Effect of injectable calcium alginate-amelogenin hydrogel on macrophage polarization and promotion of jawbone osteogenesis.

Due to persistent inflammation and limited osteogenesis, jawbone defects present a considerable challenge in regenerative medicine. Amelogenin, a major protein constituent of the developing enamel matrix, demonstrates promising capabilities in inducing regeneration of periodontal supporting tissues and exerting immunomodulatory effects. These properties render it a potential therapeutic agent for enhancing jawbone osteogenesis. Nevertheless, its clinical application is hindered by the limitations of monotherapy and its rapid release characteristics, which compromise its efficacy and delivery efficiency. In this context, calcium alginate hydrogel, recognized for its superior physicochemical properties and biocompatibility, emerges as a candidate for developing a synergistic bioengineered drug delivery system. This study describes the synthesis of an injectable calcium amelogenin/calcium alginate hydrogel using calcium alginate loaded with amelogenin. We comprehensively investigated its physical properties, its role in modulating the immunological environment conducive to bone healing, and its osteogenic efficacy in areas of jawbone defects. Our experimental findings indicate that this synthesized composite hydrogel possesses desirable mechanical properties such as injectability, biocompatibility, and biodegradability. Furthermore, it facilitates jawbone formation by regulating the bone-healing microenvironment and directly inducing osteogenesis. This research provides novel insights into the development of bone-tissue regeneration materials, potentially advancing their clinical application.

Diagnostic Value of Inflammation-Related Indicators in Distinguishing Early Colon Cancer and Adenomatous Polyps.

BACKGROUND: There are few clinical symptoms in early colorectal cancer, so it is necessary to find a simple and economical tumor detection index for auxiliary diagnosis. This study aims to explore the diagnostic value of preoperative inflammation-related indicators, such as neutrophil, lymphocyte, platelet count, platelet to lymphocyte ratio (PLA), neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII), for early colorectal cancer, and determine whether inflammation-related indicators can provide more accurate diagnostic judgment for patients. METHODS: This study was a retrospective study. Patients who were first diagnosed with colorectal cancer or colorectal adenomatous polyp at Beijing Friendship Hospital from October 2016 to October 2017 were retrospectively collected. According to inclusion and exclusion criteria, a total of 342 patients were included, including 216 patients with colorectal cancer and 126 patients with colorectal adenomatous polyp. Fasting venous blood and other clinical features were collected to compare the differences between colorectal cancer and colorectal adenoma. RESULTS: There were statistically significant differences in age, carcinoembryonic antigen, albumin, hemoglobin, mean platelet volume, lymphocyte, monocyte, NLR, PLA, SII, and mean platelet volume to platelet count ratio between colorectal cancer group and colorectal adenoma group (P < .05), and a Nomogram model was established. Using inflammatory markers to differentiate colorectal and colorectal polyps produced greater AUC than using tumor markers alone (.846 vs .695). CONCLUSION: Inflammation-related indicators, such as lymphocyte, monocyte, and mean platelet volume, may serve as potential indicators to assist in the diagnosis of early colorectal cancer.

Sarcobesity, but not visceral fat, is an independent risk factor for complications after radical resection of colorectal cancer.

