Insufficient alveolar bone thickness increases the risk of periodontal dehiscence and fenestration, especially in orthodontic tooth movement. Abaloparatide (ABL), a synthetic analog of human PTHrP (1-34) and a clinical medication for treating osteoporosis, has recently demonstrated its potential in enhancing craniofacial bone formation. Herein, we show that intraoral submucosal injection of ABL, when combined with mechanical force, promotes in situ alveolar bone thickening. The newly formed bone is primarily located outside the original compact bone, implying its origin from the periosteum. RNA sequencing of the alveolar bone tissue revealed that the focal adhesion (FA) pathway potentially mediates this bioprocess. Local injection of ABL alone enhances cell proliferation, collagen synthesis, and phosphorylation of focal adhesion kinase (FAK) in the alveolar periosteum; when ABL is combined with mechanical force, the FAK expression is upregulated, in line with the accomplishment of the ossification. In vitro, ABL enhances proliferation, migration, and FAK phosphorylation in periosteal stem cells. Furthermore, the pro-osteogenic effects of ABL on alveolar bone are entirely blocked when FAK activity is inhibited by a specific inhibitor. In summary, abaloparatide combined with mechanical force promotes alveolar bone formation via FAK-mediated periosteal osteogenesis. Thus, we have introduced a promising therapeutic approach for drug-induced in situ alveolar bone augmentation, which may prevent or repair the detrimental periodontal dehiscence, holding significant potential in dentistry.
Osteogenesis/drug effects* ; Periosteum/cytology* ; Parathyroid Hormone-Related Protein/administration & dosage* ; Animals ; Focal Adhesion Protein-Tyrosine Kinases/metabolism* ; Alveolar Process/drug effects* ; Cell Proliferation/drug effects* ; Phosphorylation ; Rats ; Male ; Humans ; Focal Adhesion Kinase 1/metabolism* ; Cell Movement/drug effects*

Objective:To investigate the prognostic effect of femoral resection on patients with soft tissue sarcoma of the thigh with cortical bone involvement.Methods:This retrospective study included patients with soft tissue sarcoma of the thigh diagnosed and treated in the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to December 2021. Patients were divided into two groups based on whether femoral resection and reconstruction were performed with 20 in the resection group and 86 in the non-resection group. Propensity score matching (PSM) was used to control confounding variables. Overall Survival, recurrence free survival, metastasis free survival, and postoperative functional outcomes were compared between groups before and after PSM. Cox proportional hazards regression was used to identify risk factors for death, recurrence, and metastasis.Results:Before PSM, the 5-year overall survival (OS) and recurrence-free survival (RFS) rates were 46.7% and 36.7% in the resection group, compared to 69.7% and 60.3% in the non-resection group without significant differences ( P>0.05). However, the 5-year metastasis-free survival (MFS) rate was significantly lower in the resection group (40.0%) compared to the non-resection group (73.1%) ( P=0.021). After PSM, the 5-year OS, RFS, and MFS in the resection group were 46.7%, 36.7%, and 35.9%, respectively, compared to 45.0%, 39.4%, and 67.7% in the non-resection group, with no significant differences ( P>0.05). The median postoperative MSTS functional score after PSM was significantly lower in the resection group 23(18, 25) points than in the non-resection group 26.5(24.3, 27.8) points ( U=43.000, P=0.007). Multivariate Cox regression analysis identified grade III histology ( HR=3.794, P=0.002) and tumor involvement angle around the femur greater than 180° ( HR=2.729, P=0.030) as independent risk factors for death. Age over 55 years ( HR=4.185, P=0.015), tumor diameter greater than 8 cm ( HR=4.290, P=0.014), and involvement of the intermuscular compartment ( HR=3.794, P=0.017) were associated with increased risk of local recurrence. Grade III histology ( HR=3.848, P=0.006) and involvement of the intermuscular compartment ( HR=2.500, P=0.045) were associated with distant metastasis. Conclusion:For patients with thigh soft tissue sarcoma involving femoral cortex involvement but no medullary cavity invasion, bone resection did not improve survival, recurrence or metastasis compared with patients in non-resection group. A relatively more conservative surgical approach may be advisable to preserve limb function without compromising oncological prognosis.

