Objective : To explore the advantages of static navigation in locating calcified root canal therapy, and to provide reference for clinical diagnosis and treatment of calcified teeth. Methods: A case of acute periapical periodontitis of anterior teeth with full-length calcification of root canal was reported. A lingual minimally invasive approach was used as a conservative method of controlling the infection of teeth and preserving the incisors through the digital guide plate. The diagnosis and treatment of this type of case were analyzed retrospectively with reference to the literature. Results: One patient complained that the pain of left anterior teeth was aggravated for 2 days. After examination, he was diagnosed with acute periapical periodontitis of 21 teeth with total root canal calcification. With the assistance of static navigation, the root canal was located after 10 minutes, the calcification was dredged for 15 minutes, and the acute pain symptoms of the patient were relieved that day. After one year of follow-up, there was no discomfort in the teeth, and the range of low-density shadow in the apical film was reduced. After 3 years of follow-up, there was no discomfort in the teeth, and the low-density shadow of the apical root was further reduced by apical film examination. As shown by the results of the literature review, static navigation technology is advantageous because the success rate of dredging calcified root canals is neither associated with the operator’s treatment experience nor the use of microscope and ultrasonic equipment. Regardless of the degree of calcification, this method can significantly reduce the iatrogenic risk, but it is closely related to the accuracy and stability of the guide plate. However, this method is not suitable for calcified teeth with calcification under root canal curvature and limited operating space. Cone-beam computed tomography (CBCT) is recommended to locate calcified root canals, and the imaging quality is an important factor that affects the correct preoperative planning. When performing static navigation endodontic treatment, thermal damage can be reduced by selecting a drill with a small diameter that matches the guide ring and cooling the drill with frozen irrigation solution. Conclusion Static navigation-assisted treatment of calcified root canals is accurate and minimally invasive, which reduces clinical treatment time, preserves the lingual approach at the incisal ridge to further ensure the integrity of teeth, and ensures the long-term preservation of affected teeth.

AIM: To investigate the effects of Conbercept on various optical coherence tomography(OCT)biomarkers in patients with retinal vein occlusion-related macular edema(RVO-ME), and to analyze the correlation of these biomarker changes with visual prognosis.METHODS: Retrospective study. A total of 57 patients(57 eyes)with RVO-ME, including 25 patients(25 eyes)with central retinal vein occlusion(CRVO)and 32 patients(32 eyes)with branch retinal vein occlusion(BRVO), were enrolled in this study. All the patients received intravitreal injection of conbercept once a month, three times in total. The preoperative and postoperative best-corrected visual acuity(BCVA), and changes in OCT biomarkers, including central macular thickness(CMT), the length of disorganization of the retinal inner layers(DRIL), the number of hyperreflective dots(HRD), the area of intraretinal fluid(IRF), the area of subretinal fluid(SRF), and the length of ellipsoid zone(EZ)disruption were compared. Furthermore, the relationship of these changes with BCVA was analyzed.RESULTS:Compared with the baseline, at 3 mo post-treatment, BCVA(LogMAR)was improved, CMT was decreased, the length of DRIL was shortened, the number of HRD was reduced, the area of IRF was decreased, the area of SRF was reduced, and the length of EZ disruption was shortened(all P<0.05). Spearman correlation analysis showed that there was no correlation between the changes in CMT, the length of DRIL, the number of HRD, the area of IRF, the area of SRF and the change in BCVA before and after treatment(P>0.05). However, the change in the length of EZ disruption was positively correlated with the change in BCVA(rs=0.34, P=0.011), and the R2 value of the fitting curve between the change in the length of EZ disruption and the change in BCVA was 0.113(P=0.011). When comparing the pre- and post-treatment changes in BCVA, the length of DRIL, the number of HRD, the area of IRF, the area of SRF, and the length of EZ disruption between patients in the CRVO group and BRVO group, no significant differences were observed(all P>0.05). In contrast, a significant difference was found in the change in CMT between the two groups(P=0.002).CONCLUSION:Conbercept effectively improves multiple OCT biomarkers in patients with RVO-ME. Repair of EZ disruption is a key driver of visual recovery, and its stability may serve as a novel indicator for personalized decision-making in anti-vascular endothelial growth factor therapy.

