Objective To assess the marginal microleakage of specimens following aging simulation of adhesive restorations for dental defects using methacryloxylethyl cetyldimethyl ammonium chloride(DMAE-CB)and nanoparticles of amorphous calcium phosphate(NACP)binder.Methods DMAE-CB and NACP were synthesized in the laboratory.Eight groups were formed by varying the mass fraction ratios of the two components in the adhesive according to previous experiments,A:binder+3％DMAE-CB+25％NACP,B:binder+4％DMAE-CB+35％NACP,C:binder+1％DMAE-CB+15％NACP,D:binder+4％DMAE-CB+15％NACP,E:binder+1％DMAE-CB+35％NACP,F:binder+3％DMAE-CB,G:binder+25％NACP,H:SBMP binder as the control group.Forty human third molars were collected and randomly divided into 8 groups to prepare standardized Class Ⅱ preparations.Subsequent-ly,dental defect adhesive restoration specimens were made by using the 8 groups of binder,and aging simulation was performed through thermal cycling.After thermal cycling,the specimens were immersed in the dye solution.Each specimen was sectioned into 4 parts of dentin tissue slices along the gingival,proximal,and occlusal walls using a low-speed cutting machine,and the depth of dye penetration was observed under a stereomicroscope and recorded according to a unified standard for microleakage level.Finally,one randomly selected adhesive specimen from each of the 8 groups was subjected to gold sputtering and observed under scanning electron microscopy(SEM)to measure the gap width between the resin and dental tissue.Results Penetration staining showed that there were no statistically significant differences in the depth of marginal microleakage between the experimental and control groups on the gingival and occlusal walls(P＞0.05).However,there was a statistically significant difference in microleakage depth between the gingival and occlusal walls(P＜0.05).Scanning electron microscopy(SEM)results,after averaging particle size measurements,revealed no statistically significant differences in the gap width between the filling restorations and dental hard tissues between the experimental and con-trol groups(P＞0.05).Conclusion Dentin adhesives modified with DMAE-CB and NACP increase antibacterial and remineralization properties without affecting marginal microleakage in adhesive restorations,providing reliable theoretical support for their clinical appli-cation.

Objective:To explore the characteristics and evolutionary features of cognitive impairment and clinical transformation in early-stage Parkinson′s disease (PD) patients.Methods:Based on the cohort of patients with primary unmedicated PD admitted to the Parkinson′s Specialized Outpatient Clinic of Affiliated Brain Hospital of Nanjing Medical University from November 2018 to July 2022, follow-up was conducted for PD patients who completed the baseline assessment and had a follow-up time of 1.5 years or more, and a total of 87 patients finally completed the follow-up and were included in the study. At follow-up, the 87 patients were divided into a cognitively impaired group ( n=36) and a cognitively normal group ( n=51) according to the norm proposed by Professor Jia Jianping and colleagues in 2011 for the Chinese elderly population. Differences in baseline clinical characteristics between the 2 groups were compared, and binary Logistic regression analysis was used to explore risk factors for cognitive impairment in PD patients. In addition, transformed grouping according to cognitive assessment results at baseline and follow-up was used to compare differences in patients′ baseline clinical characteristics among the 3 groups: a reversal group [Parkinson′s disease-mild cognitive impairment (PD-MCI), reverting to Parkinson′s disease-cognitively normal (PD-CN); n=15], a non-reversal group (persistent PD-MCI; n=24), and a stable group (stable PD-CN; n=36). Results:Cognitive reversal occurred at follow-up in 36.6% (15/41) of patients with cognitive impairment at baseline, and 21.7% (10/46) of patients with normal cognition at baseline had cognitive impairment at follow-up. At the end of the follow-up, the 87 patients with PD had higher Unified Parkinson′s Disease Rating Scale Ⅱ (UPDRS-II) scores [8 (6, 11)], Unified Parkinson′s Disease Rating Scale Ⅲ (UPDRS-Ⅲ) scores [23 (16, 30)], and Hoehn-Yahr stages [2.0 (1.5, 2.5)] than those at baseline [7(4, 10), 19(14, 25), 1.5(1.0, 2.0)]. The differences were statistically significant ( Z=-2.498, P=0.012; Z=-3.039, P=0.002; Z=-4.436, P<0.001). The cognitively impaired group had lower Montreal Cognitive Assessment scores [22.00(19.00, 23.75)] and fewer years of education [9.00(8.00, 11.75) years] but higher Parkinson′s Disease Non-Motor Symptoms Questionnaire (PD-NMSQ) scores [8.00(5.25, 12.00)] than the cognitively normal group [25.00(24.00, 27.00), 12.00(9.00, 15.00) years, 6.00(3.00, 8.00)], and the differences were statistically significant ( Z=-4.764, P<0.001; Z=-3.016, P=0.003; Z=-3.281, P=0.001). Multivariate Logistic regression showed that years of education ( OR=0.829, 95%CI 0.715-0.960, P=0.012) and PD-NMSQ scores ( OR=1.200, 95%CI 1.040-1.384, P=0.012) were independent predictors of cognitive impairment in patients with PD. There were statistically significant differences among the reversal, non-reversal, and stable groups in years of education ( F=5.366, P=0.010), PD-NMSQ scores ( H=10.795, P=0.005), and UPDRS-Ⅱ scores ( H=6.957, P=0.031). Pairwise comparisons showed lower PD-NMSQ scores [4.00(3.00, 7.00) vs 8.00(6.25, 12.75); Z=-2.989, P=0.003] and lower UPDRS-Ⅱ scores [6.00(3.00, 6.00) vs 7.00(6.00, 10.00); Z=-2.756, P=0.006] in the reversal group than in the non-reversal group, indicating better baseline quality of life in cognitive reversal patients. Conclusions:Low educational level and severe non-motor symptoms were risk factors predicting cognitive impairment in PD patients. Conversely, mild non-motor symptoms with high quality of life (lower UPDRS-Ⅱ scores) were important factors for cognitive reversal.

