Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair (version 2023) / 中华创伤杂志

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

Systemic antibiotics increase microbiota pathogenicity and oral bone loss / 国际口腔科学杂志·英文版

Periodontitis is the most widespread oral disease and is closely related to the oral microbiota. The oral microbiota is adversely affected by some pharmacologic treatments. Systemic antibiotics are widely used for infectious diseases but can lead to gut dysbiosis, causing negative effects on the human body. Whether systemic antibiotic-induced gut dysbiosis can affect the oral microbiota or even periodontitis has not yet been addressed. In this research, mice were exposed to drinking water containing a cocktail of four antibiotics to explore how systemic antibiotics affect microbiota pathogenicity and oral bone loss. The results demonstrated, for the first time, that gut dysbiosis caused by long-term use of antibiotics can disturb the oral microbiota and aggravate periodontitis. Moreover, the expression of cytokines related to Th17 was increased while transcription factors and cytokines related to Treg were decreased in the periodontal tissue. Fecal microbiota transplantation with normal mice feces restored the gut microbiota and barrier, decreased the pathogenicity of the oral microbiota, reversed the Th17/Treg imbalance in periodontal tissue, and alleviated alveolar bone loss. This study highlights the potential adverse effects of long-term systemic antibiotics-induced gut dysbiosis on the oral microbiota and periodontitis. A Th17/Treg imbalance might be related to this relationship. Importantly, these results reveal that the periodontal condition of patients should be assessed regularly when using systemic antibiotics in clinical practice.

Four-Octyl itaconate ameliorates periodontal destruction via Nrf2-dependent antioxidant system / 国际口腔科学杂志·英文版

Periodontitis is a widespread oral disease characterized by continuous inflammation of the periodontal tissue and an irreversible alveolar bone loss, which eventually leads to tooth loss. Four-octyl itaconate (4-OI) is a cell-permeable itaconate derivative and has been recognized as a promising therapeutic target for the treatment of inflammatory diseases. Here, we explored, for the first time, the protective effect of 4-OI on inhibiting periodontal destruction, ameliorating local inflammation, and the underlying mechanism in periodontitis. Here we showed that 4-OI treatment ameliorates inflammation induced by lipopolysaccharide in the periodontal microenvironment. 4-OI can also significantly alleviate inflammation and alveolar bone loss via Nrf2 activation as observed on samples from experimental periodontitis in the C57BL/6 mice. This was further confirmed as silencing Nrf2 blocked the antioxidant effect of 4-OI by downregulating the expression of downstream antioxidant enzymes. Additionally, molecular docking simulation indicated the possible mechanism under Nrf2 activation. Also, in Nrf2-/- mice, 4-OI treatment did not protect against alveolar bone dysfunction due to induced periodontitis, which underlined the importance of the Nrf2 in 4-OI mediated periodontitis treatment. Our results indicated that 4-OI attenuates inflammation and oxidative stress via disassociation of KEAP1-Nrf2 and activation of Nrf2 signaling cascade. Taken together, local administration of 4-OI offers clinical potential to inhibit periodontal destruction, ameliorate local inflammation for more predictable periodontitis.

Application of online teaching in stomatology education under the background of COVID-19 epidemic prevention and control / 中华医学教育探索杂志

Objective:To understand and compare the online learning effect of students majoring in stomatology and dental technology under the background of COVID-19 epidemic prevention and control, and to analyze the advantages and challenges of online teaching, so as to provide reference for the reform of teaching mode of stomatology education.Methods:A questionnaire survey on online learning was carried out among 267 students majoring in stomatology and 92 students majoring in dental technology in Chongqing Medical University. The results were statistically analyzed by SPSS 21.0, and chi-square test or rank sum test was used to count the data.Results:Computers and mobile phones are the main tools for students to study online. 52.92% of students used computers and 38.72% used smart phones. About 80% of the students said that they could adapt to online learning, and there was no statistical difference between the students of two majors. The online learning time of students majoring in stomatology was mainly 4-6 hours, while that of students majoring in dental technology was 2-4 hours, with statistical significance. However, the latter were more likely to ask questions to teachers than the former, and the proportion of students who often asked questions to teachers was 29.35% and 20.60%, respectively, with statistical significance. A small number of students of both majors failed log on the platform to learn and complete all the teaching materials on time. More than 50% of the students thought that online teaching was not as effective as offline teaching, and offline teaching was more conducive to mastering curriculum knowledge, without statistical differences between the students of two majors. They thought that the unsmooth learning platform, poor network conditions at home, and insufficient teaching materials prepared by teachers were the main reasons that affected the online learning effect.Conclusion:The online teaching is an important and also an advisable way to maintain teaching activities during the epidemic prevention and control of COVID-19. It will be the direction of further research on the education and teaching reform to make full use of information technology, combine the advantages of online teaching and traditional classroom teaching, and actively explore the blended teaching mode from the perspective of specialty and course characteristics.

