Periodontal homeostasis is regulated by the complex interplay between the gingival epithelial barrier, the extracellular matrix of soft tissues, the bone coupling system, and immune responses within the periodontal region. Gingival epithelial cells are primarily composed of keratinocytes and a small proportion of non-keratinocytes, and they are integral to the formation of the gingival epithelial barrier. This epithelial barrier plays a fundamental role in defending against pathogens, exogenous substances, and mechanical stress. This study aims to explore the intrinsic connections between gingival epithelial cells and periodontal homeostasis. Research has shown that gingival epithelial cells participate in maintaining periodontal homeostasis through multiple pathways: ① gingival epithelial cells respond to the inflammatory environment by undergoing proliferation, migration, epithelial-mesenchymal transition, and forming apoptosis-mediated neutrophil extracellular traps; ② when gingival inflammation damages the epithelial barrier, lipopolysaccharides cannot be easily removed, and gingival epithelial cells play a defensive role by activating innate immune responses; ③ the interactions of gingival epithelial cells with oral microbiota and immune cells are essential for maintaining periodontal homeostasis. Thus, gingival epithelial cells are closely associated with periodontal homeostasis. However, the crucial role and mechanisms of gingival epithelial cells in the maintenance of periodontal homeostasis are not clear, which provides novel insights for the research of periodontal homeostatic medicine.

Objective:To investigate the relationship between the lowest hemoglobin value during hospitalization and the prognosis in patients with extensive burns, in order to explore the hemoglobin warning threshold for blood transfusion in patients with extensive burns.Methods:The research was a retrospective observational study. From October 2012 to October 2022, 288 patients with extensive burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University), including 243 males and 45 females, aged 18 to 65 years. These patients were assigned to the death group ( n=54) and the survival group ( n=234) based on their final prognosis. The clinical data including gender, age, body mass index, total burn area, full-thickness burn area, time of first operation after injury, preoperative prothrombin time (PT) and activated partial thromboplastin time (APTT) and hemoglobin level of the first surgery, complication of inhalation injury, number of surgeries, total surgical area, total surgical time, total length of hospital stay, and highest procalcitonin value, lowest platelet count and hemoglobin values, and occurrence of sepsis during hospitalization were compared between the two groups of patients. According to the lowest hemoglobin value during hospitalization, the patients were assigned to <65 g/L group, ≥65 g/L and <75 g/L group, ≥75 g/L and <85 g/L group, and ≥85 g/L group. The total length of hospital stay, mortality and incidence of sepsis during hospitalization, and mortality within 90 days after injury were compared among the four groups of patients. The relationship between the lowest hemoglobin value during hospitalization and the mortality risk of patients with extensive burns was analyzed using a restricted cubic spline model before and after adjusting covariates. A logistic regression model was adopted to analyze the relationship between the lowest hemoglobin value during hospitalization and the mortality risk of patients with extensive burns after adjusting covariates, with the lowest hemoglobin value during hospitalization as a continuous variable and a categorical variable, separately. Results:Compared with those in survival group, the total burn area, full-thickness burn area, and total surgical area of patients in death group were significantly increased, the preoperative APTT of the first surgery was significantly prolonged, the number of surgeries was significantly reduced, the total length of hospital stay was significantly shortened, the highest procalcitonin value during hospitalization was significantly increased, the lowest platelet count and hemoglobin values during hospitalization were significantly decreased, and the incidence proportion of sepsis during hospitalization was significantly increased (with Z values of -6.72, -5.40, -2.15, -2.99, -2.21, -7.84, -6.23, -7.03, and -3.43, respectively, χ2=161.95, P values all <0.05). There were no statistically significant differences in the other clinical data of patients between the two groups ( P>0.05). There were statistically significant differences in mortality and incidence of sepsis during hospitalization, and mortality within 90 days after injury of patients among the four groups divided according to the lowest hemoglobin value during hospitalization (with χ2 values of 12.12, 15.93, and 10.62, respectively, P<0.05). There was no statistically significant difference in the total length of hospital stay of patients among the four groups ( P>0.05). The restricted cubic spline model analysis revealed an approximately linear relationship between the lowest hemoglobin value during hospitalization and the mortality risk of patients with extensive burns before and after adjusting covariates (with χ2 values of 0.81 and 0.75, respectively, P>0.05). After adjusting covariates, the logistic regression model analysis showed that the mortality risk of patients with extensive burns increased with decreasing hemoglobin when the lowest hemoglobin value during hospitalization was analyzed as a continuous variable (with odds ratio of 0.96, with 95% confidence interval of 0.92 to 0.99, P<0.05). When using the median value of 75.5 g/L as the cut-off value for categorizing the lowest hemoglobin value during hospitalization, there was no statistically significant difference in the mortality risk between patients with hemoglobin <75.5 g/L and those with hemoglobin ≥75.5 g/L ( P>0.05). When the patients were divided into four groups based on the lowest hemoglobin value during hospitalization as above, using ≥85 g/L group as a reference, only patients in <65 g/L group had a significantly increased mortality risk (with odds ratio of 5.37, with 95% confidence interval of 1.57 to 18.29, P<0.05). Conclusions:There is an approximately linear correlation between the lowest hemoglobin value during hospitalization and the mortality risk of patients with extensive burns. When the hemoglobin level drops to 65 g/L or lower, the mortality risk of patients increases significantly, suggesting that a hemoglobin level of 65 g/L could serve as a warning threshold for blood transfusion in patients with extensive burns.

