ObjectiveTo investigate the intervention effects and mechanisms of the flavonoid hyperoside （Hyp） on lipopolysaccharide （LPS）-induced inflammation in the zebrafish model. MethodsZebrafish larvae were either microinjected with 0.5 g·L^-1 LPS or immersed in 1 g·L^-1 LPS for the modeling of inflammation. The larvae were then treated with Hyp at 25， 50， and 100 mg·L^-1 through immersion for four consecutive days. The inflammatory phenotypes were assessed by analyzing the mortality rate， malformation rate， body length， and yolk sac area ratio. Behavioral tests were conducted to evaluate the inflammatory stress responses， and macrophage migration was observed by fluorescence microscopy. Additionally， the mRNA levels of inflammation-related genes， including interleukin-1β （IL-1β）， interleukin-6 （IL-6）， chemokine C-C motif ligand 2 （CCL2）， chemokine C-X3-C motif receptor 1 （CX3CR1）， chemokine C-C motif receptor 2 （CCR2）， and genes associated with the Toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor-kappa B （NF-κB） signaling pathway， were measured by Real-time quantitative polymerase chain reaction（Real-time PCR）. ResultsCompared with the pure water injection group， the model group exhibited increased mortality， malformation rates and yolk sac area ratio （P0.01）， reduced body length （P0.01）， increased total swimming distance and high-speed swimming duration （P0.01）， and up-regulated mRNA levels of TLR4， MyD88， NF-κB， IL-1β， IL-6， CCL2， CX3CR1， and CCR2 （P0.01）. Hyp at low， medium and high doses， as well as aspirin， reduced the mortality and malformation rates （P0.05，P0.01）， increased the body length （P0.05，P0.01）， decreased the yolk sac area ratio （P0.01）， reduced the high-speed swimming duration （P0.01）， and down-regulated the mRNA levels of TLR4， MyD88， NF-κB， IL-1β， IL-6， CCL2， CX3CR1， and CCR2 （P0.05，P0.01） compared with the model group. ConclusionHyp may modulate the TLR4/MyD88/NF-κB pathway to ameliorate inflammatory phenotypes and alleviate stress conditions in zebrafish， thereby exerting the anti-inflammatory effect.

A domestically produced self-expanding transcatheter aortic valve controllable bending delivery system(VitaFlow? Ⅲcontrollable bending retrievable delivery system)was first used to perform transcatheter aortic valve replacement(TAVR)in a symptomatic severe aortic valve stenosis patient with severe heart failure and high risk of surgery in China on September 22,2023.The patient successfully completed TAVR under general anesthesia,with good valve position and function after the operation.Before discharge and at one month of follow-up,the patient's symptoms and degree of heart failure were significantly improved.The follow-up results of this case showed that the VitaFlow? Ⅲ controllable bending retrievable delivery system for TAVR is safe and feasible,and future prospective,multicenter clinical trials are expected to evaluate its efficacy.

Objective To explore the relationship of the preoperative serum alanine aminotransferase(ALT)/aspartate aminotransferase(AST)ratio and imaging features to the prognosis of patients with hepatocellular carcinoma(HCC)after receiving transarterial chemoembolization(TACE),and to develop a nomogram model used for predicting the patient's overall survival(OS).Methods A total of 211 patients,who were diagnosed as HCC and were treated with TACE as the initial therapy at the Guangci Branch of the First Affiliated Hospital of Soochow University of China between July 2016 and July 2020,were enrolled in this study.The patients were randomly divided into the modeling group(n=139)and validation group(n=72).The receiver operating characteristic(ROC)curve was used to determine the optimal cutoff value of AST/ALT ratio.The univariate and multivariate Cox regression analyses were conducted in the modeling group to screen out the independent predictors affecting HCC patient's OS and to establish a prognostic model.Harrell consistency index(C-index)was used to evaluate the predictive ability of the nomogram model for OS in HCC patients,and the calibration curves were plotted to assess the predictive accuracy of the nomogram model.Results No statistically significant difference in the baseline feature distribution existed between the modeling group and validation group(P＞0.05).The median OS of the modeling group and validation group was 28.5 months(95％CI:22.1-34.9)and 25.1 months(95％CI:19.2-29.0)respectively,the difference was not statistically significant(x2=1.395,P=0.322).The optimal cutoff value of AST/ALT ratio for predicting OS was 1.10,and the area under curve(AUC)value was 0.674(95％CI:0.604-0.753).The Cox regression analysis indicated that the tumor number(HR=2.080,95％CI=1.245-3.475,P=0.005),tumor capsule(HR=1.771,95％CI=1.128-2.780,P=0.013),irregular marginal enhancement(HR=1.884,95％CI=1.190-2.984,P=0.007),and AST/ALT ratio(HR=2.450,95％CI=1.506-3.987,P＜0.01)were the independent prognostic factors for HCC patients receiving TACE treatment.Based on the above variables,a nomogram model for predicting OS was established,and the C-index values in the modeling group and validation group were 0.733(95％CI:0.650-0.826)and 0.770(95％CI:0.688-0.862)respectively.The calibration curves showed that no significant deviations existed between the predictive curves of the prognostic model and the ideal reference curves for one-,2-and 3-year OS.Conclusion The nomogram model,which is established based on the tumor number,imaging features and preoperative AST/ALT ratio,has an excellent value in predicting the prognosis of HCC patients treated with TACE.

