BACKGROUND:At present,the dental composite resin filling material composed of resin matrix monomer is the first choice material for the filling treatment of dental defects,but with the increase of its use time in the oral environment,the dental tissue will develop secondary caries and the filling material will wear and break.The main cause of these problems is the polymerization shrinkage of the filling material and its mismatch with the mechanical properties of the dental tissue. OBJECTIVE:To synthesize a new type of dental composite resin monomer by adding initiators with different components,to improve the traditional double bond conversion rate of the system and further improve the mechanical properties of the material. METHODS:A new composite resin matrix system was prepared by adding different initiators to the monomer of 3,3′,5,5′-tetramethoxybiphenyl-4,4′-diol epoxy acrylate resin.In group A,camphorquinone with a mass fraction of 1.1%was added.In group B,1-phenyl-1,2-propanedione with a mass fraction of 2.1%was added.In group C,a mixture of camphorquinone and 1-phenyl-1,2-propanedione(a mass ratio of the two was 1:1)with a mass fraction of 3.1%was added.The double bond conversion,polymerization shrinkage and mechanical properties of the samples were determined. RESULTS AND CONCLUSION:(1)The double bond conversion rate of groups B and C was higher than that of group A(P<0.05).The polymerization shrinkage of group B was higher than that of group A(P<0.05),while that of group C was lower than that of group A(P<0.05).(2)The flexural strength,elastic modulus and compressive strength of groups B and C were higher than those of group A(P<0.05,P<0.01).Vickers hardness of group B was higher than that of group A(P<0.05),and the Vickers hardness of group C was lower than that of group A(P<0.01).(3)These findings suggest that 1-phenyl-1,2-propanedione is an initiator with ideal performance.The combined application of 1-phenyl-1,2-propanedione and camphorquinone can effectively improve the double bond conversion rate of the resin matrix system and further improve the mechanical property of the resin.

OBJECTIVE: To identify phytochemical constituents present in the extract of flowers of Xanthoceras sorbifolia and evaluate their anti-oxidant and anti-hyperglycemic capacities. METHODS: The AlCl₃ colorimetric method and Prussian Blue assay were used to determine the contents of total flavonoids and total phenolic acids in extraction layers, and the bioactive layers was screened through anti - oxidative activity in vitro. The Waters ACQUITY UPLC system and a Waters ACQUITY UPLC BEH C₁₈ column (2.0 mm × 150 mm, 5 μm) were used to identify the ingredients. And anti-oxidative ingredients were screened by off-line UPLC-QTOF-MS/MS-free radical scavenging. The ameliorative role of it was further evaluated in a high-fat, streptozotocin-induced type 2 diabetic rat model and the study was carried out on NADPH oxidase (PDB ID: 2CDU) by molecular docking. RESULTS: Combined with the results of activity screening in vitro, the anti - oxidative part was identified as the ethyl acetate layer. A total of 24 chemical constituents were identified by liquid chromatography-mass spectrometry in the ethyl acetate layer and 13 main anti-oxidative active constituents were preliminarily screened out through off-line UPLC-QTOF-MS/MS-free radical scavenging. In vivo experiments showed that flowers of X. sorbifolia could significantly reduce the blood glucose level of diabetic mice and alleviate liver cell damage. Based on the results of docking analysis related to the identified phytocompounds and oxidase which involved in type 2 diabetes, quercetin 3-O-rutinoside, kaempferol-3-O-rhamnoside, isorhamnetin-3-O-glucoside, and isoquercitrin showed a better inhibitory profile. CONCLUSION The ethyl acetate layer was rich in flavonoids and phenolic acids and had significant anti-oxidant activity, which could prevent hyperglycemia. This observed activity profile suggested X. sorbifolia flowers as a promising new source of tea to develop alternative natural anti-diabetic products with a high safety margin.

