Objective To study the application value of CAD/CAM technology in the teaching of inlay manufacturing.Methods A total of 60 undergraduates interned in the Department of Stomatology,Yan'an Hospital,Kunming Medical University were randomly divided into an experimental group(n=30)and a control group(n=30).We selected appropriate clinical cases for students to prepare for mandibular molar's proximal occlusal inlays.The instructor guided the results of the first preparation in different ways,and the students made the second modification and preparation,and the assessment team scored and evaluated the five aspects of the final preparation,the shape of the preparation,the shape of the occlusal surface,the dovetail retention,and the adjacent surface.Results The scores of all detection indexes in the experimental group were higher than those in the control group(P<0.05).Conclusion The application of CAD/CAM technology in inlay manufacturing teaching can effectively improve students'clinical hands-on ability and achieve better teaching effects than traditional teaching methods.

Background::Breast cancer (BC) risk-stratification tools for Asian women that are highly accurate and can provide improved interpretation ability are lacking. We aimed to develop risk-stratification models to predict long- and short-term BC risk among Chinese women and to simultaneously rank potential non-experimental risk factors.Methods::The Breast Cancer Cohort Study in Chinese Women, a large ongoing prospective dynamic cohort study, includes 122,058 women aged 25-70 years old from the eastern part of China. We developed multiple machine-learning risk prediction models using parametric models (penalized logistic regression, bootstrap, and ensemble learning), which were the short-term ensemble penalized logistic regression (EPLR) risk prediction model and the ensemble penalized long-term (EPLT) risk prediction model to estimate BC risk. The models were assessed based on calibration and discrimination, and following this assessment, they were externally validated in new study participants from 2017 to 2020.Results::The AUC values of the short-term EPLR risk prediction model were 0.800 for the internal validation and 0.751 for the external validation set. For the long-term EPLT risk prediction model, the area under the receiver operating characteristic curve was 0.692 and 0.760 in internal and external validations, respectively. The net reclassification improvement index of the EPLT relative to the Gail and the Han Chinese Breast Cancer Prediction Model (HCBCP) models for external validation was 0.193 and 0.233, respectively, indicating that the EPLT model has higher classification accuracy.Conclusions::We developed the EPLR and EPLT models to screen populations with a high risk of developing BC. These can serve as useful tools to aid in risk-stratified screening and BC prevention.

Objective To investigate the expression of inositol polyphosphate 4-phosphatase type Ⅱ B(INPP4B)in colorectal cancer(CRC)and the relevant clinical significance,to determine the relationship between INPP4B and matrix metallopeptidase 7(MMP7)in CRC cells,and to make preliminary exploration of the effects of INPP4B on the proliferation and migration of CRC cells and mechanisms involved.Methods The TIMER2.0 and GEPIA2 databases were used to analyze the differences in INPP4B expression between cancer and para-cancerous tissues and the effects of such differences on the prognosis of CRC.The expression of INPP4B in 102 surgically resected CRC tumors was determined by immunohistochemistry(IHC),and the correlation between INPP4B and clinical pathological indicators was analyzed.In CRC cells with overexpressed/knocked-down INPP4B,the expression of INPP4B and MMP7 were examined by real time fluorogenic quantitative PCR,the protein expression of INPP4B was assessed by Western blot,cell proliferation was determined using the CellTiter 96? AQueous One assay,and cell migration and invasion were assessed using wound healing assay and real-time label-free dynamic cell analysis(RTCA).The LinkedOmics database was used to analyze signaling pathways related to INPP4B function,and the role of potential key molecules was validated at the cellular level.Results Analysis with the TIMER2.0 database and GEPIA2 database showed elevated INPP4B expression(colon adenocarcinoma[COAD]:2.30,rectal adenocarcinoma[READ]:2.33)in CRC compared to normal tissue(COAD:1.91,READ:1.89).IHC testing confirmed that INPP4B was upregulated in clinical CRC tissues and paracancerous tissues(P＜0.001).Cox regression model analysis showed that INPP4B(hazards ratio[HR]=1.457,95％confidence interval[CI]:1.003-2.115)affected the prognosis of CRC,and the Kaplan-Meier curve showed that patients with high INPP4B expression had shorter overall survival(P＜0.05).x2 test was performed to analyze the relationship between INPP4B expression and clinicopathological indexes,and it was found that high expression of INPP4B was correlated with lymph node metastasis(x2=3.997,P=0.046)and neural invasion(x2=8.511,P=0.004).In in vitro experiments,CRC cells overexpressing INPP4B showed a significantly increased cell proliferation and migration compared to the cells in the control group(P＜0.05).Analysis using the LinkedOmics database showed that INPP4B was correlated with extracellular matrix remodeling and cell migration.Pearson's correlation analysis showed that MMP7 was positively correlated with INPP4B(r=0.3782,P＜0.001).INPP4B overexpression or knockdown in vitro also led to the upregulation or the downregulation of MMP7 expression in CRC cells.Conclusion INPP4B is highly expressed in CRC tissues and significantly correlated with lymph node metastasis,neural invasion,and patient prognosis.MMP7 may mediate the role of INPP4B in promoting CRC cell migration and invasion.

