Objective:To investigate the effects of apical periodontitis of mandibular primary molars on the development of mandibu-lar permanent premolars in children in Guangzhou.Methods:335 children aged 4-9 years with apical periodontitis of mandibular pri-molar at one side and normal healthy homologous tooth at another side were included and divided into 2 groups:Group A(n=200)in-cluded the first mandibular premolars and group B(n=135)included the second mandibular premolars.Subgroup A1 and B1 were the apical periodontitis groups,subgroup A2 and B2 were the normal healthy groups.The degree of root destruction of primary teeth,the degree of destruction and development of the dental follicle of permanent teeth,the mesial and distal direction changes,and the eruption height were observed and measured on the panoramic raidiographs,data were statistically analyzed.Results:In the 7-year-old children of A1 and the 6-year-old of B1 groups,the development degree of successor permanent teeth was lower than that of group A2 and group B2 of the same age children respectively(P＜0.05).In the 6-7-year-old children of group A1,the permanent teeth development of boys was slower than that of the girls(P＜0.05).There was no gender difference in dental follicle destruction and malposition of the perma-nent teeth in both A1 and B1 groups(P＞0.05).The proportion of malposition of the successor permanent teeth in group A1 increased with the primary teeth damage degree increace(P＜0.05),while the proportion of malposition of the successor permanent teeth in group B1 showed no significant difference(P＞0.05).Positive correlation between the damage degree of primary teeth and dental follicle of per-manent teeth was observed(rA1=0.41,rB1=0.21,P＜0.05).In boys aged 7-8 years,the succesor permanent teeth eruption in group A1 was higher than that in group A2(P＜0.05),and there was no significant difference between group B1 and group B2(P＞0.05).Conclusion:In the later stages of root stabilization of primary molars,periapical inflammation of primary teeth may cause developmen-tal delay of the succesor permanent teeth,and the delay degree is higher in boys than in girls.With the deterioration of the periapical tissue of primary teeth,the destruction of the dental follicle of permanent teeth may deepen,and the mandibular first premolar is more likely to have abnormal eruption.

Objective:To investigate the effects of apical periodontitis of mandibular primary molars on the development of mandibu-lar permanent premolars in children in Guangzhou.Methods:335 children aged 4-9 years with apical periodontitis of mandibular pri-molar at one side and normal healthy homologous tooth at another side were included and divided into 2 groups:Group A(n=200)in-cluded the first mandibular premolars and group B(n=135)included the second mandibular premolars.Subgroup A1 and B1 were the apical periodontitis groups,subgroup A2 and B2 were the normal healthy groups.The degree of root destruction of primary teeth,the degree of destruction and development of the dental follicle of permanent teeth,the mesial and distal direction changes,and the eruption height were observed and measured on the panoramic raidiographs,data were statistically analyzed.Results:In the 7-year-old children of A1 and the 6-year-old of B1 groups,the development degree of successor permanent teeth was lower than that of group A2 and group B2 of the same age children respectively(P＜0.05).In the 6-7-year-old children of group A1,the permanent teeth development of boys was slower than that of the girls(P＜0.05).There was no gender difference in dental follicle destruction and malposition of the perma-nent teeth in both A1 and B1 groups(P＞0.05).The proportion of malposition of the successor permanent teeth in group A1 increased with the primary teeth damage degree increace(P＜0.05),while the proportion of malposition of the successor permanent teeth in group B1 showed no significant difference(P＞0.05).Positive correlation between the damage degree of primary teeth and dental follicle of per-manent teeth was observed(rA1=0.41,rB1=0.21,P＜0.05).In boys aged 7-8 years,the succesor permanent teeth eruption in group A1 was higher than that in group A2(P＜0.05),and there was no significant difference between group B1 and group B2(P＞0.05).Conclusion:In the later stages of root stabilization of primary molars,periapical inflammation of primary teeth may cause developmen-tal delay of the succesor permanent teeth,and the delay degree is higher in boys than in girls.With the deterioration of the periapical tissue of primary teeth,the destruction of the dental follicle of permanent teeth may deepen,and the mandibular first premolar is more likely to have abnormal eruption.

