[Comfortable initial periodontal therapy: step by step].

With the transition of the medical model from the traditional biomedical model to the biopsychosocial one, there is a growing trend and requirement for oral operations that prioritize comfort, pain management, minimally invasive techniques, and visualization. Consequently, demands for comfortable dental treatments among individuals are increasing. However, initial periodontal therapy is often accompanied by pain, and patients' reactions to pain range from nervousness to dental fear, such as irritability, hyperventilation, even nausea, vomiting, and refusal to cooperate, which make the implementation of initial periodontal therapy difficult or even impossible. This article will focus on three key steps: firstly, the preparation of the clinic, the acquisition of patients' trust and the implementation of preventive sedation before treatment; secondly, the use of comfort operation and nursing, psychological intervention measures, local anesthesia, and sedation techniques during treatment; thirdly, the health education and follow-up after treatment. By addressing these aspects, we aim to clarify how to perform comfortable initial periodontal therapy step by step.

[Advances in the periodontal surgical flaps techniques to preserve gingival papilla].

Papilla preservation in periodontal surgery is not only beneficial to maintain postoperative aesthetics and good oral hygiene but also contributes to obtaining good periodontal regeneration outcomes. Various periodontal flaps have been designed to preserve the gingival papilla, which constitutes the clinical basis for periodontal open flap debridement and periodontal regeneration surgery. A comprehensive understanding of their design purpose, indications, and technical key points will help clinicians to choose the optimal surgical plan, and thus improve the clinician's treatment levels, and obtain good clinical outcomes. Therefore, this article aims to introduce the design background, indications, and technical key points of various surgical flaps, such as papilla preservation technique, modified papilla preservation technique, simplified papilla preservation flap, etc.

[Introduction and interpretation of the European Federation of Periodontology S3 level clinical practice guideline for treatment of periodontitis].

2018 international classification of periodontal and implant diseases relates the classifications with the approaches of prevention and treatment based on the stages and grades of disease. European Federation of Periodontology (EFP) evaluated the available evidences following the methodological guidance of the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE), and published the EFP S3 level clinical practice guideline for the treatment of stage Ⅰ-Ⅲ and Ⅳ periodontitis in 2020 and 2022, respectively. The present manuscript gives introduction and interpretation based on the EFP S3 level clinical practice guideline and Chinese national conditions. On the base of the diagnostic key points of staging and grading, it introduces in detail the step treatment procedures of stageⅠ-Ⅲ periodontitis as well as the multi-disciplinary treatment procedures of stage Ⅳ periodontitis, compares the similarities and differences between the step and phase procedures, and then proposes a strategy for determining the recall interval more suitable for Chinese clinicians. The present manuscript aims to help dentists to learn and grasp the key points more quickly and accurately on the clinical application of the guideline and to assist them in making the optimal treatment plans after judging and evaluating the specific clinical circumstances, so as to maximize the chances of favorable outcome.

Effects of dezocine combined with dexmedetomidine on adverse reactions and inflammatory factors in patients undergoing HIPEC after intestinal surgery and its protective effect on the heart in the perioperative period.

