Corticotomy is a clinical procedure to accelerate orthodontic tooth movement characterized by the regional acceleratory phenomenon (RAP). Despite its therapeutic effects, the surgical risk and unclear mechanism hamper the clinical application. Numerous evidences support macrophages as the key immune cells during bone remodeling. Our study discovered that the monocyte-derived macrophages primarily exhibited a pro-inflammatory phenotype that dominated bone remodeling in corticotomy by CX3CR1^CreERT2; R26^GFP lineage tracing system. Fluorescence staining, flow cytometry analysis, and western blot determined the significantly enhanced expression of binding immunoglobulin protein (BiP) and emphasized the activation of sensor activating transcription factor 6 (ATF6) in macrophages. Then, we verified that macrophage specific ATF6 deletion (ATF6^f/f; CX3CR1^CreERT2 mice) decreased the proportion of pro-inflammatory macrophages and therefore blocked the acceleration effect of corticotomy. In contrast, macrophage ATF6 overexpression exaggerated the acceleration of orthodontic tooth movement. In vitro experiments also proved that higher proportion of pro-inflammatory macrophages was positively correlated with higher expression of ATF6. At the mechanism level, RNA-seq and CUT&Tag analysis demonstrated that ATF6 modulated the macrophage-orchestrated inflammation through interacting with Tnfα promotor and augmenting its transcription. Additionally, molecular docking simulation and dual-luciferase reporter system indicated the possible binding sites outside of the traditional endoplasmic reticulum-stress response element (ERSE). Taken together, ATF6 may aggravate orthodontic bone remodeling by promoting Tnfα transcription in macrophages, suggesting that ATF6 may represent a promising therapeutic target for non-invasive accelerated orthodontics.
Animals ; Mice ; Macrophages/metabolism* ; Tumor Necrosis Factor-alpha/genetics* ; Tooth Movement Techniques/methods* ; Activating Transcription Factor 6/metabolism* ; Bone Remodeling ; Flow Cytometry ; Blotting, Western

Objective    To investigate the surgical methods and efficacy of myocardial infarction combined with ventricular septal perforation. Methods    The clinical data of 60 patients with myocardial infarction combined with ventricular septal perforation admitted to the Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, from 2009 to 2018 were retrospectively analyzed. There were 39 males and 21 females, aged 63.3±8.3 years. Results    Among the 60 patients, 43 (71.7%) patients were perforated in the apex, 11 (18.3%) in the posterior septum and 6 (10.0%) in the anterior septum. There were 24 (40.0%) patients of single coronary artery disease. Fourteen (23.3%) patients received intra-aortic balloon counterpulsation before surgery. The waiting time from ventricular septal perforation to surgery was 48.3 (3-217) d. All patients underwent ventricular septal perforation repair, among whom 53 (88.3%) patients received ventricular aneurysm closure or resection, and 49 (81.7%) patients received coronary artery bypass graft with an average of 2 distal anastomoses during the same period. Perioperative complications in the hospital included 8 (13.3%) deaths, 8 (13.3%) heart failure, 5 (8.3%) ventricular fibrillation, 3 (5.0%) pericardial tamponade, and 11 (18.3%) secondary thoracotomy and 11 (18.3%) residual shunt. Except for 8 patients who died in the hospital, the other 52 cured and discharged patients were followed up. The median follow-up time was 4.9 years. The 2-year and 5-year survival rate of the patients was 95.8%, and the 8-year survival rate was 89.0%. Major adverse cardiovascular events incidence was 19.2%, including 3 (5.8%) deaths, 5 (9.6%) heart failure, 2 (3.8%) myocardial infarction, and 4 (7.7%) cerebrovascular events. Conclusion    For patients with ventricular septal perforation after myocardial infarction, surgery is an effective treatment method. Although the perioperative mortality rate is high, satisfactory long-term results can be achieved by carefully choosing the operation timing and methods.

