Objective : To explore the influence of apical dense bone islands on tooth movement during orthodontic treatment and its complications, and to provide a reference for orthodontic clinical treatment. Methods : This study obtained approval from the hospital ethics committee. A retrospective analysis was conducted on 33 patients with apical dense bone islands who received full-mouth fixed orthodontic treatment in the Orthodontics Department of Huizhou Stomatological Hospital from 2018 to 2022. Cone-beam CT (CBCT) was used to determine the location, distribution, and wrapping severity of the apical dense bone islands before treatment. The number of loose teeth located in the apical dense bone islands and the degree of external apical root resorption in the apical area of teeth were analyzed before treatment, immediately after treatment, and 12 months after treatment. Results: There were 33 orthodontic patients (aged 11 to 42 years, with an average age of 16.7 years and a median age of 15 years) included in this study, including 12 males (36.4%) and 21 females (63.6%). All apical dense bone islands involved a single tooth located in the mandible, mainly in the premolar-molar area. No gender differences were present in the location of the dense bone islands (P>0.05). The apical dense bone islands were mildly wrapped in 23 cases (69.7%), moderately wrapped in 10 cases (30.3%), and severely wrapped in no cases. No difficulty in tooth movement or incomplete closure of extraction space was found in the apical dense bone islands with different degrees of wrapping during orthodontic treatment. For teeth located in apical dense bone islands, 1 patient (3.0%) had loose teeth before treatment, 6 patients (18.2%) had loose teeth after treatment, and 2 patients (6.1%) had loose teeth 12 months after treatment. The number of patients with grade I loose teeth increased after treatment and 12 months after treatment. There was a statistically significant difference in the number of loose teeth before and after treatment (P<0.05), no statistically significant difference in the number of loose teeth before treatment and 12 months after treatment (P>0.05), and no statistically significant difference in the number of loose teeth after treatment and 12 months after treatment (P>0.05). After treatment, apical dense bone islands showed mild resorption in 26 cases (78.8%), moderate resorption in 7 cases (21.2%), and severe resorption in no cases. The apical dense bone islands showed mild resorption in 25 cases (75.8%), moderate resorption in 8 cases (24.2%), and severe resorption in no cases 12 months after treatment. For the severity of root resorption, there was a statistically significant difference between before and after treatment (P<0.05) as well as between before treatment and 12 months after treatment (P<0.05). However, no statistically significant difference was observed between after treatment and 12 months after treatment (P>0.05). Conclusion Apical dense bone islands were not found to affect tooth movement during orthodontic treatment. After orthodontic treatment, the number of loose teeth increased and mild-to-moderate tooth external apical root resorption occurred, which may be a potential risk of external apical root resorption. Thus, it is recommended to pay close attention during the orthodontic process.

ObjectiveTo investigate the effect and mechanism of Dahuang Zhechongwan （DHZCW） on adenine-induced renal fibrosis in rats from the perspective of intestinal flora. MethodThirty-six SD rats were randomly divided into a blank group， a model group， and high-， medium- and low-dose DHZCW groups （0.168， 0.084， 0.042 g·kg^-1）， and a pirfenidone group （200 mg·kg^-1）， with 6 rats in each group. Except for those in the blank group， rats in other groups were treated with adenine suspension （250 mg·kg^-1） by gavage for 28 days for renal fibrosis model induction. Subsequently， they received drug intervention for 4 weeks. Urine samples were collected from rats in metabolic cages， and renal function indicators including blood urea nitrogen （BUN）， urea， creatinine （Crea）， cystatin C （Cys C）， and 24-hour urine protein （24 h TP） were measured. Kidney samples were collected and subjected to hematoxylin-eosin （HE） staining and Masson's trichrome staining to observe the pathological changes in rat renal tissues. Western blot was used to detect the expression levels of key effector proteins α-smooth muscle actin （α-SMA）， type Ⅰ collagen （ColⅠ）， and type Ⅲ collagen （ColⅢ） in the kidneys. High-throughput sequencing of 16S rDNA was used to analyze the species diversity of rat intestinal flora. ResultCompared with the blank group， the model group showed increased BUN， urea， Crea， Cys C， and 24 h TP levels （P<0.01）. Compared with the model group， the high-， medium-， and low-dose DHZCW groups， as well as the pirfenidone group， showed significant reductions in BUN， urea， Crea， Cys C， and 24 h TP levels （P<0.01）， indicating that DHZCW intervention significantly improved renal function. In the model group， renal tissues exhibited significant fibrotic changes， and the protein levels of α-SMA， ColⅠ， and ColⅢ were significantly increased （P<0.01） compared to those in the blank group. Compared with the model group， the high-dose DHZCW group and the pirfenidone group had relatively normal tissue structure， with no significant pathological damage observed. However， fibrotic changes were observed in the medium- and low-dose DHZCW groups， with the changes being more significant in the low-dose group. The protein levels of α-SMA， ColⅠ， and ColⅢ were significantly decreased in the high-， medium-， and low-dose DHZCW groups， as well as the pirfenidone group （P<0.01）， indicating that DHZCW effectively reduced abnormal collagen deposition and inhibited renal fibrosis. From the perspective of intestinal flora， at the phylum level， compared with the blank group， the model group showed a significant increase in the abundance of Firmicutes and a decrease in Bacteroidetes， leading to a significant imbalance in their ratio. At the family level， the model group decreased the abundance of Lachnospiraceae， Prevotellaceae， and Bacteroidota_unclassified， and increased the abundance of Ruminococcaceae， Lactobacillaceae， and Oscillospiraceae. At the genus level， the model group showed significantly reduced abundance of Firmicutes_unclassified， Bacteroidota_unclassified， and Prevotellaceae_UCG-001， etc.， and increased abundance of UCG-005， Clostridia_UCG-014_unclassified， etc. Compared with the model group， DHZCW effectively reduced the abundance of potential pathogenic bacteria and increased the abundance of beneficial bacteria， regulating the intestinal flora. ConclusionDHZCW can effectively improve renal function and inhibit renal fibrosis， and its mechanism of action may be related to the regulation of intestinal flora.

