Necroptosis is one of the regulated cell death, which involves receptor interacting protein kinase (RIPK) 1/RIPK3/mixed lineage kinase domain like protein (MLKL) signaling pathway. Among them, MLKL is the final execution of necroptosis. The formation of RIPK1/RIPK3/MLKL necrosome induces the phosphorylated MLKL, and the activated MLKL penetrates into the membrane bilayer to form membrane pores, which damages the integrity of the membrane and leads to cell death. In addition to participating in necroptosis, MLKL is also closely related to other cell death, such as NETosis, pyroptosis, and autophagy. Therefore, MLKL is involved in the pathological processes of various diseases related to abnormal cell death pathways (such as cardiovascular diseases, neurodegenerative diseases and cancer), and may be a therapeutic target of multiple diseases. Understanding the role of MLKL in different cell death can lay a foundation for seeking various MLKL-related disease targets, and also guide the development and application of MLKL inhibitors.
Protein Kinases/metabolism* ; Necroptosis/physiology* ; Receptor-Interacting Protein Serine-Threonine Kinases ; Signal Transduction ; Pyroptosis ; Apoptosis

Background Dentists are a high-risk population of work-related musculoskeletal disorders (WMSDs), where the body part with the highest prevalence is the neck. Objective To analyze potential influencing factors of neck pain among dentists, and explore a prediction model of neck pain in dentists. Methods Dentists from different hospitals in Fuzhou were selected as study subjects by stratified cluster sampling according to hospital characteristics (dental hospitals, general hospitals, and dental clinics). The basic information, presentation of WMSDs, and its influencing factors were investigated by using the Chinese version of Musculoskeletal Disorders Questionnaire and the Subjective Workload Assessment Technique. A total of 655 questionnaires were collected, of which 603 were valid, with an effective rate of 92.1%. Multiple logistic regression was used to analyze potential influencing factors of neck pain in dentists. A prediction model of neck pain of dentists was constructed by using neural network model, and the prediction efficiency of the model was evaluated. Results The neck was the body part with the highest prevalence (43.8%, 264/603) of WMSDs among dentists. The results of multiple logistic regression analysis showed that female (OR=2.709, 95%CI: 1.852-3.962, P <0.001), working age of 10-<20 years (versus <10 years, OR=3.836, 95%CI: 2.471-5.957, P<0.001), keeping head up or down for a long time (OR=8.492, 95%CI: 2.203-32.731, P=0.002), holding head sideways for a long time (OR=2.210, 95%CI: 1.376-3.550, P<0.001), maintaining the same sitting spot for a long time (OR=4.336, 95%CI: 2.192-8.579, P<0.001), and psychological load value ≥70 (versus <40, OR=1.901, 95%CI: 1.038-3.480, P=0.037) increased the risk of neck pain in dentists. Sufficient operating space (OR=0.507, 95%CI: 0.302-0.850, P=0.010) and doing some exercise during work break (OR=0.670, 95%CI: 0.453-0.991, P=0.045) reduced the risk of reporting neck pain among dentists. A neural network prediction model of dentists' neck pain was constructed with 1 hidden layer and 6 hidden layer neurons. The percentage of correct prediction of training set was 89.6%, and the percentage of correct prediction of test set was 83.9%. The order of importance of the independent variables included in the model were working age, holding head sideways for a long time, psychological load, etc. The result of neural network model of neck pain among dentists showed that the area under the curve of receiver operator characteristic (ROC) was 0.940 (95%CI: 0.922-0.958, P<0.001). When the maximum diagnostic value was determined by the ROC curve, the sensitivity was 84.8%, the specificity was 91.2%, and the Youden Index was 0.760. Conclusion Neck pain of dentists is affected by many factors, such as individual factors (gender and working age), ergonomic factors (keeping various postures and operations for a long time, operating space, etc.), psychological factors (different levels of psychological load) and so on. The neural network model can be used as a prediction tool to explore the risk of reporting neck pain among dentists.

