目的 评估无托槽隐形矫治应用在正畸拔牙患者中的效果及对牙根吸收、可溶性细胞间黏附分子-1（sICAM-1）的影响。方法 纳入2022年1月—2024年8月的70例正畸拔牙患者，按照治疗方法分组，即对照组（35例，给予固定矫治）、观察组（35例，给予无托槽隐形矫治），评价组间牙根吸收情况、牙周指标、炎症因子、矫治时间。结果 治疗结束时，两组均出现牙根吸收情况，但是观察组无牙根吸收＞3 mm病例，而对照组存在牙根吸收＞3 mm、＞4 mm病例，P＜0.05。治疗前，两组牙周指标［龈沟出血指数（SBI）、牙龈指数（GI）、菌斑指数（PLI）］、炎症因子［白介素-1β（IL-1β）、sICAM-1］比较差异无统计学意义（P＞0.05）。治疗后，两组SBI、GI、PLI、IL-1β、sICAM-1升高，且观察组SBI、GI、PLI、IL-1β、sICAM-1低于对照组（P＜0.05）。与对照组比较，观察组矫治时间更长（P＜0.05）。结论 对正畸拔牙患者进行无托槽隐形矫治，虽然治疗时间长，但是可以抑制牙根吸收，减轻炎症反应，提高牙周健康水平。
Objective To evaluate the effect of clear aligner treatment on orthodontic tooth extraction patients and its impact on root resorption and soluble intercellular adhesion molecule-1（sICAM-1）．Methods Seventy orthodontic extraction patients from January 2022 to August 2024 were included and divided into two groups according to treatment methods：a control group（35 cases，receiving fixed orthodontic treatment）and an observation group（35 cases，receiving clear aligner treatment）．The root resorption，periodontal indicators，inflammatory factors，and orthodontic treatment time between groups were evaluated．Results At the end of treatment，both groups showed root resorption，but there were no cases of root resorption＞3 mm in the observation group，while there were cases of root resorption＞3 mm and＞4 mm in the control group，P＜0.05．Before treatment，there was no difference in periodontal indicators（gingival bleeding index［SBI］，gingival index［GI］，plaque index［PLI］），inflammatory factors（interleukin-1 β［IL-1 β］，sICAM-1） between the groups，P＞0.05．After treatment，SBI，GI，PLI，IL-1 β，sICAM-1 increased in both groups，but SBI，GI，PLI，IL-1 β，sICAM-1 were lower in the observation group，P＜0.05．Compared with the control group，the observation group had a longer orthodontic treatment time，P＜0.05．Conclusions Although the clear aligner treatment time for orthodontic extraction patients is longer，it can inhibit root resorption，reduce inflammatory reactions，and improve periodontal health．
目的 探讨单次根管疏通填充对牙体牙髓病患者的填充效果及龈沟液炎症指标的影响。方法 选择2023年8月—2024年2月天津市人民医院接收的牙体牙髓病患者84例进行研究，采用随机数字表法分为两组，各42例。对照组采取多次根管疏通填充，观察组采取单次根管疏通填充，比较2组填充效果、治疗效果、龈沟液炎症指标、口腔健康和功能指标、并发症情况。结果 观察组欠填、恰填、超填比例与对照组比较无统计学意义（χ 2 分别为0.262、1.615、0.512，P分别为0.608、0.203、0.474）。观察组的总有效率为97.62%，高于对照组80.95%（χ 2 =6.098，P=0.014）。治疗后，观察组龈沟液白细胞介素IL-1β、IL-17A、IL-35、肿瘤坏死因子-α水平低于对照组（t分别为3.271、3.028、2.699、2.968，P分别为0.002、0.003、0.008、0.004）。治疗后，观察组龈沟出血指数、牙龈指数低于对照组，咬合力、咀嚼效率高于对照组（t分别为2.311、2.686、2.262、2.776，P分别为0.023、0.009、0.026、0.007）。观察组并发症发生率4.76%低于对照组21.43%（χ 2 =5.126，P=0.024）。结论 牙体牙髓病采取单次根管疏通填充治疗可保证恰当的填充效果，取得良好的治疗效果，而且减轻龈沟液炎症反应，促进口腔健康和功能改善，并发症较少，安全性高，值得推广。
Objective To explore the effects of one-time root canal dredging and filling on the filling effect and gingival crevicular fluid inflammation indexes in patients with endodontic disease．Methods A total of 84 cases of endodontic patients admitted to the Tianjin People’s Hospital from August 2023 to February 2024 were chosen and separated into the control group（n=42，multiple-time root canal dredging and filling）and the observation group（n=42，one-time root canal dredging and filling）by random number table method．The filling effect，therapeutic effect，gingival creval fluid inflammation indicators，oral health and function indicators，and complications were compared．Results The underfilling，accurate filling and overfilling showed no significant difference between the two groups（χ 2 =0.262，1.615，0.512，P=0.608，0.203，0.474）．