Objective To identify the key differentially expressed genes in the patients with lupus nephritis(LN)using bioinformatics methods and discover potential diagnostic biomarkers of LN for exploring the pathogenic mechanisms of LN.Methods The GSE99339 dataset related to chronic kidney disease was obtained from the Gene Expression Omnibus(GEO)database.Weighted gene co-expres-sion network analysis(WGCNA)was performed to identify the core modules highly correlated with LN.The differentially expressed genes(DEGs)between the two groups(32 LN patients and 14 healthy controls)from GSE32591 dataset were identified using Limma package.The intersection of DEGs and the LN-related module genes was obtained.The Gene Ontology(GO)function annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses of intersection genes were conducted using DAVID online tool to construct protein-protein interaction(PPI)network,and the key genes were screened using Cytoscape software.Boxplots and receiver operating characteristic(ROC)curves were generated to evaluate the diagnostic efficiency of the key genes based on the the gene expression data of GSE112943 validation dataset.Results The greenyellow module(102 genes)was strongly correlated with LN(r=0.85,P＜0.01).A total of 361 DEGs were identified from GSE32591 dataset,among which 53 genes were found to intersect with the green-yellow module genes.The LN-related genes were mainly enriched in the biological processes and pathways which related to antiviral response,innate immunity,hepatitis C,and influenza A virus.The top five key genes in the PPI network were IFIT3,MX1,OAS1,RSAD2,and OAS3.The expression levels of 1FIT3,MX1,OAS1 and RSAD2 in LN were significantly different from con-trol groups(P＜0.05).ROC curve analysis showed that the AUC values for the four genes in predicting LN were all greater than 0.8,indicating high diagnostic efficiency.Conclusion IFIT3,MX1,OAS1 and RSAD2 may be the key differentially expressed genes in LN and may be potential diagnostic biomarkers and therapeutic targets for LN.

Objective To investigate the effect of hyperglycemia activated CCAAT enhancer binding protein β(C/EBPβ)promoting the expression of thyroid hormone nuclear receptor α1(THα1)on diabetic cardiomyopathy(DCM).Methods Twenty healthy male Wistar rats were randomly divided into diabetes mellitus(DM,n=10)group and DCM(n=10)group.Cardiomyocyte were divided into four groups:DM-cell,glucose intervention(Glu),knockdown C/EBPβ group(cardiomyocyte were transfected with plasmids targeting knockdown C/EBPβ)and si-NC group(cardiomyocyte were transfected with nagetive control sequence of plasmids).HE and Masson staining was performed to detect myocardial injury and collagen deposition.Echocardiography was used to evaluate left ventricular function.The mRNA and protein expression of C/EBP β and THα1 was detected using RT-qPCR,Western blot and immunofluorescence staining in myocardial cells.Apoptosis was analyzed using flow cytometric.Contraction frequency was counted by microscopy.Results Compared to DM group,count of fibroblasts,collagen volume fraction,end-systolic dimension of left ventricular,and the mRNA and protein expression of C/EBPβ and THα1 as well as fluorescence intensity increased(P<0.05);left ventricular ejection fraction and left ventricular fractional shortening(LVFS)decreased in DCM group(P<0.05).The mRNA and protein expression of C/EBPβ and THα1 were higher in the Glu group than in DM-cell group(P<0.05).The percentage of apoptosis,the mRNA and protein expression of THα1 of myocardial cells were lower in the si-C/EBPβ group than in the si-NC group(P<0.05),and LVFS was higher in the si-NC group(P<0.05).Conclusions High glucose regulates C/EBPβ expression,which in turn drives THα1 expression in myocardial tissue,leading to adverse effects on myocardial tissue.Conversely,silencing C/EBPβ downregulates THα1 expression,and exerts a protective effect on cardiomyocytes.

