Characteristics, Treatment, and Prognosis of Pediatric Symphyseal/Parasymphyseal-Condylar Fractures.

BACKGROUND: Pediatric condylar fractures combined with symphyseal or parasymphyseal fractures are common but challenging to manage. The authors present fracture characteristics, propose a treatment algorithm, and evaluate the treatment prognosis of pediatric symphyseal/parasymphyseal-condylar fractures. METHODS: A retrospective review was conducted on pediatric patients who underwent treatment for symphyseal/parasymphyseal-condylar fractures in a trauma center between January of 2006 and January of 2021. Demographic and fracture characteristics were recorded. Complications and functional evaluations, including maximum interincisal opening, Helkimo anamnestic index, and clinical dysfunction index, were assessed after at least 1 year of follow-up. RESULTS: After screening, 104 participants met the inclusion criteria. Among them, 50.96% received open reduction and internal fixation for symphyseal/parasymphyseal fractures and closed treatment for condylar fractures, 45.19% were treated by liquid diet and functional exercise, and the remaining 3.85% with severe malocclusion were treated with the assistance of orthodontic appliances. During follow-up, the average maximum interincisal opening of the patients increased from 17 ± 6.29 mm to 41.64 ± 6.33 mm. No subjective symptoms were observed in 86.54% of the patients and 79.81% showed no or mild clinical symptoms. Except for 1 patient who developed temporomandibular joint ankylosis, no other severe complication was reported. Postfracture remodeling of the nonfractured condyle was noted in 3 cases. CONCLUSIONS: Pediatric symphyseal/parasymphyseal-condylar fractures present unique biomechanical and anatomic challenges that require special consideration during management. In this study, satisfactory functional prognosis was achieved following implementation of the treatment algorithm. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Sensory Nerve Regulation via H3K27 Demethylation Revealed in Akermanite Composite Microspheres Repairing Maxillofacial Bone Defect.

Maxillofacial bone defects exhibit intricate anatomy and irregular morphology, presenting challenges for effective treatment. This study aimed to address these challenges by developing an injectable bioactive composite microsphere, termed D-P-Ak (polydopamine-PLGA-akermanite), designed to fit within the defect site while minimizing injury. The D-P-Ak microspheres biodegraded gradually, releasing calcium, magnesium, and silicon ions, which, notably, not only directly stimulated the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) but also activated sensory nerve cells to secrete calcitonin gene-related peptide (CGRP), a key factor in bone repair. Moreover, the released CGRP enhanced the osteogenic differentiation of BMSCs through epigenetic methylation modification. Specifically, inhibition of EZH2 and enhancement of KDM6A reduced the trimethylation level of histone 3 at lysine 27 (H3K27), thereby activating the transcription of osteogenic genes such as Runx2 and Osx. The efficacy of the bioactive microspheres in bone repair is validated in a rat mandibular defect model, demonstrating that peripheral nerve response facilitates bone regeneration through epigenetic modification. These findings illuminated a novel strategy for constructing neuroactive osteo-inductive biomaterials with potential for further clinical applications.

The Glu69Asp Polymorphism of EME1 Gene is Associated with an Increased Risk of Hepatocellular Carcinoma in Guangxi Population, China.