Application and effects of objective structured clinical examination in the clinical ability assessment of stomatology undergraduates / 中华医学教育探索杂志

Objective:To explore the objective structured clinical examination (OSCE) on the improvement of clinical competence of stomatology undergraduates, and to promote their ability and skills of taking the National Medical Licensing Examination (NMLE).Methods:The OSCE was implemented to evaluate the clinical skills of stomatology undergraduates from Batch 2009 to Batch 2012. The OSCE results were analyzed and compared with the NMLE (Stomatology) results on the correlation coefficient analysis of annual passing rate.Results:The passing rate of practical skills in the NMLE (Stomatology) of Batch 2009 to Batch 2012 stomatology undergraduates was basically consistent with the excellent rate of OSCE, and the correlation coefficient was 0.94.Conclusion:It has not been proved that the OSCE assessment organized by our school can increase the passing rate of practical skills in the NMLE, but it has certainly helped students better understand and apply theoretical knowledge, and it plays a positive role in promoting students' future development.

Regulation of Gut Microbiota Disrupts the Glucocorticoid Receptor Pathway and Inflammation-related Pathways in the Mouse Hippocampus

An increasing number of studies have recently indicated the important effects of gut microbes on various functions of the central nervous system.However, the underlying mechanisms by which gut microbiota regulate brain functions and behavioral phenotypes remain largely unknown. We therefore used isobaric tags for relative and absolute quantitation (iTRAQ)-based quantitative proteomic analysis to obtain proteomic profiles of the hippocampus in germ-free (GF), colonized GF, and specific pathogen-free (SPF) mice. We then integrated the resulting proteomic data with previously reported mRNA microarray data, to further explore the effects of gut microbes on host brain functions. We identified that 61 proteins were upregulated and 242 proteins were downregulated in GF mice compared with SPF mice. Of these, 124 proteins were significantly restored following gut microbiota colonization. Bioinformatic analysis of these significant proteins indicated that the glucocorticoid receptor signaling pathway and inflammation-related pathways were the most enriched disrupted pathways. This study provides new insights into the pathological mechanisms of gut microbiota-regulated diseases.

Application of online teaching in stomatology education under the background of COVID-19 epidemic prevention and control / 中华医学教育探索杂志

Objective:To understand and compare the online learning effect of students majoring in stomatology and dental technology under the background of COVID-19 epidemic prevention and control, and to analyze the advantages and challenges of online teaching, so as to provide reference for the reform of teaching mode of stomatology education.Methods:A questionnaire survey on online learning was carried out among 269 students majoring in stomatology and 92 students majoring in dental technology in Chongqing Medical University. The results were statistically analyzed by SPSS 21.0, and chi-square test or rank sum test was used to count the data.Results:Computers and mobile phones are the main tools for students to study online. 52.92% of students used computers and 38.72% used smart phones. About 80% of the students said that they could adapt to online learning, and there was no statistical difference between the students of two majors. The online learning time of students majoring in stomatology was mainly 4-6 hours, while that of students majoring in dental technology was 2-4 hours, with statistical significance. However, the latter were more likely to ask questions to teachers than the former, and the proportion of students who often asked questions to teachers was 29.35% and 20.60%, respectively, with statistical significance. A small number of students of both majors failed log on the platform to learn and complete all the teaching materials on time. More than 50% of the students thought that online teaching was not as effective as offline teaching, and offline teaching was more conducive to mastering curriculum knowledge, without statistical differences between the students of two majors. They thought that the unsmooth learning platform, poor network conditions at home, and insufficient teaching materials prepared by teachers were the main reasons that affected the online learning effect.Conclusion:The online teaching is an important and also an advisable way to maintain teaching activities during the epidemic prevention and control of COVID-19. It will be the direction of further research on the education and teaching reform to make full use of information technology, combine the advantages of online teaching and traditional classroom teaching, and actively explore the blended teaching mode from the perspective of specialty and course characteristics.