Objective To analyze the correlation between inflammation,nutritional indicators and hy-poproteinemia in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Meth-ods The clinical data of patients with AECOPD admitted to the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Xiamen University from January 2020 to September 2022 were ret-rospectively analyzed,and the patients were divided into the hypoproteinemia group(n=73)and the non-hy-poproteinemia group(n=141)according to whether the serum albumin(ALB)was lower than 35 g/L.The clinical data,inflammatory indicators and nutritional indicators of the two groups were compared,Spearman correlation analysis was performed,and binary logistic regression analysis was performed to analyze the influ-encing factors of patients with AECOPD complicated with hypoproteinemia.Results There were statistically significant differences in age,length of hospital stay,and body weight between the two groups(P＜0.05).There were no significant differences in gender,number of hospitalizations in the past 1 year,height,diabetes,hypertension and proportion of coronary heart disease(P＞0.05).Compared with the non-hypoproteinemia group,the hypoproteinemia group had longer hospital stays and higher levels of C-reactive protein,neutrophil/albumin ratio(NAR),neutrophil to lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and systemic immunoinflammatory index(SII).The prognostic nutritional index(PNI),body mass index(BMI),hemoglo-bin and total protein levels were lower,and the difference was statistically significant(P＜0.05).Body weight,BMI,hemoglobin,total protein,PNI and AECOPD patients with hypoproteinemia were negatively cor-related(P＜0.05),while age,length of hospital stay,C-reactive protein,NAR,NLR,PLR,SII and AECOPD patients with hypoproteinemia were positively correlated(P＜0.05).Binary logistic regression analysis showed that PNI,SII and NLR were the influencing factors of hypoproteinemia in AECOPD patients.Conclusion In clinical practice,attention should be paid to and timely correction of hypoproteinemia in pa-tients with AECOPD,improvement of inflammatory indicators and nutritional status of patients,and preven-tion of acute exacerbation.

The pathological classification and diagnostic criteria for lung neuroendocrine neoplasms (NENs) in the 2021 World Health Organization (WHO) lung tumor classification are similar to the prior classifications. However, the advances on the molecular studies of lung NENs have shown that both small cell lung carcinoma and large cell neuroendocrine carcinoma are highly heterogeneous tumors with neuroendocrine characteristics and can be subclassified based on the features of genomics or transcriptomics, which are valuable in the diagnosis of lung NENs subtypes and patient treatment. In addition, it is necessary to interpret emerging concepts such as "lung neuroendocrine tumor G3" and "histological transformation" from pathological perspectives, as well as to know the novel neuroendocrine biomarkers such as INSM1 and POU2F3. This article summarized the diagnostic changes and the advances of molecular pathology of lung NENs based on the latest WHO classification and molecular research.

