Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

FLASH radiotherapy (FLASH-RT) has garnered considerable attention globally in recent years. Compared to conventional radiotherapy, FLASH-RT can deliver the total radiation dose to the target volume in an extremely short time, reducing the radiation-induced damage to normal tissue while maintaining similar anti-tumor effects. FLASH-RT has been in the clinical trial stage, with several clinical research result being reported. Based on the collected global clinical research result of FLASH-RT in recent years, this study systematically reviewed FLASH-RT′s safety, radiation-related side effects, treatment efficacy, opportunities, and challenges in clinical trials.

Objective·To assess the accuracy and time of the two-in-one registration technique by comparing it with the U-shaped tube registration in dynamic navigation implantation.Methods·Thirty standardized 3D-printed models with mandibular posterior sites missing a single tooth were randomly divided into three groups:two-in-one registration group,U-shaped tube registration group and free-hand implantation group,and the implant surgical plan was designed by the"YIZHIMEI"DCARER oral implant surgery navigation system.Cone beam CT before and after operation was taken.The implant platform deviation,implant apex deviation and angular deviation of the actual implant positions and the designed implant positions were measured.The operating time for using two-in-one registration technique and the U-shaped tube registration technique was recorded to evaluate the complexity of the two registration techniques.The one-way ANOVA and SNK(Student-Newman-Keuls)test were used to analyze the implant platform deviation,implant apex deviation and angular deviation of each group.Results·There were no statistically significant differences in implant platform deviation,implant apex deviation and angular deviation between the two-in-one registration group and the U-shaped tube registration group(P>0.05).However,the implant platform deviation,implant apex deviation and angular deviation of the two-in-one registration group and the U-shaped tube group were lower than those in the free-hand implantation group,and the differences were statistically significant(P<0.001).The operating time required for the two-in-one registration was shorter than that for the U-shaped tube registration process,and the difference was statistically significant(P<0.001).Conclusion·The accuracy of the two-in-one dynamic navigation registration technique used in implanting on a model of mandibular posterior sites missing a single tooth is similar to that of the U-shaped tube dynamic navigation registration technique.But the two-in-one registration takes less time for registration procedure than the U-shaped tube registration,and is easier to operate.

Objective:To investigate the difference and relationship between synaptophysin, vimentin in positive or negative schizophrenia.Methods:Fifty-nine patients with schizophrenia mainly presented positive syndrome(positive case group), 41 patients with schizophrenia mainly presented negative syndrome(negative case group), 100 individuals without schizophrenia were enrolled.Patients with schizophrenia were assessed with positive and negative symptom scale (PANSS), then the patients were divided into positive symptom group (positive group, n=59) and negative symptom group (negative group, n=41). The serum levels of synaptophysin and vimentin were measured by enzyme-linked immunosorbent assay (Elisa). The levels of serum synaptophysin and vimentin were compared among the groups by independent t test.The correlation between positive and negative symptoms and serum levels of synaptophysin and vimentin were analyzed by Pearson correlation analysis. Results:In the positive case group: the synaptophysin level after treatment ((80.34±9.94)μg/L)was significantly lower than that before treatment ((102.89±12.03)μg/L). The vimentin level after treatment ((10.81±1.98)μg/L)was significantly lower than that before treatment((13.96±2.10)μg/L). The differences were statistically significant(both P<0.01). In the negative case group: the synaptophysin level after treatment ((80.42±10.61)μg/L) was significantly lower than that before treatment((102.98±11.04)μg/L). The vimentin level after treatment ((11.18±1.74)μg/L)was significantly lower than that before treatment((14.14±1.82)μg/L). The differences were statistically significant(both P<0.01). The synaptophysin levels in the positive case group and the negative case group were significantly higher than those in the control group((64.29±11.26)μg/L). The vimentin levels in the positive case group and the negative case group were significantly higher than those in the control group((8.33±1.62)μg/L). The differences were statistically significant(all P<0.01). The PANSS score of the positive and negative case group were significantly decreased after treatment compared with before treatment, the differences were statistically significant( P<0.05). Pearson correlation analysis suggested that synaptophysin was positively correlated with positive scale score in positive case group( r=0.650, P<0.01). Vimentin was positively correlated with negative scale score in negative case group( r=0.629, P<0.01). Conclusion:There may be different pathological mechanisms in schizophrenia with positive and negative symptoms.