Background: The dysfunction of Essential meiotic endonuclease 1 homolog 1 (EME1) can lead to genomic instability and tumorigenesis. Single nucleotide polymorphisms (SNPs) in the EME1 gene have been reported to be associated with the risk of several cancers, but its association with hepatocellular carcinoma (HCC) has not been investigated. This study aimed to determine the association between EME1 SNPs and the risk of HCC. Methods: This study included 645 HCC patients and 649 healthy controls from a Guangxi population of Southern China, and genotyped three functional SNPs (Glu69Asp: rs3760413A>C, Ile350Thr: rs12450550T>C, and rs11868055A>G) of the EME1 gene utilizing the Agena MassARRAY platform. Results: The rs3760413C variant genotypes (AC+CC: Glu/Asp+Asp/Asp) conferred a 1.419-fold risk of HCC compared to the AA (Glu/Glu) genotype (adjusted OR = 1.419, 95% CI = 1.017-1.980), and the allele C increased the risk of HCC in a dose-dependent manner (P trend = 0.017). Moreover, the effects of the rs3760413C variant genotypes were more pronounced in individuals who drank pond/ditch water (adjusted OR = 3.956, 95% CI = 1.413-11.076) than in those who never drank (P = 0.033). We further observed that a potential carcinogen microcystin-LR induced more DNA oxidative damages in peripheral blood mononuclear cells from the carriers of rs3760413C variant genotypes than those from the subjects with AA genotype (P = 0.006). A nomogram was also constructed combining the rs3760413A>C polymorphism and environmental risk factors for predicting HCC risk with a good discriminatory ability (concordance index = 0.892, 95% CI: 0.874-0.911) and good calibration (mean absolute error = 0.005). Conclusion: Our data suggest that the Glu69Asp missense polymorphism (rs3760413) of EME1 gene is associated with the risk of HCC, which may be a susceptible biomarker of HCC in the Guangxi population.

Double - network hydrogel based on exopolysaccharides as a biomimetic extracellular matrix to augment articular cartilage regeneration.

Cartilage regeneration remains a current challenge with no satisfactory strategy in surgery. Hydrogels with structurally and biochemically biomimicking characteristics have been regarded as a promising approach for the success of cartilage regeneration. Naturally sourced hydrogels from exopolysaccharides are ideal candidates for the construction of biomimetic extracellular matrix (ECM) because of their biomimetic networks, high water content, cytocompatibility, and biodegradability. Here, an approach that integrates covalent and ionic bonds in a hydrogel system is shown to form a natural polymeric hydrogel double network (DN) for promoting the adhesion and proliferation of chondrocytes and supporting the formation of matured cartilage tissue. DN hydrogels comprised of chemically crosslinked hyaluronan (HA) and physically crosslinked gellan gum (GG) were developed for potential scaffold fabrication. Compared with HA single network (SN) hydrogel and GG SN hydrogel, the obtained HA/GG DN hydrogel with Young's modulus of 28.6 kPa exhibited adequate compressive strength (208.9 kPa) and high toughness (dissipated energy 2837 J/m3) and thus can be used as a biomimetic extracellular matrix for minimal invasively repairing cartilage. In vitro studies showed that HA/GG DN hydrogel-based ECM promoted the proliferation of chondrocytes. The HA/GG DN hydrogel significantly supported the deposition of cartilage ECM-specific sulfated glycosaminoglycan and type II collagen and facilitated the formation of cartilage tissues. In a rabbit osteochondral defect model, HA/GG DN hydrogel significantly improved cartilage regeneration. The HA/GG DN hydrogel as a biomimetic ECM is a promising candidate as a biomaterial scaffold for cartilage regeneration and repair. STATEMENT OF SIGNIFICANCE: The fabrication of a biomaterial scaffold as an artificial extracellular matrix (ECM) for cartilage regeneration remains a big challenge. In this work, we fabricated a double-network (DN) hydrogel based on hyaluronan and gellan gum (HA/GG) through a sequential chemical and physical cross-linking process. The HA/GG DN hydrogel exhibited high compressive strength, high toughness, stiffness, and good self-recovery property. The HA/GG DN hydrogel can support chondrocyte proliferation and new ECM deposition correlated with the enhanced mechanical properties, good cytocompatibility, and biodegradability. In vivo animal experiments demonstrated that this HA/GG DN hydrogel facilitates hyaline-like cartilage regeneration. These findings imply that the developed HA/GG DN hydrogel as a biomimetic ECM offers a hopeful new platform for cartilage tissue engineering.

Genetic Variant of PP2A Subunit Gene Confers an Increased Risk of Primary Liver Cancer in Chinese.

