Neutrophil-to-lymphocyte ratio associated with symptomatic saccular unruptured intracranial aneurysm.

BACKGROUND AND PURPOSE: Whether symptomatic unruptured intracranial aneurysms (UIAs) lead to change in circulating inflammation remains unclear. This study aims to evaluate the role of hematological inflammatory indicators in predicting symptomatic UIA. METHODS: Adult patients diagnosed with saccular intracranial aneurysm from March 2019 to September 2023 were recruited retrospectively. Clinical and laboratory data, including the white blood cells (WBC), neutral counts (NEUT), lymphocyte counts (LYM), and monocyte counts (MONO) of each patient, were collected. The neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated as NLR = NEUT/LYM, LMR = LYM/MONO, SII = PLT*NEUT/LYM. The hematological inflammatory indicators were compared in symptomatic saccular and asymptomatic UIA patients. Multivariable logistic regression analyses were performed to explore the factors predicting symptomatic UIA. RESULTS: One hundred and fifty UIA patients with a mean age of 58.5 ± 12.4 were included, of which 68% were females. The NLR and LMR were significantly associated with symptomatic UIA, and the association remained in small UIAs (< 7 mm). The multiple logistic regression analysis showed that NLR was independently associated with symptomatic UIA. On ROC curve analysis, the optimal cutoff value of NLR to differentiate symptomatic from asymptomatic was 2.38. In addition, LMR was significantly associated with symptomatic UIA smaller than 7 mm. CONCLUSION: There was a significant correlation between NLR and symptomatic UIA. The NLR was independently associated with symptomatic UIA.

Reference Values of Carotid Ultrafast Pulse-Wave Velocity: A Prospective, Multicenter, Population-Based Study.

BACKGROUND: Ultrafast ultrasound imaging has been demonstrated to be an effective method to evaluate carotid stiffness through carotid pulse-wave velocity (PWV) with high reproducibility, but a lack of reference values has precluded its widespread use in clinical practice. The aims of this study were to establish reference values of PWV for ultrafast ultrasound imaging in a prospective, multicenter, population-based cohort study and to investigate the main determinants of carotid PWV. METHODS: A total of 1,544 healthy Han Chinese volunteers (581 men [38%]; age range, 18-95 years) were enrolled from 32 collaborating laboratories in China. The participants were categorized by age, blood pressure (BP), and body mass index (BMI). Basic clinical parameters and carotid PWV at the beginning of systole (BS) and at end-systole (ES) were measured using ultrafast ultrasound imaging techniques. RESULTS: PWV at both BS and ES was significantly higher in the left carotid artery than in the right carotid artery. PWV at BS was significantly higher in men than in women; however, no significant difference was noted in PWV at ES between men and women. Multiple linear regression analyses revealed that age, BP, and BMI were independently correlated with PWV at both BS and ES. PWV at BS and ES progressively increased with increases in age, BP, and BMI. Furthermore, age- and sex-specific reference values of carotid PWV for ultrafast ultrasound imaging were established. CONCLUSIONS: Reference values of carotid PWV for ultrafast ultrasound imaging, stratified by sex and age, were determined for the first time. Age, BP, and BMI were the dominant determinants of carotid PWV for ultrafast ultrasound imaging, which should be considered in clinical practice for assessing arterial stiffness.

Topological optimization of 3D printed bone analog with PEKK for surgical mandibular reconstruction.

PURPOSE: The purpose of this study was to analyze mechanical behaviors of a topologically optimized and 3D-printed mandibular bone block with polyetherketoneketone (PEKK) for surgical mandibular reconstruction. MATERIALS AND METHODS: 3D virtual mandibular models were reconstructed from cone beam computed tomography images. A proposed mandibular resection of the mandibular body (40 mm anterior-posteriorly) was segmented. Internal structure of the resected bone was designed with topological optimization. Dental implants and implant-supported crowns were integrated into the design. A second 3D virtual model was created with the same size and location of the defect but was reconstructed with a fibular graft and implant-supported crowns. The biomechanical behaviors of the two models were compared by finite element method (FEM) under the same boundary constraints and three loading locations, namely, central incisors, lower left and right side first molar areas. RESULTS: The FEM results showed the maximum stresses and displacements of the topology optimized model were much lower than those of the model with fibular bone graft. The highest stress of the optimized mandibular model was located on the lower edge of the posterior border of bone analog, and fixation screws. The maximum displacement occurred at the lower edge of the proximal mandibular stump or the lower edge of the distal mandibular body on the contralateral site. Under the same three loading locations, the maximum stress of the optimized model significantly decreased by 67.9%, 71.9% and 68.6% compared to the fibular graft model. CONCLUSIONS: The 3D printed bone analog with topological optimization is patient-specific and has advantages over the conventional fibular bone graft for surgical mandibular reconstruction. The optimized PEKK bone analog model creates more normal stress-strain trajectories than the fibular graft model and likely provides better functional and cosmetic outcomes.

