Biomechanical Considerations in the Orthodontic Treatment of a Patient with Stabilised Stage IV Grade C Generalised Periodontitis: A Case Report

Orthodontic treatment of periodontally compromised patients presents unique challenges, including controlling periodontal inflammation, applying appropriate force, designing an effective dental anchorage, and maintaining treatment results. Deteriorated periodontal support leads to alterations in the biological responses of teeth to mechanical forces, and thus orthodontists must take greater care when treating patients with periodontal conditions than when treating those with a good periodontal status. In this article, we report the case of a 59-year-old woman with stabilised Stage IV grade C generalised periodontitis characterised by pathological tooth migration (PTM). The assessment, planning, and treatment of this patient with orthodontic fixed appliances is described. Moreover, the anchorage planning and biomechanical considerations are detailed. Specific orthodontic appliances were employed in this case to produce force systems for achieving precise tooth movement, which included a cantilever, mini-screws, and a box loop. Careful application of those appliances resulted in satisfactory aesthetic and functional orthodontic outcomes in the patient. This case highlights the importance of multidisciplinary collaboration in the treatment of patients with severe periodontitis and the potential for tailored biomechanical approaches in orthodontic treatment to furnish good outcomes.

Radiographic Imaging for the Diagnosis and Treatment of Patients with Skeletal Class III Malocclusion

Skeletal Class III malocclusion is one type of dentofacial deformity that significantly affects patients' facial aesthetics and oral health. The orthodontic treatment of skeletal Class III malocclusion presents challenges due to uncertainties surrounding mandibular growth patterns and treatment outcomes. In recent years, disease-specific radiographic features have garnered interest from researchers in various fields including orthodontics, for their exceptional performance in enhancing diagnostic precision and treatment effect predictability. The aim of this narrative review is to provide an overview of the valuable radiographic features in the diagnosis and management of skeletal Class III malocclusion. Based on the existing literature, a series of analyses on lateral cephalograms have been concluded to identify the significant variables related to facial type classification, growth prediction, and decision-making for tooth extractions and orthognathic surgery in patients with skeletal Class III malocclusion. Furthermore, we summarize the parameters regarding the inter-maxillary relationship, as well as different anatomical structures including the maxilla, mandible, craniofacial base, and soft tissues from conventional and machine learning statistical models. Several distinct radiographic features for Class III malocclusion have also been preliminarily observed using cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI).

Association between occlusal features and masticatory function in Hong Kong preschool children: a survey with one-year longitudinal follow-up

BACKGROUND

Mastication is important for breaking down food, aiding swallowing and nutrients absorption, and is therefore fundamental to a child's development. Studies have shown poor masticatory function to be associated with younger age and presence of caries. However, studies of the association between masticatory function and malocclusion yielded contradictory results. The aim of this study is therefore to investigate the association between three-dimensional occlusal features with masticatory function, among preschool children in Hong Kong.

METHODS

Self-administered questionnaires on masticatory function in three domains, namely general chewing difficulty, requiring help when eating different food types and increased preference for soft food were completed by parents. Information on non-nutritive sucking habits and basic demographics were also collected in the questionnaire. Clinical examinations were conducted to record three-dimensional occlusal features and presence of caries. Baseline investigations and one-year follow-ups were undertaken for 1,566 and 996 preschool children. Association of poor masticatory function with occlusal features, sucking habits and caries was investigated using chi-squared tests. Binomial logistic regressions were then carried out incorporating any significant factors identified. Longitudinal analysis of the one-year follow-up data was carried out to investigate whether improved occlusal features, sucking habits and caries resulted in better masticatory function.

RESULTS

In the cross-sectional study, the first domain of general chewing difficulty was associated with caries and thumb/digit sucking. The second domain of requiring help when eating different food types was associated with the male sex, younger age, caries and pacifier use. The last domain of increased preference for soft foods was associated with caries and thumb/digit sucking. Occlusal features, including abnormal overjet and unilateral permanent molars not in contact, were significantly associated with poor masticatory function in the bivariate analyses, but were not significant in the logistic regressions. In the longitudinal analysis, general chewing difficulty was found to improve in those of older age and those with resolved anterior crossbite. Less help was required to eat meat in those with fewer caries. Similarly, less help was required to eat food containing bones in those with reduced pacifier use. Preferences for eating soft foods was reduced in those who developed a normal overjet.

CONCLUSIONS

The study identified significant relationships between masticatory difficulties and factors associated with age, gender, active caries, and non-nutritive oral habits such as thumb/digit sucking and pacifier use. Younger children and males required more assistance with certain food types. Active caries and thumb/digit sucking habits contributed to general masticatory difficulties and preference for soft foods. The one-year follow-up indicated that improvement in masticatory function varies across age cohorts and were associated with improved occlusal features, such as resolution of anterior crossbite and normalized overjet, reduced pacifier use, and a decrease in the number of decayed teeth.

Improvement of parents' oral health knowledge by a school-based oral health promotion for parents of preschool children: a prospective observational study

BACKGROUND

Parents of preschool children have inadequate oral health knowledge in Hong Kong. Parents play a critical role in preschool children's dietary patterns and oral health behaviors. A school-based oral health promotion (OHP) for parents of preschoolers was developed and investigated.

OBJECTIVES

The objective of this study was to evaluate effects of the school-based OHP for parents of preschool children on parents' oral health knowledge and preschool children's early childhood caries (ECC).

MATERIALS AND METHODS

This was a quasi-experimental study. Parents of preschool children were divided into the intervention group (IG) and the control group (CG) according to their own selection. Parents in the IG participated in a structured school-based OHP workshop, while those in the CG did not attend the OHP workshop. Parents in both groups were invited to complete a questionnaire assessing their oral health knowledge before (T0), one month after (T1), and twelve months after (T2) the OHP workshop. Preschool children's caries was examined via dmft score at T0 and T2.

RESULTS

Parents' oral health knowledge was negatively correlated with preschool children's dmft scores (R = -0.200, P < 0.001). Oral health knowledge was significantly improved in IG (P < 0.001) but not in CG (P = 0.392) at T1. Both groups experienced a significant improvement in oral health knowledge from T0 to T2 (P < 0.001). Parents' oral health knowledge in the IG was significantly higher compared to the CG at T1 (P < 0.001), but difference in the scores at T2 between the two groups showed no significant difference (P = 0.727). No significant difference was found in changes in children's dmft score from T0 to T2 between the IG and CG (p = 0.545).

CONCLUSION

Preschool children's high ECC is associated with the limited oral health knowledge of their parents. The school-based OHP workshop for parents increased parents' oral health knowledge within one month. This positive effect was maintained for twelve months and can be extended to a larger scale in the school setting.

Application of Artificial Intelligence in Orthodontics: Current State and Future Perspectives

In recent years, there has been the notable emergency of artificial intelligence (AI) as a transformative force in multiple domains, including orthodontics. This review aims to provide a comprehensive overview of the present state of AI applications in orthodontics, which can be categorized into the following domains: (1) diagnosis, including cephalometric analysis, dental analysis, facial analysis, skeletal-maturation-stage determination and upper-airway obstruction assessment; (2) treatment planning, including decision making for extractions and orthognathic surgery, and treatment outcome prediction; and (3) clinical practice, including practice guidance, remote care, and clinical documentation. We have witnessed a broadening of the application of AI in orthodontics, accompanied by advancements in its performance. Additionally, this review outlines the existing limitations within the field and offers future perspectives.

Radiomics Analysis in Characterization of Salivary Gland Tumors on MRI: A Systematic Review

Radiomics analysis can potentially characterize salivary gland tumors (SGTs) on magnetic resonance imaging (MRI). The procedures for radiomics analysis were various, and no consistent performances were reported. This review evaluated the methodologies and performances of studies using radiomics analysis to characterize SGTs on MRI. We systematically reviewed studies published until July 2023, which employed radiomics analysis to characterize SGTs on MRI. In total, 14 of 98 studies were eligible. Each study examined 23-334 benign and 8-56 malignant SGTs. Least absolute shrinkage and selection operator (LASSO) was the most common feature selection method (in eight studies). Eleven studies confirmed the stability of selected features using cross-validation or bootstrap. Nine classifiers were used to build models that achieved area under the curves (AUCs) of 0.74 to 1.00 for characterizing benign and malignant SGTs and 0.80 to 0.96 for characterizing pleomorphic adenomas and Warthin's tumors. Performances were validated using cross-validation, internal, and external datasets in four, six, and two studies, respectively. No single feature consistently appeared in the final models across the studies. No standardized procedure was used for radiomics analysis in characterizing SGTs on MRIs, and various models were proposed. The need for a standard procedure for radiomics analysis is emphasized.

