Temporal stability of tongue microbiota in older patients - A pilot study

Background/purpose

Healthy states of human microbiota depend on a stable community of symbiotic microbes irrespective of external challenges from the environment. Thus, long-term stability of the oral microbiota is of importance, particularly for older patient populations.

Materials and methods

We used next-generation sequencing (NGS) to examine the tongue microbiota of 18 individuals receiving long-term care over a 10-month period.

Results

Beta diversity analysis demonstrated temporal stability of the tongue microbiota, as microbial compositions from all time points were indistinguishable from each other (P = 0.0887). However, significant individual variation in microbial composition (P = 0.0001) was observed, underscoring the presence of a unique microbial profile for each patient.

Conclusion

The temporal dynamics of tongue microbiota exhibit long-term stability, providing diagnostic implications for oral diseases within older patient populations.

Utilization of 3D evaluation for assessing selective caries removal practice in pre-clinical dental students: a pilot study

BACKGROUND

Practicing and assessment of selective caries removal techniques in dental students remain challenges in many dental schools. The aim of this study was to utilize a 3D assessment technique, within a designated acceptable range of deviation, to evaluate the tendency of dental students in performing selective caries removal (SCR). The correlation between 3D assessment results and the conventional rubric rated by an instructor was also determined.

METHODS

Fifth-year dental students (n = 61) performed the SCR task on 3D-printed teeth containing simulated deep caries lesions in occlusal and proximal surfaces. One instructor assessed the results using a conventional analytic rubric. The excavated teeth were additionally evaluated using 3D analysis software with the designated acceptable range of deviations (± 0.5 mm) from the standard cavities. The average root mean square (RMS) value, representing the deviation between student-prepared cavities and the predefined standard cavities, was recorded. A tendency towards over-excavation was defined for RMS values > 0.5 mm, and towards under-excavation for RMS values < 0.5 mm.

RESULTS

The mean (min-max) of RMS was 0.27 (0.18-0.40) for occlusal and 0.29 (0.20-0.57)for proximal cavities. A tendency of dental students toward over-excavation was observed in both occlusal (74%) and proximal cavities (87%). There was a moderate negative correlation between the RMS values and the traditional rubric scores for both occlusal (R2 = 0.148, P = 0.002) and proximal cavities (R2 = 0.107, P = 0.010).

CONCLUSIONS

The 3D evaluation technique effectively revealed specific tendencies in dental students' caries removal skills. The integration of computerized assessments with traditional methods could potentially assist the instructors in delivering more objective and specific feedback to students. Further research is encouraged to investigate the impact of this assessment technique on improving student performance in selective caries removal skills.

Effectiveness of mobile augmented reality-integrated oral health education for community-dwelling older adults: A randomized controlled trial

BACKGROUND & PURPOSE

Oral health education helps older adults optimize their oral health. However, traditional lecture-based oral health education has limitations, exacerbated by the COVID-19 pandemic. Mobile augmented reality (MAR) has emerged as an alternative educational method. This study compared the effectiveness of MAR-integrated oral health education with that of lecture-based education and no education.

METHODS

This parallel, randomized controlled, open-label trial enrolled 75 older adults from six activity centers. The participants were randomly assigned, by a random number table technique, to the lecture-based, MAR, or control group. Data on oral healthcare-related knowledge, self-efficacy, and oral health status were collected through questionnaires and oral examinations at baseline, immediately after the intervention, and at a 2-week follow-up. The MAR system's usability was assessed. Statistical analyses, comprising descriptive statistics and inferential tests, were performed.

RESULTS

Data from 61 participants were analyzed, 22 in the lecture-based group, 20 in the MAR group, and 19 in the control group. Both lectures and MAR education significantly improved oral health status. However, changes in knowledge and self-efficacy scores were significantly different only for the MAR versus control group (p = .002 and .001, respectively). The MAR group demonstrated better knowledge and self-efficacy retention than did the lecture-based group, without significant difference. Usability assessment revealed potential for improvement in the MAR system.

CONCLUSIONS

MAR-integrated oral health education enhanced the knowledge, self-efficacy, and oral health status of community-dwelling older adults. However, addressing technology adoption and usability challenges is vital. Longer-term evaluations and broader geographical studies are recommended.

Ganoderma microsporum immunomodulatory protein as an extracellular epidermal growth factor receptor (EGFR) degrader for suppressing EGFR-positive lung cancer cells

Epidermal growth factor receptor (EGFR) abnormalities relevant to tumor progression. A newly developed strategy for cancer therapy is induction of EGFR degradation. GMI, an immunomodulatory protein from the medicinal mushroom Ganoderma microsporum, exhibits anticancer activity. However, its role in the intracellular trafficking and degradation of EGFR remains unclear. In this study, we discovered that GMI inhibits the phosphorylation of multiple tyrosine kinases. Specifically, GMI was discovered to suppress lung cancer cells harboring both wild-type and mutant EGFR by inhibiting EGFR dimerization and eliminating EGFR-mediated signaling. Functional studies revealed that GMI binds to the extracellular segment of EGFR. GMI interacts with EGFR to induce phosphorylation of EGFR at tyrosine1045, which triggers clathrin-dependent endocytosis and degradation of EGFR. Furthermore, in the mouse models, GMI was discovered to suppress tumor growth. Knockdown of EGFR in lung cancer cells abolishes GMI's anticancer activity in vivo and in vitro. Our results reveal the interaction mechanisms through which GMI induces EGFR degradation and abolishes EGFR-mediated intracellular pathway. Our study indicates that GMI is an EGFR degrader for inhibiting EGFR-expressing tumor growth.

A mobile augmented reality-integrated oral health education for community dwelling older adults: A pilot study

Background/purpose

Providing oral healthcare education can be an optimal strategy for imparting knowledge and developing self-care skills for older adults to enhance their oral health conditions. However, traditional passive lecture-based education programs have several limitations. Integrating mobile augmented reality (MAR) into oral health education can potentially enhance the effectiveness of the education by mitigating those limitations. The objectives of this study are to develop and evaluate the effectiveness of MAR-integrated oral health education. The objectives of this study were to develop and evaluate the effectiveness of MAR-integrated oral health education.

Materials and methods

Twenty-four older adults from community dwellings participated in this study. The participants received MAR-integrated oral health education once at activity centers. Self-report questionnaires were utilized to assess oral healthcare-related knowledge and self-efficacy, and the usability score of the MAR system. The assessment was conducted before and after the educational program. Data were statistically analyzed using descriptive statistics and paired-t test.

Results

The mean scores of oral healthcare-related knowledge and self-efficacy showed a significant increase after the educational program, with P-values of <0.001 and 0.002, respectively. A majority of the participants exhibited a lack of knowledge and self-efficacy regarding the proper selection of toothpaste and interdental brushes. However, there was an improvement after the intervention. The usability score of the system was lower than the average level.

Conclusion

MAR-integrated oral health education effectively increases oral health-related knowledge and self-efficacy among community dwelling older adults. Still, the usability of the MAR system needs to be improved. Further investigation of long-term effects and clinical outcomes, and the inclusion of comparative groups are recommended for the future study.

Effects of core buildup composite resin translucency on intraoral scanner accuracy: an in vitro study

AIM

The accuracy of 3D images produced by an intraoral scanner (IOS) is affected by the optical characteristics of restorative materials such as metal, ceramic, and composite resin. The present in vitro study aimed to investigate the impact of core buildup composite resin translucency on IOS accuracy.

MATERIALS AND METHODS

A core buildup procedure was performed on a proprietary 3D-printed model using injectable composite resins in four groups with different levels of translucency (highest to lowest: AE, A3, AO3, and EX). Ten experimental scans per group were performed using a Medit i700 IOS on a phantom head-mounted model. Reference scans were obtained using an industrial scanner (Solutionix C500). Values of accuracy (trueness and precision) for the respective groups were evaluated using mean deviation values following 3D superimposition.

RESULTS

Composite resin translucency caused the scale reduction of the optical impressions. Values of trueness showed the highest scale reduction in AE, significantly, followed by A3, AO3, and EX. Considering 50 μm as the cut-off value of deviations for clinical acceptability, the analysis showed most deviations in AE and A3. Similar results were found with precision, where AE showed the highest deviation value statistically, followed by A3, AO3, and EX.