Objective:To observe the clinical outcomes of continued pregnancy in pregnant women with cesarean scar pregnancy (CSP).Methods:A retrospective analysis was performed on the pregnancy outcomes of 55 pregnant women who were diagnosed with CSP at the Second Affiliated Hospital of Army Medical University during the first trimester of pregnancy from August 1st, 2018 to October 31st, 2021 and strongly requested to continue the pregnancy.Results:Of the 55 pregnant women, 15 terminated the pregnancy in the first trimester, 1 underwent hysterotomy at 23 weeks of gestation due to cervical dilation, and 39 (71%, 39/55) continued pregnancy to the third trimester achieving live births via cesarean section. The gestational age of the 39 pregnant women delivered by cesarean section was 35 +6 weeks (range: 28 +5-39 +2 weeks), of whom 7 cases at 28 +5-33 +6 weeks, 20 cases at 34-36 +6 weeks, and 12 cases at 37-39 +2 weeks. The results of pathological examination were normal placenta in 3 cases (8%, 3/39), placenta creta in 4 cases (10%, 4/39), placenta increta in 9 cases (23%, 9/39) and placenta percreta in 23 cases (59%, 23/39). Among the 36 pregnant women who were pathologically confirmed as placenta accreta spectrum disorders (PAS) after surgery, the last prenatal ultrasonography showed placenta previa in 27 cases (75%, 27/36) and not observed placenta previa in 9 cases. The median intraoperative blood loss, autologous blood transfusion, and allogeneic suspended red blood cell infusion of 39 pregnant women during cesarean section were 1 000 ml (300-3 500 ml), 300 ml (0-2 000 ml) and 400 ml (0-2 400 ml), respectively. The uterine preservation rate was 100% (39/39), and only 1 case received cystostomy due to intracystic hemorrhage. The birth weight of the newborn was 2 580 g (1 350-3 800 g), and 1 case of mild asphyxia. Conclusions:Pregnant women with CSP who continue pregnancy under close monitoring after adequate ultrasound evaluation and doctor-patient communication could achieve better maternal and infant outcomes, but pregnant women with CSP are highly likely to continue pregnancy and develop into PAS. Effective hemostasis means and multidisciplinary team cooperation are needed in perinatal period for ensuring maternal and fetal safety.

