Periodontitis and rheumatoid arthritis (RA) are chronic inflammatory diseases that share similar inflammatory mechanisms and characteristics. Programmed cell death (PCD) has recently garnered attention for its crucial role in regulating inflammation and maintaining tissue homeostasis, as well as for its potential to link these two diseases. The various forms of PCD--including apoptosis, pyroptosis, and necroptosis--are closely controlled by signaling pathways such as Toll-like receptor 4 (TLR4) /NF-κB and MAPK. These pathways determine cell fate and influence inflammatory responses, tissue destruction, and repair, and they both play important roles in the pathogenesis of RA and periodontitis. In periodontitis, periodontal pathogens such as Porphyromonas gingivalis (P. gingivalis) and its virulence factors, including lipopolysaccharide (LPS), induce pyroptosis and necroptosis in immune cells such as macrophages via the TLR4/NF-κB pathway, which leads to an excessive release of pro-inflammatory cytokines such as interleukin (IL)-1β and tumor necrosis factor (TNF)-α. Concurrently, these pathogens inhibit the normal apoptotic process of immune cells, such as neutrophils, prolonging their survival, exacerbating immune imbalance, and aggravating periodontal tissue destruction. Similarly, in RA synovial tissue, fibroblast-like synoviocytes (FLS) acquire apoptosis resistance through signaling pathways such as the Bcl-2 family, JAK/STAT, and NF-κB, allowing for the consistent proliferation and secretion of matrix metalloproteinases and pro-inflammatory cytokines. Meanwhile, the continuous activation of pyroptotic pathways in neutrophils and macrophages results in the sustained release of IL-1β, further exacerbating synovial inflammation and bone destruction. Notably, dysregulated PCD fosters inter-organ crosstalk through shared inflammatory mediators and metabolic networks. Damage-associated molecular patterns (DAMPs) and cytokines that originate from periodontal lesions can spread systemically, influencing cell death processes in synovial and immune cells, thereby aggravating joint inflammation and bone erosion. By contrast, systemic inflammation in RA can upregulate osteoclastic activity or interfere with the normal apoptosis of periodontal cells via TNF-α and IL-6, ultimately intensifying periodontal immune imbalance. This review highlights the pivotal bridging role of PCD in the pathogenesis of both periodontitis and RA, providing a reference for therapeutic strategies that target cell death pathways to manage and potentially mitigate these diseases.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Objective: To analyze the immune responses of bone-marrow derived macrophages and osteoclasts to lipopolysaccharide from Porphyromonas gingivalis (Pg-LPS) so as to provide reference for host immunomodulatory therapy of periodontitis. Methods: Bone marrow mononuclear cells from C57BL/6 mice were obtained and induced into bone marrow macrophages (BMM) and osteoclasts (OC) by conditioned medium. The BMMs and OCs were divided into blank control group and Pg-LPS treated experimental group. Pg-LPS (10 μg/ml) was used to stimulate BMM and OC. The mRNA and protein expression of TLR-2 and TLR-4 and secretion of inflammatory cytokines were detected, respectively. Furthermore, the effect of Pg-LPS on the differentiation of BMM into OC was evaluated. Results: Mouse bone marrow mononuclear cells were successfully induced into BMM and mature OC. In the presence of Pg-LPS, the gene level of TLR-2 in BMM was significantly up-regulated by (41.41±13.07) folds (P<0.01), while the level of TLR-4 mRNA was not significantly changed. TLR-2 mRNA and TLR-4 mRNA levels in OC increased by (2.24±0.23) times (P<0.05) and (4.83±1.07) times (P<0.01), respectively. Flow cytometry results showed that TLR-2 protein expression in BMM was robustly enhanced (P<0.01), as mean fluorescence intensities (MFI) were (39.85±5.27) in blank group and (221.57±13.13) in experimental group, respectively. The MFI of TLR-2 in OC also increased as (83.31±2.69) in blank group and (108.65±6.32) in experimental group, respectively (P<0.01). However, no significant TLR-4 expressions were observed in both BMM and OC (P>0.05). Moreover, the productions of tumor necrosis factor-α and interleukin-6 in response to LPS in BMM and OC remarkably increased (P<0.01). Lower cytokine expression was observed in OC than that in BMM (P<0.01). In addition, Pg-LPS obviously inhibited the number and size of OC formation, with a reduction in area percentage of approximately 47%. Conclusions Pg-LPS generated a robust immune inflammatory response to BMM, while OC had a relatively weaker immune response to the Pg-LPS. Pg-LPS might inhibite the differentiation of BMM into OC.

