[Diagnosis and orthodontic treatment strategy of complete canine transposition]

Tooth transposition is a challenge for orthodontists, especially in correcting the order of teeth. At present, the literature on transposition canines mainly focuses on epidemiological studies and case reports, and no systematic treatment guidance has been formed. In this article, the definition and classification, epidemiology and etiology, imaging diagnosis, treatment and risk control of transposed canines are systematically described in order to provide reference for clinical practice.

[Expression of 25-hydroxyvitamin D in serum of patients with periodontitis and rheumatoid arthritis and its correlation with these diseases]

Objective: To detect and analyze the expression level of serum 25-hydroxyvitamin D [25(OH)D], periodontal clinical indicators and immunological indicators of rheumatism in patients with periodontitis and rheumatoid arthritis (RA), and to explore the correlation between 25(OH)D and the two diseases. Methods: This study was a case-control study. According to the inclusion criteria, patients from the Department of Stomatology and the Department of Rheumatology and Immunology and healthy volunteers from the Physical Examination Center were selected from November 2018 to May 2019 in Shengjing Hospital, China Medical University respectively. The patients were divided into 4 groups: 26 patients with simple periodontitis were included in the periodontitis group; 23 patients with RA were included in the RA group; 22 patients with RA and periodontitis simultaneously were included in the RA with periodontitis group; 22 healthy volunteers were included in the healthy control group, adding up to a total of 93 cases. The general information and periodontal clinical indexes of subjects in these 4 groups were recorded. Median elbow venous blood samples were collected from fasting subjects in each group, and 25(OH)D and immunoglobulin (Ig) were measured. The disease activity scores of RA patients were recorded and the rheumatic immune indexes were determinated. Pearson correlation analysis was performed between 25 (OH) D level and periodontal indexes in subjects of 4 groups. Results: The expression levels of rheumatoid factor [106.5(47.1, 283.8) kU/L] and C-reactive protein [20.5(13.1, 32.3) mg/L] in RA with periodontitis group were significantly higher than those in RA group [60.1(19.0, 110.0) kU/L, 14.7(3.0, 18.0) mg/L] (Z=-2.29, P=0.022; Z=-2.25, P=0.024). The levels of IgG and IgA in RA with periodontitis group [IgG and IgA: (16.0±4.3), (3.2± 1.3) g/L] as well as RA group [IgG and IgA: (16.3±5.5), (3.7±1.8) g/L] were significantly higher than those in healthy control group [IgG and IgA: (12.0±1.8), (2.3±0.6) g/L] and periodontitis group [IgG and IgA: (12.5±2.2), (2.0±0.7) g/L](P<0.05). The level of 25(OH)D in RA with periodontitis group [(26.0±9.8) nmol/L] was significantly lower than that in periodontitis group [(35.6±8.4) nmol/L] and RA group [(32.7±8.6) nmol/L] (P<0.05). The level of 25(OH)D was negatively correlated with sulcus bleeding index (r=-0.43, P=0.032) and clinical attachment loss (r=-0.41, P=0.043). Conclusions: Expression level of 25(OH)D was significantly decreased in patients with periodontitis and RA. There was a certain correlation between 25(OH)D and periodontitis and RA.

[Expression of matrix metalloproteinase-3 in patients with reheumatoid arthritis and its correlation with chronic periodontitis and rheumatoid arthritis]

