Objective:To analyze the histopathological characteristics of peri-implant soft tissue in re-constructed jaws and the changes after keratinized mucosa augmentation(KM A)with free gingival graft(FGG).Methods:Twenty patients were enrolled in this study.Five patients of them,who were perio-dontal and systemic healthy and referred for crown lengthening before restoration with healthy keratinized gingiva collected were enrolled as healthy controls.15 patients of them were with fibula or iliac bone flaps jaw reconstruction(10 with fibula flap and 5 with iliac flap),who were referred to FGG and implant exposures before restoration.Soft tissue was collected before FGG in reconstructed jaws,and in 5 patients(3 with fibula flap and 2 with iliac flap)8 weeks after FGG if a second surgery was conducted.Histologi-cal analysis with hematoxylin-eosin stain and immunological analysis to interlukin-1(IL-1),interlukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were performed.Results:Thickness from the bottom of stratum basale to the top of stratum granulosum and thickness of keratinized layer in reconstructed jaws were significantly lower compared with that of natural healthy keratinized gingiva[0.27(0.20,0.30)mmvs.0.36(0.35,0.47)mm,P＜0.05;16.49(14.90,23.37)μm vs.26.37(24.12,31.53)μm,P＜0.05].In the reconstructed area,thickness from the bottom of stratum basale to the top of stra-tum granulosum increased after KMA with FGG[0.19(0.16,0.25)mm vs.0.38(0.25,0.39)mm,P=0.059]and the thickness of keratinized layer significantly increased after KMA with FGG[16.42(14.16,22.35)μm vs.28.57(27.16,29.14)μm,P＜0.05],which was similar to that in the con-trol group.Furthermore,the number of positive cells of IL-1,IL-6 and TNF-α significantly increased after KMA[0.67(0.17,8.93)vs.11.00(9.16,18.00);13.00(8.50,14.14)vs.21.89(15.00,28.12);0.22(0.04,0.63)vs.2.83(1.68,5.00),respectively,P＜0.05]as well as the average optical density value[0.15(0.14,0.17)vs.0.18(0.17,0.21);0.28(0.26,0.33)vs.0.36(0.33,0.37);0.23(0.22,0.29)vs.0.30(0.28,0.42),respectively,P＜0.05],which was similar to that in the healthy keratinized gingiva.Conclusion:The lack of rete pegs and inflammato-ry factors were common in soft tissue with jaw reconstruction.FGG can improve the quality of the epithe-lium and may improve the stability of the mucosa around implants.

Objective:To analyze the concentration of formic acid,propionic acid and butyric acid in gingival crevicular fluid(GCF)of patients with stages Ⅲ and Ⅳ periodontitis,and their relationship with periodontitis.Methods:The study enrolled 37 systemically healthy patients with periodontitis and 19 healthy controls who visited Department of Periodontology,Peking University School and Hospital of Sto-matology from February 2008 to May 2011.Their GCFs were collected from the mesial-buccal site of one molar or incisor in each quadrant.Periodontal clinical parameters,including plaque index(PLI),probing depth(PD),bleeding index(BI),and attachment loss(AL).Concentrations of formic acid,propionic acid and butyric acid in the supernatant of the GCFs were analyzed by high-performance capil-lary electrophoresis(HPCE).The prediction ability of formic acid,propionic acid and butyric acid with the risk of periodontitis and the differences between grade B and grade C periodontitis were analyzed.Results:In this study,32 patients with stage Ⅲ and 5 patients with stage Ⅳ were enrolled,including 9 patients with grade B and 28 patients with grade C.Clinical periodontal variables in the patients with pe-riodontitis were significantly higher than those in the control group(P＜0.001).Formic acid was signifi-cantly lower in periodontitis than that in the control group[5.37(3.39,8.49)mmol/L vs.12.29(8.35,16.57)mmol/L,P＜0.001].Propionic acid and butyric acid in periodontitis were significantly higher than those in the control group:Propionic acid,10.23(4.28,14.90)mmol/L vs.2.71(0.00,4.25)mmol/L,P＜0.001;butyric acid,2.63(0.47,3.81)mmol/L vs.0.00(0.00,0.24)mmol/L,P＜0.001.There was no significant difference in formic acid,propionic acid and butyric acid concentrations between grade B and grade C periodontitis(P＞0.05).Propionic acid and butyric acid in the deep pocket were significantly higher than in the shallow pocket,while the concentration of formic acid decreased with the increase of PD.Propionic acid(OR=1.51,95％CI:1.29-1.75)and butyric acid(OR=3.72,95％CI:1.93-7.17)were risk factors for periodontitis,while formic acid(OR=0.87,95％CI:0.81-0.93)might be a protective factor for periodontitis.Propionic acid(AUC=0.852,95％CI:0.805-0.900),butyric acid(AUC=0.889,95％CI:0.841-0.937),f(formic acid,AUC=0.844,95％CI:0.793-0.895)demonstrated a good predictive capacity for the risk of periodontitis.Conclusion:The concentration of formic acid decrease in the GCF of periodontitis patients,which is a protective factor for periodontitis,its reciprocal have good predictive capacity.However,propionic acid and butyric acid increase,which are risk factors for periodontitis and have good predictive capacity.The concentration of formic acid,propionic acid,and butyric acid vary with probing depth,but there is no significant difference between grade B and grade C periodontitis.

