Potential biomarkers for diagnosis and disease evaluation of idiopathic pulmonary fibrosis / 中华医学杂志(英文版)

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease characterized by progressive lung fibrogenesis and histological features of usual interstitial pneumonia. IPF has a poor prognosis and presents a spectrum of disease courses ranging from slow evolving disease to rapid deterioration; thus, a differential diagnosis remains challenging. Several biomarkers have been identified to achieve a differential diagnosis; however, comprehensive reviews are lacking. This review summarizes over 100 biomarkers which can be divided into six categories according to their functions: differentially expressed biomarkers in the IPF compared to healthy controls; biomarkers distinguishing IPF from other types of interstitial lung disease; biomarkers differentiating acute exacerbation of IPF from stable disease; biomarkers predicting disease progression; biomarkers related to disease severity; and biomarkers related to treatment. Specimen used for the diagnosis of IPF included serum, bronchoalveolar lavage fluid, lung tissue, and sputum. IPF-specific biomarkers are of great clinical value for the differential diagnosis of IPF. Currently, the physiological measurements used to evaluate the occurrence of acute exacerbation, disease progression, and disease severity have limitations. Combining physiological measurements with biomarkers may increase the accuracy and sensitivity of diagnosis and disease evaluation of IPF. Most biomarkers described in this review are not routinely used in clinical practice. Future large-scale multicenter studies are required to design and validate suitable biomarker panels that have diagnostic utility for IPF.

Research progress in effect of chewing-side preference on temporomandibular joint and its relationship with temporo-mandibular disorders / 浙江大学学报·医学版

Chewing-side preference is one of the risk factors for temporomandibular disorders (TMD), and people with chewing-side preference is more prone to have short and displaced condyles, increased articular eminence inclination and glenoid fossa depth. The proportion of TMD patients with chewing-side preference is often higher than that of the normal subjects. Clinical studies have shown a strong correlation between chewing-side preference and TMD symptoms and signs; and animal studies have shown that chewing-side preference can affect the growth, development, damage and repair of the mandible. After long-term unilateral mastication, changes in the stress within the joint cause the imbalance of temporomandibular joint (TMJ) structural reconstruction, the transformation and even destruction of the fiber structure of masticatory muscle, resulting in uncoordinated movement of bilateral muscles. The joint neurogenic diseases caused by the increase of neuropeptide substance P and calcitonin-gene-related-peptide (CGRP) released locally by TMJ may be the mechanism of TMD. This article reviews the research progress of the influence of chewing-side preference on the structure of TMJ, the relationship between chewing-side preference and TMD, and the related mechanisms.

Advances of aerobic glycolysis in renal interstitial fibrosis / 中华肾脏病杂志

Aerobic glycolysis is a metabolic process in which cellular energy production favors the low-efficiency energy-producing glycolytic pathway in the presence of sufficient oxygen, reducing dependence on aerobic respiration, while producing energy rapidly and providing advantages for cell survival and proliferation. In recent years, several studies have shown that aerobic glycolysis is involved in the development of renal interstitial fibrosis (RIF) and involves various cell types such as fibroblasts, endothelial cells, renal tubular epithelial cells, pericytes, and inflammatory cells. Drugs targeting glycolysis may provide new ideas for the prevention and treatment of RIF. This article reviews the research progress of abnormal aerobic glycolysis in different cells and glycolytic intervention drugs in RIF.

Role and Mechanism of Lymphoid Enhancer Binding Factor 1 in Renal Interstitial Fibrosis / 医学研究杂志

