Comparison of achieved and predicted crown movement in adults after 4 first premolar extraction treatment with Invisalign.

INTRODUCTION: In this study, we compared achieved and predicted crown movements of maxillary and mandibular first molars, canines, and central incisors in adults after 4 first premolar extraction treatment with Invisalign. METHODS: Seventeen adult patients who received 4 first premolar extraction treatment with Invisalign and completed the first series of aligners were included. Superimposition of pretreatment and actual posttreatment dental models was acquired using registrations of pretreatment and posttreatment craniofacial models on the basis of bone surfaces and registrations of craniofacial and dental models on the basis of dental crown surfaces, respectively. Superimposition of pretreatment and predicted posttreatment models was acquired from ClinCheck software. Achieved and predicted 3-dimensional crown movements of maxillary and mandibular first molars, canines, and central incisors were then compared using the paired t test. RESULTS: Relative to predicted changes, first molars achieved greater mesial displacement, mesial tipping, and buccal inclination in both the maxilla and mandible, greater intrusion in the maxilla, and greater mesial-lingual rotation and less constriction in the mandible. Canines achieved greater distal tipping in both the maxilla and mandible, less retraction in the maxilla, and greater lingual inclination and extrusion in the mandible. Central incisors achieved greater distal tipping and lingual inclination and extrusion in both the maxilla and mandible and less retraction in the maxilla. CONCLUSIONS: Tooth crown movements were not fully achieved as predicted following Invisalign treatment. Differences focused on mesial tipping, buccal inclination, mesial displacement, and intrusion of the first molars, as well as distal tipping, lingual inclination, insufficient retraction, and intrusion of the canines and central incisors.

Analysis of correlation of 3-dimensional lip vermilion morphology and dentoskeletal forms in young Chinese adults on the basis of sex and skeletal patterns.

INTRODUCTION: The objective of this research was to evaluate the correlation between 3-dimensional (3D) lip vermilion (LV) morphology and skeletal patterns as well as incisor measurements in young Chinese adults. METHODS: In all, 240 young adults were enrolled; these included 80 patients each with skeletal Class I, Class II, and Class III malocclusions, respectively. Each sagittal skeletal pattern included 40 male and 40 female subjects. Twenty-two 3D LV measurements were obtained from 3D facial scans. Skeletal and incisor measurements were evaluated on lateral cephalograms. Correlation and regression analysis were performed between soft and hard tissue measurements. RESULTS: Six of 22 LV measurements showed significant differences between male and female subjects. The 3D LV morphology showed significant differences with respect to different skeletal patterns and sex. Adults with skeletal Class III malocclusion tended to have thinner upper vermilion and fuller lower vermilion than subjects with skeletal Class II and III malocclusion. The mandibular plane angle negatively correlated with the upper-lower vermilion midsagittal curve length and surface area ratio in adults with skeletal Class I and II malocclusion, yet the vertical facial skeletal type showed no correlation in adults with skeletal Class III malocclusion. The vermilion angle, central bow angle, vermilion height, vermilion midsagittal curve length, vermilion height and width ratio, and vermilion surface area showed a significant correlation with incisor measurements. Regression analysis found that the ANB angle was an important factor affecting the upper and lower vermilion midsagittal curve length and surface area ratio. Further, the vermilion height and height and width ratio were closely correlated with the interincisal (U1/L1) angle, whereas the central bow angle was closely correlated with the maxillary incisor torque. CONCLUSIONS: Most LV morphology variables were correlated to skeletal patterns and incisor measurements. Skeletal Class III malocclusion showed significant differences in vermilion morphology. Both the sagittal and vertical skeletal pattern have effects on vermilion proportion. The incisor torque was closely correlated to vermilion shape and central bow angle and might influence the vermilion esthetics. However, the proportion of the upper and lower vermilion was mainly affected by the ANB angle.