CONCLUSIONS

Composite resin translucency affects the accuracy of optical impressions, causing a fitting error of CAD/CAM prostheses. The more translucent the composite resin, the less accurate the optical impression. This suggests the need for proper compensation during prosthesis designing for an optimal clinical result. In addition, practitioners should indicate in the digital workflow the proper restorative materials regarding not only the mechanical properties and esthetics, but also the optical characteristics.

A versatile control program for positioning and shooting targets in laser-plasma experiments

We introduce a LabVIEW-based control program that significantly improves the efficiency and flexibility in positioning and shooting solid targets in laser-plasma experiments. The hardware driven by this program incorporates a target positioning subsystem and an imaging subsystem, which enables us to install up to 400 targets for one experimental campaign and precisely adjust them in six freedom degrees. The overall architecture and the working modes of the control program are demonstrated in detail. In addition, we characterized the distributions of target positions of every target holder and simultaneously saved the target images, resulting in a large dataset that can be used to train machine learning models and develop image recognition algorithms. This versatile control system has become an indispensable platform when preparing and conducting laser-plasma experiments.

Verification of spinwave excitation in coaxial gyromagnetic nonlinear transmission lines

The knowledge of physical mechanism of microwave generation in coaxial gyromagnetic nonlinear transmission lines (GNLTLs) is not complete up until now, especially the action of spinwave excitation during this process. In this paper, control experiments on different groups of GNLTLs with a single variable of NiZn ferrite material spinwave linewidth ΔHk are proposed as an indirect way to demonstrate this microscopic process. Comparative analyses of different groups of GNLTL experimental results are conducted to clarify the existence and effect of spinwave excitation. Theoretical treatment of conditions of spinwave excitation in GNLTLs is derived to explain the experimental results. It is illustrated that spinwave can be excited when the synchronism condition between the working frequency of GNLTL and the spinwave frequency spectrum is satisfied. The unstable spinwave excitation will consume the RF energy of GNLTLs heavily and cause a rapid decrease in RF oscillation.

Survival of Four Conical Implant Abutment Connections After Removal of the Abutment Screw and Simulated Cyclic Loading: An In Vitro Comparative Study

This in vitro study evaluated the mechanical behavior of different conical connection implant systems after abutment screw withdrawal. Four conical connection systems were selected based on different conical half-angles: Ankylos (5.7°), Cowell (7.0°), Straumann (7.5°), and Astra (11.0°). In each system, 5 implants and abutments were used (n = 5). According to the recommended value, each abutment screw was torqued to settle the abutment and then withdrawn through a predesigned hole of the cemented crown. The retentiveness of the abutment was evaluated by the following mechanical testing. All specimens were subjected to cyclic loading of 20-200 N, 30°, and 4-mm off-axis to the implant axis, for 106 cycles. The pullout forces and axial displacements of the abutments were measured. The data of the Cowell system was obtained from our previous work. All groups other than Astra group, in which abutment loosened after abutment screw withdrawal, passed the cyclic loading test. Straumann group demonstrated a significantly lower pullout force (27.4 ± 21.1 N) than Ankylos (160.1 ± 41.4 N) and Cowell (183.7 ± 30.5 N) groups. All groups showed abutment rebound after screw withdrawal except Straumann group. In addition, Ankylos, Cowell, and Straumann groups demonstrated axial displacement after cyclic loading. In terms of the retentiveness of the abutment after abutment screw withdrawal examined in this study, Ankylos and Cowell groups had much higher retentiveness than Straumann group, while Astra group had none. Conical angle could be a key design parameter to make abutment screw withdrawal after conical abutment settlement feasible, but more studies must be conducted for clinical application.

Classifying Temporomandibular Disorder with Artificial Intelligent Architecture Using Magnetic Resonance Imaging

This study proposes a new diagnostic tool for automatically extracting discriminative features and detecting temporomandibular joint disc displacement (TMJDD) accurately with artificial intelligence. We analyzed the structural magnetic resonance imaging (MRI) images of 52 patients with TMJDD and 32 healthy controls. The data were split into training and test sets, and only the training sets were used for model construction. U-net was trained with 100 sagittal MRI images of the TMJ to detect the joint cavity between the temporal bone and the mandibular condyle, which was used as the region of interest, and classify the images into binary categories using four convolutional neural networks: InceptionResNetV2, InceptionV3, DenseNet169, and VGG16. The best models were InceptionV3 and DenseNet169; the results of InceptionV3 for recall, precision, accuracy, and F1 score were 1, 0.81, 0.85, and 0.9, respectively, and the corresponding results of DenseNet169 were 0.92, 0.86, 0.85, and 0.89, respectively. Automated detection of TMJDD from sagittal MRI images is a promising technique that involves using deep learning neural networks. It can be used to support clinicians in diagnosing patients as having TMJDD.

Effects of food hardness on temporomandibular joint osteoarthritis: Qualitative and quantitative micro-CT analysis of rats in vivo

BACKGROUND

Temporomandibular joint osteoarthritis (TMJ-OA) is a degenerative joint disease in which quantitative analysis based on magnetic resonance image (MRI) or cone-beam computed tomography (CBCT) remains limited. Moreover, the long-term effects of soft food on the adaptive condylar remodeling process in TMJ-OA remain unclear. This study aimed to assess the effects of food hardness on adaptive condylar remodeling in a healthy TMJ, TMJ-OA, and controlled TMJ-OA.

METHODS

Complete Freund's adjuvant (CFA) was used for TMJ-OA induction and Link-N (LN) for TMJ repair. Eighteen mature rats were randomly divided into six groups: (1) control/normal diet (Ctrl-N); (2) control/soft diet (Ctrl-S); (3) TMJ-OA/normal diet (CFA-N); (4) TMJ-OA/soft diet (CFA-S); (5) Link-N-controlled TMJ-OA/normal diet (LN-N); and (6) Link-N-controlled TMJ-OA/soft diet (LN-S). Micro-CT was performed 14, 21, and 28 days after CFA injection to analyze the bone volume, bone volume fraction (BVF), bone mineral density (BMD), and trabecular bone number and thickness (Tb.N, Tb.Th). MRI and histological imaging were performed to support the analysis.

RESULTS

Under CFA treatment, the BVF and BMD decreased significantly (p < 0.01) and later recovered to normal. However, more significant improvements occurred in normal-diet groups than soft-diet groups. Additionally, bone volume changes were more predictable in the normal-diet groups than in the soft-diet groups. The normal-diet groups presented a significant decrease and increase in the Tb.N and Tb.Th, respectively (p < 0.05), while the Tb.N and Tb.Th in the soft-diet groups remained largely unchanged. Furthermore, a significantly higher frequency of irregularities on the condylar articular surface was found in the soft-diet groups.

CONCLUSIONS

Compared with a soft diet, a normal diet may be beneficial for preserving condyle articular surface and directing bone remodeling in TMJ-OA rats.

Profiles of oral microbiome associated with nasogastric tube feeding

Background

Dysbiosis of oral microbiome causes chronic diseases including dental caries and periodontitis, which frequently affect older patient populations. Severely disabled individuals with impaired swallowing functions may require nutritional supply via nasogastric (NG) tubes, further impacting their oral condition and possibly microbial composition. However, little is known about the effect of NG tube on oral microbes and its potential ramification.

Methods

By using 16S rRNA amplicon sequencing, we characterized the tongue microbiome of 27 patients fed with NG tubes and 26 others fed orally.

Results

The microbial compositions of NG-tube and oral-feeding patients were substantially different, with more Gram-negative aerobes enriched in the presence of NG tube. Specifically, NG-tube patients presented more opportunistic pathogens like Pseudomonas and Corynebacterium associated with pneumonia and lower levels of commensal Streptococcus and Veillonella. Co-occurrence analysis further showed an inverse relationship between commensal and pathogenic species.

Conclusion

We present a systematic, high-throughput profiling of oral microbiome with regard to long-term NG tube feeding among the older patient population.