Colony-stimulating factor-1 receptor (CSF1R)-related leukoencephalopathy (CSF1R-L) is a rare autosomal dominant neurodegenerative disorder caused by mutations in the CSF1R gene. It is typically characterized by rapidly progressive cognitive decline, motor dysfunction, and psychiatric or behavioral abnormalities, leading to significant disability and early mortality. More than 100 mutations of CSF1R have been identified in CSF1R-L, but the clinical-genotype relationship is unclear. This report describes a case of CSF1R-L that initially presented with atypical symptoms of left lower limb pain, numbness, and weakness. Despite the non-specific presentation, comprehensive imaging data were available throughout the disease course. Genetic testing identified a heterozygous missense mutation in exon 18 of the CSF1R gene (c.2508CA, p.Ser836Arg), a novel variant not previously reported in the literature. This case offers valuable insights into the dynamic progression of cranial MRI changes in CSF1R-L, broadens the genetic spectrum of this disease, enhances awareness among clinicians, and provides crucial information for the early diagnosis of this condition.

Comfortable diagnosis and treatment aims to ensure that patients can receive medical exami-nations and treatments safely and comfortably.The traditional anesthesia plan often relies on opioid,but the latter is prone to cause risks such as respiratory depression,hypotension,and hypoxemia.Opioid-free anesthe-sia(OFA),as a multimodal strategy,significantly reduces opioid-related adverse reactions by combining non-opioid drugs(such as esketamine,dexmedetomidine,lidocaine)and techniques(such as surface anesthesia,re-gional block).This article systematically reviews the application progress of OFA in comfortable diagnosis and treatment such as painless gastroscopy and colonoscopy,endoscopic retrograde cholangiopancreatography,bronchoscopy and induced abortion.

Objective : To establish an interleukin-1β (Il-1β) induced inflammatory model of rat articular chondro- cytes (ACs) , and to investigate the relationship between the expression of lysine acetyltransferase 7 (KAT7) under inflammatory stimulation and the senescence of ACs. Methods: Primary ACs were obtained by digestion of rat knee cartilage with collagenase type Ⅱ and identified. The inflammatory model of ACs was induced by IL-1β . KAT7 was over-expressed or knocked down in ACs by adeno-associated virus infection or small interfering RNA transfection , respectively. A negative control group was set up. Transwell assay was used to detect cell migration ability. Senes- cent cells were stained with senescence-associated β-galactosidase (SA-β-Gal) . Western blot ( WB) was used to detect the protein expression levels of KAT7 , collagen type II (Col Ⅱ ) , matrix metalloproteinase 13 (MMP13) , tumor protein p53 (p53) and cyclin-dependent kinase inhibitor 1A (p21) . The cells of negative control group and KAT7 over-expression group were performed for RNA sequencing , and WB was used to verify the related signaling pathways obtained by Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis. Results: Compared with the control group , the SA-β-Gal staining was enhanced , the protein expression of Col Ⅱ decreased , the pro- tein expression of MMP13 and p53 increased , the cell migration ability decreased , and the expression of KAT7 also increased in the ACs of rats after IL-1β stimulation. Compared with the negative control group , the SA-β-Gal stai- ning was enhanced , the protein expression of Col Ⅱ decreased , the protein expression of MMP13 , p53 and p21 in- creased , and the cell migration ability decreased in the KAT7 over-expression group. Compared with the negative control group , the SA-β-Gal staining was weakened , the protein expression of Col Ⅱ increased , the protein expres- sion of MMP13 , p53 and p21 decreased , and the cell migration ability was enhanced in the KAT7 knockdown inflammatory model of ACs. KEGG enrichment analysis showed that phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway was activated. Compared with the negative control group , the relative protein ex⁃pression levels of phosphorylated protein kinase B (p⁃AKT)/AKT and phosphorylated mammalian target of rapamy⁃cin (p⁃mTOR)/mTOR in KAT7 over⁃expression group increased. The relative protein expression levels of p ⁃AKT/AKT and p ⁃mTOR/mTOR in KAT7 knockdown cells decreased. Conclusion Rat ACs with high expression of KAT7 exhibit senescence and osteoarthritis phenotype , and the mechanism may be related to the activation of PI3K/AKT/mTOR signaling pathway by KAT7.