Objective To comparatively analyze the friction wear performance,fracture resistance,and displacement resistance before and after aging of full crowns made from PEEK,cobalt-chromium alloy,and zirconia,providing a theoretical basis for the future application of PEEK in crown fabrication.Methods Standard anatomical full crowns of PEEK,cobalt-chromium alloy,and zirconia were fabricated by preparing the upper first premolar and taking silicone rubber impressions,resulting in 25 crowns of each material.The crowns were divided into three groups:Group A(15 crowns,5 from each material),Group B(30 crowns,10 from each materi-al),and Group C(30 crowns,10 from each material,serving as a control).Group A underwent 120 000 chewing simulations under simulated oral physiological conditions,using a stereomicroscope and Micro-image Analysis & Process system to assess and compare wear of antagonists(opposing talc ceramic balls)and material wear.Group B underwent 10 000 thermal cycling aging tests and Group C were served as the control.Universal testing machines were used to evaluate and compare the fracture resistance and displacement re-sistance of Groups B and C.Results ①The wear heights of full crown materials were as follows:cobalt-chromium alloy(0.61±0.05)mm,zirconia(0.81±0.07)mm,and PEEK(0.96±0.04)mm,with PEEK＞zirconia＞cobalt-chromium alloy(P＜0.05).For antagonist wear,the wear heights were cobalt-chromium alloy＞zirconia＞PEEK(P＜0.05).②The fracture resistance of cobalt-chromium alloy be-fore and after aging was(3 665.645±71.166)N and(2 906.830±225.143)N,respectively;for zirconia it was(2 447.825±316.961)N and(1 829.229±72.046)N;and for PEEK crowns it was(1 632.378±53.046)N and(1 074.872±105.491)N,showing cobalt-chromi-um alloy＞zirconia＞PEEK(P＜0.05).The displacement resistance for cobalt-chromium alloy before and after aging was(1 604.630±95.680)N and(1 092.137±77.869)N;for zirconia it was(1 768.851±56.273)N and(1 381.618±62.326)N;and for PEEK crowns it was(1 148.811±70.417)N and(931.723±64.454)N,indicating zirconia＞cobalt-chromium alloy＞PEEK(P＜0.05).The aging degradation of cobalt-chromium alloy's fracture and displacement re-sistance was(758.815±157.734)N and(512.492±34.530)N,re-spectively;for zirconia,it was(618.597±251.281)N and(387.233±7.947)N;and for PEEK crowns,it was(557.506±61.950)N and(217.089±14.589)N,with anti-aging performance:PEEK＞zirconia＞cobalt-chromium alloy(P＜0.05).Conclusion The wear re-sistance,fracture resistance,and displacement resistance of PEEK meet the clinical standards for full crown materials,and PEEK demonstrates good anti-aging performance while effectively protecting opposing teeth.Therefore,PEEK has the potential to become a novel material for full crown fabrication.

