BACKGROUND:Dental pulp stem cells,which derived from the dental pulp tissue,are one type of dental-derived mesenchymal stem cells,possess significant properties of self-renewal and multi-lineage differentiation.In recent years,series of researches focus on dental pulp stem cells and their derivatives such as extracellular vesicles,conditioned medium,and decellularized extracellular matrix,those have positive effects on the repair and regeneration of pulp tissue injury,showing an attractive clinical application.OBJECTIVE:To systematically review the researches and applications of dental pulp stem cells and their derivatives in dental pulp tissue engineering.METHODS:Literature searches were conducted in PubMed,China Biology Medicine(CBM),and China National Knowledge Infrastructure(CNKI)databases for articles published from January 2005 to June 2023.The search terms included"dental pulp stem cells,extracellular vesicles,exosomes,apoptotic bodies,conditioned medium,decellularized matrix,regeneration"in Chinese and English.After screening the titles and abstracts,duplicate and irrelevant studies were excluded.Finally,103 studies closely related to dental pulp regeneration were included for review and analysis.RESULTS AND CONCLUSION:Dental pulp stem cells and their derivatives are rich in lots of bioactive factors that can effectively promote odontogenic,angiogenic,and neurogenic differentiation,exhibiting significant potential in the formation of the pulp-dentin complex.However,the clinical translation of dental pulp stem cells and their derivatives still faces several challenges.Future researches should focus on optimizing preparation protocols,elucidating the underlying mechanisms of action,and refining safety assessments to provide novel therapeutic strategies for the repair of dental pulp injury.

BACKGROUND:Dental pulp stem cells,which derived from the dental pulp tissue,are one type of dental-derived mesenchymal stem cells,possess significant properties of self-renewal and multi-lineage differentiation.In recent years,series of researches focus on dental pulp stem cells and their derivatives such as extracellular vesicles,conditioned medium,and decellularized extracellular matrix,those have positive effects on the repair and regeneration of pulp tissue injury,showing an attractive clinical application.OBJECTIVE:To systematically review the researches and applications of dental pulp stem cells and their derivatives in dental pulp tissue engineering.METHODS:Literature searches were conducted in PubMed,China Biology Medicine(CBM),and China National Knowledge Infrastructure(CNKI)databases for articles published from January 2005 to June 2023.The search terms included"dental pulp stem cells,extracellular vesicles,exosomes,apoptotic bodies,conditioned medium,decellularized matrix,regeneration"in Chinese and English.After screening the titles and abstracts,duplicate and irrelevant studies were excluded.Finally,103 studies closely related to dental pulp regeneration were included for review and analysis.RESULTS AND CONCLUSION:Dental pulp stem cells and their derivatives are rich in lots of bioactive factors that can effectively promote odontogenic,angiogenic,and neurogenic differentiation,exhibiting significant potential in the formation of the pulp-dentin complex.However,the clinical translation of dental pulp stem cells and their derivatives still faces several challenges.Future researches should focus on optimizing preparation protocols,elucidating the underlying mechanisms of action,and refining safety assessments to provide novel therapeutic strategies for the repair of dental pulp injury.

Based on spleen deficiency-phlegm dampness as the core pathogenesis of obesity， and integrating recent advances in modern medicine regarding the key role of immune inflammation in obesity， this paper proposes a multidimensional pathogenic network of "obesity-spleen deficiency-phlegm dampness-immune imbalance". Various traditional Chinese medicine （TCM） herbs that strengthen the spleen， regulate qi， and resolve phlegm and dampness can treat obesity by improving spleen-stomach transport and transformation， promoting water-damp metabolism， and regulating immune homeostasis. This highlights immune inflammation as an important entry point to elucidate the TCM concepts of "spleen deficiency-phlegm dampness" and the therapeutic principle of "strengthening the spleen and eliminating dampness to treat obesity". By systematically analyzing the intrinsic connection between "spleen deficiency generating dampness， internal accumulation of phlegm dampness" and immune dysregulation in obesity， this paper aims to provide theoretical support for TCM treatment of obesity based on dampness.

