The biological clock(also known as the circadian rhythm)is the fundamental reliance for all organisms on Earth to adapt and survive in the Earth's rotation environment.Circadian rhythm is the most basic regulatory mechanism of life activities,and plays a key role in maintaining normal physiological and biochemical homeostasis,disease occurrence and treatment.Recent studies have shown that the biologi-cal clock plays an important role in the development of oral tissues and in the occurrence and treatment of oral diseases.Since there is cur-rently no guiding literature on the research methods of biological clock in stomatology,researchers mainly conduct research based on pub-lished references,which has led to controversy about the research methods of biological clock in stomatology,and there are many confusions about how to rationally apply the research methods of circadia rhythms.In view of this,this expert consensus summarizes the characteristics of the biological clock and analyzes the shortcomings of the current biological clock research in stomatology,and organizes relevant experts to summarize and recommend 10 principles as a reference for the rational implementation of the biological clock in stomatology research.

Objective:To evaluate the role of G-protein coupled receptor 37 (GPR37) in cognitive dysfunction in a mouse model of neuropathic pain.Methods:SPF-grade healthy male C57BL/6 mice and GPR37 knockout (GPR37-KO) mice, aged 3 months, with a body weight of approximately 20 g, were divided into 4 groups ( n=6 each) using a random number table method: control group (Con group), neuropathic pain group (NPP group), GPR37-KO+ control group (GPR37-KO Con group) and GPR37-KO+ neuropathic pain group (GPR37-KO NPP group). The mouse model of neuropathic pain was established by ligation of the sciatic nerve. The thermal paw withdrawal latency (TWL) and mechanical paw withdrawal threshold (MWT) were measured at 7 days after surgery. The open field test and Morris water maze test were performed at 28 days after surgery. The mice were subsequently sacrificed, and the medial prefrontal cortex (mPFC) was obtained for determination of the level of phosphorylated calcium/calmodulin-dependent protein kinase Ⅱ(p-CAMKⅡ) and expression of brain-derived neurotrophic factor (BDNF) and postsynaptic density protein 95 (PSD-95). Results:Compared to Con group, no significant changes were found in the parameters in GPR37-KO Con group ( P>0.05), and TWL was significantly shortened, MWT was decreased, the time the animal spent in central area was prolonged and the platform-crossing times were increased in the open field test, and the escape latency was prolonged and platform-crossing times were decreased in the Morris water maze test, and the expression of p-CAMKⅡ, BDNF and PSD-95 in the mPFC was down-regulated in NPP group ( P<0.05). Compared with NPP group, TWL was significantly shortened, MWT was decreased, the time the animal spent in central area was prolonged and the platform-crossing times were increased in the open field test, and the escape latency was prolonged and platform-crossing times were decreased in the Morris water maze test, and the expression of p-CAMKⅡ, BDNF and PSD-95 in the mPFC was down-regulated in GPR37-KO NPP group ( P<0.05). Conclusions:GPR37 is involved in the development of cognitive dysfunction in mice with neuropathic pain, and the mechanism may be related to its modulation of synaptic plasticity.

Objective:To compare the setup errors in the supraclavicular regions of two different postures (arms placed on each side of the body, namely the body side group; arms crossed and elbows placed above forehead, namely the uplifted group) using the chest and abdomen flat frame fixation device in lung and esophageal cancer.Methods:Clinical data of patients with stage Ⅰ to Ⅳ lung or esophageal cancer who received three-dimensional radiotherapy with chest and abdomen flat frame fixation device in our institution from November 2020 to April 2021 were retrospectively analyzed. The setup errors of two postures were compared.Results:A total of 56 patients were included, including 31 patients (55%) in the body side group and 25 patients (45%) in the uplifted group. A total of 424 CBCTs were performed in the whole group. The overall setup errors in the X, Y and Z directions were similar in both groups ( P>0.05). The setup errors of sternoclavicular joint in the X and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.163±0.120) cm vs. (0.209 ±0.152) cm, P=0.033; 0.715°±0.628° vs. 0.910°±0.753°, P=0.011]. The setup errors of acromioclavicular joint in the Y, Z and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.233±0.135) cm vs. (0.284±0.193) cm, P=0.033; (0.202±0.140) cm vs. (0.252±0.173) cm, P=0.005; 0.671°±0.639° vs. 0.885°±0.822°, P=0.023]. The margins of target volume for setup errors were smaller in the X (0.45 cm vs. 0.54 cm) and Y (0.54 cm vs. 0.65 cm) directions of the sternoclavicular joint, as well as in the Y (0.59 cm vs. 0.78 cm) and Z directions (0.53 cm vs. 0.72 cm) of the acromioclavicular joint in the body side group. Conclusions:For lung and esophageal cancer patients requiring supraclavicular irradiation, the body side group yields smaller setup errors and corresponding margins of target volume than the uplifted group. In clinical practice, it is necessary to take comprehensive consideration of the accuracy of radiotherapy and additional radiation of the limbs to select appropriate posture.

