OBJECTIVE: To establish a three-dimensional finite element model of a digital wire loop space maintainer for the mandible and primary tooth loss, in order to investigate the stress, deformation, and shear force experienced by patients with the loss of the second primary molar when wearing the wire loop space maintainer. METHODS: Cone beam computed tomography (CBCT) scans were performed on the patients to create a digital model of the mandible with the absence of the second primary molar using Mimics 21.0 software. A digital model integrating the crown's retention and the wire loop structure of the full crown and ring wire loop space maintainer was constructed using pediatric space maintainer design software, utilizing three different materials: cobalt-chromium alloy, polyether ether ketone (PEEK), and titanium alloy. In ANSYS Work Beach 2023 R2 software, vertical loads of 70 N, tilted 45° along the long axis of the tooth loads of 70 N, and a 10 N load on the surface of the wire loop were applied to the occlusal surfaces of models 46 and 84, simulating centric and lateral occlusions during chewing with the wire loop space maintainer in place. The stress states of the wire loop space maintainer and supporting teeth were analyzed. RESULTS: Under various loading conditions, the maximum principal stress of the ring wire loop space maintainer was significantly lower than that of the full crown. Stress contour maps indicated that the peak of the maximum principal stress occurred at the junction of the wire loop and crown structure, indicating that this area was more susceptible to fracture. The ring wire loop space maintainer made from PEEK material exhibited the lowest maximum shear stress on the internal organizational surfaces, with equivalent stresses of 23.18 MPa and 36.35 MPa for models 46 and 84, respectively. Stress contour maps demonstrated that the maximum stress on tooth 46 was located at its mesial, while the maximum stress on tooth 84 was situated near the root area on its distal, in contact with the wire loop space maintainer. CONCLUSION In cases of second primary molar loss, wearing the digital ring wire loop space maintainer can effectively distribute stress, and the ring wire loop space maintainer made from PEEK material reduces the stress experienced by supporting teeth to some extent, demonstrating its superiority in clinical application.
Finite Element Analysis ; Humans ; Tooth, Deciduous ; Cone-Beam Computed Tomography ; Space Maintenance, Orthodontic/methods* ; Imaging, Three-Dimensional ; Orthodontic Wires ; Dental Stress Analysis ; Mandible ; Stress, Mechanical

A chemical investigation of secondary metabolites (SMs) from Aspergillus nidulans resulted in the identification of five novel dioxopiperazine (DKP)-diphenyl ether hybrids, designated as diphenylemestrins A-E (1-5). These compounds 1-5 represent the first known dimers combining DKP and diphenyl ether structures, with compound 4 featuring an uncommon dibenzofuran as the diphenyl ether component. The structural elucidation and determination of absolute stereochemistry were accomplished through spectroscopic analysis and electronic circular dichroism (ECD) calculations. Notably, diphenylemestrin C (3) exhibited moderate cytostatic activity against NB4 cells, with a half maximal inhibitory concentration (IC₅₀) value of 21.99 μmol·L^-1, and induced apoptosis at higher concentrations.
Aspergillus nidulans/metabolism* ; Diketopiperazines/pharmacology* ; Molecular Structure ; Phenyl Ethers/pharmacology* ; Humans ; Apoptosis/drug effects* ; Cell Line, Tumor

(±)-Talapyrones A-F (1-6), six pairs of dimeric polyketide enantiomers featuring unusual 6/6/6 and 6/6/6/5 ring systems, were isolated from the fungus Talaromyces adpressus. Their structures were determined by spectroscopic analysis and HR-ESI-MS data, and their absolute configurations were elucidated using a modified Mosher's method and electronic circular dichroism (ECD) calculations. (±)-Talapyrones A-F (1-6) possess a 6/6/6 tricyclic skeleton, presumably formed through a Michael addition reaction between one molecule of α-pyrone derivative and one molecule of C₈ poly-β-keto chain. In addition, compounds 2/3 and 4/5 are two pairs of C-18 epimers, respectively. Putative biosynthetic pathways of 1-6 were discussed.
Polyketides/isolation & purification* ; Talaromyces/chemistry* ; Stereoisomerism ; Molecular Structure ; Circular Dichroism ; Pyrones/chemistry*