[Analysis of clinical prognosis of endoscopic salvage surgery in patients with rT2 recurrent nasopharyngeal carcinoma]

Objective: To investigate the feasibility of endoscopic salvage surgery for patients with rT2 recurrent nasopharyngeal carcinoma (rNPC) and to analyze their prognostic factors. Methods: The clinical data of 33 patients with rT2 rNPC who underwent endoscopic extended nasopharyngectomy in Eye & ENT Hospital Affiliated to Fudan University from January 2015 to July 2020 were analyzed, including 29 males (87.9%) and 4 females (12.1%), aging (51.7±10.6) years. The clinicopathological characteristics of these patients were recorded and analyzed, in terms of gender, sex, alcohol and cigarette use, interval between primary treatment to recurrence, adjuvant therapy, lymph node metastasis, internal carotid artery (ICA) invasion, necrosis, margin and reconstruction materials. Kaplan Meier analysis was used to plot the overall survival rate and progression free survival rate curve, Log-rank test was used to analyze the prognostic factors among patients, and multivariate Cox proportional hazards regression was used to determine the independent risk factors of tumor progression free survival. Results: Among 33 patients with rT2 rNPC, the recurrence interval of 24 patients with rNPC after primary radiotherapy was more than 2 years. A total of 25 patients received primary radiotherapy and adjuvant chemotherapy at the same time. There were 6 cases with cervical lymph node metastasis, 12 cases with ICA invasion, 8 cases with positive surgical margin, 7 cases underwent ICA embolization before operation. A total of 18 cases underwent pedicled tissue flap repairment after operation, including 12 pedicled nasal septal mucosa flaps and 6 temporalis muscle flaps. The median follow-up time was 15 months. Five patients died because of disease progression (in 2 cases), post surgical ICA hemorrhage (in 1 case), liver metastasis (in 1 case) and dysphagia (in 1 case). The 1-year, 2-year and 3-year overall survival rates of all patients were 93.9%, 81.8% and 81.8%, respectively. The 1-year, 2-year and 3-year progression free survival rates were 74.7%, 59.7% and 40.9%, respectively. Log-rank statistical analysis showed that the positive surgical margin (P=0.060) and recurrence interval (P=0.151) were possibly related to the prognosis of rT2 rNPC. Multivariate Cox regression analysis showed that the positive surgical margin was an independent risk factor for patients with rT2 rNPC (P=0.034). Nasopharynx hemorrhage occurred in 4 patients, skull base bone necrosis occurred in 2 patients, trismus occurred in 3 patients, and no obvious brain complications occurred in 7 patients with ICA embolization. Conclusion: Endoscopic salvage surgery for rT2 rNPC is a safe and effective surgical option, but the long-term effect still needs long-term follow-up in bulk cases.

[Clinical characteristics of 18 children with chronic nonbacterial osteomyelitis]

Objective: To investigate the clinical features of children with chronic nonbacterial osteomyelitis (CNO), and raise awareness among clinicians. Methods: In this retrospective study, 18 patients with CNO who were diagnosed in Children's Hospital of Fudan University from January 2015 to December 2021 were included. Results: Eighteen children with CNO (12 males, 6 females) were identified. Their age at onset was 9 (5, 11) years, the delay in diagnosis was 2 (1, 6) months, and follow-up-was 17 (8, 34) months. The most common symptoms were fever in 14 children, as well as bone pain and (or) arthralgia in 14 children. In terms of laboratory results, normal white blood cell counts were observed at onset in 17 patients; increased erythrocyte sedimentation rate (ESR) in all patients; increased C reactive protein (CRP) over the normal value in 14 patients. Of the 18 patients, 2 had positive antinuclear antibodies, while none had positive human leukocyte antigen-B27 or rheumatoid factor. Imaging examination revealed that all the patients had symmetrical and multifocal skeletal lesions. The number of structural lesions detected by imaging investigation was 8 (6, 11). The most frequently affected bones were tibia in 18 patients and femur in 17 patients. Bone biopsy was conducted in 14 patients and acute or chronic osteomyelitis manifested with inflammatory cells infiltration were detected. Magnetic resonance imaging (MRI) found bone lesions in all the patients and bone scintigraphy were positive in 13 patients. All the patients were treated with nonsteroidal anti-inflammatory drugs, among whom 10 cases also treated with oral glucocorticoids, 9 cases with traditional disease modifying anti-rheumatic drugs, 8 cases with bisphosphonates and 6 cases with tumor necrosis factor inhibitors. The pediatric chronic nonbacterial osteomyelitis disease activity score, increased by 70% or more in 13 patients within the initial 6-month follow-up. Conclusions: The clinical manifestations of CNO are lack of specificity. The first symptom of CNO is fever, with or without bone pain and (or) arthralgia, with normal peripheral blood leukocytes, elevated CRP and (or) ESR. Whole body bone scanning combined with MRI can early detect osteomyelitis at subclinical sites, and improve the diagnostic rate of CNO.

[Genotypes and phenotypes of IQSEC2 gene variants related epilepsy]

Objective: To analyze the genotypes and clinical phenotypes of patients with epilepsy associated with IQSEC2 gene variants. Methods: The genotypes, seizure types, electroencephalogram, neuroimage of 6 patients with IQSEC2 gene variants in the Department of Pediatrics, Peking University First Hospital from July 2019 to October 2021 were analyzed. Results: There were 5 males and 1 female. Six variants were de novo, including 2 frameshift variants (c.3801_3808dup/p.Q1270Rfs*130, c.1459_1460delAT/p.M487Vfs*2), 2 nonsense variants (c.3163C>T/p.R1055*, c.1417G>T/p.E473*), 1 in-frame deletion (c.2295_2297del/p.N765del) and 1 missense variant (c.2293A>G/p.N765D). Age at seizure onset ranged from 3 months to 2 years and 5 months. Multiple seizure types were observed, including epileptic spasms in 5 patients, focal seizures in 5 patients, tonic seizures in 3 patients, myoclonic seizures in 3 patients, atypical absence seizures in 2 patients and atonic seizures in 2 patients. All 6 patients showed global developmental delay before seizure onset. There were other clinical manifestations, including autistic features in 3 patients, microcephaly in 3 patients, dystonia in 2 patients and binocular esotropia in 1 patient. The electroencephalogram showed slow background activity and hypsarrhythmia in all 6 patients. Brain magnetic resonance imaging showed abnormal in 5 patients and normal in 1 patient. Five patients were diagnosed with infantile spasms. Among them, 4 patients had late-onset infantile spasms. One patient was unclassified developmental epileptic encephalopathy. The age of last follow-up ranged from 3 years and 2 months to 7 years and 2 months. All 6 patients still had seizures after multiple anti-seizure medications. Conclusions: The seizure onset of patients with IQSEC2 gene variants usually begins after 1 year of age. The common seizure types include epileptic spasms and focal seizures. Patients usually have a global developmental delay before seizure onset. IQSEC2 variants could be related to developmental and epileptic encephalopathy, and most patients are diagnosed with late onset infantile spasms. Epilepsy associated with IQSEC2 gene variants is usually refractory.

Maternal alcohol consumption and risk of postpartum depression: a meta-analysis of cohort studies

OBJECTIVES

The relationship between maternal alcohol consumption and postpartum depression (PPD) is still controversial. The objective of the present study was to assess the association between maternal alcohol consumption and the risk of developing PPD by means of a meta-analysis of cohort studies.

STUDY DESIGN

This was a meta-analysis.

METHODS

PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases were searched up to February 4, 2021, to identify relevant studies that evaluated the association between maternal alcohol consumption and PPD. Meta-analysis was conducted using RevMan software and Stata software. Subgroup and sensitivity analyses were performed to explore the potential heterogeneity source, and Begg's funnel plots and Begg's linear regression test were conducted to assess the potential publication bias.

RESULTS

A total of 12 studies involving 50,377 participants were identified in our study. Overall, pregnant women who were exposed to alcohol were at a significantly greater risk of developing PPD compared with those who did not consume alcohol (odds ratio = 1.21; 95% confidence interval: 1.04-1.41; P = 0.020).

CONCLUSIONS

Maternal alcohol consumption is significantly associated with the risk of developing PPD. These results emphasize the necessity of enhancing health awareness, improving the public health policies and regulations concerning alcohol use, and strengthening the prevention and intervention of maternal alcohol consumption to promote maternal mental health.

