Activation of the P2X7 receptor in the dental pulp tissue contributes to the pain in rats with acute pulpitis.

Treatment of acute pulpitis (AP) is beneficial for pain relief and pulp regeneration. The purinergic P2X7 receptor activation is responsible for the formation and maintenance of inflammation and pain. This study aims to determine the role of the pulp tissue P2X7 receptor to activate the mechanisms of the AP in rats. The Sprague-Dawley rats were divided into groups, namely, normal, normal saline (NS), and lipopolysaccharide (LPS) groups. Alterations in pain behavior were detected through head-withdrawal thresholds (HWTs), and the pathological changes in pulp tissue were studied through hematoxylin and eosin staining. The expression of the P2X7 receptor in pulp tissue was observed through immunohistochemistry and Western Blotting. The effect of the P2X7 receptor antagonist A-740003 on HWTs was also observed. The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the pulp tissue of rats were analyzed through enzyme-linked immunosorbent assay. The HWTs were reduced in the rats with AP. Inflammation is formed but was found more severe in the LPS group than the NS group, and the expression levels of the P2X7 receptors in the NS and LPS groups were higher than in the normal group. The periodontal ligament injection of the A-740003 dose-dependant increases the HWTs in rats with AP. The IL-6 and TNF-α levels in the pulp in the NS and LPS groups were increased but reversed by A-740003 injection. In rats with AP, the expression level of the P2X7 receptor and IL-6/TNF-α release was upregulated. The A-740003 can relieve pain and reduce the inflammation progression in rats with AP.

A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis.

OBJECTIVE: To explore the feasibility of treating cirrhosis using a multidisciplinary team approach (MDT) and to pinpoint the key factors influencing its implementation. METHODS: The data of 307 patients with decompensated cirrhosis were studied retrospectively. Patients who received more than two treatment measures were assigned to the MDT group (n=228), and patients who received symptomatic medical drug treatment only were assigned to the traditional treatment group (n=79). The follow-up period ranged from 4 to 10 years, and the average follow-up period was 5.7 years. The results of the biochemical tests for hepatitis B virus deoxyribonucleic acid, hepatitis C virus ribonucleic acid, and autoantibodies to liver disease were analyzed. RESULTS: The differences in gender and Child-Pugh grade of liver function between the two groups were not statistically significant. The MDT group had obvious advantages over the traditional treatment group in occupational composition, etiology composition, 5-year survival rate and annual hospitalization times. The leading causes of death in the MDT group, in descending order, were liver cancer, infection, mesenteric thrombosis, and non-hepatic disease, and, in the medical treatment group, they were liver failure, gastrointestinal bleeding, infection, and liver cancer. There was a significant statistical difference between the two groups (p < 0.05). In the multidisciplinary treatment, etiological treatment was the most widely used treatment, accounting for 79.8%, followed by endoscopic treatment (33.3%), peritoneal drainage and ascites reinfusion (25%), splenectomy combined with devascularization (11.4%) and stem cell transplantation and liver transplantation (1.8%). CONCLUSION: An MDT can improve the efficacy and prognosis of patients with cirrhosis and improve patient compliance. After multi-disciplinary intervention, the mortality spectrum of long-term survival patients with cirrhosis changes, and the mortality rate of liver cancer and non-liver disease increases.

Highly sensitive nucleic acid detection and transaminase level in treatment decisions for Chinese patients with cirrhosis caused by hepatitis.

OBJECTIVE: To explore the usefulness of highly sensitive nucleic acid detection for assisting with the accurate antiviral treatment of patients with cirrhosis that was caused by hepatitis. METHODS: There were 377 patients with hepatitis B with cirrhosis and 119 patients with hepatitis C with cirrhosis, either as hospitalized patients and outpatients, who were enrolled into the study. Among them, 299 were men and 197 were women between 23 and 82 years of age. All patients were examined using a domestic HBV DNA/HCV RNA test, which was negative in 162 cirrhosis with hepatitis B and 54 cirrhosis with hepatitis C patients (HBV DNA/HCV RNA <500 IU/mL). Prediction and analysis of the HBV DNA load using alanine aminotransferase (ALT) level was based on receiver operating characteristics (ROC) curve analysis. RESULTS: For patients with hepatitis C with cirrhosis, after the antiviral therapy, ALT, HCV RNA, and Child-Pugh grade were significantly improved compared with before treatment. ROC analysis results showed that an ALT level of 29 IU/mL was the most sensitive cutoff value to judge a positive HBV DNA load (sensitivity 1.0, specificity 0.237, Youden index 0.763). CONCLUSION: Precise detection for patients with cirrhosis caused by hepatitis is required for accurate therapy.

