AIM:To elucidate the possible biological mechanism of silica-induced acute lung injury in rats.METHODS:Sixteen Male Sprague-Dawley rats were divided into control and acute silicosis model groups,and instilled intratracheally with 1 mL of normal saline and 50 g/L silica suspension,respectively.After 7 d,the rats were sacrificed for collection of lung tissue and serum.The serum levels of interleukin-1β(IL-1β),IL-18 and tumor necrosis factor-α(TNF-α)were measured by using ELISA.The protein expression levels of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)and gasdermin D(GSDMD)were measured by immunohistochemistry.Bacterial DNA was ex-tracted from the lung tissue for 16S ribosomal RNA gene sequencing to characterize changes in the composition of lung flo-ra.The differences in the structure of bacterial flora between control and model groups were analyzed by bioinformatic analy-ses.RESULTS:Immunohistochemical analysis showed that the protein expression levels of NLRP3 and GSDMD were higher in the lungs of the rats in model group.In addition,serum cytokine profiling showed that IL-1β,IL-18 and TNF-α levels were significantly higher in model group.The most abundant bacterial genera in the lung flora of the rats in model group were Bifidobacterium,Clostridium sensu stricto 1,and Parasutterella.The NLRP3 and GSDMD levels in the lung tissue and IL-1β and TNF-α levels in serum were positively correlated with the abundance of Parasutterella.CONCLU-SION:The alterations in lung flora structure and increased inflammation levels may be the actual biological mechanisms underlying silica-induced acute lung injury.The modulation of lung flora may provide a basis for the prevention and treat-ment of silica-induced acute lung injury.

Periodontitis is a chronic periodontal disease with a high incidence, and chronic obstructive pulmonary disease (COPD) is considered to be a chronic airway inflammatory disease. In recent years, many studies have observed that there is a potential relationship between periodontitis and COPD. The periodontal condition of patients with COPD is relatively poor, and the composition of their oral microbiome is different from that of healthy people. The inflammation “spillage”and hypoxia may induce the occurrence and development of periodontal disease. At the same time, the risk of COPD in periodontitis patients may be related to the inhalation of periodontal pathogens and inflammatory factors. Regular periodontal sequence therapy can reduce the risk of acute exacerbation of the disease to a certain extent. Since periodontitis and COPD are both chronic progressive diseases characterized by chronic inflammation and accompanied by proteolytic destruction of connective tissue, they may share a common pathophysiological process and may be intrinsically linked. This article reviews the latest research progress on the relationship between chronic periodontitis and COPD, and possible interaction mechanism, in order to provide insight for further study on the interaction between the two conditions.

Recessive dystrophic epidermolysis bullosa (RDEB) is caused by loss-of-function mutations in the COL7A1 gene encoding the α-1 chain of type Ⅶ collagen, leading to reduced or absent expression of basement membrane type Ⅶ collagen (C7) . Currently, there is no effective treatment for this rare disease, and the management is mainly palliative and supportive. Gene therapy is expected to be an effective treatment of RDEB. This review summarizes current strategies of gene therapy in clinical trials for RDEB, as well as their progress, pros and cons, and prospects.

OBJECTIVE：To provid e reference for pharmaceutical workers to better understand Novel Coronavirus Infection ： Expert Consensus on Guidance and Prevention Strategies for Hospital Pharmacists and the Pharmacy Workforce （hereinafter referred to as “expert consensus ”），and to apply and practice in specific work ，so as to give full play to the role of pharmacists to help fight the epidemic.METHODS ：The background of the formulation and revision of the expert consensus were introduced ，and its main contents and viewpoints were interpreted. RESULTS & CONCLUSIONS ：The text of expert consensus is divided into 8 parts，mainly including disease diagnosis and treatment [SARS-CoV- 2 infection related background ，clinical manifestations and diagnosis， treatment]，hospital pharmacy （prevention and control strategy ，work guidance ），drug and facility support management（key drug/facility/equipment support ，management and use of the drug in special circumstances ），information sources and related resources ，etc.，which comprehensively and detailedly provide information ，guidance and strategies for coronavirus SARS-CoV-2 infection prevention and control to play the role of pharmacists in hospital pharmacy well ，do well in the protection of staff in different pharmaceutical posts ，drug security work in response to epidemic situation ，and develop pharmaceutical care. So far，the understanding of SARS-CoV- 2 in the pharmaceutical industry is relatively limited. Based on the accumulated experience and progress in epidemic prevention and control ，the expert consensus will be updated and improved continuously ，so as to provide guidance and help for hospital pharmaceutical personnel.

