Challenges of computer-assisted orthognathic surgery in clinical application / 口腔疾病防治

@#After years of development, the advantages of computer-assisted orthognathic surgery have been widely recognized. However, the clinical application of this technology is challenging. Each step may generate errors from data acquisition, computer-assisted diagnosis, and computer-assisted surgical design, causing errors to be transferred from the virtual surgical plan to the operation. The accumulation and amplification of errors will affect the final surgical effect. Currently, digital devices, such as intraoral scanners, are being explored for error control, utilizing automation methods and algorithms, and implementing personalized bone positioning methods. Moreover, there are still many problems that have not been fully resolved, such as precise simulation of postoperative soft tissue, functional assessment of mandibular movement, and absorbable internal fixation materials. Fully understanding computer-assisted orthognathic surgery's limitations could provide direction for optimizing existing methods while helping clinicians avoid risks and maximize its advantages to achieve the best outcome. Many emerging and cutting-edge technologies, such as personalized titanium plates, artificial intelligence, and surgical robots, will further promote the development of this discipline. We can expect future optimization of digital orthognathic surgical technology by innovations in automation, intelligence, and personalization.

Mortality and disease burden of diabetes in Hangzhou City from 2013 to 2021 / 预防医学

Objective@#To investigate the mortality and disease burden of diabetes in Hangzhou City from 2013 to 2021, so as to provide insights into improving diabetes prevention and control strategies.@*Methods@#Data on morbidity and mortality of diabetes in Hangzhou City from 2013 to 2021 were collected through the Chronic Disease and Death Cause Monitoring System of Hangzhou Center for Disease Control and Prevention, and the crude and age-standardized mortality (standardized by the population of the Seventh National Population Census in China in 2020) were calculated. Data on the prevalence of diabetes were collected from the China Chronic Disease and Risk Factors Surveillance (CCDRFS), and the burden of disease was evaluated by calculating years of life lost (YLL), years lived with disability (YLD) and disability-adjusted years (DALY) with reference to the methodology of the Global Burden of Disease Study (GBD). The trends in mortality and disease burden of diabetes were evaluated with the average annual percent change (AAPC). @*Results@#There were 8 686 deaths of diabetes in Hangzhou City from 2013 to 2021, with the average annual crude mortality of 13.17/105 and age-standardized mortality of 10.89/105. The crude mortality of diabetes showed a tendency towards a rise (AAPC=2.62%, P<0.05), while the trend in age-standardized mortality was not significant (P>0.05). The crude and age-standardized mortality of diabetes were higher in women than in men (14.11/105 vs. 12.21/105, 12.16/105 vs. 9.71/105; both P<0.05); however, the crude mortality in men increased more rapidly (men: AAPC=4.46%, P<0.05; women: AAPC=1.09%, P>0.05). The YLL, YLD and DALY of diabetes were 155.42, 1 246.73 and 1 402.15 thousand person-years, and the rates of YLL, YLD and DALY were 2.36, 18.90 and 21.25 person-years per thousand, respectively. The rates of YLL, YLD and DALY appeared a tendency towards a rise (AAPC=1.57%, 6.03% and 7.11%, all P<0.05). Higher rates of DALY and more remarkable increase were seen in men than in women (P<0.05; AAPC=8.37%, 5.54%, both P<0.05). @*Conclusions@# The mortality of diabetes in Hangzhou City from 2013 to 2021 is high, and the burden of disease, especially disability, is growing rapidly, with the burden of disease being more serious in men.

Retrospective analysis of short-term curative effect of total laparoscopic loop ileostomy reversal after radical resection of rectal cancer / 中华肿瘤杂志

Objective: To investigate the safety, feasibility and short-term efficacy of total laparoscopic loop ileostomy reversal in patients after resection of rectal cancer. Methods: The clinical data of 20 patients who underwent total laparoscopic loop ileoscopic loop ileostomy after radical resection of rectal cancer at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, or Beijing Chaoyang District Sanhuan Cancer Hospital from October 2019 to June 2020 were collected and retrospectively analyzed. Results: All patients had successfully underwent total laparoscopic ileostomy reversal without conversion to open surgery or discontinued operation. No perioperative related death cases were found. In the whole group, the median operation time was 97 (60-145) minutes and the median intraoperative blood loss was 20 (10-100) milliliters. The median Visual Analogue Scale (VAS) score was 1.9 (1-5) one day after the operation. Nobody needed to use additional analgesic drugs. The median time to grand activities was 25 (16-42) hours, the median time to flatus was 44 (19-51) hours, and the median hospitalization after operation was 6.9 (5-9) days. No patients underwent operation related complications such as operative incision infection, abdominal and pelvic infection, intestinal obstruction, anastomotic leakage, bleeding and so on. Conclusions: Total laparoscopic loop ileostomy reversal appears to be safe, feasible and with promising efficacy for selected patients.