Microscopic removal of type III dens invaginatus and preparation of apical barrier with mineral trioxide aggregate in a maxillary lateral incisor: A case report and review of literature.

BACKGROUND: Invaginated teeth pose greater challenges in clinical management because of their complex configuration. With advancements in equipment and materials, such as the dental operation microscope, cone-beam computed tomography and mineral trioxide aggregate, the preservation rate of type III dens invaginatus could be greatly increased. CASE SUMMARY: This case report presented a 31-year-old woman with complaints of spontaneous swelling and pain in the right maxillary lateral tooth. With the aid of cone-beam computed tomography, type III dens invaginatus with apical periodontitis was diagnosed and confirmed. Three-visit endodontic treatment was performed. In the first visit, the invagination was carefully removed under the dental operation microscope, and chemomechanical preparation was done. In the second visit, mineral trioxide aggregate apical barrier surgery was performed in this tooth. In the third visit, the canal was finally obturated with thermoplastic gutta-percha to recover the crown morphology. A 26-mo follow-up revealed a satisfied outcome both in the radiographic and oral examinations. CONCLUSION: In this case, removal of the entire abnormal structure provided great convenience for the follow-up treatment. When confronted with the same clinical case in the future, we can take a similar approach to address it.

In Vitro Evaluation of a Novel Osteo-Inductive Scaffold for Osteogenic Differentiation of Bone-Marrow Mesenchymal Stem Cells.

BACKGROUND: Demineralized bone matrices (DBMs) were demonstrated to be a promising candidate for bone regeneration by previous studies. However, the limited osteoinductivity of DBMs was insufficient for a better repairing of bone defect. Osteoblasts (OBs), the major cellular component of bone tissues, play an important role in the formation of new bone. The extracellular matrix (ECM) of OB is one of the main components of bone formation niche. OBJECTIVE: To combine the DBMs with the ECM of OBs to construct a novel scaffold that could be used for bone reconstruction. METHODS: In this study, OBs were cultured on the surface of DBMs for 10 days and removed by Triton X-100 and ammonium hydroxide to prepare the OBs-ECM-DBMs (OEDBMs). A series of material features such as residues of OBs and ECM, cytotoxity, and osteoinductive capability of OEDBMs were evaluated. RESULTS: Low cell residues and low content of DNA were observed in OEDBMs. Compared with DBMs, OEDBMs possessed more bone tissues organic matrix proteins, such as osteocalcin, osteopontin, and collagen I. Rat bone marrow mesenchymal stem cells (rBMSCs) presented a good viability when cultured on both 2 materials. The significant upregulations of osteogenic genes and proteins of rBMSCs were observed in OEDBMs group compared with DBMs group. CONCLUSION: Taken together, these findings suggested that the OB-secreted ECM may be qualified as an ideal modification method for enhancing the performance of engineered bone scaffold.

Protective effect of RNA interference targeting Ikkß on hepatic fibrosis in rats.

Nuclear factor-κB (NF-κB) is an important regulatory factor in cells. NF-κB has a wide range of biological activities. After activation, it participates in the transcription and regulation of many genes and plays a role in infection, inflammatory response, oxidative stress, cell multiplication, and apoptosis. The activation of the NF-κB signal pathway is dependent on the degradation of the IκB kinase ß (IKKß) complex. IKK ß is the key kinase in the NF-κB activation pathway. After inhibition, it can block the activation of NF-κB. IKKß is a key regulator of NF-κB activation, also an early regulator of inflammation in all stages of the immune response. This study aimed to investigate the effect of IKKß-siRNA lentivirus vector treatment for hepatic fibrosis of rats. An IKKß-siRNA expression plasmid was constructed and injected in the tail vein of rats. Then, IKKß-siRNA distribution in the liver was observed by immunofluorescence, and the quantitative polymerase chain reaction was used to detect inflammation-related and fibrosis-related factors. IKKß-siRNA lentiviruses could be delivered to the liver and significantly decrease carbon tetrachloride-induced hepatic fibrosis. Furthermore, serum transaminase levels significantly decreased, and inflammation-related and fibrosis-related factors decreased. IKKß-siRNA can be an effective method of anti-fibrosis gene therapy for liver fibrosis.