Cholestatic liver disease is a common disease that causes bile flow dysfunction due to various reasons. The etiology of cholestatic liver disease is complexed, and therapeutic drugs are extremely limited. To date, ursodeoxycholic acid is the only FDA-approved drug for treating primary biliary cirrhosis, whereas its efficacy is limited to early stage of the disease, therefore novel drugs are urgently needed. Nuclear receptors become therapeutic hotspot target in cholestasis since these receptors play a key role in regulating bile acid homeostasis. Peroxisome proliferator-activated receptor (PPAR) is an important nuclear receptor involved in regulating multiple mechanisms of cholestasis in vivo. It can improve intrahepatic cholestasis by inhibiting bile acid synthesis, reducing bile acid toxicity, affecting the expression of bile acid metabolic enzymes and transporters, and can play an anti-inflammatory, anti-oxidation and anti-fibrosis role. A number of studies have shown that PPAR agonists represented by fibrates alone or in combination can improve liver function indexes, inflammatory factors and fibrosis markers in patients with cholestasis. This review analyzes and summarizes the lastest advances in the molecular mechanism of PPAR as a therapeutic target for cholestasis and drug treatment in development or have been used in clinical.

【Objective】 To investigate the frequencies of HLA-B alleles in Jiangsu Han population from Chinese Marrow Donor Program (CMDP) Jiangsu Branch in 8 prefecture-level cities, compare and analyze the distribution of common susceptible alleles at HLA-B locus in 8 prefecture-level cities. 【Methods】 The HLA-B locus of 27 249 unrelated volunteers from CMDP Jiangsu Branch were genotyped by polymerase chain reaction–sequence based typing (PCR-SBT) method, and frequencies of HLA-B alleles of 8 prefecture-level cities were calculated and compared. 【Results】 A total of 145 HLA-B alleles were detected in Jiangsu Han population, among them 104, 113, 83, 88, 88, 85, 84, 72 HLA-B alleles were detected in Changzhou, Nanjing, Zhenjiang, Yangzhou, Huai’an, Suqian, Xuzhou, and Yancheng Han population, respectively. In general, the common alleles in Changzhou, Yangzhou and Zhenjiang were very similar, and the most common alleles were B^*46∶01, 13∶02, 40∶01 and 58∶01. The common alleles in Nanjing, Huai’an and Suqian were rather similar, and the most common alleles were B^*13∶02, 46∶01, 40∶01, 58∶01 and 51∶01. The common alleles in Yancheng were rather similar to Nanjing, Huai’an and Suqian, with only difference in the order of B^*40∶01 and B^*58∶01. The common alleles in Xuzhou were close to Nanjing, Huai’an and Suqian too, with only difference in the order of B^*40∶01 and B^*46∶01. 【Conclusion】 The results reflected the distribution of HLA-B alleles of Jiangsu Han population from 8 prefecture-level cities and the gene distribution was basically consistent with the regional distribution. The major difference in HLA-B locus in Jiangsu 8 prefecture-level cities was B ^* 13∶02 and B ^* 46∶01. The frequency of B ^* 13∶02 in Northern Jiangsu (Huai’an, Suqian, Xuzhou, Yancheng) is much higher than that of B ^* 46∶01, and that in Nanjing is slightly higher than the frequency of B ^* 46∶01, which is consistent with that in North China. The frequency of B ^* 46∶01 in Southern Jiangsu (Changzhou), Yangzhou and Zhenjiang is higher than that of B ^* 13∶02, which is consistent with that in South China. The polymorphism analysis of alleles at HLA-B locus in 8 cities in Jiangsu Province provided significant basic data for the study of the correlation between HLA-B locus genes and diseases, as well as the population genetics and anthropology in Jiangsu Han population.

