OBJECTIVETo evaluate the incidence of two-rooted mandibular premolar morphology using full-mouth periapical film series in a Chinese population, with particular emphasis on bilateral incidence, so as to provide a clinical anatomical basis for root canal treatment in mandibular premolars.

METHODSA total of 2015 patients who underwent dental treatment and had full mouth periapical radiographs at the Peking University School of Stomatology from April 2011 to April 2012 were enrolled in this study. Three experienced dentists reviewed the patients' periapical films and classified the root morphology of mandibular premolars bilaterally. The incidence of unilateral and bilateral double roots were recorded and calculated, including confirmed and suspected bucco-lingual root types.

RESULTSIn terms of the morphology of two-rooted mandibular first premolars, of the 2015 cases with complete root formation, two-rooted first premolars were detected in 120 cases, with a total number of 159 teeth. According to the number of teeth, the overall incidence of double roots was 4.03% (159/3972). In terms of the morphology of two-rooted mandibular second premolars, of the 2015 cases with complete root formation, two-rooted second premolars were detected in 24 cases, with a total number of 33 teeth. According to the number of teeth, the overall incidence of double roots was 0.85% (33/3880).

CONCLUSIONSThe roots of mandibular premolars display specific morphological patterns. Based on a large sample, we observed and calculated not only the occurrence rate of bucco-lingual and mesio-distal double roots in first and second mandibular premolars, but also the incidence of unilateral or bilateral double roots within the same mandible. These findings could provide useful information on the anatomical structure of mandibular premolars for endodontic, prosthodontic and surgical procedures, and could improve the quality of treatment and reduce complications.

Adolescent ; Adult ; Aged ; Bicuspid ; abnormalities ; Child ; Humans ; Mandible ; Middle Aged ; Periapical Tissue ; diagnostic imaging ; Radiography ; Tooth Root ; abnormalities

Alzheimer’s disease(AD)is a chronic neurodegenerative disorder. According to the amyloid cascade hypothesis, abnormal accumulation of amyloid peptides(Aβ)in the brain resulting in neuronal toxicity is the main cause of AD. β-secretase1 (BACE1)is a rate-limiting enzyme that hydrolyzes β-amyloid precursor protein(β-APP)to produce amyloid peptides(Aβ). Therefore, BACE1 has been considered to be an attractive therapeutic target for the treatment of AD. Different structural classes of BACE1 inhibitors have been designed and developed since BACE1 was cloned and identificated. This review highlights the core scaffold to summarize the evolution of structure-based design of BACE1 inhibitors.

Objective To explore the biological basis of TCM syndromes from a biomolecules network perspective with qi deficiency syndrome as the breakthrough point. Methods A data dictionary of neuro-endocrine-immune (NEI) related genes and qi deficiency syndrome characterization terminology thesaurus were established. Literature about qi deficiency syndrome characterization was retrieved by using Genclip, to excavate the characteristic NEI gene, thereby to explore different bioactive substances of syndromes. Results The analysis of the genetic data, showed qi deficiency related cluster with the relevance of endocrine, signal transduction, hematopoietic cell and immune deficiencies etc. It is confirmed that the intrinsic biological features of TCM syndrome can effectively identify in the NEI level. Conclusion Literature mining method as a new way to discover syndromes biological indicators has certain feasibility, and it is recommended to be further expanded into other studies on syndromes to validate the universality and reliability of this method.

BACKGROUNDSeveral techniques have been described for posterior cruciate ligament (PCL) reconstruction. However, double-bundle PCL reconstruction using the quadruple bone-tunnel technique has been seldom reported. The current study investigated this technique, focusing on the anatomy of the femoral and tibial insertions of the anterolateral (AL) and posteromedial (PM) bundles of the PCL.

METHODSTwenty-two fresh, healthy adult cadaveric knees were dissected and measured. The PCL was divided into the AL bundle and PM bundle at the insertion footprint. The insertion footprints of the AL and PM bundles, their location, size, and the clock positions were measured and described.

RESULTSOn the femur, the clock position of the footprint of the AL bundle was 11:21 ± 0:23 (left) or 0:39 ± 0:23 (right), and the PM bundle was 9:50 ± 0:18 (left) or 2:10 ± 0:18 (right), with the knee flexed at 90 degrees. The distances from the center of the femoral insertions of the AL and PM bundles to the anterior cartilage margins of the medial femoral condyle were (7.79 ± 1.22) mm and (8.36 ± 1.63) mm, respectively. On the tibia, the vertical distances from the center of the tibial insertions of the AL and PM bundles to the tibial articular surface were (3.25 ± 1.20) mm and (6.91 ± 1.57) mm, respectively.

CONCLUSIONSThese results have led to a better definition of the anatomy of the AL and PM bundle footprint of the PCL. The technique of double-bundle PCL reconstruction using quadruple bone-tunnel is feasible. Application of these data during PCL reconstruction using the quadruple bone-tunnel technique may help optimize knee stability.

