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Resin monomer-induced dental pulp injury presents a pathology related to mitochondrial dysfunction. Melatonin has been regarded as a strong mitochondrial protective bioactive compound from the pineal gland. However, it remains unknown whether melatonin can prevent dental pulp from resin monomer-induced injury. The aim of this study is to investigate the effects of melatonin on apoptosis of mouse preodontoblast cells (mDPC6T) induced by triethylene glycol dimethacrylate (TEGDMA), a major component in dental resin, and to determine whether the JNK/MAPK signaling pathway mediates the protective effect of melatonin. A well-established TEGDMA-induced mDPC6T apoptosis model is adopted to investigate the preventive function of melatonin by detecting cell viability, apoptosis rate, expressions of apoptosis-related proteins, mitochondrial ROS (mtROS) production, mitochondrial membrane potential (MMP) and adenosine triphosphate (ATP) level. Inhibitors of MAPKs are used to explore which pathway is involved in TEGDMA-induced apoptosis. Finally, the role of the JNK/MAPK pathway is verified using JNK agonists and antagonists. Our results show that melatonin attenuates TEGDMA-induced mDPC6T apoptosis by reducing mtROS production and rescuing MMP and ATP levels. Furthermore, mitochondrial dysfunction and apoptosis are alleviated only by the JNK/MAPK inhibitor SP600125 but not by other MAPK inhibitors. Additionally, melatonin downregulates the expression of phosphorylated JNK and counteractes the activating effects of anisomycin on the JNK/MAPK pathway, mimicking the effects of SP600125. Our findings demonstrate that melatonin protects mDPC6T cells against TEGDMA-induced apoptosis partly through JNK/MAPK and the maintenance of mitochondrial function, offering a novel therapeutic strategy for the prevention of resin monomer-induced dental pulp injury.

Introduction: The truncal-type occlusion (TTO) sign observed during endovascular thrombectomy is thought to predict the etiology and prognosis of acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, the interpretation of the present results and the clinical utility of this sign need further investigation. This scoping meta-review aimed to assess the predictive value of the TTO sign, thus identifying methodological limitations in current study designs. Methods: Studies published up to January 2023 were identified by systematically searching PubMed, Embase, and Web of Science. A meta-analysis was performed to quantitatively synthesize the evidence on the predictive value of the TTO sign. An 8-point scale was introduced to narratively summarize the current evidence level and methodological quality of included studies. Results: We included 10 studies in this review. For the prediction of intracranial atherosclerotic stenosis, the sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of the TTO sign were 0.73, 0.87, 5.5, and 0.31, respectively (all p < 0.05). For recanalization failure after primary thrombectomy, the sensitivity, specificity, PLR, and NLR were 0.44, 0.91, 4.9, and 0.61, respectively (all p < 0.05). The strength of evidence was low due to the methodological limitations and lack of adjustment for potential confounders. Conclusion: The predictive values of the TTO sign for the etiology of LVO-AIS were considerable but seemed limited for current interpretation. Several confounders could influence the determination and predictive value of the TTO sign, requiring methodological adjustments in future research. Endovascular practitioners encountering this sign during thrombectomy should draw specific attention to stroke etiology, thus promoting timely adjustment of intra- and postprocedural strategies. [ABSTRACT FROM AUTHOR]

