Association between sleep-disordered breathing and periodontitis: a meta-analysis.

BACKGROUND: Systemic inflammation is a feature of sleep-disordered breathing (SDB) as well as periodontitis. The association between SDB and periodontitis, however, has been inconsistent in previous studies. In order to fully evaluate the above association, we conducted a meta-analysis. MATERIAL AND METHODS: Observational studies related to the aim of the meta-analysis were identified by search of PubMed, Embase, Web of Science, Wanfang, and CNKI databases. Only studies with SDB diagnosed with the objective polysomnography examination were included. The results were analyzed using a random-effects model that incorporated potential heterogeneity between studies. RESULTS: Ten cross-sectional or case-control studies with 43,296 participants contributed to the meta-analysis. Pooled results showed that SDB was significantly associated with periodontitis (odds ratio [OR]: 1.83, 95% confidence interval [CI]: 1.52 to 2.20, I2 = 40%, p < 0.001). Sensitivity analysis showed consistent association for severe periodontitis (OR: 1.39, 95% CI: 1.20 to 1.61, I2 = 0%, p < 0.001). Subgroup analyses showed consistent results in patients with mild (OR: 1.66, p < 0.001), moderate (OR: 2.23, p = 0.009), and severe SDB (OR: 2.66, p < 0.001). Moreover, the association between SDB and periodontitis was consistent in Asian and non-Asian studies, in cross-sectional and case-control studies, in studies with univariate and multivariate regression models, and in studies with different quality scores (p for subgroup effects all < 0.05). CONCLUSIONS: Polysomnography confirmed diagnosis of SDB is associated with periodontitis in adult population.

25-Hydroxyvitamin D3 -enhanced PTPN2 positively regulates periodontal inflammation through the JAK/STAT pathway in human oral keratinocytes and a mouse model of type 2 diabetes mellitus.

BACKGROUND AND OBJECTIVE: Periodontitis is an increasingly prevalent complication of diabetes mellitus (known as diabetes mellitus-associated periodontitis), and 25-hydroxyvitamin D3 (25VD3 ) was recently found to be a critical regulator of innate immunity in this disease, but the underlying mechanisms remain poorly understood. T-cell protein tyrosine phosphatase non-receptor type 2 (PTPN2) is a potential downstream protein of the 25VD3 /vitamin D receptor pathway. The aim of this study was to investigate the regulation of PTPN2 in periodontal inflammation in diabetes mellitus-associated periodontitis. MATERIAL AND METHODS: Porphyromonas gingivalis-infected db/db mice were treated with 25VD3 . Their fasting blood glucose and body weight were monitored every other week, and the levels of alveolar bone loss and serum inflammatory cytokines (tumor necrosis factor-α, interferon-γ and interleukin-6) were determined at the time of killing. The effect of PTPN2 on human OKF6-TERT2 oral keratinocytes was examined through the knockout of PTPN2 using the CRISPR/Cas9 knockout plasmid. The expression levels of the PTPN2, vitamin D receptor and JAK1/STAT3 signaling proteins in the gingival epithelium and OKF6-TERT2 cells were determined through western blot and immunohistochemical analyses. RESULTS: After 25VD3 treatment, db/db mice exhibited alleviated serum inflammatory cytokines and alveolar bone loss, and 25VD3 -enhanced PTPN2 expression decreased the expression of the JAK1/STAT3 signaling proteins in the gingival epithelium. Analyses of human oral keratinocytes showed that 25VD3 increased the expression of PTPN2, which dephosphorylates protein substrates in the JAK1/STAT3 signaling pathway. CONCLUSION: PTPN2 contributed to a decrease in periodontal inflammation in type 2 diabetes mellitus via dephosphorylate protein substrates in the JAK1/STAT3 signaling pathway after 25VD3 treatment in human oral keratinocytes and a mouse model of type 2 diabetes mellitus. A thorough understanding of PTPN2 and its involvement in inhibiting inflammation might provide alternative therapeutic approaches for the pathogenesis and treatment of diabetes mellitus-associated periodontitis.

[Effect of acid etching of retropreparation cavities on seal of retrofill materials].

