Background The aim of this study was to evaluate the condylar morphological changes after orthodontic treatment in adult patients with Class II malocclusion using a Cone-beam computed tomography (CBCT). Methods Images of twenty-eight adult patients with Class II malocclusion who have no temporomandibular symptoms were involved in this study. To analyze the post-treatment changes in condylar morphology, mimics 17.0 software was used to measure several values and reconstruct the three-dimensional condyle, including height of the condyle, area and bone mineral density of the maximum axial and sagittal section, volume and bone mineral density of the three-dimensional condyle and condylar head before and after orthodontic treatment. Using SPSS 19.0 software package Paired t-test was applied for comparison of condylar morphology analysis between pre-treatment and post-treatment. Results Height of condylar head increase significant ( P < .05). Bone mineral density showed a decrease in the maximum axial and sagittal section, three-dimensional condyle and condylar head ( P < .01). Evaluation of volume revealed that volume of both condyle and condylar head decrease considerably ( P < .05). No significant difference was detected in other values (( P > .05). Conclusion Condylar volume decreased and height of condylar head have changed, so we speculated that adaptive bone remodeling of the condyle occurs.

OBJECTIVE To investigate and explain the beneficial effects of local intra-articular injection of Salubrinal on temporomandibular joint osteoarthritis (TMJOA) using a rabbit model of anterior disc displacement (ADD). METHODS Rabbits were divided and subjected to surgical ADD. Salubrinal was administered by intra-articular injection in the TMJ every other day for 2 and 4 weeks after operation. Histological examination and TUNEL staining were then performed. Immunohistochemistry, quantitative real-time PCR, and Western blot analysis were employed to evaluate the expression of endoplasmic reticulum (ER) stress-related markers, catabolic factors, extracellular matrix proteins, inflammatory factors, and nuclear factor-kappa B (NF-κB) activation. RESULTS In the ADD groups, we found that Salubrinal partly reversed condylar cartilage deterioration according to the histological analysis. Salubrinal reduced chondrocytes apoptosis while increased matrix components including Collagen II and Aggrecan. Meanwhile, Salubrinal downregulated the catabolic expression of MMP13, ADAMTS5, VEGF, TNF-α, and IL-1β. We also observed that Salubrinal inhibited ER stress activation by reducing the expression of GRP78, CHOP, ATF4, and Caspase-12. Additionally, Salubrinal suppressed the phosphorylation of NF-κB. CONCLUSION These results indicate that Salubrinal alleviates cartilage degradation following ADD, suggesting that intra-articular injection of Salubrinal is a potential therapeutic approach for preventing TMJOA.

Abstract Background The aim of this study was to evaluate the condylar morphological changes after orthodontic treatment in adult patients with Class II malocclusion using a Cone-beam computed tomography (CBCT). METHODS Images of twenty-eight adult patients with Class II malocclusion who have no temporomandibular symptoms were involved in this study. To analyze the post-treatment changes in condylar morphology, mimics 17.0 software was used to measure several values and reconstruct the three-dimensional condyle, including height of the condyle, area and bone mineral density of the maximum axial and sagittal section, volume and bone mineral density of the three-dimensional condyle and condylar head before and after orthodontic treatment. Using SPSS 19.0 software package Paired t-test was applied for comparison of condylar morphology analysis between pre-treatment and post-treatment. Results Height of condylar head increase significant (P < .05). Bone mineral density showed a decrease in the maximum axial and sagittal section, three-dimensional condyle and condylar head (P < .01). Evaluation of volume revealed that volume of both condyle and condylar head decrease considerably (P < .05). No significant difference was detected in other values ((P > .05). CONCLUSION Condylar volume decreased and height of condylar head have changed, so we speculated that adaptive bone remodeling of the condyle occurs.