Objective To study the relationship between the abnormal blood fat components and the serum hypersensitivity C reaction protein concentration and the progression of diabetic retinopathy.Methods Fundus examination was carried out to inpatients in the Department of Endocrinology in the hospital from From July 2015to July 2017.These patients were divided into three groups according to results of fluorescein sodium contrast:The non retinopathy group (group A) , the non proliferative retinopathy group (group B) , the retinopathy proliferative phase group (group C) .The content of blood fat component and serum hypersensitivity C reaction protein in the experimental cases were measured, and the ratio of TC/HDL-C was calculated.The statistic software of SAS9.4was used for statistical processing.Results The concentration of the serum hypersensitive C reaction protein in patients with diabetic retinopathy was significantly increased and the ratio of TC/HDL-C increased significantly (P<0.05) .The hs-CRP concentration and TC/HDL-C ratio of the three study groups were compared with those of the healthy control group:the difference was statistically significant (P<0.05) .Among them, the hs-CRP concentration and TC/HDL-C ratio of group A were compared with group B and group C respectively and the difference were statistically significant (P<0.05) .There was no significant difference in hs-CRP concentration and TC/HDL-C ratio between group B and group C (P>0.05) .Linear correlation analysis was used to analyze the concentration of serum hypersensitive C reaction protein and the ratio of TC/HDL-C.It was found that there was a positive correlation between them, and there was a positive synergistic effect.Conclusion The measurement of serum hypersensitive C reactive protein has important clinical value for the discovery, evaluation and prognosis of diabetic retinopathy.The abnormalities of the blood fat component reflected by the TC/HDL ratio are also an important factor in assessing the progression of diabetic retinopathy.

Objective To analyze the dermoscopic features and patterns of onychomycosis.Methods From February to July in 2017,hospitalized patients from the Department of Endocrine Dermatology of the People's Hospital of Xuancheng City was enrolled and subjected to direct microscopic examination of fungi in nails,and the patients with positive results for fungi were diagnosed with onychomycosis.And then,dermoscopic photographs of infected nails were taken to analyze the dermoscopic characteristics and patterns of onychomycosis.Results A total of 205 patients with 634 infected nails were investigated.The dermoscopic characteristics on the nail plates included marble-like turbid areas (47.3％,300/634),pigmentation (30.9％,196/634),splinter hemorrhages (18.3％,116/634) and onycholysis (13.2％,84/634).The prevalence rates of marble-like turbid areas,pigmentation and onycholysis all significantly differed between distal and lateral subungual onychomycosis (DLSO) group and total dystrophic onychomycosis (TDO) group (X2 =42.09,31.23,18.19,respectively,all P ＜ 0.01).The dermoscopic characteristics at the free edge of the nails included nail thickening (33.1％,210/634) and subungual deposition of keratin and debris (26.5％,168/634).The TDO group showed significantly higher prevalence rates of nail thickening and subungual deposition of keratin and detritus compared with the DLSO group (x2 =44.3,18.52,respectively,both P ＜ 0.01).Periungual skin dryness and desquamation occurred more frequently in the TDO group than in the DLSO group (X2 =16.07,P ＜ 0.01).Of the 634lesional nails,141 (22.2％) showed a short spiked pattern,210 (33.1％) showed a longitudinal striated pattern,202 (31.9％) showed a linear edge pattern,and 193 (30.4％) showed a distal irregular termination pattern.Conclusion The main characteristic dermoscopic manifestations of onychomycosis are marblelike turbid areas,subungual deposition of keratin and debris,periungual skin dryness and desquamation,and characteristic dermoscopic patterns of onychomycosis are short spiked pattern,longitudinal striated pattern,linear edge pattern and distal irregular termination pattern.