BACKGROUND: Protein phosphatase 2A (PP2A, a serine/threonine phosphatase) is frequently inactivated in many types of cancer, including primary liver cancer (PLC). Genetic variations in PP2A subunits have been reported to be associated with the risk of many types of cancer but rarely in PLC. This study aims to assess the association between functional polymorphisms of PP2A subunit genes and the risk of PLC in Chinese. METHODS: In a case-control study with a total of 541 PLC patients and 547 controls in Guangxi province of Southern China, we genotyped six putatively functional polymorphisms (rs10421191G>A, rs11453459del>insG, rs1560092T>G, rs7840855C>T, rs1255722G>A and rs10151527A>C) of three PP2A subunit genes (PPP2R1A, PPP2R2A and PPP2R5E) using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry platform. RESULTS: The rs11453459insG variant genotypes (ins/ins+del/ins) of PPP2R1A were found to be significantly associated with an increased risk of PLC compared with the del/del genotype (adjusted OR = 1.290, 95% CI = 1.009-1.650), and the number of insert G allele worked in a dose-dependent manner (P trend= 0.007). The stratified analysis showed that the effects of rs11453459insG variant genotypes were more evident in the subgroup who drink pond-ditch water (adjusted OR = 3.051, 95% CI = 1.264-7.364) than those never drink (P = 0.041). The carriers of rs11453459 del/ins genotype had a significantly lower level of PPP2R1A mRNA expression in liver cancer tissues than those of the del/del genotype (P = 0.021). Furthermore, we used microcystin-LR, a carcinogen presents in the pond-ditch water, to treat human peripheral blood mononuclear cells and found that the cells from carriers of rs11453459insG variant genotypes induced more DNA oxidative damages than those from the del/del genotype carriers (P < 0.001). CONCLUSION: These findings suggest that the PPP2R1A rs11453459del>insG polymorphism is associated with an increased risk of PLC, especially for persons with a history of drinking pond-ditch water. This insertion/deletion polymorphism may be a susceptible biomarker for PLC in Chinese.

Physically Cross-Linked Hyaluronan-Based Ultrasoft Cryogel Prepared by Freeze-Thaw Technique as a Barrier for Prevention of Postoperative Adhesions.

Postsurgical peritoneal adhesions are a common and serious postoperative complication after various peritoneal surgeries, such as pelvic and abdominal surgery. Various studies have shown that peritoneal adhesions can be minimized or prevented by physical anti-adhesion barriers, including membranes, knits, and hydrogels. Hydrogels have attracted great attention in preventing peritoneal adhesions because the dimensional architecture of hydrogels is similar to that of the native extracellular matrix. However, chemical cross-linkers had to be used in the preparation of chemical hydrogels, which may have problems in cytotoxicity or unwanted side effects. This fact prompts us to create alternative cross-linking methods for the development of biocompatible hydrogels as physical barriers. Herein, we report a physically cross-linked flexible hyaluronan (HA) cryogel prepared via a freeze-thaw technique as a novel anti-adhesion biomaterial for completely preventing postsurgical peritoneal adhesions. In vitro studies demonstrated that this physically cross-linked HA cryogel exhibited excellent biocompatibility, the inherently desirable biocompatibility and functionality of HA being integrally retained as much as possible. Intriguingly, the rheological properties and appropriate biodegradability of the cryogels were readily tailored and tunable by way of the gelation process. In vivo assessments suggested that the cryogel, as a physical barrier, satisfactorily prevented fibroblast penetration and attachment between the injured tissues and nearby normal organs. Furthermore, the molecular mechanism studies revealed that the HA cryogel could prevent peritoneal adhesion by inhibiting inflammatory response and modulation of the fibrinolytic system. Our results show that HA ultrasoft cryogel is a promising clinical candidate for prolonged adhesion prevention.

Preservation of alveolar ridge height through mechanical memory: A novel dental implant design.