Objective To comparatively analyze the friction wear performance,fracture resistance,and displacement resistance before and after aging of full crowns made from PEEK,cobalt-chromium alloy,and zirconia,providing a theoretical basis for the future application of PEEK in crown fabrication.Methods Standard anatomical full crowns of PEEK,cobalt-chromium alloy,and zirconia were fabricated by preparing the upper first premolar and taking silicone rubber impressions,resulting in 25 crowns of each material.The crowns were divided into three groups:Group A(15 crowns,5 from each material),Group B(30 crowns,10 from each materi-al),and Group C(30 crowns,10 from each material,serving as a control).Group A underwent 120 000 chewing simulations under simulated oral physiological conditions,using a stereomicroscope and Micro-image Analysis & Process system to assess and compare wear of antagonists(opposing talc ceramic balls)and material wear.Group B underwent 10 000 thermal cycling aging tests and Group C were served as the control.Universal testing machines were used to evaluate and compare the fracture resistance and displacement re-sistance of Groups B and C.Results ①The wear heights of full crown materials were as follows:cobalt-chromium alloy(0.61±0.05)mm,zirconia(0.81±0.07)mm,and PEEK(0.96±0.04)mm,with PEEK＞zirconia＞cobalt-chromium alloy(P＜0.05).For antagonist wear,the wear heights were cobalt-chromium alloy＞zirconia＞PEEK(P＜0.05).②The fracture resistance of cobalt-chromium alloy be-fore and after aging was(3 665.645±71.166)N and(2 906.830±225.143)N,respectively;for zirconia it was(2 447.825±316.961)N and(1 829.229±72.046)N;and for PEEK crowns it was(1 632.378±53.046)N and(1 074.872±105.491)N,showing cobalt-chromi-um alloy＞zirconia＞PEEK(P＜0.05).The displacement resistance for cobalt-chromium alloy before and after aging was(1 604.630±95.680)N and(1 092.137±77.869)N;for zirconia it was(1 768.851±56.273)N and(1 381.618±62.326)N;and for PEEK crowns it was(1 148.811±70.417)N and(931.723±64.454)N,indicating zirconia＞cobalt-chromium alloy＞PEEK(P＜0.05).The aging degradation of cobalt-chromium alloy's fracture and displacement re-sistance was(758.815±157.734)N and(512.492±34.530)N,re-spectively;for zirconia,it was(618.597±251.281)N and(387.233±7.947)N;and for PEEK crowns,it was(557.506±61.950)N and(217.089±14.589)N,with anti-aging performance:PEEK＞zirconia＞cobalt-chromium alloy(P＜0.05).Conclusion The wear re-sistance,fracture resistance,and displacement resistance of PEEK meet the clinical standards for full crown materials,and PEEK demonstrates good anti-aging performance while effectively protecting opposing teeth.Therefore,PEEK has the potential to become a novel material for full crown fabrication.

Objective To assess the marginal microleakage of specimens following aging simulation of adhesive restorations for dental defects using methacryloxylethyl cetyldimethyl ammonium chloride(DMAE-CB)and nanoparticles of amorphous calcium phosphate(NACP)binder.Methods DMAE-CB and NACP were synthesized in the laboratory.Eight groups were formed by varying the mass fraction ratios of the two components in the adhesive according to previous experiments,A:binder+3％DMAE-CB+25％NACP,B:binder+4％DMAE-CB+35％NACP,C:binder+1％DMAE-CB+15％NACP,D:binder+4％DMAE-CB+15％NACP,E:binder+1％DMAE-CB+35％NACP,F:binder+3％DMAE-CB,G:binder+25％NACP,H:SBMP binder as the control group.Forty human third molars were collected and randomly divided into 8 groups to prepare standardized Class Ⅱ preparations.Subsequent-ly,dental defect adhesive restoration specimens were made by using the 8 groups of binder,and aging simulation was performed through thermal cycling.After thermal cycling,the specimens were immersed in the dye solution.Each specimen was sectioned into 4 parts of dentin tissue slices along the gingival,proximal,and occlusal walls using a low-speed cutting machine,and the depth of dye penetration was observed under a stereomicroscope and recorded according to a unified standard for microleakage level.Finally,one randomly selected adhesive specimen from each of the 8 groups was subjected to gold sputtering and observed under scanning electron microscopy(SEM)to measure the gap width between the resin and dental tissue.Results Penetration staining showed that there were no statistically significant differences in the depth of marginal microleakage between the experimental and control groups on the gingival and occlusal walls(P＞0.05).However,there was a statistically significant difference in microleakage depth between the gingival and occlusal walls(P＜0.05).Scanning electron microscopy(SEM)results,after averaging particle size measurements,revealed no statistically significant differences in the gap width between the filling restorations and dental hard tissues between the experimental and con-trol groups(P＞0.05).Conclusion Dentin adhesives modified with DMAE-CB and NACP increase antibacterial and remineralization properties without affecting marginal microleakage in adhesive restorations,providing reliable theoretical support for their clinical appli-cation.

