In recent years,the autologous platelet concentrates have increasingly been used in the field of periodontal tissue regenera-tion.To furnish insights that may aid in their clinical application,this article offers a comprehensive review of the evolution of autolo-gous platelet concentrates,encompassing their properties,mechanisms,and utilization in the periodontal regeneration of both soft and hard tissues.

In recent years,the autologous platelet concentrates have increasingly been used in the field of periodontal tissue regenera-tion.To furnish insights that may aid in their clinical application,this article offers a comprehensive review of the evolution of autolo-gous platelet concentrates,encompassing their properties,mechanisms,and utilization in the periodontal regeneration of both soft and hard tissues.

To evaluate the efficacy,safety and acceptability of different drugs in the treatment of mixed states in bipolar disorder using the Cochrane systematic review method. The results showed that for the treatment of bipolar depression with mixed features,there is evidence to support the efficacy of lurasidone and quetiapine. Lurasidone has low metabolic and sedative side effects,and can be used in children and adolescents with bipolar depression with mixed features. Quetiapine has balanced anti-depressant and anti-manic effects,with low risk of phase transition. There is evidence to support the efficacy of olanzapine in the treatment of bipolar manic with mixed features. However,it is necessary to balance the efficacy and side effects of olanzapine,and pay attention to the risk of phase transition. For mixed episode in Bipolar disorder,aripiprazole had most research evidence. Aripiprazole has fewer side effects on metabolism and prolactin,and can be used in children with bipolar disorder. Valproate and lithium are recommended by experts for the treatment of mixed state in bipolar disorder. The inconsistency between current studies is still significant,and high-quality randomized controlled trials are urgently needed to provide more comprehensive evidence-based support for the treatment of mixed states in bipolar disorder.

Objective·To systematically review the effectiveness of actigraphy on the evaluation of circadian rhythm characteristics in patients with depression.Methods·A systematic literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,PsycINFO,CNKI,WanFang Data,and Chinese biomedical literature database(CBM),from the inception of each database to May 5th,2023.Case control studies that used actigraphy to evaluate circadian rhythms in patients with depression and compared them with healthy controls were collected.Literature was screened according to the inclusion and exclusion criteria,and the quality of the included literature was evaluated by using the Newcastle-Ottawa Scale.The meta-analysis was performed by using RevMan 5.4 software.Results·A total of 9 articles were included,including 390 patients with depression and 288 healthy controls.The meta-analysis showed that the MESOR(midline statistic of rhythm)(SMD=-0.29,95%CI-0.51 ?-0.07,P=0.009)of the circadian cosine function in patients with depression was lower than that in healthy controls;sleep onset(MD=33.06,95%CI 14.90 ? 51.23,P=0.000)and sleep offset(MD=53.80,95%CI 22.38 ? 85.23,P=0.000)were later in patients with depression than those in healthy controls;no statistical difference was found in the activity level of the most active 10 hours(SMD=-0.26,95%CI-0.52 ? 0.01,P=0.060)between patients with depression and healthy controls,although there was a trend for lower activity in patients with depression;no statistical difference was found in the acrophase(MD=25.33,95%CI-12.41 ? 63.06,P=0.190)of the circadian cosine function between patients with depression and healthy controls;no clear statistical significance of the difference was found in the amplitude(SMD=-0.14,95%CI-0.42 ? 0.14,P=0.340)and the activity level of the least active 5 hours(SMD=0.31,95%CI-0.10 ? 0.71,P=0.140)between patients with depression and healthy controls.Conclusion·Actigraphy can reflect circadian rhythm disruption in patients with depression to some extent,but the limited number of included studies and inconsistencies in the study populations and methodologies have affected the quality and results of the analyses.More high-quality clinical trials are needed to provide evidence.

