ObjectiveTo investigate the mechanism of the modified of Bazhentang combined with Guishentang in improving pregnancy outcomes in mouse models of embryo implantation dysfunction by regulating T helper 1/T helper 2 （Th1/Th2） immune balance. MethodsEighty ICR female mice were randomly divided into four groups （n=20 per group） on gestational day 1 （GD1）： control， model， western medicine， and traditional Chinese medicine （TCM） groups. Except for the control group， all mice received mifepristone solution （0.2 mg/mouse） via oral gavage on GD4 to induce embryo implantation dysfunction. The TCM group received a water decoction of the modified of Bazhentang combined with Guishentang （20.8 g·kg^-1）， with the western medicine group administered dydrogesterone （3.9 mg·kg^-1）， and the control/model groups given equal volumes of saline. All treatments were administered once daily from GD1 until one day before sample collection. Outcomes included implantation site counts （macroscopic observation）， pregnancy rates， body weight， endometrial histopathology （hematoxylin-eosin staining）， uterine expression of T-box expressed in T cells （T-bet）， GATA-binding protein 3 （GATA3）， interferon gamma （IFN-γ）， and interleukin-4 （IL-4） at protein （Western blot） and mRNA （real-time polymerase chain reaction， Real-time PCR） levels， serum IFN-γ and IL-4 levels （enzyme-linked immunosorbent assay， ELISA）， and Th1/Th2 immune balance evaluated by calculating T-bet/GATA3 and IFN-γ/IL-4 ratios. ResultsCompared to the control group， the model group showed no significant change in pregnancy rate but exhibited a marked reduction in average implantation sites and body weight （P<0.01）. Histopathological analysis revealed endometrial abnormalities， including decreased glandular density， stromal compaction， and absence of nucleolar vacuoles. At the molecular level， uterine tissue in the model group demonstrated significantly upregulated expression of T-bet and IFN-γ （P<0.05， P<0.01）， alongside markedly downregulated GATA3 and IL-4 expression （P<0.05， P<0.01）. Serum analysis confirmed markedly elevated IFN-γ （P<0.01） and reduced IL-4 levels （P<0.01）， resulting in significantly increased T-bet/GATA3 and IFN-γ/IL-4 ratios （P<0.01）. Compared to the model group， pregnancy rates in all treatment groups showed no significant change. Implantation sites and body weight increased substantially （P<0.01）， with restored endometrial morphology characterized by enhanced glandular density， stromal edema， and reappearance of nucleolar vacuoles. Significant downregulation of T-bet and IFN-γ （P<0.01） and upregulation of GATA3 and IL-4 （P<0.05， P<0.01） in uterine tissue were observed. Serum IFN-γ levels were significantly reduced （P<0.05， P<0.01）， while IL-4 levels were significantly elevated （P<0.05）. The Th1/Th2 ratios were significantly decreased （P<0.01）. ConclusionThe modified of Bazhentang combined with Guishentang significantly enhances the number of embryo implantation sites in mice with embryo implantation dysfunction， potentially through modulating T-bet/GATA3 expression， restoring Th1/Th2 immune balance， and improving endometrial receptivity.

Objectives:Distolingual root of the permanent mandibular first molar(PMFM-DLR)has been frequently reported,which may complicate the treatment of periodontitis.This study aimed to assess the morphological features of PMFM-DLR and investigate the correlation between the morphological features of PMFM-DLR and periodontal status in patients with Eastern Chinese ethnic background.Materials and methods:A total of 836 cone beam computed tomography(CBCT)images with 1497 mandibular first molars were analyzed to observe the prevalence of PMFM-DLR at the patients and tooth levels in Eastern China.Among them,complete periodontal charts were available for 69 Chinese patients with 103 teeth.Correlation and regression analyses were used to evaluate the correlation between the morphological features of DLR,bone loss,and periodontal clinical parameters,including clinical attachment loss(CAL),probing pocket depth(PPD),gingival recession(GR),and furcation involvement(FI).Results:The patient-level prevalence and tooth-level prevalence of DLR in mandibular first molars were 29.4%and 26.3%,respectively.Multiple linear regression analysis suggested that bone loss at the lingual site and CAL were negatively affected by the angle of separation between distolingual and mesial roots in the transverse section,while they were significantly influenced by age and the angle of separation between distobuccal and mesial roots in the coronal section.Conclusions:The prevalence of PMFM-DLR in Eastern China was relatively high in our cohort.The morphological features of DLR were correlated with the periodontal status of mandibular first molars.This study provides critical information on the morphological features of DLR for improved diagnosis and treatment options of mandibular molars with DLR.

