BACKGROUND:With the development of computer-aided design and computer-aided manufacturing technology,zirconia abutments with a titanium base are widely used in clinic due to its good application advantages,but there are still some problems and a lack of consensus design standards. OBJECTIVE:To review the fabrication methods of Ti-base zirconia abutment,and the effect of abutment connection,emergence design,abutment angle,and bonding on mechanical properties of Ti-base zirconia abutment. METHODS:Relevant literature published from 2010 to 2023 was searched in CNKI and PubMed databases with the search terms"zirconia abutment,titanium base"in Chinese and English,respectively.The search time limit was extended for some classical literature.The relevant literature was obtained through inclusion and exclusion criteria,and 57 eligible documents were included for review. RESULTS AND CONCLUSION:It is recommended that clinicians try to select antirotational titanium bases or rotational titanium bases with a Morse taper connection.Implants should be placed in the correct axial angulation of not more than 15° or with an inclination to the palatal side when using angled zirconia abutments.When a≥30° labial inclination is followed for implant placement,the bite force must be decreased effectively to reduce the risk of mechanical and biological complications of implants,abutments,and prostheses.Ti-base zirconia abutments with a higher gingival height should be selected,and its restorative angle should not exceed 40°.Multilink Hybrid Abutment could be the first choice for extraoral bonding of zirconia abutment to titanium bases.

Objective To explore the effects of tripterygium glycosides(TGs)on adipocyte differentiation,inflam-mation,and fibrosis of orbital fibroblasts(OFs)in thyroid associated ophthalmopathy(TAO).Methods OFs isolated from 12 TAO patients were cultured and identified.CCK-8 experiment was used to detect the effect of different concentra-tions of TGs(0,12.5,25.0,50.0,100.0 mg·L-1)on the activity of OFs.Then,adipocyte differentiation phenotypes of OFs were induced and divided into a control group,an adipocyte differentiation group(DM),and TG groups(12.5,25.0,and 50.0 mg·L-1 TGs).Inflammation phenotypes of OFs were induced and divided into a control group,an IL-1 β group,and TG groups(12.5,25.0,and 50.0 mg·L-1 TGs).Fibrosis phenotypes of OFs were induced and divided into a control group,a TGF-βi group,and TG groups(12.5,25.0,and 50.0 mg·L-1 TGs).Oil red O staining was used to detect the formation of lipid droplets in OFs of adipocyte differentiation phenotype.ELISA was used to measure IL-6 and TNF-α levels in OFs of inflammation phenotype and HA levels in OFs of fibrosis phenotype.Transwell experiment was used to detect the cell migration rate of OFs of fibrosis phenotype.Real time quantitative polymerase chain reaction(RT-qPCR)and Western blot were used to detect the expression levels of PPAR-γ,c/EBP-α,FABP-4,perilipin-1,and adiponectin mRNAs and pro-teins in OFs of adipocyte differentiation phenotype,the expression levels of IL-6,TNF-α,COX-2,MCP-1 and ICAM-1 mR-NAs and proteins in OFs of inflammation phenotype,and the expression levels of Vimentin,Fibronectin,COL1A1,COL1A2 and ACTA2 mRNAs and proteins in OFs of fibrosis phenotype.Results The cells were identified as OFs.12.5,25.0,and 50.0 mg·L-1 of TGs had no significant effect on OF activity and these three concentrations were used in the subsequent ex-periment.In OFs of adipocyte differentiation phenotype,the number of orange red lipid droplets greatly decreased after TG treatment.The expression levels of PPAR-γ,c/EBP-α,FABP-4,perilipin-1,and adiponectin mRNAs and proteins in cells of TG groups were significantly lower than those of the DM group(all P＜0.05).In OFs of inflammation phenotype,IL-6 and TNF-α levels in supernatant and cells of TG groups were significantly decreased,compared with those of the IL-1βgroup(all P＜0.05).The expression levels of COX-2,MCP-1,and ICAM-1 mRNAs and proteins in cells of TG groups were significantly lower than those of the IL-1 β group(all P＜0.05).In OFs of fibrosis phenotype,the cell migration rates,HA levels in cell culture supernatant,and the expression levels of Vimentin,Fibronectin,COL1A1,COL1A2,and ACTA2 mR-NAs and proteins in cells of TG groups were significant lower than those of the TGF-β1 group(all P＜0.05).Conclusion TGs can inhibit the adipocyte differentiation,IL-1 β-induced inflammatory responses and TGF-β1-induced fibrosis of TAO-OFs.

