Morphological Changes of the Temporomandibular Joint and Masseter Muscle After Mandibular Angle Osteotomy.

Mandibular angle osteotomy with outer cortex grinding is an effective cosmetic procedure for correcting square faces. However, morphological changes in the mandible may also cause temporomandibular joint (TMJ) disorders. This retrospective study aimed to investigate the morphological stabilization of the TMJ and changes in masseter muscle thickness after mandibular angle osteotomy to evaluate the safety of the procedure. Data from patients who underwent mandibular angle osteotomy with outer cortex grinding between January 2016 and January 2019 were retrospectively reviewed. Preoperative and long-term follow-up (~1 y) computed tomography data were collected from these patients, and morphological changes in the TMJ and masseter muscle were analyzed. The results from the computed tomography data showed that the condylar length and condylar height were significantly reduced 1 year after the operation (P < 0.05). In addition, the morphology of the TMJ was stable, and the distance between the mandibular condyle and the glenoid fossa did not change significantly. No significant difference was observed in masseter muscle thickness before and after the operation. After mandibular angle osteotomy with outer cortex grinding, the length and height of the mandibular condyle were functionally restored without any disorders of the TMJ. Moreover, the masseter muscle exhibited stable function. In conclusion, the procedure is safe for occlusal function and suitable for popularization.

Prediction of the Postoperative Bone Regeneration Rate After Mandibular Reduction: From the Perspective of Preoperative Inflammatory and Immune Status.

BACKGROUND: Following mandibular reduction, bone regeneration in the angle region is a problem that can affect facial aesthetics and lead to revision surgery. The bone regeneration rate (BRR) varies between individuals and is difficult to predict. However, studies focusing on preoperative patient-related factors are lacking. As bone regeneration is closely related to the inflammatory and immune status of the organism, according to in vitro and in vivo evidence, preoperative inflammatory indicators were included in this study as potential predictors. METHODS: Demographic and preoperative laboratory data were included as independent variables. The BRR calculated from computed tomography data was included as the dependent variable. Univariate analysis and multiple linear regression analysis were used to determine the key factors influencing the BRR. The ROC curves were used to analyse the corresponding predictive efficacy. RESULTS: 23 patients (46 mandibular angles) fulfilled the inclusion criteria. The mean bilateral BRR was 23.82 ± 9.90%. Preoperative monocyte count (M) was an independent positive factor for BRR, and age was a negative factor. Only M had a good predictive ability, and its optimal cut-off point to distinguish patients with BRR greater than 30% was 0.305 × 109/L. Other parameters were not significantly correlated with BRR. CONCLUSIONS: Patient age and preoperative M may influence BRR, with M having a positive effect and age having a negative effect. According to the preoperative blood routine tests that are readily available, using the diagnostic threshold (M [Formula: see text] 0.305 × 109/L) derived from this study, surgeons can better predict BRR and identify patients whose BRR is greater than the mean level. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The osteogenesis effect of rhBMP2-loaded calcium phosphate cements in repairing dental extraction sockets.

PURPOSE: After extracting impacted mandibular third molars (IMM3), the resulting bone loss at the distal surface of the distal root of mandibular second molars (MM2) is responsible for the poor stability of MM2. This study aimed to identify the clinical osteogenesis effect of recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded calcium phosphate cements (CPCs) and rhBMP-2 delivery systems (rhBMP-2/CPCs, named CPCII) on bone loss repair at the distal surface of the MM2 distal root after IMM3 extraction. METHODS: Written informed consent was obtained from every participant whose IMM3 needed extraction. The impact of IMM3 on both sides was basically identical. From April 2014 to March 2016, extraction of IMM3 was performed in 9 patients (5 males/4 females, 26-42 years old). One side was randomly selected as the experimental group, and CPCII systems were implanted into the distal surface of the distal root in dental extraction sockets. The wounds on the other side were sutured and allowed to heal naturally (be treated as the control group). New bone formation in the alveolar fossa was detected 3 and 12 months after the operation by cone-beam computed tomography (CBCT) to measure the distance from the cementoenamel junction (CEJ) to the crest of the alveolar ridge (CAR). RESULTS: The CAR-CEJ distance on the test side was less than that on the control side (P<0.5). CONCLUSION: The quantity of new bone formation in the experimental group was greater than that in the control group. CPCII systems have osteogenic potential in the healing process of tooth extraction sockets.

