BACKGROUND: There are various methods for management of allogeneic bone, xenogeneic bone and various tissue engineered materials, but there is no ideal method for treatment of insufficient bone mass following jaw defects. OBJECTIVE: To observe the repair efficiency of bone composite and biomembrane following large mandibular defect and mandibular defect combined with tooth luxation in animal studies. DESIGN, TIME AND SETTING: The controlled observational animal study was performed at the Animal Laboratory of Zhejiang University from March to July 2006. MATERIALS: The mixed proportion of Bio-oss material and autologous bone powder was 1:1. The proportion of recombinant human bone morphogenetic protein-2 freeze-dry powder dissolved in autologous fresh blood was 0.25 mg:1 mL. Bone powder mixture was moistened by blood containing human bone morphogenetic protein to stick on the medicine spoon for moulding easily. METHODS: Ten New Zealand rabbits were selected. Consecutive bone defects (15 mm×6 mm×5 mm) were made in the inferior border of bilateral mandible body. Bone composite and Bio-gide membrane were randomly implanted into one side (bone composite + Bio-gide membrane group). Another side was directly sutured as blank control group. The remaining 30 rabbits were considered bone composite + Bio-gide membrane + implantation tooth group. A bone defect (15 mm×6 mm×8 mm) was made at the upper site of inferior border of mandible, with the combination of tooth luxation. Bone composite and Bio-gide membrane were implanted, and the luxation teeth were implanted into the original site. MAIN OUTCOME MEASURES: Implantation site, composite conjugation, loose of bone formation and implanted teeth were generally observed. New bone formation at the bone defect site was observed using radiograph and histological method. RESULTS: At 12 weeks following surgery, a bone defect, which was smaller than the original bone, was found at the mandibular defect site in the blank control group. New bones were visible in the mandibular defect site in the bone composite + Bio-gide membrane group. Radiograph demonstrated that the density of defect bone site was similar to normal bone tissue. Histological method revealed that bone implant formed board-shaped bone. No significant loose was detected in implanted teeth of 17 rabbits in the bone composite + Bio-gide membrane + implantation tooth group. Radiograph demonstrated that no transparent area was found in the root tip of 13 rabbits. Histological method showed replacement resorption in 13 rabbits. CONCLUSION: Bone composite combined with Bio-gide membrane for repairing large mandibular defect obtained good efficiency. The outcome of autologous tooth implantation is acceptable in the near future.

A simple, rapid, and sensitive gas chromatography-mass spectrometry (GC-MS) method was developed and validated for the simultaneous determination of two fatty acids, methyl hexadecanoate (MH) and methyl stearate (MS), to allow the evaluation of packaging-drug compatibility. The two migrants were quantified in selective ion-monitoring (SIM) mode, with limits of detection (LOD) of 0.0030 μg/mL and 0.0121 μg/mL. Linear calibration curves for MH and MS were obtained in the concentration ranges of 0.1011–5.0570 μg/mL and 0.2015–10.0740 μg/mL, respectively. The developed method was successfully applied to estimate the safety of the injection of recombinant antitumor-antivirus protein (RAAP). The results showed that the possible maximum daily intake was 3.0 ng and 12.1 ng for MH and MS, re-spectively. As these values were both below the permitted daily exposure, the migrants can be con-sidered as having low safety risk and do not affect the quality of the injection.

OBJECTIVETo systemically investigate receptor activator of nuclear factor-kappaB ligand (RANKL) and macrophage colony-stimulating factor (M-CSF) induced differentiation of osteoclasts.

METHODSMouse protein-protein interaction(PPI) database NIA and published microarray dataset GES16749 were used to construct and analyze PPI network of RANKL and M-CSF induced mouse monocyte RAW264.7.

RESULTSIn the PPI network, transforming growth factor beta receptor 1 (TGFBR1), Rous sarcoma oncogene (SRC), myelocytomatosis oncogene(MYC) and integrin beta 3 (ITGB3) were able to interact with more proteins and they were the key nodes in the signaling transduction.