Objective:To explore the efficacy of unarmed respiratory function training combined with electric standing bed in postural sputum excretion in elderly stroke patients.Methods:60 elderly stroke patients admitted to the Second Affiliated Hospital of Guangxi Medical University from January 2017 to July 2019 were selected. Among them, 30 patients (control group) received conventional position drainage and sputum removal, and the remaining 30 patients (observation group) received hands-free respiratory function training combined with electric standing bed sputum removal. The sputum removal effect and lung function before and after treatment were compared between the two groups. T test was used for the comparison of measurement data between groups, and χ2 test was used for the comparison of counting data.Results:The total effective rate after treatment was 96.67% (29/30) in the observation group and 76.67% (23/30) in the control group, the difference was statistically significant (χ2=5.193, P < 0.05). Compared with before treatment, the longest expiratory time, maximum gas volume and forced vital capacity in 2 groups were significantly increased after treatment (observation group: t=37.826, 9.209, 13.362; control group: t=22.347, 2.606, 6.746; P < 0.05). After treatment, the maximum expiratory time, maximum gas volume and forced vital capacity in the observation group were significantly increased compared with the control group, with statistical significance (t=26.302, 7.077, 9.74, P < 0.05).Conclusion:Unarmed respiratory function training combined with electric standing bed can significantly improve the sputum excretion effect and respiratory function of stroke patients, which is worthy of application.

肿瘤免疫治疗发展迅速，程序性死亡蛋白1（programmed cell death protein 1,PD-1）抗体作为一种新型免疫治疗的药物的应用也越来越广泛，其所带来的免疫相关不良反应，包括内分泌相关不良反应也逐渐显现。笔者报道一例52岁女性肺腺癌术后患者接受PD-1抗体治疗8个疗程（16周）后出现空腹血糖受损并短时间内迅速发生糖尿病酮症酸中毒，查糖化血红蛋白8.1%，空腹和负荷后C肽均<3.33 pmol/L,糖尿病相关胰岛自身抗体均为阴性，HLA基因检测提示DRB1 *03∶03为易感基因型。该患者给予常规静脉补液以及后续胰岛素强化治疗好转后出院。经过16个月的随访，患者胰岛β细胞功能仍为衰竭状态，血糖波动较大。该病例提示PD-1抗体治疗后可能诱导暴发性1型糖尿病的发生，尤其是对于携带易感HLA基因型患者。希望借此文引起内分泌科及肿瘤科医生的广泛关注，在应用该类药物时注意血糖的监测，从而及时发现避免糖尿病酮症酸中毒等严重并发症的出现。

OBJECTIVE:Anterior disk displacement (ADD) is a most common subtype of temporomandibular disorders (TMD), which is promoted by chondrocytes apoptosis. However, the signaling pathways that trigger apoptosis are still unknown. The aim of this study was to investigate the expression of endoplasmic reticulum (ER) stress-related proteins in the condylar cartilage of rabbits following ADD.METHODS:Sixty healthy adult rabbits were randomly assigned to the experimental and sham-operated control groups (n = 12). The experimental rabbits were subjected to surgical ADD in the right temporomandibular joints. The production of ER stress-related proteins C/EBP homologous protein (CHOP), glucose-regulated protein 78 (GRP78), cleaved caspase-3, and caspase-12 in cartilage was evaluated by immunohistochemistry, quantitative real-time PCR, and Western blot analysis.RESULTS:Our results showed that the expression of CHOP, GRP78, cleaved caspase-3, and caspase-12 increased significantly along with degenerative changes in cartilage after ADD.CONCLUSION:These results indicate that the ER stress pathway is activated in ADD cartilage and might promote the development of TMD.

[Objective] In order to improve the educational quality and emphasize the importance of restoration based and precise implantation, digital oral implantology was adopted in the reform of theoretical and practical courses of Oral Implantology during undergraduate education. [Methods] Digital oral implantology and CAD/CAM technique were introduced in the undergradutes'stomatology curriculums.More model operations and computer-based courses were prepared.During the evaluation of the students'performances,multi-element evaluation system was adopted,and finally two questionnaires about the curriculum reform and comparison with other schools were employed. [Results]After the reform,the grades considerably improved,and the questionnaires' results illustrated that more than 90% of the students were very satisfied with the theoretical, practical and computer-based courses. Compared with the undergraduates and graduates from other stomatology schools, the reform of our school showed benefits for students' learning on Oral Implantology. [Conclusion] Digital technology introduced into implantology education for undergraduates could promote their awareness of restoration based and precise implantation.