OBJECTIVE: The aim of this study was to explore the effects of dezocine combined with dexmedetomidine on adverse reactions and inflammatory factors in patients undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) after intestinal surgery and its protective effect on the heart in the perioperative period. PATIENTS AND METHODS: A total of 80 patients treated with HIPEC after intestinal surgery in our hospital from September 2018 to December 2019 were enrolled as research subjects. All patients were evenly divided into two groups using a random number table. As to analgesia and sedation during treatment, dezocine was injected intramuscularly at 30 min before treatment in the control group. Meanwhile, dezocine combined with dexmedetomidine was given in the same way in the observation group. Adverse reactions and changes in numeric rating scale (NRS) pain score during intervention were compared between the two groups. The changes in the levels of inflammatory and myocardial injury-related factors, and vascular endothelial function and regeneration ability among cardiovascular indicators at 12 h after intervention were compared as well. Additionally, the correlations of left ventricular mass index (LVMI) with the changes in the levels of inflammatory factor high-sensitivity C-reactive protein (hs-CRP), myocardial injury-related factor lactic dehydrogenase (LDH), vascular endothelial function indicator endothelin-1 (ET-1) and cardiovascular regeneration ability index vascular endothelial growth factor (VEGF) were analyzed. RESULTS: Compared with control group, the total prevalence rate of severe pain, respiratory depression, nausea and vomiting, diarrhea, and muscle rigidity during intervention was significantly reduced in the observation group (p<0.05). NRS pain score at 1, 4, 8 and 12 h after intervention decreased remarkably in the observation group compared with the control group (p<0.05). Meanwhile, the levels of inflammatory factors tumor necrosis factor-α (TNF-α) and hs-CRP, and myocardial injury-related factors LDH and creatine kinase MB (CKMB) as well as ET-1 at 12 h after intervention declined remarkably in observation group compared with control group (p<0.05). However, the levels of nitric oxide (NO), VEGF and basic fibroblast growth factor (bFGF) rose significantly in the observation group (p<0.05). Besides, LVMI was positively correlated with hs-CRP and LDH, whereas was negatively associated with ET-1 and VEGF (p<0.05). CONCLUSIONS: In HIPEC, dezocine combined with dexmedetomidine used for sedation and analgesia is able to effectively reduce adverse reactions and relieve inflammatory responses in vivo, exerting a cardio-protective effect.

[Research advances in the interaction of periodontitis and psoriasis].

Periodontitis is a common chronic infectious oral disease, which is characterized by gingival inflammation,pocket formation, alveolar bone loss and tooth mobility. Psoriasis is a common chronic inflammatory skin disease, whose pathological features in skin lesions are excessive proliferation of epidermal cells, parakeratosis of the derma, and the infiltration of inflammatory cells. Both periodontitis and psoriasis are closely related to the interleukin(IL)-23/helper T cell 17(Th17)/IL-17 axis in their immunopathological mechanisms. The risk factors of psoriasis include smoking, vitamin D deficiency, obesity, emotional stress, etc, of which most factors are also common risk factors of periodontitis. The present article reviews the research advances in the interaction of the two diseases and their possible common mechanisms from three aspects, i.e. clinical study, IL-23/Th17/IL-17 pathway and common risk factors, which may be helpful to provide new ideas for clinical diagnosis and treatment.

[Relationship between interleukin-8 levels in expressed prostatic secretion and expressions of bFGF and Bcl-2 in benign prostatic hyperplasia].

OBJECTIVES: To investigate the relationship between interleukin-8 levels in expressed prostatic secretion and expressions of basic fibroblast growth factor (bFGF) and Bcl-2 in benign prostatic hyperplasia (BPH). METHODS: A series of 50 consecutive patients diagnosed with BPH and scheduled for transurethral resection of the prostate (TURP) were included. Patients were divided into two groups, simple BPH and BPH with chronic prostatitis (CP). The grade of inflammatory changes in the prostate was then determined blindly by two experienced pathologists, according to the classification system. Expressed prostatic secretion (EPS) was collected right before TURP for IL-8 detection using ELISA kits. The resected prostatic tissue was harvested for immunohistochemistry to measure the expression of Bcl-2 and bFGF. RESULTS: A total of 30 (60%) patients were confirmed to have prostatic histologic inflammation. The volume of the prostate in BPH with CP was obviously larger than that in simple BPH (P=0.022). The NIH chronic prostatitis symptom index (NIH-CPSI) and international prostate symptom score (IPSS) of BPH with CP were both higher than those of simple BPH (P<0.05). Significantly increased levels of IL-8 were observed in EPS obtained from BPH patients with CP (mean level, 43.29 ng/L), compared with patients with simple BPH (mean level, 36.90 ng/L) (P=0.003). The expression of Bcl-2 in BPH with CP (mean level, 6.17) increased significantly, compared with those in simple BPH (mean level, 2.45) (P=0.013). The expression of bFGF in BPH with CP (mean level, 7.57) also obviously elevated, compared with those in simple BPH (mean level, 5.05) (P=0.008). Correlation coefficients of IL-8 levels in EPS and expression of Bcl-2 or bFGF indicated that IL-8 had strong correlation with Bcl-2 and bFGF respectively both in simple BPH and BPH with CP (0

Mitochondrial DNA haplogroups and somatic mutations are associated with lung cancer in patients from Southwest China.

