The preparation edge of the tooth in oral restoration has always been the hot concern for dentists,and the improper preparation edge may lead to such diseases as caries and periodontitis,and ultimately lead to the restoration failure.The application of biologically oriented preparation technique has been proven to restore good periodontal soft and hard tissue morphology,which is expected to replace the traditional dental preparation methods.This article aims to comprehensively discuss the application of biologically oriented preparation technique in veneers,full crown and implantation.

From the perspective of human development history， epidemic diseases have been accompanied by human life and reproduction， causing serious threats to human health and life safety. Epidemic diseases have a rapid onset and are highly infectious， once they occur， can quickly spread to the people around them， causing many people to be infected in a short time. Pulmonary system epidemic disease is the kind of disease with the highest incidence， prevalence， and infectivity among epidemic diseases， which will also have an impact on the economic and social development and even the historical process. Overview of ancient Chinese literature， the wisdom of ancient doctors has certain reference value for possible related work today or in the future. Starting from sorting out the classical theories recorded in the ancient books of traditional Chinese medicine， this paper dug deeply into them and re⁃understood them， with a view to providing a reference for clinical diagnosis and treatment， and public health services.

Objective:To compare and analyze the clinical characteristics and long-term prognosis of patients with deep infiltrating endometriosis (DIE) and non deep infiltrating endometriosis.Methods:A retrospective analysis was conducted on the data of 178 patients with endometriosis who underwent laparoscopic surgery at the General Hospital of Northern Theater Command from January 2016 to January 2018. Among them, 95 patients with DIE were treated as the observation group, and 83 patients with non deep infiltration were treated as the control group. Both groups were followed up for at least 5 years after surgery. Perform statistical analysis on the general clinical data, intraoperative and postoperative follow-up data of the two groups.Results:Compared with the control group, the observation group had significantly older age [(33.8±5.5)years vs (32.0±5.2)years], moderate to severe dysmenorrhea [72.6%(69/95) vs 55.4%(46/83)], chronic pelvic pain [24.2%(23/95) vs 8.4%(7/83)], higher proportion of elevated blood carbohydrate antigen 125 (CA125) [80.0%(76/95) vs 65.1%(54/83)], and higher Visual Analogue Scale (VAS) [(5.4±1.2)points vs (4.3±0.9)points]; At the same time, the surgery time was longer [(75.1±20.1)min vs (56.0±18.9)min], the patient′s intraoperative bleeding was also greater [(79.2±23.0)ml vs (57.8±16.3)min], bilateral cysts [54.7%(52/95) vs 34.9%(29/83)], severe pelvic adhesions [90.5%(86/95) vs 53.0%(44/83)], and the proportion of concurrent adenomyosis [41.1%(39/95) vs 22.9%(19/83)] was higher, with higher Revised American Fertility Society (rAFS) scores [(61.8±22.1) vs (39.4±19.1)]. The proportion of rAFS stage Ⅳ [71.6%(68/95) vs 43.4%(36/83)] was higher, and the proportion of postoperative medication was higher [98.9%(94/95) vs 92.8%(7/83)]. The above indicators showed statistically significant differences between the two groups (all P<0.05 or P<0.01). There was no statistically significant difference in the recurrence rate [21.1%(20/95) vs 15.7%(13/83)] and live birth rate [100%(35/35) vs 92.1%(35/38)] between the observation group and the control group (all P>0.05). Conclusions:Compared to non DIE patients, DIE patients have more severe pain symptoms and pelvic adhesions, higher rAFS scores, and a higher proportion of stage Ⅳ. However, there was no significant difference in postoperative recurrence rate, and there was no significant impact on fertility outcomes.

