Biocompatibility of bioactive sealers Bio-C sealer vs MTA repair HP in human fibroblasts / Biocompatibilidad de selladores bioactivos Bio-C Sealer vs MTA Repair HP en fibroblastos humanos

Abstract Bioactive cements based on tricalcium silicate have been introducedto the market for use in dentistry, with a variety of clinical applications. These cements are in contact with vital tissues such as dental pulp or periodontium in cases of unintentional extrusion; thus, it is important to know the genotoxicity and cytoxicity of these materials. The objective of this study was to evaluate the cytotoxicity and genotoxicity of bioactive sealers, Bio-C® Sealer and MTA Repair HP®, in human fibroblasts. Discs of bioactive sealers Bio-C® Sealer, and MTA Repair HP®, were prepared and set for 24h under sterile conditions. The discs were placed in culture medium at 2.5mg/mL inside a SRT6D roller mixer (Stuart, UK) at 60rpm for 24h. The eluates obtained were incubated for 24h with previously activated and cultured ATCC cell line fibroblasts at 80% confluence. The cytotoxicity was evaluated by Alamar Blue® and LIVE/ DEAD assays, as well as the analysis of the Tunel and Mitotracker assays to evaluate genotoxicity using the confocal laser-scanning microscope. In the Alamar Blue® assay, the Bio-C® Sealer presented a cell proliferation of 87%, while the MTA Repair HP® Sealer was 72%. A statistically significant difference was found between the MTA Repair HP® Sealant and the negative control (p=<0.001). Regarding the genotoxicity tests, in the Tunel assay, both materials stain the nucleus of the fibroblast cells exposed to the eluates, while in the Mitotracker assay, the MTA Repair HP® Sealer showed greater mitochondrial function than the Bio-C® Sealer. Calcium silicate-based sealers, Bio-C® Sealer and MTA Repair HP®, are not cytotoxic and have low genotoxicity.

Resumen Los cementos bioactivos a base de silicato tricálcico se introdujeron en el mercado para uso en odontología, con una variedad de aplicaciones clínicas. Estos cementos pueden estar en contacto con tejidos como la pulpa dental o el periodonto, en caso de extrusión no intencionada. Por lo tanto, es importante conocer la genotoxicidad y la citoxicidad de estos materiales. El objetivo de este estudio fue evaluar la citotoxicidad y genotoxicidad de los selladores bioactivos Bio-C® Sealer y MTA Repair HP® en fibroblastos humanos. Se prepararon discos de selladores bioactivos Bio-C® Sealer y MTA Repair HP® y se colocaron durante 24h en condiciones de esterilidad. Los discos se colocaron en medio de cultivo a 2,5mg/mL dentro de un mezclador de rodillos SRT6D (Stuart, Reino Unido) a 60rpm durante 24h. Los eluidos obtenidos se incubaron durante 24h con fibroblastos de la línea celular ATCC previamente activados y cultivados al 80% de confluencia. La citotoxicidad se evaluó mediante ensayos Alamar Blue® y LIVE/DEAD; así como el análisis de los ensayos Tunnel y Mitotracker para evaluar la genotoxicidad, utilizando el microscopio confocal láser de barrido. En el ensayo Alamar Blue®, el Sellador Bio-C® presentó una proliferación celular del 87%, mientras que el sellador MTA Repair HP® fue del 72%. Se encontró una diferencia estadísticamente significativa entre el sellador MTA Repair HP® con respecto al control negativo (p=<0.001). En cuanto a las pruebas de genotoxicidad, en el ensayo Tunel, ambos materiales tiñen el núcleo de las células fibroblásticas expuestas a los eluidos, mientras que el ensayo Mitotracker, el sellador MTA Repair HP®, mostró una mayor función mitocondrial que el Bio-C® Sealer. Los selladores a base de silicato de calcio, Bio-C® Sealer y MTA Repair HP® no son citotóxicos y tienen una baja genotoxicidad.

Hernia lumbar de Grynfeltt-Lesshaft / Grynfeltt-Lesshaft lumbar hernias

RESUMEN Las hernias lumbares son defectos infrecuentes de la pared abdominal con pocos casos publicados en la literatura. En la región lumbar existen dos zonas de debilidad, un triángulo superior de Grynfeltt y otro inferior de Petit. Se presenta el caso de una mujer que consultó por dolor y tumoración lumbar derecha. Ante sospecha de hernia lumbar se realizó una tomografía computarizada que informó una hernia de Grynfeltt con contenido de grasa retroperitoneal. Se realizó una plástica protésica por abordaje abierto. No se observaron complicaciones post posoperatorias. Las hernias lumbares pueden ser congénitas o adquiridas, y estas primarias o secundarias. La tomografía computarizada (TC) es el procedimiento de referencia (gold standard) para su diagnóstico. La plástica protésica es el tratamiento de elección. El abordaje abierto y laparoscópico constituyen opciones válidas, y se deben valorar según las características del defecto, el paciente y la experiencia del equipo quirúrgico para su selección.

ABSTRACT Lumbar hernias are rare abdominal wall defects with few cases published in the literature. Two welldefined areas of weakness are identified in the lumbar region, the superior lumbar (Grynfeltt-Lesshaft) triangle and the inferior lumbar (Petit) triangle. We report the case of a female patient who sought medical care due to low back pain and a tumor in the right lumbar region. A lumbar hernia was suspected, and a computed tomography scan was performed, which revealed a Grynfeltt hernia with retroperitoneal fat content. The defect was repaired with mesh placement through an open approach. There were no postoperative complications. Lumbar hernias can be congenital or acquired (primary or secondary). Computed tomography scan is the gold standard for the diagnosis. Mesh repair is the treatment of choice. The open approach and laparoscopy are valid and safe options, and their implementation should be considered based on the characteristics of the defect, the patient, and the experience of the treating team.