ObjectiveTraditional Chinese medicine， namely Dahuang Zhechongwan （DHZCW） was used to treat myocardial fibrosis in model rats， observe its effect on myocardial fibrosis in rats， and explore its action mechanism. MethodThirty-six SPF male Kunming rats were divided into blank group， model group， low-， medium-， high-dose groups of DHZCW （0.056， 0.084， 0.168 g·kg^-1）， captopril group （10 mg·kg^-1）， with six rats in each group. Except for the blank group， the other groups were intraperitoneally injected isoproterenol solution of 5 mg·kg^-1 for 15 consecutive days to replicate the myocardial fibrosis model. At the beginning of modeling， the rats in each group took drugs， and they were sacrificed 28 days after administration. Serum and heart tissue were collected for the corresponding detection. Hematoxylin-eosin （HE） staining and Masson staining were used to observe tissue inflammation， cellular degeneration， necrosis， and fibrosis. The contents of hydroxyproline （HYP）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， hyaluronic acid （HA）， laminin （LN）， type-Ⅲ procollagen （PC Ⅲ） in serum of rats and rats were determined by enzyme-related immunosorbent assay （ELISA）. The expression levels of key pathway proteins transforming growth factor-β₁ （TGF-β₁）， α-smooth muscle actin （α-SMA）， Smad2， Smad3， and Smad7 were detected by Western blot. The expression levels of key pathway genes TGF-β₁， α-SMA， Smad2， Smad3， Smad7， miR-29a-5p， miR-29b-2-5p， and miR-29c-5p were detected by Real-time quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the blank group， the pathological changes of fibrosis in the model group were obvious， the contents of serum HYP， TNF-α， IL-1β， IL-6， HA， LN， and PCⅢ were increased （P<0.01）， the protein expression levels of TGF-β₁， α-SMA， Smad2， and Smad3 were increased； the protein expression level of Smad7 was decreased （P<0.01）. The mRNA expression levels of TGF-β₁， α-SMA， Smad2， and Smad3 were increased （P<0.05， P<0.01）， while those of Smad7， miR-29a-5p， miR-29b-2-5p， and miR-29c-5p were decreased （P<0.01）. Compared with the model group， after 28 days of administration， serum HYP， TNF-α， IL-1β， IL-6， HA， LN， and PCⅢ in high-， medium-， and low-dose groups of DHZCW and captopril groups were decreased （P<0.01）. Except for the low-dose group， the protein contents of TGF-β₁， α-SMA， Smad2， and Smad3 were decreased， while the protein content of Smad7 was increased （P<0.01）. The mRNA expression levels of TGF-β₁， Smad2， α-SMA， and Smad3 in high-dose group of DHZCW were decreased （P<0.05，P<0.01）， while those of Smad7， miR-29a-5p， miR-29b-2-5p， and miR-29c-5p were increased （P<0.05）. The mRNA expressions of TGF-β₁， Smad2， and Smad3 in the medium-dose group of DHZCW were decreased （P<0.05， P<0.01）， while mRNA expression of Smad7 was increased （P<0.01）. The mRNA levels of TGF-β₁ and Smad2 in the low-dose group of DHZCW were decreased （P<0.01）. ConclusionDHZCW can improve myocardial fibrosis in rats， and its action mechanism may be related to the regulation of the TGF-β₁/Smads/miR-29 pathway. In addition， there is dose dependence in the range of 0.056-0.168 g·kg^-1， and the effect of the high-dose group is more stable.

