Objective To investigate sodium hydrogen sulfide(NaHS)with function of regulating glutathione(GSH)synthesis to reduce reactive oxygen species(ROS)production in type 2 diabetic cardiomyopathy(DCM).Methods Mouse cardiomyocyte cell line HL-1 was incubated with high concentration of glucose(HG:40 mmol/L)and palmitate(Pal:500 μmol/L)as a cell model of type 2 DCM.HL-1 cells were incubated with NaHS(100 μmol/L),DL-propargylglycin(PPG,1 mmol/L)and N-acetyl-l-cysteine(NAC,5 mmol/L),respectively for 72 hours.The expression of cystathionine-γ-lyase(CSE)and the key enzymes of glutathione production was tested by Western blot.Dihydroethidium(DHE)and dichlorofluoromethane(DCFH)were used to detect the content of ROS in HL-1 cells.Cell viability was detected by CCK8 kit.The content of total GSH was detected.The interaction between muscle specific ring finger protein 1(Murf1)and nuclear factor erythroid-derived 2-related factor 2(Nrf2)and Nrf2 ubiquitylation was determined by co-immunoprecipitation(co-IP).Results Compared with control group,the expression level of CSE,solute carrier family 7 members 11(SLC7A11),glutamate cysteine ligase C(GCLC),glutamate cysteine ligase M(GCLM)and glutathione synthetase(GSS)in HL-1 cells treated incubated with high glucose and palmitate was decreased,however,NaHS was found to restore it.NaHS reduced the content of ROS in HL-1 cells treated with high glucose and palmitate.The interaction between murf1 and Nrf2 was confirmed by co-immunoprecipitation(Co-IP).Compared with NaHS group,the ubiquitylation level of Nrf2 was enhanced in high glucose and palmitate group.Conclusions Sodium hydrosulfide may reduce the ubiquitylation level of Nrf2 and promote the expression of key enzymes of GSH synthesis.

Objective To explore the expression level and clinical significance of α-Arrestin domain-containing protein 3(ARRDC3)gene in human brain glioma tissues.Methods Clinical data and gene expression of patients with brain glioma were analyzed using the Chinese Glioma Genome Atlas(CGGA)database and the Cancer Genome Atlas(TCGA)database.Brain glioma specimens were collected from 9 patients with primary brain gliomas treated in the Department of Neurosurgery,the Affiliated Hospital of Xuzhou Medical University from January 2018 to December 2021.The expression levels of ARRDC3 in gliomas of different grades were detected through immunohistochemical experiments.The expression levels of ARRDC3 in gliomas with different molecular types and grades were analyzed by using thenon-parametrictest.The effect of ARRDC3 expression on the survival time of brain glioma patients was analyzed by using the Kaplan-Meier survival curve,while the effect of ARRDC3 expression on prognosis of glioma patients was analyzed by using univariate and multivariate Cox regression models.Results Data in the CGGA and TCGA databases showed that the expression of ARRDC3 in the grade Ⅱ,Ⅲ and Ⅳhuman brain gliomas increased gradually(P＜0.05).The results of immunohistochemical staining experiments were consistent with the above results(P＜0.05).The ARRDC3 expression in isocitrate dehydrogenase(IDH)wild type glioma patients was significantly higher than that in IDH mutant glioma patients(P＜0.05).The overall survival of the patients with high ARRDC3 expression was significantly shorter than that of the patients with low ARRDC3 expression(P＜0.05).Multivariate Cox regression analysis revealed that age,IDH mutation state,radiotherapy and ARRDC3 expression were risk factors for prognosis of human brain glioma patients(P＜0.05).Conclusion With the pathological grade rising gradually,the relative expression level of ARRDC3 in human brain glioma tissues increases gradually.The prognosis of brain glioma patients with low expression of ARRDC3 is significantly better than that of patients with high expression of ARRDC3.ARRDC3 can be used as a prognostic factor for glioma patients.