Background: The influence of body composition on the outcome of colorectal cancer surgery is controversial. The aim of this study was to evaluate the effects of visceral obesity and sarcobesity on the incidence of total and surgical complications after radical resection of colorectal cancer. Methods: We collected a total of 426 patients who underwent elective radical resection of colorectal cancer at Beijing Friendship Hospital, Capital Medical University from January 2017 to May 2018. According to the inclusion and exclusion criteria, 387 patients were finally included. A CT scan at the level of the L3-L4 intervertebral disk was selected to measure the values of visceral fat area and skeletal muscle area. Multivariate analysis was used to explore the independent risk/protective factors affecting postoperative complications. Results: 128 (33.1%) patients developed complications, and 44 (11.4%) patients developed major complications. Among them, 111 patients developed surgical complications and 21 developed medical complications. Visceral fat area (Z = -3.271, p = 0.001), total fat area (Z = -2.613, p = 0.009), visceral fat area to subcutaneous fat area ratio (V/S, Z = -2.633, p = 0.008), and sarcobesity index (Z = -2.282, p = 0.023) were significantly associated with total complications. Visceral fat area (Z = -2.119, p = 0.034) and V/S (Z = -2.010, p = 0.044) were significantly associated with total surgical complications. Sarcobesity index, smoking, stoma, blood loss, surgery time, and American Society of Anesthesiology (ASA) score were selected as risk factors for total postoperative complications according to LASSO regression. Multivariate logistic regression analysis suggested that sarcobesity index was an independent risk factor for postoperative total complications and surgical complications. Subgroup analysis suggested that albumin level was an independent protective factor for postoperative total complications in male patients. Smoking, operative time, and sarcobesity index were independent risk factors, and cholesterol was an independent protective factor for total postoperative complications in female patients. Conclusion: Increased sarcobesity index is an independent risk factor for postoperative complications in patients with colorectal cancer, while visceral fat area is not. For female patients, smoking, operation time, and obesity index are independent risk factors for postoperative complications, while cholesterol is an independent protective factor. For male patients, serum albumin is an independent protective factor for postoperative complications.

Impact of preoperative biliary drainage on postoperative complications and prognosis after pancreaticoduodenectomy: A single-center retrospective cohort study.

Background and objectives: Obstructive jaundice is common in patients with pancreaticobiliary malignancies. Preoperative biliary drainage (PBD) can alleviate cholestasis; however, no consensus has been reached on the impact of PBD on the incidence of surgery-related complications and patient survival. This study aimed to evaluate the effect among patients treated with PBD. Methods: This retrospective study examined the clinical and follow-up prognostic data of 160 patients with pancreaticobiliary malignancies who underwent pancreaticoduodenectomy (PD) at Beijing Friendship Hospital, Capital Medical University, from January 2016 to July 2020. Outcomes were compared between patients who underwent PBD (PBD group) and those who did not (control group). Changes in biochemical indicators were evaluated before and after drainage in the PBD group. Between-group differences in inflammatory indicators after PD were assessed using the Wilcoxon signed-rank test. Postoperative complications were classified according to the Clavien-Dindo classification system. The effects of PBD and biliary drainage efficiency on postoperative complications were evaluated using the chi-square test and binary logistics regression. The Kaplan-Meier analysis was used for between-group comparison of survival analysis. Univariate and multivariate regression analyses were performed to identify prognostic factors of survival. Results: Total 160 patients were enrolled,the mean age of the study sample was 62.75 ± 6.75 years. The distribution of pancreaticobiliary malignancies was as follows: 34 cases of pancreatic head cancer, 61 cases of distal bile duct cancer, 20 cases of duodenal papilla cancer, 39 cases of duodenal ampullary cancer, and 6 cases of malignant intraductal papillary mucinous neoplasm (IPMN). PBD was performed in 90 of the 160 patients, with PBD performed using an endoscopic retrograde cholangiopancreatography (ERCP) approach in 55 patients and with percutaneous transhepatic cholangiography (PTC) used in the remaining 35 cases. The mean duration of drainage in the PBD group was 12.8 ± 8.8 days. The overall rate of complications was 48.05% (37/77) in the control group and 65.55% (59/90) in the PBD group with non-significant difference (χ2 = 3.527, p=0.473). In logsitics regression analysis, PBD was also not a risk factor for postoperative complications OR=1.77, p=0.709). The overall rate of postoperative complications was significantly higher among patients who underwent PBD for >2 weeks (χ2 = 6.102, p=0.013), with the rate of severe complications also being higher for this subgroup of PBD patients (χ2 = 4.673, p=0.03). The overall survival time was 47.9 ± 2.45 months, with survival being slightly lower in the PBD group (43.61 ± 3.26 months) than in the control group (52.24 ± 3.54 months), although this difference was not significant (hazard ratio (HR)=0.65, p=0.104). Conclusion: In patients with malignant biliary obstruction, PBD does not affect the incidence of postoperative complications after pancreaticoduodenectomy nor does it affect patient survival. Prolonged biliary drainage (>2 weeks) may increase the incidence of overall postoperative complications and severe complications.