Objective:To identify the biotypes of blood culture positive Brucella in patients with acute brucellosis in Xinjiang Uygur Autonomous Region (hereinafter referred to as Xinjiang), and to learn about the clinical characteristics of these patients. Methods:Among the 30 patients diagnosed with acute brucellosis in First Affiliated Hospital, School of Medicine, Shihezi University from January 2019 to July 2021, the positive strains of blood culture Brucella of 12 patients with acute brucellosis were used to identify the biotype by AMOS-PCR. Then the general and clinical data of the 12 patients were collected, including demographic characteristics, epidemiological characteristics, clinical characteristics, laboratory tests, treatment and prognosis. Results:AMOS-PCR results showed that all 12 strains were Brucella melitensis. Among the 12 patients, 9 were males and 3 were females, all of whom had a clear history of livestock contact, and the onset time was concentrated in April to September. All 12 patients showed fever, followed by headache and dizziness (9/12), weakness (8/12), digestive symptoms (8/12), hyperhidrosis (7/12), lumbago and backache (6/12), and arthralgia (6/12). One patient was complicated with pleural effusion and pericardial effusion. One patient was complicated with pleural effusion, pelvic effusion and ascites. Only ascites occurred in 2 patients. Liver function was abnormal in 3 patients, lactate dehydrogenase increased in 6 patients, and blood creatinine decreased in 9 patients. Among the 12 patients, 10 patients were treated with rifampicin combined with doxycycline. The other 2 patients were treated with levofloxacin and doxycycline, supplemented by symptomatic treatment with hepatoprotective drugs due to impaired liver function. After discharge, the patients received out-of-hospital oral anti-infectious drugs for 1-2 courses (6 weeks each course), and all indicators returned to normal at 6 months and 12 months after discharge. Conclusions:All the 12 patients with acute brucellosis in Xinjiang are infected with Brucella melitensis. In addition to the common clinical features, patients are characterized by decreased creatinine and increased lactate dehydrogenase. The standardized anti- Brucella treatment is still the main treatment strategy.

Objective:To explore the safety and clinical value of ultrasound-guided percutaneous core needle biopsy in the diagnosis of cardiac intermural tumors and pericardial tumors.Methods:Seven patients who underwent ultrasound-guided percutaneous cardiac tumors needle biopsy in Fujian Provincial Hospital from January 2012 to December 2019 were selected for this study. The locations and sizes of the lesions were recorded preoperatively by echocardiography and the operation time was recorded by conventional ultrasonography. The postoperative complications was followed up, and the satisfaction of pathological materials was used as the evaluation standard to comprehensively analyze the safety and clinical application value of ultrasound-guided percutaneous biopsy in the diagnosis of cardiac tumors.Results:Ultrasound-guided percutaneous biopsy was performed successfully in all the 7 cases, 3 of them were intermural tumors and 4 of them were pericardial tumors. Except for 2 patients with diffuse pericardial space, the maximum diameter of the remaining 5 patients was (58.6±23.5)mm. Six cases were punctured from the apex of the heart, and 1 case from the left parasternal through third intercostal space toward the bottom of the heart as the needle pathway. The satisfaction of pathological material was 100%, and the time of procedure was (15.1±3.3)min. There were no postoperative complications such as bleeding, infection or arrhythmia.Conclusions:Ultrasound-guided percutaneous transthoracic needle biopsy is safe and feasible, which provides a simple and easy method for the biopsy of cardiac intramural tumors and pericardial tumors.

