Effects of Stress on Biological Characteristics and Metabolism of Periodontal Ligament Stem Cells of Deciduous Teeth.

INTRODUCTION AND AIMS: Periodontal ligament stem cells (PDLSCs) from deciduous teeth (DePDLSCs) can perceive and respond to mechanical signals upon exposure to various environments. The effects of mechanical stress on the biological characteristics and metabolism of DePDLSCs were investigated using in vitro stress loading. METHODS: DePDLSCs were subjected to mechanical stresses of different strengths. Cell proliferation, expression of osteogenic/osteoclastic factors, apoptosis, and oxidative stress levels were evaluated using CCK-8 assays, alkaline phosphatase staining, real-time PCR, flow cytometry, and malondialdehyde and superoxide dismutase assays. Liquid chromatography-mass spectrometry was used to perform nontargeted metabolomic detection and analysis. RESULTS: Under stresses of 75 and 150 kPa, the expression of osteogenesis-related factors OPG, ALP, and RUNX2 decreased, and the ratio of RANKL/OPG significantly increased. A pressure of 150 kPa induced oxidative stress and caused a significant increase in cell apoptosis. Among the differential metabolites screened from the 150 kPa group, spermine, spermidine, ceramide, phosphatidylethanolamine, lysophosphatidylethanolamine, linoleic acid, and docosatrienoic acid were the most significantly upregulated. The metabolites screened from the 75 kPa group were mainly related to glycerophospholipid and sphingolipid metabolism, oxidative phosphorylation, and mineral absorption, which were common pathways affected in both experimental groups. CONCLUSION: A certain degree of mechanical stress can inhibit the proliferative activity and osteogenic differentiation of DePDLSCs, enhance their osteoclast-inducing ability, and cause elevated levels of cell apoptosis and oxidative stress. The metabolic expression profile of DePDLSCs changed significantly under stress. Understanding changes in cellular activity and metabolic reactions may provide an experimental basis for elucidating the role of mechanical stress in root resorption and periodontal tissue remodelling of deciduous teeth. CLINICAL RELEVANCE: Mechanical stress may affect periodontal tissue remodeling and root resorption of DePDLSc.

Economic evaluations of clinical pharmacy services in China: a systematic review.

OBJECTIVE: This article reviewed research conducted on economic evaluations of clinical pharmacy services (CPS) in China. We aimed to identify the types of CPS and the possible economic effects of these services and to hopefully provide some suggestions for designing future economic evaluations of pharmacy interventions in the region. DESIGN: Systematic review. DATA SOURCES: Several English databases (PubMed, Embase, The Cochrane Library, National Health Service Economic Evaluation Database), Chinese databases (China National Knowledge Infrastructure, VIP, Chinese Biomedical Literature Database and WanFang Data) and search engines (Google Scholar and BaiDu Scholar) were searched through December 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies with an economic assessment of CPSs in China were included. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened the studies, extracted the data, assessed the quality of the included studies and then qualitatively analysed the results. RESULTS: Forty articles were included in the final analysis. Most studies were performed in hospitals and the intervention populations mainly included adults. The types of pharmaceutical services included antimicrobial management, chronic disease state management and multidimensional clinical pharmaceutical services. A positive economic benefit associated with CPS was noted in 80% (n=32) of these articles, showing that CPS were associated with cost savings and improved patient outcomes. However, only three studies were full economic evaluations, using the method of cost-effectiveness analysis. CONCLUSION: CPS was associated with cost savings and generated positive economic value. With the expanding role of pharmacists in the healthcare sector, it is suggested that new pharmaceutical services be used in future studies and that high-quality full economic evaluations capturing both expenses and cost savings be conducted.

[Prevalence survey of immature permanent tooth trauma about the clinical visiting and prognosis in Xi'an schoolchildren].

OBJECTIVE: This study aims to investigate the clinical visiting and prognosis of schoolchildren in Xi'an after immature permanent tooth trauma and explore the prognostic factors associated with this type of trauma. METHODS: Through cluster and simple random sampling surveys, 4 013 pupils in schools from nine districts and four counties in Xi'an were sampled, respectively. All pupils and their parents were requested to complete a questionnaire, and children who had immature permanent tooth trauma answered a separate questionnaire and underwent oral examinations. The data of the survey were analyzed statistically. RESULTS: The amount of valid questionnaire was 3 641. Clinical visiting rate related to immature permanent tooth trauma of Xi'an schoolchildren was low (38.2%). Gender and trauma type were the factors related to clinical visiting for dental trauma concerns. The incidence of poor prognosis was 29.7%. The incidence of poor prognosis of patients with clinical visiting (35.4%) was higher than that of patients without clinical visiting (20.6%). CONCLUSIONS: Clinical visiting rate related to immature permanent tooth trauma in Xi'an schoolchildren is extremely low, and incidence of poor prognosis is high.

[Prevalence survey of dental trauma to immature permanent teeth in Xi'an schoolchildren].

OBJECTIVE: The prevalence rate, distribution, and reasons of immature permanent-tooth trauma in Xi'an were investigated and described, and a scientific basis was provided for the decision-making of health-administration departments. METHODS: Through cluster and simple random sampling survey, 4 013 pupils in schools from nine districts and four counties in Xi'an were sampled. All pupils and their parents were requested to complete a questionnaire. Oral examinations were conducted for children who had immature permanent teeth trauma. The number of trauma teeth and teeth were recorded. Survey data were analyzed statistically. RESULTS: The prevalence rate of immature permanent dental trauma was 10.5% in Xi'an. No significant differences were observed between districts and counties (P>0.05). The peak age of permanent dental trauma was at 7-9 years old, and the most was at 8 years old (31.5%). The first reason of trauma was falling down (50.9%), and the second reason was crash (36.0%). The most common trauma teeth were maxillary incisors (75.4%). CONCLUSIONS: The prevalence rate of immature permanent teeth trauma in Xi'an was in the middle of all international levels. Children, who are vulnerable to dental trauma at their age, should be provided with appropriate prevention measures to reduce the incidence of dental trauma.