Objective:To investigate the characteristics of 18F-FDG and 18F-9-fluoropropyl-(+ )-dihydrotetrabenazine (FP-(+ )-DTBZ; short for DTBZ) brain vesicular monoamine transporter type 2 (VMAT2) PET/CT imaging and analyze its clinical diagnostic value in Parkinson′s disease (PD) patients with or without rapid eye movement sleep behaviour disorder (RBD). Methods:From July 2022 to June 2023, 50 patients clinically confirmed with primary PD who underwent 18F-FDG and 18F-DTBZ PET/CT imaging in the First Affiliated Hospital of Zhengzhou University were prospectively collected. Among them, 18 patients with PD accompanied by RBD (PD-RBD(+ ) group; 16 males, 2 females, age (59.2±9.3) years); 32 patients without RBD (PD-RBD(-) group; 16 males, 16 females, age (57.7±10.2) years). Moreover, 10 healthy controls matched with the age of PD patients were included (5 males, 5 females, age (60.3±9.6) years). 18F-DTBZ specific uptake ratio (SUR) of bilateral striatum, caudate nucleus, anterior putamen, posterior putamen, nucleus accumbens, substantia nigra and other brain regions were obtained with occipital cortex as the reference region. Striatal anterior-posterior gradient and other related semi-quantitative indicators were calculated according to the corresponding formula. One-way analysis of variance (the least significant difference (LSD)- t test), Kruskal-Wallis rank sum test (Bonferroni correction), independent-sample t test and Mann-Whitney U test were used to analyze the data. Pearson correlation and Spearman rank correlation analyses were used to evaluate the correlations. ROC curve analysis was also performed. The differences in global glucose metabolism in two groups were compared using statistical parametric mapping (SPM). Results:PD-RBD(+ ) group had a significantly lower Mini-Mental State Examination (MMSE) or PD Sleep Scale (PDSS) score than PD-RBD(-) group ( z values: -3.12, -3.08, both P<0.01), and its contralateral striatal anterior-posterior gradient of the predominantly affected limbs was significantly lower than that in PD-RBD(-) group ( t=-2.73, P=0.009). SPM analysis showed that the glucose metabolism in the contralateral prefrontal lobe was higher than that in the PD-RBD (-) group ( t values: 3.11-3.57, all P<0.001). 18F-DTBZ SUR in the bilateral striatum, caudate nucleus, anterior putamen, posterior putamen, nucleus accumbens, substantia nigra were considerably lower in both groups compared to the healthy control group ( F values: 6.24-147.61, H values: 8.66-24.43, all P<0.05; post-hoc: LSD- t test, Bonferroni correction, all P<0.01). In the PD-RBD(-) group, contralateral striatal anterior-posterior gradient were negatively correlated with unified PD Rating Scale (UPDRS) score and modified Hoehn-Yahr (mH-Y) stage ( r=-0.35, P=0.048; rs=-0.39, P=0.026). The AUC for distinguishing PD-RBD(+ ) and PD-RBD(-) with a contralateral striatal anterior-posterior gradient was 0.706 (95% CI: 0.562-0.851, P=0.016), with the sensitivity and specificity of 59.4%(19/32) and 16/18, respectively. Conclusions:The decrease of contralateral striatal anterior-posterior gradient of VMAT2 is more obvious in patients with PD-RBD(+ ), and there are differences in brain metabolism between the two groups, suggesting that there may be different neuropathological changes and different pathophysiological mechanisms between PD patients with and without RBD. 18F-DTDZ PET/CT can provide imaging basis for the differential diagnosis of the disease subtypes.