A Sensor-Integrated Face Mask Using Au@SnO2 Nanoparticle Modified Fibers and Augmented Reality Technology

In this work, we develop a wireless sensor-integrated face mask using Au@SnO₂ nanoparticle-modified conductive fibers based on augmented reality (AR) technology. AR technology enables the overlay of real objects and environments with virtual 3D objects and allows virtual interactions with real objects to create desired meanings. With the help of the AR system, the size of the mask could be precisely estimated and then manufactured using 3D printing technology. The body temperature sensor and respiratory sensor were integrated into the mask so that vital parameters of the human body could be continuously monitored without removing the personal protective equipment. Furthermore, the outer part of the mask consists of conductive fabric modified with Au@SnO₂ core-shell nanoparticle additives, which enhanced the filtration efficiency of airborne aerosols. A significant improvement in the filtration efficiency of particulate matter 2.5 was observed after applying an external voltage to the conductive textiles. A smartwatch with a heart rate sensor was paired with the mask to display sensor data on the mask through wireless transmission. Therefore, this sensor-integrated mask system with AR technology provides the first line of defense to combat global threats from pathogens and air pollutants.

[Internal carotid artery embolization in endoscopic salvage surgery for recurrent nasopharyngeal carcinoma: a single-center retrospective study]

Objective: To evaluate the efficiency of internal carotid artery (ICA) embolization technology in endoscopic salvage surgery for recurrent nasopharyngeal carcinoma (rNPC) invading the ICA. Methods: From January 2016 to March 2021, 83 patients with rNPC who invaded the ICA and underwent endoscopic extended nasopharyngectomy were retrospectively collected from the Eye & ENT Hospital in Fudan University, including 60 males and 23 females. The age of the patients ranged from 27 to 77 years. The standard of ICA invasion was that the distance from the lesion to the ICA on enhanced MRI was ≤ 1.8 mm. The clinical characteristics, ICA management strategy and survival prognosis of patients were analyzed, and the effectiveness of ICA embolization was evaluated. Kaplan-Meier method was used to calculate the survival rate and Log-rank test was used to compare the difference. Results: In 83 patients with rNPC, there were 13 patients with rT2, 38 patients with rT3, 32 patients with rT4, and 16 patients had lymph node metastasis. A total of 37 patients (44.6%) underwent ICA coil embolization before surgery, of which 2 cases underwent external carotid-middle cerebral artery artery bypass grafting and ICA embolization due to positive balloon occlusion test (BOT). Patients with positive surgical margin accounted for 24.1% (20/83). Among them, patients with rT4 and patients without ICA embolization had a higher positive rate of surgical margin (P value was 0.001, 0.043, respectively). The 3-year overall survival (OS) and progression free survival (PFS) rate of all patients was 46.5% and 26.7%, respectively. In addition, the 3-year OS and PFS of patients with ICA embolization was significantly higher than those without ICA embolization, respectively (69.1% vs 27.8%, P=0.003; 33.9% vs 18.9%, P=0.018). Only 2 patients (2/37, 5.4%) had cerebral infarction complications after coil embolization of the affected ICA due to negative BOT. Conclusion: Preoperative ICA embolization can be used to treat patients with rNPC invading the ICA, improve the total removal rate and survival rate of patients, which is an effective salvage treatment.

[The application of temporalis muscle flap in the salvage nasopharyngectomy for advanced recurrent nasopharyngeal carcinoma]

Objective: To summarize the application of temporalis muscle flap in the salvage nasopharyngectomy for advanced recurrent nasopharyngeal carcinoma (rNPC), and to provide guidance for the repair of extensive skull base defects in salvage rNPC. Methods: A total of 54 patients with the application of temporalis muscle flap in the salvage nasopharyngectomy for advanced rNPC were retrospectively analyzed, including 42 males and 12 females, aging from 29 to 71 years. There were 36 patients with rT3 and 18 patients with rT4. The surgical methods of temporalis muscle flap repair were summarized. The general situation, survival time and postoperative complications of patients were recorded, and the advantages and disadvantages of temporalis muscle flap were discussed. Results: The temporal muscle flap could completely cover the defect area of nasopharynx and skull base, without the need for other autologous repair materials. The follow-up period was 2 to 28 months. The survival rate of temporalis flap was 98.1% (53/54). The 1-year overall survival rate was 84.5% while 1-year progression-free survival rate was 49.0%. None of the patients had facial nerve injury. Three patients (5.6%) had necrosis of the cranial membrane required surgical intervention and four patients (7.4%) required a chonoplasty due to severe chonostril stenosis or chonostril atresia. Eleven cases (20.4%) had mouth opening restriction, chewing weakness, dysphagia and other eating difficulties. Conclusions: Temporalis muscle flap is an alternative flap for the salvage nasopharyngectomy for advanced rNPC. Temporal muscle flap shows high survival rate and wide coverage, but the surgeon should apprehend the possible complications and reduce the occurrence of them.

[Application of pedicle nasoseptal flap in endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma: an analysis of 39 cases]

Objective: To explore the therapeutic effect and contributing factors of pedicle nasoseptal flap in endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma. Methods: Thirty-nine patients with recurrent nasopharyngeal carcinoma admitted to the Eye, Ear, Nose and Throat Hospital of Fudan University from July 2016 to July 2019 were reviewed, with 19 males and 20 females, aging from 30 to 75 years old. All patients underwent endoscopic nasopharyngectomy, followed by reconstruction with the pedicle nasoseptal flap. The methods of preoperative assessment, mucosal flap preparation and nasopharyngeal reconstruction were summarized, and factors affecting the survival of the pedicle nasoseptal flap were discussed. The rates between groups were compared by Fisher's exact test. Results: Ipsilateral mucosal flap was used in 19 cases while contralateral mucosal flap in 20 cases. After the operation, there were 33 cases with complete epithelialization and 6 cases with flap necrosis. Univariate analysis suggested that the number of radiotherapy courses was an important factor affecting the survival of flap (OR=7.429, 95%CI: 1.120-49.270, P=0.042). However, gender, age, type of transnasal endoscopic nasopharyngectomy, osteonecrosis, side of flap and internal carotid artery resection had no influence on flap survival (all P>0.05). All patients were followed-up for 24 to 60 months. Among them, 8 patients had local recurrence and then operated again, 4 patients survived with systemic metastases and 2 patients died. Conclusion: The pedicle nasoseptal flap is a good material for reconstruction for endoscopic nasopharyngectomy, but it is less effective for patients with multiple course radiotherapy.

Evaluation of the potential denture covering area in buccal shelf with intraoral scanner

Background/purpose

The characteristic of soft tissue changes in buccal shelf area during function is unclear. This study aimed for evaluating the potential denture covering area in buccal shelf area in different ranges of mouth opening by a digital approach.

Materials and methods

Nineteen qualified dentate participants were enrolled. An intraoral scanner was used to record soft tissue in buccal shelf area in different ranges of mandibular opening, which were maximum intercuspation, 10 mm, 20 mm, and 30 mm of interincisal distance. The experiment was performed by two examiners. The common area of each range was generated within the clinically acceptable denture adaptation range, which was represented as the potential denture covering area. Data were statistically analyzed using descriptive statistic, one-way repeated measure ANOVA, intraclass correlation coefficient (ICC), and the Pearson correlation test.

Results

Trends of the mean distance of the potential denture covering area increased from the frenum area to the second premolar and the first molar area then decreased in the second molar area, along with the ranges of mouth opening increased. The distance in the second molar area had drastic percentage changes during the mouth opening. The mean distances changed significantly when the mouth opening increased (P < 0.001). All ICC values of intra-, inter-rater reliability indicated good to excellent reliability. The correlation between the results from two examiners was strong (P < 0.001).

Conclusion

The characteristic of the denture covering area posteriorly to the first molar area is inversely proportional in length to ranges of mouth opening.

Locational effects on oral microbiota among long-term care patients

Background

Dysbiosis of oral microbiota is the cause of many diseases related to oral and general health. However, few Asia-based studies have evaluated the role of oral microbiota in patients receiving long-term care. Thus, new indications are needed for early prevention and risk management based on information derived from the oral microbiota.

Methods

We used next-generation sequencing (NGS) to identify the oral bacterial composition and abundance in patients receiving long-term care: 20 from the outpatient department (OPD) and 20 home-care patients. Their microbial compositions, taxonomy, and alpha/beta diversity were characterized.

Results

Microbiota from the two groups showed different diversity and homogeneity, as well as distinct bacterial species. A more diverse and stable microbial population was observed among OPD patients. Our findings indicated that home-care patients had a higher risk of oral diseases due to the existence of dominant species and a less stable microbial community.

