Piezo1 is a Ca²⁺-permeable mechanosensitive ion channel that plays a central role in mechanosensing and signal transduction in dental and periodontal tissues. In tooth tissue, Piezo1 is a key factor mediating dentin sensitive pain. The flow of dentinal tubule fluid induced by external stimulation can activate the Piezo1 channel on odontoblasts, triggering neuronal signals through the pannexin-1-purinergic 2X3 receptor (PANX-1-P2X3) receptor axis, resulting in pain perception. In addition, Piezo1 has a dual regulatory role in the process of pulp inflammation and repair : on the one hand, its expression is up-regulated in an inflammatory environment, which may aggravate pain sensitivity ; on the other hand, it activates the migration, proliferation and odontogenic differentiation of dental pulp stem cells by mediating Ca²⁺influx, ATP release and downstream purinergic 2X7 receptor (P2X7R), MEK / ERK signaling pathways, thereby promoting reparative dentin formation. In periodontal tissue, Piezo1 plays a central role in maintaining periodontal tissue homeostasis and regulating alveolar bone remodeling by sensing mechanical stimuli such as bite force. During orthodontic tooth movement, Piezo1 promotes osteogenic differentiation by activating Wnt / Ca²⁺, Notch and other pathways on the tension side. It affects osteoclast activity by regulating receptor activator of nuclear factor-κB ligand/osteoprotegerin (RANKL/OPG) balance on the pressure side. At the same time, Piezo1 is also a key regulator of periodontal immune microenvironment. It is expressed in immune cells such as macrophages, neutrophils and dendritic cells. Its activation can promote the polarization of macrophages to pro-inflammatory M1 type, enhance the release of pro-inflammatory factors and matrix metalloproteinases, and thus aggravate the inflammatory destruction of periodontal tissue.In view of its multiple functions, Piezo1 has become a potential therapeutic target, including local or systemic application of its inhibitors, mechanical intervention, physical therapy, gene therapy and stem cell therapy, showing a broad clinical transformation prospect in the treatment of oral diseases. In this paper, the structural characteristics, signal transduction mechanism of Piezo1 and its expression distribution, function and regulatory network in tooth tissue and periodontal tissue are reviewed, so as to provide ideas for the development of oral disease treatment strategies targeting Piezo1.

Objective:To evaluate the effect of lifestyle interventions based on mobile health technolo-gy on gestational weight gain among overweight or obese pregnant women,to explore the influencing fac-tors of the intervention effect,and to provide scientific evidence for weight management during pregnan-cy.Methods:The randomized controlled trial(RCT)design was used.From April 2024 to August 2024,200 singleton overweight or obese pregnant women aged 18-40 years in early pregnancy were re-cruited and stratified block-randomized according to body mass index(BMI)categories,age,and parity.The control group received routine prenatal care,while the intervention group received lifestyle interven-tions based on mobile health technology,which included biweekly face-to-face or telephone sessions;weekly recording of dietary behavior goals with personalized feedback on WeChat public account;6 000 steps per day and 150 minutes of brisk walking per week;and weekly weight recording with personalized feedback.Based on the intention-to-treat principle,generalized linear mixed models were used to analyze the effects on weight gain and weight gain rate up to 24-28 gestational weeks,gestational diabetes melli-tus(GDM),and dietary and physical activity behaviors.Additionally,subgroup analysis and interaction analysis were conducted to explore whether intervention effects on weight gain varied by different maternal characteristics.Results:The mean age of the women in the intervention and control groups was(30.49±3.99)years and(29.83±3.95)years,respectively,with gestational weeks at enrollment being(11.35±1.61)weeks and(11.26±1.52)weeks.No statistically significant differences were observed in the baseline characteristics between the two groups(P＞0.05).In the study,10 and 12 participants were lost to the follow-up in the intervention and control groups,respectively,with 178 women comple-ting the midterm follow-up.At the midterm follow-up(24-28 weeks),the weight gain in the interven-tion and control groups was(5.00±3.72)kg and(6.57±4.28)kg,respectively.After adjusting for age,parity,gravidity,region,pre-pregnancy BMI categories,and socioeconomic status,the between-group difference was-1.63 kg(95％CI:-2.80 to-0.46;P=0.007).The adjusted between-group difference in weight gain rate was-0.07 kg/week(95％CI:-0.11 to-0.02;P=0.005).Com-pared with the control group,the intervention group had lower fasting blood glucose at the oral glucose tolerance test(OGTT)by 0.19 mmol/L(95％CI:0.04 to0.33;P=0.013).No significant difference was observed in GDM incidence between the two groups.Among different subgroups based on characteris-tics,such as age,region,socioeconomic status,and parity,there was no statistically significant dif-ference in the effect on weight gain.Conclusion:The lifestyle interventions based on mobile health tech-nology effectively controlled weight gain up to 24-28 gestational weeks among overweight or obese women and improved fasting blood glucose level.This has significant public health implications for impro-ving the health of overweight or obese pregnant women in China.