Effects of Low-Level Laser Therapy on Dentin Hypersensitivity in Periodontally Compromised Patients Undergoing Orthodontic Treatment: A Randomised Controlled Trial

OBJECTIVES

This study aimed to assess the effects of low-level laser therapy (LLLT) on dentin hypersensitivity (DH) in periodontally compromised patients undergoing orthodontic treatment.

METHODS

This triple-blinded randomised controlled trial included 143 teeth with DH from 23 periodontally compromised patients. Teeth on one side of the dental arch were randomly assigned to the LLLT group (LG), while those on the contralateral side were allocated to the non-LLLT group (NG). After orthodontic treatment commenced, patients' orthodontic pain (OP) perceptions were documented in pain diaries. DH was assessed chairside by a visual analogue scale (VASDH) at fifteen timepoints across the orthodontic treatment and retention. VASDH scores were compared among timepoints by the Friedman test, among patients with varying OP perceptions using the Kruskal-Wallis tests, and between the LG and NG with the Mann-Whitney U test.

RESULTS

DH generally decreased over the observation (p < 0.001). The VASDH scores differed among patients with varying OP perceptions at multiple timepoints (p < 0.05). The generalized estimating equation model showed teeth in the LG had a significantly lower VASDH score than the NG at the 3rd month of treatment (p = 0.011).

CONCLUSION

LLLT could be potentially beneficial in managing DH in periodontally compromised patients undergoing orthodontic treatment.

3-Dimensional simulations and student learning in orthodontic education

INTRODUCTION

The electronic dental model (e-model) is an example of a digital 3-dimensional technology to support inquiry-based learning in undergraduate dental education. As student perceptions of and engagement with e-models vary, it is uncertain whether these perceptions have implications for their learning processes and outcomes.

MATERIALS AND METHODS

Third-year dental students (N = 40) completed a questionnaire to identify their perceptions of and preferences for model modalities. They were divided into three groups based on their preference: Preferring plaster models (Group 1); Preferring e-models (Group 2); No preference (Group 3). Students from three groups (N = 9) attended a hands-on digital occlusion evaluation workshop, and then completed a case-based diagnostic evaluation test using digital occlusion evaluation software. Camtasia Studio™ recorded real-time and on-screen data of the number of mouse-clicks and time spent.

RESULTS

Students reported positive feedbacks on the use of e-models, and 72.5% of the students preferred combination use of e-models and plaster models. After attending the hands-on digital dental occlusion evaluation workshop, Group 2 scored higher on the diagnostic evaluation test (p < .05) and registered more mouse-clicks than Group 1 when evaluating the arch symmetry (p < .05). Group 2 registered fewer mouse-clicks than Group 3 during tooth size measurement (p < .05). There was no significant difference regarding the time used to answer the knowledge questions amongst the three groups.

CONCLUSION

Undergraduate dental students indicated a generally high acceptance of e-models for their learning in orthodontics, and more prefer a blended approach. Students preferring e-models presented higher performance outcomes, which supports cognitive load theory regarding prior exposure to simulation-based environments.

Dynamic alternations of RANKL/OPG ratio expressed by cementocytes in response to orthodontic‑induced external apical root resorption in a rat model

The aim of the present study was to investigate the alterations in the formation of cementocytes in response to orthodontic forces and to evaluate the contribution of these cells in the biological changes of tooth movement and associated root resorption. A total of 90 Sprague Dawley rats were randomly assigned to the control, high force, and low force groups. Intrusion forces of 10 and 50 g were applied on the rat molar to induce tooth intrusion. The tooth movement was observed from 0 to 14 days by micro-computed tomography, bone histometric analysis, tartrate-resistant acid phosphatase staining, as well as reverse transcription-quantitative PCR and immunofluorescence staining assays. The results suggested that under low force conditions, osteoclasts were distributed at a higher frequency on the bone side than on the root side. Under high force conditions, both sides suffered osteoclast infiltration. In the low force group, the cementocytes exhibited downregulated sclerostin (SOST) and osteoprotegerin (OPG) mRNA levels and a lower receptor activator of nuclear factor-κB ligand (RANKL)/OPG ratio over a certain period of time. The expression levels of these genes were lower compared with those of the osteocytes at each time-point. In the high force group, both cementocytes and osteocytes upregulated the SOST and RANKL/OPG ratio on days 7 and 14, while the cementocytes expressed higher levels of SOST mRNA than those noted in the osteocytes. These data suggested that cementocytes responded to the orthodontic force via modulation of the RANKL/OPG ratio and SOST expression. The biological response of cementocytes contributed to the mechanotransduction and homoeostasis of the roots under compression. Excessive forces may act as a negative factor of this regulatory role. These results expand our knowledge on the function of cementocytes.

[Effects of cortical bone trajectory screw in adjacent-segment disease after posterior lumbar interbody fusion]

Objective: To investigate the effect of the cortical bone trajectory (CBT) screw fixation combined with midline lumbar fusion (MIDLF) for adjacent spondylopathy after posterior lumbar interbody fusion. Methods: A retrospective analysis was conducted in 16 patients, including 9 males and 7 females, with a mean age of (68±6) years, who underwent revision surgery for adjacent spondylopathy after posterior lumbar fusion surgery using CBT combined with MIDLF technology in Sir Run Run Shaw Hospital, Zhejiang University from May 2013 to August 2019. The reasons for revision were radiculalgia in 4 cases, intermittent claudication in 10 cases and protrusive dissociate in 2 cases. Eleven cases had 1 segment fused in the first operation, while the other 5 cases received fusion in 2 segments. The average interval time between the first operation and the revision operation was (7.5±2.0) years. For the levels underwent revision, 1 case was L_2/3, 6 cases were L_3/4, 7 cases were L_4/5 and 2 cases were L₅/S₁. Before the operation, all the patients took X-rays scans of the thoracic and lumbar spine. CT and MRI scans were also performed. The operation time, intraoperative bleeding, surgical complications, visual analog scale (VAS) of low back and leg pain before the operation and at each follow-up were all recorded. Oswestry disability index (ODI) questionnaire was used to evaluate the functional improvement of patients after the operation. Results: All operations were completed successfully. The operation time was 120-240 (170±30) mins, intraoperative bleeding was 100-280 (220±45) ml. One case had a slight split in the isthmus, and the screw was inserted smoothly after adjusting the insertion point. In one case, the cerebrospinal fluid leaked during the operation and was successfully treated with conservative methods including no pillow supine treatment and strengthened anti-infection. The average follow-up time was of (19.5±1.3) months. The VAS of low back pain was 2.9±1.7 before the operation and it was 1.8±0.5 at the last follow-up, and the difference was statistically significant (P<0.01). The VAS of leg pain was 5.9±1.5 before the operation and it was 1.5±0.4 at the last the follow-up (P<0.01). The ODI score was 34.5±3.2 preoperatively and it decreased to 12.6±4.2 at the last follow-up, the difference was statistically significant (P<0.01). Conclusion: CBT technique combined with MIDLF for the adjacent-segment disease after posterior lumbar interbody fusion is minimally invasive and convenient, with good clinical effects. This technique can be used as an option for the revision of adjacent spondylopathy.

Effects of low-level light therapy on dentin hypersensitivity: a systematic review and meta-analysis

OBJECTIVE

To investigate the treatment efficacy of low-level light therapy on dentin hypersensitivity.

MATERIALS AND METHODS

Following the PRISMA guideline, six electronic databases supplemented with bibliographies were searched till December 2020. Two reviewers performed the screenings independently with a reliability assessment. Studies fulfilling the pre-registered eligibility criteria were included for risk-of-bias assessment and data synthesis.

RESULTS

Thirty-five articles ultimately informed this systematic review based on the eligibility criteria and underwent risk-of-bias assessment (ĸ = 0.86). Quantitative results were deduced by meta-analysis of 20 randomised controlled trials: LLLT showed favourable outcomes compared to placebos for immediate (SMD: 1.09, 95% CI: 0.47 to 1.70), interim (SMD: 1.32, 95% CI: 0.41 to 2.23), and persistent efficacies (SMD: 2.86, 95% CI: 1.98 to 3.74). However, substantial heterogeneity existed among included studies (I2: 64-95%). Regarding comparisons with other desensitising strategies, LLLT showed no significant benefits in DH alleviation over others except fluorides for interim efficacy (SMD: 0.31, 95% CI: 0.10 to 0.52) and persistent efficacy (SMD: 0.45, 95% CI: 0.03 to 0.86).