Objective:To investigate the efficacy and safety of rivaroxaban combined with antiplatelet in ischemic stroke patients with non-valvular atrial fibrillation and moderate or severe intracranial artery stenosis.Methods:The consecutive ischemic stroke patients with non-valvular atrial fibrillation and moderate or severe intracranial artery stenosis admitted to Yantai Yuhuangding Hospital of Qingdao University from August 2019 to March 2022 were retrospectively included. According to the secondary prevention drugs, the patients were divided into rivaroxaban and rivaroxaban combined with antiplatelet treatment group. The basic characteristics of the two groups were compared. The primary outcome was the recurrence rate of stroke at 3 months, and the secondary outcome included the incidence of any bleeding event at 3 months, the all-cause mortality rate, the improvement rate of neurological function, and the good outcome rate. The good outcome was defined as the modified Rankin Scale ≤2 points at 3 months.Results:A total of 108 patients aged 70.72±8.08 years old were included in the study. There were 56 patients (51.9%) in the rivaroxaban group and 52 (48.1%) in the combined treatment group. In terms of primary outcome, the recurrence rate of stroke in the combined treatment group was significantly lower than that in the rivaroxaban group at 3 months (7.69% vs. 21.43%; P<0.05). In terms of secondary outcomes, the incidence of bleeding events in the combined treatment group at 3 months was significantly higher than that in the rivaroxaban group (26.92% vs. 7.14%; P<0.05), with one death event in each group. The rate of good outcome in the combined treatment group was significantly higher than that in the rivaroxaban group (75.00% vs. 51.79%; P=0.013). Multivariate logistic regression analysis showed that high National Institutes of Health Stroke Scale (NIHSS) score at admission was an independent risk factor for poor outcome (odds ratio 1.370, 95% confidence interval 1.057-1.776; P=0.018), while the rivaroxaban combined antiplatelet treatment was an independent protective factor for stroke recurrence (odds ratio 0.203, 95% confidence interval 0.054-0.758; P=0.018). Conclusion:After ischemic stroke in patients with non-valvular atrial fibrillation complicated with moderate and severe stenosis of intracranial artery, rivaroxaban combined with antiplatelet treatment can reduce the recurrence rate of stroke and improve the clinical outcome, but it may increase the risk of bleeding.

Objective: To perform an epidemiological survey of the first case with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Pinghu City of Jiaxing City, Zhejiang Province on March 13, 2022, so as to provide insights into the management of coronavirus disease (COVID-19) epidemics. Methods: According to the requirements of the Protocol on Prevention and Control of COVID-19 (8th Edition), epidemiological investigations were performed among 39 cases with SARS-CoV-2 infections in Pinghu City from March 13 to 20, 2022. Cases' demographics, clinical symptoms, history of immunization and exposure were collected, and close contacts were identified. Pharyngeal swabs were sampled from infected cases for detection of SARS-CoV-2 nucleic acid and whole-genome sequencing, and the source of infection and transmission route were investigated. Results: The index case for this COVID-19 epidemic was an imported case from Shanghai Municipality, who infected 6 persons via aerosol transmission when playing in the badminton venue of Pinghu National Fitness Center on March 9; subsequently, one of these infected cases infected another 18 persons when playing in the badminton venue of Jiadian Village Resident's Fitness Center in Zhapu Township on March 12. Sixteen confirmed cases were reported, and all cases were mild; another 23 asymptomatic cases were diagnosed, with no death reported. This epidemic occurred from March 11 to 20, with 3 generations of spread and a median incubation period of 3 days. The SARS-CoV-2 infected cases had a median age of 33.5 (interquartile range, 12.0) years and included 36 cases with a history of COVID-19 vaccination. There were 16 cases with fever, cough, runny nose and sore throat, and 13 cases with imaging features of pneumonia. The effective reproductive number (Rt) of the COVID-19 epidemic was 7.73 at early stage, and was less than 1 since March 21. Whole-genome sequencing identified Omicron BA.2 variant among 33 cases, which had high homology with the index cases. Conclusion This epidemic was a cluster of COVID-19 caused by imported Omicron BA.2 variant infection from Shanghai Municipality, and the COVID-19 transmission was mainly caused by indoor aerosols.

Asymmetrically prominent veins sign (APVS) displayed by susceptibility-weighted imaging (SWI) can noninvasively reflect the dynamic changes of brain tissue in patients with acute ischemic stroke (AIS). It provides blood flow and metabolic information from the perspective of pathophysiology, which is helpful to evaluate the clinical condition and outcome of patients with AIS. This article reviews the clinical significance of the presence of APVS on SWI in patients with AIS.