OBJECTIVE: To evaluate the effect of acid etching of retropreps on seal of different retrofill materials. METHODS: In the study, 80 freshly extracted lower molar teeth were used. They were examined under 3.5× magnifying glass to rull out fractures. They were cleaned and stored in distilled water before use. The distal roots were sectioned off and underwent root canal treatment. Rotary nickel-titanium instruments were used during instrumentation and the roots were obturated using lateral condensation technique. The apical portion (3 mm in length) was removed with a fine grit diamond bur, the root tip was retroprepared with a ultrasonic tip (3 mm in depth). The retroprepared roots were randomly assigned to 4 groups and retrofilled with amalgam, intermediate restorative material (IRM), iRoot BP Plus and mineral trioxide aggregate (MTA). The groups were further divided into subgroups according to treatment of the root end cavity (etch and non-etch). The root tips were covered with alginate impression material and were left to set in PBS solution for a week and stained with methylene blue for a week. The roots were removed from the dye solution, thoroughly rinsed and dried, split in halves along the long axis with a diamond disk and observed under a stereoscope. The linear dye leakage was measured and analyzed. One way ANOVA and Tamhane's T2 method were used to analyze the data. The significance level was set at 0.05. RESULTS: The dye leakage results (mean±standard deviation) according to the treatment groups were: amalgam etch (2.80±0.72) mm, amalgam non-etch (2.07±0.86) mm, IRM etch (1.54±0.19) mm, IRM non-etch (1.12±0.28) mm , iRoot BP Plus etch (0.20±0.20) mm, iRoot BP Plus non-etch (0.11±0.08) mm, MTA etch (0.19±0.19) mm, and MTA non-etch (0.17±0.14) mm. One way ANOVA showed significant differences between the groups. Comparison between the groups using Tamhane's T2 method showed roots retrofilled with iRoot BP Plus and MTA had significant less leakage than those retrofilled with amalgam and IRM (P<0.05); There was no significant difference in terms of leakage between iRoot BP Plus and MTA; Acid etching increased leakage of IRM but did not affect MTA, iRoot BP Plus or amalgam retrofillings. CONCLUSION: Acid etching is not shown to benefit apical sealing of retrofill materials.

Glyceryl trinitrate and caprylic acid for the mitigation of the Desulfovibrio vulgaris biofilm on C1018 carbon steel.

Microbiologically influenced corrosion (MIC), also known as biocorrosion, is caused by corrosive biofilms. MIC is a growing problem, especially in the oil and gas industry. Among various corrosive microbes, sulfate reducing bacteria (SRB) are often the leading culprit. Biofilm mitigation is the key to MIC mitigation. Biocide applications against biofilms promote resistance over time. Thus, it is imperative to develop new biodegradable and cost-effective biocides for large-scale field applications. Using the corrosive Desulfovibrio vulgaris (an SRB) biofilm as a model biofilm, this work demonstrated that a cocktail of glyceryl trinitrate (GTN) and caprylic acid (CA) was very effective for biofilm prevention and mitigation of established biofilms on C1018 carbon steel coupons. The most probable number sessile cell count data and confocal laser scanning microscope biofilm images proved that the biocide cocktail of 25 ppm (w/w) GTN + 0.1% (w/w) CA successfully prevented the D. vulgaris biofilm establishment on C1018 carbon steel coupons while 100 ppm GTN + 0.1% CA effectively mitigated pre-established D. vulgaris biofilms on C1018 carbon steel coupons. In both cases, the cocktails were able to reduce the sessile cell count from 10(6) cells/cm(2) to an undetectable level.

Radial free forearm flap versus pectoralis major pedicled flap for reconstruction in patients with tongue cancer: Assessment of quality of life.

BACKGROUND: This study investigated the quality of life of Chinese patients with tongue cancer who had undergone immediate flap reconstruction surgery. In addition, we compared 2 groups of patients: those who had received radial forearm free flap (RFFF) surgery and others who had received pectoralis major myocutaneous flap (PMMF) surgery. MATERIAL AND METHODS: Patients who received RFFF or PMMF reconstruction after primary tongue cancer treated with total and subtotal tongue resection were eligible for the current study. The patients' demographic data, medical history, and quality of life scores (14-item Oral Health Impact Profile (OHIP-14) and the University of Washington Quality of Life (UW-QOL) questionnaires) were collected. RESULTS: A total of 41 of 63 questionnaires were returned (65.08%). There were significant differences between the 2 groups in the gender (p< .05). Patients reconstructed with RFFF performed better in the shoulder domains, in addition to worse appearance domains. CONCLUSIONS: Using either RFFF or PMMF for reconstruction of defects after tongue cancer resection significantly influences a patient's quality of life. Data from this study provide useful information for physicians and patients during their discussion of reconstruction modalities for tongue cancers.

