Ion-tunable antiambipolarity in mixed ion-electron conducting polymers enables biorealistic organic electrochemical neurons.

Biointegrated neuromorphic hardware holds promise for new protocols to record/regulate signalling in biological systems. Making such artificial neural circuits successful requires minimal device/circuit complexity and ion-based operating mechanisms akin to those found in biology. Artificial spiking neurons, based on silicon-based complementary metal-oxide semiconductors or negative differential resistance device circuits, can emulate several neural features but are complicated to fabricate, not biocompatible and lack ion-/chemical-based modulation features. Here we report a biorealistic conductance-based organic electrochemical neuron (c-OECN) using a mixed ion-electron conducting ladder-type polymer with stable ion-tunable antiambipolarity. The latter is used to emulate the activation/inactivation of sodium channels and delayed activation of potassium channels of biological neurons. These c-OECNs can spike at bioplausible frequencies nearing 100 Hz, emulate most critical biological neural features, demonstrate stochastic spiking and enable neurotransmitter-/amino acid-/ion-based spiking modulation, which is then used to stimulate biological nerves in vivo. These combined features are impossible to achieve using previous technologies.

Ultrasound-Activated Bioresorbable Osteosynthesis in the Treatment of Craniosynostosis.

ABSTRACT: The purpose of this study is to estimate the incidence of fixation-related complications following ultrasound-activated biodegradable osteosynthesis (UBO) in the treatment of craniosynostosis. The authors searched MEDLINE, PubMed, Embase, Google Scholar, and Cochrane Library from January 2005 to January 2020 for clinical studies reporting the use of UBO for fixation in the treatment of craniosynostosis. The primary outcome was the incidence of fixation-related complications, including unstable fixation; swelling, plate visibility, or palpability; infection; inflammation, sinus formation, and discharge; implant exposure; reoperation or implant removal. The pooled incidence rates were estimated using random-effects models. Of 155 studies identified, 10 were included, representing 371 patients. Forty-six (12.4%) patients presented fixation-related complications. The incidence rates of swelling/visibility/palpability, infection, and reoperation/implant removal were pooled based on the available data. The pooled incidence rate of chronic swelling/visibility/palpability was 0.21 (95% confidence interval [CI], 0.05-0.43). Sensitivity analysis by omitting the outlier study demonstrates that the incidence of swelling/visibility/palpability was 0.07 (95% CI, 0.04-0.11). The pooled incidence rate of infection and reoperation/implant removal was 0.07 (95% CI, 0.01-0.16) and 0.04 (95% CI, 0.01-0.09), respectively. Results show that although UBO can provide stable fixation, chronic swelling/visibility/palpability, infection, and reoperation for removal are not uncommon. Based on the literature, the authors recommend judicious use of UBO in patients with large frontorbital advancement and in the area of the coronal suture or other sites with thin overlying skin/subcutaneous tissue. The high possibility of chronic swelling/palpability/visibility during degradation, needs to be discussed preoperatively.

Do Patients With Different Mandibular Plane Angles Have Different Time to Relapse After Bilateral Sagittal Osteotomy With Mandibular Advancement?

PURPOSE: This study sought to answer the following question: Do patients with different mandibular plane angles (MPAs) have a different time to relapse after mandibular advancement with bilateral sagittal split osteotomy? MATERIALS AND METHODS: We performed a retrospective cohort study of patients who underwent bilateral sagittal split osteotomy advancement at Massachusetts General Hospital between 2005 and 2017. The primary predictor variable was MPA, categorized as low (<25°), medium (between 25° and 35°), or high (>35°). The outcome variable was time to relapse (≥2-mm posterior change at the B point). Other covariates included gender, age, temporomandibular joint symptoms, bimaxillary surgery, direction of mandibular rotation, magnitude of advancement, genioplasty, and fixation method. Time to relapse was estimated using the Kaplan-Meier method. Cox and parametric regressions for interval-censored data were performed. P < .05 was considered statistically significant. RESULTS: The sample was composed of 58 patients (40 female patients), with a mean age of 26.1 ± 4.9 years, grouped as follows: low MPA, n = 15; medium MPA, n = 26; and high MPA, n = 17. Clinically significant relapse was found in 18 patients (31%). Age, temporomandibular joint symptoms, counterclockwise rotation, and magnitude of advancement were statistically significantly different among the 3 groups. When we assessed time to relapse, the Kaplan-Meier method showed that high-MPA patients had a longer mean time at risk and higher estimated probabilities of relapse at different time points compared with low- and medium-MPA patients (P < .05). However, this association was not significant in Cox and parametric regressions. CONCLUSIONS: Our results suggest that clinically significant relapse was found during the first postoperative year in low-MPA patients and from 2 to 5 years postoperatively in high-MPA patients. Multivariate regression analyses did not show a significant association between MPA and time to relapse, suggesting that other covariates may play a role in the observed time to relapse.