The total effective rate of observation group was 97.62%，higher than that of control group 80.95%（χ 2 =6.098，P=0.014）．After treatment，levels of interleukin（IL）-1β，IL-17A，IL-35 and tumor necrosis factor-α in gingival crevicular fluid of observation group were lower（t=3.271、3.028、2.699、2.968，P=0.002、0.003、0.008、0.004）．After treatment，the sulcus bleeding index and gingival index of the observation group were lower，and the biting force and mastication efficiency were higher（t=2.311、2.686、2.262、2.776，P=0.023、0.009、0.026、0.007）．The complication rate in the observation group was 4.76%，lower than that in the control group 21.43%（χ 2 =5.126，P=0.024）．Conclusions A one-time root canal dredging and filling treatment for endodontic diseases can ensure proper filling effect，achieve good therapeutic effect，reduce gingival crevicular fluid inflammation，promote oral health and function improvement，with fewer complications，high safety，which is worthy of promotion．
目的 探讨谷氨酸对HT22细胞线粒体自噬和细胞凋亡的影响，并评估虾青素预处理的保护作用及其分子机制。方法 用谷氨酸及虾青素处理HT22细胞，通过蛋白印迹及聚合酶联反应等评估其对线粒体自噬的影响。结果 谷氨酸处理显著抑制线粒体初级自噬（PINK1、Parkin、pULK1ser555和LC3Ⅱ）和次级自噬（LAMP1和Rab7），上调cleaved Caspase-3的表达（P＜0.05）。虾青素预处理减少细胞凋亡，恢复了线粒体自噬，PINK1、Parkin、pULK1ser555和LC3Ⅱ的表达水平上升（分别为2.3倍、2.6倍、83.3%及81.1%）（P＜0.05），该作用被自噬抑制剂BafA1阻断。此外，谷氨酸抑制Nrf2核内转移和NLRX1表达，而预处理显著促进Nrf2的核内转移并上调NLRX1，分别上调25.8%、33.2%。生物信息学分析显示NLRX1启动子区域含有3个Nrf2结合位点，提示Nrf2通过调控NLRX1转录活性发挥作用。结论 文章揭示虾青素通过Nrf2/NLRX1通路激活线粒体自噬，展现神经保护作用。
Objective To explore the effects of glutamate on mitophagy and apoptosis in HT22 cells and evaluate the protective effects and molecular mechanisms of astaxanthin pretreatment．Methods HT22 cells were treated with glutamate and astaxanthin．The effects on mitophagy were assessed using Western Blot and PCR．Results Glutamate treatment significantly inhibited primary mitophagy（PINK1，Parkin，pULK1ser555 and LC3II）and secondary mitophagy（LAMP1 and Rab7）while upregulating cleaved Caspase-3 expression．Astaxanthin pretreatment notably reduced apoptosis and restored mitophagy，the expression levels of PINK1，Parkin，pULK1ser555 and LC3II were significantly upregulated（by 2.3-fold，2.6-fold，83.3% and 81.1% respectively，P＜0.05），but this effect was blocked by the autophagy inhibitor BafA1．Additionally，glutamate suppressed Nrf2 nuclear translocation and NLRX1 expression，whereas astaxanthin promoted Nrf2 nuclear translocation and increased NLRX1 expression by 25.8% and 33.2%，respectively．Bioinformatics analysis revealed three Nrf2 binding sites in the NLRX1 promoter region，suggesting that Nrf2 may regulate NLRX1 transcriptional activity．Conclusions The study demonstrates that astaxanthin exhibited potential neuroprotective effect by activating mitophagy through the Nrf2/NLRX1 pathway．
目的 对入住重症监护病房（ICU）重症孕产妇患者的病种特征和住院费用进行分析。方法 从医院信息管理系统中搜索2009—2019年广州市某省级重症孕产妇救治中心ICU的重症孕产妇住院病例，对病例资料进行描述性流行病学分析。结果 2009—2019年该救治中心ICU共收治重症孕产妇1 616例，病种排名前五位依次为心血管疾病430例（26.61%）、血液及造血器官疾病310例（19.18%）、妊娠期特定并发疾病287例（17.76%）、消化系统疾病218例（13.49%）、呼吸系统疾病110例（6.81%）。患者经济负担中位数排名前五位依次为肌肉骨骼系统和结缔组织疾病（62 252.60元）、消化系统疾病（61 684.41元）、感染性疾病（42 945.70元）、血液及造血器官疾病（40 403.52元）、神经系统疾病（40 055.93元）。结论 入住ICU内的重症孕产妇以心血管疾病、血液及造血器官疾病为主，经济学分析表明肌肉骨骼系统和结缔组织疾病造成的经济损失较大。
