Objective To analyze the mechanism of Xueshuantong injection combined with intravenous thrombolysis with alteplase in the treatment of patients with acute cerebral infarction (ACI) based on the high mobility group protein B1 (HMGB1)/Toll-like receptor 4 (TLR4) signaling pathway. Methods A total of 106 ACI patients were randomly divided into control group (n=53) and study group (n=53). The control group received intravenous thrombolysis with alteplase, while the study group received Xueshuantong injection treatment on the basis of the control group. Clinical efficacy and adverse reactions, the National Institutes of Health Stroke Scale (NIHSS) scores before treatment and on the 7th and 14th day after treatment, the expression levels of HMGB1 mRNA and TLR4 mRNA in mononuclear cells of peripheral blood before and after treatment as well as the protein contents of HMGB1 and TLR4 in serum, and the levels of inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] before and after treatment were compared between two groups. Pearson test and Spearman test were used to analyze the correlations of the expression levels of HMGB1 mRNA and TLR4 mRNA in mononuclear cells of peripheral blood and the protein contents of HMGB1 and TLR4 in serum with the NIHSS score and the total effective rate in patients with ACI. Results The NIHSS score of the study group was significantly lower than that of the control group at 7 and 14 days after treatment (P < 0.05); after treatment, the expression levels of HMGB1 mRNA and TLR4 mRNA in both groups decreased significantly when compared to those before treatment, and the expression levels of HMGB1 mRNA and TLR4 mRNA in the study group were significantly lower than those in the control group (P < 0.05); after treatment, the serum protein contents of HMGB1 and TLR4 in both groups decreased significantly when compared to those before treatment, and the serum protein contents of HMGB1 and TLR4 in the study group were significantly lower than those in thecontrol group (P < 0.05); after treatment, the levels of serum TNF-α and IL-6 in both groups decreased significantly when compared to those before treatment, and serum TNF-α and IL-6 levels in the study group were significantly lower than those in the control group (P < 0.05). The total effective rate was 75.47% in the control group and 94.34% in the study group, and there was a significant difference between two groups (P < 0.05); the total incidence of adverse reactions was 9.43% in the control group and 15.09%in the study group, and there was no significant difference between two groups (P>0.05). Pearson test showed that the expression levels of HMGB1 mRNAand TLR4 mRNA in mononuclear cells of peripheral blood and the serum protein contents of HMGB1 and TLR4 in ACI patients were positively correlated with NIHSS score (r=0.431, 0.443, 0.396, 0.375, P < 0.001); Spearman test showed that the expression levels of HMGB1 mRNA and TLR4 mRNA in mononuclear cells of peripheral blood and the serum protein contents of HMGB1 and TLR4 in ACI patients were negatively correlated with the total effective rate of treatment (r=-0.536, -0.481, -0.475, -0.506, P < 0.001). Conclusion Combination of Xueshuantong injection and intravenous thrombolysis with alteplase can effectively improve the neurological function of patients with ACI and reduce the level of inflammation in the body, and the therapeutic mechanism may be related to downregulation of the HMGB1/TLR4 signaling pathway.

The biological samples of oral genetic diseases and rare diseases are extremely precious. Collecting and preserving these biological samples are helpful to elucidate the mechanisms and improve the level of diagnose and treatment of oral genetic diseases and rare diseases. The standardized construction of biobanks for oral genetic diseases and rare diseases is important for achieving these goals. At present, there is very little information on the construction of these biobanks, and the standards or suggestions for the classification and coding of biological samples from oral and maxillofacial sources, and this is not conducive to the standardization and information construction of biobanks for special oral diseases. This consensus summarizes the background, necessity, principles, and key points of constructing the biobank for oral genetic diseases and rare diseases. On the base of the group standard "Classification and Coding for Human Biomaterial" (GB/T 39768-2021) issued by the National Technical Committee for Standardization of Biological Samples, we suggest 76 new coding numbers for different of biological samples from oral and maxillofacial sources. We hope the consensus may promote the standardization, and smartization on the biobank construction as well as the overall research level of oral genetic diseases and rare diseases in China.

