Objective To observe the value of multi-detector CT(MDCT)for evaluating changes of aortic root parameters caused by aortic stenosis(AS).Methods MDCT data of 20 cases with severe AS were retrospectively analyzed.The changes of the long diameter,short diameter,mean diameter,area,circumference,as well as diameter derived from area(DA)and diameter derived from circumference(DC)of aortic annulus(AA),left ventricular outflow tract(LVOT)and sinotubular junction(STJ)during early systole,late systole,early diastole and late diastole were measured and calculated,respectively.Results In early systole,the short diameter,mean diameter,area,circumference,DA and DC of A A were all significantly larger than that those in late systole,early diastole and late diastole(all P＜0.05).No significant difference of the long diameter of AA was found among different phases(all P＞0.05).Meanwhile,the short diameter,mean diameter,area,circumference,DA and DC of LVOT in early systole were all significantly larger than those in late systole,early diastole and late diastole(all P＜0.05).The long diameter of LVOT in early systole was larger than in late systole(P＜0.05),but not significantly different compared with that in early and late diastole(both P＞0.05).No significant difference of the above parameters of STJ was found among different phases(all P＞0.05).At early systole,DA and the mean diameter of AA were both significantly smaller than those of DC(both P＜0.05).Conclusion AA parameters obtained with MDCT in patients with severe AS were valuable for selecting prosthetic valves during transcatheter aortic valve replacement.

Aim To identify the underlying target of bullatine A(BA)against rheumatoid arthritis(RA)u-sing limited proteolysis-small molecule mapping(LiP-SMap)drug target proteomics and to provide a scientif-ic basis for clinical application of Aconiti brachypodi Radix in the treatment of RA.Methods LiP-SMap drug target proteomics was employed to perform bioin-formatics analysis for comparing and validating the dif-ferential protein expression after BA intervention.A collagen-induced arthritis(CIA)model was estab-lished in DBA/1 mice using bovine type Ⅱ collagen.The mice were then divided into the CIA model group,methotrexate-positive control group(MTX group),and BA groups(10 mg·kg-1 and 20 mg·kg-1)based on their clinical scores.After drug intervention,the thera-peutic efficacy against RA was assessed by joint index scores and foot thickness measurements.Histopatholog-ical changes in the arthritic joints of CIA mice were e-valuated using hematoxylin and eosin(HE)staining.Enzyme-linked immunosorbent assay(ELISA)was employed to detect inflammatory cytokines interleukin-17(IL-17)and total IgG and IgG3 anti-collagen-spe-cific antibodies levels from the serum of CIA mice.Flow cytometry was used to detect the expression levels of intracellular Th17 cells(IL-17+CD4+T cells)and Th1 cells(IFN-γ+CD4+T cells).Fluorescent quanti-tative PCR was performed to detect the expression of genes related to differential proteins.Results The proteomic analysis identified Serpinb1a as a protein with strong binding affinity to BA,and KEGG enrich-ment analysis indicated IL-17 signaling pathway was a crucial pathway of BA in against RA.BA treatment significantly reduced clinical scores and foot thickness,improved local arthritis symptoms in CIA mice,and al-leviated inflammatory cell infiltration into arthritic joints(P＜0.05).Differential protein validation re-sults showed that BA had strong affinity with Serpinb1a(-5.92 kJ·mol-1)and downregulated the expres-sion of Serpinb1a mRNA.Furthermore,the administra-tion of BA markedly reduced serum IL-17 A levels from CIA mice,inhibited the expression of intracellular IL-17 A and IFN-γ cytokines in splenic CD4+T cells(P＜0.05),and significantly downregulated the transcrip-tional expression of IL-17F(P＜0.05).Conclusion BA exhibits therapeutic effects on collagen-induced arthritis,and its mechanism of action may involve the regulation of Serpinb1a and the IL-17 signaling path-way.

Dental unit waterlines(DUWLs)often experience severe microbial contamination.Opportunistic patho-gens such as Pseudomonas aeruginosa and Legionella pneumophila present in DUWLs can enter patients' mouths through procedural water,increasing the risk of infection during dental procedures.In response to the current situ-ation of waterline contamination,this paper systematically reviews domestic and international guidelines,local standards,and industry requirements related to contamination control in DUWLs.It discusses five aspects were explored:incoming water quality control,tubing material,physical control measures,chemical disinfection,and microbial testing.The paper deeply analyzes and distills relevant strategies for waterline contamination con-trol measures,providing a reference for infection prevention and control in dental practice to ensure patient safety.

