ObjectiveTo evaluate the application effect of morphology driven preparation technique in indirect restoration of posterior teeth. Methods84 patients with dental defects were selected and divided into the control group and the experimental group randomly， with 42 patients in each group （a total of 84 teeth）. Traditional preparation and morphology driven preparation techniques were used to complete dental preparation and adhesive glass ceramic restorations， respectively. The satisfaction， masticatory function， World Dental Federation （FDI） Scores for edge fracture and fixation，edge adaptability index，periodontal bleeding index （BI） and plaque index （PLI） of the two groups of patients were evaluated and various indicator data were recorded and statistically analyzed at 3 and 6 months after restoration completion. ResultsThere was no statistically significant difference in satisfaction between the two groups after 3 and 6 months of repair； Both groups of data showed a significant improvement in masticatory function. There was no statistical difference after 3 and 6 months of repair. However， a statistically significant difference in masticatory function was noted after 6 months of repair compared with before and after 3 months of repair. As the repair time increased， the masticatory effect improved significantly. There was no statistically significant difference in the edge fracture and fixation index between the two groups at 3 months after repair， but there was a statistically significant difference between the two groups at 6 months with the experimental group outperforming the control group（P<0.05）. The edge adaptability， BI， and PLI index were statistically significant between the two groups after 3 and 6 months of repair and the experimental group had a significant advantage （P<0.05）. ConclusionBoth types of tooth preparation techniques can improve patient masticatory function and reach high satisfaction after repair. However， morphology driven preparation technique has significant advantages in edge adaptability， edge fracture and fixation index scores and improve periodontal conditions. This technique is an effective method for improving dental preparation in adhesive indirect restoration of posterior teeth.

Tailored lipid nanoparticles (LNPs)-mediated small interfering RNA (siRNA) nanomedicines show promise in treating liver disease, such as acute liver injury (ALI) and non-alcoholic steatohepatitis (NASH). However, constructing LNPs that address biosafety concerns, ensure efficient delivery, and target specific hepatic subcellular fractions has been challenging. To evade above obstacles, we develop three novel self-degradable "gemini-like" ionizable lipids (SS-MA, SS-DC, SS-MH) by incorporating disulfide bonds and modifying the length of ester bond and tertiary amino head. Our findings reveal that the disulfide-bond-bridged LNPs exhibit reduction-responsive drug release, improving both biosafety and siRNA delivery efficiency. Furthermore, the distance of ester bond and tertiary amino head significantly influences the LNPs' pK _a, thereby affecting endosomal escape, hemolytic efficiency, absorption capacity of ApoE, uptake efficiency of hepatocytes and liver accumulation. We also develop the modified-mannose LNPs (M-LNP) to target liver macrophages specifically. The optimized M-MH_LNP@TNFα exhibits potential in preventing ALI by decreasing tumor necrosis factor α (TNFα) levels in the macrophages, while MH_LNP@DGAT2 could treat NASH by selectively degrading diacylglycerol O-acyltransferase 2 (DGAT2) in the hepatocytes. Our findings provide new insights into developing novel highly effective and low-toxic "gemini-like" ionizable lipids for constructing LNPs, potentially achieving more effective treatment for hepatic diseases.

[This corrects the article DOI: 10.1016/j.apsb.2021.08.008.].

Objective To evaluate the changes of bronchial mucosa observed by fiberoptic bronchoscopy after bronchial arterial embolization(BAE)treatment.Methods A total of 176 patients,who received BAE at the First Affiliated Hospital of Guangzhou Medical University of China from May 2019 to March 2024,were enrolled in this study.The pre-BAE and post-BAE bronchial mucosa was checked by fiberoptic bronchoscopy.Results Of the 176 patients,fiberoptic bronchoscopy showed no abnormal findings in 143 and showed abnormal findings in 33.All the abnormal findings were mucosal congestion and oedema,in some cases coexisting vascular bulge was seen,but no manifestations of ischemia or necrosis of the bronchial mucosa could be found.In 22 patients,the preoperative and postoperative 7-day fiberoptic bronchoscopy revealed that both preoperative and postoperative examinations showed no obvious abnormalities of the bronchial mucosa in 13 patients,preoperative examination had abnormalities of the bronchial mucosa in 9 patients,postoperative examination showed no obvious abnormalities of the bronchial mucosa in 3 patients,and in one patient the postoperative degree of bronchial mucosal congestion and oedema was significantly improved when compared with its preoperative degree.Conclusion BAE does not cause ischemic necrosis or shedding of bronchial mucosa,and BAE can reduce the degree of bronchial mucosal congestion in some patients.

