Objective:To investigate the efficacy and side effects of concurrent chemoradiotherapy with or without nimotuzumab in the treatment of locally advanced nasopharyngeal carcinoma after neoadjuvant chemotherapy.Methods:In the prospective study, 100 patients with stage Ⅲ-Ⅳa locally advanced nasopharyngeal carcinoma (except T 3N 0M 0 stage) who met the inclusion criteria were randomly divided into the experimental and control groups using the random number table method. Patients in both groups were treated with neoadjuvant chemotherapy using TPF (paclitaxel liposome, cisplatin, and 5-fluorouracil) regimen for 2 cycles. At 2 weeks after chemotherapy, concurrent chemoradiotherapy plus nimotuzumab targeted therapy was given in the experimental group, and concurrent chemoradiotherapy was delivered in the control group. The main observation index was the distant metastasis-free survival (DMFS) rate. Log-rank test and multivariate Cox regression analysis were used. Results:The objective remission rate and complete remission rate in the experimental and control groups were 100% vs. 98% ( P=1.000) and 92.0% vs. 80% ( P=0.084). The 3-year DMFS in the experimental and control groups were 91.4 % vs. 76.1 % ( P=0.043). The 3-year progression-free survival (PFS), locoregional recurrence-free survival (LRFS) and overall survival (OS) in two groups were 87.3 % vs. 74.1 % ( P=0.097), 94.5 % vs. 85.6 % ( P=0.227) and 90.5% vs. 85.2% ( P=0.444). Subgroup analysis showed that patients with age<60 years ( HR=0.34, 95% CI=0.12-0.94, P=0.037), neutrophil-to-lymphocyte ratio (NLR)≤4 ( HR=0.34, 95% CI=0.13-0.89, P=0.028) received concurrent chemoradiotherapy plus nimotuzumab obtained better PFS. Multivariate analysis showed that NLR was an independent risk factor for disease progression ( HR=5.94, 95% CI=1.18-29.81, P=0.030) and distant metastasis ( HR=13.76, 95% CI=1.52-124.36, P=0.020). Conclusions:Compared with concurrent chemoradiotherapy alone, concurrent chemoradiotherapy combined with nimotuzumab after neoadjuvant chemotherapy can significantly increase DMFS rate for patients with locally advanced nasopharyngeal carcinoma. The incidence of side effects is similar in two groups. Concurrent chemoradiotherapy plus nimotuzumab after neoadjuvant chemotherapy may be a preferred treatment strategy for locally advanced nasopharyngeal carcinoma.

Objective:To analyze TCM tongue diagnosis related research on coronary heart disease (CHD) at home and abroad using the method of bibliometrics; To provide reference for further research on clinical diagnosis and treatment of CHD.Methods:Research literature about TCM tongue diagnosis for CHD was retrieved from CNKI, VIP, CBM, Wanfang Data, PubMed, Embase, Cochrane Library and Web of Science from the establishment of the databases to December 31st, 2022. The key features of literature related to tongue diagnosis from CHD, including publication volume, region, institution, authors, and research hotspots, were analyzed using BICOMBS2.0, CiteSpace 6.1.R6, and Excel 2019 software.Results:Totally 364 Chinese articles and 5 English articles were included. Liaoning University of Traditional Chinese Medicine was the institution that published the most relevant research in Chinese, and Shanghai University of Traditional Chinese Medicine was the institution that published the most relevant research in English. Professor Wang Yiqin of Shanghai University of Traditional Chinese Medicine was the author with the largest number of publications in both Chinese and English, and the authors with the largest number of publications on Chinese research worked closely cooperate with each other. Chinese research focused on syndrome characteristics of CHD, objectification of tongue diagnosis and data mining based on the clinical experience of renowned TCM practitioners; the English research topic included modern data collection and analysis and expert consensus.Conclusions:The research team of tongue diagnosis for CHD in China has begun to take shape. There are few English articles on tongue diagnosis for CHD, and the development level is relatively lagging behind. In the future, different institutions and researchers need to strengthen international cooperation to enhance the international influence of TCM diagnostics.

