Formation of professor Mao Xiejun's thoughts on stomatological education / 中华口腔医学杂志

Professor Mao Xiejun wrote a report about dental education of China in 1935. From 1948 to 1950, he published three articles containing the educational idea of "developing dentistry into stomatology". When he served as the director of the Faculty of Dentistry of Peking University Medical School in July 1950, he proposed to rename the Faculty of Dentistry into the Faculty of Stomatology,which were approved by the Ministry of Health and the Ministry of Education of the People's Republic of China in one month. The Chinese Medical Association established the Society of Stomatology the next year. Later, dentistry was successively changed into stomatology, and medical content was integrated into dental education, which was of great significance and far-reaching influence. During the developments of the thought of stomatological education in China, Professor Mao Xiejun evidently played a pivotal role. In this paper, the formation process of the thoughts of stomatological education related to professor Mao Xiejun's contribution is elucidated through studying the archives, personal letters, and historical documents, so as to enrich the researches on the history of stomatology in China and to facilitate better understanding and promoting the development of stomatology.

Influence of acupuncture combined with rehabilitation therapy on limb motor function and serum cAMP and cGMP in patients with hemiplegia of cerebral ischemic stroke / 中国针灸

OBJECTIVE@#To evaluate the therapeutic effect of the combined treatment with balance acupuncture therapy and exercise re-learning rehabilitation therapy and the impact on serum cAMP and cGMP in the patients with hemiplegia of cerebral ischemic stroke.@*METHODS@#A total of 90 patients of hemiplegia of cerebral ischemic stroke were randomized into an observation group and a control group, 45 cases in each one. All of the patients in the two groups received health education, diet guidance, routine symptomatic treatment as well as exercise re-learning rehabilitation therapy. Additionally, in the observation group, balance acupuncture therapy was applied, in which, the acupoints on the aspect of the human body, on the governor vessel and bladder meridian were adopted in the morning and those on the aspect of the human body, on the conception vessel and kidney meridian were stimulated in the afternoon. In the control group, the regular acupuncture was given. In the two groups, both acupuncture and rehabilitation therapies were given 5 days a week, 2 week-treatment as one course and totally 2 courses were required. Separately, before and after treatment, the score of Fugl-Meyer assessment (FMA) and the score of Chinese stroke scale (CSS) were recorded, the levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) detected in serum and the clinical therapeutic effect were evaluated in the two groups.@*RESULTS@#After treatment, FMA score was increased in the patients of either of the groups as compared with that before treatment (<0.01) and CSS score decreased as compared with that before treatment (<0.01). After treatment, FMA score in the observation group was higher than that in the control group (<0.01) and CSS score was lower than the control group (<0.01). After treatment, the level of serum cAMP of the patients in either of the groups was increased as compared with that before treatment (<0.01) and that of cGMP decreased as compared with that before treatment (<0.01). After treatment, the level of cAMP in the observation group was higher than that in the control group (<0.01) and that of cGMP was lower than the control group (<0.01). The total effective rate was 93.3% (42/45) in the observation group, better than 73.3% (33/45) in the control group (<0.01).@*CONCLUSION@#The balance acupuncture therapy combined with exercise re-learning rehabilitation effectively improves the motor function of the affected limb, relieves injury and regulate the levels of serum cAMP and cGMP in the patients with hemiplegia of ischemic stroke.

Medical Emergencies in Dental Clinics: A Survey of 2013 Dentists in China / 中国医学科学杂志(英文版)

Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the associated factors for Chinese dentists experiencing medical emergencies.Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by Society of Sedation and Analgesia of Chinese Stomatological Association in 18 cities from December 2015 to December 2018. Demographic information of the dentists and the characteristics of medical emergencies they encountered were collected and analyzed. The associated demographic features for dentist experiencing medical emergencies were analyzed by logistic regression model.Results A total of 2013 dentists provided valid responses and reported 2923 events of medical emergencies in dental clinics. Among them, 85.0% reported that they had encountered medical emergencies, and 35.5% had encountered at least twice. Syncope (35.9%) and hypoglycemia (30.3%) were the most common reported medical emergencies. Medical emergencies were most likely to occur during local anesthesia (49.9%), out-patient oral surgery (25.9%), and root canal treatment (11.3%). There were 6 patients (0.2%) died in emergencies. 84.0% dentists reported that they had never received training courses about medical emergency management in dentistry other than Basic Life Support. Longer practicing time (10-15 years) (

