Objective: To investigate the role of butyric acid-producing bacteria in long bone homeostasis in mice with periodontitis under a high-fat/high-sugar diet and to provide new insights for the prevention and treatment of periodontitis and related bone metabolic diseases. Methods: This study has been approved by the Animal Welfare and Ethics Committee of the Experimental Animal Center. Initially, 14 mice were randomly divided into the CON group (the control group) and the LIG group (the periodontitis group). Mice in the LIG group had experimental periodontitis induced by ligating the second maxillary molars bilaterally and were fed a high-fat and high-sugar diet. After 8 weeks, samples were collected. Micro-computed tomography (Micro-CT) was used to analyze alveolar bone resorption and various parameters of the proximal tibia trabecular bone, including bone mineral density (BMD), bone volume per tissue volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp). After decalcification, hematoxylin and eosin (HE) staining was performed on maxillary bone sections to assess periodontal tissue inflammation and connective tissue destruction. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect related genes in the distal femur and proximal tibia bone tissues, including osteocalcin (OCN), osteogenic transcription factor (Osterix), osteoprotegerin (OPG), tartrate resistant acid phosphatase (TRAP), osteoclast-associated receptor (OSCAR), receptor activator of nuclear factor kappa-B (RANK), and receptor activator of nuclear factor kappa-B ligand (RANK-L). Subsequently, the other 28 mice were randomly divided into the CON group (the control group), LIG group (the periodontitis group), CON + butyric acid-producing bacteria (BP) group, and LIG + BP group. The breeding, sampling, and sample detection methods remained the same. Finally, the other 28 mice were randomly divided into the CON group (the control group), LIG group (the periodontitis group), CON + sodium butyrate (SB) group, and LIG + SB group. The breeding, sampling, and sample detection methods remained the same. Results: ①Periodontitis modeling was successful. Compared with the CON group, the LIG group exhibited significant alveolar bone resorption of the maxillary second molar, aggravated periodontal tissue inflammation, and connective tissue destruction. ②Periodontitis exacerbated long bone resorption in mice fed a high-fat high-sugar diet. Compared with the CON group, the LIG group had significantly lower BMD, BV/TV, Tb.N, and Tb.Th (P<0.05), and significantly higher Tb.Sp (P<0.05). HE staining of the proximal tibia showed that the trabeculae in the LIG group were sparse and disordered, with some areas showing fractures or dissolution. The expression of osteoblast markers (OCN, Osterix, OPG) was significantly lower in the LIG group (P<0.05), while the expression of the osteoclast marker TRAP showed an increasing trend (P>0.05). The ratio of RANK-L/OPG was significantly higher in the LIG group compared with the CON group (P<0.05). ③ Supplementation with butyric acid-producing bacteria alleviates periodontitis-induced disruption of long bone homeostasis in mice fed a high-fat/high-sugar diet. Compared with the LIG group, BMD and Tb.Th were significantly higher in the LIG + BP group. HE staining of the proximal tibia showed that bone resorption was mitigated in the LIG + BP group compared with the LIG group. The expression of OCN and Osterix was significantly higher in the LIG + BP group, while the expression of osteoclast-specific genes (OSCAR, RANK, RANK-L) was significantly lower (P<0.05). ④ Supplementation with butyrate alleviates periodontitis-induced disruption of long bone homeostasis in mice fed a high-fat/high-sugar diet. Compared with the LIG group, BV/TV and Tb.N were significantly higher in the LIG + SB group, and Tb.Sp was significantly lower (P<0.05). HE staining of the proximal tibia showed that bone resorption was mitigated in the LIG + SB group compared with the LIG group. The expression of Osterix, OPG, OSCAR, TRAP, and RANK was significantly lower in the LIG + SB group compared with the LIG group (P<0.05). Conclusion Periodontitis disrupts the long bone homeostasis of mice fed a high-fat high-sugar diet, aggravating long bone resorption. Supplementation with butyric acid-producing bacteria or butyrate can effectively alleviate the disruption of long bone homeostasis caused by periodontitis.