Chemical modification endows heparin with low anticoagulant and high antineoplastic activities / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the anticoagulant and antineoplastic activities of chemically modified low-molecular-weight heparin (LMWH).</p><p><b>METHODS</b>LMWH obtained by splitting unfractionated heparin (UFH) with sodium periodate oxidation and sodium borohydride reduction was subjected to acetylation catalyzed by DCC and DMAP to produce acetylated LMWH (ALMWH). The anticoagulant activity of ALMWH was determined in mice, and its antiproliferative and anti-invasion activities was assessed in human breast cancer cells MDA-MB-231 and MFC-7.</p><p><b>RESULTS</b>The anticoagulant activity of LMWH was decreased significantly after acetylation. The concentrations of commercial LMWH* and ALMWH for doubling the coagulation time (CT) were 33.04 µmol/L and 223.56 µmol/L, respectively, and the IC(50) of ALMWH for doubling CT was 6 times of that of LMWH*. ALMWH and LMWH at 0.1, 0.3, 0.9, 2.7 and 8.1 mmol/L both significantly inhibited the proliferation of MDA-MB-231 and MCF-7 cells in a concentration-dependent manner, but ALMWH produced stronger inhibitory effects. The IC(50) of LMWH and ALMWH for inhibiting cell proliferation was 3168.4 µmol/L and 152.6 µmol/L in MCF-7 cells, and 12299.6 µmol/L and 22.2 µmol/L in MDA-MB-231 cells, respectively. ALMWH and LMWH all markedly suppressed the invasion of MDA-MB-231 cells with comparable effects.</p><p><b>CONCLUSION</b>Chemical modification of structure can endow LMWH with a low anticoagulant and high antiproliferative activities.</p>

Comparison of Pain Thresholds and Analgesic Effects of Parecoxib Sodium in Surgical Patients of Different Racial and Religious Backgrounds / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the differences of the thresholds of pain and analgesic effects of parecoxib sodium among patients with different racial and religious backgrounds.</p><p><b>METHODS</b>A total of 48 male patients aged 18 to 38 years who had undergone elective laparoscopic appendectomy under general anesthesia in our centers were enrolled in our study and then divided into 6 groups(n=8 in each group)based on their racial backgrounds(three levels:Mongoloid,Negroid,and Europoid)and religious backgrounds(two levels:without religion background,with religion background).All subjects received the same anesthesia,surgical procedure,and postoperative analgesia with parecoxib sodium. The temperature pain threshold and electrical pain threshold were detected 1h before and after analgesia.</p><p><b>RESULTS</b>The threshold of pain was higher in Europoids than in Negroids and Mongoloids before and after treatment. The temperature pain threshold and electrical pain threshold were not significantly different between subjects with or without religious background(before analgesic therapy:F=251.119,P=0.130,F=275.861,P=0.059;after analgesic therapy:F=308.531,P=0.086,F=180.062,P=0.078). Also,there was no interaction between the racial and religious backgrous in terms of temperature pain threshold and electrical pain threshold(F=13.553,P=0.091,F=22.001,P= 0.089;after analgesic therapy:F=4.624,P=0.089,F=15.935,P=0.094).</p><p><b>CONCLUSIONS</b>The threshold of pain differs among individuals with different racial background:it is highest in Europoids,followed by Negroids and Mongoloids. It shows no obvious difference in people with different religious backgrounds.</p>

Preparation and in vitro evaluation of curcumin CTPP-PEG-PCL micelles / 中国中药杂志

To synthetize 3-carboxypropyl-triphenylphosponium bromide-polycaprolacton-CTPP-PEG-PC, and prepare curcumin CTPP-PEG-PCL micelles by using the self-assembled emulsion solvent evaporation method, in order to determine the critical micelle concentration (CMC) with the pyrene fluorescent probe technology, detect the particle size, entrapment efficiency (%), morpheme and in vitro release rate, and evaluate the cytotoxicity of hepatic stellate cells with MTT assay. The structure of CTPP-PEG-PCL had been identified by 1H-NMR spectra. Specifically, the CMC of polymer was 2.25 mg x L(-1), the average size was 190 nm, the drug content was (0.66 +/- 0.008) g x L(-1), and the entrapment efficiency was (94 +/- 0.6)%. The in vitro release results showed curcumin micelles had a significant higher inhibition ratio in the growth of hepatic stellate cells than crude curcumin (P < 0.05). This suggested that CTPP-PEG-PCL micelles feature low CMC, high encapsulation efficiency and notable inhibition effect in growth of hepatic stellate cells.

