Artículos de revistas sobre el tema "Shu fa shi"

Over the centuries, China still respectfully treasures rich Asian cultures, traditions, and customs. China is now famous all over the world for its mysterious wonders and cultural & natural heritages such as the Great Wall, the Forbidden City, the Terracotta Army, etc. The Chinese history is full with the exposition of outstanding features of Chinese culture such as great thoughts of Confucius, religious beliefs, traditional festivals and customs e.g., Chinese new year, language and calligraphy e.g., Shu Fa, four great inventions of ancient China e.g., papermaking, printing, gunpowder and the compass, traditional architecture and sculpture, traditional art forms, etc. The era of history of China before the time in power of Qin dynasty is known by name as the period of Warring States. This period started from 475 BC and ends at 221 BC. Seven Warring States were included in it i.e. Qin, Wei, Han, Yan, Chu, Zhao, and Qi. Zheng was the King of Qin, who started his journey to triumph over 6 states in the period of 230 BC. Qin was the 1st emperor of this unified state of China. Thus he was known by the name of “First Emperor of Qin” or “Qin Shi Huang”. This study provides a deep insight of Chinese history and it is illustrated that major achievements in Chinese culture and history are contributed in the era of Qin dynasty.

In Ying Xian Fogong Si Shijia Ta 應縣佛宮寺釋迦塔 (Sakyamuni Pagoda of Fogong Temple in Ying County), Shanxi, there are statues set on each floor, and 26 exist in total, with six murals painted on the first floor. The pagoda was designed as a vertically rising Buddhist temple, and the interior space of each floor was customized for the statues. Based on previous research and through surveying and mapping of the architecture and statuary (including the murals on the first floor) combined with geometric design analysis, this paper proposes the following: First, there exists a clear geometric proportion among the interior space and statues on each floor of the pagoda. Second, clear proportional relationships also exist among the statues on each floor, and each of the 26 statues has ‘classical’ proportion rules. Third, the height of the giant Buddha statue on the first floor is the module for not only the height of the statues on each floor but also the construction of the whole pagoda such that the height of the statue on the first floor is 1/6 of the total height of the pagoda (excluding the base). And the ratio of the pagoda’s total height to the first floor’s diameter, the ratio of the total height to the top-story height under the column capital, and all the other geometric proportions are closely related to the architectural modeling. And finally, in the construction of the pagoda, statues, and murals, the scale is deduced to be 1 chi 尺 (Chinese foot) = 29.5 cm. These values give clear scale logics not only to the construction but also to the details of the statues. Accordingly, the most frequently used proportions in the architectural space, statues, and murals of the Pagoda of Fogong Temple are 2, 3:2, 5:3 (or 8:5), and 9:5, which are imbued with cultural messages, like Zhou Bi Suan Jing 周髀算經 (The Mathematical classic of the Zhou shadow-gauging instrument), Ying Zao Fa Shi 營造法式 (Treatise on Architectural Methods or State Building Standards), the ancient Chinese world view—tian yuan di fang 天圜地方 (the dome-shaped heaven and the flat, square earth) reflected from “ yuan fang tu 圓方圖 (rounded-square map)” and “fang yuan tu 方圓圖 (squared-circle map)”, ancient Chinese ideas that ”san tian liang di er yi shu 參天兩地而倚數 (‘three’ is the number of the heaven and ‘two’ is the number of the earth, and all numbers are based on them)” and “jiu wu zhi zun 九五之尊 (nine and five are the numbers of the honorable central position)”, and most probably related to the “mandala” of Esoteric Buddhism and to the Western “Golden Ratio”, which all need further research in depth.

Abstract *Zi Chan in Volume 6 and *Shi fa in Volume 4 of Tsinghua University Collection of Warring States Bamboo-slip Manuscripts were written by one scribe. This study aims to use features of the brushwork to demonstrate this. In addition, this study will also examine physical features of the bamboo slips, handwriting, character forms, the orthography of different states, punctuation marks, erasures, and the binding of the bamboo slips. The texts of both manuscripts were first written and then bound. Research on the arrangement of *Shi fa and the layout of its text enriches our understanding about the activity of writing among Pre-Qin people, how ancient books were compiled, and how scrolls were opened.

Abstract Fanconi anemia (FA) is a genetic disorder characterized by bone marrow failure, a predisposition to cancer, congenital abnormalities and a cellular hypersensitivity to DNA interstrand cross-linking agents. This hypersensitivity in FA cells correlates with a defect in ability to repair interstrand cross-links. We have shown that the structural protein, nonerythroid a spectrin (aIISp), plays an important role in the repair of DNA interstrand cross-links and that there is a deficiency in aIISp in FA cells. The reduced levels of aIISp in FA cells are due to reduced stability of this protein. We propose that the stability of aIISp is dependent upon one or more of the FA proteins. The present study was undertaken in order to get a clearer understanding of the proposed role of FA proteins in maintaining the stability of aIISp in the cell and the functional importance of this relationship in the repair of DNA interstrand cross-links and the repair defect in FA cells. For these studies, FA proteins were examined for their ability to directly interact with aIISp and, if so, to map the sites of interaction. Four overlapping regions of aIISp were constructed and binding of FA proteins to each of these regions was examined using yeast two-hybrid analysis. Of the proteins examined, FANCG was found to interact with one of these regions of aIISp and specifically with the SH3 domain within this region. The site of interaction in FANCG was mapped to a SH3 domain binding motif, which contains a consensus sequence with preference for the SH3 domain of aIISp. The sites of interaction in both FANCG and aIISp were confirmed using site-directed mutagenesis. Two FA proteins that did not contain any SH3 binding motifs, FANCC and FANCF, did not interact with the SH3 domain of aIISp or any of the other regions of aIISp. These results thus demonstrate that one of the FA proteins, FANCG, contains a class of motifs that has specificity for binding to SH3 domains and binds to the SH3 domain of aIISp via this motif. This binding is important in the DNA repair process and in the FA repair defect, as is shown by our in vivo studies in which FA-G cells, transformed with the FANCG cDNA and stably expressing FANCG, showed normal levels of aIISp and a correction of the defect in ability to repair DNA interstrand cross-links. We therefore propose that the binding of FANCG to aIISp is not only important for the stability of aIISp in cells but also for the role aIISp plays in the DNA repair process. Thus a deficiency in FANCG, such as occurs in FA-G cells, could lead to reduced stability of aIISp which in turn could be an important factor in the defective DNA repair pathway in FA cells.

As condições dolorosas relacionadas ao trabalho são frequentes e atingem cerca de 70% dos trabalhadores. Atividade física regular pode ajudar a reduzir o estresse e melhorar as condições para o sistema musculoesquelético. Programas de exercícios terapêuticos chineses são utilizados por milhares de pessoas, porém poucos estudos avaliaram seu efeito sobre trabalhadores de serviços administrativos em uma população ocidental. O objetivo do presente artigo foi avaliar o efeito do exercício terapêutico chinês Lian Gong Shi Ba Fa na condição dolorosa de trabalhadores de um serviço administrativo. Foi realizado um ensaio clínico analítico tendo como amostra 48 trabalhadores de um serviço administrativo. Foi utilizado o Questionário Nórdico de Sintomas Osteomusculares (QNMQ) e a escala visual analógica (EVA) associada à algometria de pressão. O programa de exercícios consiste em 18 exercícios realizados em 15 minutos, 2 vezes na semana e implementado em um período de 1 mês. O teste de Wilcoxon foi aplicado para verificar se houve alteração no EVA e na Algometria e correlacionar com a idade, sexo e tempo de serviço. Foi considerado significante p

Abstract BACKGROUND Outcome of children with medulloblastoma (MB) and Fanconi Anemia (FA), an inherited DNA repair deficiency, has not systematically been described. Treatment is complicated by high vulnerability to treatment-associated side effects, yet structured data are lacking. This study provides a comprehensive overview about clinical and molecular characteristics of pediatric FA MB patients. METHODS Clinical data including detailed information on treatment and toxicities of six previously unreported FA MB patients were supplemented with data of 16 published cases. RESULTS We identified 22 cases of children with FA and MB with clinical data available. Biological subgroup was SHH in all cases with data available (n=9), confirmed by methylation profiling in five patients. FA MB patients exclusively belonged to complementation groups FA-D1 (n=16) or FA-N (n=3). Patients were treated with postoperative chemotherapy only (50%) or radiotherapy (RT)±chemotherapy (27%). 23% did not receive adjuvant therapy. Excessive treatment-related toxicities were frequent. Severe hematological toxicity occurred in 91% of patients treated with alkylating chemotherapy, while non-alkylating agents and RT were less toxic. 14 patients (63.6%) developed 20 other malignancies, of which ten occurred before, five simultaneously with and five after MB diagnosis. Median overall survival (OS) was 1 year (95%CI 0.3-1.9). 1-year-progression-free-survival (PFS) was 26.3±10.1% and 1-year-OS was 42.1±11.3%. Adjuvant therapy prolonged survival (1y-OS/1y-PFS 0%/0% without adjuvant therapy vs. 53.3±12.9%/33.3±12.2% with adjuvant therapy, p=0.006/p=0.086), with no difference whether the patient had received chemotherapy only or RT±chemotherapy. CONCLUSIONS MB in FA patients is strongly associated with SHH activation and FA-D1/FA-N. Despite the dismal prognosis, adjuvant therapy may improve survival. Non-alkylating chemotherapy and RT are feasible in selected patients with careful monitoring of toxicities and dose adjustments. Unlike in standard MB protocols, focal RT may be considered in FA MB patients. Curative therapy for FA MB-SHH remains an unmet medical need.

ABSTRACT Src kinase is a crucial mediator of adhesion-related signaling and motility. Src binds to focal adhesion kinase (FAK) through its SH2 domain and subsequently activates it for phosphorylation of downstream substrates. In addition to this binding function, data suggested that the SH2 domain might also perform an important role in targeting Src to focal adhesions (FAs) to enable further substrate phosphorylations. To examine this, we engineered an R175L mutation in cSrc to prevent the interaction with FAK pY397. This constitutively open Src kinase mediated up-regulated substrate phosphorylation in SYF cells but was unable to promote malignant transformation. Significantly, SrcR175L cells also had a profound motility defect and an impaired FA generation capacity. Importantly, we were able to recapitulate wild-type motile behavior and FA formation by directing the kinase to FAs, clearly implicating the SH2 domain in recruitment to FAK and indicating that this targeting capacity, and not simply Src-FAK scaffolding, was critical for normal Src function.

The Camuno dialect uses an auxiliary fa ‘do’ in an interrogative construction that strongly resembles English do-support. Stages of its grammaticalization remain within the different valley dialects. When optional, fa-support (FS) coexists with verb-subject clitic inversion (SCI), e.g fa-la mangià (does she eat) / màngia-la (eats-she)‘l peh da hena? (the fish for supper?) There are semantic restrictions on the type of supported verb: manner > result > state. Questions are pragmatically marked with speaker answer expectations, and are opinion-seeking. A wh-item (normally ‘insitu’) has specific reference. Impersonal questions are agrammatical with optional FS but not obligatory FS. A biclausal model with a lexically rich fa ‘do’ is suggested for optional FS.

Abstract Although the role of aerobic glycolysis in activated T cells has been well characterized, whether and how fatty acids (FAs) contribute to donor T cell function in allogeneic hematopoietic stem cell transplantation is unclear. Using xenogeneic graft-versus-host disease (GVHD) models, this study demonstrated that exogenous FAs serve as a crucial source of mitochondrial respiration in donor T cells in humans. By comparing human T cells isolated from wild-type NOD/Shi-scid-IL2rγnull (NOG) mice with those from MHC class I/II–deficient NOG mice, we found that donor T cells increased extracellular FA uptake, the extent of which correlates with their proliferation, and continued to increase FA uptake during effector differentiation. Gene expression analysis showed the upregulation of a wide range of lipid metabolism-related genes, including lipid hydrolysis, mitochondrial FA transport, and FA oxidation. Extracellular flux analysis demonstrated that mitochondrial FA transport was required to fully achieve the mitochondrial maximal respiration rate and spare respiratory capacity, whereas the substantial disruption of glucose supply by either glucose deprivation or mitochondrial pyruvate transport blockade did not impair oxidative phosphorylation. Taken together, FA-driven mitochondrial respiration is a hallmark that differentiates TCR-dependent T cell activation from TCR-independent immune response after hematopoietic stem cell transplant.

Impossible de considérer la promotion, l’essor et le développement des idées libérales en Chine au xx e  siècle sans prendre en compte la figure de Hu Shi (1891-1962) et l’influence que son œuvre exerça. Pendant toute sa vie intellectuelle, Hu Shi se tint au premier rang des intellectuels chinois désireux de moderniser leur pays. Parti se former aux États-Unis très tôt, il concentra ses recherches sur les (r)évolutions littéraires et entreprit d’analyser l’histoire de la philosophie chinoise avec les méthodes scientifiques occidentales. Il entendait non seulement changer les façons de parler et d’écrire dans le monde académique, mais encore les styles de pensée et de vie au sein de la population chinoise. Il devint l’un des plus prestigieux intellectuels de la Chine moderne, en s’engageant activement dans la vie politique. Il poursuivitl’idéal d’une « bonne gouvernance », même en régime de parti unique. L’invasion par le Japon interrompit ses efforts et la guerre civile le mit en difficulté, quoiqu’il ait aidé dans une certaine mesure à restaurer l’autorité d’une administration centrale indispensable à un pays en voie de développement au territoire immense et à la population énorme : les efforts à déployer pour le moderniser vite et fort sont à cette mesure. Hu Shi dut quitter la Chine continentale. Dans les dernières années de sa vie, il fut un symbole de la relation entre les États-Unis et le régime du Kuomintang à Taïwan, mais nombre de ceux qu’il avait formés et qui étaient restés en Chine continentale critiquaient sa position, au sein de la communauté académique. Or Hu Shi prit lui-même ses distances avec le Kuomintang (KMT dans cet article), en levant toujours haut la bannière du libéralisme et d’une « Chine libre ». Classification JEL  : B13, B31, N25, P26

It is considered that it is difficult to build a well-constructed building without proportional or dimensional relationships of precise parts, so it is estimated that Korea has some sort of numerical determination method now. Also, in China there is “Ying Zao Fa Shi: 営造法式” of technical books and it is doubtful that there is no similar technology in Korea with the same architectural flow, given that there are ways to decide “Kiwarisho: 木割書” in Japan. Therefore, focus on this point and aim to clarify the dimension determination method of Miruk-jõn Hall Kumsan-sa Temple using analysis method of each proportional method in Japan.

<p><strong>Abstract.</strong> By the study of the pattern book <i>Ying Zao Fa Shi</i> (building regulations of Song Dynasty, 1103 AD), while analyzing the combining and dimensioning rule of timber framework and tile work, a model self-generating program has been compiled for the first time. The operating framework has been firstly defined, while solving the issues of clustering principle, connecting method, output classification, etc. with the detailed description of algorithm theory. Taking the corner bracket set and nine-ridge roof for example, after the compilation and debug by Grasshopper, according to various input parameters, various models have been generated automatically by the plugin, proving the velocity and the veracity of the algorithm.</p>

Rituals that accompany community celebrations in China come in two kinds: vernacular and classical. The reason why these two forms exist is not easily explained. To the two forms of liturgy correspond two kinds of specialists: the tao-shi (Taoist dignitary) and the fa-shih (Master of rites). Both are commonly called “master,” and their practices are often confused by laymen. In fact, the two traditions are opposite and rivaling, but they are also largely complementary. This article, which is mainly based on fieldwork in southern Taiwan during the 1960s, explores both traditions, but emphasizes the lesser known vernacular one. An attempt is made to assess how widespread this situation was in China, and how far back in history it can be traced. The story of Hsu Chia, Lao-tzu's illiterate servant, which is considered the origin of the vernacular tradition, is studied in detail.

In traditional Chinese timber structures, few tie beams were used between columns, and the column base was placed directly on a stone base. In order to study the hysteretic behavior of such structures, a full-scale model was established. The model size was determined according to the requirements of an eighth grade material system specified in the architectural treatise Ying-zao-fa-shi written during the Song Dynasty. In light of the vertical lift and drop of the test model during horizontal reciprocating motions, the horizontal low-cycle reciprocating loading experiments were conducted using a synchronous loading technique. By analyzing the load-displacement hysteresis curves, envelope curves, deformation capacity, energy dissipation, and change in stiffness under different vertical loads, it is found that the timber frame exhibits obvious signs of self-restoring and favorable plastic deformation capacity. As the horizontal displacement increases, the equivalent viscous damping coefficient generally declines first and then increases. At the same time, the stiffness degrades rapidly first and then decreases slowly. Increasing vertical loading will improve the deformation, energy-dissipation capacity, and stiffness of the timber frame.