Assessment on health risk of drinking water in Hangzhou / 预防医学

Objective@#To assess the health risk associated with drinking water in Hangzhou from 2016 to 2017,and to provide evidence for the safety of drinking water .@*Methods@#The monitoring data of 5 genetic toxic substances（arsenic,hexavalent chromium,cadmium,chloroform,tetrachloromethane）and 13 body toxic substances（lead,mercury,selenium,cyanide,fluoride,nitrate,iron,ammonia nitrogen,manganese,copper,zinc,aluminum,volatile phenol）from 36 source water samples,36 finished water samples and 288 tap water samples in the main urban areas of Hangzhou were collected from 2016 to 2017. The health risk of drinking water containing the chemical pollutants mentioned above were assessed based on the evaluation models recommended by United States Environmental Protection Agency .@*Results@#The concentrations of 5 genetic toxic substances and 13 body toxic substances in source water,finished water and tap water were all within the reference limits issued by Standards for Drinking Water Quality（GB 5749—2006）. The carcinogenic risk,non-carcinogenic risk and total health risk caused by the chemical pollutants in the source water were 2.18×10-5/a,7.75×10-9/a and 2.18×10-5/a. The carcinogenic risk,non-carcinogenic risk and the total health risk caused by the chemical pollutants in the finished water were 1.08×10-5/a,3.70×10-9/a and 1.08×10-5/a. The carcinogenic risk,non-carcinogenic risk and total health risk caused by the chemical pollutants in the tap water were 1.96×10-5/a,3.61×10-9/a and 1.96×10-5/a. The carcinogenic risk and total health risk caused by chemical pollutants ranged from high to low in the source water,tap water and finished water. The non-carcinogenic risks ranged from high to low in the source water,finished water and tap water .@*Conclusion@#The health risks of 18 chemical pollutants in drinking water in Hangzhou were at a low level,with the greater carcinogenic risk than the non-carcinogenic risk. Hexavalent chromium had the highest carcinogenic risk,while fluoride and aluminum had the highest non-carcinogenic risk.

Effectiveness and Safety of Oral Midazolam Combined Nitrous Oxide Sedation in Treating Children with Dental Fear / 中国医学科学院学报

