Objective:To evaluate the efficacy and safety of oliceridine for treatment of moderate to severe pain after surgery with general anesthesia in patients.Methods:The patients with moderate to severe pain (numeric pain rating scale ≥4) after abdominal surgery with general anesthesia from 14 hospitals between July 6, 2021 and November 9, 2021 were included in this study. The patients were assigned to either experiment group or control group using a random number table method. Experiment group received oliceridine, while control group received morphine, and both groups were treated with a loading dose plus patient-controlled analgesia and supplemental doses for 24 h. The primary efficacy endpoint was the drug response rate within 24 h after giving the loading dose. Secondary efficacy endpoints included early (within 1 h after giving the loading dose) drug response rates and use of rescue medication. Safety endpoints encompassed the development of respiratory depression and other adverse reactions during treatment.Results:After randomization, both the full analysis set and safety analysis set comprised 180 cases, with 92 in experiment group and 88 in control group. The per-protocol set included 170 cases, with 86 in experiment group and 84 in control group. There were no statistically significant differences between the two groups in 24-h drug response rates, rescue analgesia rates, respiratory depression, and incidence of other adverse reactions ( P>0.05). The analysis of full analysis set showed that the experiment group had a higher drug response rate at 5-30 min after giving the loading dose compared to control group ( P<0.05). The per-protocol set analysis indicated that experiment group had a higher drug response rate at 5-15 min after giving the loading dose than control group ( P<0.05). Conclusions:When used for treatment of moderate to severe pain after surgery with general anesthesia in patients, oliceridine provides comparable analgesic efficacy to morphine, with a faster onset.

Objective To study the relationship between blood microRNA-133b(miR-133b)and solu-ble fms-like tyrosine kinase 1(sFLT1)levels with the prognosis in the patients with endometrial cancer.Methods A total of 122 patients with endometrial cancer visited in the gynecology department of this hospital from January 2015 to January 2016 were prospectively selected as the study subjects,and divided into the sur-vival group(n=58)and death group(n=64)according to the 5-year prognosis of the patients with endome-trial cancer.The miR-133b and sFLT1 levels were compared between the two groups.The COX regression was used to analyze the relationship between miR-133b and sFLT1 with the prognosis of the patients with en-dometrial cancer.Results The levels of miR-133b and sFLT1 in the survival group were higher than those in the death group,and the differences were statistically significant(P＜0.05).The median survival time in the miR-133b low-level group was shorter than that in the miR-133b high level group,and the difference was sta-tistically significant(P＜0.05).The median survival time of the sFLT1 low level group was shoeter than that in the sFLT1 high level group,and the difference was statistically significant(P＜0.05).The FIGO stageⅢ-Ⅳ and lymph node metastasis were the independent risk factors for the prognosis of endometrial cancer(P＜0.05),and the pathological G1-G2,high level of miR-133b and sFLT1 were the independent protective factors for the prognosis of endometrial cancer(P＜0.05).Conclusion The miR-133b and sFLTl low levels in the patients with endometrial cancer are associated with the disease progression,and both are the independ-ent risk factors of prognosis.

Objectives:To explore the risk factors for death from ruptured acute aortic dissection during emergency treatment,construct and validate a risk prediction model for death from ruptured acute aortic dissection during emergency treatment. Methods:A total of 301 cases of acute aortic dissection patients who were admitted to Chinese Academy of Medical Sciences Fuwai Hospital from January 2018 to August 2021 were included in this study.Patients were divided into survival subgroup(n=239)and death subgroup(n=62)according to whether dissection rupture occurred in the acute stage of the disease.Univariate and multivariate analyses were performed.Logistic regression analysis was used to establish the risk prediction model.The Hosmer-Lemeshow test was conducted to assess the model's goodness of fit,and the receiver operating characteristic curve(ROC curve)was used to evaluate the model's predictive performance.A prospective validation was performed on 129 cases of acute aortic dissection patients admitted to our hospital's emergency department from September 2021 to September 2022. Results:Among the 301 cases of acute aortic dissection patients,there were 62 cases of rupture and death,with an incidence rate of 20.6%.The results of multivariate analysis showed that age(OR=1.066,95%CI:1.034-1.099),type A dissection(OR=0.045,95%CI:0.006-0.364),history of hypertension(OR=0.377,95%CI:0.167-0.850),and concomitant hypotension(OR=4.424,95%CI:1.467-13.340)were determinants of deaths.The model formula was Z=-5.624+0.064×age-0.976×history of hypertension(yes=1,no=0)-3.104×type(Type A=0,Type B=1)+1.487×concomitant hypotension(yes=1,no=0).The Hosmer-Lemeshow test result showed χ2=9.328,df=8,P=0.315,the area under the ROC curve was 0.874,sensitivity was 79.0%,specificity was 81.6%,and the maximum Youden index was 0.606.The model validation result showed that the area under the ROC curve was 0.722,sensitivity was 73.7%,specificity was 69.1%,and accuracy was 89.9%. Conclusions:Age,history of hypertension,dissection type,and combined hypotension are predictors of the risk prediction model for death from dissection rupture in patients with acute aortic dissection during emergency treatment.The model constructed in this study has good predictive performance,which can provide reference for medical staffto quickly identify high-risk patients for death from ruptured acute aortic dissection and timely predictive measures could be highlighted in indicated cases.