Benign Pediatric Jaw Lesions at Massachusetts General Hospital Over 13 Years.

PURPOSE: To the best of our knowledge, no study has reported pediatric jaw lesions according to the latest World Health Organization (WHO) classification of head and neck tumors. We reviewed the spectrum of benign pediatric jaw lesions treated at the Massachusetts General Hospital during a 13-year period according to the 2017 WHO classification. PATIENTS AND METHODS: We implemented a retrospective cohort study of patients younger than 18 years old with benign bony lesions. The primary predictor variable was the histopathologic diagnosis, grouped into odontogenic tumors (OTs), non-OTs, and odontogenic cysts. The primary outcome variables were the incidence of recurrence and the interval to recurrence. Other outcome variables included symptoms, radiographic findings, and treatment modalities. Descriptive statistics were computed. Kaplan-Meier analyses and Cox regressions were performed. RESULTS: The sample included 131 patients (58 males and 73 females; mean age, 12.6 ± 3.7 years) with 14 pathologic diagnoses. These were grouped as follows: non-OTs (n = 67), OTs (n = 36), and odontogenic cysts (n = 28). Odontogenic cysts were predominantly radiolucent, unilocular, and well-circumscribed cysts compared with the OTs and non-OTs (P < .05). Enucleation was the most commonly performed surgical procedure (72.5%). Adjuvant nonoperative procedures included cryotherapy for 10 patients, interferon therapy for 9 patients, and chemotherapy with denosumab for 3 patients to treat aggressive tumors. The overall incidence of recurrence was 0.77/100 person-years. The Cox hazard ratio of non-OTs/OTs was 3.1 (P = .13) and cysts/OTs was 4.3 (P = .075). Neither the incidence of recurrence nor the interval to recurrence among the 3 groups showed significant differences. A high incidence of recurrence was noted for aggressive central giant cell tumors (39.1%) and odontogenic keratocysts (40%) during a median follow-up of 3 years. CONCLUSIONS: Although pediatric jaw lesions are uncommon, symptoms such as swelling could indicate potential pathologic findings and require panoramic examination. Management of pediatric jaw lesions should consider the biologic behavior of the lesion, maxillofacial development, and growth. Enucleation combined with pharmacologic therapy is a promising strategy for the management of aggressive central giant cell tumors in children.

Repair of Craniomaxillofacial Traumatic Soft Tissue Defects With Tissue Expansion in the Early Stage.

BACKGROUND: Craniomaxillofacial traumatic soft tissue defects severely affect the function and appearance of the patients. The traditional skin grafting or free flap transplantation can only close the defects in the early stage of operation but cannot ensure similar color, texture, and relative aesthetic contour. In the present study, the authors have explored a novel strategy to repair craniomaxillofacial traumatic soft tissue defects by tissue expansion in the early stage and have obtained satisfactory results. METHODS: Eighteen patients suffering large craniomaxillofacial traumatic soft tissue defects were treated by thorough debridement leaving the wounds unclosed or simply closed with thin split-thickness scalp grafts, adjacent expander implantation in the first stage, and expanded flap transposition in the second stage. RESULTS: There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years (mean, 19.4 ±â€Š12.2 years), with average 15 months follow-up (range, 3-67 months). The average expansion time was 74.3 days (range, 53-96 days). The 18 patients with a total of 22 expanders were treated with satisfactory results. All the flaps survived and the skin color, texture, and contour well matched those of the peripheral tissue. Only 1 complication of infection happened in the 18 cases (5.56%) and the 22 expanders (4.55%), which was similar to the rate reported in the literature. No other complications related to the expanders occurred. CONCLUSION: Debridement and tissue expansion in the early stage has been proved to be a more effective strategy to repair craniomaxillofacial traumatic soft tissue defects. This strategy can not only achieve satisfactory color, unbulky and well-matched texture similar to normal, but also avoid unnecessary donor site injuries.