BackgroundThe depressive episode is one of the most prevalent mental illnesses worldwide. Relaxation therapy as a psychotherapy for depressive disorder has shown itself to be a viable tool， yet the existing research on relaxation therapy combined with sertraline in the treatment of depressive episodes in children and adolescents is severely limited. ObjectiveTo discuss the effect of relaxation therapy combined with sertraline on the new-onset depressive episodes in children and adolescents， and to provide references for the treatment of depressive episodes in children and adolescents. MethodsFrom January 1， 2019 to December 31， 2020， a sample of 422 children and adolescents with depressive episodes attending the Child Mental Health Department of Sichuan Mental Health Center and fulfilling the International Classification of Diseases， tenth edition （ICD-10） diagnostic criteria were enrolled， and they were classified into study group （n=208） and control group （n=214） using random number table method. All participants were offered sertraline， based on this， study group was assigned to relaxation therapy for 25~30 min per day， five days per week for a period of two weeks. Hamilton Depression Scale 24-item （HAMD-24） and Hamilton Anxiety Scale （HAMA） were applied at the enrollment， the end of 2 weeks of treatment and the end of the 2^nd week after discharge. ResultsA total of 369 patients completed the study， including 185 in study group and 184 in control group. Analysis on HAMD-24 scores revealed a significant time effect， group effect and time×group interaction effect （F=813.279， 17.625， 8 994.905， P<0.01）. Significant time effect， group effect， and time×group interaction effect were noted on HAMA scores （F=635.041， 10.716， 13 945.986， P<0.01）. A reduction in HAMD-24 and HAMA scores was reported in study group at end of 2 weeks of treatment and end of the 2^nd week after discharge compared with baseline （t=0.924， 0.359， P<0.01）. At the end of the 2^nd week after discharge， study group scored lower on HAMD-24 and HAMA compared to control group （t=0.210， 0.720， P<0.05）. At the end of 2 weeks of treatment， study group resulted in greater improvements in depressive symptoms and anxiety symptoms than those of control group （95.14% vs. 66.30%， 89.18% vs. 71.74%， χ²=78.942， 22.526， P<0.05）. The overall efficacy rate yielded no statistical difference between two groups at end of the 2^nd week after discharge （P>0.05）， and no statistical difference was found in the adverse reactions between the two groups （P>0.05）. ConclusionCompared with sertraline alone， its combination with relaxation therapy may achieve a better short-term efficacy in the treatment of depressive episode in children and adolescents. ［Funded by Sichuan Medical Scientific Research Project （number， S18020）］

Two review articles summarizing the fifth edition of the World Health Organization (WHO) classification of haematolymphoid tumours were officially published on Leukemia journal in 2022. This article briefly summarizes some important advances and changes in the fifth edition of WHO classification of haematolymphoid tumours, and describes how to apply the classification dialectically and reasonably in the daily practice of pathologists, so as to accurately guide clinical treatments.

Objective:To explore the clinical characteristics of paroxysmal kinesigenic dyskinesia (PKD) secondary to pseudohypoparathyroidism (PHP), so as to improve the clinicians′ understanding of the disease.Methods:The clinical data of 2 cases of PKD secondary to PHP in Beijing Tiantan Hospital, Capital Medical University from June 2022 to October 2022 were summarized, and the related literature was reviewed to analyze the pathogenesis, clinical manifestations, laboratory examination and imaging characteristics of the disease, as well as its treatment and prognosis.Results:Ten cases of PKD secondary to PHP were previously reported. A total of 12 cases (including these 2 cases) were included in the study, of which 7 were males (7/12) and 5 were females (5/12). The onset age was 8-23 years. The clinical manifestations of the disease included paroxysmal limb torsion, limb stiffness, limb tremor, throwing movements, and dance like movements. There were 3 cases (3/12) who had seizure at the same time. Ten cases (10/12) were induced by exercise, while 2 cases (2/12) were not mentioned the inducing factor. Eleven cases (11/12) with paroxysmal symptoms lasting less than 2 minutes can be relieved automatically. Only 1 case had a family history. Laboratory examination of all patients showed low calcium, high phosphorus and significant elevation of parathyroid hormone. The head CT scans of 10 cases (10/12) showed multiple intracranial calcifications. There were 9 cases (9/12) alone received the supplementation of calcium and active vitamin D, while 3 cases (3/12) were additionally treated with antiepileptic drugs. All cases had good prognosis.Conclusions:PHP is a rare cause of secondary PKD. A small number of patients can have seizures at the same time. Most patients have a good prognosis after receiving calcium and active vitamin D supplementation.