Objective:To summarize the genetic etiology, clinical characteristics and outcomes of neonatal hypotonia in the early stage of NICU, to provide basis for clinicians to early identify diseases and choose reasonable treatments.Methods:The clinical data of neonates with hypotonia admitted to the Department of Neonatology of Children′s Hospital of Xinjiang Uygur Autonomous Region and People′s Hospital of Xinjiang Uygur Autonomous Region from July 2017 to July 2020 were analyzed.Results:A total of 49 children were enrolled in the study, all clinically manifested as unexplained hypotonia, accompanied by special appearance 29 cases(59.18%), metabolic abnormality 18 cases(36.73%), and cranial imagin abnormality 23 cases(46.93%). After gene sequencing a, total of 22(44.89%)patients were confirmed.Thirteen (26.53%) of them were copy number variation, and gene mutation in nine cases(18.36%). The oldest age of these patients was 3 years and 2 months now, while the youngest was 4 months.A total of 16 patients were dead(32.65%). Four (8.16%) patients were lost to follow-up.At present, eighteen (62.07%) patients had mental retardation, and eleven (37.93%) of whom still existed severe physical retardation.Conclusion:We could conduct genetic testing in NICU to improve the diagnosis rate of neonates with unexplained hypotonia, which have high rate of adverse events.Neonates with a clear diagnosis should be treated promptly and give the genetic counseling to reduce the risk for the next children.

Objective: To investigate the application of single-molecule PCR (SM-PCR) in the detection of plasma ctDNA for the treat-ment of patients with advanced lung adenocarcinoma. Methods: In total, 30 patients diagnosed with advanced lung adenocarcinoma were enrolled between June 2017 and May 2018. ctDNA fragments of the target genes (EGFR, KRAS, BRAF, ALK, HER2, and TP53) from the blood samples were enriched by SM-PCR, and DNA libraries were prepared. Finally, a high-throughput sequencing was performed. The EGFR detection of tumor tissue samples was performed using real-time fluorescence PCR based on the amplification refractory mutation system (ARMS) and consistency in the results of EGFR mutation detection in the plasma and tissue was compared. Results:The results of both the methods were consistent (Kappa=0.867, P<0.001). The McNemar's test also indicated that the results are not statistically different (P=0.500). Conclusions: SM-PCR can be used for the detection of plasma EGFR mutations. The target detection sites are more comprehensive and multiple mutations can be detected at the same time. Results of the analysis are more precise and can be absolutely quantified.

Phenylketonuria is a most common group of genetic metabolic diseases.Phenylketonuria is caused by enzymatic defects in the metabolic pathway,which is characterized by high blood phenylalanine concentration.Patients need early,reasonable treatment once diagnosis,otherwise there will be serious nervous system sequelae.Available treatments aim to decrease the blood phenylalanine concentration,reduce nervous system symptoms.The current primary treatment of phenylketonuria is the limitation of dietary phenylalanine intake.Considering the poor compliance with long-term eating restrictions and the heavy family burden,the application of new medicine such as trahydropterina cofactor,glycomacropeptide,large neutral amino acids can improve the therapeutic effect and living condition of phenylketonuria patients.In addition,recombinant phenylalanine ammonia lyase,hepatocyte transplantation,gene therapy,probiotics and other new treatments also seem to be a promising approach in the near future.

Objective To study the clinical and imaging features of neonatal acute osteomyelitis.Method From 2011 to 2016,the clinical feature,laboratory results,pathogen,imaging features,treatment and prognosis of neonates who were diagnosed with acute osteomyelitis in NICU of People's Hospital of Xinjiang Uygur Autonomous Region were retrospectively studied.Result A total of 13 cases were enrolled during the study period,5 males and 8 females,with onset age of 7 ～30 d.8 cases had different degrees of fever and 5 of them showed dyspnea;8 cases had elevated skin temperature and swelling at the affected area;7 cases presented with irritability;6 cases had anorexia;all cases had elevated white blood cell count.Blood culture were taken immediately after their admission,and culture from the pus were taken for some patients.5 cases had positive blood culture and Staphylococcus aureus was the main pathogen.6 cases had positive pus culture,and 4 cases showed gram positive (G +) bacteria and 2 cases gram negative (G-) bacteria.Humerus and tibia were the main foci of the infection.4 cases had X-ray examination within 7 days of onset showing soft tissue swelling and no sign of bone destruction.13 cases had X-ray examination at 7 to 14 days of disease.Among them only 1 case showed soft tissue swelling,and the rest 12 cases had different levels of bone destruction and periosteal reaction.2 cases had X-ray examination after 14 days of disease,showing stiffening ring,inflammatory changes and periosteal reaction.All patients were treated with broad-spectrum antibiotics after admission,and the affected limbs were immobilized.3 cases had further surgical treatment.11 patients recovered and were discharged,1 patient was treated at local hospital after diagnosis and 1 patient refused further treatment due to serious complications after 35 d of hospital stay and was lost on follow-up.Conclusion The clinical manifestation of neonatal osteomyelitis is atypical,the radiological and pathogen examination should be carried out once osteomyelitis is suspected.Appropriate antibiotics and timely surgery can prevent further damage and long-term sequela.

