Short-term efficacy of empagliflozin in children with glycogen storage disease type Ⅰb / 中华儿科杂志

Objective: To analyze the short-time efficacy of empagliflozin in the treatment of glycogen storage disease type Ⅰb (GSD Ⅰb). Methods: In this prospective open-label single-arm study, the data of 4 patients were collected from the pediatric department in Peking Union Medical College Hospital from December 2020 to December 2022. All of them were diagnosed by gene sequencing and had neutropenia. These patients received empagliflozin treatment. Their clinical symptoms such as height and weight increase, abdominal pain, diarrhea, oral ulcer, infection times, and drug applications were recorded at 2 weeks, 1 month, 2 months, 3 months, 6 months, 9 months, 12 months, and 15 months after treatment to assess the therapeutic effect. The liquid chromatography-tandem mass spectrometry method was used to monitor the changes in 1, 5-anhydroglucitol (1, 5AG) concentration in plasma. At the same time, adverse reactions such as hypoglycemia and urinary tract infection were closely followed up and monitored. Results: The 4 patients with GSD Ⅰb were 15, 14, 4 and 14 years old, respectively at the beginning of empagliflozin treatment, and were followed up for 15, 15, 12 and 6 months, respectively. Maintenance dose range of empagliflozin was 0.24-0.39 mg/(kg·d). The frequency of diarrhea and abdominal pain decreased in cases 2, 3, and 4 at 1, 2 and 3 months of treatment, respectively. Their height and weight increased at different degrees.The absolute count of neutrophils increased from 0.84×109, 0.50×109, 0.48×109, 0.48×109/L to 1.48×109, 3.04×109, 1.10×109, 0.73×109/L, respectively. Granulocyte colony-stimulating factor was gradually reduced in 1 patients and stopped in 3 patient. Plasma 1, 5 AG levels in 2 children were significantly decreased after administration of empagliflozin (from 46.3 mg/L to 9.6 mg/L in case 2, and from 56.1 mg/L to 15.0 mg/L in case 3). All 4 patients had no adverse reactions such as hypoglycemia, abnormal liver or kidney function, or urinary system infection. Conclusion: In short-term observation, empagliflozin can improve the symptoms of GSD Ⅰb oral ulcers, abdominal pain, diarrhea, and recurrent infection, also can alleviate neutropenia and decrease 1, 5AG concentration in plasma, with favorable safety.

Changing scanning angles on improving finish line trueness of the full crown preparation / 中华口腔医学杂志

Objective: To explore the effect of scanning methods on finish line trueness of the full crown preparation. Methods: The standard full crown preparation model of the right maxillary first molars was prepared by using the maxillary standard resin dentition model. The standard preparation was scanned by imetric scanner and data were used as the true value. CEREC Omnicam and 3Shape TRIOS were used to scan the standard preparation. According to the scanning methods, they were divided into parallel scanning group, occlusal wave scanning group and buccolingual wave scanning group. Each group was scanned repeatedly 6 times. The data were imported into Geomagic Studio 2013 software, and the local finish line image data of the mesial, distal, buccal and lingual regions of the full crown preparation were extracted respectively. Three-dimensional deviation analysis was performed with the reference true value, and the root- mean-square error (RMSE) was the evaluation index of scanning trueness. The statistical method was one-way ANOVA. Results: Parallel scanning group: in general, the RMSE value of complete finish lines of scanner B [(35±6) μm] was significantly lower than that of scanner A [(44±7) μm](P<0.05). After scanner A occlusal wave scanning, the RMSE values of the mesial and distal finish lines [(33±5) and (50±12) μm] were significantly lower than those of parallel scanning group (P<0.05). After buccal and lingual wave scanning, the RMSE values of local finish lines in the mesial, distal, buccal and lingual regions [(37±3), (50±6), (28±6) and (29±8) μm] were significantly lower than those in parallel scanning group [(45±9), (63±7), (38±3) and (40±3) μm] (P<0.05). No significant difference was found in the RMSE values of the mesial, distal, buccal and lingual regions of scanner B between parallel scanning group, occlusal wave scanning group and buccolingual scanning group (P>0.05). Conclusions: The scanning trueness of the full crown preparation finish line obtained by the active triangulation scanning equipment can be improved by changing the scanning method to wave scanning.