Objective:To investigate the prevalence of asthenopia and dry eye,and to further explore the potential occupational hazard factors,so as to provide a theoretical basis for their prevention and con-trol.Methods:A cross-sectional survey was conducted on the selected respondents.For visual display terminal(VDT)workers in employing organizations such as banks,colleges,and government depart-ments,an online questionnaire independently developed by the research group was used for population surveys.Information including general information,work-related situations,work environment,visual health,and ergonomic factors was collected.The respondents were analyzed according to whether they suffered from asthenopia and dry eye.Relevant factors of asthenopia and dry eye were screened through t-test and Chi-square test.Subsequently,binary Logistic regression analysis was carried out to determine the risk factors of asthenopia and dry eye among the VDT workers.Results:The overall prevalence of as-thenopia was 52.5％(235/448)and dry eye was 36.8％(165/448).There were no significant diffe-rences in the prevalence of asthenopia and dry eye among different genders,age groups,and groups of length of service in VDT work.However,the highest prevalence of dry eye was observed in underweight individuals(42.9％),followed by normal weight(40.6％),overweight(28.0％),and obese indivi-duals(17.4％).There was a significant difference in the prevalence of dry eye among different body mass index(BMI)groups(x2=9.505,P=0.023).The lowest prevalence of asthenopia was observed among securities industry employees(22.6％),while higher rates were found in employees in companies(59.5％)and other employing organizations(68.8％).A significant difference in the prevalence of as-thenopia among different employing organizations(x2=14.832,P=0.022).The result of Logistic re-gression showed that a longer length of service in VDT work(OR=1.006,P＜0.001),a longer dura-tion of VDT after working hours(OR=1.002,P=0.032),a too-bright monitor(OR=2.875,P=0.022),glare during work(OR=1.500,P=0.038),a louder noise in work environment(OR=1.586,P=0.012),work-related musculoskeletal disorders(WMSDs)(OR=4.366,P＜0.001)and other factors were independent risk factors of asthenopia,while wearing frame glasses(OR=0.452,P=0.037)was an independent protective factor.Glare during work(OR=2.198,P＜0.001),WMSDs(OR=2.226,P=0.001)and other factors were independent risk factors of dry eye,while overweight(OR=0.448,P=0.006),obesity(OR=0.228,P=0.032)were independent protective factors of dry eye.Conclusion:The prevalence of asthenopia and dry eye among VDT workers is relatively high,and it is associated with multiple risk factors.During prevention and control,attention should be paid to taking reasonable breaks during work,controlling glare,and strengthening visual health training and promotion.

This paper aims to discuss the application value and progress of artificial intelligence (AI) in the diagnosis and treatment of gastrointestinal tumors and teaching practice of gastrointestinal oncology. Through a comprehensive analysis of the current clinical research status and literature, this paper summarizes the application practice and exploratory thinking of AI and deep learning technologies in gastrointestinal oncology. In diagnosis, AI technologies have improved the early detection and diagnosis efficiency for gastrointestinal tumors by optimizing medical image analysis, especially in the recognition of liver metastases. Applications of AI in pathological diagnosis include automatic recognition of tumor cells and tissue structure, as well as improving diagnostic sensitivity and specificity through feature extraction and pattern recognition. In treatment, the application scenarios of AI include rapid diagnosis, accurate staging, personalized treatment plan formulation, drug development, and surgical assistance. In surgical assistance, AI technology improves the safety and effectiveness of surgery through preoperative evaluation, surgical navigation, and postoperative evaluation. In teaching, AI technology facilitates knowledge acquisition and clinical skill enhancement of medical students by providing a multidisciplinary learning platform, simulating clinical environment and case details, and establishing a remote learning platform. The application of AI technology in teaching also includes deep learning and assessment feedback, providing personalized teaching and real-time assessment for students. This paper discusses the application prospects for AI technology in the teaching practice of gastrointestinal oncology. Although AI technology shows great potential in the diagnosis and treatment of gastrointestinal tumors and teaching gastrointestinal oncology, it also has limitations and needs to be combined with traditional teaching methods to achieve the best teaching results.