Application and experience of electronic medical record in clinical practice of oral undergraduates / 中华医学教育探索杂志

Medical record writing is an important part of clinical practice for stomatology undergraduates. The application of electronic medical record system has been used under the guidance of teachers in the practice of stomatology undergraduates in our hospital. This paper investigates the use of electronic medical records of undergraduates in practice through questionnaires, and analyzes the quality of electronic medical records by spot checking. It's found that electronic medical records can guide interns to improve their clinical abilities in all aspects, but there are still some shortcomings such as dependence on medical record templates and inadequate mobilization of clinical thinking ability. This paper puts forward some measures to promote the application of electronic medical records and the quality of practice teaching by strengthening pre-job education and mobilizing students' subjective initiative.

Discussion on the construction problems and countermeasures of hospital scientific research management subsystem based on HRP system / 中华医学科研管理杂志

Objective This paper studied the characteristics and contents of the hospital scientific research management subsystem based on HRP system,analyzing its characteristics and functions,proposing solutions to identified problems to improve the hospital management and core competitiveness.Methods Through the analysis of the characteristics and design module contents of the research management subsystem of HRP system,some problems were identified in the system,such as the long adaptation process of researchers' new or old concepts,unstable research management subsystem affecting the links between departments and so on.Results To better deal with identified problems,this paper put forward some improvement measurements,such as strengthening the monitoring of H RP system's scientific research management subsystem,strengthening the safety construction of both HRP system and scientific research management subsystem.Conclusions HRP system and scientific research management subsystem reflect the refinement,scientific and integration of hospital management,which is a hospital management concept and a means to improve the core competitiveness of the hospital.We should change the percep tions,improve understandings,strengthen the collaboration,and promote the overall development of the hospital.

Practices of scientific research innovation ability training mode for the current dental undergradu-ates / 中华医学教育探索杂志

To cultivate innovative medical students is the inevitable trend to adapt to the social de-velopment in the higher medical education. Stomatology is a subject emphasizing on practical and innovation ability, so paying attention to the cultivation of students' application ability and innovation ability in the undergraduate stage, combining theoretical study and research innovation, can lay a good foundation for the study and work. In recent years, the College of Stomatology of Chongqing Medical University has created the scientific research atmosphere, established the platform of scientific research, attempted the undergraduate tutorial system, expanded the construction of teaching resource, and involved undergraduate to take part in the scientific research practice. The college has taken many active measures to train the scientific innovation ability of undergraduates, and has obtained good results. Some undergraduates have already possessed a certain ability to find and solve problems as well as independently think. They have also enhanced their awareness of reading literature and critically accepting knowledge and improved their comprehensive quality.

Comparison between lingual and labial orthodontics based on treatment of overbite by using rocking chair arch wire - A biomechanical study

Background Lingual orthodontics [LiO] has developed rapidly in recent years and research on treatment of overbite by using Rocking Chair Arch [RCA] wire of different curve depths is still limited, especially with 3-dimensional Finite Element [FE] models. The main objectives are to study the biomechanical differences in maxillary anterior teeth between lingual and labial orthodontics and observe the lingual mechanics on different inclinations of teeth

Methods The force produced by Nickel-Titanium, Stainless Steel [SS] RCA for both sides was measured using Electromechanical Universal Testing Machine. 6 FE models were constructed and divided into 2 groups according to SS wire of 0.016x0.022-inch standard and mushroom arch shaped RCA of curve depth 2, 4, 6 mm. Additional 9 FE models were constructed and divided into 3 groups based on Retroclination [-5[degree sign], -10[degree sign]] and Proclination [+10[degree sign]]

Results Use of same diameter of SS RCA with same curve depth but on different sides shows more stress and strain, displacement of teeth in lingual mechanics. Also, stress-strain, displacement increased with increasing RCA curve depth. In LiO, intrusion of normally inclined or proclined teeth are accompanied by little or no labial tipping whereas that of retroclined teeth is accompanied by further lingual tipping

Conclusion In the intrusion using Lingual RCA, to avoid the traumatic force to teeth, the curve depth should be lesser than Labial RCA or apply more elastic arch material; Aligning different inclined teeth into normal inclination firstly and proceed with the application of intrusive force can be the best approach

Effectiveness of alendronate as an adjunct to scaling and root planing in the treatment of periodontitis: a meta-analysis of randomized controlled clinical trials

PURPOSE: Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone. METHODS: Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane χ² and I2 tests. RESULTS: After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05–43.45; P<0.001; I²=94.0%), 2.29 mm for PD reduction (95% CI=2.07–2.52 mm; P<0.001; I²=0.0%) and 1.92 mm for CAL gain (95% CI=1.55–2.30 mm; P<0.001; I²=66.0%). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18–0.55 mm; P<0.001; I²=0.0%) and increased CAL by 0.39 mm (95% CI=0.11–0.68 mm; P=0.006; I²=6.0%). CONCLUSIONS: The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.

