Research progress on autologous vascularized graft bone implant repair for maxillofacial bone defect / 中华口腔医学杂志

Maxillofacial bone defect can seriously affect the patient's appearance, mastication, deglutition and speech function. At present, autologous bone grafting combined with implant repair is an effective method for reconstruction of maxillofacial bone defects. Due to the differences in density, nutrition, immunity and other aspects of bone graft at different donor sites, there may be a potential impact on implant repair. In this paper, the biological characteristics of vascularized autologous bone used in maxillofacial bone defect repair were reviewed, and the risk factors of implantation on the bone graft were discussed. It provides support for clinicians in the selection of bone graft donor site and the design of prosthesis.

Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults / Reconstrução microcirúrgica em um hospital ortopédico: Indicações e desfechos em adultos

Abstract Objective Advances in reconstructive microsurgery in orthopedic surgery provided better functional and aesthetic results and avoided many indications for amputation. In high-volume trauma and orthopedic hospitals, microsurgical reconstruction is essential to reduce costs and complications for these complex orthopedic defects. We describe a microsurgical approach to traumatic wounds, tumor resection, bone defects, and free muscle transfer, performed by an orthopedic microsurgery unit. The objective of the present study was to evaluate predictor factors for outcomes of microsurgical flaps for limb reconstruction, and to provide a descriptive analysis of microsurgical flaps for orthopedic indications. Methods Cross-sectional prospective study that included all consecutive cases of microsurgical flaps for orthopedic indications from 2014 to 2020. Data were collected from personal medical history, intraoperative microsurgical procedure, and laboratory blood tests. Complications and free-flap outcomes were studied in a descriptive and statistical analysis. Results We evaluated 171 flaps in 168 patients; the indications were traumatic in 66% of the patients. Type III complications of the Clavien-Dindo Classification were observed in 51 flaps. The overall success rate of the microsurgical flaps was 88.3%. In the multivariate analysis, the risk factors for complications were ischemia time ≥ 2 hours (p= 0.032) and obesity (p= 0.007). Partial flap loss was more common in patients with thrombocytosis in the preoperative platelet count (p= 0.001). Conclusion The independent risk factors for complications of microsurgical flaps for limb reconstruction are obesity and flap ischemia time ≥ 2 hours, and presence of thrombocytosis is a risk factor for partial flap loss.

Resumo Objetivo Os avanços da microcirurgia reconstrutiva na cirurgia ortopédica proporcionaram melhores resultados funcionais e estéticos, evitando as muitas indicações de amputação. Nos hospitais de ortopedia e traumatologia com um grande volume de atendimento, a reconstrução microcirúrgica é essencial, a fim de reduzir os custos e as complicações destes complexos defeitos ortopédicos. Descrevemos uma abordagem microcirúrgica para feridas traumáticas, ressecção tumoral, defeitos ósseos e transferência muscular livre realizada por uma unidade ortopédica especializada em microcirurgia. O objetivo do presente estudo é avaliar os fatores preditivos de resultados dos retalhos microcirúrgicos na reconstrução dos membros, fornecendo uma análise descritiva dos retalhos microcirúrgicos para as indicações ortopédicas. Métodos Estudo prospectivo transversal, que incluiu todos os casos consecutivos de retalhos microcirúrgicos com indicação ortopédica de 2014 a 2020. Foram coletados os dados do histórico clínico pessoal, procedimentos microcirúrgicos intraoperatórios e exames laboratoriais. As complicações e os desfechos de retalho livre foram estudados mediante uma análise descritiva e estatística. Resultados Avaliamos 171 retalhos em 168 pacientes. A indicação mais frequente para a realização de um retalho microcirúrgico foi a traumática, em 66% dos pacientes. Foram observadas complicações cirúrgicas em 51 retalhos, conforme a classificação de Clavien-Dindo do tipo III. A taxa de êxito global dos retalhos microcirúrgicos foi de 88,3%. Na análise multivariada, foram identificados como fatores de risco para complicações tempo de isquemia ≥ 2 horas (p= 0,032) e obesidade (p= 0,007). A perda parcial do retalho foi mais comum em pacientes com trombocitose, com contagem de plaquetas pré-operatória (p= 0,001). Conclusão Os fatores de risco independentes para complicações de retalhos microcirúrgicos para a reconstrução de membro são obesidade e tempo de isquemia do retalho ≥ 2 horas, e a presença de trombocitose como fator de risco para perda parcial do retalho.

