Objective:This study aimed to investigate the clinical value of glucocorticoids in patients with neutropenic severe pneumonia at moderate to high risk according to the Pneumonia Severity Index (PSI) in patients with hematologic diseases.Methods:Clinical data were collected from 534 patients at the Fujian Medical University Union Hospital from October 2016 to December 2018. We evaluated the changes in inflammatory cytokines, treatment failure, in-hospital mortality, and other outcomes, adjusting for potential confounders through propensity score matching.Results:Patients were categorized into glucocorticoids ( n=176) and control ( n=358) groups. The glucocorticoid group demonstrated higher levels of C-reactive protein, procalcitonin, and interleukin-6, alongside higher PSI scores. The differences in comorbidities diminished, except for inflammatory cytokine levels, with a notable reduction in inflammatory cytokines observed in the glucocorticoid group, after matching 125 pairs based on propensity scores. Late treatment failure was more prevalent in the glucocorticoid group (39.2% vs 24.8%, P=0.015), but this was primarily caused by radiographic progression. The incidences of respiratory failure, mechanical ventilation, and septic shock were similar between the groups. Logistic regression analyses revealed that glucocorticoids reduced the risk of treatment failure ( OR=0.367, 95% CI 0.165-0.818, P=0.014). The 30-day in-hospital mortality rates were comparable (8.0% in glucocorticoids vs 7.2% in controls, P=0.811), with indications that glucocorticoids may exert a protective effect on mortality. The PSI score was determined as the sole independent risk factor for 30-day in-hospital mortality ( OR=1.077, 95% CI 1.032-1.123, P=0.001). No evidence indicated that glucocorticoids increased the incidence of hyperglycemia, gastrointestinal bleeding, or 30-day infection recurrence. Conclusion:Glucocorticoids reduce inflammatory cytokine levels and are potentially related to decreased treatment failure and mortality in patients with neutropenic pneumonia classified as PSI Ⅳ and Ⅴ among hematological patients.

Objective:This study aimed to investigate the clinical value of glucocorticoids in patients with neutropenic severe pneumonia at moderate to high risk according to the Pneumonia Severity Index (PSI) in patients with hematologic diseases.Methods:Clinical data were collected from 534 patients at the Fujian Medical University Union Hospital from October 2016 to December 2018. We evaluated the changes in inflammatory cytokines, treatment failure, in-hospital mortality, and other outcomes, adjusting for potential confounders through propensity score matching.Results:Patients were categorized into glucocorticoids ( n=176) and control ( n=358) groups. The glucocorticoid group demonstrated higher levels of C-reactive protein, procalcitonin, and interleukin-6, alongside higher PSI scores. The differences in comorbidities diminished, except for inflammatory cytokine levels, with a notable reduction in inflammatory cytokines observed in the glucocorticoid group, after matching 125 pairs based on propensity scores. Late treatment failure was more prevalent in the glucocorticoid group (39.2% vs 24.8%, P=0.015), but this was primarily caused by radiographic progression. The incidences of respiratory failure, mechanical ventilation, and septic shock were similar between the groups. Logistic regression analyses revealed that glucocorticoids reduced the risk of treatment failure ( OR=0.367, 95% CI 0.165-0.818, P=0.014). The 30-day in-hospital mortality rates were comparable (8.0% in glucocorticoids vs 7.2% in controls, P=0.811), with indications that glucocorticoids may exert a protective effect on mortality. The PSI score was determined as the sole independent risk factor for 30-day in-hospital mortality ( OR=1.077, 95% CI 1.032-1.123, P=0.001). No evidence indicated that glucocorticoids increased the incidence of hyperglycemia, gastrointestinal bleeding, or 30-day infection recurrence. Conclusion:Glucocorticoids reduce inflammatory cytokine levels and are potentially related to decreased treatment failure and mortality in patients with neutropenic pneumonia classified as PSI Ⅳ and Ⅴ among hematological patients.

