1.Changes in soft and hard tissue of central incisor before and after distal migration of the maxillary dentition in adult patients with different periodontal phenotypes
CHEN Rui ; HAN Shuang ; AN Qi
Journal of Prevention and Treatment for Stomatological Diseases 2025;33(1):41-49
		                        		
		                        			Objective :
		                        			 To explore the changes of periodontal soft and hard tissue parameters of the maxillary central incisors after the distant migration of the maxillary total dentition in adult patients with different periodontal phenotypes, so as to provide a reference for orthodontic treatment. 
		                        		
		                        			Methods:
		                        			 The study was approved by the hospital ethics committee, and the patients signed the informed consent form. Fifty-two adult patients in the orthodontic department of Hefei Stomatological Hospital were selected and divided into thick gingival and thin gingival groups, with 26 cases in each group. The labial and palatal alveolar bone parameters and various periodontal indexes of the maxillary central incisor teeth of the two groups were collected and recorded before and after treatment. SPSS 26.0 statistical software was used to statistically analyze the intra-group and inter-group differences. 
		                        		
		                        			Results:
		                        			After orthodontic treatment, the differences in sella-nasion-subspinale angle (SNA), sella-nasion-supramental angle (SNB), and subspinale-nasion-supramental angle (ANB) were not statistically significant (P > 0.05). However, the inclination of the upper middle incisor teeth (U1-NA) decreased significantly (P < 0.05), and there was no significant difference in SNA, SNB, ANB, and U1-NA between the two groups after treatment (P > 0.05). The thickness of the labial alveolar bone of the maxillary central incisors in both groups increased at the labial neck 1/3 and labial middle 1/3 (P < 0.05), and decreased at the apical 1/3 (P < 0.05). The thickness of the palatal alveolar bone decreased at the labial neck 1/3 and labial middle 1/3 (P < 0.01), and increased at the apical 1/3 (P < 0.01). In both groups, the height of the lip and palate of the upper jaw decreased to different degrees, and the height of the palatal alveolar bone was lower in the thin gingival group (P < 0.05). There were no significant differences in maxillary central incisor probing depth (PD), lip keratinized tissue width (KTW), or lip gingival recession (GR) between the two groups after treatment (P > 0.05). 
		                        		
		                        			Conclusion
		                        			 In the process of maxillary central incisor adduction, the labial-palatine alveolar bone remodeling is not uniform, and the alveolar bone of palatine side is mainly absorbed, which should be paid attention to clinically. Palatal alveolar bone height decreased more significantly in patients with thin gingiva after orthodontic treatment, and the risk of bone fenestration and bone dehiscence was greater.
		                        		
		                        		
		                        		
		                        	
2.Knockdown of interferon-γ inducible protein 30 (IFI30) inhibits the proliferation, invasion and migration of human glioma U251 cells by activating STAT1 and promotes their apoptosis.
Jingjing YE ; Wenqin XU ; Tianbing CHEN
Chinese Journal of Cellular and Molecular Immunology 2024;40(1):33-42
		                        		
		                        			
		                        			Objective To establish U251 cells with inhibited expression of interferon-γ inducible protein 30 (IFI30), and to investigate the effect of IFI30 on cell biological function as well as its underlying mechanism. Methods Three knockdown sequences which target IFI30 were designed online and 3 small interfering RNAs (siRNA) were synthesized. After transfection, the inhibition efficiency was detected by real-time quantitative PCR. The siRNA sequence with the highest inhibition efficiency was selected to create short hairpin RNA (shRNA) plasmids. The recombinant plasmids and packaging plasmids were co-transfected into HEK293T cells to prepare lentivirus. The glioma U251 cells were transfected with lentivirus, and the positive cells were screened by puromycin. CCK-8 assay, 5-ethyl-2'-deoxyuridine (EdU) and colony formation assays were used to analyze cell proliferation; the flow cytometry was used to analyze cell cycle and apoptosis; the TranswellTM assay was used to detect cell invasion; the wound-healing assay was employed to detect cell migration, and western blot analysis to detect the protein expresison of cyclin D1, B-cell lymphoma factor 2 (Bcl2), epithelial cadherin (E-cadherin), neural cadherin (N-cadherin), signal transducer and activator of transcription 1 (STAT1). Results The sequence which effectively target IFI30 was screened and U251 cell line capable of inhibiting the IFI30 expression was successfully established. When IFI30 expression was knocked down, the proliferation of U251 cells was inhibited, along with increased ratio of cells in the phase G0/G1, the decreased phase S, the increased rate of cell apoptosis. The cell invasion and migration capabilities was also reduced. The decreased expression of cyclin D1, Bcl2 and N-cadherin were observed in U251 cells, and the expression of E-cadherin and the phosphorylation of STAT1 were found increased. Conclusion Knockdown of IFI30 inhibits the proliferation, invasion and migration of human glioma cell U251 and promotes its apoptosis by activating STAT1.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Cyclin D1/genetics*
		                        			;
		                        		