Comparative Analysis of the Treatment of Skin Lesions of the Lower Limbs with Sural Flap versus Propeller Flap / Análise comparativa do tratamento de lesões cutâneas dos membros inferiores com retalho sural versus retalho propeller

Abstract Objective The objective of the present study was to prospectively compare the sural and propeller flaps for soft-tissues coverage of the lower extremity. The following variables were evaluated: incidence of complete or partial flap loss and donor area morbidity (primary closure versus skin graft). Methods Prospective and randomized analysis of data collected from all patients presenting with soft tissue defects of the lower third of the leg and heel treated with reverse sural or propeller flaps. Results Twenty-four patients aged between 4 and 60 years old were evaluated between 2011 and 2017. Complete coverage was obtained in 22 of the 24 patients (91.6%). Two flaps failed (8.4%). The sural flap, being the most popular option, continues to represent a safe and versatile alternative for skin defects of the lower third of the leg and heel region. Likewise, the propeller flap was a comparable option to treat these challenging defects. Conclusion Sural and propeller flaps are good options for soft tissues coverage of the lower extremity, with low complication rates (partial or total flap loss).

Resumo Objetivo O objetivo do presente estudo foi comparar prospectivamente os retalhos sural e propeller para cobertura de partes moles da extremidade inferior. Foram avaliadas as seguintes variáveis: incidência de perda total ou parcial do retalho e morbidade da área doadora (fechamento primário versus enxerto de pele). Métodos Análise prospectiva e randomizada de dados coletados de todos os pacientes apresentando defeitos em tecidos moles da extremidade distal da perna e do retropé submetidos aos retalhos em questão. Resultados Foram avaliados 24 pacientes com idades entre 4 e 60 anos, entre 2011 e 2017. Cobertura completa foi obtida em 22 dos 24 pacientes (91,6%) e observamos falha em 2 retalhos (8,4%). O retalho sural, sendo a opção mais popular, continua a representar uma alternativa segura e versátil para defeitos cutâneos do terço distal da perna e da região do calcanhar. O retalho propeller, da mesma maneira, mostrou-se uma opção comparável para o tratamento destas lesões desafiadoras. Conclusão Os retalhos sural e propeller são boas opções para a cobertura de partes moles da extremidade inferior, demostrando baixas taxas de complicações como perda parcial ou total do retalho.

Prevention effects of nicorandil on contrast-induced nephropathy after coronary angiography or stent implantation ： a meta-analysis / 中国药房

OBJECTIVE To syste matically evaluate the prevention effects of nicorandil on contrast-induced nephropathy in patients underwent coronary angiography （CAG）or stent implantation （CSI），and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed ，Embase，Cochrane library ，Wanfang database ，CBM and CNKI ，randomized controlled trial （RCT）about nicorandil （trial group ）versus normal saline or placebo （control group ）prevented contrast-induced nephropathy in patients underwent CAG or CSI were collected during the inception to Nov. 2021. After extracting literature that met the inclusion criteria ，the bias risk assessment tool of RCT in Cochrane manual was used for quality evaluation ，and meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 17 RCTs were included ，involving 3 279 patients. Among them，there were 1 587 patients in trial group ，and 1 692 patients in control group. Results of meta-analysis showed that the incidence of contrast-induced nephropathy in trial group was significantly lo wer than control group [RR ＝0.40，95％CI（0.31，0.51）， P＜0.000 1] . Results of subgroup analysis showed that the incidence of contrast-induced nephropathy in trial group was significantly lower than control group ，whether intravenous administration [RR ＝0.47，95％CI（0.29，0.74），P＝0.001] or oral administration [RR ＝0.37，95％CI（0.28，0.50），P＜0.000 01]，whether patients with normal renal function [RR ＝0.42，95％CI（0.30， 0.59），P＜0.000 01] or with renal insufficiency [RR ＝0.38， 95％ CI（0.26，0.54），P＜0.000 01]. Scr of 24 h[SMD＝ －1.38，95％CI（－2.32，－0.44），P＝0.004]，48 h[SMD＝ －0.81，95％CI（－1.19，－0.43），P＜0.000 1] and 72 h[SMD＝ －0.24，95％CI（－0.43，－0.05），P＝0.01] after surgery in trialgroup were significantly lower than control group ；the 163.com decrease of creatinine clearance rate of 48 h[SMD＝1.27， 95％CI（0.48，2.07），P＝0.001] and 72 h[SMD＝0.37，95％CI（0.07，0.67），P＝0.02] after surgery in trial group were significantly lower than control group ；cystatin C of 24 h[SMD＝－0.93，95％CI（－1.72，－0.14），P＝0.02]，48 h[SMD＝－1.72，95％CI （－2.33，－1.10），P＜0.000 01] and 72 h[SMD＝－0.36，95％CI（－0.62，－0.10），P＝0.006] after surgery in trial group were significantly lower than control group. CONCLUSIONS Pretreatment of nicorandil can reduce the incidence of contrast-induced nephropathy in patients underwent CAG or CSI ，and reduce the damage of renal function after application of contrast.