Objective : To investigate the outcomes of a novel direct pulp capping agent containing platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA). Methods : A total of 32 New Zealand rabbits were randomly divided into 4 groups, namely, the PRF+MTA group (P+M group), PRF group (P group), MTA group (M group) and blank control group (BC group), with 8 rabbits per group. Dental pulp exposure and direct pulp capping were performed, and complete crown square sealing was performed on 2 mandibular central incisor teeth of each rabbit. Four rabbits from each group were euthanized after each observation period (7 and 28 days). The experimental teeth were subjected to HE staining. Inflammatory cell infiltration, calcified bridge formation and pulp tissue disorganization were observed and graded. Results: Inflammatory cell infiltration: on the 7th day, group P+M and group M were lighter than group BC (P<0.05); on the 28th day, group P+M was lighter than group P and group BC (P<0.05); group P+M and group M did not significantly differ (P>0.05). Calcified bridge formation: on the 7th and 28th days, group P+M was lighter than group P, group M and group BC (P<0.05); on the 28th day, group M was higher than group BC (P<0.05). Under microscope, the calcified bridge contained cellular components and was surrounded by odontoblast-like cells, sharing a structure resembled osteodentin; dentin tubule-like structure could not be observed in calcified bridge, and the calcified bridge resembled certain points of osteodentin. Pulp tissue disorganization: on the 7th day, group P+M and group M were lighter than group BC (P<0.05); on the 28th day, group P+M was lighter than group P and group BC (P<0.05). group P+M and group M did not significantly differ (P>0.05). Conclusion The combination of PRF and MTA for direct pulp capping provided light inflammatory cell infiltration, stable pulp status and a strong ability of pulp tissue to form calcified bridge, and the calcified bridge resembled certain points of osteodentin.

Objective:To explore the relationship between the polymorphisms of SIRT1 and follicle-stimulating hormone receptor (FSHR) gene and ovarian function in women who underwent assisted reproductive technology (ART) and the differences between Mongolian and Han nationalities, so as to provide basis for the individualized treatment of ART assisted pregnancy. Methods:A retrospective cohort study was performed. The clinical data of 204 ART patients who visited the Reproductive Center of the Affiliated Hospital of Inner Mongolia Medical University from September 2019 to September 2021 were collected. There were 53 cases of Mongolian nationality and 151 cases of Han nationality. MassARRAY SNP genotyping technology was used to detect three sites, which were rs2236319 of SIRT1 and rs6165 and rs6166 of FSHR. SIRT1 was divided into three groups: AA group (wild type), AG group (heterozygous type) and GG group (mutant type); FSHR rs6165 was divided into TT group (wild type), AT group (heterozygous type), AA group (mutant type); FSHR rs6166 was divided into NN group (wild type), NS group (heterozygous type) and SS group (mutant type). The differences of genotype frequency and clinical and laboratory data were compared. Results:1) The allele frequencies and genotype frequencies of SIRT1 rs2236319, FSHR rs6165, and rs6166 loci were not statistically different in composition between Mongolian and Han ART female patient groups. There were no significant differences between Mongolian and Han ART women in terms of general clinical data and basal sex hormones and ovarian reserve function (all P>0.05). 2) There was a statistically significant difference in the number of eggs captured at the rs2236319 locus of the SIRT1 gene among the mutant GG group [18.5 (13.0, 32.8)], the AA group [13.0 (7.0, 20.0)] and the AG group [10.0 (5.0, 21.0), P=0.019]. 3) There was a statistically significant difference in the basal FSH levels at the rs6165 locus of the FSHR gene among the AA group [(7.45±2.73) U/L], the TT group [(5.97±2.23) U/L] and the TA group [(6.70±2.04) U/L, P=0.005]. The proportion of ovarian hyporesponsiveness among the AA group [29.6% (8/27)], the TT group [8.5% (8/94)] and the TA group [13.3% (11/83)] was statistically significant ( P=0.017). 4) The difference in basal FSH levels at the rs6166 locus of the FSHR gene among the SS group [(7.48±2.78) U/L], the NN group [(6.08±2.28) U/L] and the NS group [(6.61±1.99) U/L] was statistically significant ( P=0.016). The proportion of ovarian hyporesponsiveness among the SS group [37.0% (10/26)], the NN group [8.5% (8/99)] and the NS group [10.8% (9/79)] was statistically significant ( P=0.001). Conclusion:There were no significant differences between Mongolian and Han ART women in terms of general clinical data, basal sex hormones and ovarian reserve function. The gene polymorphism at rs2236319 of SIRT1 gene is associated with ovarian hyperresponsiveness. FSHR rs6165 and rs6166 gene polymorphisms are associated with ovarian hyporesponsiveness. There was no significant correlation between the three polymorphisms and the clinical pregnancy rate of ART.