Objective: To investigate the effect of Kamistad gel on oral ulcer healing and the expression of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6) and epidermal growth factor (EGF) after oral administration in ulcer tissue of rats and to provide animal experimental data for the clinical application of Kamistad gel. Methods: The oral ulcer rat model was established by chemical cauterization. The rats were randomly divided into four groups: Kamistad group (Kamistad gel), befuxin group (befuxin gel), lidocaine group (lidocaine cream), blank control group (normal saline), with 12 rats in each group. The ulcer area of the rats in each group was measured before and 1, 3 and 5 days after treatment; at 1 day after treatment, the duration of swabbing behavior within 3 minutes of intraoral capsaicin infusion was recorded to evaluate the degree of pain; the ulcer tissue was collected at 5 days after treatment, and the histopathological changes were observed by HE staining, the expression of TNF-α, IL-6 and EGF in the ulcer tissue was detected by immunohistochemistry and ELISA. Results: At 1 day after treatment, the duration of mouth wiping induced by capsaicin was significantly shorter in the Kamistad group than in the blank control and befuxin groups (P < 0.05), but there was no significant difference between the Kamistad and lidocaine groups (P >0.05). At 5 days after treatment, the ulcer area was significantly smaller in the Kamistad group than in the blank control and lidocaine groups (P < 0.05), and there was no significant difference between the Kamistad and befuxin groups (P >0.05). At 5 days after treatment, H&E staining of the oral ulcer tissue sections showed significantly reduced levels of inflammatory cells and significantly proliferated fibroblasts and better epithelial hyperplasia in the Kamistad group compared with those in the lidocaine and blank control groups, and there were no differences between the Kamistad and befuxin groups. At 5 days after treatment, the expression levels of TNF-α, IL-6 and EGF in the ulcer tissue of rats in each group were significantly different (P < 0.05). Compared with the blank control and lidocaine groups, the expression of TNF-α and IL-6 was significantly decreased and the expression of EGF was significantly increased in the Kamistad group (P < 0.05); there were no significant differences in the expression of the above three factors between the Kamistad and befuxin groups (P > 0.05). Conclusion Kamistad gel exhibited anti-inflammatory, analgesic and healing effects on experimental oral ulcers.

OBJECTIVEThis work investigated mesenchymal stem cells (MSCs) modified with Runt-related transcription factor 2 (Runx2) therapy for bone regeneration in rabbit mandibular distraction osteogenesis.

METHODSForty-eight New Zealand mature white rabbits were randomly divided into three groups after the rabbit model of mandibular distraction osteogenesis was established: reconstruction plasmid modified with Runx2 (group A), plasmid without Runx2 (group B), and the same dose of saline as control (group C). At the fifth day of distraction phase, MSCs with reconstruction plasmid modified with adv-hRunx2-gfp were injected into the distraction gap of group A. MSCs with reconstruction plasmid modified with adv-gfp was injected into the distraction gap of group B, whereas group C was injected with the same dose of saline. At 8 weeks after injection, all animals were sacrificed, and the distracted mandibles were harvested. The general imaging histological observation and three-point bending test were used for evaluation.

RESULTSCT plain scan and histological analysis confirmed that the amount of new bone forming in the distraction gap of group A was significantly higher than those in groups B and C. Dual-energy X ray and three-point bending test results also showed that the bone mineral density, bone mineral content, and maximum load of the distraction gap of group A were significantly higher than those of groups B and C (P<0.01).