Relationship Between Masticatory Muscle Size and Bone Regeneration After Mandibular Angle Osteotomy.

ABSTRACT: Mandibular angle osteotomy with outer cortex grinding has become the preferred cosmetic procedure for correcting square faces. After surgery, bone hyperplasia at the mandibular angle affects the operation result. This study evaluated the effect of the masticatory muscles on bone repair. From January 2016 to January 2019, patients who underwent mandibular angle osteotomy with outer cortex grinding were retrospectively reviewed. Computed tomography data of these patients were collected, and the bone volume of the mandibular angle changes and its correlation with masticatory muscle morphology were analyzed. Computed tomography data measurement results showed that a large amount of bone in the mandibular angle area was removed by the operation; however, the long-term follow-up results showed that there was bone hyperplasia in the mandibular angle areas. Compared with the immediate postoperative bone volume, the difference was statistically significant (P < 0.01). The thickness and cross-sectional area of the masseter muscle were significantly related to bone regeneration (P < 0.01). This study suggests that mandibular angle osteotomy with outer cortex grinding could ablate the symptoms of a prominent mandibular angle; however, muscle-related bone hyperplasia in the mandibular angle area after surgery was a non-negligible event, which may significantly compromise surgical outcomes.

Craniofacial and Upper Airway Development in Patients With Treacher Collins Syndrome.

ABSTRACT: This study evaluated age-associated morphology changes in the cranial base, facial development, and upper airway of patients with Treacher Collins syndrome (TCS). A total of 33 preoperative computed tomographic images (TCS, n = 14; control, n = 19) were included in the study and divided into three age-related subgroups (2-6 years, 7-18 years, and older than 18 years). Linear, angular cephalometric measurements and upper airway volumes were collected. All measurements were analyzed using ProPlan CMF software (version 3.0; Materialize, Leuven, Belgium). The association between aging and upper airway morphology was analyzed. Compared to control subjects, TCS patients had a smaller cranial base, maxilla, and nose; they also had reduced upper airway volume compared to control subjects. The observed differences were most significant in patients between the ages of 7 and 18 years. This study used computed tomography-based three-dimensional analyses to provide a detailed description of age-related changes that occur in craniofacial measurements and upper airway volumes in children, adolescents, and young adult patients with TCS in China. These data can be used to evaluate individual patients with TCS and to select treatment to improve the growth of the craniofacial region.

[Experimental study on tissue engineered cartilage constructed by three-dimensional bioprinted human adipose-derived stem cells combined with gelatin methacryloyl].

