Objective The root-end filling is one of the key steps of the endodontic microsurgery, and the selection of the root-end filling material affects the prognosis of the surgery. The purpose of this study is to evaluate the short-term clinical efficacy of the new bioceramic material iRoot BP Plus as the root-end filling material in the endodontic microsurgery and compare it with the trioxide polymer（MTA）, so as to provide reference for clinical selection. Methods Sixty patients（81 teeth） diagnosed as chronic apical periodontitis with the need for endodontic microsurgery in the Department of Endodontics and Pediatric Dentistry of Anhui Stomatological Hospital from December 2018 to December 2020 were selected. After obtaining the informed consent of the patients, they were randomly divided into two groups through a table of random numbers, the test group was iRoot BP Plus group with 29 patients（39 teeth）, and the control group was MTA group with 31 patients（42 teeth）. A standardized surgical procedure was performed by a single operator. The patients were followed up at 3 months, 6 months, and 1-year. Clinical and radiographic evaluations acquired at the 1-year follow-up were taken as the primary outcome, and the success rate and prognostic factors of the two groups were statistically analyzed. Results The success rate in the iRoot BP Plus and MTA groups were 92.3% and 90.5%, respectively（P＞0.05）. The analysis of related factors affecting the curative effect of endodontic microsurgery showed that there was no significant difference in gender, age and tooth position（all P＞0.05）. Although the 1-year follow-up success rate of lesions with diameter ≤10 mm was higher than that of lesions with diameter＞10 mm（95.1% vs. 80.0%）, the difference was not statistically significant（χ~2=2.639, P=0.104）. Conclusion Both iRoot BP Plus and MTA can achieve satisfactory results as root-end filling materials, which are worthy of clinical promotion and application.

目的 了解六安市人民医院临床分离肠杆菌目细菌分布特征及对抗菌药物的耐药性变迁.方法 回顾性分析2016-2020年分离自临床标本的肠杆菌目细菌的分布情况,采用自动化仪器法进行药敏试验.结果 共收集肠杆菌目细菌8859株,其中大肠埃希菌占39.0％,肺炎克雷伯菌占36.9％,阴沟肠杆菌占7.0％,产气肠杆菌占3.6％,奇异变形杆菌占3.5％,其他肠杆菌目细菌占10.0％.肠杆菌目细菌标本分布以痰液最多,为39.3％.整体耐药率变化呈先升后降趋势.肠杆菌目细菌对亚胺培南和阿米卡星敏感率较高,均>90.0％,其次,对哌拉西林/他唑巴坦、头孢吡肟、头孢替坦敏感率较高,均>85.0％.共检出703株碳青霉烯类耐药肠杆菌目细菌(CRE),对常用抗菌药物耐药率除替加环素和阿米卡星外,均>50.0％.结论 六安市人民医院肠杆菌目细菌耐药率目前呈下降趋势,需要持续关注,同时应加强合理用药管理和医院感染防控.

牛牙症是一种罕见的牙齿解剖形态异常,临床特征为牙髓腔增大,根分叉向根方移位、牙根短小.该病可以单独发生,也可以伴发其他牙齿发育异常,也可以作为综合征的伴发症状.多数牛牙症为散发病例,家系少见.本文报道1例牛牙症家系,先证者为15岁男性,父母为近亲结婚,2020年11月因"左上后牙反复疼痛半年"就诊于安徽医科大学附属口腔医院.经X线和锥体束计算机断层扫描检查,先证者及其母亲均被确诊为多发性牛牙症伴髓腔髓石,进一步的基因学检查未发现与牛牙症相关度较高的变异.本文通过病例回顾,并对牛牙症的病因、临床表现、诊断及遗传学特点进行综述,旨在提高临床医师对牛牙症的认识.