		                        			HEK293 Cells
		                        			;
		                        		
		                        			Interferon-gamma
		                        			;
		                        		
		                        			RNA, Small Interfering
		                        			;
		                        		
		                        			Apoptosis/genetics*
		                        			;
		                        		
		                        			Cadherins
		                        			;
		                        		
		                        			Cell Proliferation/genetics*
		                        			;
		                        		
		                        			Glioma/genetics*
		                        			;
		                        		
		                        			Proto-Oncogene Proteins c-bcl-2
		                        			;
		                        		
		                        			Oxidoreductases Acting on Sulfur Group Donors
		                        			;
		                        		
		                        			STAT1 Transcription Factor/genetics*
		                        			
		                        		
		                        	
3. Effects of the proliferation, migration and apoptosis of AHVAC - on gastric cancer MKN-28 cells
Xiaomei HUANG ; Hui ZHI ; Hao CHEN ; Linming LU ; Xiaoqun ZHU ; Lizhen WANG ; Jue ZHOU ; Jinjin PANG ; Jinliang XU
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(3):270-276
		                        		
		                        			
		                        			 AIM: To investigate the effects of agkis-trodon halys venom anti-tumor component (AHVAC-) on the biological behavior of gastric cancer MKN-28 cells. METHODS: Gastric cancer MKN-28 cells were treated with the experimental concentrations (5, 10, 15 μg/mL) of AHAVC- for 24 h. Cell proliferation and toxicity assay (cell counting kit-8, CCK-8) was used to detect the inhibition rates of the cells in different concentrations of AHVAC-. The migration ability of the cells was evaluated by wound-healing and Transwell assay. The apoptosis were observed by laser confocal microscopy with annexin V-mCherry/DAPI double staining, and the apoptosis rates were analyzed by flow cytometry with annexin V-FITC/PI double fluorescence staining. The protein level of Caspease-3 was determined by Western blot. RESULTS: Compared with normal control group, the results of AHVAC- concentration groups showed that with the increase of AHVAC- concentration, the proliferative activity of MN-28 cells decreased gradually (P<0.01), the cell migration ability decreased gradually (P<0.01), and the cell apoptosis rate increased (P<0.05). The expression of apoptosis-related protein Caspease-3 was up-regulated (P<0.01). CONCLUSION: AHVAC- inhibits proliferation and migration of gastric cancer MSN-28 cells and induces apoptosis. 
		                        		
		                        		
		                        		
		                        	
4. Clinical value of genetic polymorphism analysis of hypertension drugs for individualized treatment of hypertension patients in the southern Anhui region
Shujun WAN ; Mengying ZHANG ; Min ZHONG ; Xiaolong ZHU ; Yingying ZHANG ; Kun LV ; Shujun WAN ; Mengying ZHANG ; Min ZHONG ; Xiaolong ZHU ; Yingying ZHANG ; Kun LV ; Qilei CHEN
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(1):68-75
		                        		
