Bionic design,preparation and clinical translation of oral hard tissue restorative materials / 北京大学学报(医学版)

Oral diseases concern almost every individual and are a serious health risk to the popula-tion.The restorative treatment of tooth and jaw defects is an important means to achieve oral function and support the appearance of the contour.Based on the principle of"learning from the nature",Deng Xu-liang's group of Peking University School and Hospital of Stomatology has proposed a new concept of"microstructural biomimetic design and tissue adaptation of tooth/jaw materials"to address the worldwide problems of difficulty in treating dentine hypersensitivity,poor prognosis of restoration of tooth defects,and vertical bone augmentation of alveolar bone after tooth loss.The group has broken through the bottle-neck of multi-stage biomimetic technology from the design of microscopic features to the enhancement of macroscopic effects,and invented key technologies such as crystalline/amorphous multi-level assembly,ion-transportation blocking,and multi-physical properties of the micro-environment reconstruction,etc.The group also pioneered the cationic-hydrogel desensitizer,digital stump and core integrated restora-tions,and developed new crown and bridge restorative materials,gradient functionalisation guided tissue regeneration membrane,and electrically responsive alveolar bone augmentation restorative membranes,etc.These products have established new clinical strategies for tooth/jaw defect repair and achieved inno-vative results.In conclusion,the research results of our group have strongly supported the theoretical im-provement of stomatology,developed the technical system of oral hard tissue restoration,innovated the clinical treatment strategy,and led the progress of the stomatology industry.

Application of expanded polytetrafluoroethylene support combined with ear cartilage in rhinoplasty / 中华医学美学美容杂志

Objective:To explore the application of expanded polytetrafluoroethylene (ePTFE) as the main support combined with a small amount of ear cartilage in rhinoplasty.Methods:Through a nasal opening approach, the ePTFE was used as a support implant for the nasal dorsum and columella, and unilateral concha cartilage was used as a nasal tip modification graft.Results:This method was applied in 56 cases of rhinoplasty (36 cases of initial nose, 20 cases of silicone augmentation rhinoplasty). The wounds of 55 patients healed at one stage without complications, with satisfactory results (average follow-up of 6 months). In one case, nasal mucosa was damaged early after surgery, and the ePTFE was partially exposed, which healed after debridement and suture.Conclusions:For most primary rhinoplasty and simple repair of the nose, using ePTFE as the main support combined with a small amount of ear cartilage, has the advantages of fewer materials, rapid surgery, mild trauma, and stable postoperative results.

Off-label use of chloroquine, hydroxychloroquine, azithromycin and lopinavir/ritonavir in COVID-19 risks prolonging the QT interval by targeting the hERG channel.

Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses an enormous challenge to the medical system, especially the lack of safe and effective COVID-19 treatment methods, forcing people to look for drugs that may have therapeutic effects as soon as possible. Some old drugs have shown clinical benefits after a few small clinical trials that attracted great attention. Clinically, however, many drugs, including those currently used in COVID-19, such as chloroquine, hydroxychloroquine, azithromycin, and lopinavir/ritonavir, may cause cardiotoxicity by acting on cardiac potassium channels, especially hERG channel through their off-target effects. The blocking of the hERG channel prolongs QT intervals on electrocardiograms; thus, it might induce severe ventricular arrhythmias and even sudden cardiac death. Therefore, while focusing on the efficacy of COVID-19 drugs, the fact that they block hERG channels to cause arrhythmias cannot be ignored. To develop safer and more effective drugs, it is necessary to understand the interactions between drugs and the hERG channel and the molecular mechanism behind this high affinity. In this review, we focus on the biochemical and molecular mechanistic aspects of drug-related blockade of the hERG channel to provide insights into QT prolongation caused by off-label use of related drugs in COVID-19, and hope to weigh the risks and benefits when using these drugs.

Clinical application of cone-beam computed tomography in sialolithiasis diagnosis / 中华口腔医学杂志

Diagnosis of sialolithiasis usually needs the combination of clinical and imaging-based examination. The use of cone-beam computed tomography (CBCT) in patients with sialolithiasis has been increasing in dental practice in recent years. CBCT has some advantages in the diagnosis and treatment of sialolithiasis. However, CBCT should not be considered as the first choice for the diagnosis and treatment of sialolithiasis, and it is suitable to be used in the case of complex sialolithiasis which can not be diagnosed by traditional imaging methods. The research progress of the use of CBCT in the diagnosis of sialolithiasis is reviewed.