Este ensaio traz elementos da medicina ocidental, da medicina tradicional chinesa e da sociologia do trabalho para reflexão sobre o Qi Gong - exercícios terapêuticos, um dos pilares da Medicina Tradicional Chinesa (MTC) - como importante meio de prevenção da LER/DORT e recuperação da saúde. Considerando a natureza interdisciplinar e diversos níveis de prevenção, aborda aspectos sociológicos sobre as condições de trabalho frequentemente relacionadas com este tipo de adoecimento e categorias de trabalhadores mais acometidos. Focaliza aspectos médicos sobre a LER/DORT e as Síndromes de Bloqueio na MTC, estabelecendo canais de articulação e contribuição entre esses campos de conhecimento sobre a saúde humana. Ressalta o Qi Gong como importante prática terapêutica e preventiva na MTC e sua adequação à LER/DORT. No âmbito do Qi Gong, focaliza o Lian Gong Shi Ba Fa - Lian Gong em 18 Terapias, já amplamente experimentado na China e divulgado, inclusive no Brasil, para tratar e prevenir síndromes de dor em região cervical, ombros, membros superiores, membros inferiores e região lombar. À guisa de conclusão, são apresentadas algumas reflexões sobre a propriedade e a importância do Qi Gong na reabilitação e na prevenção da LER/DORT.

Apart from false position and double false position, another numerical method for calculating roots of equations was known to the Ancient Chinese. Chia Hsien in the eleventh century is reputed to have given an algorithm for calculating roots as well as describing Pascal’s triangle. The algorithm was mentioned again by the twelfth century scholar Liu I. The Chinese used the method to solve quadratics and cubics as early as 100 BC, but it was not until 1247 that Ch’in Kiu-Shao from South China published its extension to higher order polynomials in his work, Mathematics in nine chapters. A year later in the book, Sea-mirror of circle measurements, Li Yeh, who was from north China, took root-finding for granted. The fact that these quite independent writers published similar work suggests that finding the zeros of polynomials was well known by the middle of the thirteenth century. It was left to one of China’s greatest mathematicians, Chu Shi-kie’ (ca. 1280–1303), to give this algorithm its name fan fa, which means the method of the Celestial Element or sometimes the Celestial Unknown [1,2]. Translations and spellings of these older Chinese words do not always give the same result. This algorithm eventually became known as the Ruffini-Horner Method or more simply Horner’s method.

Abstract The Fanconi anemia (FA) pathway is a major player in the control of DNA replication integrity in response to replication stress. Germline defect in the pathway results in the FA syndrome characterized by developmental abnormalities, bone marrow (BM) failure, and genome instability which greatly elevates the incidence of cancers. A pivotal step in the activation of the FA DNA repair pathway is the monoubiquitination of the FANCD2 and FANCI proteins (ID2) by the FA core complex, a unique ubiquitin ligase complex which includes eight proteins (FANCA-FANCG, FANCL, and FAAP100) and UBE2T/FANCT. This monoubiquitination event enables the recruitment of the ID2 complex to chromatin and nuclear foci at sites of DNA damage. Cells with mutations in any of the FA core complex proteins lack the ability to monoubiquitinated ID2, making ID2 ubiquitination a convergence point in the pathway, with an estimation of&gt;90% FA patients defective in this step. Additionally, somatic mutations In FA genes render tumor cells sensitive to DNA crosslinking agents, so identification of FA pathway defects provides an opportunity for therapeutic targeting. In search for additional potential target/substrate of this unique FA core ubiquitin ligase complex, we performed a high throughput genome-wide ubiquitin-specific proteomics (UbiScan) screen and found, in addition to the ID2 complex, many ubiquitinated proteins are dysregulated (mostly downregulated) in FA deficient cells compared with that of FA proficient cells. We used a Ubiquitin Remnant Motif (K- ∑-GG) Antibody Bead Conjugate (Cell Signaling Technology), a proprietary ubiquitin branch ("K- ∑-GG") antibody with specificity for a di-glycine tag that is the remnant of ubiquitin left on protein substrates after trypsin digestion, to enrich ubiquitinated peptides from trypsin digested cell samples (shNT vs shFANCA). This enrichment is followed by LC-MS/MS analysis for quantitative profiles of hundreds to over a thousand nonredundant ubiquitinated sequences. We were successful in demonstrating that under steady-state conditions (without proteasome inhibitor treatment), the ubiquitinated forms of both FANCD2 and FANCI proteins are much higher in control (shNT) HeLa cells compared with that of the cells depleted of FANCA (shFANCA). We then collaborated with the Cell signaling technology to perform a high throughput UbiScan® analysis of total ubiquitinated proteins both in total nuclei and chromatin fractions under replicative stress conditions. UbiScan® enables researchers to isolate, identify and quantitate large numbers of ubiquitin-modified cellular peptides with a high degree of specificity and sensitivity, providing a global overview of the ubiquitination sites in cellular proteins in cell and tissue samples without preconceived biases about where these modified sites occur. A total of 16,249 redundant modified peptide assignments to 7,856 modified sites for the Ubiquitin K-GG Remnant Motif Antibody were obtained. As expected, the amount of monoubiquitinated FANCD2 (at K651) and FANCI (at K523) were highly reduced in both the nuclear and chromatin fractions of Hela cells depleted of FANCA (shA). Consistent with the earlier findings, the amount of ubiquitinated ID2 proteins were extremely low in the chromatin fraction of the Hela cells depleted of FANCA. Since there are numerous ubiquitinated proteins found to be dysregulated in our UbiScan analyses, we used the following criteria to select the target proteins based on; a) -fold changes, and b) proteins that are known to participate in the DNA repair signaling pathways. We validated our UbiScan results by using an assay system to detect endogenous protein ubiquitination. We also found a significant reduction in the ubiquitination of several DNA repair-related proteins (found in our UbiScan analysis) in FANCA deficient cells. To assess FA pathway functions, we generated HAP1 and appropriate cells knock out of these select ubiquitinated target proteins by using CRISPR-Cas9 system. Then, the KO cells were examined for FA pathway functions. These results will be discussed. In conclusion, our findings reveal that the FA core ubiquitin ligase complex regulates (directly or indirectly) the ubiquitinated levels of many novel proteins outside of the ID2 complex, and these novel target proteins may provide important additional mechanistic insights into the FA DNA repair pathway. Disclosures No relevant conflicts of interest to declare.

BackgroundHepatocellular carcinoma (HCC) is the fourth leading cause of cancer deaths worldwide.1 The immuno-regulatory environment of the liver, coupled with tumor-specific immuno-suppressive mechanisms, has negatively impacted the development of clinically effective immunotherapies. Most HCC tumors secrete alpha-fetoprotein (AFP), which we previously demonstrated inhibited monocyte to dendritic cell (DC) differentiation and metabolism.2 3 These immunoregulatory effects depended upon a previously unidentified low molar mass ligand bound to tumor-derived (tAFP) but not cord-blood-derived 'normal' AFP (nAFP). To delineate the mechanism, we identified and tested fatty acids (FA) unique to tAFP necessary for immunosuppression.MethodsFatty acids bound to samples of ovalbumin (OVA), nAFP, and tAFP (n=3 each), were quantified by mass spectrometry and gas chromatography by the UCSD Lipidomics Core. Analysis of the single-cell metabolism was measured using the SCENITH assay4 via spectral-flow cytometry. Bulk measurement of metabolism was measured by microarray and glucose/lactate quantification of supernatants during monocyte to DC differentiation in vitro. Lastly, several fatty acids (FAs) were co-incubated with ligand-free preparations of OVA, nAFP, and tAFP to determine which FAs contribute to limiting DC differentiation in vitro.ResultsSCENITH analysis revealed a stark increase in lactate secretion and a marked switch from oxidative-phosphorylation (OXPHOS) to glycolysis in tAFP-treated DCs, which correlated with reduced co-stimulatory marker expression and increased PD-L1. g:Profiler analysis of microarray data confirmed dysregulation of FA metabolism. We identified three polyunsaturated fatty acids (PUFAs) that were enriched on tAFP by mass-spectrometry and gas chromatography. Screening of FAs on ligand-free preparations revealed two PUFAs on tAFP were uniquely able to decrease differentiation of iDC and mDCs in vitro.ConclusionsWe have identified unique FA ligands of tAFP and determined specific FAs that restore its immunoregulatory activities. To our knowledge, these are the first data demonstrating a role of a novel PUFA in inhibiting DC formation and are consistent with previous reports showing arachidonic (20:4) inhibits DC formation in vitro.5 Furthermore, we have identified key metabolic pathways of the immuno-metabolic dysregulation of DCs in HCC. These findings identify targets for strategies to reverse the tAFP induced immuno-metabolic dysfunction in vivo could be a strategy to potentiate robust anti-tumor immunity and improve survival in HCC patients.AcknowledgementsWe wish to acknowledge the Parker Institute for Cancer Immunotherapy, Dr. Oswald Quehenberger and Milda Simonaitis of the UCSD Lipid omics Core for their consultation on the lipid panel, as well as Vin Nguyen of the UCSF Flow Cytometry Core for his assistance with the flow cytometry panels.ReferencesSung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 Countries. CA Cancer J Clin 2021;71:209–49. https://doi.org/10.3322/caac.21660.Pardee AD, Shi J, Butterfield LH. Tumor-Derived α-Fetoprotein Impairs the differentiation and T Cell stimulatory activity of human dendritic cells. J Immunol 2014;193:5723–32. https://doi.org/10.4049/jimmunol.1400725.Santos PM, Menk AV, Shi J, Tsung A, Delgoffe GM, Butterfield LH. Tumor-Derived α-Fetoprotein suppresses fatty acid metabolism and oxidative phosphorylation in dendritic cells. Cancer Immunol Res 2019;7:1001–12. https://doi.org/10.1158/2326-6066.cir-18-0513.Argüello RJ, Combes AJ, Char R, Gigan J-P, Baaziz AI, Bousiquot E, et al. SCENITH: a flow cytometry-based method to functionally profile energy metabolism with single-cell resolution. Cell Metab 2020;32:1063–1075.e7. https://doi.org/10.1016/j.cmet.2020.11.007.Zeyda M, Säemann MD, Stuhlmeier KM, Mascher DG, Nowotny PN, Zlabinger GJ, et al. Polyunsaturated fatty acids block dendritic cell activation and function independently of NF-κB activation. J Biol Chem 2005;280:14293–301. https://doi.org/10.1074/jbc.m410000200.Ethics ApprovalThe Cancer Immunotherapeutics Tissue Use Committee approved samples from healthy donors at UCSF.

Efficient night-time vessel detection is of significant importance for maritime traffic management, fishery activity monitoring, and environmental protection. With the advancement in object-detection approaches, the method of night-time vessel detection has gradually shifted from traditional threshold segmentation to deep learning that balances efficiency and accuracy. However, the restricted spatial resolution of night-time light (NTL) remote sensing data (e.g., VIIRS/DNB images) results in fewer discernible features and insufficient training performance when detecting vessels that are considered small targets. To address this, we establish an Enhanced Dense Nested-Attention Network (DNA-net) to improve the detection of small vessel targets under low-light conditions. This approach effectively integrates the original VIIRS/DNB, spike median index (SMI), and spike height index (SHI) images to maintain deep-level features and enhance feature extraction. On this basis, we performed vessel detection based on the Enhanced DNA-net using VIIRS/DNB images of the Japan Sea, the South China Sea, and the Java Sea. It is noteworthy that the VIIRS Boat Detection (VBD) observations and the Automatic Identification System (AIS) data were cross-matched as the actual status of the vessels (VBD-AIS). The results show that the proposed Enhanced DNA-net achieves significant improvements in the evaluation metrics (e.g., IOU, Pd, Fa, and MPD) compared to the original DNA-net, achieving performance of 87.81%, 96.72%, 5.42%, and 0.36 Wpx, respectively. Meanwhile, we validated the detection performance of Enhanced DNA-net and strong VBD detection against VBD-AIS, showing that the Enhanced DNA-net achieves 1% better accuracy than strong VBD detection.

Background. Nigella sativa L (NS) is a powerful antioxidant and medicinal plant with many therapeutic applications particularly in traditional medicine for respiratory, gastrointestinal, rheumatic, and inflammatory disorders, as well as cancer. Objective. The aim of this study is to extract the active ingredients from the Moroccan Nigella sativa L and determine its antioxidant properties. We hypothesize that the separation of the compounds from Nigella sativa L has either a positive or negative effect on antioxidants. To study this, we explored different methods to simultaneously extract and separate compounds from Nigella sativa L and performed antioxidant tests (β-carotene and DPPH) for all collected fractions. Methods. Nigella sativa L was hot-extracted by Soxhlet and mother extracts and was separated using silica column chromatography with adequate eluents. Qualitative phytochemical tests to determine the chemical families in Nigella sativa L seeds were performed on the fractions. They were also identified and characterized by GC-MS and HPLC-DAD. Then, antioxidant activity was examined by β-carotene bleaching and DPPH radical scavenger tests. Results and Conclusion. The mother extract hexane FH generated eight different fractions (SH1-8) and the acetone extract FA generated 11 fractions (SA1-11). The FH fractions had a high percentage of fatty acids, and the FA fractions had some interesting polyphenols derivative compounds. Phytochemical screening revealed secondary metabolites such as polyphenols flavonoids, alkaloids, steroids, terpenes coumarins, tannins, and saponins. We found that only two solvents (hexane, acetone) of different polarities could easily extract and simultaneously separate the components of Nigella sativa L. The antioxidant fractions that we collected had close activity to reference compounds but were more active than the corresponding mother extracts. Moreover, several IC50 values of fractions from acetone extract were better than those from hexane. Therefore, the antioxidant activity of Nigella sativa L is more attributed to flavonoids and polyphenols than fatty acids. In summary, the separation of hexane extract presents a more pronounced positive effect for antioxidant tests than acetone extract.

Fly ash (FA) fractions with a particle size of 63 µm < FA < 250 µm obtained by sieve fractionation were used as a partial carbon black (CB) replacement in a rubber mixture based on styrene-butadiene rubber (SBR). In order to improve the interactions at the interface between rubber and fractionated ash, at the stage of preparing the rubber mixtures, two different vinyl silanes were added to the system: Vinyltrimethoxysilane (U-611) or Vinyl-tris (2-methoxy-ethoxy) silane (LUVOMAXX VTMOEO DL50), silane with epoxy groups: 3-(glycidoxypropyl)trimethoxysilane (U-50) or sulfur functionalized silanes: containing sulfide bridges: Bis(triethoxysilylpropyl)polysulfide silane (Si-266) or mercapto groups: Mercaptopropyltrimethoxysilane (Dynaslan MTMO). The conducted research confirmed the effectiveness of silanization with selected functional silanes, from the point of view of improving the processing and operational properties of vulcanizates, in which CB is partially replaced with the finest fractions of fly ash. The silanization generally increased the interaction at the rubber–ash interface, while improving the degree of filler dispersion in the rubber mixture. The results of TGA and FTIR analyses confirmed the presence of silanes chemically bonded to the surface of fly ash particles. SEM tests and determination of the bound rubber (BdR) content show that the introduction of the silanes to the mixture increases the degree of ash dispersion (DI) and the Payne effect, which is the greatest when mercaptosilane was used for modification. The highest increase in torque, which was recorded in the case of rubber mixtures containing sulfur silanes and silane with epoxy groups, may be due to their participation in the vulcanization process, which is confirmed by the results of vulcametric studies. The lowest values of mechanical strength, elongation at break, and the highest hardness of vulcanizates obtained in this case may be the result of the over-crosslinking of the rubber. The addition of sulfur-containing silanes significantly slowed down the vulcanization process, which is particularly visible (up to three times extension of the t90 parameter, compared to mixtures without silane) in the case of Si-266. The addition of silanes, except for Si-266 (with a polysulfide fragment), generally improved the abrasion resistance of vulcanizates. The Dynaslan MTMO silane (with mercapto groups) performs best in this respect. Proper selection of silane for the finest fraction of fly ash in the rubber mixtures tested allows for an increase in the mechanical strength of their vulcanizates from 9.1 to 17 MPa, elongation at break from 290 to 500%, hardness from 68 to 74 °ShA, and reduction in abrasion from 171 to 147 mm3.