Structured evaluation of a comprehensive microsurgical training program

OBJECTIVES: This study proposed a structured microsurgical training program and evaluated it with the assistance of a large sample of surgeons. METHODS: The practical course comprised 16 sessions of approximately 4 hours each. This included two sessions for suturing rubber gloves and two sessions for suturing arteries, veins, and nerves in chicken thighs. The other sessions were performed on the femoral vessels of rats: 5 sessions for end-to-end arterial anastomosis, 5 for end-to-end venous anastomosis, 1 for arterial grafting, and 1 for end-to-side anastomosis. We conducted a structured assessment of the microsurgical skills in each training session. RESULTS: In this study, 89 surgeons were evaluated. The mean scores for the different procedures were as follows: glove suturing, 33.3±0.59; chicken nerve end-to-end anastomosis, 40.3±0.49; chicken artery suturing, 40.9±0.36; chicken vein suturing, 42.3±0.36; graft interposition, 44.8±0.7; and end-to-side anastomosis, 43.7±0.63 (p<0.05 for all). The chicken thigh suturing scores were significantly higher than the rubber gloves suturing scores (p<0.01). There were no differences between scores of the rat artery and chicken thigh suturing procedures (p=0.24). The rat venous anastomosis scores were higher than the rat arterial anastomosis scores (p=0.02), as were graft interposition scores when compared with end-to-end venous anastomosis scores. The end-to-side anastomosis scores did not differ significantly from the grafting scores (p=0.85). The most common errors were inadequate knotting technique and suture rupture due to inadequate technique (both n=88 [98.9%]). CONCLUSION: We propose a 16-step, progressive microsurgical training program to learn the basic microsurgical techniques comprehensively and reliably. The program was evaluated in a large sample of trainees, and it demonstrated the adequacy of the training sequence and results.

MicroRNA-23a knockdown attenuates angiotensin Ⅱ induced hypertrophy in rat H9c2 cells via activating PTEN and AMPK pathway / 中华心血管病杂志

Objective: To investigate if microRNA (miR) -23a knockdown could attenuate angiotensin Ⅱ(AngⅡ) induced cardiac hypertrophy by activating phosphatase and tensin homolog deleted on chromosome ten(PTEN) and AMP-activated protein kinase(AMPK) pathway. Methods: Rat H9c2 cells were cultured in DMEM high glucose medium and put in 5% CO(2) incubator at 37 ℃(normal group). After 48 hours of culture, H9c2 cells were stimulated with 10 nmol/L AngⅡ to establish cell hypertrophy model (AngⅡgroup). The H9c2 cells were inoculated in a 6-well cell culture plate and cultured in an incubator at 37 ℃. When the confluence degree of cell growth was about 70%, the cells were transfected with different reagents, and 24 hours after transfection, 10 nmol/L AngⅡ was used to interfere with the cells. The H9c2 cells were divided into different groups according to the reagents, namely AngⅡ+anti-miR group(transfected with miR-23a inhibitor), Ang Ⅱ+NC group(transfected with miR-23a inhibitor negative control), Ang Ⅱ+anti-miR+si-PTEN group(cotransfected with miR-23a inhibitor and PTEN small interference RNA(siRNA)), and AngⅡ+anti-miR+si-NC group(cotransfected with miR-23a inhibitor and PTEN siRNA negative control). The surface area of single cell was measured by Image J software.The mRNA expression levels of α-actin 1 (ACTA1) and β-myosin heavy chain (β-MHC) and miR-23a were detected by quantitative real-time PCR(qRT-PCR). The expression levels of PTEN and AMPK signal pathway related proteins were detected by Western blot. In order to verify whether miR-23a targets PTEN gene, double luciferase reporter gene experiment was performed. The luciferase reporter gene vector recombinant plasmids of wild type pGL-WT-PTEN and mutant pGL-MUT-PTEN were constructed and prepared after normal sequencing. H9c2 cells was inoculated into 24-well cell culture plate and cultured overnight in 37 ℃ incubator. The cells were co-transfected with miR-23a mimic or miR-23a mimic negative control and wild type or mutant reporter gene recombinant plasmid. Forty-eight hours after transfection, firefly luciferase activity and sea kidney luciferase activity were measured, and the ratio of them was recorded as relative luciferase activity. Results: Compared with the normal group, the cell surface area, the mRNA expression levels of ACTA1, β-MHC and miR-23a were significantly higher, while the protein expression levels of PTEN and p-AMPK were significantly lower in the Ang Ⅱ group(all P<0.05). The results of double luciferase reporter gene assay showed that the relative luciferase activity of cells co-transfected with miR-23a mimic and wild-type reporter gene recombinant plasmid was lower than that of miR-23a mimic negative control (P<0.05), and PTEN served as the target gene of miR-23a. In AngⅡ+anti-miR group the mRNA expression levels of miR-23a, ACTA1 and β-MHC were lower, and the cell surface area was smaller, while the protein expression levels of PTEN and p-AMPK were higher than that in AngⅡ group and AngⅡ+NC group(all P<0.05). Compared with AngⅡ+anti-miR group, the cell surface area was bigger, the expression of ACTA1 and β-MHC mRNA was up-regulated, and the protein expression levels of PTEN and p-AMPK were down-regulated in Ang Ⅱ+anti-miR+si-PTEN group(all P<0.05). Conclusion: Inhibition of miR-23a can attenuate Ang Ⅱ-induced hypertrophy in H9c2 cells through targeting PTEN and activating AMPK signaling pathway.

