PURPOSE: . To compare the sagittal condylar inclination (SCI) in dentate individuals measured by the different methods with mechanical articulator (MA), virtual articulator (VA), and a jaw tracking device (JTD) system. MATERIALS AND METHODS: . A total of 22 healthy dentate participants were enrolled in this study. For MA workflow, the SCI was obtained by a semi-adjustable articulator with protrusive interocclusal records. The SCI was also set on a VA by aligning intraoral scan (IOS) with cone beam computed tomography (CBCT) and facial scan (FS), respectively. These virtual workflows were conducted in a dental design software, namely VAIOS-CBCT and VAIOS-FS . Meanwhile, a JTD system was also utilized to perform the measurement. Intraclass correlation was used to assess the repeatability within workflows. The bilateral SCI values were compared by Wilcoxon matched-pairs signed rank test for each workflow, and Kruskal-Wallis test and post hoc p-value Bonferroni correction were used to compare the differences among four workflows. The agreement of VAIOS-CBCT , VAIOS-FS , and JTD compared with MA was evaluated by Bland-Altman analysis. RESULTS: . Intraclass correlation of the SCI revealed a high degree of repeatability for each workflow. There were no significant differences between the left and right sides (P > .05), except for VAIOS-CBCT (P = .028). Significant differences were not found between MA and VAIOS-FS (P > .05). Bland-Altman plots indicated VAIOS-CBCT , VAIOS-FS , and JTD were considered to substitute MA with high 95% limits of agreement. CONCLUSION . The workflow of VAIOS-FS provided an alternative approach to measure the SCI compared with MA.

OBJECTIVETo evaluate the biomechanical effects of intracellular changes on the voltage-gated sodium channels (VGSCs) on trigeminal ganglion neuron (TRGN).

METHODSTRGN cells were acutely isolated from the neonatal SD rats. The voltage-dependent currents of the VGSCs on these neurons were elicited and analyzed by whole-cell patch-clamp recordings and the intracellular anisotonicity stimuli was established by adjusting the content of pipette solution. The effects of hypo-(260 mOsm) and hypertonic (350 mOsm) osmolarity on the activation and inactivation kinetics of VGSCs on TRGN were evaluated, compared with the normal intracellular environment.

RESULTSThe results demonstrated that intracellular hypotonic stimuli could influence both the activation and inactivation characteristics of VGSCs currents, including the membrane potential at half inactivation (V0.5) of the G-V and inactivation curves had obvious statistics significance (P<0.05) between hypotonicity (260mOsm) and isotonicity (306mOsm). However, only inactivation properties changed under intracellular hypertonic effects, including inactivation rate and k value.

CONCLUSIONIt suggests that the kinetics of VGSCs on TRGN can be modulated both by intracellular hypo- and hypertonic with different characteristics.

Animals ; Cells, Cultured ; Membrane Potentials ; Neurons ; Osmolar Concentration ; Patch-Clamp Techniques ; Rats ; Rats, Sprague-Dawley ; Sodium Channels ; Trigeminal Ganglion

Objective:To investigate the expression of high mobility group box‐1 (HMGB1) in rat model of ventilator‐induced lung injury (VILI) .Methods :Twenty‐four healthy adult SD rats were randomly divided into three groups ,with 8 rats in each group .The control group:autonomous respiration .The large tidal volume group :tidal volume(TV)= 30 mL/kg .The ethyl pyruvate(EP) intervention group :EP 100 mg/kg via the caudal vein and the same ventilation mode as the large tidal volume group .The levels of HMGB1 and inflammatory factors in serum and bronchoalveolar lavage fluid (BALF)and lung tissues ,as well as in the culture medium of alveolar macrophages before and after mechanical stretching ,were detected with Western blot‐ting ,RT‐PCR and ELISA .Results:The levels of HMGB1 in serum ,BALF and lung tissues of the large tidal volume group were higher than those of the control group .HMGB1 in the culture medium of alveolar macrophages was increased under me‐chanical stretching .The expression of HMGB1 decreased ,and the proteins related to signal pathway of apoptosis as Caspase3 , Caspase9 and PARP increased ,in lung tissues of rat with VILI after EP intervention .Conclusions :The expression of HMGB1 increases in rat model of VILI ,which may be related with the effect of mechanical stretching on alveolar macrophages .EP intervention had certain protective effect on lung tissues with VILI .