Association of IL28B polymorphisms with peginterferon treatment response in Chinese Han patients with HBeAg-positive chronic hepatitis B.

AIMS: To investigate whether IL28B polymorphisms could affect the treatment response to peginterferon alpha (PEG-IFN) in chronic hepatitis B (CHB) patients in the Chinese Han population. METHODS: A total of 212 hepatitis B e antigen (HBeAg)-positive patients treated with PEG-IFN monotherapy were enrolled in this study. Genotype analysis was performed for IL28B rs12980275, rs12979860 and rs8099917 using the MassArray system. Response was defined as cases showing normal aminotransferase (ALT) levels, HBV DNA level < 200 IU/ml and HBeAg seroconversion after 48 weeks of PEG-IFN therapy. RESULTS: The patients were infected with hepatitis B virus (HBV) genotype B (44.8%) and C (55.2%) with a total response rate of 34.9%. For the three SNPs, there were significant differences between the response (R) and non-response (NR) groups both in allele frequencies and genotype distributions. IL28B genotype was independently associated with R for AA vs. N-AA (OR 2.70, 95% CL 1.21-6.01; P = 0.015) at rs12980275 after adjustment for sex, age, HBV genotype, baseline levels of HBV DNA and ALT. There were similar results for rs12979860 CC vs. N-CC (OR 2.56, 95% CL 1.15-5.67; P = 0.021) and rs8099917 TT vs. N-TT (OR 2.80, 95% CL 1.23-6.39; P = 0.015) respectively. Furthermore, one block formed by rs12980275 and rs12979860 was identified in this study. In multivariate analyses, the most common haplotype A-C was independently associated with high rates of R (OR 2.53, 95% CL 1.20-5.34; P = 0.015). CONCLUSIONS: Our study suggested that genetic variations in IL28B may play a critical role in PEG-IFN efficacy in HBeAg-positive CHB patients in Han Chinese.

[Study of the effect of different methods on the removal of calcium hydroxide in root canal by micro-computed tomography in vivo].

PURPOSE: To establish molar root canal model with micro-computed tomography (Micro-CT) and evaluate the removal efficiency of calcium hydroxide by different methods. METHODS: Eight molar teeth (24 root canals) extracted from the Department of General Dentistry, Shanghai Ninth People's Hospital from October 2023 to February 2024 were collected. Root canal preparation was instrumented by M3 according to standard root canal treatment procedures, then calcium hydroxide was injected into the root canal. One week later, the samples were randomly divided into 3 groups according to different irrigation methods(n=8): lateral opening syringe group, ultrasonic group and sonic vibration group. Micro-CT was used to reconstruct the root canal system before and after irrigation, and independent root canals were marked with different colors. The root canals were divided into upper root segment, middle root segment and apex segment. The volume of calcium hydroxide in each canal was calculated, and the clearance rate of calcium hydroxide was compared among the groups. SPSS 19.0 software package was used for statistical analysis. RESULTS: None of the three methods could completely remove calcium hydroxide from the root canal. When sodium hypochlorite was used as the flushing solution, the removal effect of ultrasonic group and sonic vibration group was significantly better than that of lateral opening syringe group(P＜0.05). The removal efficiency of calcium hydroxide by ultrasonic group and sonic vibration group was similar, and the difference was not statistically significant(P＞0.05). The removal rate of calcium hydroxide in apical segment was low. CONCLUSIONS: Micro-CT can reconstruct the molar root canal model efficiently for evaluating the removal effect of calcium hydroxide. The removal efficiency of calcium hydroxide in ultrasonic group and sonic vibration group is similar, and both are better than that in lateral syringe group.

Effect of chitosan/dioleyl phosphatidyl ethanolamine - Baicalein nanohydrogel in the treatment of rat with periodontitis.

