Objective:To compare the trueness of incisal guidance of implant-supported single crowns designed by patient-specific motion(PSM)with that designed by average-value virtual articulator(AVA).Methods:The study had recruited 12 participants with complete dentition and stable incisal guidance.An intraoral scanner was used to scan digital casts and record two types of patient-specific mo-tion(data only including protrusive movement,and data including protrusive movement and lateral pro-trusive movement).The lingual surfaces of the maxillary incisors which guided the protrusive movement was selected and elevated to create a reference cast.A maxillary central incisor of original casts was vir-tually extracted and implanted to generate a working cast.The Dental system software program was used to design implant-supported single crowns with the anatomical coping design method.The incisal guidance was designed by different methods.The incisal guidance in control group was designed by the average-value virtual articulator.The incisal guidance in experiment groups was designed by the patient-specific motion only including protrusive movement(PSM1)and with the patient-specific motion including protru-sive movement and lateral protrusive movement(PSM2).The incisal guidance of prosthesis designed by these 3 methods were compared with the original incisal guidance in Geomagic Control 2015(3DSystem,America).The measurements included:Average of positive values,ratio of positive area and maximum value reflecting supra-occlusion;average of negative values,ratio of negative area and minimum value re-flecting over-correction;and root mean square reflecting overall deviation.Results:Statistical data were collected using the median(interquartile range)method.The average of positive values,ratio of positive area and average of negative values of the PSM2 group were smaller than those of the control group[8.0(18.8)μm vs.37.5(47.5)μm;0vs.7.2％(38.1％);-109.0(63.8)μm vs.-66.5(64.5)μm],and the ratio of negative area of PSM2 group was larger than those of the control group[52.9％(47.8％)vs.17.3％(45.3％)],with significant differences(P all＜0.05).The ratio of positive area[0.1％(7.0％)]and average of negative values[-97.0(61.5)μm]of PSM1 group,were smaller than those of the control group,and the ratio of negative area[40.7％(39.2％)]of the PSM1 group was larger than that of the control group,with significant differences(P＜0.05).The average of positive values[20.0(42.0)μm]and ratio of positive area of PSM1 group was larger than that of the PSM2 group with significant differences(P＜0.05).Conclusion:To establish the incisor guidance of implant-supported single crowns,compared with the average-value virtual articulator and the patient-specific motion only including protrusive movement,the patient-specific motion including protrusive movement and lateral protrusive movement is more conducive to reducing the protrusive interference of prosthesis and improving the occlusal fit.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

ACC oxidase (ACO) is one of the key enzymes that catalyze the synthesis of ethylene. Ethylene is involved in salt stress response in plants, and salt stress seriously affects the yield of peanut. In this study, AhACO genes were cloned and their functions were investigated with the aim to explore the biological function of AhACOs in salt stress response, and to provide genetic resources for the breeding of salt-tolerant varieties of peanut. AhACO1 and AhACO2 were amplified from the cDNA of salt-tolerant peanut mutant M29, respectively, and cloned into the plant expression vector pCAMBIA super1300. The recombinant plasmid was transformed into Huayu22 by pollen tube injection mediated by Agrobacterium tumefaciens. After harvest, the small slice cotyledon was separated from the kernel, and the positive seeds were screened by PCR. The expression of AhACO genes was analyzed by qRT-PCR, and the ethylene release was detected by capillary column gas chromatography. Transgenic seeds were sowed and then irrigated with NaCl solution, and the phenotypic changes of 21-day-seedings were recorded. The results showed that the growth of transgenic plants were better than that of the control group Huayu 22 upon salt stress, and the relative content of chlorophyll SPAD value and net photosynthetic rate (Pn) of transgenic peanuts were higher than those of the control group. In addition, the ethylene production of AhACO1 and AhACO2 transgenic plants were 2.79 and 1.87 times higher than that of control peanut, respectively. These results showed that AhACO1 and AhACO2 could significantly improve the salt stress tolerance of transgenic peanut.
Salt Tolerance/genetics* ; Arachis/genetics* ; Plant Breeding ; Ethylenes/metabolism* ; Plants, Genetically Modified/genetics* ; Gene Expression Regulation, Plant ; Plant Proteins/genetics*

Humans ; Waldenstrom Macroglobulinemia/genetics* ; East Asian People ; Chromosome Aberrations ; Lymphoma