Objective:To evaluate the influence of midface (nasal base and zygomatic bone) morphological changes on the overall perception of lip prominence from different perspectives.Methods:From February to March 2024, 212 volunteers were recruited in Fujian Province as study subjects and divided into three groups: orthodontists [65 participants, 28 males and 37 females, aged (31.3±6.9) years], orthodontic patients [72 participants, 24 males and 48 females, aged (27.6±5.7) years], and healthy adults [75 participants, 37 males and 38 females, aged (25.6±4.4) years]. Three-dimensional facial modeling software was used to generate facial models, which were sculpted using three-dimensional model sculpting software to simulate different nasal base, zygomatic bone, and upper lip prominence conditions. A total of 15 facial models were generated, divided into five groups (three models per group): Group A (normal nasolabial angle, normal nasal base, normal upper lip); Group B (increased nasolabial angle, normal nasal base, flattened upper lip); Group C (decreased nasolabial angle, normal nasal base, protruded upper lip); Group D (increased nasolabial angle, protruded nasal base, normal upper lip); Group E (decreased nasolabial angle, recessed nasal base, normal upper lip). Models 1, 2, and 3 in each group had normal, protruded, and flattened zygomatic bones, respectively (with Model 1 in Group A as the initial model). Forty-five-degree and ninety-degree profile images of the models were captured (30 images in total) and compiled into a questionnaire. Participants in the three study groups were selected as the most attractive and least attractive facial appearances based on the questionnaire and ratings of the lip prominence of the 45° and 90° profile images (0-10 points, where 0=very flat, 5=normal, and 10=very prominent). A one-sample t-test was used to compare the difference between model ratings and the median score of 5. Results:Among the 30 images, the proportion of lip prominence ratings deviating from the median score of 5 was the highest among orthodontists [83% (25/30)], followed by orthodontic patients [67% (20/30)], and lowest among healthy adults [53% (16/30)]. At the 90° profile view, the scores given by orthodontists, orthodontic patients, and healthy adults for the initial model (5.07±0.79, 5.00±1.03, and 4.95±1.07, respectively) showed no statistically significant difference from 5 ( t=0.65, P=0.521; t=0.00, P=1.000; t=-0.42, P=0.673). At the 45° profile view, the scores given by orthodontists, orthodontic patients, and healthy adults for the initial model (5.42±0.98, 5.40±1.15, and 5.35±1.45, respectively) were significantly higher than 5 ( t=3.30, P=0.002; t=2.98, P=0.004; t=2.11, P=0.038). At both 90° and 45° profile views, orthodontists, orthodontic patients, and healthy adults all rated the lip prominence of Model 1 in Group E (nasal base recession) significantly higher than 5 (all P<0.05). In Group E (nasal base recession model), changes in zygomatic prominence led to alterations in the overall lip prominence ratings by orthodontists and orthodontic patients, with significant differences among Models 1, 2, and 3 (all P<0.05). In the most attractive facial appearance evaluation, Model 1 of Group D had the highest frequency percentage in both the 90° profile and 45° profile views [90°: 19.8% (42/212); 45°: 22.6% (48/212)]. Conclusions:Orthodontists had the highest sensitivity to changes in lip prominence. The observation angle influenced the perception of lip prominence changes, and variations in zygomatic and nasal base prominence could shift lip prominence evaluations. A slightly larger nasolabial angle, protruded nasal base, and normal zygomatic bone configuration were perceived as the most attractive.