Objective:To develop serious games for pediatrics and to explore the effect of cultivating the clinical reasoning and reflection ability of pediatric trainee nurses.Methods:This was a non-randomized controlled trial study. The convenience sampling method was used to select 88 pediatric trainee nurses in the Second Xiangya Hospital of Central South University from April 2021 to January 2022. They were divided into the control group and the experimental group with 44 cases in each group by the method of random sampling. The control group was given clinical practice teaching in pediatrics according to the practice syllabus. Based on the teaching events of Gagne, the teaching links of serious games were designed, and teaching was carried out to the experimental group. The clinical reasoning and reflection ability, learning satisfaction and self-confidence of the two groups of pediatric trainee nurses before and after teaching were evaluated by the Self-Assessment of Clinical Reasoning and Reflection, Student Learning Satisfaction and Self-Confidence Scale, and examination scores of the two groups of pediatric trainee nurses were evaluated.Results:There was no significant difference in the clinical reasoning and reflection ability, learning satisfaction and self-confidence before teaching between the two groups( P>0.05). The total score of clinical reasoning and reflection evaluation after teaching was (101.13±6.69) points in the experimental group, which was higher than that in the control group (94.57 ± 8.86) points, the difference was statistically significant ( t=-3.92, P<0.05). The learning satisfaction and self-confidence scores after teaching were (20.82 ± 2.16), (33.20 ± 1.47) points in the experimental group, which were higher than those in the control group (19.52 ± 2.30), (31.89 ± 2.44) points, the differences were statistically significant ( t=-2.33, -3.07, both P<0.05). The scores on the theory and skill examination in the experimental group were also better than those in the control group, the differences were statistically significant ( t values were -2.59--2.14, all P<0.05). Conclusions:The serious game teaching method can effectively improve the clinical reasoning and reflection ability, practical learning satisfaction, self-confidence, and graduation performance of pediatric nursing interns, which can provide a reference for the reform of pediatric nursing practice teaching.

Objective:To investigate the prognostic value of absolute lymphocyte count (ALC) and neutrophil-lymphocyte ratio (NLR), macrophage-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) before treatment in patients with locally advanced cervical cancer (LACC).Methods:A total of 175 patients newly-diagnosed with LACC admitted to Cancer Hospital affiliated to Xinjiang Medical University from August 2016 to October 2019 were enrolled in this study. Complete clinical data and ALC before treatment were recorded and NLR, MLR and PLR were calculated. Multivariate Cox′s proportional hazard regression model was used to analyze the prognostic factors of patients with LACC.Results:The progress-free survival (PFS) of LACC patients in the NLR reduction group (<3.34) and MLR reduction group (<0.315) were significantly higher than those in the NLR and MLR elevation groups (both P<0.05). The overall survival (OS) of LACC patients in the ALC elevation group (≥1.375 × 10 9/L) and the PLR reduction group (<160.575) were significantly higher compared with those in the ALC reduction group and PLR elevation group (both P<0.05). Univariate analysis showed that EQD 2Gy, the equivalent dose of HR-CTV, was an important prognostic factor of PFS in patients with LACC ( P=0.030). Multivariate Cox′s regression analysis demonstrated that FIGO staging ( HR=2.339, 95% CI 1.22-4.48, P=0.010) and concurrent chemoradiotherapy ( HR=0.213, 95% CI 0.11-0.43, P<0.001) were the independent predicators of PFS in patients with LACC. However, concurrent chemoradiotherapy ( HR=0.229, 95% CI 0.07-0.81, P=0.023) and MLR ( HR=4.933, 95% CI 1.39-17.54, P=0.014) before treatment were the independent predictors of OS in patients with LACC. Conclusions:Patients with locally advanced cervical cancer can benefit from concurrent chemoradiotherapy. HR-CTV EQD 2Gy is a critical prognostic factor of PFS in patients with LACC. The increase of MLR before treatment is an independent prognostic factor of OS in LACC patients.

Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the cognition of patients with mild cognitive impairment (MCI).Methods:The PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, and VIP databases were searched for randomized controlled trials of rTMS treating MCI patients before March 2019. After screening the literature, extracting the data and two independent reviewers evaluating the quality of the included studies, the meta-analysis was conducted using version 5.3 of the RevMan software.Results:Nine studies covering 368 patients were included. The pooled results showed that compared with sham stimulation, rTMS treatment could effectively improve the cognitive ability (assessed using the Montreal instrument), episodic memory, verbal fluency and the amplitude of MCI patients′ P300 signals. P300 latency was also reduced. However, there was no significant difference, on average, in memory quotient or P300 latency between patients given rTMS plus donepezil hydrochloride and those given donepezil hydrochloride alone. Compared with the control groups, the rTMS treatment groups displayed slightly more frequent adverse reactions, mainly mild dizziness and scalp pain which disappeared within 1-2 hours without obvious residual effects.Conclusions:TMS treatment can effectively improve cognitive and memory function.