Objective:To investigate the effect of diabetic retinopathy (DR) on macular edema (ME) after cataract phacoemulsification in diabetic cataract patients and its risk factors.Methods:A total of 170 diabetic cataract patients (170 eyes) who underwent cataract phacoemulsification in the department of ophthalmology, BenQ Medical Center Affiliated to Nanjing Medical University from June 2017 to June 2019 were selected. All patients underwent monocular cataract phacoemulsification. They were divided into DR group (100 cases) and non diabetic retinopathy group (NDR group, 70 cases) according to whether or not DR was combined. The improvement of visual acuity and fundus lesions were compared between the two groups, the correlation between the severity of DR and the incidence of macular fovea retinal thickness and ME was analyzed, and the risk factors of DR were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of diabetes course, vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) on ME.Results:Compared with NDR group, the DR group had better postoperative best corrected visual acuity (BCVA), larger area of vascular leakage and bleeding. The retinal thickness of fovea was significantly thickened, and the incidence of ME in DR group was significantly higher than that in NDR group (all P<0.05). The severity of DR was positively correlated with the retinal thickness of fovea and the incidence of ME (all P<0.05). The duration of diabetes, VEGF and IL-6 were independent risk factors for DR (all P<0.05). The best critical values for predicting me were 4.7 years, 127.82 pg/ml and 136.45 pg/ml, respectively. The combination of the three has higher diagnostic value. Conclusions:DR can accelerate the postoperative ME of diabetic cataract patients, and is positively correlated with the severity of DR. The duration of diabetes, VEGF and IL-6 are not only independent risk factors of DR, but also have high predictive value for the occurrence of ME.

Objective:To explore the psychological experience of pregnancy termination among married and parous women with unintended pregnancy, so as to provide a reference for policy formulation and health care.Methods:From May to July 2021, 18 married and parous women who underwent artificial abortion in the Family Planning Clinic of the First Affiliated Hospital of Soochow University were selected as the interview subject by objective sampling. The in-depth interview was conducted using phenomenology research methods in qualitative research, and the themes were extracted using the Colaizzi 7-step analysis.Results:A total of 5 themes were extracted, namely, non-impulsive termination of pregnancy, the influence of marriage and reproductive customs and related policies, the responsibility of parenting and financial stress, pregnancy-related health concerns and discomfort, and women's social deprivation and role conflict.Conclusions:The reasons for termination of pregnancy in married and parous women with unintended pregnancy are complex. It requires the joint efforts of society, health care, family and couples to create a healthy and friendly reproductive environment.

Objective:To develop the Exercise Knowledge and Behavior Questionnaire for Osteoporosis Patients suitable for China, and to test its reliability and validity.Methods:Guided by the theory of knowledge, attitude and practice, a questionnaire framework was constructed, and the first draft of the Exercise Knowledge and Behavior Questionnaire for Osteoporosis Patients was formed through literature review, group discussion, semi-structured interview, Delphi expert consultation and pre-investigation. From June to August 2020, convenience sampling was used to select 120 osteoporosis patients admitted to the First Affiliated Hospital of Soochow University as the research object to conduct a questionnaire survey to test the reliability and validity of the questionnaire. A total of 120 questionnaires were distributed, 110 valid questionnaires were recovered, and the valid recovery rate was 91.67% (110/120) .Results:Among 2 rounds of Delphi expert consultation, the expert authority coefficients were 0.880 and 0.900, respectively, and the Kendall harmony coefficients were 0.308 and 0.332, respectively, with statistically significant differences ( P<0.01) . The Exercise Knowledge and Behavior Questionnaire for Osteoporosis Patients included two sub-questionnaire of knowledge and behavior, with a total of 19 items, including 10 items in knowledge and 9 items in behavior. Exploratory factor analysis showed that 2 common factors were extracted from the exercise knowledge sub-questionnaire, and the cumulative variance contribution rate was 60.712%. A total of one common factor was extracted for the exercise behavior sub-questionnaire, and the cumulative variance contribution rate was 72.075%. The content validity index of the total questionnaire and each sub-questionnaire were 0.925, 0.921, and 0.929, respectively, and the item-level content validity index of was 0.857 to 1.000. The Cronbach's α coefficients of the total questionnaire and each sub-questionnaire t were 0.935, 0.830, and 0.953, respectively, and the split-half reliability coefficients of the total questionnaire and each sub-questionnaire were 0.979, 0.898, and 0.974, respectively, and the test-retest reliability coefficients of the total questionnaire and each sub-questionnaire were 0.878, 0.813, 0.860, respectively. Conclusions:The Exercise Knowledge and Behavior Questionnaire for Osteoporosis Patients has good reliability and validity, and can be used to evaluate exercise knowledge and behavior in patients with osteoporosis.