Exogenous expression of IL-1Ra and TGF-ß1 promotes in vivo repair in experimental rabbit osteoarthritis.

OBJECTIVES: Potential gene therapy application of single and co-expression of interleukin 1 (IL-1) receptor antagonist (IL-1Ra) and transforming growth factor-ß1 (TGF-ß1) to alter disease progression was investigated in an in-vivo rabbit model of osteoarthritis (OA). METHOD: Sixteen young adult rabbits were randomly and equally divided into four groups: blank control group, IL-1Ra transfection group, TGF-ß1 transfection group, and IL-1Ra/TGF-ß1 double transfection group. Histological examinations were performed to monitor disease progression after haematoxylin and eosin (H&E) staining of articular cartilage. Immunohistochemistry was used to detect IL-1Ra and TGF-ß1 in synovial membrane tissues. Exogenous IL-1Ra and TGF-ß1 content was assessed in joint lavage fluid using an enzyme-linked immunosorbent assay (ELISA). RESULTS: ELISA measurements from the joint lavage fluid showed high expressions of IL-1Ra and TGF-ß1 in the single and double transfection groups. Remarkably, concomitant reductions in IL-1ß and tumour necrosis factor alpha (TNF-α) levels were observed in these single and double transfection groups. Radioimmunoassay (RIA)-based detection showed that IL-1ß and TNF-α levels in the gene transfection groups were significantly lower compared to the blank control group, in parallel experiments. Importantly, injection of IL-1Ra and TGF-ß1 expressing cartilage cells into joints led to a significant inhibition of cartilage matrix degradation. Finally, IL-1Ra and TGF-ß1 expression in tissues correlated with disease reversal in the experimental group, with improved tissue architecture and collagen deposition. CONCLUSIONS: Our results reveal that both single- and double-gene transfection of IL-1Ra and TGF-ß1 promote extensive repair of damaged cartilage, and double transfections showed better recovery than single transfections, suggesting that co-expression of IL-1Ra and TGF-ß1 inhibits degeneration and improves repair of articular cartilage in OA.

Experimental gingivitis, bacteremia and systemic biomarkers: a randomized clinical trial.

BACKGROUND AND OBJECTIVE: Bacteremia and systemic inflammatory markers are associated with periodontal and systemic diseases and may be linking mechanisms between these conditions. We hypothesized that in the development of gingival inflammation, systemic markers of inflammation and bacteremia would increase. MATERIAL AND METHODS: To study the effect of bacteremia on systemic inflammatory markers, we recruited 80 subjects to participate in an experimental gingivitis study. Subjects were stratified based on gender, smoking and the number of bleeding sites and then randomized to one of two groups: control group (n = 40) or experimental gingivitis group (n = 40). Subjects in the control group conducted an oral hygiene regimen: brushing twice daily with a regular sodium fluoride cavity protection dentifrice and a standard manual toothbrush, flossing twice daily, and mouth rinsing with an anti-cavity fluoride rinse once daily. The experimental group stopped brushing and flossing, and used only the fluoride anti-cavity mouth rinse for 21 d. RESULTS: Seventy-nine of 80 subjects were evaluable. One subject in the control group was excluded from the results due to antibiotic use during the study. Our data showed the experimental gingivitis group exhibited a significant (p < 0.05) increase in dental plaque level and gingival inflammatory indices relative to baseline and the control group but a decrease in bacteremia and soluble intercellular adhesion molecule-1 levels vs. baseline. Bacteremia was negatively correlated with gingival inflammatory indices and soluble intercellular adhesion molecule-1 levels in the experimental gingivitis group, thus negating our hypothesis. CONCLUSION: We conclude that there are marked differences in systemic cytokine levels over the course of short-term experimentally induced gingivitis and further conclude that a long-term periodontitis study must be considered to address mechanisms whereby oral diseases may affect systemic diseases.