Objective: To detect the expression of matrix metalloproteinase-3 (MMP-3) in serum and gingival crevicular fluid in patients with rheumatoid arthritis (RA) and its correlation with chronic periodontitis (CP). Methods: From March 2017 to July 2018, 26 patients with RA and CP [CP+RA group, (54.9±6.5) years old, 4 males and 22 females], 22 patients with RA only [RA group, (49.6±11.7) years old,5 males and 17 females] in the Department of Rheumatology and Immunology, Shengjing Hospital Affiliated to China Medical University, 22 patients with simple CP in the Department of Stomatology, Shengjing Hospital Affiliated to China Medical University [CP group, (51.4±12.5) years old, 8 males and 14 females] and 18 generally healthy controls in Physical Examination Center of Shengjing Hospital Affiliated to China Medical University [group H, (49.4±9.1) years old, 8 males and 10 females] were recruited. There were no significant differences in age and sex ratio amongst 4 groups. Patient's general status, probing depth (PD) , clinical attachment loss (CAL), sulcus bleeding index (SBI), simplified calculus index (CI-S) and simplified debris index (DI-S) were recorded in 4 groups. Samples of serum and gingival crevicular fluid were collected from patients of each group, and the expression levels of MMP-3 in serum and gingival crevicular fluid samples were detected by using enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate, rheumatoid factor, anti-cyclic citrulline peptide antibody and C-reactive protein were detected in the serum of subjects in RA group and CP+RA group. Correlation analysis was conducted between MMP-3 expression level and periodontal indices amongst 4 groups. The results were statistically analyzed using the SPSS 20.0 software package. Results: The indices of CAL [(4.12±1.13) mm], SBI (2.58±0.64) and DI-S (2.65±0.69) in CP+RA group were significantly higher than indices of CAL [(3.00±0.00) mm], SBI (2.59±1.05) and DI-S, (2.36±0.49) in CP group (P<0.05); The expression levels of MMP-3 in serum samples of CP+RA group [(1 1645.6±6 903.4) μg/L] and CP group [(9 337.0±6 719.0) μg/L] were significantly higher than that of RA group [(2 389.9±1 320.3) μg/L] and H group [(1 493.5±292.1) μg/L] (P<0.05). The expression level of MMP-3 in gingival crevicular fluid samples of CP+RA group [(164.4±45.3) μg/L] was significantly higher than that of CP group [(84.6±92.5) μg/L], RA group [(49.0±18.1) μg/L] and H group [(20.4±6.3) μg/L] (P<0.05), respectively. The erythrocyte sedimentation rate, rheumatoid factor and anti-cyclic cirullinated peptide antibodies levels in the CP+RA group were significantly higher than those in the RA group (P<0.05). The expression level of MMP-3 in serum is positively correlated with PD (r=0.45, P=0.04) and the expression level of MMP-3 in gingival crevicular fluid is positively correlated with CAL (r=0.58, P<0.01). Conclusions: The levels of MMP-3 in serum and gingival crevicular fluid of patients with RA and CP were significantly increased. MMP-3 may be associated with the development of CP and RA.

Association between DNA hypomethylation at IL13 gene and allergic rhinitis in house dust mite-sensitized subjects

BACKGROUND

Allergic rhinitis (AR) is a complex disease, in which gene-environment interactions contribute to its pathogenesis. Epigenetic modifications such as DNA methylation play an important role in the regulation of gene function. As IL13, a pleiotropic cytokine, may be important in conferring susceptibility to AR, the aim of the present work was to assess the relationship between a CpG island methylation status at the upstream of IL13 gene and house dust mite (HDM)-sensitized AR in Han Chinese subjects.

METHODS

A total of 60 patients with HDM-sensitized AR and 65 control subjects were enrolled as two independent cohorts from Beijing and Liaoning. MassARRAY EpiTYPER and pyrosequencing was used to systematically screen the status of DNA methylation in peripheral blood leucocytes. IL13 mRNA expression was measured by real-time quantitative PCR. Electrophoretic mobility shift assay was used to assess the function of methylation site.

RESULTS

The mean level of methylation was decreased in the AR patient group compared with the control group (P = 0.01). Two of a total of 33 IL13CpG units analysed (CpG units 24 : 25 : 26 and 38 : 39) showed significant differences in methylation status between the AR patient group and the control group, with DNA hypomethylation at CpG38 significantly associated with higher risk of HDM-sensitized AR in both independent cohorts and a combined cohort (Beijing: OR = 1.24, 95%CI = 1.01-1.52, P = 0.036; Liaoning: OR = 1.62, 95%CI = 1.11-2.38, P = 0.013; Combined: OR = 1.31, 95%CI = 1.10-1.56, P = 0.002). Methylation level of CpG38 correlated negatively with both IL13 mRNA expression and serum total IgE level and affected the binding affinity of SP1.

CONCLUSIONS

DNA hypomethylation of IL13 gene may be associated with increased risk of AR from HDM sensitization.