Objective: To isolate a bacteriophage against pan-drug resistant Klebsiella pneumoniae in a burn patient, and to study its biological characteristics, genomic information, and effects on bacterial biofilm. Methods: (1) In 2018, pan-drug resistant Klebsiella pneumoniae UA168 (hereinafter referred to as the host bacteria) solution isolated from the blood of a burn patient in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (hereinafter referred to as Ruijin Hospital) was used to isolate and purify the bacteriophage against pan-drug resistant Klebsiella pneumoniae from the sewage of Ruijin Hospital with sewage co-culture method, drip plate method, and double-agar plate method. The bacteriophage was named as phage KP168 and the plaque morphology was observed. (2) The phage KP168 solution was taken for cesium chloride density gradient centrifugation and dialysis, and then the morphology of phage KP168 was observed through transmission electron microscope after phosphotungstic acid negative staining. (3) The phage KP168 solution was taken to determine the lytic ability of the phage KP168 against 20 strains of pan-drug resistant Klebsiella pneumoniae isolated from the burned patients′ blood in Ruijin Hospital by the drip plate method, and then the lysis rate was calculated. (4) The phage KP168 solution at a initial titer of 9.3×10¹¹ plaque-forming unit (PFU)/mL (400 μL per tube) and the host bacteria solution at a concentration of 1×10⁹ colony-forming unit (CFU)/mL (4 mL per tube) were conventionally shaking cultured together for 4 hours at multiplicity of infection (MOI) of 10.000, 1.000, 0.100, 0.010, or 0.001, respectively (1 tube per MOI). The titer of phage KP168 was measured by the double-agar plate method (the measurement method was the same below) to select the optimal MOI. The experiment was repeated three times. (5) The host bacteria solution at a concentration of 1×10⁹ CFU/mL (4 mL per tube) and the phage KP168 solution at an adjusted titer of 5×10⁷ PFU/mL (400 μL per tube) were mixed at the MOI of 0.005. The plaques were counted 0 (immediately), 1, 2, 3, 4, 5, 15, and 30 minutes (1 tube at each time point) after mixing by the double-agar plate method (the counting method was the same below), and the percentage of adsorbed phages was calculated to screen for the optimal adsorption time. The experiment was repeated three times. (6) The host bacteria solution at a concentration of 1×10⁹ CFU/mL (300 μL per tube) and the phage KP168 solution at a titer of 5×10⁸ PFU/mL (60 μL per tube) were mixed at MOI of 0.005 and conventionally shaking cultured after standing for the optimal adsorption time. The phage KP168 titer was measured 0 (immediately), 10, 20, 30, 40, 50, 60, 70, 80, 90, and 100 minutes after culture, and a one-step growth curve was drawn. The experiment was repeated three times. (7) The phage KP168 solution at a titer of 2.5×10¹⁰ PFU/mL was left to stand for 1 hour at 37, 40, 50, 60, or 70 ℃ (3 tubes at each time point, 1 mL per tube) for counting the plaques, and then the thermal stability curve was drawn. SM buffer at a pH values of 5.0, 6.0, 7.0, 7.4, 8.0, 9.0, or 10.0 were added to the phage KP168 solution at a titer of 3.0×10¹⁰ PFU/mL, respectively. The mixed solution was left to stand for 1 hour at 37 ℃ (3 tubes of each pH, each tube containing 100 μL phage KP168 solution and 900 μL SM buffer), and then the plaques were counted, and an acid-base stability curve was drawn. (8) The phage KP168 solution was taken for DNA extraction and sequencing after dialysis as in experiment (2). The whole genome was annotated with Prokka to obtain the coding sequence of phage KP168. Nucleotide′s BLAST function was used to proceed nucleic acid sequence alignment for finding a known phage with the highest similarity to the phage KP168 nucleic acid sequence, and Blastx function was used to translate the coding sequence into protein for its function prediction. The comparison with Antibiotic Resistance Genes Database and Virulence Factors Database was proceeded. (9) In a 96-well plate, at a MOI of 1.000, 0.100, 0.010 or 0.001 (3 wells per MOI), 20 μL phage KP168 solution at a initial titer of 5.8×10¹⁰ PFU/mL was added to 200 μL host bacteria solution at a concentration of 1.5×10⁸ CFU/mL (the same concentration below) for co-cultivation for 48 hours. After 200 μL host bacteria solution was left to stand for 48 hours, 20 μL phage KP168 solution at a titer of 1×10^6, 1×10^7, 1×10^8, 1×10^9, or 1×10¹⁰ PFU/mL (3 wells per titer) was added respectively for action for 4 hours. In both experiments, 200 μL host bacteria solution added with 20 μL SM buffer (3 wells) acted as a negative control, and 220 μL LB culture medium (3 wells) acted as a blank control. Absorbance values were measured by a microplate reader, and inhibition/destruction rates of biofilm were calculated. The experiments were both repeated three times. Results: (1) The plaques of phage KP168 successfully isolated and purified were transparent and round, and its diameter was approximately 1.5 mm. (2) The phage KP168 has a regular polyhedron structure with a diameter of about 50 nm and without a tail. (3) The phage KP168 could lyse 13 of 20 strains of Klebsiella pneumoniae from burned patients, with a lysis rate of 65.0%. (4) When MOI was 1.000, the titer was the highest after co-culturing the phage KP168 with the host bacteria for 4 hours, which was the optimal MOI. (5) After the mixing of the phage KP168 with the host bacteria for 4 minutes, the percentage of the adsorbed phage reached the highest, which was the optimal adsorption time. (6) The one-step growth curve showed that during the lysis of the host bacteria by phage KP168, the incubation period was about 10 minutes, and the lysis period was about 40 minutes. (7) With the condition of 40 ℃ or pH 7.4, the number of plaques and the activity of phage KP168 reached the highest. (8) The genome of phage KP168 was a linear double-stranded DNA with a length of 40 114 bp. There were 48 possible coding sequences. It had the highest similarity to Klebsiella phage_vB_Kp1. The most similar known proteins corresponding to the translated proteins of coding sequences contained 23 hypothetical proteins and 25 proteins with known functions. No resistance genes or virulence factor genes were found. The GeneBank accession number was KT367885. (9) After 48 hours of co-cultivation of the phage KP168 and the host bacteria at each MOI, the inhibition rates of biofilm were similar, with an average of about 45%. After the phage KP168 with a titer of 1×10⁹ PFU/mL acted on the biofilm formed by the host bacteria for 4 h, the destruction rate of biofilm was the highest, reaching an average of 42%. Conclusions In this study, a bacteriophage against pan-drug resistant Klebsiella pneumoniae from a burn patient, phage KP168, is isolated from sewage, which belongs to the tailless phage. It has a wide host spectrum, short adsorption time, and short incubation period, with certain thermal and acid-base stability. Its genomic information is clear, and it does not contain resistance genes or virulence factor genes. It also has an inhibitory effect on the formation of bacterial biofilm and a destructive effect on the formed bacterial biofilm.

