Objective To observe the clinical efficacy of lumbar disc resection under unilateral biportal endoscopy(UBE)for calcified lumbar disc herniation(CLDH).Methods A retrospective analysis was conducted on 25 patients with single-segment CLDH who underwent lumbar disc resection under UBE from January 2020 to January 2022.The operation time,postoperative hospital stay,and postoperative complications were recorded.The visual analogue scale(VAS)score for low back and leg pain,Japanese Orthopaedic Association(JOA)score for the lumbar spine,and Oswestry disability index(ODI)were used to evaluate the efficacy before surgery,3 d after surgery,1 month after surgery,and at the last follow-up.At the last follow-up,the modified Macnab standard was used to assess the excellent and good rate.Results The patients were followed up for 12～24 months,with an average of(15.60±2.60)months.The average operation time was(58.67±10.73)min,and the postoperative hospital stay was(4.65±0.63)d.The VAS score,and ODI were lower,and JOA score was higher at 3 d after surgery,1 month after surgery,and the last follow-up compared with those before surgery,and the differences were statistically significant(P<0.05).At the last follow-up,according to the modified Macnab criteria,15 cases were rated as excellent,9 cases as good,and 1 case as fair.The excellent and good rate was 96.00%(24/25).Postoperative complications included a tear of the ventral dural sac of the nerve root,about 5 mm in length,without dural sac repair.The patient was instructed to stay in bed for 5 d after surgery and was given fluid replacement.The patient did not complain of discomfort such as headache when he got out of bed,and the postoperative MRI showed no massive epidural effusion.One patient had lower limb sensory disturbance and was treated with neurotrophic drugs,and recovered at the 1-month follow-up after surgery.Postoperative imaging examinations showed that the free calcified tissues were basically completely resected and the nerve roots were adequately decompressed.At the last follow-up,no recurrent cases were found.Conclusion Lumbar disc resection under UBE for CLDH is an effective and safe minimally invasive technique.

Objective To observe the clinical efficacy of lumbar disc resection under unilateral biportal endoscopy(UBE)for calcified lumbar disc herniation(CLDH).Methods A retrospective analysis was conducted on 25 patients with single-segment CLDH who underwent lumbar disc resection under UBE from January 2020 to January 2022.The operation time,postoperative hospital stay,and postoperative complications were recorded.The visual analogue scale(VAS)score for low back and leg pain,Japanese Orthopaedic Association(JOA)score for the lumbar spine,and Oswestry disability index(ODI)were used to evaluate the efficacy before surgery,3 d after surgery,1 month after surgery,and at the last follow-up.At the last follow-up,the modified Macnab standard was used to assess the excellent and good rate.Results The patients were followed up for 12～24 months,with an average of(15.60±2.60)months.The average operation time was(58.67±10.73)min,and the postoperative hospital stay was(4.65±0.63)d.The VAS score,and ODI were lower,and JOA score was higher at 3 d after surgery,1 month after surgery,and the last follow-up compared with those before surgery,and the differences were statistically significant(P<0.05).At the last follow-up,according to the modified Macnab criteria,15 cases were rated as excellent,9 cases as good,and 1 case as fair.The excellent and good rate was 96.00%(24/25).Postoperative complications included a tear of the ventral dural sac of the nerve root,about 5 mm in length,without dural sac repair.The patient was instructed to stay in bed for 5 d after surgery and was given fluid replacement.The patient did not complain of discomfort such as headache when he got out of bed,and the postoperative MRI showed no massive epidural effusion.One patient had lower limb sensory disturbance and was treated with neurotrophic drugs,and recovered at the 1-month follow-up after surgery.Postoperative imaging examinations showed that the free calcified tissues were basically completely resected and the nerve roots were adequately decompressed.At the last follow-up,no recurrent cases were found.Conclusion Lumbar disc resection under UBE for CLDH is an effective and safe minimally invasive technique.

The direct composite resin bonding is widely used in the esthetic restorations of anterior teeth. Due to the technique sensitive procedure, the esthetic effect and long-term clinical performance of direct composite resin restoration have long been the focus of dental clinicians. This article will analyze the influencing factors of esthetic effect of composite resin from three aspects, including materials, teeth and technology. Also, it will summarize the clinical performance of direct composite resin from the perspective of esthetic evaluation. Eventually, this article will provide guidance for the clinical application of esthetic restoration of direct composite resin bonding.