Objective To investigate the role and mechanism of lymphoid enhancer binding factor 1(LEF1)in renal interstitial fi-brosis.Methods Eighteen C57BL/6 mice were randomly divided into unilateral ureteral obstruction(UUO)3day group,UUO 7day group and sham operation group.The pathological changes of renal tissue were observed by hematoxylin-eosin staining and Masson stai-ning,and the expression of LEF1 was detected by Western blot and immunohistochemistry.Human renal tubular epithelial cells(HK-2)were cultured in vitro,LEF1 was detected by Western blot after treatment with 10ng/ml and 20ng/ml transforming growth factor-β1(TGF-β1)for 24h.HK-2 cells were divided into 4 groups:Ctrl siRNA group,LEF1siRNA group,Ctrl siRNA + TGF-β1group and LEF1siRNA + TGF-β1group.The expression levels of LEF1,fibronectin,α-smooth muscle actin(α-SMA),collagen Ⅰ,E-cad-herin,vimentin,cleaved poly ADP-ribose polymerase(cleaved PARP)and cleaved caspase-3 were detected by Western blot,and the relative expression levels of each protein in the 4groups were compared.Flow cytometry was used to detect the apoptosis rate of each group.Results Tubular dilation,inflammatory cell infiltration and collagen deposition were observed in UUO group.The expression lev-el of LEF1 in UUO group was higher than sham operation group(P<0.05).TGF-β1 could increase LEF1 protein expression in HK-2 cells(P<0.05).LEF1siRNA transfection of HK-2 cells decreased the fibrotic response(P<0.05).The knockdown of LEF1 can alleviate the epithelial-mesenchymal transition(EMT),meanwhile reduced the apoptosis induced by TGF-β1 in HK-2 cells(P<0.05).Conclusion LEF1 can induce renal interstitial fibrosis by promoting EMT and apoptosis of renal tubular epithelial cells.

Clinical characteristics of 103 patients with autosomal dominant polycystic kidney disease / 中华肾脏病杂志

Objective:To explore the clinical characteristics of autosomal dominant polycystic kidney disease (ADPKD).Methods:Clinical data of 103 patients with ADPKD first admitted to Renmin Hospital of Wuhan University from July 2017 to April 2021 were retrospectively analyzed. The clinical characteristics of patients in different renal function stages were analyzed, and multiple linear regression analysis was used to analyze the factors reflecting the severity of the disease.Results:Among the 103 patients with ADPKD, there were 49 males (47.6%), aged (51.23±10.99) years old. The extrarenal manifestation was mainly polycystic liver (64/71). The main clinical symptoms were gross hematuria (25 cases, 24.3%), lumbar distend and pain (37 cases, 35.9%) and hypertension (69 cases, 67.0%), appearing in the whole course of the disease. Early treatment was mainly drug conservative treatments (58 cases, 56.3%), followed by renal cyst aspiration (34 cases, 33.0%), and surgical treatments (11 cases, 10.7%). Patients in chronic kidney disease (CKD) stage 5 were mainly treated with conservative treatments (28/34). Laboratory examination results showed that hemoglobin, platelet, lymphocyte percentage and albumin in CKD stage 4-5 were lower than those in CKD stage 1-3 (all P<0.05) ; prothrombin time (PT), PT-international standardized ratio and plasma osmotic concentration in CKD stage 4-5 were higher than those in CKD stage 1-3 (all P<0.05). Multiple linear regression analysis showed that hemoglobin ( β=0.249, P=0.005), platelet ( β=0.207, P=0.005), lymphocyte percentage ( β=0.305, P<0.001) and plasma osmotic concentration ( β=-0.362, P<0.001) were correlated with estimated glomerular filtration rate. Conclusions:The clinical manifestations of ADPKD patients are hypertension, lumbar distend and pain, and gross hematuria, which can run through the whole stage of CKD. Polycystic liver is more common in extrarenal system. Hemoglobin, platelets, lymphocyte percentage and concentration osmotic concentration may be related to the disease progression of ADPKD.

A hierarchical vascularized engineered bone inspired by intramembranous ossification for mandibular regeneration / 国际口腔科学杂志·英文版

Mandibular defects caused by injuries, tumors, and infections are common and can severely affect mandibular function and the patient's appearance. However, mandible reconstruction with a mandibular bionic structure remains challenging. Inspired by the process of intramembranous ossification in mandibular development, a hierarchical vascularized engineered bone consisting of angiogenesis and osteogenesis modules has been produced. Moreover, the hierarchical vascular network and bone structure generated by these hierarchical vascularized engineered bone modules match the particular anatomical structure of the mandible. The ultra-tough polyion complex has been used as the basic scaffold for hierarchical vascularized engineered bone for ensuring better reconstruction of mandible function. According to the results of in vivo experiments, the bone regenerated using hierarchical vascularized engineered bone is similar to the natural mandibular bone in terms of morphology and genomics. The sonic hedgehog signaling pathway is specifically activated in hierarchical vascularized engineered bone, indicating that the new bone in hierarchical vascularized engineered bone underwent a process of intramembranous ossification identical to that of mandible development. Thus, hierarchical vascularized engineered bone has a high potential for clinical application in mandibular defect reconstruction. Moreover, the concept based on developmental processes and bionic structures provides an effective strategy for tissue regeneration.