Objective:To construct adjustable stiffness hydrogels based on gelatin methacryloyl (GelMA), in order to better simulate the growth environment under physiological conditions.Methods:SYLGARD 184 silicone rubber was used to prepare adjustable stiffness hydrogels. The stiffness values of the adjustable stiffness hydrogels prepared with GelMA of different grafting rates (30%, 60%, 90%) at various concentrations (5%, 10%, 15%) were quantified using Young’s modulus. Based on the result, the optimal grafting rate GelMA was selected as the material for constructing the adjustable stiffness hydrogels. The relationship between the concentration (2%, 3%, 5%, 6%, 8%, 10%, 15%) of 90% grafting rate (GM90) and the stiffness after photopolymerization was determined by measuring the Young’s modulus of GelMA at different concentrations and fitting the data. Three groups of suitable concentrations were chosen to construct three different stiffness hydrogels. After soaking in phosphate-buffered saline for 48 hours, various samples underwent biomechanical measurements, internal pore structure observation, atomic force microscopy to measure parameters such as Young’s modulus, pore size and surface roughness. Rheological tests were carried out, curves were drawn according to the energy storage modulus and loss modulus, and shear frequencies of the intersection points of the two curves were observed at each concentration to evaluate the ability of hydrogel to maintain its morphology. Data analysis was performed using GraphPad Prism 8.0.2 software. Quantitative data were expressed as Mean±SD, and one-way ANOVA was used for comparison among multiple groups, and LSD method was used for pairwise comparison. Statistical significance was set at P<0.05. Results:Increasing the grafting rate and concentration of GelMA hydrogels effectively enhanced their stiffness. GelMA with a GM90 provided a broader range of stiffness, making it suitable for constructing the adjustable stiffness hydrogels. Fitting curves of GM90 concentrations and stiffness after photopolymerization showed that at concentrations of 2%, 6%, and 15%, GelMA could mimic the stiffness of various tissues of human. Therefore, these three concentrations were selected for subsequent experiments. The Young’s modulus of GM90 at concentrations of 15%, 6% and 2% were (98.43±7.71), (14.57±1.62), and (2.11±0.32) kPa, respectively, with statistically significant differences between each pair of groups ( P<0.01). The pore sizes were (41.32±3.51), (3.26±0.33), and (1.21±0.11) μm, respectively, showing significant differences between each pair of groups ( P<0.01). Surface roughness values were (48.15±2.65), (22.65±1.78), and (24.12±1.43) nm, respectively, with 15% concentration showing significantly higher roughness than the 2% and 6% concentrations ( P<0.01), while there was no significant difference between the 2% and 6% concentrations ( P>0.05). Rheological testing indicated that as the concentration decreased, the shear frequency at the crossover point of the storage modulus and loss modulus of GM90 hydrogels decreased, >100, 30 and 18 Hz, respectively. The result showed that the solid form of GM90 hydrogel with 15% concentration was more stable, while the hydrogel with 2% concentration had better fluidity. Conclusion:Adjusting the grafting rate and concentration can regulate the stiffness of GelMA hydrogels. GelMA hydrogels with a 90% grafting rate provide a wide range of stiffness, making them ideal materials for constructing hydrogels with adjustable stiffness. At concentrations of 2%, 6%, and 15%, GM90 exhibited different mechanical properties and internal structures.

Objective:To construct adjustable stiffness hydrogels based on gelatin methacryloyl (GelMA), in order to better simulate the growth environment under physiological conditions.Methods:SYLGARD 184 silicone rubber was used to prepare adjustable stiffness hydrogels. The stiffness values of the adjustable stiffness hydrogels prepared with GelMA of different grafting rates (30%, 60%, 90%) at various concentrations (5%, 10%, 15%) were quantified using Young’s modulus. Based on the result, the optimal grafting rate GelMA was selected as the material for constructing the adjustable stiffness hydrogels. The relationship between the concentration (2%, 3%, 5%, 6%, 8%, 10%, 15%) of 90% grafting rate (GM90) and the stiffness after photopolymerization was determined by measuring the Young’s modulus of GelMA at different concentrations and fitting the data. Three groups of suitable concentrations were chosen to construct three different stiffness hydrogels. After soaking in phosphate-buffered saline for 48 hours, various samples underwent biomechanical measurements, internal pore structure observation, atomic force microscopy to measure parameters such as Young’s modulus, pore size and surface roughness. Rheological tests were carried out, curves were drawn according to the energy storage modulus and loss modulus, and shear frequencies of the intersection points of the two curves were observed at each concentration to evaluate the ability of hydrogel to maintain its morphology. Data analysis was performed using GraphPad Prism 8.0.2 software. Quantitative data were expressed as Mean±SD, and one-way ANOVA was used for comparison among multiple groups, and LSD method was used for pairwise comparison. Statistical significance was set at P<0.05. Results:Increasing the grafting rate and concentration of GelMA hydrogels effectively enhanced their stiffness. GelMA with a GM90 provided a broader range of stiffness, making it suitable for constructing the adjustable stiffness hydrogels. Fitting curves of GM90 concentrations and stiffness after photopolymerization showed that at concentrations of 2%, 6%, and 15%, GelMA could mimic the stiffness of various tissues of human. Therefore, these three concentrations were selected for subsequent experiments. The Young’s modulus of GM90 at concentrations of 15%, 6% and 2% were (98.43±7.71), (14.57±1.62), and (2.11±0.32) kPa, respectively, with statistically significant differences between each pair of groups ( P<0.01). The pore sizes were (41.32±3.51), (3.26±0.33), and (1.21±0.11) μm, respectively, showing significant differences between each pair of groups ( P<0.01). Surface roughness values were (48.15±2.65), (22.65±1.78), and (24.12±1.43) nm, respectively, with 15% concentration showing significantly higher roughness than the 2% and 6% concentrations ( P<0.01), while there was no significant difference between the 2% and 6% concentrations ( P>0.05). Rheological testing indicated that as the concentration decreased, the shear frequency at the crossover point of the storage modulus and loss modulus of GM90 hydrogels decreased, >100, 30 and 18 Hz, respectively. The result showed that the solid form of GM90 hydrogel with 15% concentration was more stable, while the hydrogel with 2% concentration had better fluidity. Conclusion:Adjusting the grafting rate and concentration can regulate the stiffness of GelMA hydrogels. GelMA hydrogels with a 90% grafting rate provide a wide range of stiffness, making them ideal materials for constructing hydrogels with adjustable stiffness. At concentrations of 2%, 6%, and 15%, GM90 exhibited different mechanical properties and internal structures.