Valproic acid attenuates the suppression of acetyl histone H3 and CREB activity in an inducible cell model of Machado-Joseph disease

Machado-Joseph disease (MJD) is caused by a (CAG)n trinucleotide repeat expansion that is translated into an abnormally long polyglutamine tract. This disease is considered the most common form of spinocerebellar ataxia (SCA). In the present study, we developed stable inducible cell lines (PC12Tet-On-Ataxin-3-Q28/84) expressing ataxin-3 with either normal or abnormal CAG repeats under doxycycline control. The expression of acetyl histone H3 and the induction of c-Fos in response to cAMP were strongly suppressed in cells expressing the protein with the expanded polyglutamine tract. Treatment with valproic acid, a histone deacetylase inhibitor (HDACi), attenuated mutant ataxin-3-induced cell toxicity and suppression of acetyl histone H3, phosphorylated cAMP-responsive element binding protein (p-CREB) as well as c-Fos expression. These results indicate that VPA can stimulate the up-regulation of gene transcription through hyperacetylation. Thus, VPA might have a therapeutic effect on MJD.

Resistin level is positively correlated with thrombotic complications in Southern Chinese metabolic syndrome patients

BACKGROUND

The metabolic syndrome (MetS) has been found to be closely related with thrombotic diseases. The mechanism, however, is far from elucidated.

AIM

This study was designed to investigate the relationship between endogenous resistin and thrombosis mediating factors, as well as its potential effects on the gene expression of cardiovascular disease biomarkers.

METHODS

Ninety patients satisfied the MetS criteria, and 55 healthy subjects were recruited as part of a single-center clinical study. Plasma levels of resistin, tissue factor (TF), tissue factor pathway inhibitor (TFPI), tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1) were measured by enzymelinked immunosorbent assays. The effect of resistin on the expression of cardiovascular disease biomarkers in human umbilical vein endothelial cells (HUVEC) was assayed by gene microarray.

RESULTS

1) The average levels of resistin in MetS patients with or without acute myocardial or cerebral infarction were significantly higher than those of the controls. 2) The TF and TFPI increase was higher in MetS with infarction patients than in MetS patients. 3) In MetS with infarction patients, resistin was positively correlated with TF and PAI-1 (r=0.313, p=0.008; r=0.401, p=0.002, respectively). 4) In HUVEC, the microarray showed that apolipoprotein C-I, ACE, tumor necrosis factor receptor superfamily member 1A (TNFRSF1A) and member 5 (CD40) genes expression were dramatically increased by resistin.

CONCLUSION

In patients with MetS, resistin is strongly associated with hypercoagulative and hypofibrinolitic activities. Moreover, resistin may induce thrombotic complications via mediating the lipoprotein metabolism and stimulating inflammation.

Acupuncture for stroke rehabilitation

BACKGROUND

Stroke is the third leading cause of death in Western society; in China it is the second most common cause of death in cities and the third in rural areas. It is also a main cause of adult disability and dependency. Acupuncture for stroke has been used in China for hundreds of years and is increasingly practiced in some Western countries.

OBJECTIVES

To assess the efficacy and safety of acupuncture for patients with stroke in the subacute or chronic stage.

SEARCH STRATEGY

We searched the Cochrane Stroke Group Trials Register (November 2005), the Cochrane Complementary Medicine Field Trials Register (November 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2005), MEDLINE (1966 to November 2005), EMBASE (1980 to November 2005), CINAHL (1982 to November 2005), AMED (1985 to November 2005), the Chinese Stroke Trials Register (November 2005), the Chinese Acupuncture Trials Register (November 2005), the Chinese Biological Medicine Database (1977 to November 2005), the National Center for Complementary and Alternative Medicine Register (November 2005), and the National Institute of Health Clinical Trials Database (November 2005). We handsearched four Chinese journals and checked reference lists of all papers identified for further trials.

SELECTION CRITERIA

Truly randomised unconfounded clinical trials among patients with ischemic or hemorrhagic stroke, in the subacute or chronic stage, which compared acupuncture involving needling with either placebo acupuncture, sham acupuncture or no acupuncture.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected trials for inclusion, assessed quality, extracted and cross-checked the data.