Objective To evaluate the safety and effectiveness of oral midazolam sedation combined nitrous oxide sedation for reducing dental fear in children.Methods Totally 77 children with a Frankl's Behavior Rating Scale score of 1 were included in this study,among whom 41 received a total of 78 person-times of oral midazolam sedation (0.50-0.75 mg·kg ) (midazolam group) and 36 children were treated with the combination of 0.4 mg/kg oral midazolam with 30%-40% nitrous oxide (totally 73 person-times)(combination group). At each visit,heart rate,arterial oxygen saturation,and treatments were recorded. The behaviors of children during the treatment were assessed by Frankl's Behavior Rating Scale,the completion of treatment was assessed by Houpt Scale,and the sedation status was assessed by Ramsay Scale. Telephone follow-up was performed to record the side effects 24 hours after treatment. Results The vital signs were stable among all the 77 subjects,with a Ramsay score of 2 or 3. In the midazolam group, the behaviors were cooperative in 52 person-times (66.7%) and not cooperative in 26 person-times (33.3%);the planned treatments were completed in 62 person-times (79.5%) and partially completed in 16 person-times(20.5%). In the combination group,the behaviors were cooperative in 56 person-times (76.7%) and not cooperative in 17 person-times (23.3%);64 person-times (87.7%) completed the planned treatments and 9 person-times (12.3%) partially completed the treatments. The success rates of sedation (χ =1.87,P= 0.17) and treatment (χ =1.83,P= 0.18) were not significantly different between these two groups. The median Frankl scale score was significantly higher in the combination group [3 (3,4)] than in the midazolam group [3 (2,4)] (Z=2.647,P=0.008]. The median score of Houpt scale in the combination group [5(4,6)] was also significantly higher than in midazolam group [5(3,5)] (Z=2.236,P=0.026]. In midazolam group,there were 7 person-times of dysphoria,3 person-times of diplopia,and 2 person-times of hiccough among 78 person-times;in the combination group,there were 5 person-times of dysphoria,5 person-times of diplopia,1 person-time of hiccough,and 2 person-times of vomit among 73 person-times of treatment. Thus,there was no significant difference in the incidence of side effects (15.4% vs.17.8%,χ =0.160,P=0.689). Logistic regression analysis showed that the success rate of treatment was not associated with sex (OR=1.704,P=0.174),dose (OR=1.289,P=0.516),and treatment types (OR=0.555,P=0.143). Children over 3 years old had a significantly high success rate than those under 3 years old (OR=3.372,P=0.011). Conclusions Oral midazolam is safe and effective for reducing dental fear in children. The combination of oral midazolam with 30%-40% nitrous oxide can improve the behaviors of children during the dental treatment,especially in children over 3 years old.

Clinical Observation of Abdominal and Wrist-ankle Acupuncture plus Rehabilitation for Hemiplegia After Ischemic Cerebral Stroke / 上海针灸杂志

Objective By taking rehabilitation as the control, to observe the effect of abdominal and wrist-ankle acupuncture plus rehabilitation in restoring the motor and neurological function in hemiplegia due to ischemic cerebral stroke, and to optimize the treatment protocol. Method By adopting a randomized controlled clinical design, a hundred patients diagnosed with hemiplegia after ischemic cerebral stroke were randomized into a treatment group (50 cases) and a control group (50 cases) regarding their visiting sequence. The patients all received basic symptomatic treatment to control blood pressure, improve cerebral circulation, stabilize vital signs and prevent complications. In addition, the treatment group received abdominal and wrist-ankle acupuncture plus kinesiotherapy; the control group received rehabilitation training. The two groups were evaluated for therapeutic efficacy after 2 courses of treatment. Before and after the intervention, the recruited patients were tested by Fugl-Meyer Assessment (FMA), China Stroke Scale (CSS) and Berg Balance Scale (BBS), and the level of homocysteine (Hcy) was also detected. Result The FMA, CSS and BBS scores all showed significant changes after the intervention in the two groups (P<0.05); after the treatment, the FMA, CSS and BSS scores in the treatment group were significantly different from those in the control group (P<0.05), and there were significant between-group differences in comparing the score differences of FMA,CSS and BBS (P<0.05). The two groups both showed decrease of Hcy, (11.68±4.53)μmol/L in the treatment group versus (13.53±4.01)μmol/L in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Compared to rehabilitation alone, abdominal and wrist-ankle acupuncture plus kinesiotherapy can produce a more significant efficacy in treating hemiplegia due to ischemic cerebral stroke.

The influence of bivalirudin in coronary blood flow during primary percutaneous coronary intervention for acute myocardial infarction / 中国介入心脏病学杂志

