Objective:To investigate the clinical characteristics and potential predisposing factors of the external cervical resorption(ECR).Methods:22 ECR cases with 38 affected teeth from 2016 to 2022 were retrospectively reviwed.Descriptive analysis combined with single factor analysis was used to study the clinical characteristics and influencing factors of ECR.Results:Maxillary anterior teeth(34.2％)were the most affected by ECR.Univariate analysis showed that ECR was more commonly noted in teeth without percussion pain and palpation pain,the probing depth of the periodontal pocket was greater than 3mm,with pulp activity reaction,without forma-tion of abscess and/or sinus tract,and without periapical lesions.There were statistically significant differences in percussion tender-ness,palpation tenderness and probing depth among the different Heithersary stages(P＜0.05).In the advanced cases,deep periodon-tal pockets and abscess formation were observed.The most common related dental factors of ECR were orthodontic treatment(15.87％)and dental traumatic injury(28.57％).Conclusion:ECR affected teeth often lack of clinical signs and symptoms.Radiology is the key to early diagnosis.

Objective To establish a lumbar radiography image quality control model by using the deep learning algorithm and evaluate clinical images in real time and retrospectively based on the developed model.Methods The anteroposterior,lateral and oblique lumbar radiographs of 1389 patients collected between January 2018 to February 2021 at the The First Affiliated Hospital of Wenzhou Medical University were analyzed.The anatomical structures in the lumbar X-ray images were segmented using a full convolutional neural network based on U-Net,and the segmentation algorithm was utilized to establish an automatic evaluation model to detect substandard images.Dice similarity coefficient(DSC)was used to evaluate the performance of the model,and the lumbar radiography images were statistically evaluated after the application of the model.Results The accuracy of the model on the validation set was 0.971-0.990(0.98±0.10),the sensitivity was 0.714-0.933(0.86±0.13),and the specificity was 0.995-1.000(0.99±0.12).The quality control model had an excellent rate of 28.8%,an intermediate rate of 54.8%,and a failure rate of 16.4%for lumbar spine radiography in 2022.Conclusion The lumbar spine X-ray image quality control model based on artificial intelligence realizes accurate segmentation of lumbar spine anatomical structures and makes accurate evaluation of image quality,which is helpful to ensure the standardization of lumbar spine X-ray radiography operation by

Objective:To investigate the feasibility of tube potential of 80 kV combined with personalized contrast agent protocol in carotid artery CT angiography (CTA).Methods:A total of 136 consecutive patients undergoing neck CTA were prospectively enrolled in this study. The patients were randomly divided into Groups A, B, C and D. Tube potential of 100 kV and 15 s contrast agent injection protocol was used for Group A (53 cases) as conventional group, while tube voltage of 80 kV and 10 s contrast agent injection protocol was used for Groups B, C and D as experimental groups, with the contrast agent dosages of 20, 25 and 30 ml used according to the body weights of ≤50 kg(Group B, 20 cases), 50-70 kg (Group C, 38 cases), and 70-90 kg (Group D, 25 cases), respectively. The subjective and objective evaluation results of image quality and the effective doses were compared among the four groups.Results:The effective doses in Groups B, C and D were 1.54±0.91, 1.89±1.08 and 2.14±1.27 mSv, respectively, significantly lower than that in Group A [(5.66±0.56) mSv] ( F=169.34, P<0.05). The image quality of four groups met the requirements of clinical diagnosis. No significant differences were found in subjective evaluation and diagnostic efficacy of the four groups ( P>0.05). The CT number of carotid artery, signal-to-noise ratio and contrast-to-noise ratio of the neck region were significantly lower in Groups B, C and D compared with Group A ( F=14.9, 12.94, 14.43, P<0.05). The CT numbers of target carotid vessel were all higher than 250 HU. Conclusions:The scanning protocol of low tube potential (80 kV) combined with 10 s contrast agent injection protocol could not only reduce the doses of radiation and contrast agent, but also preserve the diagnosis effect. Thus, this scanning protocol was feasible and valuable in clinical application.

