Multiple sclerosis (MS) is an autoimmune disease characterized by demyelination, axonal injury, and neuronal loss in central nervous system. Experimental autoimmune encephalomyelitis (EAE) animal model is widely used in MS. Accumulating evidences indicate that the programmed cell death-1/programmed cell death-ligands-1 (PD-1/PD-L1) pathway participates in pathogenesis of autoimmune diseases. The authors comprehensively review the roles of PD-1/PD-L1 pathway in pathogenesis of MS and EAE animal model, and discuss the potential of this pathway as a new therapeutic target for MS, to provide reference for immunotherapy research of MS.

The S3 level clinical practice guideline for the prevention and treatment of peri-implant diseases, developed by the European Federation of Periodontology, was published in June, 2023 (DOI: 10.1111/jcpe.13823), which culminated in the recommendations for implementation of various different interventions before, during and after implant placement/loading. Aim of the present article is to summarize and interpret the key points of this guideline and help clinicians understand this guideline better, in order to standardize the prevention and treatment of peri-implant diseases.

Objective:To investigate the correlation between hematological parameters and testicular viability, and to identify potential indicators of intraoperative testicular viability or postoperative testicular atrophy.Methods:Clinical data of 173 children with testicular torsion treated by emergency operation in the Department of Urology, Beijing Children′s Hospital, Capital Medical University from January 2006 to January 2020 were retrospectively analyzed.According to the surgical methods, 90 and 83 cases were included in the orchiectomy group and orchiopexy group, respectively.The duration of onset, spermatic cord torsion degree and hematological parameters of the 2 groups were compared by the independent-samples t test, χ2 test and Mann- Whitney U test.Risk factors for testicular resection were analyzed by multivariate Logistic regression.In addition, 30 children in the orchiopexy group were followed up for bilateral scrotal ultrasound at 6 months postoperatively.They were sub-grouped into testicular atrophy group (13 cases, 43.3%) and non-atrophy group (17 cases). Differences between 2 subgroups were compared by the independent-samples t test and Mann- Whitney U test.Receiver operating characteristic (ROC) curves were plotted to analyze the prognostic potentials of indexes with significant differences in children with the duration of onset of >6-<51 h. Results:Duration of onset (9.3 h vs.51.0 h)( Z=-8.293, P<0.001), spermatic cord torsion degree (360.0° vs. 540.0°)( Z=-5.267, P<0.001), mean platelet volume (MPV) (9.8 fL vs.10.1 fL)( Z=-2.018, P=0.044) and age (147.5 months vs. 143.0 months)( Z=-2.165, P=0.030) were significantly different between the orchiopexy group and the orchiectomy group.The multivariate Logistic regression analysis suggested that the duration of onset ( OR=1.033, P<0.001), spermatic cord torsion degree ( OR=1.004, P<0.001) and MPV ( OR=1.662, P=0.044) were positively correlated with testicular resection.For patients with the duration of onset of >6-<51 h, the area under the curve (AUC) of duration of onset, spermatic cord torsion degree and MPV was 0.753, 0.755 and 0.629, respectively.MPV was significantly different in the postoperative testicular atrophy group and the non-atrophy group [(10.2±0.5) fL vs.(9.8±0.5) fL]( t=2.426, P=0.022). The ROC curve analysis showed that the cut-off value of MPV for predicting testicular atrophy was 9.9 fL, and its sensitivity and specificity were 83.3% and 70.6%, respectively, the AUC was 0.752. Conclusions:The duration of onset, spermatic cord torsion degree and MPV can be used as predictors of intraoperative testicular viability, which are helpful for clinicians to predict and judge the testicular necrosis caused by testicular torsion before operation.In addition, 43.3% of children with testicular torsion eventually developed testicular atrophy after orchiopexy, and only MPV may be used as a predictor of postoperative testicular atrophy.