Objective To investigate the effect of hyperglycemia activated CCAAT enhancer binding protein β(C/EBPβ)promoting the expression of thyroid hormone nuclear receptor α1(THα1)on diabetic cardiomyopathy(DCM).Methods Twenty healthy male Wistar rats were randomly divided into diabetes mellitus(DM,n=10)group and DCM(n=10)group.Cardiomyocyte were divided into four groups:DM-cell,glucose intervention(Glu),knockdown C/EBPβ group(cardiomyocyte were transfected with plasmids targeting knockdown C/EBPβ)and si-NC group(cardiomyocyte were transfected with nagetive control sequence of plasmids).HE and Masson staining was performed to detect myocardial injury and collagen deposition.Echocardiography was used to evaluate left ventricular function.The mRNA and protein expression of C/EBP β and THα1 was detected using RT-qPCR,Western blot and immunofluorescence staining in myocardial cells.Apoptosis was analyzed using flow cytometric.Contraction frequency was counted by microscopy.Results Compared to DM group,count of fibroblasts,collagen volume fraction,end-systolic dimension of left ventricular,and the mRNA and protein expression of C/EBPβ and THα1 as well as fluorescence intensity increased(P<0.05);left ventricular ejection fraction and left ventricular fractional shortening(LVFS)decreased in DCM group(P<0.05).The mRNA and protein expression of C/EBPβ and THα1 were higher in the Glu group than in DM-cell group(P<0.05).The percentage of apoptosis,the mRNA and protein expression of THα1 of myocardial cells were lower in the si-C/EBPβ group than in the si-NC group(P<0.05),and LVFS was higher in the si-NC group(P<0.05).Conclusions High glucose regulates C/EBPβ expression,which in turn drives THα1 expression in myocardial tissue,leading to adverse effects on myocardial tissue.Conversely,silencing C/EBPβ downregulates THα1 expression,and exerts a protective effect on cardiomyocytes.

Objective To identify the key differentially expressed genes in the patients with lupus nephritis(LN)using bioinformatics methods and discover potential diagnostic biomarkers of LN for exploring the pathogenic mechanisms of LN.Methods The GSE99339 dataset related to chronic kidney disease was obtained from the Gene Expression Omnibus(GEO)database.Weighted gene co-expres-sion network analysis(WGCNA)was performed to identify the core modules highly correlated with LN.The differentially expressed genes(DEGs)between the two groups(32 LN patients and 14 healthy controls)from GSE32591 dataset were identified using Limma package.The intersection of DEGs and the LN-related module genes was obtained.The Gene Ontology(GO)function annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses of intersection genes were conducted using DAVID online tool to construct protein-protein interaction(PPI)network,and the key genes were screened using Cytoscape software.Boxplots and receiver operating characteristic(ROC)curves were generated to evaluate the diagnostic efficiency of the key genes based on the the gene expression data of GSE112943 validation dataset.Results The greenyellow module(102 genes)was strongly correlated with LN(r=0.85,P＜0.01).A total of 361 DEGs were identified from GSE32591 dataset,among which 53 genes were found to intersect with the green-yellow module genes.The LN-related genes were mainly enriched in the biological processes and pathways which related to antiviral response,innate immunity,hepatitis C,and influenza A virus.The top five key genes in the PPI network were IFIT3,MX1,OAS1,RSAD2,and OAS3.The expression levels of 1FIT3,MX1,OAS1 and RSAD2 in LN were significantly different from con-trol groups(P＜0.05).ROC curve analysis showed that the AUC values for the four genes in predicting LN were all greater than 0.8,indicating high diagnostic efficiency.Conclusion IFIT3,MX1,OAS1 and RSAD2 may be the key differentially expressed genes in LN and may be potential diagnostic biomarkers and therapeutic targets for LN.

