Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

Gingival mesenchymal stem cells(GMSCs)are a population of mesenchymal stem cells found in the lamina propria of gingi-val tissue and can be isolated not only from healthy gingival tissue but also from hyperplastic or even inflamed gingival tissue.GMSCs have become a hot topic of research in oral disease treatment because of their abundant sources,easy availability,unique immunomod-ulatory properties and multi-directional differentiation potential.GMSCs have been used in the treatment of periodontitis,gingival reces-sion,oral cancer,mandibular defects,peripheral nerve injury repair and so on.To prevent and treat oral diseases,this study will re-view the recent progress of research on the application of GMSCs in oral diseases.

Although surgery,radiotherapy and chemotherapy have made great progress,pancreatic cancer is still the most fatal malignant tumor,with a 5-year overall survival rate of only about 4% . Many studies have demonstrated that the local recurrence of pancreatic cancer is an important cause of high mortality,and the failure rate after local excision is still as high as 50~80% . There-fore,how to improve the local control rate of pancreatic cancer has been a hot spot of concern. Due to the adjacent organs and tissues (such as bone marrow,spinal cord,kidney,liver,intestine,etc. ),the dose of external irradiation(EBRT) is limited. Increasing local control rates and reducing treatment side effects are trends in future treatments. Intraoperative radiotherapy has the advantages of do-simetry and direct vision treatment to be increasingly used in the treatment of pancreatic cancer,becoming an important part of com-prehensive treatment. This article summarizes the clinical research results of intraoperative radiotherapy for pancreatic cancer in recent years,in order to provide the reference for clinicians.

Objective: To observe the location and the distribution of distal 1/3 segment of the second dorsal metacarpal artery, the finger web artery and the dorsal digital artery, and to provide anatomical data for repairing the soft tissue defect on the hand with bilobed or multi-lobed micro-flap with second metacarpal dorsal artery-dorsal digital artery. Methods: From June, 2018 to March, 2019, 34 fresh adult upper limb specimens were selected. The radial and ulnar arteries were perfused with red latex in 24 specimens. The radial and ulnar arteries were infused with cast materials to make cast specimens in 10 specimens. The location and distribution of the distal 1/3 segment of the second dorsal metacarpal artery, the finger web and the dorsal digital artery were observed. Results: The distal 1/3 segment of second dorsal metacarpal artery extended (4±1) cutaneous branches, and continued to become the finger web artery at the plane of the articular surface. The length of the finger web artery was (2.5±0.6) cm, and there were 4 types anastomic methods of communication with arteries. The second dorsal metacarpal artery extended 2 finger dorsal artery to the proximal dorsal skin of the middle finger and index finger. The length of dorsal digital artery was 2.6±0.4 cm and the diameter was 0.2±0.1 mm. Four to 6 micro-cutaneous branches were extended and consistent with the nearby skin cutaneous branches. Conclusion The distal segment of the second dorsal metacarpal artery and the dorsal digital artery is anatomically constant. The distal segment of the second dorsal metacarpal artery and dorsal digital artery are the pedicle for the design of the bilobed flap of middle finger and index finger to repair small soft tissue defect on the thumb and purlicue.

To provide the anatomical information for auricle replantation. Methods From March, 2016 to March, 2019, a total of 25 fresh adult cadaveric head were used, 20 of these specimens were perfused with plastic and eroded to be vascular cast mold, 5 specimens perfused with red latex for anatomy, then observed the origin, course, diameter and arteries anastomose between branches of the posterior auricular artery (PAA) and superfi-cial temporal artery (STA). Results The main blood supply to the auricle were auricle branches of PAA and STA. The auricle branches of PAA and STA both divided into superior, intermedius and inferior branches, and distributed in the auricle posterior surface and anterior surface, respectively.The auricle branches of PAA running across ear car-tilage, distributed in the anterior surface, and anastomosed with auricle branches of STA. The diameters of these branches at the initiating portion were 0.2-0.8 mm. Eighty percent of blood supply to earlobe was from the inferior branches of PAA, and 20% from the STA. Conclusion The auricle branches of PAA played an important role to the auricle replantation.The auricle branches of PAA should be the firstly selected vessle in operation, and the auricle branches of STA be the second choice.

Objective To investigate the relationship between frailty and serum biomarkers in the elderly. Methods A total of 371 elderly individuals aged 60 years and above with complete medical data were recruited during health examinations. Frailty phenotype assessment and comprehensive geriatric assessment were conducted.Serum levels of interleukin-6 (IL-6 ) ,high sensitivity C-reactive protein(hs-CRP) ,tumor necrosis factor-α(TNF-α) ,homocysteine(Hcy) ,insulin-like growth factor-1(IGF-1) ,25-hydroxyvitamin D[25(OH)D] ,folic acid and vitamin B12(VitB12) were detected by enzyme-linked immunosorbent assays ( ELISA ) and chemiluminescence immunoassays. Associations between frailty and the above factors were analyzed. Results Serum levels of IL-6 ,TNF-α ,Hcy and IGF-1 were significantly elevated along with progressive increase in frailty severity(all P＜0.05).There were a downward trend in serum 25(OH)D levels and an upward trend in serum hs-CRP ,folic acid and VitB12 levels as frailty severity increased ,but the changes did not amount to any statistical significance(all P＞0.05).Logistic regression analysis showed that ,after adjusting for age ,gender ,body mass index (BMI)and some clinical aspects (hearing loss ,urinary incontinence ,pain ,malnutrition ,cognitive dysfunction ,decreased activities of daily living ,depression , insomnia ,and anemia) ,serum levels of IL-6(OR=1.012 ,95% CI=1.005-2.041 ,P=0.033) ,IGF-1 (OR= 1.017 ,95% CI = 1.011-1.118 ,P= 0.021)and Hcy (OR= 1.007 ,95% CI :1.002-1.073 ,P=0.047)were significantly associated with frailty status. Conclusions Serum levels of IL-6 ,Hcy and IGF-1 are related to frailty status and may be used as potential biomarkers for the assessment of frailty in older adults.