OBJECTIVE: To explore the feasibility of three-dimensional (3D) bioprinted adipose-derived stem cells (ADSCs) combined with gelatin methacryloyl (GelMA) to construct tissue engineered cartilage. METHODS: Adipose tissue voluntarily donated by liposuction patients was collected to isolate and culture human ADSCs (hADSCs). The third generation cells were mixed with GelMA hydrogel and photoinitiator to make biological ink. The hADSCs-GelMA composite scaffold was prepared by 3D bioprinting technology, and it was observed in general, and observed by scanning electron microscope after cultured for 1 day and chondrogenic induction culture for 14 days. After cultured for 1, 4, and 7 days, the composite scaffolds were taken for live/dead cell staining to observe cell survival rate; and cell counting kit 8 (CCK-8) method was used to detect cell proliferation. The composite scaffold samples cultured in cartilage induction for 14 days were taken as the experimental group, and the composite scaffolds cultured in complete medium for 14 days were used as the control group. Real-time fluorescent quantitative PCR (qRT-PCR) was performed to detect cartilage formation. The relative expression levels of the mRNA of cartilage matrix gene [(aggrecan, ACAN)], chondrogenic regulatory factor (SOX9), cartilage-specific gene [collagen type Ⅱ A1 (COLⅡA1)], and cartilage hypertrophy marker gene [collagen type ⅩA1 (COLⅩA1)] were detected. The 3D bioprinted hADSCs-GelMA composite scaffold (experimental group) and the blank GelMA hydrogel scaffold without cells (control group) cultured for 14 days of chondrogenesis were implanted into the subcutaneous pockets of the back of nude mice respectively, and the materials were taken after 4 weeks, and gross observation, Safranin O staining, Alcian blue staining, and collagen type Ⅱ immunohistochemical staining were performed to observe the cartilage formation in the composite scaffold. RESULTS: Macroscope and scanning electron microscope observations showed that the hADSCs-GelMA composite scaffolds had a stable and regular structure. The cell viability could be maintained at 80%-90% at 1, 4, and 7 days after printing, and the differences between different time points were significant ( P<0.05). The results of CCK-8 experiment showed that the cells in the scaffold showed continuous proliferation after printing. After 14 days of chondrogenic induction and culture on the composite scaffold, the expressions of ACAN, SOX9, and COLⅡA1 were significantly up-regulated ( P<0.05), the expression of COLⅩA1 was significantly down-regulated ( P<0.05). The scaffold was taken out at 4 weeks after implantation. The structure of the scaffold was complete and clear. Histological and immunohistochemical results showed that cartilage matrix and collagen type Ⅱ were deposited, and there was cartilage lacuna formation, which confirmed the formation of cartilage tissue. CONCLUSION: The 3D bioprinted hADSCs-GelMA composite scaffold has a stable 3D structure and high cell viability, and can be induced differentiation into cartilage tissue, which can be used to construct tissue engineered cartilage in vivo and in vitro.

[Experimental study on adipose-derived stem cells amplified by silk fibroin/poly- L-lactic acid microcarriers in vitro].

OBJECTIVE: To investigate the effect of silk fibroin-poly- L-lactic acid (SF-PLLA) microcarriers on the expansion and differentiation of adipose-derived stem cells (ADSCs). METHODS: ADSCs were extracted from adipose tissue donated voluntarily by patients undergoing liposuction by enzymatic digestion. The 3rd generation ADSCs were inoculated on CultiSpher G and SF-PLLA microcarriers (set up as groups A and B, respectively), and cultured in the rotary cell culture system. ADSCs cultured in normal two-dimensional plane were used as the control group (group C). Scanning electron microscope was used to observe the microcarriers structure and cell growth. Live/Dead staining and confocal fluorescence microscope was used to observe the distribution and survival condition of cells on two microcarriers. DNA quantification was used to assess cell proliferation on two microcarriers. Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect chondrogenesis, osteogenesis, and adipogenesis related gene expression of ADSCs in 3 groups cultured for 18 days. Flow cytometry was used to identify the MSCs surface markers of ADSCs in 3 groups cultured for 18 days, and differential experiments were made to identify differentiation ability of the harvested cells. RESULTS: ADSCs could be adhered to and efficiently amplified on the two microcarriers. After 18 days of cultivation, the total increment of ADSCs of the two microcarriers were similar ( P>0.05). qRT-PCR results showed that chondrogenesis related genes (aggrecan, cartilage oligomeric matrix protein, SOX9) were significantly up-regulated for ADSCs on SF-PLLA microcarriers and adipogenesis related genes (peroxisome proliferator-activated receptor γ, lipoprotein lipase, ADIPOQ) were significantly up-regulated for ADSCs on CultiSpher G microcarriers, all showing significant differences ( P<0.05). Flow cytometry and differentiation identification proved that the harvested cells of the two groups were still ADSCs. CONCLUSION: The ADSCs can be amplified by SF-PLLA microcarriers, and the chondrogenic differential ability of harvested cells was up-regulated while the adipogenic differential was down-regulated.

[Three-dimensional measurement analysis of midface morphology in Treacher Collins syndromes].