A biomechanical case study on the optimal orthodontic force on the maxillary canine tooth based on finite element analysis.

Excessive forces may cause root resorption and insufficient forces would introduce no effect in orthodontics. The objective of this study was to investigate the optimal orthodontic forces on a maxillary canine, using hydrostatic stress and logarithmic strain of the periodontal ligament (PDL) as indicators. Finite element models of a maxillary canine and surrounding tissues were developed. Distal translation/tipping forces, labial translation/tipping forces, and extrusion forces ranging from 0 to 300 g (100 g=0.98 N) were applied to the canine, as well as the force moment around the canine long axis ranging from 0 to 300 g·mm. The stress/strain of the PDL was quantified by nonlinear finite element analysis, and an absolute stress range between 0.47 kPa (capillary pressure) and 12.8 kPa (80% of human systolic blood pressure) was considered to be optimal, whereas an absolute strain exceeding 0.24% (80% of peak strain during canine maximal moving velocity) was considered optimal strain. The stress/strain distributions within the PDL were acquired for various canine movements, and the optimal orthodontic forces were calculated. As a result the optimal tipping forces (40-44 g for distal-direction and 28-32 g for labial-direction) were smaller than the translation forces (130-137 g for distal-direction and 110-124 g for labial-direction). In addition, the optimal forces for labial-direction motion (110-124 g for translation and 28-32 g for tipping) were smaller than those for distal-direction motion (130-137 g for translation and 40-44 g for tipping). Compared with previous results, the force interval was smaller than before and was therefore more conducive to the guidance of clinical treatment. The finite element analysis results provide new insights into orthodontic biomechanics and could help to optimize orthodontic treatment plans.

Numerical and Experimental Analyses on the Temperature Distribution in the Dental Implant Preparation Area when Using a Surgical Guide.

PURPOSE: During dental implantation, if the temperature within the bone tissue exceeds a critical value, the thermal necrosis of bone cells may take place, inhibiting osseointegration. In contrast to conventional dental implant surgery, a surgery guided by a surgical template is a safer and more efficient technique; however, the temperature within the implant field is more difficult to control, because the surgical guide blocks irrigation water. The purpose of this study was to investigate the temperature distribution in the drilling site when preparing for dental implant placement with a surgical guide, and to derive suggestions for clinical operation. MATERIALS AND METHODS: Initially, the sources of heat during drilling were investigated, and theoretical equations were listed. Subsequently, a measurement system using thermocouples was constructed, with which the temperature increments at specific points in the simulated bone samples were recorded during guided drilling with different cooling methods. Based on the equations and data assessed, a thermal simulation model with a finite element method (FEM) was created, and the temperature change of the whole surgical field was calculated on the basis of the numerical simulation results. Consequently, the point experiencing the highest temperature within the bone was determined. RESULTS: From the experimental measurements, the highest temperature increment was located at a depth of 6 mm without irrigation and at 8 mm with cooling, rather than at the deepest point of the prepared hole. Because the surgical guide blocks the cooling water from entering the drilling site, the biggest increment of temperature using conventional irrigation with the surgical guide was 1.95 times that recorded when using a surgical guide consisting of cooling channels, and 3.6 times that recorded using a drill with an internal cooling hole. And from numerical analysis, during drilling for implant placement site with conventional irrigation, the highest temperature (45.6°C) was close to the critical point at which bone necrosis occurs. CONCLUSIONS: Based on theoretical analysis, experimentation, and FEM simulation, the temperature distribution of the drilling area in the placement of dental implants under surgical guide was determined. For clinical operation, improved cooling methods, such as using a drill with an internal cooling channel, should be used, and the drill should be regularly withdrawn during drilling.