Objective To observe the effects of Simo Decoction on the expressions of vasoactive intestinal peptide(VIP)and its receptor 2(VIPR2)in rats with functional dyspepsia(FD)of liver and spleen stagnation syndrome;To investigate its mechanism of action in regulating gastrointestinal motility.Methods Totally 60 SD rats were randomly divided into blank group,model group,mosapride group(0.305 mg/kg)and Simo Decoction high-,medium-and low-dosage groups(5.62,2.81,1.40 g/kg).The liver and spleen qi stagnation FD rat model was prepared by multifactorial modeling method,and the corresponding drugs were given by gavage for 14 days.The general conditions of rats in each group were observed,and body mass,gastric emptying rate and small intestine propulsion rate were measured;the histological structure of gastric antrum tissue and duodenal tissue were observed by HE staining;the positive expressions of VIP and VIPR2 in duodenal tissue were observed by immunohistochemistry;the protein and mRNA expressions of VIP and VIPR2 in duodenal tissue were detected by Western blot and RT-PCR,respectively.Results Compared with the blank group,the general condition of the rats in model group was poorer,body mass,gastric emptying rate and small intestine propulsion rate were significantly lower(P<0.01),and the protein and mRNA expressions of VIP and VIPR2 in duodenal tissue significantly increased(P<0.05,P<0.01).Compared with the model group,the body mass,gastric emptying rate and small intestine propulsion rate in Simo Decoction high-and medium-dosage groups and the mosapride group significantly increased(P<0.05,P<0.01),and the protein and mRNA expressions of VIP and VIPR2 in duodenal tissue significantly decreased(P<0.05,P<0.01).HE staining showed no significant changes in the morphology of gastric antrum and duodenum tissues.Conclusion Simo Decoction may promote gastrointestinal motility by inhibiting the expressions of VIP and VIPR2 in duodenal tissue of FD rats with liver and spleen qi stagnation,thereby improving FD.

Objective:To investigate the early and mid-term outcomes of aortic endovascular remodeling device (AERD) for Stanford type A aortic dissection (TAAD) in type Ⅱhybrid surgery, and to evaluate its clinical efficacy.Methods:46 patients with TAAD, including 14 females and 32 males, participated in the single-center clinical trial of West China Hospital of Sichuan University and underwent type II hybrid surgery (Bentall / ascending aorta replacement + AERD implantation) from February 2021 to October 2023. The safety and efficacy of AERD in type Ⅱ hybrid surgery for TAAD were estimated by clinical indicators (postoperative mortality, cardiovascular and cerebrovascular accidents, paraplegia, ischemia), and blood flow condition (volume of the true and false lumen, and suprachial branches).Results:Three patients (6.52%) died during the follow-up period, and the operation-related mortality was 4.35% (2/46). The remaining 43 patients were followed up for an average of (25.53±9.60) months. There were two cases (4.35%) of stroke after the operation, and paraplegia, acute renal insufficiency, and other severe complications were not noticed. The blood flow of the superior branch of the aortic arch was unobstructed, and there was no significant difference in the blood flow of the branch before the operation and at each follow-up time point. Compared to the pre-operation, the true lumen volume of the stent part increased by 59.0% and the false lumen volume decreased by 82.4%.Conclusion:AERD is a safe and effective alternative in type II hybrid surgery for acute TAAD, which is helpful in improving perioperative and short- and long-term survival rates and clinical outcomes.