OBJECTIVE: To three-dimensionally calculate the craniofacial parameters of midface of patients with Treacher Collins syndrome (TCS) in China, in order to understand the changes in the spatial position relationship between the various anatomical structures of the midface. METHODS: CT imaging data of TCS patients and age- and gender-matched normal populations between January 2013 and July 2020 was retrospectively analyzed. A total of 33 cases met the selection criteria for inclusion in the study, including 14 cases in the TCS group and 19 cases in the control group. ProPlan CMF 3.0 software was used to perform three-dimensional digital reconstruction of the craniofacial bone, measure the anatomical parameters of the midface, and analyze its morphological structure; at the same time perform three-dimensional digital reconstruction of the upper airway for morphological analysis (measure upper airway volume). RESULTS: CT images analysis revealed that all 14 patients with TCS presented the typical features with downward slanting of the palpebral fissures and different degrees of zygomatico-orbital complex dysplasia. Cephalometric and morphological analysis of the midface revealed that, multiple transverse diameters of the midface of TCS patients were significantly decreased when compared with the control group ( P<0.05), such as the width of the maxillary base, the length of the maxillary complex, and some distances related to the nasal morphology; but the distance between bilateral orbitales increased in TCS group ( P<0.05). Several anteroposterior distances in TCS group were decreased significantly when compared to control group and the distance between the skull base point and the posterior nasal spine was the most shortened ( P<0.05). But there was no significant difference of the distance between nasion and anterior nasal spine, which represented anterior midface height, between groups ( P>0.05). The skull base angle and SNB angle (the angle between the sella point-nose root point-inferior alveolar seat point) of the TCS group both decreased when compared with the control group ( P<0.05), but there was no significant difference in SNA angle (the angle between the sella point-nose root point-upper alveolar seat point) between the two groups ( P>0.05). The total volume of the upper airway was (24 621.07±8 476.63) mm 3 in the TCS group, which was significantly lower than that of the control group [(32 864.21±13 148.74) mm 3] ( t=2.185, P=0.037). CONCLUSION: The transverse distances, anteroposterior distances, and multiple craniofacial angles measurement of TCS patients were significantly decreased when compared to the control group, presented with different degrees of zygomatico-orbital complex dysplasia, nasal and maxillary dysplasia, but there was no obvious restriction in face height development. Reduced internal diameters of the upper airway maybe responsible for the decreased upper airway volume of patients with TCS.

Epicanthoplasty With Rotated-advanced-back Cut Flap.

BACKGROUND: Epicanthoplasty is one of the most popular cosmetic surgeries in Asia. The aim of this study was to present a rotated, advanced, back cut flap (R-A-B flap) that leads to correct the congenital epicanthus effectively with satisfactory results. METHODS: From January of 2017 to December of 2018, we performed the modified cut back flap epicanthoplasty to correct epicanthus. The esthetic results were evaluated with patients' feedback: perfect, good, dissatisfied, or failed. RESULTS: A total of 118 patients were involved. Postoperative evaluation using a grading scale indicated "perfect" results for 86 patients (73%) and "good" results for 32 patients (27%). No patients rated the results as "dissatisfied" or "failed." There were no significant postoperative complications. CONCLUSION: The R-A-B flap for epicanthoplasty is a reliable and simple method, resulting in good cosmetic outcome with minimal scar formation.

Downregulation of lncRNA DANCR promotes osteogenic differentiation of periodontal ligament stem cells.