BACKGROUND:As an essential trace element for body growth and development,copper participates in many processes such as redox process,energy generation,signal transduction and bone metabolism.The imbalance of copper homeostasis in diabetic patients will lead to the increase of oxidative stress and the impairment of antioxidant mechanism,which stimulate the production of inflammatory mediators and inflammatory factors,and thus lead to cytotoxicity and body damage.In recent years,the role of copper in diabetes has gradually attracted attention,and some studies have confirmed that copper plays a key regulatory role in the pathological process of diabetes.OBJECTIVE:To summarize the current progress in the role of copper in systemic complications of diabetes and provide some theoretical reference for its future research and treatment.METHODS:The first author searched PubMed,Web of Science,CNKI and WanFang databases for literature related to the role of copper in systemic complications of diabetes.The search terms were"copper,Cu,diabetes,diabetic complications,diabetic cardiomyopathy,diabetic nephropathy,diabetic retinopathy,diabetic osteoporosis,diabetic periodontitis"in English and Chinese,respectively.After screening,95 articles were included in the review.RESULTS AND CONCLUSION:(1)Copper is involved in the occurrence and development of diabetic complications and most of the damage caused by copper to the body is due to interference with the body's redox level.(2)In diabetic cardiomyopathy,increased Cu2+in the corpuscular circulation and impaired uptake of copper ions by cardiomyocytes,the accumulation of redox-active Cu2+and ceruloplasmin outside the cardiomyocyte induces copper oxidative stress in cardiomyocytes,leading to acute cardiac impairment.(3)In diabetic nephropathy,the toxic effect of excessive copper leads cause granular degeneration and vacuolar degeneration of renal tubular epithelial cells and proximal tubular necrosis,eventually leading to chronic or acute renal failure.(4)Excessive copper in diabetic patients can produce reactive oxygen species and directly or indirectly affect the function of copper protein with antioxidant function,thus damaging retinal cells.(5)In patients with diabetic osteoporosis,accumulated copper induces lipid peroxidation and interferes with bone metabolism.Copper acts on osteoblasts mainly through inhibition of superoxide dismutase,glutathione peroxidase,and alkaline phosphatase activities.(6)Excessive copper exacerbates inflammatory changes in periodontal tissue by promoting inflammatory responses.

Objective:To investigate the application value of needle-knife accurate fistulo-tomy (NKAF) for difficult biliary cannulation during endoscopic retrograde cholangiopancreato-graphy (ERCP).Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 137 patients with difficult biliary cannulation during ERCP at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2021 and December 2022 were collected. There were 51 males and 86 females, aged (69±13)years. All 137 patients received NKAF for cannulation during ERCP. Observation indicators: (1) surgical situations; (2) complications. Measurement data with normal distribution were represented as Mean± SD. Count data were repre-sented as absolute numbers. Results:(1) Surgical situations. Of 137 patients, 136 cases had succe-ssful cannulation, 1 case had failed cannulation with NKAF following unsuccessful double-guidewire technique. In the 136 successful cases, the endoscope was straightened in 42 cases, left in a long position in 37 cases, and maintained in the standard position in 57 cases. The cannulation time was (90±8)s. (2) Complications. The serum amylase at postoperative 6 hours in the 136 successful cases was (163±23)U/L. No patient developed post-ERCP pancreatitis. Of the 136 patients with successful cannulation, one case experienced post-sphincterotomy bleeding, which was observed oozing from the papillary orifice on emergency gastroscopy. The patient was successfully controlled with endoscopic clips.Conclusion:NKAF is safe and effective for difficult biliary cannulation during ERCP.

