Objective:To evaluate the efficacy and safety of preoperative intravitreal conbercept (IVC) as an adjunct to pars plana vitrectomy (PPV) in the treatment of proliferative diabetic retinopathy (PDR).Methods:A systematic search in EMbase, PubMed, Cochrane Library, Chinese periodical full text database (CNKI), Wanfang database and VIP database were conducted, studies about the effectiveness and safety of IVC combined with PPV in the management of PDR were collected.Two researchers independently screened the studies according to the inclusion criteria and exclusion criteria, and extracted the data.The quality of the randomized controlled trial (RCT) was evaluated by the modified Jadad scale, and the quality of the cohort study or case-control study was evaluated by the Newcastle Ottawa scale (NOS). Rev Man 5.3 was applied for data analysis.Results:A total of 11 RCTs, 2 cohort studies and 10 case-control studies involving 1 625 patients and 1 844 eyes were included.The final Jadad score for each RCT was more than 3, and the final NOS score for each cohort study and case-control study was more than 5.The results of Meta-analysis showed that the total effectiveness of treatment was significantly higher in the preoperative IVC group than that in the simple PPV group ( RR=1.31, 95% CI: 1.21-1.42, P<0.001). The average operation duration was significantly shorter in the preoperative IVC group compared with that in the simple PPV group (MD=-21.11, 95% CI: -26.39--15.83, P<0.001). The level of VEGF was significantly lower in the preoperative IVC group than that in the simple PPV group (MD=-15.33, 95% CI: -19.40--11.26, P<0.001). Preoperative IVC could reduce the incidences of intraoperative bleeding, iatrogenic retinal breaks, postoperative recurrent vitreous hemorrhage and temporary increase of intraocular pressure, with statistically significant differences between them (all at P<0.05). Conclusions:Preoperative intravitreal injection of conbercept shows better effect and safer than vitrectomy alone, and it has no serious side effect.

OBJECTIVETo investigate the regulatory effect of central synaptic plasticity on pain induced by experimental tooth movement and to analyzethe expression of protein kinases Mζ (PKMζ) in the anterior cingulate cortex (ACC) after applying different magnitude of orthodontic force.

METHODSOne hundred and thirty-six male Sprague-Dawley (SD) rats (200-250 g) were used in this study. Orthodontic tooth movement devices were placed on the teeth in the experimental group, and different orthodontic forces (0.39, 0.78, 1.17 N) were applied to move the maxillary first molars, respectively. The same mechanical devices were placed on the teeth in sham-treated group and no orthodontic force was applied. No orthodontic procedure was applied in blank control group. The average time spent on mouth- wiping behavior in each group was recorded after experimental tooth movement. Brain tissue of the anterior cingulate cortex was isolated on day 3 after experiment, and the expression level of PKMζ was analyzed with the method of immunohistochemistry and enzyme-linked immune sorbent assay. ζ-pseudosubstrate inhibitory peptide (ZIP), a selective inhibitor for PKMζ, was injected into ACC on day 3 after experimental tooth movement, and the effects of ZIP on mouth-wiping behavior were evaluated.

RESULTSNo statistical difference was found between the blank control group and the sham- treated group in the average time spent on mouth-wiping, value of A and expression level of PKMζ (P > 0.05). Compared with the sham-treated group and blank control group, the average time of mouth-wiping behavior [(58.6±6.9), (66.3±7.8), (78.9±8.7) s], value of A (4 569±454, 6 850±365, 8 294±558) and expression level of PKMζ [(0.32±0.02), (0.34±0.02), (0.36±0.02) mg/L] in 0.39, 0.78, 1.17 N force group were found to be up-regulated with the increase of orthodontic force (P < 0.05). LSD test in three experimental sub-group showed statistical difference (P < 0.05). After microinjection of ZIP, the average time spent on mouth-wiping behavior significantly decreased (P < 0.01), while microinjecting saline did not change rats' mouth-wiping behavior (P > 0.05).

CONCLUSIONSMore pain caused by increased orthodontic force maybe due to the up-regulation of PKMζ in the anterior cingulate cortex.

Animals ; Behavior, Animal ; Gyrus Cinguli ; enzymology ; Male ; Maxilla ; Molar ; Neuronal Plasticity ; Protein Kinase C ; metabolism ; Rats ; Rats, Sprague-Dawley ; Time Factors ; Tooth Movement Techniques ; instrumentation ; Up-Regulation