Non-optimal effectiveness of convalescent plasma transfusion and hydroxychloroquine in treating COVID-19: a case report.

BACKGROUND: Convalescent plasma (CP) transfusion was reported to be effective in treating critically ill patients with COVID-19, and hydroxychloroquine could potently inhibit SARS-CoV-2 in vitro. Herein, we reported a case receiving combination therapy with CP transfusion and hydroxychloroquine for the first time. CASE PRESENTATION: Laboratory findings showed high lactic acid level (2.1 mmol/L) and C-reactive protein (CRP, 48.8 mg/L), and low white blood cell count (1.96 × 109/L) in a 65-year-old Chinese man, who was diagnosed with severe COVID-19. CP was intravenously given twice, and hydroxychloroquine was orally administrated for a week (0.2 g, three times a day). The lactic acid and C-reactive protein levels remained high (2.1 mmol/L and 73.23 mg/L, respectively), while the arterial oxyhemoglobin saturation decreased to 86% with a low oxygenation index (OI, 76 mmHg) on day 4 after CP transfusion. His temperature returned to normal and the OI ascended above 300 on day 11. Moreover, the RNA test remained positive in throat swab, and computed tomography revealed severe pulmonary lesions on day 11 after admission. CONCLUSION: These findings suggested that the effectiveness of combination therapy with CP and hydroxychloroquine may be non-optimal, and specific therapy needs to be explored.

Impaired Th17 cell proliferation and decreased pro-inflammatory cytokine production in CXCR3/CXCR4 double-deficient mice of vulvovaginal candidiasis.

Vulvovaginal candidiasis (VVC) is a common observed infection, affecting approximately 75% of women of reproductive age. Drug resistance represents a troublesome stumbling block associated with VVC therapy. Thus the aim of the present study was to provide information regarding the selection of potential drug targets for VVC. CXCR3-, CXCR4-, or CXCR/CXCR4 double-deficient mouse models of VVC were subsequently established, with changes to the load of Candida Albicans evaluated accordingly. The biological behaviors of the vaginal epithelial cells were characterized in response to the CXCR3-, CXCR4-, or CXCR3/CXCR4 double-knockout in vivo. Our initial observations revealed that in mice with VVC, CXCR3-, CXCR4-, or CXCR3 - CXCR4 double-knockout resulted in a decreased load of C. Albicans as well as reduced levels and proportion of Th17 cells. Proinflammatory cytokine production was found to be inhibited by CXCR3-, CXCR4-, or CXCR3/CXCR4 double-knockout whereby the mRNA and protein expressions CXCR3, CXCR4, IL-17, IL-6, and TNF-α exhibited decreased levels. CXCR3-, CXCR4-, or CXCR3/CXCR4 double-knockout appeared to function as positive proliferation factors, while playing a negative role in the processes of apoptosis and the cell cycle of vaginal epithelial cells. Taken together, the key findings of the study suggested that CXCR3/CXCR4 double-knockout could act to hinder the progression of VVC, highlighting its promise as a novel therapeutic target in the treatment of VVC. CXCR3 and CXCR4 genes may regulate Th17/IL-17 immune inflammatory pathways to participate in antifungal immunity.

Correlation Between Cephalometric Measures and End-of-Treatment Facial Attractiveness.

