Objective:To analyze the inflammatory indexes and cytokines levels in serum and saliva of patients with chronic periodontitis(CP),and to explore the value of single index or multiple indexes combined detection in the clinical diagnosis and treatment of CP.Methods:The serum and saliva speci-mens of 42 CP patients and 38 periodontal healthy people admitted to the Department of Periodontology in Peking University Hospital of Stomatology were detected by inflammatory indexes and cytokines.Accord-ing to clinical periodontal parameters,CP patients were performed by clinical staging,and the correlation between inflammatory indexes and cytokines levels and the severity of CP was analyzed.To evaluate the levels of inflammatory indexes and cytokines in serum and saliva samples in the periodontal health group and CP group.Three inflammatory indexes were involved in this study:C-reactive protein(CRP),serum amyloid A(SAA),procalcitonin(PCT);and 12 cytokines:Interleukin(IL)-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12P70,IL-17,interferon(IFN)-α,IFN-γ,and tumor necrosis factor α(TNF-α).The Spearman correlation statistical method was used to analyze the correlation between the levels of inflammatory indexes and cytokines and the severity of chronic periodontitis.Mann-Whitney U test was used to identify the indicators with differences between the groups,the optimal indicators were identified through binary Logistic regression analysis with stepwise selection,and the area under the curve(AUC)of receiver operating characteristic(ROC)was used to evaluate the diagnostic efficiency.Results:By testing the levels of inflammatory markers and cytokines in patients with chronic periodontitis with dif-ferent clinical stages,it was found that CRP,SAA,IL-8 in serum and IL-1β,IL-6,IL-8,IL-12P70,IL-17,TNF-α in saliva were significantly positively correlated with the severity of chronic periodontitis.Compared with the periodontal healthy group,the serum levels of CRP,SAA,IL-2,IL-5,IL-8,IL-12P70,IL-17 and IFN-α in the CP group were significantly increased(All P＜0.05).The AUC of SAA,IL-2,IL-8,IL-12P70,IL-17,IFN-α,combination 1(IL-2+IL-8)and combination 2(CRP+SAA+IL-12P70)were＞0.7,and the AUC of combination 2(0.998)was the highest,with high sensi-tivity(97.6％)and specificity(97.4％).The levels of IL-1β,IL-6,IL-8 and IL-12P70 in the saliva of the CP group were significantly higher than those in the periodontal healthy group,while the levels of IL-4 in the saliva were significantly lower than those in the periodontal healthy group(All P＜0.05).The AUC of IL-6,IL-8 and combination 3(IL-4+IL-6+IL-8)were＞0.7,and the AUC of combina-tion 3(0.852)was the highest.In the comparative analysis of diagnostic efficacy between single index and multi-index combined,combination 2,combination 1,and serum IL-8 demonstrated the highest AUC values(ranked top 3),with multi-index combinations exhibiting superior discriminative power over single index.Conclusion:Serum levels of IL-8,CRP,SAA,and salivary levels of IL-1β,IL-6,IL-8,and other indicators may be helpful for the clinical diagnosis and treatment of CP.Serum IL-8 and multiple indicators may be used as an auxiliary diagnostic indice to identify CP.