Objective:To analyze the influencing factors related to the prognosis of delayed replantation of avulsed permanent teeth.Methods:A retrospective study was conducted on the clinical data of 35 patients with 38 affected teeth underwent delayed replantation of permanent teeth.According to the prognosis after 12 to 108 months of follow-up,the replantation results of the cases were divided into-success,survival and failure groups.Survival curves were plotted using Kaplan-Meier method,Log-Rank test was used for univariate analysis,and Cox proportional risk regression models were used for multivariate analysis to assess the effects of gender,age,degree of tooth development,mode of tooth preservation and mode of endodontic treatment on the survival rate of replanted teeth.Results:Of the 38 replanted teeth,3 were successful,28 remained and 10 failed.The 9-year cumulative survival rate of the replanted teeth was 34.7％.The results showed that there were no statistically significant differences in the survival rate of the replanted teeth in the groups with different sex,age,degree of tooth development and the mode of preservation of avulsed teeth(P＞0.05).There were statistically significant differences in the cumulative survival rate of the replanted teeth among the groups with different endodontic treatment(P＜0.01),which showed that the cumulative survival rate in the root canal filling group＞continuous root canal sealing group＞pulp preserva-tion treatment group.Conclusion:For the delayed replantation of avulsed premanent teeth,survival prognosis of the teeth treated with pulp preservation is poor,early pulp extraction and root canal filling are recommended.

BACKGROUND:Studies have shown that both Panax notoginseng saponins and concentrated growth factor can promote fracture healing,but there are few studies addressing their combined effects on fracture healing.Panax notoginseng saponins may accelerate fracture healing by promoting the release of concentrated growth factor-related factors over a certain period of time. OBJECTIVE:To study the effect of Panax notoginseng saponins on concentrated growth factor release and fracture healing in rats. METHODS:Eighteen 8-week-old Sprague-Dawley rats were numbered and randomly divided into three groups:Panax notoginseng saponins group,model control group and blank group.Panax notoginseng saponins group was fed with Panax notoginseng saponins for 2 weeks.Model control group was given 2 mL of normal saline for 2 weeks and blank group was fed normally.Concentrated growth factor was obtained by the centrifugation method both from the Panax notoginseng saponins group and model control group.After 1 week of normal feeding,all animals underwent modeling for femoral fracture.The Panax notoginseng saponins group and the model control group were implanted with autologous concentrated growth factor,and then the release concentration of growth factors at different time points(1 hour,1,3,5,7,9 and 11 days)were measured by ELISA.Fracture healing was assessed based on postoperative X-ray and hematoxylin-eosin staining of bone tissues. RESULTS AND CONCLUSION:Compared with the model control group,the Panax notoginseng saponins group had higher release concentrations of vascular endothelial growth factor A and transforming growth factor β at 7,9,and 11 days,Platelet-derived growth factor BB at 5,9,and 11 days,and basic fibroblast growth factor at 1-11 days(P<0.01).X-ray examinations indicated that fracture healing in the Panax notoginseng saponins group was better than that in the model control group,and fracture healing in these two groups was better than that in the blank group at 2 months after surgery.Hematoxylin-eosin staining results found that the constituent osteocyte density in the Panax notoginseng saponins group was greater than that in the model control group,and the constituent osteocyte density in these two groups was better than that in the blank group.These findings indicate that Panax notoginseng saponins can increase the concentration of concentrated growth factor-related factors.After intervention with Panax notoginseng saponins,concentrated growth factors are more advantageous in promoting fracture healing in rats.

Objective : The present study observed the clinical effects on reattachment and pulpotomy of young crown-fractured and pulp-exposed permanent incisors. Methods : In a one-year retrospective clinical observation study, 30 traumatic intact segments of permanent incisors with crown fracture and pulpal exposure were treated using a pulpotomy and reattachment technique with an enamel-dentin luting agent and composite resin. Results : The number of subsequent visit teeth was 30, 29, 25 at 1, 3, 6 months follow-up respectively. The pulpotomy success rates were 100% at 1 month, 93.1% at 3 months, 93.1% at 6 months. The retention rates using the reattachment technique were 100% at 1 month, 100% at 3 months, 100% at 6 months. Conclusion Pulpotomy is the preferred method of preserving live pulp after pulpal exposure of young permanent incisors, and the clinical effect is prominent. The fragment reattachment technique is an effective middle- and short-term method for temporary restoration of young crown-fractured permanent incisors.