PURPOSE:To test the hypothesis if a novel single-chamber experimental dental implant allows in vivo the quantitative assessment of osseointegration over time and as a function of different surface properties (physical, chemical, geometric, biologic [osteoconductive or osteoinductive]) in a biologically unfavorable environment (local osteoporosis).MATERIALS AND METHODS:Three prototypes of a novel experimental implant with different chamber sizes (small, medium, and large) were compared with each other to find out the minimum size of bone chambers needed to allow a discriminative quantification of osseointegration over time. For the comparison of low and high surface osteoconductivity properties, conventional sandblasted, acid-etched chamber surfaces (low surface osteoconductivity) were compared with biomimetically (calcium phosphate) coated ones (high surface osteoconductivity). The implants (4 implants per animal; 88 implants per time point) were inserted into the edentulous maxillae of a total of 66 adult goats with a physiologically osteoporotic masticatory apparatus. Two, 4, and 8 weeks later, they were excised and prepared for a histomorphometric analysis of the volume of neoformed bone within the chamber space and of the bone-to-implant contact (BIC) area.RESULTS:The implants with small chambers did not show significant differences in bone coverage (BIC) nor bone volume (relative and absolute volume), neither as a function of time nor as of implant surface property (low versus high surface osteoconductivity). However, medium and large chambers revealed significant differences respecting both of these parameters over the 8-week postoperative time period.CONCLUSION:The new implant model permits a discriminative quantification of osseointegration in vivo in an osteoporotic bone environment for implants with medium-sized and large-sized chambers. Quantitative assessment of osseointegration is possible, both over time and as a function of low and high surface osteoconductivity properties.

Purpose: Low-magnitude, high-frequency (LMHF) loading plays an important role in bone healing. The present study aimed to evaluate the effect of LMHF loading applied directly to titanium dental implants on peri-implant bone healing and implant osseointegration. Methods: The mandibular premolars and molars were extracted from six male Beagle dogs. Three months post-extraction, each of the six dogs had three titanium implants (Aadva Standard Implant Narrow, Phi 3.3 x 8 mm) inserted into the mandibular premolar and molar area (three implants per side). In each animal, one side was randomly selected to undergo daily LMHF loading (treatment group), while the other side had no further intervention (control). The loading was applied directly to the implant abutment using an individual jig and a custom-made loading device (8 mu m,100 Hz). The implant stability quotient (ISQ) was tested every week. Three dogs were euthanized after 2 weeks, and three were euthanized after 8 weeks. Tissue samples were fixed and stained for micro-computed tomography (micro-CT) and histomorphometric analyses. Data were analyzed statistically, with significance set at p < 0.05. Results: The treatment group had significantly increased peri-implant bone volume relative to tissue volume in region of interest 2 (100-500 mu m) compared with the control group after 2 weeks of loading (p < 0.05); however, there was no significant difference between groups after 8 weeks. The ISQ value and the micro-CT results did not differ between groups during the study period. Conclusions: LMHF loading positively influenced peri-implant bone healing in the early healing period. (C) 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

目的:剖析小切口治疗环状混合痔的临床疗效.方法:以2015年4月 ～2017年8月本科接诊的80例环状混合痔病患为研究对象,并将之以数字抽签的方式随机分成A、B两组,每组40例.A组实施小切口外痔剥离加内痔缝扎治疗,B组实施传统外痔剥离加内痔缝扎治疗.观察两组手术治疗的效果,并对其作出比较.结果:A组的并发症发生率为2.5％,和B组的15.0％比较明显降低,组间差异显著(P<0.05).A组的疗效总有效率为95.0％,明显比B组的77.5％高,组间差异显著(P<0.05).结论:对环状混合痔病患施以小切口外痔剥离加内痔缝扎治疗,并发症少,治疗效果好,值得临床借鉴.

