Objective To construct a model that can predict the risk of diagnosing ABO-blood group sys-tem hemolytic disease of the newborn(ABO-HDN)and to verify its effectiveness.Methods A total of 446 children with neonatal hyperbilirubinemia who met the inclusion criteria and were first diagnosed in this hos-pital from January 2022 to March 2023 were selected as the modeling group,and were divided into the develo-ping group(200 cases)and the non-developing group(246 cases)according to whether ABO-HDN was diag-nosed.Totally 17 potential influencing factors were included for univariate analysis and multi-factor analysis,and independent risk factors were included in R software to establish a Nomogram model to predict the risk of ABO-HDN.Another 105 cases of neonatal hyperbilirubinemia in the hospital from April to September 2023 were selected as the verification group.Results In the modeling group,Logistic regression analysis showed that maternal pregnancy number,prenatal serum titer,hemoglobin level,white blood cell count,creatine ki-nase level and neonatal Apgar 1 min score were all independent risk factors for ABO-HDN(P＜0.05).Multi-variate Logistic regression analysis showed that the area under receiver operating characteristic(ROC)curve of the modeling group was 0.819(95％CI:0.779-0.859),sensitivity was 0.655,specificity was 0.878.In the verification group,the area under ROC curve was 0.867(95％CI:0.800-0.933),the sensitivity was 0.803,and the specificity was 0.773.Conclusion The established predictive model scoring system can effec-tively predict the risk of ABO-HDN.

Oral diseases concern almost every individual and are a serious health risk to the popula-tion.The restorative treatment of tooth and jaw defects is an important means to achieve oral function and support the appearance of the contour.Based on the principle of"learning from the nature",Deng Xu-liang's group of Peking University School and Hospital of Stomatology has proposed a new concept of"microstructural biomimetic design and tissue adaptation of tooth/jaw materials"to address the worldwide problems of difficulty in treating dentine hypersensitivity,poor prognosis of restoration of tooth defects,and vertical bone augmentation of alveolar bone after tooth loss.The group has broken through the bottle-neck of multi-stage biomimetic technology from the design of microscopic features to the enhancement of macroscopic effects,and invented key technologies such as crystalline/amorphous multi-level assembly,ion-transportation blocking,and multi-physical properties of the micro-environment reconstruction,etc.The group also pioneered the cationic-hydrogel desensitizer,digital stump and core integrated restora-tions,and developed new crown and bridge restorative materials,gradient functionalisation guided tissue regeneration membrane,and electrically responsive alveolar bone augmentation restorative membranes,etc.These products have established new clinical strategies for tooth/jaw defect repair and achieved inno-vative results.In conclusion,the research results of our group have strongly supported the theoretical im-provement of stomatology,developed the technical system of oral hard tissue restoration,innovated the clinical treatment strategy,and led the progress of the stomatology industry.

Circadian rhythms are self-sustaining oscillations within biological systems that play key roles in a diverse multitude of physiological processes.The circadian clock mechanisms in brain and peripheral tissues can oscillate independently or be synchronized/disrupted by external stimuli.Dental enamel is a type of mineralized tissue that forms the exterior surface of the tooth crown.Incremental Retzius lines are readily observable microstructures of mature tooth enamel that indicate the regulation of amelogenesis by circadian rhythms.Teeth enamel is formed by enamel-forming cells known as ameloblasts,which are regulated and orchestrated by the circadian clock during amelogenesis.This review will first examine the key roles of the circadian clock in regulating ameloblasts and amelogenesis.Several physiological processes are involved,including gene expression,cell morphology,metabolic changes,matrix deposition,ion transportation,and mineralization.Next,the potential detrimental effects of circadian rhythm disruption on enamel formation are discussed.Circadian rhythm disruption can directly lead to Enamel Hypoplasia,which might also be a potential causative mechanism of amelogenesis imperfecta.Finally,future research trajectory in this field is extrapolated.It is hoped that this review will inspire more intensive research efforts and provide relevant cues in formulating novel therapeutic strategies for preventing tooth enamel developmental abnormalities.