Abstract Background: Brain metastases (BM) are associated with high mortality rate in lung cancer patients. Despite advancements that have led to improved survival of lung cancer patients, the prognosis of lung cancer brain metastases (LCBM) is still dismal. Brain MRI is currently the method of choice for BM assessment. However, it is limited due to a lack of surveillance. Cytosolic evaluation of cerebrospinal fluid (CSF) is generally unsatisfactory due to its poor sensitivity. Therefore, exploring a sensitive and accurate method for early detection of BM in lung cancer patients is needed to improve disease management. Methods: CSF circulating tumor DNA (ctDNA) of 81 lung cancer patients confirmed or suspected of BM who were screened between June 2019 and October 2021 were analyzed using targeted next-generation sequencing. Patients were classified into three subgroups according to their BM status and the relationship with sampling time, including 61 POS patients (patients whose BM status was already positive at CSF sampling), 10 NEG patients (patients whose BM status was negative at CSF sampling and remained unchanged during the follow-up), and 9 NTP patients (patients whose BM status turned from negative at CSF sampling to positive during the follow-up). The training dataset recruited 70 patients whose BM status at CSF sampling was definitive, including 62 POS and 8 randomly selected NEG patients. The testing dataset consisted of 11 patients, including 9 NTP and 2 randomly selected NEG patients. A robust machine learning model was developed based on the 6bp breakpoint motif (BPM) features in CSF ctDNA. The mutational profile of CSF ctDNA was also assessed to reveal potential prognostic-related genetic alterations in LCBM. Results: The BM predictive model built on BPM features demonstrated a remarkable capacity to detect LCBM, with an Area Under the Curve (AUC) of 0.929 and 0.944 in the training and testing datasets, respectively. Model performance was not significantly improved by combining CSF ctDNA status features. Our model showed consistently high performance in identifying BM regardless of the patient’s clinical characteristics, such as histologic type, smoking or treatment history, and Karnofsky performance status. The risk score of patients in the testing cohort computed by our model showed a trend of negative correlation with the BM detection time (rho=-0.4, P=0.2861, Spearman’s rank correlation). We also identified RB1 variants, EGFR amplification, and Fanconi anemia (FA) pathway mutations as promising BM-related prognostic biomarkers in patients with lung cancer. Conclusions: We established a robust BM predictive model using BPM features in CSF ctDNA and profiled genomic alterations associated with BM aggressiveness, which provided insights into the potential use of CSF ctDNA sequencing for early detection of LCBM and disease management. Citation Format: Xueting Qin, Yujun Bai, Shizhen Zhou, Hongjin Shi, Xiaoli Liu, Song Wang, Xiaoying Wu, Jiaohui Pang, Xi Song, Xiaojun Fan, Qiuxiang Ou, Yang Xu, Hua Bao, Li Li, Haimeng Tang, Yang Shao, Shuanghu Yuan. Early diagnosis of brain metastases using cerebrospinal fluid cell-free DNA-based breakpoint motif and mutational features in lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 765.

Abstract Background Outcome of children with medulloblastoma (MB) and Fanconi Anemia (FA), an inherited DNA repair deficiency, has not been described systematically. Treatment is complicated by high vulnerability to treatment-associated side effects, yet structured data are lacking. This study aims at giving a comprehensive overview about clinical and molecular characteristics of pediatric FA MB patients. Methods Clinical data including detailed information on treatment and toxicities of six previously unreported FA MB patients were supplemented with data of 16 published cases. Results We identified 22 cases of children with FA and MB with clinical data available. All MBs with subgroup reporting were SHH-activated (n=9), confirmed by methylation profiling in five patients. FA MB patients exclusively belonged to complementation groups FA-D1 (n=16) or FA-N (n=3). Patients were treated with postoperative chemotherapy only (50%) or radiotherapy (RT)±chemotherapy (27%). 23% did not receive adjuvant therapy. Excessive treatment-related toxicities were frequent. Severe hematological toxicity occurred in 91% of patients treated with alkylating chemotherapy, while non-alkylating agents and RT were less toxic. Median overall survival (OS) was 1 year (95%CI 0.3-1.8). 1-year-progression-free-survival (PFS) was 26.3±10.1% and 1-year-OS was 42.1±11.3%. Adjuvant therapy prolonged survival (1y-OS/1y-PFS 0%/0% without adjuvant therapy vs. 53.3±12.9%/33.3±12.2% with adjuvant therapy, p=0.006/p=0.086). Conclusions MB in FA patients is strongly associated with SHH activation and FA-D1/FA-N. Despite the dismal prognosis, adjuvant therapy may prolong survival. Non-alkylating chemotherapy and RT are feasible in selected patients with careful monitoring of toxicities and dose adjustments. Curative therapy for FA MB-SHH remains an unmet medical need.

Abstract In this study, a first shear horizontal (SH1) mode plate wave resonator for high-frequency and wide-band filters was investigated. From FEM simulation, SH1 mode plate wave exhibited a high phase velocity of 23 km/s and a high electro-mechanical coupling factor (k2) of 37% on (0°, 85°, 0°) LiNbO3 (LN) with a thickness of 0.1λ (λ: wavelength). The SH1 mode resonator was fabricated on a 0.5-0.57 µm thick LN film. An 80 nm Al IDT electrode was formed with λ varied from 4-16 μm. Finally, 50 nm thick Al was deposited to form an electrically short bottom plane, which was required to generate an SH1 mode wave. The fabricated device exhibited a resonance frequency (fr) of 2.24 GHz, an anti-resonance frequency (fa) of 2.8 GHz, a wide fractional bandwidth (FBW) of 20%, an impedance (Z) ratio of 35.4 dB, and TCF of -90.8 ppm/°C at fr and -74.8 ppm/°C at fa.

Abstract Although adequate periconceptional folic acid (FA) supplementation has reduced the occurrence of pregnancies affected by neural tube defects (NTDs), the mechanisms underlying FA-resistant NTDs are poorly understood, and thus NTDs still remain a global public health concern. A high level of Krüppel-like factor 12 (KLF12) exerts deleterious effects on heath in most cases, but evidence for its roles in development has not been published. We observed KLF12-overexpressing mice showed disturbed neural tube development. KLF12-overexpressing fetuses died in utero at approximately 10.5 days post-coitus, with 100% presenting cranial NTDs. Neither FA nor formate promoted normal neural tube closure in mutant fetuses. The RNA-seq results showed that a high level of KLF12 caused NTDs in mice via overactivating the sonic hedgehog (Shh) signaling pathway, leading to the upregulation of patched 1, GLI-Krüppel family member GLI1, hedgehog-interacting protein, etc., whereas FA metabolism-related enzymes did not express differently. PF-5274857, an antagonist of the Shh signaling pathway, significantly promoted dorsolateral hinge point formation and partially rescued the NTDs. The regulatory hierarchy between a high level of KLF12 and FA-resistant NTDs might provide new insights into the diagnosis and treatment of unexplained NTDs in the future.

Abstract Background Products containing humic acids (HA) and fulvic acids (FA) have significant commercial potential, however, unknown to the consumer, some products may be mislabeled or contain adulterants. The prevalence of mislabelling and adulterants is primarily found in FA products. Using UV-Vis spectroscopy to differentiate between real and fake FA products is practical and desirable. Objective The objective of this study was to expand the data set generated using a UV-VIS based method proposed by Mayhew et al., 2023. Methods In total, thirty (30) test samples were used to generate ninety test portions (3 replicates per test sample) for analysis using the UV-Vis methodology outlined in Mayhew et al., 2023, which in this study is referred to as the UVAC (UV absorbance confirmation) method. Results None of the thirteen FA test samples investigated were determined as humified using the UVAC method. The FA samples studied comprised of two IHSS standards, five commercial FA products (CFAP) and six full FA fractions (SFA), which were isolated from six known solid humic material sources (SHMS). There was a leonardite, a humalite, and four peat sources used as the SHMS. Analysis of the neutralized extract of the SHMS found only 3/6 SHMS were determined as humified. Six HA (SHA) test samples were also generated by isolating the HA from the SHMS and only 3/6 SHA were determined as humified. Conclusion Given the high prevalence of false determinations more work is needed to improve the method so it can be used by industry or regulators. Highlights The proposed method failed to determine IHSS FA standards as humified. Although the method is practical, it needs improvement and further study before it can be used for reliable differentiation of real from fake FA or HA.

AbstractAbnormal lipid metabolism promotes hepatocellular carcinoma (HCC) progression, which engenders therapeutic difficulties owing to unclear mechanisms of the phenomenon. We precisely described a special steatotic HCC subtype with HBV-related cirrhosis and probed its drivers. Hematoxylin-eosin (HE) staining of 245 HCC samples revealed a special HCC subtype (41 cases) characterized by HBV-related cirrhosis and intratumoral steatosis without fatty liver background, defined as steatotic HCC with HBV-related cirrhosis (SBC-HCC). SBC-HCC exhibits a larger tumor volume and worse prognosis than non-SBC-HCC. Screening for driver genes promoting fatty acid (FA) biosynthesis in the Gao’s HBV-related cirrhosis HCC cases and GSE121248’ HBV-related HCC cases revealed that high expression of SOCS5 predicts increased FA synthesis and that SOCS5 is upregulated in SBC-HCC. Through proteomics, metabolomics, and both in vivo and in vitro experiments, we demonstrated that SOCS5 induces lipid accumulation to promote HCC metastasis. Mechanistically, through co-IP and GST-pulldown experiments, we found that the SOCS5-SH2 domain, especially the amino acids Y413 and D443, act as critical binding sites for the RBMX-RRM domain. SOCS5-RBMX costimulates the promoter of SREBP1, inducing de novo lipogenesis, while mutations in the SH2 domain, Y413, and D443 reverse this effect. These findings precisely identified SBC-HCC as a special steatotic HCC subtype and highlighted a new mechanism by which SOCS5 promotes SBC-HCC metastasis.

Musculoskeletal problems are commonly reported after stroke resulting in abnormal gait biomechanics, pain, and limitation in performing activities of daily living. Anterior circulate ligament is the most frequently injured knee ligament accounting for approximately 50% of all ligament injuries; however, post stroke anterior cruciate ligament injury is rarely reported. We present a case of a 58-year-old female admitted for inpatient stoke rehabilitation after a left middle cerebral artery stroke. After gaining considerable functional recovery, she was planned to be discharged in two weeks’ time when she tripped resulting in a torn anterior cruciate ligament on the hemiperetic side. This resulted in increase in the length of stay and loss of functional gains. We discuss the possible mechanisms and the management plan. Patients with stroke should be monitored for musculoskeletal complications and preventive strategies should be devised to protect from possible ligamentous injuries of the knees. doi: https://doi.org/10.12669/pjms.35.6.974 How to cite this:Alzamel N, Qureshi AZ, Rathore FA, Ullah S. The negative effects of anterior cruciate ligament injury during stroke rehabilitation. Pak J Med Sci. 2019;35(6):1740-1744. doi: https://doi.org/10.12669/pjms.35.6.974 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose The surface characteristics of thermally and chemically modified wood, such as surface roughness, surface free energy (SFE) and wettability, are important properties that influence further manufacturing processes such as gluing and coating. The aim of this paper was to determine the influence of the surface roughness of thermally and chemically modified teak wood on their SFE, wettability and bonding quality for water-based acrylic and solvent-based alkyd varnishes. In addition, durability against subterranean termites in the field of these modified teak woods was also investigated to give a valuable information for their further application. Design/methodology/approach The woods tested in this study were fast-growing teak woods that were prepared in untreated and treated with furfuryl alcohol (FA), glycerol maleic anhydride (GMA) and thermal. SFE values were calculated using the Rabel method. The wettability values were measured based on the contact angle between varnish liquids and wood surfaces using the sessile drop method, and the Shi and Gardner model model was used to evaluate the wettability of the varnishes on the wood surface. The bonding quality of the varnishes was measured using a cross-cut test based on ASTM 3359-17 standard. In addition, durability against subterranean termites in the field of these modified teak woods was also investigated according to ASTM D 1758-06. Findings The results showed that furfurylated and GMA-thermal 220°C improved the durability of teak wood against termites. The furfurylated teak wood had the roughest surface with an arithmetic average roughness (Ra) value of 15.65 µm before aging and 27.11 µm after aging. The GMA-thermal 220°C treated teak wood was the smoothest surface with Ra value of 6.44 µm before aging and 13.75 µm after aging. Untreated teak wood had the highest SFE value of 46.90 and 57.37 mJ/m2 before and after aging, respectively. The K values of untreated and treated teak wood increased owing to the aging treatment. The K values for the water-based acrylic varnish were lower than that of the solvent-based alkyd varnish. The untreated teak wood with the highest SFE produced the highest bonding quality (grades 4–5) for both acrylic and alkyd varnishes. The solvent-based alkyd varnish was more wettable and generated better bonding quality than the water-based acrylic varnish. Originality/value The originality of this research work is that it provides evaluation values of the durability and SFE. The SFE value can be used to quantitatively determine the wettability of paint liquids on the surface of wood and its varnish bonding quality.

LANGUAGE NOTE | Document text in Chinese; abstract also in English. 吳喬（1611—1695）是明清之際的詩人和詩學理論家，所著詩學論著，現存的有《逃禪詩話》一卷、《圍爐詩話》六卷、《答萬季野詩問》一卷、《答萬季野詩問補遺》一卷和《西崑發微》三卷等。他認為詩是經史之學，主張詩中有人，詩要有意，反對把詩視為應酬工具，而賦、比、興三者是寫詩和評鑒詩歌的重要法則。他拿以上的主張來銓衡詩歌發展，評論詩人的成就高下，成就他的詩學理論，清初《談龍錄》作者趙執信（1662—1744）很欣賞他的詩論，三次尋訪《圍爐詩話》；史學家萬斯同（1638—1702）執弟子禮，才有兩種《詩問》，可見吳喬的詩學理論在當時受到重視。 在吳喬的詩學理論架構中，比興説是重要的支柱。他把《詩經》視為詩歌的不祧之宗，而《詩經》中的詩篇是有為而發的，説《詩》者可以因事以逆知其意。作《詩》者運用赋比興三義，成為後世詩人的楷模，因此能符合三義，尤其比興二者的，成績便卓然，否則即使極文字之工，而沒有詩意的，都不是好作品。吳喬運用這詩學觀點，去研究詩歌的發展，評論作品的優劣，從漢一直到明。以詩人論，他崇高杜甫，而李商隱號稱善學杜甫，所以又用比興論李商隱詩。以時代言，他重視唐而貶抑宋、明，尤其不滿明代前後七子的詩作。在六卷《圍爐詩話》中，有數十條談論赋比興的文字，較他別的詩學論著所説為多。選取《圍爐詩話》中的比興説來研究，可以清楚了解吳喬的詩學理論的核心，並為研究這本詩話在比興説發展史上的地位作準備。 Wu Qiao (1611-1695) was a poet as well as a poetics theorist of the late Ming and early Qing period. His extant works on poetics theory include one volume of Tao Chan Shihua, six volumes of Weilu Shihua, one volume of Da Wan Guiye Shi Wen, three volumes of Xikun Fa Wei, etc. He believed that poetry was a discipline of jing (Confucian classics) and shi (history). Wu advocated that when composing poetry, the poet should reflect his emotions on his works and also convey messages through the poetry. He objected to people who regarded writing poetry as a means of social intercourse. The major guidelines to compose and evaluate poetry were: Fu, Bi and Xing (three allegories used in Chinese writing). Wu applied these rules to assess the achievement of the poets and accomplished his own poetics theory as well. Zhao Zhixin (1662- 1774), the author of Tan Long Lu admired Wu's poetics theory and historian Wan Sitong (1638-1702) even acknowledged Wu as his teacher. These revealed the importance and impact of Wu's Poetics theory in his times. Bixing is the major skeleton of Wu Qiao's poetics theory. Wu regarded Shijing (The Classic of Songs) as the origin of all poetry. He believed that the poetry compiled in Shijing revealed some incidents or the poets' feelings and thought. The critics on Shijing could therefore interpret the poetry from different perspectives. Writers of Shijing used Fu, Bi and Xing as the writing modes to compose poetry. The three modes then became the templates of the poets later. If a poet could write poetry that fulfill the three modes, especially Bixing, then his works could be regarded as good pieces. Otherwise, they were not even if the works were flowerily written. Wu Qiao investigated the development of poetry (from Han to Ming) and accessed the merits of the poetry by applying the Bixing theory. He praised Du Fu highly. As Li Shangyin was famous for his well imitation and adaptation of Du Fu's poetry, Wu Qiao also evaluated Li's poetry by adopting the Bixing theory. Wu praised Tang's poetry and depreciated those in Song and Ming. He was particularly dissatisfied with the poetry of the late seven poets (Hou Qi Zi) of Ming Dynasty. In Wu Qiao's Weilu Shihua, there were tens of items discussing the Bixing which were obviously more than that in his other works. By looking into the Bixing theory of Weilu Shihua, this paper aims at investigating more about the crux of Wu Qiao's poetics theory and paves way for future discussion on the importance of Weilu Shihua in the development of bixing theory.