An Investigation of Two Finite Element Modeling Solutions for Biomechanical Simulation Using a Case Study of a Mandibular Bone.

The method used in biomechanical modeling for finite element method (FEM) analysis needs to deliver accurate results. There are currently two solutions used in FEM modeling for biomedical model of human bone from computerized tomography (CT) images: one is based on a triangular mesh and the other is based on the parametric surface model and is more popular in practice. The outline and modeling procedures for the two solutions are compared and analyzed. Using a mandibular bone as an example, several key modeling steps are then discussed in detail, and the FEM calculation was conducted. Numerical calculation results based on the models derived from the two methods, including stress, strain, and displacement, are compared and evaluated in relation to accuracy and validity. Moreover, a comprehensive comparison of the two solutions is listed. The parametric surface based method is more helpful when using powerful design tools in computer-aided design (CAD) software, but the triangular mesh based method is more robust and efficient.

[Protective effect of dexmedetomidine against perioperative inflammation and on pulmonary function in patients undergoing radical resection of lung cancer].

OBJECTIVE: To study the protective effect of dexmedetomidine against perioperative inflammation and on pulmonary function in patients undergoing radical resection of lung cancer. METHODS: From May, 2014 to May, 2016, 124 patients with lung cancer receiving radical surgeries were randomized into experimental group (n=62) and control group (n=62). The patients in the control group received a single anesthetic agent for anesthesia, and additional dexmedetomidine was given in the experimental group. The levels of serum interleukin-1ß (IL-1ß), IL-10, and tumor necrosis factor-alpha (TNF-α) were measured before the operation (T0), at 30 min (T1) and 60 min (T2) during one lung ventilation (OLV) and at the end of operation (T3). Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of malondialdehyde (MDA), myeloperoxidase (MPO) and xanthine oxidase (XOD), and the arterial oxygen partial pressure (PaO2), oxygenation index (OI), airway plateau pressure (APP) and airway resistance (AR) were also recorded. RESULTS: At the time points of T1 and T2, IL-1ß, IL-10, MDA, MPO, TNF-α, and XOD levels were significantly increased in both of the groups, but the levels of IL-1, IL-10, TNF-α and MDA were significantly lower and MPO and XOD levels significantly higher in the experimental group than in the control group (P<0.05). In both groups, PaO2 and OI decreased and APP and AR increased significantly at T1 and T2, but APP and AR were significantly lower and PaO2 and OI significantly higher in the experimental group than in the control group (P<0.05). CONCLUSION: Anesthesia with dexmedetomidine in lung cancer patients undergoing radical surgery can effectively reduce the inflammatory response of the lungs and protect the lung function of the patients.

Impact of Surgical Template on the Accuracy of Implant Placement.

PURPOSE: To achieve functional and esthetic results, implants must be placed accurately; however, little information is available regarding the effect of surgical templates on the accuracy of implant placement. Thus, the aim of this study was to measure the deviation between actual and planned implant positions, and determine the deviation caused by the surgical template. MATERIALS AND METHODS: Jaws from 16 patients were scanned using cone beam computed tomography (CBCT). For our study, 53 implants were planned in a virtual 3D environment, of which 35 were inserted in the mandible and 18 in the maxilla. A stereolithographic (SLA) surgical template was created. A CBCT scan of the surgical template fitted on a plaster model was performed, and the images obtained were matched to virtual implant plan images that contained the planned implant position. The actual implant position was acquired from the registration position of the surgical template. Deviation between actual and planned implant positions was analyzed. RESULTS: Mean central deviation at the hex and apex was 0.456 mm and 0.515 mm, respectively. Mean value of horizontal deviation at the hex was 0.193 mm, horizontal deviation at the apex was 0.277 mm, vertical deviation at the hex was 0.388 mm, vertical deviation at the apex was 0.390 mm, and angular deviation was 0.621°. CONCLUSION: Our study results revealed a significant deviation between actual and planned implant positions caused by the surgical template.

Digital design and fabrication of simulation model for measuring orthodontic force.