Effects of the resin base and retention depth on fracture resistance of molars restored with nano-ceramic endocrowns / 北京大学学报(医学版)

OBJECTIVE@#To compare the effects of resin base and different retention depth on the fracture resistance of mandibular molars restored with nano-ceramic endocrowns.@*METHODS@#Forty mandibular molars selected and randomly divided into 5 groups: ① The control group which was consisted of intact teeth, ② the non-resin base group, ③ the 2 mm retention depth group, ④ the 3 mm retention depth group, ⑤ the 4 mm retention depth group, respectively. After tooth preparation, in vitro root canal therapy was conducted, which was followed by endocrown design, production and adhesive of groups ②-⑤. All the samples were under load (N) of the universal mechanical testing machine after embedding. The fracture pattern of each sample was observed under stereomicroscope. Then the microstructure of the fracture surface was observed by scanning electron microscopy.@*RESULTS@#The fracture loads of each group were respectively: the control group fracture load was (3 069.34±939.50) N; experimental groups: fracture load of (2 438.04±774.40) N for the group without resin base; fracture load of (3 537.18±763.65) N for the group with 2 mm retention depth. The fracture load of the retention depth 3 mm group was (2 331.55±766.39) N; the fracture load of the retention depth 4 mm group was (2 786.98±709.24) N. There was statistical significance in the effect of resin base and different retention depth on the fracture loads of molars restored with nano-ceramic endocrown (P < 0.05). Repairable fractures in each group were as follows: control group 2/8, non-resin base group 1/8, retention depth of 2 mm group 1/8, retention depth of 3 mm group 2/8, and retention depth of 4 mm group 0/8. The effects of the retention depth and the presence of resin base on the fracture resistance of the resin nano-ceramic endocrowns were statistically significant (P < 0.05). Scanning electron microscopy showed more arrest lines and small twist hackles on the fracture surface of the restorations with resin base (retention depths of 2 mm, 3 mm, and 4 mm), with cracks extending towards the root. In addition to the characteristics above, more transverse cracks parallel to the occlusal surface, pointing outwards from the center of the pulp cavity retention, were also observed on the fracture surface of the non-resin base restorations.@*CONCLUSION@#When molar teeth with nano-ceramic endocrowns are restored, resin base and the retention depth of 2 mm help the teeth to obtain optimal fracture strength.

Influence of trueness for local finish lines of a full crown preparation on that of complete finish line / 北京大学学报(医学版)

OBJECTIVE@#To investigate the factors affecting the trueness of finish lines of full crown preparations in digital impressions.@*METHODS@#A full crown preparation of the right maxillary molar was prepared on the standard resin dentition model, the trueness of the finish lines, the full crown preparation in the whole dentition and the isolated full crown preparation were measured respectively. Detection of scanning trueness of the finish lines of the full crown preparation in the whole dentition: (1) Using Imetric scanner to scan the full crown preparation, obtaining STL (Stereo lithographic) format data as the reference true value; (2) Using CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner to scan the full crown preparation, obtaining all the STL format data, import Geomagic Studio 2013 software, extraction of images and data of the complete finish lines or local finish lines (mesial, distal, buccal, lingual) of the full crown preparation, then using the data to 3D Compare Analysis with the reference true value, outputting RMS (root mean square) values which could evaluate the scanning trueness, the lower RMS value was, the lower the trueness was. The detection of scanning trueness of the finish lines of the isolated full crown preparation: (1) the anterior and posterior adjacent teeth of the preparation were removed to establish the model of the isolated full crown preparation; (2) CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner were used to scan the isolated preparations, and each group was repeated 6 times. Data collection and analysis were the same as the first part, that is, detection of scanning trueness of finish lines of the full crown preparation in the whole dentition.@*RESULTS@#In the whole dentition, (1) the RMS value [(44±7) μm] of CEREC Omnicam oral scanner scanning complete finish lines was greater than that of 3Shape TRIOS oral scanner [(35±6) μm](P < 0.05). (2) the RMS values of the mesial [(45±9) μm], buccal [(38±3) μm] and lingual [(40±3) μm] finish lines in CEREC Omnicam oral scanner scanning were all lower than that in distal [(63±7) μm](P < 0.05), and the RMS values in mesial were higher than that in buccal and lingual (P>0.05). The RMS values of 3Shape TRIOS oral scanner scanning mesial and distal finish lines were significantly higher than those of the buccal and lingual side (P>0.05), in which:(45±8) μm in mesial, (50±10) μm in the distal, (33±8) μm in the buccal and (33±6) μm in the lingual side. The RMS value of CEREC Omnicam oral scanner scanning distal finish line was greater than that of 3Shape TRIOS oral scanner (P < 0.05). Without adjacent teeth, (1) the RMS values of the complete finish lines of CEREC Omnicam oral scanner and 3 Shape TRIOS oral scanner were significantly reduced (P < 0.05), including CEREC Omnicam oral scanner (34±3) μm and 3 Shape TRIOS oral scanner (26±4) μm; (2) the RMS values of the buccal and lingual finish lines of CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner showed no significant changes (P>0.05), among which, CEREC Omnicam oral scanner buccal (44±7) μm, lingual (43±3) μm, 3Shape TRIOS oral scanner buccal (29±5) μm, lingual (40±7) μm. The RMS values of CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner were significantly reduced and there was no significant difference between them (P>0.05). CEREC Omnicam oral scanner (32±8) μm and 3Shape TRIOS oral scanner (32±6) μm. The RMS values of the distal finish lines of CEREC Omnicam oral scanner and 3 Shape TRIOS oral scanner also decreased significantly (P < 0.05), and CEREC Omnicam oral scanner (38±3) μm decreased more significantly, similar to 3Shape TRIOS oral scanner (36±1) μm, P>0.05.@*CONCLUSION@#When adjacent teeth exist in the full crown preparation, the mesial and distal parts of the finish line will be blocked by adjacent teeth, which will affect the trueness of the local finish line, and ultimately reduce the trueness of the complete finish line.