Objective:To investigate the relationship between single nucleotide polymorphism (SNPs) of Zeste homolog enhancer 2 (EZH2) gene and the risk of breast cancer.Methods:Recruiting 1 039 breast cancer patients and 1 040 controls at 22 referral hospitals nationwide in China, the genotype distribution of 3 SNPs loci of EZH2 genes was observed to detect the correlation between different genotypes and the risk of breast cancer genotypes EZH2 expression in breast cancer tissues and its correlation with patient prognosis were analyzed using breast cancer data from the database.Results:EZH2 rs6464926 CC genotype was compared with TT genotype (TT vs. CC: OR=1.362, 95% CI: 1.063-1.746, P=0.015) and dominant model (TC+TT vs .CC: OR=1.22, 95% CI: 1.004-1.483, P=0.045) .In women with BMI ≥24 kg/m 2, the TC genotype ( P=0.050), TT genotype ( P=0.025) and dominant model (TC+TT, P=0.021) of rs6464926 locus were significantly different from CC genotype in cancer risk. rs6464926 was correlated with EZH2 gene expression ( P=6.89E-47). EZH2 gene is highly expressed in breast cancer tissues, and patients with high expression were associated with shorter OS ( HR=1.27, P=0.013), DMFS ( HR=1.37, P<0.01), and RFS ( HR=1.44, P<0.01). Conclusions:The polymorphism rs6464926 of EZH2 gene is associated with breast cancer susceptibility in Chinese women. rs6464926 might regulate breast cancer risk and prognosis by changing EZH2 expression.

Objective:To investigate the normal range of exhaled nitric oxide in healthy children aged 6-18 in Jinan.Methods:The healthy school children aged 6-18 in Jinan from October 11 to 26, 2017 were selected for questionnaire survey, physical examination and exhaled nitric oxide test.The levels of mouth exhaled nitric oxide at the flow rate of 50 mL/s (FeNO 50) and mouth exhaled nitric oxide at the flow rate of 200 mL/s(FeNO 200), alveolar nitric oxide (CaNO), and nasal exhaled nitric oxide at the flow rate of 10 mL/s(FnNO 10) were measured by the electroche-mical method.The distributions of FeNO 50, FeNO 200, CaNO and FnNO 10 were analyzed, and their correlations with gender, age, height and body mass index (BMI) were discussed by the multiple linear regression model. Results:A total of 772 healthy children were enrolled in this study, including 364 males and 408 females, with a median age of 12.1(11.8-12.3) years old, a median height of 154.8(153.6-156.0) cm, and a median BMI of 20.3 (20.0-20.6) kg/m 2. The measured values of FeNO 50, FeNO 200, CaNO and FnNO 10 fluctuated in the range of 3.0-168.0 ppb, 2.0-44.0 ppb, 0.5-44.2 ppb and 0-1 253.0 ppb, respectively.FeNO 50, FeNO 200 and CaNO values showed skewed a distribution, and their 95% upper limits were 35.0 ppb, 13.3 ppb and 8.5 ppb, respectively.The geometric mean(95% CI) of FeNO 50 in males (95% CI)[14.6 (13.7-15.5) ppb] was significantly higher than that in females [13.3(12.7-14.0) ppb], and the difference was statistically significant ( Z=1.470, P=0.027). The multiple linear regression results suggested that, FeNO 50 was positively correlated with age and height ( β=0.023, 0.007, respectively, all P<0.05), and negatively correlated with BMI ( β=-0.016, P<0.05). The geometric mean (95% CI) of FeNO 200in males[7.1 (6.8-7.4) ppb] was significantly higher than that in females[6.4 (6.1-6.6) ppb], and the difference was statistically significant( Z=1.747, P=0.004). The multiple linear regression results suggested that, FeNO 200 was positively correlated with height ( β=0.005) and negatively correlated with gender(female β=-1.126) (all P<0.05). There was no significant difference between male and female in CaNO, which had no correlation with gender, age, height and BMI (all P>0.05). FnNO 10 showed a normal distribution, with a mean value of 456.2 ppb, 95% CI of 29.3-863.4 ppb.The geometric mean (95% CI) of FnNO 10 in males [408.7 (377.1-443.0) ppb] was significantly higher than that in females [368.8 (339.0-401.3) ppb], and the difference was statistically significant ( Z=1.722, P=0.005). The multiple linear regression results indicated that FnNO 10 was related to gender ( β=-36.098, P<0.05), and not correlated with age, height and BMI (all P>0.05). Conclusions:The normal ranges of FeNO 50, FeNO 200, CaNO and FnNO 10 in healthy children aged 6-18 in Jinan are 3.0-35.0 ppb, 2.0-13.3 ppb, 0.5~8.5 ppb and 29.3-863.4 ppb, respectively.FeNO 50 is correlated with age, height and BMI.FeNO 200 is correlated with gender and height.CaNO and FnNO 10 are not correlated with age, height or BMI.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (＜ 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3％ vs.42.7％,P ＜ 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9％ vs.61.7％,P ＜0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4％ vs.4.2％,P ＜ 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.