[Gefitinib/chloroquine-liposome-microbubble complexes as ultrasound-triggered therapeutic particles for head and neck squamous cell carcinoma in vitro]

PURPOSE

To explore a kind of therapeutic particle of targeted, fewer side effects, both with value of diagnosis and treatment for head and neck squamous cell carcinoma(HNSCC) in vitro.

METHODS

Gefitinib-liposome-microbubble model and chloroquine liposome-microbubble model were prepared separately. HN-30 cells were divided into 5 groups: PBS, GE-Lipo+CQ-Lipo, MB-GE-Lipo, MB-CQ-Lipo, MB-GE-Lipo+ MB-CQ-Lipo. MTS kit was used to detect the inhibitory effect of cell proliferation in each group. SPSS17.0 software package was used to analyze the data.

RESULTS

When EPC: Chol=2:1, there was no significant difference in the entrapment efficiency between 2:1 and 8:1 group (P>0.05). Compared with 5:1,10:1,20:1 group, there was significant difference in the entrapment efficiency of 2:1 group (P<0.05) . Among group 5:1, 8:1, 10:1, and 20:1, compared with each other, there was no significant difference (P>0.05). For HN-30 cells, there was significant difference(P<0.05) between MB-GE-Lipo+ MB-CQ-Lipo group and PBS group. There was no significant difference between MB-GE-Lipo+ MB-CQ-Lipo group and MB-GE-Lipo group (P>0.05).

CONCLUSIONS

When EPC:Chol=5:1, the EE of GE-Lipo was higher, the ratio of cholesterol was appropriate, and the liposome was more stable. The inhibitory effect of gefitinib liposome-microbubbles + chloroquine liposome-microbubbles combined with ultrasound on HN-30 cell proliferation was significant.

Association between BDNF gene polymorphisms and attention deficit hyperactivity disorder in school-aged children in Wuhan, China

BACKGROUND

Brain-derived neurotrophic factor (BDNF) is vital for neuronal survival and growth, regulation of synaptic plasticity, and cognitive function. Previous studies examined the role of BDNF in susceptibility to attention deficit hyperactivity disorder (ADHD). The current study examined the association between BDNF gene polymorphisms and ADHD in Chinese children.

METHODS

Participants were 195 medication-naive ADHD children and 263 unaffected healthy controls. ADHD symptoms were diagnosed using the Vanderbilt ADHD Diagnostic Parental Rating Scale according to the Diagnostic and Statistical Manual of Mental Disorders-5. Five BDNF single nucleotide polymorphisms were detected using improved multiplex ligation detection reaction. Alleles and genotype frequency were examined using Chi-square tests. Correlations were examined using multivariate logistic regression analysis in the ADHD and control groups.

RESULTS

The results revealed that rs12291186 with one or both mutated allele(s) was significantly associated with reduced likelihood of ADHD (OR = 0.13, 95% CI: 0.02-0.77) and ADHD-Combined (OR = 0.10, 95% CI: 0.01-0.85). Children with genotype AA or CA in rs10835210 exhibited increased risk of ADHD (OR = 3.29, 95% CI: 1.03-10.55) and ADHD-Combined (OR = 4.45, 95% CI: 1.10-17.96) compared with genotype CC children. No significant associations were found between rs6265, rs7103411, rs7103873 polymorphisms and ADHD.

LIMITATIONS

Participants were recruited from urban areas. We were unable to examine all potential confounding factors.

CONCLUSIONS

BDNF gene polymorphisms of rs12291186 and rs10835210 were related to the occurrence of ADHD. These findings provide new insight on mechanisms underlying BDNF gene in ADHD.

