BACKGROUND:The long-term effect of All-on-4 implant fixed denture is closely related to biomechanics.Its occlusion design affects the stress distribution of every part of the restoration.However,there is limited and inconclusive biomechanical research on All-on-4 implant fixed denture both domestically and internationally so far.OBJECTIVE:To analyze the effect of different occlusal contacts on the stress distribution of mandibular All-on-4 implant fixed denture.METHODS:A model of mandibular All-on-4 implant fixed denture was established.By changing the loading force,direction,and position,10 loading conditions were set up to simulate centric occlusion,laterotrusive occlusion,and protrusive occlusion.The stress distribution and maximum stress values of every part of the model in different loading conditions were analyzed and compared among each group of models by loading different tooth positions to simulate different occlusal contact types.RESULTS AND CONCLUSION:(1)The stress distribution cloud diagrams of each group of models were basically similar.The stress of the implant was mainly concentrated at the implant neck.The stress of the surrounding bone tissue was mainly concentrated around the implant neck,and the stress of the cortical bone was significantly higher than that of the cancellous bone.The stress of the abutment was mainly concentrated at the connection between the abutment and the implant and the abutment and the upper restoration.The stress of the titanium bracket in the upper restoration was mainly concentrated at the connection between the abutment and the titanium bracket,and the stress of the resin surface in the upper restoration was mainly concentrated on each loading point.(2)In simulating centric occlusion,the maximum stress value of the implant significantly increased when the cantilever was not loaded.It indicates that the mandibular All-on-4 implant fixed denture can have occlusal contact in the distal cantilever during centric occlusion.(3)In simulating laterotrusive occlusion,the maximum stress values of every part of the model significantly increased when simulating canine-guided occlusion.The maximum stress value of the simulated laterotrusive balanced occlusion was slightly lower than that of the simulated group functional occlusion.It indicates that group functional occlusion can be selected in the permanent prosthesis after osseointegration and laterotrusive balanced occlusion can be selected in the provisional restoration of mandibular All-on-4 implant fixed denture.(4)In simulating protrusive occlusion,the maximum stress values of every part of the model significantly increase when only the front tooth is loaded.In simulating protrusive balanced occlusion,the maximum Von-Mises stress value is relatively small.It indicates that the protrusive occlusion of mandibular All-on-4 implant fixed denture can choose protrusive balanced occlusion.

BACKGROUND:The long-term effect of All-on-4 implant fixed denture is closely related to biomechanics.Its occlusion design affects the stress distribution of every part of the restoration.However,there is limited and inconclusive biomechanical research on All-on-4 implant fixed denture both domestically and internationally so far.OBJECTIVE:To analyze the effect of different occlusal contacts on the stress distribution of mandibular All-on-4 implant fixed denture.METHODS:A model of mandibular All-on-4 implant fixed denture was established.By changing the loading force,direction,and position,10 loading conditions were set up to simulate centric occlusion,laterotrusive occlusion,and protrusive occlusion.The stress distribution and maximum stress values of every part of the model in different loading conditions were analyzed and compared among each group of models by loading different tooth positions to simulate different occlusal contact types.RESULTS AND CONCLUSION:(1)The stress distribution cloud diagrams of each group of models were basically similar.The stress of the implant was mainly concentrated at the implant neck.The stress of the surrounding bone tissue was mainly concentrated around the implant neck,and the stress of the cortical bone was significantly higher than that of the cancellous bone.The stress of the abutment was mainly concentrated at the connection between the abutment and the implant and the abutment and the upper restoration.The stress of the titanium bracket in the upper restoration was mainly concentrated at the connection between the abutment and the titanium bracket,and the stress of the resin surface in the upper restoration was mainly concentrated on each loading point.(2)In simulating centric occlusion,the maximum stress value of the implant significantly increased when the cantilever was not loaded.It indicates that the mandibular All-on-4 implant fixed denture can have occlusal contact in the distal cantilever during centric occlusion.(3)In simulating laterotrusive occlusion,the maximum stress values of every part of the model significantly increased when simulating canine-guided occlusion.The maximum stress value of the simulated laterotrusive balanced occlusion was slightly lower than that of the simulated group functional occlusion.It indicates that group functional occlusion can be selected in the permanent prosthesis after osseointegration and laterotrusive balanced occlusion can be selected in the provisional restoration of mandibular All-on-4 implant fixed denture.(4)In simulating protrusive occlusion,the maximum stress values of every part of the model significantly increase when only the front tooth is loaded.In simulating protrusive balanced occlusion,the maximum Von-Mises stress value is relatively small.It indicates that the protrusive occlusion of mandibular All-on-4 implant fixed denture can choose protrusive balanced occlusion.

