Objective: To investigate the regulation of curculigoside on osteogenic differentiation of MG63 and the protective effect on osteoporosis model mice. Methods: The effects of curculigoside on the survival rate of dexamethasone or H₂O₂ treated MG63 were detected by methyl thiazolyl tetrazolium (MTT). The specimens were divided into six groups: blank control group, blank administration group, model group (dexamethasone or H₂O₂ treatment group), low dose group (dexamethasone or H₂O₂+1.0 μmol/L curculigoside), medium dose group (dexamethasone or H₂O₂+2.5 μmol/L curculigoside) and high dose group (dexamethasone or H₂O₂+5.0 μmol/L curculigoside), the sample size of each group was 10. Western blotting was used to detect the expression of osteogenic differentiation-related proteins [type Ⅰ collagen, integrin β1, osteoblast-specific transcription factor (Osterix), osteocalcin and osteopontin] in MG63 cells after 1, 7 and 14 days incubated with 0, 1.0, 2.5 and 5.0 μmol/L of curculigoside. The sample size for each group at each time point was six. The experimental mice were divided into 4 groups: blank group, model group (dexamethasone treatment group), curculigoside low-dose group (dexamethasone+5 mg/kg curculigoside) and high-dose group (dexamethasone+45 mg/kg curculigoside), twenty each. After treatment, the tibia of the mice in each group were subjected to sacral HE staining. The number of osteoclasts was counted, and the levels of oxidative related factors in serum were determined by enzyme-linked immunosorbent assay (ELISA). Results: The MTT results showed that compared with the blank control group [(100±3.7)%], the cell survival rate decreased to (44.1±5.7)% after treatment with dexamethasone, and the survival rate increased to (79.7±3.8)% after treatment with 5.0 μmol/L of curculigoside. The cell survival rate decreased to (59.1±4.7)% after H₂O₂ treatment, and the survival rate increased to (80.8±3.5)% after treatment with 2.5 μmol/L of curculigoside. The results of Western blotting showed that the expression of type Ⅰ collagen and integrin β1 in MG63 cells was significantly increased after 1.0, 2.5 and 5.0 μmol/L of curculigoside for 1, 7 and 14 days compared with 0 μmol/L of curculigo side for the same period. After increasing (P<0.05), the expression of Osterix and osteocalcin was significantly increased after 1 day of incubation (P<0.05). However, compared with 0 μmol/L curculigoside treatment, the expression of osteopontin in MG63 cells was not significantly different after incubation with 1.0, 2.5, 5.0 μmol/L of curculigoside for 7 and 14 days (P>0.05). Compared with the blank group, the number of tibia osteoclasts in the osteoporosis model group increased. In the low-dose and high-dose groups of curculigoside, the tibia cortex was more continuous and the number of osteoclasts decreased. Compared with the blank group, the activity of oxygen in the osteoporosis model group was significantly increased (P<0.05), and superoxide dimutase and catalase were significantly decreased (P<0.05). Conclusions Curculigoside promotes the differentiation of MG63 cells by increasing the expression of osteoblast differentiation-related proteins, and has a certain therapeutic effect on dexamethasone-induced osteoporosis mice.

Objective:To investigate the diagnosis and prognosis of one patient with carcinoma ex pleomorphic adenoma (CXPA)composed of three malignant components in parotid gland,and to raise the clinicians'awareness of the disease.Methods:A patient was presented to hospital because of the mass in left parotid gland region for more than 30 years and the accompanied pain lasted for one month.After color ultrasonography,the left parotid gland tumor resection was performed. Results: The operation was successful. The postoperative pathological diagnosis results comfirmed as CXPA,it was composed of three malignant components,including non-specific adenocarcinoma,ductal carcinoma,and myoepithelial carcinoma.Conclusion:CXPA composed of three malignant components at the same time are extremely rare.CXPA is difficult to diagnose and its prognosis is poor.The clinicians are supposed to improve the understanding of CXPA.