Conventional ultrasonography and elastography for the diagnosis of congenital and infantile hemangiomas

Infantile and congenital hemangiomas are difficult to distinguish in infants. The aim of this study was to compare the conventional ultrasonographic (US) and elastographic features of infantile and congenital hemangiomas. The US findings in 118 patients with congenital hemangioma (58 non-involuting, 36 rapidly involuting, 24 partially involuting) and 111 with 120 infantile hemangioma were retrospectively evaluated. On US imaging, 31.7% of infantile hemangiomas were hyperechoic, 31.7% hypoechoic and 36.6% mixed-echoic with hyperechoic and hypoechoic areas; 57.6% of congenital hemangiomas were mixed-echoic with a hypoechoic area and many vessels visible, 39.0% hypoechoic and 3.4% were mixed-echoic with hyperechoic and hypoechoic area. Calcifications were present in 6.8% and visible vessels involving muscle in 24.6% of congenital hemangiomas. All infantile hemangiomas and 82.2% of congenital hemangiomas were well-defined. All congenital hemangiomas were subcutaneous whereas 17.5% of the infantile hemangiomas were superficial. The maximum diameter and vascular density were greater in congenital hemangiomas. Elastography demonstrated that the congenital hemangiomas were softer than the infantile hemangiomas. The maximum diameter (including of visible vessels), thickness, vascular density, venous blood flow velocity and elasticity scores were greater for rapidly and partially involuting congenital hemangiomas than for non-involuting ones. The density of visible vessels in congenital hemangiomas decreased in the order of non-involuting, partially involuting and rapidly involuting. In conclusion, congenital hemangiomas have distinctive US imaging characteristics, including a greater maximum diameter, vascular density, number of visible vessels, visible vessels involving muscle, calcifications and elasticity score.

Soft Tissue Changes in Patients With Dentoalveolar Protrusion Treated With Maximum Anchorage: A Systematic Review and Meta-analysis

OBJECTIVE

This meta-analysis aimed at comparing the angular and linear changes of soft tissue profile using conventional anchorage techniques and mini-implant (MI)-based space closure in patients with dentoalveolar protrusion.

MATERIALS AND METHODS

Electronic databases, viz. PubMed, Embase, and Cochrane Central Register of Controlled Trials, were searched for relevant literature from their inception to December 2017 according to the specific inclusion and exclusion criteria. The following Medical Subject Heading terms were used for searching: "skeletal anchorage", "temporary anchorage devices", "miniscrew implant", "mini-implant", "micro-implant". Selected randomized control trials (RCTs) were assessed for their quality using Cochrane's Risk of Bias Tool, whereas the Newcastle-Ottawa scale was used for non-RCTs. Standardized mean difference (SMD) and 95% confidence interval (CI) were obtained with either fixed- or random-effects models based on the heterogeneity of the included studies.

RESULTS

A total of 5 articles (2 RCTs with moderate risk of bias and 3 high-quality non-RCT studies) were included in the final analysis. The nasolabial angle had significantly greater changes in the MI group than in the conventional anchorage group (SMD = 0.68, 95% CI = 0.39 to 0.97, P < .0001). Significantly higher retraction of the upper lip was seen in the MI group than in the conventional group (SMD = -0.51, 95% CI = -0.84 to -0.18; P = .002). No significant difference was seen in the facial convexity (SMD = -0.34, 95% CI = -0.76 to 0.07, P = .106) and lower lip retraction (SMD = 0.28, 95% CI = -1.72 to 2.28, P = .784) between the groups.

CONCLUSION

It was seen that MIs facilitated favorable soft tissue profile than the conventional anchorage devices. However, more high-quality studies are warranted to confirm the clinical effectiveness of MIs.