The Diagnostic Value of GGT-Based Biochemical Indicators for Choledocholithiasis with Negative Imaging Results of Magnetic Resonance Cholangiopancreatography.

To reveal the relationship between a group of preoperative biochemical indicators such as GGT, ALP, ALT, AST, TB, and DB and the occurrence of common bile duct stones in patients with negative results of magnetic resonance cholangiopancreatography, a retrospective diagnostic accuracy clinical test is conducted in this study. In order to reduce the missed diagnosis rate of choledocholithiasis and perform more accurate common bile duct exploration, 466 patients who underwent surgical treatment of cholelithiasis from January 2014 to December 2015 have been analyzed retrospectively. Firstly, the confounding factors are corrected through Binary Logistic regression. Then, the diagnostic efficacy of each indicator is measured by the ROC curve among different types of patients. In all patients, the top three individual indicators with the greatest AUC curve area for predicting common bile duct stones can be observed from the results of MRCP, γ-glutamyl transpeptidase, and alkaline phosphatase. Besides, the diagnostic efficiency of the comprehensive evaluation is higher than that of all individual indicators. For MRCP-negative patients, the top three largest AUC curve area of the diagnostic efficacy for choledocholithiasis were GGT, ALP, and DB. For patients who have a suspected diagnosis of secondary choledocholithiasis, the diagnostic efficacy of the combination of imaging results, biochemical indexes, common bile duct width, and other abnormal indicators for choledocholithiasis is much higher than that of the single abnormal biochemical indexes for the prediction of choledocholithiasis. For MRCP-negative patients, GGT, ALP, DB, and the width of common bile duct diameter are valuable for the prediction of common bile duct stones, and GGT is the most valuable diagnostic predictor.

[Clinical effect and related influencing factors of implant and implant-natural tooth in dental restoration].

PURPOSE: To investigate the clinical effect and related influencing factors of implant and implant-natural tooth in dental restoration. METHODS: A total of 67 edentulous patients receiving dental implantation in Shangrao People's Hospital from May 2016 to June 2017 were enrolled, including 34 cases of implant-natural tooth supported restoration (combined group) and 33 cases of implant restoration (single group). During the 3-year follow-up, the repair effect and bone resorption of the two groups were evaluated. The general data of patients were collected, then the influencing factors of implant failure were screened. Statistical analysis was performed using SPSS 20.0 software package. RESULTS: The success rate of dental restoration was 93.65% in combined group, and 95.08% in simple implant group, with no significant difference between the two groups (P＞0.05). The bone resorption of the alveolar ridge in combined group was significantly higher than that in simple implant group 1 and half years after operation (P＜0.05). The proportion of female, maxillary posterior area, dental pulp disease, grade IV bone mineral density loss, diabetes mellitus, smoking history, implant diameter＞4.5 mm, length＞12 mm, periodontal probe depth＞3 mm, and sulcus bleeding index≥2 were significantly higher in implant failure group than in implant success group (P＜0.05). Bone mineral density loss, diabetes mellitus, smoking history, sulcus bleeding index≥2 and periodontal probe depth＞3 mm were the risk factors of implant failure(P＜0.05). CONCLUSIONS: Both implant and implant-natural tooth are effective in dental restoration, and implant-natural tooth restoration has good short-term efficacy, while bone mineral density loss, diabetes mellitus, smoking history, sulcus bleeding index≥2 and periodontal probe depth>3mm are the risk factors of implant failure.

Identification of the hub genes RUNX2 and FN1 in gastric cancer.