Objective:To improve the knowledge of clinicians about absence status epilepsy (ASE).Methods:The ictal clinical manifestations, the interictal and ictal phase electroencephalogram (EEG) characteristics of 1 patient with ASE in the Department of Epilepsy, Beijing Tiantan Hospital, Capital Medical University on November 20, 2022 were analyzed, and the pathogenesis, clinical and EEG characteristics, differential diagnosis, treatment experience of ASE were summarized by retrospective analysis combined with previous literature review.Results:The patient was a 38-year female, with onset age of 18 years. The main clinical manifestations were repeated prolonged decline of consciousness with generalized tonic-clonic seizures. The long-range video EEG showed generalized spike-slow wave and slow wave sporadic in the interictal period, and continuous or sub-continuous 2.5-3.0 Hz generalized spike-slow wave discharge in the ictal period, and the laboratory and imaging findings were normal. A total of 17 patients consistent with ASE diagnosis were reported in 7 English literatures, and there were totally 18 cases (including this patient) analyzed in this paper. ASE is a specific subtype of idiopathic generalized epilepsy (IGE). The ratio of male to female was 1∶1. The onset age of 16/18 patients was in youth to middle age, and the average onset age was 25.3 years. Absence status epilepticus was the representative or main seizure type, and 15/18 patients presented with infrequent generalized tonic-clonic seizures, no independent myoclonic seizures were found. The interictal EEG showed generalized or incomplete generalized spike-wave or poly spike-wave discharges around 3.0 Hz under normal background, and may have focal non-localizing discharges. The ictal EEG presented as continuous or sub-continuous rhythmical or non-rhythmical≥2.5 Hz (mainly 2-4 Hz) generalized spike or poly spike-wave discharges. ASE mainly needed to be distinguished from de novo late-onset absence status epilepticus, adult IGE with phantom absences. The first choice of drugs included valproate sodium and lamotrigine. The correct drug selection resulted in better prognosis. Conclusions:ASE is clinically rare. By far, its pathogenesis is not well understood. ASE can easily be misdiagnosed as non-epileptic or focal seizure. For patients with late onset, infrequent generalized tonic-clonic seizures who are clinically consistent with IGE, ASE is necessary to be vigilant when there are long-term changes in consciousness, response ability and behavior. Long-term video EEG monitoring should be perfected in time to avoid misdiagnosis and mistreatment.

OBJECTIVE To evaluate the clinical efficacy and safety of XELOX chemotherapy （oxaliplatin+capecitabine） combined with antiangiogenic agent （apatinib） and immunotherapy （camrelizumab） in patients with inoperable metastatic colorectal cancer （CRC）of microsatellite stable （MSS） type. METHODS Clinical medical records of 40 patients with inoperable metastatic CRC of MSS type treated in Lishui People’s Hospital from January 2020 to January 2021 were retrospectively collected. According to the treatment plan， the patients were divided into control group （20 cases） and observation group （20 cases）. Control group was given XELOX+apatinib regimen， while observation group was given XELOX+apatinib+camrelizumab regimen. Every 3 weeks was a treatment cycle， and the treatment lasted for 2 consecutive cycles. The objective response rate （ORR）， disease control rate （DCR）， progression-free survival （PFS）， overall survival （OS） and adverse events （AEs） were recorded for all patients. RESULTS The ORR and DCR of observation group were 65.0% and 85.0%， respectively； and the ORR and DCR of control group were 35.0% and 75.0%， respectively， with no statistical significance between 2 groups （P＞0.05）. The median PFS of observation group and control groups were 16.0 months and 8.0 months， respectively； and the median OS were 19.0 months and 12.5 months， respectively， with statistical significance between 2 groups （P＜0.05）. Each patient in both groups had at least one AEs， and the incidences of reactive skin capillary hyperplasia and hyperthyroidism in observation group （40.0%， 20.0%） were significantly higher than those in control group （both were 0） （P＜0.05）. The incidence of nausea and vomiting in control group （90%） was significantly higher than observation group （10%） （P＜0.05）. There were 14 cases （70.0%） of patients with grade 3 or above AEs in observation group， and only 5 cases （25.0%） in control group， with statistical significance between 2 groups （P＜0.05）. However， no severe AEs that could not be tolerated or fatal occurred in the two groups， which could be alleviated after drug withdrawal or treatment. CONCLUSIONS The efficacy of XELOX chemotherapy combined with apatinib and camrelizumab in inoperable metastatic CRC patients of MSS type is comparable to that of XELOX chemotherapy combined with apatinib， but it has certain advantages in ORR， PFS and OS， and controllable safety.

Objective:To investigate the reference value of ultrasonography (US) image features, elastography and serum thyroid stimulating hormone (TSH) levels in preoperative diagnosis of differentiated thyroid carcinoma (DTC).Methods:Retrospective analysis was conducted to collect clinical data of patients undergoing thyroid surgery in the Fourth Affiliated Hospital of Harbin Medical University from September 2018 to January 2020. All patients underwent conventional ultrasound, elastography examination and serum TSH level measurement before surgery; patients were divided into benign group and DTC group according to the results of pathological results of the operation, and the US image features and elasticity score were analyzed by chi-square test and multivariate logistic regression to evaluate the causes of DTC; a multivariate logistic regression model was established and the receiver operating characteristic curve (ROC) was drawn with the regression model, by analyzing the area under the ROC curve (AUC), sensitivity, specificity and accuracy, the reference value of US image features, elastography and serum TSH levels in the preoperative diagnosis of DTC were judged.Results:Clinical data of 81 patients were collected, including 17 men and 64 women, aged (48.72 ± 10.58) years. In benign group, there were 37 cases, including 10 men and 27 women, with age of (53.24 ± 9.59) years; there were 44 patients in DTC group, including 7 men and 37 women, with age of (44.91 ± 9.95) years old, the age difference between benign group and DTC group was significant ( t = 3.822, P < 0.05), while the gender difference was not statistically significant (χ 2 = 1.498, P > 0.05). There were significant differences in the number, size, echo level, microcalcification, aspect ratio and elasticity score between benign group and DTC group (χ 2 = 49.000, 4.457, 32.111, 5.444, 4.457, 49.926, P < 0.05); multivariate logistic analysis showed that hypoecho, microcalcification, aspect ratio > 1 and elasticity score were risk factors for DTC ( OR = 8.042, 4.787, 4.160, 2.380, P < 0.05), the ROC curve of the multivariate logistic regression model showed that the AUC was 0.841 (95% CI = 0.743 - 0.939), sensitivity was 90.91%, specificity was 72.97%, and accuracy was 82.72%; the AUC of serum TSH level prediction of DTC showed that the AUC was 0.721 ( P < 0.05), sensitivity was 72.70%, specificity was 64.90%, accuracy was 54.30%, and TSH best cut-off value was 2.215 μU/ml. Conclusion:In the preoperative diagnosis of DTC, US image features, elastography and serum TSH levels are of important clinical reference value for diagnosis of DTC, and the establishment of multivariate logistic regression model is conducive in improving the clinicians prediction of the occurrence of DTC.