A Review of Environmental Occurrence, Fate, and Toxicity of Novel Brominated Flame Retardants

Use of legacy brominated flame retardants (BFRs), including polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecane (HBCD), has been reduced due to adverse effects of these chemicals. Several novel brominated flame retardants (NBFRs), such decabromodiphenyl ethane (DBDPE) and bis(2,4,6-tribromophenoxy) ethane (BTBPE), have been developed as replacements for PBDEs. NBFRs are used in various industrial and consumer products, which leads to their ubiquitous occurrence in the environment. This article reviews occurrence and fate of a select group of NBFRs in the environment, as well as their human exposure and toxicity. Occurrence of NBFRs in both abiotic, including air, water, dust, soil, sediment and sludge, and biotic matrices, including bird, fish, and human serum, have been documented. Evidence regarding the degradation, including photodegradation, thermal degradation and biodegradation, and bioaccumulation and biomagnification of NBFRs is summarized. The toxicity data of NBFRs show that several NBFRs can cause adverse effects through different modes of action, such as hormone disruption, endocrine disruption, genotoxicity, and behavioral modification. The primary ecological risk assessment shows that most NBFRs exert no significant environmental risk, but it is worth noting that the result should be carefully used owing to the limited toxicity data.

Single-cell RNA sequencing reveals compartmental remodeling of tumor-infiltrating immune cells induced by anti-CD47 targeting in pancreatic cancer

Background

Human pancreatic ductal adenocarcinoma (PDAC) responds poorly to immune checkpoint inhibitor (ICPi). While the mechanism is not completely clear, it has been recognized that tumor microenvironment (TME) plays key roles. We investigated if targeting CD47 with a monoclonal antibody could enhance the response of PDAC to ICPi by altering the TME.

Methods

Using immunohistochemistry, we examined tumor-infiltrating CD68⁺ pan-macrophages (CD68⁺ M) and CD163⁺ M2 macrophages (CD163⁺ M2) and tumor expression of CD47 and PD-L1 proteins in 106 cases of PDAC. The efficacy of CD47 blockade was examined in xenograft models. CD45⁺ immune cells from syngeneic tumor models were subjected to single-cell RNA-sequencing (scRNA-seq) by using the 10x Genomics pipeline.

Results

We found that CD47 expression correlated with the level of CD68⁺ M but not CD163⁺ M2. High levels of tumor-infiltrating CD68⁺ M, CD163⁺ M2, and CD47 expression were significantly associated with worse survival. CD47^high/CD68⁺ M^high and CD47^high/CD163⁺ M2^high correlated significantly with shorter survival, whereas CD47^low/CD68⁺ M^low and CD47^low/CD163⁺ M2^low correlated with longer survival. Intriguingly, CD47 blockade decreased the tumor burden in the Panc02 but not in the MPC-83 syngeneic mouse model. Using scRNA-seq, we showed that anti-CD47 treatment significantly remodeled the intratumoral lymphocyte and macrophage compartments in Panc02 tumor-bearing mice by increasing the pro-inflammatory macrophages that exhibit anti-tumor function, while reducing the anti-inflammatory macrophages. Moreover, CD47 blockade not only increased the number of intratumoral CD8⁺ T cells, but also remodeled the T cell cluster toward a more activated one. Further, combination therapy targeting both CD47 and PD-L1 resulted in synergistic inhibition of PDAC growth in the MPC-83 but not in Panc02 model. MPC-83 but not Panc02 mice treated with both anti-CD47 and anti-PD-L1 showed increased number of PD-1⁺CD8⁺ T cells and enhanced expression of key immune activating genes.

Conclusion

Our data indicate that CD47 targeting induces compartmental remodeling of tumor-infiltrating immune cells of the TME in PDAC. Different PDAC mouse models exhibited differential response to the anti-CD47 and anti-PD-L1 blockade due to the differential effect of this combination treatment on the infiltrating immune cells and key immune activating genes in the TME established by the different PDAC cell lines.

