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Multiple signaling pathways are involved in the regulation of cell proliferation and differentiation in odontogenesis and dental tissue renewal, but the details of these mechanisms remain unknown. Here, we investigated the expression patterns of a transcription factor, Krüppel-like factor 6 (KLF6), during the development of murine tooth germ and its function in odontoblastic differentiation. KLF6 was almost ubiquitously expressed in odontoblasts at various stages, and it was co-expressed with P21 (to varying degrees) in mouse dental germ. To determine the function of Klf6, overexpression and knockdown experiments were performed in a mouse dental papilla cell line (iMDP-3). Klf6 functioned as a promoter of odontoblastic differentiation and inhibited the proliferation and cell cycle progression of iMDP-3 through p21 upregulation. Dual-luciferase reporter assay and chromatin immunoprecipitation showed that Klf6 directly activates p21 transcription. Additionally, the in vivo study showed that KLF6 and P21 were also co-expressed in odontoblasts around the reparative dentin. In conclusion, Klf6 regulates the transcriptional activity of p21, thus promoting the cell proliferation to odontoblastic differentiation transition in vitro. This study provides a theoretical basis for odontoblast differentiation and the formation of reparative dentine regeneration.
Subject(s)
Animals , Mice , Cell Differentiation/physiology , Cell Proliferation , Odontoblasts/metabolism , Odontogenesis , Tooth GermABSTRACT
Objective:To review and analyze the clinical experience of children with aortic valve stenosis and/or insufficiency treated with autologous pulmonary valve for aortic valve replacement procedure(Ross operation) with ePTFE artificial valve for right ventricular outflow tract reconstruction.Methods:From 2015 to 2020, 8 cases of aortic stenosis and/or aortic insufficiency treated by Ross operation in our center were collected, with an age of 0.5-13.2 years old. 4 cases of aortic stenosis were diagnosed preoperatively, 3 cases of aortic stenosis with aortic insufficiency, and 1 case of infective endocarditis involving the aortic valve. The operation was carried out in three steps: Harvest autologous pulmonary valve; the diseased aortic valve was resected and autologous pulmonary valve was transplanted to the aorta by aortic root transplantation; the right ventricular outflow tract was reconstructed by a handmade ePTFE artificial flap blood vessel.Results:In 6 cases, the right ventricular outflow tract was reconstructed by hand-sewn ePTFE trileaflets, and artificial univalve in 2 cases, no death occurred during operation; all patients were cured and discharged. The patients were followed up for 1 to 36 months, with mean of(12.63±12.19) months. There was no long-term death or valvular complications. During follow-up echocardiography indicated 1 case of moderate aortic regurgitation, 1 case of mild-moderate regurgitation, and moderate regurgitation was found in 2 patients with artificial single pulmonary valve. For the remaining patients, they were mild aortic regurgitation, and a trivial or mild pulmonary artery regurgitation with hand-sewn three-leaflets ePTFE artificial vessel; All patients were followed up at the last time with a peak pressure of(6.63±3.46) mmHg(1 mmHg=0.133 kPa) across the aortic valve. The left ventricular outflow tract and aortic annulus shrank slightly after surgery(the diameter of one patient with Ross-Konno operation increased), but the annulus diameter increased with age. There was no need for further intervention.Conclusion:The Ross operation is safe for the treatment of aortic valve disease, it has good hemodynamic effect, and the autologous pulmonary artery has growth potential, especially suitable for children and young patients. Hand-sewn ePTFE with trileaflet vessels for reconstruction of right ventricular outflow tract performs well in anti-regurgitation function in the short term or may be used as a replacement material for the homograft/heterograft vessel, but longer follow-up and more cases are needed.
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Objective@#To establish a monitoring model of stellate ganglion discharge in rats.@*Methods@#Thirty healthy Sprague-Dawley rats of either sex, aged 6-7 weeks, weighing 230-270 g, were selected.The left stellate ganglion was isolated after anesthesia and hung on the platinum electrode head to observe its electrical signal.Heart rate was recorded immediately after successful anesthesia (T0), immediately after the stellate ganglion was suspended in the electrode head (T1), at 10, 20 and 30 min after the stellate ganglion was suspended in the electrode head (T2-4), the frequency and amplitude of discharge of the stellate ganglion was recorded at T1-4.After recording the nerve electrical signal at T4, the stellate ganglion was locally infiltrated with 0.2% lidocaine 0.2 ml and then the frequency and amplitude of discharge was recorded 5 min later (T5). The occurrence of Horner′s syndrome was considered as a sign of successful block, and the success of block was recorded.@*Results@#There was no significant difference in heart rate at each time point (P>0.05). Paroxysmal clustered and rhythmically regular neuroelectrical activity of stellate ganglion was found at T1-4, and there was no significant difference in the frequency and amplitude of discharge at each time point (P>0.05). The frequency and amplitude of discharge of stellate ganglion were significantly decreased at T5 than at T1-4 (P<0.01).@*Conclusion@#The discharge monitoring model of stellate ganglion is successfully established in rats.
