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Objective:To systematically review the profile of lymph node dissection (LND) for patients with intrahepatic cholangiocarcinoma (ICC) in China.Methods:Using the key words "intrahepatic cholangiocarcinoma" "intrahepatic cholangiocellular carcinoma" "lymph node dissection" "lymphadenec-tomy" "lymph node metastasis", the databases including China Zhiwang, Wanfang, Weipu, Sinomed, PubMed, Embase, Web of Science, Scopus, Cochrane Library were systematically searched. Cohort studies or randomized controlled clinical trials with intraoperative LND documentation and with analysis on the clinicopathologic characteristics or prognostic influences on patients with ICC were included into this meta-analysis from the date of database creation to April 20, 2022. The risk of bias in non-randomized controlled trials was evaluated using the Newcastle-Ottawa scale. A meta-analysis of preoperative imaging lymph node enlargement rates, LND rates, and pathological lymph node metastasis rates were performed using R software.Results:Thirty-three relevant studies that met the systematic evaluation criteria were included, all of which were retrospective cohort studies. All these publications were of medium to high quality. Patients’ enrollment ranged from 1993 to 2020. Patients were enrolled from 20 provinces/autonomous regions/municipalities with a total of 39 medical centers and 4 278 patients. The meta-analysis indicated that the LND rate, preoperative imaging lymph node enlargement rate, pathological lymph node metastasis rate were 47.8%(95% CI: 41.3%-54.3%), 18.5%(95% CI: 7.5%-29.6%) and 51.2%(95% CI: 43.8%-58.6%), respectively. Subgroup analysis showed the LND rate was 36.0%(95% CI: 27.0%-45.0%) in studies with a median year of enrollment before 2010, 48.3% (95% CI: 38.1%-58.6%) in studies from 2010 to 2017, and 53.3%(95% CI: 43.3%-63.2%) in studies after 2017. The LND rates were statistically different in the studies in the different periods of patient enrollment ( P=0.032). Conclusion:The meta-analysis indicated that the overall LND rate for ICC in China was not high but showed an increasing tendency.
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Objective:To study the efficacy of endoscopic papillary balloon dilatation (EPBD) in the treatment of non-dilated small choledocholithiasis.Methods:Clinical data of 142 patients with non-dilated small choledocholithiasis admitted to Zhanjiang Central People's Hospital from April 2021 to March 2023 were retrospectively analyzed, including 63 males and 79 females, aged (55.1±15.4) years old. Patients were divided into the EPBD group ( n=63) and endoscopic sphincterotomy (EST) group ( n=79). Blood amylase, liver enzymology, liver metabolism, and blood routine were monitored before and 48 hours after treatment. The occurrences of intraoperative bleeding, perforation, post-ERCP pancreatitis (PEP), and cholangitis were compared between the groups. Patients were followed up and screened for stone recurrence by outpatient review 3 to 12 months from discharge. Results:Compared to preoperative data, the white blood cell count, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bili-rubin, and direct bilirubin decreased 48 hours after treatment (all P<0.05). The operation time in EPBD group was slightly longer than that in EST group [(43.1±5.9) min vs. (38.5±4.5) min, P=0.064] without statistical significance. There were no case of perforation in both groups. The incidences of intraopera-tive bleeding [3.17%(2/63) vs. 6.33%(5/79)], PEP [17.46%(11/63) vs. 10.53%(8/79)], and postoperative cholangitis [4.76%(3/63) vs. 1.27%(1/79)] were comparable between the groups (all P>0.05). Conclusion:EPBD could be feasible for non-dilated small choledocholithiasis, which does not increase the operation time and incidence of adverse events compared to EST.
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@#Objective To analyze the characteristics of the muscle strength around the knee joint of chondromalacia patellae patients, and to explore the difference with normal people.Methods In March, 2021, 70 knee-onset chondromalacia patellae patients (experimental group) and 35 normal people (control group) were measured isokinetic muscle strength of flexion and extension of knee in angular velocities of 60°/s and 180°/s.Results At 60°/s and 180°/s, the peak torque, the peak torque-to-weight ratio and the total work of the flexor and extensor muscles on the affected side in the experimental group were lower than that of the control group (U > 1097.0, P<0.001). The peak torque, the peak torque-to-weight ratio and the total work of the flexor and extensor muscles at 60°/s and extensor muscles at 180°/s were lower on the affected side than on the healthy side in the experimental group (|Z| > 2.121, P<0.05). The peak torque ratios at 60°/s and 180°/s were more in the affected knees than in the healthy knees of experimental group and in the control group (U > 1810.0, |Z| >3.691, P<0.01).Conclusion The explosive force and endurance of the knee flexor and extensor has weakened in patients with chondromalacia patellae, and there is imbalance in knee joint muscle strength.