Substantial progress in the use of chemo-photodynamic nano-drug delivery systems (nano-DDS) for the treatment of the malignant breast cancer has been achieved. The inability to customize precise nanostructures, however, has limited the therapeutic efficacy of the prepared nano-DDS to date. Here, we report a structurally defined tandem-responsive chemo-photosensitive co-nanoassembly to eliminate primary breast tumor and prevent lung metastasis. This both-in-one co-nanoassembly is prepared by assembling a biocompatible photosensitive derivative (pheophorbide-diphenylalanine peptide, PPA-DA) with a hypoxia-activated camptothecin (CPT) prodrug [(4-nitrophenyl) formate camptothecin, N-CPT]. According to computational simulations, the co-assembly nanostructure is not the classical core-shell type, but consists of many small microphase regions. Upon exposure to a 660 nm laser, PPA-DA induce high levels of ROS production to effectively achieve the apoptosis of normoxic cancer cells. Subsequently, the hypoxia-activated N-CPT and CPT spatially penetrate deep into the hypoxic region of the tumor and suppress hypoxia-induced tumor metastasis. Benefiting from the rational design of the chemo-photodynamic both-in-one nano-DDS, these nanomedicines exhibit a promising potential in the inhibition of difficult-to-treat breast tumor metastasis in patients with breast cancer.

Objective:To compare the prognostic accuracy of 16 pre-transplant scoring models in predicting the post-transplant short-term outcome of patients with hepatitis B-related acute-on-chronic liver failure (HBACLF), and to explore an efficient predictive model.Methods:A retrospective analysis of the clinical data of HBACLF patients who underwent liver transplantation at the Liver Transplant Center of Beijing Youan Hospital from August 2004 to September 2014. Score of 16 models (CTP, UNOS-MELD, Updated-MELD, Integrated-MELD, MELD-Na, MLED Na, CLIF-SOFA, CLIF-OFs, CLIF-C ACLFs, CLIF-C ADs, Refit MELD, Refit MELD Na, MELD-AS, Zheng's Risk, UKELD, MESO) was based on time-dependent operation characteristic curve, and the area under the curve (AUC) was calculated to evaluate the prediction accuracy of 3-month survival after transplantation. Selection of univariate factors associated with postoperative short-term mortality was performed, and then 16 scoring models one by one with statistically significant mortality-related factors were entered into LASSO regression (Least Absolute Shrinkage and Selection Operator regression) to confirm the independent variables. Finally, a predictive model was constructed by Cox regression.Results:A total of 135 patients were included in this study, including 106 males and 29 females, aged (45.0±10.5) years old. Among the 16 scoring models, the AUC of MELD-Na and CLIF-SOFA were more than 0.7 in early survival prediction after liver transplant. The MELD-Na was confirmed as an independent predictive variable in the final model with univariate and LASSO regression multivariate selection analysis ( HR=1.0481, 95% CI: 1.0136-1.0838, P<0.05). The model was constructed by MELD-Na and combined with other clinical parameters (female, systemic infection, placement of T tube during operation) could better predict the early survival after liver transplant. The overall C-index of the final model was 0.886, and the C-index at 3-month after liver transplant was 0.844 through internal validation (Bootstrap). Conclusion:Compared with other scoring models, MELD-Na and CLIF-SOFA were better for early survival prediction after liver transplantation for patients with HBACLF. The constructed predictive model based on MELD-Na was superior than single MELD-Na or CLIF-SOFA in prognostic assessment and case selection.

Hypoxia, a salient feature of most solid tumors, confers invasiveness and resistance to the tumor cells. Oxygen-consumption photodynamic therapy (PDT) suffers from the undesirable impediment of local hypoxia in tumors. Moreover, PDT could further worsen hypoxia. Therefore, developing effective strategies for manipulating hypoxia and improving the effectiveness of PDT has been a focus on antitumor treatment. In this review, the mechanism and relationship of tumor hypoxia and PDT are discussed. Moreover, we highlight recent trends in the field of nanomedicines to modulate hypoxia for enhancing PDT, such as oxygen supply systems, down-regulation of oxygen consumption and hypoxia utilization. Finally, the opportunities and challenges are put forward to facilitate the development and clinical transformation of PDT.

