Expert consensus on the workflow of digital aesthetic design in prosthodontics / 实用口腔医学杂志

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

Impact of anesthesia modality on functional outcome after endovascular therapy in patients with anterior circulation ischemic stroke aged 80 years and older: comparison between conscious sedation and general anesthesia / 国际脑血管病杂志

Objective:To investigate the impacts of conscious sedation and general anesthesia on the functional outcome after endovascular therapy (EVT) in elderly patients with acute ischemic stroke with large vessel occlusion (AIS-LVO).Methods:The clinical and imaging data of elderly patients with AIS-LVO (≥80 years) underwent EVT at the Affiliated Hospital of Nantong University from January 2020 to January 2023 were collected retrospectively. They were divided into conscious sedation group and general anesthesia group according to anesthesia modality, and divided into good outcome group (0-2 points) and poor outcome group (>2 points) based on the modified Rankin Scale score at 90 d after onset. The multivariate logistic regression analysis was used to investigate the impact of anesthesia modality on functional outcome after EVT. Results:A total of 77 elderly patients with AIS-LVO were enrolled, including 35 males (45.5%) and 42 females (54.5%); median age of 82.0 years (interquartile range, 80.0 to 84.0 years); the median baseline NIHSS score was 16.0 (interquartile range, 10.0-20.0). Conscious sedation was used in 21 cases (27.3%) and general anesthesia was used in 56 cases (72.7%); 17 (22.1%) had good outcome, while 60 (77.9%) had poor outcome. Compared with the general anesthesia group, the conscious sedation group had a longer procedure time (110.0 min vs. 89.0 min; P=0.049), but a higher rate of good outcome at 90 d (38.1% vs. 16.1%; P=0.038), a lower incidence of stroke-associated pneumonia (33.3% vs. 58.9%; P=0.045), and a lower proportion of patients who underwent tracheostomy after procedure (4.8% vs. 25.0%; P=0.046). Compared with the poor outcome group, the good outcome group had shorter procedure time (75 min vs. 99 min; P=0.033), lower incidence of stroke-associated pneumonia (29.4% vs. 58.3%; P=0.035), lower tracheotomy rate (0% vs. 25%; P=0.022), and a lower proportion of patients who received conscious sedation (47.1% vs. 21.7%; P=0.038). Multivariate logistic regression analysis showed that conscious sedation was an independent predictor of good outcome (odds ratio 0.090, 95% confidence interval 0.010-0.771; P=0.028). Conclusion:Conscious sedation may be more appropriate for elderly patients with anterior circulation AIS-LVO undergoing endovascular treatment.

Effect of cancer-associated fibroblasts-derived CCL7 on proliferation and invasion of triple-negative breast cancer cells / 国际生物医学工程杂志

Objective To investigate the effect of cancer-associated fibroblasts (CAFs)-derived chemokine ligands 7 (CCL7) on the proliferation and invasion of triple-negative breast cancer (TNBC) cells. Methods The mRNA expression level and protein level of CCL7 in CAFs and paracancerous fibroblasts were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western Blot respectively. To confirm the paracrine level of CCL7 in CAFs and paracancerous fibroblasts, the protein levels of CCL7 in the corresponding conditional medium were detected through enzyme-linked immunosorbent assay (ELISA). The effect of CCL7 on the proliferation and invasion of MDA-MB-231 (TNBC cell line) was investigated by MTS assay and Transwell assay, respectively. Results In comparison with paracancerous fibroblasts, the mRNA expression level and protein level of CCL7 in CAFs were significantly increased (both P<0.01). There was an obviously increase of paracrine level of CCL7 in CAFs-conditional medium (P<0.01). The MTS assay and Transwell assay results indicated that CCL7 was more able to promote the proliferation and invasion of MDA-MB-231. Conclusion CAFs in the TNBC stroma can produce more chemokine CCL7, and CCL7 can promote the proliferation and invasion of TNBC cells

Clinicopathological features and prognosis analysis of 72 patients with occult breast cancer / 中华内分泌外科杂志

