无砷牙髓失活剂Antipulp临床疗效观察

目的评价Antipulp牙髓失活剂的临床效果及不良反应。方法 240例龋原性牙髓炎患者随机分为实验组和对照组,每组120例。实验组开髓后封Antipulp 14 d,对照组开髓后封亚砷酸糊剂48 h,观察并比较两组患牙失活效果以及不良反应。结果实验组和对照组失活有效率分别为93.33%和84.17%,差异有统计学意义（χ2=5.05,P=0.024）;实验组和对照组疼痛发生率分别为18.33%和44.17%,牙龈及牙周组织损伤的发生率分别为6.67%和25.83%,差异均有高度统计学意义（均P〈0.01）。结论 Antipulp牙髓失活剂可明显减少牙髓炎患者在失活及拔髓过程中的疼痛以及对牙周织的损伤,且效果优于亚砷酸糊剂。     

The association between periodontitis and interleukin-6 genetic polymorphism -174 G/C: A meta-analysis

BackgroundTo evaluate the association between periodontitis and interleukin-6 (IL6) -174 G/C polymorphism by data synthesis and subgroup analysis.MethodsEighteen case-control studies from 16 articles with 1616 cases and 1511 controls were included in this meta-analysis by searching the public databases including PubMed, Embase and Web of Science databases by Jun 2018. Data syntheses were performed using Stata 9.0.ResultsThere were inverse associations of IL6 -174 G/C polymorphism with both general periodontitis and overall periodontitis. In CC vs. GG inheritance model, whose effect was the most profound, the genetic polymorphism reduced the risks of general and overall periodontitis by 60% (95% CI = 0.25-0.65, P < 0.01) and 31% (95% CI = 0.38-0.97, P = 0.04) respectively. In addition, the G/C variation was likely to be protective against moderate (allele C vs. allele G: OR = 0.61, 95% CI = 0.43-0.87, P = 0.01; CC + GC vs. GG: OR = 0.57, 95% CI = 0.37-0.89, P = 0.01) and severe periodontitis (allele C vs. allele G: OR = 0.58, 95% CI = 0.41-0.84, P < 0.01; CC vs. GG: OR = 0.33, 95% CI = 0.13-0.82, P = 0.02) exclusively in Brazilian people. No reliable evidence was found regarding chronic periodontitis.ConclusionThis meta-analysis suggests that IL6 -174 G/C polymorphism may be negatively associated with risk of periodontitis.     

Fibrolamellar hepatocellular carcinoma

Fibrolamellar hepatocellular carcinoma (FLM) is a rare tumour that typically presents in young adults. It occurs in non-cirrhotic liver and is usually associated with normal serum alpha-fetoprotein. It is defined by a triad of morphological features: polygonal tumour cells with eosinophilic cytoplasm, prominent macronucleoli and lamellar fibrosis. A central scar can be present. The principal differential diagnosis is conventional hepatocellular carcinoma (HCC), especially the scirrhous variant. Acinar differentiation and focal mucin production are common and can be confused with adenocarcinoma. Focal neuroendocrine differentiation can occur and can be mistaken for neuroendocrine tumours. FLM also shows distinctive features at the molecular level; many of the commonly observed abnormalities in conventional HCC like p53 and β-catenin mutations are not observed in FLM. The extent of cytogenetic changes and CpG island methylation is low in FLM compared to conventional HCC. FLM is an aggressive neoplasm with 5-year survival of around 50%. Although the outcome in FLM has been considered more favourable compared to conventional HCC, this is likely to be related to absence of cirrhosis rather than unique morphological features of the tumour.     

PDCA护理管理模式在种植牙围手术期中的应用效果评价

目的 研究PDCA护理管理模式在种植牙围手术期中的临床护理效果。方法 2016年1月至2016年12月南京医科大学附属口腔医院共完成292例种植牙手术,其中2016年1月至6月围手术期实施的是常规护理,共112例,设为对照组;2016年7月至12月采用PDCA护理管理模式,共180例,设为为观察组,对两组患者术后1月的护理满意度调查表的结果进行比较。结果 实施PDCA护理管理模式后患者在护理态度、专业技能以及健康宣教等方面满意度明显提高,与对照组比较差异有统计学意义(P<0.05)。结论 PDCA护理管理模式能有效提高护理质量,降低护理差错,提高患者对护理工作的满意度。     

Hyperlipidemia Modifies Innate Immune Responses to Lipopolysaccharide via the TLR-NF-κB Signaling Pathway

The objective of this study was to investigate the effect of hyperlipidemia (HLP) on innate immune responses to lipopolysaccharide (LPS). Male New Zealand white rabbits were fed a normal diet (ND) or a high-fat diet (HFD) for 8 weeks. In vivo, the rabbits were injected intravenously with LPS for 24 h. In vitro, peripheral mononuclear cells were collected and stimulated (or unstimulated) with LPS for 24 h. Assay results were analyzed with one-way ANOVA or an equivalent non-parametric test. A P value of 0.05 was considered statistically significant. Despite having no influence in body weight, the HFD intake significantly increased serum lipids, C-reactive protein (CRP), nuclear factor (NF)-κB subunit p65, Toll-like receptor (TLR)-4, SR-A and FAS. Although we found increased circulating tumor necrosis factor (TNF)-α, interleukin (IL)-6, CRP, IL-1β, and IL-10 in the ND-fed rabbits, no significant difference was found in the LPS-stimulated production of TNF-α, IL-6, and CRP in the HFD-fed rabbits. The macrophages harvested from the HFD-fed rabbits developed a blunted inflammatory response, with lower mRNA expression of TNF-α, IL-6, CRP, TLR-4, SR-A, FAS, and Bcl-2 than that expressed by the ND group. In the HFD-fed animals, LPS incubation decreased NF-κB subunit p65 expression, whereas the cytoplasmic phosphorylation of the inhibitor of NF-κB protein was enhanced. These data indicate that HLP displayed a form of innate immune paralysis, including reduced pro- and anti-inflammatory cytokine release to external stimulus, which was related to the altered TLR-NF-κB signaling pathway and altered pro- and anti-apoptotic processes in macrophages.     