Hepatic transcriptome and proteome analyses provide new insights into the regulator mechanism of dietary avicularin in diabetic mice

Many dietary flavonoids existing as glycosides in fruits and vegetables are considered bioactive food components with various potential health benefits. Type 2 diabetes mellitus (T2DM) is a complex and polygenic disease with increasing global prevalence and economic burden. In this study, the hypoglycemic effect of avicularin (quercetin-3-O-α-arabinofuranoside), a flavonoid glycoside commonly found in natural plants and fruits, was determined in a high fat diet/streptozotocin induced type 2 diabetes mouse model. Our results demonstrated that dietary avicularin treatment reduced levels of fasting blood glucose, serum TG and LDL-C, liver AST and ALT, and increased hepatic glycogen in T2DM mice. Furthermore, we used RNA-Seq and iTRAQ to compare the gene and protein expression in the livers of the normal control mice (NC), diabetic control mice (DC) and avicularin treated mice (DA100). The differentially expressed genes (DEGs) and differentially expressed proteins (DEPs) were analyzed based on gene annotations and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. Integrated analysis of the RNA-Seq and iTRAQ data indicated that the fifteen DEGs/DEPs showed the same trend in mRNA and protein expression levels in comparisons of both NC vs DC and DC vs DA100. KEGG analysis revealed that four DEGs/DEPs (PKM, PEPCK, PYG, and PLA2) in the glycolysis, gluconeogenesis, and arachidonic acid pathway, and six DEPs (Ndufb4, Ndufa6, Cox5a, Cox5b, Cox6c, and ATPSβ) in the oxidative phosphorylation signaling pathway, play important roles in avicularin's hypoglycemic effect. We also found six other DEGs/DEPs related to T2DM (CA1, Serpinb6a, AK, Pcolce, Cand2, and Atp2a3), and five related to cancer (Phgdh, Tes, Papss1, Psat1, and Fam49b). We did further verify by qRT-PCR and explored the possible binding modes of avicularin with targeted proteins with molecular docking simulations. Taken together, our results demonstrated the protective effects of avicularin against diabetes and provided a global view about the system-level hypoglycemic mechanisms of avicularin by the comprehensive analysis of transcriptomic and proteomic data in T2DM mice.

Ultrasonography and magnetic resonance imaging features of kaposiform hemangioendothelioma and tufted angioma

Kaposiform hemangioendothelioma (KHE) and tufted angioma (TA) primarily occurring in infants are difficult to distinguish. This study evaluated ultrasonography (US) and magnetic resonance imaging (MRI) features of KHE and TA. Pathologically proven TA (n = 21) and KHE (n = 40 [11 KHE + Kasabach-Merritt phenomenon [KMP]]) occurring between January 2015 and December 2017 were reviewed. US (n = 61) and MRI (n = 50) findings were retrospectively evaluated. On US, KHE and TA lesions were subcutaneous, while 40% of KHE exhibited an infiltrative pattern extending into adjacent muscles. Of TA lesions, 42.9% were hyperechoic and 96.15% of KHE lesions exhibited mixed echogenicity. Of TA lesions, 76.2% exhibited well-defined margins and all KHE lesions exhibited ill-defined margins. The depth and vascular density of KHE and KHE + KMP were significantly increased compared with TA. The arterial peak systolic blood flow velocity of KHE + KMP was significantly higher than that in TA and KHE. KHE and KHE + KMP were significantly harder than TA on elastography. 3-D color Doppler revealed branch-shape blood flow for KHE and KHE + KMP lesions; for TA, it revealed a dot-like and striped pattern. Considering MRI findings, KHE and KHE + KMP were more likely to exhibit diffuse heterogeneous enhancement after contrast than TA. KHE was infiltrative and more likely to be thick, hypoechoic, ill-defined, richly vascular and hard than TA on US. KHE lesions were subcutaneous and reticular, with heterogeneous enhancement on MRI. Awareness of these features should prompt radiologists in the differential diagnosis of pediatric masses.