Objective:To investigate the relationship between the serum levels of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), S100 calcium binding protein B (S100B) with glycolipid metabolism, pregnancy outcome in pregnant women with gestational diabetes.Methods:The clinical data of 153 pregnant women with gestational diabetes (research group) and 153 healthy pregnant women (control group) in the Second Affiliated Hospital of Xi ′an Medical University from January 2020 to October 2023 were retrospectively analyzed. The serum levels of VEGF, MMP-9 and S100B were measured by enzyme linked immunosorbent assay, and the fasting blood glucose, triglyceride, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting insulin and glycated hemoglobin were measured, and the homeostasis model assessment insulin resistance index (HOMA-IR) was calculated. The adverse outcomes of pregnant women with gestational diabetes were recorded. Pearson method was used to analyze the correlation between glycolipid metabolism indexes and VEGF, MMP-9, S100B in pregnant women with gestational diabetes. Multivariate Logistic regression was used to analyze the independent risk factors of adverse pregnancy outcome in pregnant women with gestational diabetes. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of VEGF, MMP-9 and S100B on adverse pregnancy outcome in pregnant women with gestational diabetes. Results:The fasting blood glucose, fasting insulin, glycated hemoglobin, HOMA-IR, triglyceride, total cholesterol, LDL-C, VEGF, MMP-9 and S100B in research group were significantly higher than those in control group: (9.42 ± 0.65) mmol/L vs. (4.13 ± 0.46) mmol/L, (16.58 ± 2.37) mU/L vs. (13.41 ± 2.05) mU/L, (7.28 ± 0.46)% vs. (4.35 ± 0.39)%, 4.83 ± 0.42 vs. 2.71 ± 0.37, (3.41 ± 0.67) mmol/L vs. (2.85 ± 0.63) mmol/L, (5.54 ± 1.56) mmol/L vs. (5.12 ± 1.50) mmol/L, (3.14 ± 0.97) mmol/L vs. (2.86 ± 0.93) mmol/L, (184.02 ± 30.25) ng/L vs. (156.33 ± 26.41) ng/L, (45.78 ± 7.56) μg/L vs. (29.36 ± 5.03) μg/L and (117.51 ± 25.12) ng/L vs. (89.74 ± 22.46) ng/L, the HDL-C was significantly lower than that in control group: (1.34 ± 0.27) mmol/L vs. (1.42 ± 0.30) mmol/L, and there were statistical differences ( P<0.01 or <0.05). Pearson correlation analysis result showed that VEGF, MMP-9, S100B in pregnant women with gestational diabetes were positively correlated with fasting blood glucose, fasting insulin, glycated hemoglobin, HOMA-IR, triglyceride, total cholesterol and LDL-C ( P<0.01), negatively correlated with HDL-C ( P<0.01). Among 153 pregnant women with gestational diabetes, 49 had adverse pregnancy outcome, and 104 had good pregnancy outcome. The VEGF, MMP-9 and S100B in pregnant women with adverse pregnancy outcome were significantly higher than those in pregnant women with good pregnancy outcome: (212.75 ± 28.63) ng/L vs. (170.49 ± 26.58) ng/L, (52.37 ± 7.14) μg/L vs. (42.68 ± 6.35) μg/L and (136.83 ± 23.62) ng/L vs. (108.41 ± 21.35) ng/L, and there were statistical differences ( P<0.01). Multivariate Logistic regression analysis result showed that VEGF, MMP-9 and S100B were independent risk factors for adverse pregnancy outcome in pregnant women with gestational diabetes ( OR = 7.013, 5.382 and 6.129; 95% CI 5.206 to 9.447, 3.449 to 8.398 and 3.520 to 10.673; P<0.01). ROC curve analysis result showed that the area under the curve of VEGF, MMP-9 combined S100B in predicting adverse pregnancy outcome in pregnant women with gestational diabetes was significantly larger than that of VEGF, MMP-9 and S100B alone (0.945 vs. 0.863, 0.847 and 0.801; P<0.05 or <0.01), with sensitivity of 89.80% and specificity of 91.30%. Conclusions:The high serum levels of VEGF, MMP-9 and S100B are associated with abnormal glycolipid metabolism and adverse pregnancy outcome in pregnant women with gestational diabetes, and the combination of the three indexes has a high predictive value for adverse pregnancy outcome.