Myocardial infarction is the most common cause of heart failure,and myocardial remodeling can occur after infarction,thus contributing to the progression of heart failure.The occurrence of post-infarction ventricular remode-ling is closely related to m6A methylation.m6A methylation is a reversible and highly dynamic process.This process is mainly mediated by m6A methylation positive and negative regulatory enzymes and is involved in the occurrence of post-in-farction myocardial remodeling through mechanisms such as cellular autophagy.This article mainly reviews relevant litera-ture in recent years.Firstly,a brief introduction is given to m6A methylation,followed by an introduction to the role of m6A methylase in regulating myocardial remodeling.Finally,a summary analysis is conducted on the mechanism of m6A methylation in regulating myocardial remodeling from the perspectives of autophagy,inflammation,cell apoptosis,calcium ion homeostasis,extracellular matrix remodeling,and ferroptosis.The feasibility of using m6A methylation serological de-tection as a diagnostic tool for myocardial remodeling after myocardial infarction is discussed,in order to provide reference for related research.

Objective To investigate the effect of self-prescribed Paizhuo Qinggong Herbal Formula Granule combined with Misoprostol Tablets on uterine recovery in patients with residual intrauterine tissue after childbirth. Methods A total of 120 patients with residual intrauterine tissue after childbirth were randomly selected. According to the simple randomization method, 60 patients were assigned to control group(n=60) and experimental group(n=60). In the control group, patients were treated with a placebo of traditional Chinese medicine formula granules combined with Misoprostol Tablets. In the experimental group, patients were treated with self-prescribed Paizhuo Qinggong Herbal Formula Granule combined with Misoprostol Tablets. The clinical efficacy, syndrome score of traditional Chinese medicine, residual area of intrauterine tissue, uterine recovery indicators (sum of three uterine diameters and rate of uterine fundus descent), ultrasound blood flow parameters, matrix alloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), vaginal bleeding, adverse reactions, and uterine curettage rate were analyzed. Results The total effective rate of treatment in the experimental group was higher than that in the control group (P < 0.05). After 1 week and 2 weeks of treatment, there were statistically significant differences in the syndrome score of traditional Chinese medicine and residual area of intrauterine tissue compared with those before treatment (P < 0.05). The syndrome score of traditional Chinese medicine and residual area of intrauterine tissue in the experimental group were lower than those in the control group after 1 week and 2 weeks of treatment (P < 0.05). There were statistically significant differences in the sum of three uterine diameters between the two groups after 1 week and 2 weeks of treatment compared with those before treatment (P < 0.05). The sum of three uterine diameters in the experimental group was lower than that in the control group after 1 week and 2 weeks of treatment (P < 0.05). The rate of uterine fundus descent in the experimental group was higher than that in the control group (P < 0.05). There were statistically significant differences in the resistance index (RI), end-diastolic peak blood flow velocity (EDV), peak systolic blood flow velocity (PSV), and pulsatility index (PI) of the uterine spiral artery between the two groups after 1 week and 2 weeks of treatment compared with those before treatment (P < 0.05). The EDV and PSV in the experimental group were lower than those in the control group after 1 week and 2 weeks of treatment, while the RI and PI were higher (P < 0.05). There were statistically significant differences in the serum levels of matrix metalloproteinase-9(MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1) between the two groups after 1 week and 2 weeks of treatment compared with those before treatment (P < 0.05). The serum levels of MMP-9 and TIMP-1 in the experimental group were lower than those in the control group after 1 week and 2 weeks of treatment (P < 0.05). The duration of vaginal bleeding in the experimental group was shorter than that in the control group, and the amount of vaginal bleeding was better in the experimental group (P < 0.05). The uterine curettage rate in the experimental group was lower than that in the control group (P < 0.05). Conclusion The combination of self-prescribed Paizhuo Qinggong Herbal Formula Granule combined with Misoprostol Tablets is effective and safe in the treatment of patients with residual intrauterine tissue after childbirth. It can improve clinical symptoms, uterine blood circulation, reduce the residual area of intrauterine tissue, promote uterine recovery, improve vaginal bleeding, reduce the rate of uterine curettage, and exert its effect by correcting the imbalance of MMP-9 and TIMP-1.