Tryptophan 2,3-dioxygnease 2 (TDO2) is specific for metabolizing tryptophan to kynurenine (KYN), which plays a critical role in mediating immune escape of cancer. Although accumulating evidence demonstrates that TDO2 overexpression is implicated in the development and progression of multiple cancers, its tumor-promoting role in esophageal squamous cell carcinoma (ESCC) remains unclear. Here, we observed that TDO2 was overexpressed in ESCC tissues and correlated significantly with lymph node metastasis, advanced clinical stage, and unfavorable prognosis. Functional experiments showed that TDO2 promoted tumor cell proliferation, migration, and colony formation, which could be prevented by inhibition of TDO2 and aryl hydrocarbon receptor (AHR). Further experimentation demonstrated that TDO2 could promote the tumor growth of KYSE150 tumor-bearing model, tumor burden of C57BL/6 mice with ESCC induced by 4-NQO, enhance the expression of phosphorylated AKT, with subsequent phosphorylation of GSK3

PD-1 and CTLA-4 antibodies offer great hope for cancer immunotherapy. However, many patients are incapable of responding to PD-1 and CTLA-4 blockade and show low response rates due to insufficient immune activation. The combination of checkpoint blockers has been proposed to increase the response rates. Besides, antibody drugs have disadvantages such as inclined to cause immune-related adverse events and infiltration problems. In this study, we developed a cyclic peptide C25 by using Ph.D.-C7C phage display technology targeting LAG-3. As a result, C25 showed a relative high affinity with human LAG-3 protein and could effectively interfere the binding between LAG-3 and HLA-DR (MHC-II). Additionally, C25 could significantly stimulate CD8 T cell activation in human PBMCs. The results also demonstrated that C25 could inhibit tumor growth of CT26, B16 and B16-OVA bearing mice, and the infiltration of CD8 T cells was significantly increased while FOXP3 Tregs significantly decreased in the tumor site. Furthermore, the secretion of IFN- by CD8 T cells in spleen, draining lymph nodes and especially in the tumors was promoted. Simultaneously, we exploited T cells depletion models to study the anti-tumor mechanisms for C25 peptide, and the results combined with MTT assay confirmed that C25 exerted anti-tumor effects CD8 T cells but not direct killing. In conclusion, cyclic peptide C25 provides a rationale for targeting the immune checkpoint, by blockade of LAG-3/HLA-DR interaction in order to enhance anti-tumor immunity, and C25 may provide an alternative for cancer immunotherapy besides antibody drugs.

Objective    To analyze the characteristics and risk factors of lymph node metastasis in thoracic esophageal squamous cell carcinoma (ESCC). Methods    The clinical data of 407 patients with ESCC who underwent radical resection of esophageal carcinoma from December 2012 to October 2018 in our hospital were retrospectively analyzed. There were 390 males and 17 females with a median age of 63 (38-82) years. Esophageal lesions were found in 26 patients of upper thoracic segment, 190 patients of middle thoracic segment and 191 patients of lower thoracic segment. Results    Among the patients, 232 (57.0%) were found to have cervical, thoracic and/or abdominal lymph node metastasis. The lymphatic metastasis rates of cervical, upper, middle, lower mediastinal nodes and abdominal nodes were 0.7%, 8.8%, 21.4%, 16.7% and 37.1%, respectively. The adjacent lymph node metastasis alone occurred in 50.0% patients, and the multistage or skip lymph node metastasis accounted for 29.3% and 20.7%, respectively. Multivariate analysis showed that the length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion were independent risk factors for lymph node metastasis. Conclusion    The rates of lymph node metastasis are similar in the upper, middle and lower thoracic ESCC. The main pattern of lymph node metastasis is the adjacent lymph node metastasis, followed by multistage and skip lymph node metastases. The length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion are independent factors for lymph node metastasis. The operation and dissection range should be selected according to the location of tumor and the characteristics of the lesion.