Diffusion Tensor Imaging of the Lateral Pterygoid Muscle in Patients with Temporomandibular Joint Disorders and Healthy Volunteers

Objective@#This study aimed to explore the feasibility of functional evaluation of the lateral pterygoid muscle (LPM) using diffusion tensor imaging (DTI) in patients with temporomandibular joint disorders (TMDs). @*Materials and Methods@#A total of 119 patients with TMD (23 male and 96 female; mean age ± standard deviation, 41 ± 15 years; 58 bilateral and 61 unilateral involvements for a total of 177 joints) and 20 healthy volunteers (9 male and 11 female;40 ± 13 years; 40 joints) were included in this prospective study. Based on DTI of the jaw in the resting state, the diffusion parameters, apparent diffusion coefficient (ADC), fractional anisotropy (FA), λ1, λ2, and λ3 of the superior and inferior heads of the LPM (SHLPM and IHLPM) were measured. Patients with TMD with normal disc position (ND), anterior disc displacement with reduction (ADWR), and anterior disc displacement without reduction (ADWOR) were compared. @*Results@#Patients with TMD overall, and ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 in both the SHLPM and IHLPM than those in volunteers (p < 0.05 for all), whereas the ND subgroup only had significantly higher ADC and λ1 (p < 0.001). Meanwhile, significant differences in FA in the SHLPM and IHLPM were found between volunteers and ADWOR (p = 0.014 and p = 0.037, respectively). Among the three TMD subgroups, except for λ3 and FA in the ADWR subgroup, ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 and lower FA than those in the ND group (p < 0.050). There was no significant difference in diffusion variables between ADWR and ADWOR. In ADWOR, the osteoarthritis group had significantly higher λ3 and lower FA values in the IHLPM than those in the non-osteoarthritis group. @*Conclusion@#DTI successfully detected functional changes in the LPM in patients with TMD. The unsynchronized diffusivity changes in the LPM in different subgroups of TMD signified the possibility of using diffusion parameters as indicators to identify the severity of LPM hyperfunction at various stages of TMD.

Quantitative Analysis of Parotid Gland Secretion Function in Sjögren's Syndrome Patients with Dynamic Magnetic Resonance Sialography

OBJECTIVE: To evaluate the secretory function of parotid glands by dynamic magnetic resonance (MR) sialography and determine the clinical performance of this technique in diagnosing and evaluating Sjögren's syndrome (SS) patients. MATERIALS AND METHODS: This study enrolled 29 healthy volunteers (25 women and 4 men; mean age, 34.8 ± 6.3 years; age range, 26–47 years) and 25 primary SS (pSS) patients (23 women and 2 men; mean age, 37.7 ± 7.9 years; age range, 25–50 years) with decreased secretory function. The volume of the parotid gland ducts was precisely measured for both groups at single pre- and 6 post-gustatory-stimulated phases. Time-dependent volume change ratio curves were generated, four parameters were derived from the curves: the slope of the increase in the first post-stimulation phase (slope(1st)), the peak value, the time-to-peak, the total saliva secretion post-stimulation. All values were used to quantitatively evaluate the secretory function of the parotid gland. The repeated measurement analysis, Mann-Whitney U test and receiver operating characteristic curve were applied. RESULTS: Time-dependent volume change ratio curves demonstrated that there is a statistically significant difference between the two groups (F = 8.750; p = 0.005). A quickly increasing curve was shown in the volunteer group, whereas a slowly increasing curve was shown in the pSS patient group. The slope(1st), peak value and total saliva secretion post-stimulation of the patient group were significantly lower than those of the volunteer group (p = 0.005, p = 0.003, and p = 0.002, respectively). The time-to-peak between the two groups was not significantly different (p = 0.383). The slope(1st) can be used as a discriminator to diagnose SS patients (p = 0.015; odds ratio = 4.234; area under the curve = 0.726). CONCLUSION: Dynamic MR sialography is proven to be an effective method in evaluating salivary gland function and has a great potential in diagnosing and evaluating pSS patients.