Research progress on tissue engineering in repairing tempomandibular joint / 浙江大学学报·医学版

Temporomandibular joint osteoarthritis (TMJOA) is mainly manifested as perforation of temporomandibular joint disc (TMJD) and destruction of condylar osteochondral complex (COCC). In recent years, tissue engineering technology has become one of the effective strategies in repairing this damage. With the development of scaffold material technology, composite scaffolds have become an important means to optimize the performance of scaffolds with the combined advantages of natural materials and synthetic materials. The gelling method with the minimally invasive concept can greatly solve the problems of surgical trauma and material anastomosis, which is beneficial to the clinical transformation of temporomandibular joint tissue engineering. Extracellular matrix scaffolds technology can solve the problem of scaffold source and maximize the simulation of the extracellular environment, which provides an important means for the transformation of temporo joint tissue engineering to animal level. Due to the limitation of the source and amplification of costal chondrocytes, the use of mesenchymal stem cells from different sources has been widely used for temporomandibular joint tissue engineering. The fibrochondral stem cells isolated from surface layer of articular cartilage may provide one more suitable cell source. Transforming growth factor β superfamily, due to its osteochondrogenesis activity has been widely used in tissue engineering, and platelet-rich derivative as a convenient preparation of compound biological factor, gradually get used in temporomandibular joint tissue engineering. With the deepening of research on extracellular microenvironment and mechanical stimulation, mesenchymal stem cells, exosomes and stress stimulation are increasingly being used to regulate the extracellular microenvironment. In the future, the combination of complex bioactive factors and certain stress stimulation may become a trend in the temporomandibular joint tissue engineering research. In this article, the progress on tissue engineering in repairing COCC and TMJD, especially in scaffold materials, seed cells and bioactive factors, are reviewed, so as to provide information for future research design and clinical intervention.

Osteogenic effects of antihypertensive drug benidipine on mouse MC3T3-E1 cells in vitro / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Hypertension is a prevalent systemic disease in the elderly, who can suffer from several pathological skeletal conditions simultaneously, including osteoporosis. Benidipine (BD), which is widely used to treat hypertension, has been proved to have a beneficial effect on bone metabolism. In order to confirm the osteogenic effects of BD, we investigated its osteogenic function using mouse MC3T3-E1 preosteoblast cells in vitro. The proliferative ability of MC3T3-E1 cells was significantly associated with the concentration of BD, as measured by methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay and cell cycle assay. With BD treatment, the osteogenic differentiation and maturation of MC3T3-E1 cells were increased, as established by the alkaline phosphatase (ALP) activity test, matrix mineralized nodules formation, osteogenic genetic test, and protein expression analyses. Moreover, our data showed that the BMP2/Smad pathway could be the partial mechanism for the promotion of osteogenesis by BD, while BD might suppress the possible function of osteoclasts through the OPG/RANKL/RANK (receptor activator of nuclear factor-κB (NF-κB)) pathway. The hypothesis that BD bears a considerable potential in further research on its dual therapeutic effect on hypertensive patients with poor skeletal conditions was proved within the limitations of the present study.

Study on Inhibitory Effects and Mechanism of Bruceanine D Combined with Taxol on the Proliferation of Human Pancreatic Cancer Capan- 2 Cells / 中国药房