		                        			
		                        			 AIM: To analyze the distribution frequency of gene polymorphisms of β receptor blockers, angiotensin receptor antagonists, angiotensin converting enzyme inhibitors, calcium antagonists, and diuretics in hypertensive patients from southern Anhui province, and provide a theoretical basis for gene detection of hypertension drugs and personalized medication. METHODS: Drug gene testing information from 839 hospitalized patients with hypertension at Yijishan Hospital of Wannan Medical College from July 2021 to April 2023 were collected, and the distribution frequency of each gene locus were analyzed. RESULTS: The genotype frequencies of ACE (I/D) I/I, I/D, and D/D were 42.1%, 46.0%, and 11.9%, respectively. the genotype frequencies of ADRB1 (1165G>C) G/G, G/C, and C/C were 8.3%, 40.0%, and 51.6%, respectively. The genotype frequencies of AGTR1 (1166A>C) A/A, A/C, and C/C were 90.2%, 9.8%, and 0.0%. The genotype frequencies of CYP2C9*3 (1075A>C) *1/*1, *1/*3, and *3/*3 were 91.3%, 8.7%, and 0.0%, respectively; the genotype frequencies of CYP2D6* 10 (100C > T) *1/*1, *1/*10, and *10/*10 were 25.0%, 36.6%, and 38.4%, respectively. The genotype frequencies of CYP3A5*3 (6986A>G) *1/*1, *1/*3, and *3/*3 were 7.0%, 39.0%, and 54.0%, respectively. The frequencies of NPPA (2238T>C) T/T, T / C, and C / C genotypes were 97.9%, 2.1%, and 0.0%, respectively. In addition, there was a significant difference in the genotype distribution frequency of multiple drug related gene loci in southern Anhui compared to other regions in China (P< 0.05). CONCLUSION: The genotype distribution frequency of hypertensive drug related gene loci had certain bias in southern Anhui, and were significant different from other regions in China, indicating that conducting genetic polymorphism testing of hypertensive drugs had certain guiding significance for the individualized application of hypertensive drugs in southern Anhui. 
		                        		
		                        		
		                        		
		                        	
5.Evaluation of the implementation effectiveness of the medication pathway in the orthopedic department of a tertiary hospital under DRG payment
Jia WANG ; Feng LIU ; Lei WANG ; Min CHEN ; Yinsi GAO ; Kan QIN
China Pharmacy 2024;35(12):1426-1430
		                        		
		                        			
		                        			OBJECTIVE To provide reference for improving the disease diagnosis related groups (DRG) payment reform, promoting refined hospital operation and management and rational drug use. METHODS Taking the orthopedic department of our hospital (the Third Affiliated Hospital of Anhui Medical University) as the research object, based on evidence-based medicine, a medication clinical pathway (hereinafter referred to as medication pathway) for DRG diseases in this department was constructed and implemented. All patients who met the DRG disease were included in the medication path management, and the patients in the same DRG disease group were treated with the same treatment method. Segmented regression model (SRM) was adopted to analyze the effects of medication pathway on the medical service capacity, efficiency and quality of our hospital. RESULTS During the implementation of medication pathway, significant decreases were observed in average length of hospital stay, cost per hospitalization, the proportion of medication expenses, medication cost per hospitalization and defined daily dose; the proportion of medical service revenue and the qualified rate of medical orders significantly increased (P<0.05). After the implementation of medication pathway, the average length of hospital stay and defined daily dose continued to decrease, and the qualified rate of medical orders also continued to significantly increase (P<0.05). CONCLUSIONS The implementation of medication pathway enhances the quality of medical services, improves operational efficiency, reduces medical expenses, and contributes to the development of a refined hospital management system.
		                        		
		                        		
		                        		
		                        	
6.Production of SARS-CoV-2 Omicron Variant Main Protease for Screening Approved Drugs as Its Potential Inhibitors
Haohao YAN ; Rui ZHANG ; Zhicheng LIU ; Xiaoli LIU ; Xiaoping LIU ; Yunyu CHEN
Chinese Journal of Modern Applied Pharmacy 2024;41(2):213-220
		                        		