Expression and functions of long non-coding RNA actin filament-associated protein 1-antisense RNA1 in oral squamous cell carcinoma / 华西口腔医学杂志

OBJECTIVE@#To analyze the expression and clinical significance of long non-coding RNA (lncRNA) actin filament-associated protein 1-antisense RNA1 (AFAP1-AS1) in oral squamous cell carcinoma (OSCC) and its effect on the biobehavior of OSCC cells.@*METHODS@#Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of lncRNA AFAP1-AS1 in the tumor tissue and matching adjacent normal tissue of OSCC patients (n=55), SCC25 cells, and normal oral keratinocyte lines (NOK) cells. The correlation between AFAP1-AS1 expression and the clinicopathological characteristics of OSCC patients was analyzed. The relationship between AFAP1-AS1 and prognosis was also studied with the Kaplan-Meier method. AFAP1-AS1 siRNA was transfected into the SCC25 cells. Cell counting kit-8 (CCK-8) and Trans-well were used to detect cell proliferation, invasion, and migration. The expression of the invasion-associated protein, AFAP1, and Rho GTPase family members, was detected by Western blot. In addition, the immunofluorescence of the cytoskeletal actin filament was observed.@*RESULTS@#The expression of AFAP1-AS1 was higher in the OSCC tissues than in the NOK cells, and the relative expression of AFAP1-AS1 was higher in the SCC25 cells than in the NOK cells (P<0.001). AFAP1-AS1 expression was associated with the degree of diffe-rentiation, TNM stage, lymphatic metastasis, and poor prognosis of OSCC (P<0.05). Patients with a high expression of AFAP1-AS1 had lower survival rates than those with a low expression of AFAP1-AS1 (P<0.05). After transfected by AFAP1-AS1 siRNA, the expression of AFAP1-AS1 was downregulated. The inhibition of AFAP1-AS1 expression consequently suppressed the proliferation, invasion, and migration of SCC25. Moreover, AFAP1-AS1 siRNA upregulated the expression levels of AFAP1, RhoA, Rac2, Rab10, RhoGDI, and Pfn1 but downregulated the expression of RhoC. Immunofluorescence showed that AFAP1-AS1 also reduced the formation of stress filaments in the cytoskeleton and affected the integrity of the actin fila-ment.@*CONCLUSIONS@#The expression of AFAP1-AS1 was high in the OSCC tissues and SCC25 cells and is associated with the development and prognosis of OSCC. The knockdown of AFAP1-AS1 might inhibit the proliferation and invasion of OSCC cells by regulating the integrity of the actin filament.

