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Abstract Tuberculosis is a chronic infectious disease that gradually poses a certain threat to public health and economic growth. Tuberculosis typically affects the lungs, pleura, and lymph nodes and rarely the skin. Cutaneous tuberculosis manifesting as ulcerated lesions is also rare and often misdiagnosed and missed by clinicians. Here, the authors report a 29-year-old female patient presenting a vulvar ulcer for 10 months, accompanied by irregular menstruation and increased vaginal secretions. After a skin biopsy and endometrial PCR testing, it was finally diagnosed as vulvar ulcerative cutaneous tuberculosis secondary to genital tuberculosis. Antituberculosis treatment was effective. Cutaneous tuberculosis is called a great imitator. In order to facilitate the diagnosis and treatment of tuberculosis by clinicians, the authors systematically reviewed this disease as well.
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@#Objective To investigate the relationship between the expression of programmed cell death ligand-1 (PD-L1) and the maximal standardized uptake value (SUVmax) in 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and the correlation of clinical factors between SUVmax values and PD-L1. Methods The clinical data of 84 patients with invasive lung adenocarcinoma diagnosed pathologically in West China Hospital, Sichuan University from August 2016 to November 2018 were analyzed retrospectively, including 38 males and 46 females, aged 60 (32-85) years. The tumor was acinar-predominant in 37 patients, papillary in 20, lepidic in 19, solid in 5 and micropapillary in 3. Multivariate analysis of the relationship between SUVmax value and other clinicopathological features was performed by linear regression. Logistic regression analysis was used to analyze the relationship between PD-L1 protein expression and other pathological features. Results The SUVmax of the PD-L1 expression group was significantly higher than that of the non-PD-L1 expression group in the whole invasive lung adenocarcinoma group (P=0.002) and intermediate-grade histologic subtype (P=0.016). The SUVmax cut-off value of PD-L1 expression in the whole invasive lung adenocarcinoma group and intermediate-grade histologic subtype was 5.34 (AUC: 0.732, P=0.002) and 5.34 (AUC: 0.720, P=0.017), respectively. Multivariate analysis showed that pleura involvement, vascular tumor thrombus and the increase of tumor diameter could cause the increase of the SUVmax value, while the SUVmax value decreased in the moderately differentiated tumor compared with the poorly differentiated tumor. The SUVmax cut-off value between low-grade histologic subtype and intermediate-grade histologic subtype, intermediate-grade histologic subtype and high-grade histologic subtypes was 1.54 (AUC: 0.854, P<0.001) and 5.79 (AUC: 0.889, P<0.001), respectively. Multivariate analysis of PD-L1 expression showed pleura involvement (P=0.021, OR=0.022, 95%CI 0.001 to 0.558) and moderate differentiation (opposite to poor differentiation) (P=0.004, OR=0.053, 95%CI 0.007 to 0.042) decreased the expression of PD-L1. Conclusion The SUVmax of the PD-L1 expression group is significantly higher than that of the non-PD-L1 expression group in the whole invasive lung adenocarcinoma group and intermediate-grade histologic subtype. The level of SUVmax and the expression of PD-L1 in invasive lung adenocarcinoma are related to many clinical factors.