CONCLUSIONS

This systematic review shows that LLLT has positive immediate, interim, and persistent DH-treatment efficacies compared with placebo. No superior treatment effects of LLLT were observed except fluoride agent use. Further studies are warranted-RCTs with low risk of bias, consistent technical settings, comprehensive assessments, and long follow-up periods.

CLINICAL RELEVANCE

This systematic review bridges a critical research gap by analysing clinical evidence in the DH-alleviating efficacy of LLLT in comparison with placebo and other in-office desensitising strategies.

Nasal asymmetry changes during growth and development in 6- to 12-year-old children with repaired unilateral cleft lip and palate: A 3D computed tomography analysis

Repaired unilateral cleft lip and palate (UCLP) is often accompanied by the deformity and asymmetry of the nasal region. Three‐dimensional analysis was performed to investigate the relationship between nasal soft‐ and hard‐tissue asymmetries, as well as the changes in nasal asymmetry with age, among children with repaired UCLP (age: 6–12 years). Forty‐seven patients were included in this study. Their computed tomography records were retrieved for analysis of the 3D asymmetry of 10 landmarks of the nasal soft and hard tissues. We observed that asymmetry was more severe in nasal hard tissues than in soft tissues, particularly in the sagittal dimension. Compared with patients aged 6–9 years old, patients aged 10 to 12 years old had significantly increased vertical asymmetry at the base of the alar groove (Gbase, p = 0.027) and the lateral point of the piriform aperture (LPA), (p < 0.001). The correlation between the LPA and the alar region was weak to moderate (r = 0.290 to 0.488). In conclusion, we found no evidence of growth and development in nasal hard‐tissue asymmetry among 6‐ to 12‐year‐old children with repaired UCLP, except for the vertical dimension. Nasal soft tissue exhibited a more preferable symmetry than hard tissue, and this could be attributed to the compensatory growth of nasal soft tissue, particularly in the vertical and sagittal dimensions. The weak to moderate correlations between nasal soft‐tissue asymmetry and hard‐tissue asymmetry were observed in the three dimensions. Surgeons should consider these factors when repositioning the nasal alar and controlling the size of the nostrils.

Comprehensive Effects of Photobiomodulation Therapy as an Adjunct to Post-orthodontic Treatment Care: A Systematic Review

PURPOSE

To evaluate the comprehensive effects of photobiomodulation (PBM) therapy on teeth after active orthodontic treatment.

MATERIALS AND METHODS

This systematic review was conducted according to the PRISMA guidelines. Six databases were electronically searched and screened for eligible human and animal studies published up to August 2020. The risk of bias was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and Systematic Review Centre for Laboratory Experiment Tool. Two independent reviewers performed all procedures in duplicate. Any disagreement was resolved by discussion or consultation with a third reviewer.

RESULTS

A total of 395 records were identified from the initial search up to August 2020. Following screening, 16 full-text articles were reviewed for eligibility (κ > 0.90), and ultimately 9 studies (3 clinical studies and 6 animal studies) were included in this review. The key outcomes observed were 'tooth position maintenance' and 'root resorption rehabilitation'. Two controlled clinical trials and two animal studies supported the preventive effects of PBM therapy on the relapse of post-orthodontic tooth positions, while the other two animal studies reported opposing findings. Regarding root resorption, all evidence supported the rehabilitation potential using PBM therapy for teeth that had undergone orthodontic tooth movement. There was a high risk of bias among studies, except for one randomised controlled trial. Due to the substantial heterogeneity among studies in terms of their types, participants, designs, PBM therapy settings and variables of interest, it was not possible to conduct a meta-analysis; therefore, a qualitative synthesis is presented.

CONCLUSION

The quality of evidence for PBM therapy contributing to the maintenance of tooth position or improved dental health after orthodontic treatment remains low. There is considerable controversy over the effects of PBM therapy on orthodontic relapse. However, the use of PBM therapy after orthodontic treatment has promising effects for root resorption rehabilitation and is generally recommended.

Association between iodine intake and thyroid autoantibodies: a cross-sectional study of 7073 early pregnant women in an iodine-adequate region

PURPOSE

The association between iodine intake and thyroid autoimmunity has been debated, especially in pregnant women. This study aimed to investigate thyroid autoantibodies and their association with iodine intake and hypothyroidism in early pregnancy.

METHODS

7073 early pregnant women from an iodine-sufficient region participated in this study. Urinary iodine concentrations (UICs) were measured using an ammonium persulfate method. Serum thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and Tg were determined using an electrochemiluminescence immunoassay.

RESULTS

Iodine deficiency (UIC < 100 μg/L) was associated with higher risks of TPOAb positivity [adjusted odds ratio (aOR) = 1.64, 95% confidence interval [CI] (1.29-2.08)] and TgAb positivity [aOR = 1.44, 95% CI (1.16-1.80)]. Women with isolated TPOAb positivity, isolated TgAb positivity, or both TPOAb and TgAb positivity had a 14.64-fold, 7.83-fold, and 44.69-fold increased risk of overt hypothyroidism, and a 4.36-fold, 2.86-fold, and 6.26-fold increased risk of subclinical hypothyroidism, respectively. Moreover, the risks of overt and subclinical hypothyroidism in women with a high TPOAb titer were 16.99 and 4.80 times that in TPOAb-negative women, respectively. The risk of overt hypothyroidism in women with a high TgAb titer was 6.97 times that in TgAb-negative women.

CONCLUSIONS

Our work demonstrates that iodine deficiency during early pregnancy is an independent risk factor for both TPOAb positivity and TgAb positivity. Furthermore, positivity for both autoantibodies and a high thyroid autoantibody titer are associated with significantly higher risks of overt and subclinical hypothyroidism.

The impact of isolated maternal hypothyroxinemia during the first and second trimester of gestation on pregnancy outcomes: an intervention and prospective cohort study in China

OBJECTIVES

To explore the effect of isolated maternal hypothyroxinemia (IMH) during the first and second trimester of gestation on pregnancy outcomes. To explore whether levothyroxine (L-T4) treatment of women who had IMH identified in the first trimester improves pregnancy outcomes.

METHODS

Women in the early pregnancy in the iodine-sufficient area (n = 3398) were recruited to this prospective cohort study (ChiCTR-TRC-12002326). Serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), and thyroid peroxidase antibody (TPOAb) were detected. Women with IMH before 12 weeks chose to receive L-T4 or remain untreated. The L-T4 dose was adjusted to attain a normal FT4 and TSH level. Pregnancy outcomes were evaluated during follow-up.

RESULTS

IMH in the first trimester was not associated with increased risk of adverse pregnancy outcome compared with controls. The incidence of macrosomia (p = 0.022) and gestational hypertension (p = 0.018) was significantly higher in IMH identified in the second trimester of gestation compared with controls. IMH identified in the second trimester of gestation was a risk factor for macrosomia [adjusted odds ratio (aOR) 1.942, 95% CI 1.076-3.503, p = 0.027] and gestational hypertension (aOR 4.203, 95% CI 1.611-10.968, p < 0.01), when body mass index in the early pregnancy was < 25 kg/m².

CONCLUSIONS

IMH in the first trimester did not increase the risk of adverse outcomes irrespective of whether women received L-T4 treatment. However, IMH identified in the second trimester was associated with increased risk of adverse pregnancy outcome. The results suggest that thyroid function follow-up during the second trimester is necessary, even if thyroid function is normal during the first trimester.