Objective:To explore the correlation of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters and serum level of proprotein convertase subtilisin/kexin type 9(PCSK9)with pathological characteristics and chemotherapy sensitivity of breast cancer patients.Methods:The clinical data of 102 breast cancer patients admitted to our hospital from Feb 2022 to May 2024 were respectively analyzed.Based on the principle of 1∶1 selection,102 patients with benign breast tumors during the same period were selected as the control group.The DCE-MRI parameters[transport constant(Ktrans),rate constant(Kep),volume ratio of the external space(Ve),and apparent diffusion coefficient(ADC)]and serum PCSK9 level were compared between the two groups and patients with different pathological characteristics,and the correlation was analyzed.The value of DCE-MRI parameters(Ktrans,Kep,Ve,ADC)combined with serum PCSK9 level in assessing the sensitivity of chemotherapy in breast cancer patients was analyzed.Results:The Ktrans,Kep,Ve,ADC values,and serum PCSK9 level in breast cancer group were higher than those in the benign breast tumor group(P＜0.01).Breast cancer patients with low-to-moderate differentiation,pathological stage Ⅲ,and lymph node metastasis had higher Ktrans,Kep,Ve,ADC values,and serum PCSK9 level compared to those with high differentiation,pathological stage Ⅰ-Ⅱ,and no lymph node metastasis(P＜0.05).The degree of differentiation,pathological stage,and lymph node metastasis were positively correlated with Ktrans,Kep,Ve,ADC values,and serum PCSK9 level(P＜0.01).The Ktrans,Kep,Ve,ADC values,and serum PCSK9 level in breast cancer patients with chemotherapy resistance were higher than those in patients with chemotherapy sensitivity(P＜0.01).Patients with chemotherapy resistance had a higher proportion of low-to-moderate differentiation,pathological stage Ⅲ,and lymph node metastasis than patients with chemotherapy sensitivity(P＜0.05).After adjusting the degree of differentiation,pathological stage and lymph node metastasis,Ktrans,Kep,Ve,ADC values and serum PCSK9 level were still the influencing factors of chemotherapy sensitivity in breast cancer patients(P＜0.05).Conclusion:DCE-MRI parameters and serum PCSK9 level are correlated with the clinical pathological characteristics of breast cancer patients,and the combination of these indicators can provide certain reference value for clinical evaluation of chemotherapy sensitivity in breast cancer patients.

Objective:To establish a model for predicting the occurrence of contrast-induced acute kidney injury(CI-AKI)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Meth-ods:A total of 767 AMI patients who underwent PCI in the Second Affiliated Hospital of Harbin Medical University between January 2019 and December 2023 were retrospectively included.According to presence of CI-AKI,pa-tients were divided into CI-AKI group(n=62)and non-CI-AKI group(n=705).The risk factors of CI-AKI in AMI patients undergoing PCI were analyzed using multivariant Logistic regression,and a prediction model was es-tablished.The model was evaluated using receiver operating characteristic(ROC)curve,calibration curve and clini-cal decision curve analysis(DCA).Results:Multivariant Logistic regression analysis showed that extensive anterior wall myocardial infarction(OR=1.520,95％CI:1.140～2.028,P=0.004),Killip class≥Ⅲ(OR=1.982,95％CI:1.406～2.793,P＜0.001),chronic renal insufficiency(OR=1.397,95％CI:1.025-1.903,P=0.034),ACEF(age,creatinine,ejection fraction)score(OR=1.702,95％CI:1.246～2.327,P＜0.001)and systemic im-mune-inflammation index(SII,OR=1.419,95％CI:1.090～1.847,P=0.009)were independent risk factors for CI-AKI after PCI in AMI patients.A prediction model of CI-AKI after PCI in AMI patients was established:Logit(P)=-1.667+0.334 ×(chronic renal insufficiency)+0.419 ×(extensive anterior wall myocardial infarc-tion)+0.684 ×(Killip class ≥Ⅲ)+0.350 × SII+0.532 ×(ACEF score).The ROC curve showed that the AUC of the model predicting CI-AKI was 0.868(95％CI:0.823-0.912,P＜0.001).The calibration curve showed a good fit of the predicted results to the actual curves(x2=0.421,P=0.506),and DCA showed net benefit when the high-risk threshold was between 5％and 70％.Conclusion:The prediction model for CI-AKI after PCI in AMI patients included extensive anterior wall myocardial infarction,Killip class,chronic renal insufficiency,ACEF score and SII,which had a good predictive performance for CI-AKI.

Objective:To develop a knowledge, attitude, and practice (KAP) questionnaire on oral health for pregnant women and to evaluate its reliability and validity.Methods:Following the methodological framework of DeVellis's scale development guidelines, the initial version of the questionnaire was constructed through literature review, focus group discussions, and two rounds of expert consultations. A convenience sample of pregnant women attending the obstetrics outpatient clinic at Peking University People's Hospital was surveyed from September to October 2023 for psychometric evaluation.Results:A total of 200 questionnaires were distributed and all were returned with valid responses, yielding a 100.00% (200/200) response rate. The finalized KAP questionnaire consisted of 32 items across three dimensions: oral health knowledge, attitude, and behavior among pregnant women. The scale-level content validity index universal agreement ( S- CVI/UA) was 0.843, and the item-level CVI ( I- CVI) ranged from 0.889 to 1.000. Cronbach's α coefficients for the three dimensions ranged from 0.716 to 0.911, and test-retest reliability coefficients ranged from 0.744 to 0.952. Conclusions:The developed KAP questionnaire demonstrates good content validity and reliability and can be used to assess the level of oral health knowledge, attitude, and behavior among pregnant women.

