Objective To investigate the efficacy,safety and influencing factors of the dapagliflozin and empagliflozin in the treatment of patients with diabetic nephropathy(DN)in the real world.Methods The data of patients with DN who received dapagliflozin or empagliflozin treatment at Nanjing Drum Tower Hospital from January 2020 to December 2024 were collected.Inverse probability of treatment weighting(IPTW)was used to balance the two groups of covariates,and the glycated hemoglobin(HbA1c),fasting blood glucose(FPG),postprandial blood glucose(2hPG),urine microalbumin(mAlb),urine microalbumin/creatinine ratio(UACR),estimated glomerular filtration rate(eGFR)and uric acid(UA)level were compared between the two groups before and after 6 months of treatment,and the progress of the disease and the occurrence of adverse reactions were recorded in follow-up.The Kaplan-Meier method and Log-rank test were used to analyze disease progression,and the Logistic regression model was used to analyze the influencing factors of adverse reactions in each group.Results A total of 305 patients were included,there was no statistically significant difference in baseline between the two groups after IPTW.After treatment,the levels of HbA1c,FPG,2hPG,mAlb and UACR of the two groups decreased significantly(P＜0.05).And the 2hPG,eGFR and UA levels were better in the dapagliflozin group than in the empagliflozin group(P＜0.05).There was no significant difference in the adverse reaction rate of the two groups(P＞0.05).The median progression-free survival time of dapagliflozin group was 47 months,which was significantly higher than that of 35 months of empagliflozin treatment(P＜0.05).Multivariate analysis results showed that diabetes course over 10 years,hyperuricemia,and vitamin D deficiency are risk factors for adverse reactions in the dapagliflozin group,and the combination of uric acid-lowering drugs was the risk factor for adverse reactions in the empagliflozin group.Conclusion Compared with empagliflozin,dapagliflozin demonstrates greater advantages in delaying the progression of DN,it can significantly reduce 2hPG and UA levels,and the safety of dapagliflozin is equivalent to empagliflozin.

OBJECTIVES: To study the clinical effect of the L-shape technique combined with concentrated growth factor on the horizontal bone defects of maxillary anterior teeth. METHODS: Twenty-five implants from 25 patients who underwent single maxillary anterior tooth implantation with simultaneous bone grafting were selected as the study subjects. Based on the bone grafting techniques, the patients were divided into a test group (L-shaped technique with guided bone regeneration combined with concentrated growth factor, 11 cases) and a control group (traditional guided bone regeneration combined with concentrated growth factor, 14 cases). The early discomfort and wound healing conditions in the two groups at two weeks after surgery were compared. The horizontal bone thickness, vertical bone thickness, and grayscale values in the augmentation area were measured immediately postsurgery and six months after surgery. Implant stability, hard tissue resorption within six months, and grayscale values were compared between the two groups. RESULTS: Differences in early discomfort, wound healing, implant stability, and grayscale values between the two groups were not statistically significant (P>0.05). Vertical bone thickness in the test group was significantly better than that in the control group at six months after surgery (P<0.05). The variation in horizontal bone thickness in the test group was significantly higher than that in the control group (P<0.05). CONCLUSIONS The application of the L-shape technique with concentrated growth factor for horizontal bone defects in the anterior maxillary area yielded satisfactory short-term results in terms of bone augmentation, early discomfort, wound healing, and implant stability at six months after surgery.
Humans ; Maxilla/diagnostic imaging* ; Intercellular Signaling Peptides and Proteins/therapeutic use* ; Wound Healing ; Bone Transplantation/methods* ; Dental Implantation, Endosseous/methods* ; Bone Regeneration ; Male ; Female ; Adult ; Dental Implants, Single-Tooth ; Middle Aged

