Compared with teenage patients,adult patients generally show a slower rate of tooth movement and more pronounced alveolar bone loss during orthodontic treatment,indicating the maladaptation of alveolar bone homeostasis under orthodontic force.However,this phenomenon is not well-elucidated to date,leading to increased treatment difficulties and unsatisfactory treatment outcomes in adult orthodontics.Aiming to provide a comprehensive knowledge and further inspire insightful understanding towards this issue,this review summarizes the current evidence and underlying mechanisms.The age-related abatements in mechanosensing and mechanotransduction in adult cells and periodontal tissue may contribute to retarded and unbalanced bone metabolism,thus hindering alveolar bone reconstruction during orthodontic treatment.To this end,periodontal surgery,physical and chemical cues are being developed to reactivate or rejuvenate the aging periodontium and restore the dynamic equilibrium of orthodontic-mediated alveolar bone metabolism.We anticipate that this review will present a general overview of the role that aging plays in orthodontic alveolar bone metabolism and shed new light on the prospective ways out of the impasse.

Objective To explore the application value of single-port inflatable mediastinoscopy combined with laparoscopy in the radical resection of esophageal cancer.Methods The retrospective descriptive study was conducted.The clinicopathological data of 27 patients who underwent single-port inflatable mediastinoscopic and laparoscopic radical resection of esophageal cancer in the General Hospital of Ningxia Medical University between September 2016 and April 2018 were collected.The surgical operators were divided into neck operation group and abdomen operation group.A "Y" tube was used to inflate the abdomen and mediastinum simultaneously with CO2,and the gas pressure was 12-16 mmHg (1 mmHg =0.133 kPa).Bilateral exchange free and join forces with the esophagus and xiphoid process operating small incision,the severed esophagus cardia;residual stomach was made into a 3-5 cm tubular stomach and was sutured at the top point;at the same time,esophagus was brought up from the neck,with a pouch suture between upper esophageal and stapling head;the tubular stomach through mediastinum-esophagus bed was pulled to the left neck and then gastroesophageal anastomosis manually or instrument was performed.Observation indicators:(1) surgical and postoperative recovery;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to May 2018.The measurement data with normal distribution were represented as x-±s.The measurement data with skewed distribution were described as M (range).Results (1) Surgical and postoperative recovery:all the 27 patients underwent successful single-port inflatable mediastinoscopic and laparoscopic radical resection of esophageal cancer,with complete tumor resection and without conversion to open surgery.There was no arrhythmia or myocardial ischemia through intraoperative electrocardiography.Among 27 patients,5 had intraoperative rupture of the pleura and 3 stopped intermittently inflation with CO2 due to obvious hemodynamic changes.The operation time and volume of intraoperative blood loss were (121±21)minutes and (100± 30)mL.Twenty-seven patients had no thoracic incision,obviously decreased postoperative pain and out-of-bed activity at day 1 postoperatively.The volume of postoperative mediastinal drainage was (40± 10)mL.The mediastinal drainage-tube was removed at 1 week after regular food intake.Of 27 patients,5 with pleural effusion were cured by puncture drainage;2 were complicated with anastomotic leakage,1 of them with a small amount of subcutaneous gas under neck incision at 12 days postoperatively was cured spontaneously through oral food intake,without special treatment,and the other had a small amount of subcutaneous gas under neck incision after solid food intake at 1 month postoperatively and then was cured after 1-week fluid food intake;1 with anastomotic stenosis was improved after dilation treatment.The squamous cell carcinoma was confirmed by postoperative pathological examination,without cancer cell infiltration in the upper and lower margins.The numbers of mediastinal lymph node dissected,abdominal lymph nodes dissected and positive lymph node,postoperative pathological staging and duration of hospital stay were respectively 9.5±2.2,8.2±2.5,1 (range,0-12),T1-3N0-1M0 and 13 days (range,11-21 days).(2) Follow-up and survival situations:27 patients were followed up for 1-20 months,with a median time of 10 months.During the follow-up,there was no recurrence or metastasis and death.Conclusion The single-port inflatable mediastinoscopy combined with laparoscopy in the radical resection of esophageal cancer is safe and effective,and it is especially suitable for patients with partial respiratory failure and closed thoracic cavity.

