Objective To explore the effect of Morinda citrifolia juice(MCJ)combined with ethylene diamine tet-raacetic acid(EDTA)on premolar bonding strength and nanoleakage and compare the results with those of the most commonly used root canal irrigation solution,sodium hypochlorite(NaClO),to provide a reference for clinical applica-tion.Methods This study was approved by the ethics review committee.Sixty-three human premolars extracted for orthodontic treatment were randomly divided into a control group(distilled water group)and 6 experimental groups ac-cording to the different rinsing solutions used after the surface enamel was removed.The experimental groups included Group A(2.5%NaClO),Group B(5.25%NaClO),Group C(6%MCJ),Group D(2.5%NaClO-17%EDTA),Group E(5.25%NaClO-17%EDTA),and Group F(6%MCJ-17%EDTA)(n = 9).After soaking in the corresponding rinsing so-lution for 20 minutes,they were layered and stacked on their surfaces to form 4 mm×4 mm×3 mm Z350 resin blocks.Six samples from each group were cut into 1 mm×1 mm×8 mm specimen strips for microtensile bonding strength test-ing.The fracture type was determined under a stereomicroscope,and the remaining 3 samples from each group were aged and cut into 1 mm thick slices for interface nanoleakage testing and scanning electron microscopy observation of the resin dentin bonding interface.Results There were significant differences in the microtensile bonding strength among the groups(P＜0.05),and the control group had the highest bonding strength.Among experimental groups,Group B had the lowest bonding strength,mainly bonding interface fracture,and Group F had the highest bonding strength,mainly mixed fracture.There were significant differences in nanoleakage among all groups(P＜0.05),and the control group had the lowest nanoleakage value.Among experimental groups,Group B had the highest nanoleakage,with resin protrusions being unaltered,and Group F had the lowest nanoleakage value,with resin protrusions being thick and dense.Conclusion The higher the concentration of NaClO was,the worse the bonding strength and edge sealing of the crown dentin were.The effects of root canal irrigation with MCJ and EDTA on the adhesive strength and edge sealing of crown dentin were less pronounced than those of root canal irrigation with NaClO and EDTA.

Public hospitals serve as important windows for the Party to lead the people and serve the people,making the exploration of Party-building-led high-quality development in public hospitals highly significant in practical terms.This study delves into the current challenges faced in guiding the high-quality development of public hospitals through party building.It presents the practical exploration and outcomes of Dongguan People's Hospital,which has taken the initiative to establish a provincial demon-stration site for the"Four Orientations"project(Leading groups work effectively,Party branches work with promising methods,Party building achieves a fame with brand,and each unit has its own model)within the public hospital party-building framework.The hospital has deepened the practical application of the"Four Endeavors"project by practicing the project.These practices offer valuable insights into and references for high-quality development in public hospitals under the guidance of Party building.

As a neurological disorder in the brain, epilepsy is not only associated with abnormal synchronized discharging of neurons, but also inseparable from non-neuronal elements in the altered microenvironment. Anti-epileptic drugs (AEDs) merely focusing on neuronal circuits frequently turn out deficient, which is necessitating comprehensive strategies of medications to cover over-exciting neurons, activated glial cells, oxidative stress and chronic inflammation synchronously. Therefore, we would report the design of a polymeric micelle drug delivery system that was functioned with brain targeting and cerebral microenvironment modulation. In brief, reactive oxygen species (ROS)-sensitive phenylboronic ester was conjugated with poly-ethylene glycol (PEG) to form amphiphilic copolymers. Additionally, dehydroascorbic acid (DHAA), an analogue of glucose, was applied to target glucose transporter 1 (GLUT1) and facilitate micelle penetration across the blood‒brain barrier (BBB). A classic hydrophobic AED, lamotrigine (LTG), was encapsulated in the micelles via self-assembly. When administrated and transferred across the BBB, ROS-scavenging polymers were expected to integrate anti-oxidation, anti-inflammation and neuro-electric modulation into one strategy. Moreover, micelles would alter LTG distribution in vivo with improved efficacy. Overall, the combined anti-epileptic therapy might provide effective opinions on how to maximize neuroprotection during early epileptogenesis.

