Objective In cases and events of mixed STR typing of aborted fetus,two methods for calculating paternity index(PI)of suspected biological fathers are proposed,which could be useful for theoretical reference for parental identification including mixed STR typing.Methods Depending on whether the fetal genotypes can be identified,the simple PI calculation method and the PI calculation method of deduced biological paternal genes when the fetal genotypes cannot be identified are proposed.Results The simple PI calculation method is to indentify the fetal genotypes first and then calculate according to the standard triplet.The PI calculation method of deduced biological paternal genes is to deduce all the possible genotypes of biological fathers conforming to Mendel's law(inference)without considering the ratio of peak height and peak area in mixed typing,and then calculate the parental index separately,taking the minimum value as the parental index of the locus.Conclusion When mixture ratio of fetus in the mixed typing of aborted tissue MR≥0.43,the accuracy of separation is very high and the simple PI calculation method can be accurate,so it is recommended.If 0.05≤MR＜0.43,it is suggested to use the calculation method of deduced biological paternal genes,which can avoid misjudgment of irrelevant persons to the greatest extent.If MR＜0.05,there's a high risk of fetal allele loss,we should not perform a paternity test on the mixed spot.Since the cumulative parental index calculated by deduced the biological paternal genes is usually lower than the value calculated by dividing the fetal genotype,the CPI may be lower than 10 000 when fewer loci are identified,and then more genetic markers should be detected.

ObjectiveTo investigate the willingness of rehabilitation patients within an urban medical group to accept downward referrals and analyze the influencing factors. MethodsFrom June to October, 2023, a survey was conducted using a simple random sampling method among neurological and orthopedic rehabilitation patients in hospitals within a specific urban medical group. The 2013 version of the Andersen Model was employed to construct a theoretical framework for the willingness of rehabilitation patients to accept downward referrals and influencing factors. Within this framework, a questionnaire was designed using a 5-point Likert scale, comprising three sections including personal characteristics, environmental features and healthcare service utilization choices, totaling 23 questions. A preliminary survey was conducted, and the questionnaire had underwent reliability and validity testing. ResultsA total of 350 questionnaires were collected, with 314 valid questionnaires. The willingness of rehabilitation patients to accept downward referrals was found to be associated with age, rehabilitation specialties, rehabilitation phases, previous experiences with downward referrals, awareness of and perceptions regarding bidirectional referral policies, and understanding and opinions about the urban medical group (χ² > 7.755, P < 0.05). The primary influencing factors were rehabilitation specialties, rehabilitation phases, previous experiences with downward referrals and perceptions of the necessity of bidirectional referral policies (P < 0.05). ConclusionRehabilitation specialties, rehabilitation phases, previous experiences with downward referrals and perceptions of the necessity of bidirectional referral policies are the primary factors that influenced the willingness of rehabilitation patients to accept downward referrals. We should formulate targeted and focused improvement measures based on the specific circumstances and key influencing factors of rehabilitation patients within the urban medical group regarding their willingness to accept downward referrals. Continuously enhancing the proportion of patients willingness to accept downward referrals is essential for the effective implementation of bidirectional referral for rehabilitation patients.

Objective:To construct and validate a theoretical model of residents′ willingness to participate in tiered medical care based on harmonious management theory, providing reference for promoting the tiered medical care system and aiding governmental decision-making.Methods:Based on the harmonious management theory and literature review, a model capturing residents′ propensity to engage in tiered medical care was formulated. Using convenience sampling method, a questionnaire survey was conducted on 2 067 residents from 24 communities in Zhejiang province from April to May 2022. Descriptive statistical analysis was conducted on the survey results, and multilevel linear regression and structural equation modeling were used to analyze the driving mechanism of residents′ willingness to participate in tiered medical care.Results:The willingness rate of residents to participate in tiered medical care was 69.7%, which was at an average level. Regression insights highlighted the positive influence of policy support perception ( β=0.170, P<0.01), awareness of management mechanisms ( β=0.093, P<0.01), cognitive attitudes ( β=0.102, P<0.01), and trust levels ( β=0.244, P<0.01) on residents′ participation willingness. In contrast, resource allocation perceptions lacked a significant effect ( β=0.065, P>0.05). The structural equation model revealed that cognitive attitudes played a mediating role in the " policy system perception → participation willingness" and " management mechanism perception → participation willingness" pathways, with effect sizes of 0.030 and 0.039, respectively. Trust levels also mediated these paths, with effect sizes of 0.039 and 0.045, and entirely mediated the " resource allocation perception → participation willingness" path, registering an effect size of 0.053. Conclusions:The harmonious management theory can be used to explain the formation mechanism of residents′ willingness to participate in tiered medical care. The government and medical institutions urgently need to further improve residents′ awareness of tiered medical care, focus on enhancing residents′ trust, and further improve policies and management measures such as financial investment, medical insurance reimbursement, and referral systems.