Objective To study the expression of PLA2G2A and its significance in vaginal wall tissue of patients with pelvic organ pro-lapse(POP).Methods Twenty-three patients without POP(control group)and 26 patients with POP(POP group)admitted to the Third Affiliated Hospital of Zhengzhou University,between June 2023 and September 2024,were selected.Histological features were observed using hematoxylin and eosin and Masson's trichrome staining.Localization of PLA2G2A was detected using immunofluorescence.The PLA2G2A expression level was assessed using immunohistochemistry,real-time PCR,and Western blotting.After transfecting fibroblasts with silenced PLA2G2A,changes in collagen Ⅰ and collagen Ⅲ were measured.Results The histological structure of the vaginal wall in the POP group was significantly different from that in the control group.PLA2G2A was expressed in fibroblasts,with protein and mRNA expression levels higher than those in the control group(P＜0.05).After silencing PLA2G2A,collagen Ⅰ and collagen Ⅲ expression were upregulated.Conclusion High expression of PLA2G2A in vaginal wall tissue of patients with POP.Increased PLA2G2A expression may be closely related to the development and presence of POP.

Objective To investigate the therapeutic efficacy of combination of dapagliflozin and sacubitril valsartan on patients with heart failure(HF)complicated with type 2 diabetes mellitus(T2DM).Methods A retrospective study was conducted on 160 patients with HF and T2DM admitted to our hospital from November 2020 to November 2022.According to drug treatment,they were classified into sacubitril valsartan group(80 cases)and combined group(dapagliflozin combined with sacubitril valsartan,80 cases).After 3 months of treatment,the differences were compared between the two groups in following aspects:blood glucose fluctuations,left ventricular diastolic function,and vascular endothelial function,and the incidence of adverse events after 1 year of follow-up.Results After 3 months of treatment,serum FPG,2 h-PG and HbAlc levels,and MAGE,LAGE,MODD and SDBG values were significantly lower in the combined group than the sacubitril valsartan group(P＜0.05,P＜0.01).The combined group had obviously higher e'and LVEF values while lower LVMI and BNP levels than the other group(P＜0.05,P＜0.01).After 3 months of treatment,NO and FMD were notably higher[96.18±6.70 ng/L vs 92.34±6.85 ng/L,P=0.000;(8.25±1.16)％vs(7.72±1.28)％,P=0.007],while ET-1(59.72±4.95 ng/L vs 63.90±4.63 ng/L,P=0.000)was remarkably lower in the combined group than the sacubitril valsartan group.There was no statistical significance in the total incidence of adverse events between both groups after 1 year of follow-up(P＞0.05).Conclusion The combination of dapagliflozin and sacubitril valsartan has a significant improvement effect on blood glucose,left ventricular diastolic function and vascular endothelial function in T2DM patients with HF,with good drug safety.