Objective To explore the effects of tripterygium glycosides(TGs)on adipocyte differentiation,inflam-mation,and fibrosis of orbital fibroblasts(OFs)in thyroid associated ophthalmopathy(TAO).Methods OFs isolated from 12 TAO patients were cultured and identified.CCK-8 experiment was used to detect the effect of different concentra-tions of TGs(0,12.5,25.0,50.0,100.0 mg·L-1)on the activity of OFs.Then,adipocyte differentiation phenotypes of OFs were induced and divided into a control group,an adipocyte differentiation group(DM),and TG groups(12.5,25.0,and 50.0 mg·L-1 TGs).Inflammation phenotypes of OFs were induced and divided into a control group,an IL-1 β group,and TG groups(12.5,25.0,and 50.0 mg·L-1 TGs).Fibrosis phenotypes of OFs were induced and divided into a control group,a TGF-βi group,and TG groups(12.5,25.0,and 50.0 mg·L-1 TGs).Oil red O staining was used to detect the formation of lipid droplets in OFs of adipocyte differentiation phenotype.ELISA was used to measure IL-6 and TNF-α levels in OFs of inflammation phenotype and HA levels in OFs of fibrosis phenotype.Transwell experiment was used to detect the cell migration rate of OFs of fibrosis phenotype.Real time quantitative polymerase chain reaction(RT-qPCR)and Western blot were used to detect the expression levels of PPAR-γ,c/EBP-α,FABP-4,perilipin-1,and adiponectin mRNAs and pro-teins in OFs of adipocyte differentiation phenotype,the expression levels of IL-6,TNF-α,COX-2,MCP-1 and ICAM-1 mR-NAs and proteins in OFs of inflammation phenotype,and the expression levels of Vimentin,Fibronectin,COL1A1,COL1A2 and ACTA2 mRNAs and proteins in OFs of fibrosis phenotype.Results The cells were identified as OFs.12.5,25.0,and 50.0 mg·L-1 of TGs had no significant effect on OF activity and these three concentrations were used in the subsequent ex-periment.In OFs of adipocyte differentiation phenotype,the number of orange red lipid droplets greatly decreased after TG treatment.The expression levels of PPAR-γ,c/EBP-α,FABP-4,perilipin-1,and adiponectin mRNAs and proteins in cells of TG groups were significantly lower than those of the DM group(all P＜0.05).In OFs of inflammation phenotype,IL-6 and TNF-α levels in supernatant and cells of TG groups were significantly decreased,compared with those of the IL-1βgroup(all P＜0.05).The expression levels of COX-2,MCP-1,and ICAM-1 mRNAs and proteins in cells of TG groups were significantly lower than those of the IL-1 β group(all P＜0.05).In OFs of fibrosis phenotype,the cell migration rates,HA levels in cell culture supernatant,and the expression levels of Vimentin,Fibronectin,COL1A1,COL1A2,and ACTA2 mR-NAs and proteins in cells of TG groups were significant lower than those of the TGF-β1 group(all P＜0.05).Conclusion TGs can inhibit the adipocyte differentiation,IL-1 β-induced inflammatory responses and TGF-β1-induced fibrosis of TAO-OFs.

Objective:To investigate the application value of needle-knife accurate fistulo-tomy (NKAF) for difficult biliary cannulation during endoscopic retrograde cholangiopancreato-graphy (ERCP).Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 137 patients with difficult biliary cannulation during ERCP at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2021 and December 2022 were collected. There were 51 males and 86 females, aged (69±13)years. All 137 patients received NKAF for cannulation during ERCP. Observation indicators: (1) surgical situations; (2) complications. Measurement data with normal distribution were represented as Mean± SD. Count data were repre-sented as absolute numbers. Results:(1) Surgical situations. Of 137 patients, 136 cases had succe-ssful cannulation, 1 case had failed cannulation with NKAF following unsuccessful double-guidewire technique. In the 136 successful cases, the endoscope was straightened in 42 cases, left in a long position in 37 cases, and maintained in the standard position in 57 cases. The cannulation time was (90±8)s. (2) Complications. The serum amylase at postoperative 6 hours in the 136 successful cases was (163±23)U/L. No patient developed post-ERCP pancreatitis. Of the 136 patients with successful cannulation, one case experienced post-sphincterotomy bleeding, which was observed oozing from the papillary orifice on emergency gastroscopy. The patient was successfully controlled with endoscopic clips.Conclusion:NKAF is safe and effective for difficult biliary cannulation during ERCP.

