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【Objective】 To retrospectively analyze the detection results of blood donors with HBsAg reactivity to single reagent detected by enzyme-linked immunosorbent assay (ELISA) in our center, so as to provide basis for further consolidating the blood donor team. 【Methods】 Samples of blood donors who had been deferred for at least 6 months due to HBsAg reactivity to sole ELISA assay were collected, and HBsAg ELISA and NAT were further performed. Meanwhile, HBsAg/HBsAb/HBeAg/HBeAb/HBcAb were detected by Roche electrochemiluminescence immunoassay, and the results were statistically analyzed. 【Results】 Among these 51 selected samples, 45 were negative to two assays, 6 were reactive to sole assay, with reactivity-yield rate at 11.76% (6/51). The results of NAT/ECLIA were all negative. For five indicators of hepatitis B virus infection, 23 samples were all negative and 28 were partially positive, mainly anti-HBs, anti-HBc and anti-HBe. 【Conclusion】 The follow-up detection of HBsAg ELISA sole-reagent reactive samples, supplemented with the detection of HBV serological markers, can reduce the number of deferred blood donors, increase the willingness to donate blood again, and protect the rights and interests of blood donors.
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Objective:Analyze the efficacy and safety of gastric peroral endoscopic myotomy (G-POEM) in the treatment of gastroptosis.Methods:From August 1, 2016 to August 1, 2020, at Zhongda Hospital, Southeast University, the baseline data of 14 patients with gastroptosis who underwent G-POEM were retrospectively collected, including age, weight, length of hospital stay, and modified gastroparesis cardinal symptom index(mGCSI). Regular follow-ups were made, and relevant data were recorded for comparative analysis. The main observation indicators were body weight and mGCSI. Friedman rank sum test and Bonferroni correction test were used for statistical analysis.Results:The age of 14 patients with gastroptosis was 50.0 years old(24.5 years old), the operations were successfully completed in all patients without any serious surgical complications, the time of hospital stay was 10.5 d (5.0 d), and all the postoperative follow-up time was >12 months. There were statistically significant differences in mGCSI and body weight between before operation and at 1st week, 1st month, 3rd month, 6th month, and 12th month after operation (1.94(1.19), 0.78(0.47), 0.36(0.19), 0.17(0.45), 0.13(0.57) and 0.29(0.50), 43.5 kg(5.8 kg), 43.5 kg(5.8 kg), 42.5 kg(7.1 kg), 43.5 kg(6.9 kg), 45.0 kg(8.0 kg) and 45.5 kg(7.5 kg); Z=42.78 and 34.28, both P<0.001). After Bonferroni correction in the pairwise comparison, there were statistically significant differences in the mGCSI of the 14 patients between before operation and at 1st month, 3rd month, 6th month, and 12th month after operation ( Z=4.09, 5.05, 5.00 and 4.14, P=0.001, <0.001, <0.001 and =0.001). The weight of 14 patients at 12th month after operation were compared with the weight before operation, 1st week after operation, and 1st month after operation, and the differences were statistically significant (all Z=-3.64, all P=0.004). Conclusion:G-POEM has a good therapeutic effect on patients with gastroptosis and is expected to become a new treatment for gastroptosis.