		                        			OBJECTIVE 
		                        			To develop a high-throughput screening assay for the discovery of Omicron variant main protease(OM-Mpro) inhibitors based on the principle of fluorescence resonance energy transfer(FRET).
METHODS 
The recombinant OM-Mpro enzyme was expressed in Escherichia coli Rosetta(DE3) cells, and further purified by a HisTrapTM chelating column. Subsequently, the enzymatic activity of OM-Mpro and wild type main protease(WT-Mpro) enzymes and inhibition of nirmatrelvir against both proteases were measured using FERT assay. With the FRET assay, OM-Mpro inhibitors were identified via high-throughput screening of an approved drug library.
RESULTS 
The active OM-Mpro enzyme was successfully prepared from E. coli cells. OM-Mpro and WT-Mpro enzymes possessed the same enzymatic activity, and OM-Mpro remained susceptible to nirmatrelvir in vitro. Through high-throughput screening of the marketed drug library, it was found that cetylpyridinium chloride(CPC) is a mixed-type OM-Mpro inhibitor in vitro with an IC50 value of 8.76 μmol·L−1.
CONCLUSION 
A robust FRET assay has been successfully developed based on the production of active OM-Mpro enzyme for screening of its inhibitors, and CPC is identified as a potential lead compound against OM-Mpro in vitro. This study provides a promising avenue for rapid discovery of broad-spectrum antivirals against coronavirus protease.
		                        		
		                        		
		                        		
		                        	
7.Effects of propofol on glutamatergic neuronal activity in paraventricular thalamus
Yu-long WANG ; Qiong YI ; Wei XU ; E WANG ; Zhi-li HUANG ; Yong-quan CHEN ; Lu WANG
Acta Pharmaceutica Sinica 2023;58(4):919-927
		                        		
		                        			
		                        			 This study explored the effects of propofol on the activity of glutamatergic neurons in the paraventricular thalamus (PVT) and the underlying mechanisms at the molecular level using whole-cell patch-clamp techniques. Acute brain slices containing the PVT were obtained from 8 weeks old C57BL/6J mice. The electrophysiological characteristics of PVT neurons were recorded in current-clamp mode, then single-cell sequencing was used to identify neuronal types. The firing frequencies before, during, and after propofol or intralipid application were recorded as FB, FD and FW; and the membrane potentials were recorded as MPB and MPD. Picrotoxin (PTX) was used to block inhibitory gamma-aminobutyric acid type A (GABAA) receptors during the application of propofol at 10 μmol·L-1. Then, GABAA receptor-mediated spontaneous and miniature inhibitory postsynaptic currents (sIPSCs and mIPSCs) were recorded, and the effects of 10 μmol·L-1 propofol were investigated. The animal experiments were approved by the Medical Animal Administrative Committee of Shanghai Medical College Fudan University. The results showed that there were no significant differences in FB, FD and FW during intralipid and 2 μmol·L-1 propofol application. With propofol at 5, 10 and 20 μmol·L-1, FD decreased significantly when compared with FB, and FW increased significantly as compared with FD (
		                        		
		                        	
8.Molecular mechanism of ligustilide attenuating OGD/R injury in PC12 cells by inhibiting ferroptosis.
Lei SHI ; Chen-Chen JIANG ; Jia-Jun LU ; Zi-Xu LI ; Wang-Jie LI ; Xiu-Yun YIN ; Zhuo CHEN ; Xin-Ya ZHAO ; Hui ZHANG ; Hao-Ran HU ; Lu-Tan ZHOU ; Jun HAN
China Journal of Chinese Materia Medica 2023;48(11):3046-3054
		                        		
		                        			
		                        			The aim of this study is to explore the mechanism of ligustilide, the main active constituent of essential oils of traditional Chinese medicine Angelicae Sinensis Radix, on alleviating oxygen-glucose deprivation/reperfusion(OGD/R) injury in PC12 cells from the perspective of ferroptosis. OGD/R was induced in vitro, and 12 h after ligustilide addition during reperfusion, cell viability was detected by cell counting kit-8(CCK-8) assay. DCFH-DA staining was used to detect the level of intracellular reactive oxygen species(ROS). Western blot was employed to detect the expression of ferroptosis-related proteins, glutathione peroxidase 4(GPX4), transferrin receptor 1(TFR1), and solute carrier family 7 member 11(SLC7A11), and ferritinophagy-related proteins, nuclear receptor coactivator 4(NCOA4), ferritin heavy chain 1(FTH1), and microtubule-associated protein 1 light chain 3(LC3). The fluorescence intensity of LC3 protein was analyzed by immunofluorescence staining. The content of glutathione(GSH), malondialdehyde(MDA), and Fe was detected by chemiluminescent immunoassay. The effect of ligustilide on ferroptosis was observed by overexpression of NCOA4 gene. The results showed that ligustilide increased the viability of PC12 cells damaged by OGD/R, inhibited the release of ROS, reduced the content of Fe and MDA and the expression of TFR1, NCOA4, and LC3, and improved the content of GSH and the expression of GPX4, SLC7A11, and FTH1 compared with OGD/R group. After overexpression of the key protein NCOA4 in ferritinophagy, the inhibitory effect of ligustilide on ferroptosis was partially reversed, indicating that ligustilide may alleviate OGD/R injury of PC12 cells by blocking ferritinophagy and then inhibiting ferroptosis. The mechanism by which ligustilide reduced OGD/R injury in PC12 cells is that it suppressed the ferroptosis involved in ferritinophagy.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Rats
		                        			;
		                        		