BACKGROUND: Long non-coding RNAs (lncRNAs) have been widely known to have an appreciable effect in physiology and pathology. In tooth regeneration, periodontal ligament stem cells (PDLSCs) are regarded as a key effector, whereas, how lncRNA acts in the osteogenic differentiation of PDLSCs have not been completely understood. This study aims to find out the relationship between lncRNA DANCR and the proliferation and osteogenic differentiation of PDLSCs. METHODS: Microarray was used to observe the different expression of lncRNAs in differentiated and undifferentiated PDLSCs. And then osteogenic-related lncRNA, DANCR was screened out. Its effects on proliferation and osteogenic differentiation was explored by constructing an overexpression and inhibition model. qRT-PCR was used to detect the mRNA expression of osteogenesis related genes. MTT assay was performed to assess the effects of DANCR on cell growth curve. To quantify the effects of DANCR on osteogenic differentiation of PDLSCs, ALP staining and alizarin red was performed in basic culture medium and osteogenic medium. Data were statistically processed. RESULTS: Compared with the undifferentiated PDLSCs, the alizarin red staining level was higher in differentiated PDLSCs. And the expressions of osteogenic differentiation marker genes Runt-related transcription factor 2 (Runx2), osteocalcin (OCN) and bone morphogenetic protein (BMP-2) were significantly increased in the differentiated PDLSCs. Furthermore, we noticed that comparing with control groups, the expression of lncRNA DANCR decreases markedly in osteogenically induced PDLSCs. DANCR promoted proliferation of PDLSCs, as evidenced by cell viability. Further investigation has proven that the downregulation of DANCR shows in the calcium sediment forming, alkaline phosphatase (ALP) activation and some osteogenic-related gene markers' upregulation including Runx2, OCN and BMP-2, which finally results in the osteogenic differentiation of PDLSCs following the transfection and induction. Conversely, DANCR upregulation was shown to repress the osteogenic differentiation potential of PDLSCs. CONCLUSIONS: The osteogenic differentiation of PDLSCs has proven to related to the down regulation of lncRNA DANCR. And this paper throws light on the effects of DANCR in the process of PDLSCs' osteogenic differentiation.

Cordycepin suppresses the migration and invasion of human liver cancer cells by downregulating the expression of CXCR4.

Liver cancer is a worldwide threat to human health. High expression levels of C­X­C chemokine receptor type 4 (CXCR4) have been reported to promote the migration and invasion capacities of liver cancer cells. Cordycepin, extracted from Cordyceps militaris, has anti­inflammatory, antioxidant and anticancerous properties. Therefore, in the present study, migration assays, western blotting, reverse transcription­quantitative PCR and immunofluorescence analyses were conducted to determine whether cordycepin was able to suppress the migration and invasion abilities of liver cancer cells by inhibiting CXCR4 expression. The results suggested that cordycepin notably inhibited migration and invasion, and decreased the expression of CXCR4 in a dose­dependent manner. Activation of phosphorylated (p­) NF­κB inhibitor α (IκBα) and p­P65, the principal components of the NF­κB signaling pathway, was also downregulated. In addition, cordycepin markedly suppressed the nuclear translocation of P65, but had no effect on the expression of total IκBα (t­IκBα) and total P65 (t­P65). JSH­23, an inhibitor of the NF­κB pathway, impaired the migration of liver cancer cells, and was found to act synergistically with cordycepin. Furthermore, cordycepin treatment reduced the chemotactic migration ability of liver cancer cells to stromal cell­derived factor 1 (SDF1), which was significantly enhanced following treatment with JSH­23. Collectively, the present results indicated that cordycepin inhibited the nuclear translocation of P65 by preventing p­IκBα activation; this resulted in the downregulation of CXCR4 expression, and subsequently, in the impaired migration and invasion abilities of liver cancer cells and attenuated reactivity to SDF1. The current study revealed a novel mechanism for the antimetastatic activity of cordycepin and its potential to exert positive synergistic effects with other compounds for the treatment of liver cancer.

Application of the Bracing System in Reduction Malarplasty in Asian Population.