With the acceleration of the aging process of the population in China, the utilization rate and transfer rate of ICU have significantly increased. More and more ICU survivors have post intensive care syndrome. If they cannot be intervened in time, the quality of life of patients will be seriously affected, and at the same time, the readmission rate will increase, impacting the scarce medical resources. Critical care recovery center have been established abroad for early identification and intervention of post intensive care syndrome. This paper intended to analyze the construction theory and operation mode of foreign critical care recovery center, summarize foreign experience, and put forward corresponding suggestions in combination with China′s national conditions, so as to provide reference for the construction of ritical care recovery center in China, with a view to providing long-term rehabilitation care services for patients with post intensive care syndrome in China.

To summarize the correlation study of family resilience, family resilience factors study, theoretical model and application study of family resilience, family resilience assessment tools in cancer patients, and prospect future research on family resilience in cancer patients. This study aims to provide reference for future research directions on family resilience in cancer patients.

Objective:To verify the feasibility of a self-designed laparoscopic magnetic anchoring device for assisting thoracoscopic wedge resection.Methods:Six healthy Beagle dogs were selected as animal models, and underwent thoracoscopic wedge resection after general anesthesia. We replaced the pulmonary forceps with a magnetic anchoring device to complete the traction exposure of the lobes, and recorded the operation time of the operation, the amount of intraoperative blood loss, and the safety and feasibility of the magnetic anchoring device.Results:Six Beagle dogs successfully completed a thoracoscopic wedge resection with the aid of a magnetic anchoring device. During the operation, the magnetic anchoring device can completely replaced the exposure function of the pulmonary forceps, effectively eliminating the " chopstick effect" between the instruments during the uniportal video-assisted thoracoscopic operation. The magnetic anchoring device provided sufficient traction for the surgery to achieve a clear exposure of the field. Tissue damage and magnetic anchoring pliers slip did not occur during the operation. The operation time was(22.67±3.25)min(range 18-26 min), and the intraoperative blood loss was less than 10 ml. The experimental animals survived well after surgery.Conclusion:Magnetic anchoring device is safe and effective for thoracoscopic wedge resection, which can eliminate mutual interference between operating instruments and has potential for clinical application.

Objective: To evaluate the clinical effects of full-arch cement-retained implant-supported combined crowns and screw-retained implant-supported bridge dentures in complete or half edentulous patients. Methods : A total of 25 patients with complete or partial edentulous dentures followed up for 1, 3, and 5 years in our hospital from June 2013 to June 2018 and were treated with Straumann bone horizontal implantation, cobalt-chromium stenting and cobalt-chromium porcelain restoration with cement-retained and screw-retained implant-supported fixed dental prostheses to evaluate the accumulative implant survival rate, accumulative prosthesis survival rate, mechanical complications, and biological complications in both groups. Results : There were 25 complete or half edentulous patients who received 165 Straumann implants and 28 implant-supported fixed dental prostheses in this study. There were 11 cases with 69 implants in the cement group and 17 cases with 96 implants in the screw group. The accumulative implant survival rate was 100% in the cement group and 96.9% in the screw group. The accumulative prosthesis survival rate was 100% in both groups. The cumulative peri-implant mucositis rate was 23.2% in the cement group and 29.2% in the screw group, and the peri-implantitis rate was 6.8% in the cement group and 7.3% in the screw group. There was 1 case of porcelain collapse (n=1/11) and no screw of abutment loosening in the cement group and 4 cases of porcelain collapse (n=4/17) and 1 case of screw loosening in the screw group. No fracture of abutment was observed in either group. There was no difference in bone loss between the two groups in the first year (P > 0.05), and a higher rate of bone loss was found in the screw group in the third and fifth years (P < 0.05). There was no difference in the sulcus bleeding index(mSBI) between the two groups in the first year and the third year (P > 0.05) and a higher modified mSBI value in the cement group in the fifth year (P < 0.05). Conclusion The survival rates of the implant and prosthesis for cement-retained or screw-retained implant-supported fixed dental prostheses were both high, but there were more mechanical and biological complications in the traditional cobalt-chromium alloy screw-retainer group. The removal of residual adhesives must be reasonably considered when choosing the cement retention method.