OBJECTIVE： To investigate the inhibitory effect and potential mechanism of Brucein D （BD） combined with Taxol on the proliferation of human pancreatic cancer Capan-2 cells. METHODS： Using Capan-2 cells as object， the proliferations after treated with BD （5， 10， 15， 20 μmol/L）， Taxol （10， 20， 30， 40 nmol/L） and BD+Taxol （5 μmol/L+10 nmol/L， 10 μmol/L+20 nmol/L， 15 μmol/L+30 nmol/L， 20 μmol/L+40 nmol/L） for 48 h were determined by sulfonyl rhodamine B method. Survival rate of cells and combination index （CI） were calculated. The clone formation assay was performed to detect the formation of clonal colonies after treated with BD （20 μmol/L，hereinafter）， Taxol （40 nmol/L，hereinafter）、BD+Taxol （20 μmol/L+40 nmol/L，hereinafter） for 24 h. The rate of clone formation was calculated. DAPI method was used to observe the apoptosis of cells after treated with BD， Taxol and BD+Taxol for 24 h. Western blotting was used to detect the expression of apoptosis-related protein （Bcl-2， PARP， Caspase-3， Cleaved-caspase-3） after treated by BD， Taxol， BD+Taxol for 48 h and the expression of JNK and p-JNK after treated by BD， Taxol， BD+Taxol for 4， 6， 12 h. RESULTS： After treated with 10， 15 and 20 μmol/L BD， 20， 30 and 40 nmol/L Taxol or two-drug combination for 48 h， survival rates of cells were decreased significantly； the survival rate of drug combination group was significantly lower than the same dose of BD group and Taxol group （P＜0.05）. CI values of drug combination groups （BD 5 μmol/L+Taxol 10 nmol/L， BD 10 μmol/L+Taxol 20 nmol/L， BD 15 μmol/L+Taxol 30 nmol/L， BD 20 μmol/L+Taxol 40 nmol/L） were 0.63±0.04， 0.68±0.08， 0.89±0.12 and 0.84±0.05. After treated with 20 μmol/L BD， 40 nmol/L Taxol and two-drug combination， the formation of clonal colonies was decreased with different degrees of chromatin concentration and nuclear shrinkage； the rate of clone formation （24 h）， the expression of Bcl-2 （48 h）， PARP （48 h）， Caspase-3 （48 h） and JNK （4， 6 h， except for Taxol group） were decreased significantly， while the relative expression of Cleaved-caspase-3 （48 h） and p-JNK （4， 6， 12 h） were increased significantly. Those of BD+Taxol group were significantly better than those of BD group and Taxol group [except for JNK （4， 6， 12 h）， p-JNK （4 h）] （P＜0.05 or P＜0.01）. CONCLUSIONS： Both BD and Taxol can inhibit the proliferation and promote apoptosis of human pancreatic cancer Capan-2 cells， and the combination have a certain synergistic effect， which is better than any single drug. It may be associated with activating Caspase pathway and JNK phosphorylation.

Comparative Analysis of Volatile Oil Constituents of Glehnia littoralis from Different Producing Areas / 中国药房

OBJECTIVE： To compare the difference in volatile oil constituents of Glehniae littoralis from 3 producing areas as Shandong Laiyang， Hebei Anguo， Inner Mongolian Chifeng. METHODS： The method of steam distillation was used to extract the volatile oil of G. littoralis from different areas and calculate the extraction rate. The constituents of volatile oil were analyzed by using GC-MS. The data was corrected by Xcalibur chemical workstation. The constituents were searched by NIST 11.0 mass spectrometry database （matching degree ＞800）， and the relative mass fraction of each chemical constituent was obtained by peak area normalization. RESULTS： The extraction rate of volatile oil in G. littoralis from Laiyang was 0.013％， which was far lower than G. littoralis from Anguo （0.099％） and G. littoralis from Chifeng （0.105％）. There were 15， 18 and 27 constituents identified in volatile oil of G. littoralis from 3 producing areas； the relative mass fractions were 89.29％， 96.76％， 94.53％. Falcarinol was a common compound with the highest relative mass fraction of the volatile oil of G. littoralis from different producing areas； the relative mass fractions were 69.79％， 90.89％ and 71.04％， respectively. Fatty acids were rich in the sample from Laiyang， while C15H24 sesquiterpenoids were rich in the other samples from Anguo and Chifeng. CONCLUSIONS： Volatile oil of G. littoralis could be used as potential chemical markers to distinguish different producing areas due to their significant differences in chemical components.