Objective:To discuss the treatment and prognosis of children with torsion of inguinal cryptorchidism.Methods:Clinical data of 15 cases of inguinal cryptorchidism with testicular torsion admitted to Beijing Children's Hospital from October 2015 to February 2019 were retrospectively analyzed. The average age of onset was 5.1 years (4 months-17 years). The clinical manifestations included inguinal swelling and pain in 13 cases, abdominal pain in 1 case and abdominal pain with vomiting in 1 case. The average duration of symptoms (up to the time of surgery) was 45.9 (5-170) h. Physical examination showed scrotal voided on affected side, groin swelling with tenderness. Lesions were found in 12 cases on the left and 3 cases on the right. Groin color Doppler ultrasound examination showed testis enlargement, uneven echo, decrease or disappearance of blood flow signal, suspected testicular torsion. Clinical diagnosis was inguinal cryptorchidism testicular torsion. Inguinal canal testicular exploration under general anesthesia. During the operation, the testicle was dark and twisted with an average torsion of 600°(180°-1 080°). Testicular activity was observed after exposure and reduction and torsion. After reduction, testicular color was immediately restored in 5 cases. After cutting open the white membrane of the testicular, there was blood outflow. In 2 cases, the testis was found to be inactive during the operation, but the parents requested to retain the testis and performed orchiopexy. 8 cases underwent orchiectomy due to necrosis of testis. The mean symptom duration (up to the time of operation) of the orchiectomy group and the orchiectomy group was 24.3 (5-73) h and 64.8 (7-170) h, respectively. The average torsion degree was 514° and 675°, respectively.Results:The average operative time of 15 patients was 56.7 min (40-85 min). Intraoperative blood loss averaged 1.5 (1-2) ml. There were no complications during and after operation. Postoperative follow-up averaged 27 (8-47) months. Among the 7 patients in the orchiopexy group, 3 patients had atrophy of testis 7.3 months after operation, and the remaining 4 patients had normal testis. In the orchiectomy group, 8 cases had normal contralateral testis without torsion.Conclusions:Inguinal cryptorchidism testicular torsion is a relatively rare disease in children. Color Doppler ultrasonography and inguinal canal exploration can help diagnosis and treatment. According to the condition of testis, orchiopexy or orchiectomy can be performed. Early diagnosis of this disease is difficult, easy to lead to testicular loss or postoperative atrophy.

Objective:To explore the effect of systemic use of amoxicillin and metronidazole during mechanical therapy on the clinical parameters of the first molars and periodontal microorganisms in subgingival plaque and saliva in patients with generalized aggressive periodontitis (GAgP).Methods:A total of 23 GAgP patients were recruited from Peking University School and Hospital of Stomatology from January 2006 to December 2009 and then randomly divided into two groups according to random number table: 12 patients received scaling and root planning (SRP) only and 11 patients received SRP combined with systemic administration of antibiotics (amoxicillin and metronidazole for a week after supragingival scaling). Clinical examination of periodontal parameters and collection of saliva and pooled subgingival plaque samples from mesial-buccal sites of 4 first molars were performed before initial therapy and 2, 4 and 6 months respectively after mechanical therapy, and saliva samples were also collected 2 weeks after therapy. Eight different periodontal microorganisms were detected in these samples by PCR. In addition, semiquantitative analysis of red complex microorganisms [ Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td)] was performed. Results:Both therapies led to significant decrease of the plaque index (PLI), probing depth (PD) and bleeding index (BI) from mesial-buccal sites of first molars. Meanwhile the PD of antibiotics group [(4.21±1.50), (4.00±1.54), (3.84±1.89) mm of 2, 4 and 6 months respectively after therapy] was significantly lower than the SRP group [(5.29±1.27), (5.30±1.34), (4.98±1.36) mm of 2, 4 and 6 months respectively after therapy] at 3 different time points after mechanical therapy ( P<0.05). In the antibiotics group, the quantities of Pg, Tf and Td in subgingival plaque samples (the median quantity decreased to 0.0 ng at 2, 4 and 6 months after therapy) and saliva samples (the median quantity of Tf and Td decreased to 0.0 ng at 2, 4 and 6 months after therapy ( P<0.05), and the median quantity of Pg decreased to 16.3, 59.6 and 22.4 ng at 2, 4 and 6 months respectively after therapy) significantly decreased at 3 different time points after mechanical therapy compared with before therapy ( P<0.05). While in the SRP group, there were no significant changes in the quantities of Tf and Td in saliva at 2, 4 and 6 months after mechanical therapy ( P>0.05) , and the quantities of Tf and Td in subgingival plaque significantly decreased only at 2 months after therapy ( P<0.05). Conclusions:SRP combined with systemic administration of amoxicillin and metronidazole could achieve greater improvement in PD of first molars and better control of the amounts of red complex microorganisms in the saliva and subgingival plaque of GAgP patients over a 6-month period.

