Decompression-first or direct enucleation: The choice of treatment for medium-sized odontogenic jaw cysts.

BACKGROUND: The treatment of medium-sized odontogenic jaw cysts is inconsistent at present. Two main treatments, namely decompression and enucleation, are used overlappingly. This retrospective analysis aims to provide useful references for technique selection for future management of medium-sized odontogenic jaw cysts. METHODS: Odontogenic cysts with lesion sizes ranging 2-4 cm were included. The clinical and radiological data of the patients were reviewed. Decompression-first and direct enucleation treatments were the two main surgical techniques. The preoperative parameters and postoperative outcomes were compared between the two groups. RESULTS: Out of 69 patients included, 40 (58 %) were in the decompression group and 29 (42 %) in direct enucleation group. The logistic regression analysis of preoperative parameters demonstrated that the maximum lesion size and the chief surgeon's preference could affect the selection of surgical techniques for medium-sized cysts (P < 0.05). Receiver operating characteristic curve analyses demonstrated that a lesion size >2.5 cm was the best cutoff value for predicting a decompression selection. Most postoperative outcomes differed significantly between the two groups (P < 0.05). Lower-risk anesthesia, shorter hospitalization, tooth function protection, and fewer neurosensory impairments were decompression-favoring outcomes. However, more follow-up visits, more postoperative X-rays, and longer postoperative care were outcomes against decompression. The recurrence rate was low and did not differ significantly between the two groups (P > 0.05). CONCLUSIONS: There is no apparent preference for treating medium-sized jaw cysts. The maximum lesion size is a moderate-impact factor for treatment selection. A tendency to prefer decompression-first with larger lesion size was found in medium-sized jaw cysts. The advantages of teeth preservation and low neurosensory impairment of decompression were verified in the medium-size jaw cysts. The burden of postoperative care should be considered when selecting decompression.

Application of a modified osteotomy and positioning integrative template system (MOPITS) based on a truncatable reconstruction model in the precise mandibular reconstruction with fibula free flap: a pilot clinical study.

BACKGROUND: Mandibular defects can greatly affect patients' appearance and functionality. The preferred method to address this issue is reconstructive surgery using a fibular flap. The current personalized guide plate can improve the accuracy of osteotomy and reconstruction, but there are still some problems such as complex design process and time-consuming. Therefore, we modified the conventional template to serve the dual purpose of guiding the mandible and fibula osteotomy and facilitating the placement of the pre-bent titanium. METHODS: The surgery was simulated preoperatively using Computer-Aided Design (CAD) technology. The template and truncatable reconstruction model were produced in the laboratory using 3D printing. After pre-bending the titanium plate according to the contour, the reconstruction model was truncated and the screw trajectory was transferred to form a modified osteotomy and positioning integrative template system (MOPITS). Next, the patient underwent a composite template-guided vascularized fibula flap reconstruction of the mandible. All cases were reviewed for the total operative time and accuracy of surgery. RESULTS: The procedures involved 2-4 fibular segments in 15 patients, averaging 3 fibular segments per procedure. The osteotomy error is 1.01 ± 1.02 mm, while the reconstruction angular error is 1.85 ± 1.69°. The preoperative and postoperative data were compared, and both p > 0.05. During the same operation, implant placement was performed on four patients, with an average operative time of 487.25 ± 60.84 min. The remaining malignant tumor patients had an average operative time of 397.18 ± 73.09 min. The average postoperative hospital stay was 12.95 ± 3.29 days. CONCLUSIONS: This study demonstrates the effectiveness of MOPITS in facilitating precise preoperative planning and intraoperative execution of fibula flap reconstruction. MOPITS represents a promising and reliable tool for reconstructive surgery, particularly for inexperienced surgeons navigating the challenges of mandible defect reconstruction.

Giant calcifying epithelial odontogenic tumor after I-125 seed implantation: A case report.

Calcifying Epithelial Odontogenic Tumor (CEOT), also known as Pindborg tumor, is a rare odontogenic benign tumor. It was first reported by Thoma and Goldman in 1946 and defined as an independent tumor by Pindborg in 1957. Herein, we reported a CEOT case involving most of the mandible after I-125 implantation in a 53-year-old man. We cooperated with governmental and hospital departments to resect the tumors, reconstruct the mandible with a fibular flap graft, and properly dispose of the radioactive particles.

Long-term bone remodeling after definitive decompression for jaw cysts based on a three-dimensional analysis.

BACKGROUND: Decompression is an effective treatment for jaw cysts. Many studies have reported its effectiveness as a preliminary treatment followed by secondary enucleation. This study aimed to explore long-term bone remodeling after definitive decompression for jaw cysts based on a three-dimensional (3D) analysis. METHODS: This was a retrospective study. The clinical and radiological data of patients with jaw cysts who underwent decompression and were followed up for two years or more at Peking Union Medical College Hospital between January 2015 and December 2020 were reviewed. The 3D radiological data before and after decompression were analyzed to study the long-term reduction in cysts, especially after one year of decompression. RESULTS: A total of 17 patients with jaw cysts were included in this study. The radiological data showed a mean reduction rate of 78% one year after decompression. At the final examination, which was 36.1 months after decompression on average, the mean reduction rate was 86%. The unossified lesions could still ossify slowly after one year of decompression. The recurrence rate was 5.9% (1/17). CONCLUSIONS: Bone remodeling continued for a long time after decompression. Definitive decompression could be an option for most patients with jaw cysts. Long-term follow-up is required.

