Bonding to industrial indirect composite blocks: A systematic review and meta-analysis

ObjectiveThe aim of this systematic review and meta-analysis was to evaluate the effect of surface conditioning methods on the bond strength of industrial indirect composite blocks (ICs).MethodsBased on the PICOS strategy, the Medline via PubMed, Embase and Web of Science (ISI – Web of Knowledge) electronic databases were searched for peer-reviewed articles in both English and Chinese, with no publication year limit. In vitro studies evaluating the effects of surface conditioning on the bond strength of ICs were selected. The meta-analysis was conducted to calculate the mean difference between surface-conditioned ICs and unconditioned controls. Subgroup analysis was performed to evaluate the different surface conditioning methods, separately for polymer-infiltrated ceramic network (PICN) material and the ICs with dispersed fillers (ICDFs). Meta-analyses were performed with a random-effects model at a significance level of 0.05.Results and SignificanceFrom 802 relevant studies, 25 were selected for full-text analysis. Nineteen studies were eligible for inclusion in this systematic review, whereas 9 studies were included in the meta-analysis. A manual search of the principal periodicals specific to the area resulted in no additional articles. The meta-analysis indicated a significant difference in bond strength between the surface-conditioned ICs and controls under both non-aged and aged conditions. The combination of mechanical and chemical conditioning yielded the highest bond strength of ICs. This meta-analysis suggests that chemical etching followed by a universal primer and alumina air abrasion followed by a silane coupling agent could be considered the best strategy for optimizing the bond strength of PICN materials and ICDFs under aged conditions, respectively.     

Preparation of Zn doped mesoporous silica nanoparticles (Zn-MSNs) for the improvement of mechanical and antibacterial properties of dental resin composites

ObjectiveThe purpose of this work was to explore the enhancement effect of zinc doped mesoporous silica nanoparticles (Zn-MSNs), which could form micromechanical interlocking with resin matrix and sustainably release Zn²⁺, on the mechanical and antibacterial properties of the dental resin composites.MethodsZn-MSNs were prepared by a sol–gel method, and characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM) and N₂ adsorption/desorption. The mechanical properties of the dental composites reinforced by Zn-MSNs were measured by a universal mechanical testing machine. Antibacterial activities of dental composites were evaluated by both qualitative and quantitative analysis using Streptococcus mutans (S. mutans). The cytotoxicity of the Zn-MSNs filled dental composites was investigated by osteoblasts (OBs).ResultsThe synthesized Zn-MSNs possessed good monodispersity with an average particle size of about 138 nm. The mechanical properties of the composites gradually increased with the increase of the content of Zn-MSNs. The flexural strength, flexural modulus, compressive strength and micro-hardness of the composites containing 15 wt% Zn-MSNs were 31.21%, 50.47%, 53.83% and 26.79% higher than the samples with no Zn-MSNs, respectively. The antibacterial performance was significantly improved by the addition of Zn-MSNs and the antibacterial rate of the composite with 15 wt% of Zn-MSNs reached 100%. Cytotoxicity tests revealed that all the composites were biocompatible during OBs incubation.SignificanceThe prepared Zn-MSNs can effectively improve the mechanical and antibacterial properties of the dental resin composites.     

TIGIT and PD-1 may serve as potential prognostic biomarkers for gastric cancer

Gastric Cancer (GC) is the fifth leading cause of cancer-related death in the world, and in urgent need of specific therapeutic targets to acquire prominent effectiveness. T-cell immunoglobulin and immunoreceptor tyrosine–based inhibitory motif (ITIM) domain (TIGIT) and programmed cell death protein 1 (PD-1) are identified to be abnormally overexpressed in various types of cancers including GC. This study aimed to investigate whether TIGIT and PD-1 could serve as potential prognostic biomarkers for GC. Firstly, TCGA GC dataset analysis and correlation analysis were utilized to inspect the relationship between expression of TIGIT, PD-1 and CD8 + T cells in GC and adjacent normal tissues. Then, flow cytometry was used to verify the data after collecting the peripheral blood, GC and adjacent normal tissues from 150 GC patients. Lastly, quantitative RT-PCR was performed to detect the expression of CD155, CD113, CD112 and TIGIT in six human GC cell lines and 631 GC patients in KM Plotter Database to conduct prognostic analysis. As results, we found that TIGIT and PD-1 were upregulated in GC tissues with high CD8 + T cells infiltration, while correlation analysis indicated they were in high-positive correlation. In addition, the flow cytometry analysis further showed that the high-expression of TIGIT in tumor microenvironment of GC could suppress the function of infiltrative CD8 + T cells, which leads to the escape of GC cells from immune killing. Furthermore, CD155 and CD112 were found abnormally upregulated in GC tissues and cell lines and the high expression of CD155, CD112 and TIGIT demonstrated poor prognosis results. In conclusion, these results provided potential therapeutic targets and prognostic biomarkers for treatment of GC in clinic.     