Conclusion

This work was the first in Taiwan to use NGS to investigate the oral microbiota of long-term care patients. Our study demonstrated the potential use of dominant bacterial species as biomarkers for the risk management of posttreatment complications.

[CFTR gene variations and phenotypes in seven children]

Objective: To analyze the cystic fibrosis transmembrane conductance regulator (CFTR) gene variations and phenotypes in 7 Chinese children. Methods: In this retrospective study, the data of 7 children with CFTR gene variations admitted to Children's Hospital of Chongqing Medical University from December 2013 to October 2020 were extracted. The general information, clinical manifestations, gene variations, diagnosis and treatment were summarized. Results: Among the 7 children, 2 were males and 5 were females, aged 5.2(0.5-11.3) years. Main clinical manifestations included malnutrition (5 cases), recurrent respiratory infection (4 cases), bronchiectasis (3 cases), steatorrhea (3 cases), vomiting in infancy (2 cases), liver cirrhosis (2 cases), meconium ileus (1 case), metabolic alkalosis and hypochloremia (1 case). A total of 15 variations were found by whole exon sequencing and Sanger sequencing, among which 3 were newly discovered, and 7 were missense mutations. Four children were diagnosed as CF, and the other 3 were diagnosed as CFTR related disease (CFTR-RD). Compared with CF patients, the pancreatic insufficiency and typical CF lung disease were relatively mild in CFTR-RD patients. After treatment, 6 children were clinically improved, while the rest one withdrew treatment due to critical pulmonary infection and disturbance of water-electrolyte metabolism. Conclusions: The loci and phenotypes of CFTR gene variants vary hugely and the pathogenicity of some variations are not clear. Whole exon sequencing can facilitate the identification of CF-and CFTR-RD-causing variaions. For the cases not compatible with CF, CFTR-RD should be considered and evaluated by timely gene detection, so as to carry out appropriate long term management.

[A local case with alveolar echinococcosis in Nanzhang County, Hubei Province]

The diagnosis and treatment of a local case with alveolar echinococcosis was presented. Based on clinical data and epidemiological surveys, this is a rare, local case with alveolar echinococcosis in Nanzhang County, suggesting the possibility of local transmission of echinococcosis. The prevention, control and surveillance of echinococcosis requires to be reinforced in nonendemic areas.

[The endoscopic transnasal approach in management of the sinonasal tumor invading the anterior skull base]

Objective: To evaluate the feasibility of the endoscopic transnasal approach (ETA) and to analyze the outcomes and factors of this surgical technique in the management of the tumor invading the anterior skull base. Methods: A retrospective analysis was performed on 42 patients (31 males and 11 females, with mean age of 49 years) with sinonasal tumor invading the anterior skull base, who underwent ETA from June 2015 to April 2019 in Eye, Ear, Nose and Throat Hospital of Fudan University. Pathologically, there were 15 cases of squamous carcinoma (14 patients with T4bN0M0 and 1 patient with T4bN1M0) and 27 of olfactory neuroblastomas with Kadish stage C. Anterior skull base reconstruction was performed using the vascular pedicled nasoseptal mucoperiosteal flap and fascia lata. Brain non-contrast-enhanced CT was performed on the first postoperative day to exclude massive pneumocephalus, relevant brain edema and subarachnoid hemorrhage. Sinonasal contrast-enhanced MR was performed to assess the extent of the tumor removal. Kaplan-Meier analysis was used to calculate the overall survival (OS) and Cox multivariate regression analysis was used to determine the prognostic factors. Results: The mean duration of the surgery was 452 minutes. Total resection was performed in 36 patients (85.7%), subtotal resection in 2 patients (4.8%) with orbital involvement, partial resection in one patient (2.4%) with injury of the internal carotid artery. One patient (2.4%) underwent the second resection because of the tumor residual, two patients (4.8%) with unsure tumor residual. Mean follow-up was 20 months, with 17 months of median follow-up. One-, two-and three-year overall survival was 86.5%, 76.9% and 64.5%, respectively. For squamous carcinoma, one-, two-and three-year overall survival was 86.2%, 86.2% and 57.4%, respectively. For olfactory neuroblastomas, One-, two-and three-year overall survival was 86.9%, 75.3% and 67.8%, respectively. Multivariate analysis showed that tumor residual (P=0.001) and recurrence (P<0.01) were independent prognostic factors for survival. Conclusions: The ETA is safe and feasible in selected patients with sinonasal tumor invading the anterior skull base. Tumor residual and recurrence are independent prognostic factors for survival.

[Effects of NOX4 on radiosensitivity of nasopharyngeal carcinoma cells by activating the PI3K/AKT pathway]

Objective: To explore the relationship between NOX4 and radiosensitivity of nasopharyngeal carcinoma cells. Methods: Western blot was used to test the expression of NOX4 in nasopharyngeal carcinoma cells (CNE1, CNE2 and HONE1) and normal nasopharyngeal epithelial cells (NP69). The lentiviral vectors for RNA interference and overexpression of NOX4 gene were constructed and nasopharyngeal carcinoma cells were transfected. After treatment with radiation or/and PI3K/AKT inhibitor LY294002, the expressions of related proteins in cells were tested by Western blot, and the cell proliferation was detected by CCK-8 assay and the cell apoptosis was determined by flow cytometry. GraphPad Prism 5 was used for statistical analysis, and P<0.05 was statistically significant. Results: The expressions of NOX4 in nasopharyngeal carcinoma cells were higher than those in normal nasopharyngeal epithelial cells. Compared with the siNC group, the siNOX4 group of nasopharyngeal carcinoma cell had lower proliferation capacity [72 h absorbance (A) value:1.16 vs. 0.75] and higher apoptosis rate (2.9% vs. 10.0%). In contrast,compared with the vector group, the NOX4 group of nasopharyngeal carcinoma cell had higher proliferation capacity [72 h absorbance (A) value: 1.01 vs. 1.32] and lower apoptotic rate (1.7% vs. 1.1%).Treatment with LY294002 for nasopharyngeal carcinoma cells of NOX4 overexpression,compared with the NOX4 group, the proliferation ability of nasopharyngeal carcinoma cells in the NOX4+LY294002 group was reduced (72 h absorbance (A) value: 1.32 vs. 0.77), while the apoptotic rate was increased (1.1% vs. 3.1%).Treatment with radiotherapy, compared with the siNC/Vector group, the proliferation ability of nasopharyngeal carcinoma cells in the siNOX4 group was reduced (72 h absorbance (A) value: 0.72 vs. 0.33), and the apoptotic rate was increased (7.8% vs. 17.3%). However, in the NOX4 group, the proliferation of nasopharyngeal carcinoma cells was enhanced (72 h absorbance (A) value:0.65 vs. 0.78), and the apoptotic rate was reduced (8.1% vs. 3.8%). Compared with the NOX4+radiation group, the proliferation ability of nasopharyngeal carcinoma cells in the NOX4+radiation+LY294002 group was reduced (72 h absorbance (A) value: 0.79 vs. 0.56), while the apoptotic rate was increased (3.8% vs. 8.1%). Conclusion: NOX4 can inhibit radiosensitivity of nasopharyngeal carcinoma cells possibly by activating PI3K/AKT pathway.

Polymeric Gelatin Scaffolds Affect Mesenchymal Stem Cell Differentiation and Its Diverse Applications in Tissue Engineering

Studies using polymeric scaffolds for various biomedical applications, such as tissue engineering, implants and medical substitutes, and drug delivery systems, have attempted to identify suitable material for tissue regeneration. This study aimed to investigate the biocompatibility and effectiveness of a gelatin scaffold seeded with human adipose stem cells (hASCs), including physical characteristics, multilineage differentiation in vitro, and osteogenic potential, in a rat model of a calvarial bone defect and to optimize its design. This functionalized scaffold comprised gelatin-hASCs layers to improve their efficacy in various biomedical applications. The gelatin scaffold exhibited excellent biocompatibility in vitro after two weeks of implantation. Furthermore, the gelatin scaffold supported and specifically regulated the proliferation and osteogenic and chondrogenic differentiation of hASCs, respectively. After 12 weeks of implantation, upon treatment with the gelatin-hASCs scaffold, the calvarial bone harboring the critical defect regenerated better and displayed greater osteogenic potential without any damage to the surrounding tissues compared to the untreated bone defect. These findings suggest that the present gelatin scaffold is a good potential carrier for stem cells in various tissue engineering applications.