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Objective To establish a monitoring model of stellate ganglion discharge in rats.Methods Thirty healthy Sprague-Dawley rats of either sex,aged 6-7 weeks,weighing 230-270 g,were selected.The left stellate ganglion was isolated after anesthesia and hung on the platinum electrode head to observe its electrical signal.Heart rate was recorded immediately after successful anesthesia (T0),immediately after the stellate ganglion was suspended in the electrode head (Tt),at 10,20 and 30 min after the stellate ganglion was suspended in the electrode head (T2-4),the frequency and amplitude of discharge of the stellate ganglion was recorded at T1-4.After recording the nerve electrical signal at T4,the stellate ganglion was locally infiltrated with 0.2％ lidocaine 0.2 ml and then the frequency and amplitude of discharge was recorded 5 min later (Ts).The occurrence of Horner's syndrome was considered as a sign of successful block,and the success of block was recorded.Results There was no significant difference in heart rate at each time point (P＞0.05).Paroxysmal clustered and rhythmically regular neuroelectrical activity of stellate ganglion was found at T1-4,and there was no significant difference in the frequency and amplitude of discharge at each time point (P＞0.05).The frequency and amplitude of discharge of stellate ganglion were significantly decreased at T5 than at T1-4 (P＜0.01).Conclusion The discharge monitoring model of stellate ganglion is successfully established in rats.
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Objective To compare the effectiveness,safety and comfort of continuous brachial plexus block (BPB) guided by different methods.Methods A total of 189 patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-64 yr,weighing 46-90 kg,undergoing elective internal fixation after elbow fracture under general anesthesia,were divided into 3 groups (n =63 each) using a random number table:ultrasound combined with nerve stimulator-guided axillary approach to continuous BPB group (group A),ultrasound combined with nerve stimulator-guided subclavian coracoid approach to continuous BPB group (group B) and ultrasound-guided subclavian coracoid approach to continuous BPB group (group C).Brachial plexus nerve block was performed with 0.2％ ropivacaine 30 ml,and anesthesia was induced by Ⅳ injection of sufentanil 0.3 μg/kg,propofol 2-3 mg/kg and rocuronium 0.6 mg/kg after confirmation of satisfactory block using the acupuncture method in the three groups.Anesthesia was maintained by inhalation of 1.5％-2.5％ sevoflurane and Ⅳ infusion of propofol 2-4 mg · kg-1 · h-1.Patient-controlled nerve block analgesia was performed after removal of endotracheal tube at the end of surgery.Analgesia solution contained 0.2％ ropivacaine which was diluted to 200 ml in normal saline.Parameter settings were adjusted with background infusion at rate 5 ml/h,5 ml bolus dose and 60 min lockout interval.Analgesia lasted until 72 h after surgery,maintaining a visual analog scale score less than or equal to 3.When the visual analog scale score was more than 3,tramadol 100 mg was intramuscularly injected as a rescue analgesic.Comfort scores,requirement for rescue analgesic within 72 h after surgery,development of pneumothorax,local anesthetic intoxication and intravascular puncture during puncture operation and development of postoperative adverse reactions such as tube shedding,nausea and vomiting and nerve damage were recorded.Results Compared with group A,the comfort score was significantly increased,and the requirement for rescue analgesic was decreased in B and C groups (P＜0.05).Compared with group B,the comfort score was significantly increased (P＜0.05),and no significant change was found in the requirement for rescue analgesic in group C (P＞0.05).There was no significant difference in the incidence of adverse reactions between the three groups (P＞0.05).Conclusion The effectiveness and comfort of subclavian coracoid approach to continuous BPB is better than those of axillary approach,and the comfort of subclavian coracoid approach to continuous BPB under only ultrasound guidance is superior to that under ultrasound combined with nerve stimulator guidance.
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Objective To compare the fascia iliaca compartment block versus femoral nerve 3-in-1 block for postoperative analgesia in elderly patients undergoing hip surgery.Methods A total of 160 patients with hip fracture,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,aged 70-101 yr,weighing 30-93 kg,scheduled for elective total hip replacement or artificial femoral head replacement under general anesthesia,were divided into 2 groups (n =80 each) using a random number table:fascia iliaca compartment block group (FIB group) and femoral nerve 3-in-1 block group (FNB group).Ultrasound-guided fascia iliaca compartment and 3-in-1 blocks were performed with 0.2％ ropivacaine 40 ml in FIB and FNB groups,respectively.Patient-controlled analgesia (PCA) with 0.2％ ropivacaine 275 ml was used for postoperative analgesia until 72 h after operation in both groups.The PCA pump was set up with a 5 ml bolus dose,a 60 min lockout interval and background infusion at a rate of 5 ml/h,and the visual analog scale score was maintained≤4.When the visual analog scale score＞4,tramadol 50-100 mg was taken orally or injected intramuscularly for rescue analgesia.Before implanting the catheter,at 15 min after the initial administration and at 12 h after operation,temperature sensation and light touch sensation tests were performed in the anterior regions of thigh (innervated by femoral nerve),lateral region of thigh (innervated by lateral femoral cutaneous nerve) and superior part of the anterior region of thigh (innervated by obturator nerve).Successful sensory block was defined as the occurrence of a decline in temperature sensation or in light touch sensation in any area,and the successful sensory block was recorded.The requirement for rescue analgesia and patient's satisfaction with analgesia were recorded within 72 h after operation.The development of adverse reactions such as nerve damage,nausea and vomiting,dizziness and palpitation was also recorded within 48 h after operation.Results Compared with group FIB,the rate of successful analgesia in lateral thigh area was significantly decreased at 15 min after the initial adminstration and 12 h after operation,the requirement for rescue analgesia after operation was increased,the rate of satisfactory analgesia after operation was decreased (P＜0.05),and no significant change was found in the incidence of postoperative nausea and vomiting or dizziness in group FNB (P＞0.05).Conclusion Ultrasound-guided continuous fascia iliaca compartment block provides better efficacy for postoperative analgesia than 3-in-1 block in elderly patients undergoing hip surgery.