Objective:To explore the correlation and interaction between epidermal growth factor (EGF) rs2237051 and peroxidase proliferators activate receptor-α (PPAR-α) rs4253623 polymorphisms and the susceptibility of generalized aggressive periodontitis (GAgP).Methods:Two hundred and nineteen Chinese patients with GAgP were enrolled from the patients of the Department of Periodontology, Peking University School and Hospital of Stomatology from January 2001 to December 2015. The control group comprised 138 periodontally healthy volunteers recruited from the staff and students of the Peking University School and Hospital of Stomatology. The EGF rs2237051 and PPAR-α rs4253623 polymorphisms were genotyped using time-of-flight mass spectrometry. Logistic regression models were conducted to analyze the correlation between the EGF rs2237051 and PPAR-α rs4253623 variants with GAgP. The likelihood ratio test was used to analyze whether there was an interaction between the two polymorphisms in the susceptibility of GAgP. The interaction model adopted was the multiplication model.Results:The mean ages of GAgP group (male:87; female:132) and control group (male: 53; female: 85) were (27.3±4.5) years and (27.1±4.2) years respectively and there was no significant difference in age and gender distribution between the two groups. For EGF rs2237051, the frequency of AA genotype in the GAgP group [49.5% (107/216)] was significantly higher than that in the control group [37.7% (52/138)], and the frequency of AG/GG genotype in the GAgP group [50.5% (109/216)] was significantly lower than that in the control group [62.3% (86/138)]( P<0.05). Compared with AA genotype, individuals with AG/GG genotype had a 39% lower risk of GAgP after adjustment of age and gender ( OR: 0.61, 95 %CI: 0.40-0.95, P<0.05). For PPAR-α rs4253623, the frequency of AA genotype in the GAgP group [76.2% (160/210)] was significantly higher than that in the control group [65.9%(81/123)], and the frequency of AG/GG genotype in the GAgP group [23.8% (50/210)] was significantly lower than that in the control group [34.1%(42/123)] ( P<0.05). Compared with AA genotype, individuals with AG/GG genotype had a 40% lower risk of GAgP after adjustment of age and gender ( OR: 0.60, 95 %CI: 0.36-0.98, P<0.05). EGF rs2237051 and PPAR-α rs4253623 showed a significant interaction in the susceptibility to GAgP. Compared with AA genotype, the risk of GAgP in individuals with both AG/GG genotypes of EGF rs2237051 and PPAR-α rs4253623 was reduced by 66% ( OR: 0.34, 95 %CI: 0.17-0.66, P<0.01). Conclusions:EGF rs2237051 and PPAR-α rs4253623 are correlated with GAgP susceptibility, and there is a significant interaction between them in the susceptibility of GAgP. The G allele of the two loci has a protective effect on the disease of GAgP.

Objective:To study the prevalence of Akabane virus (AKAV) in Yunnan province.Methods:A group of sentinel animals including 5 goats and 10 cattles which were sero-negative for bluetongue virus and AKAV were located in Mangshi, Yunnan province, to monitor arbovirus activity from April to October 2015. The heparin-anticoagulated blood of the animals was collected weekly for arbovirus isolation. Erythrocytes were lysed in distilied water and inoculated onto BHK-21 monolayer for virus isolation. After the cells showed cytopathic effect (CPE), AKAV in the cell cuture were identified by RT-PCR amplification with AKAV S gene segment specific primers and gene sequencing.Results:The result indicated that BHK-21 cell inoculated with the blood from one sentinel goat showed CPE 48 h post inoculation. One day old suckling mice intracerebrally inoculated with the supernatant of the cell culture, they started to become sick and died after 3 days. RT-PCR identification and S gene sequencing showed that the isolate was AKAV (numbered as 16415). The full length of S segment gene of 16415 is 856 nt, encoding 233 amino acids of protein N, and 91 amino acids of protein Ns. Phylogenetic analysis showed that, among the AKAV strains isolated from China and abroad, the newly isolated 16415 was in the same branch with the other viruses in different geographical regions, and their S segment nucleotide sequence have a high homology of 83.8%-97.7%. The further study show that 16415 and the AKAV isolated from the domestic bamboo rat in Guangxi in 2013 have a closest realtionship in evolution, the nucleotide sequence homology was 97.7%, and amino acid homology is 99.6%. Compared with the Japanese OBE-1 strain, the amino acids of protein N of 16415 and the AKAVs, isolated from banboo rat in Guangxi and Anopheles vagas in Mangshi of Yunnan province of China, have two common diverse amino acids loci located at the 115th and 206th sites respectively. Conclusions:It is concluded that AKAV was newly isolated from goat in Mangshi of Yunnan province, which may have important epidemiological significance.