The contrastive analysis of the characteristics of dental education in Australia and China / 中华医学教育探索杂志

The dental education system and the training mode of dentists have a crucial influence on the quality of national dentists.Since 1960s,Australia has been constantly developing its dental education system,and now a mature and efficient mode of cultivating dentists has been formed,that is,bachelor degree of science being the prerequisite,four-year doctorate courses in dental medicine to produce general practice,two-year clinical experience and three-year doctorate courses in clinical dentistry to produce specialists.The dental courses in Australia are mainly composed of four parts:basic dentistry,life science,clinical dentistry model and research.The courses are characterized by a larger proportion for professional courses and an earlier time point for students to step in clinics,the co-culture of clinical and research skills,etc.The assessing method is case report,which means they put greater emphasis on intersection of clinics and lectures.We can learn a lot from their education system.The author compared and analyzed the dental education system of the two countries from background,course length and inclusion criteria,course design and etc,and came up with advice on dental education system of our own,hoping to provide Chinese dental educators with inspiration.

Reconstrução tardia na mão traumatizada com perda de múltiplos dedos / Late reconstruction of a traumatized hand with loss of multiple fingers

As lesões mutilantes de mão são um desafio para o cirurgião de mão e o paciente. O cirurgião deve tomar decisões desde o debridamento inicial, escolhendo quais dedos e articulações serão preservadas e uso apropriado das partes a serem retiradas. A reconstrução tardia é a segunda parte dessa difícil tarefa. Dificuldade que se atribui à particularidade de cada lesão, do grande número de possibilidades de tratamento e seus diversos níveis de complexidade que devem ser adequados à necessidade e motivação pessoal de cada paciente. Este relato de caso apresenta uma reconstrução tardia de mão com perda de indicador e dedo médio com transplante de articulação metacarpofalângica de indicador para função de interfalangeana proximal de dedo médio.

Mutilating hand injuries are a challenge to both the hand surgeon and the patient. The surgeon must make decisions ranging from the initial debridement to which fingers and joints will be preserved and the appropriate use of the parts to be removed. Late reconstruction constitutes the second part of this difficult task. The difficulty attributed to the characteristics of each lesion, the large number of treatment possibilities, and the different levels of complexity must be adapted to the personal needs and motivation of each patient. This case report describes a late hand reconstruction with index and middle finger loss, using metacarpophalangeal joint transplantation of the index finger to gain the proximal interphalangeal function of the middle finger.

Experimental study of histological changes in vascular loops according to the duration of the postoperative period: Application in reconstructive microsurgery

OBJECTIVES: To analyze the histological changes observed in venous grafts subjected to arterial blood flow as a function of the duration of the postoperative period to optimize their use in free flap reconstructions. METHOD: Twenty-five rats (7 females and 18 males) underwent surgery. Surgeries were performed on one animal per week. Five weeks after the first surgery, the same five animals were subjected to an additional surgery to assess the presence or absence of blood flow through the vascular loop, and samples were collected for histological analysis. This cycle was performed five times. RESULTS: Of the rats euthanized four to five weeks after the first surgery, no blood flow was observed through the graft in 80% of the cases. In the group euthanized three weeks after the first surgery, no blood flow was observed in 20% of the cases. In the groups euthanized one to two weeks after the first surgery, blood flow through the vascular loop was observed in all animals. Moreover, intimal proliferation tended to increase with the duration of the postoperative period. Two weeks after surgery, intimal proliferation increased slightly, whereas strong intimal proliferation was observed in all rats evaluated five weeks after surgery. CONCLUSION: Intimal proliferation was the most significant change noted in venous grafts as a function of the duration of the postoperative period and was directly correlated with graft occlusion. In cases in which vascular loops are required during free flap reconstruction, both procedures should preferably be performed during the same surgery.

Natural hosts infected with Babesia in Fujian Province, China / 中国人兽共患病学报

We explored the status of Babesia infection in natural hosts in Fujian Province.Rodents in Fujian Province were captured by the night trapping method during 2014-2016.Heart blood samples were collected.At the same time blood samples of ox,goats and dogs were also collected,from which the fragments of 18S rRNA gene of Babesia were amplified by polymerase chain reaction (PCR).Data on infection rate were analyzed with Chi-square or Fisher exact test to indicate statistical significance.Results showed that 5 917 cages were laid and 381 rodents were captured,density of rodent was 6.44％.The o verall Babesia infection rate in rodents was 7.61％,while infection rate in domesticated rodents was 1.68％,and the infection rate in wide rodents was 12.87％.The infection rate was higher in wild rodents than that in domesticated rodents,and the statistical analysis result revealed a significant difference.The infection rates in region of Central Fujian and Eastern Fujian was high,and no infection was found in Southern Fujian region.The statistical analysis result revealed a significant difference in infection rate among different regions.The infection rate of goats and dogs were determined to be 1.79 ％ and 0.55 ％,and no infection was found in ox.The infection rate was higher in rodents than that in other host animals,and the statistical analysis result revealed a significant difference.It is suggested that the rodents,especially the wide rodents are the main natural hosts of Babesia.

