[Professor LIANG Fan-rong's clinical application of the guiding-qi acupuncture technique]

In clinical practice, professor LIANG Fan-rong integrates the guiding-qi acupuncture technique of slow insertion and withdrawal of the needle with the thought of needling sensation reaching the affected site. These two theories were recorded in Lingshu: Wuluan (Chapter 34 of Miraculous Pivot). Professor Liang proposes that in acupuncture, both acupuncture physician and patient should be in a tranquilizing state. Firstly, the needle is inserted slowly so as to conduct the reversed turbid qi in yang back to yin. After arrival of qi, with the compound manipulation for promoting qi, qi is guided to the affected site. When the treatment ends, the needle is removed slowly to guide the reversed clear qi in yin back to yang and to guide qi of nutrient and defensive systems back to the original layers. Such acupuncture technique is applicable for various disorders induced by the impairment of qi activity. In clinical practice, it is adopted for the disorders of heart, lung, stomach, intestines, emotions and nervous system, as well as the obstruction disorders of meridians. The ying-spring and shu-stream points of the affected meridians are selected as the main acupoints in prescription. According the theory of four seas and qi street, the corresponding the front-mu, back-shu and he-sea points are combined. In acupuncture, the needle is inserted and withdrawn slowly. After arrival of qi, the needle is manipulated to guide qi to the pathogenic locations.

[The relationship between optical coherence tomography performance and visual acuity of acute retinal necrosis]

Objective: To analyze the relationship between optical coherence tomography(OCT) performance and visual acuity of patients with acute retinal necrosis (ARN). Methods: Retrospective analysis was performed on the patients diagnosed with ARN at the ophthalmology department of Peking union hospital during October 2011 and May 2016. Fourteen patients (15 eyes), 9 males and 5 females, whose anterior and posterior inflammation disappeared and the retinal necrosis lesion in the fundus of the eye subsided were included. The mean age was (41.6±12.2) years. All patients underwent careful examinations including best corrected visual acuity (BCVA), slit-lamp microscope, indirect ophthalmoscope, color fundus picture, fundus fluorescein angiography (FFA) and OCT (results of their last consultations). Results: BCVA: 8 eyes were increased, 2 eyes were unchanged and 5 eyes were decreased at the last visit; light perception (LP) 1 eye, finger count (FC) 1 eye, 3 eyes of 0.01 to 0.1, 6 eyes of 0.15 to 0.25. The inflammatory reaction in the anterior segment of 14 eyes disappeared, while the inflammatory reaction of the remaining 1 eye was relieved. The fundus lesions of all 15 eyes disappeared. According to OCT results: five eyes (5/15) exhibited normal macula area, among the 5 eyes, 4 eyes are of 0.15 to 0.25 visual acuity, and 1 eye is of 0.5 visual acuity;macular epiretinal membrane is present in three eyes (3/15), of which the visual acuity is 0.02, 0.25 and 0.3 respectively macula edema is present in three eyes (3/15), among the 3 eyes, 1 eye (visual acuity of 0.01)showed thickening of neurosensory retina, cystoid change of fovea and several fluid dark areas, the other 2 eyes (visual acuity of 0.02 and 0.5 respectively) showed small diffuse fluid dark area in the neurosensory retina;atrophy of neurosensory retina and absence of IS/OS was found in four eyes (4/15), among the 4 eyes, the visual acuity of 3 is below 0.01, and the other 1 eye is of 0.08 visual acuity. Conclusions: The OCT performance of stationary phase of ARN tends to be positively correlated with the visual acuity of patients. The prognosis of visual acuity of the patients whose OCT results showed atrophy of neurosensory retina and absence of IS/OS is poor. (Chin J Ophthalmol, 2018, 54: 369-374).

Association of serum leptin with breast cancer: A meta-analysis

BACKGROUND

Accumulating evidence has demonstrated that leptin is associated to the tumorigenesis and progression of breast cancer (BC). However, these studies remain inconsistent. Thus, a meta-analysis was conducted to investigate the role of leptin in the patients with BC.

METHOD

A systematic search in PubMed, Embase, ISI Web of Science, and Chinese National Knowledge Infrastructure (CNKI) databases was conducted up to September 1, 2017. The standardized mean difference (SMD) with 95% confidence interval (CI) was applied to pool the effect size. A funnel plot and Egger test were used to evaluate publication bias.

RESULTS

Finally, 43 eligible studies were included in the current meta-analysis. Overall, serum leptin levels in BC cases were significantly higher compared with the controls (SMD = 0.61, P <.0001). When subgroup analyses were restricted to ethnicity and menstrual status, higher serum leptin concentration was also detected in patients with BC. Moreover, BC cases with body mass index (BMI) >25 indicated significantly higher serum leptin levels (SMD = 1.48, P = .034). Furthermore, the BC cases with lymph node metastases showed significantly higher serum leptin concentration (SMD = 0.53, P = .015).