Application of modified lateral window for maxillary sinus floor augmentation / 浙江大学学报·医学版

Objective: To evaluate the clinical efficacy of modified lateral window for maxillary sinus floor augmentation (MSFA). Methods: Fifty-five patients who visited the Stomatology Hospital Affiliated to Zhejiang University School of Medicine between June 2012 and October 2014 were enrolled in the study. Patients underwent MSFA with Bio-Oss grafts based on modified access window. During the operation the vertical height of the bony window was reduced from 6-8 mm of conventional oval window to 4-5 mm of slot-shaped window. The sinus membrane was detached completely via the lateral access and large particle Bio-Oss graft was placed in the sub-mucosal space. The implant survival, graft height, graft volume and resorption rates were measured. Intra-op and post-op complications were recorded. Results: There were 86 implants inserted. The 2-4 year cumulative survival rates were 97.67% by implant-based analysis and 96.36% by patient-based analysis. The residual bone height was (4.7±2.6) mm and bone width was (8.4±2.7) mm. The bone height of implantation site immediately after operation was (16.1±2.5) mm and it was (16.2±2.2) mm at restoration. The bone heights at 1 and 2 years after operation were (14.9±2.5) mm and (13.6±2.6) mm, respectively. The graft height was (10.6±2.8) mm and the graft volume was (1569±745) mm3 immediately after operation. The resorption rate of graft height 6 months after operation was 3.79% and that of graft volume was 7.87%. The 1-year accumulative resorption rate of graft height was 6.63% and that of graft volume was 10.89%. The 2-year accumulative resorption rate of graft height was 7.58% and that of graft volume was 15.26%. Small membrane perforation during MSFA was observed in 5 cases and all were successfully repaired by a collagen Bio-Gide membrane. Conclusion: The modified lateral technique obtains high implant survival rate, excellent graft stability and low complication rate at 2-4 year clinical follow-up, indicating that it is a safe, predictable and minimally invasive surgical method for severe atrophic maxillary posterior dentition.

Clinical characteristics and prognosis of ANCA-associated vasculitis in patients with renal injury / 中华肾脏病杂志

Objective To investigate the characteristics and outcome of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in patients with renal injury. Methods AAV patients with renal injury diagnosed in the Department of Nephrology, Renmin Hospital of Wuhan University, from January 2012 to January 2017 were included into this study. Patients were divided into MPO-ANCA positive and PR3-ANCA positive groups for further study. The clinical characteristics, pathological and laboratory indexes, treatment and prognosis were retrospectively analyzed. Results A total of 68 cases were enrolled, among which 52 cases (76.5%) were MPO-ANCA positive and 16 cases (23.5%) were PR3-ANCA positive, and 41 patients (60.3%) were over 65 years old. The incidences of interstitial lung disease, digestive and nervous system damage in PR3-ANCA positive group were significantly higher than those MPO - ANCA positive group (P<0.05). There were significant differences of hemoglobin, complement C3, complement C1q, IgE, 24 h urinary protein,erythrocyte sedimentation rate, procalcitonin, BVAS score and eGFR in two groups (P<0.05). 19 cases had done renal biopsy ,among them 14 cases were MPO-ANCA positive and 5 cases were PR3-ANCA positive. Incidence of crescentic necrotizing glomerulonephritis in PR3-ANCA positive group was significantly higher than that in MPO - ANCA positive group, and incidence of diffuse global glomerulosclerosis in MPO-ANCA positive group was significantly higher than that in PR3-ANCA positive group (all P<0.05). At the median follow-up time of 32 months, the relapse rate at 6 month of MPO-ANCA-positive and PR3-ANCA-positive patients were 46.2% and 75.0%, respectively (P<0.05). Multivariate logistic regression analysis showed that PR3-ANCA positive, age≥65 years old, baseline eGFR<30 ml·min-1·(1.73 m2)-1, and combined with pulmonary interstitial lesions were all independent risk factors for relapse. And the incidence of ESRD were 42.3%and 75.0%during the follow-up period and 10 patients (14.7%) died. COX regression analysis showed that patients older than 65 years old, BVAS score≥18 points, eGFR<30 ml·min-1·(1.73 m2)-1 and complicated with pulmonary interstitial disorders at the onset were independent risk factors causing ESRD or death. Conclusion The PR3-ANCA-positive patients had more severe renal injury than those with MPO-ANCA-positive patients, and the injury of extrarenal organs was more serious, recurrence rate was higher, and the prognosis was worse.