Incidence of hepatitis B virus infection in young Chinese blood donors born after mandatory implementation of neonatal hepatitis B vaccination nationwide

This study was carried out to determine the incidence of hepatitis B virus (HBV) infection in the young generation born after mandatory implementation of hepatitis B vaccination since 1992. Repeat blood donors born between 1992 and 1997 were enrolled, who gave blood at least twice during the past 3 years. Donors were tested for HBV infection markers of HBsAg, anti-HBc, anti-HBs and viral DNA by immunoassays (EIAs) and nucleic acid tests (NAT). A total of 14 937 pre-donation screening qualified young repeat donors aged 18-23 years were tested with 9 (0.06%) being HBsAg by EIA and 10 (1:1494) HBV DNA positive by Ultrio NAT (10.4 IU/mL), respectively. HBV DNA was further detected in 1:192 (9/1732) anti-HBc+ repeat donors with Ultrio Plus NAT (3.4 IU/mL). Most cases were identified as occult HBV infection (OBI). Of 14 937 repeat donors, 20.9% were anti-HBc+ positive, while approximately 50% of 12 024 repeat donors were anti-HBs negative or had levels <100 IU/L. HBsAg+ or OBI strains were classified as wild type of genotype B or genotype C. Incident HBV infection in repeat donors was approximately 1:18.5 person-years (1.1%/year) but significantly less frequent in donors with confirmed HBV vaccination (2.4%-3.3%) than those unsure of vaccination status (10.5%; P = .0023). Hepatitis B virus vaccination appears largely protective of HBV infection, but incidence of infections increases in young adults with mostly undetectable or low anti-HBs or occasionally high anti-HBs. A boost of hepatitis B vaccine for adolescents prior to age 18 years may reduce HBV infection, and implementation of more sensitive NAT in blood donation screening may improve HBV safety in blood transfusion.

Orexin A increases sympathetic nerve activity through promoting expression of proinflammatory cytokines in Sprague Dawley rats

AIM

Accumulating evidence suggests that orexin signalling is involved in the regulation of blood pressure and cardiovascular function. However, the underlying mechanisms are not clear. Here, we test the hypothesis that upregulated orexin A signalling in the paraventricular nucleus (PVN) increases sympathetic nerve activity (SNA) through stimulating expression of proinflammatory cytokines (PICs).

METHODS

In vivo sympathetic nerve recordings were performed to test the impact of PVN orexin signalling on sympathetic outflow in Sprague Dawley (SD) rats. Real-time PCR was carried out to assess effects of central administration of orexin A on PVN PICs expression in SD rats. To test whether orexin A-induced increases in PICs were exclusively mediated by orexin receptor 1 (OX1R), OX1R-expressing PC12 (PC12-OX1R) cells were incubated with different dose of orexin A, and then, PICs mRNA and immunoreactivity were measured.

RESULTS

Orexin A microinjection (25 pmol) into the PVN significantly increased splanchnic SNA (93.5%) and renal SNA (83.3%) in SD rats, and these increases were attenuated by OX1R antagonist SB408124. Intracerebroventricular injection of orexin A (0.2 nmol) into SD rats increased mRNA levels of PICs including IL-1-β (2.7-fold), IL-6 (1.7-fold) and TNF-α (1.5-fold), as well as Fra1 (1.6-fold) in the PVN. Orexin A treatment in PC12-OX1R cells resulted in a dose- and time-dependent increase in the expression of PICs and Fra1, a subunit of AP1 transcriptional factor. The increase in the PICs was blocked by AP1 blocker curcumin.

CONCLUSION

Paraventricular nucleus orexin system activation is involved in SNA regulation maybe through triggering AP1-PICs pathway.

Osteochondral Interface Stiffening in Mandibular Condylar Osteoarthritis

Osteoarthritis (OA) of the temporomandibular joint (TMJ) is associated with dental biomechanics. A major change during OA progression is the ossification of the osteochondral interface. This study investigated the formation, radiological detectability, and mechanical property of the osteochondral interface at an early stage, the pathogenesis significance of which in OA progression is of clinical interest and remains elusive for the TMJ. Unilateral anterior crossbite (UAC) was performed on 6-wk-old rats as we previously reported. TMJs were harvested at 4, 12, and 20 wk. The progression of TMJ OA was evaluated using a modified Osteoarthritis Research Society International (OARSI) score system. Osteochondral interface was investigated by quantifying the thickness via von Kossa staining of histological slices and in vivo calcium deposition by calcein injection. Tissue ossification was imaged by micro-computed tomography (CT). Mechanical properties were measured at nanoscale using dynamic indentation. Time-dependent TMJ cartilage lesions were elicited by UAC treatment. Geometric change of the condyle head and increased value of the OARSI score were evident in UAC TMJs. At the osteochondral interface, there was not only enhanced deep-zone cartilage calcification but also calcium deposition at the osseous boundary. The thickness, density, and stiffness of the osteochondral interface were all significantly increased. The enhanced ossification of the osteochondral interface is a joint outcome of the aberrant deeper cartilage calcification at the superior region and promoted formation of subchondral cortical bone at the inferior region. The micro-CT detectable ossification from an early stage thus is of diagnostic significance. Although the environment of the cartilage and subchondral bone could be changed due to the stiffness of the interface, whether or not the stiffened interface would accelerate OA progress remains to be confirmed. With that evidence, the osteochondral interface could be a new diagnostic and therapeutic target of the mechanically initiated OA in the TMJ.

HBV/HCV co-infection is associated with a high level of HCV spontaneous clearance among drug users and blood donors in China

Understanding the biology of spontaneous clearance of hepatitis C virus (HCV) infection could lead to improved strategies to prevent the sequelae associated with chronic HCV infection. Chronic infections with hepatitis virus are very common in China, but the factors associated with spontaneous clearance of HCV have not been adequately studied. We evaluated the spontaneous clearance of HCV among 1918 drug users and 1526 HCV-seropositive blood donors in Guangzhou, China. Among participants who were co-infected with hepatitis B virus (HBV), 41.38% of drug users and 39.47% of blood donors had cleared their HCV infection without antiviral therapy compared to 9.41% of drug users and 16.73% of blood donors who were mono-infected with a single virus (P<.01). The proportion of subjects who had cleared their HCV infection was significantly greater in the co-infected subjects whose serum HBV DNA was greater than 2000IU/mL than those with lower levels. A multiple logistic regression analysis found female gender, IL28B rs8099917 TT genotype, HBV co-infection and blood donors (vs drug users) associated with increased spontaneous clearance of HCV infection. Although acute HCV infections are common in China, the incidence of chronic HCV may be reduced among the high prevalence of chronic HBV and IL28B genotypes associated with spontaneous clearance of HCV in Chinese populations.

Change in serum TSH levels within the reference range was associated with variation of future blood pressure: a 5-year follow-up study

Controversy exists on the relationship between serum thyrotropin (TSH) and blood pressure, and only a few prospective studies are available up to now. The study aimed to investigate the association between serum TSH within the reference range and blood pressure through a 5-year follow-up study. A total of 623 subjects with normal TSH were followed up for 5 years, including the measurement of demographic data, blood pressure, height, weight and serum TSH. Finally, 531 subjects were included in this prospective study. Body mass index (BMI), prevalence of hypertension, and systolic and diastolic blood pressure were all higher at follow-up than at baseline. Adjusted for age, gender, smoking status, BMI and homoeostasis model assessment of insulin resistance (HOMA-IR) at baseline, multiple linear regression analyses found no relationship between serum TSH at baseline and levels of blood pressure at follow-up, but the changes in serum TSH levels during follow-up was positively associated with the changes in systolic blood pressure (B=2.134, P<0.05), which became more significant in women but not significant in men. The change of systolic blood pressure in group of TSH increase >0.5 mIU l^-1 was significantly higher than in group of TSH decrease >0.5 mIU l^-1 within reference, after adjusting for age, gender, smoking status, BMI and HOMA-IR at baseline. This result became more significant in women, but no statistical significance was observed in men. Co-variation with serum TSH levels and blood pressure was observed during 5-year follow-up among people with normal TSH.

Glycemic control and self-monitoring of blood glucose in Chinese patients with type 2 diabetes on insulin: Baseline results from the COMPASS study

AIMS

Self monitoring of blood glucose (SMBG) is not widely utilized in insulin-treated patients with type 2 diabetes. In this analysis, we evaluated the current state of SMBG in Chinese adults with type 2 diabetes treated with insulin.

METHODS

The 2-phase COMPASS study involved 24 centers across 10 provinces and cities in China. In the first phase, a cross sectional survey was carried out in type 2 diabetes patients receiving insulin treatment. The inclusion criteria for the study subjects in the first phase were: type 2 diabetes, insulin treatment for ≥ 3 months, and age ≥ 18 years. Evaluation was made on the status of SMBG and insulin therapy in these patients by a questionnaire.