OBJECTIVE This study evaluates the biological effects of naringin (NAR) joint bone morphogenetic protein (BMP)-2 on the proliferation, alkaline phosphatase (ALP) activity, and expression of osteoblastogenic genes, such as Runt-related transcription factor 2 (Runx2), collagen Ⅰ (ColⅠ), ALP, and osteocalcin (OCN) of pre-osteoblasts. METHODS Three different NAR concentrations (10, 100, and 1 000 μmol·L⁻¹) were applied, alone or combined with BMP-2(50 ng·mL⁻¹), to restore the osteoblastogenesis of pre-osteoblasts (MC3T3-E1 cell line). Cell numbers (proliferation) were evaluated at first, fourth, and seventh days by Alamar blue assay. ALP activity and the expression of osteoblastogenic genes, such as Runx2, ColⅠ, ALP, and OCN were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR) at fourth and seventh day. RESULTS Stimulation by NAR alone and in combination with BMP-2 for 1 day and 4 days could promote cell proliferation, which peaked at a concentration of 100 μmol·L⁻¹ NAR combined with BMP-2 could promote cell proliferation significantly (P<0.05). Stimulation by NAR alone and in combination with BMP-2 for 4 and 7 days could promote ALP activity and bone-related gene(ALP, OCN, Runx2, ColⅠ) expression. ALP expression was significantly promoted after stimulation of 100 μmol·L⁻¹ NAR and BMP-2 (P<0.05). CONCLUSIONS NAR exhibits promising potential for improving MC3T3-E1 proliferation and differentiation, and appropriate concentrations of NAR and BMP-2 show synergistic effect.
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Excessive mechanical loads induce chondrocyte apoptosis and irreversible cartilage degeneration, but the underlying molecular mechanism is poorly understood. The aim of this study was to investigate the possible role of endoplasmic reticulum (ER) stress pathway in hydrostatic pressure (HP)-induced apoptosis in rat mandibular condylar chondrocytes. Chondrocytes were isolated from rat mandibular condylar cartilage and subjected to HP. Cell viability and apoptosis were assessed by Cell Counting Kit-8 and flow cytometry assay. Expression of ER stress-associated molecules was detected by quantitative real-time PCR and western blot analysis. In addition, expression of apoptosis-related proteins (bax, bcl-2, and cleaved-caspase-3) was assessed by western blot. To explore ER stress function, chondrocytes were pretreated with salubrinal before exposure to HP. Expression of type II collagen, aggrecan, MMP-13, and ADAMTS-5 was evaluated by real-time PCR. The results indicated that HP reduced cell viability in a magnitude- and time-dependent manner. HP-induced activation of ER stress pathway by increasing expression of GRP78, CHOP, caspase-12, PERK, and peIF2α in chondrocytes. Moreover, the expression of bax and cleaved-caspase-3 was increased, while the expression of bcl-2 was decreased in response to HP as the stress time prolonged. In addition, salubrinal suppressed HP-induced apoptosis, upregulated type II collagen and aggrecan mRNA expression, and downregulated MMP-13 and ADAMTS-5 mRNA expression in response to HP. These results demonstrate that HP induces apoptosis in mandibular condylar chondrocytes through ER stress-mediated apoptotic pathway. Suppression of ER stress by salubrinal prevents chondrocytes from undergoing apoptosis and matrix degradation induced by HP.

Periodontitis and peri-implantitis influence the periodontal tissues,and result in the supporting bone loss and even tooth and implant loss.Interleukin-34 is a tolerogenic cytokine sharing the same receptor——M-CSFR with M-CSF,and is a stimulator of osteoclasts differentiation that exerts synergistic effects with RANKL and might perform an important function in the occurrence and development of periodontitis and peri-implantitis.In this paper,the mechanism of bone resorption and immunoregulatory function of interleukin-34 is summarized,which is greatly significant for understanding the pathogenic mechanism and clinical treatment of periodontitis and peri-implantitis.

Objective: To assess the new model of the courses specialized for postgraduate dental students based on problem-based learning (PBL). Methods:Postgraduates students were randomly divided into two groups, PBL group and tradi-tional group. PBL teaching method was used in PBL group, and traditional teaching method was used in the control group. The effects of teaching were estimated by comparison of examination results and the questionnaire about PBL satisfaction survey. Results: The results of questionnaire showed that the PBL satisfaction of the postgraduates held 88.9%. The test scores of PBL group were significantly higher than those in the control group (P<0.05). Conclusions: PBL based courses reform can improve the self-learning ability of the postgraduates and meet the requirements of teaching reform for stomatology.