CONCLUSIONTGFBR1, SRC, MYC and ITGB3 might be the key points of RANKL and M-CSF induced differentiation of osteoclasts.

Animals ; Carrier Proteins ; Cell Differentiation ; Macrophage Colony-Stimulating Factor ; Membrane Glycoproteins ; Mice ; Osteoclasts ; Protein Interaction Maps ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B

Objective To investigate the clinical features and treatment principles of inflammatory myofibroblastic tumor of the urinary bladder (IMTUB).Methods From April 2013 to October 2016,6 cases of IMTUB patients were analyzed retrospectively.All cases were presented with gross hematuria.4 cases underwent ultrasonography,of which 3 cases showed solid mass in bladder,1 case showed inflammatory change.6 cases underwent CT examination,3 cases with bladder cancer,1 case with bladder sarcoma,1 case with malignant transformation of adenoma,1 case with rich blood supply.No lymph node metastasis.Bladder occupying lesions were considered in 2 cases of MRI examination.5 cases of cystoscopy showed bladder solid mass.In 6 cases involved,2 patients received partial cystectomy,2 patients underwent transurethral resection of bladder tumor,1 patient underwent radical resection of urachal carcinoma and the other one was treated with chemotherapy.Results Immunohistochemical staining was positive in ALK (100.0％) 、Vimentin(100.0％) 、CK(100.0％) 、SMA (83.3％) 、EMA(66.7％) and Ki-67 (5％-30％),negative in S-100 and Desmin.Final pathological diagnosis was IMTUB.So far,neither recurrence nor metastasis has been detected for 6 ～ 42 months in 5 cases and the other one lost to follow-up.Conclusions IMTUB is a kind of rare benign tumor of bladder.The golden standard of diagnosis is pathological diagnosis.Surgical resection is the first choice for treatment.Recurrence and metastasis are after the surgery treatment.All patients should be followed up closely.

Objective To explore the related factors of lymph node metastasis in early gastric cancer and to analyze the clinical efficacy between laparoscopic D2 radical resection and endoscopic submucosal dissection(ESD).Methods A retrospective cohort study was conducted on 404 patients with early gastric cancer undergoing surgical treatment in our hospital from June 2018 to June 2022 were recruited in this study.According to their surgical treatment,they were divided into laparoscopy group(n=271)and ESD group(n=133).The lymph node metastases were compared in the patients with different clinical features,and the factors affecting lymph node metastasis were analyzed with multivariate logistic regression analysis.The lymph node metastasis rate of patients with absolute and expanded indications of ESD was calculated.Kaplan-Meier survival analysis was used to compare the long-term efficacy of ESD and laparoscopic D2 radical resection in these patients.Stratified regression analysis was applied to explore the relationship between surgical methods and long-term outcome in them.Results In the 404 patients with early gastric cancer,the rate of lymph node metastasis was 12.38％(50/404).Univariate analysis showed that 7 clinical features,such as ulcer,tumor pathological features and pathological differentiation,were related to lymph node metastasis.Multivariate logistic regression analysis revealed that low differentiation and tumor infiltration depth of submucous membrane(SM)were related factors affecting lymph node metastasis in early gastric cancer.The overall survival rate was 96.29％(389/404)in the 404 patients,96.31％in the laparoscopic group and 96.24％in the ESD group,and no statistical difference was seen between the 2 groups(P＞0.05).There was no obvious difference in 5-year survival rate between the patients who met the absolute indications for ESD and underwent laparoscopic D2 radical surgery and those receiving ESD treatment(96.00％vs 96.55％),and between those who were in accordance with the expanded indications for ESD and underwent laparoscopic D2 radical surgery and those receiving ESD treatment(94.74％vs 91.67％).After adjusting the clinical features such as lesion size,pathological differentiation and depth of tumor invasion by stratified regression analysis,the mode of operation for early gastric cancer was still correlated with the long-term efficacy(β=1.173,P=0.003).Conclusion The depth of tumor infiltration and differentiation are closely related to lymph node metastasis in early gastric cancer patients.The efficacy of laparoscopic D2 radical surgery on the patients with absolute and expanded indications for ESD is comparable to that of ESD treatment.