Sixty-nine experienced Chinese orthodontists evaluated 108 Chinese patients' facial attractiveness from set of photographs (frontal, lateral, and frontal smiling photos) taken at the end of orthodontic treatment. These 108 patients, which contained an equal number of patients with Class I, II, and III malocclusion, were randomly selected from 6 orthodontic treatment centers throughout China. Spearman rank-order correlation coefficients (rs) analyses were performed to examine agreement in ranking between all judge pairs. Pearson correlation and multivariate regression were performed to examine the correlation between cephalometric measures and end-of-treatment Photo Attractiveness Rank.96.68% judge pairs showed moderate correlated (+0.4 ≤ rs < +0.7) subjective rankings. Cephalometric measures significantly correlated with end-of-treatment Photo Attractiveness Rank included interincisal angle (r = 0.330, P < 0.05), L1/MP° (r = 0.386, P < 0.05), L1-NBmm (r = 0.451, P < 0.01), L1/NB° (r = 0.374, P < 0.05), and profile angle (r = 0.353, P < 0.05) in Class I patients with an explained variance of 32.8%, and ANB angle (r = 0.432, P < 0.01), angle of convexity (r = 0.448, P < 0.01), profile angle (r = 0.488, P < 0.01), Li to E-line (r = 0.374, P < 0.05), Li to B-line (r = 0.543, P < 0.01), and Z angle (r = 0.543, P < 0.01) in Class II patient with an explained variance of 43.3%.There was less association than expected between objective measurements on the lateral cephalograms and clinicians' rankings of facial attractiveness on clinical photography in Chinese patients. Straight-stand lower incisor was desired for facial attractiveness of Class I malocclusion; and sagittal relationship and lip prominence influence the esthetics of Class II malocclusion in Chinese population.

Distalization of the maxillary and mandibular dentitions with miniscrew anchorage in a patient with moderate Class I bimaxillary dentoalveolar protrusion.

This case report describes the treatment of a 25-year-old woman with a skeletal Class I pattern and moderate bimaxillary dentoalveolar protrusion. The orthodontic treatment included distal movement of her maxillary and mandibular dentitions using 1-stage miniscrews. The total active treatment time was about 12 months. Her tooth alignment and profile were significantly improved by the orthodontic treatment. The 2-year posttreatment records show a stable occlusion and satisfactory facial esthetics.

[Reproducibility and repeatability of the determination of occlusal plane on digital dental models].

OBJECTIVE: To assess the repeatability(intraobserver comparison)and reproducibility(interobserver comparison)of two different methods for establishing the occlusal plane on digital dental models. METHODS: With Angle's classification as a stratification factor,48 cases were randomly extracted from 806 ones which had integrated clinical data and had their orthodontic treatment from July 2004 to August 2008 in Department of Orthodontics ,Peking University School and Hospital of Stomatology.Post-treatment plaster casts of 48 cases were scanned by Roland LPX-1200 3D laser scanner to generate geometry data as research subjects.In a locally developed software package,one observer repeated 5 times at intervals of at least one week to localize prescriptive landmarks on each digital model to establish a group of functional occlusal planes and a group of anatomic occlusal planes, while 6 observers established two other groups of functional and anatomic occlusal planes independently.Standard deviations of dihedral angles of each group on each model were calculated and compared between the related groups.The models with the five largest standard deviations of each group were studied to explore possible factors that might influence the identification of the landmarks on the digital models. RESULTS: Significant difference of intraobserver variability was not detected between the functional occlusal plane and the anatomic occlusal plane (P>0.1), while that of interobserver variability was detected (P<0.001). The pooled experimental standard deviation the 6 observers established for the functional occlusal plane was 0.2° smaller than that of the anatomic occlusal plane.The functional occlusal plane's variability of intraobserver and interobsever did not differ significantly (P>0.1), while the anatomic occlusal plane's variability of the intraobserver was significantly smaller than that of the interobserver (P<0.001), with a 0.12° difference value of the pooled experimental standard deviation. CONCLUSION: When one observer measures a number of digital models,both the functional and the anatomic occlusal planes are suitable as a conference plane with equal repeatability. When several observers measure a large number of digital models,the functional occlusal plane is more reproducible than the anatomic occlusal plane ,but the difference is small.

[Resting pressure of the tongue body on the tongue anchorage pad].