OBJECTIVE To investigate the management status of small pressure steam sterilizers in dental institu-tions across seven major regions of China and provide references for establishing standardized monitoring and eval-uation protocols for sterilization efficacy.METHODS From Aug.to Nov.2023,a convenience sampling method was employed to select 885 dental institutions of various levels from seven geographical regions.An online survey using a self-designed questionnaire was conducted to assess the management status of small pressure steam steri-lizers in dental institutions.RESULTS A total of 885 questionnaires were distributed,with 770 valid responses col-lected,covering 770 dental institutions at all levels.The survey involved 2 056 small pressure steam sterilizers,of which 43.14％were pre-vacuum type and 89.40％were benchtop models.Tertiary dental institutions had the high-est proportion of imported small pressure steam sterilizers(60.15％),with most devices in use for 5-10 years(36.88％).Secondary and low er-level institutions predominantly used domestically produced small pressure steam sterilizers(74.60％),which used for 3-5 years accounting for the highest proportion(34.29％).While 85.58％of dental institutions employed dedicated sterilization personnel,only 45.84％performed proper maintenance for small pressure steam sterilizers.Training rates were 80.00％for department of stomatology in ungraded general hospitals and primary medical institutions,76.19％in prejob and 71.43％during the work for department of sto-matology in primary clinics,respectively.CONCLUSIONS Although most dental institutions demonstrate sound policy formulation,challenges persist in equipment maintenance,policy implementation and grassroots training.Future efforts should be made on strengthening maintenance and inspection of equipment,enhancing sys-tem supervisory mechanisms,and optimizing training systems to ensure dental treatment safety.

Objective:To establish a model for predicting the occurrence of contrast-induced acute kidney injury(CI-AKI)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Meth-ods:A total of 767 AMI patients who underwent PCI in the Second Affiliated Hospital of Harbin Medical University between January 2019 and December 2023 were retrospectively included.According to presence of CI-AKI,pa-tients were divided into CI-AKI group(n=62)and non-CI-AKI group(n=705).The risk factors of CI-AKI in AMI patients undergoing PCI were analyzed using multivariant Logistic regression,and a prediction model was es-tablished.The model was evaluated using receiver operating characteristic(ROC)curve,calibration curve and clini-cal decision curve analysis(DCA).Results:Multivariant Logistic regression analysis showed that extensive anterior wall myocardial infarction(OR=1.520,95％CI:1.140～2.028,P=0.004),Killip class≥Ⅲ(OR=1.982,95％CI:1.406～2.793,P＜0.001),chronic renal insufficiency(OR=1.397,95％CI:1.025-1.903,P=0.034),ACEF(age,creatinine,ejection fraction)score(OR=1.702,95％CI:1.246～2.327,P＜0.001)and systemic im-mune-inflammation index(SII,OR=1.419,95％CI:1.090～1.847,P=0.009)were independent risk factors for CI-AKI after PCI in AMI patients.A prediction model of CI-AKI after PCI in AMI patients was established:Logit(P)=-1.667+0.334 ×(chronic renal insufficiency)+0.419 ×(extensive anterior wall myocardial infarc-tion)+0.684 ×(Killip class ≥Ⅲ)+0.350 × SII+0.532 ×(ACEF score).The ROC curve showed that the AUC of the model predicting CI-AKI was 0.868(95％CI:0.823-0.912,P＜0.001).The calibration curve showed a good fit of the predicted results to the actual curves(x2=0.421,P=0.506),and DCA showed net benefit when the high-risk threshold was between 5％and 70％.Conclusion:The prediction model for CI-AKI after PCI in AMI patients included extensive anterior wall myocardial infarction,Killip class,chronic renal insufficiency,ACEF score and SII,which had a good predictive performance for CI-AKI.

Dental unit waterlines(DUWLs)often experience severe microbial contamination.Opportunistic patho-gens such as Pseudomonas aeruginosa and Legionella pneumophila present in DUWLs can enter patients' mouths through procedural water,increasing the risk of infection during dental procedures.In response to the current situ-ation of waterline contamination,this paper systematically reviews domestic and international guidelines,local standards,and industry requirements related to contamination control in DUWLs.It discusses five aspects were explored:incoming water quality control,tubing material,physical control measures,chemical disinfection,and microbial testing.The paper deeply analyzes and distills relevant strategies for waterline contamination con-trol measures,providing a reference for infection prevention and control in dental practice to ensure patient safety.

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