CONCLUSION

The present meta-analysis suggests that the serum leptin may profiles as a pivotal role in the pathogenesis and metastasis of BC. In addition, leptin will provide useful information for a therapeutic target to treat BC.

[Advances in osteoradionecrosis of nasopharynx after radiotherapy for nasopharyngeal carcinoma]

Radiation therapy is the first choice for the treatment of nasopharyngeal carcinoma. However, it is inevitable that nasopharyngeal mucosa and tissue will be damaged after radiotherapy of nasopharyngeal carcinoma, which will cause corresponding complications. Nasopharyngeal osteonecrosis is a serious complication. Up to now, there are few reports about nasopharyngeal osteonecrosis, and the underlaying pathological mechanism remains unclear. The potential theories include radiotherapy damage, infection and trauma, but also the " three H" principle of hypoxic hypocellular hypovascular tissue, as well as the theory of radio induced fibrosis. It is controversial about the treatment of nasopharyngeal osteonecrosis. It takes comprehensive treatment, including local treatment, systemic treatment, surgical treatment and other treatments. Among them, local treatment as nasopharyngeal debridement usually is first choice. We reviewed the pathological mechanism and treatment methods of nasopharyngeal osteonecrosis, in order to provide a reference for better prevention and treatment of it.

Serum adiponectin in breast cancer: A meta-analysis

BACKGROUND

Accumulating data have found that adiponectin is involved in development of breast cancer (BC). However, these results were inconsistent.

METHOD

A systematic search in PubMed, Embase, ISI Web of Science, and Chinese National Knowledge Infrastructure databases were conducted up to October 1, 2017. The standardized mean difference (SMD) with 95% confidence interval was applied to pool the effect size.

RESULTS

Finally, 31 eligible studies were included in this meta-analysis. The overall results indicated that serum adiponectin levels in BC cases were significantly lower than the controls (SMD = -0.33, P < 0.0001). As for the subgroup analysis of menstrual status, serum adiponectin levels were significantly lower in pre- and postmenopausal BC cases. Moreover, the subgroup analysis by ethnicity in pre- and postmenopausal group indicated an inverse association between adiponectin levels and BC risk in Asian population, but not in Caucasian population.

CONCLUSION

The present meta-analysis suggests that low serum adiponectin concentration may be associated with an increased BC risk in premenopausal and postmenopausal women, especially among Asians. Adiponectin may serve as a biomarker of BC risk and help to identify subjects at high risk for BC development.

Subtrochanteric shortening osteotomy during cementless total hip arthroplasty in young patients with severe developmental dysplasia of the hip

BACKGROUND

This retrospective study was designed to determine complications, functional and radiographic results of transverse subtrochanteric osteotomy during cementless, modular total hip arthroplasty (THA) in a series of active patients younger than 45 years with Crowe Type-III or IV developmental dysplasia of the hip (DDH).

METHODS

We followed 49 patients (56 hips) with DDH who were treated with cementless THA, where the acetabular cup was positioned in the anatomic hip center and where a simultaneous transverse femoral osteotomy was performed. Complication rate evaluation and clinical outcomes were measured by validated clinical scores and radiographic evaluation were performed at a mean follow up of 10 years (range, 4.8-14.3 years).

RESULTS

The mean limb-length discrepancy was reduced from 4.2 cm to 1.1 cm (P < 0.01). The mean Harris hip score (HSS) significantly improved from 40.6 points to 87.4 points (P < 0.01). Similarly, severity of low back pain, modified MAP, HOOS, and SF-12 also showed significant improvement (P < 0.01). There were 3 cases of postoperative dislocation, 3 cases of transient nerve palsy, 2 cases of nonunion, and 4 cases of intraoperative fracture. At 10 years follow-up, the estimated survival rate with any component revision as end points was 92%.

CONCLUSION

The cementless THA combined with transverse subtrochanteric osteotomy is a reliable technique with restoration of a more normal limb, satisfactory clinical outcomes, and mid-term survival of components.

[Effect of curcumin on intestinal mucosal mechanical barrier in rats with non-alcoholic fatty liver disease]