Objective:To explore the relationship between the polymorphisms of SIRT1 and follicle-stimulating hormone receptor (FSHR) gene and ovarian function in women who underwent assisted reproductive technology (ART) and the differences between Mongolian and Han nationalities, so as to provide basis for the individualized treatment of ART assisted pregnancy. Methods:A retrospective cohort study was performed. The clinical data of 204 ART patients who visited the Reproductive Center of the Affiliated Hospital of Inner Mongolia Medical University from September 2019 to September 2021 were collected. There were 53 cases of Mongolian nationality and 151 cases of Han nationality. MassARRAY SNP genotyping technology was used to detect three sites, which were rs2236319 of SIRT1 and rs6165 and rs6166 of FSHR. SIRT1 was divided into three groups: AA group (wild type), AG group (heterozygous type) and GG group (mutant type); FSHR rs6165 was divided into TT group (wild type), AT group (heterozygous type), AA group (mutant type); FSHR rs6166 was divided into NN group (wild type), NS group (heterozygous type) and SS group (mutant type). The differences of genotype frequency and clinical and laboratory data were compared. Results:1) The allele frequencies and genotype frequencies of SIRT1 rs2236319, FSHR rs6165, and rs6166 loci were not statistically different in composition between Mongolian and Han ART female patient groups. There were no significant differences between Mongolian and Han ART women in terms of general clinical data and basal sex hormones and ovarian reserve function (all P>0.05). 2) There was a statistically significant difference in the number of eggs captured at the rs2236319 locus of the SIRT1 gene among the mutant GG group [18.5 (13.0, 32.8)], the AA group [13.0 (7.0, 20.0)] and the AG group [10.0 (5.0, 21.0), P=0.019]. 3) There was a statistically significant difference in the basal FSH levels at the rs6165 locus of the FSHR gene among the AA group [(7.45±2.73) U/L], the TT group [(5.97±2.23) U/L] and the TA group [(6.70±2.04) U/L, P=0.005]. The proportion of ovarian hyporesponsiveness among the AA group [29.6% (8/27)], the TT group [8.5% (8/94)] and the TA group [13.3% (11/83)] was statistically significant ( P=0.017). 4) The difference in basal FSH levels at the rs6166 locus of the FSHR gene among the SS group [(7.48±2.78) U/L], the NN group [(6.08±2.28) U/L] and the NS group [(6.61±1.99) U/L] was statistically significant ( P=0.016). The proportion of ovarian hyporesponsiveness among the SS group [37.0% (10/26)], the NN group [8.5% (8/99)] and the NS group [10.8% (9/79)] was statistically significant ( P=0.001). Conclusion:There were no significant differences between Mongolian and Han ART women in terms of general clinical data, basal sex hormones and ovarian reserve function. The gene polymorphism at rs2236319 of SIRT1 gene is associated with ovarian hyperresponsiveness. FSHR rs6165 and rs6166 gene polymorphisms are associated with ovarian hyporesponsiveness. There was no significant correlation between the three polymorphisms and the clinical pregnancy rate of ART.