Introdução: A terapia fotodinâmica representa uma abordagem alternativa para a desinfecção do tecido cariado e tem apresentando resultados promissores no que diz respeito ao seu efeito deletério sobre os microrganismos envolvidos na progressão da cárie dentária. Objetivo: Investigar a produção científica brasileira sobre Terapia Fotodinâmica no manejo da Cárie dentária. Material e método: Tratou-se de uma pesquisa transversal, com abordagem quantitativa, a partir de dados secundários. Realizou-se uma análise bibliométrica dos resumos apresentados nas últimas dez Reuniões da Sociedade Brasileira de Pesquisa Odontológica. A pesquisa dos trabalhos procedeu-se através da seguinte estratégia: localização do fragmento “terapia fotodinâmica” e/ou “fotodinâmica” entre os resumos publicados nos anais do evento (1ª fase), em seguida foi realizada a busca pelo fragmento “cárie” e/ou “cardiologia” nos resumos selecionados na 1ª fase. Resultados: Foram selecionados 21 resumos, desses, 15 (71,43%) foram realizadas em universidades públicas, 13 (61,91%) receberam auxílio financeiro, 11 (52,38%) foram desenvolvidas na região Sudeste do Brasil, 9 (42,86%) eram do tipo in vitro, 6 (28,58%) utilizaram apenas o azul de toluidina como fotossensibilizante e 5 (23,81%) utilizaram apenas o LED vermelho como fonte de luz. Conclusão: Apesar dos resultados promissores da Terapia Fotodinâmica como terapia adjunta ao manejo da cárie, observou-se que poucas pesquisas abordando esse procedimento foram desenvolvidas nos últimos dez anos no Brasil.Descritores: Fotoquimioterapia; Cárie Dentária; Coleta de Dados.ReferênciasBradshaw DJ, lynch RJ. Diet and the microbial aetiology of dental caries: new paradigms. Int Dent J. 2013;63(Suppl 2):64-72.Hasan S, Singh K, Danisuddin M, Verma PK, Khan AU. Inhibition of major virulence pathways of Streptococcus mutansby quercitrin and deoxynojirimycin: a synergistic approach of infection control. 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Photodynamic Antimicrobial Chemotherapy as a Strategy for Dental Caries: Building a More Conservative Therapy in Restorative Dentistry. Photomed Laser Surg. 2014;32:589-91.Soria-Lozano P, Gilaberte Y, Paz-Cristobal MP, Pérez-Artiaga L, Lampaya-Pérez V, Aporta et J, et al. In vitro effect photodynamic therapy with differents photosensitizers on cariogenic microorganisms. BMC Microbiology. 2015;15:2-8.Araújo PV, Correia-Silva F, Gomez RS, Massara L, Cortes ME, Poletto LT. Antimicrobial effect of photodynamic therapy in carious lesions in vivo, using culture and real time PCR methods. Photodiagnosis Photodyn Ther. 2015;12(3):401-7.Misba L, Kulshrestha S, Khan AU. Antibiofilm action of a toluidine blue O-silver nanoparticle conjugate on Streptococcus mutans: a mechanism of type I photodynamic therapy. Biofouling. 2016;32:313-28.Gursoy H, Ozcakir-Tomruk C, Tanalp J, Yilmaz S. Photodynamic therapy in dentistry: a literature review. Clin Oral Investig. 2013;17(4):1113-25.Melo MA, Rolim JP, Passos VF, Lima RA, Zanin IC, Codes BM, et al. Photodynamic antimicrobial chemotherapy and ultraconservative caries removal linked for management of deep caries lesions. Photodiagnosis Photodyn Ther. 2015;12(4):581-86.Feuerstein O. Light therapy: complementary antibacterial treatment of oral biofilm. Adv. Dent. Res. 2012;24:103-7.Longo JP, Leal SC, Simioni AR, Almeida-Santos FM, Tedesco AC, Azevedo RB. Photodynamic therapy disinfection of carious tissue mediated by aluminum-chloride-phthalocyanine entrapped in cationic liposomes: an in vitro and clinical study. Lasers Med. Sci. 2012;27:575-84.Araújo NC, Fontana CR, Bagnato VS, Gerbi ME. Photodynamic antimicrobial therapy of curcumin in biofilms and carious dentine. Lasers Med Sci. 2014;29(2):629-35.Teixeira AH, Pereira ES, Rodrigues LK, Saxena D, Duarte S, Zanin IC. Effect of photodynamic antimicrobial chemotherapy on in vitro and in situ biofilms. Caries Res. 2012;46(6):549-54.O'neill JF, Hope CK, Wilson M. Oral bacteria in multispecies biofilms can be killed by red light in the presence of toluidine blue. Lasers Surg Med. 2002;31(2):86-90.Dougherty TJ, Gomer CJ, Henderson BW, Jori G, Kessel D, Korbelik M et al. Photodynamic therapy. J Natl Cancer Inst. 1998;90(12);889-905.Dougherty TJ. An update on photodynamic therapy applications. J Clin Laser Med Surg. 2002;20(1):3-7.Bargrizan M, Fekrazad R, Goudarzi N, Goudarzi N. Effects of antibacterial photodynamic therapy on salivary mutans streptococci in 5- to 6-year-olds with severe early childhood caries. Lasers Med Sci. 2018;34(3):433-40.Hakimiha N. The susceptibility of Streptococcus mutans to antibacterial photodynamic therapy: a comparison of two diferente photosensitizers and light sources. J Appl Oral Sci. 2014;22:80-4.Baptista A, Kato IT, Prates RA, Suzuki LC, Raele MP, Freitas AZ et al. Antimicrobial photodynamic therapy as a strategy to arrest enamel demineralization: a short-term study on incipient caries in a rat model. Photochem Photobiol. 2012;88(3):584-89.Longo JPF, Azevedo RB. Efeito da terapia fotodinâmica mediada pelo azul de metileno sobre bactérias cariogênicas. Rev Clín Pesq Odontol. 2010;6(3):249-57.Guglielmi CA, Simionato MR, Ramalho KM, Imparato JC, Pinheiro SL, Luz MA et al. Clinical use of photodynamic antimicrobial chemotherapy for the treatment of deep carious lesions. J Biomed Opt. 2011;16(8):088003.Tonon CC, Paschoal MA, Correia M, Spolidório DM, Bagnato VS, Giusti JS et al. Comparative effects of protodynamic trerapy mediated by curcumin on standard and clinical isolate of streptococcus mutans. J Contemp Dental Pract. 2015;16(1):1-6.Araújo NC, Fontana CR, Bagnato VS, Gerbi ME. Photodynamic effects of curcumin against cariogenic pathogens. Photomed Laser Surg. 2012;30(7):393-99.Nagata JY, Hioka N, Kimura E, Batistela VR, Terada RS, Graciano AX, et al Antibacterial photodynamic therapy for dental caries: Evaluation of the photosensitizers used and light source properties. Photodiagnosis Photodyn Ther. 2012; 9: 122-31.Dias AA, Narvai PC, Rêgo DM. Tendências da produção científica em odontologia no Brasil. Rev Panam Salud Publica/Pan Am J Public Health. 2008;24(1):54-60.Baltazar LM, Ray A, Santos DA, Cisalpino PS, Friedman AJ, Nosanchuk JD. Antimicrobial photodynamic therapy: an effective alternative approach to control fungal infections Front Microbiol. 2015;6:202.Steiner-Oliveira C, Longo PL, Aranha AC, Ramalho KM, Mayer MP, Paula Eduardo C. Randomized in vivo evaluation of photodynamic antimicrobial chemotherapy on deciduous carious dentin. J Biomed Opt. 2015;20(10):108003.Martin ASS, Chisini LA, Martelli S, Sartori LRM, Ramos EC, Demarco FF. Distribuição dos cursos de Odontologia e de cirurgiões-dentistas no Brasil: uma visão do mercado de trabalho. Rev. ABENO. 2018;18(1):63-73.Scarpelli AC, Sadenberg F, Goursand D, Paiva SM, Pordeus IA. Academic trajectories of dental researchers receiving CNPq’s productivity grants. Braz Dent J. 2008;19(3):252-56.Oliveira Filho RS, Rochman B, Nahas FX, Ferreira LM. Fomento à publicação científica e proteção do conhecimento científico. Acta Cir Bras. 2005;20(Supl 2):35-9.Pinto GS, Nascimento GG, Mendes MS, Ogliari FA, Demarco FF, Correa MB. Scholarships for scientific initiation encourage post-graduation degree. Braz Dent J. 2014;25(1):63-8.Brasil. Ministério da Educação. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. 2016. (Acesso em 01 de agosto de 2018). Disponível em: http://www.capes.gov.br/images/documentos/Documentos_de_area_2017/18_odon_docarea_2016.pdf.Allareddy V, Allareddy V, Rampa S, Nalliah RP, Elangovan S. Global dental research productivity and its association with human development, gross national income, and political stability. J Evid Based Dental Pract. 2015;15(3):90-6.Celeste RK, Warmling CM. Produção bibliográfica brasileira da Saúde Bucal Coletiva em periódicos da saúde coletiva e da odontologia. Ciênc Saúde Colet. 2014; 19(6):1921-32.

A prótese bucomaxilofacial é uma especialidade da Odontologia que visa restaurar indivíduos com perda de estrutura na região de boca e face. Seu ensino ainda é restrito na maioria dos cursos de Odontologia no Brasil, de modo que os cirurgiões dentistas se formam sem conhecer este ramo tão bonito da reabilitação e sem o domínio de conhecimentos teóricos e técnicos sobre o assunto. Deste modo, o objetivo do presente trabalho foi realizar uma revisão de literatura acerca da especialidade de prótese bucomaxilofacial para guiar os cirurgiões-dentistas a respeito de sua indicação, tipos, materiais utilizados e técnica de confecção.Descritores: Prótese Maxilofacial; Prótese Dentária; Reabilitação.ReferênciasAlfenas ER, Lanza CRM, Barreiros ID, Novaes Junior JB, Mendonça LL. Reabilitação protética do paciente com perda de substância na região de cabeça e pescoço. Arq Odontol. 2011;47(2):28-31.Dos Santos DM, de Caxias FP, Bitencourt SB, Turcio KH, Pesqueira AA, Goiato MC.Oral rehabilitation of patients after maxillectomy. A systematic review. Br J Oral Maxillofac Surg. 2018;56(4):256-66.Gamarra RS, Oliveira JAP, Dib LL. A estética em reabilitação bucomaxilofacial. Rev APCD. 2015;3(1):42-52.de Oliveira FM, Salazar-Gamarra R, Öhman D, Nannmark U, Pecorari V, Dib LL. Quality of life assessment of patients utilizing orbital implant-supported prostheses. Clin Implant Dent Relat Res. 2018;20(4):438-43.Goiato MC, Tabata LF, Archangelo CM, Júnior MM. Uso de implantes ossointegrados associados a sistemas de retenção na reabilitação com próteses bucomaxilofaciais: Revisão de Literatura. Pesq Bras Odontoped Clín Integr. 2007;7(3):231-36.Goiato MC, de Carvalho Dekon SF, de Faria Almeida DA, Sánchez DM, dos Santos DM, Pellizzer EP. Patients' satisfaction after surgical facial reconstruction or after rehabilitation with maxillofacial prosthesis. J Craniofac Surg. 2011;22(2):766-9.Kusterer LEFL, Paraguassú GM, Silva VSM, Sarmento VA. Reabilitação com obturador maxilar após cirurgia oncológica: relato de casos. Rev Cir Traumatol Buco-Maxilo-Fac. 2012;12(4):9-16.Nemli SK, Aydin C, Yilmaz H, Bal BT, Arici YK. Quality of life of patients with implant-retained maxillofacial prostheses: a prospective and retrospective study, J Prosthet Dent. 2013;109(1):44-52.Goiato MC, Pesqueira A.A, Ramos da Silva C, Gennari Filho H, Micheline dos Santos D. Patient satisfaction with maxillofacial prosthesis. Literature review. J Plast Reconstr Aesthet Surg. 2009;62(2):175-80.Simões FG, Reis RC, Dias RB. A especialidade de prótese bucomaxilofacial e sua atuação na Odontologia. Rev Sul Bras Odontol. 2009;6(3):327-31.Aguiar L, Mozzini AR, Lersch E, De Conto F. Obturador palatino: confecção de uma prótese não convencional – relato de caso. Rev Fac Odontol Passo Fundo. 2013;18(1):125-29.Miyashita ER, Mattos BSC, Marafon PG. Sistemas de retenção em prótese obturadora cirúrgica para pacientes maxilectomizados. Pesq Bras Odontoped Clín Integr. 2011;11(2):263-68.Esteves AJ, Costa FCM, Haddad MF. Prosthetic rehabilitation of oncological patient: case report. Arch Health Invest. 2016;5(6): 291-97.Silva DP, Almeida FC, Vaccarezza GF, Brandão TB, Cazal C, Caroli A et al. Reabilitação protética de pacientes maxilectomizados. Uma contribuição da odontologia e um convite à reflexão. Pesq Bras Odontoped Clín Integr. 2004;4(2):125-30.Rezende JRV. Fundamentos da prótese buco-maxilo-facial. São Paulo: Savier, 1997;1:1-10.Tucci R, Antonio LFM, de Carvalhosa AA, Catro PHS, Nunes FD, Pinto Junior DSl. Central mucoepidermoid carcinoma: report of a case with 11 years’ evolution and peculiar macroscopical and clinical characteristics. Med Oral Patol Oral Cir Bucal. 2009;14(6):283-86.Sperb LCM, Neves ACC, Rode SM. Considerações sobre prótese ocular: Sua importância na odontologia atual. RGO. 2001;49(4):202-24.Aquino LMM, Oliveira M, Martins APVB, Barbosa CMR. Técnicas de moldagem da máscara facial. Rev Odontol UNESP. 2012;41(6):438-41.Neves ACC, Murgo DA, Campoy CD, Coas VR. Prótese facial combinada. RGO. 2005;53(1):1-4.Sousa AVB, Arriaga MH, Llorca FA, Henar TEl. Prótesis oculo-palpebral. A propósito de un caso clínico. RCOE. 2003;8(5):553-61.Filié Haddad M, Coelho Goiato M, Micheline Dos Santos D, Moreno A, Filipe D'almeida N, Alves Pesqueira A. Color stability of maxillofacial silicone with nanoparticle pigment and opacifier submitted to disinfection and artificial aging. J Biomed Opt. 2011;16(9):095004.Abu-Serriah M, McGowan D, Moos K, Bagg J. Extra-oral craniofacial endosseous implants and radiotherapy. Int J Oral maxillofac Surg. 2003;32(6):585-92.Silva RJ, Seixas ZA. Materiais e métodos de higienização para próteses removíveis. Int J Dent. 2008;7(2):125-32.Antunes AA, Carvalho RWF, Lucas Neto A, Loretto NRM, Silva EDO. Utilização de implantes osseointegrados para retenção de próteses buco-maxilo-faciais: revisão de literatura. Rev Cir Traumatol Buco-Maxilo-Fac. 2008;8(2):9-14.Haddad MF, Goiato MC, Santos DM, Crepaldi Nde M, Pesqueira AA, Bannwart LC. Bond strength between acrylic resin and maxillofacial silicone. J Appl Oral Sci. 2012;20(6):649-54.

