Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

Post-acute pancreatitis diabetes is one of the most common distant complications of acute pancreatitis. However, its incidence has been underestimated for a long time, indicating that it has not been taken seriously by healthcare professionals in clinical practice. This article provides a review of the urgent need for healthcare professionals to focus on the current status, adverse outcomes, screening and management aspects of diabetes after acute pancreatitis, and aims to provide a reference for healthcare professionals in their relevant clinical work.

Objective:To analyze the efficacy of unilateral arytenoid chondroplasty combined with minimally invasive mucosal flap plasty in the management bilateral vocal cord paralysis.Methods:A total of 66 patients with bilateral vocal cord paralysis hospitalized in the First Hospital of Sun Yat-sen University from January 2018 to December 2023 were retrospectively analyzed, among whom there were 8 males and 58 females, with ages ranging from 35 to 86 years old(mean age (57.8±11.6) years). All patients underwent suspension laryngoscopic CO 2 laser unilateral arytenoid chondroplasty and mucosal flap under general anesthesia. Postoperative follow-up period extended from 6 months to 6 years, with a median duration of 28 months. The study compared the degree of dyspnea and voice quality (subjective and objective evaluation) of the patients pre- and post-operatively, and analyzed the clinical differences between patients with and without preoperative or intraoperative tracheotomy, the extubation rate of tracheotomized patients, the recurrence rate, and the complication rate. Continuous variables conforming to normal distribution were tested by t-test and categorical variables by χ2 test,the Wilcoxon rank-sum test was used to analyze the improvement in dyspnea before and after surgery. Results:Compared with the preoperative period, 59 patients showed improvement in postoperative dyspnea ( U=161.5, P<0.01); there was no significant difference in voice disorder index 10, subjective auditory-perceptual assessment, and maximal vocalization time ( P>0.05), all of which remained within the relative normal range. Tracheotomy was performed in 32 out of 66 patients, with predominantly degree Ⅲ- dyspnea (46.9%, 15/32), including 26 patients with preoperative tracheotomy and 6 patients with intraoperative tracheotomy. Among the 34 patients who did not undergo tracheotomy, the majority presented with degree Ⅱ-dyspnea (82.4%, 28/34). All patients achieved successful extubation following surgery, with a mean median time to extubation of 1 month. Conclusions:The combination of unilateral arytenoid chondroplasty and minimally invasive mucosal flap plasty represents a refined and effective therapeutic approach for bilateral vocal cord paralysis. This minimally invasive technique has the potential to reduce the rate of tracheotomy.

Objective Taking 41 kinds of Chinese herbal medicines commonly used in Meizhou Hakka as the research object,their inhibitory activities against α-glucosidase and α-amylase were screened and the enzyme inhibition types of the species with the strongest activities were explored.Methods The inhibitory activities of 41 commonly used Hakka herbs in Meizhou against α-glucosidase and α-amylase were evaluated by the p-Nitrophenyl a-D-mannopyranoside(pNPG)method and the 3,5-Dinitrosalicylic acid(DNS)method,using the inhibitory rate of half(IC50)as an index.The inhibitory activity of 95%ethanol extracts of 41 Chinese herbal medicines commonly used in Meizhou Hakka on α-glucosidase and α-amylase were analysed.The enzymatic kinetics method and Lineweaver-Burk curve were used to analyze the inhibitory type of the most active species.Results The results showed that 40 Chinese herbal medicines commonly used in Meizhou Hakka had α-glucosidase inhibitory activity,and 23 medicines had α-amylase inhibitory activity,among which Psychotria asiatica Wall.showed the strongest inhibitory activity with the IC50 values aganist α-glucosidase and α-amylase of 0.17±0.001 mg·mL-1 and 0.09±0.001 mg·mL-1,respectively.The inhibition types were reversible competitive inhibition and reversible non-competitive inhibition,respectively.Conclusion The Psychotria asiatica Wall.Chinese herbal medicines commonly used in Meizhou Hakka has significant inhibitory effect on the activity of glucose metabolism enzymes,which has potential value for further research and development on the prevention and treatment of diabetes mellitus.

Objective:To evaluate the feasibility of PET automatic drug infusion system combined with power peripherally inserted central catheter (PICC) for 18F-FDG injection and PET/CT imaging. Methods:Fifty patients with malignant neoplasms who underwent 18F-FDG PET/CT imaging in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine between December 2021 to July 2022 were prospectively enrolled. They were equally divided into power PICC group and peripheral venipuncture group. PET automatic drug infusion system was respectively connected with the pre-established channels of power PICC and peripheral venipuncture for 18F-FDG injection. Each patient underwent a routine PET/CT imaging at 1 h post-injection. The blood glucose, body weight, prescription dose and injection dose were recorded, and SUV max in the liver and cavoatrial junction were measured in both groups. The independent-sample t test was performed to compare the differences between 2 groups. The power PICC tip positions after 18F-FDG injection in power PICC group were observed. Results:The liver SUV max in the power PICC group and peripheral group were 2.54±0.50 and 2.57±0.31 ( t=0.37, P=0.716), and the SUV max of cavoatrial junction in the 2 groups were 1.68±0.25 and 1.63±0.22 ( t=-0.78, P=0.441), respectively. No significant differences were found in blood glucose, body weight, prescription dose and injection dose between the 2 groups ( t values: 0.00-0.13, all P>0.05). The ratios of injection dose to prescription dose in the 2 groups were 0.998 3±0.007 3 and 0.997 6±0.016 5, respectively, indicating high injection accuracy of the injection methods. No obvious drug residue was displayed at the end of catheter, resulting in good imaging quality. All the tip positions after injection were between T5 and T8, in line with the standardization management of power PICC. Conclusion:PET automatic drug infusion system combined with power PICC can be safely used for 18F-FDG injection and PET/CT imaging with less injection puncture.