The diagnostic value of high frequency ultrasonography and molybdenum target imaging for early breast cancer / 实用放射学杂志

Objective To analyze and compare the independent and combined diagnostic values of high frequency ultrasonography (HFU) and molybdenum target imaging (MTI) for early breast tumor in a prospective study.Methods 258 patients with breast mass which were suspected as breast tumors by physical examination received HFU,MTI,their combined applications and operative treatments.Comparative studies were made between the surgical pathology and imaging evaluations.Results Totally 258 cases were enrolled in this study.Surgical pathology confirmed 135 cases of early breast cancer and 123 cases of benign breast tumor.For the diagnosis of early breast cancer,combined application was more effective than HFU or MTI alone in sensitivity (P0.05).In the patients of early breast cancer, compared with HFU,MTI found less nodules of calcification(18.3% vs 36.5%,P<0.01),but revealed more axillary lymph metastasis (69.0% vs 33.3%,P<0.01).Conclusion HFU and MTI alone or their combined application are reliable imaging methods for the diagnosis of early breast cancer.For the sensitivity and accuracy of diagnosis, combined applications has more superior advantages.

Effects of renal sympathetic denervation on renal interstitial fibrosis in rats with unilateral ureteral obstruction / 中华肾脏病杂志

Objective To observe the influence of renal sympathetic denervation (RSD) on renal interstitial fibrosis and transforming growth factor beta 1(TGF-β1) and microRNA-21 (miR-21) in rats with unilateral ureteral obstruction(UUO).Methods 40 male Wistar rats were randomly divided into UUO group (A group,n=10),sham UUO group (B group,n=10),RSD+UUO group (C group,n=1O) and RSD + sham UUO group (D group,n=10).Rats in A group and C group underwent unilateral ureteral ligation,while those in B group and D group underwent sham operation.Rats in C group and D group were followed by RSD.Rats were sacrificed at 21 days after the operation to evaluate the fibrosis by Masson staining.Immunohistochemical staining and Western blotting were used to detect the expressions of collagen I (COL-Ⅰ),collagen Ⅲ (COL-Ⅲ) and TGF-β1 in four groups.The expression of miR-21 was detected by fluorescence in situ hybridization (FISH) and quantitative real-time PCR (RT-qPCR).Results A large amount of collagen deposition was observed in the renal interstitial area in A and C group compared to either B or D group (P ＜ 0.05),but the change in C group was decreased significantly than that in A group (P ＜ 0.05).Similarly,the expressions of COL-Ⅰ,COL-Ⅲ,TGF-β1and miR-21 were obviously higher in A and C group compared to either B or D group (P ＜ 0.05),but those change in C group were decreased significantly than those in A group (P ＜ 0.05).The above indexes were not significantly different between B group and D group (P ＞ 0.05).Conclusion RSD may relieve the renal interstitial fibrosis in UUO rats,and down-regulate the expression of TGF-β1 and miR-21.

Clinical analysis of bisphosphonate-related osteonecrosis of the jaw / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The study aims to analyze patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ).</p><p><b>METHODS</b>Twelve patients treated in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Me-dical School, Zhejiang University from May 2013 to September 2015 were included. Patients' basic situation, medication, clinical symptoms, therapies, and effects were obtained and analyzed.</p><p><b>RESULTS</b>The treatment of nine patients focused on the mandible, whereas that of three patients was on the maxilla. The clinical symptoms appeared from 10 to 80 months, with an average of about (28.00±21.42) months. Nine patients had tooth extraction history. After operation (nine patients), eight were treated, one had stable in bone exposure and three patients received conservative treatment.</p><p><b>CONCLUSIONS</b>Intravenous infusion of bisphosphonates can induce BRONJ. The mandible is commonly involved and tooth extraction is a big inducement. Treatments nowadays seek to relieve clinical symptoms, but prevention is more important.</p>

Influence of thickness of cancellous bone and cortical bone in stress distribution in vicinity of an implant / 吉林大学学报(医学版)

