.12,4.30)and LFS(Log rank=4.54,8.51)of the high coagulation marker score group were lower than those of the low score group(all P<0.05).Bivariate analysis showed a moderate correlation between the coagulation marker score and Revise International Prognostic Scoring System(IPSS-R)(PCC=0.536,P<0.001).Multivariate analysis indicated that IPSS-R and high coagulation marker scores were independent risk factors for OS and LFS in MDS patients(P<0.05).Conclusion The coagulation marker score,based on TAT,PIC,TM and t-PAIC,can serve as an independent prognostic factor for OS and LFS in MDS patients.

Objective To study the expression levels of karyopherin β1(KPNB1) and Mer receptor tyrosine kinase (MERTK) in non-small cell lung cancer (NSCLC) tissues and their correlation with clinical pathological features,as well as the prognosis of progression-free survival. Methods A total of 118 NSCLC patients who visited Ordnance Industry 521 Hospital from February 2018 to February 2020 were selected. Immunohistochemical methods were used to detect the expression of KPNB1 and MERTK in NSCLC cancer and paracancer tissue. Kaplan-Meier survival curve analysis was conducted to assess the impact of KPNB1 and MERTK on the progression-free survival prognosis of NSCLC patients. COX regression analysis was performed to identify factors affecting the prognosis of progression-free survival in NSCLC patients. Results The positive rates of KPNB1 (61.02％) and MERTK (62.71％) in cancer tissues were higher than those in adjacent tissues (8.48％,6.78％),and the differences were statistically significant (x2=69.945,81.408,all P<0.001). There was a significant positive correlation between KPNB1 and MERTK expression in the organization (r=0.744,P<0.001). The positive rates of KPNB1(84.21％,82.50％),MERTK (84.21％,85.00％)in NSCLC tissues with lymph node metastasis and TNM stage ⅢA were higher than those without lymph node metastasis(50.00％,52.50％) and TNM stage Ⅰ～Ⅱ(50.00％,51.28％),and the differences were statistically significant (x2=11.078～12.855,all P<0.001). The 3-year progression-free survival rates of KPNB1and MERTK positive and negative groups were 26.39％ (19/72) and 56.52％ (26/46),27.03％ (20/74) and 56.82％ (25/44),respectively,with statistically significant differences (Log Rankx2=0.980,8.463,P=0.001,0.004) . KPNB1 positive,MERTK positive,lymph node metastasis and TNM stage ⅢA were risk factors for progression free survival prognosis in NSCLC patients (waldx2=7.810～10.906,all P<0.001). Conclusion The expression of KPNB1 and MERTK is elevated in NSCLC,both of which are related to TNM staging and lymph node metastasis. They are new biomarkers for evaluating the progression-free survival prognosis of NSCLC.

Objective To study the expression levels of karyopherin β1(KPNB1) and Mer receptor tyrosine kinase (MERTK) in non-small cell lung cancer (NSCLC) tissues and their correlation with clinical pathological features,as well as the prognosis of progression-free survival. Methods A total of 118 NSCLC patients who visited Ordnance Industry 521 Hospital from February 2018 to February 2020 were selected. Immunohistochemical methods were used to detect the expression of KPNB1 and MERTK in NSCLC cancer and paracancer tissue. Kaplan-Meier survival curve analysis was conducted to assess the impact of KPNB1 and MERTK on the progression-free survival prognosis of NSCLC patients. COX regression analysis was performed to identify factors affecting the prognosis of progression-free survival in NSCLC patients. Results The positive rates of KPNB1 (61.02％) and MERTK (62.71％) in cancer tissues were higher than those in adjacent tissues (8.48％,6.78％),and the differences were statistically significant (x2=69.945,81.408,all P<0.001). There was a significant positive correlation between KPNB1 and MERTK expression in the organization (r=0.744,P<0.001). The positive rates of KPNB1(84.21％,82.50％),MERTK (84.21％,85.00％)in NSCLC tissues with lymph node metastasis and TNM stage ⅢA were higher than those without lymph node metastasis(50.00％,52.50％) and TNM stage Ⅰ～Ⅱ(50.00％,51.28％),and the differences were statistically significant (x2=11.078～12.855,all P<0.001). The 3-year progression-free survival rates of KPNB1and MERTK positive and negative groups were 26.39％ (19/72) and 56.52％ (26/46),27.03％ (20/74) and 56.82％ (25/44),respectively,with statistically significant differences (Log Rankx2=0.980,8.463,P=0.001,0.004) . KPNB1 positive,MERTK positive,lymph node metastasis and TNM stage ⅢA were risk factors for progression free survival prognosis in NSCLC patients (waldx2=7.810～10.906,all P<0.001). Conclusion The expression of KPNB1 and MERTK is elevated in NSCLC,both of which are related to TNM staging and lymph node metastasis. They are new biomarkers for evaluating the progression-free survival prognosis of NSCLC.

