OBJECTIVETo regenerate dentin-pulp complex by tissue engineering with human stem cells from apical papilla cells (SCAP) as the seed cells.

METHODSSCAP was separated from from normal human impacted third molars with immature roots by outgrowth culture. The cells were then cultured in the differentiation medium for 3 weeks or in normal medium for 60 days, and analyzed for mineralization potential by Alizarin red staining. The osteo/odontogenic markers including alkaline phosphatase (ALP), bone sialoprotein (BSP), osteocalcin (OC) and dentin sialoprotein (DSP) were investigated by immunofluorescence staining and reverse transcription-polymerase chain reaction. The co-cultured mixture of SCAP and HA/TCP, or HA/TCP alone was implanted subcutaneously on the back of nude mice for 8 weeks, and the implants were collected and examined by HE and immunohistochemical staining.

RESULTSRound alizarin red-positive nodules formed in the isolated cells after cell culture in the differentiation medium for 3 weeks or in normal medium for 60 days with positive staining for osteo/odontogenic markers. SCAP with HA/TCP could regenerate pulp-dentin complex-like tissue in nude mice. The cells near the dentin-like tissue were positive for DSP. No mineral tissue was found in mice receiving HA/TCP implantation.

CONCLUSIONSSCAP may serve as a promising seed cell for dentin-pulp complex tissue engineering.

Adolescent ; Adult ; Alkaline Phosphatase ; analysis ; Animals ; Cell Culture Techniques ; Cell Differentiation ; Coculture Techniques ; Dental Papilla ; cytology ; Dental Pulp ; cytology ; Extracellular Matrix Proteins ; analysis ; Female ; Humans ; Integrin-Binding Sialoprotein ; analysis ; Mice ; Mice, Nude ; Odontogenesis ; physiology ; Osteocalcin ; analysis ; Phosphoproteins ; analysis ; Sialoglycoproteins ; analysis ; Stem Cells ; chemistry ; physiology ; Tissue Engineering ; methods ; Young Adult

OBJECTIVETo observe the effect of revascularization for treatment of immature teeth with endodontic infection mediated by calcium hydroxide.

METHODSSeventeen pediatric patients with endodontic infections of the permanent teeth were treated with routine root canal and pulp cavity irrigation and disinfection followed by application of calcium hydroxide paste to the root canal orifice to induce revascularization. Another 17 patients received conventional apexification procedures to serve as the control group. The patients were followed up to observe the therapeutic effect of the treatments.

RESULTSIn the revascularization treatment group, 4 cases showed healed periapical lesions 6 to 18 months after the surgery with thickened root canal walls and closure of the apical foramen; in 10 cases, the periapical lesions healed 12 to 18 months postoperatively with lengthened root, thickened root canal wall, and narrowed apical foramen. One patient reported pain and swelling at 2 months, and 2 patients showed the formation of gum fistula and ceased development of the roots at 7 and 8 months. In the control group, the periapical lesions healed in 1 cases at 12 months postoperatively with apical foramen closure; in 11 cases, hard tissues formed in the root apex without obviously lengthened roots 6 to 8 months after the surgery; in 5 cases, no apical barrier formed even 12 to 18 months after the surgery. The overall effective rates were similar between the two groups (P>0.05).

CONCLUSIONSRevascularization by calcium hydroxide sealing can promote root development of immature permanent teeth with pulpitis or periradicular periodontitis.

Adolescent ; Calcium Hydroxide ; therapeutic use ; Child ; Dental Pulp ; blood supply ; Dental Pulp Diseases ; therapy ; Dentition, Permanent ; Guided Tissue Regeneration, Periodontal ; Humans ; Neovascularization, Physiologic ; drug effects ; Treatment Outcome

Objective To regenerate dentin-pulp complex by tissue engineering with human stem cells from apical papilla cells (SCAP) as the seed cells. Methods SCAP was separated from from normal human impacted third molars with immature roots by outgrowth culture. The cells were then cultured in the differentiation medium for 3 weeks or in normal medium for 60 days, and analyzed for mineralization potential by Alizarin red staining. The osteo/odontogenic markers including alkaline phosphatase (ALP), bone sialoprotein (BSP), osteocalcin (OC) and dentin sialoprotein (DSP) were investigated by immunofluorescence staining and reverse transcription-polymerase chain reaction. The co-cultured mixture of SCAP and HA/TCP, or HA/TCP alone was implanted subcutaneously on the back of nude mice for 8 weeks, and the implants were collected and examined by HE and immunohistochemical staining. Results Round alizarin red-positive nodules formed in the isolated cells after cell culture in the differentiation medium for 3 weeks or in normal medium for 60 days with positive staining for osteo/odontogenic markers. SCAP with HA/TCP could regenerate pulp-dentin complex-like tissue in nude mice. The cells near the dentin-like tissue were positive for DSP. No mineral tissue was found in mice receiving HA/TCP implantation. Conclusion SCAP may serve as a promising seed cell for dentin-pulp complex tissue engineering.