Clinical efficacy of plastic surgery and wound healing to repair the wounds of chest wall tuberculosis / 中华医学美学美容杂志

Objective To treat complex wounds of the chest wall tuberculosis by the use of wound healing techniques (focal debridement + the VSD) and joint plastic surgery (transfer of skin flap, skin graft, flap stuffing, etc) and to explore the clinical features of the tuberculous chest wound, the feasibility and effectiveness of treatments.Methods Clinical data of 11 hospitalized patients with chest wall tuberculosis were collected during 2012-2014.The therapeutic effect, intraoperative and postoperative complications, and postoperative follow-up were retrospectively analyzed.Results Among 7 cases using lesion debridement, VSD suction drainage and local flap repair (skin grafting), 6 cases were cured.The response rate was 90.9%.All 4 cases using debridement and local flap repair (skin grafting) were cured.Only one case of recurrence was observed during the follow-up period of 3-34 months.Conclusions Using of wound healing techniques with plastic surgery is an effective treatment, which has good therapeutic effect on the wound deeply infiltrated.

Clinical application of surgical intervention model for repairing tuberculosis wound with sinus tract / 中华烧伤杂志

<p><b>OBJECTIVE</b>To retrospectively explore the effectiveness of surgical intervention model for repairing the tuberculosis wound with sinus tract.</p><p><b>METHODS</b>Forty-three patients with tuberculosis wound with sinus tract who met the inclusion criteria were admitted to the 309th Hospital of PLA from January 2010 to October 2015. These patients were divided into test group (n=38) and control group (n=5) according to the different treatment and patient's consent. Patients in test group were treated as follows. Firstly, antituberculosis drugs were taken orally for at least 3 weeks, and the wounds were accurately assessed using magnetic resonance imaging combined with 3-dimensional reconstruction software. Then sinus tract and its surrounding devitalized tissue were completely excised, and vacuum sealing drainage (VSD) treatment with negative pressure value of -26.6 kPa was performed for 1 to 2 weeks (dressing change was performed per 7 days). Lastly, the wounds were covered through direct suture or grafting skin or flap. Patients in control group were firstly given antituberculosis drugs orally for at least 3 weeks, and then they were treated with routine dressing change in outpatient service every 3 days. After the former therapy, patients in both groups were given antituberculosis drugs by oral administration for at least 6 months and were followed up for 6 to 36 months. Detection of Bacillus tuberculosis, Acid-fast bacilli, and tuberculosis granuloma, wound healing time, and relapse of tuberculosis wound in patients of both groups were recorded. The rates of single sinus tract, two sinus tracts, and more than or equal to 3 sinus tracts of patients in test group were recorded. Data were processed with Fisher's exact test and Wilcoxon rank-sum test.</p><p><b>RESULTS</b>Bacillus tuberculosis was respectively detected in wounds of 5 patients in test group and 2 patients in control group. Acid-fast bacilli were positively expressed in wounds of 8 patients in test group and 3 patients in control group. A typical tuberculosis granuloma phenomenon was observed in the wounds of 27 patients in test group and 4 patients in control group. These differences in above-mentioned 3 indexes between two groups were not statistically significant (with P values respectively 0.238 4, 0.154 4, 1.000 0). The median of wound healing time of patients in test group was 19.6 d, which was significantly shorter than that in control group (94.4 d, χ(2)=12.986 0, P=0.000 3). There were 2 and 1 patients with recurrent tuberculosis wound in test group and control group respectively, without statistically significant difference (P=0.363 0). Among patients in test group, the rate of single sinus tract was 23.7%(9/38), the rate of two sinus tracts was 28.9%(11/38), and the rate of more than or equal to 3 sinus tracts was 47.4% (18/38).</p><p><b>CONCLUSIONS</b>Repairing the tuberculosis wound with sinus tract in surgical intervention model of antituberculosis therapy+ accurate wound assessment+ debridement+ VSD treatment+ surgical repair is beneficial to making the optimal operation plan under the premise of knowing location of sinus tract, which can reduce surgical risk.</p>

Effect of sepsis on vecuronium-induced inhibition of acetylcholine release in neuromuscular junction in rats / 中华麻醉学杂志