Objective:To analyze the prediction of pathological classification of ground glass nodules based on artificial intelligence computed tomography (CT) quantitative parameters combined with histogram parameters.Methods:The clinical data of 268 suspected patients with ground glass nodules admitted to Foshan Fosun Chancheng Hospital from June 2021 to June 2023 were retrospectively selected as the research subjects. They were divided into pre invasive lesions group (100 cases) and invasive lesions group(168 cases) according to pathological classification. Basic data of patients with different pathological classifications and the CT characteristics were compared, the prediction of pathological classification of ground glass nodules based on CT quantitative parameters combined and histogram parameters were analyzed by receiver operating characteristic (ROC) curve.Results:The edge and boundary of the tumor, shape of the lesion, the peripheral signs of the lesion and the boundary between the two groups had statistical differences ( P<0.05). The CT quantitative parameters of maximum diameter, lesion volume, average CT value in the invasive lesions group and pre invasive lesions group had statistical differences: (15.29 ± 3.20) cm vs. (9.75 ± 2.14) cm, (1.54 ± 0.31) cm 3 vs. (0.51 ± 0.10) cm 3, (- 328.16 ± 46.35) HU vs. (-541.25 ± 100.30) HU, P<0.05. The CT histogram parameters of inproportion of solid components, entropy and maximum CT value in the invasive lesions group and pre invasive lesions group had statistical differences: (66.39 ± 13.25)% vs. (42.65 ± 11.20)%, 4.31 ± 0.52 vs. 3.32 ± 0.39, (-75.34 ± 21.27) HU vs. (-141.72 ± 32.43)HU, P<0.05. Compared with the single prediction of CT quantitative parameters and CT histogram parameters, the combined prediction of the two parameters had higher value in predicting different pathological subtypes of ground glass nodules (the area under the curve was 0.877, P = 0.001). Conclusions:The combined detection of CT quantitative parameters and histogram parameters based on artificial intelligence can effectively evaluate the invasion status of ground glass nodules, which is beneficial for improving the detection of different pathological types of ground glass nodules.

The aim of this paper was to investigate the serotypes,virulence factors and drug resist-ance of clinical isolates of Pasteurella rnultocida of porcine origin in recent years.Morphological screening and polymerase chain reaction(PCR)were used to isolate and identify 119 isolates from nasal swabs and lung tissue samples sent from swine farms in Zhejiang Province from 2010 to 2024.The isolates of Pasteurella multocida were subjected to capsular polysaccharide serotyping,lipopolysaccharide serotyping,virulence factor detection and drug resistance analysis by PCR and Kirby-Bauer disc agar diffusion method(K-B).The results showed that there were 64 strains(53.7％)of A-type,54 strains(45.3％)of D-type and 1 strain(0.9％)of F-type among the capsu-lar polysaccharide serotypes,and 10 strains(8.4％)of L1-type,20 strains(16.8％)of L3-type,86 strains(72.2％)of L6-type,and 3 strains(2.6％)of undetermined type among the lipopolysaccha-ride serotypes.The amplification results of 10 virulence genes showed that the detection rate of virulence genes hgbA,higbB and fimA was over 86.0％,the detection rate of toxA was 8.4％,while the virulence gene tbpA was not detected.There were also differences in the distribution vir-ulence genes in different capsular polysaccharide serotypes.Virulence factor pfhA was detected in type A and F but not in type D.The detection rate of adhesin gene tadD in serotype A(92.2％)was significantly higher than that of type D(9.3％),and,on the contrary,the detection rate of ad-hesin gene hsf-l in serotype D(90.7％)was significantly higher than that of type A(20.3％).Drug resistance analysis revealed that Pasteurella multocida showed high susceptibility to antimi-crobial drugs such as amoxicillin,ampicillin,cephalosporins,doxycycline,fosfenicol and ciprofloxa-cin,and showed strong resistance to antimicrobial drugs such as lincomycin,cotrimoxazole,genta-micin and amikacin,and there were 54 multi-drug resistant strains(78.3％).In summary,capsular polysaccharide serotypes were dominated by type A and D,lipopolysaccharide serotypes were dom-inated by L6,the distribution of some virulence genes varied greatly among different serotypes,and the proportion of multi-resistant strains was high,which provide reference for the prevention and control of this disease.