A Collagen-Based Scaffold for Promoting Neural Plasticity in a Rat Model of Spinal Cord Injury

In spinal cord injury (SCI) therapy, glial scarring formed by activated astrocytes is a primary problem that needs to be solved to enhance axonal regeneration. In this study, we developed and used a collagen scaffold for glial scar replacement to create an appropriate environment in an SCI rat model and determined whether neural plasticity can be manipulated using this approach. We used four experimental groups, as follows: SCI-collagen scaffold, SCI control, normal spinal cord-collagen scaffold, and normal control. The collagen scaffold showed excellent in vitro and in vivo biocompatibility. Immunofluorescence staining revealed increased expression of neurofilament and fibronectin and reduced expression of glial fibrillary acidic protein and anti-chondroitin sulfate in the collagen scaffold-treated SCI rats at 1 and 4 weeks post-implantation compared with that in untreated SCI control. This indicates that the collagen scaffold implantation promoted neuronal survival and axonal growth within the injured site and prevented glial scar formation by controlling astrocyte production for their normal functioning. Our study highlights the feasibility of using the collagen scaffold in SCI repair. The collagen scaffold was found to exert beneficial effects on neuronal activity and may help in manipulating synaptic plasticity, implying its great potential for clinical application in SCI.

[Changes of urinary monocyte chemotactic protein 1 and epidermal growth factor and their correlations with clinicopathology in idiopathic membranous nephropathy patients]

Objective: To explore the changes and clinical value of urinary monocyte chemotactic protein 1 (MCP-1), epidermal growth factor (EGF) and their ratio in patients with idiopathic membranous nephropathy (IMN). Methods: A total of 67 IMN patients were enrolled according to kidney biopsy in the Department of Nephrology of the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2018. The patients included 28 males and 39 females, with an average age of (47.6±14.2) years. Eighteen age-and sex-matched healthy controls were also enrolled. Clinical and pathological data, blood and urine samples of all subjects were collected. Urinary MCP-1 and EGF level were detected by enzyme-linked immunosorbent assay (ELISA). And then the levels of urinary MCP-1, EGF and the ratio of EGF/MCP-1 and their correlations with clinicopathology were analyzed. Results: There was no statistical difference of the urine EGF levels between the two groups [8.3(6.0,12.6) vs 8.4(6.5,10.2) ng/mg Cr, P=0.575]. The urine MCP-1 levels of IMN patients were 0.37 (0.21, 0.69) ng/mg Cr, which was statistical significantly higher than those of the control group [0.09 (0.02, 0.19) ng/mg Cr] (P<0.001), while the EGF/MCP-1 ratio was lower than that of the control group [22.2(15.1,36.6) vs 87.6(71.2,132.7), P<0.001]. Urine MCP-1 was negatively correlated with eGFR (r=-0.303, P=0.012), but positively correlated with the urinary ratio of albumin to creatinin (r=0.368, P=0.002). EGF was positively correlated with eGFR (r=0.722, P<0.001), but negatively correlated with the severity of interstitial fibrosis and renal tubular atrophy (IFTA) (r=-0.312, P=0.011). EGF/MCP-1 ratio was positively correlated with eGFR (r=0.693, P<0.001), but negatively correlated with the severity of the urinary ratio of albumin to creatinin and IFTA (r=-0.261, P=0.028 and r=-0.684, P<0.001, respectively). Further multivariate logistic regression analysis showed that EGF/MCP-1 was a protective factor for moderate-to-severe IFTA (OR=0.891, 95%CI: 0.844-0.949, P=0.008). Conclusion: Patients with IMN have elevated urine MCP-1 level and decreased EGF/MCP-1 ratio, which correlate with clinical indicators. In particular, EGF/MCP-1 ratio is independently related to moderate-severe IFTA, and may be a potential clinical biomarker for diagnosis of IMN.

Role of Link N in Modulating Inflammatory Conditions

AIMS

To elucidate the role of Link N in regulating inflammatory molecules from human mesenchymal stem cells (hMSCs) under interleukin (IL)-1β stimulation in vitro and under Complete Freund's Adjuvant (CFA)-induced arthritis of the temporomandibular joint (TMJ) in vivo.

METHODS

In vitro analysis of inflammatory cytokines and epithelial-mesenchymal transition (EMT) genes in hMSCs treated with Link N, IL-1β, and co-stimulation of IL-1β and Link N was undertaken using Luminex multiplex assays and real-time polymerase chain reaction, respectively. To determine the impact of Link N in ameliorating TMJ tissue homeostasis in arthritic conditions, histologic changes in CFA-induced arthritic TMJ tissues followed by application of Link N were examined. All data were analyzed using one-way analysis of variance with Bonferroni post hoc test.

RESULTS

Increased levels of IL-6; interferon gamma-inducible protein-10; and regulated upon activation, normal T cell expressed, and secreted (RANTES) were detected in response to IL-1β treatment, but these levels were significantly decreased in the co-stimulation group. In contrast, secreted IL-4, IL-10, and transforming growth factor β1- β3 proteins, as well as intracellular erb-b2 receptor tyrosine kinase 3 and Nodal homolog genes, were increased significantly in the co-stimulation group compared to the IL-1β group. Histologic analysis showed significant recovery for rat condyle thickness in the Link N-treated group when compared to the CFA-induced arthritis group.

CONCLUSION

These findings indicate that Link N could modulate inflammation and EMT in vitro and repair arthritis-mediated TMJ disruption in vivo. Link N could be a potential therapeutic agent for TMJ disorder patients.

Abutment screw withdrawal after conical abutment settlement: A pilot study

OBJECTIVE

This study investigated the effects of abutment screw withdrawal after conical abutment settlement on the stability of the implant-abutment connection.

MATERIALS AND METHODS

Twenty implants of a conical connection system were used. Two two-piece abutment designs were used: cone only (n = 10; NI) and cone plus octagonal index design (n = 10; I); for each design, five samples were used with (S) and without (NS) abutment screw withdrawal before a cyclic test. Finally, four groups, namely Gr S(NI), Gr S(I), Gr NS(NI), and Gr NS(I), were included. The cyclic test included cyclic loading of 20-200 N, 30°, and 4-mm off-axis to implant axis at 10 Hz for 10⁶ cycles, simulating a clinical time interval of 40 months. The fatigue cycles were recorded. The axial displacement of the conical abutments during abutment settlement, screw withdrawal, and cyclic loading were measured. Abutment morphology was examined through scanning electron microscopy (SEM).

RESULTS

Only Gr NS(NI) failed the test, indicating that without the index design and abutment screw withdrawal, and connection stability seriously deteriorated. Gr NS(I) exhibited significantly higher axial displacement into the implant after abutment settlement than did Gr NS(NI). It also exhibited continuous axial displacement into the implant after cyclic loading. SEM after cyclic testing in Gr NS(I) revealed marked burnishing on lateral edges of the index, indicating that the index design provides an antitorsional ability.

CONCLUSION

Although this study has few limitations, abutment screw withdrawal is feasible in this conical implant-abutment connection system with index design.

[Olfaction and sinonasal symptoms in CRSwNP patients with or without atopy]

Objective: Olfactory impairment is commonly observed in chronic rhinosinusitis with nasal polyps(CRSwNP) and has a significant impact on quality of life. However, the risk factors for olfactory impairment have not been fully understood, and whether atopy is predisposed to olfactory impairment in CRSwNP patients remains unclear. The present study aims to unveil differences in olfaction and sinonasal symptoms between CRSwNP with and without atopy by means of a hospital-based, cross-sectional survey. Method: In this study, 288 CRSwNP patients ready for sinus surgery were consecutively enrolled, and atopy, olfaction, sinonasal symptoms and CT scores were evaluated. Result: We found 71.3% of CRSwNP patients presented olfactory loss and 34.5% of them presented olfactory complaint in this cohort (In this study, olfactory impairment has been defined when VAS≥1 and olfactory dysfunction has been defined when VAS≥5）.The decreased olfactory function was associated with sinonasal symptoms(nasal congestion and rhino rhea) and total CT scores (P<0.01), but not with atopy. Multivariate logistic regression revealed that nasal congestion score and total CT score were risk factors for olfactory dysfunction (OR, 1.293 and 1.349; P<0.01) in CRSwNP patients. Conclusion: Our findings indicate atopic condition may not directly cause olfactory impairment, and physician should pay attention to the surgical treatment for local disease severity to improve the olfactory function and quality of life..