Objective To explore the therapeutic effect of mild hypothermia on the inflammatory response, organ function and outcome in perioperative patients with acute Stanford type A aortic dissection (AAAD). Methods From February 2017 to February 2018, 56 patients with AAAD admitted in our department were enrolled and randomly allocated into two groups including a control group and an experimental group. After deep hypothermia circulatory arrest during operation, in the control group (n=28), the patients were rewarmed to normal body temperatures (36 to 37 centigrade degree), and which would be maintained for 24 hours after operation. While in the experimental group (n=28), the patients were rewarmed to mild hypothermia (34 to 35 centigrade degree), and the rest steps were the same to the control group. The thoracic drainage volume and the incidence of shivering at the first 24 hours after operation, inflammatory indicators and organ function during perioperation, and outcomes were compared between the two groups. There were 20 males and 8 females at age of 51.5±8.7 years in the control group, 24 males and 4 females at age of 53.3±11.2 years in the experimental group. Results There was no obvious difference in the basic information and operation information in patients between the two groups. Compared to the control group, at the 24th hour after operation, the level of peripheral blood matrix metalloproteinases (MMPs) was lower than that in the experimental group (P=0.008). In the experimental group, after operation, the awakening time was much shorter (P=0.008), the incidence of bloodstream infection was much lower (P=0.019). While the incidence of delirium, acute kidney injury (AKI), hepatic insufficiency, mechanical ventilation duration, intensive care unit (ICU) stays, or hospital mortality rate showed no statistical difference. And at the first 24 hours after operation, there was no difference in the thoracic drainage volume between the two groups, and no patient suffered from shivering. Conclusion The mild hypothermia therapy is able to shorten the awakening time and reduce the incidence of bloodstream infection after operation in the patients with AAAD, and does not cause the increase of thoracic drainage volume or shivering.

Objective To investigate the impact of perioperative mild hypothermia on the neurological function and prog-nosis of patients with acute type A aortic dissection. Methods This study enrolled 65 patients with acute aortic dissection un-derwent surgery during the period of February 2017 to February 2018 and randomly divided them into mild hypothermia group and control group. After the process of deep hypothermic circulatory arrest,patients in the mild hypothermia group were re-warmed to 34 ℃ - 35 ℃ and maintained until 24 h after the operation. While,the patients in the control group were rewarmed to 36 ℃ and were treated with routine rewarm therapy. Baseline characteristics were recorded before the operation and neuro-logical and prognosis related indexes were recorded after the operation for all the patients. At the same time,peripheral venous bloods of all the patients were collected preoperatively and at 1、6、 12 and 24 h after the operation. Serum S 100β and neuron-specific enolase(NSE)levels were measured by ELISA kit. Results Compared with the control group,patients in the mild hypothermia group had a significantly shorter recovery time[ 10. 6 h(IQR:7. 6, 19. 1)vs. 25. 8 h(IQR: 13. 3,54. 2),P =0. 007]. At the same time,serum levels of NSE at 1 h and 6 h after operation and serum levels of S 100β levels at 1、6、 12 and 24 h after operation in the mild hypothermia group were significantly lower than those in the control group(P < 0. 05). In addi-tion,the length of stay in the mild hypothermia group was significantly shorter than that in the control group[ 19 days(IQR: 17, 23)vs. 24 days(IQR: 17,28),P = 0. 036]. However,there was no statistically difference in the incidence of delirium and cerebrovascular accidents between the two groups. Conclusion Perioperative mild hypothermia therapy can significantly re-duce brain cell damage in the patients with acute type A aortic dissection and can shorten postoperative recovery time and hospi-talization time,and thus improve the prognosis of patients.