BACKGROUND: Lung cancer is the second most common cancer worldwide, with non-small-cell lung cancer (NSCLC) accounting for the majority of cases. Patients with NSCLC have achieved great survival benefits from immunotherapies targeting immune checkpoints. Glucocorticoids (GCs) are frequently used for palliation of cancer-associated symptoms, as supportive care for non-cancer-associated symptoms, and for management of immune-related adverse events (irAEs). The aim of this study was to clarify the safety and prognostic significance of glucocorticoid use in advanced patients with NSCLC treated with immune checkpoint inhibitors (ICIs). METHODS: The study searched publications from PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, Chinese National Knowledge Infrastructure, Wanfang Data, and Chinese Science and Technology Journal Database up to March 1st, 2022, and conducted a meta-analysis to assess the effects of glucocorticoid use on overall survival (OS) and progression-free survival (PFS) in NSCLC patients treated with ICIs through the available data. The study calculated the pooled hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: This study included data from 25 literatures that were mainly retrospective, with 8713 patients included. Patients taking GCs had a higher risk for tumor progression and death compared with those not taking GCs (PFS: HR = 1.57, 95% CI: 1.33-1.86, P <0.001; OS: HR = 1.63, 95% CI: 1.41-1.88, P <0.001). GCs used for cancer-associated symptoms caused an obviously negative effect on both PFS and OS (PFS: HR = 1.74, 95% CI: 1.32-2.29, P <0.001; OS: HR = 1.76, 95% CI: 1.52-2.04, P <0.001). However, GCs used for irAEs management did not negatively affect prognosis (PFS: HR = 0.68, 95% CI: 0.46-1.00, P = 0.050; OS: HR = 0.53, 95% CI: 0.34-0.83, P = 0.005), and GCs used for non-cancer-associated indications had no effect on prognosis (PFS: HR = 0.92, 95%CI: 0.63-1.32, P = 0.640; OS: HR = 0.91, 95% CI: 0.59-1.41, P = 0.680). CONCLUSIONS In advanced NSCLC patients treated with ICIs, the use of GCs for palliation of cancer-associated symptoms may result in a worse PFS and OS, indicating that they increase the risk of tumor progression and death. But, in NSCLC patients treated with ICIs, the use of GCs for the management of irAEs may be safe, and the use of GCs for the treatment of non-cancer-associated symptoms may not affect the ICIs' survival benefits. Therefore, it is necessary to be careful and evaluate indications rationally before administering GCs in individualized clinical management.
Humans ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Glucocorticoids/therapeutic use* ; Immune Checkpoint Inhibitors/therapeutic use* ; Lung Neoplasms/drug therapy* ; Retrospective Studies

Objective:To evaluate correlation between left ventricular mechanical contraction synchrony and left ventricular systolic function by gated myocardial perfusion imaging(GMPI) using Cadmium-Zine-Telluride (CZT) SPECT.Methods:Three hundred and forty three consecutive patients( 232 males, 111 females, age (60.08±12.88) years) who underwent CZT SPECT GMPI in Shanxi Cardiovascular Hospital between January and August 2019 were retrospectively analyzed. The Emory cardiac toolbox was used to process the imaging data, and the left ventricular systolic synchrony parameters and systolic function parameters were acquired, including peak phase(PP), phase standard deviation (PSD), phase histogram bandwidth(PHB), histogram skewness(HS), histogram kurtosis(HK), and end-diastolic volume( EDV), end-systolic volume (ESV), left ventrieular ejection fraction (LVEF). All patients were divided into 4 groups: the normal group (147 cases), ischemic cardiomyopathy group (114 cases), nonischemic cardiomyopathy without left bundle branch block (LBBB) group(50 cases)and nonischemic cardiomyopathy with LBBB group(32 cases). The relationship between systolic synchrony parameters and systolic function parameters were analyzed with Pearson correlation analysis.Results:Statistic results for all patients showed that PSD and PHB were well correlated with LVEF( r values: -0.790, -0.799, both P<0.01), but PP was poorly correlated with LVEF( r=-0.194, P<0.01); HS, HK were positively correlated with LVEF( r values: 0.767, 0.676, both P<0.01); PSD, PHB were positively correlated with ESV( r values: 0.778, 0.795, both P<0.01) and EDV ( r values: 0.722, 0.732, both P<0.01); but PP was poorly correlated with ESV( r=0.145, P<0.01) and not correlated with EDV ( r=0.095, P>0.01). HS, HK were negatively correlated with EDV and ESV ( r values: -0.700 to -0.580, all P<0.01). PSD and PHB showed negatively correlation with LVEF ( r values: -0.834 to -0.492, all P<0.01), while HS, HK showed positive correlation with LVEF ( r values: 0.243-0.792, all P<0.01) in normal group, the ischemic cardiomyopathy group, the nonischemic cardiomyopathy without LBBB group and the nonischemic cardiomyopathy with LBBB group. Conclusions:The left ventricular systolic synchrony parameters provided by CZT SPECT GMPI correlate well with the left ventricular systolic function parameters, and the worse systolic function, the worse systolic synchrony. Both ischemic cardiomyopathy and non-ischemic cardiomyopathy can affect left ventricular mechanical contraction synchrony, and the effect on contraction synchrony in non-ischemic cardiomyopathy patients with LBBB is greater.