Objective:To investigate the expression of microRNA (miR)-206 in chronic obstructive pulmonary disease (COPD) and its effect on the proliferation of human airway smooth muscle cells (HASMCs) and to explore its mechanism.Methods:Lung tissue samples of 15 patients with COPD (COPD group) who underwent lung volume reduction surgery in the General Hospital of Ningxia Medical University from September 2017 to September 2018 and of 15 patients with benign lung tumors without a history of COPD were collected. Microarray technology was used to analyze the miR and RNA omics in lung tissues of 4 COPD patients and normal controls, and reverse transcriptase polymerase chain reaction(RT-PCR) was used to verify the results. Bioinformatics and double luciferase gene reporting assay were used to detect the target genes of miR-206 in HASMCs. The miR-206 mimic/inhibitor was transfected into HASMCs by liposome transfection technology, and the expression level of miR-206 was detected by RT-PCR. Methyl thiazolyl tetrazolium (MTT), flow cytometry and apoptosis assay were used to detect the effects of miR-206 on the proliferation, cell cycle and apoptosis of HASMCs. The expression of PTEN, cell cycle and apoptotic protein in HASMCs was detected by Western blot.Results:The results of miR and mRNA omics analysis showed that the expressions of miR-206, miR-3187-5p and miR-124 in COPD group were significantly up-regulated (0.09 ± 0.01 vs. 2.17 ± 0.57, 0.60 ± 0.04 vs. 1.32 ± 0.15, 0.22 ± 0.08 vs. 1.09 ± 0.23) ( P<0.05), while the expressions of miR-574 and miR-337-3p decreased significantly (0.79 ± 0.03 vs. 0.15 ± 0.02, 0.95 ± 0.02 vs. 0.17 ± 0.01) ( P<0.05). RT-PCR was used to detect the expression of these five miRNAs in 15 COPD lung tissues, and the results showed that their expression was consistent with that in microarray. The prediction results of miRNA target genes showed that miR-206 could directly inhibit the expression of PTEN. RT-PCR results showed that the expression of miR-206 in miR-206 transfected HASMCs was significantly higher than that in miR-NC transfected group(7.44 ± 0.51 vs. 4.02 ± 0.19), and miR-206 inhibitor could significantly inhibit the expression of miR-206 in cells (1.86 ± 0.32), the difference was statistically significant ( P<0.05); MTT and apoptosis experiments showed that miR-206 mimcs could significantly promote the proliferation rate of cells compared with normal HASMCs or miR-NC transfected cells (0.62 ± 0.14 or 0.57 ± 0.09 vs. 0.83 ± 0.05), inhibit cell apoptosis (9.13 ± 1.71 or 10.02 ± 1.15 vs. 3.06 ± 0.82), the differences were statistically significant ( P<0.05), while miR-206 inhibitor could significantly inhibit cell proliferation and promote cell apoptosis ( P<0.05) The results of cell cycle distribution showed that compared with HASMCs group, the proportion of cells in S phase and G2/M phase in miR-206 mimcs group increased significantly ( P<0.05), while the proportion of cells in S phase and G2/M phase in miR-206 inhibitor group decreased significantly ( P<0.05), and there was no significant difference in miR-NC group ( P>0.05). The results of Western blot showed that compared with normal HASMCs or miR-NC transfected cells, miR-206 mimcs could significantly upregulate the expression of cyclin D1 (0.43 ± 0.07 or 0.41 ± 0.02 vs. 0.63 ± 0.17), and cyclin B1 (0.47 ± 0.13 or 0.50 ± 0.09 vs. 0.79 ± 0.31), and inhibit the expression of PTEN (0.34 ± 0.10 or 0.29 ± 0.05 vs. 0.14 ± 0.02), cyclin p21 (0.34 ± 0.03 or 0.30 ± 0.05 vs. 0.11 ± 0.02), and apoptosis related protein caspase-3 (0.29 ± 0.03 or 0.31 ± 0.05 vs. 0.15 ± 0.03), the differences were statistically significant ( P<0.05). miR-206 inhibitor could significantly inhibit the expression of cyclin D1 and cyclin B1, and promote the expression of PTEN, cyclin p21 and caspase-3 ( P<0.05). Conclusions:In COPD patients, miR-206 could targeted inhibit the expression of PTEN protein in airway smooth muscle cells and regulate the progress of cell cycle, so as to up regulate the proliferation of cells and inhibit their apoptosis.

Objective To analyze the clinical efficacy of microwave ablation in the colorectal cancer with simultaneously multiple liver metastases that was initially evaluated as potentially resectable.Methods The patients with potentially resectable colorectal cancer with simultaneous multiple liver metastases treated in the De-partment of General Surgery of the First Affiliated Hospital of Hebei North University,the Center of Minimally Invasive Therapy in Oncology of Traditional Chinese and Western Medicine in Dongzhimen Hospital of Beijing U-niversity of Chinese Medicine,and the Second Department of General Surgery in the Fourth Hospital of Hebei Medical University from October 1,2018 to October 1,2020 were selected in this study.The general data,pathological features,treatment methods,and clinical efficacy of the patients were collected.According to the treatment methods,the patients were assigned into a surgical resection group(conversion therapy + laparoscopic primary resection +hepatectomy)and a microwave ablation group(conversion therapy +laparoscopic primary re-section +microwave ablation).The surgical indicators(operation duration,time to first postoperative anal ex-haust,hospital stay,etc.)and postoperative complications(anastomotic stenosis,anastomotic hemorrhage,incision infection,etc.)were compared between the two groups.The survival period was followed up,including the overall survival period and disease-free survival period,and the survival curves were drawn to analyze the clinical efficacy of the two treatment regimens.Results A total of 198 patients with potentially resectable color-ectal cancer with simultaneous multiple liver metastases were included in this study.Sixty-six patients were cured by neoadjuvant chemotherapy(FOLFOX or FOLFIRI),including 30 patients in the surgical resection group and 36 patients in the microwave ablation group(with 57 tumors ablated).After the first ablation,54(94.74%)tumors achieved complete ablation,and all of them reached no evidence of disease status after re-ablation.The microwave ablation group had shorter operation duration,less intraoperative blood loss,shorter time to first post-operative anal exhaust,shorter time of taking a liquid diet,shorter hospital stay,and lower hospitalization cost than the surgical resection group(all P<0.001).In addition,the microwave ablation group had lower visual analogue scale score(P<0.001)than the surgical resection group.The incidences of complications such as inci-sion infection(P =0.740),anastomotic fistula(P =1.000),and anastomotic stenosis(P =1.000),the over-all survival period(P =0.191),and the disease-free survival period(P =0.934)showed no significant differ-ences between the two groups.Conclusions For patients with colorectal cancer with simultaneous multiple liver metastases initially assessed as potentially resectable,laparoscopic primary resection +surgical resection/microwave ablation after conversion therapy was safe,effective,and had similar survival outcomes.Microwave ablation outper-formed surgical resection in postoperative recovery,economy,and tolerability,being worthy of clinical promotion.

