Objective To evaluate the efficacy of shoulder arthroscopic double row suture bridge repair program in patients with rotator cuff tears.Methods 118 cases of rotator cuff tear patients admitted from September 2019 to July 2023 were selected,then they were divided in the control group and pilot group,each with 59 cases(the random number table method was used as the basis for dividing the groups),and each of two groups 1 case was lost,and finally 58 cases were included in each.Both underwent shoulder arthroscopic rotator cuff repair under general anesthesia,the control group was treated with single-row fixed suture,the pilot group was treated with double row suture bridge repair program,and were followed up for 6 months after surgery.Two groups were compared operative-related conditions,pain[visual analogue scale(VAS)score],shoulder function[the Constant-Murley scale,University of California at Los Angeles(UCLA)scale,American Shoulder and Elbow Surgeons(ASES)scale],shoulder mobility,inflammatory reaction[C reactive protein(CRP),transforming growth factor-β1(TGF-β1)and interleukin-6(IL-6)]and safety.Results Compared to control group,surgery time of the pilot group was shorter,the difference was statistically significant(P<0.05);Compared to before surgery,VAS score in two groups 6 months after surgery was lower,the pilot group was lower than that of control group,the differences were statistically significant(P<0.05);Constant-Murley scale,UCLA scale and ASES scale of pilot group 6 months after surgery were higher than those of control group,and the shoulder joint mobility 6 months after surgery was bigger than that of control group,the differences were statistically significant(P<0.05);CRP,TGF-β1,IL-6 3 days after surgery in two groups were higher than those before surgery,but the pilot group was lower than control group,the differences were statistically significant(P<0.05);Compared to control group(13.79%and 18.97%),the incidence of rotator cuff re-tear and joint stiffness were lower in the pilot group(3.45%and 3.45%),the differences were statistically significant(P<0.05).Conclusion The application of double-row suture bridge repair technique in patients with rotator cuff tear could shorten the operation time,reduce the postoperative inflammatory stress and pain,improve the shoulder mobility,restore the shoulder function,and reduce the occurrence of rotator cuff re-tear and joint stiffness.

Geriatric oral health care encounters significant challenges with the increase in the proportion of older individuals. Age-related changes in the dentition, muscles, and joints result in a decline in objective masticatory function, subjective restoration requirements, and acceptability among the elderly population, with individual variations influenced by systemic health. Considering functional requirements, the adaptability of stomatognathic and systemic health conditions, health economics and other factors, the authors believe that it should not be limited to the conventional "one-to-one" strategy for replacing missing teeth in geriatric prosthodontics. There is an urgent need for a precise and adaptable restoration strategy that is more suitable for older individuals. The proposal of a new concept of functional tooth loss updates the minimal restoration standards for elderly patients and establishes the theory of age-friendly functional restoration. Based on the restoration strategy of functional tooth loss, this paper proposes a new concept termed "age-friendly functional restoration of the stomatognathic system", which integrates treatment considerations including endodontics, periodontology, mucosa, muscles, temporomandibular joint, and systemic health. Efforts should be made in four areas as follows. Firstly, the "assessment of accessible function" should be enhanced by considering the interrelationship between stomatognathic and systemic health. Secondly, the "evaluation of appropriate function" is supposed to be optimised in view of subjective needs and objective evaluation of the stomatognathic system. Moreover, the "formulation of treatment plans" needs to be accomplished with the aid of assistive technologies, such as artificial intelligence, to accurately exert appropriate functional restoration. Lastly, the "management and maintenance of health" is likely to be strengthened through follow-ups, propaganda and education, and preventive healthcare, so as to improve quality of life and ultimately achieve healthy ageing among older individuals.
Humans ; Tooth Loss/therapy* ; Aged ; Stomatognathic System ; Oral Health ; Dental Care for Aged ; Dental Restoration, Permanent/methods*