Objective To investigate the clinical value of indocyanine green (ICG) fluorescence navigation in laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) in elderly patients with acute cholecystitis. Methods A retrospective analysis was performed for the perioperative clinical data of the elderly patients with acute cholecystitis who underwent LC after PTGBD in Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2021 to February 2022. The 36 patients who underwent ICG fluorescence navigation were enrolled as experimental group, and the 26 patients who did not undergo ICG fluorescence navigation during the same period of time were enrolled as control group. Preoperative general information was analyzed for both groups, as well as time to identify the biliary system during surgery, time of operation, intraoperative blood loss, bile tract injury, conversion to laparotomy, time to first flatus after surgery, time to ambulation, time to removing abdominal drainage tube, time to return to normal diet, and length of postoperative hospital stay. The group t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between groups. Results Compared with the control group, the experimental group had a significantly shorter time to identify the biliary system during surgery (19.9±3.7 min vs 36.5±5.9 min, t =13.56, P < 0.05), a significantly shorter time of operation (50.6±8.5 min vs 80.9±10.6 min, t =12.48, P < 0.05), and a significantly lower amount of intraoperative blood loss ( χ 2 =6.91, P < 0.05). No patient was converted to laparotomy in the experimental group, while 2 patients in the control group were converted to laparotomy, and no bile duct injury was observed in either group. Compared with the control group, the experimental group had significantly shorter time to ambulation (10.2±2.4 hours vs 16.6±3.2 hours, t =8.92, P < 0.05), time to removing abdominal drainage tube (20.1±3.4 hours vs 30.7±4.7 hours, t =10.2, P < 0.05), time to return to normal diet (20.3±3.8 hours vs 31.2±6.0 hours, t =8.68, P < 0.05), and length of postoperative hospital stay [3.3 (3.0-4.3) days vs 5.3 (5.0-6.2) days, Z =5.91, P < 0.05]. Conclusion ICG fluorescence navigation can visualize the extrahepatic biliary system during LC after PTGBD in elderly patients with acute cholecystitis, which may help to achieve accurate operation, reduce the risk of surgery, shorten the time of operation, and accelerate postoperative recovery.

OBJECTIVE To screen the potential drug targets and signaling pathways of Acanthopanax senticosus for the treatment of Alzheimer’s disease(AD) by bioinformatics and network pharmacology-based approach, and to preliminarily validate its efficacy. METHODS The ingredients of Acanthopanax senticosus were obtained through literature, the ingredients were screened by Swiss ADME, and potential targets were predicted by Swiss Target Prediction. AD’s differentially expressed genes were screened from the GSE28146 dataset. The target of Acanthopanax senticosus and AD target were mapped to construct a “drug-ingredients-potential target-disease” network and protein-protein interaction network. The DAVID database was used for GO and KEGG enrichment analysis. Autodock software was used to verify the molecular docking between key active ingredients and core targets. AD mice model was induced by D-galactose combined with aluminum chloride. Morris water maze test was performed to examine the learning memory ability of each group of mice and to observe the pathological changes in the hippocampus of mice. RESULTS Screened to obtain 24 active components and 74 potential targets of Acanthopanax senticosus for the treatment of AD. “Drug-ingredients-potential target-disease” network indicated that quercetin and kaempferol were the main components of Acanthopanax senticosus for the treatment of AD, and the protein-protein interaction network indicated that STAT3, MAPK1 and PIK3CA were the key targets. Obtained 366 GO enrichment entries(P<0.01) and 109 KEGG enrichment pathways(P<0.01). It mainly involved PI3K-AKT, AGE-RAGE, TNF and other pathways. The molecular docking results showed that the main active ingredients of Acanthopanax senticosus were able to bind well to the main targets. The in vivo pharmacological results showed that Acanthopanax senticosus could significantly improve the learning and memory ability of mice, reduce hippocampal tissue damage, and decrease the content of TNF-α, IL-6, and IL-1β in hippocampal tissue. CONCLUSION Acanthopanax senticosus may exert anti-AD effects by inhibiting the expression of inflammatory factors and reducing inflammatory damage.