Irritable bowel syndrome(IBS)is a kind of gastrointestinal dysfunction disease characterized by abdominal pain and abnormal defecation accompanied by changes in frequency or fecal character as the main clinical symptoms,and diarrhea-type irritable bowel syndrome(IBS-D)is the most common.It has been found that Chinese medicine therapy has achieved good results in the treatment of IBS-D through multi-component,multi-target and multi-pathway targeted regulation of intestinal flora.Therefore,based on intestinal flora,this paper reviews the relationship between intestinal flora and IBS-D,the understanding of Chinese medicine on IBS-D and intestinal flora,and the role of Chinese medicine therapy on intestinal flora.

Objective To explore the application value of serum Syndecan-1 and endocan-1 combined with rapid sequential organ failure(qSOFA)score in the diagnosis and prognosis of sepsis.Methods The severity of 118 patients with sepsis was divided into the general sepsis group(48 cases),the severe sepsis group(42 cases)and the septic shock group(28 cases).According to the prognosis,patients were divided into the death group(n=32)and the survival group(n=86).A total of 118 healthy volunteers were selected as the control group.Serum Syndecan-1 and endocan-1 levels were detected by enzyme-linked immunosorbent assay(ELISA).The value of serum Syndecan-1,endocan-1 and qSOFA scores in the early diagnosis and prognosis of sepsis was analyzed by receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was compared.Results Compared with the control group,levels of Syndecan-1,endocan-1 and qSOFA scores were increased in the study group(P＜0.05).The serum Syndecan-1,endocan-1 and qSOFA score in the general sepsis group,the severe sepsis group and the septic shock group were significantly increased in sequence(P＜0.05).ROC curve analysis showed that the AUC of serum Syndecan-1,endocan-1 and qSOFA score in the diagnosis of sepsis(0.967)were higher than that of Syndecan-1(AUC=0.868),endocan-1(AUC=0.798)and qSOFA score(AUC=0.873)alone(Z=6.541,5.495 and 6.395,P＜0.001).Compared with the survival group,the levels of Syndecan-1,endocan-1 and qSOFA scores were significantly increased in the death group(P＜0.05).The combined prediction of AUC(0.983)was higher than that of Syndecan-1(AUC=0.814),endocan-1(AUC=0.834)and qSOFA score(AUC=0.924)alone(Z=6.596,9.268 and 6.904,P＜0.001).Conclusion Serum levels of Syndecan-1,endocan-1 and qSOFA are increased in patients with sepsis,and the combination of the three has higher clinical value in the diagnosis and prognosis evaluation of sepsis.