Objective:To explore the effect of systemic use of amoxicillin and metronidazole during mechanical therapy on the clinical parameters of the first molars and periodontal microorganisms in subgingival plaque and saliva in patients with generalized aggressive periodontitis (GAgP).Methods:A total of 23 GAgP patients were recruited from Peking University School and Hospital of Stomatology from January 2006 to December 2009 and then randomly divided into two groups according to random number table: 12 patients received scaling and root planning (SRP) only and 11 patients received SRP combined with systemic administration of antibiotics (amoxicillin and metronidazole for a week after supragingival scaling). Clinical examination of periodontal parameters and collection of saliva and pooled subgingival plaque samples from mesial-buccal sites of 4 first molars were performed before initial therapy and 2, 4 and 6 months respectively after mechanical therapy, and saliva samples were also collected 2 weeks after therapy. Eight different periodontal microorganisms were detected in these samples by PCR. In addition, semiquantitative analysis of red complex microorganisms [ Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td)] was performed. Results:Both therapies led to significant decrease of the plaque index (PLI), probing depth (PD) and bleeding index (BI) from mesial-buccal sites of first molars. Meanwhile the PD of antibiotics group [(4.21±1.50), (4.00±1.54), (3.84±1.89) mm of 2, 4 and 6 months respectively after therapy] was significantly lower than the SRP group [(5.29±1.27), (5.30±1.34), (4.98±1.36) mm of 2, 4 and 6 months respectively after therapy] at 3 different time points after mechanical therapy ( P<0.05). In the antibiotics group, the quantities of Pg, Tf and Td in subgingival plaque samples (the median quantity decreased to 0.0 ng at 2, 4 and 6 months after therapy) and saliva samples (the median quantity of Tf and Td decreased to 0.0 ng at 2, 4 and 6 months after therapy ( P<0.05), and the median quantity of Pg decreased to 16.3, 59.6 and 22.4 ng at 2, 4 and 6 months respectively after therapy) significantly decreased at 3 different time points after mechanical therapy compared with before therapy ( P<0.05). While in the SRP group, there were no significant changes in the quantities of Tf and Td in saliva at 2, 4 and 6 months after mechanical therapy ( P>0.05) , and the quantities of Tf and Td in subgingival plaque significantly decreased only at 2 months after therapy ( P<0.05). Conclusions:SRP combined with systemic administration of amoxicillin and metronidazole could achieve greater improvement in PD of first molars and better control of the amounts of red complex microorganisms in the saliva and subgingival plaque of GAgP patients over a 6-month period.

Objective:To explore the correlation and interaction between epidermal growth factor (EGF) rs2237051 and peroxidase proliferators activate receptor-α (PPAR-α) rs4253623 polymorphisms and the susceptibility of generalized aggressive periodontitis (GAgP).Methods:Two hundred and nineteen Chinese patients with GAgP were enrolled from the patients of the Department of Periodontology, Peking University School and Hospital of Stomatology from January 2001 to December 2015. The control group comprised 138 periodontally healthy volunteers recruited from the staff and students of the Peking University School and Hospital of Stomatology. The EGF rs2237051 and PPAR-α rs4253623 polymorphisms were genotyped using time-of-flight mass spectrometry. Logistic regression models were conducted to analyze the correlation between the EGF rs2237051 and PPAR-α rs4253623 variants with GAgP. The likelihood ratio test was used to analyze whether there was an interaction between the two polymorphisms in the susceptibility of GAgP. The interaction model adopted was the multiplication model.Results:The mean ages of GAgP group (male:87; female:132) and control group (male: 53; female: 85) were (27.3±4.5) years and (27.1±4.2) years respectively and there was no significant difference in age and gender distribution between the two groups. For EGF rs2237051, the frequency of AA genotype in the GAgP group [49.5% (107/216)] was significantly higher than that in the control group [37.7% (52/138)], and the frequency of AG/GG genotype in the GAgP group [50.5% (109/216)] was significantly lower than that in the control group [62.3% (86/138)]( P<0.05). Compared with AA genotype, individuals with AG/GG genotype had a 39% lower risk of GAgP after adjustment of age and gender ( OR: 0.61, 95 %CI: 0.40-0.95, P<0.05). For PPAR-α rs4253623, the frequency of AA genotype in the GAgP group [76.2% (160/210)] was significantly higher than that in the control group [65.9%(81/123)], and the frequency of AG/GG genotype in the GAgP group [23.8% (50/210)] was significantly lower than that in the control group [34.1%(42/123)] ( P<0.05). Compared with AA genotype, individuals with AG/GG genotype had a 40% lower risk of GAgP after adjustment of age and gender ( OR: 0.60, 95 %CI: 0.36-0.98, P<0.05). EGF rs2237051 and PPAR-α rs4253623 showed a significant interaction in the susceptibility to GAgP. Compared with AA genotype, the risk of GAgP in individuals with both AG/GG genotypes of EGF rs2237051 and PPAR-α rs4253623 was reduced by 66% ( OR: 0.34, 95 %CI: 0.17-0.66, P<0.01). Conclusions:EGF rs2237051 and PPAR-α rs4253623 are correlated with GAgP susceptibility, and there is a significant interaction between them in the susceptibility of GAgP. The G allele of the two loci has a protective effect on the disease of GAgP.