CONCLUSIONRunx2-ex vivo gene therapy based on MSCs can effectively promote the bone regeneration in rabbit mandibular distraction osteogenesis and shorten the stationary phase. Therefore, reconstruction of craniofacial fracture would be a valuable strategy

Absorptiometry, Photon ; Animals ; Bone Density ; Bone Regeneration ; physiology ; Core Binding Factor Alpha 1 Subunit ; genetics ; pharmacology ; Genetic Therapy ; Mandible ; physiology ; surgery ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; Osteogenesis ; genetics ; Osteogenesis, Distraction ; methods ; Plasmids ; Rabbits ; Random Allocation ; Transcription Factors ; genetics ; physiology ; Treatment Outcome

Objective To investigate the role of Th17/Treg balance in immune mechanism in severe exacerbation of hepatitis B.Methods The clinical data of 41 patients with chronic hepatitis B were collected,and according to the conditions during hospitalization,these patients were divided into exacerbation group (19 patients) and improvement group (22 patients).On admission,at weeks 1 and 2 of treatment,and at the end of treatment,flow cytometry was used to measure the frequencies of Th 17 and Treg cells in peripheral blood,and enzyme-linked immunosorbent assay was used to determine the serum levels of interleukin-17 (IL-17),interleukin-10 (IL-10),and transforming growth factor-β (TGF-β).The dynamic changes in the frequencies of Th17 and Treg cells were compared between the two groups,and the correlation between clinical indices for hepatitis and cytokines was analyzed.The t-test was used for comparison between groups,a one-way analysis of variance was used for comparison within one group across different time points,and Pearson correlation analysis was performed.Results With disease progression,the exacerbation group showed an increase in the frequency of Th 17 cells and a relatively low frequency of Treg cells;compared with the improvement group,the exacerbation group had a higher frequency of Th 17 cells and a lower frequency of Treg cells.Th1 7/Treg ratio gradually increased with exacerbation and decreased with improvement in conditions;in the exacerbation group and the improvement group,Th17/Treg ratio was positively correlated with total bilirubin and negatively correlated with prothrombin activity.In the exacerbation group and the improvement group,Th 17 cells were positively correlated with IL-17,and Treg cells were positively correlated with IL-10 and TGF-β.Conclusion Th1 7 and Treg cells play important roles in severe exacerbation of hepatitis B,and Th1 7/Treg ratio may be used as an immunobiological marker for the judgment of severity during severe exacerbation of hepatitis B.

Objective To assess the value of contrast-enhanced ultrasonography (CEUS ) in diagnosing BI-RADS 4 breast lesion.Methods The CEUS findings of 79 breast lesions of BI-RADS 4 were analyzed,and the CEUS diagnosis was made according to our preliminary study results.Histology results were served as golden reference.Results Of all the 79 breast lesions that were confirmed by histopathology results,36 were malignant and 43 were benign.The differences of morphologic features of area variety, margin,heterogeneous or homogeneous distribution between benign and malignant lesions were significant (P < 0.05 ).The area under ROC curve of correction BI-RADS classification in the diagnosis of breast cancer was 0.938,and it was significantly higher than that of the BI-RADS classification (0.889,Z =2.209, P =0.0272).Conclusions CEUS can improve the diagnostic accuracy of breast lesions preoperatively.

Objective To discuss the relationship between echogenicity and fat content in renal tumor.Methods 52 renal tumors were examined with preoperative ultrasonography,all tumors were 3 cm in diameter or less.The tumor echogenicity was classified as echogenicity increasement type (including hyperechoic and slightly hyperechoic) and echogenicity decreasement type (hypoechoic).The relationship between echogenicity and adipose staining in tumor were analyzed.Results In 18 cases pathologically proved benign renal tumor,14(77.8 ％) of the tumors were hyperechoic and were angiomyolipoma(AMLs),4(22.2％) of the tumors were hypoechoic including 2 poor fat AMLs and 2 rare benign tumors,slightly hyperechoic case was not detected.In 34 cases malignant renal tumors,27(79.4％) of the tumors were slightly hyperechoic including 22 clear cell renal cell carcinomas (RCCAs) and 5 papillary RCCAs,7 (20.6％) of the tumors were hypoechoic including 2 clear cell RCCAs,3 papillary RCCAs and 2 chromophobe RCCAs.Hyperechoic case was not detected.The adipose staining of 41 cases of echogenicity increasement type was all positive,in the 11 cases of echogenicity decreasement type,9 tumors were adipose staining negative,while the other 2 tumors were positive,and there were statistically significant between two groups (P ＜0.05).Conclusions Echogenicity was obviously correlate with fat content in renal tumor.Tumors containing rich fat appear to be increased in echogenicity,tumors without fat content appear to be decreased in echogenicity.