The coinfection of respiratory viruses and bacteria is a major cause of morbidity and mortality worldwide, despite the development of vaccines and powerful antibiotics. As a macromolecule that is difficult to absorb in the gastrointestinal tract, a homogeneous polysaccharide from Houttuynia cordata (HCPM) has been reported to exhibit anti-complement properties and alleviate influenza A virus (H1N1)-induced lung injury; however, the effects of HCPM without in vitro antiviral and antibacterial activities on more complicated pulmonary diseases resulting from viral-bacterial coinfection remains unclear. This study established a representative coinfection murine pneumonia model infected with H1N1 (0.2 LD₅₀) and methicillin-resistant Staphylococcus aureus (MRSA, 10⁷ CFU). HCPM significantly improved survival rate and weight loss, and ameliorated gut-lung damage and inflammatory cytokine production. Interestingly, the therapeutic effect of HCPM on intestinal damage preceded that in the lungs. Mechanistically, HCPM inhibited the overactivation of the intestinal complement (C3a and C5a) and suppressed the activation of the NLR family pyrin domain-containing 3 (NLRP3) pathway, which contributes to the regulation of the Treg/Th17 cell balance in the gut-lung axis. The results indicate the beneficial effects of an anti-complement polysaccharide against viral-bacterial coinfection pneumonia by modulating crosstalk between multiple immune regulatory networks.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

[Objective]To collate the records of needle withdrawal techniques from Huangdi Neijing and related ancient Chinese medical texts,summarize the principles of these techniques,and analyze the occasion of needle withdrawal.[Methods]By organizing and analyzing ancient Chinese medical texts,the discussion and summary focus on pathogenic Qi and grain Qi,the deficiency and excess of Qi and blood,Yin and Yang,cold and heat,breathing and exhalation.[Results]Before needle withdrawal,it is necessary to diagnose the patient's condition and constitution.This involves determining the balance of pathogenic and healthy Qi and the deficiency and excess of Qi and blood through pulse diagnosis,assessing cold and heat,Yin and Yang through observation and palpation,and determining the appropriate occasion for needle withdrawal by listening to the patient's breathing.Proper needle withdrawal methods can tonify deficiency and reduce excess.[Conclusion]Huangdi Neijing places great emphasis on the occasion of needle withdrawal.It states that needles should only be withdrawn when the pathogenic factors have been removed and the body is in a state of harmony,with Yin and Yang in balance.Sudden needle withdrawal may cause disruptions in the circulation of Qi and blood or result in the retention of remaining pathogenic factors in the body,which can lead to adverse consequences.This concept holds certain reference value for contemporary clinical acupuncture practice.

[Objective]To collate the records of needle withdrawal techniques from Huangdi Neijing and related ancient Chinese medical texts,summarize the principles of these techniques,and analyze the occasion of needle withdrawal.[Methods]By organizing and analyzing ancient Chinese medical texts,the discussion and summary focus on pathogenic Qi and grain Qi,the deficiency and excess of Qi and blood,Yin and Yang,cold and heat,breathing and exhalation.[Results]Before needle withdrawal,it is necessary to diagnose the patient's condition and constitution.This involves determining the balance of pathogenic and healthy Qi and the deficiency and excess of Qi and blood through pulse diagnosis,assessing cold and heat,Yin and Yang through observation and palpation,and determining the appropriate occasion for needle withdrawal by listening to the patient's breathing.Proper needle withdrawal methods can tonify deficiency and reduce excess.[Conclusion]Huangdi Neijing places great emphasis on the occasion of needle withdrawal.It states that needles should only be withdrawn when the pathogenic factors have been removed and the body is in a state of harmony,with Yin and Yang in balance.Sudden needle withdrawal may cause disruptions in the circulation of Qi and blood or result in the retention of remaining pathogenic factors in the body,which can lead to adverse consequences.This concept holds certain reference value for contemporary clinical acupuncture practice.