Objective To investigate the inhibitory effect of Allicin on the apoptosis of hippocampal neurons induced by lead in rats.Methods Sixty male Sprague-Dawley rats aged 3 weeks were randomly divided into 6 groups,10 rats in each group,which were low dose group(A-L),medium-dose group(A-M) and high dose (A-H) Allicin group and lead exposure group (Pb group),dimercaptosuccinic acid (DMSA) group and blank control group.The blank control group animals were treated with ultrapure water,and the other 5 groups received 1.0 g/L lead acetate aqueous solution instead of ultrapure water after 20 days and they were treated them with compounds by oral gavage.The doses of Allicin in group A-L,A-M group and A-H group were 2.7 mg/kg and 5.4 mg/kg,and 10.8 mg/kg,respectively.The DMSA dose was 10.8 mg/kg,and the Pb group was given 9 g/L saline.After the model was established,the rats were sacrificed to collect whole blood and hippocampus.Blood lead and tissue lead concentrations were measured,and the level of apoptosis in hippocampus was observed by TUNEL staining.The levels of cysteine-containing aspartate-specific proteases (caspase)-3,caspase-9,poly adenosine diphosphate-ribose polymerase (PARP) mRNA and caspase-3,caspase-9,PARP activated protein and cytochromes C distribution in the hippocampus cells were detected by using real-time quantitative PCR (qPCR),Western blot,and immunofluorescence staining.Results (1) Lead levels in the blood lead and hippocampus of rats in A-L group,A-M group and A-H group [(190.54±11.33) μg/L,(0.28 ±0.03) μg/L;(159.55 ±16.94) μg/L,(0.22 ±0.06) μg/L;(l16.62 ±8.85) μg/L,(0.19 ±0.01) μg/L] were lower than those in Pb group [(271.34 ±21.23) μg/L,(0.31 ±0.04) μg/L],and there were significant differences (all P ＜ 0.05).The blood lead and hippocampal lead levels in the DMSA group [(50.12 ± 7.44) μg/L,(0.15 ± 0.03) μg/L] were lower than those in the A-L group,A-M group and A-H group.(2) The results of TUNEL staining showed that the apoptosis levels of hippocampus in A-L group,A-M group and A-H group were lower than that in Pb group [(2.81 ±0.17)％,(2.08 ±0.28)％,(1.33 ±0.08)％ vs.(4.23 ±0.17)％],and there were significant differences (all P ＜ 0.05);the apoptosis level of hippocampus in the DMSA group [(2.63 ± 0.32) ％] was higher than that in the A-M group and the A-H group,which was lower than that in the Pb group.(3) qPCR results showed that the levels of caspase-3,caspase-9 and PARP mRNA in A-H group were down-regulated compared with Pb group (1.07 ± 0.05,1.02 ± 0.02,1.11 ± 0.02 vs.1.34 ± 0.02,1.26 ±0.05,1.93 ± 0.07).The differences were statistically significant (P ＜ 0.05).The expression levels of caspase-3 and PARP mRNA in A-L group and A-M group were down-regulated (1.21 ± 0.05,1.43 ± 0.12,1.16 ± 0.02,1.20 ± 0.06 vs.1.34 ± 0.02,1.93 ± 0.07),and there were significant differences (all P ＜ 0.05),and there was no significant change in caspase-9 mRNA;the mRNA levels of caspase-3,caspase-9 and PARP in A-H group (1.07 ± 0.05,1.02 ± 0.02,1.11 ± 0.02) were lower than those in DMSA group (1.14 ± 0.02,1.15 ± 0.08,1.32 ±0.05).(4) Western blot results:compared with Pb group,the expression levels of activated caspase-3,caspase-9 and PARP protein in A-H group were down-regulated (A-H group:0.44 ± 0.15,0.58 ± 0.25 and 0.31 ±0.19,0.23 ±0.07 vs.Pb group:0.69 ±0.13,0.72 ±0.22 and 0.55 ±0.21,0.43 ±0.10),the expression of activated caspase-9 protein in A-M group was lower than that in Pb group (A-M group:0.59 ±0.18 vs.Pb group:0.72 ± 0.22),and there were significant differences (all P ＜ 0.05);the expression of activated caspase-3 and RARP protein in A-H group was lower than that in DMSA group.(5) Fluorescence staining showed that the expression of cytochrome C in cytoplasm of A-L group,A-M group and A-H group were significantly lower than that of Pb group and DMSA group.Conclusion Allicin can inhibit the apoptosis of hippocampus cells in rats with lead poisoning through mitochondrial pathway.The effect of Allicin on apoptosis inhibition may be better than DMSA.