Explantador de Cabrera: un nuevo dispositivo para explantar endoprótesis aórticas después de reparo endovascular de aneurisma de aorta, un estudio experimental ex vivo / Cabrera explanter: a new device to explant aortic stents after endovascular aortic aneurysm repair, an ex vivo experimental study

Introducción. Las complicaciones posteriores a la reparación endovascular de aneurisma (EVAR) pueden resolverse con técnicas endovasculares. Sin embargo, cuando está indicada, la explantación de una endoprótesis es un procedimiento complejo, que se asocia a lesiones vasculares o viscerales, con alta morbimortalidad, en pacientes con edad avanzada y múltiples comorbilidades, y por lo tanto, alto riesgo quirúrgico. No existen dispositivos producidos por la industria para explantar las endoprótesis aórticas, por lo que el objetivo de este trabajo fue desarrollar un dispositivo para la explantación de endoprótesis aórticas. Métodos. Se llevó a cabo un estudio experimental, en fase preclínica, para desarrollar un dispositivo para la explantación de endoprótesis aórticas, con pruebas en modelos 3D y en un modelo animal porcino cadavérico. Resultados. Es factible desarrollar un modelo experimental de un nuevo dispositivo para explantar endoprótesis aórticas, denominado explantador de Cabrera, y comprobar su funcionamiento en un modelo animal cadavérico. El uso del explantador de Cabrera limitó el daño de la pared aórtica por parte de la endoprótesis en un 100 % al momento de su explantación en un modelo experimental ex vivo. Conclusión. Usando una jeringa septo, el explantador de Cabrera es superior a la técnica estándar de explantación de una endoprótesis al limitar la lesión de la pared aórtica, al colapsar y liberar los ganchos de fijación suprarrenal de forma controlada y segura al interior de la luz aórtica y, posteriormente, extraerla de forma rápida y efectiva, conservando la mayor cantidad de aorta sana para la posterior reconstrucción aorto-ilíaca.

Introduction. Complications after endovascular aneurysm repair (EVAR) can be resolved with endovascular techniques; however, when indicated, stent explantation is a complex procedure, which is associated with vascular or visceral injuries, with high morbidity and mortality in patients, with advanced age and multiple comorbidities, and therefore high surgical risk. There are no devices produced by the industry to explant aortic endoprostheses, so the objective of this work was to develop a device for the explantation of aortic endoprostheses. Methods. An experimental study was carried out, in the preclinical phase, to develop a device for the explantation of aortic endoprostheses, with tests in 3D models and in a cadaveric porcine animal model. Results. It is feasible to develop an experimental model of a new device for explanting aortic endoprostheses, called Cabrera explanter, and verify its operation in a cadaveric animal model. The use of the Cabrera explanter limited damage to the aortic wall by the endoprosthesis by 100% at the time of explantation in an ex vivo experimental model. Conclusions. Using a septum syringe, the Cabrera explanter is superior to the standard stent explantation technique by limiting injury to the aortic wall, collapsing and releasing the adrenal fixation hooks in a controlled and safe manner into the aortic lumen, and subsequently, extract it quickly and effectively, preserving the greatest amount of healthy aorta for the subsequent aorto-iliac reconstruction.

Reparación tisular de los tejidos orales: una revisión de la literatura / Oral tissues healing: a review of the literature

El odontólogo realiza de forma rutinaria procedimientos que generan lesiones en los tejidos duros y blandos, por lo que resulta importante que el profesional conozca los procesos normales de cicatrización y reparación. La cicatrización es un fenómeno fisiológico que se presenta en cualquier tejido vivo que ha sido lesionado, que tiene importantes componentes vasculares y celulares que llevan una secuencia específica y que dependiendo de la magnitud de la lesión, el tejido podrá regenerar o cicatrizar según sea el caso. Asimismo, existen patologías sistémicas específicas y locales capaces de retrasar el proceso normal de cicatrización. El objetivo del presente artículo es explicar el proceso normal de reparación tisular de los tejidos orales y periorales (AU)

The dentist routinely performs procedures that generate injuries to hard and soft tissues, so it is important that the professional knows the normal healing and repair processes. Cicatrization is a physiological phenomenon that occurs in any living tissue that has been injured that has important vascular and cellular components that carry a specific sequence and that, depending on the magnitude of the lesion, the tissue may regenerate or heal as the case may be. Likewise, there are specific systemic and local pathologies capable of delaying the normal healing process. The aim of this article is to explain the normal tissue repair process of oral and perioral tissues (AU)

Perfil molecular de cáncer de endometrio en mujeres de Bogotá DC, Colombia / Molecular profile of endometrial cancer in women from Bogota DC, Colombia

Introducción: El cáncer de endometrio ocupa el sexto lugar en incidencia del cáncer en mujeres. La caracterización molecular de este cáncer permite optimizar la estratificación de riesgo para mejorar el tratamiento de las pacientes. Objetivo: Determinar el perfil molecular TCGA de pacientes con cáncer de endometrio en Bogotá, D.C., Colombia. Método: Estudio descriptivo en una cohorte de pacientes con cáncer de endometrio. Las mutaciones en los exones 9 a 14 del gen POLE fueron identificadas mediante amplificación por reacción en cadena de la polimerasa, seguida de secuenciación Sanger y análisis bioinformático. La expresión de las proteínas MMR y p53 se identificó mediante inmunohistoquímica. Resultados: Se incluyeron 40 pacientes con una mediana de edad de 66 años. El 15% presentaron mutaciones en el dominio exonucleasa de POLE. El 32% de las pacientes que no presentaron mutaciones manifestaron deficiencia en el sistema MMR. El 43,47% de las pacientes sin mutaciones en POLE ni alteración del sistema MMR presentaron alteración de la proteína p53. Conclusiones: La población de cáncer de endometrio analizada presenta un perfil molecular TCGA similar a lo reportado para otras poblaciones.