Platinum-based chemotherapy resistance is a key factor of poor prognosis and recurrence in hepatocellular carcinoma (HCC). Herein, RNAseq analysis revealed that elevated tubulin folding cofactor E (TBCE) expression is associated with platinum-based chemotherapy resistance. High expression of TBCE contributes to worse prognoses and earlier recurrence among liver cancer patients. Mechanistically, TBCE silencing significantly affects cytoskeleton rearrangement, which in turn increases cisplatin-induced cycle arrest and apoptosis. To develop these findings into potential therapeutic drugs, endosomal pH-responsive nanoparticles (NPs) were developed to simultaneously encapsulate TBCE siRNA and cisplatin (DDP) to reverse this phenomena. NPs (siTBCE + DDP) concurrently silenced TBCE expression, increased cell sensitivity to platinum treatment, and subsequently resulted in superior anti-tumor effects both in vitro and in vivo in orthotopic and patient-derived xenograft (PDX) models. Taken together, NP-mediated delivery and the co-treatment of siTBCE + DDP proved to be effective in reversing chemotherapy resistance of DDP in multiple tumor models.

Enzyme-catalyzed CO₂ reduction to value-added commodities is important for alleviating the global environmental issues and energy crises due to high selectivity and mild conditions. Owing to high energy density, formic acid or methanol produced from CO₂ using formate dehydrogenase (FDH) or multi-enzyme cascades are promising target chemicals for CO₂ utilization. However, the low activity, poor stability and low reusability of key enzymes involved in such process hampered its large-scale application. Enzyme immobilization provides an effective solution to these problems and significant progress have been made in immobilization carriers. Moreover, integration of enzyme immobilization with other catalysis techniques have been explored extensively. This review summarized the recent advances in the immobilization of enzymes using membranes, inorganic materials, metal-organic frameworks, covalent organic frameworks and other carriers, and illustrated the characteristics and advantages of different immobilization materials and immobilization methods. The synergistic effects and applications of immobilized enzymes and electrocatalytic or photocatalytic coupling reaction systems for CO₂ reduction were further summarized. Finally, the current challenges of enzyme immobilization technology and coupling reaction systems were pointed out and their development prospects were presented.
Enzymes, Immobilized ; Carbon Dioxide ; Catalysis ; Formate Dehydrogenases ; Metal-Organic Frameworks

Objective:To analyze the clinical features and long-term prognosis of ovarian endometrioma (OMA) with deep infiltrating endometriosis (DIE).Methods:A retrospective analysis was conducted on the clinical data of 178 OMA patients admitted to the Northern Theater General Hospital from January 2014 to January 2017. All patients received laparoscopic ovarian cyst removal. There were 83 patients with OMA (control group) and 95 patients with OMA combined with DIE (observation group) diagnosed by postoperative pathology.The general clinical data of patients were collected, including age, number of pregnancies, body mass index (BMI), duration and severity of dysmenorrhea, levels of carbohydrate antigen 125 (CA125), type of infertility, and other pain symptoms.The surgical related indicators of patients were collected, including the operation time, intraoperative bleeding, cyst diameter and location, whether combined with adenomyosis, severe pelvic adhesion, and the grading and staging of the American Fertility Society's revised staging standard for Endometriosis (rAFS). The postoperative follow-up indicators of patients were collected, including postoperative medication, medication regimen, medication time, pregnancy outcome, recurrence status, and type of recurrence (pain recurrence, cyst recurrence). The measurement data was represented by xˉ± s, and independent sample t-test was used for inter group comparison.The counting data was represented by example(%), and χ 2 test was used for inter group comparison. Results:The age, VAS score, moderate and severe dysmenorrhea, chronic pelvic pain, and CA125 elevation in the observation group were higher than those in the control group [(33.8±5.5) years vs (32.0±5.2) years, (5.4±1.2) points vs (4.3±0.9) points, 72.6% (69/95) vs 55.4% (46/83),24.2%(23/95) vs 8.4%(7/83), 80.0% (76/95) vs 65.1% (54/83)], the differences between the two groups were statistically significant ( t=2.23、 P=0.031, t=6.83、 P<0.001, χ 2=5.74、 P=0.017, χ 2=7.87、 P=0.005, χ 2=5.02、 P=0.025). The operation time in the observation group was longer than that in the control group [(75.1±20.1) min vs (56.0±18.9) min], the intraoperative bleeding was more than that in the control group [(79.2±23.0) mL vs (57.8±16.3) mL], and the proportion of bilateral cysts, severe pelvic adhesion, combined adenomyosis and r-AFS stage Ⅳ and rAFS score in the observation group were higher than those in the control group [54.7%(52/95) vs 34.9%(29/83),90.5% (86/95) vs 53.0% (44/83), 41.1% (39/95) vs 22.9% (19/83), 71.6% (68/95) vs 43.4 (36/83), (61.8±22.1) points vs (39.4±19.1) points], the differences between the two groups were statistically significant ( t=6.50、 P<0.001, t=7.06、 P<0.001, χ 2=8.27、 P=0.016, χ 2=31.65、 P<0.001, χ 2=6.65、 P=0.010, χ 2=14.69、 P=0.002, t=7.18、 P<0.001). The proportion of postoperative medication in the observation group was higher than that in the control group [98.9% (94/95) vs 92.8% (77/83)], the difference between the two groups was statistically significant (χ 2=4.47、 P=0.034). In the observation group 35 cases of postoperative pregnancy were all alive (100.0%), and in the control group 38 cases of postoperative pregnancy 35 cases were alive (92.1%), there were 3 cases of spontaneous abortion.There was no statistically significant difference in pregnancy outcomes between the two groups (χ 2=2.88, P=0.090). Conclusions:The OMA with DIE patients have more severe pain symptoms than those without DIE, severe pelvic adhesion is more during operation, r-AFS score is higher and more in stage Ⅳ, but there are no significant differences in the total recurrence rate and fertility outcome after operation