[Capabilities of contrast-enhanced ultrasound for preoperative assessment of regional lymphatic basin in patients with early oral cavity squamous cell cancer]

This review paper describes the possibilities of visualization of regional lymph nodes using contrast-enhanced ultrasound. Discussed is the experience of contrast-enhanced ultrasound implication for differential diagnosis of regional metastases of squamous cell carcinoma of the oral mucosa. The basics of the technique of contrast-enhanced ultrasound examination of the neck lymphatic basin are described.

Synergistic inhibition of pancreatic cancer with anti-PD-L1 and c-Myc inhibitor JQ1

Human pancreatic ductal adenocarcinoma (PDAC) exhibits marginal responses to anti-PD-1/PD-L1 immunotherapy and its mechanism remains poorly understood. We have investigated the effect of anti-PD-L1 and c-Myc inhibition in PDAC. Using 87 patients with PDAC from our hospital database we found a significant correlation between the expression of PD-L1 and c-Myc. Moreover, the expression of both PD-L1 and c-Myc was associated with poor overall survival. In addition, we confirmed this finding with the PDAC patients in the TCGA database. Using several PDAC cell lines we demonstrated a significant correlation between the expression of PD-L1 and c-Myc. We also found that expression of PD-L1 correlated with high-grade histology. JQ1, an inhibitor of c-Myc inhibited PD-L1 expression and tumor growth. Using xenograft models, we demonstrated that the combination of JQ1 and anti-PD-L1 antibody exerted synergistic inhibition of PDAC growth. Our data demonstrated that the expression of PD-L1 and c-Myc may be helpful prognostic biomarkers, and their inhibition may potentially serve as an effective treatment for PDAC.

High-Frequency Ultrasound Investigation of Port-Wine Stains: Hemodynamic Features Revealed By 10- and 22-MHz Transducers

OBJECTIVES

The hemodynamics of the ultrasound (US) features of port-wine stains (PWSs) have not been reported. The purpose of this study was to evaluate the high-frequency US findings of PWSs.

METHODS

We retrospectively reviewed 98 PWS cases and categorized them into 4 groups based on clinical manifestations and pathologic findings (14 nodular, 28 thickened, 52 flattened, and 4 acquired). We evaluated the US findings with 10- and 22-MHz transducers.

RESULTS

For nodular PWSs, the mean thickened skin ± SD was 0.6 ± 0.5 mm, and the nodule thickness was 5.7 ± 3.3 mm; 63.6% of skin lesions showed vessel density of 2.16 ± 0.93/cm² with venous flow of 4.6 ± 1.1 cm/s, and all nodules showed vessel density of 6.14 ± 1.92/cm² with arterial and venous flow of 26.6 ± 17.9 and 9.9 ± 5.1 cm/s, respectively. The thickened skin of the thickened type was 1.4 ± 2.7 mm; 76.5% of skin lesions showed vessel density of 3.81 ± 1.98/cm² with venous flow 4.6 ± 2.1 cm/s. The thickened skin of 36 flattened lesions was 0.1 ± 0.1 mm; 91.7% of skin lesions showed vessel density of 1.08 ± 0.28/cm² . The thickened skin of 4 acquired lesions was 0.7 ± 0.4 mm; 50% showed vessel density of 1.08 ± 0.28/cm² . The thickened skin and vessel density of nodular and thickened PWSs were thicker and higher than those of the flattened ones. The 22-MHz transducer produced clearer contrast and higher vessel density than the 10-MHz transducer.

CONCLUSIONS

These results showed differences in US findings of PWSs, which may be useful for clinical diagnosis.