RESULTS

A total of 2819 patients (age 58.2 ± 10.8 years; 49.6% females; BMI 24.6 ± 3.4 kg/m(2)) with insulin-treated type 2 diabetes were recruited in phase I of this study. The majority of patients (80.4%) were receiving insulin treatment for at least 6 months. At baseline, the mean HbA1c was 8.5 ± 1.9% and 54.6% of patients had an HbA1c above 8%. 50.4% of the cohort had diabetes for at least 10 years, and fewer of these patients achieved HbA1c <7.0% (53 mmol/mol). At baseline, 65.8% of patients reported that daily SMBG frequency was performed on a random basis. 59.2% of patients reported that they occasionally, rarely or never follow their physician's instructions regarding SMBG. Hypoglycemia occurred in over 50% of patients, although in 71.8% of patients this was a rare occurrence.

CONCLUSIONS

There is low utilization of SMBG in Chinese adults with insulin-treated type 2 diabetes, with approximately two-thirds of patients reporting irregular use of SMBG. This is in line with an overall poor level of glycemic control.

Impact of structured self-monitoring of blood glucose on the quality of life of insulin-treated Chinese patients with type 2 diabetes mellitus: Results from the COMPASS study

AIMS

To evaluate the effect of structured self-monitoring of blood glucose (SMBG) regimen on quality of life (QoL) in poorly controlled insulin-treated patients with type 2 diabetes.

METHODS

Phase II of the COMPASS trial was a 6-month, multicenter, prospective, single-arm, interventional study. This study recruited 820 outpatients from 19 clinical sites in China who met the following inclusion criteria: type 2 diabetes, insulin treatment for ≥ 3 months, and age 18-65 years, an HbA1c >8.0% (64 mmol/mol), and willingness to perform SMBG. Subjects were advised to follow a structured SMBG regimen specific to their insulin regimen, and were trained to respond to SMBG readings via lifestyle changes and insulin dose self-adjustment. QoL assessments (SF-36) were performed at baseline and 6 months.

RESULTS

Patients with a mean age of 55.13 ± 9.77 years had an average diabetes duration of 9.83 ± 7.05 years and had been receiving insulin therapy for a mean of 45.4 ± 46.79 months. All QoL parameters were significantly improved following structured SMBG after 6 months, most notably the physical role functioning (p<0.0001) and emotional role functioning (p<0.0001) component scores. Overall, 40.6% of patients rated their overall QoL as 'a bit' or a lot better' after structured SMBG compared with 16.5% prior to the intervention (p<0.0001). SMBG also improved overall feelings of wellbeing, with 39.13% of patients believing that their health was deteriorating prior to SMBG compared with only 14.4% of patients after the intervention (p<0.0001).

CONCLUSIONS

The structured SMBG program in insulin-treated Chinese outpatients with type 2 diabetes significantly improved QoL outcomes. Physical and emotional role functioning are the 2 QoL scales that demonstrate the largest improvement with SMBG.

Comparison of the effects on glycaemic control and β-cell function in newly diagnosed type 2 diabetes patients of treatment with exenatide, insulin or pioglitazone: a multicentre randomized parallel-group trial (the CONFIDENCE study)

OBJECTIVE

Progressive β-cell dysfunction hinders the maintenance of glycaemic control in type 2 diabetes, but comparative data on β-cell-protective therapies are lacking in the early stage of type 2 diabetes. Here we evaluated the comparative glycaemic efficacy and impact on β-cell function of three antihyperglycaemic agents that have a β-cell-protective effect, exenatide, insulin and pioglitazone, in newly diagnosed patients with type 2 diabetes.

DESIGN AND METHODS

In this 48-week, multicentre, parallel-group study, 416 patients newly diagnosed with type 2 diabetes were randomly assigned 1 : 1 : 1 to receive exenatide, insulin or pioglitazone. The primary end-point was the change in glycosylated haemoglobin (HbA1c) from baseline. Secondary end-points included effects on weight, blood pressure, lipid profiles and β-cell function assessed by homeostasis model assessment, fasting proinsulin:insulin (PI/I), disposition index (DI) and acute insulin response (AIR).

RESULTS

At week 48, mean [95% confidence interval (CI)] HbA1c changes from baseline were -1.8% (-1.55% to -2.05%) with exenatide, -1.7% (-1.52% to -1.96%) with insulin and -1.5% (-1.23% to -1.71%) with pioglitazone. Treatment differences were -0.20% (95% CI -0.46% to 0.06%) for exenatide versus insulin (P = 0.185), and -0.37% (95% CI -0.63% to -0.12%) for exenatide versus pioglitazone (P = 0.002). Significant improvements from baseline in AIR, PI/I and DI were observed with all treatments, with the greatest improvements in DI, as well as weight, blood pressure and lipid profile, observed with exenatide.

CONCLUSIONS

All three agents showed efficacy regarding glycaemic control and metabolic benefits; however, exenatide showed the greatest efficacy. β-cell function improved in all treatment groups; hence, early initiation of β-cell-protective therapy may halt the decline in β-cell function in type 2 diabetes.

The construction of cDNA library and the screening of related antigen of ascitic tumor cells of ovarian cancer

OBJECTIVE

To construct the cDNA library of the ascites tumor cells of ovarian cancer, which can be used to screen the related antigen for the early diagnosis of ovarian cancer and therapeutic targets of immune treatment.

MATERIALS AND METHODS

Four cases of ovarian serous cystadenocarcinoma, two cases of ovarian mucinous cystadenocarcinoma, and two cases of ovarian endometrial carcinoma in patients with ascitic tumor cells which were used to construct the cDNA library. To screen the ovarian cancer antigen gene, evaluate the enzyme, and analyze nucleotide sequence, serological analysis of recombinant tumor cDNA expression libraries (SEREX) and suppression subtractive hybridization technique (SSH) techniques were utilized. The detection method of recombinant expression-based serological mini-arrays (SMARTA) was used to detect the ovarian cancer antigen and the positive reaction of 105 cases of ovarian cancer patients and 105 normal women's autoantibodies correspondingly in serum.

RESULTS

After two rounds of serologic screening and glycosides sequencing analysis, 59 candidates of ovarian cancer antigen gene fragments were finally identified, which corresponded to 50 genes. They were then divided into six categories: (1) the homologous genes which related to the known ovarian cancer genes, such as BARD 1 gene, etc; (2) the homologous genes which were associated with other tumors, such as TM4SFI gene, etc; (3) the genes which were expressed in a special organization, such as ILF3, FXR1 gene, etc; (4) the genes which were the same with some protein genes of special function, such as TIZ, ClD gene; (5) the homologous genes which possessed the same source with embryonic genes, such as PKHD1 gene, etc; (6) the remaining genes were the unknown genes without the homologous sequence in the gene pool, such as OV-189 genes.

CONCLUSION

SEREX technology combined with SSH method is an effective research strategy which can filter tumor antigen with high specific character; the corresponding autoantibodies of TM4SFl, ClD, TIZ, BARDI, FXRI, and OV-189 gene's recombinant antigen in serum can be regarded as the biomarkers which are used to diagnose ovarian cancer. The combination of multiple antigen detection can improve diagnostic efficiency.

Catheter-directed thrombolysis in the treatment of acute deep venous thrombosis: a meta-analysis

We performed a meta-analysis for systematic evaluation of the status quo of catheter thrombolysis for the treatment of acute lower limb deep vein thrombosis in China. We searched the China Biomedical bibliographic database (CBM), China National Knowledge Infrastructure (CNKI), Weipu full-text electronic journals, Wanfang full-text database, and Medline (1990 through June 2011) for clinical randomized controlled trials of catheter-directed thrombolysis and superficial venous thrombolysis to compare their efficacies for the treatment of acute deep vein thrombosis. The results were analyzed by using the Cochrane-recommended RevMan 4.2 software package, and the odds ratio (OR) was used as the combined measure of efficacy. The search retrieved 8 randomized controlled trials, and meta-analysis using the total rate of effective treatment as the clinical observation index found that the combined OR for the catheter thrombolysis group versus the superficial venous thrombolysis group was significant (P < 0.01; OR = 11.78; 95% confidence interval = 6.99-19.87). In conclusion, the meta-analysis indicated that catheter thrombolysis was more effective than superficial venous thrombolysis for the treatment of acute deep vein thrombosis in the lower limb in Chinese individuals. However, the included trials were only of medium quality, so more rational and scientific clinical trials are needed to validate this conclusion.