Objective:To investigate the correlation between serum uric acid levels and thyroid hormones in hospitalized elderly gout patients.Methods:A total of 646 hospitalized gout patients, including 616 males and 30 females, aged(68.8±5.1)years, who were hospitalized at the Department of Gout, Chu Hsien-I Memorial Hospital from April 2014 to December 2019, were retrospectively analyzed.Clinical information was collected and relevant biochemical tests were conducted.Serum uric acid (SUA)levels were divided into quartiles and their associations with thyroid hormone levels were analyzed.Results:With the increase of SUA, body mass index, the prevalence of obesity, the prevalence of dyslipidemia, and the prevalence of fatty liver, the number of involved joints, cholesterol, low-density lipoprotein cholesterol, triacylglycerol, and homeostasis model assessment trended upward significantly( P<0.05); FUA showed a downward trend( F=9.42, P>0.05). The prevalence of subclinical hypothyroidism in older patients was 11.3%(73 cases). With the increase of SUA, the prevalence of subclinical hypothyroidism and free triiodothyronine levels showed an upward trend, whereas free thyroxine levels showed a downward trend( P<0.01). Conclusions:In elderly gout patients, the prevalence of subclinical hypothyroidism increases with SUA levels.Hyperuricemia and multiple metabolic disorders are independent risk factors for subclinical hypothyroidism in these patients.

Objective:To evaluate the effect of pectoral nerve block type Ⅱ combined with esketamine on anxiety and depression in the patients with breast cancer undergoing modified radical mastectomy under general anesthesia.Methods:Eighty-four female patients, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, with body mass index of 18-25 kg/m 2, undergoing elective first-time modified radical mastectomy for unilateral breast cancer, were divided into 2 groups ( n=42 each) using a random number table method: routine group (R group) and pectoral nerve block type Ⅱ combined with esketamine group (PS group). Sufentanil was used for anesthesia induction and postoperative patient-controlled intravenous analgesia (PCIA) in group R, esketamine was used for anesthesia induction and postoperative PCIA, and type Ⅱ thoracic nerve block was performed under ultrasound guidance after anesthesia induction in group PS, and the rest of the drugs used were the same in both groups.The observer′s assessment of awareness/sedation scale score was recorded at the end of surgery, 30 min after the end of surgery, and at 6, 12 and 24 h after surgery.The Hospital Anxiety and Depression Scale was used to assess patients′ anxiety and depression at 1 day before surgery and at discharge.The intraoperative consumption of anesthetics, emergence time, postanesthesia care unit stay time, pressing times of PCIA, requirement for rescue analgesia, hospital costs, length of postoperative hospital stay, satisfaction scores of surgeons and patients were recorded at discharge.The occurrence of adverse reactions was also recorded after operation. Results:Compared with group R, the observer′s assessment of awareness/sedation scale score were significantly increased at the end of surgery and 30 min after surgery, the consumption of propofol and remifentanil was decreased, the emergence time and postanesthesia care unit stay time were shortened, the incidence of nausea and vomiting was decreased, the Hospital Anxiety and Depression Scale score was decreased at discharge, the incidence of anxiety and depression was decreased, the satisfaction scores of surgeons and patients were increased, and the length of postoperative hospital stay was shortened in group PS ( P<0.05). Conclusions:Pectoral nerve block type Ⅱ combined with esketamine can optimize the efficacy of anesthesia and relieve early postoperative anxiety and depression in the patients undergoing modified radical mastectomy for breast cancer under general anesthesia.