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Objective: To analyze the facial profile of the patients with congenitally missing 2 mandibular incisors, and to investigate the changes of facial profile of the patients before and after orthodontic treatment by extraction of 2 maxillary premolars. Methods: The cephalometrics of 64 patients with congenitally missing 2 mandibular incisors were collected. The initial cephalometrics of 64 patients were used to characterize the facial profile. A total of 38 cases among all the 64 patients underwent the orthodontic treatment by extraction of 2 maxillary premolars, and the initial and final cephalometrics were used to compare the changes of facial profile before and after treatment. The cephalometric measurement (including hard tissue and soft tissue items) was performed and the results were analyzed statistically. Results: Compared with the normal values, the overjet, overbite, ANB, U1-NA angle, face angle, Y axis, Pg-NB, face convexity, soft tissue facial angle, H angle, and men to labial sulcus to H-Line in the patients with congenitally missing 2 mandibular incisors were increase d, SNB, L1-NB angle, L1-NB distance, L1-MP, occlusal plane angle, mentolabial sulcus angle were decreased, and the differences were statistically significant (P<0. 05). After orthodontic extraction treatment, the overjet, overbite, U1-NA angle, U1-NA distance, U1-SN, H angle, and subnasale to H-Line of the patients were decreased, the L1-NB angle, L1-NB distance, L1-MP, occlusal plane angle, Pg-NB, and mentolabial sulcus angle were increased; the differences were statistically significant (P<0. 05). Conclusion: The mandibular development is insufficient but the chin development is adequate in the patients with congenitally missing 2 mandibular incisors, with larger overjet and overbite, lingually inclined mandibular incisors, deeper and sharper mentolabial sulcus. After treatment by extraction of 2 maxillary premolars, the overall appearance of the lateral profile of the patients remains unchanged, but the occlusion of anterior teeth is significantly improved.
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Objective SIV30 protein of simian immunodeficiency virus(SIV)was prepared by genetic engineering technique as an antigen diagnostic reagent, to establish an immune comb method for the specific detection of anti SIV IgG in monkey serum. Methods Recombinant expression plasmid of SIV SIV30 gene was constructed by prokaryotic expression vector pGEX-4T-1, and expressed in the competent BL21 cells. The recombinant protein was purified as a diagnostic antigen, and a standardized procedure for the detection of immune comb was established and applied for clinical detection. Results The optimum coating amount of antigen was 0.02 mg/mL. The prepared IC was able to specifically detect the positive serum of SIV. There was no cross reaction between the sera of other viruses. It showed a high specificity of the detection method. Sensitivity analysis showed that the SIV30 protein was able to detect 1:400 times diluted SIV positive sera. The result of stability and repeatability test(the same sample was repeated 3 times) showed that the coefficient of variation(CV)was less than 10%. The serum samples of 10 suspicious monkeys were detected by this method, showing a consistent rate of comb method and ELISA test result of 100%, Kappa =1.000. Conclusions SIV30 protein is expressed in prokaryotic cells. The immune comb is prepared,and is successfullyl applied in clinical examination. It shows that the method has a high sensitivity, strong specificity, good reproducibility and practicability.