Objective:To analyzed the 3-year follow-up results in a single center to evaluate the mid-term clinical efficacy of aortic endovascular remodeling device(AERD).Methods:From January 2019 to June 2019, 18 patients with residual aortic dissection after proximal repair of acute aortic dissection were treated with AERD in our heart center of West China Hospital of Sichuan University. They were followed up for 3 years after surgery and underwent vascular enhanced CT review. The primary outcome of our study included all-cause mortality and stent-related mortality. Secondary outcome included branch patency rate, reoperation rate and the incidence of serious adverse events. Morphological measures assessed the effectiveness of AERD in treating residual distal dissection.Results:17 patients completed the 3-year follow-up, and 1 was lost to follow-up. There was no stent-related death, branch artery occlusion, or new serious adverse events. 12 patients completed vascular enhanced CT review, the true lumen was significantly expanded and the false lumen was reduced considerably at 3-year follow-up, true lumen volume, (52.39±22.32)cm 3 vs. (74.34±14.64) cm 3( P<0.01), false lumen volume(50.42±25.44) cm 3 vs. (32.32±31.75)cm 3( P<0.01). Increased true lumen diameter and area ( P<0.001) and decreased false lumen diameter( P<0.001) were significantly different from those before operation, especially in the level below the renal artery and 5 cm below the renal artery. Conclusion:The mid-term effect of AERD in treating distal residual dissection is satisfactory, and it promoted positive distal aorta remodeling with safety and effectiveness.

OBJECTIVE To investigated the anti-de-pressant effects of the fruit Areca catechu L.(ACL)and elucidated its potential underlying mechanism using a rat model of chronic unpredictable mild stress(CUMS).METHODS CUMS was induced in rats to establish a depression animal model for 28 d.According to the baseline sucrose preference,the male rats were divided into six different groups.They were treated with parox-etine hydrochloride,ACL,and water once a day until the behavioral tests were performed.The levels of corticoste-rone(CORT),malondialdehyde(MDA),catalase(CAT),and total superoxide dismutase(T-SOD)in serum were de-tected using a commercial kit,and the concentrations of 5-hydroxytryptamine(5-HT)and dopamine(DA)mono-amine neurotransmitters in the brain tissues were detect-ed by liquid chromatography-tandem mass spectrometry.Doublecortin(DCX)expression in the hippocampal den-tate gyrus(DG)was determined by immunofluorescence,and the relative abundance of brain-derived neurotrophic factor(BDNF),TrkB,PI3K,p-Akt/Akt,PSD-95,and p-GSK-3β/GSK-3β of brain tissues were assayed by West-ern blotting.RESULTS ACL markedly increased sucrose preference,decreased the immobility time,and short-ened the feeding latency of CUMS-induced rats.CUMS induction resulted in marked changes in the contents of the monoamine neurotransmitters(5-HT and DA)in the hippocampus and cortex of brain tissues and the levels of CORT,MDA,CAT,and T-SOD in serum,whereas ACL administration alleviated these considerable changes.ACL promoted DCX expression in DG and increased the protein levels of BDNF,TrkB,PI3K,p-Akt/Akt,PSD-95,and p-GSK-3β/GSK-3β in the brains of CUMS-induced rats.CONCLUSION Our results indicated that ACL may improve depression-like behaviors in CUMS-induced rats by decreasing the hyperfunction and oxidative stress of the hypothalamic-pituitary-adrenal axis,stimulating hippo-campal neurogenesis,and activating the BDNF signaling pathway.