OBJECTIVE: To investigate the effect of Akt2 inhibitor on macrophage polarization in the periapical tissue in a rat model of periapical inflammation. METHODS: Rat models of periapical inflammation were established in 28 normal SD rats by opening the pulp cavity of the mandibular first molars, followed by injection of normal saline and Akt2 inhibitor into the left and right medullary cavities, respectively. Four rats without any treatment served as the healthy control group. At 7, 14, 21 and 28 days after modeling, 7 rat models and 1 control rat were randomly selected for observation of inflammatory infiltration in the periapical tissues by X-ray and HE staining. Immunohistochemistry was used to detect the expression and localization of Akt2, macrophages and the inflammatory mediators. RT-PCR was performed to detect the mRNA expressions of Akt2, CD86, CD163, inflammatory mediators, miR-155-5p and C/EBPβ to analyze the changes in macrophage polarization. RESULTS: X-ray and HE staining showed that periapical inflammation was the most obvious at 21 days after modeling in the rats. Immunohistochemistry and RT-PCR showed that compared with those in the control rats, the expressions of Akt2, CD86, CD163, miR-155-5p, C/EBPβ, and IL-10 increased significantly in the rat models at 21 days (P < 0.05). Compared with saline treatment, treatment with the Akt2 inhibitor significantly decreased the expression levels of Akt2, CD86, miR-155-5p and IL-6 and the ratio of CD86⁺M1/CD163⁺M2 macrophages (P < 0.05) and increased the expression levels of CD163, C/EBPβ and IL-10 in the rat models (P < 0.05). CONCLUSION Inhibition of Akt2 can delay the progression of periapical inflammation in rats and promote M2 macrophage polarization in the periapical inflammatory microenvironment possibly by reducing miR-155-5p expression and activating the expression of C/EBPβ in the Akt signaling pathway.
Rats ; Animals ; Proto-Oncogene Proteins c-akt/metabolism* ; MicroRNAs/genetics* ; Interleukin-10 ; Rats, Sprague-Dawley ; Macrophages/metabolism* ; Inflammation/metabolism*

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective:To explore the status and influencing factors of incontinence-associated dermatitis among elderly inpatients in 52 hospitals nationwide, and to analyze the nursing of elderly inpatients with incontinence, so as to provide a reference for clinical intervention.Methods:On March 31, 2021, convenience sampling was used to select 14 675 elderly inpatients from 52 hospitals across the country as the research object. The self-designed Incontinence-associated Dermatitis Questionnaire for Elderly Inpatients was used to collect general demographic data, health status, incontinence, and skin nursing. Binomial Logistic regression was used to investigate the influencing factors of incontinence-associated dermatitis in elderly inpatients.Results:Among 14 675 elderly inpatients, the prevalence rates of xerosis cutis, incontinence and incontinence-associated dermatitis were 38.78% (5 691/14 675) , 11.06% (1 623/14 675) and 1.91% (280/14 675) , respectively. The prevalence of mild, moderate and severe incontinence-associated dermatitis were 1.27% (186/14 675) , 0.55% (81/14 675) , and 0.09% (13/14 675) , respectively. Among the nursing of 1 623 elderly inpatients with incontinence, the items with low implementation rate were the use neutral lotion to clean skin (14.17%, 230/1 623) , use of skin protectant after moisturizing (17.68%, 287/1 623) , moisturizing after cleansing the skin (28.90%, 469/1 623) . The results of binomial Logistic regression analysis showed that xeroderma, fecal incontinence, urinary and fecal incontinence, ≥2 kinds of combined medication, and hospital stay >30 days were risk factors for incontinence-associated dermatitis in elderly inpatients.Conclusions:The risk factors of incontinence-associated dermatitis in elderly inpatients mainly include xerosis cutis, type of incontinence, ≥2 kinds of combined medication, and hospital stay >30 days.