Throughout history,the development of medicine has been accompanied by the embodiment of humanity.In recent years,with the vigorous development of medical humanities,its connotation has been continuously enriched.Intensive care unit(ICU),at the forefront of treatment for critically ill patients,encounters many ethical risks and moral issues.Therefore,humanistic care for patients and the humanistic literacy of medical staff are particularly important.From the perspective of frontline doctors in the ICU,this article briefly discusses the reflection on the cognition of humanistic literacy,medical humanistic education,and humanistic practice within the ICU.

PURPOSE: . The purpose of this in vitro study was to assess whether scanning strategies of virtual interocclusal record (VIR) affect the accuracy of VIR during intraoral scanning. MATERIALS AND METHODS: . Five pairs of reference cubes were added to the digital upper and lower dentitions of a volunteer, which were printed into resin casts. Subsequently, the resin casts were articulated in the maximal intercuspal position in a mechanical articulator and scanned with an industrial computed tomography system, of which the VIR was served as a reference VIR. The investigated VIR of the upper and lower jaws of the resin master cast were recorded with an intraoral scanner according to 9 designed scanning strategies.Then, the deviation between the investigated VIRs and reference VIR were analyzed, which were measured by the deviation of the distances of six selected reference points on the upper reference cubes in each digital cast to the XY-plane between the investigated VIRs and reference VIR. RESULTS: . For the deviation in the right posterior dentitions, RP group (only scanning of right posterior dentitions) showed the smallest deviation. Besides, BP group (scanning of bilateral posterior dentitions) showed the smallest deviation in the left posterior dentitions. Moreover, LP group (scanning of left posterior dentitions) showed the smallest deviation in the anterior dentitions. For the deviation of full dental arches, BP group showed the smallest deviation. CONCLUSION . Different scanning strategies of VIR can influence the accuracy of alignment of virtual dental casts. Appropriate scanning strategies of VIR should be selected for different regions of interest and edentulous situations.

Objective To analyze the values of renal resistance index(RRI),cystatin C(CysC),blood β2-microglobulin(β2-MG)and urinary N-acetyl-β-glucosamine glycosidase(NAG)in early prediction of contrast-induced acute kidney injury(CI-AKI).Methods A retrospective cohort analysis on 207 postoperative patients after intervention therapy was conducted.The patients were divided into AKI group(18 patients)and non-AKI group(189 patients)based on whether CI-AKI occurred.General and clinical data were collected and compared.Accord-ing to the time of diagnosis of AKI(D0 on the day of surgery or D1 on the first day after surgery),the AKI group was divided into AKI(D0)group and AKI(D1)group.Indicators RRI,CysC,and blood β2-MG,serum creatinine(sCr),and urinary NAG were compared between the two groups.The risk factors of CI-AKI were explored using logistic regression and linear regression.Results In the AKI group,males,preoperative sCr,acute physiological and chronic health(APACHⅡ)score and sequential organ failure(SOFA)score,surgical duratrion,sCr,CysC,blood β2-MG,urinary NAG on the day of surgery and the first day after surgery,and RRI were higher than those in the non-AKI group;Higher APACHEⅡ and SOFA scores and higher CysC level on D1 were independent risk factors for the occurrence of CI-AKI(P<0.05).Levels of CysC and urinay NAG on D0 were higher in the AKI(D0)group than in the AKI(D1)group(P<0.05).RRI,urinary NAG and blood β2-MG were not independent risk factors for CI-AKI.Conclusions CysC and urinary NAG are powerful predictors for the prediction of CI-AKI,and RRI and blood β2-MG cannot predict the occurrence of CI-AKI early.

Objective:To investigate the risk factors related to intensive care unit (ICU) readmission .Methods :A total of 2491 patients who had been transferred into Department of Critical Care Medicine of Zhongshan Hospital ,Fudan University from Nov 2008 to Dec 2011 were included .Clinical data of all the patients during their first admission to ICU were collected .All the patients were classified into non‐readmission group(Group A) and readmission group(Group B) on the basis of whether there was readmission to ICU .All the patients’ treatments were conducted under supervision of attending intensivist and in accordance with routine treatment of Department of Critical Care Medicine and related clinical guidelines .Logistic regression was performed in multivariate analyses of ICU readmission .Results:If the first admission to ICU was due to emergency ,then the chance of ICU readmission was raised(HR=4 .929 ,95% CI:1 .936‐12 .549 ,P<0 .01) .If patient underwent tracheotomy during the first ICU stay ,then the chance of ICU readmission increased (HR= 3 .395 ,95% CI:1 .622‐7 .107 , P< 0 .01) . Conclusions :Both the admission to ICU under emergency and the tracheotomy during the first ICU admission are independent risk factors for ICU readmission .