Objective To analyze the sensitivity of ARHGAP8 in predicting the efficacy of neoadjuvant chemotherapy in the patients with locally advanced mid-low colorectal cancer and provide accurate evidence for the treatment of advanced colorectal cancer.Methods The differentially expressed gene ARHGAP8 was screened out by bioinformatics analysis.Cancer tissue and rectal tissue of 68 patients with primary rectal cancer were select-ed.The rectal cancer tissue samples and the rectal tissue samples were collected for clinical validation of ARH-GAP8 expression by quantitative real-time PCR,Western blotting,and immunohistochemistry.The clinical and pathological features such as gender,age,tumor stage,differentiation degree,and pathological type of the pa-tients were collected for functional validation.Forty-four patients with locally advanced mid-low rectal cancer who received neoadjuvant chemotherapy were selected for immunohistochemical examination of ARHGAP8 expres-sion.The expression level of ARHGAP8 was compared between before and after chemotherapy and among different efficacy groups.Results The bioinformatics analysis revealed differences in the expression level of ARHGAP8 between the cancer tissue and rectal tissue(P＜0.001).The expression level of ARHGAP8 was correlated with tumor stage(P=0.024),lymph node metastasis(P=0.007),and age(P=0.005).Quantitative real-time PCR results showed that the mRNA level of ARHGAP8 in the cancer tissue was higher than that in the rectal tis-sue(P＜0.001).Western blotting and immunohistochemistry results demonstrated that the protein level of ARH-GAP8 in the cancer tissue was higher than that in the rectal tissue(P=0.011).The expression of ARHGAP8 was correlated with tumor size(P=0.010)and pathological stage(P=0.005),while it showed no significant association with tumor differentiation degree,lymph node metastasis,liver metastasis,Ki-67,or microsatellite instability expression level.The 44 patients receiving neoadjuvant chemotherapy included 13,8,8,and 15 pa-tients of tumor regression grades 0,1,2,and 3,respectively.Among them,65.91％(29/44)patients showed responses to the treatment.After neoadjuvant chemotherapy,the expression of ARHGAP8 in the cancer tissue was down-regulated in the patients who responded to the chemotherapy(P＜0.001).The response rate in the patients with low protein level of ARHGAP8 was 92.86％,which was higher than that(53.33％)in the patients with high pro-tein level of ARHGAP8(P=0.033).Conclusions ARHGAP8 is highly expressed in the rectal cancer tissue.The pa-tients with locally advanced mid-low rectal cancer and low ARHGAP8 expression are more sensitive to neoadjuvant chemotherapy with the XELOX protocol.ARHGAP8 can serve as a potential biomarker for the occurrence and develop-ment of rectal cancer and an important index for evaluating the efficacy of neoadjuvant chemotherapy with the XELOX protocol in the patients with locally advanced mid-low rectal cancer.

Palliative care not only embodies modern life perspectives, but also encompasses significant traditional Chinese cultural elements.The primary objective of palliative care is to alleviate patient suffering, preserve their dignity, and facilitate a peaceful passing.Traditional Chinese medicine, known for its simplicity, accessibility, affordability, and efficacy in disease prevention and treatment, adopts a holistic approach to address systemic pain through personalized treatment based on symptom differentiation.This approach aims to enhance the quality of life for terminally ill patients.To equip palliative care providers with essential clinical skills in traditional Chinese medicine, the National Center of Gerontology and Beijing Palliative Care Guidance Center collaborated with experts and scholars to develop guidelines focusing on common end-of-life symptoms.Through extensive deliberation, expert evaluation, and revisions, this guidance document was crafted as a valuable resource for palliative care practitioners, traditional Chinese medicine clinicians, and researchers in the field.