Objective : To explore the "clinical normal reference range" of pulpal blood flow (PBF) in the physiological state in an effort to provide a reference for clinical diagnosis and treatment. Methods: According to the working principle and operational considerations of laser Doppler flowmetry (LDF), the PBF blood flow value of the first molars of the upper and lower mandibles of normal adults was detected by LDF, and the clinical reference value range under physiological conditions was analyzed and calculated. The differences in PBF values by sex, dental position and location (left and right side, upper and lower jaw) were analyzed. Results : A total of 200 normal adult participants with an average age of (22.76 ± 3.26) years were included. The cohort included 95 males and 105 females, with a total of 800 first molars. Neither the PBF values of the left and right first molars nor the PBF values of the upper and lower first molars in males or females significantly differed (P>0.05). The PBF value for females was higher than that of males. Specifically, the clinical reference PBF values for males and females were (8.56 ± 3.25) PU and (9.51 ± 3.47) PU, respectively. Conclusion The PBF values of normal adult first molars in healthy subjects were higher in females than in males, and in the PBF values of first molars of the same sex did not significantly differ between the left side and right side or upper and lower jaw; these values could be used as a reference for the selection of control teeth.

OBJECTIVE: To evaluate the clinical efficacy of weight management combined with pharyngoplasty for treatment of obesity-related obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: Sixty obese patients with OSAHS were randomly assigned into the combined treatment group and control group ( RESULTS: After 6 months of treatment, the patients receiving the combined treatment showed significant reductions of BMI, neck circumference and waist circumference as compared with the measurements before treatment and with those in the control group ( CONCLUSIONS Weight management combined with uvulopalatopharyngoplasty can produce a good clinical efficacy for treatment of OSAHS with obesity, and the patients should have strengthened continuous family weight management while receiving surgical treatment.
Body Mass Index ; Humans ; Obesity/surgery* ; Reconstructive Surgical Procedures ; Sleep Apnea, Obstructive/surgery* ; Waist Circumference

Objective To investigate the effects of circumferential pulmonary vein isolation (CPVI) on atrial effective refractory period (ERP) in patients with paroxysmal atrial fibrillation.Methods 30 patients who underwent radiofrequency catheter ablation for paroxysmal AF were enrolled in this study.Using FAM mode,the RA and LA anatomical models were achieved in the CARTO 3 system.SVC,MRA,RAA,LA-A,LA-R,LA-P,LAA,LSPV,LIPV,RSPV,RIPV,CSp,CSd,were respectively located in the RA or LA anatomical model.Before and after CPVI,ERPs were measured in different locations of the atrium using programmed stimulation.The ERPs of the RA (SVC,MRA,RAA,CSp),LA (LA-A,LA-R,LA-P,LAA,CSd),PVs (LSPV,RSPV,LIPV,RIPV) were compared.Bilateral CPVIs were completed in all patients,and PV-LA bidirectional conduction block was achieved.The changes of electrophysiological characteristics of atrium before and after CPVI were observed.Results (1) ERP at different locations in the atrium before CPVI:Comparisons of ERPs at different locations of atrium:RAA had the minimal ERPs[(197.4 ± 28.6) ms (P ＜ 0.01);followed by PVs measuring,respectively,LSPV (213.0 ± 47.5) ms,LIPV (208.9 ± 45.9) ms,RSPV (209.3 ± 43.6) ms,RIPV (213.5 ± 48.1) ms and LAA (218.1 ± 27.7) ms.Comparisons of ERPs in RA,LA,and PVs showed:PVs had the lowest ERPs (211.2 ± 35.2) ms versus RA ERP (227.0 ± 23.7) ms versus LA ERP (241.0 ± 21.5) ms (P ＜ 0.05).(2) Comparisons of ERPs before and after CPVI:Comparisons of ERPs at different locations of atrium showed:RAA [(197.4 ± 28.6) ms vs.(208.6 ± 32.2) ms,P=0.003],CSp [(234.7 ± 29.1) ms vs.(246.9 ± 29.7) ms,P=0.007],LA-R [(242.9 ± 28.9) ms vs.(258.3 ± 26.9) ms,P=0.003],LA-P [(252.2 ± 28.5) ms vs.(261.1 ± 30.2) ms,P=0.039]and CSd [(238.6 ± 28.3) ms vs.(250.3 ± 23.6) ms,P =0.009].ERPs were found statistically prolonged at all different locations after CPVI.Comparisons of ERPs at RAand LA after CPVI showed:RA [(227.0 ± 23.7) ms vs.(235.9 ± 21.7)ms,P=0.002]and LA [(241.0 ± 21.5) ms vs.(249.7 ± 19.9) ms,P =0.001],which were statistically increased after CPVI.(3) A total of 90 episodes of atrial arrhythmias were induced before CPVI which were found at RAA (n =17),LAA (n =12),and PVs (n =36).After CPVI,8 episodes of atrial arrhythmias were induced which were found at,RAA (n =4),LAA (n =3),and SVC (n =1).Conclusions (1) Compared with other parts of atrium,ERPs at PVs,LAA and RAA are significantly shorter in patients with paroxysmal AF.At PVs,LAA and RAA,atrial arrhythmias are easily to be induce by programmed stimulation.(2) In patients with paroxysmal Af:PVs has the shortest ERPsfollowed by RAs whereas LA ERPs is the longest.There is a large ERP gradient change between PVs and LA.(3) The ERPs at RAs,LAs,As,and LA-PV are prolonged after CPVI.(4) Atrial arrhythmia is less likely to be induced after CPVI.

