Objective This study aimed to compare the clinical efficacy and impact on masticatory function of lithium disilicate ceramic onlays fabricated using CAD/CAM technology versus conventional impression techniques for restoring pulpless posterior tooth defects.Methods A prospective randomized controlled trial was conducted from February 2021 to February 2023,enrolling 104 patients requiring lithium disilicate ceramic onlay restoration for posterior teeth.Patients were randomized into two groups using a random number table:52 patients in the study group received lithium disilicate ceramic onlays fabricated with CAD/CAM technology,and 52 patients in the control group received onlays fabricated via conventional impression.The two groups were compared in terms of gingival index,tooth mobility,plaque index,masticatory efficiency,patient satisfaction with aesthetics,and incidence of adverse reactions.Results After restoration,the study group showed lower scores of tooth mobility,gingival index,and plaque index than the control group(P<0.05).One year after restoration,the masticatory efficiency of the study group was higher than that of the control group(P<0.05).The incidence of adverse reactions in the study group was 5.77%,which was significantly lower than 25.00%in the control group(P<0.05).The aesthetic satisfaction rate in the study group was 94.23%,which was significantly higher than that in the control group(P<0.05).Conclusions Compared with conventional impression techniques,CAD/CAM technology provides better restoration fit and masticatory efficiency,and improves patient satisfaction when restoring pulpless posterior tooth defects.These findings indicate that CAD/CAM technology has significant advantages in posterior tooth onlay restoration and is worthy of clinical promotion.

Objective This study aimed to compare the clinical efficacy and impact on masticatory function of lithium disilicate ceramic onlays fabricated using CAD/CAM technology versus conventional impression techniques for restoring pulpless posterior tooth defects.Methods A prospective randomized controlled trial was conducted from February 2021 to February 2023,enrolling 104 patients requiring lithium disilicate ceramic onlay restoration for posterior teeth.Patients were randomized into two groups using a random number table:52 patients in the study group received lithium disilicate ceramic onlays fabricated with CAD/CAM technology,and 52 patients in the control group received onlays fabricated via conventional impression.The two groups were compared in terms of gingival index,tooth mobility,plaque index,masticatory efficiency,patient satisfaction with aesthetics,and incidence of adverse reactions.Results After restoration,the study group showed lower scores of tooth mobility,gingival index,and plaque index than the control group(P<0.05).One year after restoration,the masticatory efficiency of the study group was higher than that of the control group(P<0.05).The incidence of adverse reactions in the study group was 5.77%,which was significantly lower than 25.00%in the control group(P<0.05).The aesthetic satisfaction rate in the study group was 94.23%,which was significantly higher than that in the control group(P<0.05).Conclusions Compared with conventional impression techniques,CAD/CAM technology provides better restoration fit and masticatory efficiency,and improves patient satisfaction when restoring pulpless posterior tooth defects.These findings indicate that CAD/CAM technology has significant advantages in posterior tooth onlay restoration and is worthy of clinical promotion.

Objective To evaluate the ability of the ratio of peripheral blood white blood cell(WBC)counts to platelet counts to predict the onset of radiation-induced thymic lymphoma(TL)in a mouse model.Methods Mice were subjected to fractionated total-body irradiation(TBI)to established a TL model before the changes of the WBC-to-platelet ratio during the development and progression of TL were investigated.Four-week-old male C57BL/6J mice were randomized into the normal(non-irradiation)group and radiation exposure group that was subjected to 1.8 Gy TBI once weekly for four consecutive weeks.The survival and TL-incidence of those two groups were compared within 370 days of TBI.Histomorphology and hematoxylin & eosin(H&E)staining of the thymus were used for definite diagnosis of TL while flow cytometry was adopted to detect the frequency changes of T cells in the thymus,bone marrow and spleen.Peripheral blood(PB)cell counts were measured to analyze the changes of peripheral hemogram during TL pathogenesis.Results No mice in the normal group were diagnosed with TL while 83％of the irradiated mic suffered from TL within 370 days of fractionated TBI(P＜0.0001).Using histopathologic technology,medium-sized tumor cells were observed in the thymus of irradiated mice diagnosed with TL.Cytometric analysis showed decreased frequencies of CD4 mono-positive cells and increased frequencies of CD8 mono-positive cells in the thymus,bone marrow and spleen of mice diagnosed with TL.PB analysis displayed a significant increase in the WBC-to-platelet ratio one week prior to the TL-caused death in the irradiated mice(P＜0.01).Conclusion Elevation of the peripheral blood WBC-to-platelet ratio can help predict the onset of IR-induced TL of mice.