Introduction: Endometrial cancer ranks sixth in cancer incidence among women. Its molecular characterization allows for a more precise risk stratification with the aim of improving patient treatment. Objective: To determine the TCGA molecular profile of patients with endometrial cancer in Bogota, Colombia. Method: A descriptive study of a cohort of patients with endometrial cancer. The expression of MMR proteins and p53 was identified through immunohistochemistry. Mutations in exons 9 to 14 of the POLE gene were identified through polymerase chain reaction amplification, followed by Sanger sequencing and bioinformatic analysis. Results: Forty patients were included in the study, with a median age of 66 years, 15% of them exhibited mutations in the exonuclease domain of POLE, while 32% of patients without mutations showed deficiency in the MMR system. Forty three percent of patients without mutations in POLE or MMR alterations showed aberrant p53 protein expression. Conclusions: The analyzed population of endometrial cancer presents a TCGA molecular profile similar to that reported for other populations.

Aneurisma de arteria carótida interna. Caso clínico

Introducción: Los aneurismas de la arteria carótida extracraneal (ACEC) son poco frecuentes en comparación con las lesiones oclusivas. Los ACEC son menos del 1% de todos los aneurismas arteriales y solo el 10% son considerados aneurismas verdaderos. Caso Clínico: Paciente femenina de 84 años, en excelentes condiciones generales, hipertensa e hiperlipidémica, neurológicamente asintomática, con hallazgo de aneurisma de carótida interna derecha en el contexto de una arteria elongada, estenosis moderada ostial y oclusión de arteria carótida interna contralateral. Se realiza resección de aneurisma con anastomosis término terminal, endarterectomía del ostium y angioplastía con parche. Su evolución fue favorable, manteniéndose asintomática y con la reconstrucción permeable a 6 meses de seguimiento en eco duplex. Discusión: La elección del manejo del ACEC va a depender de sus características morfológicas, en este caso la presencia de tortuosidad extrema de la arteria carótida interna dificultaba la posibilidad de manejo endovascular, pero facilitaba la resección del aneurisma con anastomosis primaria término terminal. Conclusión: La aneurismectomía y reconstrucción es una modalidad de manejo disponible para los ACEC.

Introduction: Extracranial carotid artery aneurysms (ECAA) are rare compared to occlusive disease, less than 1% of all arterial aneurysms and only 10% are considered true aneurysms. Clinical case: A 84-year-old female, active and in excellent general health, with a prior history significant only for hypertension and hyperlipidemia was referred for a right internal carotid artery aneurysm and elongation in the context of contralateral internal carotid artery occlusion. The patient denied neurologic symptoms. Resection of the aneurysm and end-to-end anastomosis, endarterectomy of the ostium and patch angioplasty was performed. The patient had an uneventful recovery, remaining asymptomatic and the reconstruction patent on duplex scan at 6 month follow up. Discussion: The choice of repair alternatives for EICA depend on its morphological characteristics. The presence of extreme tortuosity of the internal carotid artery in this case, on one hand make difficult to consider endovascular alternatives, but facilitates aneurysm resection and primary end-to-end anastomosis. Conclusion: Aneurysmectomy and arterial reconstruction is a treatment alternative for EICA repair.

Hernia de la línea arcuata, una patología poco difundida

La hernia de la línea arcuata (HLA), es una entidad claramente reconocida, sin embargo, existen escasas publicaciones al respecto. Corresponde a un defecto en la vaina posterior del músculo recto del abdomen, separándose la línea arcuata del musculo, formando un bolsillo, lo que corresponde a un defecto inter-parietal y no una verdadera hernia. Probablemente este subdiagnosticado y sub reportado. Su relevancia es que puede constituir una parte relevante de las consultas en servicio de urgencia por dolor abdominal sin etiología demostrada1. El diagnóstico debe sospecharse ante la presencia de dolor abdominal de tipo orgánico, sin otra etiología demostrada. Se confirma con imágenes, especialmente la tomografía computada. El tratamiento, apoyándose en lo reportado en la literatura, sugiere que la vía laparoscópica sería de elección. A continuación, analizamos la anatomía de la linea arcuata, la presentación clínica de esta afección, sus hallazgos imagenológicos, quirúrgicos, y las diferentes alternativas de tratamiento que se han propuesto en la literatura.

The arcuate line hernia is a clearly recognized entity, but of which little is mentioned. It corresponds to a defect in the posterior wall of the rectus abdominis, separating the arcuate line of the muscle, forming a pocket, which corresponds to an interparietal defect and not a true hernia. It is probably underdiagnosed and underreported. Its relevance is that it can constitute a significant part of the consultations in the emergency department for abdominal pain without proven etiology. The diagnosis should be suspected in the presence of organic abdominal pain, with no other proven etiology. It is confirmed with images, especially computed tomography. The treatment, based on what has been reported in the literature, suggests that the laparoscopic approach should be the choice. We analyze the anatomy of the arcuate line, its clinical presentation, imaging and surgical findings, and the different treatment alternatives that have been proposed in the literature.

