Objective To assess the exposure levels of heavy metals,including lead,arsenic,mercury,and cadmium,in the local population in Sichuan and Chongqing,China,to compare and analyze the differences in reference intervals(RIs)obtained from direct and indirect sampling methods,and to explore the interchangeability and limitations of these two sampling methods.Methods RIs were obtained by the direct sampling method and the indirect sampling method.In the direct sample method,the levels of blood arsenic,urinary cadmium,urinary mercury,and blood lead levels of 5562 healthy participants aged 22-50 years in Sichuan and Chongqing,China were measured by atomic absorption spectrometry and inductively coupled plasma-mass spectrometry.Using the human biomonitoring(HBM)data,we established RIs for the population by a nonparametric method.On the other hand,in the indirect sampling method,RIs were established via a nonparametric method based on data from the laboratory information system(LIS)of a local hospital after stratifying healthy individuals using a Gaussian mixture model(GMM).Comparative analysis of the RIs derived from the two sampling methods were then conducted.Results The RI for blood arsenic was 0.11-1.3 μmol/L.The RI for urinary cadmium was 0.51-2.80 μmol/mol creatine for adults aged 22 to under 43 years and 0.66-2.96 μmol/mol creatine for adults aged 43-50 years.The RI for urinary mercury was 0.12-1.10 μmol/mol creatine.The RI for blood lead was 14.00-47.00 pg/L for adults aged 22 to under 41 year,16.00-53.38 pg/L for males aged 41-50 year,and 15.00-51.02 pg/L for females aged 41-50 year.Most of the RIs established by the direct sampling method had a narrower range compared to those established by the indirect sampling method,and the RIs established by both sampling methods were partially biased.Conclusions The RIs for blood arsenic,urine cadmium,urine mercury,and blood lead in healthy individuals aged 22-50 years in Sichuan and Chongqing,China were established using both direct and indirect sampling methods,which contributes to a better understanding of environmental exposure to metals in the general population and provides a reference for metal poisoning.For data from the same lab,the GMM-based indirect sampling method demonstrated relatively consistent performance in establishing RIs compared with the direct sampling method.

Post-induction hypotension(PIH)is very common in clinical anesthesia after induction of general anesthesia.Intravenous anesthetic drugs could decrease cardiac output and systemic vascular re-sistance and then lead to PIH.PIH is associated with adverse postoperative outcomes such as myocardial in-jury,renal injury,stroke,prolonged hospital stays,and even death.Therefore,predicting PIH and taking corresponding preventive measures will improve the prognosis of patients.However,the effective way to pre-dict PIH is still controversial.This article reviews the research progress of PIH predictors in order to provide a reference for the clinical identification of high-risk patients,improvement of PIH,and reduction of adverse postoperative outcomes.

【Objective】 To genetically analyze the D^el sample from a blood donor in Jiangyin and make clear the molecular basis of the serological phenotype. 【Methods】 The EDTA anticoagulant blood were collected: buffy coat were used for nucleic acid extract and cDNA analysis; red blood cells for serological test. Tube method and microcolumn gel were used for serological test. Genotyping kit were used for exon analysis. Gene mutation was analyzed using the sequence analyzer. 【Results】 Serological analysis demonstrated the sample′s RhD phenotype was D^el. The phenotype of RhCE was CCEe. Real-time fluorescence quota PCR result demonstrated the existence of all exones. Weak D15 and RHD^* DEL1 [RHD(1227G>A)], which had a high frequency of occurrence in China, were excluded according to real-time fluorescence quota PCR result. Sequence analyzing result verified RHD(28C>T) SNP mutation in cDNA. The genotype of this sample was RHD^*01 W. 61[RHD(28C>T)]. 【Conclusion】 A weak D61 was found among blood donors in our city, Jiangyin.

Objective:To understand the characteristics of type D personality in patients with ischemic stroke, and to explore the correlation between type D personality and carotid plaque vulnerability in patients with ischemic stroke.Methods:From November 2019 to December 2020, convenience sampling was used to select 125 patients with ischemic stroke who underwent carotid color Doppler ultrasound examination in the Department of Neurology, Affiliated Hospital of Jining Medical University as the research subject. Carotid plaques were measured by color Doppler ultrasound in patients with ischemic stroke to determine whether they were vulnerable plaques. The patients were investigated using the Type D Personality Scale.Results:The proportion of type D personality in ischemic stroke patients was 52.8% (66/125) . Logistic regression analysis showed that type D personality and the social inhibition dimension of type D personality were the influencing factors of carotid plaque vulnerability in patients with ischemic stroke ( P<0.05) . Conclusions:Type D personality is closely associated with carotid plaque vulnerability in ischemic stroke patients. Medical and nursing staff should strengthen the screening of type D personality in patients with ischemic stroke and implement early intervention.