Objective:To investigate the risk factors for the occurrence and poor in-hospital prognosis in patients with peripartum cardiomyopathy (PPCM).Methods:The clinical data of 35 patients with PPCM and 35 healthy pregnant women in Xuanwu Hospital, Capital Medical University and Beijing Friendship Hospital Affiliated to Capital Medical University from January 2003 to January 2022 were retrospectively analyzed. The personal histories, laboratory examination, imaging examination, cardiac function outcome, etc were collected. According to the left ventricular ejection fraction (LVEF) at discharge, the patients with PPCM were divided into in-hospital recovery group (LVEF≥50%, 18 cases) and prolonged disease group (LVEF<50%, 17 cases). Multivariate Logistic regression analysis was used to analyze independent risk factors of poor in-hospital prognosis in patients with PPCM.Results:Among 35 patients with PPCM, the age was (29.81 ± 5.37) years old, 17 cases (48.57%) complicated with gestational hypertension, 6 cases (17.14%) complicated with gestational diabetes mellitus, 24 cases (68.57%) of New York Heart Association (NYHA) cardiac function classification was Ⅲ to Ⅳ class, and 4 cases died (11.43%). The gestational age in patients with PPCM was significantly shorter than that in healthy pregnant women: (36.26 ± 4.27) weeks vs. (38.54 ± 4.59) weeks, the rates of multiple pregnancy and gestational hypertension were significantly higher than those in healthy pregnant women: 17.14% (6/35) vs. 2.86% (1/35) and 48.57% (17/35) vs. 11.43% (4/35), and there were statistical differences ( P<0.05 or <0.01). Compared with hospital recovery group, the patients in protracted disease group had shorter gestational age, larger left ventricular end-diastolic diameter, higher serum creatinine, C-reactive protein and amino-terminal pro-brain natriuretic peptide (NT-proBNP), worse NYHA cardiac function classification, and there were statistical differences ( P<0.05 or <0.01); but there were no statistical difference in LVEF at the first diagnosis and troponin I between two groups ( P>0.05). Multivariate Logistic regression analysis result showed that elevated creatinine was an independent risk factor for poor in-hospital prognosis in patients with PPCM ( OR = 4.554, 95% CI 1.536 to 13.684, P = 0.018). Conclusions:The gestational hypertension may be a risk factor for PPCM. The gestational hypertension, earlier onset time, enlarged left ventricular end-diastolic diameter, high NT-proBNP, high C-reactive protein, high creatinine and high cardiac function NYHA classification may be risk factors for poor in-hospital prognosis in patients with PPCM; and elevated creatinine is an independent risk factor for poor in-hospital prognosis in patients with PPCM.

Objective:To explore the anxiety state of the main caregivers of dementia patients and analyze its influencing factors.Methods:The convenient sampling method was adopted to select 220 main caregivers of dementia patients who were outpatients and inpatients in a ClassⅢ Grade A specialty hospital in Jiangsu province from January to October 2019. The self-developed General Information Questionnaire was used to collect demographic data and disease-related data of caregivers and patients. Hamilton Anxiety Rating Scale (HAMA) , Eysenck Personality Questionnaire (EPQ) , Mini-Mental State Examination (MMSE) and Activity of Daily Living (ADL) were used to measure the anxiety status of the main caregivers and its influencing factors.Results:220 questionnaires were distributed, and valid questionnaires were 212. HAMA score of 212 main caregivers was (7.45±2.86) , and the incidence of anxiety was 55.19% (117/212) . The results of multiple regression analysis showed that the seven independent variables entered the regression equation. According to the regression coefficients in descending order, they were the medical payment method (self-pay, medical insurance) , whether the patient had mental symptoms, whether the main caregivers had support, the education level of the main caregivers, the neurotic personality characteristics of the main caregivers, the total score of MMSE and the total score of ADL. All of them were independent influencing factors of the anxiety of main caregivers, explaining 33.3% variation of the anxiety of the main caregivers ( F=8.512, P<0.001) . Conclusions:There is a high incidence of anxiety among caregivers of dementia patients. In the process of clinical nursing, nurses should focus on caregivers who have neurotic tendency and high education level and has no social support. They should pay attention to the independent influencing factors such as the medical expenses of the caregivers who are mainly paid at their own expense, the impaired ADL ability of patients, lower total score of MMSE and patients accompanied with mental symptoms, and take active interventions to improve the anxiety of caregivers.