Objective To explore the effect of virtual reality video games on gross motor skills of children with cerebral palsy.Methods The 56 patients with cerebral palsy treated in the Fifth Affiliated Hospital of Zhengzhou University from April 2015 to April 2017 were selected as the subjects.The age of the patients was (5.4 ± 1.2) years old (5-7 years old).According to the results of Gross Motor Function Classification System (GMFCS) assessment,all patients belonged to level Ⅰ-Ⅱ.All patients were randomly divided-into 2 groups:video-game group and conventional exercise group for 6 weeks of functional exercise.The evaluation criteria included the average exercise time,the 6-minute walk test (6MWT) and general motion function challenge module (GMFMS-CM) measurement and evaluation.Results The average exercise time of video games in video game group was (44.2 ± 6.1) minutes.The encouragement from the therapists in the intervention process was very important.The technical problems also had a relatively high proportion,and the technical guidance and training should be emphasized at the beginning of the study.The average score of the Likert scale showed that the practice program was suitable for the patients;GMFMS-CM in video game group was significantly higher [mean difference was 4.8,the quartile (IQP) was 4.68,Z =-2.025,P =0.035],while conventional exercise group showed an increasing trend which was not significantly different;6MWTshowed a significant increase in the mean level of video-game group (mean difference was 69.1 m,IQR was 40.2 m,Z =-2.108,P =0.045),conventional exercise group was significantly lower than the average level of subjects in video-game group and there was no significant change in the study period.Conclusion For children with cerebral palsy,routine functional rehabilitation exercise plus family-style virtual reality video game practice,on the one hand to improve patient compliance with the treatment,on the other hand can significantly improve their physical movement function,which is conducive for the patients' quality of life and self-care ability.

Artificial genetic parts should be modularized and can be predictably scaled up via assembly or reused in other contexts. Under intracellular physiological conditions, however, the functions of the assembled parts are severely impeded by multi-level physiological interference, i.e., most artificial assembled systems cannot be functional as predicted. Here we proposed a concept of synthetic physiology, defining it as the branch of synthetic biology to investigate and control interferences between artificial genetic parts and intracellular physiological system. Under such framework, we describe the part-host interactions and review the methods and strategies used to characterize and address these interactions.

Objective To evaluate the effect of conversion from mycophenolic acid (MPA) to mizoribine (MZR) in renal transplant recipients with gastrointestinal tract (GI) symptoms.Methods A total of 355 renal transplant recipients with GI symptoms caused by MPA administration were enrolled from April 2015 to March 2017 in 25 different renal transplant centers in China.The symptomatic improvement of GI before (baseline) and after conversion to MZR (1,2,4 weeks) was assessed by each item of GI symptoms indication.In addition,the efficacy and safety of the conversion therapy during 12 months were determined.Results Patients showed improvement in GI symptoms including diarrhea,abdominal pain,abdominal distention and stomachache after conversion to MZR 1,2,4 weeks (P＜0.05).In patients with different severity of diarrhea,conversion to MZR therapy significantly improved diarrhea (P＜0.05).During 12 months,no patient experienced clinical immune rejection.We did not observe any infections,leucopenia and other serious side effects.Conclusion MZR could markedly improve GI symptoms caused by MPA administration in renal transplant recipients.

Objective To study the microscopic changes of white matter and the relationship between white matter changes and cognitive impairment in Alzheimer's disease (AD) using voxel-based analysis of DTI. Methods Thirty-sev?en patients with probable AD,and 32 normal controls(NC) were all examined by MMSE scores, and underwent a diffusion tensor imaging. The value of FA changes and the correlations between FA and MMSE scores were investigated. Results FA reduction was detected in the right frontal, temporal and parietal lobes as well as the thalamus, the bilateral cingu?lum, corpus callosum, precuneus, inferior parietal lobule, inferior patieto gyrus, supramaginal gyrus and hippocampus in AD. FA values in the right cingulum, left corpus callosum, left inferior temporal gyrus and the bilateral inferior parietal lobule, inferior patieto gyrus and precuneus were significantly decreased in AD than in the health control groups (P<0.05, FWE corrected). There was a positive correlation between the values of FA and MMSE scores(P<0.001,uncorrect?ed). Conclusion AD patients have significant reduction of FA values in the specific regions. There is a positive correla?tion between white matter changes and impairments of cognitive function.