Objective: To investigate the role and molecular mechanism of miR-520d in reversing the chemoresistance of triple negative breast cancer (TNBC) by regulating autophagy. Methods: Docetaxel (Doc) resistant cell lines MDA-MB-231/Doc and MDA-MB468/Doc were constructed by using human TNBC cell lines MDA-MB-231 and MDA-MB-468 as parental cells, and the cells were divided into blank group (parental cells), control group (drug-resistant group), and miR-520d over-expression group. The expression levels of miR-520d in cells of the blank and drug-resistant groups were detected by qPCR. The Doc-sensitivity of resistant cells over-expressing miR-520d was detected by MTT assay.After MDC staining, the generation of autophagosome in cells was observed under fluorescence microscopy; the number of miR-520d over-expressed resistant cells with positive LC3 expression was observed under confocal microscopy. The luciferase reporter gene assay was used to verify the targeting relationship between miR-520d and Beclin1. The effect of miR-520d mimics on the expression of autophagy-associated protein Beclin1, and LC3Ⅰ, LC3Ⅱ in cells was detected by WB assay. Results: The results of qPCR showed that the expression of miR-520d in the drug-resistant TNBC cells was significantly lower than that of normal cells (P<0.01). In drug-resistant cells over-expressing miR-520d, the Doc-sensitivity was significantly improved, while the autophagy activity was significantly reduced (all P<0.01).At the same time, luciferase experiments demonstrated that Beclin1 was a possible target molecule of miR-520d (P<0.05). WB results showed that the combination of docetaxel and miR-520d mimics reduced the LC3-II/I ratio and the expression of autophagy protein Beclin1 in drug-resistant TNBC cells (all P<0.05). Conclusion: The regulation of miR-520d levels may alter the expression of autophagy protein Beclin1, thereby reversing Doc chemotherapy resistance in TNBC cells.

Objective To explore the long-term clinical effect of kidney transplantation in children.Methods The clinical data of 53 children with kidney transplantation from March 2008 to September 2014 were retrospectively analyzed.The influence of the dependent factors on the estimated glomerular filtration rate (eGFR) (greater than 90 mL/min/1.73 m2 or ＜90 mL/min/1.73 m2) was estimated in the three years after the operation,and the influencing factors were analyzed by the dual logistic regression equation.Results There were 19 cases of living donors,17 cases of organ donors after death,and 6 others.The 53 patients were followed up for 3-9 years.The level of blood creatinine was decreased from the preoperative (820.1 ± 323.1) μmol/L to (51.6 ± 24.9) μmol/L 3 years after the operation (P＜0.05).eGFR was increased to (103.5 ± 11.4) mL/min/1.73 m2at 3rd year after the operation from the preoperative (17.1 ± 7.8) mL/min/1.73 m2 (P＜0.05).The age of recipients,preoperative dialysis time,number of HLA mismatching and postoperative delayed graft function healing (DGF),rejection and infection were the influencing factors of eGFR at 3rd year postoperation (P＜0.05).The multi-factor binary logistic regression equation analysis showed that only rejection was the risk factor for eGFR at 3rd year p0ostoperation.Eight cases of DGF (8/53,15.1％) recovered rapidly.There were 6 cases of acute rejection (6/47,12.8 ％) and 1 case of chronic rejection (1/47,2.1％).There were 9 cases of infection (9/47,19.1％).There were 6 cases of recurrence after surgery.The 3-year recipient and kidney survival rate was 94.3％ (50/53) and 88.7％ (47/53) respectively.The average height of the patients in the first,second and third year after the surgery was increased by (4.6 ± 1.9) cm (0.5-19.1 cm),(3.7 ± 1.8) cm (0.7-14.3 cm) and (2.8± 1.2) cm (0.3-8.7 cm) respectively.Conclusion The long-term effect of children kidney transplantation is satisfactory.

Objective To evaluate the clinical efficacy of en-bloc kidney transplantation from pediatric organ donation after death. Methods Clinical data of donors and recipients undergoing en-bloc kidney transplantation from pediatric donor kidneys were retrospectively analyzed. The 1-year survival rates of the recipient and grafted kidney were calculated. The recovery of renal function at postoperative 1 year was observed. The changes in the length of grafted kidney and incidence of postoperative adverse events were monitored. Results The 1-year survival rate of the recipients was 8/9, and 72% for the grafted kidney. During 1-year follow-up, the serum creatinine (Scr) level was down-regulated from (747± 170) μmol/L before transplantation to (83±27) μmol/L post-transplantation, the blood urea nitrogen concentration was decreased from (24.5±4.9) mmol/L to (6.8±2.0) mmol/L, and the length of transplanted kidney was increased from (61.1±9.8) mm to (100.3±1.7) mm. Two recipients suffered from delayed graft function(DGF) and restored after hemodialysis. Two cases developed acute rejection and healed after methylprednisolone shock therapy. One recipient presented with lung fungal infection at postoperative 2 weeks after transplantation, and was treated by the withdrawal of immunosuppressive agents and antibacterial treatment with poor clinical efficacy. Then the recipient died at 3rd month. One case had renal arterial thrombosis at postoperative 7 d, underwent nephrectomy at postoperative 10 d and returned to hemodialysis. At postoperative 1st month, one recipient suffered from thrombosis of unilateral renal artery. The grafted kidney in other side normally functioned and significantly grew in size at postoperative 6 months. In addition, two cases had ureterostenosis of the transplanted kidney, albuminuria in 2, abdominal aortic stenosis in 1 and urinary fistula in 1. All these symptoms were cured or alleviated after corresponding treatment. Conclusions The incidence of perioperative complications is relatively high in en-bloc kidney transplantation from pediatric organ donation after death, whereas the clinical efficacy of such kidney transplantation can be gradually increased along with the accumulation of clinical experience.