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OBJECTIVE：To provide reference for r ational use of TCM decoction piece. METHODS ：Electronic questionnaire survey was conducted on the use （dose，ingredient number ）of TCM decoction piece prescriptions in 12 TCM hospitals from 10 provinces（regions，cities）. Through the hospital information system ，416 100 outpatient prescriptions of TCM decoction piece were collected from the First Affiliated Hospital of Henan University of TCM （our hospital ）during May 2016 to Apr. 2019，and were analyzed in terms of prescription dose ，the number of ingredients and use of TCM decoction pieces. At the same time ，the use of TCM decoction piece prescription were analyzed in different departments ，and the clinical application status of TCM decoction pieces prescription were investigated and relevant suggestions were put forward. RESULTS ：The average dose of TCM decoction piece prescriptions in 12 hospitals were 129.60-245.00 g，and the average number of ingredients were 11.90-18.25；the average dose of TCM decoction piece prescriptions in pediatric department was lower than other departments. The average dose of TCM decoction piece prescriptions in our hospital was 242.21 g；55.75％ of the prescription dose were distributed in 201-300 g，and 15.22％ were over 300 g. The average number of ingredients in prescriptions was about 15，and the prescriptions with 11-20 ingredients accounted for 87.75％，those with more than 20 ingredients accounted for 6.64％. Top 20 TCM decoction pieces in TCM prescriptions of our hospital had different degrees of overdose. Three decoction pieces with the highest frequency of overdose were Radix Curcumae processed by vinegar （85.51％），Atractylodes macrocephala stir-fried with bran （82.10％）and A. macrocephala（79.13％）. The number of TCM decoction piece prescriptions in internal medicine department accounted for 40.84％ in our hospital ；there were a lot of TCM prescriptions with dose exceeding 300 g（11.98％ and 18.69％）and the number of ingredients exceeding 18（14.60％ and 9.53％）in internal medicine department and surgery department. The proportion of pediatric TCM decoction piece prescriptions with more than 18 ingredients accounted for 24.09％. CONCLUSIONS ：The overall dosage of TCM decoction piece prescriptions is relatively high ，the number of ingredients is too much ，and the overdose of single-flavored TCM decoction piece is common. Internal medicine department and surgery department should focus on controlling the number of and the dosage of single-flavored decoction pieces of TCM prescriptions to standardize the prescribed dosage. Gynecology department needs to focus on controlling the dosage of single-flavored TCM pieces and pediatrics department should pay special attention to the use of prescription ingredients ，so as to ensure a more scientific and reasonable standard for the clinical application of TCM decoction piece.
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【Objective】 To retrospectively analyze the key performance indicators of two hepatitis B surface antigen (HBsAg) ELISA reagents used in blood stations, so as to provide basis for reagent selection from the perspective of laboratory performance. 【Methods】 The test results, reactive rate of initial/repeat test, concordance rate of initial and repeat test, and the NAT-yield implicated in ELISA-reactive samples with one assay from 2016 to 2019 were analyzed to compare the detection performance of two ELISA reagents. 【Results】 The total ELISA reactive rate of HBsAg was 0.39%(1 863/480 741), with 0.31% and 0.29% in two reagents, respectively. The initial reactive rate were 0.44% and 0.39%, concordance rate of initial and repeat test was 70.21% and 74.55%, respectively. 43 NAT-yield samples were implicated in ELISA-reactive samples with one assay. 【Conclusion】 There are differences underlying in the detection performance of the two reagents. In order to avoid blood waste and ensure blood safety, the key performance indexes and test results should be taken into consideration when selecting reagents.
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Objective:To develop nursing quality evaluation indicator system for perioperative patients with Da Vinci robotic under enhanced recovery after surgery(ERAS), in order to provide references for clinical evaluation of nursing quality for lobectomy patients.Methods:Based on the theory of structure-process-outcome quality model and ERAS, literature review, semi-structured interviews were adopted to determine nursing quality indicator system for perioperative patients. Delphi method was used in two rounds of consultation among 21 experts.Results:The positive coefficient was 100%, authority coefficient was 0.839,0.901, and the coefficients of concordance were 0.317,0.335. The final indicator system consisted of 3 first-level indicators, 14 second-level indicators, and 52 third-level indicators.Conclusion:The nursing quality evaluation indicator system for lobectomy patients with Da Vinci robotic was scientific and reliable, which can provide scientific references for evaluating nursing quality for perioperative patients with Da Vinci robotic under ERAS.