Responsáveis por amplo e variado quadro de sinais e sintomas de difícil diagnóstico, as desordens da articulação temporomandibular exigem tratamento complexo e multifatorial, já que envolvem ruptura do equilíbrio biomecânico e a forte presença de componentes emocionais. Em razão de etiologia multifatorial (fatores oclusais, alterações esqueléticas, musculares, problemas degenerativos, hábitos nocivos, estresse e/ou problemas emocionais) exige abordagem terapêutica interdisciplinar por vários especialistas (cirurgião dentista, fisioterapeuta, psicólogo e fonaudiólogo)uma vez que a abordagem transdisciplinar e individualizada alicerça o tratamento bem-sucedido.Cada paciente requer procedimentos diferentes em seu tratamento, e é necessário saber em que ponto cada especialista deve intervir para o sucesso da terapêutica. As Desordens temporomandibulares (DTM), relacionadas ao desconforto na articulação temporomandibular (ATM), respondem por importante impacto negativo sobre a qualidade de vida e bem estar. São patologias multifatoriais que exigem diferentes estratégias de abordagem. Cada paciente requer procedimentos diferentes em seu tratamento, e é necessário saber em que ponto cada especialista deve intervir para o sucesso do tratamento.Descritores: Dor Facial; Equipe de Assistência ao Paciente; Sistemas de Saúde.ReferênciasAlves-Rezende MCR, Silva JS, Soares BS, Bertoz FA, Oliveira DTN, Alves-Claro APR. Estudo da prevalência de sintomatologia temporomandibular em universitários brasileiros de Odontologia. Rev Odontol Araçatuba 2009; 30(1): 9-14.Alves-Rezende MCR, Cortiglio S, Sant’anna CBM, Alves-Rezende LGR, Montanher IS, Alves-Rezende ALR. Aplicação da acupuntura no tratamento da Síndrome de Costen: relato de caso clínico. Arch Health Invest 2012; 1(Spec):15.Alves-Rezende MCR, Sant'Anna CBM, Capalbo BC, Zuim PRJ. Intervenção interdisciplinar no tratamento do paciente com dor orofacial: uso de acupuntura. Rev Odontol Unesp 2012; 41: 181Alves-Rezende MCR, Sant'Anna CBM, Verri ACG, Cunha-Correia AS, Aguiar SMHCA, Bertoz APM, et al. Sinais e sintomas na Síndrome de Costen associada a desordens temporomandibulares: relato de caso clínico. Rev Odontol Araçatuba 2011; 32(1):65-9.Alves-Rezende MCR, Soares BMS, Silva JB. Frequência de hábitos parafuncionais: estudo transversal em acadêmicos de Odontologia. Rev Odontol Araçatuba 2009; 30:59-62.Cortiglio S, Alves-Rezende MCR, Alves-Rezende LGR, Montanher IS, Alves-Rezende ALR. Estudo da associação entre bruxismo, consumo de álcool e tabaco em universitários brasileiros Arch Health Invest 2012; 1 (Spec): 36.Koopman JS, Huygen FJ, Dieleman JP, Mos M, Sturkenboom MC. Pharmacological treatment of neuropathic facial pain in the dutch general population. J Pain, 2009; 11(3): 264 –72.Oliveira AS, Bermudez CC, Souza RA, Souza CMF, Dias EM, Castro CES, et al. Impacto da dor na vida de portadores de disfunção temporomandibular. J Appl Oral Sci 2003; 11(2): 138-43.Reisine ST, Fertig J, Weber J, Leder S. Impact of dental conditions on patients’ quality of life. Community Dent Oral Epidemiol 1989; 17(1): 7- 10.Rodrigues D, Siriani AO, Bérzin F. Effect of conventional TENS on pain and electromyographic activity of masticatory muscles in TMD patients. Braz Oral Res 2004;18(4):290-5.Rossi AC, Resende MCRA, Araújo OP Jr, Garcia AR, Zuim PRJ, Marinho LVD. Fisioterapia no tratamento multidisciplinar da disfunção temporomandibular. Rev Odonto UNESP. 2008;37(Número Especial):190Seligman ME, Schulman P, Tryon AM. Group prevention of depression and anxiety symptoms. Behav Res Ther 2007; 45:1111-26.Simi MD, Alves-Rezende MCR, Ruiz MAF, Zuim PRJ. Abordadem extensionista multidisciplinar: fisioterapia aplicada ao tratamento de disfunção temporomandibular. Rev Odontol UNESP. 2012;41(Número Especial):180.Widmer CG. Convicções correntes e diretrizes pedagógicas. In: Lund JP, Lavigne GJ, Dubner R, Sessle BJ. Dor orofacial: da ciência básica à conduta clínica. São Paulo: Quintenssence Books: 2002. p. 27-34.Granja DVA, Lima AP. Influência dos recursos fisioterapêuticos nas algias orofaciais. Rev Fisioter Brasil 2003;4(6):394-401.Pereira Jr FJ, Vieira AR, Prado R, Miasato JM. Visão geral das desordens temporomandibulares. RGO 2004;52(2):117-21.Barbosa GAS, Barbosa KVMS, Badaró CR Filho. Recursos fisioterápicos disponíveis para o tratamento das disfunções temporomandibulares. JBA 2003; 3(11):257-62.Castro FM, Gomes RCV, Salomão JR, Abdon APV. A efetividade da terapia de liberação posicional (TLP) em pacientes portadores de disfunção temporomandibular. Rev Odont Univ Cidade São Paulo. 2006; 18(1):67-74.Maciel RN. Oclusão e ATM: procedimentos clínicos. São Paulo: Ed. Santos; 1998. Maluf SA, Moreno BGD, Alfredo PP. Exercícios terapêuticos nas desordens temporomandibulares: uma revisão de literatura. Fisioter Pesq. 2008; 15(4): 408-15.Medlicott MS, Harris SR. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder. Physical Ther 2006; 86(7):955-73.Torres F, Campos LG, Fillipini HF, Weigert KL, Dalla Vecchia GF. Efeitos dos tratamentos fisioterapêutico e odontológico em pacientes com disfunção temporomandibular Fisioter Mov 2012; 25(1):117-25Teixeira MJ, Teixeira WGJ, Santos FPSS, Andrade DCA, Bezerra SL, Figueirdo JB, et al. Epidemiologia clínica da dor músculo-esquelética. Rev Med 2001; 80(1): 1-21.Melzack R. The McGill pain questionnaire. From description to measurement. Anesthes 2005; 103(1):199-202Chaves TC, Oliveira AS, Grossi DB. Principais instrumentos para avaliação da disfunção temporomandibular, parte I: índices e questionários; uma contribuição para a prática clínica e de pesquisa. Fisioter Pesq. 2008;15(1):92-100El Fatih I A, Ibrahim AI, El Laithi A. Efficacy of physiotherapy and intraoral splint in the management of temporomandibular disorders. Saud Dent J 2004;16(1):16-20.Guerra LMC. Eficácia do ultra-som na terapia das Disfunções Temporomandibulares: avaliação clínica e eletromiográfica. [dissertação]. Pernambuco: Universidade Federal de Pernambuco; 2003.Biasotto DA. Efeito da técnica Fisioterapeutica (massoterapia) em indivíduos portadores de Desordem Temporomandibular Miogênica: um estudo eletromiográfico. [dissertação]. Piracicaba: Faculdade de Odontologia de Piracicaba da Universidade Estadual de Campinas; 2002.Eisensmith LP. Massage therapy decreases frequency and intensity of symptoms related to temporomandibular joint syndrome in one case study. J Bodywork Move Therap 2007;11:223-30.Chaitow L. Teoria e prática da manipulação craniana: abordagens em tecidos ossos e mole. São Paulo: Manole, 2001.Troian MA. Tratamento interdisciplinar entre fisioterapia e odontologia na redução da dor em pacientes com disfunção do sistema craniocervicomandibular. Reabilit. 2005;7(26):29-39.Mourão NLA, Mesquita VT. A Importância da fisioterapia no tratamento das disfunções da Atm. Terapia Manual. 2006;4:66-9.