目的 了解肺炎克雷伯菌对碳青霉烯类抗菌药物的主要耐药基因携带情况、毒力、分子分型及同源性.方法 收集六安市人民医院2018年1月～2019年12月分离自血培养的非重复CRKP菌株共23株,拉丝试验筛查高毒力菌株;Wzi分型检测荚膜血清型别;聚合酶链式反应检测荚膜多糖合成调节基因(rmpA)、毒力基因及常见碳青霉烯酶基因;多位点序列分型对菌株进行分子分型;脉冲场凝胶电泳技术进行同源性分析.结果 23株菌均携带KPC-2基因,18株拉丝试验阳性且携带rmpA的高毒力菌株.Wzi分型22株为K14.64型,1株为K19型.多位点序列分型为ST11型18株、ST307型4株和ST15型1株,脉冲场凝胶电泳技术进一步将18株ST11型菌株分为3个型别.结论 本研究中肺炎克雷伯菌对碳青霉烯类抗菌药物耐药机制主要是携带KPC-2基因,主要荚膜血清型为K14.64,优势序列型为ST11型,可能存在院内暴发流行.

Objective:To explore whether sleep quality suffers in patients with mild Alzheimer's disease(AD)and mild cognitive impairment(MCI), and to further investigate the correlation between sleep disorders and cognitive function in these patients.Methods:In this study, 30 mild AD patients, 39 MCI patients and 43 demographically matched healthy controls were enrolled.Sleep quality was assessed by the Pittsburgh sleep quality index(PSQI), and cognitive function was assessed by the mini-mental state examination(MMSE), the Montreal cognitive assessment(MoCA)and a set of neuropsychological scales.The correlation of sleep quality with cognitive function was analyzed for the three groups.Results:Differences were significant in sleep time score[0.0(1.0), 1.0(2.0) vs.1.0(1.0), F=8.18, P=0.02]and daytime function score[1.0(1.0), 1.0(1.0) vs.0.0(1.0), F=8.73, P=0.01]between mild AD, MCI and health control groups.Spearman correlation analysis suggested that scores of sleep disorders were negatively correlated with DSB( r=-0.43, P=0.02)and scores of daytime function were positively correlated with ADL( r=0.39, P=0.03)in patients with mild AD.In addition, scores of sleep quality were negatively correlated with the DSB score( r=-0.40, P=0.01), scores of sleep disorders were positively correlated with ADL( r=0.45, P<0.01), scores of daytime function were negatively correlated with DSF( r=-0.42, P=0.01), DSB( r=-0.62, P<0.01)and VFT-S( r=-0.33, P=0.04), and the total PSQI score was negatively correlated with DSF( r=-0.45, P=0.01)and DSB( r=-0.44, P=0.01)in the MCI group. Conclusions:Patients with mild AD and MCI have longer sleep time and impaired daytime function than healthy people, and sleep quality is correlated with memory, attention and daily living ability in patients with mild AD and MCI.

目的 通过对1例乳酸依沙吖啶引产失败继续妊娠患者胎儿风险的评估,为妊娠期用药风险评估提供参考.方法 药师查阅国内外相关资料,从依沙吖啶药物代谢、毒性研究、动物试验数据等方面分析可能对胎儿造成的影响,与患者充分沟通,并进行药学监护.结果 现有资料提示依沙吖啶可能对胎儿的皮肤、肾脏、骨关节、脑神经和甲状腺有影响,但影响程度及发生率不详.患者要求继续妊娠,最终顺利分娩一健康男婴.结论 孕中期依沙吖啶引产失败后继续妊娠,依沙吖啶可能对胎儿无显著影响,但长期影响需随访.

