Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Objective:To compare the effects of different anesthetic methods on the prognosis in the patients with stage Ⅲ breast cancer.Methods:Based on a multicenter randomized controlled trial (NCT00418457), 274 patients with untreated stage Ⅲ breast cancer, aged 18-85 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, were enrolled in the study and assigned to thoracic paravertebral block (TPVB) combined with total intravenous anesthesia group (TPVB+ TIVA group, n=141) and general anesthesia group (GA group, n=133) by computer-generated randomization stratified by study site.The primary outcome parameter of this study was postoperative recurrence rate.The secondary outcome parameters were the degree of postoperative acute pain (assessed using visual analogue scale score), the incidence of postoperative nausea and vomiting (PONV), postoperative hospital stay time, and the incidence of persistent pain after breast cancer surgery (PPBCS) at 6 and 12 months after surgery (assessed using the modified Brief Pain Inventory). Results:Compared with group GA, no significant change was found in the postoperative recurrence rate ( HR=0.711, 95% confidence interval (CI) 0.418-1.210, P=0.209), the degree of postoperative acute pain and the incidence of PONV were decreased (mean difference ( MD) of visual analogue scale score -0.890, 95% CI -1.344--0.436, P<0.001; OR=0.236, 95% CI 0.083-0.674, P=0.007), and no significant change was found in postoperative hospital stay time and the incidence of PPBCS ( HR=1.000, 95% CI 0.778-1.286, P=1.000; OR=2.100, 95% CI 0.599-7.362, P=0.246) in group TPVB+ TIVA. Conclusion:Compared with general anesthesia alone, TPVB combined with total intravenous anesthesia can provide lower degree of postoperative acute pain and lower incidence of PONV, and exert no effects on postoperative recurrence, postoperative hospital stay time and PPBCS in patients with stage Ⅲ breast cancer.

Objective: To report the experience on the multi-disciplinary management of metastatic renal cell (mRCC) patients in a single center. Methods: Data of 168 mRCC patients treated by multi-disciplinary team (MDT) at Sun Yat-sen University Cancer Center from December 2007 to February 2019 was retrospectively analyzed.Three treatment groups were identified, including 76 patients with 55 males and 21 females, received anti-angiogenic agents alone (Group A), 66 patients with 55 males and 11 males, received anti-angiogenic agents plus local therapy (Group B)and 26 patients, with 19 males and 7 females, received anti-angiogenic agents plus immunotherapy and local therapy (Group C). The Sunitinib, Sorafenib, Axitinib were chosen for the TKI. The Pembrolizumab was used for immunotherapy. The stereotactic body radiation therapy and surgical excision were considered as the local therapy. The study aims to compare the age, gender, IMDC score, pathology, nbephrectomy, adverse events, progression-free survival and overall survival (OS). Results: Of all patients, the median follow-up duration was 23 months (ranging 6-117 cmonths). The PFS was 18.3 months and median OS was 33.5 months. The 2 years and 5 years survival rate was 66% and 35%, respectively. The median OS of Group A, B and C were 29.8 months, 44.6 months and not reached. 2y-OS was 58%, 67% and 89%, while 5y-OS 12%, 46% and 57%.There was no difference in age, gender, IMDC score, pathology, synchronous metastases or nephterectomy between the three groups. The prognostic result in TKI based combination therapy was superior to TKI therapy alone, which the 5y-OS was 51% and 11%, respectively. The prognostic result in group C's moderate-high risk mRCC patients was superior to group A and B. The median OS in TKI+ DC and CIK+ Pembrolizumab was 49.1 months and 53.1 months. On univariate analyses, IMDC score, nephrectomy and treatment group was associated with OS (P<0.05). On multivariate analyses, treatment group, nephrectomy was associated with OS (P<0.05). The risk of death of Group C decreased about 60% [HR 0.39 (0.17, 0.89), P=0.026]. 78 (46.4%) patients on TKI alone and 16 (61.5%) patients treated with TKI plus immunotherapy had Grade 3 or 4 adverse events. 16 (20.3%) patients had Clavien Ⅲ-Ⅳ toxicity after surgical procedures. 6 (5.7%) patients had Grade 3 toxiciy after SBRT. Conclusions Patients treated with combined therapy had better survival than those treated with anti-angiogenic agents alone. MDT approach could bring survival benefit to mRCC patients.