Objective:To explore the characteristics and evolutionary features of cognitive impairment and clinical transformation in early-stage Parkinson′s disease (PD) patients.Methods:Based on the cohort of patients with primary unmedicated PD admitted to the Parkinson′s Specialized Outpatient Clinic of Affiliated Brain Hospital of Nanjing Medical University from November 2018 to July 2022, follow-up was conducted for PD patients who completed the baseline assessment and had a follow-up time of 1.5 years or more, and a total of 87 patients finally completed the follow-up and were included in the study. At follow-up, the 87 patients were divided into a cognitively impaired group ( n=36) and a cognitively normal group ( n=51) according to the norm proposed by Professor Jia Jianping and colleagues in 2011 for the Chinese elderly population. Differences in baseline clinical characteristics between the 2 groups were compared, and binary Logistic regression analysis was used to explore risk factors for cognitive impairment in PD patients. In addition, transformed grouping according to cognitive assessment results at baseline and follow-up was used to compare differences in patients′ baseline clinical characteristics among the 3 groups: a reversal group [Parkinson′s disease-mild cognitive impairment (PD-MCI), reverting to Parkinson′s disease-cognitively normal (PD-CN); n=15], a non-reversal group (persistent PD-MCI; n=24), and a stable group (stable PD-CN; n=36). Results:Cognitive reversal occurred at follow-up in 36.6% (15/41) of patients with cognitive impairment at baseline, and 21.7% (10/46) of patients with normal cognition at baseline had cognitive impairment at follow-up. At the end of the follow-up, the 87 patients with PD had higher Unified Parkinson′s Disease Rating Scale Ⅱ (UPDRS-II) scores [8 (6, 11)], Unified Parkinson′s Disease Rating Scale Ⅲ (UPDRS-Ⅲ) scores [23 (16, 30)], and Hoehn-Yahr stages [2.0 (1.5, 2.5)] than those at baseline [7(4, 10), 19(14, 25), 1.5(1.0, 2.0)]. The differences were statistically significant ( Z=-2.498, P=0.012; Z=-3.039, P=0.002; Z=-4.436, P<0.001). The cognitively impaired group had lower Montreal Cognitive Assessment scores [22.00(19.00, 23.75)] and fewer years of education [9.00(8.00, 11.75) years] but higher Parkinson′s Disease Non-Motor Symptoms Questionnaire (PD-NMSQ) scores [8.00(5.25, 12.00)] than the cognitively normal group [25.00(24.00, 27.00), 12.00(9.00, 15.00) years, 6.00(3.00, 8.00)], and the differences were statistically significant ( Z=-4.764, P<0.001; Z=-3.016, P=0.003; Z=-3.281, P=0.001). Multivariate Logistic regression showed that years of education ( OR=0.829, 95%CI 0.715-0.960, P=0.012) and PD-NMSQ scores ( OR=1.200, 95%CI 1.040-1.384, P=0.012) were independent predictors of cognitive impairment in patients with PD. There were statistically significant differences among the reversal, non-reversal, and stable groups in years of education ( F=5.366, P=0.010), PD-NMSQ scores ( H=10.795, P=0.005), and UPDRS-Ⅱ scores ( H=6.957, P=0.031). Pairwise comparisons showed lower PD-NMSQ scores [4.00(3.00, 7.00) vs 8.00(6.25, 12.75); Z=-2.989, P=0.003] and lower UPDRS-Ⅱ scores [6.00(3.00, 6.00) vs 7.00(6.00, 10.00); Z=-2.756, P=0.006] in the reversal group than in the non-reversal group, indicating better baseline quality of life in cognitive reversal patients. Conclusions:Low educational level and severe non-motor symptoms were risk factors predicting cognitive impairment in PD patients. Conversely, mild non-motor symptoms with high quality of life (lower UPDRS-Ⅱ scores) were important factors for cognitive reversal.