AdLTR2EF1α-FGF2-mediated prevention of fractionated irradiation-induced salivary hypofunction in swine

Patients frequently experience a loss of salivary function following irradiation (IR) for the treatment of an oral cavity and oropharyngeal cancer. Herein, we tested if transfer of fibroblast growth factor-2 (FGF2) cDNA could limit salivary dysfunction after fractionated IR (7.5 or 9 Gy for 5 consecutive days to one parotid gland) in the miniature pig (minipig). Parotid salivary flow rates steadily decreased by 16 weeks post-IR, whereas blood flow in the targeted parotid gland began to decrease ~3 days after beginning IR. By 2 weeks, post-IR salivary blood flow was reduced by 50%, at which point it remained stable for the remainder of the study. The single preadministration of a hybrid serotype 5 adenoviral vector encoding FGF2 (AdLTR2EF1a-FGF2) resulted in the protection of parotid microvascular endothelial cells from IR damage and significantly limited the decline of parotid salivary flow. Our results suggest that a local treatment directed at protecting salivary gland endothelial cells may be beneficial for patients undergoing IR for oral cavity and oropharyngeal cancer.

Defective expression of regulatory B cells in iodine-induced autoimmune thyroiditis in non-obese diabetic H-2(h4) mice

INTRODUCTION

The ability of B cells to negatively regulate cellular immune responses and inflammation has been described. The regulatory B (Breg) cells with the unique CD1d(hi)CD5(+)CD19(+) phenotype and the capacity to produce IL-10 are potent negative regulators of inflammation and autoimmunity in several in vivo mouse models of autoimmune disease.

AIM

To investigate whether Breg cell deficiency participates in autoimmune thyroiditis (AIT) in an animal model.

MATERIALS AND METHODS

Non-obese diabetic (NOD).H-2(h4) mice at 4 weeks of age were randomly divided into control and iodine-treated groups; the iodine-treated group received sterile water containing 0.005 % NaI for 10 or 20 weeks. The percentage of CD1d(hi)CD5(+)CD19(+) Bregs, CD4(+)CD25(+)FoxP3(+) regulatory T cells (Treg) and CD4(+)IL17(+) T helper 17 cells (Th17) in splenic mononuclear cells was detected by multicolor flow cytometry. The expression of IL-10 mRNA and TGF-β mRNA in splenocytes was measured by real-time RT-PCR.

RESULTS

NOD.H-2(h4) mice spontaneously develop anti-thyroglobulin autoantibodies and intrathyroidal lymphocyte infiltration when supplied with iodine in drinking water. Mice with AIT had a decreased CD1d(hi)CD5(+)CD19(+) Breg subset and reduced IL-10 mRNA expression in splenocytes compared with controls (p < 0.05) and maintained relatively low levels during the development of thyroiditis. The proportion of Breg cells was negatively correlated with the proportion of Th17 cells, but positively correlated with CD4(+)CD25(+)FoxP3(+) Treg cells in splenocytes (All p < 0.05).

CONCLUSIONS

The defective expression of Breg cells combined with impaired Treg cells and enhanced Th17 cells might play an important role in the development of iodine-induced AIT in NOD.H-2(h4) mice.

Allogeneic bone marrow mesenchymal stem cell transplantation for periodontal regeneration

In this study, we investigated the possibility of using local administration of allogeneic bone marrow mesenchymal stem cells (BMMSCs) to induce tissue regeneration in periodontal defects in a rat model of periodontitis. BMMSCs isolated from rats were mixed with 0.9% NaCl solution and injected into periodontal defects. Control groups were 0.9% NaCl solution or left untreated. The clinical assessments, x-rays, and histological examinations were used to evaluate the effect. At 12 wks post-transplantation, quantitative analysis revealed average probing bone loss values of 1.2 ± 0.19, 1.6 ± 0.2, and 1.7 ± 0.14; the bone regeneration rate was 53%, 45%, and 44% in the BMMSC+NaCl group, NaCl group, and untreated group, respectively. The clinical assessments, x-rays, and histological examinations revealed significant periodontal tissue regeneration in the BMMSC injection group, compared with the control groups. The ELISA results showed that TNFα, IFNγ, and IL1β were 2,674.88 ± 102.77 pg/mL vs. 3,422.1 ± 51.98 pg/mL, 609.85 ± 25.5 pg/mL vs. 803.79 ± 33.85 pg/mL, and 1,038.46 ± 76.29 pg/mL vs. 1,175.26 ± 105.55 pg/mL in the BMMSC+NaCl group and NaCl group, respectively, indicating that BMMSC injection inhibited the inflammatory factors TNFα, IFNγ, and IL1β. Our results indicate that local administration of BMMSCs can repair defects due to periodontitis, exerting anti-inflammatory and immunomodulatory functions.

Prevalence of cardiovascular disease and risk factors in the Chinese population with impaired glucose regulation: the 2007-2008 China national diabetes and metabolic disorders study

Cardiovascular disease (CVD) is one of the most common chronic diseases in China. This aim of this study is to determine the prevalence of CVDs and risk factors in Chinese impaired glucose regulation subjects.We used a multistage, stratified sampling method to select subjects from the general Chinese population aged 20 years and older. Subjects underwent an oral glucose tolerance test to identify normal glucose tolerance (NGT) and impaired glucose regulation including isolated impaired fasting glucose (i-IFG), impaired glucose tolerance (i-IGT), and combined IFG/IGT and diabetic mellitus (DM). A logistic regression analysis was performed to examine the association between glucose abnormalities and CVD events.We identified that 34 293 subjects had NGT, 1 469 i-IFG, 4 571 i-IGT, 957 IFG/IGT and 4 949 DM. The age-sex standardized prevalence rate of cardiovascular disease was 1.06% (95% CI 0.87-1.28), 1.79% (95% CI 1.37-2.33) and 3.83% (95% CI 2.79-5.24) in NGT, impaired glucose regulation and DM, respectively. Among impaired glucose subjects, prevalence of defined CVD risk factors (smoking, overweight, obesity, hypertension and dyslipidemia) was 29.52% (95% CI: 27.8-31.21), 36.25% (95% CI: 34.29-38.26), 10.05% (95% CI: 8.86-11.37), 36.43% (95% CI: 34.53-38.36) and 69.96% (95% CI: 67.87-71.98), respectively. Compared to 1 risk factor, the odds ratios (ORs) of CVDs with 2, 3 or 4 risk factors were 1.94 (95% CI: 0.74-5.09), 2.76 (95% CI: 1.06-7.21) and 5.84 (95% CI: 1.68-20.26), respectively. Additionally, compared to i-IFGs, ORs of CVDs with i-IGT and IFG/IGT were 2.88 (95%CI 1.36-6.01) and 2.12 (95% CI 0.83-5.44), respectively.The prevalence of cardiovascular risk factors was high in the Chinese impaired glucose regulation population. The postprandial hyperglycemia is more associated with CVD than isolated fasting hyperglycemia.

First Report of Phomopsis Seed Decay of Soybean Caused by Phomopsis longicolla in South China