La importancia de evaluar el daño al DNA / The Importance of Assessing DNA Damage

Resumen Se calcula que el cuerpo humano está conformado por billones de células, las cuales sufren cientos de miles de lesiones al día en su DNA. Aunque el DNA no es la única biomolécula que sufre daños, su importancia radica en que es la única que no puede ser sustituida por la célula, así que, cuando esta sufre daños, la célula debe repararlos, tolerarlos o, en el caso extremo, activar las vías que la llevarán a la muerte, ya que lo importante es mantener la integridad celular y la homeostasis del organismo. Hay miles de agentes que pueden dañar al DNA, algunos los produce la misma célula y se les denomina 'agentes endógenos', mientras que otros son agentes externos y se les conoce como 'agentes exógenos'. La célula no puede evitar el daño causado por los agentes endógenos, ya que son productos de la actividad metabólica, por ejemplo; así que, cuando suceden se activan de forma inmediata los mecanismos celulares para mitigarlos. Lo mismo pasa con los daños causados por agentes exógenos, ya que la célula hará todo lo posible por disminuir los efectos adversos que pueden causar. El problema se pone de manifiesto cuando la célula no puede reparar los daños o los repara mal o son tantos que los mecanismos de reparación se ven rebasados, es entonces cuando el daño permanece en el DNA y se genera un estado de inestabilidad cromosómica que puede conducir a la célula a la disfunción y a la malignización. Este estado de inestabilidad cromosómica se puede ver reflejado en el aumento de rompimientos de DNA o de micronúcleos en las células expuestas, lo que se puede cuantificar por medio de métodos especiales como el 'Ensayo Cometa' y el 'Ensayo de Micronúcleos', ya que identificar el daño en el DNA es una forma de evaluar el potencial tóxico que tienen los agentes a los que están expuestas las poblaciones, permite conocer los mecanismos de acción que tienen y, además, ayuda a comprender los factores que influyen en el detrimento de la salud poblacional.

Abstract It is estimated that the human body is made of trillions of cells, which suffer hundreds of thousands of DNA lesions every day. Although DNA is not the only biomolecule that suffers damage, its importance lies in the fact that it is the only biomolecule that cannot be replaced by the cell, so when it suffers damage, the cell must repair it, tolerate or, in a extreme case, activate pathways that will lead to death, since the objective is to maintain cell integrity and the homeostasis of the organism.There are thousands of agents that can damage DNA, some are produced by the cell and are called 'endogenous, while others are external agents and are known as 'exogenous. The cell cannot avoid the damage caused by endogenous agents, since they are products of its metabolic activity, for example, so when they occur, cellular mechanisms are immediately activated to mitigate them. The same happens with the damage caused by exogenous agents, since the cell will do everything possible to diminish the adverse effects they can cause. The problem becomes apparent when the cell is unable to repair the damage or poorly repairs it, or repairs so much that the mechanisms are overwhelmed, when the damage remains in the DNA and a state of chromosomal instability is generated that can lead the cell to dysfunction and malignization. This state of chromosomal instability can be reflected in increased DNA breaks or micronuclei in exposed cells, which can be quantified by special methods such as the 'Comet Assay' and the 'Micronucleus Assay'. Since identifying DNA damage is a way of evaluating the toxic potential of the agents to which populations are exposed, it allows us to know their mechanisms of action and helps to understand the factors that influence the detriment in population's health.

Effect of different design and surface treatment on the load-to-failure of ceramic repaired with composite / Efeito de diferentes tratamentos de superficie e formas do preparo de cerámicas na resistencia de uniao de reparos em resina composta

ABSTRACT Glass ceramics are widely used to manufacture esthetic veneers, inlays, onlays, and crowns. Although the clinical survival rates ofglass-ceramic restorations arefavorable,fractures or chips are common. Certain cases can be repaired with direct composite. Aim The aim of this study was to investigate the interaction effect of different designs and surface treatments on the load-to-failure of lithium disilicate glass-ceramic repaired with nanofilled composite. Materials and Method Lithium-disilicate glass-ceramic slabs (IPS e.max Press, Ivoclar Vivadent) with three different designs of the top surface (flat, single plateau, or doubleplateau) (n=U) received 'no treatment', '5% HF etching', or "AI2O3 sandblasting". HF-etched and sandblasted slabs also received silane and universal one-step adhesive application. All slabs were incrementally repaired with nanofilled composite (Filtek Z350, 3M ESPE) up to6 mm above the highest ceramic top plateau. Specimens were stored in artificial saliva at 37 °C for 21 days and then subjected to 1,000 thermocycles between 5 and 55 °C. The interface composite-ceramic of each specimen was tensile tested until failure in a universal testing machine and the mode of failure was determined under a stereomicroscope. The ceramic surface morphology of one representative tested specimen from each subgroup (design/surface treatment) was observed through scanning electron microscopy (SEM). Results Regardless of ceramic design, the absence of surface treatment resulted in significantly lower load-to-failure values. No significant differences in load-to-failure values were observed between HF-etched and sandblasted specimens for the flat design; however, HF etching resulted in significantly higher load-to-failure values than sandblasting for both single plateau and double plateau designs. The majority (60%) of HF-etched specimens with single plateau or double plateau presented mixed failures. SEM photomicrographs showed that HF-etched specimens had smoother surfaces than sandblasted specimens. Conclusion The surface treatment of a defective lithium disilicate glass-ceramic restoration has more influence than its macroscopic design on the retention of the composite repair. HF etching seems to provide higher bond strength to the composite repair.