Objective To analyze the clinicopathological features and prognosis of patients with occult breast cancer ( OBC) , as well as to explore the best treatment .Methods The clinical data of 72 patients with OBC confirmed by pathology were retrospectively analyzed , while 320 cases with other kind of breast cancer were the control group .Results Axillary mass was the first sign of the 72 patients with OBC.The diagnosis rate of MRI was higher than mammary graphy ( 71.4% vs 53.5%) .The difference had statistical significance (χ2 =11.876, P=0.001) .The characteristics of OBC with axillary lymph node metastasis was mainly moderately or low differenti -ated, usually with diffuse infiltrative cancer cells , flaky, like large Apocrine cells.Compared with the control group, the positive rate of CK7, CK20 and TTF-1 had no statistical differences (χ2 =0.058, P=0.810).The posi-tive rate of ER and PR was 46.7% and 36.7%, lower than the control group (χ2 =4.535, P=0.033).Clinical stage, operating method and the number of lymph node metastasis may be the independent factors influencing prog -nosis.Conclusions Axillary mass is the first symptom of OBC .To combine MRI with immunohistochemistry is helpful in diagnosis and differential diagnosis of the disease .The positive rate of ER and PR for OBC patients is low.Modified radical mastectomy combined with adjuvant therapy may be the better choice .

Effects of soluble components derived from bone marrow mesenchymal stem cells on the expression of vascular endothelial growth factor and liver regeneration in rats / 中华肝胆外科杂志

Objective To investigate the effects of soluble components derived from bone marrow mesenchymal stem cells (BMSCs) on the expression of vascular endothelial growth factor (VEGF) and liver regeneration caused by 70％ portal branch ligation (PBL) in rats.Methods Isolated and cultured BMSCs were lysed by sonication.PBL was performed in male SD rats followed by splenic injection of BMSCs or PBS as control.Animals were analyzed for liver regeneration index,hepatocytes proliferation,hepatic function,histopathological changes,and hepatic genes expression.Expression of VEGF was assessed by Western blot and immunohistochemistry.Results The liver regeneration index increased in the BMSCs group especially 2 and 5 days after PBL compared with the control group (P＜0.05) and reached (51.71±1.62)％ and (76.82±0.81)％ respectively.A 2-fold increase was showed in the PCNA labeling index of hepatocytes in rats treated with BMSCs compared with the control group (P＜0.05).Histopathological findings showed that vacuolar change and sinusoidal congestion were lower in the BMSCs group.Alanine transaminase (ALT) and Aspartate transferase (AST) showed no significant difference between the two groups (P＞0.05).On post operation day 2,hepatic interleukin-6 (IL6),tumor necrosis factor α (TNFα),hepatocyte growth factor (HGF),vascular endothelial growth factor A (VEGFA),and vascular endothelial growth factor 2 (VEGFR2) mRNAs tended to increase in the BMSCs group (P＜0.05) while transforming growth factor β1 (TGFβ1) mRNA decreased (P＜0.05).Western blot showed that the expression level of VEGF in the two groups were equal 2 and 5 days after surgery (P＞0.05).On day 2 post operation,positive VEGF immunoreactivity was present in both pericentral and periportal hepatocytes in the BMSCs group,while only in periportal hepatocytes in the control group.Conclusion These results demonstrate that BMSCs accelerated liver regeneration caused by PBL,which may result from hepatoprotection,enhanced hepatocyte proliferation,and VEGF-mediated angiogenesis early after the operation,potentially creating a new avenue for the study of hepatic regeneration.

Applications of mesenchymal stem cells in the study of hepatic regeneration / 中华肝胆外科杂志

Remarkable progress has been achieved in the transplantation of mesenchymal stem cells (MSCs)for the treatment of liver injury and hepatic failure.However,there are obstacles such as low engraftment capacity,tumorigenesis,and a fibrogenic potential that all hamper the use of MSCs in clinical trials.Therefore,it is worthwhile to talk about the alternatives that will increase the safety and efficacy of MSCs therapy.To date,applications of MSCs-derived hepatocytes,genetically modified MSCs,or MSC-conditioned medium for promoting liver regeneration have shown encouraging results.This review summarizes the current applications of MSCs in the study of hepatic regeneration.

Stress analysis of distal-extension removable partial dentures supported by mini implants / 上海交通大学学报（医学版）

Objective To analyse the stress distribution of distal-extension removable partial dentures supported by mini implants. Methods The finite element analysis models of conventional removable partial dentures ( CRPD) and mini implants supported removable partial dentures (ISRPD) were established by modular denture model. The stress distribution of abutments and supporting tissues was compared by finite element analysis software Abaqus 6.5.Results Under vertical loading, the stress of abutment teeth, mucosa of edentulous region and alveolar bone of ISRPD model was lower than that of CRPD model. Under oblique loading, the stress of each part of CRPD model and alveolar bone of ISRPD model significantly increased, while that of abutment teeth and parodontium of ISPRD model decreased. Conclusion The distal-extension removable partial dentures supported by mini implants work well in protecting the abutments and supporting tissues.