Phomopsis seed decay of soybean (Glycine max (L.) Merr.) causes poor seed quality and suppresses yield in most soybean-growing areas in the world. The disease is caused primarily by Phomopsis longicolla Hobbs. During the spring of 2010, soybean seeds without symptoms were planted in the fields but emergence was poor and the emergence rates ranged from 30 to 70% in south China. Approximately 3,000 symptomless seeds were randomly collected from seven fields at three locations in Guangzhou, Nanchang, and Wuhan. Seeds were surface disinfected with 1% sodium hypochlorite for 12 min, rinsed in sterile distilled water three to four times, and placed on 2% agar. Plates were then incubated at 26°C under 16/8-h photoperiod for 3 to 4 days. About 10 to 20% of the seeds produced white hyphae that spread rapidly and covered the whole seed. The hyphae from fungal isolates were transferred to potato dextrose agar (PDA) and incubated at 26°C in the dark. After 3 to 4 weeks, conidia were elliptical with two oil drops at both ends and hyaline (6.2 to 7.2 × 2.6 to 3.2 μm). The cultural and morphological characteristics of the isolates corresponded with the description of P. longicolla (2). Colonies on PDA were floccose, dense, and white. Stromata were large, black, and spreading. To confirm the morphological identification, the ribosomal internal transcribed spacers (ITS1-5.8S-ITS2) from three isolates were sequenced (GenBank Accession Nos. JQ899030, JQ899031, and JQ899032). BLAST analysis indicated that the isolates had 99% nucleotide sequence identity with P. longicolla (GenBank Accession Nos. AY857868.1, EF026104, and HQ130441.1). Pathogenicity tests were conducted on 2-week-old soybean seedlings (3). A mycelial plug (3 mm in diameter) from the margin of 1-week-old PDA culture of the Wuhan isolate was individually placed mycelial side down directly on the top of cut stem 1 to 2 cm above cotyledon node of the soybean seedling. PDA plugs without the fungus was used as the negative control. All seedlings were kept in a growth chamber at 26°C with 92 to 94% relative humidity. After 2 weeks, all inoculated seedlings showed browning, stem wilt, and the lesions were 0.3 to 2.0 cm long. No symptoms were observed in the control plants. P. longicolla was reisolated from the infected seedlings. The pathogenicity test was repeated three times. Soybean stem blight caused by P. longicolla has been reported in northeast China (1). To our knowledge, this is the first report of P. longicolla causing Phomopsis seed decay of soybean in south China. This report will establish a foundation for developing a program for screening germplasm for resistance to this disease in south China. References: (1) Y. L. Cui et al. Plant Pathol. 58:799, 2009. (2) T. W. Hobbs et al. Mycologia 77:535,1985. (3) S. Li et al. Plant Dis. 85:1031, 2001.

C1 catecholamine neurons form local circuit synaptic connections within the rostroventrolateral medulla of rat

C1 catecholamine neurons reside within the rostroventrolateral medulla (RVLM), an area that plays an integral role in blood pressure regulation through reticulospinal projections to sympathetic preganglionic neurons in the thoracic spinal cord. In a previous investigation we mapped the efferent projections of C1 neurons, documenting supraspinal projections to cell groups in the preautonomic network that contribute to the control of cardiovascular function. Light microscopic study also revealed putative local circuit connections within RVLM. In this investigation we tested the hypothesis that RVLM C1 neurons elaborate a local circuit synaptic network that permits communication between C1 neurons giving rise to supraspinal and reticulospinal projections. A replication defective lentivirus vector that expresses enhanced green fluorescent protein (EGFP) under the control of a synthetic dopamine beta hydroxylase (DβH) promoter was used to label C1 neurons and their processes. Confocal fluorescence microscopy demonstrated thin varicose axons immunopositive for EGFP and tyrosine hydroxylase that formed close appositions to C1 somata and dendrites throughout the rostrocaudal extent of the C1 area. Dual-labeled electron microscopic analysis revealed axosomatic, axodendritic and axospinous synaptic contacts with C1 and non-C1 neurons with a distribution recapitulating that observed in the light microscopic analysis. Labeled boutons were large, contained light axoplasm, lucent spherical vesicles, and formed asymmetric synaptic contacts. Collectively these data demonstrate that C1 neurons form a synaptic network within the C1 area that may function to coordinate activity among projection-specific subpopulations of neurons. The data also suggest that the boundaries of RVLM should be defined on the basis of function criteria rather than the C1 phenotype of neurons.

Treatment with levothyroxine in pregnant rats with subclinical hypothyroidism improves cell migration in the developing brain of the progeny

AIM

This study aims to investigate whether maternal subclinical hypothyroidism (SCH) influences the developing brain, and the effect of treatment with levothyroxine (L-T4) in early maternal SCH on the progeny's developing brain.

MATERIALS AND METHODS

Seventy-five thyroidectomized female Wistar rats were divided randomly into groups of hypothyroidism (CH), SCH, SCH treated with L-T4 from embryonic day (E) 10, E13, and E17 till post-natal day 21. There were 15 sham operated controls.

RESULTS

Pups from SCH or CH group had significantly lower body weight than euthyroid group. Pups from E10, E13 or E17 groups had normal body weight compared to control pups at P3 and P7. The levels of TSH and total T4 (TT4) of all pups were normal. The mean latencies were longer in pups from CH, SCH, and E17 group than controls. The latencies from E10 and E13 pups were comparable to those from control pups. There were changes in the cytoarchitecture of the barrel cortex and of the hippocampus in CH, SCH, and E17 pups. The barrel cortex of E10 or E13 pups was similar to that of control pups. The distribution of bromodeoxyuridinelabeled cells was more widespread in CH, SCH, and E17 pups than in control, E10, and E13 progeny.

CONCLUSIONS

Maternal SCH disturbs learning and memory performances in pups, and affects cytoarchitecture and cell migration in the developing brain of the progeny. Treatment with L-T4 in early maternal SCH before E13 improves cell migration in the developing brain, as well as learning and memory function of the progeny.

Early levothyroxine treatment on maternal subclinical hypothyroidism improves spatial learning of offspring in rats

Maternal hypothyroidism has adverse effects on neural development in the offspring. The present study aimed to investigate whether maternal subclinical hypothyroidism impairs spatial learning in the offspring, as well as the efficacy and optimal time of levothyroxine (L-T(4)) treatment in pregnancy. Female adult Wistar rats were randomly divided into six groups (n = 10 per group): control, hypothyroid (H), subclinical hypothyroid (SCH) and SCH treated with L-T(4), starting from the tenth, thirteenth and seventeenth gestational day (GD10, GD13 and GD17), respectively, to restore normal thyroid hormone levels. Spatial learning was assessed on progenies by a water maze test, a field excitatory postsynaptic potential (fEPSP) recording, and an long-term potentiation induction assay. Protein levels of early growth response protein 1 (Egr1), activity-regulated cytoskeleton-associated protein (Arc), Ras-proximate-1 (Rap1), p-extracellular signal-regulated kinase (p-ERK) and brain-derived neurotrophic factor (BDNF) were determined by western blotting. Progenies from the SCH and H groups demonstrated significantly longer mean latency in the water maze test and a lower amplification percentage of the amplitude and slope of the fEPSPs compared to offspring of the control group. L-T(4) treatment for the GD10 and GD13 groups significantly shortened mean latency and increased the amplification percentage of the amplitude and slope of the fEPSPs of the progeny of rats with subclinical hypothyroidism. However, L-T(4) treatment for the GD17 group showed only minimal effects on spatial learning in the offspring. Progenies of SCH and H groups had lower levels of Egr1, Arc, p-ERK and BDNF but higher levels of Rap1 compared to those of the controls. L-T(4) treatment ameliorated these protein expression changes in the progeny of rats with subclinical hypothyroidism. Maternal subclinical hypothyroidism impaired spatial learning in the offspring; L-T(4) treatment in early pregnancy recovered this adverse effect, and the optimal time of treatment should start from early pregnancy (GD10 and GD13).

Successful treatment of a paraneoplastic pemphigus in a teenager using plasmapheresis, corticosteroids and tumour resection

Paraneoplastic pemphigus (PNP) is a severe autoimmune blistering disease. Bronchiolitis obliterans (BO) is a common complication of PNP, is the major cause of death. PNP is rarely seen before the age of 18 years, and the prognosis is poor because of BO. We report a 16-year-old girl with the typical findings of PNP associated with Castleman's tumour. She was treated with tumour resection in combination with plasmapheresis and corticosteroids. Fifteen months after the operation, the patient had recovered without the development of BO.

Identification and Characterization of the Huanglongbing Bacterium in Pummelo from Multiple Locations in Guangdong, P. R. China

Huanglongbing (HLB, yellow shoot disease, ex. citrus greening disease), caused by Candidatus Liberibacter spp., is highly destructive to citrus production in Asia, Africa, and South America. Although primarily affecting sweet orange and mandarin, HLB has long been observed in pummelo in Guangdong Province, People's Republic of China; however, the disease in pummelo has received little research attention. Accordingly, it remains unclear how closely related the strains of Ca. Liberibacter in pummelo are to those in other citrus species. In this study, the loci of 16S rDNA, rplAJ (β-operon of ribosomal protein), and an outer membrane protein (omp) gene were analyzed and characterized among strains of Ca. Liberibacter in pummelo samples from six different locations in Guangdong. Sequence comparisons indicated that 'Candidatus Liberibacter asiaticus', but not 'Ca. Liberibacter africanus' or 'Ca. Liberibacter americanus', was exclusively associated with HLB symptoms in pummelo. The pummelo strains of 'Ca. Liberibacter asiaticus' from Guangdong were highly homogeneous. Analyses of single-nucleotide polymorphisms in the omp locus showed that the Guangdong pummelo strains grouped with 'Ca. Liberibacter asiaticus' strains from Thailand, Nepal, and an unspecified location in China but differed from the Philippine and China-Behai strains. Based on the sequence homogeneity at the omp locus, the history of pummelo culture and the means by which HLB is known to be spread, we believe that, likely, the pummelo strain of 'Ca. Liberibacter asiaticus' recently was spread to pummelo in the study areas from infected sweet orange or mandarin trees by insect vectors or by propagation of pummelo infected elsewhere.