Objective: this work aimed to investigate the effectiveness of chitosan (CS)/dioleyl phosphatidyl ethanolamine (DOPE) - baicalein (CS/DOPE-BAE) nanohydrogel as a novel drug delivery system for the treatment of periodontitis in rats. Materials and methods: the CS/DOPE-BAE nanohydrogel was synthesized and characterized for its morphology, particle size (PS), drug loading, and release properties. A rat periodontitis model was established, and the rats were randomly assigned to four groups, receiving treatment of normal saline, CS/DOPE blank nanohydrogel, baicalein solution, and CS/DOPE-BAE nanohydrogel through local injection, respectively. Clinical symptoms, periodontal tissue morphology, and the levels of interleukin (IL)-1ß, tumor necrosis factor-α (TNF-α), and IL-10 in the periodontal tissue were observed and compared. Results: the CS/DOPE-BAE nanohydrogel exhibited a spherical shape with a PS of approximately 200 nm and a drug loading of 8.6 %. It demonstrated excellent sustained-release properties. The group treated with CS/DOPE-BAE nanohydrogel showed significant improvement in clinical symptoms, such as reduced gingival redness and bleeding in rats, decreased inflammatory cell infiltration, and weakened fibroblast proliferation in the periodontal tissue. Additionally, IL-1ß and TNF-α levels were downregulated, while IL-10 level was elevated. Conclusion: the CS/DOPE-BAE nanohydrogel was an effective baicalein delivery system that can inhibit the progression of periodontitis, improve the inflammatory response in periodontal tissue, and deliver promising therapeutic effects.

The antiviral effect of 7-hydroxyisoflavone against Enterovirus 71 in vitro.

Enterovirus 71 (EV71) is the major causative agent of hand foot and mouth disease. And EV71 causes epidemics worldwide, particularly in the Asia-Pacific region. Unfortunately, currently there is no approved vaccine or antiviral drug for EV71-induced disease prevention and therapy. In screening for anti-EV71 candidates, we found that 7-hydroxyisoflavone was active against EV71. 7-Hydroxyisoflavone exhibited strong antiviral activity against three different EV71 strains. The 50% inhibitory concentration range was between 3.25 and 4.92 µM by cytopathic effect assay. 7-Hydroxyisoflavone could reduce EV71 viral RNA and protein synthesis in a dose-dependent manner. Time course study showed that treatment of Vero cells with 7-hydroxyisoflavone at indicated times after EV71 inoculation (0-6 h) resulted in significant antiviral activity. Results showed that 7-hydroxyisoflavone acted at an early step of EV71 replication. 7-Hydroxyisoflavone also exhibited strong antiviral activity against coxsackievirus B2, B3, and B6. In short, 7-hydroxyisoflavone may be used as a lead compound for anti-EV71 drug development.

Microplastics reduce nitrogen uptake in peanut plants by damaging root cells and impairing soil nitrogen cycling.

Microplastic (MP) pollution severely impairs the sustainable development of modern agriculture. However, the mechanisms underlying the effects of MP contaminants on nutrient cycles in agroecosystems are poorly understood. In this study, we examined the impacts of two types of MPs, polypropylene (PP) and rubber crumb (RC), on nitrogen (N) transformation and N cycling in soil-peanut system. High concentrations of PP (1% w/w) and RC (1% w/w) inhibited vegetative growth and N uptake in peanut plants by damaging root cells and disturbing soil N cycling. These MPs damaged the plasma membranes of root cells and caused oxidative stress, as evidenced by the decreased number of xylem vessels, which in turn inhibited N uptake by roots. Integrated metagenomic and metabolomic analyses revealed that the differential soil metabolite levels in response to MP treatment affected the microbial community structure in the rhizosphere and the expression of key N cycling-related genes, resulting in altered N transformation and the decreased availability of N in rhizosphere soil. These findings provide the first evidence of the effects of MPs on N uptake in peanut plants and shed light on the importance of rational management of MPs for crop growth and yield in agroecosystems.

Cryo-Shocked Platelet Coupled with ROS-Responsive Nanomedicine for Targeted Treatment of Thromboembolic Disease.

Thrombolysis with tissue plasminogen activator (tPA) provides the most common therapy for ischemic stroke onset within the past 4.5 h. However, enhanced neutrophil infiltration and secondary blood-brain barrier injury caused by tPA administration have limited its therapeutic application, and tPA treatment is often accompanied by hemorrhagic transformation. To overcome the limitations of thrombolysis by tPA, maximize the therapeutic efficacy, and improve the safety, herein, we report a cryo-shocked platelet-based cell-hitchhiking drug delivery system, which consists of cryo-shocked platelet (CsPLT) and reactive oxygen species (ROS)-responsive liposomes loaded with thrombolytic tPA and anti-inflammation drug aspirin (ASA). CsPLT and liposomes were facilely conjugated via host-guest interactions. Under the guidance of CsPLT, it selectively accumulated in the thrombus site and quickly released the therapeutic payloads in response to the high ROS. tPA subsequently exhibited localized thrombolytic activity to suppress the expansion of thrombus, while ASA assisted in the inactivation of reactive astrogliosis, microglial/macrophage, and obstruction of neutrophil infiltration. This cryo-shocked platelet-hitchhiking tPA/ASA delivery system not only improves the thrombus-targeting efficiency of the two drugs for highly localized thrombolytic effects and anti-inflammation actions and platelets inactivation but also provides insights to the development of targeted drug delivery systems for thromboembolic disease treatment.