Preliminary exploration and practice on digital oral medicine instructional management platform / 中华医学教育探索杂志

In recent years, various network assistant teaching platforms which have flooded into universities have been well received by the majority of teachers and students and educators. Network teach-ing platforms in oral medicine education now, especially the assistant teaching and information management have gradually risen to play a decisive role position. Combined with the characteristics of oral medical un-dergraduate course and the present situation of teaching, a preliminary practical use has been made on the new digital teaching management platform of College of Stomatology, Chongqing Medical University, and the analysis based on its advantages and disadvantages has also been made, in order to make an improvement of oral medicine teaching quality and management efficiency.

The Thinking of realizing information management of scientific research archives / 中华医学科研管理杂志

Scientific research archives management work is a basic work in the hospital work,establish hospital scientific research management information system,implementation of scientific research archives management informationization can not only realize the scientific research resources sharing,and can greatly improve the scientific quality of service and efficiency.This paper analyzes the necessity of scientific research archives information management,and the main plate and the function of information management system of scientific research archives has carried on the detailed introduction.

Research on ultrasonic permeability of low intensity pulsed ultrasound through PTFE membrane and Bio-Gide collagen membrane / 生物医学工程学杂志

The aim of the present study was to detect the transmission rate of ultrasonic low intensity pulsed ultrasound (LIPUS) through polytetrafluoroethylene (PTFE) membrane (Thickness: 0.01 mm) and Bio-Gide collagen membrane, and to provide the basis for the barrier membrane selection on the study of LIPUS combined with guided tissue regeneration (GTR). The ultrasonic (LIPUS, frequency 1.5 MHz, pulse width 200 micros, repetition rate 1.0 kHz) transmission coefficient of the two kinds of barrier membrane were detected respectively through setting ten groups from 10 to 100mW/cm2 every other 10 mW/cm2. We found in the study that the ultrasonic transmission coefficient through 0.01 mm PTFE membrane was 78.1% to 92.%, and the ultrasonic transmission coefficient through Bio-Gide collagen membrane was 43.9% to 55.8%. The ultrasonic transmission coefficient through PTFE membrane was obviously higher than that through Bio-Gide collagen membrane. The transmission coefficient of the same barrier membrane of the ultrasonic ion was statistically different under different powers (P < 0.05). The results showed that the ultrasonic transmittance rates through both the 0.01 mm PTFE membrane and Bio-Gide collagen membrane were relatively high. We should select barrier membranes based on different experimental needs, and exercise ultrasonic transmission coefficient experiments to ensure effective power.

The impact of Forsus on mandible's stress and displacement / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To further explore the best Forsus load power by analyzing the change of mandible's stress and displacement after Forsus protruded mandible instantaneously under different vertical component for providing theoretical basis.</p><p><b>METHODS</b>The pre-built Forsus protruding mandible model were build through Abaqus 6.5 software. The change of mandible's stress, displacement, and pathway trend under three different working conditions(horizontal component 4 N and vertical component 2, 4, 1 N).</p><p><b>RESULTS</b>Torsion occurred in all condyles under three working conditions, and the stress was large. Under vertical component 2 and 1 N, the mandible demonstrated counterclockwise rotation, the maximum displacement occurred in the chin, respectively 1.150 mm and 2.141 mm; under vertical component 4 N, mandible rotation was not obvious, the maximum displacement of chin was only 0.188 mm.</p><p><b>CONCLUSION</b>With the vertical component gradually decreased, the protrusion trend of chin increased; Forsus could promote the mandible counterclockwise rotation and modification when protruding mandible.</p>

A comparative study on three-dimensional movement of anterior teeth between applying MDD appliances and applying three common fixed appliances in the initial alignment stage / 生物医学工程学杂志