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Objective To explore the predictive value of short term cognitive assessment in the acute phase of ischemic stroke for 3-6 months after stroke.Methods The demographic data,vascular risk factors,clinical and imaging data of 254 patients with acute ischemic stroke from August 2016 to December 2017 were prospectively registered.The cognitive function was assessed by Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) 3 weeks after stroke onset.Comprehensive cognitive function assessment was performed after 3-6 months of stroke.Multiple factor Logistic regression was used to screen the independent risk factors of cognitive domain and overall cognitive function in 3-6 months.Results Totally 254 consecutive patients with acute ischemic stroke were enrolled.Combined with the inclusion and exclusion criteria,161 patients completed the baseline cognitive assessment,and 138 completed the comprehensive cognitive assessment in 3-6 months after stroke.Logistic regression analysis showed that 3 weeks baseline cognitive status was an independent factor affecting memory (P＜0.05,OR =62.47,95％CI=13.00-205.00),execution (P＜0.05,OR=38.29,95％CI=8.00-170.00),language (P＜0.05,OR=6.46,95％CI=2.31-18.04) and information processing speed (P＜0.05,OR=5.88,95％CI=2.24-15.41) in 3-6 months after stroke.According to the number of impaired cognitive domains,the overall cognitive function was defined.There were 61 cases of no or mild cognitive dysfunction group and 77 cases of moderate or severe cognitive impairment group.Multifactor logistic analysis showed that baseline cognitive status was independent of the overall cognitive function of 3-6 months after apoplexy adjusting for the age and education level (P＜0.05,OR=25.32,95％ CI =7.52-85.39).Conclusion Short cognitive assessment in early apoplexy can predict the short-term functional status of cognitive domains such as memory,execution,language and information processing speed after stroke,and can also predict the overall cognitive level.
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Objective To investigate the efficacy and safety of gastric peroral endoscopic myotomy ( G-POEM) for postsurgical gastroparesis. Methods A retrospective analysis was performed on data of 47 patients with gastroparesis after subtotal gastrectomy, who underwent G-POEM at Zhongda Hospital Southeast University form August 2016 to June 2018. G-POEM procedure, complications related to G-POEM, and improvement of symptoms and gastric emptying function were observed. Results All patients underwent G-POEM successfully. No serious G-POEM-related complications were observed. During a follow-up period of 9. 8±5. 8 months (range 3-18 months), the scores of gastroparesis cardinal symptoms index (GCSI) were 1. 6±0. 5, 1. 2±0. 4, 1. 1±0. 6, 1. 4±0. 3 and 1. 7±0. 3 respectively at the 1st, 3rd, 6th, 12th, and 18th months after G-POEM, and all scores were lower than that before G-POEM (3. 8±1. 1, all P<0. 01). The results showed the symptoms of gastroparesis were improved significantly. Gastric emptying imaging showed the hemi-emptying time was 23. 8±8. 8 min, 21. 2±9. 5 min, 20. 9±8. 3 min and 26. 4±7. 8 min at the 1st, 6th, 12th and 18th months after G-POEM, respectively, significantly shorter than that before G-POEM (67. 8±12. 5 min, all P<0. 01). Three-dimensional ultrasonography results of gastric antrum volume showed that the hemi-emptying time was 26. 4 (21. 8, 40. 3) min, 22. 6 (13. 9, 32. 7) min, 24. 3 (18. 2, 36. 5) min and 26. 8 (16. 4, 38. 5) min at the 1st, 6th, 12th and 18th months after G-POEM, respectively, which were all significantly shorter than that before G-POEM [ 72. 5 ( 48. 3, 108. 6 ) min, all P<0. 01 ] . Conclusion G-POEM has a satisfactory long-term efficacy on the treatment of gastroparesis after subtotal gastrectomy with good safety.
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Systemic lupus erythematosus (SLE) is a multiorgan-involved autoimmune disease, and it can overlap organ-specific autoimmune diseases such as autoimmune thyroid diseases, autoimmune hepatitis and inflammatory bowel disease. There may be some association between SLE and these autoimmune diseases, such as common immunological and genetic basis, but the pathogenic mechanism is still unclear. This review focuses on current knowledge regarding the prevalence and possible pathogenesis of SLE overlapping the above three autoimmune diseases.