Objective To analyze the disease characteristics and hospitalization expenses of severe maternal patients in intensive care unit（ICU）．Methods Hospitalized cases of severe maternal disease in ICU of a provincial critical care center in Guangzhou from 2009 to 2019 were searched from the hospital information management system，and case data was analyzed by descriptive epidemiology．Results From 2009 to 2019，a total of 1616 critically ill maternal patients received intensive care treatment at this center．The predominant diseases observed were cardiovascular disorders（26.61%），blood and hematopoietic organ diseases（19.18%），specific pregnancy-related complications（17.76%），gastrointestinal ailments（13.49%），and respiratory disorders（6.81%）．Among the top five patient groups，the median economic burden was the highest in musculoskeletal system and connective tissue diseases（62 252.600 yuan），followed by digestive system diseases（61 684.410 yuan），infectious diseases（42 945.700 yuan），blood and hematopoietic organ diseases（40 403.515 yuan），and nervous system disorders（40 055.930 yuan）Furthermore，a discernible correlation between hospitalization cost and length of stay was identified．Conclusions Cardiovascular diseases and disorders of blood and hematopoietic organs are the primary causes for maternal admissions to ICU．Economic analysis shows that musculoskeletal system and connective tissues diseases cause bigger economic loss ．
目的 通过对广东省下的卫生资源配置的公平性进行分析，找出当前卫生资源配置存在的问题并提出优化建议，以进一步减少健康不平等的现象，为实现广东省均衡化配置卫生资源的“十四五”目标提供实践参考依据。方法 收集整理《广东省统计年鉴》中2018—2022年相关数据，采用集聚度法、空间自相关分析，从人口、地理、空间三个纬度对卫生资源分布的公平性进行分析。结果 珠三角、粤东地区的卫生资源配置公平性，在地理维度上较高，人口维度上较低；粤西、粤北地区的卫生资源配置的公平性与之相反。在空间分布上，2018年部分城市的卫生资源分布呈现出一定的空间集聚特征，但到2022年这种空间集聚特征均弱化，空间自相关性消失。结论 广东省卫生资源在地域之间存在分布不均衡情况，其配置公平性有待提升。尽管空间自相关消失可能意味着资源不再集中在某些特定区域，但政策制定者在未来进行卫生资源规划时，要考虑如人口密度、经济发展水平等因素给各地区带来的影响，以进一步促进资源的均等化配置。
Objective By analyzing the equity of health resource allocation in Guangdong Province，to identify the current problems in health resource allocation and put forward optimization suggestions to further reduce health inequalities and provide practical references for achieving the “14th Five-Year Plan” goal of balanced allocation of health resources in Guangdong Province．Methods Relevant data from 2018-2022 in the Guangdong Provincial Statistical Yearbook were collected and organized，and the equity of health resource distribution was analyzed in three dimensions：demographic，geographic and spatial，by using the agglomeration method and spatial auto-correlation analysis．Results The equity of health resource allocation in the Pearl River Delta and Guangdong East regions was higher in geographical dimension and lower in population dimension；the equity of health resource allocation in Guangdong West and Guangdong North regions was the opposite．In terms of spatial distribution，the distribution of health resources in some cities showed some spatial clustering characteristics in 2018，but all such spatial clustering characteristics weakened and spatial auto-correlation disappeared by 2022．Conclusions Health resources in Guangdong Province were unbalanced in terms of their geographic distribution，and the equity of their allocation needs to be improved．Although the disappearance of spatial auto-correlation may mean that resources are no longer concentrated in certain regions，policymakers should consider the impact of factors such as population density and level of economic development on regions when planning health resources in the future to further promote the equalization of resource allocation．