Objective:To evaluate the influence of midface (nasal base and zygomatic bone) morphological changes on the overall perception of lip prominence from different perspectives.Methods:From February to March 2024, 212 volunteers were recruited in Fujian Province as study subjects and divided into three groups: orthodontists [65 participants, 28 males and 37 females, aged (31.3±6.9) years], orthodontic patients [72 participants, 24 males and 48 females, aged (27.6±5.7) years], and healthy adults [75 participants, 37 males and 38 females, aged (25.6±4.4) years]. Three-dimensional facial modeling software was used to generate facial models, which were sculpted using three-dimensional model sculpting software to simulate different nasal base, zygomatic bone, and upper lip prominence conditions. A total of 15 facial models were generated, divided into five groups (three models per group): Group A (normal nasolabial angle, normal nasal base, normal upper lip); Group B (increased nasolabial angle, normal nasal base, flattened upper lip); Group C (decreased nasolabial angle, normal nasal base, protruded upper lip); Group D (increased nasolabial angle, protruded nasal base, normal upper lip); Group E (decreased nasolabial angle, recessed nasal base, normal upper lip). Models 1, 2, and 3 in each group had normal, protruded, and flattened zygomatic bones, respectively (with Model 1 in Group A as the initial model). Forty-five-degree and ninety-degree profile images of the models were captured (30 images in total) and compiled into a questionnaire. Participants in the three study groups were selected as the most attractive and least attractive facial appearances based on the questionnaire and ratings of the lip prominence of the 45° and 90° profile images (0-10 points, where 0=very flat, 5=normal, and 10=very prominent). A one-sample t-test was used to compare the difference between model ratings and the median score of 5. Results:Among the 30 images, the proportion of lip prominence ratings deviating from the median score of 5 was the highest among orthodontists [83% (25/30)], followed by orthodontic patients [67% (20/30)], and lowest among healthy adults [53% (16/30)]. At the 90° profile view, the scores given by orthodontists, orthodontic patients, and healthy adults for the initial model (5.07±0.79, 5.00±1.03, and 4.95±1.07, respectively) showed no statistically significant difference from 5 ( t=0.65, P=0.521; t=0.00, P=1.000; t=-0.42, P=0.673). At the 45° profile view, the scores given by orthodontists, orthodontic patients, and healthy adults for the initial model (5.42±0.98, 5.40±1.15, and 5.35±1.45, respectively) were significantly higher than 5 ( t=3.30, P=0.002; t=2.98, P=0.004; t=2.11, P=0.038). At both 90° and 45° profile views, orthodontists, orthodontic patients, and healthy adults all rated the lip prominence of Model 1 in Group E (nasal base recession) significantly higher than 5 (all P<0.05). In Group E (nasal base recession model), changes in zygomatic prominence led to alterations in the overall lip prominence ratings by orthodontists and orthodontic patients, with significant differences among Models 1, 2, and 3 (all P<0.05). In the most attractive facial appearance evaluation, Model 1 of Group D had the highest frequency percentage in both the 90° profile and 45° profile views [90°: 19.8% (42/212); 45°: 22.6% (48/212)]. Conclusions:Orthodontists had the highest sensitivity to changes in lip prominence. The observation angle influenced the perception of lip prominence changes, and variations in zygomatic and nasal base prominence could shift lip prominence evaluations. A slightly larger nasolabial angle, protruded nasal base, and normal zygomatic bone configuration were perceived as the most attractive.

BACKGROUND:For elderly patients with traumatic hip fractures,the related factors of prognosis are very complex,and the integrity of the lateral wall is one of the influencing factors.It is of important clinical value to understand the effect of lateral wall injury on the prognosis of femoral intertrochanteric fracture. OBJECTIVE:To evaluate the relationship between the integrity of the lateral wall and hip functional recovery and other outcomes in patients with femoral intertrochanteric fractures. METHODS:Totally 82 patients with femoral intertrochanteric fractures were screened and all patients received proximal femoral nail antirotation fixation.According to the thickness of the lateral wall,the patients were divided into the lateral wall intact group(n=31)and lateral wall risk group(n=51).The perioperative indexes,weight-bearing time,fracture healing time,hip joint function and range of motion,postoperative pain and complications were compared between the two groups. RESULTS AND CONCLUSION:(1)The time of hospitalization and the number of fluoroscopies during operation in the lateral wall intact group were significantly lower than those in the lateral wall risk group(P<0.05),but there was no significant difference in other perioperative indexes.(2)Both groups were able to get down to the ground early after surgery and finally complete weight-bearing,but in the lateral wall risk group,the time of fracture healing was longer;the time of complete weight-bearing was significantly delayed;the Harris score of the last follow-up was lower;the range of motion of hip extension and flexion and neck trunk angle on the affected side were smaller(P<0.05).(3)There was no significant difference in the incidence of postoperative complications between the two groups,but the overall incidence of complications in the lateral wall intact group was significantly lower(P<0.05).(4)In summary,after internal fixation of proximal femoral nail antirotation,patients with the intact lateral wall had a relatively better prognosis than those with risk lateral wall.