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Humans , Autoimmune Diseases , Epidemiology , Hepatitis, Autoimmune , Epidemiology , Inflammatory Bowel Diseases , Epidemiology , Lupus Erythematosus, Systemic , Epidemiology , Prevalence , Research , Thyroiditis, Autoimmune , EpidemiologyABSTRACT
OBJECTIVE: To provide reference for strengthening safe use and supervision of set prescription preparations containing toxic decoction pieces [called "Chinese patent medicine (CPM) containing toxicity" for short] in clinic. METHODS: The CPM containing toxicity in 2015 edition of Chinese Pharmacopoeia (part I) were summarized and analyzed to put forward the suggestion on improving safe use of them in clinic. RESULTS & CONCLUSIONS: A total of 474 CPM containing toxicity are included in 2015 edition of Chinese Pharmacopoeia (part I), accounting for 31. 75％ of set prescription preparations. There are 435 oral preparations (12 preparations both for oral and external use), 38 preparations for external use, one intramuscular injection, accounting for 91. 77％, 8. 02％, 0. 21％ of CPM containing toxicity, respectively. There are 318, 93, 32, 31 set prescription preparations containing 1, 2, 3 or more ingredients toxic decoction pieces, accounting for 67. 09％, 19. 62％, 6. 75％, 6. 54％, respectively. At present, basic research on CPM containing toxicity is weak; the information of the instructions is not perfect; guidance for clinical drug use is absent. It is suggested to strengthen basic research on CPM containing toxicity, develop drug use study among special population, improve rational use of Chinese patent medicine and strengthen post-marketing safety reevaluation so as to guarantee the safety of CPM containing toxicity use in clinic.
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Objective To investigate the predictive role of cerebral white matter lesions (WML) and subcortical atrophy on cognitive function in patients with acute ischemic stroke (AIS) after 3 months.Methods 233 cases of AIS patients admitted to hospital continuously from September 2016 to March 2018 were enrolled and all of them underwent brain MRI.The degree of WML on FLAIR was evaluated according to the Fazekas grading standard.The linear measurement of subcortical atrophy on T1WI was carried out on the subcortical brain atrophy index,including EVANS ratio (ER),inverse cella media index (iCMI),caudate head index (CHI) and basal cistern index (BCI).Demographic,clinical and imaging data of all patients were also recorded.Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were conducted at 3 months after AIS.The patients were divided into normal cognitive function (NCI) group and post stroke cognitive impairment (PSCI) group according to evaluation results of MMSE and MoCA.Multivariate logistic regression analysis was used to screen the independent risk factors of cognitive impairment.Results Univariate analysis showed that age (t=-4.233,P=0.000),sex (x2 =7.501,P=0.006),education (H=21.188,P=0.000),NHISS score (H =5.791,P=0.016),history of atrial fibrillation (x2 =6.484,P=0.011),TIA (x2 =9.015,P=0.003),smoking history (x2 =6.943,P=0.008),Fazekas WML score (x2 =27.885,P=0.000),EVANS ratio (H =31.129,P =0.000),inverse cella media index (H =9.434,P =0.002),caudate head index (H=15.148,P=0.000),basal cistern index (t=-1.979,P=0.049) and baseline cognitive function (x2=136.994,P=0.000) were related to cognitive impairment in patients with AIS after 3 months (P＜0.05).Multivariate logistic regression analysis showed that WML score (OR=3.416,P=0.047,95％CI:1.017-11.482),EVANS ratio (OR=1.245,P=0.038,95％CI:1.012-1.531) and caudate head index (OR =1.187,P=0.040,95 ％ CI:1.008-1.397) were risk factors for cognitive impairment in AIS patients after 3 monfths adjusting for age,education,disease severity and baseline cognitive function.Conclusion WML,EVANS ratio and caudate head index can predict short-term cognitive function in patients with AIS.
