Advancing drug delivery to articular cartilage: From single to multiple strategies

Articular cartilage (AC) injuries often lead to cartilage degeneration and may ultimately result in osteoarthritis (OA) due to the limited self-repair ability. To date, numerous intra-articular delivery systems carrying various therapeutic agents have been developed to improve therapeutic localization and retention, optimize controlled drug release profiles and target different pathological processes. Due to the complex and multifactorial characteristics of cartilage injury pathology and heterogeneity of the cartilage structure deposited within a dense matrix, delivery systems loaded with a single therapeutic agent are hindered from reaching multiple targets in a spatiotemporal matched manner and thus fail to mimic the natural processes of biosynthesis, compromising the goal of full cartilage regeneration. Emerging evidence highlights the importance of sequential delivery strategies targeting multiple pathological processes. In this review, we first summarize the current status and progress achieved in single-drug delivery strategies for the treatment of AC diseases. Subsequently, we focus mainly on advances in multiple drug delivery applications, including sequential release formulations targeting various pathological processes, synergistic targeting of the same pathological process, the spatial distribution in multiple tissues, and heterogeneous regeneration. We hope that this review will inspire the rational design of intra-articular drug delivery systems (DDSs) in the future.

Discussion of N staging category of the eighth edition of The AJCC Esophageal Cancer Staging System / 中华外科杂志

AJCC Esophageal Cancer Staging System, 8th edition will be implemented on January 1, 2018. The N staging in 8th edition of staging system remains following 7th edition based on the number of metastatic nodes, except the limited revision of the regional lymph node map. N staging revision was reviewed from the simple definition of negative (N0) and positive (N1) lymph node(s) to the positive node number based proposal (7th edition). The 7th edition staging system, especially the N staging, were proved with more advantages on distinguishing disease progression and predicting prognosis of the esophageal cancer. On other hand, the disadvantages of 7th edition N staging are discussed. The refined N staging based on the number of metastatic node station is introduced. The extent and station of metastatic node could better reflect the disease progression and prognosis according to our research. The controversy on N staging of esophagogastric junction cancer is discussed as well. Other reported N staging associated index including lymph node ratio, lymphatic vessel invasion and biomarkers are reviewed and evaluated.

Investigation on dental caries among 2 713 preschool children from private kindergarten in Chongqing city / 重庆医学

Objective To investigate the status of dental caries of deciduous teeth among preschool children from private kin-dergarten in Chongqing city.Methods According to the criteria recommended by The Third National Oral Health Investigation,the deciduous caries of 2 713 preschool children aged 3 to 6 years from 40 private kindergartens in Yuzhong district were examined.The prevalence of dental caries and the mean dmft were calculated.The results were analyzed using SPSS21.0 software package. Results The prevalence of dental caries was 61.04%.The mean dmft score was 3.12,the filling rate was 0.4%.The caries preva-lence of 3-,4-,5-,6-year-old children were found to be 42.51%,59.53%,67.76% and 74.85%,and the mean dmft score were 2. 71,3.68,3.96 and 4.09.The prevalence of dental caries and mean dmft increased gradually as the children was statistically signifi-cant(P 0.05).Conclusion Deciduous dental caries of preschool children from private kindergartens was an important problem in Chongqing city,and the filling rate was very low.

[Investigation on deciduous dental caries among preschool children in Chongqing city].