OBJECTIVE：To provide re ference f or hospital pharmacy prevention and control management during novel coronavirus（SARS-CoV-2）infection epidemic period. METHODS ：Based on 5M1E analysis method ，according to the needs of epidemic prevention and control ，it is necessary to analyze the risks of 5 aspects as personnel ，equipment and materials ，methods， environment，monitoring of the pharmacy work in hospital ，and establish the prevention and control strategy of hospital pharmacy infection in response to the epidemic situation of novel coronavirus pneumonia （COVID-19）according to the corresponding risks. RESULTS & CONCLUSIONS ：Personnel management strategies include carrying out pharmacist prevention and control training ， focusing on physical and mental health of pharmacists during infection prevention and control ；equipment and materials management strategies include strengthening equipment disinfection management and strengthening the management of materials for infection prevention and control ；method management strategies include developing emergency plans for infection prevention and control，standardizing individual infection prevention and control method ；environment management strategies include environment cleaning and disinfection management ，infection exposure management of related medical material ，medical waste management ； monitoring management strategies include strengthening pharmacists infection monitoring and evaluating pharmacists ’prevention and control effect. By establishing the strategy for COVID- 19 epidemic prevention and control ，it can effectively guiding pharmacists to carry out epidemic prevention and control.

A 74-year-old male patient underwent posterior lumbar decompression, fusion, and internal fixation under general anesthesia for lumbar spinal stenosis. Sevoflurane (1.5%), propofol, sufentanil, etomidate, and cisatracurium were used for anesthesia, followed by dexamethasone for allergy prevention, cefuroxime for infection prevention, and hydroxyethyl starch for hemodynamic stabilization. Inhalation of sevoflurane (1.5%) and introvenous pumping of remifentanil 300 μg/h and phenylephrine 0.4 mg/h were given for anesthesia maintenance during the operation. The operation process went smoothly and no anaphylaxis occurred within 4 hours. At the end of the operation, vancomycin powder 1 g was given topically at the surgical site and intravenous injection of flurbiprofen axetil 50 mg was given 15 minutes later. Twenty minutes after the medication, the patient′s pulse oxygen saturation was not detectable and the blood pressure fell to 45/20 mmHg. Severe anaphylaxis was diagnosed. The central vein was immediately switched on, and intravenous injection of epinephrine and norepinephrine and intermittently intravenous injection of norepinephrine were given. Ten minutes later, the pulse oxygen saturation returned to 1.00 and 15 minutes later, the blood pressure became stable. At the same time, 2 000 ml of sodium lactate Ringer′s injection was given. The patient was in stable condition 5 hours later and was transferred out of the operating room. The severe anaphylaxis in this patient was considered to be related to vancomycin and flurbiprofen axetil.

A 74-year-old male patient underwent posterior lumbar decompression, fusion, and internal fixation under general anesthesia for lumbar spinal stenosis. Sevoflurane (1.5%), propofol, sufentanil, etomidate, and cisatracurium were used for anesthesia, followed by dexamethasone for allergy prevention, cefuroxime for infection prevention, and hydroxyethyl starch for hemodynamic stabilization. Inhalation of sevoflurane (1.5%) and introvenous pumping of remifentanil 300 μg/h and phenylephrine 0.4 mg/h were given for anesthesia maintenance during the operation. The operation process went smoothly and no anaphylaxis occurred within 4 hours. At the end of the operation, vancomycin powder 1 g was given topically at the surgical site and intravenous injection of flurbiprofen axetil 50 mg was given 15 minutes later. Twenty minutes after the medication, the patient′s pulse oxygen saturation was not detectable and the blood pressure fell to 45/20 mmHg. Severe anaphylaxis was diagnosed. The central vein was immediately switched on, and intravenous injection of epinephrine and norepinephrine and intermittently intravenous injection of norepinephrine were given. Ten minutes later, the pulse oxygen saturation returned to 1.00 and 15 minutes later, the blood pressure became stable. At the same time, 2 000 ml of sodium lactate Ringer′s injection was given. The patient was in stable condition 5 hours later and was transferred out of the operating room. The severe anaphylaxis in this patient was considered to be related to vancomycin and flurbiprofen axetil.