BACKGROUND:As an essential trace element for body growth and development,copper participates in many processes such as redox process,energy generation,signal transduction and bone metabolism.The imbalance of copper homeostasis in diabetic patients will lead to the increase of oxidative stress and the impairment of antioxidant mechanism,which stimulate the production of inflammatory mediators and inflammatory factors,and thus lead to cytotoxicity and body damage.In recent years,the role of copper in diabetes has gradually attracted attention,and some studies have confirmed that copper plays a key regulatory role in the pathological process of diabetes.OBJECTIVE:To summarize the current progress in the role of copper in systemic complications of diabetes and provide some theoretical reference for its future research and treatment.METHODS:The first author searched PubMed,Web of Science,CNKI and WanFang databases for literature related to the role of copper in systemic complications of diabetes.The search terms were"copper,Cu,diabetes,diabetic complications,diabetic cardiomyopathy,diabetic nephropathy,diabetic retinopathy,diabetic osteoporosis,diabetic periodontitis"in English and Chinese,respectively.After screening,95 articles were included in the review.RESULTS AND CONCLUSION:(1)Copper is involved in the occurrence and development of diabetic complications and most of the damage caused by copper to the body is due to interference with the body's redox level.(2)In diabetic cardiomyopathy,increased Cu2+in the corpuscular circulation and impaired uptake of copper ions by cardiomyocytes,the accumulation of redox-active Cu2+and ceruloplasmin outside the cardiomyocyte induces copper oxidative stress in cardiomyocytes,leading to acute cardiac impairment.(3)In diabetic nephropathy,the toxic effect of excessive copper leads cause granular degeneration and vacuolar degeneration of renal tubular epithelial cells and proximal tubular necrosis,eventually leading to chronic or acute renal failure.(4)Excessive copper in diabetic patients can produce reactive oxygen species and directly or indirectly affect the function of copper protein with antioxidant function,thus damaging retinal cells.(5)In patients with diabetic osteoporosis,accumulated copper induces lipid peroxidation and interferes with bone metabolism.Copper acts on osteoblasts mainly through inhibition of superoxide dismutase,glutathione peroxidase,and alkaline phosphatase activities.(6)Excessive copper exacerbates inflammatory changes in periodontal tissue by promoting inflammatory responses.

BACKGROUND:Periodontitis is an inflammatory and destructive disease with plaque biofilm as the main pathogenic material,which occurs in the gingiva,periodontal ligament,alveolar bone and cementum.The antigen of bacterial complex and its secreted toxin and enzyme directly lead to the destruction of periodontal tissue and trigger the host's immune response,causing indirect damage to the body tissue.Silence information regulatory factors(Sirtuins,SIRTs)play an important role in anti-aging,anti-oxidative stress,regulating inflammation,and mediating autophagy,and are closely related to the occurrence and development of periodontitis. OBJECTIVE:To review the research status of Sirtuins in periodontitis. METHODS:The first author used the computer to search the relevant research regarding the role of Sirtuins in periodontitis in PubMed,Web of Scene,CNKI and WanFang databases.The key words were"Sirtuins,Sirtuin1-7,periodontitis"in English and Chinese.After literature screening,57 articles were included for review and analysis. RESULTS AND CONCLUSION:SIRT1,SIRT2,SIRT3,and SIRT6 participate in regulating the occurrence and development of periodontitis.Inhibition of SIRT1 expression may be the target of periodontitis treatment,while overexpression of SIRT1 can inhibit periodontitis and protect periodontal tissue.The activator of SIRT1 can reduce the inflammation of periodontal tissue and improve the systemic pathological changes caused by periodontitis.SIRT2 is involved in nicotinamide phosphoribosyltransferase-mediated periodontal inflammation and plays a role in the treatment and prognosis of periodontal diseases.SIRT3 can improve age-related periodontal disease.Gastrodin promotes the osteogenic differentiation of periodontal ligament stem cells through the up-regulation of SIRT3.The activator of SIRT3 reduces the damage of periodontitis to periodontal and renal tissues by regulating the level of autophagy in the cells.SIRT6 can inhibit the inflammatory reaction of periodontal tissue and inhibit the differentiation and mineralization of cementoblasts.SIRT6 is beneficial to the prognosis of periapical periodontitis.The relationship between SIRT4,SIRT5,SIRT7 and periodontitis is rarely reported.