Introdução: Devido às altas taxas de mortalidade, a candidemia têm se tornado um grave problema de saúde na realidade pediátrica, sobretudo quando se considera o aumento de infecções e a letalidade dos casos em grupos de risco como as crianças hospitalizadas e com sistema imunológico deficiente. Ultimamente têm-se percebido um aumento de infecções fúngicas provocadas por espécies não-albicans, trazendo uma nova realidade para o combate destas infecções, especialmente por envolver espécies resistentes à terapia convencional. Já foi demonstrado que o óleo essencial de Cymbopogon winterianus possui uma vasta gama de propriedades farmacológicas, incluindo atividade antifúngica. Objetivo: Este trabalho buscou avaliar a atividade antifúngica do óleo essencial de Cymbopogon winterianus Jowitt ex Bor (Poaceae) contra isolados de Candida não-albicans de importância clínica pediátrica. Material e Método: A concentração inibitória mínima (CIM) e a concentração fungicida mínima (CFM) foram determinadas pelas técnicas de microdiluição em caldo. Resultados: Tanto a CIM50 quanto a CFM50 do óleo essencial de C. winterianus para os isolados testados foi de 128 μg/mL.Conclusão: Este produto natural apresentou potencial antifúngico in vitro contra cepas de Candida não-albicans clinicamente relevante para a pediatria médica. Contudo, mais estudos são necessários para elucidar seu mecanismo de ação.Descritores: Técnicas de Tipagem Micológica; Candida; Candidemia; Cymbopogon; Óleos; Pediatria.ReferênciasSteinbach WJ. Pediatric invasive candidiasis: epidemiology and diagnosis in children. J Fungi (Basel). 2016;2(1):5.Ruiz LS, Khouri S, Hahn RC, da Silva EG, de Oliveira VK, Gandra RF et al. Candidemia by species of the Candida parapsilosis complex in children’s hospital: prevalence, biofilm production and antifungal susceptibility. Mycopathologia. 2013;175(3-4):231-39.Oliveira VKP, Ruiz LS, Oliveira NAJ, Moreira D, Hahn RC, Melo ASA et al. Fungemia caused by candida species in a Children´s Public Hospital in the city of São Paulo, Brazil: study in the period 2007-2010. Rev Inst Med Trop Sao Paulo. 2014;56(4):301-5.Morace G, Borghi E, Iatta R, Amato G, Andreoni S, Brigante G et al. Antifungal susceptibility of invasive yeast isolates in Italy: the GISIA3 study in critically ill patients. BMC Infect Dis. 2011;11:130.Khan SMA, Malik A, Ahmad I. Anti-candidal activity of essential oils alone and in combination with amphotericin B or fluconazole against multi-drug resistant isolates of Candida albicans. Med Mycol. 2012;50(1):33-42.Svetaz L, Aguero MB, Alvarez S, Luna L, Feresin G, Derita M et al. Antifungal activity of Zuccagnia punctata Cav.: evidence for the mechanism of action. Planta Med. 2007;73(10):1074-80.Ganjewala D, Silviya S, Khan HK. Biochemical composition and antibacterial activities of Lantana Camera plants with yellow, lavender, red and white flowers. EurAsia J BioSci. 2009;3:69-77.Scazzocchio F, Garzoli S, Conti C, Leone C, Renaioli C, Pepi F et al. Properties and limits of some essential oils: chemical characterisation, antimicrobial activity, interaction with antibiotics and cytotoxicity. Nat Prod Res. 2016;30(17):1909-18.Silva MR, Ximenes RM, da Costa JG, Leal LK, de Lopes AA, Viana GS. Comparative anticonvulsant activities of the essential oils (EOs) from Cymbopogon winterianus Jowitt and Cymbopogon citratus (DC) Stapf. in mice. Naunyn Schmiedebergs Naunyn Schmiedebergs Arch Pharmacol. 2010;381(5):415-26.Silva CT, Wanderley-Teixeira V, Cunha FM, Oliveira JV, Dutra KA, Navarro DM et al. Biochemical parameters of Spodoptera frugiperda (J. E. Smith) treated with citronella oil (Cymbopogon winterianus Jowitt ex Bor) and its influence on reproduction. 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J Clin Microbiol. 2002;40(10):3776-81.Falagas ME, Roussos N, Vardakas KZ. Relative frequency of 3 albicans and the various non-albicans Candida spp among candidemia isolates from inpatients in various parts of the world: a systematic review. Int J Infect Dis. 2010;14(11):e954-66.Nucci M, Queiroz-Telles F, Alvarado-Matute T, Tiraboschi IN, Corte J, Zurita J et al. Epidemiology of candidemia in Latin America: a laboratory-based survey. Plos One. 2013;8(3):e59373.Simões ER, Santos EA, de Abreu MC, Silva JN, Nunes NM, da Costa MP et al. Biomedical properties and potentiality of Lippia microphylla Cham. and its essential oils. J Intercult Ethnopharmacol. 2015;4(3):256-63.Bilia AR, Santomauro F, Sacco C, Bergonzi MC, Donato R. Essential Oil of Artemisia annua L.: An Extraordinary Component with Numerous Antimicrobial Properties. Evid Based Complement Alternat Med. 2014; 2014:159819.Duarte MCT, Figueira G M, Sartoratto A, Rehder VLG, Delarmelina C. 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IntroductionIn this article, I set out to accomplish two tasks. The first is to map coffee and cafés in Mainland China in different historical periods. The second is to focus on coffee and cafés in the socio-cultural milieu of contemporary China in order to understand the symbolic value of the emerging coffee/café-scape. Cafés, rather than coffee, are at the centre of this current trend in contemporary Chinese cities. With instant coffee dominating as a drink, the Chinese have developed a cultural and social demand for cafés, but have not yet developed coffee palates. Historical Coffee Map In 1901, coffee was served in a restaurant in the city of Tianjin. This restaurant, named Kiessling, was run by a German chef, a former solider who came to China with the eight-nation alliance. At that time, coffee was reserved mostly for foreign politicians and military officials as well as wealthy businessmen—very few ordinary Chinese drank it. (For more history of Kiessling, including pictures and videos, see Kiessling). Another group of coffee consumers were from the cultural elites—the young revolutionary intellectuals and writers with overseas experience. It was almost a fashion among the literary elite to spend time in cafés. However, this was negatively judged as “Western” and “bourgeois.” For example, in 1932, Lu Xun, one of the most important twentieth century Chinese writers, commented on the café fashion during 1920s (133-36), and listed the reasons why he would not visit one. He did not drink coffee because it was “foreigners’ food”, and he was too busy writing for the kind of leisure enjoyed in cafés. Moreover, he did not, he wrote, have the nerve to go to a café, and particularly not the Revolutionary Café that was popular among cultural celebrities at that time. He claimed that the “paradise” of the café was for genius, and for handsome revolutionary writers (who he described as having red lips and white teeth, whereas his teeth were yellow). His final complaint was that even if he went to the Revolutionary Café, he would hesitate going in (Lu Xun 133-36). From Lu Xun’s list, we can recognise his nationalism and resistance to what were identified as Western foods and lifestyles. It is easy to also feel his dissatisfaction with those dilettante revolutionary intellectuals who spent time in cafés, talking and enjoying Western food, rather than working. In contrast to Lu Xun’s resistance to coffee and café culture, another well-known writer, Zhang Ailing, frequented cafés when she lived in Shanghai from the 1920s to 1950s. She wrote about the smell of cakes and bread sold in Kiessling’s branch store located right next to her parents’ house (Yuyue). Born into a wealthy family, exposed to Western culture and food at a very young age, Zhang Ailing liked to spend her social and writing time in cafés, ordering her favourite cakes, hot chocolate, and coffee. When she left Shanghai and immigrated to the USA, coffee was an important part of her writing life: the smell and taste reminding her of old friends and Shanghai (Chunzi). However, during Zhang’s time, it was still a privileged and elite practice to patronise a café when these were located in foreign settlements with foreign chefs, and served mainly foreigners, wealthy businessmen, and cultural celebrities. After 1949, when the Chinese Communist Party established the People’s Republic of China, until the late 1970s, there were no coffee shops in Mainland China. It was only when Deng Xiaoping suggested neo-liberalism as a so-called “reform-and-open-up” economic policy that foreign commerce and products were again seen in China. In 1988, ten years after the implementation of Deng Xiaoping’s policy, the Nestlé coffee company made the first inroads into the mainland market, featuring homegrown coffee beans in Yunnan province (China Beverage News; Dong; ITC). Nestlé’s bottled instant coffee found its way into the Chinese market, avoiding a direct challenge to the tea culture. Nestlé packaged its coffee to resemble health food products and marketed it as a holiday gift suitable for friends and relatives. As a symbol of modernity and “the West”, coffee-as-gift meshed with the traditional Chinese cultural custom that values gift giving. It also satisfied a collective desire for foreign products (and contact with foreign cultures) during the economic reform era. Even today, with its competitively low price, instant coffee dominates coffee consumption at home, in the workplace, and on Chinese airlines. While Nestlé aimed their product at native Chinese consumers, the multinational companies who later entered China’s coffee market, such as Sara Lee, mainly targeted international hotels such as IHG, Marriott, and Hyatt. The multinationals also favoured coffee shops like Kommune in Shanghai that offered more sophisticated kinds of coffee to foreign consumers and China’s upper class (Byers). If Nestlé introduced coffee to ordinary Chinese families, it was Starbucks who introduced the coffee-based “third space” to urban life in contemporary China on a signficant scale. Differing from the cafés before 1949, Starbucks stores are accessible to ordinary Chinese citizens. The first in Mainland China opened in Beijing’s China World Trade Center in January 1999, targeting mainly white-collar workers and foreigners. Starbucks coffee shops provide a space for informal business meetings, chatting with friends, and relaxing and, with its 500th store opened in 2011, dominate the field in China. Starbucks are located mainly in the central business districts and airports, and the company plans to have 1,500 sites by 2015 (Starbucks). Despite this massive presence, Starbucks constitutes only part of the café-scape in contemporary Chinese cities. There are two other kinds of cafés. One type is usually located in universities or residential areas and is frequented mainly by students or locals working in cultural professions. A representative of this kind is Sculpting in Time Café. In November 1997, two years before the opening of the first Starbucks in Beijing, two newlywed college graduates opened the first small Sculpting in Time Café near Beijing University’s East Gate. This has been expanded into a chain, and boasts 18 branches on the Mainland. (For more about its history, see Sculpting in Time Café). Interestingly, both Starbucks and Sculpting in Time Café acquired their names from literature, Starbucks from Moby Dick, and Sculpting in Time from the Russian filmmaker Andrei Tarkovsky’s film diary of the same name. For Chinese students of literature and the arts, drinking coffee is less about acquiring more energy to accomplish their work, and more about entering a sensual world, where the aroma of coffee mixes with the sounds from the coffee machine and music, as well as the lighting of the space. More importantly, cafés with this ambience become, in themselves, cultural sites associated with literature, films, and music. Owners of this kind of café are often lovers of foreign literatures, films, and cultures, and their cafés host various cultural events, including forums, book clubs, movie screenings, and music clubs. Generally speaking, coffee served in this kind of café is simpler than in the kind discussed below. This third type of café includes those located in tourist and entertainment sites such as art districts, bar areas, and historical sites, and which are frequented by foreign and native tourists, artists and other cultural workers. If Starbucks cultivates a fast-paced business/professional atmosphere, and Sculpting in Time Cafés an artsy and literary atmosphere, this third kind of café is more like an upscale “bar” with trained baristas serving complicated coffees and emphasising their flavour. These coffee shops are more expensive than the other kinds, with an average price three times that of Starbucks. Currently, cafés of this type are found only in “first-tier” cities and usually located in art districts and tourist areas—such as Beijing’s 798 Art District and Nanluo Guxiang, Shanghai’s Tai Kang Road (a.k.a. “the art street”), and Hangzhou’s Westlake area. While Nestlé and Starbucks use coffee beans grown in Yunnan provinces, these “art cafés” are more inclined to use imported coffee beans from suppliers like Sara Lee. Coffee and Cafés in Contemporary China After just ten years, there are hundreds of cafés in Chinese cities. Why has there been such a demand for coffee or, more accurately, cafés, in such a short period of time? The first reason is the lack of “third space” environments in Mainland China. Before cafés appeared in the late 1990s, stores like KFC (which opened its first store in 1987) and McDonald’s (with its first store opened in 1990) filled this role for urban residents, providing locations where customers could experience Western food, meet friends, work, or read. In fact, KFC and McDonald’s were once very popular with college students looking for a place to study. Both stores had relatively clean food environments and good lighting. They also had air conditioning in the summer and heating in the winter, which are not provided in most Chinese university dormitories. However, since neither chain was set up to be a café and customers occupying seats for long periods while ordering minimal amounts of food or drink affected profits, staff members began to indirectly ask customers to leave after dining. At the same time, as more people were able to afford to eat at KFC and McDonald’s, their fast foods were also becoming more and more popular, especially among young people. As a consequence, both types of chain restaurant were becoming noisy and crowded and, thus, no longer ideal for reading, studying, or meeting with friends. Although tea has been a traditional drink in Chinese culture, traditional teahouses were expensive places more suitable for business meetings or for the cultural or intellectual elite. Since almost every family owns a tea set and can readily purchase tea, friends and family would usually make and consume tea at home. In recent years, however, new kinds of teahouses have emerged, similar in style to cafés, targeting the younger generation with more affordable prices and a wider range of choices, so the lack of a “third space” does not fully explain the café boom. Another factor affecting the popularity of cafés has been the development and uptake of Internet technology, including the increasing use of laptops and wireless Internet in recent years. The Internet has been available in China since the late 1990s, while computers and then laptops entered ordinary Chinese homes in the early twenty-first century. The IT industry has created not only a new field of research and production, but has also fostered new professions and demands. Particularly, in recent years in Mainland China, a new socially acceptable profession—freelancing in such areas as graphic design, photography, writing, film, music, and the fashion industry—has emerged. Most freelancers’ work is computer- and Internet-based. Cafés provide suitable working space, with wireless service, and the bonus of coffee that is, first of all, somatically stimulating. In addition, the emergence of the creative and cultural industries (which are supported by the Chinese government) has created work for these freelancers and, arguably, an increasing demand for café-based third spaces where such people can meet, talk and work. Furthermore, the flourishing of cafés in first-tier cities is part of the “aesthetic economy” (Lloyd 24) that caters to the making and selling of lifestyle experience. Alongside foreign restaurants, bars, galleries, and design firms, cafés contribute to city branding, and link a city to the global urban network. Cafés, like restaurants, galleries and bars, provide a space for the flow of global commodities, as well as for the human flow of tourists, travelling artists, freelancers, and cultural specialists. Finally, cafés provide a type of service that contributes to friendly owner/waiter-customer relations. During the planned-economy era, most stores and hotels in China were State-owned, staff salaries were not related to individual performance, and indifferent (and even unfriendly) service was common. During the economic reform era, privately owned stores and shops began to replace State-owned ones. At the same time, a large number of people from the countryside flowed into the cities seeking opportunities. Most had little if any professional training and so could only find work in factories or in the service industry. However, most café employees are urban, with better educational backgrounds, and many were already familiar with coffee culture. In addition, café owners, particularly those of places like Sculpting in Time Cafe, often invest in creating a positive, community atmosphere, learning about their customers and sharing personal experiences with their regular clients. This leads to my next point—the generation of the 1980s’ need for a social community. Cafés’ Symbolic Value—Community A demand for a sense of community among the generation of the 1980s is a unique socio-cultural phenomenon in China, which paradoxically co-exists with their desire for individualism. Mao Zedong started the “One Child Policy” in 1979 to slow the rapid population growth in China, and the generations born under this policy are often called “the lonely generations,” with both parents working full-time. At the same time, they are “the generation of me,” labelled as spoiled, self-centred, and obsessed with consumption (de Kloet; Liu; Rofel; Wang). The individuals of this generation, now aged in their 20s and 30s, constitute the primary consumers of coffee in China. Whereas individualism is an important value to them, a sense of community is also desirable in order to compensate for their lack of siblings. Furthermore, the 1980s’ generation has also benefitted from the university expansion policy implemented in 1999. Since then, China has witnessed a surge of university students and graduates who not only received scientific and other course-based knowledge, but also had a better chance to be exposed to foreign cultures through their books, music, and movies. With this interesting tension between individualism and collectivism, the atmosphere provided by cafés has fostered a series of curious temporary communities built on cultural and culinary taste. Interestingly, it has become an aspiration of many young college students and graduates to open a community-space style café in a city. One of the best examples is the new Henduoren’s (Many People’s) Café. This was a project initiated by Wen Erniu, a recent college graduate who wanted to open a café in Beijing but did not have sufficient funds to do so. She posted a message on the Internet, asking people to invest a minimum of US$316 to open a café with her. With 78 investors, the café opened in September 2011 in Beijing (see pictures of Henduoren’s Café). In an interview with the China Daily, Wen Erniu stated that, “To open a cafe was a dream of mine, but I could not afford it […] We thought opening a cafe might be many people’s dream […] and we could get together via the Internet to make it come true” (quoted in Liu 2011). Conclusion: Café Culture and (Instant) Coffee in China There is a Chinese saying that, if you hate someone—just persuade him or her to open a coffee shop. Since cafés provide spaces where one can spend a relatively long time for little financial outlay, owners have to increase prices to cover their expenses. This can result in fewer customers. In retaliation, cafés—particularly those with cultural and literary ambience—host cultural events to attract people, and/or they offer food and wine along with coffee. The high prices, however, remain. In fact, the average price of coffee in China is often higher than in Europe and North America. For example, a medium Starbucks’ caffè latte in China averaged around US$4.40 in 2010, according to the price list of a Starbucks outlet in Shanghai—and the prices has recently increased again (Xinhua 2012). This partially explains why instant coffee is still so popular in China. A bag of instant Nestlé coffee cost only some US$0.25 in a Beijing supermarket in 2010, and requires only hot water, which is accessible free almost everywhere in China, in any restaurant, office building, or household. As an habitual, addictive treat, however, coffee has not yet become a customary, let alone necessary, drink for most Chinese. Moreover, while many, especially those of the older generations, could discern the quality and varieties of tea, very few can judge the quality of the coffee served in cafés. As a result, few Mainland Chinese coffee consumers have a purely somatic demand for coffee—craving its smell or taste—and the highly sweetened and creamed instant coffee offered by companies like Nestlé or Maxwell has largely shaped the current Chinese palate for coffee. Ben Highmore has proposed that “food spaces (shops, restaurants and so on) can be seen, for some social agents, as a potential space where new ‘not-me’ worlds are encountered” (396) He continues to expand that “how these potential spaces are negotiated—the various affective registers of experience (joy, aggression, fear)—reflect the multicultural shapes of a culture (its racism, its openness, its acceptance of difference)” (396). Cafés in contemporary China provide spaces where one encounters and constructs new “not-me” worlds, and more importantly, new “with-me” worlds. While café-going communicates an appreciation and desire for new lifestyles and new selves, it can be hoped that in the near future, coffee will also be appreciated for its smell, taste, and other benefits. Of course, it is also necessary that future Chinese coffee consumers also recognise the rich and complex cultural, political, and social issues behind the coffee economy in the era of globalisation. 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Introdução: Os estudos sobre perda dentária mostram a sua alta prevalência e com isso a necessidade do uso de próteses dentais, logo, a disfunção temporomandibular (DTM) é bastante frequente nesses pacientes edentados total ou parcialmente. Objetivo: Caracterizar fatores predisponentes, sinais e sintomas de DTM nos pacientes atendidos nas Clínicas de Prótese Dentária da Universidade Federal de Campina Grande (UFCG), Patos-Paraíba, Brazil. Metodologia: Foi realizado um estudo do tipo transversal, observacional, com abordagem indutiva e procedimento comparativo, descritivo, retrospectivo adotando como estratégia de coleta de dados as fichas das Clínicas de Prótese Dentária da UFCG. A amostra foi constituída de 200 fichas do ano de 2014 a 2018. Resultados: O presente estudo apontou 67 (33,5%) pacientes do gênero masculino e 133 (66,5%) do gênero feminino e média de idade e erro padrão da média de 48,6 ± 13,9 anos; 38 (19%) possuíam desconforto ou dor na mastigação e 39 (19,5%) apresentavam o barulho quando mastigavam. Além disso, 28 (14%) pacientes informaram presença de bruxismo e verificou-se 27 (13,5%) pacientes com apertamento dentário e 150 (75%) respiração nasal. Conclusão: Houve a prevalência no sexo feminino, média de idade de 48,6 ± 13,9 anos e presença de diversos fatores predisponentes, sinais e sintomas da DTM dado ao seu caráter multifatorial. Os dados levantados servirão para guiar ações de promoção e prevenção de saúde bucal, para evitar a perda de elementos dentais tão precocemente.Descritores: Prótese Dentária; Oclusão Dentária; Articulação Temporomandibular; Má Oclusão.ReferênciasProjeto SB Brasil 2003. Condições de saúde bucal da população brasileira 2002-2003. Resultados principais. 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Contribuição para o diagnóstico, prognóstico e plano de tratamento de pacientes com disfunção e/ou desordens temporomandibulares: avaliação clínica, radiográfica e laboratorial [tese de livre-docência]. Araçatuba: Faculdade de Odontologia de Araçatuba da Universidade Estadual Paulista; 1997.Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K. Bruxism physiology and pathology: na overview for clinicians. J Oral Rehabil. 2008;35(7):476-94.Cardoso LM, Kraychete DC, Araújo RPC. A relevância do apertamento dentário nas desordens temporomandibulares. R Ci med biol. 2011;10(3):277-83.Okeson JP. Etiology of functional disturbances in the masticatory system. In: Okeson JP, editor. Management of temporomandibular disorders and occlusion, 6.ed. St. Louis: Mosby; 2008.Bortolleto PPB, Moreira APSM, Madureira PR. Análise dos hábitos parafuncionais e associação com Disfunção das Articulações Temporomandibulares. Rev assoc paul cir dent. 2013;67(3):216-21.Trindade APNT, Custódio MAC, Carvalho AS, Rodrigues W, Oliveira LCN. Prevalência de DTM e hábitos parafuncionais em estudantes de uma instituição de ensino superior. Fiep Bulletin. 2018;88(1):425-28.