OBJECTIVES: This study aimed to compare the effects of virtual adjustment on occlusal interferences in mandibular posterior single crown and three-unit bridge restorations by using the mandibular movement track and the movement parameters of a virtual articulator. METHODS: Twenty-two participants were recruited. Digital casts of the maxillary and mandibular arches were obtained using an intraoral scanner, and the jaw registration system was used to record the data of the mandibular movement track and the movement parameters of the articulator. Four kinds of restorations with 0.3 mm occlusal interferences were designed with dental design software. In particular, single crowns were designed for teeth 44 and 46, whereas three-unit bridges were designed for teeth 44-46 and 45-47, and the corresponding natural teeth were virtually extracted. Virtual adjustment of the restorations was performed using two dynamic occlusal recordings, namely, the mandibular movement track and the movement parameters of the virtual articulator. A reverse-engineering software was used to measure the root-mean-square of the three-dimensional deviation of the occlusal surfaces between natural teeth and the adjusted restorations. The differences between the two methods of virtual-occlusion adjustment were compared and analyzed. RESULTS: For the same group of restorations, the three-dimensional deviation of the mandibular movement track group were lower than those of the virtual articulator group, and the differences were statistically significant (P<0.05). For the four groups of restorations adjusted by the same method, the three-dimensional deviation of the 46-tooth single crown was the largest and the smallest three-dimensional deviation was that of the 44-tooth single crown. Statistical differences existed between the 44-tooth single crown and the other groups (P<0.05). CONCLUSIONS For the occlusal design of posterior single crown and three-unit bridge, the mandibular movement track could be a more effective approach to virtual occlusal adjustment than the movement parameters of the virtual articulator.
Humans ; Mouth, Edentulous ; Occlusal Adjustment ; Jaw Relation Record ; Dental Articulators ; Software

Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy, resulting in abnormal sensation in lower lip. It is generally believed that spontaneous sensory recovery in this nerve injury is difficult. However, during our follow-up, patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery. In this study, a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery. A mental nerve transection model of Thy1-YFP mice and tissue clearing technique were used to explore possible mechanisms in this process. Gene silencing and overexpression experiments were then conducted to detect the changes in cell morphology and molecular markers. In our follow-up, 75% of patients with unilateral inferior alveolar nerve neurectomy had complete sensory recovery of the lower lip 12 months postoperatively. Patients with younger age, malignant tumors, and preservation of ipsilateral buccal and lingual nerves had a shorter recovery time. The buccal nerve collateral sprouting compensation was observed in the lower lip tissue of Thy1-YFP mice. ApoD was demonstrated to be involved in axon growth and peripheral nerve sensory recovery in the animal model. TGF-β inhibited the expression of STAT3 and the transcription of ApoD in Schwann cells through Zfp423. Overall, after sacrificing the inferior alveolar nerve, the collateral compensation of the ipsilateral buccal nerve could innervate the sensation. And this process was regulated by TGF-β-Zfp423-ApoD pathway.
Mice ; Animals ; Lip/innervation* ; Prospective Studies ; Mandibular Nerve/pathology* ; Sensation/physiology* ; Trigeminal Nerve Injuries/pathology*

By removing a part of the structure, the tooth preparation provides restorative space, bonding surface, and finish line for various restorations on abutment. Preparation technique plays critical role in achieving the optimal result of tooth preparation. With successful application of microscope in endodontics for >30 years, there is a full expectation of microscopic dentistry. However, as relatively little progress has been made in the application of microscopic dentistry in prosthodontics, the following assumptions have been proposed: Is it suitable to choose the tooth preparation technique under the naked eye in the microscopic vision? Is there a more accurate preparation technology intended for the microscope? To obtain long-term stable therapeutic effects, is it much easier to achieve maximum tooth preservation and retinal protection and maintain periodontal tissue and oral function health under microscopic vision? Whether the microscopic prosthodontics is a gimmick or a breakthrough in obtaining an ideal tooth preparation should be resolved in microscopic tooth preparation. This article attempts to illustrate the concept, core elements, and indications of microscopic minimally invasive tooth preparation, physiological basis of dental pulp, periodontium and functions involved in tool preparation, position ergonomics and visual basis for dentists, comparison of tooth preparation by naked eyes and a microscope, and comparison of different designs of microscopic minimally invasive tooth preparation techniques. Furthermore, a clinical protocol for microscopic minimally invasive tooth preparation based on target restorative space guide plate has been put forward and new insights on the quantity and shape of microscopic minimally invasive tooth preparation has been provided.