Self-fused concatenation of interferon with enhanced bioactivity, pharmacokinetics and antitumor efficacy.

We report an easy but universal protein modification approach, self-fused concatenation (SEC), to biosynthesize a set of interferon (IFN) concatemers with improved in vitro bioactivity, in vivo pharmacokinetics and therapeutic efficacy over the monomeric IFN, and the results can be positively enhanced by the concatenated number of self-fused proteins.

Effectiveness of case-based learning in Chinese dental education: a systematic review and meta-analysis.

OBJECTIVE: The application of case-based learning (CBL) pedagogy has been emerging as an improved and more practical learning method across the Chinese dental education system. This article provides a critical overview of CBL pedagogy and further assesses the effectiveness of this teaching model in Chinese dental education. DESIGN: A systematic review and meta-analysis. METHODS: Studies published up to December 2019 were searched in the following electronic databases: China National Knowledge Infrastructure, China Science Periodical Database, Chinese Biomedical documental database, Wanfang data, PubMed, EMBASE and Cochrane Central Register of Control Trials. All randomised controlled trials (RCTs) that compared the effectiveness of the CBL teaching model and the traditional lecture-based learning (LBL) model in all dental disciplines were included. The assessment of methodological quality was based on the guidelines described in the Cochrane Handbook for Systematic Reviews, and the meta-analysis was performed using the software RevMan V.5.3 RESULTS: A total of 30 RCTs were finally included, with a total sample size of 2356 dental students. The CBL pedagogy significantly increased knowledge scores (standardised mean difference (SMD)=1.58, 95% CI: 0.95 to 2.20, p<0.0001), skill scores (SMD=1.22, 95% CI: 0.34 to 2.11, p<0.0001), comprehensive ability scores (SMD=1.91, 95% CI: 1.74 to 4.07, p<0.0001) and teaching satisfaction (risk ratio=1.38; 95% CI: 1.15 to 1.65; p=0.01) compared with the LBL teaching model among the dental students. Additionally, a subgroup analysis showed significant differences in the effects of CBL on knowledge scores, skill scores and comprehensive ability scores when comparing theoretical and practical courses. CONCLUSIONS: The meta-analysis and systematic review of the eligible literature showed that the CBL pedagogy in Chinese dental education is an effective way to increase knowledge scores, skill scores, comprehensive ability scores and teaching satisfaction. Successful adaptation of this teaching model could solve the scarcity of highly skilled and professional dentists in dental schools and hospitals across China.

Enhancement of bioactivity, thermal stability and tumor retention by self-fused concatenation of green fluorescent protein.

The widespread application of protein and peptide therapeutics is hampered by their poor stability, strong immunogenicity and short half-life. However, the existing protein modification technologies require the introduction of exogenous macromolecules, resulting in inevitable immunogenicity and decreased bioactivity. Herein, we reported an easy but universal protein modification approach, self-fused concatenation (SEC), to enhance the in vitro thermal stability and in vivo tumor retention of proteins. In this proof of concept study, we successfully obtained a set of green fluorescence protein (GFP) concatemers, monomer (GFP 1), dimer (GFP 2) and trimer (GFP 3) of GFP, and systematically studied the effects of SEC on the biological activity and stability of GFP. Notably, GFP concatemers displayed remarkable improvement in in vitro bioactivity and thermal stability over the monomeric GFP. In a murine tumor model, GFP 2 and GFP 3 exhibited significantly prolonged duration, with increases of 220- and 381-fold relative to GFP 1 in tumor retention 4 h after administration. Furthermore, the biological activity, thermal stability and tumor retention can be enhanced by the concatenated number of self-fused proteins. These findings demonstrate that SEC may be a promising alternative to design advanced protein and peptide therapeutics with enhanced pharmaceutic profiles.

The development of a magnetic iron/nitrogen-doped graphitized carbon composite with boosted microwave attenuation ability as the wideband microwave absorber.

Magnetic carbon-based composites have been attractive candidates for electromagnetic (EM) absorption due to their dual magnetic and dielectric loss ability. In this study, a novel magnetic carbon consisting of N-doped graphitized carbon and magnetic Fe nanoparticles was produced. First, the graphitized carbon doped with N has been demonstrated to be an efficient way to strengthen the conductivity loss ability. Based on the N-doped graphitized carbon (NGC), the magnetic Fe nanoparticles were further decorated on the NGC, which was not only favored the dielectric loss ability but also introduced the magnetic loss ability. The electromagnetic absorbing properties of the NGC-Fe nanoparticles were evaluated in the frequency range of 2-18 GHz, and as expected, the sample exhibited the excellent wideband EM absorbing ability, with an effective absorption region of 5.2 GHz under a thickness of 1.2 mm. Ulilization of element doping method consisted to modify magnetic carbon material can be a candidate for producing wideband EM absorbers but showing thin thickness.