Coloring Agents ; Diagnostic Uses of Chemicals ; Esophageal Neoplasms ; diagnosis ; Esophagoscopy ; Esophagus ; pathology ; Humans ; Iodine

OBJECTIVETo understand the distribution of esophageal squamous cell cancer and precursor lesions in high-risk areas of China, and to provide evidence for determining the reference ranges of detection rates in high-risk areas.

METHODSEndoscopy with Lugol's iodine staining was performed on 15 709 local residents aged 40 to 69 years old in Linzhou of Henan province and Feicheng of Shandong province from 2005-2009. 35 cases without accurate pathology diagnosis and 11 cases with vital disease before screening were excluded. 15 663 subjects were enrolled in this study. Compliance was calculated by the percentage of the people who had endoscopic screening among the target population. Chi-square test and trend chi-square test were used to compare the distribution differences in age, gender and areas of esophageal squamous cell cancer and precancer. 95% CI of the detection rates was then employed to represent the reference ranges of esophageal squamous cell cancer and precursor lesions.

RESULTSThe compliance rate of screening endoscopy of this study was 49.36% (15 709/31 826) of all, and female's compliance (54.05%, 8 447/15 628) was much higher than that of male (44.83%, 7 262/16 198) (χ(2) = 88.14, P < 0.001). The detection rates of basal cell hyperplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and esophageal squamous cell cancer of males were 4.17% (302/7 246), 17.22% (1 248/7 246), 1.67% (121/7 246), 0.83% (60/7 246), and were higher than that of females (3.45% (290/8 417), 14.82% (1 247/8 417), 1.41% (119/8 417), 0.48% (40/8 417), respectively). Except for high-grade intraepithelial neoplasia, the detection rates of male were higher than that of female (P values were 0.018, < 0.001, 0.960, 0.006). The detection rates of all grades of precursor lesions increased with age rising (all P values < 0.001), among which the detection rates of the mentioned four lesions for 40-44 years old were 2.69% (94/3 500), 8.11% (284/3 500), 0.40% (14/3 500), 0.14% (5/3 500), and that of 65-69 years old were 5.46% (46/843), 23.25% (196/843), 3.68% (31/843), 2.14% (18/843). The proportion of esophageal precursor lesion of Linzhou were higher than that of Feicheng observably except for esophageal squamous cell cancer (P values were < 0.001, < 0.001, < 0.001, 0.437). The detection rates of the four lesions of Linzhou and Feicheng were 4.90% (504/10 287), 17.37% (1 787/10 287), 1.79% (184/1 0287), 0.60% (62/10 287) and 1.64% (88/5 376), 13.17% (708/5 376), 1.04% (56/5 376), 0.71% (38/5 376). The 95% CI of detection rates of various lesions were, 3.78% (3.48%-4.08%) for basal cell hyperplasia, 15.93% (15.37%-16.50%) for low-grade intraepithelial neoplasia, 12.31% (11.79%-12.82%) for mild dysplasia and 3.62% (3.33%-3.91%) for moderate hyperplasia, 1.53% (1.34%-1.72%) for high-grade intraepithelial neoplasia and 0.64% (0.51%-0.76%) for esophageal squamous cell cancer, respectively.

CONCLUSIONUp to 21.88% residents that were asymptomatic were suffered from esophageal squamous cancer or precursor lesions in high-risk areas in China. The distribution of esophageal squamous cell cancer and precursor lesions was closely related to the gender and the age, which suggested that males were supposed to be paid more attention to.

Adult ; Age Distribution ; Aged ; Carcinoma, Squamous Cell ; epidemiology ; China ; epidemiology ; Endoscopy ; Esophageal Neoplasms ; epidemiology ; Female ; Humans ; Iodides ; Male ; Middle Aged ; Precancerous Conditions ; epidemiology ; Sex Distribution