Objective: To investigate the effect of curcumin on intestinal mucosal mechanical barrier in rats with non-alcoholic fatty liver disease. Methods: A total of 30 male Sprague-Dawley rats were equally divided into normal control group, model group, and curcumin intervention group. The rats in the model group and the curcumin intervention group were given high-fat feed for 16 weeks, and those in the curcumin intervention group were given curcumin 200 mg/kg/day by gavage once a day after 8 weeks of high-fat feeding. The rats were sacrificed at the end of week 16. A light microscope was used to observe pathological changes in the liver, an electron microscope was used to observe the tight junction of the intestinal mucosa, an automatic biochemical analyzer was used to measure the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), chromogenic substrate Limulus amebocyte lysate assay was used to measure plasma lipopolysaccharide (LPS) level, spectrophotometric method was used to measure the activity of serum diamine oxidase, ELISA was used to measure the serum level of tumor necrosis factor-α (TNFα), and immunohistochemistry was used to measure the expression of the tight junction protein occludin. One-way ANOVA test and SNK-q test were used for statistical analysis. Results: Under the light microscope, the control group had no hepatocyte steatosis, the model group had significant hepatocyte steatosis and inflammatory cell infiltration, and the curcumin intervention group had reduced hepatocyte steatosis and inflammatory cell infiltration. Under the electron microscope, the control group had a clear and complete structure of the tight junction of the intestinal mucosa and normal structures of mitochondria and endoplasmic reticulum; in the model group, the structure of the tight junction of the intestinal mucosa was destroyed, the intercellular space was widened, the desmosomes had a loose structure, there was edema in some mitochondria, and the endoplasmic reticulum was dilated; the curcumin intervention group had improvements in the structure of tight junction of the intestinal mucosa, intercellular space, edema in the mitochondria, and dilation of the endoplasmic reticulum. Compared with the control group, the model group had significant increases in the serum levels of AST, ALT, DAO, TNFα, and LPS (q = -15.918, -14.402, -33.700, -8.944, and -10.832, P < 0.05); compared with the model group, the curcumin intervention group had significant reductions in the serum levels of AST, ALT, DAO, TNFα, and LPS (q = 10.457, 7.752, 18.802, 5.202, and 4.279, P < 0.05). In the control group, occludin showed a linear distribution along the top of small intestinal mucosal epithelial cells. The model group had a significant reduction in positive staining compared with the control group, and the curcumin intervention group had a significant increase in positive staining compared with the model group. The relative expression of occludin was 0.29±0.03 in the control group, 0.12±0.02 in the model group, and 0.21±0.02 in the curcumin intervention group (P < 0.05). Conclusion: Intestinal mucosal mechanical barrier is impaired in rats with NAFLD. Curcumin can reduce such damage, and its mechanism of action may be related to up-regulating the expression of occludin in the intestinal mucosa and reducing the levels of TNFα and LPS.

[DNA Repair Function and Mutation of an H2B Monoubiquitination Factor WDR70 in Ovarian Cancer]

OBJECTIVE

To investigate the roles of enzyme DCAF proteinDNA damagebinding protein 1 (DDB1)/cullin4 (CRL4) complex family members CRL4WD40 repeat domain protein 70 (WDR70) in DNA repair process and its mutation in ovarian cancer.

METHODS

Immunofluorescent assay was employed to measure H2AX (γH2AX) and phosphorylated replication protein A2 (RPA32) formed in siDDB1 or siWDR70 ovarian cancer cells after the treatments of chemical medicine and radioactive threapy. 5Brdu immunohistochemical staining was used to explore the function of WDR70 in DNA replication. The expressions of WDR70 and histone protein H2B monoubiquitination (uH2B) was measured by immunohistochemistry,the function of DNA repair,expression and mutations of CRL4 in ovarian cancer were detected by semiquantitative PCR and DNA sequencing.

RESULTS

Immunofluorescent assay indicated that distinct subunits of CRL4 played different roles in checkpoint activation and H2Bmonoubiquitinationdepedendent homologous recombination,while the scaffold subunit DDB1 participated in both processes,WDR70 was only required for DNA end resection,chromatin loading of RPA32 and HR. The dose of WDR70 was not effect on DNA replication. Ovarian cancer had different expression of WDR70 and uH2B compared with normal tissue,transcripts of WDR70 was diminished or truncated in 50% of ovarian cancer,which corresponded to multiple mutations.

CONCLUSION

CRL4 ubiquitin ligase plays multiple roles in DNA repair and is critical for genome stability. It may be an potential anticancer barrier against ovarian malignancies.

[The fundus manifestations and SD-OCT findings of patients with acute Vogt-Koyanagi-Harada disease]

Objective: To conclude the characteristics of fundus appearance and spectral domain optical coherence tomography(SD-OCT) findings of patients with acute Vogt-Koyanagi-Harada (VKH) disease. Methods: The clinical data of 17 patients (34 eyes) diagnosed of acute VKH in Peking Union Medical College Hospital from Jan. 2012 to Dec. 2014 were studied retrospectively.Examinations included visual acuity, slit lamp, fundus, color fundus pictures, FFA and SD-OCT. Results: Eight men and 9 women were enrolled with mean age of (40.5±11.6) years old ranging from 26.0 to 62.0 years old. Vision acuity of their first consultations were as follows: 14 eyes (41.2%) were below 0.01-0.09, 17 eyes(50%) were among 0.1-0.3, 3 eyes (8.8%) were among 0.4-0.7. All patients were divided into 3 groups according to their fundus appearance: 14 eyes (41.2%) were optic disc swelling-type, 10 eyes (29.4%) were retinal detachment type and 10 eyes(29.4%)were mixed type. Subretinal fluid and serous retinal detachment appears in SD-OCT of all 34 eyes, with highly reflective signals in detached area. Other common characters were also noticeable, suh as RPE folds(19 eyes, 55.9%), subretinal septa (16 eyes, 47.1%) and internal limiting membrane(ILM) fluctuation (8 eyes, 23.5%). In addition, SD-OCT features were in accordance with multilobular dye pooling at late period of FFA. Conclusion: SD-OCT of acute VKH presents some typical features: subretinal fluid and serous retinal detachment, RPE folds, ILM fluctuation, and subretinal septa.(Chin J Ophthalmol, 2017, 53: 436-439).