Sphingosine-1-phosphate mediates AKT/ERK maintenance of dental pulp homoeostasis.

AIM: To investigate the cell status of dental pulp cells (DPCs) in a sphingosine-1-phosphate (S1P)-induced microinflammation environment and the possible mechanisms of cell homoeostasis maintenance by S1P. METHODOLOGY: Sphingosine-1-phosphate receptor (S1PR) expression was examined in DPCs within a local S1P-induced microinflammation model established using 1 µmol L(-1) S1P. U0126 [extracellular signal-regulated kinase (ERK) inhibitor], LY294002 (AKT inhibitor) and Y27632 (ROCK inhibitor) were used to inhibit corresponding signalling pathways of DPCs. CCK8 and cell cycle analysis tested cell proliferation. Immunofluorescence staining JC-1 detected changes of mitochondrial membrane potential (ΔΨm). Tests for apoptosis and the apoptosis-related proteins Bax and Bcl-2 were assessed by flow cytometry and western blot analysis, respectively. Expressions of ERK and AKT were evaluated by western blot analysis. The results were analysed using the Student's t-test and the significance level set at P < 0.05. RESULTS: Expressions of S1PR1, S1PR2 and S1PR3 in DPCs differed amongst individuals. DPCs maintained self-homoeostasis in response to S1P-induced microinflammation via S1PRs. During this repair process, ERK, AKT and ROCK had a short-term complementary interaction at 60 min, but then AKT and ERK gradually played decisive roles after 24 h in proliferation enhancement and apoptosis inhibition, respectively (P > 0.05). CONCLUSIONS: The AKT-ERK balance may determine whether DPC homoeostasis in S1P-induced microinflammation is maintained by synergistic regulation of cell growth and apoptosis.

Treatment of vertebral body compression fractures using percutaneous kyphoplasty guided by a combination of computed tomography and C-arm fluoroscopy with finger-touch guidance to determine the needle entry point.

This study aimed to evaluate the results and complications of image-guided percutaneous kyphoplasty (PKP) using computed tomography (CT) and C-arm fluoroscopy, with finger-touch guidance to determine the needle entry point. Of the 86 patients (106 PKP) examined, 56 were treated for osteoporotic vertebral compression fractures and 30 for vertebral tumors. All patients underwent image-guided treatment using CT and conventional fluoroscopy, with finger-touch identification of a puncture point within a small incision (1.5 to 2 cm). Partial or complete pain relief was achieved in 98% of patients within 24 h of treatment. Moreover, a significant improvement in functional mobility and reduction in analgesic use was observed. CT allowed the detection of cement leakage in 20.7% of the interventions. No bone cement leakages with neurologic symptoms were noted. All work channels were made only once, and bone cement was distributed near the center of the vertebral body. Our study confirms the efficacy of PKP treatment in osteoporotic and oncological patients. The combination of CT and C-arm fluoroscopy with finger-touch guidance reduces the risk of complications compared with conventional fluoroscopy alone, facilitates the detection of minor cement leakage, improves the operative procedure, and results in a favorable bone cement distribution.

[Clinical characteristics and risk factors of newly developed vertebral fractures after vertebral augmentation].

OBJECTIVE: To identify the characteristics and risk factors of the refractures after percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP). METHODS: A retrospective analysis of 148 patients who had undergone PKP or PVP between March 2006 and October 2013 in Peking University People's Hospital was conducted. In the study, 29 patients with 42 refractured vertebra and 119 patients without refracture were included. All the patients were observed for a time of (34.4±26.8) months. Clinical, imaging and procedure related factors (gender, age, height, weight, body mass index, the level of the injured vertebra, the time interval between the procedure and the refracture, the level of the refractured vertebra, the bone cement volume injected, performed PKP or PVP,performed unilateral or bilateral, the percentage of anterior vertebral height restoration, the correction of the Cobb angle, cement diffusion, bone mineral density, presence or absence of diabetes mellitus, history of fractures of the whole body, anti-osteoporosis treatment, cement leakage) for each group were analyzed by Cox proportional hazards regression analysis. RESULTS: Of all the patients,16 (55.17%, 16/29) had refractures in the adjacent vertebra, and 13 (44.83%, 13/29) had refractures in the nonadjacent vertebra. Refractures within 3 months accounted for 31.03% (9/29) of all the refractures, and within 1 year accounted for 55.17% (16/29). Both older age (P=0.027, HR=1.051, 95% CI=1.006-1.098) and a history of fractures of the whole body (P=0.012, HR=0.386, 95% CI=0.184-0.812) were statistically significant as the independent risk factors for predicting refractures. Others were not associated with refractures (P>0.05). CONCLUSION: Older age and a history of fractures of the whole body are the independent risk factors of the refractures after PKP and PVP. The mechanism of the refractures after PKP and PVP is mainly the natural development of osteoporosis.