Objective:To explore the effect of colonoscopy combined with X-ray stent implantation in the treatment of colorectal cancer intestinal obstruction, and analyze the risk factors of postoperative delayed bleeding.Methods:From November 2016 to December 2020, 382 patients with colorectal cancer intestinal obstruction in Hainan Provincial People′s Hospital were selected. Among them, 254 patients were treated by colonoscopy combined with X-ray stent implantation (stent implantation group), and 128 patients were treated by emergency radical resection (control group). The operation time, intraoperative bleeding, number of lymph node dissections, tumor diameter, incision length, exhaust time, hospital stay, fluid feeding time, fistulation, perioperative death and delayed bleeding were compared between 2 groups. Based on the random number generated by the computer, 254 patients who underwent colonoscopy combined with X-ray stent implantation were divided into training set (190 cases) and test set (64 cases) according to the ratio of 3∶1. In the training set, the patients were divided into postoperative delayed bleeding and non postoperative delayed bleeding, and the clinical indicators were compared; the multivariate Logistic regression model was performed to analyze the independent risk factors of postoperative delayed bleeding, and the prediction model of postoperative delayed bleeding was established and verified according to the independent risk factors.Results:All patients in the stent implantation group were successfully implanted with stents, and the obstructive symptoms were relieved 24 to 48 h after operation. The operation time, intraoperative bleeding, incision length, fistulation rate, exhaust time, hospital stay and fluid feeding time in stent implantation group were significantly lower than those in control group: (88.89 ± 5.97) min vs. (116.58 ± 20.17) min, (33.18 ± 16.52) ml vs. (92.35 ± 25.64) ml, (4.50 ± 0.96) cm vs. (14.26 ± 2.88) cm, 10.24% (26/254) vs. 98.44% (126/128), (1.18 ± 0.58) d vs. (1.53 ± 0.77) d, (7.69 ± 5.12) d vs. (12.88 ± 6.54) d and (1.46 ± 0.68) d vs. (2.12 ± 1.18) d, the number of lymph node dissections was significantly higher than that in control group: (19.88 ± 4.47) lymph nodes vs. (17.47 ± 3.11) lymph nodes, and there were statistical differences ( P<0.01); there were no statistical differences in tumor diameter and perioperative fatality rate between 2 groups ( P>0.05). Among 190 patients in the training set, 18 patients had postoperative delayed bleeding, with an incidence of 9.47%; 172 cases did not have postoperative delayed bleeding. The age, course of obstruction, complete obstruction rate, intestinal almost occlusion rate under enteroscopy, intraoperative bleeding rate and preoperative intestinal surgery history rate in patients with postoperative delayed bleeding were significantly higher than patients without postoperative delayed bleeding: (69.52 ± 10.54) years old vs. (58.65 ± 15.87) years old, (14.56 ± 10.12) d vs. (8.13 ± 7.68) d, 11/18 vs. 20.35% (35/172), 11/18 vs. 16.28% (28/172), 7/18 vs. 11.63% (20/172) and 12/18 vs. 37.79% (65/172), and there were statistical differences ( P<0.01 or <0.05). Multivariate Logistics regression analysis result showed that old age, long duration of obstruction, complete obstruction, almost intestinal obstruction under enteroscopy and intraoperative bleeding were independent risk factors for postoperative delayed bleeding in patients with colorectal cancer intestinal obstruction undergoing colonoscopy combined with X-ray stent implantation ( OR = 3.925, 4.802, 1.727, 2.710 and 2.581; 95% CI 1.352 to 8.330, 1.064 to 8.869, 1.063 to 2.804, 1.118 to 4.400 and 1.689 to 3.479; P<0.05 or<0.01), while the history of preoperative intestinal surgery was not related to postoperative delayed bleeding ( P>0.05). The consistency indexes of nomogram training set and test set were 0.742 and 0.726 (95% CI 0.684 to 0.845 and 0.640 to 0.812). The receiver operating characteristic (ROC) curve analysis results of 2 models showed that the area under the curve (AUC) of the training set nomogram model and Tree Augmented Na?ve Bayes (TAN) model was 0.758 and 0.752 respectively, and the AUC of the test set nomogram model and TAN model was 0.702 and 0.706 respectively. The prediction accuracy of training set nomogram model and TAN model was 84.74%(161/190) and 85.26%(162/190) respectively, the prediction accuracy of test set nomogram model and TAN model was 82.81%(53/64) and 84.38%(54/64) respectively. Conclusions:Colonoscopy combined with X-ray stent implantation is safe and feasible in patients with colorectal cancer intestinal obstruction. But for the old age, long duration of obstruction, complete obstruction, almost intestinal obstruction under colonoscopy and intraoperative bleeding, careful operation should be carried out to reduce the occurrence of postoperative delayed bleeding.