Development of a valid Simplified Chinese version of the International Hip Outcome Tool (SC-iHOT-33) in young patients having total hip arthroplasty

OBJECTIVE

The International Hip Outcome Tool (iHOT-33) is a questionnaire designed for young, active patients with hip disorders. It has proven to be a highly reliable and valid questionnaire. The main purpose of our study was to adapt the iHOT-33 questionnaire into simplified Chinese and to assess its psychometric properties in Chinese patients.

METHOD

The iHOT-33 was cross culturally adapted into Chinese and 138 patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the EuroQol-5D (EQ-5D), and the Chinese version of the iHOT-33(SC-iHOT-33) pre- or postoperatively within 6 months' follow-up. The Cronbach's alpha, intraclass correlation coefficient (ICC), Pearson's correlation coefficient (r), effect size (ES), and standardized response mean (SRM) were calculated to assess the reliability, validity, and responsiveness of the SC-iHOT-33, respectively.

RESULTS

Total Cronbach's alpha was 0.965, which represented excellent internal consistency of the SC-iHOT-33. The ICC ranges from 0.866 to 0.929, which shows excellent test-retest reliability. The subscales of SC-iHOT-33 had the highest correlation coefficient (r = 0.812) with the physical function subscales of the WOMAC, as well as good correlation between the social/emotional subscale of the SC-iHOT-33 and the EQ-5D (r = 0.740, r = 0.743). No floor or ceiling effects were found. The ES and SRM values indicated good responsiveness of 2.44 and 2.67, respectively.

CONCLUSION

The SC-iHOT-33 questionnaire is reliable, valid, and responsive for the evaluation of young, Chinese, active patients with hip disorders.

[Durability of protective effect of resin-based coating material on root surface]

OBJECTIVE

To compare the durability of resin-based root-surface coating material and all-in-one self-etching adhesive on root surface in vitro.

METHODS

Human extracted premolars or molars with intact roots were selected. The cementum was removed using a periodontal scaler to expose root dentin. The root surface was coated with an acid-resistant nail varnish, leaving a window of 3 mm×3 mm on the exposed dentin.The window was covered with either PRG Barrier Coat (PRG) or Clearfil S3 Bond (CS3). After water aging for 14 d, specimens were immersed in acid buffer at pH 4.5 for 4 d and the demineralization buffer was changed every 24 h. Then the specimen was split longitudinally through the center of the 'window' and the cross-sectional surface was observed with scanning electron microscope (SEM). After fixed and dehydrated, the prepared samples were coated with platinum. The coating material, root dentin and the interface was observed by scanning electron microscope (SEM). The thickness of the coating material was measured on the SEM images. Regarding toothbrush wear test, coronal dentindisks were prepared and covered with PRG and CS3, respectively. After storage in water for 24 h, the specimen was subjected to the toothbrush wear tester for 100, 200, 300, 500, 700, 1 500 brushing cycles. A slurry of fluoride toothpaste (1:2 ratio of toothpaste and deionized water by weight) was used and the brushing load was 300 N. The surface microstructure of remaining coating material was analyzed using SEM. The wear depths were determined by a profilometer. Statistical analysis was performed with SPSS 20.0 by one-way ANOVA. The level of significance was at 0.05.

RESULTS

Application of PRG Barrier Coat produced a coating layer of (47.1±27.3) μm, while CS3 presented a thin film of (5.7±2.1) μm in thickness. The exposed dentin was hermetically sealed and no obvious gap was observed at the interface in both PRG and CS3 groups. There was no dentin demineralization observed in both groups after water aging. The wear depths of PRG and CS3 increased along with the numbers of brushing cycles. PRG wore at a significant lower pace than CS3 did (P<0.05).

CONCLUSION

PRG coating resin had similar performances as CS3 on protecting root dentin from demineralization after water aging. What's more, PRG demonstrated a higher toothbrush wear resistance than CS3. We concluded that PRG Barrier Coat contained S-PRG filler may be an effective coating material for protecting exposed root from both chemical and mechanical challenges. Further studies should be carried out to evaluate the long-term reliability of the rootsurface coating materials under the clinical setting.

Femtosecond pulse generation with an a-cut Nd:CaYAlO4 disordered crystal

We experimentally demonstrated a diode-pumped 587 fs ultrafast laser by using an a-cut Nd:CaYAlO₄ crystal. Pumped by an 808 nm fiber-coupled laser diode, a stable continuous-wave mode-locked ultrafast laser was achieved with a semiconductor saturable absorber. The ultrafast pulses had a repetition rate of 75 MHz at the center wavelength of 1080.8 nm. A maximum average output power of the mode-locked laser reached 375 mW delivering a slope efficiency of 9%.