Objective To quantitatively analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1) in bone marrow mononuclear cells of patients with acute myeloid leukemia (AML) at intermediate-risk after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to measure the expression level of LEF-1 gene in AML patients at intermediate-risk after initial diagnosis and chemotherapy, and its relationship with effectiveness and survival were analyzed. Results The LEF-1 mRNA level in preliminarily diagnosed patients with AML was significantly higher than that in control arm [0.00519 (0.00015-0.09207) vs. 0.00101 (0.00009-0.00233)], and the difference was statistically significant (u=134.50, P<0.01). The LEF-1 mRNA level in patients after chemotherapy was significantly declines as compared to that in patients before chemotherapy [0.00107 (0.00008 - 0.00744) vs. 0.00519 (0.00015 - 0.09207)], and the difference was statistically significant (u= 317.00, P< 0.01) and LEF-1 mRNA expression level before chemotherapy in complete remission (CR) patients was significantly higher than that in non-CR patients [(0.01108 (0.00164 - 0.09207) vs. 0.00110 (0.00015 - 0.00916)], and the difference was statistically significant (u=19.00, P<0.01). High LEF-1 expression predicted a significantly better overall survival in AML patients with intermediate-risk cytogenetics (χ2= 4.549, P= 0.033). Conclusions LEF-1 may be involved in the development and progression of AML at intermediate-risk patients and is closely related to tumor burden and treatment efficacy. LEF-1 may be a good predictor of better prognosis and a novel target for therapeutic effect.

Objective To investigate the mRNA level of lymphoid enhancing factor-1 ( LEF-1) in bone marrow mononuclear cells after the initial diagnosis and chemotherapy of patients with multiple myeloma (MM) and its clinical significance. Methods The LEF-1 mRNA of target gene in 42 MM patient was detected by real-time fluorescence quantitative polymerase chain reaction (RTQ-PCR), and 20 patients without hematological disease were enrolled as the healthy controls. Results The LEF-1 mRNA median level in previously diagnosed MM patients was significantly higher than that in the healthy controls [0.01068 (0.00017 - 0.14100) vs. 0.00101 (0.00009 - 0.002326)], and the difference was statistically significant (U = 91.00, P< 0.001); The LEF-1 mRNA median level in MM patients after chemotherapy was declined compared with the patients before chemotherapy [0.00011 (0.00001 - 0.01548) vs. 0.01068 (0.00017 -0.14100)], and the difference was statistically significant (U = 343.0, P< 0.001). The LEF-1 mRNA median level of MM patients after chemotherapy in progression of disease (PD) group was higher than that in the non-PD groups [0.08386 (0.00288 - 0.14100) vs. 0.003454 (0.000156 - 0.05660)], and the difference was statistically significant (U = 343.0, P< 0.001). The overall survival (OS) rate in the high LEF-1 expression group was shorter than that in the low LEF-1 expression group for MM patients in the initial diagnosis (47.6%vs. 65.5 %, χ2 = 3.931, P= 0.0414). Conclusion LEF-1 may be involved in the occurrence and development of MM, which has a potential to become an indicator of evaluating the poor prognosis and PD of MM patients, and could be served as a novel therapy target for the treatment of MM.

Objective To analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1), and to investigate its clinical significance in bone marrow mononuclear cells of patients with chronic myeloid leukemia chronic-phase (CML-CP) after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction was used to measure the expression level of LEF-1 gene in 38 CML-CP patients after initial diagnosis and chemotherapy and 20 persons without blood system diseases and neoplastic diseases as normal control. The difference of LEF-1 expression level between the patients and healthy control was compared, and the effect of imatinib on the main molecular response (MMR) was analyzed. Results The expression of LEF-1 mRNA in 38 newly diagnosed patients [0.00214 (0.00020 - 0.02120)] was significantly higher than that in normal controls [0.00101 (0.00009 - 0.00233)] (U= 163.0, P< 0.01). The expression of LEF-1 mRNA in MMR group [0.00107 (0.00010 - 0.00519)] was significantly lower than that in non-MMR group [0.01015 (0.00091 -0.03615)] (U= 25.0, P< 0.01). There was no significant difference in LEF-1 mRNA expression between the normal control group and the MMR group after imatinib treatment (U= 201.0, P> 0.05). The level of LEF-1 mRNA expression of non-MMR group was also higher than that of the normal control group (U= 14.0, P<0.01). The rate of acquiring MMR was significantly higher in high LEF-1 mRNA expression group [84.2 %(16/19)] than that in low expression group [47.4%(9/19)] (χ2=4.209, P<0.01). The time of acquiring MMR was significantly shorter in the high LEF-1 mRNA expression group [(10.0 ± 4.5) months] than that in the low expression group [(14.6 ± 3.8) months] (t= 2.705, P< 0.01). Conclusions LEF-1 may be involved in the occurrence and development of CML, and reflects the tumor burden. It may be one of the indicators to predict the efficacy of imatinib.

OBJECTIVETo investigate the effect of epigallocatechin-3-gallate (EGCG) on biomodification of demineralized dentine substrate, in its permeability, hydrophobicity, and inhibition ability to collagen enzymatic degradation.