Objective To determine the risk factors for postoperative hyperactive-type delirium (PHTD) in elderly patients undergoing orthopedic surgery.Methods A total of 7 171 elderly patients of both sexes,aged more than or equal to 65 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅳ,who underwent orthopedic surgery from January 2008 to December 2012 in Second Affiliated Hospital of Wenzhou Medical University,were retrospectively analyzed.Data such as gender,age,preoperative electrolytes,blood glucose,hemoglobin,albumin,senile dementia and use of benzodiazepines,type of operation,anesthesia methods,operation time,intraoperative use of anticholinergic agents and benzodiazepines and hypotension (decrease more than 20％ of the baseline),and postoperative electrolyte,hemoglobin,albumin and hypotension were collected.The patients were divided into postoperative PHTD group (group PHTD) and postoperative non-PHTD group (group non-PHTD) according to whether PHTD developed within 7 days after operation.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression to stratify the risk factors for postoperative PHTD.Results Ninety-nine patients developed PHTD,and the incidence was 1.38％.The results of logistic regression analysis showed that age more than or equal to 80 yr,hip surgery and preoperative anemia were independent risk factors for postoperative PHTD (P＜0.05).Conclusion Age more than or equal to 80 yr,hip surgery and preoperative anemia are independent risk factors for postoperative PHTD in elderly patients undergoing orthopedic surgery.

Objective To explore the integration of the digital imaging medical records system and the hospital information system ( HIS), for a hospital-wide information platform for digital medical records management. Methods All the medical records were classified as " to copy and not to copy" by sampling, and an item corresponding table was developed for both HIS medical record files and imaging records copying types. The imaging copying system for paper-based medical records only covers those must-copy ones, while those medical record files without need to be copied were directly transcoded via the interface to the imaging medical records system from the HIS system. This makes digital imaging medical records complete. Results The digital imaging medical record system is thus integrated, and the cost of making imaging medical records was sizably reduced without compromising the quality and integrity of medical records. Conclusions Imaging medical records produced by copying paper-based ones are integrated with those directly sent via the interface to the imaging medical records system, forming complete digital imaging records, at a much lower cost.

Objective To investigate the effects of amino acid combined with Salvia miltiorrhiza injection on fetal growth restriction.Methods 122 pregnant women diagnosed with fetal growth restriction were chosen,and they were divided into study group(amino acid+Salvia miltiorrhiza injection) and control group(amino acid).The course of treatment was 7d,and the patients were treated for 3 treatment courses.The clinical efficacy,weight increment,uterine height increment,abdominal circumference increment,fetal biparietal diameter (BPD) increment,femur length (FL) increment,umbilical cord blood flow S/D value and neonatal weight between the two groups were compared.Results The total effective rate in the study group was 84.13%,which was higher than 67.79% in the control group (χ2=4.484,P<0.05).In the study group,the body weight gain,the uterine height increment,abdominal circumference increment were (523.21±103.72)g,(2.88±0.52)cm and (3.19±0.75)cm,respectively,which were significantly higher than those in the control group(t=2.215,4.402,2.328,all P<0.05).The uterine height increment and abdominal circumference increment in the intermediate stage of the study group were (2.14±0.27)cm and (2.89±0.52)cm,respectively,which were significantly higher than those of the control group,and the differences were significant(t=1.503,2.097,all P<0.05).In the study group,the BPD increment and FL increment at prophase and intermediate stage were (2.69±1.23)mm and (2.24±0.97)mm,(2.61±1.28)mm and (2.19±1.28)mm,respectively,which were significantly higher than those in the control group (t=2.053 and 2.244,2.038 and 2.128,all P<0.05).The S/D values of umbilical cord blood flow in early stage,middle stage and anaphase of the study group were (2.33±0.19),(2.46±0.17) and (2.12±0.14),which were significantly lower than those of the control group (t=4.040,2.9817 and 4.418,all P<0.05),the differences were statistically significant.The neonatal weight of the study group was (2 576.18±621.04)g,which of the control group was (2 384.09±428.76)g,and there was significant difference between the two groups(t=1.999,P<0.05).Conclusion Amino acid combined with Salvia miltiorrhiza injection can effectively improve the clinical indicators of pregnant woman and fetal growth restriction,with good clinical effects.