Influences of Schneiderian membrane conditions on the early outcomes of osteotome sinus floor elevation technique: a prospective cohort study in the healing period

OBJECTIVES

To radiographically investigate early outcomes of osteotome sinus floor elevation in the healing phase utilizing cone beam computed tomography and evaluate influences of Schneiderian membrane conditions.

MATERIAL AND METHODS

One hundred patients were consecutively recruited for osteotome sinus floor elevation (OSFE) surgery using deproteinized bone mineral. CBCT was taken prior to (T0), immediately post-operatively (T1), and after the healing period (T2). Linear and volumetric measurements of the elevated region from T0 to T1 were performed for evaluation on computed tomography (CT).

RESULTS

Osteotome sinus floor elevation were performed in 100 patients. One implant of each patient was selected. Mean residual bone height (RH) was 7.21 ± 1.12 mm. Mean sinus floor elevation height (SE) was 4.81 ± 0.75 mm. The mean endo-sinus bone gain after the healing period was 3.25 ± 0.83 mm. Pre-opterative CBCT scans revealed that 72 patients had a normal sinus membrane in osteotome region, 13 patients presented with flat thickened mucosa and 15 patients with antral pseudocysts. There is no significant difference in sinus mucosa elevation height, bone graft volume and new bone formation in group of Thickening membrane and Antral pseudocysts compared with normal.

CONCLUSIONS

The radiographical results show that OSFE is a safe and predictable surgical procedure in residual bone height of 7.21 ± 1.12 mm. Mild flat thickening (>2 and <5 mm) and antral pseudocysts in a small size without clinical symptoms may not be contraindications to OSFE surgery.

Polymorphisms in the nuclear factor kappa B gene association with recurrent embryo implantation failure

Despite more than a century of intensive study, the mechanisms of successful pregnancy remain unclear. Recent research suggests that NF-κB (nuclear factor kappa B) plays an important role in embryo implantation. In the current study, we aimed to identify SNPs that contribute to genetic susceptibility for recurrent implantation failure (RIF). Thus, we examined the potential associations between RIF and ten SNPs (rs28362491, rs3774932, rs1598856, rs230528, rs230521, rs3774956, rs4648055, rs3774964, rs4648068, and rs3774968) of the NF-κB gene. Participants included 209 patients with RIF and 395 controls. Our results revealed that there were statistically significant differences observed in the allelic and genotypic frequencies of the rs28362491 promoter in the NF-κB gene. The frequency of the del/ del genotype was significantly higher in RIF patients than in healthy controls (P = 0.004). Compared with healthy controls, the RIF patients carried a higher frequency of the rs28362491 del allele (P = 0.010). Furthermore, strong linkage disequilibrium was observed in the three identified haplotype blocks (D' > 0.9). Particularly, in block 1 (rs230528-rs230521), the A-C haplotype occurred significantly more frequently (P = 0.029) in subjects with RIF (P = 0.0003). In contrast, the A-G haplotype occurred significantly less frequently (P = 0.008) in RIF subjects. These findings support an important role for G-712A polymorphisms of NF-κB in RIF, and may guide future studies that aim to characterize genetic risk factors for RIF.

The clinical significance of CA19-9 in ovarian mature cystic teratoma

OBJECTIVE

To evaluate the clinical significance of CA19-9 in patients with ovarian mature cystic teratoma (MCT).

MATERIALS AND METHODS

A retrospective study was performed on 65 patients with pathologically-confirmed MCT and 80 patients with benign epithelial ovarian tumors. Serum tumor markers for all patients and tissue CA19-9 for MCTs were measured. The relationships between clinical characteris- tics of MCTs and CA19-9, as well as the correlation between serum and tissue level of CA19-9 in MCTs, were evaluated.

RESULTS

The mean serum level of CA19-9 in MCTs was significantly higher than that in benign ovarian epithelial tumors (49.9 ± 73.4 IU/ml vs. 17.08 ± 24.8 IU/ml). CA19-9 was the only tumor marker with a mean serum level above the cut-off value and the elevation rate was 30.76% in MCTs. The positive tissue expression rate of CA19-9 in MCT patients were 50.9% and were higher than that of preoperative serum levels (50.9% vs. 32.7%).

CONCLUSION

Serum CA19-9 has the highest positivity rate among other tumor markers in MCT. Elevated serum CA19-9 is not an uncommon finding MCT and could be used as a marker in the differential diagnosis of MCT in patients with pelvic mass.