Objective: To explore the effects of long non-coding RNA (LncRNA) MIR22HG on proliferation，apoptosis and inflammatory response of rheumatoid arthritis (RA) fibroblast-like synoviocytes (FLSs) and its molecular mechanism． Methods: Synovial tissue samples were collected from 37 RA patients and 30 joint trauma patients in our hospital，and the expression levels of MIR22HG and miR-22-5p in synovial tissue were detected by qRT-PCR. RA-FLSs in human was isolated ，cultured and identified in vitro． MIR22HG siRNA interference plasmid (si-MIR22HG) and its negative control plasmid (si-NC) ，miR-22-5p inhibitor and its negative control (inhibitorNC) were transfected into RA-FLSs respectively or simultaneously．The expression levels of MIR22HG and miR- 22-5p were detected by qRT-PCR. CCK-8 was used to detect the proliferation activity of cells in various groups. Annexin Ⅴ- FITC / PI was used to detect the apoptosis rates of cells in various groups．ELISA was used to detect the levels of TNF-α , IL-1 β and IL-6 in the supernatant of cells in various groups．Western blot was used to detect the protein expression levels of Bcl-2，Bax and Cleaved caspase-3 of cells in various groups．The targeting relationship between MIR22HG and miR-22-5p was verified by dual luciferase reporter gene assay. Results : Compared with joint trauma patients，the expression level of MIR22HG in synovial tissues of RA patients increased (P＜0. 05) ， while the expression level of miR-22-5p decreased (P＜0. 05) ．Interference with MIR22HG inhibited the proliferation activity of RA-FLSs，decreased the levels of TNF-α , IL-1 β and IL-6 in cell supernatant and the protein expression level of Bcl-2 in cells (P＜0. 05) ，and increased the apoptosis rate，the expression level of miR-22-5p and the protein expression levels of Bax and Cleaved casepase-3 (P ＜0. 05 ) ．However，inhibition of miR-22-5p expression reversed the effects of MIR22HG gene silencing on proliferation，apoptosis and inflammation of RA-FLSs (P＜0. 05) ．Dual luciferase reporting assay showed that miR-22-5p was a potential downstream miRNA target of MIR22HG． Conclusion MIR22HG is highly expressed in synovial tissues of RA patients，and it may promote the proliferation and the inflammatory response of RA-FLSs and inhibit cell apoptosis by down regulating the expression of miR-22-5p.

Objective:To explore the effect of core muscle strength training intervention on postoperative rehabilitation of patients after total knee arthroplasty, and to provide reference for the rehabilitation of patients after total knee arthroplasty.Methods:A total of 109 patients with total knee arthroplasty who were admitted to Medical Health Group of First People′s Hospital of Xiangshan County from May 2020 to July 2021 were selected as the research objects, and were divided into an intervention group of 54 cases and a control group of 55 cases according to the random number table method. The control group received conventional rehabilitation methods after surgery, and the intervention group received core muscle strength training on the basis of conventional rehabilitation. The intervention time was 6 weeks. The knee joint function, balance function and activities of daily living were evaluated by Hospital for Special Surgery Knee Score, Berg Balance Scale, modified Barthel Index before and after intervention and the results were compared between the two groups.Results:In the end, there were 50 cases in the intervention group and 52 cases in the control group. There was no significant difference in the score of the knee joint function, balance function and activities of daily living before intervention between the two groups( P>0.05). The scores of the knee joint function, balance function and activities of daily living were (74.78 ± 3.12), (46.50 ± 3.82), (92.80 ± 5.17) points in the intervention group, and (72.15 ± 3.31),(44.44 ±3.66),(89.42 ± 4.50) points in the control group, the differences were statistically significant ( t=4.12, 2.78, 3.52, all P<0.01). The knee joint function recovery grade in the intervention group was higher than that in the control group, and the difference was statistically significant ( Z=3.43, P<0.01); the degree of dependence on self-care ability in daily life in the intervention group was lower than that in the control group, and the difference was statistically significant ( Z=3.98, P<0.01). Conclusions:Core muscle strength training can effectively improve postoperative knee function, balance function and activities of daily living in patients with total knee arthroplasty. This program is practical in clinical work and has clinical application value.