OBJECTIVE: To measure the resting pressure of the tongue body on the sagittal and vertical dimensions of the tongue anchorage pad (TAP), and to investigate the proper position of TAP as an anchorage. METHODS: Nineteen volunteers with individual normal occlusion (4 males and 15 females, age 23-33 years) were recruited in the study. Individualized TAP was designed and made for each subject. On the sagittal dimension, the pressure along the midline at the level of the distal of the second premolar (PM2), the first molar (M1) and the second molar (M2) were measured. On the vertical dimension, pressures on TAPs with height of -3 mm, 0 mm, and 3 mm were measured, with 0 mm standing for the reference point recorded by the tongue position record. The tongue resting pressure of the volunteers in the upright position was measured by miniature sensors (FSS1500NS, Honeywell, USA) embedded in TAP. Nonparametric analysis was applied with the significant level of 0.05. RESULTS: On the vertical dimension, the pressure obtained at the height of -3 mm, 0 mm, and 3 mm were 105.83 Pa, 167.75 Pa, and 254.25 Pa, respectively (P<0.001). On the sagittal dimension, the pressure detected at the level of PM2, M1, and M2 were 177.64 Pa, 126.72 Pa, and 109.37 Pa, respectively (P<0.001). CONCLUSION: Tongue pressure rises significantly with the increase of TAP height. On the sagittal dimension, pressure decreases along the palatal midline in an anteroposterior direction. But in the clinical practice, we should also put comfort into consideration.

[Validation of subjective and objective evaluation methods for orthodontic treatment outcome].

OBJECTIVE: To assess the correlations between objective measurements of 108 finished orthodontic cases and subjective assessments made by 69 orthodontic specialists, to explore the statistically significant measuring categories of cast and cephalogram and to validate the regression model. METHODS: A stratified random sample of 108 cases was drawn from the large sample of 2 383 patients who finished orthodontic treatment between July 2006 and August 2008 in six orthodontic treatment centers around China. For each patient, the post-treatment information sources evaluated in this study included standardized plaster study casts and a lateral cephalometric X-ray image. These information sources were evaluated both singly and in combination by a panel of 69 orthodontic specialists. The average subjective grading scores of 69 orthodontists were regarded as the gold standard. Six examiners used the peer assessment rating (PAR) index and American board of orthodontics-objective grading system (ABO-OGS) to measure all the study casts respectively and three other examiners measured all the lateral cephalometric X-ray images by using customized software. The objective measuring data were correlated with the gold standard. The correlations between the objective measurement and the subjective evaluation were assessed, the statistically significant measuring categories of cast and cephalogram were explored and the regression model was validated. RESULTS: The ABO-OGS scores of "occlusal relationship" correlated most strongly with the subjective scores of cast (r=0.655, P<0.01), and the secondarily correlated category with those were the PAR scores of "overjet" (r=0.525, P<0.01). The proclination of the lower incisors correlated most strongly with the subjective scores of cephalogram (r=0.446, P<0.01), and the secondarily correlated category with those was the protrusion of the lower lips (r=0.436, P<0.01). Nine components were predictive for the post-treatment model and lateral ephalometric film (Post-M+C) outcome: alignment (ABO-OGS), occlusal relationship (ABO-OGS), interproximal contact(ABO-OGS), L1/NB°, overjet (PAR), SNB°, occlusal contacts (ABO-OGS), U1/SN2° and centerline (PAR). These 9 components accounted for 72% of the variability in the average subjective grading scores. CONCLUSION: The objective regression model could replace the averaged opinion of Chinese orthodontic experts effectively, making objective assessment of orthodontic treatment outcome for Chinese patients.

In vitro and in vivo anti-cancer activity of formononetin on human cervical cancer cell line HeLa.