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Objective:To prepare the multilayer alginate chitosan microspheres loading vascular endothelial growth factor (VEGF) and vancomycin (VAN), and to study in vitro release characteristics.Methods:The microspheres were prepared by emulsion cross-linking and self-assembly techniques.The effects of sodium alginate concentration, calcium chloride concentration, oil/water ratio and span80 concentration on the entrapment efficiency(EE) and drug loading(DL) of VEGF and VAN were investigated by orthogonal experimental design to optimize the preparation process.The surface morphology and particle size of microspheres were observed by scanning electron microscope (SEM).Self-assembly was detected by Fourier transform infrared spectroscope (FTIR).The EE, DL and in vitro release of VEGF and VAN were detected by ELISA double antibody sandwich method and ultraviolet spectrophotometry,and the cumulative release curve was drawn.Results:The prepared microspheres were yellowish brown powder.The SEM results showed that the microspheres were spherical, the surface was smoothy, and the dispersity was better.The average particle size was about 50 μm.Sodium alginate concentration of 1.0 g·mL-1, CaCl2 concentration of 8 g·mL-1, oil to water ratio of 3∶1, and span80 concentration of 2% were the best formula.The EE of VEGF and VAN were 49.63% and 16.67%, respectively.In vitro, the cumulative release last 16.5 d and 12.5 d respectively and the amount reached up to 95%.Conclusion:The multilayer alginate chitosan microspheres loading VEGF and VAN present several advantages, such as smaller particle size, higher EE and better controlled release.
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Objective:To observe the clinical effects of split post crown and split post-core crown in restoring the molars with low occlusogingival distance and large root furcation,and to clarify its advantages and analyze its improvement methods.Methods:Forty-nine molars of twenty-nine patients,which had been completely treated with root canal therapy,were restored by split post crown or split post-core crown according to their wills.Split post crown was used in twenty-three cases,and split post core crown was applied in the other twenty-six cases.The clinical effects of the patients in two groups were observed after 12 and 24 months follow-up.The levels of MMP-8 in gingival crevicular fluid were checked and compared 12 months after restoration.Results:The restoration success rates of split post crown were 95.7% after 12-month treatment and 82.6 % after 24-month treatment,respectively;there was no significant difference between them (P> 0.05).The success rates of split post-core crown were 84.6% after 12-month treatment and 52.2% after 24-month treatment,respectively;there was significant difference between them (P<0.05).The success rate of split post crown was significantly higher than that of split post-core crown after 24-month treatment (P<0.05).The levels of MMP-8 in gingival crevicular fluid of the patients were close to each other,there was no statistical significance (P>0.05).Conclusion;The split post crown shows better clinical effect in restoring the molars with low occlusogingival distance in 24 months than split postcore crown.Targeted improvement will help to improve the clinical success rate.
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Objective:To observe the clinical effects of split post crown and split post-core crown in restoring the molars with low occlusogingival distance and large root furcation,and to clarify its advantages and analyze its improvement methods.Methods:Forty-nine molars of twenty-nine patients,which had been completely treated with root canal therapy,were restored by split post crown or split post-core crown according to their wills.Split post crown was used in twenty-three cases,and split post core crown was applied in the other twenty-six cases.The clinical effects of the patients in two groups were observed after 12 and 24 months follow-up.The levels of MMP-8 in gingival crevicular fluid were checked and compared 12 months after restoration.Results:The restoration success rates of split post crown were 95.7% after 12-month treatment and 82.6 % after 24-month treatment,respectively;there was no significant difference between them (P> 0.05).The success rates of split post-core crown were 84.6% after 12-month treatment and 52.2% after 24-month treatment,respectively;there was significant difference between them (P<0.05).The success rate of split post crown was significantly higher than that of split post-core crown after 24-month treatment (P<0.05).The levels of MMP-8 in gingival crevicular fluid of the patients were close to each other,there was no statistical significance (P>0.05).Conclusion;The split post crown shows better clinical effect in restoring the molars with low occlusogingival distance in 24 months than split postcore crown.Targeted improvement will help to improve the clinical success rate.
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Objective:To study the changes of oral health indexes in adolescent orthodontic patients under different brushing time, and to provide basis for the orthodontists to give effective dental health promotion in clinic.Methods:A total of 123 adolescent orthodontic patients were included, and they were divided into 1-3min, 3-5 min, 5-7 min and 7-10 min groups based on the brushing time recorded in the period of orthodontic treatment.The relationship between different brushing time and oral health indexes was evaluated 1,3,and 6 months after experiment, such as sulcus bleeding index(SBI),plaque index(PLI), debris index-simplified(DI-S) and enamel demineralization index(EDI).Results:Compared with 1-3 min and 3-5 min groups, the SBI, PLI, and DI-S of the patients in 5-7 min group were significantly reduced(P0.05).Conclusion:Brushing teeth more than 5 min can improve the oral hygiene significantly and the best time is 5-7 min;the orthodontists should require the patients to brush teeth at least for 5 min.