Objective:To analyze the clinical features of a kindred of X-linked adrenoleukodystrophy(X-ALD) with the onset of primary adrenocortical insufficiency, and to detect the mutation of ATP-binding cassette, sub-family D, member l(ABCD1) gene.Methods:A Chinese X-ALD kindred with two affected males from two-generations was studied. The clinical data of the proband′s family members were collected. The sequences of ABCD1 of the proband, his parent and young brother were detected by next-generation sequencing. X-ALD was diagnosed according to clinical manifestations, cranial MRI image, and serum level of very long chain fatty acid(VLCFA).Results:The two cases were all males. The proband was characteristic of primary adrenocortical insufficiency and neurological dysfunction, with extensive cerebral white matter demyelination and high serum VLCFA level. At the age of 2 years and 10 months, the younger brother of the proband presented with primary adrenocortical dysfunction, without neurological symptoms. Gene sequencing results of two patients showed a novel missense substitution(c.1666C>T) in exon 7 of ABCD1 inherited from their mother.Conclusion:The new mutation of ABCDl gene c. 1666C>T may lead to adrenoleukodystrophy. Primary adrenocortical insufficiency and neurological dysfunction are the typical manifestations of X-ALD.

Objective To investigate the significance of lactate dehydrogenase(LDH) in the diagnosis and treatment of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods This was a study of children with Mycoplasma pneumoniae pneumonia(MPP) admitted to hospital from June 2013 to June 2016.All patients were treated with erythromycin.Based on the definition of RMPP,subjects were divided into usual MPP group and RMPP group.The children in RMPP group were treated with erythromycin combined with methylprednisolone.The indicators including LDH,WBC counts,C-reactive protein,erythrocyte sedimentation rate(ESR),alanine aminotransferase(ALT),aspartate amino ransferase(AST) and creatine kinase were analyzed between RMPP group and usual MPP group.The differences of the above indicators between the effective and ineffective group before and after methylprednisolone treatment were also compared.Results In total,253 subjects were enrolled,including 161 in the usual MPP group and 92 in the RMPP group.The average age in RMPP group was older than that in the usual MPP group.The indicators(including LDH,AST,ALT,and ESR) of RMPP group were higher than those in the usual MPP group.Logistic regression showed that LDH and ESR were the significant factors in predicting RMPP.The odds ratio(OR) of LDH was 1.029 with 95%CI 1.020-1.037,and the OR of ESR was 1.063 with 95%CI 1.009-1.120.Receiver operating characteristic curve analysis showed that the area under the curve of LDH(400.50U/L) was the largest(0.959,95%CI 0.936-0.983).The administration of methylprednisolone to patients in the RMPP group resulted in the rapid improvement of symptoms and decrease in serum LDH and ESR levels in effective group(P＜0.05).Conclusion Serum LDH may be used as a biomarker to predict RMPP at the early stage,also may be an important marker for the evaluation of therapeutic efficacy in RMPP.

Objective To investigate illness perceptions of primary nocturnal enuresis(PNE) children's parents,to summarize the nursing countermeasures.Methods A total of 232 children's parents were evaluated using PNE knowledge questionnaire from November 2011 to November 2014.According to the results,children and parents were cared and educated targetly.Then parents were evaluated again after the treatment and nursing intervention.Results A total of 210 parents completed the evaluation,95.2％ parents knew PNE was a disease,90.0％ parents had correct knowledge of PNE,91.9％ parents clearly knew the inducing factors of PNE,91.0％ parents clearly knew the detriment of PNE,89.5％ parents clearly knew the treatment method of PNE,94.8％ parents knew the recovery of PNE.There were significant differences before and after the nursing intervention (x2 =235.347,215.872,207.239,196.039,207.499,216.463,respectively;P ＜ 0.05).Conclusions Newly diagnosed PNE children's parents have a little awareness of the disease,especially lack of the awareness of inducing factors and treatment methods.According to personalcharacter,nursing education can improve the awareness of the disease,and enhance the level of disease control so as to reduce the economic burden on family and society.