BACKGROUND: In the East, a broad and prominent malar is considered to express an aggressive and unpleasing impression; therefore, patients seek to improve their appearance through malar reduction. Although most of the techniques have been greatly improved, still there are some pitfalls in the form of cheek sagging or bone nonunion. In this study, we performed a reduction malarplasty using a firm bracing system to minimize major postoperative complications. METHOD: This was a retrospective study evaluating the results of a total of 157 patients (139 women and 18 men) who underwent reduction malarplasty using a bracing system via intraoral and periauricular. The age of the patients ranged from 17 to 44 with a mean age of 25.3 years. The mean follow-up period was 9.4 months. All patients underwent routine physical and laboratory examinations. Facial photographs in the frontal, oblique, and submentovertical views were taken. Patients with severe facial asymmetry and facial deformities were excluded from the study. Preoperative states and patients' desires were considered. In some patients, combined malarplasty with mandibular angle reduction or genioplasty was performed. RESULTS: A total of 157 patients who underwent this modified reduction malarplasty between January 2015 and January 2019 were retrospectively reviewed. Decent postoperative facial stability and satisfactory aesthetic results were realized among all patients. Major complications such as severe asymmetry or bone nonunion were not observed in our patients. CONCLUSION: Based on a thorough anatomic understanding of zygoma and masseter action, we modified previous L-shaped reduction malarplasty through constructing a firm bracing system on the malar complex. Satisfactory surgical outcomes were obtained. Our method is an ideal surgical method to effectively reduce the height and width of the zygomatic arch and prevent complications such as bone nonunion and cheek drooping. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Preservation of alveolar ridge after tooth extraction with hypoxia-inducible factor-1α protein in a dog model.

Hypoxia-inducible factor (HIF)-1α protein, which is upregulated by hypoxia, serves an important role in angiogenesis during osteogenesis. The aim of the present study was to investigate the effect of HIF-1α on alveolar ridge preservation in a dog tooth extraction model. Six beagle dogs were used in the present study. The second and fourth premolar teeth of the lower jaws on both sides were extracted. Two unilateral extraction sockets were randomly selected and filled with Bio-Oss and Bio-Oss + HIF-1α. The contralateral sockets remained unfilled and served as the negative control. Micro-computed tomography examination and histological staining were performed to examine the difference of new bone formation among the three groups. Western blotting and reverse transcription-quantitative polymerase chain reaction analysis were used to detect the expression levels of osteogenesis- and angiogenesis-associated genes in the bone tissues of the three groups. Twelve weeks post-surgery, trabecular bone formation in the Bio-Oss + HIF-1α group was significantly increased compared with the other groups. The expression levels of osteogenesis-associated genes (runt-related transcription factor 2, osteoblast-specific transcription factor osterix and osteocalcin) and angiogenesis-associated genes (HIF-1α and vascular endothelial growth factor) were all significantly increased in the Bio-Oss + HIF-1α group compared with the other two groups (P<0.05). The present results indicated that Bio-Oss with HIF-1α can promote osteogenesis and angiogenesis in vivo and may be used as an effective treatment for the preservation of the alveolar ridge.

Osteogenic Enhancement Between Icariin and Bone Morphogenetic Protein 2: A Potential Osteogenic Compound for Bone Tissue Engineering.

Icariin, a typical flavonol glycoside, is the main active component of Herba Epimedii, which was used to cure bone-related diseases in China for centuries. It has been reported that Icariin can be delivered locally by biomaterials and it has an osteogenic potential for bone tissue engineering. Biomimetic calcium phosphate (BioCaP) bone substitute is a novel drug delivery carrier system. Our study aimed to evaluate the osteogenic potential when Icariin was internally incorporated into the BioCaP granules. The BioCaP combined with Icariin and bone morphogenetic protein 2 (BMP-2) was investigated in vitro using an MC3T3-E1 cell line. We also investigated its efficacy to repair 8 mm diameter critical size bone defects in the skull of SD male rats. BioCaP was fabricated according to a well-established biomimetic mineralization process. In vitro, the effects of BioCaP alone or BioCaP with Icariin and/or BMP-2 on cell proliferation and osteogenic differentiation of MC3T3-E1 cells were systematically evaluated. In vivo, BioCaP alone or BioCaP with Icariin and/or BMP-2 were used to study the bone formation in a critical-sized bone defect created in a rat skull. Samples were retrieved for Micro-CT and histological analysis 12 weeks after surgery. The results indicated that BioCaP with or without the incorporation of Icariin had a positive effect on the osteogenic differentiation of MC3T3-E1. BioCaP with Icariin had better osteogenic efficiency, but had no influence on cell proliferation. BioCap + Icariin + BMP-2 showed better osteogenic potential compared with BioCaP with BMP-2 alone. The protein and mRNA expression of alkaline phosphatase and osteocalcin and mineralization were higher as well. In vivo, BioCaP incorporate internally with both Icariin and BMP-2 induced significantly more newly formed bone than the control group and BioCaP with either Icariin or BMP-2 did. Micro-CT analysis revealed that no significant differences were found between the bone mineral density induced by BioCaP with icariin and that induced by BioCaP with BMP-2. Therefore, co-administration of Icariin and BMP-2 was helpful for bone tissue engineering.