Ovariectomy induces osteoporosis in the maxillary alveolar bone: an in vivo micro-CT and histomorphometric analysis in rats.

OBJECTIVE: To investigate whether porotic changes occur in maxillary alveolar bone in ovariectomized rats. METHODS: Thirty-two 6-week-old female Sprague-Dawley rats were divided into an ovariectomy group (OVX) and a sham-ovariectomy group (sham). Twelve weeks after surgery, maxillae of 16 rats (eight OVX and eight sham) were analyzed by micro-CT. Inter-radicular alveolar bone of the maxillary first molar was reconstructed and analyzed. The remaining 16 maxillae were used for histochemistry, including hematoxylin-eosin staining and tartrate-resistant acid phosphatase enzyme staining. RESULTS: Three-dimensional reconstructed images of the irregular alveolar bone showed an intuitive view of porotic changes in the OVX group. The alveolar bone in OVX rats had a porous microarchitecture including lower bone mass and a looser structure of more widely separated trabeculae. Bone mineral density (BMD), bone volume fraction (BV/TV), and trabecular thickness (Tb.Th.) were significantly lower in the OVX group than those in the sham group (P < 0.05). Trabecular separation (Tb.Sp.) increased significantly in the OVX rats compared to the sham rats (P < 0.05). Histomorphometric analysis of alveolar bone also revealed porotic changes in the OVX rats. Bone area ratio significantly decreased in the OVX group compared with the sham group (P < 0.01). There were also more osteoclasts present in the alveolar bone of OVX rats compared to sham rats (P < 0.05). CONCLUSION: Ovariectomy induces osteoporosis in maxillary alveolar bone in rats, which may be related to the increased number of osteoclasts.

Polymicrobial Infection Induces Adipose Tissue Dysfunction via Gingival Extracellular Vesicles.

Recent studies have indicated that periodontitis promotes metabolic dysregulation and insulin resistance by affecting the function of white adipose tissue (WAT). However, the mechanisms linking periodontitis to adipose tissue dysfunction still need to be explored. Extracellular vesicles (EVs) deliver messages to distal sites and regulate their function. Also, recent studies have shown that periodontitis changes the composition of EVs in body fluids and that EVs might be one of the mechanisms underlying the relationship between periodontitis and insulin resistance. Herein, we explored the impact of polymicrobial oral infection with periodontal pathogens on the function of WAT and the role of gingival EVs (gEVs) in the process. Mice were subjected to oral inoculation with 109 Porphyromonas gingivalis and 108 Fusobacterium nucleatum every other day for 14 wk. This prolonged bacterial infection induced WAT dysfunction, characterized by reduced levels of AKT phosphorylation, adiponectin, leptin, and genes associated with adipogenesis and lipogenesis. We successfully isolated gEVs with satisfactory yield and purity. The RNA sequencing results showed that the differentially expressed microRNAs in the gEVs of mice with polymicrobial oral infection were involved in insulin signaling and adipose tissue function. Notably, our in vitro experiments and RNA sequencing results revealed the functional similarities between gEVs and plasma-derived EVs. Furthermore, intraperitoneal injection with gEVs derived from mice with oral infection induced the dysfunction of WAT in healthy mice. Overall, our findings provide evidence for the influence of polymicrobial oral infection on WAT function and propose gEVs as a novel pathway through which periodontal infection may exert its effects on WAT.

Epigenetic Regulation of Ameloblast Differentiation by HMGN Proteins.