Magnesium-doped calcium silicate(CS)bioceramic scaffolds have unique advantages in mandibular defect repair;however,they lack antibacterial properties to cope with the complex oral microbiome.Herein,for the first time,the CS scaffold was functionally modified with a novel copper-containing polydopamine(PDA(Cu2+))rapid deposition method,to construct internally modified(*P),externally modified(@PDA),and dually modified(*P@PDA)scaffolds.The morphology,degradation behavior,and mechanical properties of the obtained scaffolds were evaluated in vitro.The results showed that the CS*P@PDA had a unique micro-/nano-structural surface and appreciable mechanical resistance.During the prolonged immersion stage,the release of copper ions from the CS*P@PDA scaffolds was rapid in the early stage and exhibited long-term sustained release.The in vitro evaluation revealed that the release behavior of copper ions ascribed an excellent antibacterial effect to the CS*P@PDA,while the scaffolds retained good cytocompatibility with improved osteogenesis and angiogenesis effects.Finally,the PDA(Cu2+)-modified scaffolds showed effective early bone regeneration in a critical-size rabbit mandibular defect model.Overall,it was indicated that considerable antibacterial property along with the enhancement of alveolar bone regeneration can be imparted to the scaffold by the two-step PDA(Cu2+)modification,and the convenience and wide applicability of this technique make it a promising strategy to avoid bacterial infections on implants.

Feature extraction methods and classifier selection are two critical steps in heart sound classification. To capture the pathological features of heart sound signals, this paper introduces a feature extraction method that combines mel-frequency cepstral coefficients (MFCC) and power spectral density (PSD). Unlike conventional classifiers, the adaptive neuro-fuzzy inference system (ANFIS) was chosen as the classifier for this study. In terms of experimental design, we compared different PSDs across various time intervals and frequency ranges, selecting the characteristics with the most effective classification outcomes. We compared four statistical properties, including mean PSD, standard deviation PSD, variance PSD, and median PSD. Through experimental comparisons, we found that combining the features of median PSD and MFCC with heart sound systolic period of 100-300 Hz yielded the best results. The accuracy, precision, sensitivity, specificity, and F1 score were determined to be 96.50%, 99.27%, 93.35%, 99.60%, and 96.35%, respectively. These results demonstrate the algorithm's significant potential for aiding in the diagnosis of congenital heart disease.
Humans ; Heart Sounds ; Neural Networks, Computer ; Algorithms ; Heart Defects, Congenital

Tumor volume increases continuously in the advanced stage, and aside from the self-renewal of tumor cells, whether the oncogenic transformation of surrounding normal cells is involved in this process is currently unclear. Here, we show that oral squamous cell carcinoma (OSCC)-derived small extracellular vesicles (sEVs) promote the proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of normal epithelial cells but delay their apoptosis. In addition, nuclear-cytoplasmic invaginations and multiple nucleoli are observed in sEV-treated normal cells, both of which are typical characteristics of premalignant lesions of OSCC. Mechanistically, miR-let-7c in OSCC-derived sEVs is transferred to normal epithelial cells, leading to the transcriptional inhibition of p53 and inactivation of the p53/PTEN pathway. In summary, we demonstrate that OSCC-derived sEVs promote the precancerous transformation of normal epithelial cells, in which the miR-let-7c/p53/PTEN pathway plays an important role. Our findings reveal that cancer cells can corrupt normal epithelial cells through sEVs, which provides new insight into the progression of OSCC.
Carcinoma, Squamous Cell/pathology* ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Cell Transformation, Neoplastic ; Down-Regulation ; Epithelial Cells/metabolism* ; Extracellular Vesicles/pathology* ; Humans ; MicroRNAs/metabolism* ; Mouth Neoplasms/pathology* ; PTEN Phosphohydrolase/metabolism* ; Tumor Suppressor Protein p53/metabolism*