Objective To optimize and compare four in vitro cytotoxicity assays in order to find a relatively rapid assay that can replace the traditional 51Cr release assay to evaluate the cytotoxicity of immune cells prepared for immunotherapy.Methods Four assays including BATDA, CAM (calcein acetoxymethyl ester), CytoTox-Glo and PKH were optimized and used to measure the in vitro cytotoxicity of NK-92 cells to K562 cell line.Intra-and inter-assay reproducibility of these assays and their correlation with 51Cr release assay were analyzed.Results After optimization, all of the four cytotoxicity assays showed good correlation with effector to target (E/T) ratio in a certain range.Compared with the other three assays, CytoTox-Glo assay showed obvious hook effect at a high E/T ratio of 40∶1.BATDA assay could detect the significant cytotoxicity of NK-92 cells to K562 cells after incubating them for one hour and that was the shortest time taken by the four assays to detect in vitro cytotoxicity.Both CAM and PKH assays took about four hours and CytoTox-Glo assay took six to eight hours to detect the significant cytotoxic potency.All of the four assays, especially BATDA and CAM assays, showed good intra-and inter-assay reproducibility.Among these assays, BATDA assay showed the best correlation with the traditional 51Cr release assay.BATDA assay, as compared with the other three assays, could be used to detect the cytotoxicity of Caov3 cells, an adherent cell line, and showed good results in evaluating the cytotoxic potency of autologous primary NK cells and CD19-CAR T cells.Conclusion Compared with the other three assays, BATDA assay shows the best linear correlation with 51Cr release assay and has the advantages of time-saving and good reproducibility.Besides, it is a better assay for detecting the cytotoxicity of adherent cells.BATDA assay is a promising substitute for 51Cr release assay in evaluating the in vitro cytotoxic potency of NK cells and other immune cells.

Objective:To investigate the expression of C-X-C chemokine ligand-14 (CXCL14) and epidermal growth factor receptor (EG-FR) in human gastric cancer and to analyze the relationship of CXCL14 with clinicopathological features. Methods:The expression of CXCL14 and EGFR was detected by Immunohistochemical SP method in 121 cases of gastric cancer tissue, 62 cases of the adjacent non-tumor gastric mucosa, and 60 cases of allogeneic non-tumor gastric mucosa. Results:The positive rates of CXCL14 and EGFR expres-sion were 80.17%and 48.76%in gastric cancer, respectively, and both were significantly higher in the adjacent non-tumor gastric mu-cosa and allogeneic non-tumor gastric mucosa. The differences were significant (P<0.01). Overexpression of CXCL14 was closely corre-lated with the depth of cancer invasion, differentiation, and clinical stage, and the differences were significant (P<0.05). Overexpres-sion of EGFR was correlated with cancer differentiation, lymph node metastasis, and clinical stage. The differences were significant (P<0.05). Based on the Spearman correlation analysis, the expression of CXCL14 and EGFR in gastric cancer was positively correlated (rs=0.195, P<0.05). Conclusion:Abnormal CXCL14 expression in gastric cancer may be associated with the occurrence and development of gastric cancer. CXCL14 expression is positively correlated with EGFR expression, suggesting that the two have a synergistic effect in gas-tric cancer development.