Objective: The aim of this study was to investigate the effect of changes in nasal tip protrusion on the sense of upper lip protrusion in different populations and to provide a reference for the improvement of soft tissue beauty. Methods : Informed consent and portrait authorization were obtained from the model. A female model whose face met the criteria was selected, and a 3D model of her was obtained using a 3D stereo camera. Based on the original model, ZBRUSH2019 software was used to simulate changes in nose tip protrusion. Then, 9 segments of facial dynamic rotation videos were produced, and an electronic questionnaire was created through a questionnaire website to evaluate the effect of different nose tip protrusions on perceived upper lip protrusion. Randomly selected orthodontic patients, orthodontics professionals and general adults completed the electronic questionnaire. In the questionnaire, a Visual Analog Scale was used to evaluate the perceived degree of protrusion of the upper lip. The higher the score, the more prominent the upper lip of the model in the image. The questionnaire data were statistically analyzed using a generalized linear mixed model. Results : As the nasal tip position became progressively more retracted, the subjects' upper lip protrusion scores increased. Among male subjects, the results showed that the general population thought that the upper lip protrusion was higher than the patients did when the nasal tip protrusion was +6 mm and +4.5 mm (P = 0.023, P = 0.047). When the nasal tip protrusion was +6 mm, the scores of the general population were higher than those of the orthodontics professionals (P = 0.023). However, when the nasal tip variable was -6 mm, their score was lower than that of the patients (P = 0.003), and there was no significant difference in other retest distances between groups (P>0.05). Conclusion When the protrusion of the nasal tip decreased, the three groups experienced a visual illusion of upper lip protrusion. When the nasal tip protrusion is too large, the general population perceived the visual illusion of the upper lip protrusion as being more obvious.

Objective To investigate the function of sodium hydrosulfide(NaHS)to regulate mitochondrial fusion/fission in diabetic cardiomyopathy and underlying mechanism.Methods Db/db mice as type 2 diabetes animal model were treated by NaHS.H9C2 cells incubated with glucose(40 mmol/L),palmitic acid(200 μmol/L,Pal)and oleate(200 μmol/L,Ole)were intervened by NaHS(100 μmol/L).H2C9 cellswere divided into control,HG+Pal+Ole,HG+Pal+Ole+NaHS and Pal+Ole+DJ-1 siRNA+NaHS groups.The protein level of Mfn2,Fis1,CSE,and DJ-1 was determined by Western blot.Mitotracker staining was used to observe the morphology of mitochondria.The ultra-structural alteration of cardiac tissues was detected by transmission electron microscopy.The cardiac functions were detected by echocardiography.Results Expression of Fis1 was increased(P＜0.05)and expression of Mfn2 was decreased(P＜0.05)in db/db and H9C2 treated by HG+Pal+Ole compared to control group.NaHS could upregulate the expression DJ-1,enhance the expression of Mfn2,and reduce the expression of Fis1.In db/db mice,cardiac systolic function was reduced.Disordered arrangement of myofilament,loss of cristae and mitochondrial fission were observed.NaHS could ameliorate these alterations.Conclusions NaHS may alleviate mitochondria injury by promoting mitochondrial fusion.

Objective To provide guidance for pre-hospital emergency treatment by studying the disease spectrum and distribution characteristics of pre-hospital emergency treatment patients in Wuxi area from 2015 to 2020. Methods The medical records of 120 pre-hospital emergency patients in Wuxi area from January 2015 to December 2020 were retrospectively analyzed, and the disease types, gender, age, and seasonal distribution of the pre-hospital emergency patients were statistically analyzed. Results The top five emergency diseases of 16 437 pre-hospital patients were trauma (24.51%), cerebrovascular disease (19.16%), cardiovascular disease (18.33%), digestive system disease (9.70%) and respiratory disease (7.20%). In the distribution of disease types, the proportions of injuries, cerebrovascular diseases, cardiovascular diseases, digestive system diseases, respiratory system diseases, poisoning diseases and urinary system diseases in males were significantly higher than those in females (χ²=4.975, P<0.05). The proportion of male species (9 812/16 437) was higher than that of female species (6 625/16 437). From 2015 to 2020, the age group with high incidence of pre-hospital emergency patients in Wuxi area was distributed in the 50-60 years old (19.30%) and 40-50 years old (16.28%), and the least age group was 0-10 years old (2.60%). The number of pre-hospital emergency patients was 46.60% from 6 to 12 hours per day, and 10.26% from 18 to 24 hours per day. The number of pre-hospital emergency patients was the highest in summer (38.69%), and the lowest in spring (11.87%). Conclusion The pre-hospital emergency diseases in Wuxi area are mainly cardiovascular and cerebrovascular diseases, and the acute and severe diseases show an increasing trend. It is necessary to rationally allocate the pre-hospital emergency resources according to the disease spectrum and the peak months and time periods of different diseases, so as to improve the medical service level in Wuxi.