OBJECTIVE: To investigate the status of deciduous dental caries among preschool children in Chongqing city and to compare the oral health status of preschoolers from public and private kindergarten. METHODS: According to the criteria recommended by The Third National Oral Health Investigation, the deciduous caries of 5 030 preschool children aged 3 to 6 years old from 40 private kindergartens and 16 public kindergartens in Yuzhong district of Chongqing were examined. The prevalence of dental caries and the mean dmft and filling rate were calculated. The results were analyzed using SPSS 21.0 software package. RESULTS: Maxillary deciduous central incisors and mandibular deciduous molar were most prone to decay in 5,030 children. The prevalence of dental caries was 54.08% (2,720/5,030). The mean dmft score was 2.58 and the filling rate was 0.98% (127/12,993). The prevalence of dental caries and mean dmft increased gradually as the children were growing up (P < 0.05). The rate of filling teeth of the 6 year old group was higher than other groups (P < 0.05). No significant difference between males and females were noted (P > 0.05). The prevalence rate of deciduous dental caries among private kindergartens was 61.04% (1,656/2,713), with a mean dmft of 3.12 and filling rate of 0.35% (30/8,465). The prevalence rate of deciduous dental caries among public kindergartens was 45.92% (1,064/2,317), with a mean dmft of 1.95 and filling rate of 2.14% (97/4,528). Statistical analysis revealed significant differences in the prevalence rate, mean dmft, and filling rate between two kinds of kindergarten (P < 0.05). CONCLUSION: Deciduous dental caries of preschool children is an important problem in Chongqing city and the children from private kindergarten had very low filling rate.

Investigation on deciduous dental caries among preschool children in Chongqing city / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the status of deciduous dental caries among preschool children in Chongqing city and to compare the oral health status of preschoolers from public and private kindergarten.</p><p><b>METHODS</b>According to the criteria recommended by The Third National Oral Health Investigation, the deciduous caries of 5 030 preschool children aged 3 to 6 years old from 40 private kindergartens and 16 public kindergartens in Yuzhong district of Chongqing were examined. The prevalence of dental caries and the mean dmft and filling rate were calculated. The results were analyzed using SPSS 21.0 software package.</p><p><b>RESULTS</b>Maxillary deciduous central incisors and mandibular deciduous molar were most prone to decay in 5,030 children. The prevalence of dental caries was 54.08% (2,720/5,030). The mean dmft score was 2.58 and the filling rate was 0.98% (127/12,993). The prevalence of dental caries and mean dmft increased gradually as the children were growing up (P < 0.05). The rate of filling teeth of the 6 year old group was higher than other groups (P < 0.05). No significant difference between males and females were noted (P > 0.05). The prevalence rate of deciduous dental caries among private kindergartens was 61.04% (1,656/2,713), with a mean dmft of 3.12 and filling rate of 0.35% (30/8,465). The prevalence rate of deciduous dental caries among public kindergartens was 45.92% (1,064/2,317), with a mean dmft of 1.95 and filling rate of 2.14% (97/4,528). Statistical analysis revealed significant differences in the prevalence rate, mean dmft, and filling rate between two kinds of kindergarten (P < 0.05).</p><p><b>CONCLUSION</b>Deciduous dental caries of preschool children is an important problem in Chongqing city and the children from private kindergarten had very low filling rate.</p>

Application and dimensional structure of the early childhood oral health impact scale / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate influence of oral diseases on child oral health-related quality of life, and to identify the dimensional structure of the early childhood oral health impact scale (ECOHIS).</p><p><b>METHODS</b>The Chinese language version of ECOHIS was applied to 280 patients aged 2-5 years old from the paediatric dentistry clinic of West China School of Stomatology, Sichuan University. The three-dimensional construct was confirmed by confirmatory factor analysis(CFA).</p><p><b>RESULTS</b>Two hundred and sixty-eight valid questionnaires (95.7%) were reclaimed. For the child impact section of the ECOHIS, "pain in the teeth, mouth or jaws" was the most frequently reported item by the parents. Item of "feeling upset or guilty" was most frequently reported in the family impact section of the ECOHIS. The CFA results indicated that all factor loadings to its items were 0.25-0.81 with one factor loadings less than 0.30. The modified factor model revealed a better fit to the data.</p><p><b>CONCLUSION</b>Oral diseases have negative impact on the children's oral health-related quality of life. ECOHIS is a three-dimensional structure.</p>