The condylar cartilage was adapted to hypoxic conditionsin vivo. However, condylar cartilage cells exposed in normoxiain vitro affect the chondrocyte phenotype and cartilage matrix formation. This condition also resulted in great difficulty in chondrocyte research. Culturing chondrocyte should be simulated inin vivo hypoxia environment as much as possible. The hypoxia-inducible factor-1α (HIF-1α) demonstrates an important transcription factor of adaptive response to hypoxic conditions. HIF-1α also plays an active role in maintaining homeostasis and function of chondrocytes. This review summarized current knowledge of the HIF-1α structure, signaling pathway, and mechanism of HIF-1α in the condylar cartilage repair.

Internal derangement (ID) in the temporomandibular joint (TMJ) comprises a group of clinical problems with relatively high prevalence. However, the temporal changes in gene expression of condylar cartilage during continuous ID remain unclear. The aim of the current study is to investigate by microarray analysis, the differentially-expressed gene pattern in condylar cartilage of rabbits with ID from one to eight weeks of ID progression. Histological results (hematoxylin and eosin staining) indicated that abnormal collagen fiber arrangements, fragmentation of fibrils, and inflammatory cell-infiltration were detected from one to four weeks in joint disc specimens, while newly formed vessels, mucoid degeneration, meniscal tears, and the presence of osteoclasts and osteoblasts were observed at later time points. The microarray analysis revealed 6478 genes among all tested transcripts, to have a greater than two-fold expression change compared to controls. The inflammation-associated gene group including ace and il1β increased rapidly in the early stage of disease and decreased later. In contrast, bone construction-related genes showed low expression levels at first and increased at later period in the ID progression. The current study also found some genes such as hla2g, which have not been previously reported, to be potentially relevant within ID. Our findings provide useful insights into the pathological mechanism of ID in TMJ.

PURPOSE:To evaluate the diagnostic sensitivity and specificity of panoramic radiography in detection of maxillary teeth roots projecting into the maxillary sinus.METHODS:Paired panoramic radiographs and cone-beam CT (CBCT) images of maxilla from 110 subjects were analyzed. 42 males and 68 females (15~36 years old) with the second molars erupted completely were included. The 2 radiographic techniques were used to observe if the roots of maxillary teeth project into the sinus, including canine, the first premolar, the second premolar, the first molar and the second molar. With CBCT as a gold standard, the diagnostic sensitivity and specificity of panoramic radiography were evaluated, as well as the accuracy, prevalence, positive likehood ratio, and negtive likehood ratio.RESULTS:The sensitivity for canine, the first premolar, the second premolar, the first molar, and the second molar was 100%, 100%, 96%, 99%, and 96%, respectively. The specificity for canine, the first premolar the second premolar, the first molar, and the second molar was 94%, 92%, 84%, 67%, and 67%, respectively.CONCLUSIONS:Panoramic radiography has a high diagnostic sensitivity in detection of the teeth roots projecting into the maxillary sinus for maxillary teeth. However, it can't afford sufficient proof for orthodontic anchorage design because of low specificity, especially for the second premolar, the first molar and the second molar.

OBJECTIVEThis study aimed at using cone beam computed tomography (CBCT) to study the influence ofprolonged unilateral posterior teeth loss on bilateral condylar morphology.METHODSThe CBCT images of 30 patients withprolonged unilateral posterior teeth loss and 30 healthy people as controls were corrected. Mimics 15.0 software was used tomeasure volume, area, distance, and bone density of condyle. The results were statistically analyzed.RESULTSThe volumeand bone density of condylar head and the entire condyle on missing teeth side were less than the contralateral side (P<0.05).The area and bone density of condylar transverse plane were greater than the contralateral side (P<0.05).CONCLUSIONAfter prolonged unilateral posterior teeth loss, adaptive reconstruction occurs in the bilateral condyles, and condyle of missing teethside is smaller than the contralateral side.