Objective:To investigate the method of arthroplasty for reconstructing femporomandibular joint (TMJ) after the establishment of TMJ articular defect models in the rabbits,and to clarify the replacement and repair effects of carboh fiber reinforced polyetheretherketone (CFR-PEEK) material TMJ prostheses,and to provide an experimental basis for the clinical application of CFR-PEEK artificial joints to replace TMJ.Methods:Thirteen healthy adult Japanese rabbits were randomly divided into experimental group (n=6),positive control group (n=4) and negative control group (n =3).The right TMJ articular process of the rabbits in experimental group were resected to establish the joint defect models,and then the CFR-PEEK artificial joints were impanted.The right TMJ articular process of the rabbits in positive control group were resected,and the joint defect models were established without the CFR-PEEK artificial joint implantation.The rabbits in negative control group didn't receive any treatment.The body weights of the rabbits in each group were measured in 13 weeks.The effects of fixation and replacement after artificial joint implantation were assessed by CT imaging.Results:The TMJ articular process defect model was successfully implanted with the CFR-PEEK artificial joint.The CT imaging results after threedimensional reconstruction and CT images by contrast in vitro showed that the CFR-PEEK-implanted artificial joint was fixed well,it could be instead of the normal joint function.Compared with positive control group,the weights of rabbits in experimental group were significantly increased (P＜ 0.05) at 13 weeks;compared with positive control group,the weights of rabbits in experimental group and negative control group were both significantly increased (P＞0.05) at 13 weeks,but there was no significant difference between them (P＞0.05).The weights of rabbits in experimental group and negative control group kept normal growth;the weights of rabbits in positive control group was increased slowly,and even stopped growing or was negative.Conclusion:The CFR-PEEK artificial joint can be successfully implanted into the TMJ defect model and be used to repair the defect which help to restore chewing function.The CFR-PEEK is expected to be an ideal material for reconstructing TMJ.

Objective : To provide a reference for the diagnosis and treatment of mucoepidermoid carcinoma arising in Warthin’s tumor of the lip by investigating the diagnosis, treatment and prognosis of the disease. Methods : A case of mucoepidermoid carcinoma arising in Warthin’s tumor of lip was reported, including the clinical manifestation, treatment, pathological characteristics and prognosis. The related literature was also reviewed and analyzed. Results: A painless mass on the left lip lasting more than one month was found. Resection of the left lip was performed. Pathological examination showed that the tumor was a hybridoma composed of mucoepidermoid carcinoma and Warthin’s tumor. There was no recurrence or distant metastasis after 34 months. To date, this type of disease has been rarely reported. After thorough resection, the prognosis and survival rate are promising in most cases, with no recurrence or metastasis. Conclusion Mucoepidermoid carcinoma in Warthin’s tumor of the lip is rare. Clinical manifestations, imaging features and histological examination are useful when diagnosing the disease. Thorough resection will reduce the risk of disease recurrence.

Objective:To study the expression level of programmed death ligand 1 (PD-L1) in combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and its correlation with the clinical characteristics and prognosis.Methods:The clinical data of 75 patients with cHCC-CCA undergoing surgery in Tianjin Medical University Cancer Institute and Hospital from January 2011 to December 2019, including 61 males and 14 females, with a median age of 55 years (36 to 77). Immunohistochemistry was conducted to determine the PD-L1 expression in tumor. The status of PD-L1 expression, clinicopathological data and prognosis of patients were analyzed.Results:In low-differentiated cHCC-CCA tissues, the proportion of PD-L1 expression (21.1%, 8/38) was higher than that in moderately to well-differentiated cHCC-CCA tissues (2.70%, 1/37, χ2=4.366, P=0.037). The median disease-free survival (DFS) and overall survival (OS)of PD-L1 positive patients were 12.3 and 15.1 months, respectively, lower than those of PD-L1 negative patients (14.4 and 23.3 months). The difference of DFS was statistically significant ( χ2=4.052, P=0.044). In multivariate analysis, major vascular invasion (DFS: HR=1.965, 95% CI: 1.119-3.450, P=0.019; OS: HR=1.781, 95% CI: 1.022-3.105, P=0.042) and lymph node metastasis (DFS: HR=2.451, 95% CI: 1.1033-5.814, P=0.042; OS: HR=2.652, 95% CI: 1.120-6.279, P=0.027) were identified as independent prognostic factors affecting DFS and OS. Conclusions:The proportion of PD-L1 positive is higher inthe low-differentiated cHCC-CCA tissue compared to that in moderately to well-differentiated cHCC-CCA. The major vascular invasion and lymph node metastasis are independent factors affecting the prognosis of patients with cHCC-CCA.