Objective:To evaluate the efficacy of digitally assisted design of surgical template for fibular composite tissue flap in reconstruction of segmental mandibular defect with soft tissue defect.Methods:A retrospective analysis was conducted on 30 patients who were treated at the Department of Otolaryngology Head and Neck Surgery, the 920th Hospital of the Joint Logistics Support Force of Chinese PLA from July 2020 to May 2024 for segmental mandibular defects combined with soft tissue defect. The cohort comprised 19 males and 11 females and aged 11-71 years (44.33 years±15.31 years). Pathological diagnoses of the patients were ameloblastoma (14 cases), squamous cell carcinoma (9 cases), osteomyelitis (4 cases), and odontogenic keratocyst (3 cases). Primary reconstructive surgery were performed on 21 patients after surgical resection of lesions, and 9 patients received secondary reconstructive surgery. The length of mandibular defect ranged from 75.83 mm to 111.45 mm (87.31 mm±12.00 mm), and soft tissue defects were measured at 5.0 cm×1.8 cm to 8.6 cm×2.1 cm (mean area 13.63 cm 2±2.42 cm 2). Preoperative CTA was performed to locate the perforator of peroneal artery and for design of digital surgical template. Intraoperatively, a modified fibula composite tissue flap harvesting technique was employed and that involved in: CTA-guided perforator planning, fibula osteotomy, anterior intermuscular septum exposure for identifying the peroneal artery, and a digital template-assisted fibula crafting for reconstruction of mandibule and soft tissue defect. Postoperative follow-ups were conducted at 1, 3, and 6 months, followed by quarterly reviews at outpatient clinic or via telephone interviews. Statistical analysis was performed using SPSS 27.0 software with descriptive statistical methods. Results:After surgery, all the fibula composite tissue flaps were viable and the incision wound healed well. Two patients had partial necroses at distal edge of the flaps, and they were healed after treatment. One patient had donor site infection and healed after anti-infective treatment. One month after the surgery, patients were assessed according to the recovery of face, mouth opening and occlusion, of which 25 patients (83.3%) were rated of Grade I, 4 (13.3%) of Grade Ⅱ, and 1 (3.4%) of Grade Ⅳ, with an excellent and good rates of 96.6%. The average distance of condylar movement on the affected side was 1.28 mm±0.35 mm. Postoperative follow-up lasted for 10 to 22 months, with 19.17 months±2.14 months in average. Assessment at the final follow-up was found that a total of 26 patients (86.8%) were of Grade I, 3 (10.0%) of Grade Ⅱ, and 1 (3.3%) of Grade Ⅳ and all the transferred fibula showed good alignment with the mandible over the postoperative follow-up period.Conclusion:Digital template-assisted design of fibular composite tissue flap enables a precise vascular protection, individualised osteotomy and functional restoration in reconstruction of segmental mandibular defect with soft tissue defect. It demonstrates a high clinical feasibility.

Objective To investigate the transgenerational effects of paternal PM2.5 exposure on offspring growth and development,and to preliminarily elucidate the role of sperm DNA methylation modifications in mediating these effects.Methods Eight-week-old male C57BL/6 mice were randomly divided into filtered air(FA),unfiltered air(UA),and concentrated PM2.5(CAP)groups,with 10 animals in each group.The exposure was conducted from November 2019 to April 2020,and then,these male mice were mated with unexposed females to generate F1 offspring,which were bred successively to produce F2 and F3 generations.All the offspring were living in PM2.5-free environment.The birth body weight,birth number,and sex ratio of the offspring were recorded,body weight growth was monitored,and organ coefficients of the heart,liver,lung,and brain were calculated.Whole-genome methylation sequencing was performed on the sperm DNA of the CAP group,FA group,and their F1 generation offspring to screen for differentially methylated regions,and the genes and pathways associated with these regions were analyzed.Results When compared with the F1～F3 offspring of the FA group,the CAP group had significantly reduced birth body weight in the F1 generation(P<0.05),no statistical differences were observed in the birth body weight in the F2 and F3 generations(P>0.05),or either in the sex ratio and birth number among the F1,F2 and F3 generations.Compared with the FA group offspring,the F1～F3 offspring of CAP group exhibited delayed body weight gain,especially in the males(P<0.05),the CAP-F1 male generation had obviously elevated liver organ coefficient(P<0.01),but no statistical changes were observed in the heart,lung,or brain coefficients among the F1～F3 generations.Between the FA group and the CAP group,37 997 differentially methylated regions were detected,with a reduction of approximately 50%in the number of differentially methylated regions in the F1 generation.Differentially methylated genes in F0 and F1 sperm were potentially related to developmental processes,including imprinting genes(Gnas,Igf2)and metabolic genes(Ppard,Rps6kb1).Conclusion Paternal exposure to PM2.5 leads to reduced birth weight and intergenerational growth retardation in offspring.Its impact on phenotypic effects is gradually weakened during intergenerational transmission.Changes in the methylation of development-related genes in sperm may be one of the mechanisms mediating this intergenerational effect.