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Objective:To study the expression characteristics of Dickkopf1 (DKK1) in different time and space during tooth development of the postnatal mice, and to provide the theoretical basis for clarifying the mechanism of Wnt signaling pathway in regulating the tooth development.Methods:The postnatal Kunming mice at days 0.5, 6.5, 12.5, 18.5, 24.5, and 30.5 respectively after birth were selected and divided into various groups by time,three in each group.The mice in each group were sacrificed and the paraffin sections of mandibular bone including the first molar were prepared at the thickness of 5 μm, followed by HE staining and immunohistochemical staining in order to detect the expressions of DKK1 in tooth tissue and periodontal tissue.Results:At 0.5 d after birth, the mandibular first molar tooth germ was in the bell stage.At 6.5 d the enamel development of mandibular first molar was almost completed, and the epithelium root sheath extended to the root direction.At 12.5 d the dentin development of crown was completed, with the root formatted about 1/3. At 18.5 d the root had formatted about 2/3.At 24.5 d the root had reached the full length.At 30.5 d the apical foramen was narrow, and the root development was basically completed.There was no DKK1 expression at 0.5 d, but it expressed in the odontoblasts and predentin at 6.5 d. From days 12.5 to 30.5,the expressions of DKK1 were positive in periodontal ligament, alveolar bone, and cellular cementum as odontoblasts, which were gradually increased with the prolongation of time.However, no expression of DKK1 was detected in the pulp.Conclusion:DKK1 shows regular expressions at different tooth developmental stages after birth, suggesting its potential role in the growth of dentin and periodontal tissues.
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Objective:To investigate the influence of multilayer alginate chitosan sustained-release microspheres loading vascular endothelial growth factor(VEGF) and vancomycin in the proliferation and osteogenic differentiation of human plaacenta-derived mesen chymal stem cells(HPMSCs),and to provide theoretical basis for its clinical application in the repair of bone defect.Methods:The microspheres were prepared based on the previous research and HPMSCs were co-cultured with drug (VEGF/vancomycin)-loaded microspheres (drug-loaded microspheres+HPMSCs group), non-drug loaded microspheres (microspheres+HPMSCs group) and without any microspheres (HPMSCs group).Then the proliferation rate of HPMSCs was identified by CCK-8 kit.The osteogenic differentiation potential of HPMSCs was detected by Alizarin red staining and alkaline phosphatase (ALP) kit when the HPMSCs had been co-cultured with drug loaded microspheres in osteogenic medium (HPMSCs+drug-loaded microspheres+induction group), non-drug loaded microspheres in osteogenic medium (HPMSCs+microspheres+induction group), without any microspheres in osteogenic medium (HPMSCs+induction group) and without any micropheres in normal medium (HPMSCs+PBS group) for 21 d.Results:Compared with HPMSCs group,the proliferation rates of HPMSCs in drug-loaded microspheres+HPMSCs and microspheres+HPMSCs groups had no significant changes (P>0.05).The calcium deposition in HPMSCs+drug-loaded microspheres+induction group was more than those in microspheress+HPMSCs+indution group and HPMSCs+induction group after Aalizarin red staining;the ALP activity in drug-loaded microspheres+HPMSCs+indution group was higher than those in microspheres+HPMSCs+indution group and HPMSCs+induction group (P<0.05),and the ALP activity in microspheres+HPMSCs+induction group was higher than that in HPMSCs+induction group(P<0.05).Conclusion:The sustained-release microspheres loading VEGF and vancomycin have no significant effect on the proliferation activity of HPMSCs and the microspheres could stimulate the osteogenic differentiation of HPMSCs.