OBJECTIVES: There is less clinical data on multiple myeloma (MM) in China, and the aim of this study was to collect and analyze the clinical data of newly diagnosed multiple myeloma (NDMM) patients in Hunan Province during 1 year, to understand the real clinical features and treatment outcome for Hunan Province patients with MM, and to strengthen the understanding of the standardized diagnosis process and treatment plan of MM. METHODS: The clinical data of 529 patients with NDMM in 12 large-scale general hospitals in Hunan Province from January 1 to December 31, 2019 were collected and analyzed, including baseline data, treatment regimens, duration of treatment, and adverse reactions. The clinical characteristics, treatment, and safety of patients were analyzed by SPSS 21.0. RESULTS: Among the 529 NDMM patients, the age was 33-90 (median 64) years and the male-female ratio was 1.38꞉1. The clinical features ranged from high to low were as follows: Bone pain (77.7%), anemia (66.8%), renal insufficiency (40.6%), hypercalcemia (15.1%). Typing: IgG 46.5%, IgA 24.6%, IgD 2.6%, IgM 0.8%, light chain 15.7%, double clone 3.0%, no secretion 0.6%, absence 6.2%. Staging: Durie-Salmon stage I, II, and III were 4.5%, 10.6%, 77.3%, respectively, and 40 cases (7.6%) missed this data. International Staging System (ISS) stage I, II, and III were 10.4%, 24.4%, and 47.6%, respectively, and 93 cases (17.6%) were missing. Revised International Staging System (R-ISS) stage I, II, and III were 5.5%, 27.0%, 23.1%, respectively, and 235 cases (44.4%) missed this data. Among the 98 NDMM patients in the Third Xiangya Hospital, Central South University, Durie-Salmon (DS) stage missing 2.0%, ISS stage missing 12.3%, and R-ISS stage missing 12.3%.Treatment: Among the 529 patients,475 received treatment, the rate of treatment was 89.8%; 67.4% of the patients were able to complete four courses of chemotherapy at induction phase, 90.3% of the patients received proteasome inhibitor based combination chemotherapy regimen more than once, 67.2% received immunomodulator based regimen more than once, and 59.8% of the patients received proteasome inhibitor and immunomodulator based combination chemotherapy regimen more than once. Curative: Overall response rate (ORR) and high quality response rate (HQR) of the 4-course group were better than those of the 2-course group (ORR: 85% vs 65%, P=0.006; HQR: 68.3% vs 24.0%, P<0.001). The HQR of the standard chemotherapy group was better than that of the non-standard chemotherapy group (65.1% vs 48.2%, P=0.035). Adverse reactions during treatment included hematologic toxicity (17.5%), peripheral neuropathy (24.8%), gastrointestinal adverse events (23.8%), pulmonary infection (25.9%), herpes zoster (4.6%), and venous thrombotic events (1.7%). CONCLUSIONS In 2019, the missed diagnosis rate of MM patients was high, the medium age of diagnosis was older, and the accuracy of patient diagnosis was not high. There is a great difference among medical centers, especially in the stage and risk stratified, nearly half of NDMM patients are not diagnosed with R-ISS stage; the lack of cytogenetic data needs to be supplemented by follow-up studies. A high proportion of patients with NDMM present with bone pain and anemia.Patients received treatment have higher use of chemotherapy regimens containing proteasome inhibitors and/or immunomodulators, but there is a significant gap among different medical centers, and standardized treatment needs to be strengthened. The safety during chemotherapy is controllable.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Female ; Humans ; Immunologic Factors/therapeutic use* ; Male ; Middle Aged ; Multiple Myeloma/therapy* ; Neoplasm Staging ; Pain ; Prognosis ; Proteasome Inhibitors/therapeutic use*

The pathogenesis of autoimmune diseases(AID)involves the inflammatory response of the human body, and inflammatory pathways are also shared by mechanisms of aging.Clinical observations of AID have revealed evidence of aging-related diseases in younger adults.This article reviews the literature related to research progress on AID combined with aging-related diseases, such as cardiovascular diseases, diabetes and osteoporosis, and briefly explains the underlying mechanisms, in order to promote interdisciplinary research between the two fields.