Objective:To explore the clinical characteristic and risk factors of subcutaneous tophus among hospitalized gout patients.Methods:The clinical data of 646 inpatients with gout from April 2014 to December 2019 in Tianjin Medical University Chu Hsien-I Memorial Hospital were retrospectively analyzed. The patients were divided into tophus group (172 cases) and non-tophus group (474 cases) according to the presence of subcutaneous tophus. The body height, body mass, waist circumference, hip circumference and blood pressure were measured. The total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), urea nitrogen, creatinine, uric acid and C-reactive protein (CRP) were detected; urine was collected for 24 h to detect uric acid. The body mass index (BMI), estimated glomerular filtration rate (eGFR) and uric acid excretion fraction (FUA) were counted. Binary Logistic regression analysis was used to analyze the independent risk factors of subcutaneous tophus among hospitalized gout patients.Results:The proportion of male, course of disease, number of joint involved in attack, rate of smoking history, rate of drinking history, smoking amount, alcohol consumption volume, length of time spent drinking, length of time spent smoking, LDL-C, urea nitrogen, serum creatinine and serum uric acid in tophus group were significantly higher than those in non-tophus group: 98.84% (170/172) vs. 94.09% (446/474), 10 (5, 16) years vs. 5 (2, 9) years, 6 (4, 8) joints vs. 3 (2, 5) joints, 66.86% (115/172) vs. 58.44% (277/474), 65.70% (113/172) vs. 57.38% (272/474), 11 (0, 20) cigarettes /d vs. 10 (0, 20) cigarettes/d, 100 (0, 250) ml/d vs. 50 (0, 162) ml/d, 10 (0, 26) years vs. 0 (0, 20) years, 20 (0, 30) years vs. 10 (0, 20) years, (3.44 ± 0.98) mmol/L vs. (3.25 ± 0.97) mmol/L, 5.81 (4.61, 7.46) mmol/L vs. 5.38 (4.39, 6.66) mmol/L, 89.4 (74.3, 107.5) μmol/L vs. 85.1 (72.5, 98.9) μmol/L and 514.4 (452.9, 595.2) μmol/L vs. 499.0 (404.8, 572.4), the onset age, red blood cell, hemoglobin and eGFR were significantly lower than those in non-tophus group: (37.78 ± 10.56) years old vs. (40.17 ± 13.06) years old, (4.72 ± 0.74) × 10 9/L vs. (4.88 ± 0.56) × 10 9/L, (141.15 ± 17.19) g/L vs. (146.00 ± 13.06) g/L and 87.7 (65.9, 108.4) ml/min vs. 93.3 (75.9, 113.1) ml/min, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in family history of diabetes, family history of hypertension, family history of gout, BMI, waist-hip ratio, blood pressure, FUA, white blood cell, TC, TG, HDL-C and CRP between 2 groups ( P>0.05). The patients were grouped according to the course of disease, the incidences of tophus in patients with course of disease ≤5.0 years, 5.1 to 10.0 years and >10.0 years were 15.34% (50/326), 27.67% (44/159) and 48.45% (78/161), and there was statistical difference ( χ2 = 60.59, P<0.01); the patients were grouped according to the quartiles of serum uric acid, the incidences of tophus in patients with serum uric acid <424.05 μmol/L, 424.05 to 505.24 μmol/L, 505.25 to 576.17 μmol/L and ≥576.18 μmol/L were 14.91% (24/161), 32.72% (53/162), 29.01% (47/162) and 29.81% (48/161), and there was statistical difference ( χ2 = 15.70, P<0.01). Binary Logistic regression analysis result showed that the course of gout, smoking amount, number of joint involved in attack, serum uric acid and LDL-C were the independent risk factors of subcutaneous tophus among hospitalized gout patients ( OR = 1.069, 1.020, 1.317, 1.002 and 1.262; 95% CI 1.032 to 1.097, 1.006 to 1.032, 1.223 to 1.417, 1.000 to 1.003 and 1.033 to 1.541; P<0.01 or <0.05). Conclusions:The duration of disease, number of involved joint, serum uric acid level, unhealthy lifestyles and lipid metabolism disorders are the independent risk factors of subcutaneous tophus among hospitalized gout patients.