RESUMO Embora fraturas e lascamento de restauragoes vitrocerámicas sejam comuns, alguns casos podem ser reparados com compósito direto. Objetivo investigar o efeito da interagao de diferentes formas e tratamentos de superficie na carga de ruptura de uma vitrocerámica reforgada com dissilicato de litio reparada com compósito nanoparticulado. Materials e Método A superficie superior de espécimes de vitroceramica (IPS e.max Press, Ivoclar Vivadent) foi preparada com tres formas (plana, plato único, ou duplo) e recebeu (n=11): 'nenhum tratamento', 'condicionamento com ácido hidrofluoridrico 5%', ou 'jateamento com AfOf. Ambos espécimes condicionados e jateados receberam silano e adesivo universal. Todos os espécimes foram reparados incrementalmente com compósito (Filtek Z350, 3M ESPE) até6 mm acima do plato cerámico mais alto, armazenados em saliva artificial á 37 °C por 21 dias, e submetidos á 1.000 termociclos (5 e 55 °C). A interface compósito-cerámica de cada amostra foi testada á tragao até sua falha em máquina universal e o modo de falha foi determinado com estereomicroscópio. A morfologia da superficie de uma amostra representativa de forma/tratamento de superficie foi observada através de microscopia eletronica de varredura (MEV). Resultados Independentemente da forma ceramica, a ausencia de tratamento superficial resultou em valores de carga de ruptura significativamente menores. Nao foi observada differenga significativa entre os espécimes planos condicionados ou jateados; no entanto, o condicionamento resultou em valores significativamente maiores que o jateamento para espécimes com plato único e duplo. A maioria (60%) dos espécimes condicionados e com plato único ou duplo apresentou falhas mistas. Imagens SEM demonstraram rugosidade superficial mais regular dos espécimes condicionados que os jateados. Conclusoes O tratamento superficial de uma restauragao defeituosa de vitrocerámica reforgada por dissilicato de litio tem maior influencia na retengao do reparo de compósito do que sua forma macroscópica; ainda, o condicionamento com ácido hidrofluoridrico parece proporcionar maior resistencia de uniao ao reparo com compósito.

Effect and mechanism of Sitravatinib combined with Niraparib on proliferation,apoptosis and autophagy in mucosal melanoma cell lines / 基础医学与临床

Objective To investigate the effect of anti-angiogenic drug Sitravatinib combined with poly(adenosine diphosphate[ADP]-ribose)polymerase inhibitor(PARPi)Niraparib on mucosal melanoma cell lines and its possible mechanism.Methods The CCK8 assay was used to detect the maximal half inhibitory concentration(IC50)of Sitravatinib and Niraparib targeting at mucosal melanoma(MM)cell lines.CompuSyn was used to detect the Combination Index(CI)in different concentrations of the two drugs.Flow cytometry was used to detect the effect of drugs on cell apoptosis.Colony formation assay was used to detect the effect of drugs on cell proliferation.Western blot was used to detect the protein expressions and RT-qPCR was used to detect mRNA expression.Results CI values was respectively 0.19 and 0.15 for Sitravatinib(2 μmol/L)in combination with Niraparib(20 μmol/L)in a human vaginal maligant melanoma cell line(HMVII)and a metastasis inguinal lymph node of vulvar malignant melanoma cell line(GAK).Compared with the control group and single-drug groups,the cell proliferation of the combination group was significantly reduced(P＜0.05 or P＜0.01 or P＜0.001).The cell apoptosis rate was signifi-cantly increased(P＜0.01 or P＜0.001).The protein and mRNA expression of apoptosis-related biomarkers signifi-cantly increased(P＜0.001);In addition,the protein and mRNA expression of cell autophagy biomarkers signifi-cantly increased(P＜0.01 or P＜0.001).The protein expression of DNA damage marker significantly increased.Moreover,compared with the control group,The expression of radiation sensitive protein 51(RAD51)recombinase in the Sitravatinib single-drug group and combination group significantly reduced.As the dose of Sitravatinib gradu-ally increased up to 2 μmol/L,the protein and mRNA expression of RAD51 both significantly reduced(P＜0.05 or P＜0.01),the mRNA expression of BRCA1 and BRCA2 also significantly reduced(P＜0.05 or P＜0.01 or P＜0.001).Conclusions Sitravatinib combined with Niraparib inhibits the proliferation of mucosal melanoma cells,induces cell apoptosis and promotes autophagy.The mechanism is potentially related to the inhibition of ho-mology-dependent recombination repairs(HRR).

To compare the effects of false hernia sac exclusion,barbed suture and circular suture in transperitoneal preperitoneal laparoscopic hernia repair for direct hernia / 临床外科杂志

Objective To investigate the difference of surgical effect of exclusion,simple continuous suture and circular suture suspension in TAPP for the treatment of false hernia sac in patients with direct inguinal hernia.Method From May 2020 to May 2022,120 patients diagnosed with direct inguinal hernia and treated with TAPP in our hospital were retrospectively.The false hernia sacs were divided into three groups according to different methods of treatment patients treated with false hernia sac exclusion were included in group A,those treated with simple continuous suture were included in group B,and those treated with circular suture suspension were included in group C.There were 40 patients in each group.The perioperative indicators(operation time,intraoperative blood loss,postoperative hospital stay,hospitalization cost)and postoperative effects(chronic pain,seroma,incision or mesh infection,foreign body traction feeling)were compared among the three groups.Results All 120 patients successfully completed TAPP surgery.There was no significant difference in general condition,intraoperative blood loss,postoperative hospital stay,wound or mesh infection and chronic pain among the three groups(P＞0.05).The operation time of group B and C was longer than that of group A,and the incidence of seroma was significantly lower than that of group A,the difference was statistically significant(P＜0.05).The incidence of foreign body traction in group A and group C was lower than that in group B,and the difference was statistically significant(P＜0.05).The hospitalization cost of group B and group C was lower than that of group A,with statistically significant difference(P＜0.05).Conclusion In clinical practice,direct hernia and false hernia sac often need to be treated.In direct hernia TAPP operation,simple continuous suture method and circular suture suspension method have the effect of improving the condition of the false hernia sac,but in terms of economy and postoperative effect,the circular suture suspension method can benefit patients more.