In order to further standardize the diagnosis and treatment of long-term systemic complications in kidney transplant recipients,Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of"Clinical Diagnosis and Treatment Guidelines for Long-term Systemic Complications in Kidney Transplant Recipients in China".Experts on organ transplantation were organized to summarize and integrate the latest progress in this field based on existing clinical guidelines,systematic evaluations,case studies,expert consensus.The guideline was formed after multiple rounds of discussion and reaching a consensus which included complications of hematological system,central nervous system,cardiovascular system,ocular,cutaneous and osteoporosis disorders.The full text focuses on 27 clinical problems and forms 40 recommendations,mainly involving the risk factors,classification,diagnosis,treatment and prevention of various complications.This guideline graded the quality of evidence and the strength of recommendation for each clinical issue using 2009 Oxford Centre for Evidence-Based Medicine(OCEBM)Grading and Strength of Recommendation criteria,so as to provide reference for the diagnosis and treatment of late complications,comprehensively improve the management capacity of clinicians to benefit kidney transplant recipients.

Objective To investigate the relationship between the expression level of miRNA Let-7 and the deletion of DNA mismatch repair(dMMR)proteins in endometrial carcinoma(EC).Methods A total of 74 patients with EC who underwent radical surgery at Lianyungang Maternal and Child Health Hospital in Jiangsu Province from May 2016 to December 2022 were selected.Immunohistochemistry was used to detect the expression of dMMR proteins(including MLH1,PMS2,MSH2,and MSH6),while real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was performed to measure the relative expression levelof miRNA Let-7.According to the expression of dMMR proteins,EC patients were divided into the complete expression group(n=43)and the absent expression group(n=31).Logistic multivariate regression analysis was conducted to identify risk factors associated with dMMR protein deficiency,and receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of relevant factors.Results In 74 cases of EC,the expression level of miRNA Let-7 was higher in the myographic infiltration＜1/2 group than in the myographic infiltration ≥ 1/2 group,and the difference was significant(t=1.79,P=0.04).The deletion rate of dMMR protein expression was 41.89％,the deletion rate in patients aged＜55 years and miRNA Let-7 low expression group(＜0.715)were higher than those in ≥ 55 years and miRNA Let-7 high expression group(≥ 0.715),with significant differences(x2=3.92,4.50,all P＜0.05).Logistic regression analysis revealed that miRNA Let-7 expression level was an independent risk factor for dMMR expression deletion(P=0.012).Spearman correlation analysis demonstrated a negative correlation between miRNA Let-7 expression level and dMMR protein deletion(r=-0.247,P=0.034).ROC curve analysis indicated that the expression level of miRNA Let-7 had a certain predictive value for dMMR protein deletion in EC patients,with an AUC of 0.737,an optimal critical value of 0.77,a sensitivity and a specificity of 0.651 and 0.806,respectively.Conclusion The expression level of miRNA Let-7 was correlated with the deletion of dMMR proteins in patients diagnosed with EC.Moreover,it served as a potential risk factor for dMMR protein deficiency.It may offer valuable insights into predicting dMMR expression deletion.