To observe the results of different treatment of congenital heart disease (CHD) complicated with severe pneumonia in infants.
 Methods: A total of 27 infants with CHD and severe pneumonia were admitted to the Department of Pediatrics, Xiangya Hospital from January 2014 to December 2014, of whom 18 were male and 9 were female. The average age was 2.0-19.0(5.9±4.3) months, with an average body weight of 3.3-10.0 (5.8±1.8) kg. Infants were treated with a strategy of complete control of the lung infection before surgery (internal medicine group). From January 2015 to December 2015, 29 infants with same condition were admitted, of whom 15 were males and 14 females. The average age was 2.0-27.0 (6.1±3.9) months, with an average body weight of 3.1-8.0 (4.8±1.0) kg. Infants were treated with a strategy of combined treatment (combined treatment group), in which early surgical treatment were performed after a short time antibiotics and supportive treatment.
 Results: One nosocomial death in internal medicine group, with an average hospital stay for 3-26 (11±6) d. Further surgeries were performed in 5 patients after discharge with no surgical death. The mean preoperative hospital stay in combined treatment group was 1-21 (10±6) d. The mean total hospital stay for combined treatment group was 14-48 (24±9) d and the mean postoperative hospital stay was 6-35 (14±7) d. One patient died soon after surgery in combined treatment group. Thirty-day follow-up found that no other patient died in combined treatment group, and 6 patients died in internal medicine group. The 30-day mortality was 3.4% in combined treatment group and 22.2% in internal medicine group (P<0.01).
 Conclusion: Infant congenital heart disease complicated with severe pneumonia requires early surgical treatment, which contributed to the control of pulmonary infection and reduce mortality.
Female ; Heart Defects, Congenital ; therapy ; Humans ; Infant ; Length of Stay ; Male ; Pneumonia ; therapy ; Postoperative Period

Object: To explore the electrocardiographic characteristics of ventricular arrhythmias (VAs) originating from tricuspid annulus region. Methods: Present study included 169 consecutive patients undergoing catheter ablation of VAs from tricuspid annulus origin in our department from August 2007 to September 2016. Based on the origin sites, the patients were divided into two subgroups, the free wall group (81 cases) and septal wall group (88 cases). Based on the location, patients in the free wall group were classified into anterolateral (22 cases), lateral (26 cases) and posterolateral (33 cases) subgroups. Patients in the septal group were classified into anteroseptal (10 cases), midseptal (71 cases) and posteroseptal (7 cases) subgroups. We analyzed the electrocardiographic features of these patients and in 87 patients with PVCs/VT originating from right ventricular outflow tract. Results: (1) A positive R wave inⅠ, aVL, V₅-V₆ leads were found among most of patients, only few cases originating from tricuspid annulus anteroseptum group and tricuspid annulus anterolateral group demonstrated qr or qs pattern in aVL lead. 97.53% (79/81) patients demonstrated rS pattern in V₁-V₃ leads with VAs originating from tricuspid annulus free wall, and 9/10 patients demonstrated rS pattern in V₁ lead with VAs originating from anteroseptum, and 97.44% (76/78) patients demonstrated QS pattern in V₁ lead with VAs originating from midseptum and posteroseptum. Precordial lead transition zone was on or behind V₃ for tricuspid annulus free wall group (96.3%, 78/81), but in front of V₃ for tricuspid annulus septum wall group (47.73%, 42/88) (P<0.01). The S wave's amplitude smaller than-1.81 mV in lead V₂ can be used as a cutoff value to identify if PVC/VT is originating from free wall or septum of TA. R wave in inferior wall leads was found among 98.85% (86/87) patients with PVCs/VT originating from right ventricular outflow tract. Conclusion A positive R wave in Ⅰ, aVL, V₅-V₆ leads was found among most of patients with idiopathic ventricular arrhythmias originating from the tricuspid annulus regions, but VAs originating from different portions of tricuspid annulus area have distinct electrocardiographic characteristics.

