Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Child ; Humans ; Case-Control Studies ; East Asian People ; Genetic Predisposition to Disease/genetics* ; Methyltransferases/genetics* ; Polymorphism, Genetic ; Wilms Tumor/pathology*

Objective     To evaluate the effect of frailty on postoperative complications in elderly patients with esophageal cancer. Methods     We enrolled the patients aged≥65 years and with esophageal cancer who underwent surgical treatment in Shanghai Chest Hospital in 2021. The modified frailty index (mFI) was calculated and the patients were divided into a non-frailty group and a frailty group. The primary outcomes were the incidence of postoperative pulmonary infection, arrhythmia, anastomotic fistula and chylothorax complications. Secondary outcomes were the time of extubation, the rate of unplanned re-intubation, the length of ICU stay, hospital stay, rate of readmission within 30 days after discharge and the mortality within 30 days after operation. Results     Finally 607 patients were collected. There were 273 patients in the non-frailty group and 334 patients in the frailty group. The non-frailty group had lower rates of complications including pulmonary infection (5.5% vs. 13.5%), arrhythmia (3.7% vs. 9.3%), anastomotic fistula (2.9% vs. 7.5%), and shorter ICU stay [2.0 (0.0, 4.0) d vs. 4.0 (1.0, 6.0) d] and in-hospital stay [11.5 (9.5, 13.0) d vs. 13.0 (11.0, 18.0) d], lower rates of the readmission within 30 days (2.9% vs. 6.6%) and the mortality within 30 days (0.4% vs. 1.2%) compared with the frailty group (P<0.05). Conclusion     Frail elderly patients with esophageal cancer have higher rates of postoperative complications. mFI can be used as an objective index to identify high-risk elderly patients with esophageal cancer.

ObjectiveTo investigate the effect of intermittent theta burst stimulation (iTBS) of the multi-target cerebral cortex after stroke on functional recovery of the upper limb of the hemiplegic side. MethodsFrom November, 2019 to August, 2020, 40 stroke patients in Gansu Provine Hospital Rehabilitation Center were included and randomly divided into single-target stimulation group (n = 20) and multiple-target stimulation group (n = 20). Both groups underwent basic neurorehabilitation drug therapy and conventional rehabilitation exercises. The single-target stimulation group received repetitive transcranial magnetic stimulation (rTMS) (iTBS mode) only in the primary motor cortex (M1) of the affected side. The multi-target stimulation group received rTMS (iTBS mode) in the cerebellar cortex of the healthy brain and M1 of the affected side, once a day, six days a week, for four weeks. Before and after treatment, the scores of Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT) and modified Barthel Index (MBI), and the latency and amplitude of somatosensory-evoked potentials N20 were compared. ResultsNo serious adverse reaction occurred during treatment. After treatment, the scores of FMA-UE, MBI and ARAT, and the amplitude and latency of N20 improved in both groups (|t| > 3.478, |Z| > 2.243, P < 0.05); and the scores of FMA-UE and ARAT, and the amplitude of N20 were better in the multiple-target stimulation group than in the single-target stimulation group (t > 2.939, Z = -2.697, P < 0.01). ConclusionMulti-target stimulation is superior to single-target stimulation for improving upper limb motor function and N20 amplitude in the hemiplegics after stroke.

Objective: To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease. Methods : A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss. Results: The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05). Conclusion The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.

For a long time, researchers and clinicians have strictly divided fatty liver diseases into alcoholic and non-alcoholic fatty liver disease. When one was diagnosed as alcoholic liver disease, the effects of non-alcoholic factors, including obesity, diabetes or metabolic syndrome, on liver diseases have been neglected. Conversely, when the patient was diagnosed as non-alcoholic fatty liver disease, the impacts of alcohol drinking are usually ignored. In the new era, physicians and scientific researchers need to pay more attention to the dual factors of alcohol and obesity, which often exist together and affect liver disease progression.This article elaborates on the clinical features of fatty liver disease in the new era from the aspects of changes in the clinical features of alcoholic liver disease, disease pattern of nonalcoholic fatty liver disease with drinking, and differential diagnosis of alcoholic and nonalcoholic fatty liver diseases.

Leigh syndrome (French-Canadian type, LSFC) is a rare autosomal recessive hereditary severe neurological disorder that begins in infancy. Herein we report a case with LSFC in China. The patient was 8 months old, male, whose clinical manifestations included delayed development, low muscle tone, unstable vertical head, inability to sit alone, cognitive impairment, slightly smaller forehead, oblique eyes, epilepsy, etc. Gene sequencing results showed that the LRPPRC gene in the infant had complex heterozygous mutations of c.2989G>A (newly reported) and c.4078G>A. Combined with the clinical manifestations, gene mutations and literatures, the infant was diagnosed as LSFC, and symptomatic rehabilitation was performed. The results of genetic testing can contribute to the early diagnosis and genetic counseling of LSFC patients, and help reduce the burden on the patients and their families.