目的 探讨非手术综合康复治疗颈椎管狭窄症患者的疗效和可能的相关影响因素.方法 收集2012年8月～2017年9月我院108例颈椎管狭窄症患者,在治疗前后分别进行JOA评分、VAS疼痛评定.1年随访患者治疗的远期疗效,并对其中复诊的32例患者复查颈椎MRI进行前后比较,分析远期疗效与相关因素间的关系.结果 108例颈椎管狭窄症患者治疗后,JOA评分和VAS评分比治疗前有明显改善(P<0.01);随访结果 显示非手术综合康复治疗的远期总有效率为91.7％;治疗前后颈椎MRI对比提示非手术综合康复治疗对颈椎结构退变无明显疗效.颈椎管狭窄症患者非手术治疗长期疗效与患者的年龄(r=-0.881,P=0.000)、黄韧带增厚程度(r=-0.873,P=0.000)、椎间盘突出程度(r=-0.914,P=0.000)呈负相关关系.结论 非手术综合康复治疗颈椎管狭窄症具有安全、无创、简单、远期疗效满意的特点,是颈椎管狭窄症患者治疗手段中的一种优良选择.

社会认知是一种多系统多层次的高级认知功能.既往研究提示临床中多类脑疾病患者都存在社会认知功能障碍[1],但是对社会认知功能障碍的有效治疗仍在探索中.经颅磁刺激(transcranial magnetic stimulation, TMS)作为一种非侵入性大脑刺激技术,已较为广泛的应用于神经科学研究及部分神经精神疾病的治疗中,本文将从TMS 对常见几类脑疾病社会认知功能障碍的干预研究进行简要综述.

In this paper, the parallel decomposition problem of Boolean control networks (BCNs) is investigated by using graph theory method. Necessary and sufficient vertex partition conditions for the parallel decomposition of BCNs are obtained, under which logical coordinate transformations can be constructed to realize the parallel decomposition. Finally, an illustrative example is provided to validate t...

目的 分析脑电仿生电刺激联合康复治疗对交感型颈椎病(SCS)的临床疗效.方法 将2018年1月至2019年6月于安徽医科大学第一附属医院治疗的SCS患者46例随机分成观察组与对照组,各23例.所有患者均给予颈椎牵引、推拿、运动疗法等常规康复治疗,观察组另给予脑电仿生电刺激治疗.采用《颈椎病临床评价量表》(CASCS量表)评估患者治疗前及治疗2周后临床疗效;以治疗后1年复发率评价远期疗效.结果 治疗后观察组CASCS量表评分、总有效率及优良率均显著优于对照组(P<0.05).治疗后1年观察组远期复发率低于对照组(P<0.05).结论 给予SCS患者脑电仿生电刺激联合康复治疗,可提高临床疗效,降低远期复发率,具有临床应用价值.

目的 探讨高精度经颅直流电刺激(HD-tDCS)对恢复期精神分裂症患者认知及社会功能的影响.方法 招募医院收治的恢复期精神分裂症患者100例,随机分为真刺激组和假刺激组,每组各50例,两组均在精神科药物治疗基础上采用HD-tDCS刺激患者左侧背外侧前额叶.真刺激组采用1.5 mA的电流刺激20 min,假刺激组仅在刺激开始与结束的30 s内有电流通过,每天1次,持续进行10 d.在治疗前后分别采用住院精神病患者社会功能评定量表(SSPI)、中文版MATRICS认知成套测验(MCCB)对两组患者的社会功能与认知功能进行测评,并比较两组在HD-tDCS治疗过程中出现的不良反应.结果 治疗前两组SSPI及MCCB总分与各项评分比较,差异均无统计学意义(P＞0.05);治疗后两组患者SSPI总分及各项因子分均较治疗前升高(P＜0.05),且真刺激组的SSPI总分及各项因子分高于假刺激组(P＜0.05);治疗后真刺激组MCCB总分、信息处理速度、注意/警觉、工作记忆、推理和问题解决单项分均较治疗前升高(P＜0.05),假刺激组仅MCCB总分与推理和问题解决单项分较治疗前升高(P＜0.05);治疗后真刺激组的MCCB总分及4个因子分(信息处理速度、注意/警觉、工作记忆、推理和问题解决)高于假刺激组(P＜0.05).两组患者均对电刺激或者假刺激耐受良好,未出现严重不良事件,且两组疼痛感、痒感、皮肤发红等不良反应比较,差异均无统计学意义(P＞0.05).结论 对于恢复期精神分裂症患者采用HD-tDCS治疗,有利于促进患者认知功能康复,并进一步提高社会功能,且安全性高,有着良好的应用前景.