Development of Clinical Decision Models for the Prediction of Systemic Lupus Erythematosus and Sjogren's Syndrome Overlap.

OBJECTIVE: To explore the clinical features of patients with systemic lupus erythematosus and Sjögren's syndrome overlap (SLE-SS) compared to concurrent SLE or primary SS (pSS) patients, we utilized a predictive machine learning-based tool to study SLE-SS. METHODS: This study included SLE, pSS, and SLE-SS patients hospitalized at Nanjing Drum Hospital from December 2018 to December 2020. To compare SLE versus SLE-SS patients, the patients were randomly assigned to discovery cohorts or validation cohorts by a computer program at a ratio of 7:3. To compare SS versus SLE-SS patients, computer programs were used to randomly assign patients to the discovery cohort or the validation cohort at a ratio of 7:3. In the discovery cohort, the best predictive features were determined using a least absolute shrinkage and selection operator (LASSO) logistic regression model among the candidate clinical and laboratory parameters. Based on these factors, the SLE-SS prediction tools were constructed and visualized as a nomogram. The results were validated in a validation cohort, and AUC, calibration plots, and decision curve analysis were used to assess the discrimination, calibration, and clinical utility of the predictive models. RESULTS: This study of SLE versus SLE-SS included 290 patients, divided into a discovery cohort (n = 203) and a validation cohort (n = 87). The five best characteristics were selected by LASSO logistic regression in the discovery cohort of SLE versus SLE-SS and were used to construct the predictive tool, including dry mouth, dry eye, anti-Ro52 positive, anti-SSB positive, and RF positive. This study of SS versus SLE-SS included 266 patients, divided into a discovery cohort (n = 187) and a validation cohort (n = 79). In the discovery cohort of SS versus SLE-SS, by using LASSO logistic regression, the eleven best features were selected to build the predictive tool, which included age at diagnosis (years), fever, dry mouth, photosensitivity, skin lesions, arthritis, proteinuria, hematuria, hypoalbuminemia, anti-dsDNA positive, and anti-Sm positive. The prediction model showed good discrimination, good calibration, and fair clinical usefulness in the discovery cohort. The results were validated in a validation cohort of patients. CONCLUSION: The models are simple and accessible predictors, with good discrimination and calibration, and can be used as a routine tool to screen for SLE-SS.

[Growth and migration of umbilical cord mesenchymal stem cells on polycarbonate membrane with different pore sizes].

OBJECTIVE: To observe the growth and migration of human umbilical cord mesenchymal stem cells (hUCMSCs) on polycarbonate membrane with different pore sizes and explore the criteria of selecting optimal Transwell insert for indirect co-culture to induce the differentiation of hUCMSCs. METHODS: hUCMSCs were isolated in vitro and then expanded in culture medium. After the treatment of mitomycin C, the cells were seeded on porous membranes of 6-well-dish Transwell inserts with different pore sizes of 0.4, 3.0 and 8.0 µm respectively. After culturing for 7 days, the cells were observed and counted on the bottom of each porous membrane. Then the calculation of migration ratio was performed. The growth and migration of hUCMSCs on porous membranes were also examined under scanning electron microscope (SEM). RESULTS: The migration ratios of hUCMSCs on membranes of 0.4, 3.0 and 8.0 µm pore sizes were 0, 1.8% and 8.0% respectively. The migration ratio of cells on 0.4 µm pore size membrane was statistically different from that of the other two pore size groups (P < 0.01). Under SEM, a small portion of cells were growing on the bottoms of membranes and moving through the pores. But there was no cell movement through 0.4 µm pore size membrane. CONCLUSIONS: hUCMSCs can migrate through the polycarbonate membranes of 3.0 µm and 8.0 µm pore sizes but not through the 0.4 µm one. Thus both sides of polycarbonate membrane of 0.4 µm pore size may be used for close indirect co-culture to induce the differentiation of hUCMSCs.