A five-year follow-up study of goiter and thyroid nodules in three regions with different iodine intakes in China

OBJECTIVE

The association between iodine status and the prevalence of goiter and thyroid nodules has been well established but the extent to which different iodine intake levels influence the incidence of goiter and thyroid nodules is unclear. The aim of the study was to determine the incidence of goiter and thyroid nodules in 3 regions with different iodine intake levels: mildly deficient, more than adequate, and excessive.

DESIGN, PATIENTS AND MEASUREMENTS

Of the 3385 unselected subjects enrolled in 1999 in Panshan, Zhangwu, and Huanghua where median urinary iodine excretion (UIE) was 83.5 microg/l, 242.9 microg/l, and 650.9 microg/l, respectively, 2708 (80.0%) participated in the follow-up study in 2004. The examinations of thyroid ultrasonography, thyroid function, thyroid autoantibodies and UIE were performed at baseline and follow-up.

RESULTS

The cumulative incidence of diffuse goiter was 7.1%, 4.4%, and 6.9%, respectively, higher in Panshan and Huanghua than in Zhangwu (p=0.013 and p=0.015) and that of nodular goiter was 5.0%, 2.4%, and 0.8%, respectively, declining with increasing iodine intake levels (p<0.001). Mild iodine deficiency, chronic iodine excess as well as positive thyroid autoantibodies were associated with the occurrence of goiter [Logistic regression: odds ratio (OR)=1.83 (95% confidence interval (CI) 1.26-2.65), OR=1.46 (95% CI 1.01-2.11) and OR=1.68 (95% CI 1.14-2.48), respectively]. The cumulative incidence of single nodule was 4.0%, 5.7%, and 5.6%, respectively and that of multiple nodules was 0.4%, 1.2%, and 1.0%, respectively.

CONCLUSIONS

The relationship between iodine and the risk for the occurrence of diffuse goiter shows a U-shaped curve. Nodular goiters are more prevalent in iodine-deficient areas.

Effective management of main bronchial rupture in patients with chest trauma

BACKGROUND

The purpose of the current study was to investigate the most effective diagnostic method and the effect of surgical treatment on traumatic main bronchial rupture.

METHODS

Chest X-rays, CT and fiberoptic bronchoscopy were the main means used to confirm the diagnosis. Surgery was performed as early as possible.

RESULTS

Pneumonectomy was performed in 1 patient. Bronchial end-to-end anastomosis was performed in 10 patients whose lungs were well ventilated, and lung function recovered.

CONCLUSION

Main bronchial rupture occurs relatively rarely. Early diagnosis and operative intervention can save lives.

High iodine intake is a risk factor of post-partum thyroiditis: result of a survey from Shenyang, China

The aim of the present study is to obtain the epidemiological data on post-partum thyroiditis (PPT) firstly in Chinese women, and to tryto evaluate whether excessive intake of iodine in post-partum women imposes any danger of occurring PPT. Sixty hundred and ten pregnant women were involved in the cohort just before delivery. Four hundred and eighty-eight (80%) of them accepted taking part in follow-ups more than 6 months post-partum. A blood sample was taken from participants before delivery and every 3 months post-partum for testing of serum TSH, thyroid autoantibodies. Free T3 (FT3), free T4 (FT4) and TSH receptor antibody (TRAb) were detected if TSH was abnormal. The iodine nutrition was evaluated according to the mean level of the fasting urinary iodine excretions at different times during the studying period, and participants were subgrouped into 3 categories with low, adequate and high iodine intake. For those participants who had thyroid dysfunction within 6 months post-partum, the follow-up persisted for 1 yr. Of 488 pregnant women, PPT developed in 11.9% (58/488). Given overt and subclinical PPT, the prevalence was 7.17% (no.=35) and 4.71% (no.=23), respectively. There was a strong association between the presence of thyroid peroxidase antibody (TPOAb) at delivery and the risk of developing PPT [RR=6.76, 95% (CI) 4.42-10.34]. Overt cases had much higher titers of TPOAb than subclinical patients (all p<0.05). The median urinary iodine (MUI) of patients with PPT was significantly higher than that of healthy women (231.93 vs 199.88 microg/l p=0.00153). Both the prevalence of PPT and positive TPOAb rise with the increment of iodine intakes. Pregnant women with high iodine intake had more risk of developing PPT when compared with those with low iodine intake (RR=2.92, 95%CI 1.31-6.50). We concluded that positive TPOAb was of value for predicting the occurrence and severity of PPT, and a high iodine intake was a risk factor triggering PPT.

Increased fluid secretion after adenoviral-mediated transfer of the human aquaporin-1 cDNA to irradiated miniature pig parotid glands

The treatment of most head and neck cancer patients includes ionizing radiation (IR). Salivary glands in the IR field suffer irreversible damage. Previously, we reported that adenoviral (Ad)-mediated transfer of the human aquaporin-1 (hAQP1) cDNA to rat submandibular glands following IR restored salivary flow to near normal levels. It is unclear if this strategy is useful in larger animals. Herein, we evaluated AdhAQP1-mediated gene transfer after parotid gland IR (20 Gy) in the miniature pig. Sixteen weeks following IR, salivation from the targeted gland was decreased by >80%. AdhAQP1 administration resulted in a dose-dependent increase in parotid salivary flow to approximately 80% of pre-IR levels on day 3. A control Ad vector was without significant effect. The effective AdhAQP1 dose was 2.5 x 10(5) pfu/microl infusate, a dose that leads to comparable transgene expression in murine and minipig salivary glands. Three days after Ad vector administration little change was observed in clinical chemistry and hematology values. These findings demonstrate that localized delivery of AdhAQP1 to IR-damaged salivary glands increases salivary secretion, without significant general adverse events, in a large animal model.

Effects of prolactin on HLA-DR and CD40 expressions by human thyrocytes

OBJECTIVE

To study the effects of prolactin (PRL) on HLA-DR and CD40 expressions by human thyrocytes, and to investigate the possible mechanisms for PRL to affect the development of Graves' disease (GD).

METHODS

Thyrocytes in secondary culture, which were from GD thyroid glands and the tissues adjacent to the lesions of multinodular goiter and adenoma (control group), were treated respectively with ovine PRL (oPRL), interferon-gamma (IFN-gamma), interlukin-4 (IL-4) and oPRL plus IFN-gamma (10 U/ml) or IL-4 (5 ng/ml) for 7 days. HLA-DR and CD40 expressions on the thyrocytes were determined by immunofluorescent staining and flow cytometry.

RESULTS

oPRL (12.5 ng/ml-1000 ng/ml) had no significant direct effect on HLA-DR or CD40 expression. It did not significantly affect the stimulation of HLA-DR expressions on the two groups of thyrocyte treated with IFN-gamma or on GD thyrocytes treated with IL-4. oPRL could antagonize the stimulation of CD40 expressions by IFN-gamma and the inhibition by IL-4 on both groups of thyrocytes. The antagonizing effects were related to the concentrations of PRL. IFN-gamma-stimulated percentages of CD40+ thyrocytes and delta mean fluorescence intensity (dMF) in both thyrocyte sources were significantly reduced in the presence of 200 ng/ml oPRL (both GD and

CONTROL

P < 0.01 and P < 0.05, respectively;

CONTROL

P < 0.05) and 1000 ng/ml oPRL (GD: P < 0.01;

CONTROL

P < 0.05). oPRL caused significant increasing in IL-4-inhibited percentages of CD40+ cells from the two groups of thyrocytes at 12.5 ng/ml and 1000 ng/ml and dMF from GD thyrocytes at 1000 ng/ml (P < 0.05).

CONCLUSIONS

PRL can exert indirect effects on CD40 expressions on thyrocytes by antagonizing the modulatory actions of IFN-gamma and IL-4 with dose-related effects. This may be one important mechanism for PRL to affect the development of GD.