Objective:To analyze the inflammatory indexes and cytokines levels in serum and saliva of patients with chronic periodontitis(CP),and to explore the value of single index or multiple indexes combined detection in the clinical diagnosis and treatment of CP.Methods:The serum and saliva speci-mens of 42 CP patients and 38 periodontal healthy people admitted to the Department of Periodontology in Peking University Hospital of Stomatology were detected by inflammatory indexes and cytokines.Accord-ing to clinical periodontal parameters,CP patients were performed by clinical staging,and the correlation between inflammatory indexes and cytokines levels and the severity of CP was analyzed.To evaluate the levels of inflammatory indexes and cytokines in serum and saliva samples in the periodontal health group and CP group.Three inflammatory indexes were involved in this study:C-reactive protein(CRP),serum amyloid A(SAA),procalcitonin(PCT);and 12 cytokines:Interleukin(IL)-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12P70,IL-17,interferon(IFN)-α,IFN-γ,and tumor necrosis factor α(TNF-α).The Spearman correlation statistical method was used to analyze the correlation between the levels of inflammatory indexes and cytokines and the severity of chronic periodontitis.Mann-Whitney U test was used to identify the indicators with differences between the groups,the optimal indicators were identified through binary Logistic regression analysis with stepwise selection,and the area under the curve(AUC)of receiver operating characteristic(ROC)was used to evaluate the diagnostic efficiency.Results:By testing the levels of inflammatory markers and cytokines in patients with chronic periodontitis with dif-ferent clinical stages,it was found that CRP,SAA,IL-8 in serum and IL-1β,IL-6,IL-8,IL-12P70,IL-17,TNF-α in saliva were significantly positively correlated with the severity of chronic periodontitis.Compared with the periodontal healthy group,the serum levels of CRP,SAA,IL-2,IL-5,IL-8,IL-12P70,IL-17 and IFN-α in the CP group were significantly increased(All P＜0.05).The AUC of SAA,IL-2,IL-8,IL-12P70,IL-17,IFN-α,combination 1(IL-2+IL-8)and combination 2(CRP+SAA+IL-12P70)were＞0.7,and the AUC of combination 2(0.998)was the highest,with high sensi-tivity(97.6％)and specificity(97.4％).The levels of IL-1β,IL-6,IL-8 and IL-12P70 in the saliva of the CP group were significantly higher than those in the periodontal healthy group,while the levels of IL-4 in the saliva were significantly lower than those in the periodontal healthy group(All P＜0.05).The AUC of IL-6,IL-8 and combination 3(IL-4+IL-6+IL-8)were＞0.7,and the AUC of combina-tion 3(0.852)was the highest.In the comparative analysis of diagnostic efficacy between single index and multi-index combined,combination 2,combination 1,and serum IL-8 demonstrated the highest AUC values(ranked top 3),with multi-index combinations exhibiting superior discriminative power over single index.Conclusion:Serum levels of IL-8,CRP,SAA,and salivary levels of IL-1β,IL-6,IL-8,and other indicators may be helpful for the clinical diagnosis and treatment of CP.Serum IL-8 and multiple indicators may be used as an auxiliary diagnostic indice to identify CP.

Objective: To examine the inflammatory indicators in patients with oral squamous cell carcinoma (OSCC), so as to provide insights into early screening and recognition of OSCC. Methods: A total of 86 OSCC patients, 61 patients with chronic periodontitis (CP) and 71 patients without the above diseases were selected from Peking University Hospital of Stomatology and were enrolled in the OSCC group, CP group and control group. Procalcitonin (PCT), serum amyloid A (SAA), C-reactive protein (CRP), white blood cell count (WBC), neutrophil percentage (NEUT%), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet count and lymphocyte ratio (PLR) were measured in peripheral blood. Receiver operating characteristic (ROC) curves were used to evaluate the effectiveness of the aforementioned inflammatory indicators in OSCC screening. Results: The OSCC group consisted of 46 males and 40 females, with a median age of 59.50 (interquartile range, 18.25) years; the CP group consisted of 32 males and 29 females, with a median age of 53.00 (interquartile range, 14.50) years; the control group consisted of 36 males and 35 females, with a median age of 54.00 (interquartile range, 16.00) years. Compared with the control group and the CP group, the PCT, SAA, CRP, WBC, NEUT%, NLR and PLR in the OSCC group were increased, and the LMR was decreased, and the difference was statistically significant (all P<0.05). The combined use of PCT, SAA and CRP had a good effect in distinguishing the OSCC group from the control group, with an area under the ROC curve (AUC) of 0.992, which was higher than the individual identification of the 8 indicators (all P<0.05). The combined use of PCT, WBC, and NLR also had a good effect in distinguishing the OSCC group from the CP group, with an AUC value of 0.841, which was higher than the individual identification of WBC, LMR and PLR (all P<0.05). Conclusion Compared with patients with CP, as well as patients without OSCC and CP, patients with OSCC exhibit significant differences in inflammatory indicator levels, which may facilitate early identification of OSCC.