Runx1 regulates osteogenic differentiation of BMSCs by inhibiting adipogenesis through Wnt/ß-catenin pathway.

OBJECTIVE: Bone marrow stem cells (BMSCs) can commit to both adipocyte and osteoblast lineages. However, the mechanism underlying how transcription factors regulate this process remains elusive. Our aims were to determine the role of runt-related transcription factor 1 (Runx1) in BMSCs lineage determination and the underlying mechanisms. STUDY DESIGN: BMSCs from mouse femur bone marrow were harvested and cultured in osteogenic medium. Runx1 was knocked down in BMSCs using lentivirus. Alkaline phosphatase (ALP), Von Kossa and Oil Red O staining were performed on the Runx1-transduced BMSCs and control cells to see the differences of osteogenic and adipogenic differentiation in these groups. Real-time quantitative PCR and Western blot were performed to analyse the expression levels of osteogenic and adipogenic factors regulated by Runx1 at gene and protein levels. RESULTS: In BMSCs with Runx1 knockdown, the expression levels of osteogenic-related genes decreased significantly while the adipogenic genes C/EBPα, PPARγ and Fabp4 increased by 12-fold, 10-fold, and 30-fold, respectively, compared with the control cells. ALP activity and Von kossa staining were greatly decreased in Runx1-transfected cells while the Oil Red O staining was comparable to that in the control groups. Canonical Wnt signaling was investigated in the Runx1-deficient BMSCs, and a 50% decrease in the expression of active ß-catenin in these cells was found. Lef1 and Tcf1, which are regulated by ß-catenin were also decreased in Runx1-deficient cells compared with the levels in controls. Moreover, although there was no difference in the expression of Wnt3a among the three groups of cells, the expression of Wnt10b decreased by 80% in Runx1-deficient BMSCs compared with the levels in the other two groups. CONCLUSIONS: Our results show Runx1 promotes the capacity of osteogenesis in BMSCs while inhibits their adipogenesis through canonical Wnt/ß-catenin pathway, which provides new insights into osteoblast development.

Icariin Reduces Cartilage Degeneration in a Mouse Model of Osteoarthritis and is Associated with the Changes in Expression of Indian Hedgehog and Parathyroid Hormone-Related Protein.

BACKGROUND The aim of this study was to determine the role of icariin, a Chinese traditional herbal medicine extracted from Epimedium, in osteoarthritis (OA), using the murine anterior cruciate ligament transection (ACLT)-induced model of OA and micromass culture of murine chondrocytes. MATERIAL AND METHODS Twenty-four three-month-old C57/6J mice were randomly divided into three groups: the sham group (no surgery and joint injection with normal saline) (N=8); the ACLT + ICA group (ACLT surgery and icariin treatment) (N=8); and the ACLT group (ACLT surgery and joint injection with normal saline) (N=8). At 12 weeks after ACLT surgery, murine articular cartilage was harvested from all mice for histological evaluation of any differences in cartilage degeneration. In vitro micromass culture of mouse chondrocytes was used to study the effects of icariin on chondrocyte differentiation and growth from the three mouse groups. RESULTS Icariin treatment (mice in the ACLT + ICA group) significantly reduced degeneration of cartilage in OA with increased cartilage thickness, associated with increased expression of collagen type II alpha 1 (COL2A1), decreased chondrocyte hypertrophy, and decreased expression of collagen type X (ColX) and matrix metalloproteinase 13 (MMP13). In vitro, icariin promoted chondrocyte differentiation by upregulating the expression of agrrecan, Sox9 and parathyroid hormone-related protein (PHrP) and down-regulation of Indian hedgehog (Ihh) and genes regulated by Ihh. CONCLUSIONS In a mouse model of OA icariin treatment reduced destruction of cartilage, promoted chondrocyte differentiation, upregulated expression of PHrP and down-regulated the expression of Ihh.