Objective To explore the value of probe-based confocal laser endomicroscopy(pCLE)in the differential diagnosis of fundic gland polyps.Methods A total of 63 patients who underwent conventional white light image(WLI)and suggested with gastric polyps in our gastroenterology endoscopy center during June and December 2023 were enrolled,and their clinical data,WLI,narrow band images(NBI),pCLE images and postoperative histopathological findings were collected.The characteristics of fundic gland polyps under pCLE were statistically verified,and the sensitivity,specificity,accuracy and consistency of different endoscopic diagnoses were calculated respectively.Results Under pCLE,fundic gland polyps were mainly manifested as elongated gastric pit opening,"hand-in-hand"gastric pit opening,well-arranged blood vessels around the pit opening,and no luciferin oozing.The sensitivity,specificity,accuracy of WLI were 72.73％,75.00％,73.13％and 0.343 for fundic gland polyps,and 81.82％,71.43％,71.64％and 0.354 for hyperplastic polyps,respectively.While,the above values of NBI were 87.27％,83.33％,86.57％and 0.673 for fundic gland polyps,and 81.82％,85.71％,85.07％and 0.554 for hyperplastic polyps;and those of pCLE were 92.73％,91.67％,92.53％and 0.769 for fundic gland polyps,and 90.91％,94.64％,94.03％and 0.797 for hyperplastic polyps pCLE had better sensitivity,specificity and accuracy than WLI and NBI,and had the results consistent with histopathological findings.Conclusion pCLE can be used in the differential diagnosis of fundic gland polyps.

Objective To construct an optimal prediction model for lymph node metastasis(LNM)in early gastric cancer(EGC)using machine learning techniques and assess its predictive performance.Methods Clinical data of 433 EGC patients undergoing radical surgery in our hospital from January 2015 to December 2022 were collected.They were divided into a training set and a validation set in a 7:3 ratio.LASSO regression was used to screen variables and multivariate logistic regression analysis was employed to identify independent risk factors for LNM in the EGC patients.Ten machine learning models were constructed using categorical boosting(Catboost),light gradient boosting machine(LightGBM),extreme gradient boosting machine(XGboost),random forest(RF),gradient boosting machine(GBM),neural networks(NNET),support vector machine(SVM),K nearest(KNN),Naive Bayes(NB)and Logistic regression.The predictive power of the above models was evaluated and compared in terms of accuracy,precision,recall,F1 score value,sensitivity,specificity,positive predictive rate,negative predictive rate,Kappa value,area value under the receiver operating characteristic curve(AUC),calibration curve,decision curve,and precision-recall curve.Finally,SHAP(SHapley Additive exPlanations)was applied to explain the contribution of each variable in the best model for the prediction outcomes.Results Depth of tumor invasion,lymphovascular invasion and smoking history were independent risk factors for LNM in the EGC patients.Catboost model obtained the best predictive performance,and had 5 performance indicators outperforming the other models in the training set,that is,an AUC value of 0.904(95％CI 0.868～0.940),a F1-score of 0.633,a Brier score of 0.100,a negative predictive rate of 0.975,and a Kappa value of 0.520.Finally,calculating the SHAP values of Catboost revealed that the depth of tumor invasion and lymphovascular invasion were two key characteristic variables for predicting LNM.Conclusion The depth of tumor invasion of submucosal and lymphovascular invasion and smoking history are independent risk factors for LNM in early gastric cancer.ML can be used to predict LNM risk,the Catboost model has the best predictive performance and can provide guidance for clinical diagnosis and treatment decisions.