Objective: To investigate the efficiency and safety of hypofractionated radiotherapy (HFR) combined with chemotherapy using paclitaxel for the treatment of esophageal cancer (EC) patients with post-operative tracheoesophageal groove lymph node (TGLN) metastasis. Methods: A total of fifty-three post-operative EC patients with TGLN metastasis were randomly divided into HFR group (n=25), receiving a radiation of 60 Gy/20 fractions, and conventional fractionated radiotherapy (CFR) group (n=28), receiving a radiation of 60 Gy/30 fractions combined with chemotherapy using paclitaxel with a dosage of 50 mg once per week through tossing a coin. the adverse events and the prognosis between two groups were compared. Results: The incidence of radiation esophagitis and pneumonitis (grade 3-4) between the HFR group and CFR group showed no statistically significant difference (44.0%, 25.0%, P>0.05; 16.0%, 7.1%, P>0.05). No statistical difference was noticed in the efficiency between the HFR group and the CFR group (P>0.05). The efficiency in patients with lymph node metastasis at diameters ≤2 cm was significantly higher than that with lymph node metastasis at diameters >2 cm (P<0.05). The median overall survival (OS) of the HFR group showed a significant increase compared with that of the CRF group [24.2 months (95%CI 16.2-32.1 months) vs. 11.8 months (95%CI 9.2-14.4 months)] (χ²=5.063, P<0.05). Both univariate and multivariate analysis indicated that TGLN diameter (P<0.05) and fractioned types (P<0.05) were factors that affected the prognosis. Conclusions: The combination of HFR and chemotherapy contributed to the improvement of prognosis in EC patients with TGLN metastasis and there was no obvious increase in the adverse events. Trial registration Chinese clinical trial registry, ChiCTR1800016848

Objective To explore the effects of self-role recognition nursing on the agitation behavior and social interaction in schizophrenic patients with diabetes mellitus. Methods A total of 98 cases of schizophrenia patients with diabetes mellitus treated in Wuxi Mental Health Center of Jiangsu Province from October 2014 to October 2016 were selected as the research objects. The patients were randomly divided into control group and study group by random number table method. The control group was given routine nursing intervention, while the study group was given self-role recognition nursing intervention for 6 months. The level of fasting blood glucose and 2-hour postprandial blood glucose were compared between the two groups. Patients' agitation behavior was evaluated by Cohen-Mansfield agitation inventory (CMAI); social communication ability was evaluated by social skills checklist (SSC) and social adaptive functioning evaluation (SAFE); mental status was evaluated by positive and negative syndrome scale (PANSS). The data of this study were statistically analyzed with SPSS 19.0 statistical software, in which the measurement data were tested by t-test, and the enumeration data were tested by χ2test. Results Before intervention, there was no significant difference in fasting blood glucose and 2-hour postprandial blood glucose between the two groups (P> 0.05). After intervention, the fasting blood glucose and 2-hour postprandial blood glucose level in the study group were significantly lower than those in the control group, and the differences were statistically significant (P< 0.01). The scores of physically aggressive agitation, physically non-aggressive agitation, verbal agitation and the total score of CMAI in the control group were (16.4±3.7), (31.5±4.9), (25.2±4.5), (73.1±4.5) respectively after intervention, and the scores were (11.8±3.2), (24.1±5.3), (17.5±4.2), (53.4±4.7) in the study group. The differences between the two groups after intervention were statistically significant (t=7.268, 8.617, 8.561, 15.341;P<0.01). The results of SSC scale and SAFE scale in both groups decreased than before intervention, and the scores of the study group were all lower than those of the control group, with statistical significance (P<0.01). After intervention, the scores of positive symptoms, negative symptoms, negative symptoms and the total score of PANSS scale of the study group were significantly lower than those of the control group, and the differences were statistically significant (P<0.01). Conclusions Self-role recognition nursing intervention can be used to improve the patients' social interaction ability and mental status in the nursing process of schizophrenia patients with diabetes mellitus, and it is worthy of clinical promotion.