Dens invaginatus (DI) is a developmental anomaly as a result of a deepening or invagination of the enamel organ into the dental papilla during tooth development. In addition, DI is a malformation with varying anatomical features, which poses numerous challenges to treatment. Endodontic treatment of dens in dente is one of the most complica-ted cases of DI. Herein, an immature lateral incisor that employed regenerative endodontic treatment was presented. The mentioned tooth was diagnosed with DI, pulp necrosis, and chronic apical periodontitis. Hence, a favorable prognosis has been shown by a 2-year review with cone beam computed tomography. The tooth was functional with normal periodontal parameters and exhibited a normal response to the electric pulp sensibility test. Thus, regenerative endodontic treatment can also be recommended to endodontists for teeth with DI.
Humans ; Regenerative Endodontics ; Incisor/diagnostic imaging* ; Dens in Dente ; Dental Pulp Necrosis/therapy* ; Odontogenesis

【Objective】 To establish a prediction model of clinical blood demand in Suzhou urban area by ARIMA model, and to predict future clinical blood demand by sorting out the historical data, so as to guide the reasonable collection and scientific deployment of blood resources, and achieve the balance of clinical blood supply and demand. 【Methods】 The monthly data of clinical use of plasma components in Suzhou city from 2009 to 2019 were obtained, and analyzed by SPSS26 software and ARIMA model. Through model identification, parameter estimation and optimal model test, the optimal model for clinical blood prediction was determined and used to predict the clinical consumption of plasma components from January to November 2020. The predicted value was compared with the actual value to verify the prediction effect of the model. 【Results】 The optimal model was ARIMA(0, 1, 1)(0, 1, 1)12. The values of ACF autocorrelation function and PACF partial autocorrelation function of residual were both within 95%CI. Meanwhile, the Yang-Box Q statistic value was 11.596, P>0.05, which passed the white noise test. The predicted values of clinical consumption of plasma components in Suzhou urban area from January to November 2020 were all within 95%CI, consistent with the trend of actual values, with small mean relative error(7.9%) and good prediction effect. 【Conclusion】 ARIMA model can be used for short-term prediction on clinical use of plasma components in Suzhou city, and provide reference for reasonable collection, preparation and scientific deployment.

Objective: To investigate the effect of adding glutathion(GSH) to tumescent solution on autologous fat graft survival. Methods: 14 male and female New Zealand rabbits were divided into experimental group and control group randomly, 7 in each group. Experimental group: The donor areas of the rabbits were injected with 3 ml of tumescent solution with GSH. Control group: The donor areas of the rabbits were injected with 3 ml regular tumescent solution. DCFH-DA probe was used for fluorescent staining of harvested fat cells. Then stained fat cells were measured for the intracellular reactive oxygen species(ROS)content by fluorescence microplate. The grafts were harvested at 3 months after transplantation and assessed by general observation, volume measurement, wet weight measurement, HE staining for the number of fat cells, and CD34 immunohistochemical staining for the measurement of micro-vascular density. T test was performed by using SPSS 24.0. Results: The intracellular ROS content of harvested fat cells in experimental group was lower than that in control group, and the difference was statistically significant (P<0.05). At 3 months after transplantation, the wet weight of fat grafts in experimental group was (1133.21±87.97) mg and that in control group was (718.79±79.27) mg. The volume of fat grafts in experimental group was (1.00±0.04) ml and that in control group was (0.59±0.03) ml. The number of fat cells in experimental group was (746.6±15.7)/10 high magnification vision and that in control group was (350.1±32.4)/10 high magnification vision. The density in group experimental was (8.1±2.0)/high magnification vision and that in control group was (6.7±2.4)/high magnification vision. The grafts′ volume, wet weight, and the number of fat cells in experimental group were higher than those in control group, and the differences were statistically significant (P<0.05). The difference of micro-vascular density between experimental group and control group had no statistical significance (P>0.05). Conclusions The addition of GSH to tumescent solution optimizes the process of autologous fat harvest, thereby improving the survival of fat graft.

Objective: To investigate the clinical features of children with infectious mononucleosis (IM), to compare the difference of therapeutic effects between general treatment to antiviral therapy for IM. Methods: This prospective study analyzed the clinical data and laboratory test results of 201 cases with IM in our hospital from January 1, 2016 to December 31, 2016. The follow-up period was 6-12 months. The patients were divided into two groups according to the order of admission. The clinical symptoms and laboratory test results of the two groups were observed after hospitalization. Results: Of the total of 201 patients, male to female is 1.72∶1; Age: 8 months to 13 years 6 months (average 4.8±2.8 years), The disease frequently occurred in summer and autumn, accounted for 64.18%.The major clinical manifestations was fever (97.51%), angina (79.10%), enlarged of lymph node(68.66%), eyelid swelling (67.16%), hepatomegaly (53.73%) and splenomegaly (46.77%). There was no statistical difference in duration of fever, improved angina time, lymph nodes(liver, spleen) enlargement recovery time, heterotypic lymphocytes normalization time, lymphocyte function normalization time.There was significant difference in reducing the serum/plasma or total blood EBV-DNA in the short term between antiviral group and general treatment group (P<0.01), but for the long-term reduction of EBV-DNA, there was no significant difference (P>0.05). The low affinity EBV-CA-IgG was converted to high affinity EBV-CA-IgG in 89.41% of patients after 3 months and in 98.68% of patients after 6 months. With the recovery of the disease, the positive rate of EBV-CA-IgM and EBV-EA-IgG decreased. But the positive rate of EBV-NA-IgG increased. Serum/plasma EBV-DNA was completely overcast after 3 months, but after 12 months, the patient’s total blood EBV-DNA positive rate was still 71.11%. Conclusions In general IM patients, there was no significant difference between antiviral therapy and general treatment, so antiviral therapy is not generally recommended. EBV DNA in the whole blood of patients with IM will continue to be positive more than 6-12 months, indicating that to observe changes of IM should not use whole blood samples for EBV DNA testing.