Cobalt disulfide-modified cellular hierarchical porous carbon derived from bovine bone for application in high-performance lithium-sulfur batteries

Improving the insulating nature of sulfur and retaining the soluble polysulfides in sulfur cathodes are crucial for realizing the practical application of lithium-sulfur batteries (LSBs). Biomass-based carbon is becoming increasingly popular for fabricating economical and efficient cathodes for LSBs owing to its unique structure. Herein, we report a facile strategy to transform bovine bone with an organic-inorganic structure into cellular hierarchical porous carbon via carbonization and KOH activation, followed by CoS₂ modification through hydrothermal treatment. The synthesized composite can load abundant sulfur and produce a dual effect of "physical confinement and chemical entrapment" on polysulfides. The conductive carbon frame with the developed porous structure provides adequate space to accommodate sulfur and physically suppress the shuttle effect of polysulfides. The embedded half-metallic CoS₂ sites can chemically anchor the polysulfides and enhance the electrochemical reaction activity as well. Owing to the multifunctional structure and dual restraint effect, the designed electrode exhibits enhanced electrochemical properties including high initial capacity (1230.9 mAh g^-1 at 0.2 C), improved cycling stability and enhanced rate capability.

Dysphagia and risk of aspiration pneumonia: A nonrandomized, pair-matched cohort study

Background/purpose

Dysphagia was associated with increased prevalence of aspiration pneumonia (AP) in studies that were criticized for either their small sample size or lack of prospective design. Using a considerably larger nationwide, population-based database and a long-term prospective cohort design, our study aimed to explore the relationship between dysphagia and the subsequent development of AP.

Materials and methods

From 2000 to 2009, we gathered a study cohort consisting of 6979 newly diagnosed cases of dysphagia from Taiwan's National Health Insurance Research Database. For the control group, another 20,937 individuals without dysphagia were matched for age, sex, and comorbidity. The two cohorts were followed-up to observe the occurrence of AP and correlated mortality.

Results

During an average of 3.88 ± 2.73 years of follow-up, we observed 315 cases of new AP [non-dysphagia (193, 0.92%) vs. dysphagia (122, 1.75%), p < 0.0001], and the incidence of AP was significant in the dysphagia group. After adjusting for age, sex, and comorbidity, dysphagia-related AP [hazard ratio (HR) 2.499; 95% confidence interval (CI), 2.089-2.99; p < 0.0001], dysphagia related mortality [HR 3.229; 95% CI, 3.052-3.417; p < 0.0001], and many other systemic diseases were independently associated with a diagnosis of AP.

Conclusion

Dysphagia was highly associated with an increased risk of AP according to data derived from a large nationwide cohort database. Nonetheless, larger prospective studies or meta-analyses are recommended to confirm our findings.

Wet-spinning-based Molding Process of Gelatin for Tissue Regeneration

This article presents an inexpensive method to fabricate gelatin, as a natural polymer, into monofilament fibers or other appropriate forms. Through the wet spinning method, gelatin fibers are produced by smooth extrusion in a suitable coagulation medium. To increase the functional surface of these gelatin fibers and their ability to mimic the features of tissues, gelatin can be molded into a tube form by referring to this concept. Examined by in vitro and in vivo tests, the gelatin tubes demonstrate a great potential for application in tissue engineering. Acting as a suitable filling gap material, gelatin tubes can be used to substitute the tissue in the damaged area (e.g., in the nervous or cardiovascular system), as well as to promote regeneration by providing a direct replacement of stem cells and neural circuitry. This protocol provides a detailed procedure for creating a biomaterial based on a natural polymer, and its implementation is expected to greatly benefit the development of correlative natural polymers, which help to realize tissue regeneration strategies.

[Retrospective analysis of 188 cases of parapharyngeal space tumors]

Objective:To explore the diagnosis,treatment,surgical approach and prognosis of parapharyngeal space tumors.Method:The clinical data of 188 patients with parapharyngeal space tumor who were treated from January 2007 to December 2016 were analyzed retrospectively.All patients underwent imaging examination before operation.Surgical approach was as follows:transcervical approach applied in 159 cases,endoscopic-assisted transnasal approach in 9 cases,transcervical-transmandibular approach in 8 cases,transcervical-transparotid approach in 8 cases,transoral approach in 7 cases,and infratemporal fossa approach in 4 case.Result:Of the 188 cases,the tumor was benign in nature in 168 cases(89%)and malignant in 20 cases(11%).Complications occurred in 28(15%)patients,with the most common symptom being hoarseness.168 cases of benign tumors were followed up for 10 months to 10 years,and 3 cases were lost and 4 cases had recurrence.All cases underwent re-operation.Patients with malignant tumors received combined treatment after surgery,and 3 cases were lost to follow-up,1 case died of recurrence 9 months after surgery,the rest survived.Conclusion:Surgery is the preferred method for treating parapharyngeal space tumors and postoperative recurrence rate is pretty low.Endoscopy provides a new surgical management method,helping to reduce postoperative complications and recurrence rate.

[One case report of subglottic schwannomaresected with CO₂ laser]

A 26 years female patient was in hospital with repeated asthma, hoarseness and dyspnoea. Fiber laryngoscope examination showed that a mass in subglottic area. The tumor was completelyresected with CO₂ laser and finally diagnosed as subglottic schwannomaby pathological examination. The characteristics of subglottic schwannoma and the resection methods of CO₂ laser were discussed. There was no recurrence in three months follow.

Supplementation with CTGF, SDF1, NGF, and HGF promotes ovine in vitro oocyte maturation and early embryo development

The strategies for improving the in vitro maturation (IVM) of domestic animal oocytes focus on promoting nuclear and cytoplasmic maturation. The identification of paracrine factors and their supplementation in the culture medium represent effective approaches for oocyte maturation and embryo development. This study investigated the effects of paracrine factor supplementation including connective tissue growth factor (CTGF), nerve growth factor (NGF), hepatocyte growth factor (HGF), and stromal derived factor 1 (SDF1) on ovine oocytes and early parthenogenetic embryos using an in vitro culture system. First, we identified the optimal concentrations of CTGF (30 ng/mL), SDF1 (10 ng/mL), NGF (3 ng/mL), and HGF (100 ng/mL) for promoting oocyte maturation, which combined, induced nuclear maturation in 94.19% of oocytes. This combination also promoted cumulus cell expansion and inhibited oocyte/cumulus apoptosis, while enabling a larger proportion (33.04%) of embryos to develop into blastocysts than in the controls and prevented embryo apoptosis. These novel findings demonstrate that the paracrine factors CTGF, SDF1, NGF, and HGF facilitate ovine oocyte and early parthenogenetic embryo development in vitro. Thus, supplementation with these factors may help optimize the IVM of ovine oocytes and early parthenogenetic embryo development strategies.

Correction to: Osteogenic prospective of deriving human dental stem cells in collagen matrix boost

The original version of this article unfortunately contained a mistake. The country was incorrect in the authors affiliations. It should read as "ROC". The corrected affiliations are given below.

[The surgical management of nasal skull base schwannoma under endonasal endoscope: a retrospective review of 52 cases]

Objective: To discuss the surgical technique and outcome of nasal skull base schwannoma treated under endonasal endoscope. Methods: Fifty-two patients with nasal skull base nonvestibular schwannoma were treated under endonasal endoscope from May 2006 to June 2017 in Shanghai E&ENT Hospital. Of the patients, there were 21 men and 31 women. The age of the patients ranged from 33 to 71 years.Schwannoma mainly came from trigeminal nerve.Clinical symptoms included facial numbness, facial pain, nasal obstruction, headache, hypopsia, diplopia and tinnitus. Surgical approaches included pure endonasal endoscope approach (18 cases) and endoscopic endonasal resection asissted with sublabial transmaxillary approach (34 cases). Results: Total tumor resection was achieved in 42 patients(80.8%), subtotal resection in 8 patients, and partial resection in 2 patients. The relief rate of facial numbness, facial pain, nasal obstruction, headache, hypopsia, diplopia and tinnitus were 68.8%, 45.5%, 100.0%, 90.0%, 60.0%, 40.0% and 100.0%, respectively. During surgery, cerebrospinal fluid leakage was observed in 5 cases. All cases were successfully repaired with a nasoseptal flap or autologous fascia lata and fat obtained from thigh. Four cases with recurrence were observed in the follow-up period (6-134 months). Conclusion: Endonasal endoscopic approach is a safe and feasible procedure for schwannoma in nasal cavity, paranasal sinus, orbital apex, pterygopalatine fossa, infratomporal fossa, cavernous sinus and Meckel cave.

