Objective The study examined the influence on marginal bone levers at implants which implants were assigned to open healing and implant-abutment connection restored according to a platform-switching concept. Methods One implant were placed in the first molar of mandible of 48 patients , randomly assigned to open (OH) or submerge (SH) healing. Standardized radiographs were obtained after implant surgery, when implant transfer and crown mounting, and 6 ,12 and 24 months after implants restoration, then evaluated for implant-bone-lever alterations(ΔIBL). Results After 6 months after implants restoration,ΔIBL were (-0.25 ± 0.08)mm mm(OH)and (-0.26 ± 0.12)mm(SH). After 12 months follow-up, ΔIBL were (-0.29 ± 0.13)mm (OH)and (-0.31 ± 0.14) mm(SH), and after 24 months later, ΔIBLwere (-0.34 ± 0.15)mm(OH)and (-0.33 ± 0.11)mm (SH). Conclusions Platform-switched implants showed very limited peri-implant bone-lever alterations. The healing-mode neither affected the total amount nor the temporal patterns of ΔIBL.

Primary processing is important links and closely related to the quality of traditional Chinese medicinal materials. The methods and technologies system of traditional primary processing were derived from the long-term practices and experiences, which is distinctive, colorful and diverse, and scientific, it is not only to cleaning of remove the non-officinal parts, drying for termination the physiological status of organisms, but also to retain the most active substances, decrease the toxic components, and promote the transformation among chemical ingredients through primary processing. So the traditional primary processing endowed with characters, quality, specifications and properties of traditional Chinese medicine, and embodied some important science truth. This paper analyzed the traditional experiences and modern cognition on primary processing of TCM materials based on the changes of chemical compositions and explored the scientific truth. These data may be providing foundation and support for process of normalization and standardization of primary processing of TCM materials.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Medicine, Chinese Traditional ; methods ; Molecular Structure

The rapid absorption of labial alveolar bone after tooth extraction not only reduces the aesthetic effect of implant repair but also affects the long-term success rate of implants. The socket shield technique is reported as the latest alveolar preservation technique in the aesthetic zone from both domestic and international case reports and shows a high success rate of short-term osseointegration and excellent aesthetic effects. However, some investigations have shown short- and long-term complications with the socket shield technique, such as failure of osseointegration, loss of crestal bone and buccal bone, inflammation, etc. In this review, the socket shield technique will be reported in detail with its pros and cons. Although the socket shield technique has achieved good clinical effects and short-term success rates in many cases, there are still no conclusions regarding the surgical procedure, such as the thickness, the position of the shield, whether to put the graft material between the shield and implant, etc. Due to the lack of long-term research or a large amount of clinical literature support and technical sensitivity, the socket shield technique should be carefully used in clinical application to reduce unexpected risks.

Objective: To investigate the clinical value of gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery on patients with cholecystolithiasis. Methods: A retrospective study was performed on data of 15 patients with cholecystolithiasis, who underwent gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery from April 2018 to July 2018. The operative data, including situation of operation, operative time, intraoperative hemorrhage, and postoperative complications were recorded. Results: The procedure was performed successfully in all patients with a mean operative time of 108±12 min (ranged from 92-129 min). The intraoperative hemorrhage was 10-30 mL. Eight patients suffered from slight right upper abdominal pain, and 7 patients felt slight pain in umbilical a week after surgery. No fever, incision infection, umbilical hemia, peritonitis, and ascites were reported. The clear-liquid diet was recommended for one day after operation, and postoperative activity was allowed since the second day after operation. All patients were discharged on the fourth or fifth day, and all recovered to their normal life at one week after discharge. Follow-up showed that the scar was small and hidden in umbilical without visible incision after one month. Ultrasonic examination results showed that gallbladder contractile function worked perfectly in four patients and no gallbladder stone was found after three months. Conclusion Gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery is a safe and effective option for patients with cholecystolithiasis, provides excellent cosmetic outcomes, and can be appropriately carried out under the strict control of surgical indications.

Objective : To explore the clinical effect of the alveolar crest approach in the treatment of odontogenic maxillary sinusitis and the repair of edentulous implants in this area. Methods: This was a retrospective case series of 20 patients with odontogenic sinusitis. The pathogenesis in each case was investigated. After elimination of the dental origin, each patient was treated with flushing, drainage and anti-inflammatories through the alveolar crest approach. Postoperative CBCT reexamination was performed to evaluate the therapeutic effect. Maxillary sinus elevation surgery with simultaneous or delayed implantation was performed after maxillary sinusitis healing was confirmed. The patients were followed postoperatively. Results : Twenty patients with odontogenic sinusitis were treated by the alveolar crest approach, and 17 were cured, for a cure rate of 85%. Among them, 17 of the maxillary sinusitis patients were followed for 1 year, with good results. Conclusion The alveolar crest approach is feasible for the treatment of odontogenic maxillary sinusitis and can serve as a minimally invasive method for the repair of edentulism in this area and implantation.