Objective To investigate the effects of titanium miniplates used for anchorage between the maxilla and the mandible for maxilly hypoplasia in cleft patients.Methods Miniplates were inserted into the infrazygomatic crests and between the canine and lateral incisor in the mandible on both the right and left sides in 6 subjects (mean age,11.3 years).Maxillomandibular elastics were attached between the upper and lower miniplates on each side.Cephalometric radiographs of each patient were evaluated at the beginning of treatment and at the end of active protraction treatment.Results A-point movement was increased mean 3.67 mm,SNA angle and ANB angle were increased by 2.75° and 3.1° respectively.Wit's appraisal was increased by 4.52 mm,and upper lip to E-plane was decreased mean 2.8 mm in a mean of 15 months and the significant difference was found (P＜0.05).Miniplates stability was excellent in all patients throughout treatment.Conclusions Remarkable advancement in the middle face and consequent fullness in the soft-tissue profile can be achieved by using titanium miniplates protraction for maxilly hypoplasia in cleft patients in the late mixed-dentition and initial stage of permanent dentition period.

Traditional Chinese medicine (TCM) is an important part of the overall strategy of "Belt and Road",special resources and national advantages.In the face of the "Belt and Road" strategy to the internationalization of Chinese medicine brought an excellent opportunity.This paper proposed the important TCM treatment principle of syndrome differentiation and treatment "according to local conditions",which can be applied to the internationalization construction of TCM.It put forward the implementation of recommendations to create a full range of Chinese medicine open pattern.

BACKGROUND: The neurotoxicity and cardiotoxicity of bupivacaine have been reported frequently. However, the studies on bupivacaine-induced muscle toxicity are few.
OBJECTIVE: To establish and evaluate local intramuscular injection of bupivacaine on the changes in histomorphology and ultrastructure of rat multifidus muscle at various time points.
METHODS: A total of 54 male Sprague-Dawley rats weighing 280-320 g were randomly divided into black group (n=18), model group (n=18) and model control group (n=18). Each group was then equal y subdivided into three subgroups according to time points (4, 7 and 14 days) (n=6). Both sides of multifidus muscle of the rats (L4 and L5) were injected with 0.5% bupivacaine. The morphological and ultrastructural changes of multifidus muscle were observed and analyzed with light microscope and transmission electron microscope at 4, 7 and 14 days after model establishment.
RESULTS AND CONCLUSION: (1) A single intramuscular injection of 0.5% bupivacaine induced muscular damage. (2) Hematoxylin-eosin staining results showed fiber necrosis, inflammatory cel infiltration, and a smal amount of macrophages in local skeletal muscle. (3) Under the transmission electron microscope, the structure of myofibrils was destroyed or disintegrated; kinds of bands and lines were indistinct, disrupted or disappeared; the structure of mitochondria was abnormal, the mitochondrial cristae were reduced or disappeared. In the 7- and 14-day groups, multifidus muscle proliferated and repaired. (4) Ultrastructural change scores in skeletal muscle were significantly higher in the model group than in the blank and model control groups (P < 0.05). Above scores were significantly greater in the 4-day group than in the 7- and 14-day groups (P < 0.05), and higher in the 7-day group than in the 14-day group (P < 0.05). (5) Results suggest that a single intramuscular injection of 0.5% bupivacaine can result in pathological changes of skeletal muscle from morphology and ultrastructure. This method can establish a suitable model of skeletal muscle injury.