Transforming growth factor-β1 involved in urotensin II-induced phenotypic differentiation of adventitial fibroblasts from rat aorta / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Urotensin II (UII) is a new vasoconstrictive peptide that may activate the adventitial fibroblasts. Transforming growth factor-β1 (TGF-β1) is an important factor that could induce the phenotypical transdifferentiation of adventitial fibroblasts. This study aimed to explore whether TGF-β1 is involved in UII-induced phenotypic differentiation of adventitial fibroblasts from rat aorta.</p><p><b>METHODS</b>Adventitial fibroblasts were prepared by the explant culture method. TGF-β1 protein secretion from the cells was determined by enzyme-linked immunosorbent assay (ELISA). The mRNA and protein expression of α-smooth nuscle actin (α-SM-actin), the marker of phenotypic differentiation from fibroblasts to myofibroblasts, were determined using real-time quantitative RT-PCR (real-time RT-PCR) and Western blotting, respectively.</p><p><b>RESULTS</b>UII stimulated the secretion of TGF-β1 in cultured adventitial fibroblasts in a time-dependent manner. The secretion reached a peak at 24 hours, was higher by 69.8% (P < 0.01), than the control group. This effect was also concentration dependent. Maximal stimulation was reached at 10(-8) mol/L of UII (P < 0.01), which was increased by 59.9%, compared with in the control group (P < 0.01). The secretion of TGF-β1 induced by UII was significantly blocked by SB-710411 (10(-7) mol/L), a specific antagonist of UII receptor. In addition, both UII (10(-8) mol/L) and TGF-β1 significantly stimulated α-SM-actin mRNA and protein expression. Moreover, the α-SM-actin induced by UII was inhibited by the specific neutralizing antibody (20 µg/ml) of TGF-β1, while the α-SM-actin expression stimulated by TGF-β1 (20 ng/ml) was inhibited by SB-710411 (10(-7) mol/L), the UII receptor antagonist.</p><p><b>CONCLUSION</b>This study suggests that UII could induce TGF-β1 secretion in adventitial fibroblasts via UT activation, and TGF-β1 might be involved in phenotypic differentiation from adventitial fibroblasts into myofibroblasts induced by UII, and TGF-β1 signaling might be one of the important pathways by which UII is involved in vascular fibrosis.</p>

In situ rats single pass perfusion intestinal absorption of the effectivein components in Radix Angelicae Pubescentis / 药学学报

In order to study the intestinal absorption behaviors of three active constituents, columbianetin acetate, osthole and columbianadin in Radix Angelicae Pubescentis extracts, in situ rat single pass intestine perfusion (SPIP) was carried out by the perfusion solution of the extract I containing less than 10% total coumarins. The absorption of extract II containing more than 60% total coumarins was compared with that of extract I by rat colon SPIP to elucidate the influence on absorption of the different coumarin content extracts of the Chinese traditional medicine. The samples of the perfusion solution were collected in certain intervals. The concentrations of three active components in the perfusion samples were determined by HPLC method. The results demonstrated that the absorption rate constants (Ka) or apparent permeability coefficients (Papp) of columbianetin acetate, osthole and columbianadin from extract I had no significant difference among concentration ranges of 62-555 microg x mL(-1), 101-887 microg x mL(-1), 19-186 microg x mL(-1), respectively. The absorption quantity of three components was proportional to its concentration respectively and the saturate absorption phenomena were not observed. This suggested that the absorption of columbianetin acetate, osthole and columbianadin showed the passive diffusion process. Three components could be absorbed in whole intestinal sections. The Ka and Papp of three components all showed colon > duodenum > jejunum > ileum in four different regions of rat intestine. At colon, Ka and P app were significant different from the others. The Ka or Papp of three components from the extract I was significantly more than that of same components from extract II. The extract I redounded to increase the absorption of three active components.