Objective To explore the characteristics of TCM syndromes in patients with coronary heart disease complicated with hypertension and diabetes based on latent structure model.Methods A multi-center cross-sectional study was used to collect the four diagnostic information of patients with coronary heart disease by using the Four Diagnostic Collection Scales of TCM developed by our research group,and a clinical database was established.Combined with frequency analysis and expert opinions,the four diagnostic information was screened to construct a latent structure model.Results Totally 702 patients with coronary heart disease complicated with hypertension and diabetes were collected.A total of 40 high-frequency four-diagnosis symptoms were screened,and 18 latent variables were obtained by latent structure model analysis.The model BIC score was-17 604.38.The latent variables in the model were comprehensively clustered,and it was found that the syndrome elements of disease location in patients with coronary heart disease complicated with hypertension and diabetes were mainly heart,liver,kidney,etc.,and the syndrome elements of disease nature were mainly qi deficiency,yin deficiency,qi stagnation,phlegm turbidity,blood stasis,etc.The syndrome types were mainly phlegm and blood stasis syndrome,spleen and kidney yang deficiency syndrome,liver depression and qi stagnation syndrome,liver and kidney yin deficiency syndrome,damp-heat intrinsic syndrome,and the mutual information and information coverage between each syndrome type and the four diagnostic information were suggested.Conclusion Latent structure model analysis can provide a qualitative and quantitative basis for the syndrome classification of patients with coronary heart disease complicated with hypertension and diabetes.

BACKGROUND: Poor root canal filling or poor post-core crown restoration can cause microleakage between the implant material and the tooth, leading to secondary infection of the periapical tissue and affecting long-term effect of tooth restoration. OBJECTIVE: To analyze the microleakage in a glucose penetration model when post space preparation is performed with different timing and remaining lengths. METHODS: Eighty-six freshly extracted mandibular premolars from the Orthodontics Department of Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University were randomly divided into eight groups: positive control group (n=10) undertook root canal preparation; negative control group (n=10) undertook root canal preparation and filling but not post space preparation; A1, B1 and C1 groups (n=11 per group) were subjected to root canal filling immediately followed by post space preparation with the filling material of 4 mm, 5 mm, and 6 mm in length, respectively; A2, B2 and C2 groups were subjected to root canal filling and 1 week after filling, the three groups underwent post space preparation with the filling material of 4, 5 and 6 mm in length, respectively. At 48 hours after post space preparation, the integration of root canal wall and filling material was observed by scanning electron microscopy. The glucose microleakage model was used to detect the amount of glucose leaking from the crown to the root in each group. RESULTS AND CONCLUSION: (1) Under the scanning electron microscope, the fillings were most tightly bonded to the root canal wall in C1, while microcracks were most apparent in A2. (2) According to the measurement of glucose penetration model, A2 showed more microleakage than A1 (P < 0.05), B2 showed more microleakage than B1 (P < 0.05), and there was no statistically significant difference between C1 and C2 (P> 0.05). No significant difference was found among A1, B1 and C1 (P> 0.05), B2 showed no statistical difference in the microleakage from A2 and C2 (P> 0.05), but A2 showed more microleakage than C2 (P′ < 0.017). These results indicate that immediate post space preparation is superior to delayed preparation in reducing the microleakage. For immediate post space preparation, the remaining length of the filling material has no effect on the microleakage, but for delayed preparation, the filling material of at least 5 mm in length should be preserved.

Objective: To investigate the effect and mechanism of proprotein convertase subtilisin type 9 (PCSK9) on lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) mediated oxidized low-density lipoprotein (ox-LDL) uptake by mononuclear macrophage (THP-1) derived macrophages. Methods: THP-1 monocyte was incubated with PMA for 48 hours to induce the differentiation into macrophages. Macrophages were pretreated with human recombinant PCSK9 protein for 1 hour and incubated with ox-LDL for 24 hours to induce foam cells. Oil red O staining was used to observe the accumulation of lipid in the control group (foam cells) and groups treated with different concentrations of recombinant PCSK9 protein, and the intracellular cholesterol content was measured by enzyme method, and mRNA and protein expressions of LOX-1 were detected by real-time PCR and Western blot. The uptake of Dil-labeled oxidized low density lipoprotein (Dil-ox-LDL) was observed by fluorescence microscopy in control group (macrophage), PCSK9 protein treated group and PCSK9 protein plus anti-LOX-1 antibody and IgG antibody treated group. mRNA and protein expression of toll-like receptor 4 (TLR4), nuclear factor-kappa B (NF-κB), cyclooxygenase-2 (COX-2) were detected in control and PCSK9 protein treated group in the absence and presence of TLR4 inhibitor (TAK-242), NF-κB inhibitor (PDTC). In addition, reactive oxygen species (ROS) production was evaluated in the absence or presence of COX-2 inhibitor (NS-398) or reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase inhibitor (DPI). The mRNA and protein expression of LOX-1 in the control group (PCSK9 protein pretreated foam cells) and PCSK9 protein group in the absence or presence of TAK-242, PDTC, NS-398 and DPI respectively. Results: (1) The total optical density of intracellular lipid droplets, total cholesterol level, cholesterol ester level and cholesterol ester/total cholesterol ratio as well as expression of LOX-1 were significantly higher in PCSK9 group than those in control group (all P<0.05). (2) The fluorescence intensity of Dil-ox-LDL was significantly higher in PCSK9 group and PCSK9+IgG antibody group than in the control group (all P<0.05). The fluorescence intensity was significantly lower in PCSK9+anti-LOX-1 antibody group than in PCSK9 group and PCSK9+IgG antibody group (all P<0.05). (3) The expressions of TLR4, NF-κB and COX-2 were significantly higher in PCSK9 group than in control group (all P<0.05). The expressions of TLR4, NF-κB and COX-2 were significantly lower in PCSK9+TAK-242 group and PCSK9+PDTC group than in PCSK9 group (all P<0.05). The ROS level was significantly higher in PCSK9 group than in the control group (P<0.05). The ROS levels were significantly lower in PCSK9+NS-398 and PCSK9+DPI groups than in PCSK9 group (all P<0.05). (4) The expressions of LOX-1 mRNA and protein were lower in respective PCSK9 protein plus TAK-242, PDTC, NS-398 or DPI group than in PCSK9 protein alone (all P<0.05). Conclusion PCSK9 may regulate LOX-1 mediated ox-LDL uptake by the THP-1 derived macrophage via TLR4/NF-κB/COX-2/ROS pathway.