Objective To study the changes of endotoxin in blood,Escherichia coli,lactobacillus,bifidobacterium,enterococci in feces of HCC patients.Methods Real-time fluorescence quantitative PCR was used to detect the difference between HCC group and normal group in the expression in bifidobacterium,lactobacillus,enterococcus and Escherichia coli,and the difference of endotoxin level.Results The expression levels of Escherichia coli and enterococcus in HCC group were significantly higher than those in normal control group (P＜ 0.05).Bifidobacterium and lactobacillus in primary liver cancer group significantly decreased compared with the normal group (P ＜ 0.05).The serum endotoxin level in HCC group was significantly higher than that in normal control group (P ＜ 0.05).Bifidobacterium and lactobacillus increased in HCC group.Enterococcus and escherichia coli decreased in HCC group.There was a significant positive correlation between endotoxin content and tumor number and tumor diameter in HCC patients.Conclusion Bifidobacterium,lactobacillus decreased,enterococcus and Escherichia coli increased in HCC patients.These changes along with the increase of endotoxin may relate to the development of HCC.

Objective To evaluate the effects of different anesthetic methods on postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy.Methods Fifty-four patients of both sexes,aged 18-64 yr,with body mass index of 20-28 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective video-assisted thoracoscopic thymectomy,were allocated into 2 groups (n =27 each) using a random number table method:sevoflurane-based anesthesia group (group S) and propofol-based anesthesia group (group P).After routine anesthesia induction in two groups,anesthesia was maintained by inhaling sevoflurane and target-controlled infusion of remifentanil in group S and by target-controlled infusion of propofol and remifentanil in group P.Heart rate and mean arterial pressure were recorded before operation and at 5 and 10 min after extubation (T1.2).The intensity of pain at T2 and visual analog scale (VAS) score and consumption of morphine at 1,2,4,24 and 48 h after operation (T3-7) were recorded.The pressing times of analgesia pump,requirement for rescue analgesia and development of nausea and vomiting were recorded at T7.Results There were no significant differences in heart rate or mean arterial pressure at each time point between two groups (P＞0.05).Compared with group S,the intensity of pain was significantly alleviated at T2,and VAS scores and morphine consumption were decreased at T3,4 in group P (P＜0.05).There were no significant differences between group P and group S in VAS scores or consumption of morphine at T5-7,or pressing times of analgesia pump,requirement for rescue analgesia or incidence of nausea and vomiting at T7 (P＞0.05).Conclusion Propofol-based anesthesia provides better efficacy in alleviating postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy.

Objective To evaluate the efficacy of dexmedetomidine in preventing agitation during recovery from general anesthesia in patients undergoing uvulopalatopharyngoplasty (UPPP).Methods Sixty adults patients with obstructive sleep apnea syndrome,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,aged 24-62 yr,with body mass index of 24-37 kg/m2,undergoing elective UPPP,were divided into dexmedetomidine group (group D) and conventional group (group C) using a random number table method,with 30 patients in each group.Dexmedetomidine was infused in a loading dose of 0.8 μg/kg over 10 min starting from 10 min before anesthesia induction,followed by a continuous infusion of 0.4 μg · kg-1 · h-1 for 30 min in group D,while the equal volume of normal saline was given instead of dexmedetomidine in group C.Anesthesia was induced and maintained by target-controlled infusion of propofol and remifentanil,and bispectral index value was maintained at 40-60 during surgery.Patients were extubated after they restored spontaneous breathing completely,opened eyes on verbal command and responded to verbal command,and then the patients were transferred to the recovery room,and oxygen was inhaled by mask.The emergence time,extubation time and development of agitation were recorded.Verbal rating scale was used to assess pain at 30 min after patients were transferred to the recovery room.Results Compared with group C,the incidence of agitation was significantly decreased,pain was reduced,and the emergence time was prolonged in group D (P＜0.05).There was no significant difference in extubation time between two groups (P＞0.05).Conclusion Dexmedetomidine can effectively prevent the occurrence of agitation during recovery from general anesthesia in patients undergoing UPPP.