Toll-like receptor 4 (TLR4) is a key regulator of innate and adaptive immune response. The role of TLR4 in pancreatic diseases is a research hotspot in recent years, and a large number of studies have shown that TLR4 is closely associated with pancreatic cancer. This article mainly discusses the abnormal expression and regulation mechanism of TLR4 in pancreatic cancer and its potential in cancer treatment, so as to provide new ideas for the pathogenesis and treatment of pancreatic cancer.

ObjectiveTo investigate the clinical effect of laparoscopic splenectomy and pericardial devascularization (LSPD) in patients with portal hypertension and the long-term effect of LSPD. MethodsA total of 40 portal hypertension patients with Child-Pugh A/B liver function who received LSPD in The First Hospital of Jilin University from August to December 2017 were enrolled as surgical group, and 44 portal hypertension patients with Child-Pugh A/B liver function who received conservative treatment during the same period of time was enrolled as internal medicine group. The patients were followed up to June 30, 2019, and liver function parameters, upper gastrointestinal bleeding, and portal vein thrombosis were recorded for all patients at each time point. The t-test was used for comparison of normally distributed continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the Bonferroni test was used for further comparison between two groups. The Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution; between multiple groups, and the Mann-Whitney U test was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between groups. ResultsAt 6, 12, and 24 months after discharge, compared with the internal medicine group, the surgical group had a significantly higher level of cholinesterase (t=3.527, 3.849, and 5.555, all P＜0.05) and a significantly lower Child-Pugh score (t=2.498, 2.138, and 2.081, all P＜0.05). Compared with the internal medicine group at 12 and 24 months after discharge, the surgical group had a significantly higher level of albumin (t=3.120 and 2.587, both P＜0.05) and a significantly lower incidence rate of upper gastrointestinal bleeding (χ2=4.947 and 5.155, both P＜0.05). At 24 months after discharge, the surgical group had a significantly lower number of patients who had a significant increase in alpha-fetoprotein level than the internal medicine group (χ2=4.648, P=0.031). At 12 months after discharge, the surgical group had a significantly higher incidence rate of portal vein thrombosis than the internal medicine group (χ2=4.395, P=0.036). The surgical group had significant improvements in albumin (F=2.959, P=0.013), cholinesterase (F=11.022, P＜0001), prothrombin time (H=94.100, P＜0.001), and Child-Pugh score (F=3.742, P=0.003) from admission to 12 and 24 months after surgery. ConclusionIn portal hypertension patients with Child-Pugh A/B liver function, LSPD can improve liver function and reduce the incidence rate of upper gastrointestinal bleeding, and the high incidence rate of portal vein thrombosis can be effectively reduced by oral aspirin and rivaroxaban.

Common bile duct stones are a common of digestive system disease, and as one of the long-term complications after Billroth II subtotal gastrectomy, it has attracted more and more attention from clinicians. Common bile duct stones after Billroth II subtotal gastrectomy have a complex pathogenesis, including neurological, humoral, and mechanical factors. Even though there are many methods to remove stones, there are still controversies over the selection of digestive endoscopy, surgical operation, or percutaneous transhepatic approach. Clinicians should fully evaluate the specific conditions of patients and formulate individualized treatment regimens to achieve the best treatment outcome.