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Objective@# To study the remodeling of alveolar bone after retraction of the maxillary incisors assisting with micro-implant anchorage in adult patients with maxillary protrusion by CBCT.@*Methods@#Forty patients who were treated with extraction of the maxillary first premolars with microimplant anchorage meeting the inclusion criteria were selected. The CBCT data before and after treatment were collected, and the Dolphin Imaging 3D measurement software was used to measure and analyze the height and thickness of the alveolar bone of the 80 upper central incisors and the 80 lateral incisors.@*Results @#After retraction of the incisors assisting with microimplant anchorage, the labial alveolar bone height of the maxillary central incisors decreased (0.11 ± 0.33) mm, and the lingual alveolar bone height of the maxillary central incisors decreased (0.85 ± 1.23) mm. The labial alveolar bone height of the maxillary lateral incisors decreased (0.18 ± 0.42) mm, and the lingual alveolar bone height of the maxillary lateral incisors decreased (1.13 ± 1.14 ) mm. The reduction in the lingual alveolar bone height was greater than that of the labial side, and the difference was statistically significant (P < 0.05). The labial alveolar bone thickness of the maxillary central incisors increased (the root cervix, the root media and the root apex), and the difference was statistically significant (P < 0.001). The labial alveolar bone thickness of the maxillary lateral incisors also increased (P < 0.05), while the lingual alveolar bone thickness and the total alveolar bone thickness of the maxillary central and lateral incisors decreased (P < 0.001). @*Conclusion@#In adults with maxillary protrusion, the microimplant was used to assist the reduction of the anterior teeth. The alveolar bone height of the maxillary incisors was reduced, and the palatal alveolar bone height decreased more than that of the labial side. The alveolar bone of the labrum was thickened, and the palatal alveolar bone thickness and the total alveolar bone thickness of the maxillary incisors were reduced after treatment.
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Objective@#Objective To explore the role of the Er: YAG laser in periodontal surgery.@*Methods @#Twenty patients with chronic periodontitis in two quadrants were selected for this study. One quadrant was subjected to pure periodontal flap surgery, whereas the other was subjected to flap surgery with an adjunctive Er: YAG laser. The preoperative and 3- and 6-month postoperative clinical parameters, including the probing depth, clinical attachment level, gingival recession, plaque index, gingival index and tooth mobility, were recorded.@* Results@# Significant differences were not observed between the open flap surgery + Er: YAG laser-assisted treatment group and the open flap surgery group except for the gingival index after 3 months (0.36 ± 0.26 vs. 0.58 ± 0.29, t=3.831, P < 0.001) and 6 months (0.60 ± 0.23 vs. 0.83 ± 0.22, t=4.013, P < 0.001). @*Conclusion@#Er:YAG as an auxiliary treatment for periodontal flaps, does not significantly reduce the depth of periodontal pockets, nor could it improve the clinical adhesion level and the gingival recession, but it can improve the recovery of gingival inflammation and accelerate the healing of tissue.
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Objective@#The present study investigated the effects of the inflammatory microenvironment mediated by macrophages on the proliferation and osteogenic differentiation of periodontal ligament cells (PDLCs).@*Methods@#Conditioned medium containing inflammatory factors was collected following macrophage activation with 1 μg/mL lipopolysaccharide (LPS). PDLCs were isolated from healthy teeth and cultured in conditioned medium (LPS-CM group) or normal medium (control group), and the proliferation of PDLCs was detected using the MTT assay. The cells were cocultured with an osteogenic inducer for 3 d and 7 d, and the alkaline phosphatase (ALP) activity of PDLCs was detected using an ALP kit. The mRNA expression levels of runt-related transcription factor 2 (RUNX2), osteocalcin (OCN), and collagen I (COL-I) were detected using real-time PCR, and the protein levels of RUNX2, OCN, and COL-I were detected using Western blotting. Mineralization nodules were observed using Alizarin red staining after osteoinduction for 14 d. @*Results@#The OD value of PDLCs in the LPS-CM group was lower than that in the control group (P < 0.05). The mRNA levels of RUNX2, OCN, and COL-I in the LPS-CM group were lower than those in the control group (P < 0.05). In addition to the OCN 3 d group (t = 2.75, P = 0.056), the protein expression of RUNX2, OCN, and COL-I in the LPS-CM group was lower than that in the control group (P < 0.05). However, the ALP activity of the LPS-CM group was higher than that of the control group, which was 1.58-fold greater (t = 5.91, P = 0.030) at 3 d and 1.29-fold greater (t = 6.01, P = 0.046) at 7 d. The number of calcified nodules in the LPS-CM group was significantly less than that in the control group (t = 8.63, P = 0.048). @*Conclusion@# The inflammatory microenvironment mediated by macrophages may inhibit the proliferation and osteogenic differentiation of PDLCs.