Objective To study the trends of lung cancer mortality among adult residents in Macheng City, Hubei Province from 1984 to 2018． Methods Mortality data was extracted from Macheng City disease surveillance points (DSPs) system and China Demographic Yearbook. The age-period-cohort (APC) model and Intrinsic Estimator algorithm were used to estimate the age effect, period effect and cohort effect of lung cancer mortality. Results The age effect coefficient of lung cancer mortality increased with age from 20 to 74 years old. The mortality risk of the 70-74 group was 42.62 times that of the 20-24 group. The period effect coefficient of lung cancer mortality also continued to rise with time. The cohort effect coefficient was parabolic, and residents born in 1939-1943 had the highest coefficient (1.298 4). Conclusion The risk of lung cancer death of adult residents in Macheng City significantly increased with the year and the rapid development of socio-economics.

Objective To investigate the effectiveness of the affinity adsorption material developed by our team for the specific removal of exogenous endotoxin in the blood circulation. Methods Fifteen beagle dogs were intravenously injected with endotoxin to establish a dog model of endotoxemia, and then they were randomly divided into the treatment group(n=10)and the control group(n=5). The treatment group received an extracorporeal perfusion to remove the endotoxin using the self-made disposable hemoperfusion device,while the control group using routine perfusion device. The levels of endotoxin, tumor necrosis factor α(TNF-α), interleukin 1β(IL-1β), interleukin 6(IL-6)and interleukin 8 (IL-8)in the blood of the dogs were measured at the beginning and 120 min after hemoperfusion for 120 minutes. The vital signs of the dogs were monitored during the hemoperfusion. Results After successful establishment of the endotoxemia model,the level of endotoxin at the beginning of hemoperfusion in the treatment group and control group was 118.63 ± 27.98 EU/mL and 117.16 ± 22.95 EU/mL,respectively. After hemoperfusion for 120 min,it was 0.039 ± 0.01 EU/mL and 131.98 ± 7.01 EU/mL, showing a significant difference(P﹤0.05). The clearance rate of hemoperfusion in the treatment group was 94.07%. At the beginning of hemoperfusion, the levels of TNF-α, IL-1β, IL-6 and IL-8 in the treatment group were 1.53 ± 0.27 ng/mL,12.82 ± 1.66 ng/mL,54.77 ± 3.98 ng/mL and 0.25 ± 0.32 ng/mL, and the levels in the control group were 1.53 ± 0.06 ng/mL,13.05 ± 0.18 ng/mL,54.58 ± 0.19 ng/mL and 0.28 ± 0.06 ng/mL, respectively. After hemoperfusion for 120 min, the levels of TNF-α, IL-1β, IL-6 and IL-8 in the treatment group were 0.13 ± 0.06 ng/mL, 0.70 ± 0.36 ng/mL, 1.62 ± 0.80 ng/mL and 0.01 ± 0.00 ng/mL, respectively, and as for the control group,the levels were 2.26 ± 0.15 ng/mL,15.12 ± 0.18 ng/mL,62.54 ± 0.93 ng/mL and 0.73 ± 0.93 ng/mL. There were significant differences between the beginning and after perfusion for 120 min in those two groups(P< 0.05). Conclusions This affinity adsorption material can effectively remove endotoxin and the inflammatory mediators in the blood of experimental dogs,with a clearance rate of 94.07%.

Objective To evaluate the clinical value of fetal intelligent navigation echocardiography (5D Heart) in the display of key diagnostic elements in basic fetal echocardiographic views.Methods Using volume probe,3D volume datasets of the 209 normal singleton fetuses in the second and third trimesters were acquired from a four-chamber view.After processing the datasets by using 5D Heart,9 cardiac diagnostic planes were acquired and then the image qualities of key diagnosis elements of the heart and great vessels were graded by 3 doctors with different experiences of performing fetal echocardiography.Results Two hundred and sixty-two volume datasets were acquired from 209 normal fetuses,including 53 volume datasets collected when cardiac apex was in different directions,satisfactory datasets failed to be acquired in 27 fetuses because of the maternal obesity,the artifacts of fetal movement,or other influencing factors.Two hundred and thirty-one volume datasets of 182 fetuses could be used for 5D Heart analyzing and displaying,and the displaying rate of 9 standard diagnostic views was up to 88.2％.No significant difference was found when comparing the grading results of one observer in different periods of time,the grading results between two experienced doctors and the grading results among the experienced doctor and one relatively inexperienced doctor (P ＞ 0.05).Conclusions 5D Heart has high reliability and repeatability in obtaining fetal echocardiographic diagnosis views and displaying fetal elemental diagnostic information.