To explore the safety and efficacy of levosimendan in treating the patients with severe aortic stenosis and to analyze the cardial function before and after medication in order to guide clinical treatment. Methods: A total of 20 patients admitted in our hospital from 2014-01 to 2015-12 were enrolled with the standard of echocardiography confirmed severe aortic stenosis, left ventricular ejection fraction (LVEF)≤45%, NYHA III-IV and inefficacy for conventional anti-heart failure drug therapy. The patients received intravenous infusion of levosimendan at 0.1μg/(kg·min) by persistent pumping for 24 hours. Echocardiography, LVEF, dyspnea condition, NYHA grading and plasma levels of NT-proBNP were recorded pre- and post-medication to compare the cardiac function and symptoms of levosimendan therapy. Results: After levosimendan treatment, NYHA grade was improved, P=0.025 and NT-proBNP was reduced (9101.6±7368.0) pg/mLvs (13776.5±9503.7) pg/mL, P=0.018. The following parameters were similar before and after levosimendan therapy: LVEF (31.1±7.5)% vs (33.1±8.5)%, P=0.078, the average heart rate (79.6±13.8) bmp vs (82.8±9.5)bmp, P=0.200 and systolic blood pressure (99.6±11.7) mmHg vs (97.2±12.1) mmHg, P=0.071. There were 40% (8/20) patients with obviously improved and 50% (10/20) with improved dyspnea symptoms after levosimendan treatment. Conclusion: Our preliminary study presented that levosimendan could improve NYHA grading, remit dyspnea symptom and reduce blood NT-proBNP level in patients with severe aortic stenosis and heart failure; it had safety and tolerability at certain degree in clinical practice.

Objective To study the correlation of nurse -perceived organizational atmosphere climate and their job involvement. Method About 465 clinical nurses were involved in the investigation by nursing organizational climate scale and work engagement scale. Results The total score on the organizational climate and job involvement were (149.24 ± 21.36) and (52.80 ± 6.31), respectively. The nurse -perceived organizational climate was positively correlated with job involvement ( P <0.01). Conclusions The nurse-perceived organizational climate and job involvement are at a medium level. Nursing managers should create a good organizational climate and promote their positive status into nursing, thereby improving the quality of care.

Objective: To explore the cardiac function and outcomes in patients of aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR) within 6 months in order to provide the guidance for clinical treatment. Methods: A total of 49 consecutive severe AS patients with surgical contradiction or STS high risk score and received successful TAVR in our hospital from 2013-12 to 2015-12 were studied. Echocardiography and blood levels of NT-proBNP were examined at pre- and 1 month, 6 months after TAVR. Left ventricular ejection fraction (LVEF), aortic valve mean gradient (MG), peak gradient (PG) and peak velocity (PV) were recorded. Based on pre-operative LVEF, the patients were divided into 2 groups: Cardiac dysfunction group, LVEF<50%,n=15 (30.6%) and Normal cardiac function group, LVEF≥50%, n=34 (69.4%). Post-operative cardiac function and blood levels of NT-proBNP were compared between 2 groups. Results: In all 49 patients, the following parameters were significantly improved within 7 days after TAVR: LVEF (56.0±14.6) % vs (52.5±13.8)%, MG (11±5) mmHg vs (58±18) mmHg, PG (21.7±9.5) mmHg vs (93.0±28.6) mmHg, PV (2.3±0.5) m/s vs (4.8±0.7) m/s, blood NT-proBNP level [1831 (1098-3363)] pg/ml vs [3842 (1763-8664)] pg/ml and aortic valve area (1.57±0.43) cm2 vs (0.58±0.23) cm2 allP<0.05. Within 6 months after TAVR, LVEF was continuously increasing especially in Cardiac dysfunction group; MG, PV and NT-proBNP level were continuously decreasing, NYHA grade was continuously improving, allP<0.05. Conclusion: TAVR was an effective treatment in AS patients with surgical contradiction or STS high risk score; it may continuously improve cardiac function, especially in patients with left heart dysfunction.

BACKGROUND:Biomechanical compatibility is the necessary condition to ensure the stable osseointegration with implants that then can function over a long period; therefore, it is especialy important to get knowledge about distribution of stress and strain between the maxilary central incisor and its surrounding bone tissue. OBJECTIVE: Based on five different anatomical types of natural teeth, to study the regularity of stress distribution between the maxilary central incisor root and implant.METHODS: According to the five different anatomical types of natural maxilary central incisors, UGNX and ANSYS were used to set up three-dimensional finite element models (B1, B2, M1, M2, P1) for the implant and surrounding structures, which were under 100 N static load at angles of 0o, 30o, 45o, 60o, 90o with the long axis of teeth. Then, the stress distribution between the five kinds of maxilary central incisor roots and implants was analyzed. RESULTS AND CONCLUSION:Among the five different anatomical types, the equivalent stress for both the natural central incisor and implant were increased with the increasing of angles, and the implant had a higher raising trend. The equivalent stress for the natural tooth concentrated upon B1 for the maximum value and M1 for the minimum value; while the equivalent stress for the implant focused on the maximum value at M1 and the minimum value at M2. There was a gap of 2%-31% between the equivalent stresses for the natural tooth roots and a gap of 4%-21% for the implants. The stress distribution range for the implant was just smaler than that for the natural tooth roots. It implies that the bit force of implant and natural tooth is in positive proportion to the bite angles, and the bite force that implant can burden is smaler than that the central incisor can.