Objective To explore the shared mechanisms of genes related to three common chronic diseases non-alcoholic fatty liver disease(NAFLD),type 2 diabetes mellitus(T2DM)and atherosclerosis(AS)with ageing as well as potential therapeutic agents by using bioinformatics analysis,machine learning algorithms and molecular docking methods and techniques.Methods Ageing-related genes were collected and organized from AgeingAtlas,CellAge,GenAge,and MSigDB databases.After taking the intersection of genes related to NAFLD,T2DM and AS obtained from databases such as CTD,DisGeNET,GeneCards,OMIM,PharmGKB,and TTD and the gene sets obtained based on the GEO differential gene analysis,we obtained the set of related disease genes for these three common chronic diseases.The KEGG pathway enrichment analysis was performed on the ageing gene set and the three disease-related gene sets using the clusterProfiler package,and the intersection was taken.The enriched genes in the KEGG pathway were merged and imported into the STRING database;the PPI network was constructed.We analyzed the core sub-modules in the PPI network using the MCODE tool and calculated the essential values of Nim and Cim for each node and module.Meanwhile,three machine learning models were used to screen the feature genes:the Lasso regression model,the Boruta algorithm,and the random forest model.The HIT2.0 database was utilized to find the targeted TCM small molecules related to the key feature genes.Small molecules were evaluated and analyzed by ADMET using SwissADME and ADMETlab 3.0 online system.The molecular docking method was utilized to dock the key action targets and screen small molecules.Results A total of 1 325,616,78,and 597 genes related to ageing,NAFLD,T2DM,and AS were obtained.The KEGG pathway enrichment analysis results for ageing and the three diseases were taken to intersect to get two shared intersecting pathways containing 243 genes.The PPI network was constructed,and Cluster 2 had the highest Cim value among the three core submodules.According to the results of signature gene screening,combined with PPI network module analysis results,four signature genes related to ageing were found:CDK6,CDKN1A,MYC,and PTEN.These four targets have 94 potential TCM small molecule candidates,among which resveratrol(RSV)is a TCM small molecule common to these four targets.The ADMET evaluation showed that it had good drug-forming properties.The PTEN target had a high Nim value,and molecular docking of RSV with PTEN showed good binding stability.Conclusion A potential herbal small molecule,RSV,was identified from the perspective of ageing,which may prevent and treat three common chronic diseases,namely,NAFLD,T2DM and AS,by regulating the key gene PTEN.