Long persistence of EV71 specific nucleotides in respiratory and feces samples of the patients with Hand-Foot-Mouth Disease after recovery.

BACKGROUND: EV71 is associated with the fatal cases of brain stem encephalitis during large HFMD outbreaks from 1998 to 2008. EV71 may continuously shed from upper respiratory tracts and feces of HFMD patients for relatively long time after recovery. However, the persistence of viruses in the patients' secretions and excretions is not clear. METHODS: Serial throat swabs and feces of 34 definitely diagnosed patients, including 30 mild cases and 4 severe cases, were traced and collected with the interval of 2 to 4 days for up to 32 and 48 days, respectively, and tested by a nested RT-PCR. RESULTS: The EV-71 specific sequences were identified by a Nested RT-PCR in all specimens of 0-4 days, and 5-8 days. The positive rates of EV71 in throat swabs dropped markedly to 42.86% during 9-12 days, and maintained at 20-30% during 13-24 days, while that in feces reduced to 71.43% during 9-12 days, and maintained roughly 20% till 37-40 days. EV71 nucleotide of 36.36% cases disappeared simultaneously both in throats and feces, 39.39% cases showed longer persistence of EV71 nucleotides in feces, and 21.21% were longer in throats. The longest duration of shedding observed was 24 days for throat swabs and 42 days for fecal specimens. CONCLUSIONS: EV71 shedding from respiratory tract may continue for nearly four weeks after onset, but its excretion through feces can persist more than five weeks.

Interaction analysis of risk factors for long-term skeletal relapse following mandibular advancement with bilateral sagittal split osteotomy.

The aim of this study was to identify interaction effects among risk factors for long-term skeletal relapse. The study sample consisted of 96 patients who underwent mandibular advancement with bilateral sagittal split osteotomy. Ten predictor variables were analyzed for an interaction effect: sex, age, preoperative temporomandibular joint symptoms, mandibular plane angle (MPA), single or double jaw surgery, clockwise or counterclockwise mandibular rotation, magnitude of mandibular advancement, concomitant genioplasty, type of fixation, and follow-up duration. Modeling interactions between pairs of covariates were applied to detect a significant interaction among these risk factors on horizontal and vertical long-term skeletal relapse, respectively. Stratification analyses and two-way full factorial interaction analyses were performed to demonstrate how the interaction influenced the associations between covariates and relapse. The interactions between sex and mandibular rotation (P=0.006) and between MPA and mandibular rotation (P=0.002) were statistically significant for horizontal long-term skeletal relapse. No significant interaction was identified for vertical relapse. This study showed that female patients and those with an MPA ≥30° undergoing counterclockwise mandibular rotation are predisposed to greater horizontal long-term skeletal relapse. Therefore, the judicious use of counterclockwise rotation is recommended in order to minimize the relapse, especially in female patients and those with a high MPA.

Human facial allotransplantation: a 2-year follow-up study.

BACKGROUND: Progress in composite tissue allotransplantation could provide a new treatment for patients with severe facial disfigurements. We did a partial facial allotransplantation in 2006, and report here the 2 year follow-up of the patient. METHODS: The recipient, a 30-year-old man from China, had his face severely injured by a bear in October, 2004. Allograft composite tissue transplantation was done in April, 2006, after careful systemic preparation. The surgery included anastomosis of the right mandibular artery and anterior facial vein, whole repair of total nose, upper lip, parotid gland, front wall of the maxillary sinus, part of the infraorbital wall, and zygomatic bone. Facial nerve anastomosis was done during the surgery. Quadruple immunomodulatory therapy was used, containing tacrolimus, mycophenolate mofetil, corticosteroids, and humanised IL-2 receptor monoclonal antibody. Follow-up included T lymphocyte subgroups in peripheral blood, pathological and immunohistochemical examinations, functional progress, and psychological support. FINDINGS: Composite tissue flap survived well. There were three acute rejection episodes at 3, 5, and 17 months after transplantation, but these were controlled by adjustment of the tacrolimus dose or the application of methylprednisolone pulse therapy. Hepatic and renal functions were normal, and there was no infection. The patient developed hyperglycaemia on day 3 after transplantation, which was controlled by medication. INTERPRETATION: Facial transplantation could be successful in the short term, but the procedure was not without complications. However, promising results could mean that this procedure might be an option for long-term restoration of severe facial disfigurement.