Objective:To discuss the effect of adipose-derived stem cell-derived exosomes(ADSC-Exos)on the migration ability of the macrophages RAW264.7,and to clarify its role in promoting function of the macrophages.Methods:The adipose tissue adjacent to epididymis of the SD rats was isolated to perform primary culture of the adipose-derived stem cells(ADSCs).The adipogenic and osteogenic differentiation induction was conducted,and the multidirectional differentiation potential of the ADSCs was detected by oil Red O and Alizarin red staining.Western blotting and immunofluorescence methods were used to detect the positive expressions of the ADSCs markers CD29 and CD44;the ADSC-Exos were extracted by Exos isolation kit,and the morphology,size,and distribution of particle size of the ADSC-Exos were examined by transmission electron microscope and nanoparticle tracking analyzer;the expression levels of exosome-specific markers CD9 and TSG101 proteins in the ADSC-Exos were detected by Western blotting method;the uptake of ADSC-Exos by the macrophages was observed by tracing method.The macrophages RAW264.7 were divided into control group,10 mg·L-1 ADSC-Exos group,20 mg·L-1 ADSC-Exos group,and 40 mg·L-1 ADSC-Exos group.The activities of the macrophages in various groups were detected by 5-ethynyl-2'-deoxyuridine(EdU)staining;the number of migration macrophages in various groups was detected by Transwell chamber assay;the adhesion of macrophages in various groups was observed by fluorescence microscope.Results:After 24 h of primary culture,the ADSCs adhered to the wall and exhibited scattered,elongated shapes;after 7 d of culture,the adherent cells showed a comb-like,vortex-like orderly arrangement,resembling fibroblasts;after 10 passages,the irregular morphology of the ADSCs and decreased proliferation rate were found.The isolated ADSCs showed potential for the osteogenic and adipogenic differentiation,and the expressions of CD29 and CD44 proteins were positive.The transmission electron microscope observation resuls showed that the ADSC-Exos appeared disc-shaped,and the main peak of particle size distribution was around 132 nm.The CD9 and TSG101 proteins were positively expressed in the ADSC-Exos,indicating successful extraction.The fluorescence microscope results showed red fluorescence signals around the nuclei of the RAW264.7 cells,indicating the uptake of ADSC-Exos by the macrophages.Compared with control group,the rates of EdU positive cells in 10,20,and 40 mg·L-1 ADSC-Exos groups were significantly increased(P<0.05);compared with 10 mg·L-1 ADSC-Exos group,the rate of EdU positive cells in 20 mg·L-1 ADSC-Exos group was significantly increased(P<0.05).Compared with control group,the numbers of migration cells in 10,20,and 40 mg·L-1 ADSC-Exos groups were significantly increased(P<0.05);compared with 10 mg·L-1 ADSC-Exos group,the numbers of migration cells in 20 and 40 mg·L-1 ADSC-Exos groups were significantly increased(P<0.05).Compared with control group,the numbers of the adherent macrophages in 10,20,and 40 mg·L-1 ADSC-Exos groups were significantly increased(P<0.05);compared with 10 mg·L-1 ADSC-Exos group,the number of adherent macrophages in 20 mg·L-1 ADSC-Exos group was significantly increased(P<0.05).Conclusion:The ADSC-Exos can be internalized by the macrophages and they can enhance the migration ability of the macrophages by affecting the cell adhesion.

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death, and most patients with HCC are diagnosed at an advanced stage. Before 2017, tyrosine kinase inhibitors were the main drugs for the treatment of advanced hepatocellular carcinoma. With the emergence of immune checkpoint inhibitors (ICIs), immunotherapy has gradually brought new hope to such patients. At present, the combination of ICIs and other systemic or local treatments has become a potential strategy for the treatment of advanced hepatocellular carcinoma, and some of these combinations have been included in large-scale clinical trials. The main challenges of immunotherapy for advanced hepatocellular carcinoma include the exploration of predictive biomarkers, management of immune-related adverse events, and exploration of effective combination regimens. This article provides the latest research progress on the single or combined use of ICIs and other immunotherapy for hepatocellular carcinoma and discusses the limitations of current research and clinical application and the future development direction.