BACKGROUND:With the increasing demand for edentulous jaw restoration,"All-on-4"concept is widely used.The load transfer mode of implant is different from that of natural tooth.The three-dimensional finite element analysis can study the stress distribution of implants and surrounding bone tissues under functional loading.On this basis,it provides research methods for finding suitable implant materials,optimizing implant geometry,and designing clinical surgical protocols. OBJECTIVE:To review researches related to three-dimensional finite element analysis in"All-on-4"concept. METHODS:Relevant literature published from 2003 to 2023 was searched in CNKI and PubMed databases with the search terms of"finite element method;All-on-4;edentulous;biomechanics"in Chinese and English.Finally,65 articles were included for review. RESULTS AND CONCLUSION:(1)In the case of insufficient horizontal bone mass,we can choose to apply narrow diameter implants,but we need to pay attention to the effect of the presence of the cantilever on the stress distribution and reduce the risk of failure.(2)The"All-on-4"concept reduces the stress distribution of bone by tilting the distal middle implant,but the ideal angle of the distal implant tilt in different jaw types requires further study.(3)The presence of cantilevers increases the risk of implant failure,and keeping the cantilever length/AP distance ratio at 0.9 helps to minimize mechanical complications.(4)When a framework is made of a material with a lower elastic modulus,the stress on the framework itself will be smaller,but it will increase the stress on the implant,prosthetic screw,abutment and peri-implant bone.On the contrary,when a material with a higher elastic modulus is used,it can reduce the stress on the prosthetic components,implants and peri-implant bone in the restoration,but the stress on the framework itself is higher.(5)The"All-on-4"concept allows for a better mechanistic balance,but requires the development of a long-term,effective treatment program that is tailored to the patient's specific situation.(6)Proper occlusal scheme is the key to the success of implant treatment,and there is no difference between canine-guide occlusion and group function occlusion in terms of the longevity of the restoration.However,there are many factors that influence occlusal design,and further in vitro experiments as well as a number of clinical studies are needed to explore the ideal occlusal design of the"All-on-4".

The pathogenesis theory of"spleen deficiency and stasis toxin"in gastric cancer holds that spleen is the source of generation and transformation of qi and blood,that spleen deficiency is the internal basis of disease and throughout the disease.Stasis toxin is based on spleen deficiency,which is the fundamental pathogenesis of gastric cancer.In the pathological process of gastric cancer,a variety of metabolic substances in tumor cells and tumor microenvironment,mainly glucose metabolic reprogramming,undergo metabolic changes to reconstruct the phenotype and function of tumor-related macrophages,which is consistent with the pathogenesis theory of"spleen deficiency and stasis toxin".Therefore,this article focused on the reprogramming of glucose metabolism in tumor microenvironment to drive the phenotypic remodeling of tumor-related macrophages,explored the scientific connotation of the pathogenesis theory of"spleen deficiency and stasis toxin"of gastric cancer,and provided references for the theoretical and clinical research on the treatment of gastric cancer by TCM.