Objective To evaluate clinical efficacy and safety of loratadine combined with desloratadine in the treatment of chronic spontaneous urticaria(CSU)in children. Methods A total of 177 children with CSU were enrolled into this study, and randomly and equally divided into 3 groups:combination group treated with an age?based dose of desloratadine tablet every morning and a weight?based dose of loratadine tablet before sleep every night for consecutive 28 days, loratadine group treated with a half tablet of placebo(starch tablet)every morning and oral loratadine tablet before sleep every night for consecutive 28 days, and desloratadine group treated with a half tablet of placebo (starch tablet) every morning and oral desloratadine tablet before sleep every night for 28 consecutive days. Possible adverse reactions were observed and recorded after the start of treatment, and therapeutic effects were evaluated at the end of treatment. Results A total of 166 patients completed the trial, including 55 in the combination group, 56 in the loratadine group and 55 in the desloratadine group. After 28?day treatment, the total response rate was significantly higher in the combination group(90.9%, 50/55)than in the loratadine group (71.4%[40/56],χ2=6.865, P<0.05)and desloratadine group(74.5%[41/55],χ2=5.153, P<0.05). No significant difference in the incidence of adverse reactions was observed among the combination group (10.9%[6/55]), loratadine group (8.9%[5/56]) and desloratadine group (9.1%[5/55], P > 0.05). Conclusion Combination of loratadine and desloratadine was superior to loratadine or desloratadine alone in the treatment of childhood CSU, and there was no significant difference in the incidence of adverse reactions among the 3 treatment groups.

BACKGROUND:Shengjiyuhong ointment has been reported to inhibit hypertrophic scarring. OBJECTIVE:To verify the effects of Shengjiyuhong ointment on hypertrophic scarring of in a rabbit ear model. METHODS:Each ear of thirty-six Japanese rabbits was used to make four 1-cm-diameter circular ful-thickness skin wounds with the entire perichondrium removed. Final y, 288 wounds were made and randomly divided into 6 groups:model, negative control (no drugs were administered), low-, moderate-, high-crude herbal dose drugs (Shengjiyuhong ointment was administered topical y at concentrations of 8.39%, 25.18%, and 75.54%), and positive control (recombinant bovine basic fibroblast growth factor was administered topical y). Shengjiyuhong ointment was administered twice daily til wound healing. The wounds were evaluated by the Vancouver scar scale (VSS). Scar elevation index (SEI) of scar specimens was calculated under a microscope at 40× magnification. mRNA expression levels of type I and III col agen, connective tissue growth factor, fibronectin, andα-smooth muscle actin (α-SMA) were determined by fluorescent quantitative PCR. Protein expression levels of type I and III col agen andα-SMA were detected by western blot assay.α-SMA immunoreactivity was determined by immunofluorescent staining. RESULTS AND CONCLUSION:VSS scores and SEI were significantly increased in each group at 30 days (P<0.05). VSS scores and SEI were significantly decreased in the moderate-and high-crude herbal dose drug groups and positive control groups compared with the model, negative control, and low-crude herbal dose drug groups (P<0.05 or P<0.01). mRNA expression levels of type I and III col agen, connective tissue growth factor and fibronectin, and protein expression levels of type I and III col agen andα-SMA were significantly inhibited after moderate-crude herbal dose Shengjiyuhong ointment and positive drug treatment (P<0.01). These findings suggest that Shengjiyuhong ointment can reduce hypertrophic scars by inhibiting fibroblast proliferation and col agen deposition.

Objective To investigate the animal model of acute lung injury (ALI) induced by caudal vein injection of trypsin in rats and to evaluate the model.Methods The model of lung injury was established by caudal vein injection of trypsin in rats.The rats were killed at the time point of 3 h,6 h,12 h,24 h,and 24 h and then the pathological changes of structure of lungs,peripheral blood neutrophil count,arterial blood gas analysis and lung wet/dry (W/D) weight ratio in rats were measured and observed.Results The results of hematoxylin eosin (HE) staining showed that there was no obvious pathological changes in lung tissues of the control group,while alveolar and pulmonary septal edema,thickening,and a large number of inflammatory cells infiltration in the lung tissues of the model group.Compared to the control group,the peripheral blood neutrophil counts,W/D and PaCO2 were significantly increased,PaO2 was significantly decreased (P ＜0.01).There was significant differences in the number of peripheral blood neutrophils,PaCO2,W/D and PaO2 between the model groups (P ＜ 0.01).Conclusions The rat model of ALI induced by trypsin can successfully simulate the lung damage caused by the release of a large number of trypsin when severe acute pancreatitis occurred.