Humans ; Bicuspid ; Dental Pulp Cavity ; Root Canal Therapy ; Tooth Root ; Mandible

Objective: To explore the clinical effects of proximal ulnar artery perforator flap combined with iliac bone graft in the reconstruction of subtotal thumb or finger defects. Methods: A retrospective observational study was conducted. From August 2016 to August 2019, 7 patients with thumb or finger defects caused by mechanical damage who met the inclusion criteria were admitted to Ruihua Affiliated Hospital of Soochow University, including 6 males and 1 female, aged 46 to 58 years. Their length of fingers was repaired with iliac bone, with length of 2.0 to 3.0 cm. After the bone graft, the skin defect area of the affected finger ranged from 2.8 cm×2.2 cm to 6.0 cm×3.2 cm. Then the free proximal ulnar artery perforator flap with area of 3.0 cm×2.4 cm to 6.5 cm×3.5 cm was used to cover the wounds. The wounds in donor sites of iliac crest and flap were directly sutured. The survival of flap in one week post surgery and the donor site wound healing in 2 weeks post surgery were observed, respectively. During the follow-up, the appearance and sensory function of the affected finger, bone healing, and scar hypertrophy of wound in the donor site were observed and evaluated. At the last follow-up, the functional recovery of the affected finger was evaluated with trial standard for the evaluation of functions of the upper limbs of the Hand Surgery Society of Chinese Medical Association. Results: In one week post surgery, all the flaps survived. In 2 weeks post surgery, the iliac bone and the wounds in forearm donor site healed. During the follow-up of 5 to 13 months, the flap was good in appearance, without obvious pigmentation; the sensory recovery reached level S₂ in 5 patients and S₀ in 2 patients; all the grafted iliac bones were bony union without obvious resorption; the wounds in donor site healed well, with only mild scar formation. At the last follow-up, the shape of the reconstructed finger was close to the healthy finger, and the functional evaluation results were excellent in 3 cases and good in 4 cases. Conclusions: The use of proximal ulnar artery perforator flap combined with iliac bone graft to reconstruct subtotal thumb or finger can partially restore part of the appearance and function, with less damage to the donor site. It is a good choice for patients who have low expectations of appearance and function for the reconstructed finger.
Male ; Humans ; Female ; Soft Tissue Injuries/surgery* ; Perforator Flap/transplantation* ; Skin Transplantation/methods* ; Thumb/surgery* ; Plastic Surgery Procedures ; Ulnar Artery/surgery* ; Cicatrix/surgery* ; Ilium/surgery* ; Treatment Outcome

To investigate the inflammatory mechanism of nasal instillation of fine particulate matter (PM)on hippocampal tissue injury in mice. Thirty C57BL/6J mice were randomly divided into 3 groups(n=10):control group, low-dose group, high-dose group. The nasal instillation doses of PM in the low-dose group and the high-dose group were 1.5 mg/kg BW and 7.5 mg/kg BW, respectively, and the control group was given saline with an equal volume. Saline was sprayed once every other time for 12 times. The serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were determined by ELISA method. HE staining and electron microscopy were used to observe the pathological changes and ultrastructure of lung tissue and hippocampus. The inflammatory cytokine levels in hippocampus were detected by antibody chip technique. There was no significant effect of PM nasal instillation on serum TNF-α, IL-1β and IL-6 levels (P＞0.05), and there was no obvious pathological changes in lung tissue structure. In hippocampus, low-dose and high-dose PM exposure could lead to disordered neuronal arrangement in the hippocampal CA3 region, and there were neurological changes around the neuron cells and ultrastructural changes such as edema around small blood vessels. Compared with the control group, the levels of inflammatory cytokines such as CX3CL1, CSF2 and TECK in the low-dose group were increased significantly (P ＜0.05), while sTNFR1 was decreased significantly (P＜0.05); the inflammatory factors CX3CL1, CSF2, and TCA-3 were significantly increased in the high-dose group (P＜0.05), while leptin, MIG, and FASLG were significantly decreased (P＜0.05). Nasal instillation of PM can induce tissue damage in the hippocampus of mice, and its mechanism of action may be the olfactory brain pathway. The increasing of TNF-α and IL-6 and the decreasing of sTNFR1 and FASLG may be involved in inflammatory mechanisms.

Objective To explore the plasma levels of soluble CD40 (sCD40) and soluble CD40 ligand (sCD40L) in the patients with Alzheimer’s disease (AD) and those with amnestic mild cognitive impairment (aMCI). Methods The levels of plasma sCD40 and sCD40L were measured in 20 patients with AD, 35 patients with aMCI, and 32 cognitively normal controls (NC) using commercially available ELISAs. The cognitive function of AD and aMCI patients was mea?sured by mini-mental state examination (MMSE). Results There were significant differences in plasma sCD40 among AD, aMCI and NC groups (P<0.05) as the medians (the upper and lower quartiles) of plasma levels were 123.3 (97.4, 149.5) pg/mL, 102.9 (63.6, 124.0) pg/mL and 70.66 (51.0, 90.8) pg/mL, respectively. There were significant differences in plasma sCD40L among AD, aMCI and NC groups (P<0.05) as plasma levels were 537.0 (316.0, 1134.0) pg/mL, 316.0 (190.0,546.0) pg/mL and 167.0 (107.5,478.0) pg/mL. A negative correlation between the plasma concentrations of sCD40L and the MMSE scores was found in aMCI patients (r=-0.736, P<0.001). Conclusions There are relevant chang?es of plasma sCD40 and sCD40L levels in patients with AD and aMCI. The present results suggest that plasma levels of sCD40 and sCD40L may be appropriate biomarkers for AD patients and indicate that CD40-CD40L signaling may be in?volved in AD pathophysiology.