Three dimensional (3D) forces are the key factors for determining movement of teeth during orthodontic treatment. Designing precise forces and torques on tooth before treatment can result accurate tooth movements, but it is too difficult to realize. In orthodontic biomechanical systems, the periodontal tissues, including bones, teeth, and periodontal ligaments (PDL), are affected by braces, and measuring the forces applied on the teeth by braces should be based on a simulated model composed of these three types of tissues. This study explores the design and fabrication of a simulated oral model for 3D orthodontic force measurements. Based on medical image processing, tissue reconstruction, 3D printing, and PDL simulation and testing, a model for measuring force was designed and fabricated, which can potentially be used for force prediction, design of treatment plans, and precise clinical operation. The experiment illustrated that bi-component silicones with 2:8 ratios had similar mechanical properties to PDL, and with a positioning guide, the teeth were assembled in the mandible sockets accurately, and so a customized oral model for 3D orthodontic force measurement was created.

CEUS helps to rerate small breast tumors of BI-RADS category 3 and category 4.

PURPOSE: The primary aim of this study was to explore if classification, whether using the BI-RADS categories based on CEUS or conventional ultrasound, was conducive to the identification of benign and malignant category 3 or 4 small breast lesions. MATERIAL AND METHODS: We evaluated 30 malignant and 77 benign small breast lesions using CEUS. The range of enhancement, type of enhancement strength, intensity of enhancement, and enhancement patterns were independent factors included to assess the BI-RADS categories. RESULTS: Of the nonenhanced breast lesions, 97.8% (44/45) were malignant, while, of the hyperplasic nodules, 96.8% (30/31) showed no enhancement in our study. Category changes of the lesions were made according to the features determined using CEUS. The results showed that these features could improve diagnostic sensitivity (from 70.0 to 80.0, 80.0, 90.0, and 90.0%), reduce the negative likelihood ratio (from 0.33 to 0.22, 0.25, 0.11, and 0.12), and improve the NPV (from 88.8 to 92.2, 91.2, 96.2, and 95.5%). However, this was not conducive to improve diagnostic specificity or the PPV. CONCLUSION: The vast majority of nonenhanced small breast lesions were malignant and most of the hyperplasic nodules showed no contrast enhancement. As a reference, CEUS was helpful in identifying BI-RADS category 3 or 4 small breast lesions.

Methylenetetrahydrofolate reductase genetic polymorphisms and esophageal squamous cell carcinoma susceptibility: a meta-analysis of case-control studies.

BACKGROUND: Genetic factors and environmental factors play a role in pathogenesis of esophageal squamous cell carcinoma (ESCC). Previous studies regarding the association of folate intake and Methylenetetrahydrofolate reductase C677T polymorphism with ESCC was conflicting. We conducted a meta-analysis to investigate the association of MTHFR C677T and folate intake with esophageal cancer risk. METHODS: MEDLINE, EMBASE and the Chinese Biomedical Database were searched in our study. The quality of studies were evaluated by predefined scale, and The association of polymorphisms of MTHFR C677T and folate intake and ESCC risk was estimated by Odds ratio (ORs) with 95% confidence intervals (CIs). RESULTS: 19 studies (4239 cases and 5575 controls) were included for meta-analysis. A significant association was seen between individuals with MTHFR 677 CT [OR(95%)=1.47(1.32-1.63)] and TT [OR(95%)=1.69(1.49-1.91)] genotypes and ESCC risk (p<0.05). Low intake of folate had significantly higher risk of esophageal cancer among individuals with CT/TT genotype [OR(95%)=1.65(1.1-2.49)], while high intake of folate did not find significant high risk of esophageal cancer among individuals with CT/TT genotype [OR(95%)=1.64 (0.82-3.26)]. CONCLUSIONS: Our meta-analysis indicated the folate intake and MTHFR 677CT/TT are associated with the risk of ESCC, and folate showed a significant interaction with polymorphism of MTHFR C677T.

[Application of bolt-like post crown system in restoration of molar residual root and crown with low occlusogingival distance].