Objective:To compare the effects of five different types of videolaryngoscopes in patients with a simulated difficult airway.Methods:575 patients who needed endotracheal intubation in Nanjing Hospital Affiliated to Nanjing Medical University from May 2021 to September 2021 were randomly divided into 5 groups [UE videolaryngoscope group (U group), GlideScope videolaryngoscope group (G group), C-MAC videolaryngoscope group (C group), Airtraq videolaryngoscope group (A group) and A. P.advance videolaryngoscope group (AP group)], with 115 patients in each group. They all wore cervical collar to simulate difficult airway. The main observation index was the success rate of first endotracheal intubation. Secondary observation indicators included overall success rate, laryngoscope exposure field, intubation time, operator′s subjective score, cause of failure, adverse events, and complications of intubation.Results:The patients′ mouth opening degree was reduced from (46±6)mm to (24±4)mm ( P<0.05) after wearing the cervical collar; The success rate of the first endotracheal intubation were 96%(UE), 92%(C-MAC), 86%(GlideScope), 85%(Airtraq), and 60%(AP.Advance) respectively, with statistically significant difference ( P<0.05); Compared with AP group and G group, the incidence of soft tissue injury or bleeding in U group and C group were lower ( P<0.05); There were significant difference in the overall success rate of videolaryngoscopes, laryngoscope visual field exposure, intubation time, the subjective score of the operator and adverse events ( P<0.05); There was no significant difference in the complications of intubation among the groups ( P>0.05). Conclusions:Among 575 patients with a simulated difficult airway with limited neck mobility and limited mouth opening, there were significant differences in the use of five videolaryngoscopes. Among them, UE video laryngoscope had the highest first intubation success rate and lowest tissue trauma rate, C-MAC video laryngoscope, GlideScope video laryngoscope and Airtraq video laryngoscope followed in performance, while A. P.Advance video laryngoscope performed the worst.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Objective:To investigate the changes of T1 and T2 values in residual liver after major liver resection in rats and the relationship with pathologic indices related to liver regeneration.Methods:Seventy healthy male Sprague Dawley rats, SPF grade, aged 7-8 weeks, weighting 250-280 g, were divided into MR scan group ( n=14) and pathologic analysis group ( n=56). The MR scan group was further divided into partial hepatectomy group ( n=7) and the sham operation group ( n=7). MRI T 1 mapping and T 2 mapping were performed before surgery and on day 1, 2, 3, 5, 7, 14, 21 after surgery. T1 and T2 values of liver parenchyma were measured. In the pathologic analysis group, 7 rats were randomly included at each time point before and after surgery for pathologic examination, the diameter and proliferative activity (Ki-67 indices) of hepatocytes were assessed. The changes of imaging and pathologic indices were observed, and the correlations between MR parameters and liver volume and pathologic indices were analyzed. Results:Both T1 and T2 values in liver parenchyma were increased on day 1 after surgery and reached their maximum values on day 2 ( P=0.005 and P<0.001, compared with baseline), then were gradually decreased, and recovered to the preoperative level on day 14 and 21 ( P>0.05), respectively. T2 value was correlated with hepatocyte diameter, liver volume and Ki-67 indices better ( r=0.640, -0.764, 0.765, respectively, all P<0.001). T1 value was correlated with hepatocyte diameter, liver volume and Ki-67 indices ( r=0.472, -0.481 and 0.444, all P<0.001). Conclusion:The T1 and T2 values of rats liver remnant parenchyma showed regular changes, and were correlated with liver regeneration indices, which reflect the microscopic changes of rat liver remnant parenchyma, and are expected to be used for quantitative monitoring of liver remnant regeneration.

Objective:To explore the clinical effect of different flow rates of transnasal humidified rapid-insufflation ventilatory exchange (Thrive) on hypoxic events during painless gastroscopy.Methods:Patients who underwent painless gastroscopy in Nanjing First Hospital from April to July 2020 were randomly selected by random number table method and assigned to Thrive groups of 30 L/min ( n=52), 50 L/min ( n=55) and 70 L/min ( n=54). The incidences of different degree of hypoxic events (including subclinical respiratory depression, hypoxia and severe hypoxia) and adverse events related to Thrive were recorded. Results:The total incidence of hypoxic events in the 70 L/min group was 0 (0/54), which was significantly lower than that in the 30 L/min group (21.3%, 11/52, χ2=12.75, P<0.001) and 50 L/min group (12.7%, 7/55, P=0.007). There were no significant differences in subclinical respiratory depression [13.5% (7/52) VS 5.5% (3/55), χ2=1.19, P=0.194] or hypoxia [7.7% (4/52) VS 7.3% (4/55), P=0.610] between 30 L/min group and 50 L/min group. No severe hypoxia occurred in any group. The oxygenation of patients with hypoxemia in 30 L/min and 50 L/min groups was improved (SpO 2>95%) after opening the airway by mandibular support. In addition, there were no significant differences in the incidence of adverse events except hypoxemia among the three groups ( P>0.05). Conclusion:The flow rates of Thrive of 30 L/min, 50 L/min, and 70 L/min can prevent the occurrence of severe hypoxia during painless gastroscopy, and the flow rate of 70 L/min can further reduce the incidence of subclinical respiratory depression.