Evaluation of therapeutic effects of 125I particles brachytherapy for recurrent bladder cancer.

The aim of the present study was to evaluate the clinical value of 125I particles implantation in the treatment of recurrent bladder cancer. The study is a retrospective analysis of 32 patients with recurrent bladder cancer treated between May 2010 and January 2010. Of these, 16 cases (chemotherapy group) received conventional chemotherapy. A total of 16 patients (125I group) received radiotherapy with 125I particles, followed by conventional chemotherapy. By guidance of B ultrasound, 125I radioactive particles were implanted. All 32 patients were relieved after treatment, and the tumors were significantly reduced after 2 months. However, the tumors in the 125I group were significantly smaller than those in the chemotherapy group (P<0.05). The patients were followed-up for 1 year and no recurrence was found. Additionally, no complications occurred. Compared with the chemotherapy group, the tumor volume of the 125I group was significantly reduced (P<0.05). The disease-free survival and 5-year survival rates of the patients in the follow-up showed that the disease-free survival and 5-year survival rates of the patients in 125I group were significantly improved compared to those in the chemotherapy group. Therefore, the results have shown that 125I radioactive particles in the treatment of bladder cancer improve the symptoms of patients with bladder cancer in the short term, and continuously kill residual tumor and prevent recurrence.

Clinical effect of platelet-rich fibrin on the preservation of the alveolar ridge following tooth extraction.

The aim of the present study was to evaluate the clinical efficacy of platelet-rich fibrin (PRF) in preserving the alveolar ridge following human tooth extraction. A total of 28 patients were divided into two groups: The experimental and control groups (n=14 each). Following tooth extraction, the experimental group was implanted with PRF membrane, whereas the control group was not. The gingival healing effect was assessed at 7 days, 1 and 3 months later. Cone-beam computed tomography was performed immediately and at 3 months following tooth extraction. The changes in alveolar ridge height, width, and bone mineral density were compared between the two groups. The alveolar bone was removed using the ring drill during the implant surgery at 3 months following tooth extraction. Histomorphometric evaluation was performed to compare new bone formation between groups. The patients in the experimental group reportedly felt better compared with the patients in the control group. The healing of gingival tissue was better in the experimental group than in the control group. A significantly greater novel bone area was observed in the PRF group compared with the control group (P<0.01). However, no statistically significant differences were observed in the mean value of buccal alveolar ridge height, lingual/palatal alveolar ridge height and alveolar ridge width between the two groups. These results suggested that PRF was advantageous in human alveolar ridge preservation with ease of use and simple handling. Histological analysis of novel bone formation confirmed that PRF increased the quality of the novel bone and enhanced the rate of bone formation, despite the effect of PRF was not significant to reduce alveolar bone resorption in the extraction socket alone.

[Effect of platelet rich fibrin combining with Bio-oss to treat furcation involvement].

PURPOSE: To evaluate the effect of platelet rich fibrin (PRF) combining with Bio-oss in treating Class II furcation involvement. METHODS: Thirty patients who had Class Ⅱ furcation involvement in the mandibular first molar were included. They were all free of systemic disease. After initial periodontal therapy, they were randomly divided into 2 groups. In the experimental group, PRF combining with Bio-oss were placed in the areas with furcation defect and covered with PRF. In the control group, only flap surgery was performed. All patients were followed up for 6 months after operation. The efficacy was evaluated with clinical parameters and cone-beam computed tomography (CBCT). The data were analyzed with SPSS 2.0 software package. RESULTS: Periodontal indexes including probing depth (PD), clinical attachment loss (CAL), horizontal probing depth (HPD) significantly decreased in both groups after operation (P<0.05); alveolar bone significantly increased in the experimental group (P<0.05). CONCLUSIONS: The clinical effect of PRF combined with Bio-oss on Class II furcation involvement are remarkable.