Objective To regenerate dentin-pulp complex by tissue engineering with human stem cells from apical papilla cells (SCAP) as the seed cells. Methods SCAP was separated from from normal human impacted third molars with immature roots by outgrowth culture. The cells were then cultured in the differentiation medium for 3 weeks or in normal medium for 60 days, and analyzed for mineralization potential by Alizarin red staining. The osteo/odontogenic markers including alkaline phosphatase (ALP), bone sialoprotein (BSP), osteocalcin (OC) and dentin sialoprotein (DSP) were investigated by immunofluorescence staining and reverse transcription-polymerase chain reaction. The co-cultured mixture of SCAP and HA/TCP, or HA/TCP alone was implanted subcutaneously on the back of nude mice for 8 weeks, and the implants were collected and examined by HE and immunohistochemical staining. Results Round alizarin red-positive nodules formed in the isolated cells after cell culture in the differentiation medium for 3 weeks or in normal medium for 60 days with positive staining for osteo/odontogenic markers. SCAP with HA/TCP could regenerate pulp-dentin complex-like tissue in nude mice. The cells near the dentin-like tissue were positive for DSP. No mineral tissue was found in mice receiving HA/TCP implantation. Conclusion SCAP may serve as a promising seed cell for dentin-pulp complex tissue engineering.

Objective:To systematically review the qualitative studies on the experience of lifestyle improvement in patients with polycystic ovary syndrome (PCOS) , so as to provide a basis for formulating operable lifestyle management measures.Methods:PubMed, Web of Science, Embase, CINAHL, Cochrane Library, Scopus, Science Direct, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang, VIP and other Chinese and English databases were searched by computer. Qualitative studies on the experience of lifestyle improvement in PCOS patients were searched from January 1, 2016 to November 30, 2021. According to the Joanna Briggs Institute (JBI) Evidence-based Health Care Center Qualitative Research Quality Assessment Criteria (2016 edition) , the pooled integration method was used to integrate the research results.Results:A total of 9 studies were included, 58 clear study results were extracted, similar study results were summarized into 13 new categories and 3 integrated results were synthesized including, including the motivation of PCOS patients to improve their lifestyle, the perceived obstacles of PCOS patients to improve their lifestyle and the reasons for PCOS patients to gradually adapt to the improvement of their lifestyle.Conclusions:Medical staff should promote the internal drive of health management based on the motivation of lifestyle improvement of PCOS patients, help PCOS patients overcome obstacles in lifestyle improvement with the help of mobile applications and provide comprehensive and systematic support for patients through the multi-linkage of medical institutions, family and society. At the same time, a multidisciplinary management team is formed to jointly participate in the improvement of patients' individualized lifestyle to improve their health-promoting lifestyle level.

Objective:To explore the reasons for delayed medical treatment in patients with polycystic ovary syndrome (PCOS) using the treatment pathway theory as a framework, and to propose corresponding strategies to guide timely medical care for PCOS patients.Methods:Purposeful sampling was used to select 14 PCOS patients who sought treatment at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School between November 2022 and May 2023. Semi-structured interviews were conducted, and directed content analysis was applied to analyze and extract data.Results:The delay in seeking medical treatment for PCOS patients ranged from five to 60 months. Four main themes and 11 sub-themes were identified as reasons for treatment delays: misconception and delayed recognition of the disease (misunderstanding of symptoms, intermittent symptom presentation) ; delayed seeking of medical help (mismanagement of symptoms, feelings of shame, role conflict, distance and financial constraints, lack of social support) ; delayed diagnosis by healthcare providers (misdiagnosis by healthcare providers, lack of medical resources and services) ; and delayed participation in treatment (lack of health education from medical staff, no immediate fertility needs) .Conclusions:Delays in seeking medical care for PCOS patients are common. Efforts should be made to enhance public education on PCOS for adolescent and reproductive-age women, emphasize the management of the disease in patients without immediate fertility needs, improve primary healthcare institutions' capacity for managing PCOS, and mobilize the social support system to encourage patients to seek medical treatment early, thus reducing the occurrence of delayed medical care.