Objective:To observe the adverse effects of skin toxicity after the administration of programmed cell death protein 1 (PD-1) inhibitor, summarize the nursing measures, and provide a basis for taking corresponding management measures.Methods:Totally 94 patients who were treated with PD-1 inhibitor in Cancer Hospital of Chinese Academy of Medical Sciences between February and October 2019 were selected by convenient sampling, among whom 37 cases (39.4%) with skin toxicity reaction were included as the research subjects. Their skin toxicity was observed and assessed. Meanwhile, health education, psychological counseling and nursing care for skin toxicity reaction were provided to them.Results:Of the 37 patients, 34 (91.9%) had G1 skin toxicity and were not treated with drugs. After the rash subsided, they were treated according to the original plan. 2 (5.4%) had G2 skin toxicity, whose rash subsided after drug treatment, with scattered pigmentation. They were treated according to the original plan. 1 (2.7%) had G4 skin toxicity. The medical staff from the Dermatology Department and the Infection Department were consulted. The body temperature was normal, and the skin and mucous membranes were ruptured, crusted and detached. The patient was discharged after the condition was improved.Conclusions:After receiving PD-1 inhibitor immunotherapy, patients may have different degrees of immune-related skin toxicity reactions, which requires clinicians and nurses to carry out standardized treatment and care to improve their quality of life.

By removing a part of the structure, the tooth preparation provides restorative space, bonding surface, and finish line for various restorations on abutment. Preparation technique plays critical role in achieving the optimal result of tooth preparation. With successful application of microscope in endodontics for >30 years, there is a full expectation of microscopic dentistry. However, as relatively little progress has been made in the application of microscopic dentistry in prosthodontics, the following assumptions have been proposed: Is it suitable to choose the tooth preparation technique under the naked eye in the microscopic vision? Is there a more accurate preparation technology intended for the microscope? To obtain long-term stable therapeutic effects, is it much easier to achieve maximum tooth preservation and retinal protection and maintain periodontal tissue and oral function health under microscopic vision? Whether the microscopic prosthodontics is a gimmick or a breakthrough in obtaining an ideal tooth preparation should be resolved in microscopic tooth preparation. This article attempts to illustrate the concept, core elements, and indications of microscopic minimally invasive tooth preparation, physiological basis of dental pulp, periodontium and functions involved in tool preparation, position ergonomics and visual basis for dentists, comparison of tooth preparation by naked eyes and a microscope, and comparison of different designs of microscopic minimally invasive tooth preparation techniques. Furthermore, a clinical protocol for microscopic minimally invasive tooth preparation based on target restorative space guide plate has been put forward and new insights on the quantity and shape of microscopic minimally invasive tooth preparation has been provided.