Objective To investigate the risk factors associated with cerebrospinal fluid (CSF) fistulas due to endoscopic transnasal surgery for pituitary neoplasms.Methods The data of 1,063patients were reviewed who had undergone transnasal surgery for pituitary adenomas between January 2009 and December 2012 at Department of Neurosurgery,General Hospital of PLA in Beijing.Intra-operative CSF fistulas were observed in 122 patients but not in the other 941 ones;post-operative CSF fistulas were observed in 29 patients but not in the other 1,034 ones.The clinical data were compared between the patients with and without intra-operative CSF fistulas and between those with and without post-operative CSF fistulas.Chi-square was used to identify the potential risk factors associated with intra-and post-operative CSF fistulas.Multivariate Logistic analysis was performed for correlated variables.Results There was a significant difference in tumor size between the patients with and without intra-operative CSF fistulas (P＜0.05).There were significantly more patients undergoing reoperation in those with intra-operative CSF fistulas than in those without (P＜0.05).The multivariate Logistic analysis revealed that giant adenoma,macroadenoma and reoperation were independently associated with intraoperative CSF fistulas.There was a significant difference in age and tumor size between the patients with and without post-operative CSF fistulas (P＜0.05).There were significantly more patients undergoing reoperation and suffering intraoperative CSF fistulas in those with post-operative CSF fistulas than in those without (P＜0.05).The multivariate Logistic analysis revealed that giant pituitary neoplasms,reoperation and intra-operative CSF fistulas were independently associated with post-operative CSF fistulas.Conclusions In endoscopic transnasal surgery for pituitary neoplasms,the risk factors for intra-operative CSF fistulas are larger tumor size and reoperation and the risk factors for post-operative CSF fistulas are giant pituitary neoplasms,intra-operative CSF fistulas and reoperation.

Objective:To investigate the potential association between FADS1 rs1 74537 polymorphism and serum proteins in patients with aggressive periodontitis,which may provide benefits for diagnosis and treatment of aggressive periodontitis.Methods:A total of 353 patients with aggressive periodontitis (group AgP)and 1 25 matched controls (group HP)were recruited in the study.Genotyping of FADS1 rs1 74537 and serum biochemical indexes were tested at the study’s start.The relationships between the levels of TP,GLB,ALB,A/G and genotyping were analyzed.Results:(1 )The detection rate of allele G in group AgP was higher than that in group HP(68.1% vs.61 .2%,P=0.046,OR=1 .35,95% CI 1 .00-1 .83 );the detection rate of genotype GG in group AgP was higher than in group HP(45 .5%vs. 34.4%,P=0.029,OR=1 .60,95%CI 1 .05 -2.44).(2)In group AgP,the patients with GG geno-type exhibited significantly lower TP,GLB than the patients with GT+TT genotype [(77.08 ±7.88)g/L vs.(79.00 ±4.66)g/L,P=0.007;(28.1 7 ±7.63)g/L vs.(29.88 ±3.49)g/L,P=0.007)and the higher A/G(1 .72 ±0.22 vs.1 .67 ±0.22,P=0.040),but there was no significant difference in ALB between the patients with GG genotype and the patients with GT+TT genotype.In group HP,there were no significant differences in TP,GLB,A/G and ALB between individuals with genotype GT+TT and with genotype GG.(3 )Compared with individuals with genotype GT+TT in group HP,the AgP pa-tients with genotype GT +TT exhibited significantly higher TP,GLB [(79.00 ±4.66 ) g/L vs. (75.20 ±4.53)g/L,P<0.01;(29.88 ±3.49)g/L vs.(26.55 ±2.94)g/L,P<0.01 )and the lo-wer A/G(1 .67 ±0.22 vs.1 .88 ±0.30,P<0.01 ),but there was no significant difference in ALB. There were no significant differences in TP,GLB,A/G and ALB the between the AgP patients with ge-notype GG and the healthy subjects with the same genotype either.Conclusion:FADS1 rs1 74537 poly-morphism is associated with aggressive periodontitis.The patients with genotype GG in group AgP had relatively lower TP,GLB and higher A/G.Genotype GG might be a risk indicator for aggressive periodon-titis by reducing host defense capability and contributing to inflammatory response in the occurrence and development of aggressive periodontitis.

Objective:To analyze the serum IgG titers to Aggregatibacter actinomycetemcomitans ( Aa ) and associated factors in patients with aggressive periodontitis (AgP).Methods:Venous blood samples were collected from 62 AgP patients and 45 periodontal healthy controls , unstimulated whole saliva and pooled subgingival plaque samples of AgP patients were also collected for the detection of Aa ( PCR method) .Serum IgG titers to Aa serotype c were measured by enzyme-linked immunosorbnent assay ( ELISA) .Results:The detection rates of serum IgG to Aa serotype c in the AgP patients and the healthy controls were both 100%.The AgP patients exhibited significantly higher IgG titers to Aa serotype c than the healthy controls (11.1 ±1.9 vs.9.1 ±1.8, P<0.01).There was no significant difference in serum IgG levels to Aa serotype c and in the prevalence of high-responding patients to Aa serotype c between the incisor-first molar type AgP patients and generalized AgP patients .Serum IgG titers to Aa serotype c in the Aa-positive AgP patients ( the patients who were Aa-positive in subgingival plaque or saliva ) were sig-nificantly higher than those of the Aa-negative patients (11.9 ±1.3 vs.10.7 ±2.1, P<0.05).Con-clusion:Serotype c was the main serotype of Aa in Chinese patients with AgP .Serum IgG responses in generalized AgP patients were comparable to those in incisor-first molar type AgP patients .