ObjectiveTo explore an appropriate way and its effect on neonatal resuscitation training in Uygur area of Xinjiang, China.MethodsFrom October 2014 to February 2015, obstetricians, neonatologists (pediatricians), midwives and anesthetists from Turpan Region Central Hospital, Turpan City People's Hospital,Aksu Region First People's Hospital and other five hospitals at county level were chosen to attend the training course of neonatal resuscitation. The textbook for the course was Guidelines for Resuscitation which had been translated to Uygur language from English and the class was lead by less than ten Uygur trainees with Mandarin and Uygur when necessary in addressing some difficult or important points. The duration of theoretic courses took 6 h and the operational course took 8 h. Theorectical exam was taken before, immediately after and three months after (before re-training) the training. The accuracy rate was applied to assess the effect of training through evaluation for each resuscitation techniques. Repeated measures analysis of variance andChi-square test were used for statistical analysis.ResultsA total of 220 health care staff were included in the study. The average score of theoretical examination after the training was higher than that before (85.68±8.52 vs 65.37±12.08,t=18.532,P=0.000), and that before re-training was lower than that after training (80.08±12.70 vs 85.68±8.52,t=-4.943,P=0.000). After the training, the proportions of Done in each item, including rapid assessment, preliminary resuscitation, correct positive pressure artificial ventilation, external cardiac massage together with artificial ventilation, proper endotracheal intubation and proper administration of resuscitation drugs, were all higher that those before [72.7%(160/220) vs 1.4%(3/220), 40.0%(88/220) vs 0%(0/220), 15.9%(35/220) vs 0%(0/220), 37.7%(83/220) vs 8.2%(18/220), 51.8%(114/220) vs 5.9%(13/220) and 48.2%(106/220) vs 10.5%(23/220), allP<0.01]. But at the time before re-training, only one proportion ofDone which was higher than those immediately after initial training was proper administration of resuscitation drugs [49.6%(109/220) vs 48.2%(106/220),χ2=9.129,P<0.05].ConclusionBilingual (Mandarin and Uygur) neonatal resuscitation training in Xinjiang minority areas might enhance the recovery skills for local medical personnel.

Objective To observe the efficacy and safety of recombinant human interleukin-11 (rnIL-11) in the treatment of thrombocytopenia induced by chemoradiotherapy in patients with solid tumor.Methods Solid tumor patients whose PLT count was lower than 50 × 109/L from December 2010 to December 2012 in PLA general hospital of Chengdu Commond were studied.They were divided into two groups randomly.The observed group was given subcutaneous injection of recombinant human interleukin-11 (Ⅰ) at the dose of 25 g · kg-1 · d-1,until the PLT rising subsolute value was more than 50 × 109/L.The control group was given usual treatment.The vital signs,hepatorenal function,coagulation function and cardio-pulmonary function of the patients were recorded during the whole process of treatment.Results The patients after chemotherapy had the platelet lowest average of (27.4 ± 7.6) × 109/L,and the average of the control group was (28.1 ± 7.9) × 109/L.The difference was not statistically significant (t =1.083,P ＞ 0.05),but treatment after the observation of elevated had the platelet highest average of (116.3 ± 22.8) × 109/L,which was significantly higher than that of (76.2 ± 21.3) × 109/L; the difference was significant (t =21.092,P ＜ 0.05).Platelets of patients in the observation group were ＜50 × 109/L for several days with an average of (4.3 ± 1.7) d,while platelets rose from the lowest value of the average absolute value greater than 50 000 hours (6.8 ± 2.4) d,shorter than the control group.By comparing the two groups,the differences were significant (t =11.347,P ＜ 0.05 ; t =15.196,P ＜ 0.05).Two groups of patients can tolerate adverse reactions.Ⅲ,Ⅳ degree of adverse reaction was not observed.Conclusion This study shows that rhIL-11 is well tolerated and has thrombopoietic activity in the treatment of thrombocytopenia.