Mitochondrial DNA mutations play crucial roles in the pathogenesis and progression of human malignancies. Therefore, to determine whether maternal background or mitochondrial DNA somatic mutations were essential cofactors in the lung cancer of Chinese patients as well, the complete mitochondrial DNA displacement loop of the primary cancerous, matched para-cancerous normal and distant normal tissues for 79 Chinese patients with lung cancer were analyzed in this study. Our results indicated that the higher detected frequency of haplogroups prevalent in southern East Asia (53.16%; 42/79) versus those of northern East Asia in the studied population supported the southern East Asian characteristics of the Chinese lung cancer group. Further statistical analysis revealed that the haplogroups F* and G* contributed to the susceptibility to lung cancer in Chinese patients. In addition, by comparing sequences from different tissues of the same patients, a total of eight somatic mutations from six patients were detected. Combined with the fourteen somatic mutations identified in our previous study, the somatic mutation spectrum of the 79 Chinese patients with lung cancer was 25.32% (20/79). Our results suggest that mitochondrial DNA haplogroups and somatic mutations are associated with lung cancer in patients from Yunnan, Southwest China, and that somatic mitochondrial DNA mutations in the displacement loop can serve as potential biomarkers for clinical utility.

General/epidural anesthesia in combination preserves NK cell activity and affects cytokine response in cervical carcinoma patients undergoing radical resection: a cohort prospective study.

OBJECTIVE: Emerging evidence has shown that epidural anesthesia may help to preserve the body's defenses against tumor progression in comparison with general anesthesia in malignant patients receiving operation. This study aims to evaluate the effect of epidural anesthesia on postoperative immune suppression in cervical carcinoma patients undergoing radical resection. MATERIALS AND METHODS: Eighty five cervical carcinoma patients receiving radical resection were randomized to combined general/epidural anesthesia (study group) or general anesthesia alone (control group). Natural killer (NK) cell activity and serum concentrations of protumorigenic cytokines (IL-1ß, IL-6, and 1L-8) and antitumorigenic cytokines (IL-2 and IFN-γ) were measured before anesthesia (T1), four hours after skin incision (T2), and 24 hours after skin incision (T3) in both groups. RESULTS: No difference was observed in basal NK cell activity and cytokine concen- trations between study and control groups. The study group exhibited less suppression of NK cell activity, higher levels of IL-2 and IFN-γ, and lower levels of IL-1ß, IL-6, and IL-8 at T2 and T3 compared with the control group. CONCLUSIONS: Combined general/epidural anesthesia seems to be helpful to maintain the body's perioperative immune function compared to general anesthesia alone in cervical carcinoma patients receiving operation.

Local and bulk melting of shocked columnar nanocrystalline Cu: Dynamics, anisotropy, premelting, superheating, supercooling, and re-crystallization.

We perform large-scale molecular dynamics simulations to study shock-induced melting transition of idealized hexagonal columnar nanocrystalline Cu. The as-constructed nanocrystalline Cu consists of unrotated (reference) and rotated columnar crystals, relative to the columnar axis. Shock loading is applied along three principal directions of the columnar Cu: two transverse (zigzag and armchair) and one longitudinal directions. Dynamic local melting processes are highly anisotropic with respect to the shock directions. For the transverse directions, hotspot effect and disparate dynamic responses of grains with different orientations may lead to partial or complete premelting of the initially rotated grains, which in turn leads to transient supercooling and heterogeneous recrystallization, and thus, the formation of nanocrystalline solids with modified grain structures or solid-liquid mixtures, depending on the extent of supercooling. With increasing shock strengths, the reference grains melt heterogeneously at interfaces and homogeneously inside. Conversely, "bulk" premelting of the rotated grains is absent for the longitudinal direction, except for grain boundary melting. The progression of recrystallization or heterogenous melting diminishes and eventually eliminates the transient premelting or superheating of the system via latent heat and thermal diffusion. Premelting or superheating appears unlikely for bulk melting or well-defined Hugoniot states, if the thermal and mechanical equilibria are achieved, and the thermodynamic melting curve coincides with the partial melting Hugoniot states of a polycrystalline solid.