As plantas medicinais têm demonstrado elevado poder de cura em estado natural, além disso, esse conhecimento tradicional sobre o uso das plantas e de suas propriedades terapêuticas no combate a doenças vêm sendo transmitida entre as gerações. A busca por novos produtos com maior atividade terapêutica, tem estimulado a realização de pesquisas com produtos naturais no meio odontológico para o tratamento de doença periodontal. Logo, objetivou-se apresentar uma revisão da literatura de espécies vegetais como Malva Sylvestris, Vitis Vinífera e Punica Granatum, comuns do cotidiano no tratamento da periodontite. A periodontite é uma doença inflamatória crônica decorrente da resposta imunológica do hospedeiro à presença de fatores microbianos, causando dano tecidual, resultando em formação de bolsas periodontais, reabsorção do osso alveolar, e perda de tecidos de sustentação. O estudo trata-se de uma revisão bibliográfica do tipo narrativa e foi realizada uma seleção de artigos científicos recuperados a partir das bases de dados: BVS Brasil (Biblioteca Virtual em Saúde), Scielo (Scientific Eletronic Library Online), Pubmed (National Center for Biotechnology Information) e Portal Periódico Capes no período de 05 a 28 de Fevereiro de 2018. Conclui-se que a Malva, Uva e Romã possuem ação terapêutica e estão entre os fitoterápicos com grande influência na cavidade bucal, que funcionam como auxiliares no tratamento de afecções orais sendo alternativas de fácil acesso, já que a atuação profissional frente à ação farmacológica dos vários medicamentos fitoterápicos e contraindicações tem sido importante nos últimos anos.Descritores: Fitoterapia; Plantas Medicinais; Periodontite.ReferênciasPasa M, Soares J, Guarim G. Estudo etnobotânico na comunidade de Conceição-Açu (alto da bacia do rio Aricá Açu, MT, Brasil). Acta bot bras. 2005;19(2):195-207.Agra MF, Silva KN, Basílio IJLD, Freitas PF, Barbosa-Filho JM. Survey of medicinal plants used in the region Northeast of Brazil. Rev bras farmacogn. 2008;18(3):472-508.Jesus NZT, Lima JCS, Silva RM, Espinosa MM, Martins DTO. Levantamento etnobotânico de plantas popularmente utilizadas como antiúlceras e antiinflamatórias pela comunidade de Pirizal, Nossa Senhora do Livramento-MT, Brasil. Rev bras farmacogn. 2009;19(1a):130-39.Amaral JF do. Atividade antiinflamatória, antinociceptiva e gastroprotetora do óleo essencial de Croton sonderianus Muell. Arg [dissertação]. Fortaleza: Universidade Federal do Ceará. Faculdade de Medicina; 2004.Rosa C, Câmara SG, Béria JU. Representações e intenção de uso da fitoterapia na atenção básica à saúde. Ciênc saúde coletiva. 2011;16(1):311-18.Calixto JB. Biodiversidade como fonte de medicamentos. Cienc Cult. 2003;55(3):37-9.Dewick P. Medicinal Natural Products: A Biosynthetic Approach, 3.ed. Chichester: Wiley; 2009.Middleton E, Kandaswami C, Theoharides TC. The effects of plant flavonoids on mammalian cells: Implications for inflammation, heart disease, and cancer. Pharmacol Rev. 2000;52(4):673-751.Simões CMO, Schenkel EP, Gosmann G, Mello JCP, Mentz LA, Petrovick PR(Orgs). Farmacognosia: da planta ao medicamento. 6.ed. Porto Alegre: Editora da UFRGS: Florianópolis: Editora da UFSC, 2010.Coutinho MAS, Muzitano MF, Costa SS. Flavonoids: Potential therapeutic agents for the inflammatory process. Rev Virtual Quim. 2009;1(3):241-56.Agra MF, Freitas PF, Barbosa-Filho JM. Synopsis of the plants known as medicinal and poisonous in Northeast of Brazil. Rev bras farmacogn. 2007;17(1):114-40.Lima V, Bezerra MM, Leitão RFC, Brito GAC, Rocha FAC, Ribeiro RA. Principais mediadores inflamatórios envolvidos na fisiopatologia da periodontite- papel de moduladores farmacológicos. R Periodontia. 2008;18(3):7-19.Madianos PN, Bobetsis YA, Kinane DF. Generation of inflammatory stimuli: how bacteria set up inflammatory responses in the gingiva. J Clin Periodontol. 2005;32(Suppl 6):57-71.Sorsa T, Tjäderhane L, Salo T. Matrix metalloproteinases (MMPs) in oral diseases. Oral Dis. 2004;10(6):311-18.Uğar-Çankal D, Ozmeric N. A multifaceted molecule, nitric oxide in oral and periodontal diseases. Clin Chim Acta. 2006;366(1-2):90-100.Kinane DF, Preshaw PM, Loos BG, Working Group 2 of Seventh European Workshop on Periodontology. Host-response: understanding the cellular and molecular mechanisms of host-microbial interactions - consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol. 2011;38(Suppl 11):44-8.Meira ALT, Todescan SMC, Azoubel E, Bittencourt S, Azoubel MCF. Uso de antimicrobianos locais em periodontia: uma abordagem critica. R Periodontia. 2007;17(1):83-9.Filter M, Freitas EM de, Périco E. Influência de diferentes concentrações dos fitorreguladores ácido 6-benzilaminopurina e ácido naftalenoacético na propagação vegetativa de Malva sylvestris L. Rev bras plantas med. 2014;16(1):47-53.Ferro D. Fitoterapia: conceitos clínicos. São Paulo: Atheneu; 2006.Moreira MJS, Ferreira MBC, Hashizume LN. Avaliação In Vitro da Atividade Antimicrobiana dos Componentes de um Enxaguatório Bucal contendo Malva. Pesq Bras Odontoped Clin Integr. 2012;12(4):505-9.Ecker ACL, Martins IS, Kirsch L, Lima LO, Stefenon L, Mozzini CB. Efeitos benéficos e maléficos da Malva sylvestris. J Oral Invest. 2015;4(1):39-43.Ribeiro ASC, Pinto ATM, Silva DJ, Peixoto ITA. Atividade antimicrobiana de diferentes colutórios fitoterápicos. Ensaios Cienc, Cienc Biol Agrar Saúde. 2015;19(4):178-183.Torres CRG, Kubo CH, Anido AA, Rodrigues JR. Agentes antimicrobianos e seu potencial de uso na Odontologia. Pos-Grad Rev Fac Odontol São José dos Campos. 2000;3(2):43-52.Costa G. Efeito do extrato da casca de uva Vitis Vinífera (GSE) na pressão arterial, no perfil lipídico e glicídico e no estresse oxidativo em ratos espontaneamente hipertensos [mestrado]. Rio de Janeiro: Universidade Estadual do Rio de Janeiro, Centro Biomédico; 2008.Ishimoto EY. Efeito hipolipemiante e antioxidante de subprodutos da uva em hamsters [dissertação]. São Paulo: Universidade de São Paulo, Faculdade de Saúde Pública; 2008.Gris EF. Perfil fenólico e atividades antioxidante e hipolipemiante de vinhos de variedades Vitis vinifera cultivadas em São Joaquim-SC-Brasil [dissertação]. Florianópolis: Universidade Federal de Santa Catarina, Centro de Ciências Agrárias; 2010.Machado MM. Desenvolvimento de uma bebida nutracêutica a partir de resíduos da produção do suco de uva: avaliação de propriedades antioxidantes e fisio-bioquímicas [tese]. Santa Maria: Universidade Federal de Santa Maria; 2010.Rockenbach II, Silva GL, Rodrigues E, Gonzaga LV, Fett R. Atividade antioxidante de extratos de bagaço de uva das variedades Regente e Pinot Noir (Vitis vinifera). Rev Inst Adolfo Lutz. 2007;66(2):158-63.Bozan B, Tosun G, Özcan D. Study of polyphenol content in the seeds of red grape (Vitis vinifera L.) varieties cultivated in Turkey and their antiradical activity. Food Chem. 2008;109(2):426-30.Rockenbach II, Silva GL, Rodrigues E, Kuskoski EM, Fett R. Influência do solvente no conteúdo total de polifenóis, antocianinas e atividade antioxidante de extratos de bagaço de uva (Vitis vinifera) variedades Tannat e Ancelota. Ciênc Tecnol Aliment. 2008;28(Suppl):238-44.Rockenbach I, Gonzaga LV, Rizelio VM, Gonçalves AES, Genovese MI, Fett R. Phenolic compounds and antioxidant activity of seed and skin extracts of red grape (Vitis vinifera and Vitis labrusca) pomace from Brazilian winemaking. Food Res Int. 2011;44(4):897-901.Santos L, Morais D, Souza N, Cottica S, Boroski M, Visentainer J. Phenolic compounds and fatty acids in different parts of Vitis labrusca and V. vinifera grapes. Food Res Int. 2011;44(5):1414-18. Lachman J, Hejtmánková A, Hejtmánková K, Horníčková Š, Pivec V, Skala O et al. Towards complex utilisation of winemaking residues: characterisation of grape seeds by total phenols, tocols and essential elements content as a by-product of winemaking. Ind Crop Prod. 2013;49:445-53.Ahmadi SM, Siahsar BA. Analogy of physicochemical attributes of two grape seeds cultivars. Cien Inv Agr. 2011; 38(2):291-301.Ribeiro MEM, Manfroi V. Vinho e Saúde: uma visão química. Rev Bras Vitic Etnol. 2018;2(2):91-103.Ribéreau-Gayon P, Glories Y, Maujean A, Dubourdieu D. Handbook of enology. 2.ed. Chichester: Wiley; 2006.Lorrain B, Ky I, Pechamat L, Teissedre P. Evolution of analysis of polyhenols from grapes, wines, and extracts. molecules. 2013;18(1):1076-100.Yoo Y, Saliba A, Prenzler P. Should Red Wine Be Considered a Functional Food?. Comprehensive Reviews in Food Science and Food Safety. 2010;9(5):530-51.Çetin A, Sagdiç O. A Concise review: antioxidant effects and bioactive constituents of grape. Erciyes Med J. 2009;31(4):369-75.Xia EQ, Deng GF, Guo YJ, Li HB. Biological activities of polyphenols from grapes. Int J Mol Sci. 2010;11(2):622-46Rayyan M, Terkawi T, Abdo H, Abdel Azim D, Khalaf A, AlKhouli Z et al. Efficacy of grape seed extract gel in the treatment of chronic periodontitis: A randomized clinical study. J Investig Clin Dent. 2018;9(2):e12318.Barreto VL, Feitosa AC, Araújo TJ, Chagas FK, Costa LK. Acción antimicrobiana in vitro de dentí- fricos conteniendo fitoterápicos. Av Odontoestomatol. 2005; 21(4):195-201.Lorenzi H, Souza H. Plantas ornamentais no Brasil. Nova Odessa: Instituto Plantarum de Estudos da Flora; 2004.Ferreira A, Ferreira M, Anjos M. Novo dicionário Aurélio da língua portuguesa. Curitiba: Positivo; 2009.Vasconcelos LC, Sampaio FC, Sampaio MC, Pereira Mdo S, Higino JS, Peixoto MH. Minimum inhibitory concentration of adherence of Punica granatum Linn (pomegranate) gel against S. mutans, S. mitis and C. albicans. Braz Dent J. 2006;17(3):223-27.Menezes SM, Cordeiro LN, Viana GS. Punica granatum (pomegranate) extract is active against dental plaque. J Herb Pharmacother. 2006;6(1):79-92.Barbosa M. Avaliação da atividade antimicrobiana “in vitro” da Punica granatum Linn. frente à Enterococcus faecalis isolados clinicamente [monografia de conclusão do curso]. Universidade Federal da Paraíba; 2010.Catão RMR, Antunes RMP, Arruda TA, Pereira MSV, Higino JS, Alves JA et al. Atividade antimicrobiana "in vitro" do extrato etanólico de Punica granatum linn (romã) sobre isolados ambulatoriais de Staphylococcus aureus. Rev bras anal clin. 2006;38(1):111-14.Jardini FA, Mancini Filho J. Avaliação da atividade antioxidante em diferentes extratos da polpa e sementes da romã (Punica granatum, L.). 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As maloclusões são classificadas como o terceiro maior problema de saúde bucal no mundo, perdendo apenas para cárie e doença periodontal. A mordida cruzada posterior é definida como a relação anormal vestíbulo-lingual de um ou mais dentes da maxila, com um ou mais dentes da mandíbula, quando os arcos dentários estão em relação cêntrica, podendo ser uni ou bilateral. Objetiva-se Realizar uma revisão de literatura sobre a mordida cruzada posterior. Foi feita uma seleção de artigos científicos a partir das bases de dados Lilacs e Scielo utilizando os descritores “Mordida Cruzada” e “Diagnóstico de Mordida Cruzada”. Foram incluídos trabalhos publicados entre 2000 a 2018. Dos 694 artigos encontrados e delimitados pelos critérios inclusivos, foram selecionados 49 artigos como amostra, que apresentaram a temática elencada para a pesquisa e que foram discutidos nos seguintes tópicos: a) Epidemiologia; b) Etiologia; c) Diagnóstico; d) Tratamento. As causas da mordida cruzada posterior são multifatoriais e seu diagnóstico precoce é fundamental uma vez que, a literatura mostra resultados satisfatórios, através de medidas interceptativas com um prognostico favorável quando o tratamento ocorre precocemente. O tratamento da mordida cruzada posterior de origem funcional, por contato prematuro em dentes decíduos, dentoalveolar e esquelético consiste, respectivamente, em desgaste seletivo, expansão dentoalveolar e disjunção maxilar.Descritores: Ortodontia; Aparelhos Ortodônticos; Má Oclusão; Odontopediatria.ReferênciasAlmeida MR, Pereira ALP, Almeida RR, Almeida-Pedrin RR, Silva Filho OG. Prevalência de má oclusão em crianças de 7 a 12 anos de idade. Dental Press J Orthod. 2011;16(4):123-31.Janson G, Barros SEC, Simão TM, Freitas MR. Variáveis relevantes no tratamento da má oclusão de Classe II. Rev Dental Press Ortodon Ortop Facial. 2009;14(1):149-57.Sousa RV, Pinto-Monteiro AKA, Martins CC, Granville-Garcia AF, Paiva SM. Maloclusion and socioeconomic indicators in primay dentition. Braz Oral Res. 2014;28(1):54-60.Carvalho CM, Carvalho LFPC, Forte FDS, Aragão MS, Costa LJ. Prevalência de mordida aberta anterior em crianças de 3 a 5 anos em Cabedelo/PB e relação com hábitos bucais deletérios. Pesq Bras Odontoped Clin Integr. 2009;9(2):205-10.Sousa RV, Clementino MA, Gomes MC, Martins CC, Graville-Garcia AF, Paiva SM. Maloclusion and quality of life in Brazilian preschoolers. Eur J Oral Sci. 2014;122(3):223-29.Bittencourt MA, Machado AW. Prevalência de má oclusão em crianças entre 6 e 10 anos: um panorama brasileiro. Dental Press J Orthod. 2010;15(6):113-22.Stahl F, Grabowski R, Gaebel M, Kundt G. Relationship between occlusal findings and orofacial myofunctional status in primary and mixed dentition. Part II: Prevalence or orofacial dysfunctions. J Orofac Orthop. 2007;68(2):74-90. Grabowski R, Stahl F, GaebeL M, Kundt G. Relationship between occlusal findings and orofacial myofunctional status in primary and mixed dentition. Part I: Prevalence of malocclusions. J Orofac Orthop. 2007;68(1):26-37. Locks A, Weissheimer A, Ritter DE, Ribeiro GLU, Menezes LM, Derech CDA et al. Mordida cruzada posterior: uma classificação mais didática. Rev Dent Press Ortodon Ortop Facial 2008;13(2):146-58.Pinto AS, Buschang PH, Throckmorton GS, Chen P. Morphological and positional asymmetries of yang children with functional unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 2001;120(5):513-20. Iodice G, Danzi G, Cimino R, Paduano S, Michelotti A. Association between posterior crossbite, skeletal, and muscle asymmetry: a systematic review. Eur J Orthod. 2016;38(6):638-51. Andrade AS, Gavião MB, Gameiro GH, De Rossi M. Characteristics of masticatory muscles in children with unilateral posterior crossbite. Braz Oral Res. 2010;24(2):204-10. Sonnesen L, Bakke M, Solow B. Bite force in pre-orthodontic children with unilateral crossbite. Eur J Orthod. 2001;23(6):741-49.World Health Organization-Who. Geneva. The world oral health report 2003: continuous improvement of oral health in the 21st century-the approach of the WHO Global Oral Health Programme. 2003. Disponível: http://www.who. int/oral_health/media/en/orh_report03_en.pdf.Tomita NE, Bijella V T, Franco LJ. Relação entre hábitos bucais e má oclusão em pré-escolares. Rev Saúde Pública. 2000;34(3):299-303.Peres KG, Traebert ES, Marcenes W. Differences between normative criteria and self-perception in the assessment of malocclusion. Rev Saude Publica. 2002;36(2):230-36.Bezerra PKM, Cavalcanti AL. Características e distribuição das maloclusões em pré-escolares. R Ci méd biol. 2006;5(2):117-23. Carvalho CM, Carvalho LFPC, Forte FDS, Aragão MS, Costa LJ. Prevalência de mordida aberta anterior em crianças de 3 a 5 anos em Cabedelo/PB e relação com hábitos bucais deletérios. Pesq Bras Odontoped Clin Integ. 2009;9:205-10. Fernandes KP, Amaral MT. Freqüência de maloclusões em escolares na faixa etária de 3 a 6 anos, Niterói, Brasil. Pesq Bras Odontoped Clin Integr. 2008;8:147-51. Gimenez CMM, Moraes ABA, Bertoz AP, Bertoz FA, Ambrosano GB. Prevalência de más oclusões na primeira infância e sua relação com as formas de aleitamento e hábitos infantis. Rev Dent Press Ortodon Ortop Facial. 2008;13(2):70-83. Pizzol KEDC, Montanha SS, Fazan ET, Boeck EM, Rastelli ANS. Prevalência dos hábitos de sucção não nutritiva e sua relação com a idade, gênero e tipo de aleitamento em pré-escolares da cidade de Araraquara. Rev CEFAC. 2012;14(3):506-15. Thomaz EBAF, Valença AMG. Prevalência de má-oclusão e fatores relacionados à sua ocorrência em pré-escolares da cidade de São Luís-MA-Brasil. RPG Rev Pós Grad. 2005;12(2):212-21.López FU, Cezar GM, Ghisleni GL, Farina JC, Beltrame KP, Ferreira ES. Prevalência de maloclusão na dentição decídua. Rev Fac Odontol Porto Alegre. 2001;43(2):8-11. Leite-Cavalcanti A, Medeiros-Bezerra PK, Moura C. Aleitamento natural, aleitamento artificial, hábitos de sucção e maloclusões em pré-escolares brasileiros. Rev Salud Pública. 2007;9(2):194-204. Macena MC, Katz CR, Rosenblatt A. Prevalence of a posterior crossbite and sucking habits in Brazilian children aged 18-59 months. Eur J Orthod. 2009;31(4):357-61.Peres KG, Barros AJ, Peres MA Victora CG. Effects of breastfeeding and sucking habits on malocclusion in a birth cohort study. Rev Saude Publica. 2007;41(3):343-50.Heimer MV, Katz CR, Rosenblatt A. Non-nutritive sucking habits, dental malocclusions, and facial morphology in Brazilian children: a longitudinal study. Eur J Orthod. 2008;30(6):580-85.Katz CR, Rosenblatt A, Gondim PP. Nonnutritive sucking habits in Brazilian children: effects on deciduous dentition and relationship with facial morphology. Am J Orthod Dentofacial Orthop. 2004;126(1):53-7.Scavone-Júnior H, Ferreira RI, Mendes TE, Ferreira FV. Prevalence of posterior crossbite among pacifier users: a study in the deciduous dentition. Braz Oral Res. 2007;21(2):153-58.Amary ICM, Rossi LAF, Yumoto VA, Ferreira VJA, Marchesan IQ. Hábitos deletérios – alterações de oclusão. Rev CEFAC. 