Objective:To explore the clinical efficacy of microsurgical technique combined with cosmetic suture technique in situ replantation of total scalp avulsion.Methods:The clinical data of patients with total scalp avulsion admitted to the Department of Burn and Plastic Surgery of General Hospital of Northern Theatre Command from January 2015 to December 2020 were collected. All patients were treated by microsurgical technique combined with cosmetic suture technique. Thorough debridement was performed during the operation. Active anti-shock treatment was given to the patient with hemorrhagic shock. The vascular was explored and labeled. The vascular anastomosis was conducted by microsurgical technique. The venous anastomosis was performed in the first place. The arterial anastomosis was performed according to the patient's condition. Symptomatic treatment, such as routine anti-coagulation, was given to patients after the operation. An infection prevention strategy was performed in patients. The recovery of patients was observed.Results:A total of six patients were involved in this study. All patients were females, aged from 36 to 55 years old. Various degrees of wound contamination can be seen, and one patient with hemorrhagic shock. The superficial temporal vein, supraorbital vein and sentinel vein were anastomosed in two patients, and the superficial temporal vein and sentinel vein were anastomosed in four patients. The superficial temporal artery and supratrochlear artery were anastomosed in two patients, and the superficial temporal artery was anastomosed in four patients. All patients were followed up for 3 months to 2 years, averaging 13.71 months. More than 90% of the scalp survived in three patients, 80% in two patients, and 50% in one patient. The necrotic area survived after replantation of a split-thickness skin graft. The sensory function of surviving scalp after replantation was slightly regressed. The hair growth was normal. Only superficial linear scar left. All patients were satisfied with the efficacy.Conclusions:The application of the microsurgical technique for vascular anastomosis combined with cosmetic suture technique for repair can achieve good clinical efficacy in situ replantation of total scalp avulsion.

Objective:To explore the clinical efficacy of microsurgical technique combined with cosmetic suture technique in situ replantation of total scalp avulsion.Methods:The clinical data of patients with total scalp avulsion admitted to the Department of Burn and Plastic Surgery of General Hospital of Northern Theatre Command from January 2015 to December 2020 were collected. All patients were treated by microsurgical technique combined with cosmetic suture technique. Thorough debridement was performed during the operation. Active anti-shock treatment was given to the patient with hemorrhagic shock. The vascular was explored and labeled. The vascular anastomosis was conducted by microsurgical technique. The venous anastomosis was performed in the first place. The arterial anastomosis was performed according to the patient's condition. Symptomatic treatment, such as routine anti-coagulation, was given to patients after the operation. An infection prevention strategy was performed in patients. The recovery of patients was observed.Results:A total of six patients were involved in this study. All patients were females, aged from 36 to 55 years old. Various degrees of wound contamination can be seen, and one patient with hemorrhagic shock. The superficial temporal vein, supraorbital vein and sentinel vein were anastomosed in two patients, and the superficial temporal vein and sentinel vein were anastomosed in four patients. The superficial temporal artery and supratrochlear artery were anastomosed in two patients, and the superficial temporal artery was anastomosed in four patients. All patients were followed up for 3 months to 2 years, averaging 13.71 months. More than 90% of the scalp survived in three patients, 80% in two patients, and 50% in one patient. The necrotic area survived after replantation of a split-thickness skin graft. The sensory function of surviving scalp after replantation was slightly regressed. The hair growth was normal. Only superficial linear scar left. All patients were satisfied with the efficacy.Conclusions:The application of the microsurgical technique for vascular anastomosis combined with cosmetic suture technique for repair can achieve good clinical efficacy in situ replantation of total scalp avulsion.

Reports of tuberculosis (TB) outbreaks among schoolchildren have increased in recent years in countries across the Western Pacific Region. Cases from China, Japan, Mongolia and the Republic of Korea were studied to derive lessons from the challenges and responses to TB outbreaks in schools. Despite differences in the TB burden and outbreak preparedness, the four countries reported similar challenges. These included delayed diagnosis of index cases, lack of experienced health professionals and sustained financial support, and difficulty in responding to intensified media and community attention. Early detection of outbreaks, established resource mobilization networks, coordination among stakeholders and proactive communication were highlights of successful outbreak responses. These principles could be adapted to each context for responses to future TB outbreaks in schools.