Objective: Evaluate GII.4 norovirus infection and blocking effects of serum antibodies against HBGAs binding to GII.4 norovirus of population in oyster culture area, provide references for screening of fully human monoclonal antibody. Methods: Using a random survey method to collect blood and saliva samples in oyster culture area, select serum samples from the inland region of Guangdong as control group. Identification of salivary HBGA receptor phenotype and detection of serum antibody levels between two areas by ELISA. A vitro neutralization model was to determine the efficiency of serum antibodies blocking GII.4 norovirus and HBGA receptors binding. Results: The age were (50.68 ± 15.17), (52.52 ± 15.90) and (51.37 ± 13.32) years old of 2015, 2016 in experimental group, and in control group, respectively. Males accounted for 5.9% (70/195), 36.6%(60/164), 40.8% (69/169) (χ²=0.93, P=0.334). The mean value of serum antibodies Absorbance value was 2.521±0.05 of 2015 and was 2.583±0.045 of 2016 in oyster culture area, the mean value was 2.249±0.05 in control group, there was a statistical difference among three group (F=13.28, P<0.001). The antibody prevalence in the three groups was 100%. BT50 geometric mean titer (GMT) of oyster culture area in 2015 was 423.1±40.11, culture group was 248.2±25.63, there was a statistical difference (t=3.73, P<0.001). Conclusion The population in oyster culture area does have more chance of exposure and infection GII.4 norovirus, Serum antibody of blocking ability in oyster culture areas is better than the general population in inland city. Suggesting that the population is more immunity resistant infected GII.4 norovirus.

Objective To discuss the advantages of postoperative early ambulation for patients after high-viscosity bone cement injection treatment for osteoporotic vertebral compression fracture.Methods A total of 42 patients with osteoporotic vertebral compression fracture were divided into the study group (n=21)and the control group (n=21).High-viscosity bone cement injection was used to perform percutaneous vertebroplasty for the patients in the study group,while low-viscosity bone cement injection was adopted to complete percutaneous vertebroplasty for the patients in the control group.The patients of the study group were asked to get out of bed in 4 hours after vertebroplasty and to do off-bed activity in 8 hours after vertebroplasty,while the patients of the control group were asked to get out of bed in 12 hours after vertebroplasty and to do off-bed activity in 24 hours after vertebroplasty.CT reexamination was performed within 3 days after vertebroplasty to observe the paravertebral leakage and the cement distribution in vertebrae.The visual analogue scale (VAS),the ability score of daily life activy (Barthel),the risk score of pressure skin ulcer (Braden) and the risk rating of deep venous thrombosis were used to evaluate the clinical effectiveness for both groups.Results The procedure of vertebroplasty was successfully accomplished in all patients of both groups.No statistically significant differences in VAS score and in Barthel score at 24 hours and 7 days after vertebroplasty existed between the two groups (P＞0.05).Eight days after vertebroplasty,the differences in Barthel score,Braden score and the risk rating of deep venous thrombosis between the two groups were statistically significant (P＜0.05),although the difference in VAS score between the two groups was not statistically significant.Conclusion In treating osteoporotic vertebral compression fracture by using high-viscosity bone cement injection,postoperative early ambulation can effectively improve the patient's daily activities,reduce the risk of the formation of pressure skin ulcer and deep vein thrombosis,thus,reduce the nursing workload for both nurses and patient's family members.(J Intervent Radiol,2017,26:749-752).

Cholestasis ; metabolism ; Humans ; NF-kappa B ; metabolism ; Pneumonia ; metabolism ; Toll-Like Receptor 4 ; metabolism

Objective To compare the effects of rat proinsulin gene therapy via intraportal infusion and intramuscular injection blood glucose level in streptozotocin-induced diabetic rots. Methods (1) Recombinant eukaryotic cell expression plasmid of rat proinsulin gene pCMV/proiusulin was transferred into streptozotocin-induced diabetic rats by intraportal infusion and intramuscular injection to observe the effect of rat proiusulin gene therapy in diabetic rats. The treatment group by intraportal infusion (group A) and the group by intramuscular injection (group C) were given pCMV/proinsulin naked plasmid DNA 100 μg, while the control groups by intraportal infusion (group B) or by intramuscular injection (group D) were treated with similar amount of pCMV DNA. Normal group and diabetes mellitus group were also observed at the same time. (2) Blood glucose level was tested and serum insulin was determined by radioimmunoassay. RT-PCR and immunohistochemistry were used to detemine proinsulin mRNA and protein expressions in liver and skeletal muscle and protein. Results (1) The blood glucose levels in two treated groups were both decreased. In group A, levels of blood sugar decreased about 7 mmol/L and glycemie control was maintained for 3-4 weeks. Serum insulin levels step up significantly after pCMV/proinsulin gene therapy. The blood glucose level in group A was significantly lower than those of group B and DM group (P<0.05), while the serum insulin level was higher than those of two groups (P<0.05). In group C, blood glucose levels decreased about 4 mmol/L and glycemic control was maintained for 1-2 weeks. Meanwhile, the concentrations of insulin increased markedly after gene therapy. The blood glucose in group C was significantly lower than those of group D and DM group (P<0.05), while the serum insulin level was higher than those of two groups (P<0.05). (2) Proinsulin mRNA and protein expressions could be detected in either hepatic cell of group A or skeletal muscle cell of group C, not in group B and group D. Conclusion Proiusulin genetherapy via intraportal infusion or intramuscular injection lowers significantly blood glucose in diabetic rats, and thus offers a potential approach to treatment of diabetes.