Objective To investigate the effect of sepsis on vecuronium-induced inhibition of acetylcholine release in neuromuscular junction in rats.Methods Thirty-six adult male SPF SpragueDawley rats,aged 2-3 months,weighing 200-220 g,were randomly divided into 3 groups (n=12 each) using a random number table:control group (group C),sham operation group (group S) and sepsis group (group Sep).Sepsis was induced by cecum ligation and puncture (CLP) in rats anesthetized with intraperitoneal chloral hydrate 350 mg/kg.At 12 h after CLP,the sciatic nerve-pretibial muscle was prepared.Vecuronium was added to the culture medium with the final concentration of 0.08 μg/ml,and the sciatic nerve-pretibial muscle was incubated for 15 min.Before and after administration,evoked endplate potentials (EPPs) and miniature endplate potentiais (MEPPs) were recorded by using intracellular microelectrode.EPP/MEPP ratio was calculated.Results Compared to C and S groups,EPPs,MEPPs and EPP/MEPP ratio were significantly increased before and after administration in group Sep.EPPs,MEPPs and EPP/MEPP ratio were significantly lower after administration than before administration in the three groups.Conclusion Sepsis can promote acetylcholine release in neuromuscular junction,thus weakening vecuronium-induced inhibition of acetylcholine release in neuromuscular junction in rats.

Treatment of severe gynecomastia by double-ring supra-medialis pedicle for breast reduction / 中华医学美学美容杂志

Objective To introduce a surgical method for treatment of severe gynecomastia.Methods After designing double rings and ectomizing epidermis between two rings,a supra-medialis derma mammary pedicle of the nipple and areola was formed,most of the gland and fatty tissue was ectomized,the pedicle was fixed with the sarcolemma,and the two rings were sutured together.Resuits There were no severe postoperative complications.Following-up of 9 cases (18 sites) for 6 to 24 months showed symmetrical and satisfactory contour.Conclusions The breast reduction with doublering supra-medialis pedicle can be an effective procedure of severe gynecomastia,in which the supramedialis pedicle can ensure the blood supply of nipple and areola and avoid late mastoptosis.

Clinical study of expander placement through intralesional perpendicular short incisions for fast tissue expansion / 中华医学美学美容杂志

Objective To investigate a expander placement technique for fast tissue expansion. Methods Port-free thin wall expanders with long tube were specially made and tested on 45 cases of patients with skin scar. All expanders were placed subcutanuously through intralesional perpendicular short incisions with injection tube laid out. A large amount of saline was injected to expanders intraoperatively. Three sorts of fast expansion were carried out. Results Under the local tumescent anaesthesia, subcutaneous pockets were all dissected successfully. The amount of bleeding was less and no patient received blood infusion. All of forty five cases completed fast expansion satisfactorily without incision infection and dehiscence. Conclusion The technique of intralesional perpendicular short incisions has the advantages of less invasion and better safety, and suitable for fast tissue expansion.

Influnence of 17-? estradiol and progesterone on synthesis of transforming growth factor beta-1 in hyperplastic scar fibroblasts / 中华医学美学美容杂志

Objective To study the influnence of estrogen and progestin on scar formation. Methods By culturing hyperplastic scar fibroblast(HSFB), we investigated TGF ? 1 synthesis by immunohistochemical staining and image analysis. Results The detectable level of TGF ? 1 in HSFB treated with 17 ? E 2 was higher than that of the control significantly( P 0.05). Conclusion In vitro, 17 ? E 2 can stimulate TGF ? 1 synthesis in HSFB significantly.

Dexamethasone prevents expanding flap in stage two from necrosis / 中华医学美学美容杂志

Objective To find an effective method to prevent expanding flap from necrosis when expanders were removed. Methods After the expanders were removed, dexamethasone (5mg/kg) was injected into vein immeadiately when flaps showed blood flow disturbance, then decreased gradually and stopped until 6 days after operation. Results 33 of 35 patients recovered completely, and other 2 flaps survived mostly. Conclusion Dexamethasone given immeadiately could prevent expanding flap from necrosis.

Application of tissue expansion in repair of scalp avulsion with skull exposure / 中华医学美学美容杂志

Objective To investigate a better method for repair of scalp avulsion with skull exposure.Methods After primary debridement and skin grafting,tissue expanders were placed into subgaleal layer of normal scalp.After enough expansion,expanded scalp flaps were used to repair the skull exposure and the bald deformity.Results All of 6 cases had satisfactory results,wounds were repaired,no bald deformity occurred and no tissue expander infected case was encountered.Conclusion Using this method,we can treat the scalp avulsion with skull exposure without bald deformity.