Evaluation of the degradation, biocompatibility and osteogenesis behavior of lithium-doped calcium polyphosphate for bone tissue engineering.

BACKGROUND: Calcium polyphosphate (CPP) is a commonly used biomaterial in bone tissue engineering, but CPP is insufficient in osteoinduction. This study aimed to fabricate lithium doped CPP (LiCPP) scaffolds and assess their characterization, degradation, biocompatibility and osteogenesis behavior for bone tissue engineering. METHODS: The novel scaffold was characterized by XRD, FTIR and SEM. The porosity, cell mediated degradation behavior and mechanical properties were also investigated. Meanwhile, cell proliferation activity and adhesion in vitro was exploited. Finally, osteogenesis the LiCPP scaffolds in vitro and in vivo was researched. RESULTS: The outcomes revealed that low-content Li doping had no significant influence on the structure of CPP. The results of cells mediated degradation experiments from the weight loss and the release of ions indicated that Li doped CPP improved biological degradation. The compressive strength of CPP with 66% porosity was improved to 7 MPa. Cells proliferation experiment and adhesion experiment demonstrated 2.0%LiCPP scaffold was most beneficial to cell growth and attachment. Furthermore, Li doped CPP up-regulated Wnt signal pathway when co-cultured with MG63 and increased osteogenic marker ALP expression and calcium phosphate deposition in vitro. At the same time, new bone formation in vivo was also enhanced by using LiCPP scaffolds and the 2.0%LiCPP scaffolds obtained best osteogenesis outcomes. CONCLUSION: The results obtained in our study suggest that 2.0%LiCPP scaffold could benefit from improving the osteogenesis behavior and is a promising biomaterial for bone repairing applications.

Cyclic fluid shear stress promotes osteoblastic cells proliferation through ERK5 signaling pathway.

Fluid shear stress plays an important role in bone remodeling, however, the mechanism of mechanotransduction in bone tissue remains unclear. Recently, ERK5 has been found to be involved in multiple cellular processes. This study was designed to investigate the potential involvement of ERK5 in the proliferative response of osteoblastic cells to cyclic fluid shear stress. We reported here that cyclic fluid shear stress promoted ERK5 phosphorylation in MC3T3-E1 cells. Inhibition of ERK5 phosphorylation attenuated the increased expression of AP-1 and cyclin D1 and cell proliferation induced by cyclic fluid flow, but promoted p-16 expression. Further more, we found that cyclic fluid shear stress was a better stimuli for ERK5 activation and cyclin D1 expression compared with continuous fluid shear stress. Moreover, the pharmacological ERK5 inhibitor, BIX02189, which inhibited ERK5 phosphorylation in a time-dependent manner and the suppression lasted for at least 4 h. Taken together, we demonstrate that ERK5/AP-1/cyclin D1 pathway is involved in the mechanism of osteoblasts proliferation induced by cyclic fluid shear stress, which is superior in promoting cellular proliferation compared with continuous fluid shear stress.

New gene groups associated with dissimilar osteoblastic differentiation are linked to osteosarcomagenesis.

BACKGROUND: Osteosarcoma has been recently redefined as a differentiation disease and its investigation is hampered by broad and complex genetic alterations. Gene expression analysis of two human osteosarcoma cell lines that are dissimilar in tumour differentiation status and osteogenic property would advance our understanding of osteo-sarcomagenesis. MATERIALS AND METHODS: Gene ontology classification, hierarchical clustering, functional annotation analysis and inspection of transcription factors and their targets were used to examine differences between Saos-2 and U-2 OS cells. Microarray data were verified with real-time quantitative PCR and immunocytochemistry. RESULTS: Genes from cell binding, cell adhesion and nervous system, as well as some well-known factors of bone formation and osteoblast characterization were identified as being differentially altered in this study. CONCLUSION: The osteogenicity of osteosarcoma or the disrupted osteoblast differentiation is correlated to cell binding, cell adhesion and the nervous system, as well as the osteogenic signalling system.

Feasibility of diagnosing renal allograft dysfunction by oligonucleotide array: Gene expression profile correlates with histopathology.

BACKGROUND: Effective non-invasive monitoring method to tell histopathology is a big challenge in renal transplantation. METHODS: We used 70-mer long oligonucleotide array with 449 immune related genes to determine gene expression profiles of peripheral blood mononuclear cells (PBMCs) under different immune status including stable renal function (TX), acute tubular necrosis (ATN), biopsy conformed acute rejection (AR), clinical rejection with pathology of borderline changes (BL), clinical rejection without biopsy proven/presumed rejection (PR) and renal dysfunction without rejection (NR). RESULTS: Distinct molecular expression signatures in each group were found to correlate with histopathology. And we concluded that B cell chemokine CXCL13 and mast cell may play a role in renal allograft rejection through significant difference analysis and functional pathway analysis. CONCLUSIONS: It provides a potential non-invasive method for monitoring renal allograft function and immune status of renal transplant recipients.