Ultrasonic versus conventional gap arthroplasty for the release of ankylosis of temporomandibular joint: a prospective cohort study.

The purpose of this study was to compare the clinical outcomes of ultrasonic surgery to the conventional bone cutting technique using bur and saw for the release of ankylosis of temporomandibular joint. We conducted a prospective cohort study on 25 patients with 38 ankylotic joints at Chinese PLA General Hospital from March 01, 2012 to March 01, 2016. Patients were followed up at least 2 years postoperatively. The primary outcome was the intraoperative blood loss per joint. The secondary outcome was the long-term (≥2 years) improvement of maximum mouth opening. The blood loss was significantly reduced in the ultrasonic group compared to the conventional group (107.3 ± 62.3 ml vs. 186.3 ± 92.6 ml, P = 0.019). The long-term improvements of maximum mouth opening were substantial and stable in both groups (33.5 ± 4.8 mm in the ultrasonic group vs. 29.2 ± 6 mm in the conventional group, P = 0.06). Multivariate linear regression analysis showed a significant association between blood loss and technique used (coefficient: 66.3, 95% confidence interval: 22.1,110.4, P = 0.006). The ultrasonic surgery was associated with less intraoperative blood loss when compared to the conventional method for the release of ankylosis of temporomandibular joint while providing a stable and comparable long-term improvement of maximum mouth opening.

[Effect of catalase on marginal microleakage of resin restoration after external bleaching].

PURPOSE: To investigate the effect of catalase on marginal microleakage of resin restoration after external tooth bleaching with 10% carbamide peroxide. METHODS: Forty extracted human premolars, both intact and health, were randomly divided into 4 groups: group 1, direct composite resin filling without bleaching; group 2, composite resin filling immediately after external bleaching; group 3, immersed in artificial saliva for 3 weeks after external bleaching ,then filling with composite resin; group 4 ,cavity treated with catalase after external bleaching and then filled with composite resin. After 2000 thermal cycles, the teeth were immersed in 2% methylene blue for 24 hours, then the microleakage of interface of resin restorations was observed under stereomicroscope. The data were analysed with SPSS17.0 software package. RESULTS: Group 1 displayed the least amount of microleakage, while group 2 showed the greatest amount of microleakage, group 3 behaved similarly as group 2, having great amount of microleakage, with no significant difference (P>0.05); the microleakage of group 4 decreased significantly (P<0.05) compared to group 2. CONCLUSIONS: The microleakage increases significantly after external bleaching with 10% carbamide peroxide, then decreases if cavities are treated with catalase, but delay filling can not improve microleakage effectively.

Self-assembling HA/PEI/dsRNA-p21 ternary complexes for CD44 mediated small active RNA delivery to colorectal cancer.

Our previous work proved that sequence specific double strand RNA (dsRNA-p21) effectively activated p21 gene expression of colorectal cancer (CRC) cells and consequently suppressed CRC growth. However, efficient delivery system is a significant challenge to achieve sufficient therapy. In this study, a self-assembled HA/PEI/dsRNA-p21 ternary complex (TC-dsRNA-p21) was developed for the tumor-target delivery of dsRNA-p21 into CRC cells. Hyaluronic acid (HA) was introduced to shield the PEI/dsRNA-p21 binary complexes (BC-dsRNA-p21) for reducing the cytotoxicity of PEI and for increasing the tumor-targeted intracellular uptake by cancer cells through HA-CD44 mediated endocytosis. Comparing to the BC-dsRNA-p21, the TC-dsRNA-p21 showed increase in size, decrease in zeta potential, low cytotoxicity as well as high stability in physiological conditions due to the anionic shielding. Confocal microscopy analysis and flow cytometry confirmed that TC-dsRNA-p21 had high transfection efficiency in the CD44-abundant Lovo cells, as compared with binary complex. In vitro physiological experiment showed that, comparing to the control group, the TC-dsRNA-p21 effectively activated the expression of p21 mRNA and P21 protein, causing blockage of cell cycle at G0/G1 phase and suppression of cancer cell proliferation as well as colony formation. Furthermore, in vivo distribution experiment demonstrated that the TC-dsRNA-p21 could effectively accumulate at rectal wall for up to 10 h, following in situ application. These findings indicated that TC-dsRNA-p21 might hold great potential for delivering dsRNA-p21 to treat CRC.