Objective To investigate the efficacy,safety and influencing factors of the dapagliflozin and empagliflozin in the treatment of patients with diabetic nephropathy(DN)in the real world.Methods The data of patients with DN who received dapagliflozin or empagliflozin treatment at Nanjing Drum Tower Hospital from January 2020 to December 2024 were collected.Inverse probability of treatment weighting(IPTW)was used to balance the two groups of covariates,and the glycated hemoglobin(HbA1c),fasting blood glucose(FPG),postprandial blood glucose(2hPG),urine microalbumin(mAlb),urine microalbumin/creatinine ratio(UACR),estimated glomerular filtration rate(eGFR)and uric acid(UA)level were compared between the two groups before and after 6 months of treatment,and the progress of the disease and the occurrence of adverse reactions were recorded in follow-up.The Kaplan-Meier method and Log-rank test were used to analyze disease progression,and the Logistic regression model was used to analyze the influencing factors of adverse reactions in each group.Results A total of 305 patients were included,there was no statistically significant difference in baseline between the two groups after IPTW.After treatment,the levels of HbA1c,FPG,2hPG,mAlb and UACR of the two groups decreased significantly(P＜0.05).And the 2hPG,eGFR and UA levels were better in the dapagliflozin group than in the empagliflozin group(P＜0.05).There was no significant difference in the adverse reaction rate of the two groups(P＞0.05).The median progression-free survival time of dapagliflozin group was 47 months,which was significantly higher than that of 35 months of empagliflozin treatment(P＜0.05).Multivariate analysis results showed that diabetes course over 10 years,hyperuricemia,and vitamin D deficiency are risk factors for adverse reactions in the dapagliflozin group,and the combination of uric acid-lowering drugs was the risk factor for adverse reactions in the empagliflozin group.Conclusion Compared with empagliflozin,dapagliflozin demonstrates greater advantages in delaying the progression of DN,it can significantly reduce 2hPG and UA levels,and the safety of dapagliflozin is equivalent to empagliflozin.

Objective This study aimed to evaluate the clinical outcomes of immediate implantation of single maxil-lary central incisor and explore factors affecting post-implant bone volume.Methods Clinical data and imaging records from pre-surgery,the day of surgery,and 6 months post-surgery of 100 patients(100 implants)with non-salvageable maxillary central incisors who underwent immediate implantation were collected.Bone thickness at the cervical,middle,and apical regions of the implant's labial and palatal sides were measured immediately post-surgery and at 6 months,and bone volume changes were observed.A regression analysis model was used to assess predictive factors for labial and pal-atal bone plate thickness.Results At 6 months post-surgery,the labial bone thicknesses at the cervical,middle,and api-cal regions were 2.35,2.29,and 3.28 mm,respectively,and those of the palatal side were 0.00,2.40,and 6.05 mm,re-spectively.The cervical region had the highest alveolar crest collapse rates,with 32.87%on the labial side and 62.20%on the palatal side.The regression model indicated that factors influencing the thickness of bone at the cervical labial side of the implant included initial bone thickness,the implant center to adjacent tooth center angle,implant diameter,and the type of implant closure(P<0.05).The initial bone thickness on the palatal side was the sole predictor for bone thickness on the palatal side(P<0.05).Conclusion Immediate implantation of single maxillary central incisors yields effective clinical results.The thickness of new bone around the implant is influenced by multiple factors.A comprehensive consideration of these factors in the plan-ning of immediate implantation is necessary to achieve optimal therapeutic outcomes.