Objective To evaluate the clinical efficacy of transcranial ultrasound thrombolysis combined with Xing-naokaiqiao (XNKQ) acupuncture in treatment of acute cerebral infarction. Methods A total of 120 cases of acute cere-bral infarction were randomly selected from January 2012 to June 2014 in the course of our hospital diagnosed 6 to 12 h, in which 56 cases did not agree treated with transcranial ultrasound thrombolysis combine with XNKQ acupuncture as control group, they only accepted conventional western medicine; 64 cases agreed transcranial ultrasound thrombolysis combine with XNKQ acupuncture were as treatment group. The treatment group received transcranial ultrasound throm-bolysis combined with XNKQ acupuncture treatment based on the conventional western medicine. Then the whole blood viscosity, plasma viscosity, platelet aggregation, hematocrit and other indicators were measured in two groups of patients before and after treatment, the NIHSS scores and efficacy were compared between two groups. Results The clinical ef-ficacy of the treatment group was better than control group, blood rheology and NIHSS scores were superior than the control group, the differences were statistically significant (P<0.05). Conclusion The transcranial ultrasound thrombol-ysis combined with XNKQ acupuncture treatment can significantly improve the efficacy of the treatment of acute cere-bral infarction, improve blood rheology state, which has good prospect.

Objective To understand the distribution of esophageal squamous cell cancer and precursor lesions in high-risk areas of China, and to provide evidence for determining the reference ranges of detection rates in high-risk areas. Methods Endoscopy with Lugol's iodine staining was performed on 15 709 local residents aged 40 to 69 years old in Linzhou of Henan province and Feicheng of Shandong province from 2005-2009. 35 cases without accurate pathology diagnosis and 11 cases with vital disease before screening were excluded.15 663 subjects were enrolled in this study. Compliance was calculated by the percentage of the people who had endoscopic screening among the target population. Chi-square test and trend chi-square test were used to compare the distribution differences in age, gender and areas of esophageal squamous cell cancer and precancer.95%CI of the detection rates was then employed to represent the reference ranges of esophageal squamous cell cancer and precursor lesions. Results The compliance rate of screening endoscopy of this study was 49.36%(15 709/31 826) of all, and female's compliance (54.05%,8 447/15 628) was much higher than that of male(44.83%,7 262/16 198)(χ2=88.14, P<0.001). The detection rates of basal cell hyperplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and esophageal squamous cell cancer of males were 4.17%(302/7 246),17.22%(1 248/7 246),1.67%(121/7 246),0.83%(60/7 246),and were higher than that of females(3.45%(290/8 417),14.82%(1 247/8 417),1.41%(119/8 417),0.48%(40/8 417), respectively). Except for high-grade intraepithelial neoplasia, the detection rates of male were higher than that of female (P values were 0.018,<0.001,0.960,0.006) . The detection rates of all grades of precursor lesions increased with age rising(all P values <0.001), among which the detection rates of the mentioned four lesions for 40-44 years old were 2.69%(94/3 500),8.11%(284/3 500),0.40%(14/3 500), 0.14%(5/3 500), and that of 65-69 years old were 5.46% (46/843), 23.25% (196/843), 3.68% (31/843), 2.14% (18/843). The proportion of esophageal precursor lesion of Linzhou were higher than that of Feicheng observably except for esophageal squamous cell cancer (P values were<0.001,<0.001,<0.001,0.437). The detection rates of the four lesions of Linzhou and Feicheng were 4.90%(504/10 287),17.37%(1 787/10 287),1.79%(184/1 0287),0.60%(62/10 287) and 1.64%(88/5 376),13.17%(708/5 376),1.04%(56/5 376),0.71%(38/5 376).The 95%CI of detection rates of various lesions were, 3.78%(3.48%-4.08%) for basal cell hyperplasia, 15.93%(15.37%-16.50%) for low-grade intraepithelial neoplasia,12.31% (11.79%-12.82%)for mild dysplasia and 3.62% (3.33%-3.91%) for moderate hyperplasia, 1.53%(1.34%-1.72%) for high-grade intraepithelial neoplasia and 0.64%(0.51%-0.76%) for esophageal squamous cell cancer, respectively. Conclusion Up to 21.88%residents that were asymptomatic were suffered from esophageal squamous cancer or precursor lesions in high-risk areas in China. The distribution of esophageal squamous cell cancer and precursor lesions was closely related to the gender and the age, which suggested that males were supposed to be paid more attention to.