Objective:To study the clinical manifestations, genetic profiles and treatment of Kagami-Ogata syndrome (KOS).Methods:A neonate admitted to our hospital was genetically diagnosed of KOS from amniocentesis sampling. The phenotype, genotype and treatment of the neonate were analyzed. Multiple databases were searched using key words including "Kagami-Ogata syndrome", "14q32 microdeletion syndrome", "coat-hanger ribs", "paternal uniparental disomy (pUPD)(14) " from the inception of the databases to Jan. 23th 2023. The clinical features, genotype and treatment of patients from the literature were summarized.Results:The neonate in our hospital was born at 30 weeks gestational age with a birth weight of 2 035 g. Prenatal ultrasound indicated overgrowth, bilateral fetal renal pelvis dilatation (FRPD), dilatation of intestines in lower abdomen, clenched hands with overlapping fingers and polyhydramnios. After birth, the neonate showed progressively worsening respiratory distress, distinct facial features (small jaw, short neck, flat nasal bridge, upward-facing nostrils, small and malformed ears with auricular deformity and narrow external auditory canals), bell-shaped thorax, diastasis recti and abnormal posture (overlapping fingers, clenched fists), as well as feeding difficulties, recurrent fever and dependence of respiratory support. Whole exome sequencing (WES) revealed a 268.2Kb deletion (101034306_101302541) in 14q32.2 region on both the neonate and the mother and the father was otherwise normal. The prognosis was poor and the parents refused further treatment. The neonate died at one month of age after two days of palliative care. A total of 36 articles were identified in the literature review, including 78 KOS cases with complete clinical data (a total of 79 cases adding our case).The primary clinical manifestations included distinctive facial and thoracic abnormalities (79/79, 100%), polyhydramnios (71/75, 94.7%), feeding difficulties (55/63, 87.3%), abdominal wall defects (57/72, 79.2%), joint contractures (39/70, 55.7%) and dependence of respiratory support (29/56, 51.8%). Long-term follow-up revealed 86.8% (59/68) experienced physical, movement and intellectual development delay, 39.7% (25/63) died or gave up treatments within five years. Genetic testing showed pUPD in 44 cases (55.7%), maternal deletions in 23 cases (29.1%), epimutations in 8 cases (10.1%) and unreported variations in 4 cases (5.1%).Conclusions:KOS is a genetic imprinting disorder affecting multiple organs. Prenatal screening can detect abnormalities such as polyhydramnios. Specific clinical signs, radiological findings and 14q32 gene analysis are helpful for the diagnosis of the disease.

Objective:To evaluate the effect of online and offline blended teaching in microendodontics, attempting to promote the widespread application of blended teaching mode in Operative Dentistry and Endodontics.Methods:A questionnaire survey was carried out among 865 trainees who attended the blended teaching in microendodontics combined the online theory curriculum and offline practice training from April 6 to 28 in 2022, organized by Department of Operative Dentistry and Endodontics, Hospital of Stomatotogy, Sun Yat-sen University. The content of questionnaire included trainees′ basic information as well as their perspectives and expectations on the teaching mode. Data was analyzed by SPSS 24.0 and Chi-square test was used for enumeration data.Results:A total of 855 trainees participated in the valid survey with the effective recall rate of 98.8% (855/865), 50.3% (430/855) of which were young people in 18-30 years old. Their working period ranged from 0.5 to 40 years. Physicians and physician assistants occupied 40.9% (350/855) and 32.9% (281/855), respectively. And the intermediate and senior titles accounted for 26.2% (224/855). The proportion of trainees who had used and never used dental operative microscope (DOM) were 70.5% (603/855) and 29.5% (252/855), respectively. The blended teaching in microendodontics was universally approved by the trainees, which showed more superiority in the improvement of learning efficiency and interest, comprehension of knowledge as well as practical ability, etc., compared to the traditional offline teaching. For the current stomatology education, trainees were inclined to choose the blended teaching mode combining online theory curriculum and offline practice training, whereas 41.3% (353/855) and 39.6% (339/855) of trainees agreed that the teaching effectiveness was likely influenced by the condition and frequency of the offline training, respectively. Besides, significant differences were detected in the question about the factors affecting the blended teaching effectiveness of microendodontics between the trainees who had used and not used DOM (χ2=13.37, P=0.004). Conclusions:The application of online and offline blended teaching in microendodontics was affirmed to have some advantages, and it should be considered that the discrepancy in the level of expertise among trainees probably influenced the teaching effectiveness, which may promote the quality and effect of teaching, the spread and sharing of microendodontics, and provide experience and reference for the practice teaching of Operative Dentistry and Endodontics.