A cardioid oscillator with asymmetric time ratio for establishing CPG models

Nonlinear oscillators are usually utilized by bionic scientists for establishing central pattern generator models for imitating rhythmic motions by bionic scientists. In the natural word, many rhythmic motions possess asymmetric time ratios, which means that the forward and the backward motions of an oscillating process sustain different times within one period. In order to model rhythmic motions with asymmetric time ratios, nonlinear oscillators with asymmetric forward and backward trajectories within one period should be studied. In this paper, based on the property of the invariant set, a method to design the closed curve in the phase plane of a dynamic system as its limit cycle is proposed. Utilizing the proposed method and considering that a cardioid curve is a kind of asymmetrical closed curves, a cardioid oscillator with asymmetric time ratios is proposed and realized. Through making the derivation of the closed curve in the phase plane of a dynamic system equal to zero, the closed curve is designed as its limit cycle. Utilizing the proposed limit cycle design method and according to the global invariant set theory, a cardioid oscillator applying a cardioid curve as its limit cycle is achieved. On these bases, the numerical simulations are conducted for analyzing the behaviors of the cardioid oscillator. The example utilizing the established cardioid oscillator to simulate rhythmic motions of the hip joint of a human body in the sagittal plane is presented. The results of the numerical simulations indicate that, whatever the initial condition is and without any outside input, the proposed cardioid oscillator possesses the following properties: (1) The proposed cardioid oscillator is able to generate a series of periodic and anti-interference self-exciting trajectories, (2) the generated trajectories possess an asymmetric time ratio, and (3) the time ratio can be regulated by adjusting the oscillator's parameters. Furthermore, the comparison between the simulated trajectories by the established cardioid oscillator and the measured angle trajectories of the hip angle of a human body show that the proposed cardioid oscillator is fit for imitating the rhythmic motions of the hip of a human body with asymmetric time ratios.

[Clinical research of anxiety and depression state among patients suffered from sudden deafness with vertigo]

Objective:To offer the objective evidences for the diagnosis by analyzing anxiety and depression among patients with sudden deafness and vertigo and their possible causes. Method:Eighty patients with sudden deafness and vertigo of single ear as the observation group; 80 patients with sudden deafness without vertigo and 60 healthy people as control group.Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD) are used for quantitative analysis and compare the results of each group score. Result:①The HAMA score of the deafness group with vertigo was significantly higher than that of the group without vertigo and the healthy group (P<0.01). The HAMD score of the deafness group with vertigo was significantly higher than that of the group without vertigo and the healthy group (P<0.01). ②There was correlation between HAMA and sex, age, duration of dizziness, tinnitus, DHI and efficacy grading (P<0.05). There was no correlation between HAMA and the mean hearing threshold, urban and rural distribution, ear fullness (P> 0.05). There was a correlation between HAMD and sex, age, tinnitus, DHI and efficacy grading (P<0.05). There was no correlation between HAMD and the mean hearing threshold, duration of dizziness, urban and rural distribution, ear fullness (P>0.05). Conclusion:There are anxiety and depression in patients with deafness and vertigo. It is mainly related to sex, age, dizziness duration, tinnitus, DHI and grade of efficacy. It is necessary to pay attention to the mental state of patients in clinical treatment. Psychological counseling or treatment can be used to improve clinical efficacy.

Observational evidence of a long-term increase in precipitation due to urbanization effects and its implications for sustainable urban living

Although projected precipitation increases in East Asia due to future climate change have aroused concern, less attention has been paid by the scientific community and public to the potential long-term increase in precipitation due to rapid urbanization. A ten-year precipitation dataset was analysed for both a rapidly urbanized megacity and nearby suburban/rural stations in southern China. Rapid urbanization in the megacity was evident from satellite observations. A statistically significant, long-term, increasing trend of precipitation existed only at the megacity station (45.6mm per decade) and not at the other stations. The increase was attributed to thermal and dynamical modifications of the tropospheric boundary layer related to urbanization, which was confirmed by the results of our WRF-SLUCM simulations. The results also suggested that a long-term regional increase in precipitation, caused by greenhouse gas-induced climate change, for instance, was not evident within the study period. The urbanization-induced increase was found to be higher than the precipitation increase (18.3mm per decade) expected from future climate change. The direct climate impacts due to rapid urbanization is highlighted with strong implications for urban sustainable development and the planning of effective adaptation strategies for issues such as coastal defenses, mosquito-borne disease spread and heat stress mortality.

Osteogenic prospective of deriving human dental stem cells in collagen matrix boost

Stem cells derived from oral tissue represent a highly attractive alternative source for clinical bone regeneration because they can be collected by non-invasive or minimally invasive procedures. Herein, we describe the human dental stem cells (DSCs) deriving from buccal fat pads (BFP), dental pulp (DP) of impacted teeth, and periodontal ligaments (PDL) to obtain BFPSCs, DPSCs, and PDLSCs, respectively. Cells were purified with selected medium and expanded through passages in stem cell culture medium. Purified cells were characterized for stemness by their growth rate, immunostaining, and multilineage differentiation ability. They showed plastic adherence, expression of stemness-specific markers, and multilineage differentiation potential. Immunocytochemistry analysis confirmed that DPSCs had more osteogenic potential than BFSCs and PDLSCs. Calcium-rich deposits, evaluated by von Kossa and Alizarin red staining, showed greater mineralization when DPSCs were cultured on collagen type I matrix than without collagen. Furthermore, DPSC-seeded collagen type I matrix maintained consistent osteogenesis and boosted mineral formation by 1-2 weeks over that in DPSCs cultured without collagen. Radiographic analysis of DPSC-seeded collagen type I matrix transplanted into rat cranial defects showed significant bone regeneration after 8 weeks. These results suggested that the redundant oral tissue can be used as a source of adult multipotent stem cells for clinical bone regeneration. Triple overlay images with biomarkers (red), nuclei (blue) and bright field morphology of DPSCs. The specifically osteo-differentiation shown by osteocalcin (left) expression and lack of sox9 (right) expressed in the images below which were cultured with collagen matrix, contrast with no collagen matrix group above.

[Characterization and uncertainty evaluation of aqueous reference materials for cholesterol]

Objective: Characterization and evaluation of the uncertainty of the reference materials of cholesterol in aqueous solution. Methods: The certified reference material GBW09203b was weighed accurately and dissolved into methyl cyclodextrin aqueous solution to prepare six kinds of candidate reference materials of cholesterol according to the concentration. The materials were tested for homogeneity and stability using routine methods and were evaluated the uncertainty derived from the inhomogeneity and instability. The uncertainty due to measurement was derived from the purity of the raw material, the weighing and the density measurement. The certified values and expanded uncertainties were calculated according to the ISO Guide. The expanded uncertainty of the certified value was the combination of standard uncertainty of measurement, inhomogeneity and instability. The coverage factor, k, was determined from the Student's t-distribution corresponding to the calculated effective degrees of freedom and 95% level of confidence. Results: It showed that the six candidate reference materials were homogeneous and were tested to be stable for at least 1 year at -70 ℃ and -20 ℃ using the isochronous stability study. The relative uncertainties due to the inhomogeneity were 0.14%, 0.11%, 0.13%, 0.47%, 0.39% and 0.11%. The relative uncertainty due to the instability was 0.25% at -70 ℃. The uncertainties of measurement were 0.06%, 0.05%, 0.05%, 0.05%, 0.05% and 0.05%.The certified values (reference value ± expanded uncertainty, mmol/L) were as follows: (0.651±0.004), (1.310 ±0.007), (2.574±0.015), (5.210±0.055), (7.710±0.072), (10.242±0.056) mmol/L. Conclusions: Six kinds of certified reference materials for cholesterol in aqueous solution have been prepared, which were homogeneity, stable and reliable. It showed that the uncertainty of measurement was very small compared with the uncertainty due to inhomogeneity and instability.