Objective:To explore the role of glycoprotein nonmetastatic melanoma protein B (Gpnmb) in chronic intestinal fibrosis of mice induced by dextran sodium sulfate (DSS) .Methods:Twelve BALB/c mice were randomly and equally divided into model group and control group. The mice in model group received water containing 2.5% dextran sodium sulfate (DSS) to establish a chronic intestinal fibrosis model, while the mice in control group were not treated. The body mass, colon length, colonic histomorphology score and histological damage score of mice were calculated. The inflammatory degree of colitis was assessed by HE staining and the degree of colonic fibrosis was assessed by Masson staining. The protein expression of collagen typeⅠ alpha 2 (Col1α2) , Gpnmb and its receptor CD44 in colonic tissues was determined by immunohistochemistry and Western blot. The mRNA expression of Col1α2 and Gpnmb was detected by fluorescent quantitative PCR. The differences of the above indexes between the two groups were compared by t test. Results:Compared with the control group, the colon length of the model group was shorter and the colonic histomorphology score was higher (all P<0.05) . HE staining results showed that the intestinal glands in the colonic mucosa were disorderly arranged, atrophic and reduced, the goblet cells were less, and edema, neutrophil and lymphocyte infiltration were seen in the mucosa and submucosa in the model group. The mucosa of the control group was normal without inflammation. Compared with the control group, the histological damage score of the colon in the model group was higher and the fibrotic area was larger, the protein expression of Col1α2, Gpnmb and CD44 was higher, the mRNA expression of Col1α2 and Gpnmb were higher (all P<0.05) . Conclusion:Gpnmb may promote the occurrence and development of DSS-induced chronic intestinal fibrosis in mice through CD44.

Objective:To explore the role of glycoprotein nonmetastatic melanoma protein B (Gpnmb) in chronic intestinal fibrosis of mice induced by dextran sodium sulfate (DSS) .Methods:Twelve BALB/c mice were randomly and equally divided into model group and control group. The mice in model group received water containing 2.5% dextran sodium sulfate (DSS) to establish a chronic intestinal fibrosis model, while the mice in control group were not treated. The body mass, colon length, colonic histomorphology score and histological damage score of mice were calculated. The inflammatory degree of colitis was assessed by HE staining and the degree of colonic fibrosis was assessed by Masson staining. The protein expression of collagen typeⅠ alpha 2 (Col1α2) , Gpnmb and its receptor CD44 in colonic tissues was determined by immunohistochemistry and Western blot. The mRNA expression of Col1α2 and Gpnmb was detected by fluorescent quantitative PCR. The differences of the above indexes between the two groups were compared by t test. Results:Compared with the control group, the colon length of the model group was shorter and the colonic histomorphology score was higher (all P<0.05) . HE staining results showed that the intestinal glands in the colonic mucosa were disorderly arranged, atrophic and reduced, the goblet cells were less, and edema, neutrophil and lymphocyte infiltration were seen in the mucosa and submucosa in the model group. The mucosa of the control group was normal without inflammation. Compared with the control group, the histological damage score of the colon in the model group was higher and the fibrotic area was larger, the protein expression of Col1α2, Gpnmb and CD44 was higher, the mRNA expression of Col1α2 and Gpnmb were higher (all P<0.05) . Conclusion:Gpnmb may promote the occurrence and development of DSS-induced chronic intestinal fibrosis in mice through CD44.

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tumor.It has attracted much attention in recent years and become a targeted therapy of precision medical era′s most successful examples. Surgical operation has always been one of the main ways to treat gastric GIST. The surgical methods are multiplex, the skills are complex and the application of laparoscopy is controversial. In combination with recent studies, a brief review is made on the surgical indications, surgical principles and surgical methods of gastric GIST.