OBJECTIVE To investigate the acute lung injury effects of pulmonary phospholipids and their phospholipase A2(PLA2)decomposition products-lysophospholipids and fatty acids-on mice.METHODS Mice were randomly assigned to the following groups:① solvent control(PBS)and PLA2;② solvent control and glycerol phospholipid groups:1,2-dioleoyl-sn-glycero-3-phosphoserine(DOPS),1,2-dipalmitoyl-sn-glycero-3-phosphoserine(DPPS),1,2-dioleoyl-sn-glycero-3-phosphoethanol-amine(DOPE),1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine(DPPE),1,2-dipalmitoyl-sn-glycero-3-phosphocholine(DPPC),and 1-stearoyl-2-oleoyl-sn-glycero-3-phosphocholine(SOPC);③ solvent con-trol and fatty acid groups:palmitic acid(PA),oleic acid;④ solvent control and lysophospholipid groups:1-oleoyl-2-hydroxy-sn-glycero-3-phosphoserine(18∶1 LysoPS),1-stearoyl-sn-glycero-3-phosphoserine(18∶0 LysoPS),1-palmitoyl-sn-glycero-3-phosphoserine(16∶0 LysoPS),1-palmitoyl-sn-glycero-3-phos-phoethanolamine(16∶0 LysoPE),1-palmitoyl-sn-glycero-3-phosphocholine(16∶0 LysoPC);⑤ solvent control,PLA2,DPPC,PA,16∶0 LysoPC,16∶0 LysoPS,and 18∶1 LysoPS.Following anesthesia,mice were administered nebulized PBS in the solvent control group,2.1 ug·kg-1 PLA2 in PBS in the PLA2 group and 2.5 mg·kg-1 of the corresponding substance in PBS in other experimental groups.For group①,survival times were recorded and survival curves were plotted.At 1 h post-treatment,lung tissues from groups ①②③④ were collected,photographed to obtain white light images,and subjected to HE staining to assess histopathological changes and pathological scoring.At 2 h post-treatment,pulmonary blood flow in group ⑤ was assessed using laser speckle contrast imaging,arterial blood gas was analyzed with a blood gas analyzer,and lung function was evaluated using whole-body pleth-ysmography.At 6 hours post-treatment,blood cells from group ⑤ were analyzed using an automated hematology analyzer.RESULTS Compared with the solvent control group,severe pathological changes were observed in lung tissues of the PLA2 group,accompanied by extensive inflammatory infiltration and interstitial thickening,with all mice succumbing within 240 min.In mice treated with glyc-erol phospholipids,alveolar structures remained clear,alveolar walls were intact and continuous,and alveolar spaces were translucent,with only occasional minor inflammatory cell infiltration in the septa.No significant pathological alterations were detected in the fatty acid groups.Minor inflammatory cell infiltration was seen in the 16∶0 LysoPE and 16∶0 LysoPC groups.However,such pathological changes as patchy hemorrhage,alveolar interstitial edema,increased alveolar wall thickness,and elevated neutrophil counts were observed in the 18∶1 LysoPS,18∶0 LysoPS,and 16∶0 LysoPS groups.Pathological scores based on HE staining were significantly increased in the 16∶0 LysoPS and 18∶1 LysoPS groups com-pared with the solvent control.The percentage of the lung tissue injury area was also markedly higher in the 16∶0 LysoPS group.A significant decrease in the mean fluorescence intensity of blood flow was observed in the 16∶0 LysoPS group.Arterial partial pressure of oxygen(pO2)was significantly reduced in the PLA2 group,while arterial partial pressure of carbon dioxide(pCO2)was markedly elevated in the 16∶0 LysoPS and 18∶1 LysoPS groups.Lung function tests revealed that the 16∶0 LysoPS group exhibited significant increases in expiratory time,end-expiratory pressure,and enhanced pause,in contrast to significant decreases in tidal volume,expired volume,and minute volume.The 18∶1 LysoPS group also exhibited a significant decline in minute volume.No significant changes in inflammatory cell concentrations were detected in blood,with the exception of neutrophils in the 16∶0 LysoPS group,which showed a significant but physiologically normal increase.CONCLUSION Pulmonary phospholipids and their PLA2-derived fatty acid metabolites do not induce severe lung injury in mice while the lyso-phospholipid metabolites,particularly lysophosphatidylserine,are found to cause significant lung injury.