Biomarkers-based Biosensing and Bioimaging with Graphene for Cancer Diagnosis

At the onset of cancer, specific biomarkers get elevated or modified in body fluids or tissues. Early diagnosis of these biomarkers can greatly improve the survival rate or facilitate effective treatment with different modalities. Potential nanomaterial-based biosensing and bioimaging are the main techniques in nanodiagnostics because of their ultra-high selectivity and sensitivity. Emerging graphene, including two dimensional (2D) graphene films, three dimensional (3D) graphene architectures and graphene hybrids (GHs) nanostructures, are attracting increasing interests in the field of biosensing and bioimaging. Due to their remarkable optical, electronic, and thermal properties; chemical and mechanical stability; large surface area; and good biocompatibility, graphene-based nanomaterials are applicable alternatives as versatile platforms to detect biomarkers at the early stage of cancer. Moreover, currently, extensive applications of graphene-based biosensing and bioimaging has resulted in promising prospects in cancer diagnosis. We also hope this review will provide critical insights to inspire more exciting researches to address the current remaining problems in this field.

Effects of mimicked acetylated HMGB1 on macrophages and dendritic cells

Extracellular high mobility group box 1 (HMGB1) serves a critical role in inflammatory diseases. HMGB1 is released into the extracellular environment mainly by passive release from necrotic cells or active secretion from monocytes/macrophages following stimulation. However, the translocation of actively secreted HMGB1 from the nucleus to the cytoplasm with post‑translational modifications such as acetylation is required; HMGB1 is then released into the extracellular space. Whether acetylation influences the extracellular function of HMGB1 remains unknown. In the present study, an optimized method of gene mutation by using well‑designed primers in particular, which were employed to identify the mutant gene. The substitution of six lysine residues for glutamines was conducted to mimic acetylated HMGB1 (HMGB1‑M) and observe the effects of HMGB1‑M on macrophages and dendritic cells (DCs). Tumor necrosis factor (TNF)‑α production in RAW 264.7 cells was assessed by ELISA. The phagocytic potential of RAW 264.7 cells, DC maturation and CXCR4 expression were analyzed by flow cytometry. The results of the present study revealed that HMGB1‑M increased cytoplasmic translocation. Compared with HMGB1, HMGB1‑M increased TNF‑α production within RAW 264.7 cells and decreased the mean fluorescence intensity (MFI) of integrin α X, and the percentage and MFI of major histocompatibility complex‑II on DCs. HMGB1‑M exhibited no significant effects on phagocytosis of macrophages and expression frequency of cluster of differentiation 80 and chemokine receptor type 4 on DCs. These results suggested that HMGB1‑M may partly promote inflammation and decrease DC maturation. Thus, the findings of the present study may provide insight into the complex role of HMGB1 in inflammatory diseases.

Nurses' knowledge, attitudes and practices related to physical restraint: a cross-sectional study

AIM

To investigate nurses' knowledge, attitudes and practices related to physical restraint in tertiary hospitals and identify the factors that influence physical restraint use.

BACKGROUND

Physical restraint is used to maintain patient safety. Nurses play an important role in the restraint process. It is important to identify their understanding, feelings and approach regarding the use of physical restraint.

INTRODUCTION

Physical restraint is widely practiced in hospitals in China. However, it results in a range of serious negative consequences. This article provides a clear description of nurses' knowledge, attitudes and practices related to physical restraint.

METHODS

A cross-sectional survey was conducted. The participants were asked to complete a questionnaire examining their knowledge, attitudes and practices related to physical restraint use. A total of 200 questionnaires were distributed in four tertiary hospitals in Hubei Province, China between August and October 2014.

RESULTS

The nurses' responses indicated a good level of knowledge regarding physical restraint use. However, they held some misconceptions. The nurses' attitudes towards physical restraint tended to be neutral. The nurses were well experienced in the use of physical restraint. Nurses who had received on-the-job training performed better than those who had received no training related to knowledge and practices regarding physical restraint use.

CONCLUSIONS AND IMPLICATION FOR NURSING/HEALTH POLICY

In-service training is highly recommended for nursing managers to improve nurses' physical restraint related knowledge and practices. Regulations regarding the use of restraints should be established as soon as possible by healthcare administration system.

IMPLICATIONS FOR NURSING

Nurses should be open to evaluate and improve their views and attitudes regarding effective physical restraint use via multidimensional interventions.