Female ; Humans ; In Vitro Techniques ; Knee Joint ; anatomy & histology ; Male ; Posterior Cruciate Ligament ; anatomy & histology

OBJECTIVETo compare the clinical results of double and single bundle anterior cruciate ligament (ACL) reconstruction.

METHODSFrom 2005 May to December the data of 33 patients (4 lost follow) with double-bundle and 41 patients (8 lost follow) with single-bundle reconstruction of ACL using auto-hamstring tendons was retrospectively investigated. The follow-up was 14-22 months (average 18 months) of double-bundle group and 14-21 months (average 18 months) of single-bundle group. The IKDC, Lysholm and Tegner scores, KT-2000 and Biodex were used to evaluate the clinical results.

RESULTSThe IKDC, Lysholm and Tegner scores were increased significantly from 60, 66, 4 before the operation to 85, 94 and 6 respectively after the double-bundle reconstruction. The KT-2000 results showed that at 30 and 90 degree 134 N the anterior-posterior translations were significantly decreased from 5.8 and 2.4 mm to 1.2 and 1.1 mm respectively of the double-bundle group (P < 0.01). The peak torques of the extend and flex muscles of the involved knee at 60 degrees/s and 120 degrees/s were only at 81%, 87%, 76% and 85% of the contralateral knee of the double-bundle group. And the differences were statistically significant (P < 0.01). There were no differences between the two groups of any index, but the KT value at 30 degree and the extensor peak torque of the double-bundle group manifested a better tendency.

CONCLUSIONSBoth double-bundle and single-bundle ACL reconstruction can restore the stability and improve the function of the knee, and the double-bundle group shows a better tendency at the 30 degree stability and the extensor strength.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Female ; Follow-Up Studies ; Humans ; Joint Instability ; surgery ; Knee Injuries ; surgery ; Male ; Tendons ; transplantation ; Transplantation, Autologous ; Treatment Outcome

Background/Aims: Chronic hepatitis C (CHC) patients who failed antiviral therapy are at increased risk for hepatocellular carcinoma (HCC). This study assessed the potential role of metformin and statins, medications for diabetes mellitus (DM) and hyperlipidemia (HLP), in reducing HCC risk among these patients. Methods: We included CHC patients from the T-COACH study who failed antiviral therapy. We tracked the onset of HCC 1.5 years post-therapy by linking to Taiwan’s cancer registry data from 2003 to 2019. We accounted for death and liver transplantation as competing risks and employed Gray’s cumulative incidence and Cox subdistribution hazards models to analyze HCC development. Results: Out of 2,779 patients, 480 (17.3%) developed HCC post-therapy. DM patients not using metformin had a 51% increased risk of HCC compared to non-DM patients, while HLP patients on statins had a 50% reduced risk compared to those without HLP. The 5-year HCC incidence was significantly higher for metformin non-users (16.5%) versus non-DM patients (11.3%; adjusted sub-distribution hazard ratio [aSHR]=1.51; P=0.007) and metformin users (3.1%; aSHR=1.59; P=0.022). Statin use in HLP patients correlated with a lower HCC risk (3.8%) compared to non-HLP patients (12.5%; aSHR=0.50; P<0.001). Notably, the increased HCC risk associated with non-use of metformin was primarily seen in non-cirrhotic patients, whereas statins decreased HCC risk in both cirrhotic and non-cirrhotic patients. Conclusions Metformin and statins may have a chemopreventive effect against HCC in CHC patients who failed antiviral therapy. These results support the need for personalized preventive strategies in managing HCC risk.

Background/Aims: Real-world studies assessing the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) plus ribavirin (RBV) for Child-Pugh B/C hepatitis C virus (HCV)-related cirrhosis are limited. Methods: We included 107 patients with Child-Pugh B/C HCV-related cirrhosis receiving SOF/VEL plus RBV for 12 weeks in Taiwan. The sustained virologic response rates at off-treatment week 12 (SVR12) for the evaluable population (EP), modified EP, and per-protocol population (PP) were assessed. Thesafety profiles were reported. Results: The SVR12 rates in the EP, modified EP and PP were 89.7% (95% confidence interval [CI], 82.5–94.2%), 94.1% (95% CI, 87.8–97.3%), and 100% (95% CI, 96.2–100%). Number of patients who failed to achieve SVR12 were attributed to virologic failures. The SVR12 rates were comparable regardless of patient characteristics. One patient discontinued treatment because of adverse events (AEs). Twenty-four patients had serious AEs and six died, but none were related to SOF/VEL or RBV. Among the 96 patients achieving SVR12, 84.4% and 64.6% had improved Child-Pugh and model for endstage liver disease (MELD) scores. Multivariate analysis revealed that a baseline MELD score ≥15 was associated with an improved MELD score of ≥3 (odds ratio, 4.13; 95% CI, 1.16–14.71; P=0.02). Patients with chronic kidney disease (CKD) stage 1 had more significant estimated glomerular filtration rate declines than patients with CKD stage 2 (-0.42 mL/min/1.73 m2/month; P=0.01) or stage 3 (-0.56 mL/min/1.73 m2/month; P<0.001). Conclusions SOF/VEL plus RBV for 12 weeks is efficacious and well-tolerated for Child-Pugh B/C HCV-related cirrhosis.