Objective To evaluate the effect of thoracic paravertebral block ( TPVB) combined with general anesthesia on early postoperative recovery in patients undergoing breast cancer surgery. Meth-ods A total of 201 patients with untreated primary breast cancer, aged 18-69 yr, with body mass in-dex <35 kg∕m2 , of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective surgery for treatment, were enrolled and randomly assigned to general anesthesia group (group GA, n =102) and TPVB combined with general anesthesia group (group TGA, n= 99). In group TGA, TPVB was performed under ultrasound guidance at 30 min before surgery, and 0. 75％ ropivacaine 5 ml was injected at each puncture site of T1-5 . In group GA, local infiltration anesthesia was performed with 1％ lidocaine 0. 2 ml at each puncture site. Anesthesia was induced with IV fentanyl, propofol and rocuronium in both groups. Anesthesia was maintained by inhaling sevoflurane ( group GA), target-controlled infusion of propofol (group TGA) and intermittent IV boluses of fentanyl or rocuronium. Bispectral index value was maintained at 40-60 during surgery. Verbal Rating Scale score was used to assess the severity of pain after surgery. Parecoxib sodium 40 mg, pethidine 50 mg, tramadol 50 mg or fentanyl 50 μg was selected and intrave-nously injected as rescue analgesics when Verbal Rating Scale pain score>4. The requirement for rescue analgesia and development of nausea and retching∕vomiting were recorded within 2 days after surgery. Chinese quality of recovery score was used to assess the early postoperative quality of recovery on days 1 and 2 after surgery. Results Compared with group GA, the quality of recovery score was significantly increased on days 1 and 2 after surgery, the incidence of postoperative nausea was decreased (P<0. 05), and no signifi-cant change was found in the requirement for rescue analgesia or incidence of retching∕vomiting after surgery in group TGA (P>0. 05). Conclusion TPVB combined with general anesthesia is more helpful than gen-eral anesthesia alone for early postoperative recovery in the patients undergoing breast cancer surgery.

Objective To evaluate the effect of thoracic paravertebral block ( TPVB) combined with general anesthesia on the long-term quality of life in the patients undergoing breast cancer surgery. Methods A total of 156 patients, aged 18-64 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, undergoing breast cancer surgery, were randomly assigned to TPVB combined with general anes-thesia group (TPVB+GA group, n= 78) and general anesthesia group (GA group, n = 78), and the pa-tients in two groups were matched with a ratio of 1 : 1. In group TPVB+GA, propofol (target effect-site concentration 2. 5-4. 0 μg∕ml) was given by target-controlled infusion, and patients received either single or multiple injections (T1-T5 ) of TPVB under ultrasound guidance at 30 min before induction of general an-esthesia. Group GA inhaled 2. 0％-2. 5％ sevoflurane. The patients were followed up at 6 and 12 months after operation, postoperative chronic pain and chronic pain affecting daily life were assessed using the mod-ified Brief Pain Inventory, the development of neuropathic pain using neuropathic pain questionnaire-short form, and the development of long-term health-related quality of life by using the 12-item short-form scale. Results There was no significant difference in the incidence of chronic pain and chronic pain affecting dai-ly life, incidence of neuropathic pain or quality of life scale score at 6 and 12 months postoperatively be-tween the two groups (P>0. 05). Conclusion TPVB combined with general anesthesia exerts no effect on the long-term quality of life in the patients undergoing breast cancer surgery.

Objective CD44, a cell surface glycoprotein, plays an important role in tumor growth and glycolysis.The aim of this study was to investigate the effects of neutralizing CD44 antibodies on the growth and glycolytic metabolism of B16 cells in melanoma in vitro.Methods B16 cells were treated with control antibodies (50 μg/mL) or different concentrations of CD44 antibodies (2, 10, and 50 μg/mL) for 24 hours, followed by examination of the activation of the AKT pathway in the B16 cells by Western blot.Then the tumor cells were also treated with control antibodies (50 μg/mL) or CD44 antibodies (50μg/mL) after pretreated with API-2 (4 μmol/L) in a parallel test.After 48 hours of treatment, the expression of lactate dehydrogenase A (LDHA) in the B16 cells and the level of lactate in the culture supernatant were detected by immunofluorescence and colorimetry, respectively.Lastly, the B16 cells were treated with control antibodies (50μg/mL), API-2 (4 μmol/L), CD44 antibodies (50μg/mL), or API-2 + CD44 antibodies for 96 hours, followed by measurement of the proliferation of the cells by MTT and their apoptosis by AO/EB and AnnexinV staining.Results In comparison with the control antibody group, the level of AKT phosphorylation (p-AKT) in the B16 cells showed a concentration-dependent increase in the 2, 10, and 50 μg/mL CD44 antibody groups (1.00±0.25 vs 2.51±0.32, 3.89±0.46, and 4.07±0.42, P<0.01), and the expression of LDHA was increased by (2.13±0.24) times, with the lactate level in the culture supernatant significantly elevated from (35.32±3.24) to (56.34±8.19) mmol/L (P<0.01) after 96 hours of treatment with 50 μg/mL CD44 antibodies.Treatment with API-2+CD44 antibodies, however, suppressed the increase in the LDHA expression and reduced the level of lactate.Compared with the control antibody group, the proliferation rate of the B16 cells was markedly decreased in the API-2, CD44 antibody, and API-2+CD44 antibody groups ([103±12.91] vs [84.87±19.35], [71.35±16.23], and [41.16±9.15]%, P<0.05), while the apoptosis rate remarkably increased ([5.23±0.96] vs [13.65±4.27], [19.21±3.53], and [43.21±7.87]%, P<0.01).Conclusion Neutralizing the function of CD44 in the B16 cells in vitro can inhibit the growth of the cells and promote AKT-mediated glycolytic metabolism, while suppressing the AKT pathway may enhance the antitumor activity of the CD44 antibody.