Objective:To explore the clinical characteristics of interleukin-6 (IL-6) and interleukin-8 (IL-8) in cerebrospinal fluid (CSF) of children with bacterial meningitis (BM) and provide reference for clinical diagnosis and treatment of BM.Methods:The clinical data of BM children hospitalized in Women and Children′s Medical Center Affiliated to Guangzhou Medical University from December 2019 to March 2022 were collected and retrospectively analyzed in this case series study.Cytokines in CSF of these children were detected at least twice during the treatment. t test, Mann-Whitney test or analysis of variance were carried out for statistical analysis. Results:There were 40 patients included in this study.The age of onset was 2(1, 8) months, ranging from 2 days to 8 years, and the length of time from onset to hospitalization was (15±17) days, ranging from 1 day to 69 days.The main symptoms at the onset were fever (40 cases, 100%), poor mental state (16 cases, 35.0%), convulsion (9 cases, 22.5%), and vomiting (9 cases, 22.5%).According to pathogens, the patients were divided into the Streptococcus agalactia group (GBS group, 9 cases), Streptococcus pneumoniae group (SP group, 9 cases), other bacteria group (9 cases), and unknown bacteria group (13 cases).The levels of cytokines in the CSF of BM children were increased, along with significantly elevated levels of IL-6 and IL-8 within 1 st week of BM, followed by the peak at 2 nd-3 rd weeks, and then levels of IL-6 and IL-8 presented an overall decreasing trend with the progression of BM.The level of IL-6 in CSF of 10 cases significantly decreased in the 4 th week of BM [within 2 weeks: 773.5(164.1, 1 781.2) ng/L vs. 4 th week: 10.8(2.2, 21.1) ng/L, P=0.005].Such statistical differences didn′t occur to the level of IL-8 [within 2 weeks 182.9(33.6, 657.7) ng/L vs. 4 th week: 92.9(22.6, 226.6) ng/L, P=0.303].After effective antibiotic therapy, 6 patients had elevated white blood cell count in CSF during the 4 th-20 th weeks, with or without repeating intermittent fever.Among them, 4 cases of GBS and 1 case of SP were negative for pathogens in CSF during the retest after treatment, and the levels of IL-6 and IL-8 [(149.1-4 218.6) ng/L and (124.2-1 890.3) ng/L, respectively] in CSF were elevated.Low-dose glucocorticoid was administered for anti-inflammatory treatment, with additional gamma globulin for 1 case and Ibuprofen instead for 1 case.Subsequently, the fever completely subsided.The white blood cell count in CSF decreased significantly ( P=0.024). Conclusions:The levels of IL-6 and IL-8 in CSF increase significantly in the acute phase of BM and generally decrease with the progression of BM.If they are still significantly elevated in the later course of BM, it should be noted that an intracranial hyperinflammatory response may occur, especially when the pathogenic bacteria are GBS or SP.

To evaluate the efficacy,safety and acceptability of different drugs in the treatment of mixed states in bipolar disorder using the Cochrane systematic review method. The results showed that for the treatment of bipolar depression with mixed features,there is evidence to support the efficacy of lurasidone and quetiapine. Lurasidone has low metabolic and sedative side effects,and can be used in children and adolescents with bipolar depression with mixed features. Quetiapine has balanced anti-depressant and anti-manic effects,with low risk of phase transition. There is evidence to support the efficacy of olanzapine in the treatment of bipolar manic with mixed features. However,it is necessary to balance the efficacy and side effects of olanzapine,and pay attention to the risk of phase transition. For mixed episode in Bipolar disorder,aripiprazole had most research evidence. Aripiprazole has fewer side effects on metabolism and prolactin,and can be used in children with bipolar disorder. Valproate and lithium are recommended by experts for the treatment of mixed state in bipolar disorder. The inconsistency between current studies is still significant,and high-quality randomized controlled trials are urgently needed to provide more comprehensive evidence-based support for the treatment of mixed states in bipolar disorder.

The anterior disc displacement (ADD) leads to temporomandibular joint osteoarthritis (TMJOA) and mandibular growth retardation in adolescents. To investigate the potential functional role of fibrocartilage stem cells (FCSCs) during the process, a surgical ADD-TMJOA mouse model was established. From 1 week after model generation, ADD mice exhibited aggravated mandibular growth retardation with osteoarthritis (OA)-like joint cartilage degeneration, manifesting with impaired chondrogenic differentiation and loss of subchondral bone homeostasis. Lineage tracing using Gli1-CreER⁺; Tm^fl/-mice and Sox9-CreER⁺;Tm^fl/-mice showed that ADD interfered with the chondrogenic capacity of Gli1⁺ FCSCs as well as osteogenic differentiation of Sox9⁺ lineage, mainly in the middle zone of TMJ cartilage. Then, a surgically induced disc reposition (DR) mouse model was generated. The inhibited FCSCs capacity was significantly alleviated by DR treatment in ADD mice. And both the ADD mice and adolescent ADD patients had significantly relieved OA phenotype and improved condylar growth after DR treatment. In conclusion, ADD-TMJOA leads to impaired chondrogenic progenitor capacity and osteogenesis differentiation of FCSCs lineage, resulting in cartilage degeneration and loss of subchondral bone homeostasis, finally causing TMJ growth retardation. DR at an early stage could significantly alleviate cartilage degeneration and restore TMJ cartilage growth potential.
Animals ; Mice ; Osteogenesis ; Zinc Finger Protein GLI1 ; Fibrocartilage ; Temporomandibular Joint ; Disease Models, Animal ; Osteoarthritis ; Stem Cells ; Growth Disorders