		                        			PC12 Cells
		                        			;
		                        		
		                        			Ferroptosis/genetics*
		                        			;
		                        		
		                        			Reactive Oxygen Species
		                        			;
		                        		
		                        			Transcription Factors
		                        			;
		                        		
		                        			Glutathione
		                        			
		                        		
		                        	
9.Analysis of the causes and clinical results of vertebral fracture during oblique lateral lumbar interbody fusion.
Zhong-You ZENG ; Xing ZHAO ; Yu ZHANG ; Ping-Quan CHEN ; Wei YU ; Yong-Xing SONG ; Shun-Wu FAN ; Fei PEI ; Shi-Yang FAN ; Guo-Hao SONG ; Hai-Feng WANG
China Journal of Orthopaedics and Traumatology 2023;36(5):406-413
		                        		
		                        			OBJECTIVE:
		                        			To analyze the causes of vertebral fracture during oblique lateral interbody fusion in the treatment of lumbar spondylopathy, summarize the clinical results, and propose preventive measures.
		                        		
		                        			METHODS:
		                        			Retrospective analysis was made on the data of 8 cases of lumbar spondylopathy and vertebral fracture treated by oblique lateral interbody fusion in three medical centers from October 2014 to December 2018. All were female, aged from 50 to 81 years with an average of 66.4 years. Disease types included 1 case of lumbar degenerative disease, 3 cases of lumbar spinal stenosis, 2 cases of lumbar degenerative spondylolisthesis and 2 cases of lumbar degenerative scoliosis. Preoperative dual energy X-ray bone mineral density test showed that 2 cases had T-value >-1 SD, 2 cases had T-value -1 to -2.5 SD, and 4 cases had T-value <-2.5 SD. Single segment fusion was in 5 cases, two segment fusion in 1 case and three segment fusion in 2 cases. Four cases were treated with OLIF Stand-alone and 4 cases were treated with OLIF combined with posterior pedicle screw fixation. Postoperative imaging examination showed vertebral fracture, and all of them were single vertebral fracture. There were 2 cases of right lower edge fracture of upper vertebral body at fusion segment, 6 cases of lower vertebral body fracture at fusion segment, and 6 cases with endplate injury and fusion cage partially embedded in vertebral body. Three cases of OLIF Stand-alone were treated with pedicle screw fixation via posterior intermuscular approach, while one case of OLIF Stand-alone and four cases of OLIF combined with posterior pedicle screw fixation were not treated specially.
		                        		
		                        			RESULTS:
		                        			The 5 cases of initial operation and 3 cases of reoperation did not show wound skin necrosis or wound infection. The follow-up time was from 12 to 48 months with an average of 22.8 months. Visual analogue scale (VAS) of low back pain was preoperative decreased from 4 to 8 points (averagely 6.3 points) and postoperative 1 to 3 points (averagely 1.7 points) at the final follow-up. Oswestry disability index (ODI) was preoperative 39.7% to 52.4% (averagely 40.2%), and postoperative 7.9% to 11.2% (averagely 9.5%) at the final follow-up. During the follow-up, there was no loosening or fracture of the pedicle screw system, and no lateral displacement of the fusion cage;however, the fusion cage at the vertebral fracture segment had obvious subsidence. The intervertebral space height of vertebral fracture segment was preoperaive 6.7 to 9.2 mm (averagely 8.1 mm), and postoperative 10.5 to 12.8 mm (averagely 11.2 mm). The improvement rate after operation was 37.98% compared to preoperative. The intervertebral space height at final follow-up was 8.4 to 10.9 mm (averagely 9.3 mm), and the loss rate was 16.71% compared with that after operation. At the final follow-up, interbody fusion was achieved in all cases except for one that could not be identified.
		                        		