OBJECTIVETo evaluate the effects of an exercise-based treatment programme (dyslexia, dyspraxia and attention-deficit treatment, DDAT) on various subtypes of attention-deficit/hyperactivity disorder (ADHD).

METHODNinety-one ADHD children with standing balance dysfunction (ADHD-I 43, ADHD-HI 15 and ADHD-C 33) were given DDAT for 6 months, the efficacy of DDAT was evaluated before DDAT, three, six months after the treatment and three month after end of the treatment according to SNAP-IV, before and after the treatment by balancing function test and Conners Parents Rating Scale.

RESULTInattention subscale scores of ADHD-I, ADHD-HI and ADHD-C before and after the interventions were 1.99 ± 0.34, 0.96 ± 0.31, 2.17 ± 0.31and 1.19 ± 0.45, 0.81 ± 0.28, 1.32 ± 0.37, differences of ADHD-I and ADHD-C were significant (P < 0.05), hyperactivity subscale scores of three subtypes of ADHD were 0.81 ± 0.35, 2.01 ± 0.35, 1.96 ± 0.33 vs.0.45 ± 0.33, 0.79 ± 0.41, 1.10 ± 0.35, there were significant differences as well (P < 0.05). The score of hyperactivity symptom was reduced more compared to that of inattention symptom by the SNAP-IV scale parent forms. There were significant difference before and after the treatment based on Conners parent scale for conduct problem (1.11 ± 0.48 vs. 0.76 ± 0.44) , learning problem (1.97 ± 0.58 vs.1.60 ± 0.67), psychosomatic problems (0.61 ± 0.49 vs. 0.29 ± 0.35) , activity/ hyperactivity (1.46 ± 0.69 vs.1.09 ± 0.55) and anxiousness (1.05 ± 0.63 vs.0.62 ± 0.47) as well (P < 0.05); the standing balance dysfunction improved for most of the children, total effective rate was 87.9%, no significant difference was found among the three subtypes (P > 0.05).

CONCLUSIONDDAT is a safe and efficient intervention for the ADHD children with standing balance dysfunction, the improvement on hyperactivity symptom was better than that on inattention symptom. This study shows that an exercise-based treatment programme for cerebellum function improves symptoms of ADHD and balance function.

Adolescent ; Anxiety ; physiopathology ; therapy ; Attention Deficit Disorder with Hyperactivity ; physiopathology ; therapy ; Cerebellum ; physiopathology ; Child ; Exercise ; physiology ; Female ; Humans ; Impulsive Behavior ; physiopathology ; therapy ; Learning Disorders ; physiopathology ; therapy ; Male ; Postural Balance ; physiology ; Psychiatric Status Rating Scales ; Surveys and Questionnaires ; Treatment Outcome

Objective To explore the diagnostic value of ultrasound in thyroid nodular disease.Methods Eighty-seven patients with thyroid nodule in hospital from 2010-2011 were taken ultrasound examination,including 23 cases with benign nodules and 64 cases with malignant nodules.Univariate analysis and mutivariate Logistic regression analysis were taken to test the ultrasonic index (internal echo,boundary,size,shape,microcalcifications,and aspect ratio) for discovery of the best diagnostic ultrasonic index to identify benign and malignant nodules.Results The ultrasound in the patients with malignant thyroid nodules showed the hypoecho,unclear border,irregular shape,microcalcifications,low blood supply,the aspect ratio ＞ 1.The ultrasound in the patients with benign thyroid nodules showed high or equal echo,clear border,regular shape,high blood supply,and the aspect ratio≤ 1.The ultrasonic indices between two groups had statistically significant difference (P ＜ 0.05).The shape and microcalcifications were the best ultrasonic diagnostic index to indentify the benign and malignant nodules with an EXP(B) 20.12 and 19.14,respectively.Conclusions The ultrasound is helpful in the diagnosis of thyroid nodular disease and identification of benign and malignant thyroid nodules.The ultrasonic images are the basic data for the clinical diagnosis of thyroid nodules.