Worldwide, cervical cancer (CC) is the third most common malignancy in women, and it remains a leading cause of cancer-related death of women. Genomic studies indicate that phosphoinositide 3-kinase (PI3K)/AKT signaling is one of the most frequently deregulated pathways in several human cancers, including CC. This signaling pathway has an important role in cancer cell proliferation, survival, motility, and metabolism, and therefore could be an attractive therapeutic target. In a previous study, we used a sensitive and high-speed homogeneous assay for the detection of kinase activity and for screening of PI3K/AKT signaling inhibitors in a high-throughput screening (HTS) format and then obtain formononetin, as an O-methylated isoflavone existed in a number of plants and herbs like Astragalus membranaceus. We showed that formononetin inhibited the phosphorylation of AKT and induced the apoptosis of CC cell line HeLa in a dose-dependent manner. Furthermore, formononetin suppressed xenograft tumor growth in nude mice. Our results indicated that formononetin may be used as an anti-cancer drug for cervical cancer in the future.

Reflections on the complex mechanisms of endometriosis from the perspective of ferroptosis.

Ferroptosis is a novel type of iron-dependent programmed cell death characterised by intracellular iron overload, increased lipid peroxidation and abnormal accumulation of reactive oxygen species.It has been implicated in the progression of several diseases including cancer, ischaemia-reperfusion injury, neurodegenerative diseases and liver disease. The etiology of endometriosis (EMS) is still unclear and is associated with multiple factors, often accompanied by various forms of cell death and a complex microenvironment. In recent decades, the role of non-traditional forms of cell death, represented by ferroptosis, in endometriosis has come to the attention of researchers. This article reviews the transitional role of iron homeostasis in the development of ferroptosis, the characteristics and regulatory mechanisms of ferroptosis, and focuses on summarising the links between iron death and various pathogenic mechanisms of EMS, including oxidative stress, dysregulation of lipid metabolism, inflammation, autophagy and epithelial-mesenchymal transition. The possible applications of ferroptosis in the treatment of EMS, future research directions and current issues are discussed with the aim of providing new ideas for further understanding of EMS.

Mechanical force increases tooth movement and promotes remodeling of alveolar bone defects augmented with bovine bone mineral.

BACKGROUND: Orthodontic tooth movement (OTM) in a region containing alveolar bone defects with insufficient height and width is hard to achieve. Bovine bone mineral (Bio-Oss) is available to restore the alveolar defect; however, whether the region augmented with a bovine bone mineral graft (BG) is feasible for OTM, and the mechanisms by which macrophages remodel the BG material, is uncertain under the mechanical force induced by OTM. MATERIAL AND METHODS: Rats were divided into three groups: OTM (O), OTM + BG material (O + B), and Control (C). First molars were extracted to create bone defects in the O and O + B groups with bovine bone mineral grafting in the latter. Second molars received OTM towards the bone defects in both groups. After 28 days, maxillae were analyzed using microfocus-computed tomography (µCT) and scanning-electron-microscopy (SEM); and macrophages (M1/M2) were stained using immunofluorescence. THP-1 cell-induced macrophages were cultured under mechanical force (F), BG material (B), or both (F + B). Phagocytosis-related signaling molecules (cAMP/PKA/RAC1) were analyzed, and conditioned media was analyzed for MMP-9 and cytokines (IL-1ß, IL-4). RESULTS: Our study demonstrated that alveolar defects grafted with BG materials are feasible for OTM, with significantly increased OTM distance, bone volume, and trabecular thickness in this region. SEM observation revealed that the grafts served as a scaffold for cells to migrate and remodel the BG materials in the defect during OTM. Moreover, the population of M2 macrophages increased markedly both in vivo and in cell culture, with enhanced phagocytosis via the cAMP/PKA/RAC1 pathway in response to mechanical force in combination with BG particles. By contrast, M1 macrophage populations were decreased under the same circumstances. In addition, M2 macrophage polarization was also indicated by elevated IL-4 levels, reduced IL-1ß levels, and less active MMP-9 in cell culture. CONCLUSION: This study explored the mechanisms of mechanical force-induced alveolar bone remodeling with bovine bone mineral grafts during OTM. The results might provide molecular insights into the related clinical problems of whether we can move teeth into the grafted materials; and how these materials become biologically remodeled and degraded under mechanical force.