Objective:To investigate the short-term effects of acute fructose intake on serum antioxidant capacity and liver enzymes in healthy young adults.Methods:From January to June 2019, 64 healthy young subjects were recruited, and divided into 75 g glucose group, 25 g fructose group, 50 g fructose group and 75 g fructose group by random digits table method with 16 cases each. The subjects took corresponding amounts of glucose or fructose according to grouping. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), glutathione peroxidase (GPX), superoxide dismutase (SOD), C-Jun amino terminal kinase (JNK), malondialdehyde (MDA) and 8-OH deoxyguanine (8-OHdG) before taking sugar and 30, 60, 120, 180 min after taking sugar, and the changes of ALT, AST and LDH at 30, 60, 120 and 180 min after taking sugar compared with that before taking sugar.Results:One case in 50 g fructose group, 2 cases in 75 g fructose group and 1 case in 75 g glucose group dropped out due to adverse reaction; finally, 15 cases in 75 g glucose group, 16 cases in 25 g fructose group, 15 cases in 50 g fructose group and 14 cases in 75 g fructose group completed the study. The increase of ALT and AST after taking sugar in 25 g fructose group, 50 g fructose group and 75 g fructose group was significantly higher than that in 75 g glucose group, and there were statistical differences ( P<0.05); there was no statistical difference in the change of LDH after taking sugar among 4 groups ( P>0.05). One hundred and eighty min after taking sugar, the receiver operating characteristic (ROC) curve analysis result showed that there were no statistical differences in the areas under curve of ALT, AST and LDH among 4 groups ( P>0.05). There was no statistical difference in SOD before taking sugar among 4 groups ( P>0.05); the SOD 60 min after taking sugar in 50 g fructose group and 75 g fructose group, and SOD 180 min after taking sugar in 25 g fructose group, 50 g fructose group and 75 g fructose group were significantly lower than those in 75 g glucose group: (4.84 ± 1.88) and (4.38 ± 1.12) μg/L vs. (6.25 ± 1.65) μg/L, (4.46 ± 1.66), (5.22 ± 1.66) and (3.99 ± 0.96) μg/L vs. (6.55 ± 1.78) μg/L, and there were statistical differences ( P<0.05). There were no statistical differences in the changes of JNK, GPX, MDA and 8-OHdG before and after taking sugar among 4 groups ( P>0.05). The ROC curve 180 min after taking sugar analysis result showed that the area under curve of SOD in 75 g fructose group was significantly lower than that in 75 g glucose group (9.06 ± 1.88 vs. 12.74 ± 3.15), and there was statistical difference ( P<0.05); there were no statistical differences in the areas under curve of GPX, JNK, MDA and 8-OHdG among 4 groups ( P>0.05). Conclusions:Acute fructose intake can lead to the decrease of antioxidant capacity, and the increasing of oxidative damage and liver enzymes in healthy adults.