Changes in endolymphatic hydrops visualized by magnetic resonance imaging after sac surgery / 华中科技大学学报（医学）（英德文版）

The purpose of the study was to observe changes in endolymphatic hydrops by using intratympanic injection of gadolinium and magnetic resonance imaging (MRI) before and after endolymphatic sac surgery in patients with unilateral Meniere's disease. Thirteen patients with unilateral Meniere's disease undergoing endolymphatic sac surgery were retrospectively and prospectively analyzed. Three-dimensional fluid-attenuated inversion recovery or three-dimensional real inversion recovery MRI was performed 24 h after an intratympanic injection of gadolinium to grade the presence of endolymphatic hydrops. Among the 13 patients with hydrops confirmed by preoperative MRI, vestibular hydrops had no significant change in all patients; cochlear hydrops became negative in 2 patients, and remained unchanged in the other 11 patients after surgery. Definite vertigo attacks were substantially controlled in one patient and completely controlled in 12 patients during a follow-up period of 8-34 months after surgery. The hearing levels were improved in 3 patients, remained unchanged in 7 patients, and decreased in 3 patients. In conclusion, endolymphatic sac surgery does not always alleviate endolymphatic hydrops in patients with Meniere's disease. Relief from vertigo cannot always be attributed to the remission of hydrops. A change in hearing levels cannot be explained by hydrops status alone.

Melanocortin-4 receptor expression in the rostral ventromedial medulla involved in modulation of nociception in transgenic mice / 华中科技大学学报（医学）（英德文版）

The rostral ventromedial medulla (RVM) is a prominent component of the descending modulatory system involved in the control of spinal nociceptive transmission. In the current study, we investigated melanocortin-4 receptor (MC4R) expression in the RVM, where the neurons involved in modulation of nociception reside. Using a line of mice expressing green fluorescent protein (GFP) under the control of the MC4R promoter, we found a large number of GFP-positive neurons in the RVM [nucleus raphe magnus (NRM) and nucleus gigantocellularis pars α (NGCα)]. Fluorescence immunohistochemistry revealed that approximately 10% of MC4R-GFP-positive neurons coexpressed tyrosine hydroxylase, indicating that they were catecholaminergic, whereas 50%-75% of those coexpressed tryptophan hydroxylase, indicating that they were serotonergic. Our findings support the hypothesis that MC4R signaling in RVM may modulate the activity of serotonergic sympathetic outflow sensitive to nociceptive signals, and that MC4R signaling in RVM may contribute to the descending modulation of nociceptive transmission.

Melanocortin-4 receptor expression in the rostral ventromedial medulla involved in modulation of nociception in transgenic mice / 华中科技大学学报（医学）（英德文版）

The rostral ventromedial medulla (RVM) is a prominent component of the descending modulatory system involved in the control of spinal nociceptive transmission. In the current study, we investigated melanocortin-4 receptor (MC4R) expression in the RVM, where the neurons involved in modulation of nociception reside. Using a line of mice expressing green fluorescent protein (GFP) under the control of the MC4R promoter, we found a large number of GFP-positive neurons in the RVM [nucleus raphe magnus (NRM) and nucleus gigantocellularis pars α (NGCα)]. Fluorescence immunohistochemistry revealed that approximately 10% of MC4R-GFP-positive neurons coexpressed tyrosine hydroxylase, indicating that they were catecholaminergic, whereas 50%-75% of those coexpressed tryptophan hydroxylase, indicating that they were serotonergic. Our findings support the hypothesis that MC4R signaling in RVM may modulate the activity of serotonergic sympathetic outflow sensitive to nociceptive signals, and that MC4R signaling in RVM may contribute to the descending modulation of nociceptive transmission.

Role of diffusion-weighted imaging in early ankylosing spondylitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>With the advanced MRI techniques, pathologic features can be detected at an early stage and quantitatively evaluated, resulting in the advantages of early diagnosis and prompt treatment. This study aimed to determine the value of diffusion-weighted MR imaging (DWI) in detection of early ankylosing spondylitis (AS) and investigate the characteristic manifestations of AS on whole body DWI (WB-DWI).</p><p><b>METHODS</b>Twenty patients with the diagnosis of early AS, twenty patients with low back pain (LBP), and twenty-five healthy volunteers were included in this study. The subchondral bone apparent diffusion coefficients (ADC) among these groups in the bilateral ilia and sacrum along the sacroiliac joints were compared. An independent sample t-test was utilized to analyze ADC value differences among groups. P-values less than 0.05 denoted statistical significance. The mean ADC values of focal DWI lesions in AS patients were also measured. Whole body diffusion-weighted imaging was performed in fifteen additional AS patients, and analyzed with MIP and MPR techniques in comparison to conventional MR images in order to evaluate the ability to detect AS lesions with whole body DWI.</p><p><b>RESULTS</b>Mean ADC values in AS patients were (0.518 ± 0.122) × 10(-3) mm(2)/s in the ilium and (0.503 ± 0.168) × 10(-3) mm(2)/s in the sacrum. These were significantly greater than the values measured in the ilium and sacrum of LBP patients, (0.328 ± 0.053) × 10(-3) mm(2)/s in the ilium and (0.311 ± 0.081) × 10(-3) m(2)/s in the sacrum, and control group, (0.325 ± 0.015) × 10(-3) mm(2)/s in the ilium and (0.318 ± 0.011) × 10(-3) mm(2)/s in the sacrum respectively. No statistically significant differences were found between LBP group and control group. The mean ADC value of focal DWI lesions in early AS patients was (0. 899 ± 0.265) × 10(-3) mm(2)/s, which was significantly higher than that of adjacent normal-appearance areas ((0.454 ± 0.079) × 10(-3) mm(2)/s). WB-DWI detected abnormalities in the 15 additional AS patients both within the sacroiliac joints and at other sites, corresponding to the clinical symptoms of the patients. The mean ADC value of focal DWI lesions of this patient cohort was (1.286 ± 0.311) × 10(-3) mm(2)/s in the sacrum and (1.220 ± 0.299) × 10(-3) mm(2)/s in the ilium.</p><p><b>CONCLUSIONS</b>Subchondral marrow ADC values of subchondral marrows near the sacroiliac joints allow for the differentiation of patients with early AS from normal volunteers and LBP patients. Combined with post-processing techniques such as MIP and MPR, WB-DWI allows for the comprehensive assessment of AS patients, an evaluation potentially helpful in determining prognosis and following the therapeutic response.</p>