Objective To explore the effects of bone marrow mesenchymal stem cells (BMSCs) on viral myositis in mice. Methods Four-week-old BALB/C male mice were randomly divided into normal control group, myocarditis group, and BMSCs intervention group at different stages (3 days and 2 weeks). The mouse model of viral myocarditis was established by intraperitoneal injection of Coxsackie virus B3. The mice in the intervention group were injected with BMSCs in the tail vein at 3 days and 2nd week after the injection of the virus. Four weeks later, echocardiography was performed, and the pathological integral and collagen volume fraction (CVF) were observed and calculated by light microscopy. The qRT-PCR method was used to detect the mRNA expression of homogenates collagen I (col1α1) and collagen fiber III (col3α1) in myocardial tissue. Results Compared with the normal control group, the left anterior and posterior wall became thinner, the diameter and volume of the left ventricle at end systolic period was increased; left ventricular ejection fraction (LVEF) and short axis shortening rate (FS) decreased in the myocarditis group. The differences were statistically significant (P all<0.05). The LVEF and FS in each subgroup of the intervention group were better than those of the myocarditis group, and the improvement in the intervention group was more obvious at the 2nd week after the treatment of the myocarditis. The differences were significant (P all<0.05). Light microscope showed that myocardial CVF in myocarditis group was higher than in normal control group, and CVF in intervention group was reduced compared with myocarditis group and CVF in the 2nd week intervention group was lower than that in the 3 day intervention group. The differences were significant (P all<0.05). Compared with the control group, the mRNA expressions of col1α1 and col3α1 in the myocarditis group were increased, and they were lower in the intervention group than in the myocarditis group, and the differences were significant (P all<0.05). Conclusions BMSCs can reduce the degree of cardiac fibrosis and improve cardiac function in mice with viral myositis, and the intervention effect is better when the virus is infected in the 2nd week.

Objective To study the effect of cognitive dysfunction of gangliosides on in the treatment of the patients with traumatic brain injury intraoperative and postoperative. Methods From February 2015 to August 2016, 100 patients with cognitive dysfunction after operation were randomly divided into two groups, the control group and the experimental group, 50 cases in each group. The control group were received routine treatment, including medication, brain rehabilitation, and dehydration and intracranial pressure reduction. At this basis, the experimental group were treated with gangliosides. The clinical indexes in the experimental group and the control group were compared and analyzed. Results The cure rate was 90% in the experimental group, and 54% in the control group. The difference in the two groups has statistically significant (P<0.05). Before treatment, there was no significant difference of the MMSE in the two groups. After treatment, the MMSE score in the experimental group was (28.34 ± 4.12) points, and the score of MMSE in the control group was (22.19 ± 5.49) points. The difference in the two groups has statistically significant (P<0.05). Conclusion The effect of cognitive dysfunction is better which ganglioside was used on the treatment of the patients with traumatic brain injury intraoperative and postoperative, and the cure rate is higher. It has the significance of further popularization and application.

BACKGROUND:Recent studies have suggested that intranasal administration is one of the ways to target drugdelivery, and can effectively make the drug that cannot pass through the blood brain barrier by other pathways to bypass the blood brain barrier, resulting in targeted delivery to the brain. It provides a promising route for the treatment of central nervous system diseases. OBJECTIVE: To study the pharmacokinetic and brain-targeted channel-tropism tissue distribution character of cimicifugoside H-1 after nasal and intravenous administration in plasma and tissues in rats, in order to evaluate the feasibility of developing brain-targeted nasal delivery system of cimicifugoside H-1 by the passage between nose and brain in nasal olfactory area. METHODS: After intravenous injection and nasal administration of cimicifugoside H-1, the drug concentrations of plasma and channel-tropism organs (lung, spleen, stomach, large intestine, liver, kidney, brain, brain, cerebelum, cerebrospinal fluid, olfactory bulb and olfactory region) were detected. Drug-time curve was drawn. DAS program was used to select apartment model and pharmacokinetics parameters. RESULTS AND CONCLUSION:(1) The pharmacokinetics characters of cimicifugoside H-1 are rapidly absorbed and extensively distribution. Among major channel-tropism organs, drug concentrations were higher in the lung and brain than in the other organs. (2) Cimicifugoside H-1 could be straightly transported into brain by the intranasal administration. The molecule through olfactory mucosa in nasal cavity entered into olfactory bulb in arachno-hypostegal cavity, and then entered into olfactory region, cerebrospinal fluid, cerebrum and cerebelum gradualy. Olfactory bulb was the only way for drug molecule to go through nasal cavity into brain. (3) Compared with the intravenous injection, cimicifugoside H-1 through the intranasal administration has a significant