Natural hosts infected with Babesia in Fujian Province, China / 中国人兽共患病学报

We explored the status of Babesia infection in natural hosts in Fujian Province.Rodents in Fujian Province were captured by the night trapping method during 2014-2016.Heart blood samples were collected.At the same time blood samples of ox,goats and dogs were also collected,from which the fragments of 18S rRNA gene of Babesia were amplified by polymerase chain reaction (PCR).Data on infection rate were analyzed with Chi-square or Fisher exact test to indicate statistical significance.Results showed that 5 917 cages were laid and 381 rodents were captured,density of rodent was 6.44％.The o verall Babesia infection rate in rodents was 7.61％,while infection rate in domesticated rodents was 1.68％,and the infection rate in wide rodents was 12.87％.The infection rate was higher in wild rodents than that in domesticated rodents,and the statistical analysis result revealed a significant difference.The infection rates in region of Central Fujian and Eastern Fujian was high,and no infection was found in Southern Fujian region.The statistical analysis result revealed a significant difference in infection rate among different regions.The infection rate of goats and dogs were determined to be 1.79 ％ and 0.55 ％,and no infection was found in ox.The infection rate was higher in rodents than that in other host animals,and the statistical analysis result revealed a significant difference.It is suggested that the rodents,especially the wide rodents are the main natural hosts of Babesia.

Advance and review: implant-abutment microgap / 中华口腔医学杂志

Implant-abutment microgap (IAM) exists in two-piece implant systems. Researchers have proved that IAM influences success rate of dental implants in the long term. The relationship between IAM and the biological, mechanical complication of dental implants has been proven in some studies. Implant-abutment connection type, abutment material and insertion torque may all have impact on IAM size. On the other hand, ways to reduce or seal this gap are discussed in some literature. The relationship between IAM and bacteria colonization, long-term implantation complication and its influencing factors are discussed in this review.

COMPARATIVE STUDY OF MICROANASTOMOSIS WITH DISTINCT 10-0 NYLON SUTURES IN RATS

ABSTRACT Objective: The aim of this study is to compare micro-sutures commonly used in our midst. Methods: In this double-blind study, 30 Wistar rats were operated randomly divided into three groups matched according to the suture used (Nylon 10-0, 75micron, brands Microsuture(r), Polysuture(r) and Ethicon(r)). We analyzed the number of surgical nodes required, bleeding, surgical time and histological evaluation. Results: There was no significant difference between the amount of stitches of arterial suture per anastomosis. Surgical time was longer in Microsuture(r) group as compared to Polysuture(r) (p ≤ 0.05). Bleeding in Microsuture(r) group was higher when compared to the others (p <0.01). In the histological analysis, the Microsuture(r) group showed a greater tendency to develop fibrosis and aneurysm in surgical site than the others (p <0.01 and p≤0,05, respectively). Similarly, the Ethicon(r) group showed less tendency to myointimal proliferation than the rest. (p = 0.025). Conclusion: The results confirm the relevance of the choice of surgical thread as an independent determining factor for the success of the procedure, besides serving as a rational subsidy for a better cost-benefit analysis. Level of Evidence I, Experimental Study, Controlled Animal Study.

Study on biomimetic mineralization of lipopolysaccharide-amine nanopolymersomes/hyaluronic acid polyelectrolyte films on titanium surface / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To explore biomimetic mineralization of polyelectrolyte multilayer films (PEM) of gene-loaded lipopolysaccharide-amine nanopolymersomes/hyaluronic acid self assembled on titanium surface.</p><p><b>METHODS</b>Via lay-by-layer self assembly technology, PEM were constructed on titanium or quartz surface using bone morphogenetic protein-2(BMP-2) plasmid-loaded lipopolysaccharide-amine nanopolymersomes(pLNP) as a polycation, and hyaluronic acid(HA) as a polyanion. The constructed PEM were defined as substrate-pLNP-(HA-pLNP)n, where a successive deposition of HA and pLNP on substrate surface was defined as one assembly cycle, and n was the cycle number. Biomimetic mineralization on surfaces of Ti-pLNP-(HA-pLNP)4(Group A, with outermost layer of pLNP), Ti-pLNP-(HA-pLNP)4.5(Group B, with outermost layer of HA), blank control(polished titanium, Ti) and alkaline-heat treated titanium(Ti-OH) were investigated. The biomimetic mineralization was analyzed by observing the topography under field-emisssion electron microscopy(FE-SEM), characterizing the surface chemical structure and components via X-ray diffractometer(XRD) and X-ray energy disperse spectroscopy(EDS).</p><p><b>RESULTS</b>For experiment groups, XRD analysis showed that the diffraction peak of hydroxyapatite appeared, and its intensity was higher than that for Ti group. FE-SEM images showed that its surface was homogeneously covered by discrete agglomerate of big particles. EDS spectra showed that the percentage of Ca and P were 77.24% and 64.23%, and these were much higher than those in Ti group.</p><p><b>CONCLUSIONS</b>The surface of Ti-pLNP-(HA-pLNP)n is favorable for in vitro biomimetic mineralization.</p>