Research progress on wound repair of severe open injury of lower limbs / 临床外科杂志

Severe open injury of lower limbs is complex and difficult to cure in a short time,which can lead to serious infection,amputation and so on.For the treatment of open injury,wound repair is extremely important.A variety of new technologies such as new dressings,platelet-rich plasma(PRP),and vacuum sealing drainage(VSD)have recently been applied to lower limb wound repair,which can not only improve the functional prognosis and aesthetic effect,but also improve the quality of wound healing.This review will summarize the research progress of wound repair methods for open injury of lower limbs,so as to further guide clinical application.

Application of WHO molecular classification in endometrial cancer(2020)and its clinicopathological significance / 临床与实验病理学杂志

Purpose To explore the application and clini-copathological significance of molecular classification in endome-trial cancer(EC)of WHO(2020)tumors of the female repro-ductive system.Methods Sixty-two EC patients were collected and categorized into four subgroups,namely POLE mutation type,mismatch repair deficient(MMRd)type,non-specific molecular spectrum(NMSP)type,and p53 mutation type,based on WHO molecular classification tested by PCR and im-munohistochemistry.The correlation among four molecular sub-groups and their clinicopathological features were analyzed.Re-sults The molecular classification was distributed as follows:3(4.8％)cases were POLE-mutated,15(24.2％)cases MMRd,36(58.1％)cases NSMP and 8(12.9％)cases p53 abnormal expression.There were no significant differences a-mong POLE-mutated and infiltration depth,grade,lymph vascu-lar space invasion and other pathological factors such as lymph node metastasis and FIGO stage(P＞0.05).Among 15 patients with MMRd,the proportion of FIGO stage Ⅱ+Ⅲ significantly increased.One case showed abnormal overexpression of p53 pro-tein,while two cases showed complete loss of expression in MMRd subgroup.36 cases of NSMP were associated with low histopathological grade(Grade Ⅰ+Ⅱ)(P＜0.05),and no significant differences were observed among NSMP and other clinicopathological factors(P＞0.05).The p53 abnormal ex-pression in 8 cases was related to high histopathological grade(Grade Ⅲ)(P＜0.05),and the rate of lymph node metastasis and FIGO stage Ⅱ+Ⅲ significantly increased in patients with p53 abnormal expression,and although the difference was not statistically significant(P＞0.05).Conclusion The molecu-lar subgroups of EC have certain clinical application value,the cases with MMRd and p53 abnormal expression may have poor prognosis than these with POLE-mutated and NSMP.

The efficacy of modified everStick C&B fiber resin bonded bridge in the restoration of incisor missing teeth in senile patients / 实用口腔医学杂志

Objective:To evaluate the clinical effects of modified everStick C&B fiber resin bonded bridge in the restoration of inci-sor missing teeth in senile patients.Methods:32 patients over 65 years with incisor loss old were included.13 of them were with missing maxillary incisors and 19 with missing mandibular incisors.13 had 1 missing tooth,11 had 2,5 had 3 and 3 had 4 missing teeth.The abutment was loose in 24 cases and not loose in 8 cases.All patients were treated with modified everStick C&B fiber resin bonded bridge repair.Re-examination was conducted at 6,12 and 18 months after completion of repair.The re-examination includ-ed 6 indexes including prosthesis debonding,fracture,color change,defect,abutment loosening and periodontal tissue inflamma-tion.The patients'satisfaction was investigated 6 months after the repair was completed.The investigation included 3 indexes:whether the treatment was comfortable,whether the aesthetic effect was satisfactory,and whether the pronunciation and chewing were comfortable after the repair.Results:The 32 patients were reexamined 6 months after completion of the repair,and all 6 indexes were grade A.Reexamination at 12 months showed that 1 case of treated defect was grade B,2 cases of abutal periodontal tissue in-flammation was grade B,and the rest indexes were grade A.Reexamination at 18 months showed that 1 case of treated defect was grade B,3 cases of abutal periodontal tissue inflammation was grade B,and the rest indexes were grade A.All the 2 cases of grade B defects reached grade A after resin filling.All the 5 cases of abutal periodontal tissue inflammation grade B reached grade A 5-7 days after periodontal cleaning.All 3 indicators in the patient satisfaction survey were graded A.Conclusion:The modified ever-Stick C&B fiber resin bonded bridge is effective in the restoration of incisor missing teeth in senile patients.

The role and mechanism of purinergic signaling in oligodendrocytes development and myelin repair:A literature review / 实用医学杂志

Oligodendrocytes(OLs)play a crucial role in myelination during the development and repair of the central nervous system.ATP serves not only as an important signaling molecule involving in the intercellular com-munications,but also as an energetic molecule,with its purinergic receptor subtypes widely present in neurons and glial cells.These subtypes are composed of two purinergic receptors:P1 and P2:The former are primarily activated by adenosine,and the latter mainly by ATP,ADP,and UTP.The two receptors paly their respective role in various regions of the CNS under physiological or pathological conditions through distinct mechanisms.In this paper,we review recent literature on the roles and mechanisms of the purinergic receptors in OL development,myelination,and myelin repair.It may be of great significance for further understanding the role of purinergic signaling in demy-elinating diseases and myelin dysplasia and exploring potential therapeutic targets.