Objective: To study the change of STAT1 expression in the anterior cingulate cortex on rats under orthodontic force, and to further explore the roles of STAT1 and related JAK-STAT1 signaling pathway in the mediation and regulation of pain during tooth movement. Methods: 112 male Sprague-Dawley (SD) rats (225±25 g) were used in this study. They were randomly divided into experimental groups (96 rats) and control groups (16 rats). All rats were installed bilateral maxillary device for tooth movement models. Rats in the experimental groups were applied 80g orthodontic force on both sides and were divided into six subgroup 4 h, 12 h, 24 h, 2 d, 3 d, 7 d, with 16 rabbits in each subgroup. The control groups were only installed the same orthodontic devices, without the application of orthodontic force. Brain tissue of the anterior cingulate cortex was isolated after 4 h, 12 h, 24 h, 2 d, 3 d, 7 d since experiment, and the expression level of STAT1 and p-STAT1 was analyzed with the method of immunofluorescence and PCR. Results : For the immunofluorescence result, there was significant difference in STAT1 expression between control groups and different experimental groups at different time points in total (P < 0.05). The STAT1 expression amount in the 4 h group decreased significantly when compared with the control group (P < 0.05); to the 2 d group, the difference is still statistically significant (P < 0.01). 3 d group, 7 d group and control group had no statistically significant difference. The STAT1 expression amount in 4 h group, 12 h group, 24 h group was significantly lower than that in 3 d and 7 d groups, differences were statistically significant (P < 0.05). The STAT1 expression in the 2 d group was significantly lower than that of 7 d (42.35 ± 5.77) group, the difference was statistically significant (P < 0.05). There was significant difference in p-STAT1 expression between control groups and different experimental groups at different time points in total (F = 623.518, P < 0.05). The p-STAT1 expression amount in experimental groups were higher than that in the control group (P < 0.05). The p-STAT1 expression in 4 h group was lower than that in 12 h and 24 h group and higher than that in 2 d, 3 d and 7 d groups, of which the differences were statistically significant (P < 0.05). The p-STAT1 expression in 12 h group was lower than that in 24 h group and higher than that in 2 d, 3 d and 7 d groups, of which the differences were statistically significant (P < 0.05). For the PCR result, the expression of mRNA in STAT1 of experimental groups of 4 h, 12 h, 24 h, 2 d, 3 d, 7 d and the control groups were not statistically significant (P > 0.05). Conclusions After applying orthodontic force, the expression of STAT1 decreased transiently and the expression of p-STAT1 increased transiently. The reduction of STAT1 was probably caused by the phosphorylation of STAT1 and decrease in the translation level of STAT1, rather than changes in the transcriptional levels. The orthodontic pain might be related with the activation of STAT1 into phosphorylated STAT1.

Objective To study the clinical characteristicsand prognosis in pediatric sudden sensorineural hearing loss and provide guidance for clinical practice.Methods We retrospectively analyzed the clinical data of 23 pediatric sudden sensorineural hearing loss patients (25 ears) treated in our department during the past 9 years (from January 2008 to October 2016).Comparatively we looked into those related factors (age,gender,ear side,treatment onset,initial hearing threshold,virus infection history,audiogram configuration,presence of tinnitus,vertigo,ear fullness and recovery) between pediatric patients and 202 adult patients (219 ears).Results Pediatric patients comprised 10.2 ％ of pediatric/adult cases of sudden sensorineural hearing loss.The average hearing threshold (87.7± 16.1 dB),rate of presence of vertigo (48.0％) and rate of virus infectionin in the pediatric group,were significantly higher than those of in the adult group (P＜0.05).Tinnitus occurred in 80％ of pediatric patients,and 96 ％ of the audiogram configurations showed total deafness curves and flat lines.After positive treatment,the overall recovery rate of the pediatric and the adult group were 52.0％ and 46.6％,and the rate of complete recovery was 4.0％ and 14.2％,respectively.The difference was not statistically significant (P＞0.05).Conclusion Pediatric sudden sensorineural hearing loss was generally identified as severe hearing loss with a high rate of presence of tinnitus and vertigo,and most audiogram configurations were total deafness in fiat lines.Virus infection probably is one of the primary etiologies for sudden sensorineural hearing loss in children.

Objective: To detect 20 common deafness gene mutations in non-syndromic hearing loss patients in China using the melting curve method, and analyze and summarize the mutation data to explore the clinical value of this method. Methods: The real-time fluorescence PCR melting curve method was used to detect 20 common mutations of four deafness genes(GJB2,GJB3,SLC26A4 and mtDNA) in 492 patients with non-syndromic hearing loss recruited between March 2014 and September 2016 from the Otolaryngology Department of Xiangya Hospital, Central South University(283 males and 209 females, the age ranged from 1 to 48 years old). The Sanger sequencing method was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, and total coincidence rate of the deafness mutation detected by the real-time fluorescence PCR melting curve method. Results: A total of 492 samples were detected. 193 wild-type samples, 93 homozygous mutant samples, 145 heterozygous mutant samples, 59 composite heterozygous mutant samples and 2 samples with unknown mutations were detected using the real-time fluorescence PCR melting curve method within the range of 20 gene mutations, whichwere identical to the Sanger sequencing results.The two samples were detected as unknown mutations by the real-time fluorescent PCR melting curve method were confirmed by Sanger sequencing, including a composite heterozygous mutant sample and a homogenous mutation sample. GJB2 c.235delC and SLC26A4 c.919-2 A>G were the most common hotspot mutations in this study, followed by mtDNA m.1555 A>G. Compared with the Sanger sequencing method, the sensitivity, specificity, positive predictive value, negative predictive value, and total coincidence rate of the real-time fluorescence PCR melting curve method were 100%, the Youden′s index was 1.0, and the Kappa value was 1. Conclusions The real-time fluorescence PCR melting curve method is suitable for the detection of deafness gene mutations. It has the advantages in terms of simple, rapid, high sensitivity and strong specificity and can accurately detect the 20 gene mutations of 4 common deafness genes in Chinese population, which is expected to be used for the clinical detection of deafness genes in the future.

External apical root resorption is among the most common risks of orthodontic treatment, and it cannot be completely avoided and predicted. Risk factors causing orthodontic root resorption can generally be divided into patient- and treatment-related factors. Root resorption that occurs during orthodontic treatment is usually detected by radiographical examination. Mild or moderate root absorption usually does no obvious harm, but close attention is required. When severe root resorption occurs, it is generally recommended to suspend the treatment for 3 months for the cementum to be restored. To unify the risk factors of orthodontic root resorption and its clinical suggestions, we summarized the theoretical knowledge and clinical experience of more than 20 authoritative experts in orthodontics and related fields in China. After discussion and summarization, this consensus was made to provide reference for orthodontic clinical practice.
Humans ; Tooth Movement Techniques/adverse effects* ; Root Resorption/etiology* ; Consensus ; Dental Cementum ; Risk Factors