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Objective To evaluate the efficacy of lateral femoral approach to continuous sciatic nerve block for patient-controlled analgesia after foot and ankle surgery.Methods One hundred American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients of both sexes,aged 18-60 yr,weighing 50-100 kg,with body height of 145-190 cm,scheduled for elective foot and ankle surgery,were divided into 2 groups (u =50 each) using a random number table:patient-controlled nerve block analgesia (PCNA) group and patient-controlled intravenous analgesia (PCIA) group.In group PCNA,the lateral femoral approach to sciatic nerve block was performed under the guidance of ultrasound and a neurostimulator,0.2％ ropivacaine 20 ml was injected after successful location,the catheter was inserted,and 0.2％ ropivacaine 10 ml was injected again.In group PCIA,0.2％ ropivacaine 30 ml was injected after successful location of the sciatic nerve.General anesthesia was performed using laryngeal mask airway in both groups.In group PCNA,PCNA was performed with 0.2％ ropivacaine (diluted to 200 ml in normal saline) at the end of surgery,and the PCNA pump was set up with a 0.5 ml bolus dose,a 15-min lockout interval and background infusion at a rate of 5 ml/h.In group PCIA,PCIA was performed with sufentanil 100 μg,tramadol 500 mg and tropisetron 10 mg (diluted to 200 ml in normal saline) at the end of surgery,and the PCIA pump was set up with a 0.5 ml bolus dose,a 15-min lockout interval and background infusion at a rate of 2 ml/h.The visual analog scale score was maintained≤ 3,and postoperative analgesia lasted until postopera-tive 72 h.When visual analog scale scores ≥ 4,tramadol 100 mg was intramuscularly injected as rescue analgesic.The requirement for rescue analgesia and development of adverse effects such as nausea and vomiting,insomnia,puncture site infection and bleeding were recorded within 72 h after surgery.Results The requirement for rescue analgesia and incidence of nausea and vomiting were significantly lower in group PCNA than in group PCIA (P＜ 0.05).Conclusion The lateral femoral approach to continuous sciatic nerve block can be safely and effectively used for patient-controlled analgesia after foot and ankle surgery.
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Objective To investigate the relationship between bed rest time and development of prethrombotic state in the elderly patients with hip fracture.Methods One hundred and sixty-six patients who stayed in bed after hip fracture,aged ≥65 yr,were divided into 5 groups according to the bed rest time on admission to hospital:bed rest time ＜ 24 h (Ⅰ group,n =61),bed rest time 24-48 h (Ⅱ group,n =29),bed rest time 3-6days (Ⅲ group,n =29),bed rest time 7-14 days (Ⅳ group,n =34),and bed rest time ＞ 14 days (Ⅴ group,n =13).Venous blood samples were collected to measure the platelet count,coagulation function,and concentrations of plasma D-Dimer and serum α-granule membrane protein 140 (GMP-140).The development of abnormality in each index was recorded.The development of deep vein thrombosis in both lower extremities was diagnosed using color Doppler ultrasound in D-Dimer-positive patients.Results Compared with group Ⅰ,the abnormal rate of fibrinogen (Fib) and D-Dimer and serum GMP-140 concentrations were significantly increased in Ⅱ and Ⅲ groups,the abnormal rate of platelet count,Fib and D-Dimer and serum GMP-140 concentrations were increased in lⅣ group,and the abnormal rate of platelet count was increased,and no significant change was found in the serum GMP-140 concentrations and abnormal rate of Fib and D-Dimer in Ⅴ group.Compared with group Ⅱ,the serum GMP-140 concentrations were significantly increased in Ⅲ and Ⅳ groups,the abnormal rate of Fib and D-Dimer was increased in Ⅳ group,and no significant change was found in the abnormal rate of Fib and DDimer in Ⅲ group.The abnormal rate of platelet count was significantly lower in Ⅳ group than in Ⅲ group.Color Doppler Ultrasonography showed no sign of deep vein thrombosis.Conclusion For the elderly patients with hip fracture,the possibility of pre-thrombotic state developed is increased when the bed rest time is more than 24 h,and the patients were classified as high-risk patients when the bed rest time is more than 3 days.