Objective To evaluate the value of fetal intelligent navigation echocardiography ( 5D Heart) and Virtual Intelligent Sonographer Assistance ( VIS-Assistance ? ) in the display of key diagnostic elements in basic fetal echocardiographic views . Methods The heart volumes data of 209 normal fetuses were collected and then the offline analysis was conducted . Processing of the built-in VIS-Assistance ? for each diagnosis plane was optimized . The display success rate and image quality difference of diagnosis images and diagnosis elements before and after the VIS-Assistance ? processing as well as the repeatability between observers were analyzed and compared . Results Totally 262 fetal heart volume data were collected from 209 fetuses ,and 231 volume data of 182 cases could be used for the analysis ,with the acquiring success rate of 88 .2% . For the display rate of 8 diagnosis sections of the 231 fetal heart volume data before and after VIS-Assistance ? processing ,abdominal transverse section at stomach level showed no significant difference ,while the other diagnostic sections showed significant differences ( all P < 0 .05) ,and the display rate after the processing was higher than that before the processing . For the image quality scores of diagnosis sections before and after VIS-Assistance ? processing ,abdominal transverse section at stomach level showed no significant differences ,while other diagnostic sections showed significant differences ( all P < 0 .01) ,and the image quality scores after the processing were higher than those before the processing . According to Bland-Altman analysis ,95% credibility interval of the total scores of 8 sections measured by different observers before and after VIS-Assistance ? were ( - 0 .17/ + 0 .18 ) and ( - 0 .17/ + 0 .18 ) , respectively ,6 .06% (14/231) and 3 .89% (9/231) of the points were outside the 95% credibility interval , and the rest had high consistency . Conclusions 5D Heart and VIS-Assistance ? technology can significantly improve the display rate of diagnostic section and image quality of element structures , and has high reliability and repeatability in obtaining fetal cardiac diagnosis sections and displaying fetal elemental diagnostic information .

The application of information management for ethical review work help improve the quality of audit work quality and efficiency in our country , further standardize the ethical review work , also helps to protect the pri-vacy of the subjects in medical research , and establish the medical research ethics review information system in our country has certain feasibility .Therefore , can be based on the experience of the informatization construction of drug clinical trials , through the establishment of ethical review information and tracking system , to set up the electronic signature of information rights management system , building the continuing education training , establish a commu-nication platform with the principal investigator , to build and perfect the medical research ethics review information system.

Objective To prepare the liver targeting nano-liquid perfluorocarbon ultrasound contrast agent and observe its general characteristics;to observe the targeting combined effects of the human liver cells L02 and the targeted ultrasound contrast agent ;to evaluate the gathering imaging effects of the targeted ultrasound contrast agent. Methods Amine method was used to prepared asialoglycoprotein Gal specific ligand polylysine (Gal-PLL), rotary evaporator and sonicated liquid fluorocarbon were used to prepare nano lipid ultrasound contrast agent. Human liver cell L02 were cultured, the combined effects were observed according to the reacting time of the cells and the targeted nano-lipid ultrasound contrast agent. The nanolipid ultrasound contrast agent and the degassed_ water_ were loaded into cysts and their ultrasound imaging effects were observed by ultrasound diagnostic apparatus Philips iU22. Results The particle size of the liquid fluorocarbon nano-targeted lipid ultrasound contrast agent was extremely small, uniform, cylindrical and spherical. The cysts in vitro showed that the side of the targeted liquid perfluorocarbon nano-lipid ultrasound contrast agent showed high echo. Conclusions The targeted liquid perfluorocarbon nano-lipid ultrasound contrast agent can be effectively targeted to the human liver cells L02 due to carrying home-made Gal-PLL. The targeted ultrasound contrast agents can be imaging by ultrasound and be confirmed in vitro.The size of the contrast agent was small, therefore, it can be considered an ideal ultrasonic molecular probe and achieve the ultrasound molecular imaging in cell level.