Objectives:To investigate the relationship between QRS duration and its changes during hospitalization and long-term all-cause mortality in patients with chronic heart failure.Methods:A total of 3 580 patients who attended three tertiary hospitals in Shanxi Province(First Hospital of Shanxi Medical University,Shanxi Cardiovascular Hospital,Shanxi Bethune Hospital)and were diagnosed with chronic heart failure from March 2014 to November 2021,were enrolled in this study.QRS duration at admission and discharge were collected,and the changes in QRS duration during hospitalization(ΔQRS)and the ΔQRS ratio(ΔQRS/admission QRS duration×100% )were calculated.Patients were divided into three group according to tertiles of ΔQRS:the group with decreasing QRS duration(n=1 364),the group with stable QRS duration(n=1 248),and the group with progressing QRS duration(n=968).Telephone follow-up was conducted at months 1,3,6,12,and every 6 months thereafter after discharge till May 1,2023,long-term all-cause mortality was the primary endpoint.Survival curves were plotted using the Kaplan-Meier method,and comparisons between groups were made using the log-rank method.Cox proportional risk regression model was used for prognostic analysis,and restricted cubic spline curves were calculated to evaluate QRS duration-related variables during hospitalization and the risk of long-term all-cause mortality in patients with chronic heart failure.Results:The median follow-up was 71(56,92)months,and all-cause mortality occurred in 502(14.0% )patients.Long-term all-cause mortality was lower in the group with decreasing QRS duration and the group with stable QRS duration compared with the progressing QRS duration group(13.9% vs.10.7% vs.18.6%,χ2=28.607,P<0.001).Multifactorial Cox regression analysis showed that admission QRS duration(HR=1.005,95% CI:1.002-1.009,P=0.003)and higher ΔQRS ratio during hospitalization(HR=2.071,95% CI:1.247-3.440,P=0.005)were independent influencing factors of long-term all-cause mortality in chronic heart failure patients.Restricted cubic spline curves showed that when the admission QRS duration was>96.36 ms,the longer the QRS duration,the higher the risk of all-cause mortality;when the admission QRS duration fluctuated from 89.32-96.36 ms,the QRS duration was a protective factor for long-term all-cause mortality in patients with chronic heart failure;and when the ΔQRS ratio during hospitalization was≥3.40%,higher ΔQRS ratio was linked with increased risk of all-cause mortality.Conclusions:QRS duration and ΔQRS ratio during hospitalization are independent predictors of long-term all-cause mortality in patients with chronic heart failure.Admission QRS duration>96.36 ms and ΔQRS ratio during hospitalization≥3.40% are associated with increased risk of long-term all-cause mortality in patients with chronic heart failure.

Objective To analyze the efficacy of autologous tissue repair for rectocele through the perineal approach in treating constipation and fecal incontinence in patients.Methods From January 2021 to November 2022,23 female patients with symptomatic rectal protrusion were treated with perineal autologous tissue repair.Preoperatively and at 12 months postoperatively,the Cleveland Clinic Constipation Score(CCCS),Cleveland Clinic Incontinence Score(CCIS),and Patient Assessment of Constipation Quality of Life(PAC-QOL)questionnaires were used to assess postoperative outcomes and quality of life.Results Among the 23 patients,with a median follow-up time of 12.6 months,CCCS decreased from 17.09±1.68 to 3.96±2.08(P＜0.05);CCIS decreased from 1.52±4.15 to 0.52±1.41(P＞0.05);PAC-QOL:physical discomfort decreased from 13.00±1.51 to 4.74±1.98;psychological discomfort decreased from 20.96±3.27 to 5.74±2.67;concern and anxiety decreased from 26.13±4.37 to 8.78±3.14;satisfaction decreased from 15.39±2.35 to 4.60±1.59(P＜0.05).All patients showed significant improvement in constipation and incontinence symptoms postoperatively,with no serious postoperative complications and a marked improvement in postoperative quality of life.Conclusion Rectocele repair with perineal approach using autologous tissue is an effective and safe method,avoiding potential potential complications associated with grafts.