Electrical level of defects in single-layer two-dimensional TiO2

The remarkable properties of graphene and transition metal dichalcogenides (TMDCs) have attracted increasing attention on two-dimensional materials, but the gate oxide, one of the key components of two-dimensional electronic devices, has rarely reported. We found the single-layer oxide can be used as the two dimensional gate oxide in 2D electronic structure, such as TiO2. However, the electrical performance is seriously influenced by the defects existing in the single-layer oxide. In this paper, a nondestructive and noncontact solution based on spectroscopic ellipsometry has been used to detect the defect states and energy level of single-layer TiO2 films. By fitting the Lorentz oscillator model, the results indicate the exact position of defect energy levels depends on the estimated band gap and the charge state of the point defects of TiO2.

Longitudinal response of membrane thickness and ostium patency following sinus floor elevation: a prospective cohort study

OBJECTIVES

To investigate the influence of sinus floor elevation (SFE) on sinus physiology, including Schneiderian membrane thickness (MT) and ostium patency, using cone beam computed tomography (CBCT).

MATERIALS AND METHODS

Based on pre-established selection criteria, 53 patients in combination with 53 sinuses were referred for SFE with a lateral approach using deproteinized bone mineral. CBCT was performed prior to, immediately after surgery and before staged implant placement. The Schneiderian MT of the elevated region, ostium patency, and other clinical data was evaluated.

RESULTS

The two-stage sinus augmentation technique was applied in 33 males and 20 females. Four membrane perforations were observed during the surgical procedure. The Schneiderian membrane exhibited significant swelling immediately after augmentation (P < 0.0001), but this difference disappeared after a mean healing period of 7.51 months. The corresponding changes were also observed for ostium patency with a tendency of transient obstruction after surgery. Sinuses with flat mucosal thickening or pseudocysts did not present a liability of perforation compared to the normal cases, and the augmentation procedure was not likely to deteriorate the pathology of mucosal thickening or pseudocysts.

CONCLUSIONS

The results show that SFE with a lateral approach has no significant influence on MT and ostium patency after the healing period except for postoperative transient swelling and obstruction. Thickened membranes and antral pseudocysts in a small size might not be contraindications to SFE from the standpoint of the surgical impact on the Schneiderian membrane.

Associations of depression with impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in Chinese adults

AIM

To examine the association between depression and impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in middle-aged and elderly Chinese people, and whether depression was associated with different treatment regimens or durations of diabetes.

METHODS

A cross-sectional study was performed among 229,047 adults living in the community aged ≥ 40 years from 25 centres in China. The self-reported depression rating scale Patient Health Questionnaire 9 (PHQ-9) was used to diagnose probable and sub-threshold depression. Glucose metabolism status was determined according to World Health Organization 1999 diagnostic criteria.

RESULTS

The numbers of participants with normal glucose regulation, impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes were 120,458, 59,512, 24,826 and 24,251, respectively. The prevalence of sub-threshold depression in the total sample of participants was 4.8% (4.8%, 4.8%, 4.4% and 5.6% from normal glucose regulation to previously diagnosed diabetes, respectively), and the prevalence of probable depression was 1.1% (1.1%, 1.0%, 0.9% and 1.8% from normal glucose regulation to previously diagnosed diabetes, respectively). Compared with participants with normal glucose regulation, those with previously diagnosed diabetes had increased odds of probable depression [odds ratio (OR) = 1.61, 95% confidence interval (CI) 1.39-1.87] and sub-threshold depression (OR = 1.14, 95% CI 1.06-1.24), after adjustment for multiple confounding factors. Newly diagnosed diabetes or impaired glucose regulation was not associated with depression. Among those with previously diagnosed diabetes, insulin treatment was associated with greater odds of depression compared with no treatment or oral anti-diabetic medicine.

CONCLUSION

Previously diagnosed diabetes, but not newly diagnosed diabetes or impaired glucose regulation, was associated with a higher prevalence of depression. Patients receiving insulin were more likely to have depression than those not receiving treatment or being treated with oral anti-diabetic medicine.

Regulatory role of B-cell maturation antigen on the toxic effect of chromium ions on human SaOS-2 osteoblasts

Metal prostheses of artificial joints undergo wear, producing numerous metal particles and ions, such as Cr³⁺ . Cr³⁺ is considered a key factor leading to aseptic loosening. Many studies focus on the effect of Cr³⁺ on osteoblasts; however, little is known about the effect of Cr³⁺ on the B-cell maturation antigen (BCMA) in the osteoblasts. In this study, we first demonstrated the BCMA expressed in human SaOS-2 osteoblasts through reverse transcriptase-PCR, Western blot, and immunocytochemical analyses. Cr³⁺ decreased alkaline phosphatase (ALP), osteocalcin (OC), cell mineralization, and collagen type I mRNA and protein expression. Moreover, Cr³⁺ has an inhibitive effect on the expression of the BCMA in human SaOS-2 osteoblasts. However, after we upregulated the expression of the BCMA, ALP, OC, cell mineralization, and collagen type I mRNA and protein expression were increased. Overall, this study demonstrates that the BCMA is involved in human SaOS-2 osteoblast osteogenetic metabolism and plays a regulatory role on the toxic effect of chromium ions on human SaOS-2 osteoblasts.