Objective To investigate the effect of axial load test in Taylor spatial frame treatment of external fixation for tibia and fibula fractures.Methods A retrospective case-control study was conducted to analyze the clinical data of 36 patients with open fracture of tibia and fibula admitted to Tianjin Hospital from March 2015 to June 2017.There were 22 males and 14 females,aged 21-71 years[(46.1±14.2)years].All patients received Taylor spatial frame external fixation for tibia and fibula fracture within 1 week after injury.After operation,18 patients received axial load test(experiment group),and the other 18 did not(control group).When the value of axial load test was less than 5% in experiment group,the Taylor spatial frame was removed.The control group used traditional method to remove the Taylor spatial frame.Comparisons were made between the two groups in terms of treatment duration,total cost,re-fracture after Taylor spatial frame removal and incidence of stent-tract infection.Results All patients were followed up for 3-14 months with an average of 8.6 months.Compared with control group,the treatment duration[(36.17±11 .44)weeks vs.(44.50±9.16)weeks]and total cost[(93.7±7.9)thousand yuan vs.(120.1±10.6)thousand yuan]of experiment group were significantly lower(P＜0.05).In the experiment group,there was 0 patient with re-fracture and two patients with stent-tract infection,with the complication incidence of 11%,while there were two patients with re-fracture and three patients with stent-tract infection,with the complication incidence of 28% in the control group(P＞0.05).Conclusions After Taylor spatial frame external fixation for tibia and fibula fractures,regular axial load test can safely and timely guide the removal of Taylor spatial frame.It can reduce the treatment duration and cost compared with the traditional removal method,being safe and reliable.

Objective To investigate the clinical manifestations, auxiliary examination, diagnosis and therapy of Aspergillus tracheobronchitis (ATB).Methods Clinical data of 4 ATB patients treated in Qingdao Municipal Hospital from June 2012 to September 2015 were analyzed retrospectively. The related literature was also reviewed.Results The main clinical manifestations were cough, sputum production, short of breath, fever and hemoptysis. All the four patients had predisposing factors. The ifndings of CT scan mainly included bronchial wall thickening, obstruction of bronchial lumen or no significant abnormality. Bronchoscopy showed mucosal erosion, necrosis, tracheal stenosis and obstruction of airway by pseudo-membrane. The diagnosis was confirmed by histopathology in all the four cases. They were treated with anti-Aspergillus therapy. The two patients with airway stenosis were treated with interventional therapy via bronchoscope. As for the outcome, one patient was improved after therapy. Another was cured. The remaining two patients died.Conclusions The clinical manifestations and chest imaging of ATB are nonspecific. Bronchoscopy is an important tool for diagnosis of ATB. Early diagnosis and proper anti-Aspergillus treatment are critical for improving prognosis.

BACKGROUND:An ideal scaffold material needs appropriate degradation rate and certain mechanical properties, but the traditional colagen sponge scaffold has rapid degradation velocity and low mechanical strength, which is easy to colapse and difficult to maintain its natural form. Traditional cross-linking methods also have the problems of cytotoxicity or colagen denaturation, severely limiting the application of colagen. OBJECTIVE:To design a new cross-linking method for colagen and to optimize the self-assembly process so as to develop a colagen sponge scaffold with good mechanical properties and resistance to degradation. METHODS:Colagens were modified by self-assembly technology to prepare colagen fibrils which were then freeze-dried into fibrilar colagen sponges. Meanwhile, we optimized the conditions of self-assembly by using orthogonal experiment based on univariate analysis of the effect of initial colagen mass concentration, final phosphate concentration and pH value on the conversion yield of colagen self-assembly. RESULTS AND CONCLUSION:We optimized the conditions of self-assembly revealed that the optimum conditions to prepare colagen fibrils were determined as pH=8.0, initial colagen concentration=2 mg/mL, and final concentration of phosphate=15 mmol/L. The results of scanning electron microscope showed that fibrilar colagen sponges were characterized by refined porous structure which was connected by colagen fibrils. In addition, the fibrilar colagen sponges showed better equilibrium-sweling ratio, water retaining property and mechanical strength compared with unmodified colagen spondages (P < 0.05), to solve the problems in rapid degradation.