Objective:To detect the level of long non-coding RNA LINP1 (lncRNA-LINP1) in endometrial carcinoma and to explore the prognostic value of the expression leve.Methods:From January 2015 to December 2016, the tissue samples of 82 patients with endometrial carcinoma in North China University of Science and Technology Affiliated Hospital were used as endometrial carcinoma group, and the normal adjacent tissues were selected as the paracancerous control group.The expression of LINP1 mRNA was measured by real-time fluorescence quantitative PCR (qRT-PCR). The clinicopathological data of the patients were collected, and the relationship between the expression of LINP1 mRNA and clinicopathological parameters was analyzed.Kaplan-Meier method was used to analyze the relationship between the expression of LINP1 mRNA and the survival rate of endometrial patients; and COX multivariate analysis was used to identify the risk factors of death in patients with endometrial cancer.Results:The expression of LINP1 mRNA in endometrial carcinoma group and paracancerous control group were (2.38±0.43) and (1.00±0.24). There was significant difference between the two groups ( t=25.376, P<0.001). The results of clinicopathological parameters showed that the expression of LINP1 mRNA was not related to the age and histological type of endometrial carcinoma (all P>0.05). It was related to lymph node metastasis, FIGO stage, tumor differentiation and vascular invasion (all P<0.05). the three-year total survival rate of the group with high expression of LINP1 mRNA (48.78%) was lower than that of the group with low expression of LINP1 mRNA (80.49%), and the differences were statistically significant (χ 2=6.306, P<0.05). COX Regression analysis showed that, high expression of LINP1 mRNA and FIGO Stage III, IV and lymph node metastasis were the risk factors for death in endometrial cancer patients (HR(95% CI) were 2.898(2.031-4.136), 1.831(1.448-2.316), 1.708(1.364-2.138), P values were 0.002, 0.004 and 0.008, respectively. Conclusion:The high expression of LINP1 mRNA in endometrial carcinoma is closely related to lymph node metastasis, FIGO stage, tumor differentiation, vascular invasion and prognosis.It is a risk factor for the death of patients with endometrial cancer and may be used as an index to evaluate the prognosis of patients with endometrial cancer.

Objective:To evaluate the clinical effect of basic periodontal therapy combined with low-level laser irradiation on patients with severe periodontitis.Methods:18 patients with severe periodontitis (a total of 43 teeth samples) were enrolled from the Dental Department of Tianjin First Central Hospital from June 2018 to May 2019. The patients were averagely divided into the control group (20 teeth) and the experimental group (23 teeth) according to the random number table method. All the teeth were firstly received basic periodontal treatment. In the experimental group, the gingival pouch of the teeth was irradiated with low energy laser for 15 s on the 1st, 2nd, and 7th days after the basic periodontal treatment, in which the output power is 80 mw, the energy density is 4 J/cm 2, and irradiated area is 0.28 cm 2. Before the treatment and 1 week and 4 weeks after the treatment, the periodontal probing depth (PD), clinical attachment level (CAL), gingival sulcus bleeding index (SBI) of the teeth of the control group and the experimental group were detected, and the gingival sulcus of the two groups were collected at the same time. The level of basic fibroblast growth factor (b-FGF) in gingival crevicular fluid was detected by enzyme-linked immunosorbent assay (ELISA), and the level of serum hypersensitive C-reactive protein (hs-CRP) was detected by immunoturbidimetry. Results:Before the treatment, there were no significant differences in the age, PD, CAL, SBI, hs-CRP and b-FGF levels of patients with severe periodontitis between the two groups (all P>0.05). One week after the treatment, there was no statistically significant difference in PD, CAL, hs-CRP and b-FGF levels between the two groups (all P>0.05), and the SBI of the experimental group (2.43±0.97) was lower than that of the control group (4.13±0.78), and the difference was statistically significant ( P<0.05). Four weeks after the treatment, the SBI of the experimental group (2.26±0.96) was lower than that of the control group (3.75±0.72) ( P<0.01), there was no statistical difference between the two groups in PD and CAL (all P>0.05), the b-FGF level of the experimental group [(35.28±5.41) pg/30 s] was higher than that of the control group [(33.45±2.37) pg/30 s] ( P<0.05), and the serum hs-CRP level of the experimental group [(3.23±1.73) mg/L] was significantly lower than that of the control group [(5.79±0.63) mg/L] ( P<0.05). Conclusions:Low-level laser therapy can effectively reduce the SBI of severe periodontitis patients in the short term, but it has little significance for reducing PD and improving CAL. At the same time, low-level laser therapy can reduce the serum hs-CRP level of patients and increase the level of b-FGF in gingival sulcus fluid, which is beneficial to the control of severe periodontal inflammation.