Objective:To evaluate the effect of oxiracetam on sevoflurane-induced cognitive dysfunction in mice and the role of phosphatidylinositol 3-kinase/serine/threonine protein kinase (PI3K/Akt) signaling pathway.Methods:Eighty adult Kunming mice, half male and half female, weighing 35-55 g, were divided into 4 groups ( n=20 each) using a random number table method: control group (group C), sevoflurane group (group S), oxiracetam plus sevoflurane group (group OS), and LY294002 plus oxiracetam plus sevoflurane group (group LOS). Group S inhaled 2% sevoflurane for 6 h. A 2 h before sevoflurane anesthesia, oxiracetam 105 mg/kg was injected via the tail vein in group OS, oxiracetam 105 mg/kg and LY294002 0.3 mg/kg were injected via the tail vein in group LOS, and the equal volume of normal saline was injected in group S. The apoptosis rate of hippocampal neurons was detected using TUNEL.The expression of PI3K, phosphorylated PI3K (p-PI3K), Akt and phosphorylated Akt (p-Akt) was determined by Western blot.Cognitive function was assessed using Y-maze at 14 days after the end of anesthesia. Results:Compared with group C, the apoptosis rate of hippocampal neurons was significantly increased, the total number of times and the number of errors required for 10 times of correct responses in Y-maze test were increased, and the expression of PI3K, Akt p-PI3K and p-Akt in hippocampal tissues was down-regulated in group S ( P<0.05). Compared with group S, the apoptosis rate of hippocampal neurons was significantly decreased, the total number of times and the number of errors required for 10 times of correct responses in Y-maze test were decreased, the expression of PI3K, Akt, p-PI3K and p-Akt in hippocampal tissues was up-regulated in group OS ( P<0.05), and no significant changes were found in the parameters mentioned above in group LOS ( P>0.05). Compared with group OS, the apoptosis rate of hippocampal neurons was significantly increased, the total number of times and the number of errors required for 10 times of correct responses in Y-maze test were increased, and the expression of PI3K, Akt, p-PI3K and p-Akt in hippocampal tissues was down-regulated in group LOS ( P<0.05). Conclusion:Oxiracetam can alleviate sevoflurane-induced cognitive dysfunction in mice, and the mechanism may be related to activating PI3K/Akt signaling pathway and inhibiting apoptosis in neurons.

T-Vec（talimogene laherparepvec）是由Ⅰ型单纯疱疹病毒（HSV-1）改造而来的一种溶瘤病毒，能够选择性地在恶性肿 瘤细胞中复制而不伤及其他正常细胞。T-Vec在治疗晚期黑色素瘤患者的Ⅲ期临床试验中显示出良好的安全性和肿瘤治疗效 果，已于2015年经美国FDA批准用于治疗晚期黑色素瘤。为了提高T-Vec的疗效，扩大其应用范围，T-Vec联合其他抗肿瘤疗法 以及应用于其他肿瘤的临床试验仍在陆续开展。近期，T-Vec联合免疫检查点抑制剂在治疗晚期黑色素瘤的临床试验中取得新 进展，临床数据显示T-Vec联合疗法具有更强的抗肿瘤活性。此外，T-Vec在治疗头颈癌、胰腺癌、肝癌等肿瘤的临床研究中也取 得了一定进展。本文对近年来T-Vec治疗肿瘤的临床试验的相关研究进展做一综述。