Objective:To explore the clinical characteristics and treatment of a family with inherited generalized epilepsy with febrile seizures plus (GEFS + ) caused by the KCNT2 gene mutation and review the literature. Methods:Clinical data of a child with GEFS + and his family members who visited Department of Pediatric Neurology, Guangzhou Women and Children′s Medical Center in May 2019 were collected.DNA samples were collected from the peripheral blood of the proband, his parents, his elder brother, and his maternal grandparents, and genetic analysis and verification were performed using the next-generation sequencing technique.Using " KCNT2" as the key word, literature was retrieved from PubMed, China National Knowledge Infrastructure and Wanfang databases (up to August 2019). Results:The proband was a 3-year-old boy who was admitted to Guangzhou Women and Children′s Medical Center because of frequent epileptic seizures in the past 5 months.He presented with a binocular gaze and experienced 3 to 8 times of extremities myoclonic-spastic epileptic attacks every day.He had a history of 3 times of febrile seizures at the age of 2 years old.His seizures were refractory to Sodium valproate, Topiramate, Nitrazepam and Levetiracetam.His elder brother and mother had a history of childhood febrile seizures.Other members in the family had no history of convulsion.Ictal electroencephalogram showed general 1 Hz high voltage spike-slow waves.A heterozygous nonsense mutation of KCNT2 gene c. 574C>T(p.Q192X) that was never reported previously was detected in the proband, his brother, mother and maternal grandmother.Furthermore, no other family members carried the mutation at the c. 574 locus of the KCNT2 gene.No article in Chinese was found, and 2 articles in a language other than Chinese provided the complete data of 3 sporadic cases.Together with 4 cases in the family studied in this article, there were 7 cases and 4 mutation sites in KCNT2 gene.Of these mutations, there were 3 missense mutations and 1 nonsense mutation.Three sporadic patients presented with early infantile epileptic encephalopathy.The family of this study was characterized with febrile seizures and febrile seizures plus. Conclusions:A de novo mutation and phenotype of the KCNT2 gene is found in a family with GEFS + .It would expand the gene mutation spectrum and provide basis for family genetic counseling. KCNT2 mutation induced GEFS + is refractory to antiepileptic drugs.

The rapid development of technology in the information age has brought profound changes to healthcare. In particular, the close integration of artificial intelligence technology and medical services has demonstrated potential application value in disease diagnosis, treatment and clinical research.Psychiatry strives to keep pace with the times and of information technology. Artificial intelligence has made multi-faceted explorations in psychiatric clinical research. The process is not only full of opportunities and challenges, but also insightful dawn.Meanwhile, the application of information technology in psychiatric clinical research also has inevitable limitations.Psychiatric clinical research needs to pay attention to real data in the real world. On the basis of standardization and safety, it should be expected that artificial intelligence technology and real data in psychiatric clinical diagnosis and treatment should be combined to strengthen evidence-based studies, update clinical diagnosis and treatment guidelines, and promote a tool for translational application.From the perspective of scientific development, these tools will eventually help psychiatrists benefit the majority of patients with mental illness and promote the vigorous development of psychiatry.

The rapid development of technology in the information age has brought profound changes to healthcare. In particular, the close integration of artificial intelligence technology and medical services has demonstrated potential application value in disease diagnosis, treatment and clinical research.Psychiatry strives to keep pace with the times and of information technology. Artificial intelligence has made multi-faceted explorations in psychiatric clinical research. The process is not only full of opportunities and challenges, but also insightful dawn.Meanwhile, the application of information technology in psychiatric clinical research also has inevitable limitations.Psychiatric clinical research needs to pay attention to real data in the real world. On the basis of standardization and safety, it should be expected that artificial intelligence technology and real data in psychiatric clinical diagnosis and treatment should be combined to strengthen evidence-based studies, update clinical diagnosis and treatment guidelines, and promote a tool for translational application.From the perspective of scientific development, these tools will eventually help psychiatrists benefit the majority of patients with mental illness and promote the vigorous development of psychiatry.