Objective: To investigate the physical properties of Ti-6Al-4V clasps generated by selective laser melting (SLM) with different construction directions and to compare these clasps with cast clasps, which could provide a basis for fabricating SLM clasps with high precision and excellent mechanical properties. Methods: Ti-6Al-4V clasps were fabricated by SLM at 0 degrees (SLM0 group), 45 degrees (SLM45 group) and 90 degrees (SLM90 group) (n = 12). Twelve clasps were cast by the casting method as the control group. Meanwhile, four metal abutments were cast randomly as the abutments of the four groups. X-ray was used to detect cracks in the clasps of each group. The roughness of the clasps was measured by confocal microscopy, the fitness tests between clasps and abutment were processed by stereomicroscopy, and the microstructure of clasps in each group was observed under a metallographic microscope to evaluate the physical properties. Results : There were 0-8 visible cracks in the casting group but no obvious defects in the SLM groups. The maximum surface roughness was observed in the cast group (18.102 ± 3.762) μm, while the minimum roughness was observed in the SLM90 group (5.942 ± 1.486) μm (P < 0.05). There was no statistically significant difference in surface roughness between the SLM0 group [(8.711 ± 2.378) μm] and the SLM45 group [(8.513 ± 1.161) μm]. Fitness was worst in the casting group [(68.445 ± 14.876) μm] and best in the SLM90 group [(33.417 ± 5.880) μm] (P < 0.05). There was no statistically significant difference in fitness between the SLM0 group [(52.917 ± 12.102) μm] and the SLM45 group [(50.889 ± 7.011) μm]. In addition, the growth direction of the β grains was roughly parallel to the build direction, and acicular α grains were present between β grains. SLM was composed of fine grains, while the cast group had large grains. Conclusions Specimens generated by SLM had finer grains than cast specimens. In addition, SLM90 clasps had the highest fitness and the lowest surface roughness.

Objective To explore the influence of collateral circulation on the cognition of persons with severe unilateral carotid artery stenosis or occlusion using transcranial Doppler (TCD) imaging combined with P300.Methods A total of 185 patients with stenosis or occlusion of the carotid artery were enrolled and randomly divided into a monocollateral group (n=83),a multicollateral group (n=79) and a noncollateral group (n=23).The monocollateral group was further divided into an anterior communicating artery (AcoA) group,an ophthalmic artery (OA)group and a post communicating artery (PcoA) group according to their collateral circulation.All patients and 40 normal controls (NC) were tested using the Montreal cognitive assessment (MoCA) and P300,and the correlation between the MoCA and P300 scores was analyzed.Results Compared with the NC group,all the other three groups had significantly lower average MoCA scores and P300 amplitudes.They also had significantly longer average P300 latency periods.Compared with the multicollateral group,both the monocollateral and noncollateral groups had significantly lower average MoCA scores and P300 amplitudes and longer P300 latencies.Comparing the monocollateral group with the noncoilateral group revealed the same trends.Among the monocollateral patients the average MoCA score of the AcoA group was significantly higher than the PcoA and OA group averages,while their average P300 latency period was significantly shorter and the amplitude significantly greater than the PcoA group's average.Correlation analyses showed that the MoCA score was negatively correlated with the P300 latency,but positively correlated with the P300 amplitude.Conclusions Collateral circulation can protect the cognitive function of patients with unilateral stenosis or occlusion of the internal carotid artery to some extent,with multicollateral circulation being more effective than monocollateral and AcoA circulation superior to both PcoA and OA circulation.The MoCA score is significantly correlated with the latency period of P300 in such cases.