Amisulpride,a kind of the second generation antipsychotics,was marketed in China in 2010.A series of clinical research and experience before and after listed,especially the data based on Chinese population,provided evidence for the generalization and application of amisulpride.In order to optimize the clinical application of amisulpride,and improve the prognosis of patients,Expert Advice on the Practical Use of Amisulpride in the Treatment of Schizophrenia is presented here.This advice is based on the recent evidence and clinical experience,for guiding the clinical medication of amisulpride.

BACKGROUND: Most of studies focus on the biomechanical characteristics of thoracic spine neoplasm, but there is little report on the fracture risk in the patients with vertebral hemangioma through finite element analysis.OBJECTIVE: To establish a finite element model of vertebral hemangioma, and to analyze its biomechanical characteristics, and assess the risk of vertebral fracture.METHODS: Three-dimensional finite element models of T12-L2 vertebrae from normal individuals, the patients with vertebral hemangioma (hemangioma accounting for 20%, 40%, 60%, 80% of the vertebral cancellous bone) and bone cement filling were established, respectively, and then the mechanical characteristics were analyzed. The stress distribution and characters of each model were determined under a vertical static pressure of 600 N.RESULTS AND CONCLUSION: (1) Three-dimensional finite element models of T12-L2 vertebrae were established successfully. Under static pressure, the stress distribution of L1 cortical bone showed no significant difference among models, and the maximum stress all occurred at the base of pedicle, zygapophysial joint and isthmus. (2) The stress distribution did not differ significantly between vertebral hemangioma accounting for 20%-40% of vertebral cancellous bone with complete cortical bone and normal ones, but which differed significantly in hemangioma accounting for 60%-80%. (3) To conclude, the established thoracolumbar three-dimensional model is available. Additionally,biomechanical tests manifest that the completeness of cortical bone and destruction ratio of cancellous bone destruction are key factors for the fracture risk of vertebral hemangioma.

OBJECTIVE To analyze the clinical manifestation,diagnosis and treatment of cervical lymph node tuberculosis.METHODS The clinical data of 100 patients with cervical lymph node tuberculosis admitted in our hospital from 2007 to 2015 were retrospectively analyzed.RESULTS Most of the patients with cervical lymph node tuberculosis presented with cervical mass alone,only 8 cases associated with fever,night sweats,fatigue and other systemic symptoms of poisoning.Ninety five patients were diagnosed by postoperative pathological examination,while 15 patients were diagnosed with fine needle aspiration preoperatively.Ninety five patients received surgical treatment with postoperative systemic anti-tuberculosis treatment for 6 months,the remaining 5 patients given standard antituberculosis treatment.All of the patients got satisfactory results.There were three operative methods:simple cervical lymph node resection(31 cases),cervical lymph node dissection(53 cases),and abscess incision debridement(ll cases).All patients had no recurrence.CONCLUSION The clinical manifestation of cervical lymph node tuberculosis are complicated,the positive rate of fine needle aspiration biopsy is low.Postoperative pathological examination can help to further confirm the diagnosis.Surgical treatment combined with postoperative systemic standard anti-tuberculosis therapy can be used to cervical lymph node tuberculosis.

Objective To observe the effects of bisphosphonate on the inhibit proliferation and the apoptosis effect in osteo‐sarcoma MG‐63 cells in vitro ,explore the phosphonic acid salt of bone sarcoma cells ,induce apoptosis and its possible mechanism . Methods Sixty three osteosarcoma MG‐63 cells were cultured in vitro .After treated with bisphosphonate 400 μg/mL ,without bi‐sphosphonate but normal saline ,they were incubated 72 h after the application of the two group cell immunofluorescence test ;then observe the expression of apoptosis factors Caspase 3 and Fas ;Flow cytometry detection line was used to detect the osteosarcoma cell line MG‐63 cells apoptosis rate of each group .Results 72 h after treatment with bisphosphonate ,the expression of apoptosis factor of Caspase‐3 and Fas in osteosarcoma MG‐63 cells were strongly expressed ,and it was observed by immunofluorescent assay , while in blank control group ,we could barely see the expression of apoptosis factors Caspase‐3 and Fas ;Flow cytometry test results showed that two phosphonic acid salt 400 μg/mL intervention group cell apoptosis rate was 54 .00% ,far more than normal saline blank control group ,of which the apoptosis rate was 3 .10% ,the difference was statistically significant (P<0 .05) ,there is an obvi‐ous phenomenon of induced apoptosis .Conclusion Bisphosphonate has a strong apoptotic effects of bisphosphonate in osteosarcoma MG‐63 cells in vitro .Bisphosphonate can inhibit osteolysis of osteosarcoma MG‐63 cells via regulating the expression of Caspase‐3 , Fas in osteosarcoma MG‐63 cells .Bisphosphonate may serve as a potential therapeutic agent for treatment of osteosarcoma .