With the increasing cost of drug development and clinical trials, it is of great value to make full use of all kinds of data to improve the efficiency of drug development and to provide valid information for medication guidelines. Model-based meta-analysis (MBMA) combines mathematical models with meta-analysis to integrate information from multiple sources (preclinical and clinical data, etc.) and multiple dimensions (targets/mechanisms, pharmacokinetics/pharmacodynamics, diseases/indications, populations, regimens, biomarkers/efficacy/safety, etc.), which not only provides decision-making for all key points of drug development, but also provides effective information for rational drug use and cost-effectiveness analysis. The classical meta-analysis requires high homogeneity of the data, while MBMA can combine and analyze the heterogeneous data of different doses, different time courses, and different populations through modeling, so as to quantify the dose-effect relationship, time-effect relationship, and the relevant impact factors, and thus the efficacy or safety features at the level of dose, time and covariable that have not been involved in previous studies. Although the modeling and simulation methods of MBMA are similar to population pharmacokinetics/pharmacodynamics (Pop PK/PD), compared with Pop PK/PD, the advantage of MBMA is that it can make full use of literature data, which not only improves the strength of evidence, but also can answer the questions that have not been proved or can not be answered by a single study. At present, MBMA has become one of the important methods in the strategy of model-informed drug development (MIDD). This paper will focus on the application value, data analysis plan, data acquisition and processing, data analysis and reporting of MBMA, in order to provide reference for the application of MBMA in drug development and clinical practice.

Objective To explore prophylactic bilateral internal iliac arteries balloon occlusion in treating pernicious placenta previa complicated with placenta implantation before cesarean section.Methods Data of 32 patients with pernicious placenta previa complicated with placenta implantation underwent prophylactic bilateral internal iliac arteries balloon occlusion(Balloon Group)were analyzed retrospectively.40 patients with pernicious placenta previa complicated with placenta implantation without treatment of prophylactic bilateral internal iliac arteries balloon occlusion(Control Group)were selected.The mean blood loss and infusion amount during the operation,operative time,newborn Apgar score were compared between the two groups.Results The mean blood loss and infusion amount during the operation,operative time,newborn Apgar score of balloon group was superior to the control group and the difference was significant.All mothers and infants were healthy detected by clinical checking on 3-6 months after birth.Conclusion Prophylactic bilateral internal iliac arteries balloon occlusion is a safe and effective treatment before cesarean section used in pernicious placenta previa complicated with placenta implantation,and worthy of further promotion.

Objective: To evaluate the method and curative effect of plate fixation or percutaneous screws for the treatment of calcaneal fractures of Sanders type Ⅱ and Ⅲ via a minimally invasive sinus tarsi incision combined with a variety of manipulative reduction methods. Methods: Twenty-one patients with closed calcaneal fractures treated in the Department of Orthopedics, the First Affiliated Hospital of Nanchang University from January 2014 to January 2016 were collected. There were 15 men and 6 women, with an average age of 39.3 years(from 25 to 63 years). According to the Sanders classification, 16 cases were type Ⅱ and 5 were type Ⅲ.All cases were treated with internal fixation with plate and percutaneous screws via the mini-open sinus tarsi approach following reduction of the posterior articular surface of the subtalar joint and calcaneal length, width and height.Statistical analysis was performed on calcaneal width and Böhler angle, Gissane angle preoperatively and postoperatively (3 days and 3 months). All data were analyzed by ANOVA, functional recovery was evaluated according to the Ankle and Hind-foot Score of American Orthopedic Foot and Ankle Society (AOFAS). Results: Twenty one patients were followed up for a mean duration of 13.4 months(6 to 24 months). All cases gained primary incision healing, without complications such as skin necrosis, wound infection, tenosynovitis of peroneus longus and brevis muscles, or fracture displacement and hardware failure.Bone union was achieved at an average of 10.5 weeks(9 to 11 weeks). No obvious malunion occurred by the last follow-up. Compared to preoperative, calcaneal width(F=25.62, 38.90) were significantly improved 3 days and 3 months after surgery, Böhler angle(F=440.24, 272.42) and Gissane angle(F=91.86, 43.74) were normal, the differences were statistically significant (all P<0.05). Compared to 3 days after surgery, calcaneal width, Böhler angle and Gissane angle kept normal 3 months after surgery, there were no statistically differences (F=0.26, 1.35, 2.60, all P>0.05). By the AOFAS scoring, 10 cases were rated as excellent, 7 were good and 4 were fair. Conclusions Fixation with plate and percutaneous screws via the mini-open sinus tarsi approach is an effective treatment for Sanders types Ⅱ and Ⅲ calcaneal fractures, which with the advantages of small wound, simple operation, reliable fixation, no incision complication, especially suitable for elderly patients and the patients with severe injury of local soft tissue.