Typodont models of bilateral canines gingival displaced vertically for 3 mm and bilateral lateral incisors palatal displaced horizontally for 3 mm are made and every kind of the two kind models was divided into four groups: MDD, MBT, self-ligating and Tip-Edge. Each group of the two kinds of models had 5 models, so a total of 40 models for the two kinds of models were set up. The experimental models were aligned with a 0.30 mm of nickel titanium round wire in a water-bath with constant temperature 45 degrees C for 30 minutes. The three-dimensional digital images of the experimental models before and after the water bath were obtained by scanning with the three dimensional optical scanner ATOS. Geomagic software was used to overlap the digital images taken before and after the water bath treatment. The vertical changes of sign points of canines, the movements of sign points of lateral incisors in the sagittal plane and the horizontal plane were quantified by using the Color map. The data was then processed by a two-factor analysis of variance by using SAS 9.2 software package. Analysis of the results shows that the vertical changes of sign points of canines , the movements of sign points of lateral incisors in the sagittal plane and the horizontal plane of MDD group are all less than those in the other three groups, a statistically significant difference (P < 0.0001). And the size of the teeth displacement is directly related to the size of orthodontic force on the typodont models. Thus the preliminary results suggest that MDD appliance might have advantages of light force in the alignment stage, and that the possible relevant factors are the improvement of its sub-slot and the single ligation wing design.

The preliminary study on biological characteristics of the SD rat dental follicle cells infected with SV40Tag / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To provide reliable seed cells with unlimited passage proliferation and stable biological characteristics for periodontal tissue engineering research through infecting a retrovirus carrying SV40Tag into SD rat dental follicle cells.</p><p><b>METHODS</b>Retroviral virus vector containing SV40Tag by 293 cells was packaged and infected into SD rat dental follicle cells. Normal dental capsule cells were used as control group. The cell morphology and vitality were observed by inverted microscope, telomerase activity, osteogenic differentiation and proliferation of dental follicle cells were analyzed.</p><p><b>RESULTS</b>The SD rat dental follicle cells infected with SV40Tag could be passaged for 60 generations in vitro culture with strong growth activity. The telomerase activity was significantly enhanced compared with the control group (P = 0.033). The expression of alkaline phosphatase, osteocalcin, bone morphogenesis protein-2, Runx2, basic fibroblast growth factor, insulin-like growth factors had no statistical difference compared with control cells (P > 0.05).</p><p><b>CONCLUSION</b>The SD rat dental follicle cells infected with SV40Tag not only have a strong growth activity and infinite passaged capacity, but also have a stable biological property as normal dental follicle cells, so it can be regarded as the excellent seed cells in periodontal tissue engineering.</p>

Low intensity pulsed ultrasound irradiating combined with guided bone regeneration for promoting the repair effect of periodontal bone defect / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the repair effect of low intensity pulsed ultrasound (LIPUS) irradiating combined with guided bone regeneration (GBR) on the defect of Beagle dog canines periodontal bone.</p><p><b>METHODS</b>Four canine teeth of every beagle dog (8 beagle dogs) were randomly distributed: Group 1 (LIPUS disposal + GBR+ autogenous bone graft group), group 2 (LIPUS disposal + autogenous bone graft group), group 3 (GBR + autogenous bone graft group), blank control group. The model of periodontal bone defect was established in the 1/3 part of the root buccal area. According to the group division, autogenous bone were grafted, group 1 and group 2 were disposed by LIPUS 20 min x d(-1). The intensity of ultrasound were 30 mW x cm(-2). Group 1 and group 3 were injected with Bio-Gide collagen membrane. The beagle dogs were executed at 6 and 8 weeks of the disposal of LIPUS and then Micro-CT test and analysis were conducted to periodontal bone defect area of each group.</p><p><b>RESULTS</b>By clinical observation, there were different degrees of shrinkages of the area of periodontal bone defect in each group. The Micro-CT test analysis indicated that there was a statistical difference among the number, the thickness as well as the size of bone trabecula of each group (P < 0.05). However, there was no statistical difference (P > 0.05) in terms of bone issue measurement index between 6 to B weeks of each group. Group 1 had the most new bone.</p><p><b>CONCLUSION</b>LIPUS has the potential to promote the repair of periodontal bone defect. Therefore the combination of LIPUS and GBR may be more conducive to the repair and regeneration of periodontal bone defect.</p>