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Interventions of expressive writing in cancer patients are mainly implemented in foreign countries. This paper reviews the proposal and development, implementation methods and mechanisms of expressive writing, and its effect on health outcomes of cancer patients, which indicates the population sensitivity and cultural sensitivity.In recent years,more and more attention has been paid to the intermediary variables, objective index and the analysis of the writing text in order to fully explain the mechanism and identify the social psychological needs of cancer patients at different stages. Future research can focus on sensitive populations, explore intermediary variables, incorporate objective indicators, optimize intervention methods, and explore the best intervention model for localization.
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Objectives To study the early effect of treating teenagers with tibial insertion avulsion fracture of anterior cruciate ligament using the single-tibal tunnel,double Endobutton miniature steel plate combined with twin high-strength Ultrabraid Suture suspension fixation under an anthroscopy.Methods Retrospective analysis was conducted on 21 teenagers with tibial insertion avulsion fracture of anterior cruciate ligament treated between May 2012 and June 2015.They were treated using the single-tibal tunnel,double Endonbutton plate combined with twin Ultrabraid Suture suspension system fixation.The X-ray was taken postoperatively at 1 week,1 month,3 months and every 6 months.Anterior drawer and Lachman tests were used to evaluate the postoperative stability of knee joints,while the Lysholm score was recorded to assess the postoperative recovery.Results The average total intraoperative blood loss,operation duration and follow-up time were(53.95 ± 7.10) ml (ranging from 43 to 68 ml),(38.76 ± 7.71)min(ranging between 27 and 55 min),and(21.86 ± 2.78)months,ranging from 18 to 25 months.All fractures were healed without malunion or nonunion as could be seen in the X-ray taken 3 months after the operation.Moreover,none of the patients suffered from complications such as soft tissue infections or extension lag of the knee joints caused by the femoral intercondylar notch impingement syndrome.The Lysholm score of the last follow-up(97.14 ± 1.35)was significantly higher than that before surgery (40.24 ± 5.81).Conclusion The early efficacy of the single-tibal tunnel,double Endonbutton plate combined with twin Ultrabraid Suture suspension system fixation for teenagers with tibial insertion avulsion fracture of anterior cruciate ligament under arthroscopy is satisfactory.
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This paper discussed the characteristics of hospitalized patients ' physical and psychological changes in different stages of health -disease conversion , and analyzed the reasons and types of role conversion disorders . Combined with the author ' s clinical nursing experience for many years , this paper proposed the countermeasures to help hospitalized patients achieve role conversion quickly and successfully at the different node .Furthermore , it could elevate the compliance of patients , improve the effectiveness of treatment and nursing , reduce the medical disputes, shorten the hospitalization time , and significantly save the medical resources .
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This paper discussed the characteristics of hospitalized patients ' physical and psychological changes in different stages of health -disease conversion , and analyzed the reasons and types of role conversion disorders . Combined with the author ' s clinical nursing experience for many years , this paper proposed the countermeasures to help hospitalized patients achieve role conversion quickly and successfully at the different node .Furthermore , it could elevate the compliance of patients , improve the effectiveness of treatment and nursing , reduce the medical disputes, shorten the hospitalization time , and significantly save the medical resources .
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The mainstay of nonpharmacological therapy of chronic heart failure patients is low sodium diet. This paper introduced the modified and unmodified influencing factors of patient compliance to low-sodium diet in chronic heart failure patients in order to provide new clues for the development of patient compliance.
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A cadmium column reduction-azo dyes spectrophotometric method based on micro sequential injection lab-on-valve was established for the determination of total nitrogen in seawater. The experimental parameters were optimized, and the interference experiment was carried out. The results showed that the interference of the main components and salinity in sea water could be eliminated by using a series of standard solution prepared by national standard seawater with certain salinity. The concentration of total nitrogen in seawater was linear with the absorbance in the range of 0 . 03-1 . 00 mg/L with a correlation coefficient of 0. 9993. When determining the national standard seawater at nitrogen concentration of 0. 20 mg/L, the relative standard deviation (RSD) was 4. 9%, the detection limit was 0. 010 mg/L, and the recoveries were 99. 5%-101 . 1%. There were not significance differences between the results of this method and national standard method in the t-test analysis. The method is suitable for the determination of total nitrogen in seawater.