Multimodal therapy and twenty years of valid management of a patient with chronic hepatitis B in a less developed Western Region in China---case report and review of the literature.

BACKGROUND: For patients with chronic hepatitis B and cirrhosis in less developed western regions in China, due to constraints of local economic conditions, the choice of treatment measures is often limited. However if patients recieved valid management and effective treatment, they were able to maintain their health and benign prognosis. CASE PRESENTATION: This study narrates the long-term treatment and careful follow-up of a patient with chronic hepatitis B and cirrhosis in a less developed western region in China, and analyzes the prognosis of the disease and countermeasures. CONCLUSIONS: This would partly reflect the development of antiviral therapy for chronic hepatitis B and multidisciplinary comprehensive treatment for cirrhosis-related complications in remote region with limited resources in the past 20 years.

[The influence of salvia miltiorhiza on the expression of TGF-ß1 in periodontal tissue during orthodontic tooth movement in rats].

PURPOSE: To investigate the effect of salvia miltiorhiza on the expression of TGF-ß1 within periodontal tissues during orthodontic tooth movement in rat. METHODS: One hundred and ninety-two male Sprague-Dawley rats were randomly divided into 4 groups (group A, B, C and D). Group A and B were used as orthodontic tooth movement model based on afterburner time. Group A, C and B, D were injected salvia miltiorhiza and NS under the buccal mucosa of left maxillary first molar every other day. Animals in each group were sacrificed at 6 time points (day 1,3,5,7,10 and 14) after appliance placement for collection of specimens. The distance of the tooth movement was measured by stereomicroscope, periodontal tissue was investigated by H-E staining and the protein expression of TGF-ß1 was examined by immunohistochemical techniques. SPSS17.0 software package was used for statistical analysis. RESULTS: Except for the first day, the protein expression of TGF-ß1 in group A was highest and there was significant up-regulation on day 3, with a peak on day 5. Compared with group B, the average optical density of TGF-ß1 in group A was 0.5181±0.0037 on day 3, 0.5857±0.00235 on day 5 and 0.4363±0.0021 on day 7, both with significant differences (P<0.01). Compared with group C and group D, significant differences were formed at each time point in group A (P<0.05). CONCLUSIONS: Salvia injection may improve periodontal tissue microcirculation,thus promote the expression of TGF-ß1 protein,which may be one of the mechanisms to accelerate orthodontic tooth movement. Supported by Research Fund of Science and Technology of Honghuagang District, Zunyi City[(2010)11].

[Distribution of the muscle spindles in human masticatory muscles].

OBJECTIVE: To investigate the characteristics in the topographic distribution of the muscle spindles in human masticatory muscles. METHODS: The muscle spindles of the masticatory muscles on both sides of 3 human corpses fixed in formalin for more than 1 year were observed histologically and analyzed quantitatively using an image analysis system. RESULTS: The mean muscle spindle density was 32.11/g in the masseter, significantly higher in the deep muscular fibers (70.76/g) with high proportion of spindle complexes than in the superficial layers of the muscle belly (P<0.05). The mean spindle density in the temporalis was 5.44/g, higher in the anterior portion (7.44/g) than in the posterior portion (3.78/g, P<0.01). The medial pterygoid had a mean spindle density of 4.43/g. CONCLUSION: These results indicate a heterogeneous distribution of muscle spindles in the masticatory muscles with different morphologies or in different portions of the same muscle, depending on muscle fiber type and muscular architecture.

[Stereology investigation of muscle spindles in human masseter and temporalis muscle].

OBJECTIVE: To find out the characteristic topographic distribution of the muscle spindles in human masseter and temporal muscle, and to clarify the neurobiology roles of masticatory muscles during chew and adjusting mandibular position. METHODS: The muscle spindles of masseter and temporal muscle on both sides of 5 human corpses fixed in formalin for more than 1 year were observed and quantitatively analyzed by picture analysis equipment. RESULTS: The muscle spindles were maldistributed and spindles were commonly clustered in some individual portions, and the muscle spindle figures were diversiform, which were predominantly composed of the spindle simple and spindle complexes. The masseter spindles of the deep portion were obviously more than that of the superficial. Spindles of temporal muscle were concentrated in the anterior approach to the coracoid. CONCLUSION: The distribution of muscle spindles in the masseter and temporal muscle is heterogeneous, spindle density in the deep portion of masseter and the anterior of temporolis muscle is greater than others. The deep of masseter and the anterior of temporal muscle play an important part in maintaining mandibular position and balance.