Objective To evaluate the efficacy of shoulder arthroscopic double row suture bridge repair program in patients with rotator cuff tears.Methods 118 cases of rotator cuff tear patients admitted from September 2019 to July 2023 were selected,then they were divided in the control group and pilot group,each with 59 cases(the random number table method was used as the basis for dividing the groups),and each of two groups 1 case was lost,and finally 58 cases were included in each.Both underwent shoulder arthroscopic rotator cuff repair under general anesthesia,the control group was treated with single-row fixed suture,the pilot group was treated with double row suture bridge repair program,and were followed up for 6 months after surgery.Two groups were compared operative-related conditions,pain[visual analogue scale(VAS)score],shoulder function[the Constant-Murley scale,University of California at Los Angeles(UCLA)scale,American Shoulder and Elbow Surgeons(ASES)scale],shoulder mobility,inflammatory reaction[C reactive protein(CRP),transforming growth factor-β1(TGF-β1)and interleukin-6(IL-6)]and safety.Results Compared to control group,surgery time of the pilot group was shorter,the difference was statistically significant(P<0.05);Compared to before surgery,VAS score in two groups 6 months after surgery was lower,the pilot group was lower than that of control group,the differences were statistically significant(P<0.05);Constant-Murley scale,UCLA scale and ASES scale of pilot group 6 months after surgery were higher than those of control group,and the shoulder joint mobility 6 months after surgery was bigger than that of control group,the differences were statistically significant(P<0.05);CRP,TGF-β1,IL-6 3 days after surgery in two groups were higher than those before surgery,but the pilot group was lower than control group,the differences were statistically significant(P<0.05);Compared to control group(13.79%and 18.97%),the incidence of rotator cuff re-tear and joint stiffness were lower in the pilot group(3.45%and 3.45%),the differences were statistically significant(P<0.05).Conclusion The application of double-row suture bridge repair technique in patients with rotator cuff tear could shorten the operation time,reduce the postoperative inflammatory stress and pain,improve the shoulder mobility,restore the shoulder function,and reduce the occurrence of rotator cuff re-tear and joint stiffness.

Objective:To evaluate the efficacy of digitally assisted design of surgical template for fibular composite tissue flap in reconstruction of segmental mandibular defect with soft tissue defect.Methods:A retrospective analysis was conducted on 30 patients who were treated at the Department of Otolaryngology Head and Neck Surgery, the 920th Hospital of the Joint Logistics Support Force of Chinese PLA from July 2020 to May 2024 for segmental mandibular defects combined with soft tissue defect. The cohort comprised 19 males and 11 females and aged 11-71 years (44.33 years±15.31 years). Pathological diagnoses of the patients were ameloblastoma (14 cases), squamous cell carcinoma (9 cases), osteomyelitis (4 cases), and odontogenic keratocyst (3 cases). Primary reconstructive surgery were performed on 21 patients after surgical resection of lesions, and 9 patients received secondary reconstructive surgery. The length of mandibular defect ranged from 75.83 mm to 111.45 mm (87.31 mm±12.00 mm), and soft tissue defects were measured at 5.0 cm×1.8 cm to 8.6 cm×2.1 cm (mean area 13.63 cm 2±2.42 cm 2). Preoperative CTA was performed to locate the perforator of peroneal artery and for design of digital surgical template. Intraoperatively, a modified fibula composite tissue flap harvesting technique was employed and that involved in: CTA-guided perforator planning, fibula osteotomy, anterior intermuscular septum exposure for identifying the peroneal artery, and a digital template-assisted fibula crafting for reconstruction of mandibule and soft tissue defect. Postoperative follow-ups were conducted at 1, 3, and 6 months, followed by quarterly reviews at outpatient clinic or via telephone interviews. Statistical analysis was performed using SPSS 27.0 software with descriptive statistical methods. Results:After surgery, all the fibula composite tissue flaps were viable and the incision wound healed well. Two patients had partial necroses at distal edge of the flaps, and they were healed after treatment. One patient had donor site infection and healed after anti-infective treatment. One month after the surgery, patients were assessed according to the recovery of face, mouth opening and occlusion, of which 25 patients (83.3%) were rated of Grade I, 4 (13.3%) of Grade Ⅱ, and 1 (3.4%) of Grade Ⅳ, with an excellent and good rates of 96.6%. The average distance of condylar movement on the affected side was 1.28 mm±0.35 mm. Postoperative follow-up lasted for 10 to 22 months, with 19.17 months±2.14 months in average. Assessment at the final follow-up was found that a total of 26 patients (86.8%) were of Grade I, 3 (10.0%) of Grade Ⅱ, and 1 (3.3%) of Grade Ⅳ and all the transferred fibula showed good alignment with the mandible over the postoperative follow-up period.Conclusion:Digital template-assisted design of fibular composite tissue flap enables a precise vascular protection, individualised osteotomy and functional restoration in reconstruction of segmental mandibular defect with soft tissue defect. It demonstrates a high clinical feasibility.