Heart sound analysis is significant for early diagnosis of congenital heart disease. A novel method of heart sound classification was proposed in this paper, in which the traditional mel frequency cepstral coefficient (MFCC) method was improved by using the Fisher discriminant half raised-sine function (F-HRSF) and an integrated decision network was used as classifier. It does not rely on segmentation of the cardiac cycle. Firstly, the heart sound signals were framed and windowed. Then, the features of heart sounds were extracted by using improved MFCC, in which the F-HRSF was used to weight sub-band components of MFCC according to the Fisher discriminant ratio of each sub-band component and the raised half sine function. Three classification networks, convolutional neural network (CNN), long and short-term memory network (LSTM), and gated recurrent unit (GRU) were combined as integrated decision network. Finally, the two-category classification results were obtained through the majority voting algorithm. An accuracy of 92.15%, sensitivity of 91.43%, specificity of 92.83%, corrected accuracy of 92.01%, and F score of 92.13% were achieved using the novel signal processing techniques. It shows that the algorithm has great potential in early diagnosis of congenital heart disease.
Humans ; Heart Sounds ; Algorithms ; Neural Networks, Computer ; Heart Defects, Congenital/diagnosis* ; Signal Processing, Computer-Assisted

Automatic classification of heart sounds plays an important role in the early diagnosis of congenital heart disease. A kind of heart sound classification algorithms based on sub-band envelope feature and convolution neural network was proposed in this paper, which did not need to segment the heart sounds according to cardiac cycle accurately. Firstly, the heart sound signal was divided into some frames. Then, the frame level heart sound signal was filtered with Gammatone filter bank to obtain the sub-band signals. Next, the sub-band envelope was extracted by Hilbert transform. After that, the sub-band envelope was stacked into a feature map. Finally, type Ⅰ and type Ⅱ convolution neural network were selected as classifier. The result shown that the sub-band envelope feature was better in type Ⅰ than type Ⅱ. The algorithm is tested with 1 000 heart sound samples. The test results show that the overall performance of the algorithm proposed in this paper is significantly improved compared with other similar algorithms, which provides a new method for automatic classification of congenital heart disease, and speeds up the process of automatic classification of heart sounds applied to the actual screening.
Algorithms ; Heart ; Heart Defects, Congenital/diagnosis* ; Heart Sounds ; Humans ; Neural Networks, Computer ; Signal Processing, Computer-Assisted

Objective:To explore the clinical effect of multidisciplinary cooperative intervention in improving self-management and improving fluid retention in the elderly patients with chronic heart failure.Methods:Totally 130 cases of the elderly patients with chronic heart failure from January to December 2018 were enrolled and were divided into control group and observation group with 65 cases randomly. The control group received routine nursing instruction and telephone follow-up. The observation group was given multidisciplinary team guidance to patients self-management in addition to routine nursing instruction and telephone follow-up. After 3 months, the self-management and fluid retention of the two groups were compared.Results:After 3 months of intervention, the scores and total scores of the observation group in the four dimensions of drug management, diet management, psychological and social adaptation management, symptom management were 19.43±0.71,11.51±0.59,19.07±0.65,25.24±1.31, 72.65±7.16, the control group was 11.09±3.40, 6.05±1.71, 12.73±2.49, 15.72±4.18, 46.35±7.83. The scores and total scores of the observation group were better than those of the control group ( t value was 4.835-13.727, all P < 0.05).After intervention for 3 months, the proportion of severe edema, moderate edema and mild edema in the observation group was 4.61% (3/65), 13.85% (9/65), 81.54% (53/65), respectively, and the control group was 38.46% (25/65), 52.31% (34/65) and 9.23% (6/65) respectively. The degree of fluid retention in the observation group was better than that in the control group ( Z value was -2.373, all P < 0.05). Conclusion:Multidisciplinary cooperative intervention can improve self-management and improve fluid retention in elderly patients with chronic heart failure.