Effect of stiffness of polyelectrolyte multilayer on titanium surface on bacterium adhesion / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To provide a theoretical basis for surface modification of titanium implants, the effects of the stiffness of polyelectrolyte multilayer films on titanium surface on bacterium adhesion was explored.</p><p><b>METHODS</b>Via layer-by-layer technique, catechol functionalized polyelectrolyte multilayer film (cPEM) was constructed on titanium surface by using catechol functionalized hyaluronic acid (cHA) and lipopolysaccharide-amine nanopolymersomes (NP). The stiffness of cPEM was controlled by adjusting the catechol substitution degree of cHA (5%, 10%, 20%, 30%, 40%, 50%, 60%, 70%). Titanium samples covered with cPEM were selected as test group, and the cPEM was constructed with the lowest, medium and highest stiffness. The polished titanium was used as a control. The surface topography of titanium before and after film construction was observed by scanning electron microscopy (SEM). At 1 and 24 h after incubation, the adhesion and clonal formation of Streptococcus mutans (S. mutans) on different titanium surfaces were quantified, and their morphology and survival status were observed by SEM and laser scanning confocal microscope (LSCM).</p><p><b>RESULTS</b>When the catechol grafting ratio was 5%, 30% and 70%, the lowest, medium and highest cPEM stiffness were obtained, and the cPEM stiffness were (10.69±4.54) GPa(cPEM-L), (20.99± 5.81) GPa (cPEM-M) and (32.57±6.93) GPa (cPEM-H) respectively, and the stiffness of polished titanium was (107.12±8.68) GPa (P<0.05). SEM observation showed that after cPEM coating, the titanium surface became smoother. After incubation for 1 and 24 h, the amount of adhesion and clonal formation of S. mutans on cPEM were higher than those on control titanium, and the difference was statistically significant (P<0.05). SEM images showed that for 1 h incubation, softer surfaces were beneficial for S. mutans adhering and agglomerating, while this difference nearly disappeared at 24 h. Observation under LSCM revealed that most of bacteria were alive on titanium disks at 1 h, and their amount decreased with the increase of stiffness. At 24 h, the living/dead bacterium ratios on cPEM-L and control titanium was higher than that on cPEM-M and cPEM-H, and cPEM-L surface was dominated by living bacteria, while stiffer cPEM-M and cPEM-H had more dead bacteria than living bacteria.</p><p><b>CONCLUSIONS</b>Increasing the stiffness of polyelectrolyte films on titanium limits the adhesion of S. mutans. As an independent factor, stiffness influences the bacterium adhesion.</p>

Observations on the Therapeutic Effect of Acupuncture on Tourette's Syndrome / 上海针灸杂志

ObjectiveTo investigate the clinical efficacy of acupuncture in treating Tourette's syndrome.MethodEighty patients were allocated, using a random number table, to a treatment group of 40 cases and a control group of 40 cases. The treatment group received acupuncture and the control group, Western drug treatment.ResultThe YGTSS score decreased significantly in the two groups of patients after treatment(P<0.01). After treatment, the range of decrease in the YGTSS tic score was larger in the treatment group than in the control group; there was a statistically significant difference (P<0.05). The total efficacy rate was higher in the treatment group than in the control group (P<0.05). The incidences of adverse reactions were significantly lower in the treatment group than in the control group.ConclusionThe effect and safety of treatment for Tourette's syndrome are higher in the treatment group than in the control group.