目的 观察脑电仿生电刺激小脑顶核对脑梗死后认知功能障碍的影响,并探讨其可能的机制.方法 选取脑梗死后并发认知功能障碍患者50例,随机分成治疗组与对照组各25例.2组患者均接受康复治疗及认知功能训练,治疗组同时加用脑电仿生电刺激进行干预.2组患者分别于治疗前后应用蒙特利尔认知评估量表(MoCA)、简易精神状态量表(MMSE)评定认知功能变化,采用经颅多普勒超声(TCD)评估颅内动脉血流动力学改变.结果 治疗后2组患者MoCA评分、MMSE评分均较组内治疗前提高(P<0.05),且治疗组评分明显较对照组高,差异有统计学意义(P<0.05).治疗后2组患者颅内动脉血流动力学较组内治疗前改善(P<0.05),且治疗组较对照组改善更显著,差异有统计学意义(P<0.05).治疗组与对照组总有效率分别为92％和64％,差异有统计学意义(P<0.05).结论 脑电仿生电刺激小脑顶核可有效改善脑梗死患者的认知功能,其可能机制是通过改善患者的脑循环进一步改善认知功能.

目的 探讨慢性阻塞性肺病(COPD)患者在风险概率明确下的风险决策认知功能.方法 采用风险概率明确的骰子博弈试验(GDT)对34例COPD患者(COPD组)和与其人口资料学相匹配的30例健康对照组(HC组)进行风险决策能力测试,同时采用词汇流畅性、数字广度等认知功能测验进行背景认知功能测试.结果 在GDT中,与HC组(8.09 +6.65)分比较,COPD组(12.67±3.11)分更倾向于选择风险选项(F=-3.594,P=0.001);与COPD组(23.30±30.73)分比较,HC组(58.46±34.14)分更倾向于在输钱后暂时选择安全选项,两组负反馈利用率差异有统计学意义(F=-4.122,P＜0.001);与HC组掷骰子最终总资产为正数(966.67±2 785.60)元比较,COPD组(-1 623.53±4121.57)元的最终总资产为负数,差异有统计学意义(F=-2.975,P=0.004).结论 COPD患者存在广泛认知功能损害,风险决策功能也显著下降,并与负反馈利用率相关.

目的:分析肺炎克雷伯菌(KPN)耐药性,抗菌药物使用情况及它们之间的关联,为临床用药提供建议.方法:采用回顾性调查方法,选取2017-2018年住院病人分离到的KPN,统计分析KPN检出率、耐药率,住院病人抗菌药物使用强度(AUD),用Spearman相关法分析AUD与耐药率之间的关系.结果:2018年1季度产超广谱β-内酰胺酶(ESBLs)的KPN检出率低于2017年同期(P<0.05);2018年1季度、4季度、全年耐碳青霉烯类药物KPN(CRKP)检出率高于2017年同期(P<0.05～P<0.01).2018年KPN对头孢唑林的耐药率较2017年下降(P<0.01);2018年KPN对氨苄西林、氨苄西林/舒巴坦、头孢他啶、头孢曲松、头孢替坦、头孢吡肟、庆大霉素、阿米卡星、环丙沙星、复方新诺明、妥布霉素、亚胺培南、哌拉西林/他唑巴坦的耐药率与2017年相比均有上升(P<0.05～P<0.01);KPN对厄他培南耐药率由2017年0％上升至2018年17.9％(P<0.01).AUD数值较高的抗菌药物有头孢硫脒、头孢呋辛钠、哌拉西林他唑巴坦、头孢西丁、左氧氟沙星.2018年第一代、第二代头孢菌素,含β-内酰胺酶抑制剂的复方制剂及碳青霉烯类药物的AUD较2017年均有下降,尤其以头孢呋辛钠和头孢替安下降明显.第二代头孢菌素的AUD与KPN对头孢唑啉耐药率呈正相关关系,与氨苄西林、头孢替坦、厄他培南耐药率呈负相关关系(P<0.05～P<0.01);头孢曲松钠的AUD与KPN对头孢替坦耐药率呈正相关关系(P<0.05);头孢哌酮舒巴坦钠的AUD与KPN对氨苄西林、头孢替坦、厄他培南、阿米卡星耐药率呈正相关关系(P<0.05～P<0.01),与头孢唑啉呈负相关关系(P<0.05);碳青霉烯类药物的AUD与KPN对氨苄西林舒巴坦及复方新诺明的耐药率呈负相关关系(P<0.05).结论:KPN耐药情况日渐严重,CRKP检出率升高,KPN耐药率与抗菌药物使用强度存在一定相关性,需合理使用抗菌药物,遏制耐药性的产生.