Irreversible marginal bone loss can hinder recovery around dental implants. Insufficient alveolar osteogenesis and stress concentration during chewing contribute to marginal bone resorption and can result in implant failure. A biomaterial with a micropore-channel structure was developed using 3D printing technology. This design facilitated bony ingrowth and provided similar mechanical stimulation at the implant neck during mastication to a natural tooth. The micropore channels provided a guiding structure for bone mesenchymal stem cell proliferation and differentiation without the need for growth factors. Specifically, this was achieved through mechanical transduction by F-actin remodeling and the activation of Yes-associated protein (YAP). The implants were verified in a canine dental implant surgery model, which demonstrated the promising use of biomaterial-based dental implants in future clinical applications.

In situ gas foaming based on magnesium particle degradation: A novel approach to fabricate injectable macroporous hydrogels.

Injectable hydrogels are attractive biomaterials for cell delivery in tissue engineering. However, the in vivo viability of transplanted cells remains limited. Typically, macroporous structures constructed in hydrogels are utilized to enhance oxygen and nutrients diffusion for cell survival and to promote integration between the material and host tissue. A new gas-foaming method to generate pores was proposed by directly adding Mg particles into cell-laden hydrogel solutions, taking advantage of the H2 gas formed during the degradation of Mg. The optimization design of the size and amount of Mg particles added into the hydrogels was investigated. Improved cell viability and proliferation were demonstrated in the group with Mg particles. Additionally, Mg2+ ions generated during Mg degradation facilitated the osteogenic differentiation of stem cells encapsulated in hydrogels. Extensive vascularized bone regeneration in the femoral defects of rats revealed that the use of Mg particles as the foaming agent is feasible, endowing injectable hydrogels with optimized porosity and enhanced bioactivity, and providing a new strategy for future designs of porous hydrogels in tissue engineering.

Bilateral intermittent nasal obstruction in adolescent rats leads to the growth defects of mandibular condyle.

OBJECTIVE: This study aimed to evaluate the effects of nasal obstruction on mandibular growth, especially condyle, in adolescent rats and explore the possible mechanism with a focus on mesenchymal stem cells (MSCs) from condylar tissues. DESIGN: 4-week-old male Sprague-Dawley rats were randomly divided into bilateral intermittent nasal obstruction (i.e. mouth-breathing, MB) and nasal-breathing (NB) groups. Self-made plugs were used to obstruct the nasal cavity in the MB group for 4 weeks, from 8:00 a.m. to 4:00 p.m. every day. The body weights were recorded. Three-dimensional computed tomography (3D-CT) scanning of the craniomaxillary region was performed after 2 and 4 weeks of nasal obstruction. Other rats were sacrificed, and MSCs were isolated from condylar tissues and cultured in vitro for examining the cell proliferation and expression of chondrogenic marker genes. RESULTS: Significant decreases in body weight were observed in the MB group compared with the NB group during 4 weeks of nasal obstruction. All mandibular parameters in the sagittal, vertical, and transverse dimensions (except bi-condylar width) measured via 3D-CT were significantly smaller in the MB group. No significant difference was found in the proliferative ability of cultured MSCs derived from condylar tissues between the two groups. However, the expression of chondrogenic marker genes Acan, Col2a1 and Sox9 was significantly lower in the MB group-derived MSCs, using Cell Counting Kit-8 and quantitative polymerase chain reaction. CONCLUSION: The findings suggested that mouth breathing forced by nasal obstruction lead to developmental defects in the mandibular condyle, which might be related to the reduced cartilage differentiation of condylar MSCs.

A Comparative evaluation of CBCT outcomes of two closed treatment methods in intracapsular condylar fractures.

PURPOSE: The cone beam computed tomography (CBCT) images of 2 closed treatments are compared for intracapsular condylar fractures (ICFs) to learn whether splint treatment could promote better radiologic outcomes. PATIENTS AND METHODS: Fifty-four patients with 60 sides of ICF were divided into 2 groups. In the control group (C-group), patients had a liquid diet for 1 month. In the trial group (T-group), patients wore splints with anterior elastic traction. Local CBCT images of the temporomandibular joint were obtained at T0 (mean 8.8 days), T1 (mean 37.4 days), and T3 (mean 3.3 months) after trauma. Six parameters, including 2 horizontal, 1 sagittal, and 3 vertical distances, were calculated using the coordinates of 10 points marked on CBCT sections. Statistical analysis included intragroup comparison at T0, T1, and T3, and intergroup comparison among subgroups classified by age and ICF types. RESULTS: Compared to C-group, vertical distances were significantly changed in T-group, specifically in adults and patients with ICF type B. Significant changes at stage T1 were also observed in T-group. CONCLUSION: During the natural healing process, ICF healed in the displaced position and the stump tended to move closer to the joint fossa in the vertical dimension. Splint treatment with elastic traction was helpful to increase joint space and promote better radiologic healing shape.