2002;4(1):123-26. Albuquerque Junior HR, Barros AM, Braga JPV, Carvalho MF, Maia MCG. Hábito bucal deletério e má-oclusão em pacientes da clínica infantil do curso de Odontologia da Universidade de Fortaleza. Rev Bras em Promoção de Saúde. 2007;20(1):40-5.Corrêa-Faria P, Ramos-Jorge ML, Martins-Júnior PA, Vieira-Andrade RG, Marques LS. Malocclusion in preschool children: prevalence and determinant factors. Eur Arch Paediatr Dent. 2014;15(2):89-96. Boeck EM, Pizzol KDC, Barbosa EGP, Pires NCA, Lunardi N. Prevalência de má oclusão em crianças de 3 a 6 anos portadoras de hábito de sucção de dedo e/ou chupeta. Rev Odontol UNESP. 2013;42(2):110-16Figueiredo MA, Siqueira DF, Bommarito S, Scanavini MA. Tratamento precoce da mordida cruzada posterior com o Quadrihélice de encaixe. Rev clín ortodon Dental Press. 2007;5(6):83-94.Neves AA, Castro LA, Freire MFM. Tratamento precoce de mordida cruzada vestibular bilateral: relato de caso. J bras ortodon ortop facial. 2002;7(42):487-92.Santos-Pinto A, Rossi TC, Gandini Jr LG, Barreto GM. Avaliação da inclinação dentoalveolar e dimensões do arco superior em mordidas cruzadas posteriores tratadas com aparelho expansor removível e fixo. Rev Dent Press Ortodon Ortop Facial. 2006;11(4):91-103.Woitchunas FE, Azambuja WV, Signor J, Grando K. Avaliação das distâncias transversais em indivíduos com mordida cruzada posterior que procuraram a clínica de Ortodontia Preventiva II da Faculdade de Odontologia da Universidade de Passo Fundo. RFO Passo Fundo. 2010;15(2):190-96.Petren S, Bjerklin K, Bondemark L. Stability of unilateral posterior crossbite correction in the mixed dentition: a randomized clinical trial with a 3-year follow-up. Am J Orthod Dentofacial Orthop. 2011;139(1):e73-81.Moskowitz EM. The unilateral posterior functional crossbite: an opportunity to restore form and function. NY State Dent J.2005;71(5):36-9.Allen D, Rebellato J, Sheats R, Ceron AM. Skeletal and dental contributions to posterior crossbites. Angle Orthod. 2003;73(5):515-24.Ferreira R. Causas e consequências da mastigação unilateral e métodos de diagnóstico do lado mastigatório com enfoque na reabilitação neuroclusal. Mundo da Ortopedia Funcional dos Maxilares e Ortodontia. 2003;1(1):32-5.Martinelli FL, Couto PS, Ruellas AC. Three palatal arches used to correct posterior dental crossbites. Angle Orthod. 2006;76(6):1047-51.Petren S, Bjerklin K, Bondemark L. Stability of unilateral posterior crossbite correction in the mixed dentition: a randomized clinical trial with a 3-year follow-up. Am J Orthod Dentofacial Orthop. 2011;139(1):e73-81.Wong CA, Sinclair PM, Keim RG, Kennedy DB. Arch dimension changes from successful slow maxillary expansion of unilateral posterior crossbite. Angle Orthod. 2011;81(4):616-23.Godoy F, Godoy-Bezerra J, Rosenblatt A. Treatment of posterior crossbite comparing 2 appliances: a community-based trial. Am J Orthod Dentofacial Orthop. 2011;139(1):e45-52.Oliveira SR. Má oclusão Classe III, com mordida cruzada posterior unilateral e assimetria facial. Dental Press J Orthod. 2010;15(5):182-91.Ribeiro GLU, Vieira GL, Ritter D, Tanaka OM, Weissheimer A. Expansão maxilar rápida não cirúrgica em paciente adulto. Uma alternativa possível Rev clín ortodon Dental Press. 2006;5(2):70-7.Suga SS, Bonecker MJS, Sant’ana GR, Duarte DA. Caderno de dontopediatria: ortodontia na dentadura decídua: diagnóstico, planejamento e controle. São Paulo: Santos; 2001.Batista ER, Santos DCL. Mordida cruzada posterior em dentição mista. 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We describe a case of vancomycin-induced linear IgA bullous dermatosis (LABD) with unusual features in a 75-year old woman who received intravenous vancomycin for methicillin-resistant Staphylococcus Aureus infection. Our patient demonstrated an unusual lesional distribution with initial facial involvement and a longer latent period than usual, which to our knowledge has not yet been reported in the literature. A skin punch biopsy including direct immunofluorescence study (IMF) confirmed the diagnosis of LABD. The patient’s cutaneous eruptions resolved over the next 14 days with stoppage of medication and supportive care without the need for systemic steroids. Physicians should be aware of this rare type of autoantibody mediated drug reaction in patients put on vancomycin. Early diagnosis using a skin punch biopsy with direct IMF study would avoid unnecessary laboratory investigations and initiate prompt management.RésuméNous décrivons ici un cas de dermatose bulleuse à IgA linéaire (DIgAL) d’origine médicamenteuse et aux caractéristiques inhabituelles, chez une femme âgée de 75 ans ayant reçu de la vancomycine par voie intraveineuse pour traiter une infection causée par un Staphylococcus Aureus résistant à la méthicilline. La patiente présentait une distribution inhabituelle des lésions avec une atteinte initiale à la face et une période de latence plus longue que la normale. À notre connaissance, cela n’a jamais été rapporté dans la littérature. Une biopsie à l’emporte-pièce de la peau, doublée d’un test d’immunofluorescence directe, a confirmé le diagnostic de DIgAL. Les lésions cutanées de la patiente se sont résorbées dans les quatorze jours suivant l’arrêt du médicament, avec des soins de soutien et sans recours à des stéroïdes systémiques. Il est important que les médecins soient informés de ce type rare de réaction médicamenteuse à médiation d’autoanticorps chez les patients sous vancomycine. Un diagnostic précoce par biopsie à l’emporte-pièce et test d’immunofluorescence directe permet d’éviter des examens de laboratoire superflus et de débuter une prise en charge rapide.Case SynopsisA 75-year-old woman presented to the emergency department with an altered level of consciousness and sepsis requiring intubation. She had been treated with Keflex for a wound infection post L5-S1 lumbar discectomy and fusion surgery, but now presented with an epidural abscess and ventriculitis confirmed to be due to methicillin-resistant Staphylococcus Aureus bacteremia. The patient was taking naproxen, baclofen, levothyroxine, fenofibrate, omeprazole, sotalol, hydrochlorothiazide, ativan, zopiclone, and acetaminophen. The patient was started on vancomycin just prior to duraplasty with incision and drainage. 27 days later, she developed a morbilliform maculopapular cutaneous eruption, which started on her face before progressing diffusely to the trunk and limbs (Figure 1A). The lesions were pruritic and urticarial with blanchable, erythematous, well-demarcated plaques containing some fine scale (Figure 1B). Blistering began ten days after presentation of the eruption resulting in erosion (Figure 1C and Figure 1D). There was no mucous membrane involvement or fever present.A BCD Figure 1. (A) Initial presentation of malar erythema on face. (B) Eruption involving extremities with a maculopapular (morbilliform) appearance. (C&D) Blistering began ten days after initial presentation of eruption. Investigations were unremarkable except for an elevated eosinophil level of 2.6 × 109/L and mild leukocytosis of 11.2 × 109/L. Peak serum vancomycin was found to be within therapeutic range at 21.2 μmol/L. A drug rash with eosinophilia and systemic symptoms (DRESS) syndrome was originally suspected; however, the patient had no fever nor any systemic symptoms making this diagnosis unlikely. A punch biopsy of skin lesion was performed for definitive diagnosis. Vancomycin was discontinued and changed to linezolid and the patient received intravenous fluids and topical steroids (betamethasone valerate 0.05% with 0.25% camphor and 0.25% menthol to affected areas of the body and valerate 2% to lesions on the face) to treat the eruption. The patient’s cutaneous eruptions resolved over the next 14 days with additional supportive care, which included pain control, fluid and electrolyte management and nutritional support without the need for systemic steroids.Histologic examination of the diagnostic skin punch biopsy showed a subepidermal blister with abundant inflammatory infiltrate in the dermis composed of numerous neutrophils, a few eosinophils and lymphocytes. The blister contained fibrin, neutrophils and eosinophils (Figure 2A and Figure 2B). Punch biopsy of peri-lesional skin for direct immunofluorescence (DIF) study showed IgA deposition in a linear fashion along the basement membrane zone (Figure 2C) confirming the diagnosis of LABD.ABC Figure 2. (A) Hematoxylin and eosin (H & E) stain of punch biopsy skin back shows a subepidermal blister (star) (B) Higher magnification showing abundant neutrophils (arrow, H&E stain). (C) Direct immunofluorescence (IMF) test on the perilesional skin shows linear IgA deposition along the basement membrane zone (arrow). DiscussionLinear immunoglobulin A (IgA) bullous dermatosis (LABD) is an acquired autoimmune subepidermal blistering disease of the skin and/or mucous membranes, which is defined by the histopathological finding of subepidermal vesicles with predominantly neutrophilic infiltration and linear IgA deposits in the basement membrane zone. This disease can occur in idiopathic and drug-induced forms. While the idiopathic form is more often seen in children and has been associated with specific HLA haplotypes, drug-induced LABD occurs predominantly in adulthood. 1,2 Drug-induced LABD has been reported with many drugs, including amiodarone, ampicillin, captopril, cefamandole, cyclosporine, diclofenac, glibenclamide, INF-gamma, IL-2, lithium, penicillin G, phenytoin, piroxicam, somatostatin, trimethoprim, vigabatrin, NSAIDs and acetaminophen.3,4 However, it has been most consistently associated with intravenous administration of vancomycin, which is responsible for approximately half the cases in the literature,5 and does not appear to be dose dependent.3 Although our patient was taking other medications that can precipitate LABD (NSAIDs and acetaminophen), the onset and time course of the disease strongly suggest that vancomycin is the causative agent.Vancomycin is known to produce a diverse variety of adverse drug reactions including the red man syndrome, which is an infusion-related reaction peculiar to vancomycin. Non- bullous maculopapular rash is the most frequent type of skin eruption, a hypersensitivity reaction. Systemic involvement causing DRESS syndrome has been rarely reported. Severe drug reactions such as leukocytoclastic vasculitis, extensive fixed drug eruptions (which are localized), Stevens-Johnson syndrome, toxic epidermal necrolysis and LABD are very rare.Vancomycin-induced LABD is a subepidermal blistering eruption, which is classically characterized by the appearance of many pruritic tense bullae on a base of annular erythema. However, the presentation can clinically mimic a variety of other vesiculobullous diseases, including patterns resembling dermatitis herpetiformis, bullous pemphigoid, erythema multiforme, and even more severe disorders like Stevens-Johnson syndrome and toxic epidermal necrolysis which makes the diagnosis difficult. 6 The histologic differential diagnoses for subepidermal blistering disease include bullous pemphigoid and dermatitis herpetiformis. Although there is histologic overlap between these conditions, predominance of neutrophils in the infiltrate and the classic IMF pattern of linear deposition of IgA along the basement membrane zone confirmed the diagnosis of LABD in our patient.Our patient presented with some unique clinical features worth mentioning. Firstly, cases of vancomycin-induced LABD in the literature are varied, but lesions have been reported to appear within 1–3 weeks of vancomycin administration.1,3,7 This is in contrast to the latency period of this case, where our patient’s lesions erupted almost one month after vancomycin administration. Additionally, cases in literature have most commonly reported cutaneous involvement affecting the limbs and trunk with sparing usually of the face and neck.1,8,9 However, our patient presented with a malar type eruption on the face at the initial presentation before spreading to the extremities. The variability in the presentation (latency period, lesional morphology, distribution) is important for clinicians to recognize so vancomycin-induced LABD is kept in the differential diagnosis and confirmatory skin biopsies are performed without delay. The variability of vancomycin-induced LABD may reflect the pathophysiology of the disease, which has still not been fully elucidated. Like other drug-induced immune conditions, it is possible the vancomycin cross-reacts with a component of the epidermal basement membrane, exposes sequestered antigens or alters the confirmation of epitopes resulting in the formation of autoantibodies.10 While the target antigens in idiopathic LABD have been extensively investigated, there are few reports of the causative target antigens in the drug-induced form.2 Reported basement membrane zone (BMZ) antigens include a 97 KDa protein (which may be identical to the extracellular portion of BPAg2), a 230 KDa protein (similar to BPAg1), BP180, LAD285, unidentified 210 KDa, 130 KDa and 83 KDa antigens.2,4,5,7,11 Most recently, IgA antibodies to the 145- and 165-kDa a3 subunits of laminin-332 have been reported in a case of vancomycin-induced LABD.12 The fact IgA autoantibodies have been reported to react with numerous BMZ antigens may explain why the disease presentation is so heterogeneous. Other laboratory investigations also underscore the variable and unpredictable manifestations of this drug-induced cutaneous disease because in addition to linear IgA deposition along the BMZ, patients may also have deposition of C3, IgG and circulating IgG and IgA autoantibodies (none of which were seen in our patient). 8,9A careful drug history is extremely important as immunohistopathological and clinical features are identical between drug-induced and idiopathic forms, yet prognosis and treatment are quite different.1 The prognosis of drug-induced LABD is usually favourable as patients experience remission with drug withdrawal, while spontaneous remission in the idiopathic form is 10–50%.7 Idiopathic LABD usually requires dapsone and if needed topical or oral steroid treatment, but its course may be protracted.13In conclusion, we report a case of vancomycin-induced LABD, which presented with a few unique clinical features that to the authors’ best knowledge have not been previously reported in the literature. Specifically, our patient’s morbilliform eruption started almost one month after the initiation of vancomycin and began on the face before spreading to the extremities. Prompt histological evaluation with IMF study allows precise diagnosis of this condition. This case report highlights the importance of keeping LABD in the differential diagnosis of vancomycin-induced blistering drug reactions which would prompt clinicians to perform a diagnostic skin biopsy, make a rapid diagnosis, initiate appropriate treatment and avoid unnecessary delay and investigations.DisclosureThe authors have no conflicts of interest.Ethics approval is not required for this type of research at our institution.References1. Fortuna G, Salas-Alanis JC, Guidetti E, et al. A critical reappraisal of the current data on drug-induced linear immunoglobulin A bullous dermatosis: A real and separate nosological entity? JAAD 2012;66:988–94.2. Palmer RA, Ogg G, Allen J, et al. Vancomycin-induced linear IgA disease with autoantibodies to BP180 and LAD 285. Br J Dermatol 2001;145:816–20.3. Neughebauer BI, Negron G, Pelton S, et al. Bullous skin disease: an unusual allergic reaction to vancomycin. Am J Med Sci 2002;323:273–8.4. Chanal J, Ingen-Housz-Oro S, Ortonne N, et al. Linear IgA bullous dermatosis: comparison between the drug-induced and spontaneous forms. Br J Dermatol 2013;169:1041–8.5. Eisendle K, Bonatti H, Sepp N, et al. Vancomycin-induced linear IgA bullous dermatosis in an immunosuppressed transplant recipient. JEADV 2007;21:996–97.6. Delavalle RP, Burch JM, Tayal S, et al. Vancomycin-associated linear IgA bullous dermatosis mimicking toxic epidermal necrolysis. JAAD 2003;48:S56–7.7. Waldman MA, Black DR, Callen JP. Vancomycin-induced linear IgA bullous disease presenting as toxic epidermal necrolysis. Clin Exp Dermatol 2004;29:633–6.8. Armstrong AW, Fazeli A, Yeh SW, et al. Vancomycin-induced linear IgA disease manifesting as bullous erythema multiforme. J Cutan Pathol 2004;31:393–97.9. Nousari HC, Kimyai-Asadi A, Caeiro JP, et al. Clinical, demographic and immunohistologic features of vancomycin-induced linear IgA bullous disease of the skin. Medicine (Baltimore) 1999;78:1–8.10. Selvaraj PK, Khasawneh FA. Linear IgA bullous dermatosis: a rare side effect of vancomycin. Ann Saudi Med 2013;33(4):397–99.11. Paul C, Wolkenstein P, Prost C, et al. Drug-induced linear IgA disease: target antigens are heterogeneous. BJD 1997;136(3):406–11.12. Zenke Y, Nakano T, Eto H, et al. A case of vancomycin-associated linnear IgA bullous dermatosis and IgA antibodies to the α3 subunit of laminin-332. BJD 2013;170(4):965–69.13. Jones DH, Todd M, Craig TJ. Early diagnosis is key in vancomycin-induced linear IgA bullous dermatosis and Stevens-Johnson syndrome. JAOA 2004;104:157–63.