Objective To assess the value of transesophageal echocardiography (TEE) in left atrial appendage (LAA) closer with Amplatzer Cardiac Plug (ACP).Methods Consecutive 32 atrial fibrillation patients (CHADS2≥1) with high risk bleeding underwent LAA occlusion with ACP LAA occlusion device under the guidance of TEE.Measurements of LAA anchoring area diameter (AAD) and LAA anatomical orifice diameter (AOD) including maximum,minimum values,and LAA depth on 2 dimentional TEE (2D TEE) were conducted before closer device implantation.The outcomes of LAA occlusion were analyzed.Results Among 32 patients,27 cases achieved successful LAA occlusion,including 2 cases with peripheral leakage ≤5 mm,and 5 cases failed occlusion.Among 5 failed closed patients,3 cases with LAA AAD≥ 30 mm,1 case with LAA of short depth,and 1 case with anatomical variation of LAA of low position that access sheath could not be positioned in the LAA.LAA AAD maximum,minimum and LAA depth were (25.9±4.9)mm,(20.0±3.8)mm,(31.0±5.6)mm,respectively,and LAA AOD maximum,minimum diameters were (26.2±6.2)mm,(19.4±4.3)mm,respectively.Among 10 cases with LAA AAD≥30 mm,7 cases achieved successful LAA occlusion,but 3 cases failed.The implanted device diameter was (26.4±3.8)mm,and device compression rate was (7.6±5.5)%.The coefficient of correlation between device diameter and large LAA AAD and AOD is 0.770 and 0.717,respectively.There was no complication but 1 case with pericardial effusion.Conclusions Two dimentional TEE measurements of LAA have clinical guiding significance in the selection of proper size of ACP LAA occluder.The AAD of 2D TEE has the good correlation with ACP occluder′s size,the AADs are important factors which affect the success of LAA occlusion.

Objective To evaluate right ventricular (RV)systolic function in type-2 diabetes mellitus (T2DM)patients.Methods Fifty T2DM patients and fifty normal controls were included in the study and underwent echocardiographic examinations.The following parameters were measured:1 ) Right heart dimensions,pulmonary artery (PA)diameter,pulmonary acceleration time (AT)and PA systolic pressure (PASP);2)RV systolic function:RV fractional area change (RVFAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (S'),tricuspid annular plane systolic excursion (TAPSE),longitudinal strain of six RV segments by 2-dimensional speckle tracking imaging (2D-STI);3 )RV diastolic function:E,A ratio of the tricuspid inflow spectrum (E/A),E,E'(peak early diastolic velocity of the tricuspid annulus) ratio (E/E');4)RV Tei index.Results Statistic analysis showed that T2DM patients had thicker RV walls,wider PAs and shorter AT than the control group (P =0.000,0.001 and 0.000),while their right heart chamber sizes and PASP remained unchanged.Among systolic parameters,absolute values of RV longitudinal strain at the lateral wall-mid (lat-m),septum-mid (sep-m)and septum-basal (sep-b)segments were significantly lower in the diabetic group than the control group (P =0.001 ,0.000 and 0.005),whereas strain of the other three RV segments and RVFAC,TAPSE.S'were not significantly different.Moreover, E/A,E/E'and Tei index were all significantly different between the two groups (P = 0.000,0.000 and 0.006),indicating declined diastolic and general function of RV in the T2DM group.Conclusions RV myocardial strain by 2D-STI is more sensitive in detecting RV systolic dysfunction than TAPSE,S' and RVFAC.Among the six segments of RV walls,lat-m,sep-m and sep-b are better locations for 2D-STI than the other three.

Objective To observe and analyze the application of ultrasonography to clinical treatment and diagnosis of patients with hemodialysis before and after artificial arteriovenous fistula. Methods A total of 72 cases with uremia hemodialysis treated in our hospital received ultrasonography before and after artificial arteriovenous fistula. The suit-able blood vessels were selected, and the functions of artificial arteriovenous fistula were evaluated and analyzed. Re-sults The ultrasound indicated that the success rate of fistulization with low blood flow was 25.00%, and that with nor-mal blood flow was 55.56%, and that with high blood flow was 19.44%. The success rate of the normal group was evi-dently higher than that of the high or low blood-flow group. The blood flow and blood velocity of patients 1 week, 2 weeks and 4 weeks after operation increased steadily. Conclusion Applying ultrasonography to diagnose and monitor the patients with hemodialysis of artificial arteriovenous fistula can improve the diagnostic level and treatment level for the disease, which can be promoted and applied in clinical practice.

OBJECTIVE: To investigate the inhibitory effect of gonadotropin-releasing hormone II(GnRHII) and gonadotropin-releasing hormone I agonist (GnRH Ia) on the proliferation of endometrial stromal cells in vitro from endometriosis patients. METHODS: Different concentrations of GnRHII or GnRH Ia were added into the cultured endometrial stromal cells in vitro to detect the cell proliferation inhibition by MTT test. RESULTS: The inhibitory rate of GnRHII or GnRH Ia on eutopic and ectopic endometrial stromal cells in vitro was both dose- and time-dependent (P<0.05). Effect of GnRHII or GnRH Ia on the inhibitory rate of ectopic endometrial stromal cells was significantly higher than that of eutopic (P<0.05). GnRH II had a higher inhibitory rate on the endometrial stromal cells in vitro than did GnRH Ia (P<0.05). CONCLUSION GnRHII has more antiproliferative effect on endometrial stromal cells than GnRH Ia in vitro, especially on ectopic endometrial stromal cells, suggesting that GnRHII may be more effective than GnRH Ia on endometriosis.
Adult ; Cell Proliferation ; drug effects ; Cells, Cultured ; Endometriosis ; pathology ; Endometrium ; metabolism ; pathology ; Female ; Gonadotropin-Releasing Hormone ; agonists ; analogs & derivatives ; pharmacology ; Humans ; Middle Aged ; Stromal Cells ; pathology ; Young Adult