Dental arch dimensional changes after adenoidectomy or tonsillectomy in children with airway obstruction: A meta-analysis and systematic review under PRISMA guidelines.

BACKGROUND: Children with severe airway obstruction tend to have a vertical direction of growth, class II malocclusion, and narrow arches. Adenoidectomy and tonsillectomy were recommended for the promotion of balanced dentition growth in these children.The aim of this study was to determine the effect of adenoidectomy and tonsillectomy on the growth of dental morphology in children with airway obstruction. METHODS: A comprehensive search of the Medline, Embase, Web of science, and OVID databases for studies published through to January 17, 2016 was conducted. Prospective, comparative, clinical studies assessing the efficacy of adenoidectomy, or tonsillectomy in children with airway obstruction were included. The weighted mean difference (WMD) and 95% confidence interval (CI) were used for continuous variables. Forest plots were drawn to demonstrate effects in the meta-analyses. RESULTS: Eight papers were included in our study. We found that adenoidectomy and tonsillectomy led to a significant change in nasal-breathing in children with airway obstruction. Children with airway obstruction had a significantly narrower posterior maxillary dental arch than children without airway obstruction (WMD = -0.94, 95% CI [-1.13, -0.76]; P < 0.001). After surgery, these children still had a significantly narrower dental arch than the nasal-breathing children (WMD = -0.60, 95% CI [-0.79, -0.42]; P < 0.001). In terms of dental arch width, malocclusion, palatal height, overjet, overbite, dental arch perimeter, and arch length, a tendency toward normalization was evident following adenoidectomy or tonsillectomy, with no significant differences evident between the surgical group and the normal group. The small number of studies and lack of randomized controlled trials were the main limitations of this meta-analysis. CONCLUSIONS: Following adenoidectomy and tonsillectomy, the malocclusion and narrow arch width of children with airway obstruction could not be completely reversed. Therefore, other treatments such as functional training or orthodontic maxillary widening should be considered after removing the obstruction in the airway.

Er:YAG laser versus scaling and root planing as alternative or adjuvant for chronic periodontitis treatment: a systematic review.

AIM: To perform a systematic review to evaluate the erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser versus scaling and root planing (SRP) as alternative or adjuvant for chronic periodontitis treatment. MATERIAL AND METHODS: We performed a literature search using six electronic databases and completed by manual searches up to July 2013. We conducted a meta-analysis as well as heterogeneity, sensitivity, subgroup and power analyses to clarify and validate the pooled results. The 3-, 6- and 12-month clinical outcomes were evaluated. RESULTS: Twelve eligible randomized clinical trials were finally included. Our meta-analysis showed that Er:YAG laser resulted in similar clinical improvements as SRP 3 months postoperatively. For subgroups by laser level, quality of trials and fluorescence feedback device, the results remained consistent. The 6- and 12-month observations between Er:YaG laser and SRP demonstrated no difference but inconclusive, due to large heterogeneity. The advantage of Er:YAG laser adjuvant to SRP for periodontitis treatment was not significant. CONCLUSIONS: This systematic review indicated that the clinical efficacy of Er:YAG laser was similar to SRP 3 months postoperatively. The clinical benefits of Er:YAG laser as adjuvant to SRP was still lacking. Since Er:YAG laser has certain advantages, it could be expected to be a novel short-term alternative choice for chronic periodontitis.