Treatment of a severe transverse dental arch discrepancy assisted by 3-dimensional planning.

This report describes the treatment of a 16-year-old girl with a severe transverse dental arch discrepancy resulting from a mildly constricted maxillary arch and an overexpanded mandibular arch. The patient had a Class I skeletal relationship, a high mandibular plane angle, a Class III molar relationship, bilateral posterior crossbites, and deviated midlines. A 3-dimensional digital setup was used to assist treatment planning. The digital setup allowed us to evaluate multiple treatment options before deciding on the most suitable one for the patient. The final treatment protocol consisted of extraction of upper second premolars and lower first molars due to enamel hypoplasia. Starting with the leveling and alignment stage of treatment, the maxillary archwires were expanded and the mandibular wires were constricted to correct the transverse discrepancy. An auxiliary expansion arch was used to achieve overcorrection. The active treatment period was 24 months. Proper overbite and overjet, facial balance, and good occlusion were achieved.

Validation of the American Board of Orthodontics Objective Grading System for assessing the treatment outcomes of Chinese patients.

INTRODUCTION: Orthodontics in China has developed rapidly, but there is no standard index of treatment outcomes. We assessed the validity of the American Board of Orthodontics Objective Grading System (ABO-OGS) for the classification of treatment outcomes in Chinese patients. METHODS: We randomly selected 108 patients who completed treatment between July 2005 and September 2008 in 6 orthodontic treatment centers across China. Sixty-nine experienced Chinese orthodontists made subjective assessments of the end-of-treatment casts for each patient. Three examiners then used the ABO-OGS to measure the casts. Pearson correlation analysis and receiver operating characteristic curve analysis were conducted to evaluate the correspondence between the ABO-OGS cast measurements and the orthodontists' subjective assessments. RESULTS: The average subjective grading scores were highly correlated with the ABO-OGS scores (r = 0.7042). Four of the 7 study cast components of the ABO-OGS score-occlusal relationship, overjet, interproximal contact, and alignment-were statistically significantly correlated with the judges' subjective assessments. Together, these 4 accounted for 58% of the variability in the average subjective grading scores. The ABO-OGS cutoff score for cases that the judges deemed satisfactory was 16 points; the corresponding cutoff score for cases that the judges considered acceptable was 21 points. CONCLUSIONS: The ABO-OGS is a valid index for the assessment of treatment outcomes in Chinese patients. By comparing the objective scores on this modification of the ABO-OGS with the mean subjective assessment of a panel of highly qualified Chinese orthodontists, a cutoff point for satisfactory treatment outcome was defined as 16 points or fewer, with scores of 16 to 21 points denoting less than satisfactory but still acceptable treatment. Cases that scored greater than 21 points were considered unacceptable.

[Evaluation of craniofacial asymmetry based on cone-beam CT image].

Cone-beam CT (CBCT) was developed for the three-dimensional (3D) imaging of the maxillofacial area and has become popular in dentistry, orthodontics, and maxillofacial surgery. The advantages of CBCT include less radiation exposure (than conventional CT), less artifacts, and submillimeter spatial resolution. CBCT has been shown to produce accurate 3D images of the craniofacial region and a 1-to-1 image-to-reality ratio, which has greatly reduced errors of frontal cephalometry and improved our ability to diagnose asymmetry. Several new analyses to diagnose asymmetries on 3D images described in recent literature were reviewed, including 3D linear and angular measurements, mirror-image analysis (superimposition of the mirror image of the anatomically correct part of the anatomy over the deformity), 3D cephalometric analysis based on constructing an individual coordinate system for each facial unit or element (local coordinate systems) to differentiate them from the world coordinate system (whole head orientation), and method of application of asymmetry indices.

CAR-T Cells in the Treatment of Ovarian Cancer: A Promising Cell Therapy.