Effect of ultraviolet-photofunctionalization of titanium on protein adsorption and competition / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To study the adsorption behavior of bovine serum albumin (BSA) and fibrinogen (Fg) and the competition of them on titanium before and after ultraviolet (UV)-photofunctionalization, and to provide the evidence of photofunctionalization on the surface modification of titanium implants.</p><p><b>METHODS</b>Titanium disks and sensors of quartz crystal microbalance-D (QCM-D) were stored and sealed in the dark for 4 weeks before being divided into two groups, namely the UV-treated group and control group. Samples in the UV-treated group were treated with UV rays for 48 hours. Then the Fg adsorbing property of disks in both groups was tested at 1, 12 and 24 h. Protein films of Fg and BSA formed on QCM sensors after 1 h incubation were imaged via atomic force microscopy (AFM). Then with QCM-D, for both surfaces the adsorption of Fg and BSA as well as the competition between them was tested by introducing proteins with different sequences.</p><p><b>RESULTS</b>After being incubated for 1 and 12 h, UV-treated group attracted more Fg[(0.250 ± 0.005) and (0.172 ± 0.006) mg] than control group did [(0.207 ± 0.004) and (0.144 ± 0.004) mg] (P < 0.05). However, after 24 h incubation, Fg residual on the UV-treated group [(0.080 ± 0.003) mg] was smaller than that in the control group [(0.127 ± 0.004) mg] (P < 0.05). AFM showed protein clustered more densely on UV-treated surfaces than control surfaces and QCM displayed the same result. In addition, when Fg was introduced into QCM-D after BSA, the mass of protein film increased on both surfaces. However, when BSA was introduced after Fg, the mass of protein film on the control group had no change, but slightly decrease on the UV-treated group.</p><p><b>CONCLUSIONS</b>UV-photofunctionalization promotes protein adsorption but has no influence on the competition between Fg and BSA.</p>

Comparison of platelet adhesion behavior on pure titanium surfaces modified by different techniques / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the platelet adhesion ability on pure titanium surfaces modified with different techniques.</p><p><b>METHODS</b>Pure titanium specimens were treated with 5 different surface modification techniques, including machine polish (MP), dual acid-etch (DAE), sand blast-large grit and acid-etch (SLA), micro-arc oxidation (MAO) and anodized titania nanotube (TNT). The surface topographies of specimens were observed by scanning electron microscopy (SEM). Chemical compositions, surface roughness and static water contact angle of specimens were detected by energy dispersive spectrometer (EDS), laser scanning confocal microscope (LSCM) and contact angle analyzer respectively. Platelets were cultured on specimen surfaces for 30 min. The amount and viability of adhered platelets adhered were evaluated. Platelet distribution and morphology were observed by LSCM and SEM.</p><p><b>RESULTS</b>Surface topographies of the five groups of specimens differed significantly. MP, DAE, SLA and MAO surfaces showed micro-scale topographies, while TNT surfaces showed nano-scale topography with nanotubes at the diameter of (80.46 ± 0.35) nm. The surface roughness of MAO was the highest among the 5 groups. TNT surfaces demonstrated the lowest roughness as well as the lowest static water contact angle as 13.55° ± 0.96°. The amount of platelets adhered on TNT surface was the greatest as (300 729 ± 8 325) platelet/µl and the viability was the highest (A450 value 2.14 ± 0.05). Platelet adhered intensively on TNT surfaces, forming pseudopodia, extending and connecting with each other.</p><p><b>CONCLUSIONS</b>Surface properties of pure titanium affect platelet adhesion ability. Nano-scale topography can greatly improve platelet adhesion. Increased surface roughness and hydrophilicity can improve platelet adhesion ability.</p>

Meta Analysis of the Association of Polymorphism in IL-28B Gene and Virological Response to Interferon in HBeAg-positive Chronic Hepatitis B / 中国医科大学学报

Objective To explore the association between the polymorphism in IL-28B gene and the interferon virological response in HBeAg-posi-tive chronic hepatitis B patients. Methods A literature search was performed on PubMed,web of Science,China Bio Medicine(CBM)and wan-Fang database. The references was screened with the inclusion and exclusion criteria,and then data were extracted and methodological quality of the studies was judged. Statistical analysis was carried out with RevMan 5.3 and STATA 11.0. Results Totally 7 publications were recruited for the study,including 1 345 patients. The meta-analysis showed that there was no significant difference of interferon response between HBeAg-positive chronic hepatitis B patients with rs8099917TG/GG alleles and rs8099917TT alleles (P= 0.20). There was no statistical difference between Rs12979860CC and CT/TT allele for the sustained virological response(P=0.75). Conclusion Our current meta-analysis suggests that there was no correlation of rs8099917,rs12979860 polymorphism in IL-28B with the sustained virological response to interferon in HBeAg-positive chronic hepatitis b.