Direct formation of reduced graphene oxide and 3D lightweight nickel network composite foam by hydrohalic acids and its application for high-performance supercapacitors.

Here, a novel graphene composite foam with 3D lightweight continuous and interconnected nickel network was successfully synthesized by hydroiodic (HI) acid using nickel foam as substrate template. The graphene had closely coated on the backbone of the 3D nickel conductive network to form nickel network supported composite foam without any polymeric binder during the HI reduction of GO process, and the nickel conductive network can be maintained even in only a small amount of nickel with 1.1 mg/cm(2) and had replaced the traditional current collector nickel foam (35 mg/cm(2)). In the electrochemical measurement, a supercapacitor device based on the 3D nickel network and graphene composite foam exhibited high rate capability of 100 F/g at 0.5 A/g and 86.7 F/g at 62.5 A/g, good cycle stability with capacitance retention of 95% after 2000 cycles, low internal resistance (1.68 Ω), and excellent flexible properties. Furthermore, the gravimetric capacitance (calculated using the total mass of the electrode) was high up to 40.9 F/g. Our work not only demonstrates high-quality graphene/nickel composite foam, but also provides a universal route for the rational design of high performance of supercapacitors.

Facile synthesis of nickel network supported three-dimensional graphene gel as a lightweight and binder-free electrode for high rate performance supercapacitor application.

Here we report a simple strategy to prepare three-dimensional graphene gel coated on nickel foam for supercapacitor applications by a simple 'dipping and drying' process. The supercapacitors based on three-dimensional graphene gel (G-gel@NF-1) exhibited high rate capability of 152 F g(-1) at 0.36 A g(-1) and 107 F g(-1) at 90.9 A g(-1), good cycle stability with capacitance retention of 89% after 2000 cycles and low internal resistance (0.58 Ω). Furthermore, a flexible electrode (G-gel@NF-2) was obtained by etching most of the nickel foam but maintains the conductive backbone of the nickel foam, which greatly reduces the total mass of the electrode (can be reduced from 30 mg cm(-2) to less than 5 mg cm(-2)), and can be compressed from a thickness of 1 mm to ∼30 µm. With the aid of a conductive network composed of a small amount of nickel, G-gel@NF-2 still has good performance in high rate capability and displays excellent flexible properties. The specific capacitance when the mass density of the electrode was only 5.4 mg cm(-2) still reached ∼115 F g(-1). This strategy can improve the rate capability performance, greatly reduce the mass of the electrode, and lower the fabrication cost of supercapacitors.

Interleukin-16 gene polymorphisms rs4778889, rs4072111, rs11556218, and cancer risk in Asian populations: a meta-analysis.

OBJECTIVES: Some polymorphisms of the interleukin-16 (IL-16) gene are associated with various cancers. To resolve inconsistencies in published data, we performed a meta-analysis of studies of IL-16 polymorphisms and cancer risk. MATERIALS AND METHODS: Seven eligible studies pooling 1678 cases and 1937 controls were quantitatively analyzed to evaluate three IL-16 polymorphisms (rs4778889, rs4072111, rs11556218) and cancer risk. Hardy-Weinberg equilibrium (HWE) for controls was evaluated by goodness-of-fit chi-squared tests. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for each genetic model and allelic comparison. Data were pooled using fixed- or random-effects models depending on heterogeneity across studies. RESULTS: Our meta-analysis demonstrated that the IL-16 polymorphism rs11556218 was significantly associated with increased susceptibility to cancer in several models, including allelic contrast (OR=1.307; 95% CI, 1.108-1.541), heterozygote contrast (OR=1.650; 95% CI, 1.424-1.911), and dominant model (OR=1.605; 95% CI, 1.391-1.845). The result remained consistent after adjustment for age and gender. No significant association was found between IL-16 polymorphisms rs4778889 rs4072111 and cancer risk. CONCLUSIONS: The rs11556218 T/G polymorphism of the IL-16 gene was significantly associated with elevated cancer risk in Asian populations. Our results warrant larger, better-designed studies, including a greater ethnic variety.