Objective:To evaluate the clinical effect and safety of periodontal-orthodontic treatment in patients with aggressive periodontitis (AgP) and malocclusion.Methods:A retrospective analysis was conducted in 25 AgP patients,who had received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology.Clinical indexes,including probing depth (PD),bleeding index (BI) and percentage of sites with bleeding on probing (BOP％) were evaluated at three time points:Baseline (T0);active periodontal treatment finished and before orthodontic treatment (T1);and after orthodontic treatment (T2).Also changes of ratio of the residual alveolar bone height (RBH) and the occurrence of root resorption were evaluated by periapical radiographs.Results:(1) Compared with T0,all the clinical parameters including PD,BI,BOP％ and percentage of sites with PD ＞ 3 mm were significantly improved (P ＜0.001).(2) Significant difference was observed in the average RBH between T0 (68.37％ ± 15.60％ and T2 (70.27％ ± 14.23％).RBH in upper incisors [(58.79％ ± 16.71％ at T0,65.54％ (55.74％,78.13％) at T2],upper canines [77.62％ (66.06％,87.17％) at T0,79.57％ (69.75％,86.52％) at T2] and upper molars [74.30％ (61.69％,84.45％) at T0,76.76％ (68.12％,85.09％) at T2] showed significant increase (P ＜ 0.05).(3) After orthodontic treatment,varying degrees of root resorption occurred in (23.94％ ± 13.45％) of teeth per capita,among which the lower and upper incisors showed the highest incidence (68.48％ and 65.31％ in homogeneous teeth,respectively).Conclusion:After active periodontal treatment,orthodontic treatment in AgP patients had not aggravated inflammation and alveolar bone resorption;root resorption occurred in two-thirds of incisors approximately.

Objective To evaluate the efficacy of laryngeal mask airway (LMA) Guardian for airway management in the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy.Methods Sixty patients of both sexes,aged 26-64 yr,weighing 48-95 kg,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,with Mallampati grade Ⅰ-Ⅲ,scheduled for elective laparoscopic cholecystectomy under general anesthesia,were divided into group Ⅰ and group Ⅱ (n =30 each) using a random number table.In group Ⅰ,the nasogastric tube was inserted through the drain tube of LMA Guardian.In group],the nasogastric tube was inserted through the nostril before operation,and after successful LMA Guardian placement,another nasogastric tube was inserted through the drain tube of LMA Guardian.The hemodynamic parameters,SpO2,end-tidal pressure of carbon dioxide and peak airway pressure (Ppeak) were monitored during operation.The fiberoptic laryngoscopy scores were assessed after successful LMA placement,and the nasogastric tube displacement was recorded.The LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,occurrence of air leakage of LMA and nasogastric tube drainage were recorded.The bloodstains and gastroesophageal reflux were observed after removal of the LMA.The pH values were tested at the tip of LMA and on the dorsal and ventral sides of the body of LMA using pH test papers.The development of adverse reactions in the oropharynx was recorded within 24 h after operation.Results The hemodynamics was stable,the SpO2 and Ppeak were within the normal range during operation,and Ppeak was lower than airway sealing pressure in the two groups (P＞0.05),and there was no significant difference between the two groups.There was no significant difference between the two groups in the LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,score for exposure of oropharynx,development of adverse reactions in the oropharynx,consumption of anesthetics,development of bloodstains within the body of LMA and gastroesophageal reflux,and pH values at the tip of LMA and on the dorsal and ventral sides of the body of LMA (P＞0.05).Nasogastric tube drainage:the rate of nasogastric tube drainage through the LMA Guardian was 67％ in group Ⅰ;the rate of nasogastric tube drainage through the nostril was 40％,and the rate of nasogastric tube drainage though the LMA Guardian was 50％ in group Ⅱ.No nasogastric tube displacement was found after operation in group Ⅱ.Conclusion For the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy,insertion of LMA Guardian is easy,and LMA Guardian can assure good airway sealing and adequate ventilation and can be safely and effectively used for airway management in this type of patients.