Cancer therapy improvement with mesoporous silica nanoparticles combining photodynamic and photothermal therapy

In this work, we develop novel mesoporous silica composite nanoparticles (hm-SiO2(AlC4Pc)@Pd) for the co-delivery of photosensitizer (PS) tetra-substituted carboxyl aluminum phthalocyanine (AlC4Pc) and small Pd nanosheets as a potential dual carrier system to combine photodynamic therapy (PDT) with photothermal therapy (PTT). In the nanocomposite, PS AlC4Pc was covalently conjugated to a mesoporous silica network, and small Pd nanosheets were coated onto the surface of mesoporous silica by both coordination and electrostatic interaction. Since small Pd nanosheets and AlC4Pc display matched maximum absorptions in the 600-800 nm near-infrared (NIR) region, the fabricated hm-SiO2(AlC4Pc)@Pd nanocomposites can generate both singlet oxygen and heat upon 660 nm single continuous wavelength (CW) laser irradiation. In vitro results indicated that the cell-killing efficacy by simultaneous PDT/PTT treatment using hm-SiO2(AlC4Pc)@Pd was higher than PDT or PTT treatment alone after exposure to a 660 nm CW-NIR laser.

Torsional resonance frequency analysis: a novel method for assessment of dental implant stability

OBJECTIVES

To establish and experimentally validate a novel resonance frequency analysis (RFA) method for measurement of dental implant stability by analyzing torsional resonance frequency (TRF).

MATERIAL AND METHODS

A numerical study and in vitro measurements were performed to evaluate the feasibility and reliability of the method of torsional RFA (T-RFA) using a T-shaped bilateral cantilever beam transducer. The sensitivity of this method was assessed by measuring the TRFs of dental implants with 8 sizes of T-shaped transducers during polymerization, which simulated the process of bone healing around an implant. The TRFs of the test implants detected using this new method and the bending resonance frequencies (BRFs) measured by Osstell(®) ISQ were compared. TRFs and BRFs on implant models in polymethyl methacrylate (PMMA) blocks with three exposure heights were also measured to assess the specificity of this method.

RESULTS

Finite element analysis showed two bending modes (5333 and 6008 Hz) following a torsional mode (8992 Hz) in the lower rank frequency. During in vitro measurements, a bending formant (mean 6075 Hz) and a torsional formant (mean 10225 Hz) appeared, which were verified by multipoint measurement with invariable excitation frequency in the laboratory. In the self-curing resin experiments, the average growth rate at all time points of TRFs using the new method with Transducer II was 2.36% and that of BRFs using Osstell(®) ISQ was 1.97%. In the implant exposure height tests, the mean declined rate of TRFs was 2.06% and that of BRFs using Osstell(®) ISQ was 12.34%.

CONCLUSION

A novel method for assessment of implant stability through TRF was established using a T-shape transducer, which showed high reliability and sensibility. The method alleviated the effects of implant exposure height on the measurements compared with Osstell(®) ISQ. The application of T-RFA represents another way in the investigation of dental implant osseointegration.

Serum and tissue level of YKL-40 in endometrial cancer

OBJECTIVE

Serum YKL-40 level is elevated in patients with several malignancies. This study was designed to assess the correlation between serum YKL-40 and the corresponding tissue expression in endometrial cancer (EC).

MATERIALS AND METHODS

Preoperative serum levels of YKL-40 were measured by enzyme-linked immunosorbent assay (ELISA) from 41 patients with EC, 27 patients with uterine myoma, and 30 healthy women. YKL-40 protein expression in tissue was determined by immunohistochemistry for patients with EC and patients with uterine myoma.

RESULTS

Median preoperative serum YKL-40 level was 157.2 microg/l (range 76.0 - 301.2) in EC compared with 86.6 microg/l (range 69.3 - 191.1) in uterine myoma, and 86.2 microg/l (range 52.1 - 201.1) in healthy women (p < 0.05). Of 41 patients with EC, 26 patients with elevated serum YKL-40 level statistically differed from the remaining 15 patients with normal serum YKL-40 level with respect to FIGO Stage, tumor grade, washing cytology, and serum CA125 (p < 0.05). In multivariate analysis, elevated serum YKL-40 significantly correlated with FIGO stage (p < 0.05) and tumor grade (p < 0.01). The percentage of positive YKL-40 tissue staining was higher in EC patients (34.1%, 14/41) than in uterine myoma patients (11.1%, 3/27) (p < 0.05) and was lower than that of elevated serum levels in EC (26/41, 63.4%) (p < 0.05).

CONCLUSIONS

The elevated preoperative serum YKL-40 is related to stage and histologic grade of EC. The discordance between serum and tissue level of YKL-40 in EC indicates intrauterine tumor may not be the only source of serum YKL-40.

Ridge expansion alone or in combination with guided bone regeneration to facilitate implant placement in narrow alveolar ridges: a retrospective study

OBJECTIVE

To evaluate the long-term outcomes of ridge expansion technique in dealing with horizontal bony insufficiency of alveolar ridges for implant placement.