Type 2 diabetes mellitus (T2DM) is a common chronic metabolic disorder,it results from an interaction of environmental as well as genetic factors.There were several kinds of oral antidiabetic drugs (OADs),including biguanides,sulfonylureas,thiazolidinediones,and meglitinides,etc.Several genes have been identified to be associated with disease development and therapeutic outcomes.Inter-individual variations in the human genome affect both,risk of T2DM development and personalized response to identical drug therapies.Pharmacogenomics approaches focus on single nucleotide polymorphisms and their influence on individual drug response,efficacy and toxicity.Therefore,pharmacogenomics in T2DM is of great importance towards precision medicine which will greatly improve the efficacy of diabetes treatment.In this paper,antidiabetic drugs and related gene polymorphism researches are reviewed.

40 cases(control group)with aggressive periodontitis (AgP)received scaling and root planning (SRP)and 38 cases(test group)received SRP followed by oral administration of amoxicillin plus metronidazole for 7 d.Gingival crevicular fluid samples were exam-ined for the levels of MMP-1,MMP-8 and tissue TIMP-1 by ELISA before therapy,3 and 6 months after therapy,TIMP-1 /MMP-1 and TIMP-1 /MMP-8 ratios were calculated.The levels of MMP-1 and MMP-8 were decreased in both groups (P <0.05)at 3 and 6 months after therapy.TIMP-1 /MMP-1 and TIMP-1 /MMP-8 ratios were increased in the 2 groups(P <0.05)after treatment,3 months after therapy the ratio in test group was higher than that in control group(P <0.05).

Objective To investigate the clinical effect of active immunotherapy combined with endometrial local injury in women with recurrent spontaneous abortion( RSA) caused by negative-blocking antibodies.Methods 112 patients diagnosed RSA with negative -blocking antibodies were randomly divided into the treatment group (62 patients) and control group (50 patients).The patients in treatment group were treated by active immunotherapy combined with endometrial local injury.The patients in the control group were treated by active immunotherapy.The pregnancy outcomes were observed.Results The rate of pregnancy was 93.54%in treatment group,and 80.00%in the control group.The success pregnancy rate in the treatment group was significant higher than that in the control group (χ2 =4.65,P<0.05).The rate of abortion was 3.44% in the treatment group and 12.50% in the control group.It was significant lower than the control group(χ2 =4.90,P<0.05).After active immunotherapy,the pregnan-cy rate was 90.58%in positive-blocking antibodies group and 77.77%in negative-blocking antibodies group.The success pregnancy rate in positive-blocking antibodies group was significant higher than that in negative-blocking antibodies group (χ2 =4.27,P<0.05).The abortion rate in positive-blocking antibodies group was 2.60% and 19.05%in negative-blocking antibodies group.It was significant lower than that in negative-blocking antibodies group (χ2 =6.14,P<0.05).Conclusion It can significantly improve pregnant outcome and reduce the abortion rate with active immunotherapy combined with endometrial local injury in women with recurrent spontaneous abortion ( RSA) caused by negative-blocking antibodies.

OBJECTIVETo assess a minipig model of acute myocardial infarction (AMI) established by percutaneous balloon occlusion using delayed-enhanced magnetic resonance imaging (DE-MRI).

METHODSA minipig model of AMI was established by placement of a 2.0 mm×15.0 mm percutaneous transluminal coronary angioplasty balloon in the middle left anterior descending artery (LAD) through a percutaneous femoral puncture in the right inguinal region. The left anterior descending coronary artery (LAD) was occluded for 90 min, followed by assessment of the infarct size and cardiac function with DE-MRI, and the results were confirmed by pathological examination.

RESULTSDE-MRI showed a mean infarcts size of 10.2∓2.9 cm3 in the minipig models. Compared to the control group, the minipigs with AMI had significantly increased end-diastolic and end-systolic volumes (P<0.05) with a decreased stroke volume, ejection fraction and cardiac output (P<0.001). These DE-MRI values were matched with the microsphere values obtained from short-axis slices in pathological examination.

CONCLUSIONWe have established a feasible approach for evaluating minipig models of AMI as a platform for assessing the therapeutic effect of stem cell transplantation for AMI.