Objective To investigate the effects of magnesium isoglycyrrhizinate on liver regeneration and hepatic function following partial hepatectomy in thioacetamide induced cirrhotic rats.MethodsForty-five cirrhotic Wistar rats undergoing 2/3 hepatectomy were randomly assigned to control group ( Group A), Group B and Group C starting the day of hepatectomy, rats in Group B were injected 60mg per kg body-weight magnesium isoglycyrrhizina daily intraperitoneally until the day of sacrifice. Rats in Group A recevied same dose of sodium chloride. In Group C, magnesium isoglycyrrhizina was administered daily 3 days before hepatectomy until the rats were sacrificed. Liver function, serum HGF, serum PLA2,BrdU labelling index and percentage of intial liver weight on days 1, 2 and 7 post hepatectomy were assessed. ResultsRats in Group A had significantly lower BrdU labelling index and serum HGF level than Group C ( t = 2. 831, P ＜ 0.05; t = 3.427, P ＜ 0.05 ) and a markedly higher level of serum PLA2 than the other groups on day 1 posthepatectomy ( Group B t = 2. 794, P ＜ 0.05; Group C t = 2. 902, P ＜ 0.05 ).Rats in Group A had a lower BrdU labelling index and a more increased level of serum PLA2 than Group B and Group C on day 2 posthepatectomy ( BrdU labelling index: Group B t = 2. 736, P ＜ 0.05; Group C t =3.083, P＜0.05; PLA2: Group B t =2.794, P＜0.05; Group C t =2.902, P＜0.05), but had no significant difference in HGF level with the other two groups. The three groups were similar in ALT, AST,TP and intial liver weight on days 1,2 after operation. On the 7th day posthepatectomy, rats in Group A had a higher level of AST ( Group B t = 4. 508, P ＜ 0.05; Group C t = 2. 967, P ＜ 0.05 ) and a lower level of TP ( Group B t = 2. 838, P ＜ 0.05; Group C t = 2. 743, P ＜ 0.05 ), lower liver weight than the other two groups ( Group B t = 3.316, P ＜ 0.05; Group C t = 4. 093, P ＜ 0.05) but there was no difference between the three groups in BrdU labelling index, HGF and PLA2 level. Rats in Group C had significantly higher BrdU labelling index and serum HGF level than the rats in Group B on day 1 after hepatectomy( t = 2. 831, P ＜0.05; t = 2. 836, P ＜ 0.05 ).ConclusionsMagnesium isoglycyrrhizinate inhibits aminopherase release and enhancing liver regeneration in cirrhotic rats after partial hepatectomy.

Objective To investigate the value of global longitudinal strain (GLS) in detecting severe coronary artery stenosis (SCAS) in patients with coronary artery disease. Methods Fourty-two patients with SCAS confirmed with coronary arteriongraphy (CAG) underwent two-dimensional strain echocardiography. GLS, wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) were obtained. Taking CAG as gold standard, the sensitivity, specificity and areas under the ROC curve (AUC) of definition of SCAS with GLS, WMSI and LVEF were calculated, respectively. Fifteen healthy volunteers were recruited as control. Results ①Definition of one or more branches with severe stenosis: The sensitivity and specificity was 77.51% and 100% with GLS of -17.50% as a cutoff value, 70.01% and 100% with WMSI of 1.00, and 57.51% and 100% with LVEF of 59.21%. ②Definition of two or more than two branches with severe stenosis: The sensitivity and specificity was 62.52% and 80.81% with GLS of -11.05% as a cutoff value, 56.22% and 65.31% with WMSI of 1.60 and 56.21% and 65.42% with LVEF of 54.31%. ③The correlation coefficient was 0.78 between GLS and LVEF, and -0.82 between WMSI and LVEF. The AUC of detecting one or more branch with severe stenosis with GLS, WMIS and LVEF was 0.87, 0.80 and 0.78, respectively, and AUC of GLS was more than that of LVEF (P＜0.01). AUC of detecting two or more than two branches with severe stenosis with GLS, WMIS and LVEF was 0.76, 0.64 and 0.64, AUC of GLS was more than that of LVEF and WMSI (all P＜0.01). Conclusion GLS can be used in detecting SCAS, and the value of GLS is better than that of WMIS and LVEF.