Objective To compare the efficacy of triangular anchor reduction forceps and towel forceps in the treatment of long oblique or spiral distal tibial fractures.Methods The data of 58 patients admitted to the Department of Traumatic Orthopaedics in Second Affiliated Hospital of Anhui Medical University from June 2019 to March 2021 were analyzed prospectively.According to the reduction methods during operation,they were divided into point reduction forceps group(n=26)and triangle anchor reduction forceps group(n=32).The operation time,intraoperative fluoroscopy times,intraoperative blood loss,postoperative fracture reduction quality,hospital stay,fracture healing time,American orthopedic foot and ankle society(AOFAS)score,curative effect and com-plications at the last follow-up were compared between the two groups.Results All patients participated in the follow-up for more than one year.There was no significant difference in age,sex,basic diseases and injury mechanism between the two groups.The operation time and fluoroscopy times of patients in triangle anchor reduction group were significantly lower than those in point reduction forceps group(P<0.05),while the quality of fracture reduc-tion was higher than that in point reduction forceps group(P<0.05),and there was no significant difference in other perioperative indexes.The fracture healing time of patients in triangle anchor reduction group was shorter,and the ankle joint function was better than that in point reduction forceps group(P<0.05).There was no signifi-cant difference in the incidence of various complications between the two groups,but the overall incidence of complications in the triangle anchor reduction group was significantly lower(P<0.05).Conclusion Triangular anchor reduction forceps can improve the quality of fracture reduction,shorten the healing time of fracture,reduce the occurrence of complications,reduce the operation time and the number of fluoroscopy during operation,and there is no obvious increase in local infection.It is an effective and reliable reduction method.

BACKGROUND: Epidural block(EB) is one of the effective and widely used remedies for lumbar disc herniation(LDH) . Animal experiments have been conducted to study the changes in the local tissue structure in the spinal canel after several treatments with EB.OBJECTIVE: To study the effect of EB for LDH on the local tissue structures in the spinal canel.DESIGN: A non-randomized and controlled clinical observation.PARTICIPANTS: Department of Pathology and Laboratory of Electron Microscope of an Affiliated Hospital of a University.SUBJECTS: Forty patients with LDP, who failed to respond to EB treatment and subsequently received discectomy in the Department of Orthopaedics,First Affiliated Hospital of Sun Yat-sen University from May 1992 to December 1997, were enrolled in this study, with 20 patients receiving discectomy but not EB treatment serving as the control group.METHODS: From the 60 cases, totally 120 specimens of yellow ligament and the disc tissues were obtained during discectomy for optical microscopical examination. A portion of the yellow ligament and the lumbar disc tissues were chosen from EB group(12 cases) and non-EB group(10 cases), respectively, for electron microscope examination(involving altogether 44specimens) . The changes in histology and ultrastructnres in the specimens were compared between the two groups.MAIN OUTCOME MEASURES: ① Main results: the reactive proliferation of the tunica adventitia and inflammatory reaction of the intervertebral disc and yellow ligament; ② Secondary results: changes in the ultrastructure of the anulus fibrosus, nucleus pulposus and yellow ligament.RESULTS: No significant difference was found between the two groups either in light microscopy or electron microscopy in the degree of smoothness and the inflammatory reaction of the cavosurface of the yellow ligament and the disc tissues, nor in the cellular ultrastructures and fibrous arrangement.CONCLUSION: There is no direct relationship between lumbar EB and epidural scar adhesion formation. EB does not affect the ultrastructures of the local tissues in the spinal canal, but care must be taken of the sterilization in the surgical procedure, as chronic inflammatory reaction in the yellow ligament and disc tissues can be present in some patients.

Objective: To study the effects of soluble multi-peptide agent,marked “Gu Kang Tai Ling”,derived from bone tissue on rat bone fracture healing.Methods 80 right tibia defects of rats were sawed.The “Gu Kang Tai Ling”were intramuscularly injected to the rats.The quality of the defect healing was investigated continuously and respectively by the defect bone histomorphometry,biomechanics,X-ray film,and bone mineral density(BMD).Results: Under the treatment of the agent,at early stage trabecular bone volume (TBV)ratio increased 24.7%,and osteoblast surface(OBS)26.7%,at late stage mean trabecular healing surface rate(MTHSR)was increased 38.8%,tibia anti-fracture strength 0.4527～1.4350N，and BMD 7.65% compared with the control group.Conclusion: “Gu Kang Tai Ling”can accelerate rat fracture healing and improve the quality of healing.