Glycyrrhizin Protects Mice Against Experimental Autoimmune Encephalomyelitis by Inhibiting High-Mobility Group Box 1 (HMGB1) Expression and Neuronal HMGB1 Release

The inflammatory mediator high-mobility group box 1 (HMGB1) plays a critical role in the pathogenesis of human multiple sclerosis (MS) and mouse experimental autoimmune encephalomyelitis (EAE). Glycyrrhizin (GL), a glycoconjugated triterpene extracted from licorice root, has the ability to inhibit the functions of HMGB1; however, GL’s function against EAE has not been thoroughly characterized to date. To determine the benefit of GL as a modulator of neuroinflammation, we used an in vivo study to examine GL’s effect on EAE along with primary cultured cortical neurons to study the GL effect on HMGB1 release. Treatment of EAE mice with GL from onset to the peak stage of disease resulted in marked attenuation of EAE severity, reduced inflammatory cell infiltration and demyelination, decreased tumor necrosis factor-alpha (TNF-α), IFN-γ, IL-17A, IL-6, and transforming growth factor-beta 1, and increased IL-4 both in serum and spinal cord homogenate. Moreover, HMGB1 levels in different body fluids were reduced, accompanied by a decrease in neuronal damage, activated astrocytes and microglia, as well as HMGB1-positive astrocytes and microglia. GL significantly reversed HMGB1 release into the medium induced by TNF-α stimulation in primary cultured cortical neurons. Taken together, the results indicate that GL has a strong neuroprotective effect on EAE mice by reducing HMGB1 expression and release and thus can be used to treat central nervous system inflammatory diseases, such as MS.

[Preparation optimization of extract of Moringa oleifera leaves and its immune regulation effect on immunosuppressed mice]

With total flavonoid content and dry extract yield as the observation indexes, the optimal extraction conditions of Moringa oleifera leaves were determined by using single factor test and orthogonal test, and cyclophosphamide modeling method was used to establish immunosuppressed mice models, so as to investigate the effects of M. oleifera leaves extract on immune regulation in mice. The results showed that the optimal preparation conditions were as follows: extraction with 70% ethanol, material-liquid ratio 1:15, extraction temperature 80 °C, three times, 1.5 hours for each time. Under these conditions, the content of total flavonoids from M. oleifera leaves was 15.64 mg·g⁻¹, which can significantly enhance macrophage phagocytosis and immune organ index, promote the synthesis of serum immunoglobulin IgG and hemolysin, and decrease AST activity, with regulation effect on immune dysfunction.

Addressing Cultural Determinants of Health for Latino and Hmong Patients with Limited English Proficiency: Practical Strategies to Reduce Health Disparities

We explored how addressing culture may improve patient-provider relationships and reduce health disparities for racial and ethnic individuals with limited English proficiency (LEP). We analyzed qualitative data collected to explore health disparities in preventive cancer screenings for Hmong and Spanish-speaking LEP patients in a large Midwest healthcare system. We interviewed 20 participants (10 from each group) and the audiotaped interviews were transcribed verbatim, then back translated focusing on meaning. Data was analyzed using content analysis. Two themes are: conversation is relational and quality time is valued. Good communication skills involve the amount of conversation, clear explanations, and engaging with the patient. Quality of time meant physical time spent with patient and the task-oriented nature of the encounter. Cultural literacy in healthcare practice helps to understand the whole patient rather than focusing on the symptoms of illness. Patients should not be treated in isolation of their culture. A patient-centered approach to care means physicians should not remain culturally neutral but be more culturally sensitive. We propose steps to reduce disparities by increasing the awareness of cultural literacy for physicians to improve patient-provider relationship.