Objective To evaluate the efficacy of bivalirudin on reperfusion of coronary artery in patients with acute myocardial infarction undergoing percutaneous coronary intervention. Methods In our study, we evaluated 245 patients with acute myocardial infarction who underwent percutaneous coronary intervention between April 2012 to May 2015. Based on the therapy during operation, bivalirudin were used in 122 patients and heparin was used in 123 patients. Study outcomes included immediate TIMI(thrombolysis in myocardial infarction)flow and CTFC(Corrected TIMI Frame Count)by angiogrophy once the target lesion was opened rates of ,in-hospital thrombocytopenia, bleeding events myocardial infarction, repeat revascularization and the incidence of MACE(major adverse cardiac events)in 30 days and 1 year. Results The mean heart rate was higher in the bivalirudin group(P=0.034). There was no significant difference between the two groups in laboratory results or interventional data(P>0.05). After the target vessel was opened, the effect of bivalirudin on slow/no-reflow in primary PCI has no difference between heparin in terms of TIMI blood evaluation or CTFC (P>0.05). Hospitalization data analysis showed that bivalirudin was able to obtain a higher activated whole blood coagulation time(ACT)value(P<0.001)with lower decrease in the number of platelets. Follow-up data of 30 days and 1 year showed no difference in the incidence of MACE and net adverse clinical events(NACE)between the two groups(P>0.05). Conclusions Bivalirudin has well efficacy and safety in patients with acute myocardial infarction in patients with acute myocardial infarction undergoing PPCI without increasing the incidence of slow/no-reflow.

Preparation and evaluation of the rat model of chronic nonbacterial prostatitis induced by carrageenan / 中国实验动物学报

Objective To establish an animal model of chronic nonbacterial prostatitis induced by chemical sub-stances, and provide a reliable animal model and evaluation method for pathological mechanism and pharmaceutical re-search of chronic nonbacterial prostatitis. Methods SD male rats were randomly divided into control group and model groups A, B and C. The three model groups were respectively treated with 20, 50 and 100 μL of 1% sterile carrageenan, injected into the left and right ventral lobes of rat prostate. The control group was injected 50μL sterile normal saline. The rats were sacrificed at 7 days after carrageenan injection, and the anatomical changes were analyzed, and the prostate in-dex, leukocyte count, the histology of prostate, and the protein expressions of TNF-α, NF-κB, IKKα, p-IKB-α and COX-2 were analyzed. Results Compared with the sham operation group, the softness of prostate tissue of groups A, B and C was decreased, the elasticity of the prostatic tissue was weakened, and the prostate tissues of model groups were ad-hered to surrounding tissues. The total number of leukocytes and the prostate index of model groups A, B and C were signif-icantly increased (P<0. 01), by 21. 1%, 61. 7% and 72. 7%, respectively. The total increase rate of white blood cell in the model groups A, B and C was 75%, 103. 6% and 114. 8%, respectively. Pathological examination showed that the in-terstitial edema of the prostate of model group A was minimal, but obvious in the groups B and C. Moreover, in the group C, the prostate atrophy was obvious, and some of the glands were degenerated and necrotic. The protein expression levels of NF-κB, IKKα, p-IKB-α, TNF-α, and COX-2 in the prostate tissue were increased to a different extent in all model groups. Conclusions Inflammatory reactions can be induced by injecting 20, 50 or 100 μL of 1% sterile carrag-eenan into the right and left ventral lobes of the rat prostate. However, the 20μL dose is too small, inducing only weak in-flammatory response, with considerable operation error, while the dose of 100μL induced excessive inflammatory response, even rat death. The dose of of 50 μL injection is most suitable to establish rat models of nonbacterial prostatitis, showing apparent activation of NF-κB inflammatory signaling pathway.

Preparation and evaluation of the rat model of chronic nonbacterial prostatitis induced by carrageenan / 中国实验动物学报