Objective:To investigate the value of the detection of serum carbohydrate antigen( CA) 153 and carcinoembryonic antigen (CEA) combined with fine needle aspiration cytology(FNAC) in the diagnosis of breast cancer. Methods:The serum levels of CA153, CEA,and FNAC in 67 patients with breast cancer and 32 patients with benign breast disease were detected. The values of the combined detection of CA 153,CEA and FNAC in the diagnosis of breast cancer were analyzed. Results:The sensitivity,specificity and accuracy of CA153 examination were 8. 96％,100. 00％ and 38. 38％,respectively. The sensitivity,specificity and accuracy of CEA examination was 16. 42％,96. 88％ and 43. 43％, respectively. The sensitivity, specificity and accuracy of FNAC examination were 83. 58％, 100. 00％and 88. 89％,respectively. The sensitivity,specificity and accuracy of three combined inspection were 88. 06％,90. 91％ and 96. 88％,respectively. The AUC values of CA 153,CEA and FNAC in the diagnosis of breast cancer were 0. 910,0. 709 and 0. 705, respectively,and the AUC value of combined detection(0. 942) was significantly higher than that of any signal marker. Conclusions:The combined detection of CA153,CEA and FNAC can improve the sensitivity and accuracy in the diagnosis of breast cancer,which has a high reference value in the early diagnosis of breast cancer.

Desmoplastic small round cell tumor (DSRCT) is a rare malignancy most commonly originating in the peritoneum. Only rare cases occur outside the abdomen. The present study describes a case of DSRCT in a young adolescent male who initially presented with an orbital mass. The diagnosis was confirmed by the presence of a polyphenotypic immunoprofile (positive for desmin and neural markers) and the characteristic EWS-WT1 gene fusion. Tumor histologically had an entirely solid pattern, lacking evidence of desmoplastic stroma. This purely solid variant shows that when occurring at an atypical location, DSRCT may be difficult to recognize. This reported case of DSRCT draws attention to the importance of including DSRCT in the differential diagnosis of orbital tumors.