Preparation and characterization of 7-ethyl-10-hydroxycamptothecin-loaded hypomicron of amphiphilic block copolymer / 药学学报

Methoxypolyethylene glycol-poly lactic acid (PELA) was synthesized by ring-opening copolymerization of lactide in the presence of mPEG and its structure was characterized by 1H NMR. The novel hypomicrons were prepared by solution-casting method using PELA block copolymer as a matrix and 7-ethyl-10-hydroxycamptothecin (SN-38) as an antitumor agent. The morphology, size and size distribution, drug loading, entrapment efficiency, and release characteristics in vitro of the SN-38 loaded hypomicrons were studied. The results showed that the obtained hypomicrons showed spherical shape with the core-shell structure, the sizes are in the range of 157-238 nm, and the drug loading content varied from 1.35%-3.58% depending on the copolymer composition and the SN-38 fed amount. The in vitro release behavior in phosphate-buffered saline, pH 7.4, exhibited a sustaining release manner and was affected by the copolymer composition. The drug-loaded amount and entrapment efficiency decreased with increasing the molecular weight of the copolymer. With the increasing of the SN-38 fed amount, the drug-loaded amount and the size of hypomicrons increased, the entrapment efficiency decreased. The SN-38 hypomicrons increased the solubility of SN-38 in water and were valuable for the development of the novel dosage form of SN-38.

The absorption characteristics of silybin in small intestine of rat / 药学学报

<p><b>AIM</b>To investigate the intestinal absorption of silybin (SLB) in male rats.</p><p><b>METHODS</b>Single-pass intestinal perfusion (SPIP) technique was performed in each isolated region of the small intestine at a flow rate of 0.1 mL x min(-1). The samples of perfusate and portal plasma were collected at the designated periods of time after rat intestinal perfusion and analyzed for drug by HPLC.</p><p><b>RESULTS</b>The absorption rate constant (k(a)) and the effective permeability (P(eff)) of SLB at 190 microg x mL(-1) were determined for each segment. These data indicated the absorption rate were duodenum > jejunum > ileum > colon. SPIP was also performed in duodenum with three concentrations of SLB (80, 190 and 300 microg x mL(-1)). The concentration dependent changes of k(a) and P(eff) were evident in the duodenum perfusion of silybin. At silybin perfusate concentrations of 80 microg x mL(-1), k(a) and P(eff) were different from the values at either of the two higher concentrations (190 and 300 microg x mL(-1), P < 0.05). However there was no difference between 190 microg x mL(-1) and 300 microg x mL(-1) groups. The drug mass appearing in the plasma further indicated the absorption were duodenum > jejunum > ileum > colon.</p><p><b>CONCLUSION</b>SLB can be absorbed in whole intestinal sections. When the concentration raises to a certain level, the uptake of SLB will not increase.</p>

Studies on the preparation of camptothecin niosomes / 药学学报

<p><b>AIM</b>To study the non-ion surfactant vehicle (niosome) entrapped-camptothecin.</p><p><b>METHODS</b>The niosome loaded with camptothecin was prepared from Span and cholesterol using aqueous dispersion of film. The vehicles were visualised by transmission electron microscopy and sized by laser particle analyzer on a Malvern Mastersizer. An HPLC analysis method of the camptothecin was established by fluorescence detection. The entrapment efficiency of the niosomes containing camptothecin was determinated after the ultracentrifugation of the niosome. The antitumor activities of the vehicles on S180 sarcoma in mouse were studied.</p><p><b>RESULTS</b>The given niosomes were the suspension finely dispersed in aqueous solution. They were spherical vehicles with the single lamellar bilayers similar to phospholipid vehicles. The mean sizes of the vehicles were (565 +/- 6) nm. The recovery of the HPLC analysis method was 100.3% with 0.4% RSD. The entrapment efficiency of the camptothecin encapsulated by the niosome was 61%. The inhibition (%) of the niosome loaded with camptothecin on S180 sarcoma in mouse were 76.1% (P < 0.05). After the given dose the weight of the mouse of the niosome groups were 92.7% (P > 0.05) and 134.7% of blank control groups and compatothecin solution groups, respectively.</p><p><b>CONCLUSION</b>The camptothecin niosomes were spherical in shape and similar to phospholipid vehicles with singlelamellar bilayers. Their size distributions were narrow. Their entrapment efficiency were higher. Its antitumor activity was better than camptothecin.</p>