Objective To investigate the impact of high mobility group box 1(HMGB1)on hydrogen peroxide(H2O2)-induced DNA damage and senescence in lens epithelial cells(LECs)under oxidative stress conditions.Methods Fluorescent quantitative real-time polymerase chain reaction(RT-PCR)technology was used to detect the mRNA expres-sion of HMGB1 in the anterior capsule tissue of patients with age-related cataract(ARC group)and epiretinal membrane(control group).Western blot analysis was employed to examine the changes in the protein expression of HMGB1 in the LEC line SRA01/04 after treatment with varying concentrations of H2O2(0,100,200,and 400 μmol·L-1).The optimal concentration was selected for subsequent establishment of a cellular oxidative damage model.The cultured SRA01/04 cells were divided into three groups:Control(untreated),HA(transfected with the control plasmid HA),and OE-HMGB1 groups(transfected with the HMGB1 plasmid).The mRNA and protein expression levels of HMGB1 were detected by RT-PCR and Western blot.The cultured SRA01/04 cells were divided into three groups:H2O2(treated with 400 μmol·L-1 H2O2),H2O2+HA(transfected with the control plasmid HA and simultaneously treated with 400 μmol·L-1 H2O2),and H2O2+OE-HMGB1 groups(transfected with the HMGB1 plasmid and simultaneously treated with 400 μmol·L-1 H2O2).Immunofluorescence was used to detect DNA oxidative damage in cells from each group.Western blot analysis was per-formed to assess the protein expression levels of phosphorylated histone H2A(γH2A),tumor protein p53(P53),cyclin-dependent kinase inhibitor 1A(P21),and cyclin-dependent kinase inhibitor 2A(P16)in cells from each group.Additional-ly,senescence-associated-β-galactosidase(SA-β-gal)staining was conducted to detect senescent changes in cells from each group.Results RT-PCR results indicated that the relative mRNA expression level of HMGB1 in the anterior capsule tissue of the ARC group was significantly decreased,compared with that in the control group(P＜0.001).Furthermore,in the H2O2-induced oxidative damage model,the relative protein expression level of HMGB1 decreased with the increase of the concentration of H2O2.Both RT-PCR and Western blot analyses revealed that the mRNA and protein expression levels of HMGB1 were both significantly elevated in the OE-HMGB1 group,compared with those in the HA group(both P＜0.001).The immunofluorescence staining results demonstrated that the protein expression of γH2A and the fluorescence intensity in the H2O2+OE-HMGB1 group were significantly decreases,compared with those in H2O2 and H2O2+HA groups(all P＜0.001).SA-β-gal staining results showed that the H2O2+OE-HMGB1 group had significantly less cells stained by SA-β-gal than H2O2 and H2O2+HA(both P＜0.001).Additionally,Western blot analysis revealed that,compared with those in H2O2 and H2O2+HA groups,the relative expression levels of senescence-associated proteins P53,P21,and P16 were significantly decreased in the H2O2+OE-HMGB1 group(all P＜0.01).Conclusion HMGB1 inhibits the accumula-tion of damaging DNA and senescence in LECs by enhancing DNA damage repair capabilities.

Objective To investigate the status of feeding intolerance in patients with enteral nutrition after lung transplantation and analyze its influencing factors,to provide a reference for formulating a reasonable enteral nutrition plan and improving patients'nutritional status.Methods Convenient sampling method was used to retrospectively collect the clinical data of 115 patients who received enteral nutrition support after lung transplantation and were hospitalized in the ICU of a tertiary hospital in Guangdong Province from August 2022 to November 2023.According to the occurrence of feeding intolerance during ICU hospitalization,the patients were divided into a feeding tolerance group and a feeding intolerance group.Univariate and logistic regression analysis were used to analyze the influencing factors of feeding intolerance patients with enteral nutrition after lung transplantation.Results Within 7 days of initiating enteral nutrition,a total of 63 patients developed feeding intolerance,with an incidence of 54.78％.Among them,the incidence of feeding intolerance was relatively high within 1 to 3 days after initiating enteral feeding.The clinical manifestations of feeding intolerance were diarrhea,bloating,gastric retention,vomiting/regurgitation,among which the diarrhea was the highest incidence(87.30％).Logi-stic regression analysis showed that intraoperative net balance volume(OR=0.999),intraoperative blood transfusion(OR=1.001)volume and diabetes history(OR=0.170)were independent influencing factors for feeding intolerance in patients with enteral nutrition after lung transplantation(P＜0.05).Conclusion There was a high incidence of feed-ing intolerance in patients with enteral nutrition after lung transplantation.Patients undergoing lung transplantation who have a high net intraoperative fluid balance,receive a low volume of intraoperative blood transfusions,and have a history of diabetes are at a lower risk of developing feeding intolerance when receiving postoperative enteral nutrition.When starting enteral nutrition,medical staff should dynamically evaluate the risk factors of feeding intolerance,screen high-risk patients as early as possible,and formulate reasonable enteral nutrition programs to improve the nutritional status of patients and promote their rehabilitation.