BACKGROUND:Abnormal extracellular matrix accumulation and excessive proliferation of fibroblasts are the main manifestations of pathological scars.Excessive proliferation of fibroblasts leads to the production of large amounts of collagen-based extracellular matrix.Therefore,to investigate the role of fibroblast fibrosis in the formation of pathological scar will provide a new idea for revealing the mechanism of pathological scar and biological therapy. OBJECTIVE:To investigate the effect of RAS-selective lethal small molecule 3(RSL3)on the fibrosis of human pathological scar fibroblasts. METHODS:Then cases of pathological scar tissue and normal skin tissue samples from the same individuals,provided by the Department of Burn Plastic Surgery,General Hospital of Ningxia Medical University,were collected.Fibroblasts of human pathological scar and human normal skin were extracted and used in the following experiments.The general condition of the pathological scar tissue and the normal skin tissue was detected by hematoxylin-eosin staining.The appearance of fibroblasts from pathological scar and normal skin were observed by inverted microscope.The fibroblasts were verified by immunofluorescence assay.The cells were treated with different concentrations of RSL3(1,3,5,7,9,11,13 μmol/L).The inhibitory concentration of RSL3 on fibroblasts was detected by cell counting kit-8.Control group(without treatment)and RSL3 intervention group(treated with 7 μmol/L RSL3 for 24 hours)were set up.The mRNA and protein expressions of glutathione peroxidase 4,type Ⅰ collagen,type Ⅲ collagen and α-smooth muscle actin were detected by Qrt-PCR and western blot,respectively.Level of malondialdehyde in cells was detected.The residual scratch area was measured by cell scratch test after 24 hours to calculate the percentage of residual scratch area. RESULTS AND CONCLUSION:The expression of glutathione peroxidase 4 in the pathological scar group was higher than that in the normal skin group(Mrna:t=3.252,P<0.01;protein:t=5.075,P<0.01).The expression of glutathione peroxidase 4 in the pathological scar fibroblast group was higher than that in the normal skin fibroblast group(Mrna:t=10.32,P<0.01;protein:t=26.22,P<0.01).Compared with the control group,the expression of glutathione peroxidase 4 was decreased(Mrna:t=2.798,P<0.05;protein:t=4.643,P<0.01),the content of malondialdehyde was increased(t=2.917,P<0.05),the expression of type Ⅰ collagen(Mrna:t=15.84,P<0.01;protein:t=4.610,P<0.01),type Ⅲ collagen(Mrna:t=28.86,P<0.01;protein:t=7.713,P<0.01)and α-smooth muscle actin(Mrna:t=2.671,P<0.05;protein:t=7.417,P<0.01)were decreased in the RSL3 intervention group.Compared with the control group,the migration ability was weakened in the RSL3 intervention group(t=14.06,P<0.01).To conclude,RSL3 can inhibit the expression of glutathione peroxidase 4 and then inhibit the ability of fibrosis and migration of pathological scar fibroblasts.

Drug resistance presents one of the major causes for the failure of cancer chemotherapy. Cancer stem-like cells (CSCs), a population of self-renewal cells with high tumorigenicity and innate chemoresistance, can survive conventional chemotherapy and generate increased resistance. Here, we develop a lipid-polymer hybrid nanoparticle for co-delivery and cell-distinct release of the differentiation-inducing agent, all-trans retinoic acid and the chemotherapeutic drug, doxorubicin to overcome the CSC-associated chemoresistance. The hybrid nanoparticles achieve differential release of the combined drugs in the CSCs and bulk tumor cells by responding to their specific intracellular signal variation. In the hypoxic CSCs, ATRA is released to induce differentiation of the CSCs, and in the differentiating CSCs with decreased chemoresistance, DOX is released upon elevation of reactive oxygen species to cause subsequent cell death. In the bulk tumor cells, the drugs are released synchronously upon the hypoxic and oxidative conditions to exert potent anticancer effect. This cell-distinct drug release enhances the synergistic therapeutic efficacy of ATRA and DOX with different anticancer mechanism. We show that treatment with the hybrid nanoparticle efficiently inhibit the tumor growth and metastasis of the CSC-enriched triple negative breast cancer in the mouse models.

Molecular glues can specifically induce aggregation between two or more proteins to modulate biological functions. In recent years, molecular glues have been widely used as protein degraders. In addition, however, molecular glues play a variety of vital roles, such as complex stabilization, interactome modulation and transporter inhibition, enabling challenging therapeutic targets to be druggable and offering an exciting novel approach for drug discovery. Since most molecular glues are identified serendipitously, exploration of their systematic discovery and rational design are important. In this review, representative examples of molecular glues with various physiological functions are divided into those mediating homo-dimerization, homo-polymerization and hetero-dimerization according to their aggregation modes, and we attempt to elucidate their mechanisms of action. In particular, we aim to highlight some biochemical techniques typically exploited within these representative studies and classify them in terms of three stages of molecular glue development: starting point, optimization and identification.

Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.