METHODSThe dentine substrates were treated with simulated pulpal pressure created by mixtures of 0.02%, 0.1% EGCG/bovine serum albumin (BSA) in acidic environment (pH4.4) for 48 h. A fluid-transport model was used to measure the fluid permeability through demineralized dentine substrate. Positive replicas of dentine substrate were fabricated before and after being subjected to acidic environment for scanning electron microscope (SEM) examination. The blank group contained no EGCG and the positive group were treated with Gluma desensitizer. Static contact angle measurements on demineralized dentin and 0.1% EGCG primed dentin were performed by contact angle analyzer. The priming time were 60 s, 120 s, 0.5 h, 1 h. Dentine specimens bonded with Adper single bond 2 were subjected to 100 mg/L collagenase and observed under SEM. Resin-bonded specimens (with 0.02%, 0.1%, 0.5% EGCG priming, or without EGCG priming) were created for micro-tensile bond strength evaluation (MTBS). Resin-bonded specimens after thermol cycling were created for MTBS evaluation.

RESULTSThe fluid permeability in the blank control group increased ([151.3±22.3]%), the fluid permeability in 0.1% EGCG/BSA group decreased ([23.7±6.3]%). Compared to the blank control group, the contact angle of 120 s, 0.5 h, 1 h groups increased by 31.0%, 53.5%, 57.8% in deep dentin and 37.4%, 59.3%, 62.4% in shallow dentin. The SEM examination showed that 0.1% and 0.5% EGCG priming for 120 s significantly increased dentin collagen's resistance to collagenase. The immediate MTBS of 0.1% and 0.5% EGCG groups were (29.4±4.8) and (19.8± 4.9) MPa. After thermol cycling, the MTBS of 0.1% and 0.5% EGCG groups were (19.9±5.1) and (15.3± 6.3) MPa.

CONCLUSIONSUnder acidic environment (pH4.4), the 0.1% EGCG can reduce dentine permeability under acidic environment. The 0.1% EGCG can increase hydrophobicity of dentin substrate, and strengthen dentin substrate's resistance to collagenase hydrolysis, thus increased the resin-dentin bonding durability.

Acid Etching, Dental ; Catechin ; analogs & derivatives ; pharmacology ; Collagen ; chemistry ; drug effects ; Collagenases ; pharmacology ; Composite Resins ; Dental Bonding ; Dental Cements ; Dental Pulp ; Dentin ; chemistry ; drug effects ; Dentin Permeability ; drug effects ; Dentin-Bonding Agents ; Glutaral ; pharmacology ; Hydrogen-Ion Concentration ; Hydrolysis ; Methacrylates ; pharmacology ; Microscopy, Electron, Scanning ; Pressure ; Resin Cements ; Serum Albumin, Bovine ; pharmacology ; Tensile Strength ; Time Factors

Objective To evaluate the sealing properties of three resin-based sealers,EndoREZ,RealSEAL and RealSEAL SE.Methods Forthy-eight extracted human anterior teeth with single root and canal were prepared using ProTaper files with crown-down technique to F3.The teeth were filled with three sealer respectively with hot gutta-percha vertical condensation technique simulating the clinical situation.Leakage quantity was detected using computerized fluid filtration meter with 10 samples in each group.The cross section morphology of apical parts of roots of 5 mm was observed with scanning electron microscope and transmission electron microscope in 3 samples of each group,respectively.Results The leakage quantity of EndoREZ,RealSEAL and RealSEAL SE were (2.61 ± 0.60),(1.43± 0.11) and (1.76 ± 0.18) μl/min,respectively.The gaps between the the sealer and the canal wall were increased in in order of RealSEAL,RealSEAL SE and EndoREZ.No obvious demineralized dentin under EndoREZ and the smear layer was not completed removed.The partly demineralized dentin was observed under RealSEAL and the smear layer was totally removed.The partly demineralized dentin was seen under RealSEAL SE and the majority of smear layer was removed.Conclusions Among the three resin-based sealers,RealSEAL has the best sealing properties,followed by RealSEAL SE and EndoREZ.

Objective To explore the systematic , standardized nursing intervention on stress response during perioperative period of Laser Assisted in Situ Keratomileusis (LASIK) patients.Methods A total of 200 cases of LASIK patients were randomly divided into the observation group and the control group with 100 cases in each group.The control group was treated with conventional care , while the observation group was treated with systematic and standardized nursing interventions .The blood pressure and anxiety scores of two groups of patients with heart rate were compared .Results Before the study the blood pressure , heart rate and anxiety scores between the groups had no significant difference (P>0.05).After the nursing intervention, the blood pressure, heart rate and anxiety scores were (112.73 ±16.95) mmHg, (76.43 ±11.29) beat/min and (32.67 ±3.94) in the observation group, which were significantly lower than (129.45 ±21.17) mmHg, (84.32 ±12.13) beat/min and (50.03 ±2.95) in the control group (t =-6.17, -4.76, -35.32, respectively;P<0.01).Conclusions The standardized and systematic nursing intervention can reduce the stress response of patients during the LASIK operation period and can help patients to better adapt to the operation.It can also improve the operation effect , promote the postoperative recovery and prevent the complications .