Objective: To investigate the classification of atrophic glossitis and to study the correlation between the classification and changes of VitB12, folic acid (FOL) and blood cell parameters Methods: A total of 70 patients with atrophic glossitis (AG) were divided into complex type and simple type according to whether they had ulcer or erosion on the tongue mucosa or not. Another 65 healthy subjects during the same period were collected as the control group. The levels of vitamin B12, FOL and blood cell parameters were statistically analyzed using SPSS 25.0 software package. Results: The levels of vitamin B12, red blood cell count (RBC) (3.52 ± 0.69) × 1012·L-1, hemoglobin (HGB)(11.97 ± 1.70) g·dL-1, white blood cell count (WBC) (4.85 ± 1.16) × 109·L-1, neutrophil count (NEUT) (2.76 ± 0.99) × 109·L-1, lymphocyte count (LYMPH) (1.48 ± 0.44) × 109·L-1 in complex type AG group were lower than those in simple type AG group (P<0.05). The levels of mean red blood cell volume (MCV) (104.90 ± 11.13) fL, mean corpuscular hemoglobin (MCH) (34.83 ± 4.56) pg, mean corpuscular hemoglobin concentration (MCHC) (331.09 ± 13.60) g·L-1 were higher than those in the simple type AG group (P<0.05). There was no significant difference in FOL content between these two groups (P>0.05). The levels of VitB12, MCV, MCH, MCHC, WBC, lymph and neut were correlated with the classification of atrophic glossitis (P < 0.05). Conclusion VitB12 deficiency was more apparent in complex AG, especially in large cell anemia, which correlated with the levels of WBC, NEUT, and LYMPH.

Objective : To investigate the pathogenic factors and clinical manifestations of contact stomatitis, and to provide references for its clinical diagnosis and prevention. Methods: The data of 55 subjects with contact stomatitis were analyzed retrospectively, including age, gender, pathogenic factors, type of lesions and site of occurrence. Results: Among the 55 patients, contact stomatitis occurred at all ages, 19 were male, 36 were female, and the ratio of males to females was 1∶1.89. Among 55 patients, 78.18% (43/55) were caused by oral mucosal contact with dental materials: amalgam fillings accounted for 52.73% (29/55), metal crowns accounted for 9.09% (5/55), removable denture plastic bases accounted for 9.09% (5/55), resin fillings accounted for 5.45% (3/55), and alginate impression materials accounted for 1.82% (1/55); 21.82% (12/55) were caused by oral mucosal contact with food and daily necessities. The clinical manifestations of contact stomatitis include lichenoid reaction, erythema and erosion. The most common site of contact stomatitis was the cheek, followed by the tongue, and the lips, and the gingival and palatal areas were relatively rare. In the buccal mucosa, the incidence of lichenoid reaction was 55% (22/40), which was higher than that of erosion (20%) and erythema (25%), and the difference was statistically significant (P < 0.05). For tongue, lip, gingiva and palate, there was no significant difference in the incidence of the three lesion types（P > 0.05）. Conclusion Contact stomatitis occurred at all ages, and there are more female patients than males with contact stomatitis. Dental materials, especially metal and acrylic materials (such as the plastic base of removable dentures, resin fillings, adhesives, and self-setting plastics), are the main pathogenic factors. In buccal mucosa, the incidence of lichenoid reaction is higher.