Objective : To investigate the effect of a laser-etched pure titanium surface on proliferation of the human osteosarcoma cell line MG63 and to provide a basis for study of implant surface modification. Methods: The pure titanium plate was cut into titanium pieces by a numerical control machine tool and divided into smooth surface and laser etching groups. The titanium surface of the laser etching group was etched with an Nd:YAG continuous wave laser using predetermined parameters, and the surfaces were observed by scanning electron microscopy (SEM). The surface micromorphology of each titanium sheet was evaluated. The relative element content of the titanium surface was measured by energy dispersive X-ray spectroscopy (EDS). The Ra value of each surface was determined using the Veeco roughness tester. MG63 cells were inoculated on 2 sets of titanium tablets. At 1, 3, and 6 h postinoculation, cell adhesion to the two groups of titanium sheets was observed under the microscope. At 24 h after inoculation, cellular F-actin was directly stained using immunofluorescence, and the morphology of the cytoskeleton was observed by laser confocal microscopy. Cell proliferation was examined at 1, 3, and 5 d using a MTS kit, and the data were analyzed with SAS 9.4. Results : The surface of the smooth surface group was smooth and flat, the element composition was pure titanium, and the roughness Ra was 179.23 nm. The surface of the laser-etched group formed a regular and uniform pore structure. The composition was mainly Ti, O, C, etc, and the surface roughness Ra was 14.11 μm. A large number of cells were uniformly distributed on the two titanium sheets in the observations at 1, 3, and 6 h. At 24 h postinoculation, MG63 cells were completely stretched on the two sets of titanium sheets and had extended a large number of pseudopods and microfilaments to cross-link with peripheral cells; moreover, the cell division phase was observed. The cell proliferation of the two groups at 1, 3, and 5 d showed a significant increase with time, indicating that no cytotoxicity occurred on the surfaces of the two groups. However, the cell proliferation in the laser-etched group was superior to that in the mechanical smooth surface group. Conclusion The surface morphology of titanium can be controlled by laser etching, which is conductive to increase the microstructure of implants without cytotoxicity and promoting osteoblast proliferation in the early stage.

Objective: To investigate the effect of pure titanium surface of large diameter TiO2 nanotubes modified by RGD peptide on the adhesion and proliferation of MG63 osteoblasts. to provide theoretical proof for developing titanium implants. Methods: Commercially pure titanium discs were divided into four groups and treated with SLA to obtain a microrough surface (SLA group). Then, nanotubes were imposed on this microrough surface by anodization (SLA+80 group). The surface was then modified by dopamine (DOPA) (DOPA Group), after which bioactive RGD peptide layers were generated on the TiO2 nanotube surfaces via electrochemical and molecular self-assembly techniques (RGD group). The titanium surface morphology and elemental composition of each group were characterized by field emission scanning electron microscopy (FE-SEM) and X-ray photoelectron spectroscopy (XPS). MG63 cells were cultured in vitro to evaluate biological activities of titanium before and after treatment, including the evaluation of early-stage cell adhesion capacity by fluorescence microscopy, proliferation capacity by MTS assay, and mRNA expression of the cell osteoblast-related genes alkaline phosphatase (ALP) and osteocalcin (OCN) by qRT-PCR. Results: FE-SEM and XPS showed that hierarchical micro/nanosurfaces decorated with TiO2 nanotubes were produced on titanium using sandblasting and large grit etching combined with anodization, dopamine was then self-polymerized to form a polydopamine film on the TiO2 nanotube surfaces, and RGD peptides were then conjugated to the polydopamine film, finally forming RGD peptide-modified bioactive layers. In vitro experiments showed that compared with the other three materials, the RGD-modified material was more conducive to cell adhesion and proliferation (P < 0.05). The expression levels of ALP and OCN mRNA in the RGD group were significantly higher than those in the SLA group and DOPA group (P < 0.05). Conclusion Hierarchical micro/nanosurfaces decorated with TiO2 nanotubes functionally modified with RGD peptides have good biocompatibility and could be used for developing titanium implants and further improving early osseointegration.

Tuberculosis (TB) is an ancient infectious disease. Before the availability of effective drug therapy, it had high morbidity and mortality. In the past 100 years, the discovery of revolutionary anti-TB drugs such as streptomycin, isoniazid, pyrazinamide, ethambutol and rifampicin, along with drug combination treatment, has greatly improved TB control globally. As anti-TB drugs were widely used, multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis emerged due to acquired genetic mutations, and this now presents a major problem for effective treatment. Genes associated with drug resistance have been identified, including katG mutations in isoniazid resistance, rpoB mutations in rifampin resistance, pncA mutations in pyrazinamide resistance, and gyrA mutations in quinolone resistance. The major mechanisms of drug resistance include loss of enzyme activity in prodrug activation, drug target alteration, overexpression of drug target, and overexpression of the efflux pump. During the disease process, Mycobacterium tuberculosis may reside in different microenvironments where it is expose to acidic pH, low oxygen, reactive oxygen species and anti-TB drugs, which can facilitate the development of non-replicating persisters and promote bacterial survival. The mechanisms of persister formation may include toxin-antitoxin (TA) modules, DNA protection and repair, protein degradation such as trans-translation, efflux, and altered metabolism. In recent years, the use of new anti-TB drugs, repurposed drugs, and their drug combinations has greatly improved treatment outcomes in patients with both drug-susceptible TB and MDR/XDR-TB. The importance of developing more effective drugs targeting persisters of Mycobacterium tuberculosis is emphasized. In addition, host-directed therapeutics using both conventional drugs and herbal medicines for more effective TB treatment should also be explored. In this article, we review historical aspects of the research on anti-TB drugs and discuss the current understanding and treatments of drug resistant and persistent tuberculosis to inform future therapeutic development.
Humans ; Pyrazinamide/therapeutic use* ; Isoniazid/therapeutic use* ; Antitubercular Agents/therapeutic use* ; Tuberculosis, Multidrug-Resistant/microbiology* ; Mycobacterium tuberculosis/genetics* ; Tuberculosis/drug therapy* ; Rifampin/therapeutic use* ; Mutation ; Drug Resistance, Multiple, Bacterial/genetics*