		                        			CONCLUSION
		                        			The incidence of vertebral fracture during oblique lateral interbody fusion in the treatment of lumbar spondylopathy is lower, and there are many reasons for fracture, including preoperative bone loss or osteoporosis, endplate injury, irregular shape of endplate, excessive selection of fusion cage, and osteophyte hyperplasia at the affected segment. As long as vertebral fracture is found in time and handled properly, the prognosis is well. However, it still needs to strengthen prevention.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Spinal Fractures/surgery*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Treatment Outcome
		                        			;
		                        		
		                        			Lumbar Vertebrae/surgery*
		                        			;
		                        		
		                        			Spondylolisthesis/surgery*
		                        			;
		                        		
		                        			Scoliosis
		                        			;
		                        		
		                        			Spinal Fusion/methods*
		                        			
		                        		
		                        	
10.Establishment and Verification of Benign and Malignant Prediction Model of Subcentimeter Pulmonary Ground Glass Nodules Based on HRCT.
Zhengwei CHEN ; Gaoxiang WANG ; Hanran WU ; Mingsheng WU ; Xianning WU ; Meiqing XU ; Mingran XIE
Chinese Journal of Lung Cancer 2023;26(5):377-385
		                        		
		                        			BACKGROUND:
		                        			Pre-operative accuracy of subcentimeter ground glass nodules (SGGNs) is a difficult problem in clinical practice, but there are few clinical studies on the benign and malignant prediction model of SGGNs. The aim of this study was to help identify benign and malignant lesions of SGGNs based on the imaging features of high resolution computed tomography (HRCT) and the general clinical data of patients, and to build a risk prediction model.
		                        		
		                        			METHODS:
		                        			This study retrospectively analyzed the clinical data of 483 patients with SGGNs who underwent surgical resection and were confirmed by histology from the First Affiliated Hospital of University of Science and Technology of China from August 2020 to December 2021. The patients were divided into the training set (n=338) and the validation set (n=145) according to 7:3 random assignment. According to the postoperative histology, they were divided into adenocarcinoma group and benign lesion group. The independent risk factors and models were analyzed by univariate analysis and multivariate Logistic regression. The receiver operator characteristic (ROC) curve was constructed to evaluate the model differentiation, and the calibration curve was used to evaluate the model consistency. The clinical application value of the decision curve analysis (DCA) evaluation model was drawn, and the validation set data was substituted for external verification.
		                        		
		                        			RESULTS:
		                        			Multivariate Logistic analysis screened out patients' age, vascular sign, lobular sign, nodule volume and mean-CT value as independent risk factors for SGGNs. Based on the results of multivariate analysis, Nomogram prediction model was constructed, and the area under ROC curve was 0.836 (95%CI: 0.794-0.879). The critical value corresponding to the maximum approximate entry index was 0.483. The sensitivity was 76.6%, and the specificity was 80.1%. The positive predictive value was 86.5%, and the negative predictive value was 68.7%. The benign and malignant risk of SGGNs predicted by the calibration curve was highly consistent with the actual occurrence risk after sampling 1,000 times using Bootstrap method. DCA showed that patients showed a positive net benefit when the predictive probability of the predicted model probability was 0.2 to 0.9.
		                        		
		                        			CONCLUSIONS
		                        			Based on preoperative medical history and preoperative HRCT examination indicators, the benign and malignant risk prediction model of SGGNs was established to have good predictive efficacy and clinical application value. The visualization of Nomogram can help to screen out high-risk groups of SGGNs, providing support for clinical decision-making.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Lung Neoplasms/surgery*
		                        			;
		                        		
		                        			Adenocarcinoma
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Hospitals
		                        			;
		                        		
		                        			Multiple Pulmonary Nodules
		                        			
		                        		
		                        	
            

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