Background and purpose:Human papilloma virus(HPV)infection status is crucial for diagnosing cervical precancerous lesions and classifying cervical cancer.High-risk(HR)HPV is often linked to P16 protein overexpression,so P16 detection via immunohistochemistry(IHC)is commonly used to assess HPV infection.However,the differences between HPV status and P16 expression remains unclear.An in-depth study of the correlation between HPV and P16 is essential for clinical guidance.Methods:We retrospectively collected clinical and pathological data of cervical lesions from 618 patients diagnosed at the Department of Pathology,Fudan University Shanghai Cancer Center from January 2020 to December 2023(Ethical number:050432-4-2307E).Polymerase chain reaction(PCR)reverse dot hybridization was used to detect HPV including HR and low-risk(LR)subtypes,and immunohistochemistry was used to detect P16 for comparative analysis.Based on different clinical and pathological diagnoses,the sensitivity and specificity of P16 expression in evaluating HPV infection were evaluated.Among the 618 cases of cervical lesions,there were 92 cases of cervical squamous cell carcinoma,257 cases of cervical adenocarcinoma,79 cases of high-grade squamous intraepithelial lesions(HSIL),105 cases of low-grade squamous intraepithelial lesions(LSIL),and 85 cases of chronic cervical inflammation.Results:According to clinical diagnosis,the HR-HPV positive rate in cervical squamous cell carcinoma was 88.0%(81/92),the P16 positive rate was 91.3%(84/92),and the overall consistency rate between P16 and HPV detection was 90.2%(88/92);for HR-HPV infection,the sensitivity and specificity of P16 were 96.3%and 45.5%.The positive rate of HR-HPV in adenocarcinoma was 54.5%(140/257),the positive rate of P16 was 58.8%(151/257),and the overall consistency rate between P16 and HPV detection was 82.5%(212/257);for HR-HPV infection,the sensitivity and specificity of P16 were 87.9%and 76.1%.In HSIL,the HR-HPV positive rate was 75.9%(60/79),the positive rate of P16 was 70.9%(56/79),and the overall consistency rate between P16 and HR-HPV detection was 82.2%(65/79);for HR-HPV infection,the sensitivity and specificity of P16 were 85.0%and 73.7%.In LSIL,the HR-HPV positive rate was 73.3%(77/105),the positive rate of P16 was 8.5%(9/105),and the overall consistency rate between P16 and HR-HPV detection was 33.3%(35/105);for HR-HPV infection,the sensitivity and specificity of P16 were 10.4%and 96.4%.In chronic cervical inflammation,the HR-HPV positive rate was 20%(17/85),the positive rate of P16 was 0.0%(0/85);for HR-HPV infection,the sensitivity and specificity of P16 were 0.0%and 100.0%.There was a significant positive correlation between P16 positivity and HPV16/18 in cervical squamous cell carcinoma,adenocarcinoma,and HSIL(P=0.000),while there was no significant correlation in LSIL and chronic cervical inflammation(P＞0.05).Conclusion:In cervical squamous cell carcinoma and adenocarcinoma,the consistency of P16 expression and HPV DNA positivity are high,especially in HPV16/18 subtype.There is a good concordance between HR-HPV positivity and P16 protein overexpression.The positive expression of P16 in HSIL may initially reflect HPV infection status.However,in LSIL and chronic cervicitis,P16 expression may not accurately correlate with HPV infection.The inconsistency between P16 and HPV DNA testing could be influenced by multiple factors,including HPV subtypes,histopathological categories,specimen quality,and technical limitations.In clinical practice,it is recommended to conduct comprehensive analysis or employ multiple diagnostic methods to confirm HPV infection status for precise evaluation.

Objective To observe changes in the lactate(Lac)receptor,G protein-coupled receptor 81(GPR81),and apoptosis after hypoxic ischemic brain injury in newborn piglets,and to clarify the mechanism of Lac/GPR81 signal pathway on the cell apoptosis through the intervention of Lac.Methods Thirty newborn piglets were selected.A total of 21 newborn piglets were randomly divided into Sham and hypoxia-ischemia(HI)model groups,and the HI model group was subdivided into 0-2 h,2-6 h,6-12 h,12-24 h,24-48 h,and 48-72 h HI groups,with n=3 each group.Changes in GPR81 expression and apoptosis in the basal ganglia after HI injury were observed using immunohistochemical and TUNEL staining.Nine newborn piglets were randomly divided into Sham+normal saline(NS),HI+NS,and HI+Lac groups,with n=3 each group.The effects of Lac on the expression of GPR81,apoptotic cell percentage,and the expressions of PI3K,AKT,Bcl-2,and Bax in the basal ganglia after HI injury were observed.Results The cell apoptosis rate increased gradually after HI injury and peaked at 24-48 h(P＜0.05).After HI injury,GPR81 expression initially increased and then decreased,peaking at 2-6 h(P＜0.05).The cell apoptosis rate and the expressions of Bax were higher and p-AKT/AKT ratio and the expressions of PI3K and Bcl-2 were lower in the HI+NS group compared with the Sham+NS group(all P＜0.05).The cell apoptosis rate and the expressions of Bax were lower and p-AKT/AKT ratio and the expressions of GPR81,P13K,and Bcl-2 were higher in the HI+Lac group compared with the HI+NS group(all P＜0.05).Conclusion After HI injury,exogenous Lac can inhibit cell apoptosis through activation of the PI3K/AKT signaling pathway mediated by GPR81.