Research progress of bioactive glass in bone and soft tissue repair / 实用医学杂志

Bioactive glass(BG)has been used as a candidate for bone and soft tissue repair materials because of its compatibility,bioactivity and ability to form a crystalline hydroxyapatite layer.This paper introduces the mechanism of BG ion release,discusses the application of borosilicate bioactive glass(BBG)in bone and soft tissue repair,and provides an overview of the potential and clinical translational challenges faced by BBG in bone cement,scaffold,hydrogel,and fiber research applications.

Clinical experience in surgical treatment of T4a thyroid cancer / 西安交通大学学报(医学版)

Objective To analyze the clinical features and surgical treatment strategies of T4a thyroid cancer.Methods We retrospectively analyzed patients with thyroid cancer treated in the Department of Head and Neck Surgery of Sichuan Cancer Hospital from January 2004 to May 2021.A total of 303 cases were included and statistically analyzed for pathological type,invaded organs,surgical approach,survival time,and overall survival rate.The postoperative survival curves of the patients were analyzed using the Kaplan Meier method.Results Of the 303 patients enrolled,53 patients were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 98.4％(246/250),97.0％(224/231)and 90.2％(92/102),respectively.Of the 94 patients with recurrent laryngeal nerve invasion only,13 were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 100％(81/81),98.7％(77/78)and 97.4％(38/39),respectively.There were 151 patients with invasion of recurrent laryngeal nerve and tracheal/laryngeal/esophageal nerve,31 of them were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 96.7％(116/120),95.3％(101/106)and 82.2％(37/45),respectively.According to the survival curve analysis,the group with recurrent laryngeal nerve invasion only had an advantage in overall survival time over the group with recurrent laryngeal nerve and tracheal/laryngeal/esophageal invasion.Conclusion Surgical resection is supposed to be preferred for T4a thyroid cancer if there is a chance of surgery.A reasonable surgical strategy,radical surgery while preserving the vital tissues and organs,and one-stage repair and reconstruction can bring patients a better quality of life and prognosis.

Adipose-derived mesenchymal stem cells overexpressing bone morphogenetic protein 2 promote alveolar bone defect repair in osteoporosis rats / 中国组织工程研究

BACKGROUND:Jaws are most vulnerable to osteoporosis.Adipose-derived mesenchymal stem cells and bone morphogenetic protein 2 have the effect of promoting bone regeneration in osteoporosis.However,the repair effect of bone morphogenetic protein 2 modified adipose-derived mesenchymal stem cells on alveolar bone defects in osteoporosis is rarely reported. OBJECTIVE:To explore the repair effect of adipose-derived mesenchymal stem cells overexpressing bone morphogenetic protein 2 on alveolar bone defects in osteoporosis rats. METHODS:(1)The rat adipose-derived mesenchymal stem cells were infected with lentivirus overexpressing bone morphogenetic protein 2 gene,and identified by detecting the expression of green fluorescent protein and bone morphogenetic protein 2.(2)Osteoporosis rat model was established by ovariectomy.A 3 mm×3 mm×3 mm cylindrical defect was prepared at the first molar position on both sides of the upper jaw.(3)Gelatin sponge was implanted in rats of the sham operation group and osteoporosis group.In the adipose-derived stem cell group,the adipose-derived mesenchymal stem cells infected with empty vector lentivirus and gelatin sponge complex were implanted.In the adipose-derived mesenchymal mesenchymal stem cell group overexpressing bone morphogenetic protein 2,a complex of adipose-derived mesenchymal stem cells overexpressing bone morphogenetic protein 2 and gelatin sponge was implanted.Relevant indexes were tested one month later. RESULTS AND CONCLUSION:(1)The transfection efficiency of the adipose-derived mesenchymal stem cell group and adipose-derived mesenchymal stem cell group overexpressing bone morphogenetic protein 2 reached more than 70%.Compared with the adipose-derived mesenchymal stem cell group,the level of bone morphogenetic protein-2 protein in the adipose-derived mesenchymal stem cell group overexpressing bone morphogenetic protein-2 was significantly higher(P<0.05).(2)A large amount of new bone could be seen in the bone defect area of the sham operation group.Compared with the sham operation group,the osteoporotic group had a small amount of new bone formation;the new bone area was significantly reduced,and alkaline phosphatase,osteocalcin,and bone morphogenetic protein 2 mRNA and protein levels were significantly reduced.Compared with the osteoporosis group,the adipose-derived mesenchymal stem cell group and the adipose-derived mesenchymal stem cell group overexpressing bone morphogenetic protein 2 had a large number of new bone formation;the area of new bone was significantly increased,and the levels of alkaline phosphatase,osteocalcin,and bone morphogenetic protein 2 mRNA and protein were significantly increased.Moreover,the adipose-derived mesenchymal stem cell group overexpressing bone morphogenetic protein 2 was superior to the adipose-derived mesenchymal stem cell group(all P<0.05).(3)The results showed that bone morphogenetic protein 2 was less expressed in the alveolar bone of osteoporosis rats,and adipose-derived mesenchymal stem cells overexpressing bone morphogenetic protein 2 could promote osteogenesis and regeneration of alveolar bone defects in osteoporosis rats.