Objective : To investigate the clinical efficacy of prosthesis retained by metal clasp and flexible clasp in the repair of type Ⅴ maxillary defects after tumor resection. Methods: 23 maxillary tumor surgical patients were selected in this study and restored with maxillofacial prosthesis. Total 24 prosthesis combined with metal clasp and flexible dentures were followed up for half a year to 2 years. Results : After the application of prosthesis, better maxillofacial appearances are presented in all of the patients, Watian drinking water tests are improved to grade Ⅰ or Ⅱ from grade Ⅳ or Ⅴ in 21 patients, there was significant difference (P < 0.05); Soft diet can be masticated on affected side in 15 patients; The mean speech intelligibility score with and without prosthesis were (83.2 ± 7.3)% and (36.6 ± 5.6)%, there was significant difference (P < 0.05); Favorable hygienic situations of oral cavity and prosthesis are maintained in 18 patients. Conclusion Prosthesis combined with metal clasp and flexible denture performed favorable clinical efficacy and contributed to improve the living quality and mental health after tumor resection.

Objective Recent studies show that, tesaglitazar can reduce vascular plaque lipid deposition and inflammatory response in mice.This paper aims to investigate the effects of tesaglitazar, the peroxisome proliferator-activated receptor α/γ( PPARα/γ) agonist on serum lipid, serum nitric oxide ( NO) and heart type inducible nitric oxide synthase ( iNOS) mRNA expression in diabetic mice. Methods Thirty female 3-week-old clean grade mice were fed with ordinary adaptive diet for 7 days.The diabetic mouse model was established by feeding these mice with high-glucose-high-fat diet for four weeks and then taking small doses of streptozotocin( STZ) .These mice were randomly divided into two groups by means of ran-dom number table:control group and tesaglitazar group.Control group continued to be fed with high-glucose-high-fat diet, whereas te-saglitazar group was administered with tesaglitazar orally( high-glucose-high-fat fodder mixed with 20μg/kg tesaglitazar) .After 6 weeks′administration, body weight, total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipo-protein cholesterol(HDL-C) and blood glucose(Glu) levels were measured.Serum NO content were detected with nitrate reductase method, and the expression of iNOS mRNA in heart were detected by RT-PCR. Results Compared with control group[(3.62 ± 0.45)、(2.58 ±0.34)、(1.35 ±0.26)、(19.55 ±3.40) mmol/L], serum levels of TC、TG、LDL-C and Glu in tesaglitazar group [(2.93 ±0.38)、(1.87 ±0.41)、(1.07 ±0.30)、(14.33 ±2.08)mmol/L] were significantly decreased, difference was statistically significant(P<0.01).However, the levels of HDL-C were increased obviously campared with the control group[(1.32 ±0.21) mmol/L vs (1.05 ±0.24)mmol/L, P<0.01];The serum NO content in control group were significantly higher than that in tesaglita-zar group[(75.60 ±8.06)μmol/L vs (41.35 ±5.82)μmol/L] , difference was statistically significant(P<0.01); The ralative quantitative expression of iNOS mRNA in treatment group was significantly lower than that in control group[(0.435 ±0.064) vs (0.568 ±0.067)], difference was statistically significant(P<0.01). Conclusion Tesaglitazar can reduce the production of NO by means of inhibit excessive expressions of iNOS mRNA in diabetic mice.It can also improve the levels of serum lipid, and can delay the progression of atherosclerosis.

Objective To investigate the changeof plasmadiponectin and N-terminal pro-brain natriuretipeptide (NT-proBNP) levelin the patientwith differentypeof atrial fibrillation (Af) .MethodTwo hundred and thirty-fouresearch sub-jectwere divided into 4 group:sinurhythm group (n= 70) ,paroxysmal Af group (n=52) ,permanenAf group (n=62) and control group (n=50) .The plasmadiponectin level wameasured by the enzyme-linked immunosorbenassay (ELISA) and the NT-proBNP level wadetected by chemiluminescence .4 groupwere comparable in age ,gende,body masindex and basidisea-se.ResultThe NT-proBNP level in the paroxysmal Af group and the permanenAf group wasignificantly increased compared with the sinurhythm group and the control group ,the difference wastatistically significan(P＜0 .05) ,buthe difference be-tween the sinurhythm group and the control group had no statistical significance (P＞0 .05) .The NT-proBNP level in the perma-nenAf group wasignificantly increased compared with the paroxysmal Af group (P＜0 .05) .Compared with control group ,the adiponectin level in the sinurhythm group wasignificantly decreased (P＜0 .05) ,which in the paroxysmal Af group and the per-manenAf group wasignificantly increased compared with the sinurhythm group and the control group ,the difference wastatis-tically significan(P＜0 .05) .The adiponectin level in the permanenAf group wasignificantly increased compared with the parox-ysmal Af group (P＜0 .05) .Conclusion The adiponectin level could be related with the repeated occurrence of permanen Af .