Objective: To construct a novel carrier with core-shell structure-inner core of pFGF2-EGFP-loaded TACS coated by hydroxybutyl chitosan (HBC), and to explore its effects on granular fat graft survival. Methods: The core-structured particles (TACS-pFGF2-EGFP) and core-shell-structured particles (HBC@ TACS-pFGF2-EGFP) were prepared to explore the release pattern of pFGF2-EGFP of these particles. The expression of FGF2 protein was detected by Western-Blot in 293T cells transfected with the sustained - release microspheres in vitro. Cell proliferation assay demonstrated that 10μg/ml pFGF2 plasmid could promote 293T cells growth. Eighteen New Zealand white rabbits were used for adipose tissue transplantation experiment. Rabbit left ear was treated as experimental group, 2 ml fat granules and HBC@TACS-pFGF2-EGFP were implanted; rabbit right ear was used as control group, 2 ml fat granules and HBC@TACS-empty plasmids were transplanted. The specimens were harvested at 4, 8, 12 weeks separately after fat transplantation. Gross view, HE staining, and immunohistochemical staining were performed to observe graft survival, biological characteristics, and neovascular density. Results: HBC@TACS-pFGF2-EGFP particles could sustained release Pfgf2 gene in vitro, and successfully express FGF2 protein after transfecting 293T cells. At different time points after transplantation, the volume of adipose tissues was gradually reduced with time. The fat volume and survival rate of adipose tissues in the experimental group were significantly higher than that in the control group (P<0.05). HE staining showed that the arrangement of new adipocytes in the experimental group was more regular than that in the control group. Immunohistochemistry staining showed that the micro vessel density and FGF2 protein expression level in the adipose tissue of the experimental group were higher than those in the control group (P< 0.05). Conclusions HBC@TACS-pFGF2-EGFP particles with sustained release of FGF2 can improve the survival of granule fat transplantation.

OBJECTIVE:To evaluate the efficacy and safety of the application of airway secretions expurgation cluster manage-ment in oxygen-driven aerosol inhalation. METHODS:280 patients with chronic obstructive pulmonary disease in the Respiratory Second Division of our hospital from Mar. 2012 to Dec. 2013 were randomly divided into group A,B,C and D,with 70 cases in each group.Group A and B were treated with compound isopropyl bromide 2 ml+nomal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalation for 7 days;group C and Dreceived Ambroxol hydrochloride injection 15 ml+normal saline 5 ml,10 min/time,twice a day,and 6 L/min oxygen-driven aerosol inhalatiom for 7 days. group A and C were treatment groups, group B and D were control groups. Two treatment groups inhaled compound medications while the application of airway secretions expurgation cluster management. Two control groups inhaled compound medications with single effective cough guidance. RE-SULTS:Compared with control groups,the patients in treatment groups eliminated more phlegm,had lower (PaCO2)and higher (PaO2),also had a shorter hospitalization period,with significant difference(P<0.05). CONCLUSIONS:Airway secretions expur-gation cluster management technology is a simple,safe and effective method,especially in patients with chronic obstructive pulmo-nary disease in oxygen-driven inhalation therapy.

Traditional T vector cloning method requires onerous procedures for identifying recombinant, and directional cloning was impossible. In order to overcome these problems, we have devised a directional T vector pETG based on pET-23a(+). For gene cloning, 7 bp partial LacO sequence was introduced into DNA fragment to reconstitute a full length LacO with Bfu I digested T vector. After transformation, blue colonies were selected on LB plate supplemented with X-gal. Restriction enzyme digestion and PCR identification showed that all blue colonies contained the directionally inserted recombinants and the recombinant efficiency was nearly 100%. We have successfully cloned 103 genes from human liver cDNA; in the study complicated procedures for screening of recombinant were not required. Eight pETG clones were picked for protein expression, and all the clones successfully produced corresponding proteins. We demonstrated that the directional T vector was successfully constructed, and it was very suitable for gene cloning and expression.
Cloning, Molecular ; methods ; DNA, Complementary ; biosynthesis ; genetics ; Escherichia coli ; genetics ; metabolism ; Gene Expression ; genetics ; Genetic Vectors ; genetics ; Humans ; Liver ; chemistry ; Polymerase Chain Reaction ; methods ; Recombinant Proteins ; biosynthesis ; genetics