Abstract: Objective To develop an ELISA kit to detect IgG antibodies of Chikungunya virus (CHIKV), providing a new method for epidemiological investigation and detection in the field for CHIKV infection. Methods Using the CHIKV-specific recombinant protein pMal-chik23 as diagnostic antigen, HRP-labeled anti-IgG antibody as color-developing antibody, and the working concentration of diagnostic antigen, serum to be tested and second antibody were optimized using orthogonal. The reaction conditions of ELISA reaction, such as coating, blocking, incubation, and color-developing were systematically optimized. The cut-off value for ELISA detection was established based on the assessment of a large clinical sample set. On this basis, the specificity, sensitivity, and stability of the ELISA response were evaluated to develop and assemble a rapid ELISA kit for the detection of Chikungunya fever IgG antibodies. Results On the basis of systematic conditions optimization, an indirect ELISA kit for the detection of IgG antibodies against CHIKV was developed and assembled. The optimal reaction conditions were identified as 1.0 μg/mL antigen was coated using carbonate buffer at 4 ℃ for 24 hours. Then the microplate was blocked using HBV blocking solution at 37 ℃ for 4 hours. 100 μL/well samples to be tested were diluted at 1∶101, reacted at 37 ℃ for 40 minutes, and washed 4 times with PBST. Thus, HRP-labeled rabbit anti-human IgG was diluted at 1∶20 000, HRP-labeled sheep anti-mouse IgG was diluted at 1∶10 000, reaction at 37 ℃ for 30 minutes, and washed 5 times with PBST. Finally, 100 μL/well TMB solution was added and incubated at 37 ℃ for 10 minutes. Then terminate the reaction with 50 μL of 20% H2SO4 and measure the A450 value at dual wavelengths of 450/630 nm (A450) . The evaluation results showed that ELISA A450 of Chikungunya fever-positive samples were more than 0.43, while the ELISA A450 of negative samples was less than 0.04, and the S/N ratio > 10. Specificity test showed that the developed kit had no cross-reaction with 9 other similar arbovirus species such as Sindbis, Geta, Ross River, and Dengue virus. The stability evaluation of the reagent kit indicated that it had high stability, with a coefficient of variation (CV) within the microplate ranging from 0.76% to 2.12%, the coefficient of variation between the microplate ranged from 0.64% to 1.85%, and the coefficient of variation between batches ranged from 0.83% to 2.31%, all of which were less than 3%. The sensitivity of the kit did not decrease significantly after being stored at 4°C for 1 year. Conclusions A rapid indirect ELISA kit for the detection of Chikungunya fever IgG antibodies was successfully developed, exhibiting good sensitivity, specificity, and stability.

Objective:To compare the characteristics and differences of intestinal flora in premature infants with late-onset sepsis (LOS) and pneumonia by high-throughput sequencing technology, and to investigate the relationship between intestinal flora and LOS.Methods:Through the case-control method, premature infants with late-onset sepsis who were hospitalized in the neonatal department of Hunan Children′s Hospital from August 2018 to October 2019 were selected as the case group ( n=8). At the same time, premature infants diagnosed with pneumonia were selected as the control group ( n=8). The fecal samples of 16 premature infants were collected for the first time, and the DNA was extracted. The DNA of the target region was amplified by polymerase chain reaction(PCR). High-throughput sequencing was performed using NovaSeq 6000 platform to analyze the composition and diversity of intestinal flora between the two groups. Results:(1) Alpha diversity analysis showed that there was no significant difference in the richness and diversity of intestinal flora between the two groups(all P>0.05). (2) The intestinal flora in premature infants of LOS group and control group were dominated by Firmicutes and Proteobacteria, and facultative anaerobes such as Enterococcus and Escherichia-Shigella were the dominant flora at the genus level. Metastas statistical analysis showed that there was no statistically significant difference in flora composition between the two groups at the phylum level ( P>0.05). (3) Metastas statistical analysis was carried out at the level of class, order, family, genus, and species. The relative abundance of actinomycetes, digestive streptococcaceae and Clostridium in LOS group was higher than that in pneumonia group, and the difference was statistically significant (all P<0.05). (4) The relative abundance of Staphylococcus in the LOS group was significantly greater than that in the control group, but Metastas statistical analysis showed that there was no statistically significant difference in the relative abundance of staphylococcus between the two groups ( P>0.05). (5) Among the 8 cases of LOS, 3 premature infants had positive blood cultures, namely Streptococcus agalactiae, Streptococcus mitis, and Enterococcus faecalis. Enterococcus faecalis belongs to the genus Enterococcus, and Enterococcus belongs to the dominant genus in the LOS group. Conclusions:Different site infections have effects on intestinal microecology of premature infants. There were differences in intestinal flora composition between premature infants with LOS and premature infants with pneumonia.