Objective:To investigate the stress distribution surrounding an implant under different thickness of cancellous bone and cortical bone,and to analyze the influence of thickness ratio and total thickness of bone tissues on the reliability of an implant.Methods:By using the commercial finite element method software Abaqus, a simplified three-dimensional model of a jawbone consisting of a cancellous bone,a cortical bone,an implant,and a ceramic crown was constructed,and then the computation was performed.Under the condition that the system was loaded by lateral and normal stresses, the influence of thickness ratio and total thickness of cancellous bone and cortical bone in the stress distribution surrounding the implant was studied,where the thickness ratios were 3∶1, 2∶1, 1∶1, 1∶2, and 1∶3;the total thickness were 0.5, 1.0, 2.0, 3.0 and 4.0 mm, respectively. Results:The maximum stresses on the cortical bone,the cancellous bone as well as the implant were all found to decrease with the increasing of the total thickness of cortical and cancellous bones,with a higher decreasing rate in the range between 0.5-2.0 mm and a lower decreasing rate between 2.0-4.0 mm. More importantly, the maximum value of stress in the cortical bone within the neck region of the implant was observed to increase dramatically via reducing the total thickness below 2 mm, while it was increased insignificantly when the total thickness was above 2.0 mm. Conclusion:The thickness ratio and the total thickness of cancellous bone and cortical bone have strong influence in the stress distribution surrounding the implant.In dental implantation surgery, the total thickness of cancellous bone and cortical bone should be at least 2 mm, and therefore 2 mm is an optimal value.

Role of scaffolding protein JLP on the progression of renal interstitial fibrosis in mice model of unilateral ureteral obstruction and its underlying mechanism / 中华肾脏病杂志

Objective To observe the effect of JLP deficiency on the progression of renal interstitial fibrosis in mice model of unilateral ureteral obstruction (UUO),and to investigate the role and underlying mechanism of JLP in the development of renal fibrosis in obstructive nephropathy.Methods jlp Wild type (jlp+/+) and jlp deficient (jlp-/-) mice were divided into four groups:jlp+/+-and jlp-/--sham-operated groups(jlp-/--sham group and jlp+/+-sham group),jlp+/+-and jlp-/--unilateral ureteral obstruction (UUO)-operated groups (jlp/--UUO group and jlp+/+-UUO group).Mice were sacrificed at 7 days and 14 days after the operation respectively to evaluate the fibrosis by Masson staining.The expression of JLP in jlp +/+ renal tissue was assayed by immunohistochemistry staining,immunofluorescence and Western blotting.Immunohistochemical staining was used to detect the expression of α-smooth muscle actin (α-SMA),collagen Ⅰ (COL-Ⅰ),collagen Ⅲ (COL-Ⅲ) and transforming growth factor-β1 (TGF-β1) in sham and UUO groups.Besides,the α-SMA,COL-Ⅰ,COL-Ⅲ,TGF-β1,p-Smad2 and p-Smad3 protein levels were also analyzed by Western blotting in four groups.Results The expression of JLP was mainly demonstrated in the renal tubules of mice.A large amount of collagen deposition was observed in the renal interstitial area in jlp-/--UUO group compared to jlp+/+-UUO group.Similarly,the expression of α-SMA,COL-Ⅰ,COL-Ⅲ and TGF-β1 was significantly increased in the kidney cortices in jlp-/--UUO-operated groups.Meanwhile,Western blotting showed that the expression of α-SMA,COL-Ⅰ,COL-Ⅲ,and TGF-β1 protein was obviously higher in jlp-/--UUO group.Moreover,the expression of p-Smad2 and p-Smad3 protein was markedly higher in jlp-/--UUO group.Conclusion Scaffolding protein JLP is critical in preventing renal fibrosis through the inhibition of TGF-β1 expression and myo-fibroblast production.