Objective To establish an animal model of chronic nonbacterial prostatitis induced by chemical sub-stances, and provide a reliable animal model and evaluation method for pathological mechanism and pharmaceutical re-search of chronic nonbacterial prostatitis. Methods SD male rats were randomly divided into control group and model groups A, B and C. The three model groups were respectively treated with 20, 50 and 100 μL of 1% sterile carrageenan, injected into the left and right ventral lobes of rat prostate. The control group was injected 50μL sterile normal saline. The rats were sacrificed at 7 days after carrageenan injection, and the anatomical changes were analyzed, and the prostate in-dex, leukocyte count, the histology of prostate, and the protein expressions of TNF-α, NF-κB, IKKα, p-IKB-α and COX-2 were analyzed. Results Compared with the sham operation group, the softness of prostate tissue of groups A, B and C was decreased, the elasticity of the prostatic tissue was weakened, and the prostate tissues of model groups were ad-hered to surrounding tissues. The total number of leukocytes and the prostate index of model groups A, B and C were signif-icantly increased (P<0. 01), by 21. 1%, 61. 7% and 72. 7%, respectively. The total increase rate of white blood cell in the model groups A, B and C was 75%, 103. 6% and 114. 8%, respectively. Pathological examination showed that the in-terstitial edema of the prostate of model group A was minimal, but obvious in the groups B and C. Moreover, in the group C, the prostate atrophy was obvious, and some of the glands were degenerated and necrotic. The protein expression levels of NF-κB, IKKα, p-IKB-α, TNF-α, and COX-2 in the prostate tissue were increased to a different extent in all model groups. Conclusions Inflammatory reactions can be induced by injecting 20, 50 or 100 μL of 1% sterile carrag-eenan into the right and left ventral lobes of the rat prostate. However, the 20μL dose is too small, inducing only weak in-flammatory response, with considerable operation error, while the dose of 100μL induced excessive inflammatory response, even rat death. The dose of of 50 μL injection is most suitable to establish rat models of nonbacterial prostatitis, showing apparent activation of NF-κB inflammatory signaling pathway.

Effectiveness and safety of computer-controlled periodontal ligament injection system in endodontic access to the mandibular posterior teeth / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the effectiveness and safety of a computer-controlled periodontal ligament (PDL) injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis.</p><p><b>METHODS</b>A total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth: the premolar group (PM, n=38), first molar group (FM, n=66), and second molar group (SM, n=58). All the patients received computer-controlled PDL injection with 4% articaine and 1:100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure.</p><p><b>RESULTS</b>The overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups (92.1%, 53.0%, 93.1%, respectively; χ² = 34.3, P<0.01). Both the PM and SM groups showed higher success rates than that of the FM group (v=1, χ² = 16.73, P<0.01; v=1, χ² = 24.5, P<0.01). No irreversible adverse effects on the periodontal soft tissues at the injection sites were observed in the follow-up visits in any of the groups.</p><p><b>CONCLUSION</b>The computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.</p>

Comparison of periodontal ligament anesthesia and submucosal infiltration anesthesia in healthy volunteers / 中国医学科学院学报

<p><b>OBJECTIVE</b>To compare periodontal ligament anesthesia using a computer-controlled local anesthetic delivery system (C-CLADS) and submucosal infiltration anesthesia using a manually operated syringe in terms of the injection pain, anesthetic effect, anesthetic dose, and complications in healthy volunteers.</p><p><b>METHODS</b>Fifty healthy volunteers, aged 18 to 56 years, were recruited from September 2012 to May 2013 in the Department of Stomatology of Peking Union Medical College Hospital. A randomized self-controlled trial was conducted by applying a periodontal ligament anesthesia on one side and conventional manual submucosal infiltration anesthesia to the other (control) side. The differences in the onset time of anesthesia, drug dosage, anesthetic effect, and the degree of injection pain were compared. The complications associated with the two anesthesia methods were also recorded.</p><p><b>RESULTS</b>When using C-CLADS to perform a periodontal ligament anesthesia, the drug dosage and the severity of injection pain were significantly less than those of conventional manual infiltration anesthesia [drug dosage: (0.34±0.09)ml vs.(0.55±0.13)ml, P<0.01; VRS: 0.42±0.73 vs. 1.38±0.92, P<0.01; VAS: 1.34±1.21 vs. 3.10±1.70, P<0.01]. The anesthesia success rate was approximately 90.0%, showing no significant difference relative to conventional submucosal infiltration anesthesia. Approximately 24% of the volunteers experienced postoperative pain after periodontal ligament anesthesia.</p><p><b>CONCLUSION</b>Compared with conventional submucosal infiltration anesthesia using manual syringes, periodontal ligament anesthesia performed using C-CLADS can reduce the injection pain and drug dosage while achieving a satisfactory anesthetic effect; however, a considerable proportion of cases may experience postoperative pain.</p>