MAIN RESULTS

Five trials (368 patients) met the inclusion criteria. Methodological quality was considered inadequate in all trials. Although the overall estimate from four trials suggested the odds of improvement in global neurological deficit was higher in the acupuncture group compared with the control group (odds ratio (OR) 6.55, 95% confidence interval (CI) 1.89 to 22.76), this estimate may not be reliable since there was substantial heterogeneity (I(2 )= 68%). One trial showed no significant improvement of motor function between the real acupuncture group and the sham acupuncture group (OR 9.00, 95% CI 0.40 to 203.30), but the confidence interval was wide and included clinically significant effects in both directions. No data on death, dependency, institutional care, change of neurological deficit score, quality of life or adverse events were available.

AUTHORS' CONCLUSIONS

Currently there is no clear evidence on the effects of acupuncture on subacute or chronic stroke. Large, methodologically-sound trials are required.

Human small intestinal epithelial cells constitutively express the key elements for antigen processing and the production of exosomes

In humans, the small intestinal epithelial cells (IEC) have a high constitutive expression of MHC class II (MHC II), and contains lysosomes. The IEC also contains MHC II rich multivesicular compartments and has been shown to produce exosomes. This suggests a role for the IEC in antigen processing and presentation either directly or indirectly by the production of exosomes. However, the presence and localisation in the IEC of other key molecules involved in this process has not been studied previously. In the present work, we have investigated small intestinal biopsies from healthy adults and the HT29 IEC cell line with monoclonal antibodies against molecules involved in the antigen processing/presenting systems and molecules typically found on exosomes derived from professional APCs and IECs. Immunohistology was performed to study the expression and localisation of MHC II (HLA-DR), HLA-DM, MHC I (HLA-ABC), CD1d, Invariant chain, Lamp-1, CD68, CD63, B7.1, B7.2, ICAM-1, Cathepsin D/S/L and the IEC specific marker A33 in the IECs. We found that the IECs from the biopsies constitutively express MHC II, HLA-DM, MHC I, Invariant chain, Lamp-1, CD 68, CD63 and A33, and these markers were also found in the IFN-g treated HT-29 cells. All these molecules were found apically in the IECs of the biopsies, localised mainly in vesicular structures. Interestingly, in the baso-latereral area of the IEC, only MHC II, MHC I, Lamp 1, CD68, CD63 and A33 were found and also here with vesicular staining pattern which matches the molecules previously found on exosomes derived professional APCs and human IEC lines. CD1d, B7, ICAM-1, CD9 and cathepsin D and L were absent in the IEC compartment, but cathepsin S showed a relatively weak staining in the apical part of the IEC. The staining pattern and the morphological localisation of these markers suggest a prominent antigen processing/loading and trafficking compartment, and a possible baso-lateral release of exosomes in the normal human IEC.

Expression of CD1d in the duodenum of patients with cow's milk hypersensitivity

CD1 cell surface glycoproteins represent a family of non-major histocompatibility complex (MHC) encoded antigen-presenting molecules. All members of the CD1 family appear to mediate the recognition of microbial or endogenous lipid and glycolipid antigens. The recognition of CD1d by a unique subset of natural killer (NK) T cells that leads to rapid production of large amounts of both type 1 and type 2 cytokines can be augmented by some synthetic glycolipids. Because of the proposed role of such CD1d-restricted T cells in immunoregulation, we hypothesized that CD1d molecules participate in mucosal immune responses in patients with gastrointestinal symptoms owing to food hypersensitivity. Patients of that category represent a heterogeneous group in which poorly defined immunological mechanisms are believed to contribute to disease pathogenesis. The expression of CD1 in duodenal biopsy samples from six patients with verified intolerance to cow's milk and six healthy controls was studied by immunoperoxidase staining of cryostat sections using a panel of mouse monoclonal antibodies (MoAbs) specific for CD1a, b, c, and d. Large numbers of CD1d positive cells were found in the lamina propria of all the patients, both during the symptomatic and the asymptomatic periods, whereas healthy controls were virtually devoid of CD1d expression in the duodenum. The localization of CD1d positive cells corresponded to areas where B cells, plasma cells and dendritic cells (DC) were present. A positive correlation was found between the numbers of CD1d(+) and CD19(+) cells in the lamina propria. In contrast to previous reports, no CD1d expression was found on the epithelial cells. Although less numerous than CD1d(+) the CD1c(+) cells were also present in all the patients and in five out of six controls. No staining for CD1a or CD1b was detected in the duodenal biopsy samples from any of the subjects. The exclusive presence of CD1d in the duodenal lamina propria of the patients with cow's milk hypersensitivity might suggest the participation of these molecules in the pathogenesis of allergic reactions to food.