Background and Purpose: Cochlear vascular micro-thrombosis has been hypothesized as one of the pathogenic mechanisms for sudden sensorineural hearing loss (SSNHL) refractory to regular management. This study aimed to evaluate the feasibility and safety of intra-arterial pulsed-injection urokinase (IAPU) as a salvage therapy for SSNHL after the failure of conventional therapy. Methods: We retrospectively reviewed our patient database to identify refractory SSNHL patients between November 2017 and July 2020. Study outcomes before and after the IAPU therapy were compared between IAPU and conventional therapy groups. Results: Sixty-seven moderate-profound SSNHL patients (29 in IAUP group, 38 in control group) were included in this study. Compared to the control group, patients in the IAPU group showed more significant improvement in pure tone average (PTA) (34.2 ± 23.5 vs. 10.7 ± 13.1, p < 0.001) and degree of hearing recovery (total: 20.7% vs. 5.3%, partial: 24.1% vs. 10.5%, mild: 27.6% vs. 13.2% and non: 27.6% vs. 71.1%) 2 weeks after admission. In the IAPU group, a significant improvement of PTA (86.6 ± 11.5 vs. 54.6 ± 20.1 dB, p < 0.005) was observed on the first day after IAPU treatment. Conclusion: In carefully selected SSNHL cases with a highly suspected vascular origin, IAPU is a safe and effective therapy when conventional treatments have failed. Despite the encouraging findings of our work, large studies are needed to better investigate the strengths and limitations of this salvage therapy. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether staged angioplasty (SAP) is a safe and effective treatment to prevent hyperperfusion syndrome after carotid artery stenting (CAS). Methods: A systematic literature search was performed according to established criteria to identify eligible articles published before October 2020. Pooled dichotomous data were presented as odds ratios (OR) and corresponding 95% confidence intervals (CI) using random-effect models. The efficacy endpoints were hyperperfusion syndrome (HPS), hyperperfusion phenomenon (HPP), and intracerebral hemorrhage (ICH). The safety endpoint was post-procedural thromboembolic events. The feasibility of the procedure was assessed by device-related adverse events (vessel dissection and failed angioplasty) in SAP. Results: Ten studies (1030 participants) were eligible. SAP was superior to regular CAS in preventing HPS (OR = 0.35, 95% CI 0.14–0.86, P = 0.02). There was no significant difference in the rate of thromboembolic events between the SAP group and the regular CAS group. The rates of vessel dissection and failed angioplasty with the use of a 3.0-mm-diameter balloon were 5.4% and 0.4%, respectively. Conclusion: SAP may reduce the incidence of post-CAS HPS without increasing procedure-related complications. A 3.0-mm-diameter balloon used in SAP may be appropriate for Asian populations. However, the confounded study design and confused definitions of reporting items hinder the current recommendation of SAP in clinical use. [ABSTRACT FROM AUTHOR]

Backgrounds: Dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel for minor strokes or TIAs has been demonstrated in several RCTs. Whether drug selection for mono-antiplatelet therapy (MAPT) following DAPT may influence stroke recurrence has not been clarified, especially for patients with intracranial atherosclerosis stenosis (ICAS). The Thrombelastography Platelet Mapping (TEG-PM) assay claimed to be capable of monitoring platelet function secondary to antiplatelet therapy., Purpose: The aim of this study was to investigate the preventive role of TEG-PM in individualized drug selection for MAPT following DAPT in patients with minor stroke or TIA., Methods: We retrospectively reviewed our patient database to identify individuals with minor stroke or TIA between February 2019 and July 2022. Patients were divided into ICAS and non-ICAS groups, and the efficacy and safety of TEG-PM-guided MAPT for stroke prevention after minor stroke or TIA were investigated in each group., Results: ICAS patients with TEG-PM-guided MAPT had lower rates of recurrent stroke than patients without TEG-PM guidance during a mean follow-up period of 18.1 months (6.3% vs 15.2%; p = 0.04). Patients without ICAS also tended to benefit from TEG-PM-guided MAPT with lower rates of stroke recurrence (2.6% vs 8.7%; p = 0.02). No difference in the safety outcome of any bleeding events was observed in patients with TEG-PM-guided MAPT and those without (ICAS group, 2.1% vs 3.0%; p = 0.68; non-ICAS group, 1.3% vs 2.3%; p = 0.79)., Conclusion: The TEG-PM could be a tangible preprocessing in drug selection for MAPT following DAPT in patients with minor strokes or TIAs, especially for those with non-stented ICASs.