Dental enamel formation is coordinated by ameloblast differentiation, production of enamel matrix proteins, and crystal growth. The factors regulating ameloblast differentiation are not fully understood. Here we show that the high mobility group N (HMGN) nucleosomal binding proteins modulate the rate of ameloblast differentiation and enamel formation. We found that HMGN1 and HMGN2 proteins are downregulated during mouse ameloblast differentiation. Genetically altered mice lacking HMGN1 and HMGN2 proteins show faster ameloblast differentiation and a higher rate of enamel deposition in mice molars and incisors. In vitro differentiation of induced pluripotent stem cells to dental epithelium cells showed that HMGN proteins modulate the expression and chromatin accessibility of ameloblast-specific genes and affect the binding of transcription factors epiprofin and PITX2 to ameloblast-specific genes. Our results suggest that HMGN proteins regulate ameloblast differentiation and enamel mineralization by modulating lineage-specific chromatin accessibility and transcription factor binding to ameloblast regulatory sites.

Fabrication and evaluation of porous coatings doped with bioactive elements on titanium surfaces.

OBJECTIVE: Although pure titanium (PT) and its alloys exhibit excellent mechanical properties, they lack biological activity as implants. The purpose of this study was to improve the biological activity of titanium implants through surface modification. MATERIALS AND METHODS: Titanium was processed into titanium discs, where the titanium discs served as anodes and stainless steel served as cathodes, and a copper- and cobalt-doped porous coating [pure titanium model (PTM)] was prepared on the surface of titanium via plasma electrolytic oxidation. The surface characteristics of the coating were evaluated using field emission scanning electron microscopy (FE-SEM), energy dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), and profilometry. The corrosion resistance of PTM was evaluated with an electrochemical workstation. The biocompatibility and bioactivity of coated bone marrow mesenchymal stem cells (BMSCs) were evaluated through in vitro cell experiments. RESULTS: A copper- and cobalt-doped porous coating was successfully prepared on the surface of titanium, and the doping of copper and cobalt did not change the surface topography of the coating. The porous coating increased the surface roughness of titanium and improved its resistance to corrosion. In addition, the porous coating doped with copper and cobalt promoted the adhesion and spreading of BMSCs. CONCLUSIONS: A porous coating doped with copper and cobalt was prepared on the surface of titanium through plasma electrolytic oxidation. The coating not only improved the roughness and corrosion resistance of titanium but also exhibited good biological activity.

Intestinal Translocation of Live Porphyromonas gingivalis Drives Insulin Resistance.

Periodontitis has been emphasized as a risk factor of insulin resistance-related systemic diseases. Accumulating evidence has suggested a possible "oral-gut axis" linking oral infection and extraoral diseases, but it remains unclear whether periodontal pathogens can survive the barriers of the digestive tract and how they play their pathogenic roles. The present study established a periodontitis mouse model through oral ligature plus Porphyromonas gingivalis inoculation and demonstrated that periodontitis aggravated diet-induced obesity and insulin resistance, while also causing P. gingivalis enrichment in the intestine. Metabolic labeling strategy validated that P. gingivalis could translocate to the gastrointestinal tract in a viable state. Oral administration of living P. gingivalis elicited insulin resistance, while administration of pasteurized P. gingivalis had no such effect. Combination analysis of metagenome sequencing and nontargeted metabolomics suggested that the tryptophan metabolism pathway, specifically indole and its derivatives, was involved in the pathogenesis of insulin resistance caused by oral administration of living P. gingivalis. Moreover, liquid chromatography-high-resolution mass spectrometry analysis confirmed that the aryl hydrocarbon receptor (AhR) ligands, mainly indole acetic acid, tryptamine, and indole-3-aldehyde, were reduced in diet-induced obese mice with periodontitis, leading to inactivation of AhR signaling. Supplementation with Ficz (6-formylindolo (3,2-b) carbazole), an AhR agonist, alleviated periodontitis-associated insulin resistance, in which the restoration of gut barrier function might play an important role. Collectively, these findings reveal that the oral-gut translocation of viable P. gingivalis works as a fuel linking periodontitis and insulin resistance, in which reduction of AhR ligands and inactivation of AhR signaling are involved. This study provides novel insight into the role of the oral-gut axis in the pathogenesis of periodontitis-associated comorbidities.

The in vitro study of ursolic acid and oleanolic acid inhibiting cariogenic microorganisms as well as biofilm.