MATERIALS AND METHODS

During the period 2004-2009, 168 patients with width insufficiency of alveolar ridges were treated using the ridge expansion technique to obtain an improved bony base for implant placement. Depending on the severity of width insufficiency, the surgical procedures were classified into two groups: ridge expansion alone (Group 1) and ridge expansion in combination with guided bone regeneration (Group 2). After 4-6 months of unloaded healing, the implants were restored. The patients were followed up until 2013 with clinical and radiographic examinations.

RESULTS

Among the 168 patients, 11 patients underwent a fracture of labial/buccal bony plate during surgery, which was corrected by changing the procedure into bone grafting, yielding a surgical failure rate of 6.5%. In the remaining 157 patients successfully treated by ridge expansion alone or in combination with GBR, 226 implants were simultaneously placed as planned. No implant failed over 2.8 years (6 months to 8 years) of follow-up, yielding a cumulative implant survival rate of 100% in each group. Six implants in Group 1 and 4 implants in Group 2, although osseointegrated and in function, did not fulfill success criteria: Cumulative implants' success rates were 93.2% in Group 1 and 95.6% in Group 2. The mean marginal bone losses during the first year in Group 1 and Group 2 were 0.69 and 0.43 mm, respectively, followed by an annual loss of ~ 0.06 and 0.07 mm, respectively, in the following years. No clinical parameter was abnormal. Twenty-two (10.4%) implants were exposed to peri-implant mucositis, whereas 19 (11.0%) implant-supported restorations were involved in prosthetic complications.

CONCLUSIONS

The preliminary results of this retrospective study indicate that ridge expansion alone or in combination with GBR can be considered an effective and safe procedure for treatment of width insufficiency of alveolar ridges on the purpose of implant application.

Polymorphisms in the endothelial nitric oxide synthase gene associated with recurrent miscarriage

Endothelial nitric oxide synthase (eNOS) is an enzyme that influences placental human chorionic gonadotropin production during gestation. Previous studies have indicated an association between eNOS activity, implantation, and maintenance of pregnancy, but proposed associations between polymorphisms of the eNOS gene and recurrent miscarriage (RM) are controversial. To identify markers contributing to the genetic susceptibility to RM, we examined the potential association between RM and 8 single nucleotide polymorphisms (SNPs; rs1799983, rs2070744, rs11771443, rs3918188, rs2853796, rs7830, rs1541861, and rs2853792) of the eNOS gene using the MassARRAY system (Sequenom, USA). The enrolled participants included 192 RM patients and 201 women with normal fertility as controls. The results showed that rs1799983 at exon 7 of the eNOS gene was significantly associated with RM (genotype: chi-square = 15.071, P = 0.001; allele: chi-square = 6.250, P = 0.016). Another significant association was observed for rs11771443 in the promoter (genotype: chi-square = 6.259, P = 0.044; allele: chi-square = 7.076, P = 0.008). Furthermore, strong linkage disequilibrium was observed in 3 blocks (D' > 0.9), and significantly fewer T-T-G haplotypes (chi-square = 5.981, P = 0.015) residing in block 1 were found in RM patients. These findings point to a role for eNOS gene polymorphisms in RM in the Chinese Han population and may be informative for future genetic or neurobiological studies of RM.

Loss of cell adhesion molecule CHL1 improves homeostatic adaptation and survival in hypoxic stress

Close homologue of L1 (CHL1) is a transmembrane cell adhesion molecule that is critical for brain development and for the maintenance of neural circuits in adults. Recent studies revealed that CHL1 has diverse roles and is involved in the regulation of recovery after spinal cord injury. CHL1 expression was downregulated in the cerebral cortex, hypothalamus, and brain stem after the induction of acute hypoxia (AH). In the current study, we sought to address the role of CHL1 in regulating homeostasis responses to hypoxia using CHL1-knockout (CHL1^−/−) mice. We found that, compared with wild-type littermates, CHL1^−/− mice showed a dramatically lower mortality rate and an augmented ventilatory response after they were subjected to AH. Immunofluorescence staining revealed that CHL1 was expressed in the carotid body (CB), the key oxygen sensor in rodents, and CHL1 expression level in the CB as assayed by western blot was decreased after hypoxic exposure. The number of glomus cells and the expression of tyrosine hydroxylase (a marker for glomus cells) in the CB of CHL1^−/− mice appeared to be increased compared with CHL1^+/+ mice. In addition, in the ex vivo CB preparation, hypoxia induced a significantly greater afferent nerve discharge in CHL1^−/− mice compared with CHL1^+/+ mice. Furthermore, the arterial blood pressure and plasma catecholamine levels of CHL1^−/− mice were also significantly higher than those of CHL1^+/+ mice. Our findings first demonstrate that CHL1 is a novel intrinsic factor that is involved in CB function and in the ventilatory response to AH.