Objective To observe the pathological response in the tumor tissue and the changes of serum level of vascular endothelial growth factor ( VEGF) in esophageal cancer patients receiving concurrent chemoradiotherapy, in order to study the impacts of these two factors on the prognosis of patients. Methods One hundred pathologically confirmed esophageal cancer patients were treated with radiotherapy including 72 patients with concurrent chemoradiotherapy. After 4 weeks, gastroscopy was performed to collect tumor biopsies for examination of pathological changes. The responses to radiotherapy were classified into three degrees: mild, moderate and intensive. Moreover, serum samples were collected from the patients prior to, at the fourth week during radiotherapy, and one week after radiotherapy, and serum VEGF level was determined. The changes of serum VEGF were classified as increased, unchanged and decreased. Serum samples from 30 healthy subjects were collected and represented as VEGF healthy control. Results Among the eighty?nine patients evaluable, the 1? and 3?year overall survival ( OS) rates were 70.8% and 33.3%, respectively;1?year and 3?year progression?free survival ( PFS) rates were 61.8% and 28.2%, respectively;and 1?year and 3?year local control ( LC) rates were 76.9% and 50.0%, respectively. The 1?year OS rates in the patients with mild, moderate and intensive pathological responses were 50. 0%, 76. 9% and 78. 0%, respectively. The 1?year OS rate in the mild response group was significantly lower than that in the intensive response group ( P<0.05) . The 1?year and 3?year PFS rates in the three groups were 36.4%, 73.1%, 68.3%, and 0. 0%, 40.0% and 38. 9%, respectively, showing that the rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . The PFS rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . Moreover, the 1?year local control ( LC) rates in the three groups were 52.9%, 83.3%and 83.8%, and the three?year LC rates were 0. 0%, 64. 3% and 64. 0%, respectively, showing that the lowest LC rates in the mild response group were significantly lower than that in the moderate and intensive response groups (P<0.05 for both). The average serum VEGF levels in the patients prior to, during and after radiotherapy were (109.6±33.7) ng/L, (101.2±24.3) ng/L and (99.5±22.9) ng/L, respectively, all significantly higher than that in the healthy subjects [(79.6±39.2) ng/L, P<0.05 for both]. The level of serum VEGF was decreased during and after radiotherapy compared with that before radiotherapy ( F=6.124, P=0.004). The 1?year OS rates in the VEGF?increased, unchanged and decreased groups were 50.0%, 67.4% and 86.7%, respectively, and the 3?year OS rates in these three groups were 15. 4%, 27. 0% and 50.0%, respectively. The OS rates in the increased group were significantly lower than that in the VEGF?decreased group (P<0.05). Moreover, the 3?year PFS rates in the three groups were 7.7%, 21.6% and 46.4%, respectively, and the rate in the VEGF?increased group was significantly lower than that in the VEGF?decreased group ( P<0.05) . The multi?variate analysis showed that TNM stage, pathological response and serum VEGF were independent factors affecting the survival in the non?surgical patients with esophageal cancer (P<0.05 for all). Conclusions Tumor tissue pathological response and variation of serum VEGF level in response to chemoradiotherapy can be used to predict the efficacy of chemoradiotherapy in non?surgical patients with esophageal cancer. Hence, monitoring the pathological response and VEGF changes during the course of therapy is of utmost importance to evaluate and perform an individualized therapy in clinical practice.