Objective A stable model of acute obstructive suppurative cholangitis was established in rats to detect pathophysiological indexes and provide a reliable standardized animal model for the study of acute cholangitis and cholestasis.Methods SPF-grade male SD rats were selected,and the model was constructed via the injection of toxoid into the lower bile duct,followed by ligation of the common bile duct.Changes in body weight,mortality,major indexes of liver function,and histopathological changes in the liver were evaluated before and after modeling.Results After modeling,the body weight of rats in the model group decreased significantly.There were no deaths and no abnormalities of liver function in the sham-operation group.Three rats died in the model group,and the mortality rate of the model group was 12％.The main indexes of liver function and liver pathology showed obvious cholestasis and injurious changes to hepatic function in the model.Conclusions In this study,an acute obstructive suppurative cholangitis model rat was successfully established.The model has the advantages of ease of operation,minimal injury,low mortality,and a highly successful modeling rate,and it can provide a standardized experimental animal model for studying the mechanisms of and developing drugs for these common diseases.

Objective:To compare and evaluate the quality of wild and different cultivation methods of Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai through analysis on UPLC characteristic atlas and multi-component content determination results. Methods:UPLC was used to establish the characteristic chromatogram and multi-component content determination method of Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai, and clustering analysis, orthogonal partial least squares - discriminant analysis method were used for chemical pattern recognition analysis. Results:The results showed that there were 10 common peaks in 18 batches of Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai. Five components were identified, erythrothioneine(peak 1), protocatechuic acid (peak 2), protocatechualdehyde (peak 3), caffeic acid (peak 4) and Hispidin (peak 5). HCA and OPLS-DA could distinguish Sanghuang porus vaninii (Ljub.) with different cultivation methods. Conclusion:Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai in wood is closer to wild Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai than in substitute cultivation. The UPLC characteristic atlas and multi-component content determination method established in this study can provide reference for the quality evaluation of Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai.

Differentiated thyroid cancer usually has a good prognosis;however,recurrence occurs in 5％to 20％of patients after initial treatment,which causes physiopsychological and financial burdens for the patients.In the meantime,it complicates the treatment decision-making for clinicians.Different from initial treatment,the management of recurrent thyroid cancer should take comprehensive consideration of factors such as risks and benefits.Surgery is considered to be the first choice of treatment while radioactive iodine therapy is recommended for radioiodine-avid recurrent disease.Smaller lesions can be managed with active surveillance temporarily,and thermal ablation should only be applied to patients not suitable for additional surgery.In contrast,external beam radiotherapy and systemic therapies are considered only after all therapy options have been exhausted.

Objective:To investigate surgical treatment of carotid artery diseases in neck tumor surgery. Methods:A retrospective analysis of the clinical data on carotid artery treatment was conducted in the five cases of neck tumor surgeries treated at Department of Surgical Oncology, the First Peoples Hospital of Lanzhou from March 2010 to May 2020. Surgical methods, including carotid artery resection and ligation, tumor-involved artery resection and vascular reconstruction, and tumor peeling and carotid rupture repairing were used, respectively. Results:Five cases were successfully operated on. One case of carotid artery ligation was followed by intermittent dizziness and decreased contra-lateral limb strength after the surgery. The remaining patients exhibited no neurological complications. A patient with cervical low-grade myofibroblastoma developed into lung metastases 8 months after the surgery. Another patient with cervical lymph node metastases in papillary thyroid cancer developed into lung metastases 24 months after the surgery. Conclusion:Currently, surgical methods for clinical treatment of diseased carotid arteries include carotid artery resection and ligation, simple tumor peeling, tumor invasion artery resection and vascular reconstruction, and interventional therapy. Each surgical method has its own advantages and disadvantages. Therefore, the choice of treatment depends on the patient's specific conditions, physician's clinical experience, and the equipment available.
Humans ; Retrospective Studies ; Carotid Arteries/pathology* ; Head and Neck Neoplasms/pathology* ; Thyroid Neoplasms/surgery* ; Lung Neoplasms/pathology*