BACKGROUND:Slow bone repair and poor bone formation quality are still problems during masquelet technique in the treatment of large segment bone defects.H-type vessels can induce osteogenesis,enhance the local angiogenesis and osteogenesis coupling,and promote bone repair.However,there are few reports on the role of H-type blood vessels in the bone induced membrane.OBJECTIVE:To construct a large segment bone defect model of SD rat tibia,observe the expression characteristics of H-type blood vessels in the bone induced membrane,then to identify the expression peak point of H-type blood vessels in the bone induced membrane and determine the optimal period of bone grafting.METHODS:Sixty SD rats were randomly divided into a control group(n=30)and a model group(n=30)by random number table method.The two groups were further divided into three subgroups at 4,6,and 8 weeks after bone cement implantation,with 10 rats in each group.A 4 mm bone defect model of the right tibia was constructed in both the control and the model groups.Polymethyl methacrylate bone cement was implanted in the model group to induce bone biomembrane formation,while bone cement was not implanted in the control group.At 4,6,and 8 weeks after bone cement implantation,6 rats were randomly selected at each time point.The bone induction membrane tissue was cut from the model group,and the non-bone soft tissue of the corresponding part was cut from the control group.The dynamic expressions of H-type blood vessels in the bone induced membrane were identified by immunofluorescence.The morphological changes of the bone induced membrane were observed by hematoxylin-eosin staining.The formation of blood vessels in the bone induced membrane was observed by angiography.The expression levels of osteoblast-specific transcription factor in the bone induced membrane were detected by immunohistochemistry.Four rats remained at each time point.In the model group,the bone induced membrane was cut open and the bone cement was removed and autologous coccyx was implanted.In the control group,autologous coccyx was implanted in the bone defect area.Micro-CT evaluation of the tibial defect was performed 8 weeks after bone grafting.RESULTS AND CONCLUSION:(1)Immunofluorescence staining showed that the expression of H-type vessels in the model group was most obvious 6 weeks after bone cement implantation,and the expression of H-type vessels in the model group at each time point after bone cement implantation was higher than that in the control group(P＜0.05).(2)Hematoxylin-eosin staining and angiography showed that the number and volume of new blood vessels at each time point after bone cement implantation in the model group were greater than those in the control group(P＜0.05).The order of the number and volume of new blood vessels in the model group was:8 weeks after bone cement implantation＞6 weeks after bone cement implantation＞4 weeks after bone cement implantation.(3)Immunohistochemical staining showed that the positive expression of osteoblast-specific transcription factors at each time point after bone cement implantation in the model group was higher than that in the control group(P＜0.05),and the positive expression of osteoblast-specific transcription factors in the model group was most obvious 6 weeks after bone cement implantation.(4)Micro-CT detection showed that the bone repair effect of the three subgroups in the model group was significantly better than that of the corresponding subgroups in the control group,and the bone repair effect of the subgroup in the model group 6 weeks after bone cement implantation was better than that of the subgroups 4 and 8 weeks after bone cement implantation.The results indicate that H-type blood vessels are dynamically expressed in the bone induced membrane and reached a peak 6 weeks after bone cement implantation.Good bone repair effects can be obtained by the bone induced membrane bone grafting 6 weeks after bone cement implantation.

Objective To analyze the efficacy of autologous tissue repair for rectocele through the perineal approach in treating constipation and fecal incontinence in patients.Methods From January 2021 to November 2022,23 female patients with symptomatic rectal protrusion were treated with perineal autologous tissue repair.Preoperatively and at 12 months postoperatively,the Cleveland Clinic Constipation Score(CCCS),Cleveland Clinic Incontinence Score(CCIS),and Patient Assessment of Constipation Quality of Life(PAC-QOL)questionnaires were used to assess postoperative outcomes and quality of life.Results Among the 23 patients,with a median follow-up time of 12.6 months,CCCS decreased from 17.09±1.68 to 3.96±2.08(P＜0.05);CCIS decreased from 1.52±4.15 to 0.52±1.41(P＞0.05);PAC-QOL:physical discomfort decreased from 13.00±1.51 to 4.74±1.98;psychological discomfort decreased from 20.96±3.27 to 5.74±2.67;concern and anxiety decreased from 26.13±4.37 to 8.78±3.14;satisfaction decreased from 15.39±2.35 to 4.60±1.59(P＜0.05).All patients showed significant improvement in constipation and incontinence symptoms postoperatively,with no serious postoperative complications and a marked improvement in postoperative quality of life.Conclusion Rectocele repair with perineal approach using autologous tissue is an effective and safe method,avoiding potential potential complications associated with grafts.

Objective To study the expression of PLA2G2A and its significance in vaginal wall tissue of patients with pelvic organ pro-lapse(POP).Methods Twenty-three patients without POP(control group)and 26 patients with POP(POP group)admitted to the Third Affiliated Hospital of Zhengzhou University,between June 2023 and September 2024,were selected.Histological features were observed using hematoxylin and eosin and Masson's trichrome staining.Localization of PLA2G2A was detected using immunofluorescence.The PLA2G2A expression level was assessed using immunohistochemistry,real-time PCR,and Western blotting.After transfecting fibroblasts with silenced PLA2G2A,changes in collagen Ⅰ and collagen Ⅲ were measured.Results The histological structure of the vaginal wall in the POP group was significantly different from that in the control group.PLA2G2A was expressed in fibroblasts,with protein and mRNA expression levels higher than those in the control group(P＜0.05).After silencing PLA2G2A,collagen Ⅰ and collagen Ⅲ expression were upregulated.Conclusion High expression of PLA2G2A in vaginal wall tissue of patients with POP.Increased PLA2G2A expression may be closely related to the development and presence of POP.