Objective:To analyze the relationship and clinical value between serum matrix metalloproteinases-3 (MMP-3) and rheumatoid arthritis (RA).Methods:By using retrospective study to collect 123 patients with RA diagnosed in our hospital from January 2019 to January 2020 as the RA group. Among the patients, there are 25 males and 98 females, the median age is 60 years old. During the same term, 53 healthy people were selected as the control group, with 12 males and 41 females, the median age is 55 years old. MMP-3, erythrocyte sedimentation rate (ESR), high sensitivity C-reactive protein (hs-CRP), rheumatoid facotrs (RF), anti-cyclocitrulline factor (ACCP) in peripheral blood of all subjects were detected. Disease activity score of 28 joints (DAS28) were collected. This research used T test, Spearman correlation analysis and receiver operating characteristic curve (ROC curve) to analyze the relationship between MMP-3 and other clinical biochemical indices, and the efficacy of MMP-3 in the diagnosis of RA.Results:Compared with the control group (26.30±14.83)ng/ml, the levels of serum MMP-3 in the RA group (79.71±123.54) ng/ml had significantly increased ( t=-4.95, P<0.001). The serum concentration of MMP-3 in RA patients was significantly correlated with ESR, hs-CRP and DAS28 ( r value were 0.521, 0.372, 0.405 respectively, P<0.001). The area under the curve (AUC) of MMP-3 to diagnose RA was 0.765, and the sensitivity was 64.44%, and the specificity was 75.76%, cut-off of MMP-3 were 32.50 ng/ml. Conclusions:The levels of serum MMP-3 in the RA group had significantly increased. MMP-3 and the disease activity were highly correlated. MMP-3 can be used as an indicator of RA disease activity, also can significantly improve the diagnostic efficacy, treatment and warning of early RA.

Objective: To investigate the visual application of the CiteSpace software in the field of work-related musculoskeletal disorders (WMSDs) . Methods: The literature on WMSDs research, published from 1991 to 2017, was retrieved in Web of Science database. The CiteSpace 5.2 was used to make visualization analysis on the hotspots and tendency of the keywords, authors, countries (regions) and research institutes in relevant literature. Results: A total of 3224 literatures were included in the analysis. The amount of the literatures published was increasing annually. The key word co-occurrence network showed that the research hotspots mainly focused on the study of epidemiology, risk factors, symptoms, and other aspects of WMSDs. The cooperation network and time network of counties and regions showed that America and Europe were at the leading position in the field of WMSD, and the top three were America, Canada and Sweden. The developing countries, like Brazil and China, had also begun to make relative research since 2000. In research cooperation, the collaboration among countries, research institutions was relatively close, and multiple leading core authors and teams were formed in the international arena. Conclusion The CiteSpace software can directly demonstrate the hotspots and tendency in the area of WMSDs.

Objective To investigate the serum levels of IL-10 and TGF-β1 and their significance for patients with sys-temic lupus erythematosus( SLE) .Methods A total of 135 cases were available for the study including 63 cases in primary group(A), 40 cases in remission group(B) and 32 cases in healthy control group(C).ELISA method was used to deter-mine the concentrations of IL-10 and TGF-β1 in serum.Finally, the results of group A were analyzed on the basis of System-ic Lupus Erythematosus Disease Activity Index( SLEDAI) .Results The level of IL-10 in serum of group A was significant-ly higher than that of group B and group C.The level of IL-10 in serum of group B was significantly higher than that of group C(P<0.05).The level of IL-10 in group A had active correlation with SLEDAI.The level of TGF-β1 in serum of group A was significantly lower than that of group B and group C.There was no statistical difference between group B and group C(P>0.05).The level of TGF-β1 in serum of group A had negative correlation with SLEDAI.The cases in group A were divided into three subgroups by SLEDAI:21 cases in mild activities subgroup, 30 cases in moderate activities sub-group,and 12 cases in severe activities subgroup, the levels of IL-10 and TGF-β1 in the three subgroups were significantly different(P<0.05).Conclusions IL-10 and TGF-β1 are involved in activity and severity of SLE.

Objective To understand the feeling of mothers of children with osteogenesis imperfecta during the accompany of children's diagnosis and treatment.Methods A total of 20 mothers of children with osteogenesis imperfecta participated the semi-structured interview.The data were analyzed by Colaizzi's method of phenomenology.Results Three themes were acquired including heavy psychological burden,facing multiple pressure and mother's support through analysis,reorganization and extraction of the subjects.Conclusions Mothers of children with osteogenesis imperfecta needed humanistic concern and emotional support.Nursers should adopted personalized care measures to improve their quality of life.