Objective:To explore the relationship between the childhood trauma and neruocognition in patients with schizophrenia.Methods:Sixty-two patients with schizophrenic were selected from Anhui mental health center, and sixty-three community health controls were selected. All subjects were assessed with the childhood trauma questionnaire (CTQ), Wisconsin card sorting Test (WCST), attention network test (ANT), verbal fluency test (VFT) and digit span test (DST). SPSS 17.0 was used for statistical analysis. t-test was used to compare the measurement data of normal distribution and Mann-Whitney U test was used to compare the measurement data of non-normal distribution. Spearman correlation analysis was used to analyze the relationship between CTQ score and cognitive function score. Results:Compared with health controls(34.00(30.00, 37.00), 6.00 (5.00, 7.00), 5.00(5.00, 5.00), 5.00(5.00, 5.00), 9.00(6.00, 11.00), 7.00(6.00, 10.00)), the total score of CTQ, subscores of emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect in patients with schizophrenia were significantly increased (48.50(37.75, 57.00), 9.00(6.00, 12.25), 7.00(5.00, 9.25), 5.50(5.00, 7.25), 13.00 (9.00, 16.25), 11.00(8.00, 13.00)) ( Z=-4.781--6.724, all P<0.01). Compared with the control group, the number of WCST classification completed in the patient group was lower, while the number of wrong answers, continuous answers and persistent errors increased ( Z=-5.655--6.060, all P< 0.01). The correct rate of ant decreased, but the reaction time increased ( Z=-5.796, -6.094, all P< 0.01). VFT and DST scores were decreased ( Z=-3.492--8.499, both P< 0.01). In patients with schizophrenia, CTQ sexual abuse subscore were negatively correlated with completed categories scores ( r=-0.384) and positively correlated with total errors ( r=0.360), perseverative responses( r=0.394) and perseverative errors ( r=0.381) on WCST(all P<0.01). CTQ physical neglect scores were negatively correlated with the ANT correct ratio( r=-0.400) and conflict resolution( r=-0.417) (all P<0.01). CTQ emotional neglect scores were negatively correlated with VFT scores( r=-0.345) ( P<0.01). The significant associations remained after controlling for age, education and PANSS scores. Conclusion:Patients with schizophrenia experience more traumatic events in their early years and have extensive cognitive defects. The childhood trauma has negative effects on cognitive flexibility, attention, memory and speech function in patients with schizophrenia.However, the positive correlation between childhood trauma and executive conflict of attention network needs to be further verified and explored.

Objective: To investigate the incidence and prognosis of cognitive impairment and to find out the risk factors associated with the outcome for better understanding and preventing cognitive impairment in maintenance hemodialysis (MHD) patients. Methods: The patients who met the criteria as below: MHD patients (≥3 months) in Renji Hospital, Shanghai Jiao Tong University School of Medicine from January 2000 to July 2014, ≥18 years old were enrolled and could carry on the montreal cognitive assessment (MoCA) of voluntary cooperation. According to the score of MoCA, all enrolled patients were divided into two groups: cognitive impairment (MoCA<26) group and non-cognitive impairment (MoCA≥26) group. The follow-up period was 3 years. There were 130 males, and the incidence, demography data, medical history, hemodialysis data, laboratory examination and prognosis of cognitive impairment in hemodialysis patients were prospectively compared and analyzed. Logistic regression analysis was used to investigate the risk factors of cognitive impairment. Kaplan-Meier survival curve and Cox regression model were used for prognostic analysis. Results: A total of 219 MHD patients were enrolled. The incidence of cognitive impairment in MHD patients was 51.6%. There were 130 males, and the ratio of male to female was 1.46∶1. Age was (60.07±12.44) years old and dialysis vintage was (100.79±70.23) months. Compared with non-cognitive impairment group (n=106), patients in cognitive impairment group (n=113) were older, and had higher proportion of education status<12 years, history of diabetes and anuria (all P<0.05); however, the post-dialysis systolic pressure, pre-dialysis diastolic pressure, post-dialysis diastolic pressure, platelet and spKt/V were lower (all P<0.05). Multivariate logistic regression analysis showed that education status<12 years (OR=3.428, 95%CI 1.919-6.125, P<0.001), post-dialysis diastolic pressure<73 mmHg (OR=2.234, 95%CI 1.253-3.984, P=0.006) and spKt/V<1.72(OR=1.982, 95%CI 1.102-3.564, P=0.022) were the independent risk factors for cognitive impairment in MHD patients. The Kaplan-Meier survival curve analysis showed that the survival rate of patients with cognitive impairment was lower than that of non-cognitive impairment group in MHD patients during 3 years follow-up (χ²=3.977, P=0.046). Multivariate Cox regression analysis showed that cognitive impairment was an independent risk factor for death in MHD patients (RR=2.661, 95%CI 0.967-7.321, P=0.058). Conclusions Cognitive impairment is one of the common complications and an independent risk factor for death in MHD patients. The mortality is high in patients who suffer cognitive impairment. Education status<12 years, post-dialysis diastolic pressure<73 mmHg and spKt/V<1.72 are the independent risk factors for cognitive impairment in MHD patients.

Adult ; Child ; Female ; Humans ; Keratoderma, Palmoplantar ; genetics ; pathology ; Male ; Pedigree

Adolescent ; Adult ; Aged, 80 and over ; Arthrogryposis ; genetics ; Child ; Female ; Humans ; Male ; Middle Aged ; Pedigree

Adult ; Brachydactyly ; genetics ; Chromosome Aberrations ; Female ; Fingers ; abnormalities ; Humans ; Male ; Pedigree