Microscopic dynamics of structural transition in iron with a nanovoid under shock loading.

The shock-induced bcc (body-centered cubic) to hcp (hexagonal-closed packing) transition in iron containing a nanovoid was investigated by molecular dynamics simulations with a shock-front absorbing boundary condition. The results demonstrate the transition time induced by a nanovoid reduces exponentially with increasing shock pressure, which indicates a similar law to the recent experimental observations. Micromorphology evolution of hcp nuclei is presented by the atomic centrosymmetry parameter. A flaky growth pattern along the {111} planes is observed, while the system finally forms into a laminar structure along the {110} planes. Furthermore, the atomic mechanical path through the transition is analyzed in detail. It is found that the transformed atoms do cross a shear pressure barrier and then show an over-relaxation of pressure, while their potential increases to a much higher value than bcc atoms.

Nucleation of hcp and fcc phases in bcc iron under uniform compression: classical molecular dynamics simulations.

By classical molecular dynamics simulations employing an embedded atom method potential, we have simulated the bcc to hcp/fcc structural transition in single-crystal iron under uniform compression. Results showed that the transition pressure is different from uniaxial compression and shock loading. The transformation occurs on a picosecond timescale and the transition time decreases along with the increase of pressure. The nucleation and growth of the hcp and fcc phases under constant pressure and temperature are analyzed in detail. The nucleation planes, all belonging to the {110}(bcc) family and parallel to the three compression directions [100], [010], and [001], have been observed. About 20% bcc atoms have transformed to fcc phase under pressure just over the critical point, and under higher pressure the fraction of the fcc phase increases steadily to exceed that of the hcp phase. We have investigated the transition mechanism of iron from initial bcc to hcp/fcc and found that the transition mainly consists of compression, rotation, and shuffle.

Dynamic properties of structural transition in iron under uniaxial compression.

By using molecular dynamics simulations, we have successfully simulated the bcc [Formula: see text] hcp structural transition in single-crystal iron under isothermal compression along the [001] direction. The results reveal a distinct softening of C(33) and a hardening of C(31) (or C(32)) prior to the transition and an over-relaxation of the stress after transition. Above the critical stress the morphology evolution of structural transition is analyzed, which can be divided into four stages: hcp homogeneously nucleated, columnar grains formed, nuclei competed and merged, and a laminar structure formed along {110} planes. Besides, our simulations demonstrate that in mixed phases the hcp phase has negative shear stress and the potential of the hcp phase is higher than the bcc phase, and the shear stress of the system keeps a linear decrease with hcp mass fraction. The effect of temperature on the structural transition is also discussed.

Molecular dynamics simulations of hcp/fcc nucleation and growth in bcc iron driven by uniaxial compression.

Molecular dynamics simulations have been performed to study the structural transition in bcc iron under uniaxial strain loading. We found that the transition pressures are less dependent on the crystal orientations, ∼14 GPa for [001], [011], and [111] loadings. However, the pressure interval of a mixed phase for [011] loading is much shorter than loading along other orientations. In addition, the temperature increased amplitude for [001] loading is evidently lower than other orientations. The nucleation and growth of the hcp/fcc phases, and their crystal orientation dependence, were analyzed in detail, where the atom structure was presented by the topological medium-range-order analysis. For [001] compression, the hcp structure occurs first and grows into a laminar morphology in the (011)(bcc) plane with some fcc atoms as an intermediate structure. For loading along [011] and [111] directions, both hcp and fcc structure nucleation and growth along the {110}(bcc) planes are observed; their morphology is also discussed.

[A method of cephalometric analysis].

In this paper, 220 children ranging from age 11 to 15 were selected. Each of them received a cephalometric roentgenographic examination. 153 cephalometric items from 13 types of methods which had been widely in use were studied through statistic analysis. By means of "t" test, several items which expressed little difference between the normal occlusion and the malocclusion were eliminated. By using of the cluster analysis we selected one item to represent the items which were with similar effect. Finally, 17 cephalometric items were pick out to provide references for clinical work.