PURPOSE: To evaluate the clinical effects of bolt-like post crown system in restoration of molar residual root and crown with low occlusogingival distance and large root bifurcation angle. METHODS: Thirty two molar residual roots and crowns from 25 patients with low occlusogingival distance (<4 mm) and large root bifurcation angle were involved in this study. First, the root canals were prepared according to their natural directions following the standard procedures. Accurate impressions were taken with silicone. The core crown and the post which would inserted the straight root canal were founded together,and the blot-like post which would inserted the root canal with bigger bifurcat were founded alone. Finally, the two parts were cemented together in patient after try-in with RelyX™ Unicem cement. RESULTS: Except 3 patients who were lost during the follow up period, the remaining 22 patients (29 restorations) were followed up for 1 to 5 years. No prosthetic loosening or root fracture was observed during the follow-up period. All the fixed restorations were found with good marginal fitness, well masticatory function and favorable proximal contact relationship. CONCLUSIONS: Bolt-like post crown system is an ideal method for restoration of molar residual root and crown with low occlusogingival distance and large root bifurcation angle. This approach has positive effect on the retention, function and aesthetic outcome of the fixed restorations of molar residual root and crown with low occlusogingival distance.

[Features of preoperative contrast-enhanced ultrasound of breast cancer: relationship with the syndrome classification in traditional Chinese medicine].

OBJECTIVE: To analyze the relationship between the features of preoperative contrast-enhanced ultrasound and the differentiation of symptoms and signs for syndrome classification by traditional Chinese medicine (TCM). METHODS: Eighty-two patients with malignant breast tumor were examined with contrast-enhanced ultrasound before the operation. The tumor diameter was greater than 2.0 cm in 48 cases and below 2.0 cm in 34 cases. According to the curative effect standard of TCM disorder, differentiation of symptoms and signs for classification of syndrome were performed, and the ultrasonic manifestations of different syndrome types were compared. RESULTS: In patients with maximum tumor diameter < or = 2 cm, Chong and Ren disorder type and liver Qi stagnation type were prevalent. In those with tumor diameter of <2 cm, Zeyi liver Qi stagnation type and virtual drug junction were more common. The mass peak intensity, slope of increase, enhancement intensity index and time-intensity curve of ultrasound differed significant between different syndrome types (P<0.05). CONCLUSION: The preoperative ultrasound features of breast cancer are associated with the syndrome types in TCM.

[Effects of a new houttuyfonate derivative on proliferation of NIH3T3 cell and expression of syndecan-4 induced by tumor necrosis factor alpha].

OBJECTIVE: To investigate the effect of a new houttuyfonate derivative (NHD) on proliferation of NIH3T3 cell and expression of Syndecan-4 induced by TNF-alpha in vitro. METHODS: NIH3T3 cells were cultured and exposed to TNF-alpha or NHD respectively, and then cotreated with TNF-alpha and NHD. All the groups were cultured for 24 hour in vitro, in addition to the untreated control group established for comparison. The ratio of proliferation of NIH3T3 cell was determined by non-radioactive MTS/PMS assay and the expression of Syndecan-4 was evaluated by western blot using anti-Syndecan-4 antibody. RESULTS: Statistical analysis showed that, compared with the control group, NHD had no effect on VSMCs growth, but significantly inhibited NIH3T3 cell proliferation while induced by TNF-alpha. It also showed that compared with control group, NHD had no effect on the expression of Syndecan-4, but significantly inhibited its expression while induced by TNF-alpha (P < 0.05). CONCLUSIONS: NHD can inhibit the proliferation of NIH3T3 cell and the expression of syndecan-4 protein induced by TNF-alpha in vitro.

[Contrast-enhanced ultrasound findings of breast cancer].

OBJECTIVE: To study the manifestation of breast cancers of different sizes in contrast-enhanced sonography. METHODS: Eighty-four patients with breast cancers were examined by contrast-enhanced ultrasound. Among them, the tumor diameter was beyond 2.0 cm in 50 cases, and no greater than 2.0 cm in the rest cases. The time-intensity curve (TIC) on the enhanced images was analyzed quantitatively, and the relations between the type of TIC and the enhancement patterns of the tumors were analyzed. RESULTS: The enhancement patterns of the breast cancers showed significant difference between patients with tumor diameter beyond 2.0 cm and those with smaller tumors (P<0.01), but the other parameters were comparable between the two groups (P>0.05). CONCLUSION: The enhancement patterns of breast cancers differ between tumors with sizes over 2.0 cm and smaller tumors, and differential analysis is suggested in the diagnosis of breast cancer using contrast-enhanced ultrasound.