Objective:To study the effect of low-level laser therapy (LLLT) on cytokines in gingival crevicular fluid of patients with severe periodontitis, and to analyze the effect of LLLT on periodontal inflammation control and bone healing.Methods:A total of 43 teeth from 18 patients with severe periodontitis were selected. There were no differences in age, gender, and periodontal status of all patients enrolled. 20 teeth in the control group received basic periodontal treatment, and 23 teeth in the experimental group were received combination of basic periodontal treatment and LLLT. During the LLLT treatment, the gingival pocket was irradiated by low-level laser for 15 s on days 1, 2, and 7. One and four weeks after treatment, the gingival crevicular fluid the patients in the control group and the experimental group was collected, and the interleukin-1β (IL-1β), transforming growth factor-β (TGF), tumor necrosis factor-α (TNF-α), metal matrix protease-8 (MMP-8), soluble intercellular adhesion molecule-1 (sICAM-1) and periosteal protein levels were determined by enzyme-linked immunosorbent assay (ELISA).Results:After treatments, the levels of IL-1β, TNF-α, MMP-8 and sICAM-1 in the control group and the experimental group decreased, and the levels of TGF-β and periosteal protein increased. The basic periodontal treatment combined with LLLT had better therapeutic effect. One week after treatments, the differences in the levels of IL-1β and TNF-α between the two groups were statistically significant (all P<0.05). Four weeks after treatments, the differences in the levels of IL-1β, TNF-α, TGF-β, MMP-8 and sICAM-1 between the two groups were statistically significant (all P<0.05). Conclusions:LLLT treatment can effectively reduce the levels of IL-1β, TNF-α and MMP-8 in the gingival crevicular fluid of patients with severe periodontitis in a short period of time. LLLT has a certain effect on the recovery of periodontal tissue, including controlling periodontal inflammation, reducing the expression of sICAM-1 in gingival crevicular fluid, alleviating the symptoms of gum bleeding, promoting the secretion of TGF-β, increasing the level of periosteal protein, and inhibiting the destruction of periodontal tissue.

The "vicious cycle" established between tumor growth and osteolysis aggravates the process of breast cancer bone metastasis, leading to life-threatening skeletal-related events that severely reduce survival and quality of life. To effectively interrupt the "vicious cycle", innovative therapeutic strategies that not only reduce osteolysis but also relieve tumor burden are urgently needed. Herein, a bone-seeking moiety, alendronate (ALN), functionalized coordination polymer nanoparticles (DZ@ALN) co-delivering cisplatin prodrug (DSP) and antiresorptive agent zoledronate (ZOL)

Objective To investigate the effect of low level laser treatment combined with periodontal therapy on interleukin-8 (IL-8), basic fibrobast growth factor (b-FGF) and interleukin-1β (IL-1β) level in gingival crevicular fluid on peri-implantitis , so as to evaluate the curative effect . Methods A total of 38 patients (50 implants) with early peri-implantitis were randomly divided into experimental group and control group, with 19 patients (25 implants) in each group. The patients in the experimental group were underwent level laser treatment combined with periodontal initial, and in the control group were only treated with periodontal initial. The implant gingival crevicular fluid was collected before the treatment (baseline), and 4 weeks and 12 weeks after the treatment. The levels of IL-8, b-FGF and IL-1βwere determined by enzyme-linked immunosorbent assay (ELISA). The SPSS19.0 software was used for the statistically analysis. Results The levels of IL-8, b-FGF and IL-1β of the experimental group and the control group were both improved at 4 weeks and 12 weeks after treatment comparing with that at the baseline, and the differences were statistically significant (all P<0.01). The differences in IL-8 and b-FGF levels in the gingival crevicular fluid were statistically significant at different time points for each group (all P<0.01). For the two groups, the differences in IL-1βwere not statistically significant at 4 weeks and 12 weeks after the treatment (all P>0.05). The levels of IL-8 and IL-1βof the experimental group were lower than those of the control group at 4 weeks after treatment, and the differences were statistically significant (all P<0.05). The level of b-FGF of the experimental group was higher than that of the control group at 12 weeks after the treatment, and the difference was statistically significant (P<0.05). Conclusions Low-energy laser can affect the level of cytokines in the gingival crevicular fluid on peri-implantitis. The combination of low level laser treatment and periodontal initial therapy is effective for treating peri-implantitis.