Objective To observe the pharmacokinetics and pharmacodynamics of doxorubicin hydrochloride liposomes combined with iodized oil in hepatic artery embolization of rabbit VX2 liver cancer.Methods Doxorubicin hydrochloride liposomes-lipiodol suspension were prepared at ratios of 1∶1,1∶2 and 2∶1,respectively,and the delamination time of each suspension was observed.Twenty New Zealand white rabbits were randomly divided into group A—D(each n=5).Doxorubicin hydrochloride liposomes-iodized oil emulsion was injected into group A,while doxorubicin hydrochloride-iodized oil emulsion was injected into group B for embolization of hepatic artery.Hepatic artery infusion was performed in group C with doxorubicin hydrochloride liposomes,while in group D with doxorubicin hydrochloride.The blood drug concentrations 1,4,8,12,16,20 and 24 h after treatments were compared among 4 groups.Another 20 healthy New Zealand white rabbits were modeling,and the rabbit models of VX2 liver cancer were randomly divided into experimental group and control group(each n=10).Doxorubicin hydrochloride liposomes-iodized oil emulsion was used in experimental group,while doxorubicin-iodized oil emulsion was used in control group for embolization of hepatic artery.The therapeutic effect was evaluated according to modified response evaluation criteria in solid tumors(mRECIST),and the objective response rate(ORR)and disease control rate(DCR)were recorded.Results Doxorubicin hydrochloride liposomes-lipiodol suspension with different proportions were all stratified within 1 min.Pharmacokinetic experiment showed that the blood drug concentration of group A and C were similar at each time point after treatment,and both higher than that in group B and D.Pharmacodynamics experiments showed that ORR and DCR in experimental group was 50.00%(5/10)and 90.00%(9/10),respectively,while in control group was 40.00%(4/10)and 80.00%(8/10),respectively.Conclusion Blood drug concentrations of doxorubicin hydrochloride were similar at each time point after hepatic artery embolization or hepatic artery infusion.Doxorubicin hydrochloride liposomes-iodized oil suspension had the same effect of doxorubicin-lipiodol emulsion for hepatic artery embolization of rabbit VX2 liver cancer.

Objective:To investigate the prognostic effect of femoral resection on patients with soft tissue sarcoma of the thigh with cortical bone involvement.Methods:This retrospective study included patients with soft tissue sarcoma of the thigh diagnosed and treated in the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to December 2021. Patients were divided into two groups based on whether femoral resection and reconstruction were performed with 20 in the resection group and 86 in the non-resection group. Propensity score matching (PSM) was used to control confounding variables. Overall Survival, recurrence free survival, metastasis free survival, and postoperative functional outcomes were compared between groups before and after PSM. Cox proportional hazards regression was used to identify risk factors for death, recurrence, and metastasis.Results:Before PSM, the 5-year overall survival (OS) and recurrence-free survival (RFS) rates were 46.7% and 36.7% in the resection group, compared to 69.7% and 60.3% in the non-resection group without significant differences ( P>0.05). However, the 5-year metastasis-free survival (MFS) rate was significantly lower in the resection group (40.0%) compared to the non-resection group (73.1%) ( P=0.021). After PSM, the 5-year OS, RFS, and MFS in the resection group were 46.7%, 36.7%, and 35.9%, respectively, compared to 45.0%, 39.4%, and 67.7% in the non-resection group, with no significant differences ( P>0.05). The median postoperative MSTS functional score after PSM was significantly lower in the resection group 23(18, 25) points than in the non-resection group 26.5(24.3, 27.8) points ( U=43.000, P=0.007). Multivariate Cox regression analysis identified grade III histology ( HR=3.794, P=0.002) and tumor involvement angle around the femur greater than 180° ( HR=2.729, P=0.030) as independent risk factors for death. Age over 55 years ( HR=4.185, P=0.015), tumor diameter greater than 8 cm ( HR=4.290, P=0.014), and involvement of the intermuscular compartment ( HR=3.794, P=0.017) were associated with increased risk of local recurrence. Grade III histology ( HR=3.848, P=0.006) and involvement of the intermuscular compartment ( HR=2.500, P=0.045) were associated with distant metastasis. Conclusion:For patients with thigh soft tissue sarcoma involving femoral cortex involvement but no medullary cavity invasion, bone resection did not improve survival, recurrence or metastasis compared with patients in non-resection group. A relatively more conservative surgical approach may be advisable to preserve limb function without compromising oncological prognosis.