Objective To study the impact of splenectomy and devascularization on liver function and liver fibrosis in patients with non-cirrhotic portal hypertension (NCPH). Methods The clinical data of patients with NCPH who were treated in Beijing You'an Hospital of Capital Medical University from April 2008 to December 2017 were retrospectively analyzed. The patients were divided into the observation group (n=16 ) and the control group ( n =30 ) according to their treatment methods. The observation group underwent splenectomy combined with devascularization, while the control group received conservative treatment. The changes in liver function, ascites, varicose vein rupture and bleeding before and after treat-ment, and the changes in liver blood flow before and after treatment in the observation group were compared. Results The before and after treatment of the 2 groups in ALT, AST, total bilirubin, albumin showed no statistically significant difference (P＞0. 05). Six months after treatment, the rates of ascites and bleeding were significantly higher than the observation group, (P＜0. 05). Ten patients who had a history of preoper-ative variceal hemorrhage in the observation group did not bleed within 6 months after treatment. Further-more, in the observation group after treatment when compared with the control group, the PC-Ⅲ [(32. 3 ± 12. 1) g/L vs. (56. 7 ± 15. 3)g/L],Ⅵ-C [(46. 6 ± 35. 0) g/L vs. (121. 3 ± 30. 4)g/L], LN [(32. 5 ± 10. 5) g/L vs. (65. 8 ± 11. 1) g/L] were significantly lower than the control group ( P ＜0. 05). The preoperative portal venous blood flow in the observation group was significantly higher than that after surgery [(1 056. 8 ± 679. 8) ml/min vs. (481. 0 ± 227. 6) ml/min, P＜0. 05]. Conclusion Splenectomy and devascularization effectively stopped variceal bleeding and delayed liver fibrosis in NCPH patients without affecting the liver function.

Objective To study the value of preoperative MELD-Na score (Model for End-Stage Liver Disease-Sodium) in predicting complication severity grades after liver transplantation (LT) for severe hepatitis.Methods Patients who underwent LT for severe hepatitis between August 1,2004,and September 1,2014 were retrospectively studied.The Accordion severity grading system was used to classify the complication severity grades after LT.The grades were classified as grade 1 (mild),grade 2 (moderate),grade 3-5 (severe),and grade 6 (death).The area under the curve (AUC) was calculated by plotting the receiver operating characteristic curve (ROC) to evaluate the predictive accuracy of the MELD-Na score for the severe and mortality grades after LT.The correlation between the MELD-Na score with the complication severity grade after LT was studied by the Spearman correlation and by multivariate analysis.Results The incidences of postoperative complications for the 159 patients in this study were:grade 2 in 43 patients (27.0％,MELD-Na score 27.3 ±7.4),grade 3 in 41 patients (25.8％,MELD-Na score 32.7 ± 12.4),grade 4 in 31 patients (19.5％,MELD-Na score 34.3 ± 12.1),grade 5 in 9 patients (5.7％,MELD-Na score 30.7 ± 12.3),grade 6 in 35 patients (22％,MELD-Na score 37.1 ± 10.4).There was no grade 1 patient.The AUC of the MELD-Na score for the severe and death groups were 0.631 (P ＜ 0.05;95 ％ CI,0.533 ～ 0.728) and 0.670 (P ＜ 0.05;95 ％ CI,0.574 ～ 0.766) respectively.The MELD-Na score was significantly correlated with the Accordion severity grade (rho 0.297,P ＜ 0.01) on Spearman correlation analysis.Multivariate analysis showed that a MELD-Na score ≥25 was a risk factor of postoperative severe grade complication (P ＜ 0.05,OR =4.35),a MELD-Na score ≥35 was a risk factor of postoperative mortality (P ＜0.01,HR =4.72).Conclusion The MELD-Na score was significantly correlated with the Accordion severity grade,which efficaciously predicted the complication severity grades after liver transplantation.

Objective To explore the value of the Accordion severity grading system (ASGS) in predicting short-term outcomes after orthotopic liver transplantation for severe hepatitis by classifying post-surgery complications.Methods The clinical documents of 159 patients were retrospectively analyzed who underwent orthotopic liver transplantation for severe hepatitis between Aug.1,2004 to Sept.1,2014 at our center.Complications were categorized according to the ASGS:grade 1 (mild),grade 2 (moderate),grade 3-5 (severe),and grade 6 (death).Outcome measures included ventilator support time,the length of ICU stay,postoperative recovery time.Spearman rank correlation analysis was used to test the correlation between the different grades with these outcome measures.1-year survival trends of different grade complication groups were demonstrated by Kaplan-Meier method and compared by Log-rank test.Results In total,43 (27.0％) patients had a grade 2 complication;41 (25.8％) grade 3;31 (19.5％) grade 4;9 (5.7％) grade 5;and 35 (22.0％) grade 6.There was no grade 1 patient.There was a significant correlation between the complication grades and the ventilator support time,the length of ICU stay and postoperative inpatient time (P＜0.01).With the increase of the complication grades,the outcome measures were even worse.Severe grade complication group had a longer ventilator support time,the length of ICU stay and postoperative inpatient time than the moderate grade complication group (P＜0.01).There was a significant downward trend in 1-year survival with the increase of the complication grade (P＜0.01).Conclusion The ASGS is helpful to assess risks and predict short-term outcomes after liver transplantation for severe hepatitis.Higher Accordion grades are correlated with even worse short-term outcomes.