Objective: To investigate the effect of elective cesarean section (ECS) on infants' developmental behaviors. Methods: A total of 3 474 pregnant women living in Ma'anshan more than 6 months and accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. Excluding participants with pregnancy termination (162), twin pregnancy (39), assisted delivery (14), emergency cesarean section (76) and unclear delivery mode (141), 3 042 pair of mother and infant entered the final analysis. Information of maternal basic demographic characteristics, pregnancy histories, pregnancy life style and pregnancy-related diseases were collected by using self-complied Maternal and Child Health Questionnaire. Information of infants' general condition and delivery modes were acquired from obstetric record. The Ages and Stages Questionnaires-third edition was used to assess infants' communication, gross motor, fine motor, problem solving and person-social function, which was completed at age of 6 months old and 18 months old, respectively. And multi-factor non-conditional logistic regression model was used to analyze the association between ECS and infants' developmental behaviors. Results: The prevalence of ECS was 47.5% (1 443/3 042), among which ECS without medical indication and ECS with medical indication were 27.2% (826/3 042) and 20.3% (617/3 042), respectively. After maternal demographic characteristics, pregnant exposure and infants' basic information adjusted, compared to women with vaginal delivery, both ECS with medical indication and without medical indication increased the risk of a delay in gross motor on infants at 6 months old (RR (95%CI: 1.72 (1.08-2.77) and 1.87 (1.11-3.15), respectively.) ECS without indication decreased the risk of a delay in fine motor on infants at 6 months old (RR (95%CI):0.48 (0.28-0.82)), both ECS without medical indication and with medical indication had no statistically significant effect on 18 months infants' communication, gross motor, fine motor, problem solving and person-social function, the RR (95%CI) for ECS without medical indication were 0.86 (0.43-1.74), 1.55 (0.86-2.78), 0.74 (0.49-1.15), 1.10 (0.68-1.78) and 1.17 (0.66-2.08), respectively; and the RR (95%CI) for ECS with medical indication were 0.33 (0.12-1.02), 1.10 (0.55-2.21), 0.79 (0.48-1.29), 0.58 (0.29-1.13) and 1.48 (0.78-2.81), respectively. Conclusion ECS affected motor development in infants at the age of 6 months old, and no influence was found in infants at the age of 18 months old.

OBJECTIVETo screen and identify dengue virus type 2 specific antigens and establish an enzyme-linked immunosorbent assay (ELISA) for detecting dengue virus type 2 antibody.

METHODSUsing the bioinformatic software DNAstar and ANTHEPROT, we analyzed the hydrophilicity, flexibility, surface probability and antigenicity of dengue virus type 1-4, Japanese encephalitis virus, and Yellow fever virus M and E protein amino acid sequences, and also evaluated the influence of secondary structure. The specific epitopes of dengue virus type 2 were predicted according to the epitope location and amino acid sequence similarity, and the epitope conservation was assessed using the sequence information of different dengue virus type 2 strains in GenBank. Based on the results of bioinformatic analysis, 5 specific epitopes were amplified and inserted into the prokaryotic expression vector pET32a, which were transferred into E. coli Rosetta (DE3) for expression of the proteins. SDS-PAGE and Western blotting were used to identify the expressed proteins and test their antigenicities. The antigen selected by Western blotting was used to establish the ELISA system for dengue virus type 2 antibody detection.

RESULTSBioinformatic analysis predicted 8 possible dengue virus type 2 specific epitopes, and 6 of them were efficiently expressed in E. coli. Western blotting confirmed 1 dengue virus type 2 specific antigen, the ELISA system for dengue virus antibody detection was successfully established using this specific antigen.

CONCLUSIONWe have obtained a dengue virus type 2 specific antigen and established an ELISA system for detection of dengue virus type 2 antibody.

Antibodies, Viral ; immunology ; Antigens, Viral ; immunology ; Computational Biology ; Dengue Virus ; classification ; immunology ; isolation & purification ; Enzyme-Linked Immunosorbent Assay ; methods ; Humans ; Immunodominant Epitopes ; Software