Caries status of primary and permanent teeth among 6-year-old children in Sichuan province and their correlation / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate caries status of primary and permanent teeth among 6-year-old children in Sichuan Province and correlation between caries of deciduous molars and first permanent molars.</p><p><b>METHODS</b>Referenced to the sampling programme of the third national epidemiological survey of oral health status, a total of 714 children aged 6 were randomly sampled in clusters including 3 urban sampling spots and 3 rural sampling spots, the correlation between caries of deciduous molars and first permanent molars was explored.</p><p><b>RESULTS</b>The prevalence rate of deciduous tooth caries of 6-year-old children in Sichuan province was 74.37%, the mean number of dmft of 6-year-old was 3.94 +/- 3.93, the filling rate was only 4.96%. The prevalence rate and mean dmft of deciduous tooth caries showed no significant difference between different area and gender (P>0.05), however, the children came from city showed significant higher filling rate than those from countryside (P<0.05). The first permanent molars erupted have 2.98% in caries, the filling rate was 7.69%. Caries of deciduous molars was the first permanent molars caries risk factors among 6-year-old children in Sichuan province [P=0.001, r=0.175, OR=5.756, 95%CI (1.733, 19.121)]. There was weak correlation between caries of deciduous molars and first permanent molars (P<0.001, r=0.194).</p><p><b>CONCLUSION</b>Caries status of primary among 6-year-old children in Sichuan Province are serious. Caries experience of deciduous molars may play an important role in predicting the first permanent molars caries in clinic and prevention.</p>

Influence of problem-based learning on theoretical knowledge of Chinese students majoring in stomatology: a meta-analysis / 中华医学教育探索杂志

ObjectiveTo evaluate the theoretical knowledge level of Chinese students majoring in stomatology based on the problem-based learning (PBL).MethodsThe Cochrane reviewer's handbook was followed by.Domestic published articles from 1989 -2010 were selected by computer and handwork.All these retrieved studies were controlled clinical trials related to oral theoretical education and were conducted by PBL and the traditional teaching methods.The quality of included studies was critically evaluated and the data were analyzed by the RevMan 5.0.1 software.ResultsA total of 138 articles were selected,but only 8 were included.Significant differences were found when the data were pooled(P ＜ 0.01,I2 =80％ ) and random effect model was used for meta-analysis.The results showed that comparing with the traditional teaching methods,PBL can improve the theoretical score of dental students [ MD 5.39,95％ CI(2.20,8.58)],and sensitivity analysis showed that the result was stable.ConclusionPBL can improve the theoretical score of Chinese students majoring in stomatology.However,as part of the studies are not high quality literature,the above conclusion needs to be verified by more large sample-sized,rigorously designed randomized controlled clinical trials.

Meta-analysis of the effectiveness of laser therapy in the treatment of dentin hypersensitivity in China / 实用口腔医学杂志

Objective: To evaluate the effectiveness of laser therapy in the treatment of dentin hypersensitivity in China.Methods: The Cochrane reviewer's handbook was followed.Domestic published articles from 1989～2009 were selected by computer and handsearch.All these retrieved study were clinical control trials related to laser therapy in the treatment of dentin hypersensitivity.The quality of included studies was critically evaluated and data were analyzed by the RevMan 5.0.1 software.Results: A tota1 of 114 articles were selected,but only 9 were included.The results showed that: although the data of immediate efficiency of laser treating dentin hypersensitivity could be combined,significant heterogeneity was found when the other studies' data were pooled.So the data could not be merged,only the descriptive analysis could be used.The immediate efficiency for the treatment of dentine hypersensitivity using lasers was higher than the control group,the difference was statistically significant[OR=3.83,95%CI(2.86,5.12)],other period of efficacy had a trend which was superior to the control group.Conclusion: Comparing with the control group,the desensitizing of dentin hypersensitivity with laser is more effective.However,because the literature quality of this study is not high,the above conclusion needs to be verified by larger sample-size,rigorously designed,randomized controlled clinical trials.