Objective: To verify the diagnostic value of adenosine deaminase (ADA) for tuberculous pleural effusion. Methods: Forty-three cases with tuberculous pleural effusion and 163 cases with non-tuberculous pleural effusion were consecutively collected. The concentration of ADA in pleural effusion was determined by enzyme kinetics. The receiver operating characteristic (ROC) analysis curve was used to calculate the optimal cut-off value of ADA for diagnosing tuberculous pleural effusion based on the control groups with non-tuberculous pleural effusion. Meanwhile, the specificity and sensitivity of ADA level for diagnosis of tuberculous pleural effusion were compared with previous reports. Results: The concentration of ADA in tuberculous pleural effusion (median 52.5 U/L) was significantly higher than that in non-tuberculous pleural effusion (median 9.8 and 10.6 U/L) (P＜0.05). With a cut-off level for ADA of 25 U/L, the diagnostic sensitivity and specificity was 88.0% and 91.0%, respectively. A system review analyzed data from 17 studies with QUADAS score ≥10 points and revealed the cut-off value of ADA to be （28.1±12.8） U/L (range 10.2 to 55.8 U/L) with a sensitivity of 89% (95%CI: 87% to 91%) and a specificity of 89% (95%CI: 88% to 91%). Conclusion The specificity and sensitivity of ADA for diagnosis of tuberculous pleural effusions should be up to over 85%, while the cut-off value of ADA from different literature reports were diverse.

Objective To investigate the revascular and transplanted effects of islet grafts after co-transplantation with vascular endothelial cells ( ECs) in diabetic rats. Methods The rat ECs and islet cells were isolated and purified, then subcutaneously co-transplanted to the inbred SD male rats with diabetes mellitus, the group of islets transplanted alone, group of phosphate buffered solution, and group of normal rats served as control. Islet grafts revascularization degree, islet cells activity and apoptosis were observed by immunohistochemical double staining of CD31, insulin and factor associated suicide (Fas) antibody. The results of intraperitoneal glucose tolerance test (IPGTT) and intraperitoneal insulin tolerance test (IPITT), the blood glucose and insulin levels of the rats and the survival time of the islet grafts were compared. Results The blood glucose concentrations of IPGTT and IPITT, the blood glucose and insulin levels of rats analyzed by multivariate analysis in the ECs and islets transplantation group were better than those in the islets transplantation alone group (P<0.05). The islet grafts mean survival time of the ECs and islets transplantation group was longer than that of the islets transplantation alone group (P<0.05). On the 7th day after transplantation, mean microvascular density of islet grafts per square millimeter in the ECs and islets transplantation group was 26.4 ± 6.1, significantly greater than that in the islets transplantation alone group 18.3 ± 5.7 (P<0.05). In the ECs and islets transplantation group, insulin staining intensity was higher than that in the islets transplantation alone group (P<0.05), while factor associated suicide(Fas) staining intensity was lower than that in the islets transplantation alone group ( P<0. 05 ). Conclusion Co-transplantation with ECs could promote the revascularization of islet grafts and improve the effect of islet transplantation.

Objective To investigate the influence of VEGF165 gene transfection on the revascularization and transplantation effect of islet grafts.Methods The rat islet cells were transfected with lentivirus containing VEGF165 gene (LV-VEGF165) in vitro,then transplanted to the renal capsule of inbred SD male rats with diabetes mellitus.Islet cells transfected with lentivirus marked with AcGFP1 and no VEGF165 gene were set as null vector control group (LV-AcGFP1 group),individual islet cells as blank control group.VEGF165 expression in vivo and in vitro was detected by ELISA.The islet grafts revascularization degree and islet cell activity were observed by immunohistochemical double staining of insulin and CD31 antibody.Blood glucose and insulin level of rats with diabetes mellitus and survival time of islet grafts were compared.Results The VEGF165 concentrations in the LV-VEGF165 group secreted by islet cells in vivo and in vitro were significantly higher than those in the LV-AcGFP1 group and the blank control group (P＜0.01).Mean microvascular density (MVD) of islet grafts per square millimeter in the LV-VEGF165 group was (24.3 ± 3.7),significantly greater than that in the LV-AcGFP1 group (12.4 ± 2.5) and the blank control group (12.4 ± 2.5) (P＜ 0.01).Insulin staining intensity in the LV-VEGF165 group was also higher than that in the LVAcGFP1 group and the blank control group.The blood glucose and insulin levels in rats with diabetes mellitus analyzed by multivariate analysis in the LV-VEGF165 group were controlled more effectively than those in the LV-AcGFP1 group and the blank control group (P＜0.01).The islet grafts mean survival time (MST) after transplantation in the LV-VEGF165 group was longer than that of the LVAcGFP1 group and the blank control group (P＜0).01).Conclusion The VEGF165 gene transfection to islet cells could promote the revascularization of islet grafts and improve the effect of islet transplantation.