Objective To investigate the value of MRI in diagnosis of congenital cystic lung disease.Methods The MRI was per-formed in 105 fetuses with congenital cystic lung disease.Subjects were classified into two groups including group A (the gestational age ranged from 12-20 w)and group B (the gestational age>20 w).The MRI and ultrasonography characteristics,as well as path-ologic diagnosis were compared.Results Among 105 cases,there were 80 cases of congenital cystic adenomatoid malformation (CCAM)(including 23 cases of typeⅠ,38 cases of typeⅡ and 1 9 cases of typeⅢ),18 cases of bronchopulmonary sequestration (BPS),5 cases of congenital lobar emphysema,1 case of bronchogenic cyst,and 1 case was BPS with CCAM.In group A,MRI can diagnose the majority of the anomalies (41/45),ultrasonography can diagnose anomalies of 39 cases.There was no significant differ-ence of diagnostic accuracy between the two methods (P >0.05).In group B,compared with ultrasonography,MRI could diagnose more cases accurately (58 vs 52),with statistical significance (P <0.05).Conclusion MRI is a reliable method in diagnosing con-genital cystic lung disease;MRI can provide more useful information for the cases in the gestational age >20 w compared with ultra-sonography.

Objective To investigate the relationship between the helper T cell 17 (TH 17)/ Regulatory T cells (Treg cells) balance in peripheral blood with acute graft-versus-host reaction (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT),as well as the impact of anti-thymocyte immunoglobulin (ATG) on helper T cells in peripheral blood.Method Seventyeight hematologic patients underwent allo-HSCT,conditioning with or without ATG.Ten healthy volunteers severed as a control group.The helper T and regulatory T cells in peripheral blood were detected by flow cytometry.Enzyme-linked irnmunosorbent assay (ELISA) was used to detect serum concentrations of interleukin(IL)-17,IL-21,IL22,IL23,γ interferon (IFN-γ),and transforming growth factor β1 (TGF-β1).Result The percentage of Treg cells,TH17 cells and ratio of TH17/Treg cells in patients without aGVHD showed no significant difference from the healthy controls (P＞ 0.05).As compared with control group and non aGVHD group,the ratio of Treg cells was increased,the percentage of TH 17 cells,and TH 17/Treg cells were significantly increased in 1-2-degree aGVHD group (P＜0.01).With increased degree of aGVHD,the difference as above was more significant in 3-4-degree aGVHD recipients (P＜0.01).In aGVHD group,the IL-17,IL-23,IL-21 and IFN-γ concentrations were higher than the healthy group (P＜0.01) and non-aGVHD group (P＜0.05).Serum TGF-β1 level in aGVHD group was significantly decreased as compared with healthy group and non-GVHD group (P＜0.05),while IL-22 concentrations showed no statistically significant difference among three groups (P＞0.05).In anti-thymocyte immunoglobulin (ATG) pretreatment group,the absolute count of peripheral blood lymphocytes was less than in healthy control group (P＜0.01).In ATG group,the absolute counts of TH1 cells,TH17 cells,CD3+ CD4+ cells and non-TH1/17 cells were less than in non-ATG group (P =0.0000),while the absolute counts of lymphocytes,CD3+ CD4-cells,and TH 1/17 cells were less than in non-ATG group,but there was significant difference (P＞0.05).Conclusion The balance of TH 17/Treg cells and related cytokines were closely associated with aGVHD after allo-HSCT,and ATG influences the reconstruction of TH 17 and Th1 cells at early stage.