PURPOSE: MicroRNAs (miRs) were recently recognized to be important for immune cell differentiation and immune regulation. However, whether miRs were involved in allergen-specific immunotherapy (SIT) remains largely unknown. This study sought to examine changes in miR-146a and T regulatory cells in children with persistent allergic rhinitis (AR) after 3 months of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). METHODS: Twenty-four HDM-sensitized children with persistent AR were enrolled and treated with SCIT (n=13) or SLIT (n=11) for 3 months. Relative miR-146a and Foxp3 mRNA expression, the TRAF6 protein level, and the ratio of post-treatment to baseline IL-10+CD4+ T cells between the SCIT and SLIT groups were examined in the peripheral blood mononuclear cells (PBMCs) of AR patients using quantitative reverse transcription polymerase chain reaction (qRT-PCR), flow cytometry, and Western blot analysis, respectively. Serum levels of IL-5 and IL-10 were determined using ELISA. RESULTS: After 3 months of SIT, both the TNSS and INSS scores were significantly decreased compared to the baseline value (P<0.01). The relative expression of miR-146a and Foxp3 mRNA was significantly increased after both SCIT and SLIT (P<0.01). The ratio of post-treatment to baseline IL-10+CD4+ T cells and the serum IL-10 level were significantly increased in both the SCIT and SLIT groups (P<0.01), whereas the TRAF6 protein level and serum IL-5 level were significantly decreased (P<0.01). No significant differences in these biomarkers were observed between the SCIT and SLIT groups. CONCLUSIONS: Our findings suggest that miR-146a and its related biomarkers may be comparably modulated after both SCIT and SLIT, highlighting miR-146a as a potential therapeutic target for the improved management of AR.
Biomarkers ; Blotting, Western ; Cell Differentiation ; Child* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Immunotherapy* ; Interleukin-10 ; Interleukin-5 ; MicroRNAs ; Polymerase Chain Reaction ; Reverse Transcription ; Rhinitis* ; RNA, Messenger ; Sublingual Immunotherapy ; T-Lymphocytes ; TNF Receptor-Associated Factor 6

PURPOSE: Chronic rhinosinusitis (CRS) is characterized by the excessive production of mucus. However, the molecular mechanism underlying mucin overproduction in CRS with or without nasal polyps (CRSwNP and CRSsNP, respectively) is poorly understood. This study was conducted to assess the importance of the transcription factor FoxA2 in mucin production and to investigate the targeting of FoxA2 as a potential therapeutic strategy for mucus hypersecretion in CRS patients. METHODS: We enrolled 15 CRSwNP patients, 15 CRSsNP patients, and 10 normal controls in this study. The expression levels of FoxA2, MUC5AC, and MUC5B in inflamed and healthy nasal tissues were examined via immunohistochemistry and quantitative reverse transcription-polymerase chain reaction, and the levels of several proinflammatory cytokines in nasal secretions were measured via FlowCytomix analysis. In addition, the expression of MUC5AC and FoxA2 was determined in polyp-derived epithelial cells and NCI-H292 cells after in vitro stimulation. RESULTS: FoxA2 was significantly down-regulated, and MUC5AC and MUC5B were significantly up-regulated in both the CRSwNP and CRSsNP patients compared to the controls (P<0.05), and the protein level of FoxA2 was negatively associated with the IL-6 level in the CRS patients (P<0.05). IL-6 significantly increased MUC5AC expression but inhibited FoxA2 expression in vitro (P<0.05). Transfection with a FoxA2 expression plasmid significantly decreased MUC5AC promoter activity (P<0.05) and inhibited IL-6-induced MUC5AC production (P<0.05). In addition, clarithromycin significantly alleviated IL-6-induced FoxA2 suppression and decreased MUC5AC expression in vitro (P<0.05). CONCLUSIONS: Our findings suggest that FoxA2 may be considered a therapeutic target for the modulation of mucus hypersecretion in CRS patients.
Clarithromycin ; Cytokines ; Epithelial Cells ; Humans ; Immunohistochemistry ; Interleukin-6 ; Mucins ; Mucus ; Nasal Polyps* ; Plasmids ; Transcription Factors* ; Transfection

Objective To introduce a practical method that can be used to efficiently express,purify and identify Alzheimer's disease (AD) related beta-site app-cleaving enzyme 1 (BACE1) in common eukaryotic cells.Methods BACE1 cDNA was fished out from human brain cDNA library and ligated into the pEGFP-c3 expression vector,and then,the recombinant plasmid was transfected into the HEK293 cells.The BACE1 protein was purified with TALON Mental Affinity Resins column.The target protein was identified by Western blotting and fluorescence resonance energy transfer (FRET).BACE1 Activity Assay Kit was employed to test the activity of purified BACE1 in vitro.The recombinant BACE1/pEGFP-c3 plasmid and amyloid precusor protein (APP)/pDsRed-Monomer-N1 plasmid were co-transfected to the HEK293 cells and the cleavage activity of BACE1 in the cells was identified by Western blotting.Results The sequencing data of the obtained BACE1 gene were identical with those in GenBank.Activity test showed that the fluorescent values of blank controls,expressed BACE1 and standard BACE1 were 55.013±3.597,1836.629±154.195 (n=3) and 2639.548±207.1901 (n=3),respectively;as compared with the control group,significant differences were noted in both of the two groups (F=78.681,P=0.000);however,there is no significant difference between expressed BACE1 and standard BACE1 groups (P＞0.05).Westem blotting showed the co-transfected BACE1 could cleave APP in HEK293 cells and the CTF-APP band was detectable.Conclusion A practical protocol is established for high expression,purification and identification of BACE1 in HEK293 cells,which is helpful to obtain BACE1,an important molecular target in AD research and treatment.