OBJECTIVE: The aim of this study was to examine the effect of ursolic acid (UA) and oleanolic acid (OA), triterpenoid compounds that are isolated from many edible and medicinal plants, on cariogenic microorganisms and biofilms. METHODS: A microtitre plate dilution assay was used to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of UA and OA against two Actinomyces spp. and four Streptococcus spp. The antibacterial activity of UA and OA was assessed by crystal violet staining, scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). RESULTS: UA and OA displayed differential antibacterial activities against the six tested bacteria, with UA showing greater antibacterial activity than OA. Furthermore, the two drugs had greater antibacterial activity against Actinomyces spp. than Streptococcus spp. UA and OA at 1/4 MIC can reduce bacterial biofilm formation, whereas higher UA concentrations displayed antibacterial activity against Actinomyces viscosus and Streptococcus mutans in mature biofilms. For instance, 2.0 mg ml(-1) UA was sufficient to kill an A. viscosus biofilm. CONCLUSIONS: UA and OA inhibit the growth of cariogenic microorganisms, which suggests that UA and OA have considerable potential as antibacterial agents for dental caries prevention.

Local hemodynamic disturbance accelerates early thrombosis of small-caliber expanded polytetrafluoroethylene grafts.

OBJECTIVE: Small-caliber expanded polytetrafluoroethylene (ePTFE) grafts cannot be used widely in the clinical situation because of early thrombosis and occlusion. This unsolved and under-recognized problem warrants further investigation. METHODS: Grafts of uncoated ePTFE (n = 6) and anti-CD34-coated ePTFE (n = 6) were implanted unilaterally into the carotid artery in 12 domestic pigs. Ultrasonography was used to test the proximal and distal anastomotic stoma morphology, diameters and blood velocities. A thrombosis instrument was used to examine the blood coagulation state. After seven days, the pigs were sacrificed and the implanted grafts were excised for general and histological analysis. Computational fluid dynamics was used to investigate the blood flow fields of the implanted grafts and to calculate parameters that might be indicative of thrombosis. RESULTS: Thrombosis was detected in 10 of 12 (83.3%) implanted ePTFE grafts, 5 in uncoated grafts and 5 in anti-CD34-coated grafts. Endothelial cell coverage was observed in both uncoated and anti-CD34-coated grafts. No obvious abnormalities in anastomotic stoma or blood coagulation state were observed. Computer-based local hemodynamic simulation showed the low flexibility of synthetic ePTFE grafts caused obvious coarctation. Local wall pressure, velocity and wall shear stress were much higher than in the contralateral normal vessel. CONCLUSIONS: The patency of small-caliber ePTFE grafts for clinical use is impaired by early thrombosis due to mixed causes. Local hemodynamic disturbance was the most powerful predictor of early thrombosis. Decreasing local hemodynamic disturbance, improving the quality of anastomotic stoma, selecting reasonable anticoagulation strategies and promoting rapid endothelialization may increase the long-term patency of small-caliber vascular grafts.

[A case of intellectual developmental disorder with behavioral abnormalities and craniofacial dysmorphism with or without seizures caused by PHF21A gene variation and review of literature].

Objective: To discuss the clinical and genetic features of intellectual developmental disorder with behavioral abnormalities and craniofacial dysmorphism with or without seizures (IDDBCS). Methods: The clinical and genetic records of a patient who was diagnosed with IDDBCS caused by PHF21A gene variation at Children's Hospital Capital Institute of Pediatrics in 2021 were collected retrospectively. Using " PHF21A gene" as the keyword, relevant articles were searched at CNKI, Wanfang Data and PubMed from establishment of databases to February 2023. Clinical and genetic features of IDDBCS were summarized in the combination of this case. Results: An 8 months of age boy showed overgrowth (height, weight and head circumference were all higher than the 97th percentile of children of the same age and sex) and language and motor developmental delay after birth, and gradually showed autism-like symptoms like stereotyped behavior and poor eye contact. At 8 months of age, he began to show epileptic seizures, which were in the form of a series of spastic seizures with no reaction to adrenocorticotropic hormone but a good response to vigabatrin. Physical examination showed special craniofacial appearances including a prominent high forehead, sparse eyebrows, broad nasal bridge, and downturned mouth with a tent-shaped upper lip. The patient also manifested hypotonia. Whole exome sequencing showed a de novo heterogeneous variant, PHF21A (NM_001101802.1): c.54+1G>A, and IDDBCS was diagnosed. A total of 6 articles (all English articles) were collected, involving this case and other 14 patients of IDDBCS caused by PHF21A gene variation. Clinical manifestations were intellectual disability or developmental delay (15 patients), craniofacial anomalies (15 patients), behavioral abnormalities (12 patients), seizures (9 patients), and overgrowth (8 patients). The main pathogenic variations were frameshift variations (8 patients). Conclusions: IDDBCS should be considered when patients show nervous developmental abnormalities, craniofacial anomalies, seizures and overgrowth. PHF21A gene variation detection helps to make a definite diagnosis.