Objective: To explore the application and effect of superficial temporal fascia flap combined with avulsion auricular tissue in emergency auricular restoration. Methods: From June 2015 to December 2015, 6 patients with auricular large area complete avulsion were underwent treatment in Department of Plastic Surgery of General Hospital of Shenyang Military. After thorough debridement, the auricular cartilage scaffold of the avlusion ear and skin was completely stripped. The auricular cartilage was repositioned on its anatomical site and subsequently covered by superficial temporal fascia flap. The free skin was stripped as full-thickness graft to cover the surface of reconstructed ear. Results: All 6 patients with auricle large area complete avulsion achieved immediate repair under emergency condition. The operations were successfully completed and the ears were healed primarily. The patients were followed-up for one year. Five patients with partial auricular avulsion achieved obvious reconstructed auricle profile. The color of reconstructed ear was close to the surrounding skin and the cranioauricular angle was nearly normal. Patients and their families were very satisfied. One patient of total auricular reconstruction had auricular contracture. The auricle profile was not obvious with small size, morphological changes and external auditory canal stenosis. Conclusions Avulsion auricle and temporal superficial fascia flap can be used to repair partial auricle defects as a first-stage repair with ideal results. It is the best choice for large auricle defects in emergency cases.

Objective To explore the reliability and validity of poly ether ether ketone (PEEK) rods and pedicle screw system for lumbar degenerative diseases.Methods Sixty-three patients,including 23 men and 40 women with the mean age of 56.2±5.1 years (range,35-75 years),treated by PEEK rods pedicle screw system from September 2012 to March 2013 were retrospectively recruited.Fusion procedure were performed in 10 patients,with 2 cases at L3,4,5 cases at L4,5,3 cases at L5S1; nonfusion procedure were performed in 17 patients,with 4 cases at L3,4,10 cases at L4,5,3 cases at L5S1; hybrid procedure were performed in 36 patients,with 22 case fusion at L4,5 and nonfusion at L3,4,with 2 cases fusion at L3,4 and nonfusion at L4,5,with 12 cases fusion at L5S1 and nonfusion at L4,5.Clinical effects were evaluated via Japanese Orthopedics Association (JOA) score and Oswestry disfunction index (ODI) at 3 months,6 months and 24 months postoperatively.Disc heights were measured by disc height index on lateral lumbar radiograph.Range of motion (ROM) was measured by extension-flexion lumbar X-ray.Three-dimensional CT reconstruction was achieved to observe the integrity of PEEK rods at the final follow-up.Results The mean follow-up were 23.4±3.3 months.The mean operation time were 110±17 min in the fusion group,98±22 min in the non-fusion group and 121±25 min in the hybrid group.The mean blood loss were 270±85 ml in the fusion group,255±72 ml in the non-fusion group and 316±80 ml in the hybrid group.The JOA score improved from 10.5±2.6 preoperatively to 24.0±3.1 at the final follow-up in the fusion group,from 10.3±2.2 to 24.3±3.4 in the non-fusion group and from 11.1±2.3 to 23.9±3.3 in the hybrid group (P＜0.05).The ODI decreased from 51.8％±10.3％ preoperatively to 14.1％±3.7％ at the final follow-up in the fusion group,from 52.2％±11.1％ to 13.2％±3.2％ in the non-fusion group and from 53.4％±9.2％ to 13.8％±2.5％ in the hybrid group.There was no significantly statistical difference in the disc height index at 3 months,6 months and 24 months postoperatively compared with that at preoperative.The ROM decreased from 8.8°±1.8° preoperatively to 2.2°±0.3° at the final follow-up (P＜0.05).One case demonstrated cage migration at one month follow-up,bony fusion in situ at 3 months follow-up,and the patient had no related symptoms during the follow-up.No screw loosening or breakage and rods breakage was observed during the follow-up.Conclusion PEEK rods and pedicle screw system for lumbar degenerative diseases by fusion,non-fusion and hybrid procedure can achieve considerable clinical outcome with low complication rate.

OBJECTIVE:To systematically review the efficacy and safety of Deproteinised calf blood serum injection in the treatment of cerebral infarction,and to provide evidence-based reference for clinical treatment.METHODS:Retrieved from Co-chrane Library,EMBase,Medline,CBM,CJFD,VIP and Wanfan database,randomized controlled trials(RCT)about theeffica-cy and safety ofDeproteinised calf blood serum injection(test group)based on basic treatment(control group)in the treatment of cerebral infarction were collected.Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality eval-uation with Cochrane system evaluation manual 5.1.0.RESULTS:A total of 18 RCTs were included,involving 2 111 patients.Re-sults of Meta-analysis showed the total effective rate [OR=3.30,95%CI(2.48,4.39),P<0.001],National Institutes of Health Stroke Scale (NIHSS) score[MD=-1.47,95%CI(-2.06,-0.88),P<0.001] and activities of daily living(ADL) score[MD=9.09,95%CI(6.46,11.72),P<0.001] in test group were significantly better than control group,there were significant differences be-tween the 2 groups;and there was no obvious adverse reactions during treatment. CONCLUSIONS:Both efficacy and safety of De-proteinised calf blood serum injectionin the treatment of cerebral infarction are good.