Objective To investigate the ability of intertemporal choices in patients with dorsolateral frontal cortex(dLPFC)lesions.Methods Twenty five dLPFC damaged individuals and 27 healthy controls(HC)were investigated by intertemporal choice test.Results Compared with HC, the forward digital span and the verbal fluency test scores of dLPFC were decreased significantly,and the time of stroop test was increased significantly(P<0.05-0.01),no group difference was observed in the backward digital span(P>0.05).The ratio of later-larger (LL)choice in dLPFC demonstrated significantly lower than that in HC for now trails(P<0.05), and the ratio in intermediate relative differences of reward magnitudes in dLPFC was significantly lower than that in HC(P<0.05). The contrasts of the ratio of LL in terms of small relative differences and large relative differences of reward magnitudes were non-significant(all P>0.05).The choices between two groups for not-now trails were non-significant,and the same as that for small,intermediate and large relative differences(P>0.05).The ratio of LL in dLPFC and HC both correlated with the magnitude of the reward difference significantly(F=26.615, P=0.000;F=21.683,P=0.000),not related to now or not-now trails(F=0.427,P=0.517;F=0.587,P=0.447).The Pearson correlation analysis showed that there was a positive correlation in dLPFC between the stroop test and the LL ratio of intermediate relative differences in reward magnitudes(r=0.475, P=0.019).Conclusion The ability of intertemporal choices in dLPFC patients has been impaired, demonstrating the dLPFC as a causal structure for intertemporal choice.

The relationship between autophagy and tumour is well studied, but tumour cell morphological changes associated with autophagy defects are rarely reported, especially in renal cell carcinoma (RCC). We collected 10 renal tumour samples with characteristic eosinophilic cytoplasmic inclusions (ECIs) and found that the ECIs were majorly composed of sequestosome 1/P62, neighbor of BRCA1 gene 1 (NBR1), PEX14, and CATALASE1 (CAT1). Further, transmission electron microscopy analysis revealed that ECIs were aggregates of proteinaceous material and peroxisomes. These results confirmed that ECIs in RCCs were the products of autophagy defects. The presence of ECIs was correlated with high Fuhrman grade components of RCCs. Whole-exome sequencing (WES) and Sanger sequencing confirmed that tumours with ECIs showed somatic mutations or high frequency of genetic variations in autophagy-related (ATG) genes, such as ATG7, ATG5, and ATG10. These results indicate that nucleotide changes in ATG genes are associated with autophagy defect, ECI formation, and even tumour grade in RCCs.

Previous studies have reported the miR-513b is located on the X chromosome and is preferentially expressed in testis. However, the underlying mechanisms of miR-513b involved in spermatogenesis remains unknown. In this study, we found that hsa-miR-513b-5p was highly expressed in the testes of infertile males with maturation arrest compared with normal controls. Overexpression of hsa-miR-513b-5p suppressed testicular embryonal carcinoma (NT2) cell proliferation and induced apoptosis in vitro, whereas silencing of hsa-miR-513b-5p reversed these effects. In addition, we found that interferon regulatory transcription factor 2 (IRF2) was a direct and functional target of hsa-miR-513b-5p. Silencing of endogenous IRF2 enhanced hsa-miR-513b-5p-mediated effects on cell proliferation in NT2 cells, whereas overexpression of IRF2 reversed these effects. Moreover, immunoblotting showed that overexpression of hsa-miR-513b-5p or silencing of endogenous IRF2 could promote the expression of P53. Moreover, overexpression of hsa-miR-513b-5p in the absence of p53 could also induce cell apoptosis. Together, our results suggest that hsa-miR-513b-5p suppresses NT2 cell proliferation and promotes P53 protein expression by targeting IRF2, and abnormal testicular hsa-miR-513b-5p expression may contribute to maturation arrest.

未成年人刑事案件社会调查制度贯穿于刑事诉讼的整个过程,有助于了解未成年人走犯罪道路的根本原因,探求犯罪行为表象背后的深层次社会原因,准确地把握未成年犯罪嫌疑人的主观恶性,全面评价犯罪行为的社会危害性,科学评估未成年人再犯新罪的可能性和回归社会再教育的可行性.各地对未成年人社会调查进行了有益尝试,但普遍存在社会调查的调查主体多元并不专业、调查适用范围不够广泛、开展调查流于形式,缺乏对调查内容的挖掘和剖析,没有就个案有针对性地分析和表述,报告的参考性严重不足等问题.本文重点分析了我国未成年人刑事案件社会调查制度所存在的问题,并提出了进一步完善该制度的有效对策.