[MRI evaluation of condylar bone regeneration after temporomandibular joint disc reduction and suture and analysis of factors affecting bone regeneration].

Objective: To evaluate the MRI manifestations of condylar bone regeneration after disc reduction and suture for anterior disc displacement without reduction (ADDWoR) patients and to analyze the relevant factors affecting bone regeneration. Methods: A total of 61 patients of 75 joints with ADDWoR who attended the Department of Maxillofacial Surgery of the Affiliated Hospital of Stomatology of Nanjing Medical University from April 2020 to December 2021 were enrolled in the study. The characteristics of MRI condylar bone regeneration were analyzed before and after surgery (follow-up for 6 months or more), and logistic regression analysis was performed on the influencing factors of bone regeneration. Results: The new bone formation of the condyle was found in 28 patients, with age of (20.2±4.9) years. However, there were 33 patients that had no condylar bone regeneration, with age of (41.9±17.5) years. A total of 35 joints in this study were found new bone formation. There were 16 joints (45.7%) had new bone formation on the posterior slope of the condyle, 10 joints (28.6%) around the condyle, 6 joints (17.1%) on the anterior slope of the condyle, and only 3 joints (8.6%) on the top of the condyle. Multivariate logistic regression analysis showed that age, preoperative disc length and degree of condylar bone resorption correlated with postoperative condylar bone regeneration(P<0.05). Patients younger than 30 years with non-shortened preoperative disc length and less condylar bone resorption have a higher probability of new bone formation. Conclusions: The condyle has bone regeneration capacity after correcting the abnormal relationship between disc and condyle, and young age, non-shortened preoperative disc length and less condylar bone resorption are conducive to postoperative condylar bone regeneration.

Injected matrix stimulates myogenesis and regeneration of mouse skeletal muscle after ischaemic injury.

Biomaterial-guided regeneration represents a novel approach for the treatment of myopathies. Revascularisation and the intramuscular extracellular matrix are important factors in stimulating myogenesis and regenerating muscle damaged by ischaemia. In this study, we used an injectable collagen matrix, enhanced with sialyl LewisX (sLeX), to guide skeletal muscle differentiation and regeneration. The elastic properties of collagen and sLeX-collagen matrices were similar to those of skeletal muscle, and culture of pluripotent mESCs on the matrices promoted their differentiation into myocyte-like cells expressing Pax3, MHC3, myogenin and Myf5. The regenerative properties of matrices were evaluated in ischaemic mouse hind-limbs. Treatment with the sLeX-matrix augmented the production of myogenic-mediated factors insulin-like growth factor (IGF)-1, and IGF binding protein-2 and -5 after 3 days. This was followed by muscle regeneration, including a greater number of regenerating myofibres and increased transcription of Six1, M-cadherin, myogenin and Myf5 after 10 days. Simultaneously, the sLeX-matrix promoted increased mobilisation and engraftment of bone marrow-derived progenitor cells, the development of larger arterioles and the restoration of tissue perfusion. Both matrix treatments tended to reduce maximal forces of ischaemic solei muscles, but sLeX-matrix lessened this loss of force and also prevented muscle fatigue. Only sLeX-matrix treatment improved mobility of mice on a treadmill. Together, these results suggest a novel approach for regenerative myogenesis, whereby treatment only with a matrix, which possesses an inherent ability to guide myogenic differentiation of pluripotent stem cells, can enhance the endogenous vascular and myogenic regeneration of skeletal muscle, thus holding promise for future clinical use.