BACKGROUND: This study identified key genes in gastric cancer (GC) based on the mRNA microarray GSE19826 from the Gene Expression Omnibus (GEO) database and preliminarily explored the relationships among the key genes. METHODS: Differentially expressed genes (DEGs) were obtained using the GEO2R tool. The functions and pathway enrichment of the DEGs were analyzed using the Enrichr database. Protein-protein interactions (PPIs) were established by STRING. A lentiviral vector was constructed to silence RUNX2 expression in MGC-803 cells. The expression levels of RUNX2 and FN1 were measured. The influences of RUNX2 and FN1 on overall survival (OS) were determined using the Kaplan-Meier plotter online tool. RESULTS: In total, 69 upregulated and 65 downregulated genes were identified. Based on the PPI network of the DEGs, 20 genes were considered hub genes. RUNX2 silencing significantly downregulated the FN1 expression in MGC-803 cells. High expression of RUNX2 and low expression of FN1 were associated with long survival time in diffuse, poorly differentiated, and lymph node-positive GC. CONCLUSION: High RUNX2 and FN1 expression were associated with poor OS in patients with GC. RUNX2 can negatively regulate the secretion of FN1, and both genes may serve as promising targets for GC treatment.

Usefulness of Inflammation-Based Prognostic Scores for Predicting the Risk of Complications After Radical Resection of Colorectal Carcinoma.

PURPOSE: We aimed to investigate the value of inflammation-based prognostic scores for predicting early complications after radical surgery for colorectal carcinoma. METHODS: We retrospectively analyzed data of 154 patients who underwent elective resection of colorectal carcinoma between January 2017 and December 2018 at Beijing Friendship Hospital. Univariate, multivariate, and receiver operating characteristic curve analyses were conducted. As inflammation indices, we evaluated the preoperative modified Glasgow Prognostic Score (GPS), as well as the C-reactive protein/albumin ratio (CAR), postoperative GPS, and C-reactive protein levels on postoperative day 3 (POD3). RESULTS: Within 30 days postoperatively, complications occurred in 80 patients (51.9%). And high levels of preoperative mGPS (P=0.002), preoperative CAR (P=0.019), POD3 CAR (P<0.001) and POD3 poGPS (P<0.001) can significantly affect postoperative complications after surgery for colorectal cancer, with CRP on POD3 (odds ratio, 1.015; 95% confidence interval, 1.006-1.024; P=0.001) as independent risk factors. Among all inflammation-based indicators, POD3 CAR had the highest area under the curve (0.711) and positive predictive value (83.2%). Higher CAR (≥2.6) on POD3 was associated with a higher rate of complications (92.9% vs 36.6%, P<0.001), especially of infectious nature (54.8% vs 16.1%, P<0.001). CONCLUSION: CAR≥2.6 on POD3 reflects sustained systemic inflammation and represents a useful predictor of complications after surgery for colorectal carcinoma, facilitating early detection, timely intervention, and enhanced recovery.

Diagnostic value of a microRNA signature panel in exosomes for patients with hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is the fifth most frequently diagnosed cancer worldwide and the second most frequent cause of cancer death. The aim of this study is to investigate the early diagnostic value of a panel of peripheral blood exosomal micro-RNAs (miRNAs) in patients with HCC compared with patients with Hepatitis B virus (HBV) and hepatocirrhosis. PATIENTS AND METHODS: Blood samples from 72 patients with HCC, 72 patients with hepatocirrhosis and 72 patients with HBV were obtained at Beijing Friendship Hospital, Capital Medical University. The miRNA expression levels were detected by real-time polymerase chain reaction (RT-PCR). Areas under curve (AUCs) were used to compare diagnostic values of plasmic and exosomal miRNAs. RESULTS: We screened plasmic and exosomal solutions of 3 HCC, 3 cirrhosis and 3 HBV patients to perform miRNA microarray analysis. Three distinctly differential microRNAs including miRNA-26a, miRNA-29c, and miRNA-21 were selected to perform further evaluation. First, we found that the expressions of miRNA-26a, miRNA-29c, and miRNA-21 were significantly lower in patients with HCC compared with cirrhotic and HBV group in both exosomes and plasma. Second, we found miRNA-26a, miRNA-29c, and miRNA-21 were significantly down-regulated in HCC tumor tissues compared with normal tissues. Thirdly, we found miRNAs in exosomes had better diagnostic value for patients with HCC compared with plasmic miRNAs among different groups. CONCLUSIONS: In conclusion, we found that the expression of miRNA-26a, miRNA-29c, and miRNA-21 were significantly lower in patients with HCC, and we confirmed miRNA-26a, miRNA-29c, and miRNA-21 could be identified as independent diagnostic biomarkers for patients with HCC.