Stress analysis of precision attachment dentures for mandibular distal-extension edentulous cases / 上海交通大学学报（医学版）

Objective To analyse the stress distribution of precision attachment dentures used in distal-extension edentulous cases. Methods The finite element models of conventional removable partial dentures and precision attachment dentures were established by modular denture model, and the models of precision attachment dentures were established with 4┬4 as one abutment or 43┬34 as two abutments. The stress distribution of abutments and supporting tissues was compared by finite element analysis software Abaqus 6.5.Results Under vertical loading or oblique loading, the stress of abutments and supporting tissues from attachment dentures with two abutments was significantly lower than that from attachment dentures with one abutment. The stress of conventional removable partial dentures significantly increased under oblique loading. Conclusion It is reasonable for the design of attachment dentures with two abutments for mandibular distal-extension edentulous cases.

Comparison of stress distribution on telescopic denture and clasp-retention denture for bilateral free-ended cases / 上海交通大学学报（医学版）

Objective To establish three dimensional finite element model libraries of telescopic dentures and removable partial dentures by means of model libraries, and compare the characteristics of stress distribution among three prostheses. Methods Normal model libraries were imported and edited, and models of bilateral free-ended cases were established. Based on the model libraries of fixed partial dentures and removable partial dentures, the finite element models of telescopic dentures and removable partial dentures with medial or distal occlusal rest were established using softwares such as DELL Precision Graphics Workstation, UG 5.0, HyperMesh 7.0 and Abaqus 6.5, then finite element stress analysis was performed. Results The stress distribution on abutment root, parodontium, alveolar mucosa and alveolar bone was uniform. The maximum value of stress on the abutment root (6.205 Mpa) was much less than those of two removable partial dentures (18.41 Mpa and 34.49 Mpa). Conclusion For bilateral free-ended cases, the telescopic denture design is uniform in stress distribution with less stress on abutment root, which is healthy to the abutment root and surrounding tissues.

Stress analysis of distal-extension prosthetics with mesial and distal occlusal rest / 上海交通大学学报（医学版）

Objective To investigate the stress distribution in the abutment and supporting tissues of distal-extension removable partial dentures with mesial and distal occlusal rest under loading. Methods A modular denture model was used to build a model of mandibular dentition defect ( 765┬567 loss) with HyperMesh 7.0 software. Prosthetics with mesial (M model) and distal occlusal rest (D model) were designed with UG 5.0 software, and the finite element models were completed with HyperMesh 7.0 software. The stress distribution was analyzed in the abutment and supporting tissues of distal-extension removable partial dentures with mesial and distal occlusal rest when bilateral vertical forces were applied. Results Compared with M model, D model provided much larger maximum stress in abutments and periodontal membrane. Stress of D model mainly concentrated on roots of 4┬4 , while that of M model uniformly distributed on roots of 43┬34 . The maximum stress of M model was significantly larger than that of D model on the mucosa of edentulous region. The maximum stress on alveolar bone of two models' edentulous region was equal, while the stress of M model distributed more widely. Conclusion It is prior to select mesial occlusal rest in distal-extension removable partial dentures.

Model establishment and stress analysis of telescopic crown-retained removable partial dentures / 上海交通大学学报（医学版）

Objective To redevelop the finite element model libraries and to analyse the stress distribution of telescopic crown dentures. Methods The finite element model libraries were redeveloped based on the model libraries of normal dentition, fixed partial denture and removable partial denture. With the help of softwares such as DELL Precision Graphics Workstation, UG 5.0, HyperMesh 7.0 and Abaqus 6.5, the telescopic denture models on the bilateral free-ended case were imported and edited, then the finite element stress analysis was performed. Results The models were easily established. The maximum value of stress and its distribution on abutment root, periodontal membrane, alveolar mucosa, alveolar bone and dental prostheses were observed and studied by the finite element stress analysis. Conclusion The way to establish models of telescopic crown dentures by model libraries is feasible and reliable.

Optimization of matrix composition and technology for Jiefushuang Emulsion / 中成药

Objective: To optimize matrix composition and technology for Jiefushuang Emulsion. Methods: Orthogonal design was used, oil phase, agitation velocity, emulsifiers and emulsify temperature were selected as variable factors. Results: The optimum matrix composition and technology were: The ratio of oil to water was 2∶3, emulsifiers: 320g(oil 500mL), HLB: 15, emulsity temperature: 70?C , agitation velocity: 800 revolutions per minute, lasting for 20 minutes. Conclusion: The emulsion prepared accords with the stipulation of the appendix of Chinese pharmacopoeia (2000).