Role of JLP on the epithelial to mesenchymal transition in renal tubular epithelial cells / 中华肾脏病杂志

Objective To observe the effect of JLP on transdifferentiation of human renal proximal tubular epithelial cells (HK-2),and to investigate the role of p38 MAPK signaling pathway in this process.Methods The knock-down plasmids of JLP were constructed.HK-2 cells were randomly divided into four groups:negative control cells (Ctrl-shRNA group),knock-down jlp cells (jlpshRNA group),negative control cells with FGF-2 treatment (FGF-2 group) and knock-down jlp cells with FGF-2 treatment(jlp-shRNA +FGF-2 group).The expressions of JLP,E-cadherin,TGF-β1,α-SMA,p-p38 MAPK protein were detected by Western blotting.After the induction of FGF-2 for 24 hours,the expressions of α-SMA,COL-Ⅰ,FN were detected by immunocytochemistry.Results Compared with Ctrl-shRNA group,the expression of JLP protein was significantly down-regulated in FGF-2 group.Compared with FGF-2 group,the expressions of TGF-β1,α-SMA,p-p38 MAPK protein were significantly up-regulated,while E-cadherin protein was significantly down-regulated (P ＜ 0.05).Compared with FGF-2 group,the expressions of α-SMA,COL-Ⅰ,FN immunostaining increased markedly in jlp-shRNA+FGF-2 group.Conclusion Scaffolding protein JLP is critical in preventing EMT in the course of fibrosis through the inhibition of p-p38 activation in HK-2 cells.

Intrapertoneal Administration of Dezocine Alleviates Neuropathic Pain in Rats / 昆明医科大学学报

Objective To study wether dezocine (DZ) can attenuate neuropathic pain in rats and to investigate its mechanism.Methods Neuropathic pain was induced by tight ligation of the left L5 spinal nerve of the male SD rats. 24 Spinal nerve ligation (SNL) model rats were randomly divided into three groups:the first group (saline group, n=8), rats were given intraperitoneal injection of 1ml of saline 14 days after SNL surgery; the second group (dezocine group, n=8), rats were given intraperitoneal injection of 5mg/kg of dezocine in 1ml saline 14 days after SNL surgery;the third group (morphine group,n=8),rats were given intraperitoneal injection of 5 mg/kg of morphine 14 days after SNL surgery. Results Intraperitoneal injection dezocine and morphine had significant analgesic effect in neuropathic pain rats. This analgesic effect lasted for 4-6 hours.Continuous injection of morphine for 3 days produced significant tolerance, while continuous injection of dezocine for 7 days still had significant analgesic effect on neuropathic pain. Conclusion Intraperitoneal injection of dezocine and morphine can attenuate SNL neuropathic pain, continuous injection of morphine for 3 days can produce significant tolerance, while continuous injection of dezocine for 7 days still has significant analgesic effect on neuropathic pain.

Effect of dexmedetomidine combined anesthesia on postoperative delirium in elderly patients undergoing hip joint replacement / 中华麻醉学杂志

Objective To investigate the effect of dexmedetomidine combined anesthesia on postoperative delirium in the elderly patients undergoing hip joint replacement.Methods One hundred and sixty ASA Ⅱ or Ⅲ patients,aged 75-85 yr,with a body mass index of 20-25 kg/m2,scheduled for elective total hip joint replacement under general anesthesia,were randomly divided into 2 groups (n =80 each):sevoflurane-fentanyl control group (group C) and dexmedetomidine-sevoflurane-fentanyl group (group D).Dexmedetomidine was intravenously infused at 0.2 μg· kg-1 · h-1 until the end of operation after a loading dose of 0.6μg/kg over 15 min before induction of anesthesia in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with iv injection of fentanyl 2-4 μg/kg and etomidate 0.1-0.3 mg/kg at 5 min after the end of administration of the loading dose.Tracheal intubation was facilitated with cisatracurium 0.15 mg/kg and the patients were mechanically ventilated.Anesthesia was maintained with target-controlled inhalation of sevoflurane (the end-tidal concentration 1％-3％) and intermittent iv boluses of fentanyl 0.05 mg.BIS was maintained at 40-60 during operation.The consumption of etomidate,fentanyl,and sevoflurane,agitation during emergence from anesthesia,and postoperative delirium within 24 h after operation were recorded.Results Compared with group C,the consumption of etomidate,fentanly,and sevoflurane was significantly reduced and the incidences of agitation during emergence from anesthesia and postoperative delirium within 24 h after operation were significantly decreased in group D (P ＜0.05).Conclusion Dexmedetomidine combined anesthesia can reduce the occurrence of postoperative delirium in the elderly patients undergoing hip joint replacement.