Ovarian cancer (OC) is among the most common gynecologic malignancies with a poor prognosis and a high mortality rate. Most patients are diagnosed at an advanced stage (stage III or IV), with 5-year survival rates ranging from 25% to 47% worldwide. Surgical resection and first-line chemotherapy are the main treatment modalities for OC. However, patients usually relapse within a few years of initial treatment due to resistance to chemotherapy. Cell-based therapies, particularly adoptive T-cell therapy and chimeric antigen receptor T (CAR-T) cell therapy, represent an alternative immunotherapy approach with great potential for hematologic malignancies. However, the use of CAR-T-cell therapy for the treatment of OC is still associated with several difficulties. In this review, we comprehensively discuss recent innovations in CAR-T-cell engineering to improve clinical efficacy, as well as strategies to overcome the limitations of CAR-T-cell therapy in OC.

A novel modified-curcumin 2.24 resolves inflammation by promoting M2 macrophage polarization.

To assess resolving-like activity by a novel chemically-modified curcumin (CMC2.24) in a "two-hit" model of diabetes-associated periodontitis. Macrophages from rats were cultured in the presence/absence of either Lipopolysaccharide (LPS, 1st hit); or advanced-glycation-end products (AGE, 2nd hit); or both combined. CMC2.24 was added as treatment. The conditioned media were analyzed for MMP-9, cytokines (IL-1ß, IL-6, TNF-α), resolvins (RvD1, RvE1, lipoxin A4), and soluble receptor for AGE (sRAGE). The phenotypes of M1/M2 macrophage were analyzed by flow cytometry. Both LPS/AGE-alone, and two-combined, dramatically increased the secretion of MMP-9 by macrophages. CMC2.24 "normalized" the elevated levels of MMP-9 under all conditions. Moreover, CMC2.24 significantly reduced the secretion of IL-1ß and IL-6 with a fewer effects on TNF-α. Importantly, CMC2.24 increased RvD1 and sRAGE secretion by macrophages exposed to LPS/AGE; and both treatment groups exhibited increased M2 relative to M1 populations. Furthermore, scatter-diagram showed the macrophages gradually shifted from M1 towards M2 with CMC2.24-treated, whereas LPS/AGE-alone groups remained unchanged. CMC2.24 "normalized" cytokines and MMP-9, but also enhanced RvD1 and sRAGE in macrophages. Crucially, CMC2.24 appears to be a potent inhibitor of the pro-inflammatory M1 phenotype; and a promotor of the pro-resolving M2 phenotype, thus acting like a crucial "switch" to reduce inflammation.

[Agreement analysis of subjective evaluation of orthodontic treatment outcome].

OBJECTIVE: To investigate the agreement of subjective evaluation of orthodontic treatment outcome and to analyze possible factors that may be related to it. METHODS: As a randomized clinical trial, with Angle's classification as a stratification factor, our study contained 48 cases with integrity data, which were randomly extracted from 806 orthodontic treatment cases in Peking University School and Hospital of Stomatology during July 2004 and August 2008, and gathered post-treatment study casts, cephalometrics and photographs of the 48 cases as the research subjects. Similarly with Angle's classification as a stratification factor, the 48 cases were randomly divided into 4 groups. According to the monomial and combined subjects, 12 clinicians were asked to act as the raters to rank the 12 cases in each group. RESULTS: Overall, there were 1 584 pairings between the raters in the examination of evaluation. The mean Spearman r was 0.565 3 ± 0.239 9. Grouping factor was related to the agreement of subjective evaluation (P<0.05). In the third trial item-Post-M+P, the correlations were the greatest among the judge-pairs (P<0.001). The other five items were at the same agreement level. The level of orthodontic treatment outcome was a factor that influenced the agreement level of subjective evaluation (P<0.05). The score stability of the patients, whose treatment duration was longer than 2.5 years, was significantly higher than that of the patients whose treatment duration was between 1.5 years and 2.5 years (P<0.05). The following factors, such as Angle's classification, age of patients and whether the teeth was extracted or not, were the insignificant factors (P>0.05). CONCLUSION: The average correlations present a moderate agreement level. Grouping, experimental item, the length of treatment duration and the level of orthodontic treatment outcome are the factors that affect the agreement of subjective evaluation. Several factors including Angle's classification, age of patients and whether the teeth is extracted or not, do not affect the agreement of subjective evaluation.