Objective To develop a health-promoting lifestyle scale for women with polycystic ovary syndrome(PCOS),and to test its reliability and validity,and preliminarily apply it.Methods Based on the Pender health promotion model,the item pool of the scale was constructed through literature research,semi-structured interviews and group discussions.After 2 rounds of Delphi expert consultation and pre-survey,the initial scale was formed.From April to July 2022,316 patients with PCOS in the health management center,reproductive medicine center and endocrinology department of a tertiary hospital in Nanjing were selected for item analysis,exploratory factor analysis and reliability test,respectively.From August to October 2022,358 PCOS patients were selected for confirmatory factor analysis.From November 2022 to February 2013,294 PCOS patients were selected,and the scale was used to investigate the status of health-promoting lifestyle in PCOS patients.Results The health-promoting lifestyle scale for PCOS patients included 5 dimensions and 33 items.The total content validity index of the scale was 0.942,and the content validity index of each item was 0.810-1.000.5 common factors were extracted by 2 exploratory factor analyses,and the cumulative variance contribution rate was 62.399％.Confirmatory factor analysis showed that the model fit was good.The Cronbach's a coefficient of the total scale was 0.930;the split-half reliability was 0.842;the test-retest reliability was 0.888.The preliminary application results showed that the total score of health-promoting lifestyle in PCOS patients was(96.925±14.273),and the average score of items was(2.937±0.433),which was at a medium level.Conclusion The health-promoting lifestyle scale for PCOS patients has good reliability and validity,which can be used as a tool for medical staff to assess the level of health-promoting lifestyle of PCOS patients,and can help nurses to quickly identify the level and dimensions of health-promoting lifestyle of patients,so as to formulate individualized precise health management plans.

Objective:To construct the admission criteria and job responsibility scheme for polycystic ovary syndrome (PCOS) case managers.Methods:The first draft of the scheme was constructed through literature research, pre-consultation and group discussion. From February to April 2022, the convenient sampling method was used to select 18 experts for two rounds of Delphi expert letter consultation. Analytic hierarchy process was used to determine the weight of each indicator.Results:The effective response rates of the questionnaire for two rounds of expert inquiries were 94.74% (18/19) and 100.00% (18/18), respectively. The expert authority coefficients were 0.892 and 0.897, respectively. After two rounds of expert consultation, the Kendall's W of the first, second, and third level indexes for the admission criteria and job responsibilities of PCOS case managers were 0.361, 0.306, 0.283 and 0.250, 0.134, 0.142 ( P<0.05), respectively. The final admission criteria for PCOS case managers included 3 first level indicators, 8 second level indicators and 30 third level indicators. Their job responsibilities included 5 first level indicators, 13 second level indicators and 46 third level indicators. Conclusions:The admission standards and job responsibility scheme for PCOS case managers systematically and comprehensively reflect the characteristics of disease management for PCOS patients in China, which are reliable and scientific, and provide reference value for the screening and work practice of PCOS case managers.

Objective:To explore the current status and influencing factors of exercise intention in patients with polycystic ovary syndrome (PCOS) .Methods:From March to July 2022, 174 PCOS patients admitted to the Health Management Center of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected as the study subject by convenience sampling. A survey was conducted using the General Information Questionnaire, Exercise Intention Scale, Exercise Self-efficacy Scale and the Exercise Social Support Scale.Results:The Exercise Intention Scale score of 174 PCOS patients was 15.00 (13.00, 18.00). The results of multiple linear regression analysis showed that education level, PCOS related disease visits, exercise self-efficacy, exercise social support, and exercise self-identification were the influencing factors of exercise intention in PCOS patients, and the difference was statistically significant ( P<0.05), which could explain 42.4% of the total variation. Conclusions:The subjective intention of patients with polycystic ovary syndrome to participate in exercise needs further improvement. Medical and nursing staff should focus on patients with polycystic ovary syndrome who have low levels of education and fewer visits, and focus on enhancing their self-efficacy and self-identification in exercise. At the same time, medical and nursing staff should actively mobilize social support systems to promote their subjective intention to exercise at a high level.