[Effect of continuously compressive pressure on the expression of RANKL mRNA in human periodontal ligament cells in vitro].

OBJECTIVE: To determine the effect of continuously compressive pressure (CCP) on the expression of receptor activator of nuclear factor kappa B ligand (RANKL) in human periodontal ligament cells (HPDLCs) and to investigate the role of RANKL in alveolar bone rebuilding during orthodontic tooth movement. METHODS: The primary HPDLCs were isolated from human periodontal ligament by explanting enzymatic digestion with trypsin and collagenase to establish a pressure model. Top-bottom axial pressures (1, 2, and 3 g/cm(2)) were laid on HPDLCs for 0.5, 1.5, 6, 12, 24, and 48 h, respectively. The RANKL expression was identified by the reverse transcription-polymerase chain reaction (RT-PCR) at the mRNA level. RESULTS: The expression of RANKL mRNA significantly increased in a time-dependent manner (P<0.01), so did the value of pressure, especially in the 2 g/cm(2) group (P<0.05). CONCLUSION: CCP can up-regulate the expression of RANKL mRNA in human periodontal ligament cells.

[Tension-force induced cyclooxygenase-2 expression mediated by microfilament in human periodontal ligament fibroblast].

OBJECTIVE: To study the role of microfilament polymerization in menchanotransduction by human periodontal ligament fibroblast (hPDLFs). METHODS: In tension-force group, hPDLFs were treated by tension-force values of 18% for 8 h, 16 h, 24 h. In tension-force and inhibitor group, the sample was treated with 5 microg/mL cytochalasin B before using tension-forece. Each sample was collected and the expression of cyclooxygenase-2 was measured by using immunohistoche staining. RESULTS: In tension-force group, the expression of cyclooxygenase-2 enhanced with the extension of loading time. In tension-force and inhibitor group, cyclooxygenase-2 expression was depressed and had no relation with loading time. CONCLUSION: Tension-force induced cyclooxygenase-2 expression is mediated by microfilament, disruption of the microfilament polymerization will destroy mechanotransduction in hPDLFs.

[Effect of erigeron breviscapus on the expression of vascular endothelial growth factor in the periodontal tissues of rabbits during orthodontic tooth movement].

OBJECTIVE: To detect the effect of erigeron breviscapus on the expression of vascular endothelial growth factor (VEGF) in the periodontal tissues during orthodontic tooth movement. METHODS: 45 rabbits were divided into 3 groups (groups A, B and C). Groups A and B included experimental group of 1, 3, 7 and 14 days respectively. The mandibular first molar of each experimental rabbit was observed. The rabbits of group A and group B received iontophoresis with erigeron breviscapus into the right (group A-R and group B-R) and with normal sodium into the left as the control (group A-L and group B-L). Additionally, the rabbits of group B were designed orthodontic appliance, by which 0.78 N mesial force was applied to pull the mandibular first molars. Group C, group of 0 day, was no iontophoresis and orthodontic appliance as the control. After killed on schedule, the amount of experimental tooth movement was measured and the expression of VEGF was examined by immunohistochemical method. RESULTS: The amount of experimental tooth movement increased successively from 1 to 14 days. The differences among days 3, 7 and 14 were significant in the comparison between group B-R and group B -L (P < 0.01). The expression of VEGF in groups A-R and B-L enhanced apparently compared with that in groups C and A-L (P < 0.01), but that in group B-R was the most apparent (P < 0.01). The expression of VEGF reached the peak level on day 3 in groups A-R and B-R (P < 0.01), but it reached the peak level on day 7 in group B-L (P < 0.01). CONCLUSION: Erigeron breviscapus by iontophoresis can accelerate orthodontic tooth movement, and can meanwhile up-regulate the expression of VEGF in periodontium in the earlier period of orthodontic tooth movement. Thus it can be presumed that one of its mechanisms for erigeron breviscapus to accelerate orthodontic tooth movement is erigeron breviscapus effects the metabolism and differentiation of osteoblast and osteoclast through up-regulating the expression of VEGF in periodontium.