Objective To explore the impact of rituximab on Th17 cells and related cytokines in patients with diffuse large B-cell lymphoma (DLBCL) in vitro and its significance.Methods 20 cases of DLBCL untreated patients and 20 healthy subjects were enrolled in the name of DLBCL group and health control group, respectively.4 peripheral blood samples were collected from every case to separate peripheral blood mononuclear cells (PBMCs), which were assigned to 4 subgroups according to different culture conditions: blank subgroup(subgroup A), rituximab subgroup (subgroup B), rituximab and serum subgroup (subgroup C) and polarization subgroup (subgroup D) (added IL-6 and TGF-β).After cultured in vitro, the percentage of Th17 cells in each subgroup was tested by flow cytometry, and the cytokine IL-17 in the abovementioned culture fluid was measured by enzyme-linked immunosorbent assay (ELISA).Results In health control group, the percentage of Th17 cells and the level of IL-17 in subgroup D [(17.12 ± 4.90) ％ and (45.735±10.012) pg/ml] were significantly higher than those in subgroup A, B, C (P ＜ 0.05), and there was no difference in each other subgroup A, B, C (P ＞ 0.05).The percentage of Th17 cells and the level of IL-17 in the DLBCL subgroup A were significantly lower than those in health control subgroup A [(0.69±0.24) ％ and (6.012±1.312) pg/ml vs (2.43±0.61) ％ and (8.217±1.681) pg/ml (P ＜ 0.05)].In DLBCL group, after cultured with rituximab, the percentages of Th17 cells in subgroup B, C, D were (2.34±0.48) ％, (2.31±0.53) ％ and (16.92±4.81) ％, and the levels of IL-17 were (7.944±1.538) pg/ml, (7.957±1.533) pg/ml and (44.417±9.881) pg/ml, respectively, which were all significantly higher than those in subgroup A.Besides, the percentage of Th17 cells and the level of IL-17 in DLBCL subgroup D were significantly higher than those in subgroup B, C (P ＜ 0.05), while there was no difference between subgroup B and subgroup C.Conclusion Experiments in vitro confirmed that the percentage of Th17 cells in PBMCs of DLBCL patients was lower than that in healthy persons, and rituximab could elevate the percentage of Th17 cells in PBMCs of DLBCL patients.

Objective To observe the effects of over expression and inhibition expression of SAA protein on biological behavior of nasopharyngeal carcinoma CNE2 cells.Methods pcDNA3.1 (+)-SAA-CNE2 cell lines of high expression and pGPU6/GFP/Neo-SAA-CNE2 cell lines of interference expression of SAA protein in vitro.These two cells constructed by transfection of pcD-NA3.1(+)-SAA plasmid of SAA high expression and pGPU6/GFP/Neo-SAA plasmids of SAA inhibition expression respectively, plasmids of which were previously successfully reconstructed by the research group.Cell cycle of these two cells was analyzed by flow cytometry with PI staining.The ability of cell proliferation was inspected by plate cloning-forming test.Results Flow cytome-try showed that with the increase of expression of SAA protein,it had effect on promoting CNE2 cell division.Plate cloning-forming test showed that SAA protein can improve proliferation of the CNE2 cells.Conclusion SAA protein has the effect on promoting proliferation of human nasopharyngeal carcinoma CEN2 cell and migration in vitro.