Objective To investigate the clinical characteristics and prognosis in the patients with type 2 diabetes mellitus and invasive pulmonary aspergillosis(IPA) for better management of the disease .Methods Clinical data of 9 cases of type 2 diabetes associated with IPA treated in Qingdao Municipal Hospital from January 2008 to December 2013 were analyzed retrospectively . Results The diagnosis of IPA was proven in 5 and probable in 4 of the 9 patients .The main clinical manifestations were fever , cough and expectoration .The findings of CT scan mainly showed pulmonary nodules along the bronchovascular bundle and cavity signs .Bronchoscopy showed congestion ,edema ,and erosion of bronchial mucosa covered with yellow‐white or brown pus ,partially or completely blocking the lumen .Antifungal treatment was effective for 4 patients .The other five patients died . Conclusions Type 2 diabetes mellitus is a risk factor for developing invasive pulmonary aspergillosis .Early diagnosis and proper treatment are critical for improved prognosis .

Objective:To compare the effect for establishing rat model of chronic obstructive pulmonary disease(COPD)be-tween two methods,inhalation of PM2.5 and intratracheal instillation of PM2.5 suspension.Methods:A total of 30 adult rats were randomly divided into control group(group A),group fumigated with PM2.5(group B),and group instilled intratracheal-ly with PM2.5 suspension(group C).Then the lung function of rats,the counts of inflammatory cells in bronchoalveolar lavage fluid(BALF),and the pathological sections of lung tissues,were observed on different phases.Results:Compared with that in group A,the body mass in group B or group C decreased.And the tidal volume(VT)and the peak expiratory flow(PEF)de-creased.Furthermore,total cell count,lymphocyte count(L),neutrophil count(N),lymphocyte proportion(L%),and neutro-phil proportion(N%)in BALF increased.All the differences showed statistical significance(all P <0.05).Morphological de-tection showed enlarged alveolar space,disruption of alveolar septa,fusion of alveoli,and formation of emphysema in group B. And it also showed disordered arrangement of airways epithelial cells,partial airway epithelial hyperplasia,inflammatory cell infiltration and proliferation of smooth muscle in group B.Furthermore,mean linear intercept (MLI)and mean alveolar num-ber (MAN)in group B increased,while compared with that in group A.The pathological changes in group C were similar to those in group B.However,the degrees of pathological changes in group C were more severe,and most of them were acute in-juries.Conclusions:Rat model of COPD established by inhalation of PM2.5 was more reasonable than that established by intra-tracheal instillation of PM2.5 suspension.

Adult ; Aged ; Aspergillosis ; epidemiology ; Female ; Humans ; Lung Diseases, Fungal ; epidemiology ; Male ; Middle Aged

Objective To summarize our experience of harvesting and using the organs of donors after cardiac death.MethodsForm March 2010 to October 2011,56 potential donors were diagnosed with cardiac death,who conformed to the classification of Maastricht Ⅲ criteria.There were 40 failure cases whose family refused to donate,and one failure case who suffered from serious infection.Finally,the success ratio of donation after cardiac death was 26.8％ (15/56).Twelve livers and 22 kidneys were transplanted into 12 and 20 recipients respectively.ResultsTwelve cases of liver transplantations had acceptable outcomes. The grafts of 4 cases out of 20 cases of kidney transplantations were removed after transplantation,and other recipients had acceptable outcomes.ConclusionCitizens organ donation after cardiac death can expand the number of suitable organs,but we need to strictly control the criteria for potential donors.

Objective To study the prognosis of patients with end-stage liver cirrhosis who using controlled cardiac death liver donor in situ liver transplantation. Methods Seven cases of transplants which used liver donated after cardiac death were done in our center. The preoperative and postoperative data were analyzed. The prognosis of these patients was observed. Results Except one recipient died of upper gastrointestinal bleeding at the 9th day after surgery, the remaining 6 patients were followed up for more than 12 months (mean 15.7 months) and the prognosis was satisfactory.Conclusion Patients can get good prognosis after the liver transplants with donated liver after cardiac death which meets the Maastricht Classification type Ⅲ.