[Consistency of the subjective evaluation of malocclusion severity by the Chinese orthodontic experts].

OBJECTIVE: To assess the consistency of the subjective evaluation of malocclusion severity by the Chinese orthodontic experts. METHODS: Sixty-nine Chinese orthodontic experts subjectively evaluated the malocclusion severity for 120 cases which were selected randomly from 6 University orthodontic clinics by checking each case's pretreatment records including study cast, lateral head film, panoramic radiograph, facial photographs and patient chart. Each orthodontist was asked to independently rate the severity of every case into five grades: mild, mildly moderate, moderate, severely moderate and severe. Rating data was finally gathered to evaluate the intra-judge's reliability and the inter-judges' consistency. RESULTS: Weighted Kappa test revealed that 8.33% orthodontists showed excellent intra-judge's reliability (Kappa ≥ 0.81), 78.33% orthodontists showed good intra-judge's reliability (Kappa ≥ 0.61) and 96.67% specialists displayed general intra-judge's reliability (Kappa ≥ 0.41). And intra-class correlation coefficient demonstrated a high level of inter-judges' consistency (r=0.989, P<0.01). CONCLUSION: Good intra-judge's reliability and inter-judges' consistency can be demonstrated in the subjective evaluation of malocclusion severity by the Chinese orthodontic experts, which could the basis for establishing the objective grading system of malocclusion severity.

Potential clinical implications of iron metabolism in ovarian endometriosis.

OBJECTIVE: The purpose of this study was to investigate iron metabolism indices in ovarian endometriosis (OEMs) and to demonstrate the potential clinical implications in the initiation and development of OEMs. METHODS: Three datasets in Gene Expression Omnibus (GEO) database were selected to assess the expression levels of iron metabolites in endometrial tissues from patients with EMs and the health. To evaluate the differential expression of serum iron indices , hospitalized patients with OEMs and health examinees in Jilin University Second Hospital from November 2018 to December 2019 were recruited. Serum samples were obtained from 38 patients with OEMs and 36 health examinees. To compare the iron metabolism between peripheral circulation blood and local ectopic lesion, cyst fluid samples were obtained from 15 patients with ovarian chocolate cyst at the time of surgery. Iron metabolism indices include iron, transferrin (TF), ferritin, and unsaturated iron-binding capacity (UIBC)), which were measured by automatic biochemical analyzer. RESULTS: The present study indicated the increased levels of the iron storage protein, ferritin, in the endometriotic tissues of patients with EMs. The expression of iron and ferritin in cyst fluid of patients with OEMs showed higher than that in serum, the results of TF and UIBC were opposite (P < 0.05). There was no statistical difference in the content of iron metabolites between patients with OEMs and the healthy examinees(P > 0.05). CONCLUSION: The ovarian chocolate cyst fluid and endometriotic tissues in patients with OEMs could more directly reflect the pathological changes of local ectopic lesion, which usually manifested as high levels of free iron and/or iron deposits in the ectopic sites. The implications of our work suggest iron metabolites in the serum may have potentially limited value as circulating biomarkers for OEMs. The iron variation in local lesions may be not only regulated by liver that mainly manipulate the systematic iron homeostasis, but also be tuned by the iron regulatory protein (IRP)/ iron responsive element (IRE) system. In summary, the iron metabolites, especially the iron and ferritin in the cyst fluid and endometriotic tissues, are meaningful biomarkers involved in the process of pathophysiology and pathogenesis of OEMs.