Effect of traditional Chinese medicine and compounds for supplementing qi and activating blood circulation and inducing resuscitation on regulating stem cells to promote nerve repair of acute ischemic stroke / 中国组织工程研究

BACKGROUND:Endogenous neurogenesis and exogenous stem cell transplantation in the brain show great therapeutic potential for neurological diseases including ischemic stroke,repairing and replacing lost neurons,promoting synaptic remodeling,and inhibiting apoptosis.Traditional Chinese medicine and compound therapy for supplementing qi,activating blood circulation and inducing resuscitation for the treatment of neurological dysfunction after ischemia have certain advantages,targeting nerve repair through a variety of ways,including promoting endogenous neurogenesis and exogenous stem cell survival,proliferation,homing,and inducing neuronal differentiation. OBJECTIVE:To summarize the mechanism of traditional Chinese medicine and compound for supplementing qi,activating blood circulation and inducing resuscitation to promote nerve repair in the acute phase of ischemic stroke,in order to provide a reference for the research and treatment of new drugs in ischemic stroke. METHODS:The articles from CNKI and PubMed databases about traditional Chinese medicine and compound for supplementing qi,activating blood circulation and inducing resuscitation in promotion of nerve repair in the acute phase of ischemic stroke from 2010 to 2022 were searched,with"supplementing qi and activating blood circulation;inducing resuscitation;traditional Chinese medicine(TCM);compounds;ischemic stroke;nerve repair;stem cells"as Chinese and English search terms.After excluding old and duplicate views,the retrieved literature was analyzed and collated,and a total of 124 articles were included for analysis. RESULTS AND CONCLUSION:(1)The definition of stem cells,ischemic stroke and the nerve repair pathway in the acute phase of ischemic stroke were sorted out.(2)The mechanism of action of traditional Chinese medicine and compound for supplementing qi,activating blood circulation and inducing resuscitation to promote nerve repair in the acute phase of ischemic stroke was summarized,mainly including promoting stem cell proliferation,improving stem cell viability and survival rate,promoting nerve cell homing,inducing stem cell differentiation to neurons,inhibiting apoptosis of nerve cells,promoting axon regeneration,regulating angiogenesis and remodeling,improving the level of neurotrophic factors and repairing the integrity of the blood-brain barrier.(3)Through the existing research,the relevant factors and signaling pathways of traditional Chinese medicines and compounds for supplementing qi,activating blood circulation and inducing resuscitation to promote nerve repair in the acute phase of ischemic stroke were summarized,such as Nestin protein expression,DCX protein expression,brain-derived neurotrophic factor,vascular endothelial growth factor and Wnt/β-catenin signaling pathway,Notch signaling pathway,PI3k/Akt signaling pathway,BDNF/TrkB signaling pathway and ERK/MAPK signaling pathway.It provides a relevant reference for future research on ischemic stroke-specific drugs and new clinical treatment methods.

Finite element analysis of the influence of scaffold materials on the fixed restoration of edentulous maxillary implants under two designs / 中国组织工程研究

BACKGROUND:In the treatment of edentulous maxillary implants supported fixed repair,the selection of upper scaffold structure materials and the design of different distal implant implantation methods have a close influence on the long-term stability of the whole mouth implant repair. OBJECTIVE:To comprehensively explore the influence of three different materials of upper scaffold and two implant fixation designs on the biomechanics of the fixed maxillary implant repair based on the three-dimensional finite element method. METHODS:Based on the conical beam CT data of a healthy adult with normal jaws,the Mimics software was used to separate the maxillary and maxillary dentin three-dimensional solid models,and the Geomagic Studio software was used to construct the three-dimensional finite element model of denture with denture implant and fixed maxillary arch combined with specific model parameters.According to the different designs of distal implants in the maxillary posterior region,two scheme models were established.Scheme 1(Design 1)was designed in accordance with the"All-on-4"design used in clinical practice.Two implants were vertically implanted in the bilateral incisor region of the maxilla,and the other two implants were implanted in the bilateral second premolar region at a 30° angle.In scheme 2(Design 2),two implants were vertically implanted in the lateral incisor region of the maxilla,and two short implants were vertically implanted in the posterior region of the maxilla in the bilateral second premolar region.Three materials(titanium,zirconia and polyether ether ketone)were used to assign values to the upper scaffold structure in the two designs,and six different models were obtained.The biomechanical effects of the implant,surrounding bone tissue and the upper scaffold structure were compared and analyzed in the oblique loading direction. RESULTS AND CONCLUSION:(1)The maximum stress peaks of all models were distributed in the neck region around the posterior implant and the cortical bone under the two edentulous implant fixed restoration schemes,regardless of the material of the upper scaffold.(2)Compared with the alternative design of Design 2,which adopted vertical implantation of short implants,Design 1 showed a more ideal stress distribution on the maxilla.(3)The scaffold model constructed by polyether ether ketone material transferred higher stress to the implant and surrounding bone tissue close to the loading zone of the upper jaw bone,followed by titanium and zirconia.As for the support itself,the peak stress of the upper scaffold of polyether ether ketone was significantly lower than that of the zirconia and titanium scaffolds.Zirconia scaffolds were used among the three upper scaffolds to disperse the stress distribution of implant and bone tissue.(4)The results suggest that both designs can be applied to clinical practice.However,from the perspective of biomechanics,the stress distribution of the implant,surrounding bone tissue and upper scaffold in Design 1 is more rational,which is more conducive to the long-term prognosis of fixed implant repair in patients with edentulous jaws.The upper scaffold material has a certain influence on the stress distribution of the implant-bone interface.