Objective? To compare predicted incidence of chemotherapy induced nausea and vomiting (CINV) by doctors, nurses and patients with its actual incidence. Methods? We used the prospective paired design to select 320 patients with the induced vomiting plan of medicine department at Peking Union Medical College Cancer Hospital by convenience sampling, and we allocated 72 doctors and 48 responsibility nurses for patients. The predicted chemotherapy induced nausea and vomiting scale was filled in by doctors, nurses and patients as required to understand the incidence of CINV predicted by them. After patients completed their chemotherapy, the Chinese version of MASCC antiemesis tool (MAT) was filled out by nurses to investigate the actual incidence of CINV. Results? The paired chi-square test showed that the incidence of acute and delayed CINV were 38.75% and 61.25% respectively. There was no statistical difference between the incidence of acute CINV predicted by doctors, nurses as well as patients and the actual incidence (P＞0.05). There was also no statistical difference between the incidence of delayed CINV predicted by nurses and the actual incidence (P＞0.05). Doctors and patients all underestimated the incidence of delayed CINV with a statistical difference (P＜0.05). The consistency between the incidence of acute as well as delayed CINV predicted by doctors, nurses, patients and the actual incidence was poor with Kappa value ranging from 0.02 to 0.34. A total of 54.93% to 57.77% of doctors and nurses predicted that CINV could be controlled well lower than that (about 70%) of patients with statistical differences (P＜0.05). Conclusions? There is still much improvement space for control of delayed CINV. Medical staff should take effective measures to improve the level of estimate and the level of CINV symptom management, and to improve the quality of life among patients.

Objective To explore the influential factors of esthetic evaluation of mandibular prominence by orthodontic patients from two dimensions (ideal value and tolerance range).Methods 226 orthodontic patients were investigated by an electronic questionnaire of esthetic evaluation of mandibular prominence.Binary logistic regression was adopted to analyze the influential factors.Results The tolerable boundary value for female mandibular retrognathism was affected by age (OR1.360) and orthodontic history (OR2.849).The tolerable boundary value for female mandibular prognathism and male mandibular retrognathism were found to be affected by orthodontic history (OR2.557 and 2.845,respectively).The tolerable boundary value for male mandibular prognathism was affected by age (OR1.347) and orthodontic history (OR2.310).The ideal value of male mandibular prominence was affected by age (OR1.420).Conclusions Orthodontic patients' esthetic evaluation of mandibular prominence is influenced by age and treatment condition,but not by sex,education level,marital status and personal profile.

Objective To explore the clinical symptom clusters in breast cancer patients with anthracycline treatment, which could provide evidence for prevention. Methods The M.D.Anderson Symptom Inventory of Chinese version (MDASI-C) was applied to assess clinical symptoms in 506 breast cancer patients received anthracycline therapy during their 1stto 4thcycle chemotherapy.Thirteen symptoms were analyzed using main-component analysis and variance orthogonal rotation. The exploratory factor analysis was conducted to find factors value greater than 1. Results The number of symptoms with incidence rate more than 50% was 5, 6, 7 and 9 during the 1stto the 4thcycle, respectively. Fatigue, poor appetite, and nausea were the most common symptoms, and the incidence of these symptoms were 92.5% to 97.1% ,84.8% to 95.1% and 81.1% to 91.3% with the increasing cycle of chemotherapy.Three factors value greater than 1 were detected during the 1stto 2ndcycle chemotherapy by exploratory factor analysis.The cumulative variance contribution rates were 63.233% and 61.434% in the 1stand 2ndcycle, respectively. The main symptom clusters concentrate on fatigue and digestive tract symptoms, including fatigue, sleep disturbance, hypersomnia, nausea, vomit, poor appetite, dry mouth. Two factors value greater than 1 were detected during 3rdto4thcycle in chemotherapy. The cumulative variance contribution rates were 62.660% and 61.148% in the 3rdand 4thcycle, respectively. The main symptom clusters concentrate on psychological and nervous system symptoms including sadness, pain, dry mouth, numbness, hypersomnia, shortness of breath, amnesia and so on. The Cronbach α of cluster symptoms from the 1stto the 4thcycle chemotherapy was between 0.829 to 0.911. Conclusions Symptom clusters vary with the cycles of chemotherapy in breast cancer patients treated with anthracycline. Nurses should provide targeted intervention measures to improve symptom and enhance quality of life, according to specific situation.