Epidemiological,clinical, and 3-dimentional CBCT radiographic characterizations of supernumerary teeth in a non-syndromic adult population: a single-institutional study from 60,104 Chinese subjects

Objective

This study was aimed to delineate the prevalence, clinical, and 3-dimentional radiographic characteristics of adult supernumerary teeth (ST found) in a Chinese non-syndromic, dental population.

Materials and methods

Medical records and cone beam computed tomography (CBCT) images were utilized to identify adult patients with ST in a tertiary referral dental hospital between June 2012 and December 2018. CBCT scan coupled with 3-dimentional reconstruction was used to characterize the detailed location, morphology, orientation of ST, and their relationship with adjacent teeth and neighboring structures. All relevant information regarding age and gender of patients, morphology, and 3-dimentional topography of ST as well as ST-associated complications were recorded and statistically analyzed.

Results

A total number of 1149 ST was identified in 921 eligible patients screened from 60,104 subjects with the prevalence of 1.5%. Male patients outnumbered females with a gender ratio of 1.76:1. The majority of ST was single, located in the maxilla, especially the maxillary central incisor region. Most ST were conical shape, inverted orientation, and impacted. ST-associated complications including impaction or root resorption of adjacent teeth, and cystic/tumor-like lesions were totally found in 13% ST and significantly associated with location, orientation, and morphology of ST.

Conclusions

Most ST in Chinese adults were conical, inverted, impacted, and located in the maxillary central incisor region, and associated with various complications. Our findings offer valuable information concerning the prevalence, clinical, and radiographic characteristics of ST in non-syndromic Chinese adults.

Clinical relevance

These findings are beneficial for clinicians to comprehensively understand the incidence, pathogenesis, and clinical management of ST.

     

Effect of Nd: YAG laser irradiation on surface properties and bond strength of zirconia ceramics

Lasers in Medical Science - This study investigated the effect of neodymium-doped yttrium aluminum garnet (Nd: YAG) laser irradiation on surface properties and bond strength of zirconia ceramics....     

Identification of a bacteriolysis-associated virulence factor against lung epithelial cells in Pseudomonas aeruginosa PAO-1 cell lysate

The precise identities of the virulence factors of Pseudomonas aeruginosa after bacteriolysis are still unknown. In the present study, we identified PA0423 protein, which was isolated from the Pseudomonas PAO-1 strain, as the factor responsible for cytotoxicity in lung epithelial cells. Whole bacterial cell lysate of P. aeruginosa PAO-1 caused cytotoxicity in A549 lung epithelial cells. This cytotoxic factor could be partially purified via gel-filtration and anion-exchange column chromatography, and its activity was attenuated by proteinase K treatment. The cytotoxic fraction increased caspase-3/7 activity in A549 cells, suggesting the induction of apoptosis. This fraction was then subjected to amino-acid sequence analysis by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, resulting in the identification of 7 matches, 4 of which were with known proteins (PA0122, PA2687, PA3406, and PA0423). Deletion mutant analysis of these 7 candidates revealed that only the PA0423 mutation led to reduced cytotoxicity, indicating that this protein is the virulence factor. Furthermore, PA0423 recombinant protein was constructed, purified, and refolded. Transduction of recombinant PA0423, but not PA0122, into A549 cells engendered a dose-dependent cytotoxic effect. These results show the first evidence that specific bacteriolysis-induced virulence factor PA0423 from Pseudomonas is toxic to lung epithelial cells.     

不同骨型人群髁突不对称性的锥形束CT评价

目的 利用锥形束CT（cone-beam CT, CBCT）评价不同骨型人群中的髁突不对称性。方法 收集拍摄CBCT的个体共110名,年龄18~30岁。对CBCT数据进行三维重建、建立参考系并三维定点。所有个体按照不同骨型进行分组,组Ⅰ（Cl Ⅰ）为骨性Ⅰ类（0°≤ANB≤5°）,组Ⅱ（Cl Ⅱ）为骨性Ⅱ类（ANB>5°）,组Ⅲ（Cl Ⅲ）为骨性Ⅲ类（ANB<0°）,每组按性别进一步分组。输出定点坐标,计算髁突（Co-Sig）的不对称情况,同时分析下颌支（Go-Sig）以及髁突-下颌支（Co-Go）的对称性。采用SPSS 17.0软件包对数据进行统计学分析。结果 组Ⅱ和组Ⅲ间的髁突-下颌支不对称性（Co-Go R-L）具有统计学差异（P<0.05）,差异在三维上主要体现在y坐标（P<0.05）;组Ⅰ和组Ⅲ以及组Ⅱ和组Ⅲ间的下颌支不对称性（Go-Sig R-L）也受不同骨型影响,具有统计学差异（P<0.05）,差异在三维上同样体现在y坐标（P<0.05）。左右侧髁突、下颌支以及髁突-下颌支在部分人群中体现出性别差异及偏侧性差异（P<0.05）,且这种偏侧性均表现为右侧优势。颏下点（Me）的z坐标在不同骨型人群中的差异较大（P<0.05）,而x和y坐标无统计学差异（P>0.05）。结论 髁突-下颌支以及下颌支的不对称性与不同人群的骨型相关,差异主要来源于高度。骨性Ⅲ类和Ⅱ类人群分别表现为下颌骨前突和下颌骨后缩。颏部偏斜与髁突不对称性的关系需要进一步探讨。