Objective To evaluate the association of prostate volume, PSAD and F/T with prostate cancer detection rate in males with a total PSA of 4?10 μg/L. Methods Clinical data of 196 patients who underwent prostate biopsy from November 2006 to September 2010 and with a PSA of 4?10 μg/L were retrospectively analyzed. The association of detection rate of prostate cancer with prostate volume, prostate specific antigen density PSAD) and free PSA/total PSA ratio ( F/T) was analyzed by Spearman coefficient, receiver operating characteristic curve and logistic regression analysis. Results The prostate volume, PSAD and F/T had a significant association with detection rate of prostate cancer ( P<0.05 for all) . The odd ratio was 0. 96, 1. 91 and 0. 02, respectively. The area under curve ( AUR ) was 0. 31, 0. 66 and 0. 63, respectively. The cancer detection rate was decreased along with the increase of prostate volume. When PSAD 0.15 ng·ml-1·ml-1 was used as the cut?off value, the sensitivity, specificity, positive prediction rate and negative prediction rate was 72. 3%, 51. 1%, 42. 3% and 21. 2%, respectively. When the patients were divided by prostate volume into <19. 9, 20?39. 9, 40?59. 9, 60?79. 9 and >80 ml subgroups, the cancer detection rate of each subgroup was 50.0%, 45.6%, 30.8%, 15.4% and 5.6%, respectively. Conclusion In patients with a total PSA of 4?10μg/L, the prostate cancer detection rate has a significant association with prostate volume, PSAD and F/T.

Objective To evaluate the association of prostate volume, PSAD and F/T with prostate cancer detection rate in males with a total PSA of 4?10 μg/L. Methods Clinical data of 196 patients who underwent prostate biopsy from November 2006 to September 2010 and with a PSA of 4?10 μg/L were retrospectively analyzed. The association of detection rate of prostate cancer with prostate volume, prostate specific antigen density PSAD) and free PSA/total PSA ratio ( F/T) was analyzed by Spearman coefficient, receiver operating characteristic curve and logistic regression analysis. Results The prostate volume, PSAD and F/T had a significant association with detection rate of prostate cancer ( P<0.05 for all) . The odd ratio was 0. 96, 1. 91 and 0. 02, respectively. The area under curve ( AUR ) was 0. 31, 0. 66 and 0. 63, respectively. The cancer detection rate was decreased along with the increase of prostate volume. When PSAD 0.15 ng·ml-1·ml-1 was used as the cut?off value, the sensitivity, specificity, positive prediction rate and negative prediction rate was 72. 3%, 51. 1%, 42. 3% and 21. 2%, respectively. When the patients were divided by prostate volume into <19. 9, 20?39. 9, 40?59. 9, 60?79. 9 and >80 ml subgroups, the cancer detection rate of each subgroup was 50.0%, 45.6%, 30.8%, 15.4% and 5.6%, respectively. Conclusion In patients with a total PSA of 4?10μg/L, the prostate cancer detection rate has a significant association with prostate volume, PSAD and F/T.

BACKGROUNDPersistent/secondary infections of human root canals play an important role in the failure of endodontic treatment. This study used 16S rRNA sequencing to assess microbial diversity in root-filled teeth associated with failed endodontic treatment.

METHODSDNA was extracted from 15 teeth with persistent intraradicular infections, and the 16S rRNA of all present bacteria were amplified by PCR, followed by cloning and sequencing of the 16S rRNA amplicons.

RESULTSAll sample extracts were positive for PCR amplification using the universal 16S rRNA gene primers. Negative control reactions yielded no amplicons. Sixty-five phylotypes belonging to seven phyla were identified from 760 clones; a mean of 9.4 phylotypes were detected in each sample (range 3 - 15). Twenty-eight phylotypes were detected in more than one sample, revealing a high inter-sample variability. Parvimonas micra (60%, 9/15), Solobacterium moore (47%, 7/15), Dialister invisus (33%, 5/15), Enterococcus faecalis (33%, 5/15), Filifactor alocis (27%, 4/15), and Fusobacterium nucleatum (27%, 4/15) were the prevalent species. Nineteen as-yet-uncultivated phylotypes were identified, comprising a substantial proportion of the bacteria in many cases.

CONCLUSIONSPersistent intraradicular infections were present in all root-filled teeth associated with failed endodontic treatment. The current observations reveal new candidate endodontic pathogens, including as-yet-uncultivated bacteria and phylotypes that may participate in the mixed infections associated with post-treatment apical periodontitis.

Adolescent ; Adult ; Aged ; Bacteria ; classification ; isolation & purification ; Female ; Humans ; Male ; Middle Aged ; RNA, Ribosomal, 16S ; genetics ; Tooth, Nonvital ; microbiology ; Treatment Failure