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The article introduced the research status of medication safety of elderly patients with chronic diseases at home,and discussed their attitudes and ways of participation in medication safety and the factors which influenced them.In the end,it summarized multiple interventions of patients participating in medication safety and put forward the development of strategies which were suitable for Chinese cultural backgrounds and operable for patients participating in medication safety at home.
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Ensuring the safety of patients is the the duty of medical workers. Nursing safety is the key factor to reflect the quality of nursing service, which is closely related to patient safety. The effective communication between physicians and nurses is a powerful guarantee for the safety of patients. The positive effect of SBAR communication model in clinical communication has been validated in many aspects, which gradually becomes an important communication model. Now reviews the origin, connotation, characteristics and application status of SBAR communication model, then put forward the matters needing attention when using the model, in order to provide theoretical reference for clinical application.
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Objective:To observe the differences in the dynamic change of the EB virus antibody between general population and first-degree relatives (FDR) of nasopharyngeal carcinoma patients during follow-up study one year after initial screening and discuss the difference among the nasopharyngeal carcinoma detections. Methods: Serologic data of all subjects that participated in the fol-low-up study were collected. Changes in EB virus antibodies were investigated and correlation of these changes with gender and age level was analyzed. Differences in the nasopharyngeal cancer detection rate of different populations were also compared. Results:NA1/IgA negative conversion rate was higher in the family group than in the control group (χ2=20.28, P<0.001). This rate was also higher in both male and female family groups than in the male and female control groups (χ2=22.59, P<0.001;χ2=4.03, P<0.05, respectively). NA1/IgA positive conversion rate was lower in the family group than in the control group (χ2=7.79, P<0.05). Likewise, this rate was lower in both male and female family groups than in the male and female control groups (χ2=9.46, P<0.05;χ2=0.74, P=0.39, respective-ly). VCA/IgA negative conversion rate was higher in the family group than in the control group (χ2=1.90, P<0.001). This rate was also higher in the male and female family groups than in the male and female control groups (χ2=7.50, P<0.05; χ2=no expression, P=0.108, determined by Fish exact test, respectively). VCA/IgA positive conversion rate was higher in the family group than in the control group (χ2=0.10, P=0.70). This rate was again higher in both male and female family groups than in the male and female control groups (χ2=0.02, P=0.90,χ2=0.51, P=0.48, respectively). Ten cases from the control group manifested nasopharyngeal carcinoma;the same disease was not observed in the family group. Nasopharyngeal carcinoma detection rate was significantly higher in the control group than in the family group, but the difference was not statistically significant (χ2=1.05, P=0.31). Conclusion:a. Reactivation of the EB virus is not closely linked with genetic factors. b. The detection rate of NPC in FDR was lower compared with the general population after initial screening;thus, the rule of selective follow-up is not applicable for FDR.
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<p><b>OBJECTIVE</b>To investigate the expression and the distribution of human beta defensin (hBD)-4 in healthy gingiva.</p><p><b>METHODS</b>Healthy gingival specimens were collected. The expression of hBD-4 peptides in 18 gingival specimens were detected by immunohistochemistry. The hBD-4 mRNA were determined in freshly isolated gingival tissue by real time reverse transcription-polymerase chain reaction (real time RT-PCR) in 30 gingival specimens.</p><p><b>RESULTS</b>In 18 gingival specimens, hBD-4 peptides were expressed in 13 gingival specimens. In 30 gingival specimens, hBD-4 were detected in 4 gingival specimens by real time RT-PCR.</p><p><b>CONCLUSION</b>The distribution and the expression levels of hBD-4 are different in healthy gingiva. This result may suggest that the hBD-4 play a role in maintaining the periodontal health.</p>