Background/Aims: Real-world studies assessing the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) plus ribavirin (RBV) for Child-Pugh B/C hepatitis C virus (HCV)-related cirrhosis are limited. Methods: We included 107 patients with Child-Pugh B/C HCV-related cirrhosis receiving SOF/VEL plus RBV for 12 weeks in Taiwan. The sustained virologic response rates at off-treatment week 12 (SVR12) for the evaluable population (EP), modified EP, and per-protocol population (PP) were assessed. Thesafety profiles were reported. Results: The SVR12 rates in the EP, modified EP and PP were 89.7% (95% confidence interval [CI], 82.5–94.2%), 94.1% (95% CI, 87.8–97.3%), and 100% (95% CI, 96.2–100%). Number of patients who failed to achieve SVR12 were attributed to virologic failures. The SVR12 rates were comparable regardless of patient characteristics. One patient discontinued treatment because of adverse events (AEs). Twenty-four patients had serious AEs and six died, but none were related to SOF/VEL or RBV. Among the 96 patients achieving SVR12, 84.4% and 64.6% had improved Child-Pugh and model for endstage liver disease (MELD) scores. Multivariate analysis revealed that a baseline MELD score ≥15 was associated with an improved MELD score of ≥3 (odds ratio, 4.13; 95% CI, 1.16–14.71; P=0.02). Patients with chronic kidney disease (CKD) stage 1 had more significant estimated glomerular filtration rate declines than patients with CKD stage 2 (-0.42 mL/min/1.73 m2/month; P=0.01) or stage 3 (-0.56 mL/min/1.73 m2/month; P<0.001). Conclusions SOF/VEL plus RBV for 12 weeks is efficacious and well-tolerated for Child-Pugh B/C HCV-related cirrhosis.

OBJECTIVE: To estimate the prevalence rate of bone and joint injury in China and to describe the three-dimension distribution of the disease (area, time and people). METHODS: Based on a cross-sectional design, a retrospective study was conducted by using Chinese basic medical insurance database from January 1, 2013 to December 31, 2017 to analyze the epidemiological characteristics of bone and joint injury. The prevalence rate of bone and joint injury in each city was calculated, and then using meta-analyses to estimate the pooled prevalence of each area and the whole country. The pooled prevalence rates were compared among the different groups of populations, in terms of geographical area, time and population characteristics (age and gender). RESULTS: A total of 28 419 264 subjects were included in this study, including 705 793 patients with bone and joint injury. From 2013 to 2017, in Chinese basic medical insurance database, the overall prevalence rate of bone and joint injury was 141.5(95%CI: 90.4－203.7) per 10 000 population, and the prevalence rates of non-specific or polyarticular disease, knee disease, and shoulder disease were 101.6 (95%CI: 63.5－148.4)per 10 000 population, 22.5(95%CI:15.1－31.4)per 10 000 population and 10.9 (95%CI: 6.4－16.4)per 10 000 population. The prevalence rates varied across the areas, the highest rate was observed in North China, with the prevalence of 310.6 (95%CI: 12.6－989.7) per 10 000 population, and the lowest rate was observed in Southwest China, with the prevalence of 59.0 (95%CI: 37.5－85.2) per 10 000 population. The prevalence rate of bone and joint injury increased over the study period, from 111.1 (95%CI: 56.0－182.5)per 10 000 population in 2013 to 175.5 (95%CI: 116.8－245.5)per 10 000 population in 2017. The prevalence of bone and joint injury in the female population was 149.1 (95%CI: 94.2－215.9) per 10 000 population, which was higher than that of men [133.6(95%CI: 86.2－190.9) per 10 000 population]. The higher prevalence of knee disease, unspecified or polyarticular disease, and bone and joint injury were observed in people aged 60 years and older, while the prevalence of shoulder disease peaked in 40－59 years old people [20.6 (95%CI: 12.5－30.5) per 10 000 population]. CONCLUSION This study reported a relative low prevalence of bone and joint injury in China from 2013 to 2017. The prevalence increased over the study period, and the highest prevalence rate was observed in North China. The prevalence rate showed differences among different groups of populations, and higher rates were observed in females and people aged 60 years and older.
Adult ; China ; Databases, Factual ; Female ; Humans ; Insurance, Health ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Urban Population

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.