A new classification of nevus of Ota / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The nevus of Ota, is a common benign pigmentary dermatosis, mainly involve innervation area of first and second branch of trigeminal nerve. The classification of nevus of Ota was proposed by Tanino, based on 26 cases of nevus of Ota from 1937 to 1940. Studies about its classification are rarely seen in last 70 years, while it is still practical today.</p><p><b>METHODS</b>Based on the clinical photographs, 1079 consecutive patients with nevus of Ota were verified and reclassified according to the innervation areas of the trigeminal nerve branches.</p><p><b>RESULTS</b>In these 1079 cases, 866 patients were in line with Tanino's classification (80.26%), and 213 patients were not (19.74%). We put forward a new clinical classification (Peking Union Medical College Hospital classification, PUMCH classification) of nevus of Ota based on the innervation area of the trigeminal nerve branches, composed of 5 types and 14 subtypes. The 5 types were as follows: Type I - pigmentation maculeses involving the innervation area of one of the three trigeminal nerve branches, of which there were 424 cases (39.3%), comprising 6 subtypes; Type II - pigmentation macules involving the innervation area of two branches of the three trigeminal nerve branches, of which there were 221 cases (20.48%), comprising 4 subtypes; Type III - pigmentation macules involving the innervation area of all three trigeminal nerve branches, of which there were 361 cases (33.45%), comprising 2 subtypes; Type IV - bilateral type, in which the pigmentation macules involves the bilateral cheek, of which there were 63 cases (5.84%), comprising 2 subtypes; and Type V - complications occurred in the patient, of which there were 10 cases (0.93%).</p><p><b>CONCLUSION</b>The new classification of nevus of Ota is based on the innervation area of the trigeminal nerve branches, and it covers all types of Tanino's classifications; on that basis, some new types and subtypes are brought in and cover almost every clinical condition.</p>

Evaluation of oral midazolam sedation for reducing dental fear in children with dental fear / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To assess the safety, effectiveness and influential factors of oral midazolam sedation for reducing dental fear in children with dental fear.</p><p><b>METHODS</b>30 children with traumatic dental experience, who were classified as 1 by Frankl behavior rating scale, were included in the study. Each child was treated under sedation with oral midazolam (0.5-1.0 mg x kg(-1)), and totally 46 person-time sedation treatments were conducted. At each visit, heart rate, arterial oxygen saturation, persistent period and treatment types were recorded. Treatment performed was rated by Houpt scale. Telephone following up was performed to record the side effects 24 h after treatment.</p><p><b>RESULTS</b>In all of the 46 person-time treatments, the heart rate, arterial oxygen saturation levels were within acceptable clinical limits. 37 person-time planned treatments (80.4%) were completed satisfactorily. Oral sedation was ineffective in 9 person-time treatments (19.6%), and only a part of planned treatments were completed. Dysphoria after treatment is the main side effect. Children over 3 years old had a high success rate than those under 3 years old. And the success rate of treatment had no relation with sex, dose and treatment types.</p><p><b>CONCLUSION</b>Oral midazolam could be a safe and acceptable approach of sedation for pediatric dental patients with dental fear, especially to the children over 3 years old.</p>

Multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate whether multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin.</p><p><b>METHODS</b>Twelve caries-free human primary molars were randomly divided into 2 groups. In group 1, each tooth was hemisected into 2 halves. One half was assigned to the control subgroup 1, which was bonded with a commercially available one-step self-etching adhesive according to the manufacturer's instructions; the other half was assigned to experimental subgroup 1, in which the adhesive was applied three times before light curing. In group 2, one split half tooth was bonded with a commercially available one-step self-etching adhesive according to the manufacturer's instructions; for the other half, three layers of adhesive were applied with each successive layer of light curing. Specimens were stored in 0.9% NaCl containing 0.02% sodium azide at 37℃ for 18 months and then were subjected to microtensile bond strength test and the fracture mode analysis.</p><p><b>RESULTS</b>When the adhesive was applied three times before light curing, the bond strength of the experimental subgroup 1 was significantly higher than that of the control subgroup 1 (47.46∓13.91 vs. 38.12∓11.21 MPa, P<0.05). When using the technique of applying multiple layers of adhesive with each successive layer of light curing, no difference was observed in bond strength between the control subgroup and the experimental subgroup (39.40±8.87 vs. 40.87±9.33 MPa, P>0.05).</p><p><b>CONCLUSION</b>Multiple coatings can improve the bond durability of one-step self-etching adhesive to primary dentin when using the technique of light-curing after applying 3 layers of adhesive.</p>

Effect of multiple coatings of one-step self-etching adhesive on microtensile bond strength to primary dentin / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effect of multiple coatings of the one-step self-etching adhesive on immediate microtensile bond strength to primary dentin.</p><p><b>METHODS</b>Twelve caries-free human primary molars were randomly divided into 2 groups with 6 teeth each. In group 1, each tooth was hemisected into two halves. One half was assigned to control subgroup 1, which was bonded with a single-step self-etching adhesive according to the manufacturer's instructions; the other half was assigned to experimental subgroup 1 in which the adhesive was applied three times before light curing. In group 2, the teeth were also hemisected into two halves. One half was assigned to control subgroup 2, which was bonded with the single-step self-etching adhesive according to the manufacturer's instructions; the other half was assigned to experimental subgroup 2 in which three layers of adhesive were applied with light curing each successive layer. Microtensile bond strength was immediately tested after specimen preparation.</p><p><b>RESULTS</b>When the adhesive was applied three times before light curing, the bond strength of the experimental subgroup 1 (n=33, 57.49 +/-11.61 MPa) was higher than that of the control subgroup 1 (n=31, 49.71 +/-11.43 MPa, P<0.05). When using the technique of applying multiple layers of adhesive with light curing each successive layer, no difference of immediate bond strength was observed between the control subgroup 2 and the experimental subgroup 2 (P>0.05).</p><p><b>CONCLUSION</b>strength to primary dentin when using the technique of light-curing after applying three layers of adhesive.</p>

Evaluation of oral midazolam conscious sedation in different age groups in pediatric dentistry / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To summarize the effect of oral midazolam sedation in a group of uncooperative patients in pediatric dentistry and analyze the influence of age on treatment results and safety.</p><p><b>METHODS</b>Oral midazolam conscious sedation (dosages range: 0.50 - 0.75 mg/kg) was applied to 109 uncooperative pediatric patients in outpatient department. The patients were divided into two age groups: group A (under 3 years) and group B (over 3 years). Treatment results and safety were statistically analyzed.</p><p><b>RESULTS</b>The mean success rate was 71% (77/109), which was higher in group B [78% (54/69)] than in group A [58% (23/40)]. The incidence of adverse reactions was 17% (19/109), which was higher in group A [28% (11/40)] than in group B [12% (8/69)].</p><p><b>CONCLUSIONS</b>Oral midazolam conscious sedation at a dosage range of 0.50 - 0.75 mg/kg is more effective and safe in pediatric dental patients over 3 years of age.</p>

Evaluation of the attention shift effect of a video-audio eyewear in pediatric dental treatment / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the attention shift effect produced by a video-audio eyewear in pediatric dentistry.</p><p><b>METHODS</b>Totally 40 children aged 4-7 years were equally randomized into fissure sealant group(group S) and caries filling group(group F). A self-control comparison method was used in each group: each child took two visits to finish the whole study, they received the dental treatment either with normal method(SC, FC) or with attention shift by wearing the video-audio eyewear (SI, FI) for each visit. The degree of pain, accomplishment of treatment, and co-operation were analyzed and compared.</p><p><b>RESULTS</b>All children were successfully managed in the whole course. The pain scores were not significantly different between SC group and SI group or between FC group and FI group (P0.05), while the Frankl scores were significantly different between SC group and SI group (P=0.04) and between FC group and FI group (P=0.03). Houpt scores were significantly different between SC group and SI group (P=0.04), but not between FC group and FI group (P=0.85). Most children (90% in group S) and (85% in group F) expressed the willingness to receive the video-audio eyewear if they were asked to do so again.</p><p><b>CONCLUSIONS</b>The video-audio eyewear provides satisfactory attention shift for children during dental treatment and increases their cooperation. However, it has little effect on pain relieving.</p>