关节镜联合直接前方入路在髋关节疾病中的应用研究

目的探讨应用关节镜联合直接前方入路治疗髋关节疾病的近期疗效。方法2015 年 1 月—2016 年 12 月，采用关节镜下清理联合直接前方入路治疗 23 例（23 髋）髋关节疾病患者。男 9 例，女 14 例；年龄 27～49 岁，平均 38.6 岁。髋关节后脱位并股骨头骨折（Pipkin Ⅰ型）11 例、股骨颈骨折（Garden Ⅳ型）7 例，受伤至手术时间 2～8 d，平均 4.3 d；塌陷前期股骨头缺血性坏死 5 例，国际骨循环协会（ARCO）分期为ⅡA 期，病程 3～8 个月，平均 5.9 个月。术前 Harris 髋关节评分为（57.3±8.2）分，牛津大学髋关节评分（OHS）为（11.2±3.6）分，Postel 系统评分为（3.2±1.5）分，疼痛视觉模拟评分（VAS）为（7.2±1.3）分。手术联合骨折内固定或清理坏死股骨头并植骨治疗。结果术后切口均Ⅰ期愈合。3 例出现股外侧皮神经损伤。患者均获随访，随访时间 8～19 个月，平均 15.6 个月。术后骨折均愈合，愈合时间为 14～19 周，平均 15.8 周；未出现继发性骨关节炎及异位骨化等。末次随访时，Harris 髋关节评分为（92.5±5.3）分，OHS 评分为（36.5±5.9）分，Postel 系统评分为（14.2±2.6）分，均较术前显著提高（t=45.274，P=0.000；t=36.586，P=0.000；t=32.486，P=0.000）；VAS 评分为（1.8±0.9）分，较术前显著降低（t=21.314，P=0.000）。 结论应用关节镜联合直接前方入路治疗髋关节疾病，可有效缓解关节疼痛、改善关节功能，近期疗效满意。     

胸廓内动脉穿支螺旋桨皮瓣联合放射治疗女性胸部瘢痕疙瘩

目的探讨胸廓内动脉穿支（internal mammary artery perforator，IMAP）螺旋桨皮瓣修复结合术后放射治疗女性患者胸部瘢痕疙瘩的疗效。方法2015 年 1 月—2016 年 12 月，收治 15 例胸部瘢痕疙瘩女性患者。年龄 28～75 岁，平均 45.2 岁。患者瘢痕疙瘩病史 1～28 年，中位时间 6 年。病因：毛囊炎致继发性瘢痕疙瘩 7 例，心脏手术后 4 例，皮肤擦刮伤 2 例，蚊虫叮咬 1 例，原因不明 1 列。瘢痕疙瘩范围为 5 cm×3 cm～17 cm×6 cm。采用 IMAP 螺旋桨皮瓣修复胸部瘢痕疙瘩切除后创面，皮瓣切取范围 7 cm×5 cm～14 cm×8 cm；供区均直接缝合。术后均行放射治疗。结果术后所有 IMAP 螺旋桨皮瓣均成活良好，供区切口均Ⅰ期愈合。15 例患者均获随访，随访时间 12～24 个月，平均 16 个月。无毛细血管扩张或切口裂开发生，随访期间未见放射相关的癌变。患者对术后乳房外形、对称性均较满意。13 例（86.7%）瘢痕疙瘩区域痒痛症状缓解，供受区瘢痕未见明显增生复发；2 例复发（13.3%），继续给予保守治疗。结论采用 IMAP 螺旋桨皮瓣修复女性患者胸壁瘢痕疙瘩切除后创面，可更好地保留乳房外形；联合术后早期放射治疗可有效降低瘢痕疙瘩复发率，效果满意。     

多孔钽在骨组织工程中的研究进展

目的对多孔钽在骨组织工程中的研究进展作一综述。方法查阅近年多孔钽在制备、细胞生物学、表面修饰等领域的基础研究文献，并总结分析。结果多孔钽自身特有的理化性质赋予其良好的组织相容性、骨整合能力，并可诱导软骨、肌腱修复再生。目前因多孔钽制备条件苛刻、成本较高等因素，限制了其临床广泛应用；新的制备方法及表面修饰技术的发展，为拓展多孔钽的应用范围，优化其骨组织修复再生能力提供了新的路径。结论多孔钽在修复骨缺损方面具有独特优势，但仍需在材料制备及表面修饰方面有进一步突破。     

应用 Ilizarov 技术胫骨横向骨搬移术治疗合并全身性炎症反应综合征的重度糖尿病足

目的探讨应用 Ilizarov 技术胫骨横向骨搬移术治疗合并全身性炎症反应综合征（systemic inflammatory response syndrome，SIRS）的重度糖尿病足（Wagner 3～5 级）的临床疗效。方法2014 年 8 月—2017 年 12 月，采用 Ilizarov 技术胫骨横向骨搬移术治疗合并 SIRS 的重度糖尿病足患者 33 例。其中男 27 例，女 6 例；年龄 34～79 岁，平均 60.6 岁。均患 2 型糖尿病，糖尿病病程 1～28 年，平均 10 年。糖尿病足病程 1～12 个月，平均 2.7 个月。根据 Wagner 分级，3 级 8 例，4 级 23 例，5 级 2 例。术后观察患足创面愈合情况, 并计算保肢率。评估体温、心率、呼吸频率、白细胞计数、红细胞沉降率和 C 反应蛋白浓度变化。测量足背皮肤温度；行疼痛视觉模拟评分（VAS）评价患足疼痛改善情况。结果术后 33 例患者均获随访，随访时间 3～30 个月，平均 14.1 个月。足部溃疡全部愈合，愈合时间 3～12 个月，平均 5.3 个月；保肢率 100%。术后体温、心率、呼吸频率、白细胞计数、红细胞沉降率和 C 反应蛋白浓度均较术前显著下降（P<0.05）。术后 1 个月患足皮温为（32.64±2.17）℃，较术前的（31.28±1.99）℃ 显著改善（t=0.05，P=0.00）；但与健侧皮温（32.46±2.10）℃ 比较差异无统计学意义（t=2.04，P=0.41）。术后 1 个月 VAS 评分为（2.4±0.7）分，较术前的（4.3±0.8）分显著改善（t=3.10，P=0.00）。 结论Ilizarov 技术胫骨横向骨搬移术能有效治疗合并 SIRS 的重度糖尿病足，可促进患足溃疡愈合，避免截肢。