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Objective:To investigate the effects of ursolic acid (UA) on the proliferation and differentiation of osteoclasts (OC), and to explore its role in orthodontic force-induced root resorption and its relationship with OC.Methods:The mononuclear / macrophage cells RAW264.7 were induced to the OC.Tacrolimus acid phosphatase (TRAP) staining and bone resorption lacunae observation were used to identify the induction.CCK-8 method was used to select the appropriate concentration of UA for RAW264.7 cell-free biotoxicity and to observe its effect on the proliferation and differentiation of RAW264.7.In experimental groups, UA with gradient concentrations (1.0,2.5,5.0,10.0,20.0and 40.0 μmol·L-1)were added.UA was not added in control group.Results:The TRAP staining and bone resorption lacunae observation showed that after the RAW264.7 cells were induced for 5 d, the TRAP staining positive cells were found;the resorption lacunae were rounded,and oval, etc,the bottom wall was coarser,and the boundary was clear,which indicated that the RAW264.7 cells were successfully differentiated into the osteoclasts.The CCK-8 detection results showed that high concentration of UA (> 10.0 μmol·L-1) significantly inhibited the proliferation of OC;the appropriate concentration of UA (5.0 μmol·L-1) was in the biological safety concentration range and could inhibit the OC proliferation;low concentration of UA (<2.5 μmol·L-1) had no effect.Conclusion:RANKL can induce the differentiation and maturation of RAW264.7 cells.UA is correlated with the proliferation and differentiation of OC;UA has inhibitory effect on OC at the appropriate concentration (5.0 μmol·L-1) in a time-dependent manner.
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Objective:To make the fixed partial dentures with different materials and the magnetic resonance imaging (MRI)examination of head and neck was carried out to investigate the effects of fixed partial dentures on MRI.Methods:A qualified volunteer was recruited,who was conventionally restored using fixed partial denture. Co-Cr alloy,Au-Pt alloy and Zirconia were chosen as the inner crown materials,respectively.Three kinds of fixed partial dentures were put into the mouth of patient,and 2 kinds of MRI scan sequences (T1-TSE and T2-TSE) were performed.The scanning images without restorations were used as controls.The change of shape,image signal and involving layers of artifacts of different materials in three groups were observed.The maximum diameter of artifact of three materials in coronal, sagittal and axial images were detected. The safeties of fixed partial dentures were observed. Results: The artifacts were found in all the restorations and showed the changes of strengthen and weaken of the signal and the changs of shapes of images.The range of artifacts was the largest in the involved central plane and varied in sagittal,coronal and axial images. The number of involving layers of artifacts in Co-Cr alloy group was significantly more than those in Au-Pt alloy and Zirconia groups;the artifacts were limited in the repaired lateral maxillofacial region without the cervical spine and head region involvement.The artifacts in Co-Cr alloy group involved or slightly involved in all adjacent tissues,and the artifacts in Au-Pt alloy and Zirconia groups only slightly affected the mandibular teeth,lingual muscles and maxillary crowns.The maximum diameter of artifacts in Co-Cr alloy group was larger than those in Au-Pt alloy group and Zirconia group (P <0.05). No displacement was found in the prosthesis,and the patient had no discomfort.Conclusion:The artifact of the fixed partial denture can be seen in MRI examination.Co-Cr alloy or zirconia can significantly reduce the effect of artifact.Fixed adhesive prosthesis in mouth does not affect the safety of MRI examination.
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AIM: To explore the immunotheraptical drugs for multi-drug resistant pulmonary tuberculosis (MDR-TB). METHODS: 79 patients with MDR-TB were randomly assigned to two groups. 46 cases in M.vaccae group were treated with "3AkPaThLevL/15PaThLevL" and M. vaccae, and 33 cases in control group were treated only with "3AkPaThLevL/15PaThLevL". The clinical effect and T-lymphocyte subsets in patients were observed after being treated for 1,2 and 3 months, respectively. RESULTS: The sputum negative rates ((41.3)%, (63.0)%, and (80.4)%) and the X-ray resolution rates ((30.4)%, (50.0)%, and (67.4)%) of the M.vaccae group were superior to those ((12.1)%, (27.3)%, and (39.4)%, P
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OBJECTIVE:To observe the hepatoprotective effect of compound glycyrrhizin in treating patients with multidrug resistant pulmonary tuberculosis(MDR-TB).METHODS:A total of 68 MDR-TB cases were enrolled:36(treatment group) were randomly assigned to receive additional glycyrrhizin,and 32(control group) to receive additional glucurolactone and legalon,the hepatoprotective effects and side effects between 2 groups were compared before and after treatment.RESULTS:The total effective rates of the treatment group and the control group were 94.4% and 62.5%,respectively 1month after hepatoprotective treatment,and significant difference was noted between 2 groups(P0.05).CONCLUSION:Compound glycyrrhizin has a reliable hepatoprotective efficacy and few adverse drug reactions in treating MDR-TB patients complicating with lesion of liver function.