Continuous intravenous infusion of midazolam: a clinical study of conscious sedation for dental phobia / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the sedative effect of continuous intravenous infusion of midazolam in treating severe dental phobia.</p><p><b>METHODS</b>31 patients with severe dental phobia were enrolled and all of them had good communication with dentists. Two teeth in each patient were assigned to control group and experiment group seperately. The control group received root canal therapy. The experiment group were sedated by intravenous midazolam and received root canal therapy. The treat dependence and behavior therapy efficacy were evaluated. The vital signs and side effects during treatment were noted.</p><p><b>RESULTS</b>Continuous intravenous infusion of midazolam showed a significant good sedative effect on patients with severe dental phobia. There were statistical difference in the Houpt score and the Frankl score between experiment group and control group (z = -4.846, P = 0.000; z = -4.907, P = 0.000). The total dose of midazolam was (9.58 +/- 3.76) mg, and mean infusion rate was (0.28 +/- 0.06) mg x kg(-1) x h(-1). The blood pressure, heart rate and respiration of experiment group were depressed. But these changes didn't interfere with the completion of the whole treatment. No severe side effects were detected.</p><p><b>CONCLUSION</b>The single use of midazolam as an intravenous sedation agent has satisfactory effect on patients with severe dental phobia.</p>

Evaluation of midazolam intravenous sedated patient's comfort degree in mandibular third molar surgery / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of continuous low-flow intravenous infusion of midazolam sedation in mandibular third molar surgery.</p><p><b>METHODS</b>Fifty healthy patients with symmetrically placed impacted bilateral mandibular third molars were included in this self controlled, randomized clinical study. Degree of comfort (their actual current anxiety level) was assessed using a visual analogue scale (VAS) of pain and anxiety. Patients' satisfaction and degree of amnesia were also evaluated. Vital signs and oxygen saturation were recorded.</p><p><b>RESULTS</b>Low dose midazolam sedation obviously increased the degree of patients' comfort and satisfaction. Vital signs and oxygen saturation levels did not differ significantly between the two groups.</p><p><b>CONCLUSIONS</b>Midazolam as an intravenous sedation agent in mandibular third molar surgery showed satisfactory effect on patients with mild dental fear.</p>

Blood pressure changes of elderly hypertensive patients during dental extraction under sedation with continuous intravenous infusion of midazolam / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the changes in blood pressure (BP) of elderly hypertensive patients having dental extraction under sedation with continuous intravenous infusion of midazolam.</p><p><b>METHODS</b>One hundred elderly hypertensive patients undergoing dental extraction were recruited for this single-blind, randomized, controlled study. Patients in intervention group (n = 50) were given midazolam dissolved in glucose solution and patients in control group (n = 50) were given glucose solution only with communication technique. Systolic BP (SBP) and diastolic BP (DBP) were recorded in five time points.</p><p><b>RESULTS</b>Under basal conditions, intervention group did not show significant difference in BP compared with control group. Before sedation, mean values of SBP and DBP (especially SBP) significantly increased compared with basal conditions in both groups (P < 0.05). During dental extraction sessions, mean values of BP in intervention group significantly decreased than control group (P < 0.05), but coefficient of variation did show significant difference in both groups.</p><p><b>CONCLUSION</b>Continuous intravenous infusion of midazolam has been proved to be very successful in controlling BP of elderly patients having dental extraction.</p>