To investigate the effectiveness and safety of ultrasound-guided microwave ablation (MWA) in treatment of primary hyperparathyroidism (PHPT). A total of 12 PHPT patients with parathyroid adenoma were treated with MWA in Nanjing University of Chinese Medicine Affiliated Hospital of Integrated Traditional Chinese and Western Medicine from May 2019 to February 2021. The patients were followed up once every 3 months for 3-12 months. Levels of serum parathyroid hormone (PTH), calcium and phosphorus were detected before and 20 min, 4h and 1day after ablation, and during follow-up period. The volume and volume reduction rate of parathyroid lesion were compared before the treatment and at the end of follow-up. The technical and clinical success of MWA were assessed as well. At the end of follow-up, median serum PTH [66.60 (42.21,80.03) ng/L vs.169.90 (89.01,396.50) ng/L] and calcium [2.39 (2.32,2.49) mmol/L vs. 2.75 (2.57,2.96) mmol/L] levels in 12 patients decreased significantly (all P<0.05). A complete response in terms of PTH and calcium levels was achieved in 6 of the 12 patients, while 4 of the patients had slightly elevated PTH levels just above the upper limit of normal reference range, and 2 of the patients remained abnormal PTH and calcium levels. The clinical cure rate was 50%. The volumes of all lesion after ablation were significantly decreased ( P<0.05), with the technical success rate reaching 92.3%. No serious complications were observed. Ultrasound-guided MWA, thus, is safe and effective in the treatment of PHPT.

Objective:To investigate the adult thyroid structural abnormalities and epidemiological characteristics in different regions of Heilongjiang Province.Methods:From December 2017 to November 2018, 30 survey sites were selected in 13 prefecture-level cities under the jurisdiction of Heilongjiang Province by the population probability sampling (PPS) method, and 120 local residents aged 20 to 70 who lived for more than 1 year in the local area were selected from each survey site for thyroid ultrasound examination. The occurrence of thyroid structural abnormalities in different genders, ages and regions were analyzed.Results:A total of 3 870 residents were investigated, including 1 248 males and 2 622 females, aged (48.3 ± 12.6) years; 2 075 urban residents and 1 795 rural residents. A total of 2 144 cases of thyroid structural abnormalities were detected, with a total detection rate of 55.40% (2 144/3 870); among them, 1 476 cases of thyroid focal nodular lesions, 359 cases of diffuse lesions, and 309 cases of diffuse lesions with focal nodules, the detection rates were 38.14%, 9.28%, and 7.98%, respectively. The detection rate of thyroid structural abnormalities was 61.25% (1 606/2 622) in women and 43.11% (538/1 248) in men, the difference was statistically significant (χ 2=111.899, P < 0.01). There was significant difference in the total detection rate of thyroid structural abnormalities among different age groups (χ 2=185.959, P < 0.01); and with the increase of age, the total detection rate of thyroid structural abnormalities showed an upward trend (χ 2trend=173.576, P < 0.01). There was significant difference in the total detection rate of thyroid structural abnormalities in adults among different prefecture-level cities (χ 2=108.487, P < 0.01); but there was no significant difference in the total detection rate of thyroid structural abnormalities between urban and rural (χ 2=0.103, P > 0.05). Conclusions:The main thyroid structural abnormalities in Heilongjiang Province are focal nodular lesions. The detection rate of women is higher than that of men, and the older the age, the higher the detection rate. There are differences in the detection rate of thyroid structural abnormalities in adults of different prefecture-level cities, but there is no significant difference between urban and rural.