[Evaluation on the short term effectiveness of two doses mumps-containing vaccine policy in Shandong, China]

Objective: To evaluate the effectiveness of mumps prevention and control after implementation of two doses mumps-containing combined vaccine (MuCV) policy by analyzing epidemiological characteristics of mumps and mumps antibody levels in general population. Methods: We obtained data on cases of mumps reported during 2004-2015 from National Notifiable Diseases Reporting System (NNDRS). Descriptive analysis methods were used to describe the epidemiological characteristics of mumps during 2004-2015. MuCV immunization information from 2005 to 2015 was obtained from the immunization information management system in Shandong Province. Antibody data of mumps in healthy people were from a cross-sectional survey according to the principle of stratified random sampling from 0 to 60 years old healthy people in 2015. Commercial ELISA kits were used to detect and quantify human IgG antibodies against mumps virus in sera, and the results were analyzed statistically. Results: The average incidence of mumps from 2004 to 2015 was 11.43/100 000 in Shandong. The incidence of mumps in the central region (14.64/100 000) was higher than that in the eastern and western regions (11.14/100 000, 11.33/100 000). The incidence of mumps was still high in 2009-2013 (stage of one-dose MuCV free, 16.07/100 000) with the highest incidence of 25.33/100 000 and 24.45/100 000 occurred in 2012 and 2013 and the cases were mainly 6 to 9 years old group (172.67/100 000). Since the second dose MuCV was introduced into NIP for 6 years old children in May 2013 in Shandong, the incidence of mump decreased significantly in 2014-2015 (7.81/100 000), especially in children of 6-8 years old who were vaccinated with two doses of MuCV (2009-2013 was 114.02/100 000; 2014-2015 was 45.66/100 000) and lower than 3-5 years old vaccinated one doses of MuCV. A total of 1 785 serum samples were collected from the healthy population, the average seroprevalence was 80.62% and Geometric Mean Concentration (GMC) was 38.11 IU/ml (95%CI: 37.03-39.19 IU/ml) . There was no significant difference about seroprevalence in different regions, while the GMC in middle region was significantly higher compared to east and west region. The prevalence and GMC in children aged 19 months-2 years and 3-5 years old who received one dose of MuCV were significantly higher than those of <19 months old children. The GMC (46.88 IU/ml, 95%CI: 39.43-55.74 IU/ml) in children aged 6-9 years old who received the two doses MuCV was significantly higher than that of aged 3-5 years old children (31.71 IU/ml, 95%CI: 27.23-36.93 IU/ml). Conclusion: The incidence of mumps in Shandong was still at a high level in spite of coverage one doses MuCV to children. Compared with the period of the 1 dose MuCV immunization strategy, the incidence the groups coverage two doses MuCV was significantly reduced and lower the groups coverage one dose MuCV, but the prevalence and GMC were higher than that of the groups coverage one dose MuCV.

[The value of ultrasonic elastography in diagnosis of salivary gland lesions in patients with Sjogren's syndrome]

PURPOSE

The present study was aimed to clinically evaluate transitional treatment of pulpitis during pregnancy.

METHODS

Sixty pregnant women with pulpitis were divided into the first, second and third trimester. They were anesthetized locally using STA system combined with psychological intervention during treatment. The teeth were given one-appointment root canal preparation and filled with vitapex pasta. Normal obturation of the root canal was conducted after delivery. The effects of dental treatment, pregnancy outcomes and neonatal health status were observed. Data of the survey were analyzed by SPSS 20.0 software package, including Student's t test and chi-square test.

RESULTS

The symptoms of pulpitis were significantly improved 24h after treatment,and the effective rate was 96.7%. The difference of VAS before and after treatment was statistically significant (P<0.05). Patients had no discomfort till the end of pregnancy,and the success rate was 98.3%. No adverse pregnancy outcomes were observed after treatment during different periods of pregnancy. Neonatal health was good. Significant differences were not found in birth gestational age, body weight, malformations, and neonatal complications between three treatment periods (P>0.05).

CONCLUSIONS

Transitional treatment of pulpitis during pregnancy is a safe and effective procedure and worthy of wide use clinically.