Msh homebox-1 polymorphisms and susceptibility to 198 sporadic tooth agenesis: a case-control study / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To study the relationships between single nucleotide polymorphisms (SNP) of gene msh homebox-1 (MSX-1) (rs3821949, rs12532) and sporadic tooth agenesis by filtering the susceptibility genes in a Jiangsu province population.</p><p><b>METHODS</b>DNA samples were extracted from 198 patients with sporadic tooth agenesis and 207 control subjects. Two MSX-1 gene polymorphisms were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. The association between the genetic polymorphism and risk of sporadic tooth agenesis was estimated by chi(2) and logistic regression. The Phase was used to determine the Hardy-Weinberg equilibrium and haplotype association.</p><p><b>RESULTS</b>In the population, the allele frequency and genotype rates of the SNP rs3821949 were significant different between the patients with sporadic tooth agenesis and normal controls: the A allele frequency in the patients (43.2%) was significantly higher than that in the normal controls (31.4%, P = 0.008), and the AA genotype rate of the patients (14.7%) was significantly higher than that of the controls (12.6%, P = 0.030). However, There were no significant differences in the allele frequency and genotype rates of the SNP rs12532 between the patients with sporadic tooth agenesis and normal controls. Similar results were obtained between the mandibular incisor agenesis cases and controls. The haplotype frequencies of GA (27.9%) were significantly lower in non-mandibular incisor agenesis cases group than that in the control group (37.0%, P = 0.03, OR = 0.51).</p><p><b>CONCLUSIONS</b>The results show that SNP rs3821949, which is located at 5';near region of the MSX-1 gene, is likely to have an influence on the transcriptional activity of this gene and be associated with sporadic tooth agenesis. The haplotypes constructed with these 2 SNP sites may be linked with the susceptibility gene of non-mandibular incisor agenesis.</p>

Studies on the chemical constituents from culbs of hybridized Bulbus Fritillariae Ussuriensis / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of hybridized Bulbus Fritillariae Ussuriensis.</p><p><b>METHOD</b>The chemical constituents were isolated by silica column chromatography and their structures were identified by physical and chemical eveidences and spectral analysis (IR, 1H-NMR, 13C-NMR, 2D-NMR, MS).</p><p><b>RESULT</b>Seven compounds were obtained and identified as (20S,25S)5alpha, 14alpha, 17beta-cevanine-6beta-hydroxy-3-one (hupehenirine, ZF1), (20S,25S)5alpha, 14alpha, 17beta-cevanine-3beta-hydroxy-6-one (hupehenizine, ZF2), (20R,25S)5alpha, 14alpha-cevanine-3beta,20beta-dihydroxy-6-one (peiminine, verticinone, ZF3), (20S,25S)5alpha, 14alpha, 17beta-cevanine-3beta, 6beta-dihydroxy (hupehenine, ZF4), (20R,25S)5alpha, 14alpha-cevanine-3beta, 6beta, 20beta-trihydroxy (isoverticine, ZF5), (20R,25S)5alpha, 14alpha-cevanine-3beta, 6alpha, 20beta-trihydroxy (peimine, verticine, ZF6), (20S,25S)5alpha, 14alpha, 17beta-evanine-6beta-hydroxy-3beta-O-beta-D-glucoside (hupeheninoside, ZF7).</p><p><b>CONCLUSION</b>Compounds ZF1-7 were isolated from hybridized Bulbus Fritillariae Ussuriensis for the first time.</p>