[An approach to use cancer registration to assess cancer risks by occupation and industry]

This study explored how to use cancer registration data to assess cancer risk. Based on the data of the Tianjin Cancer Registry, the occupational and industrial risk for lung cancer were assessed as examples. All cases of cancer aged at least 20 years and reported during 1981-1987 to the TCR formed the basis of the study. A comparison was made using case-case methodology that cases of one cancer site compared with cases of all other sites. Data were re-coded according to 30 occupational and 27 industrial categories. The individuals employed in the interested category were considered as exposed, and subjects employed in all other categories were considered as unexposed. Statistical analysis was conducted by unconditional multiple logistic regression. Regression models included sex, age and year of diagnosis. From our study, the results are constant with previous reports. The systematic analysis of the association between occupation and industry of employment and cancer among men and women registered in the TCR provided confirmation in this population of a number of known or suspected occupational cancer risk factors studied in industrialized countries. The main advantages of this design are 1. To use the data of a cancer registration that are already existed. 2. It is easy, fast and less cost to screening the cancer risk or potential cancer risk. 3. All factors in the database of cancer registration could be evaluated, for example, occupation, industry, education, etc. 4. The way to define cases and exposed groups could decrease the influence of confounding and bias.

[Aerosolized recombinant interferon-gamma prevent antigen-induced eosinophil recruitment in guinea pig trachea]

OBJECTIVE

In order to determine whether interferon-gamma (IFN-gamma) inhibits eosinphil infiltration in the trachea of asthmatic guinea pigs induced by Rhizopus nigricans.

METHOD

We had administered aerosolized rIFN-gamma in the tracheas of 30 sensitized guinea pigs which had been divided into six groups, then teated animal inhaled rIFN-gamma of 5 x 10(4), 20 x 10(4), and 40 x 10(4) concentration, BDP and normal saline respectively at 24 h, 12 h, 2 h before being challenged.

RESULT

(1) Provocation positive rates decreased in 40 x 10(4) rIFN-gamma and BDP group compared with that in normal saline group and before intervention (P < 0.05), airway resistence decreased (P < 0.01). (2) The administration of aerosolized rIFN-gamma (40 x 10(4)) and BDP also decreased fungus-induced eosnophils but not other cells infiltration in the trachea. (3) In BALF, Eos count and ECP level were obviously lower than those in other groups. However, eosinophil numbers did not show significant change in the peripheral blood.

CONCLUSION

Local administration of rIFN-gamma (40 x 10(4)) may reduce airway inflammation and intervene asthmatic attack by inhibition of Eos, ECP infiltration in airways.

[Risk factors for severe subarachnoid hemorrhage following aneurysmal rupture]

Major reduction in disability and death from severe subarachnoid hemorrhage (SAH) can probably be brought about more effectively by prevention than by better medical or surgical treatment. Identification of the major risk factors for severe SAH should facilitate the preventive efforts. As risk factors for severe SAH, a patient's age, sex, location and size of aneurysms, hypertension, rebleeding including minor leak, and cigarette smoking were selected. The relation between the incidence of severe SAH, a surgical results, and the risk factors was examined in 81 severe SAH cases. Hypertension, rebleeding from aneurysms, large aneurysm exceeding 1.0 cm/sec in size were closely connected to severe SAH. Treatment of hypertension, acute surgery for aneurysms and aggressive surgery for unruptured large aneurysms were the only hope for achieving substantial reduction in the incidence of severe SAH and for improving the surgical results.