Objective:To analyze the incidence and risk factors of acute kidney injury in children with biliary atresia after liver transplantation.Methods:The retrospective case-control study was conducted.The clinical data of 115 children with biliary atresia who received liver transplantation for the first time in Beijing Friendship Hospital Affiliated to Capital Medical University from December 2018 to November 2020 were collected.The patients were divided into AKI group ( n=39) and non-AKI group ( n=76) according to the diagnostic criteria of the Kidney Disease Improving Global Outcomes(KDIGO). The differences of clinical indicators between the two groups were compared, and multivariate logistic regression analysis was performed for statistically significant variables ( P<0.05) to further determine the independent risk factors for AKI after liver transplantation. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for comparison between groups.Measurement data with non-normal distribution were represented by M( Q1, Q3), and Mann-Whitney U test was used for comparison between groups.Count data were expressed as cases and percentage, and comparisons between groups were made using Chi-square test or Fisher′s exact test. Results:The incidence of AKI in biliary atresia patients after liver transplantation was 33.9%. Univariate analysis showed that there were statistically significant differences in age ( OR=0.721, 95% CI: 0.553-0.938, P=0.014), preoperative infection ( OR=3.307, 95% CI: 1.294-8.468, P=0.013), PELD score ( OR=1.065, 95% CI: 1.031-1.101, P<0.001), serum creatinine numerical value ( OR=0.745, 95% CI: 0.657-0.858, P<0.001), intraoperative red blood cell transfusion ( OR=1.034, 95% CI: 1.028-1.051, P<0.001) and intraoperative plasma transfusion ( OR=1.055, 95% CI: 1.025-1.086, P=0.002) between the AKI group and the non-AKI group ( P< 0.05). Multivariate logistic regression analysis was performed on the selected indicators by univariate analysis, and the results showed that preoperative infection ( OR=3.763, 95% CI: 1.185-11.945, P=0.025) and low serum creatinine ( OR=0.685, 95% CI: 0.570-0.823, P<0.001), intraoperative red blood cell transfusion ( OR=1.033, 95% CI: 1.015-1.056, P=0.028) was independently associated with postoperative AKI ( P<0.05). The inpatient treatment time in ICU and in hospital between the two groups were statistically significant ( P<0.05). Conclusions:Preoperative infection, low creatinine numerical value and intraoperative red blood cell transfusion are independent risk factors for postoperative AKI in children with biliary atresia. AKI may prolong the time in ICU and in hospital.

Objective: To explore the intervention effect of sedentary interval on body composition and blood lipid metabolism of obese female college students, so as to provide reference for health promotion among obese students. Methods: Eighty obese female college students from first and second grades were randomly assigned into three groups, the control group ( n =28), experimental group A ( n =26), and experimental group B ( n =26), between September and November 2022. The participants received appropriate dietary guidance, a 90-minute optional physical education course was offered to control group once a week, on the basis of the control group, experimental group A performed 5-minute-intermittent brisk walking (6 km/h) during each break. Experimental group B performed 5-minute-intermittent brisk walking (6 km/h) during each break for the first 4 weeks, then changed to 4-minute-brisk walking (6 km/h) and 1-minute-rope skipping (60 skips/min) during each break for weeks 5-8, and changed to 4-minute-brisk walking (6 km/h) and 1-minute-rope skipping (80 skips/min) during each break for 9-12 weeks. The intervention was performed 10 times per day, with the interruption time and frequency on weekends remaining the same. Body mass index (BMI), body fat rate (BFR), waist hip ratio (WHR), visceral fat index (VFI), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured before and after the experiment. Results: After 12 weeks intervention, there were no significant differences in body composition and blood lipids in control group ( P >0.05), BMI, BFR, VFI and TG in Group A were lower than those before intervention ( t=3.20, 2.80, 8.19, 2.21, P <0.05), BMI, BFR, WHR, VFI, TG, TC, LDL-C were lower and HDL-C in group B were higher than those before intervention ( t=6.27, 5.85, 10.82 , 19.91, 3.86, 3.29, 7.20, -4.93, P <0.01). There were significant differences in BMI, BFR, WHR, VFI and HDL-C among the three groups ( F=24.01, 23.77, 10.00, 15.28, 6.72, P <0.01), and the intervention effects of BMI, BFR and HDL-C in group B were better than those in group A and control group ( P <0.01). Conclusion The intervention of brisk walking and rope skipping had a good effect on improving body composition and blood lipid metabolism of obese female college students. Schools should make good use of the time between classes and adopt short-time and high-intensity exercise intervention to improve the body composition and blood lipid metabolism of obese students.

"Healthy China 2030" states that health is a necessary requirement for all-round human development and a basic condition for economic and social development. Achieving national health and longevity is an important symbol of national prosperity and rejuvenation, and also the common aspiration of the people of all ethnic groups in China. Traditional Chinese medicine (TCM) health preservation has been fully integrated into the construction of "Healthy China", and the development of TCM health preservation culture and thought has a profound historical origin. Starting from the development of TCM health preservation culture thought and ethical principles, this paper analyzed the TCM health preservation thought contained in Master Lyu’s Spring and Autumn Annals, and further discussed and summarized the ethical principles contained in them, with a view to comprehensively and systematically promoting the development of TCM health preservation culture and providing a theoretical basis for people to use health preservation ethical principles to achieve physical fitness, disease prevention and longevity.