Curing method affecting the formation of oxygen inhibition layer on the surface of resin cement / 北京大学学报(医学版)

OBJECTIVE@#To explore the conversion of resin monomer, the change of inorganic component and the influencing factors on the oxygen inhibition layer formed on the cured surface of resin cement.@*METHODS@#Three kinds of resin cement were divided into three groups: (1) light-cured group: RelyX Veneer, NX3 (light-cured), Variolink N; (2) dual-cured group: RelyX U200 Automix, NX3 (dual-cured), Multilink Speed; (3) chemically-cured group, and the above 3 types of dual-cured resin cement cured without illumination could be used as chemically-cured resin cement. Each sample was provided with and without oxygen exposure of two matching surfaces, cured respectively, and the variables of light intensity and illumination time were set in the light-cured group and the dual-cured group. Scanning electron microscopy was used to observe the samples' surface morphology. Energy dispersive spectrometer was used to analyze the samples' composition of surface elements. Confocal Raman spectroscopy was used to measure the monomer conversion of resin cement and to obtain the thickness of the oxygen inhibition layer.@*RESULTS@#(1) On the surface of cured resin cement, the weight percentage of oxygen element in the aerobic side was higher than that in the anaerobic side (P < 0.05), and the weight percentage of inorganic element was lower than that in the anaerobic side (P < 0.05). (2) The surface monomer conversion of the cured resin cement on the aerobic surface was significantly lower than that on the anaerobic surface (P < 0.05), and the surface monomer conversion on the aerobic surface and the anaerobic surface was the lowest in the chemically-cured group (P < 0.05), the dual-cured group was the highest (P < 0.05), and the light-cured group was between them. With the increase of light intensity or illumination time, the surface monomer conversion increased (P < 0.05). (3) The thickness of the oxygen inhibition layer was the thickest in the chemically-cured group [(40.27±2.81) μm](P < 0.05), the thinnest in the dual-cured group [(21.87±5.42) μm](P < 0.05) and light-cured group [(23.73±3.84) μm] was between them. With the increase of light intensity or illumination time, the thickness of the oxygen inhibition layer of resin cement decreased (P < 0.05).@*CONCLUSION@#When resin cement is exposed to oxygen, it will form an oxygen inhibition layer, its surface's inorganic filler is less, the surface monomer conversion is lower. The surface monomer conversion and the thickness of oxygen inhibition layer are affected by curing mode and illumination factors.

Characterization of Streptococcus oligofermentans sucrose metabolism demonstrates reduced pyruvic and lactic acid production / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Streptococcus (S.) oligofermentans is a newly identified bacteria with a yet to be defined mechanism of sucrose metabolism that results in acid production. This study aimed to investigate the biochemical mechanisms of S. oligoferm-entans glucose metaolism.</p><p><b>METHODS</b>The S. oligofermentans LMG21532, Lactobacillus (L.) fermentum 38 and the S. mutans UA140 were used to characterize sucrose metabolism by measuring lactate dehydrogenase (LDH) activity and lactic acid production. Continuous dynamics and high performance capillary electrophoresis were used to determine LDH activity and lactic acid production, respectively, from bacteria collected at 0, 10 and 30 minutes after cultured in 10% sucrose.</p><p><b>RESULTS</b>These analyses demonstrated that LDH activity of the three bacterial strains examined remained stable but significantly different throughout the sucrose fermentation process. The S. oligofermentans LDH activity ((0.61 ± 0.05) U/mg) was significantly lower than that of L. fermentum ((52.91 ± 8.97) U/mg). In addition, the S. oligofermentans total lactate production ((0.048 ± 0.021) mmol/L) was also significantly lower than that of L. fermentum ((0.958 ± 0.201) mmol/L). Although the S. oligofermentans LDH production was almost double of that produced by S. mutans ((0.32 ± 0.07) U/mg), lactic acid production was approximately one sixth that of S. mutans ((0.296 ± 0.058) mmol/L). Additional tests examining pyruvic acid production (the LDH substrate) demonstrated that lactic acid concentrations correlated with pyruvic acid production. That is, pyruvic acid production by S. oligofermentans was undetectable following sucrose incubation, however, (0.074 ± 0.024) and (0.175 ± 0.098) mmol/L pyruvic acid were produced by S. mutans and L. fermentum, respectively.</p><p><b>CONCLUSION</b>S. oligofermentans is incapable of fermenting carbohydrates to produce enough pyruvic acid, which results in reduced lactic acid production.</p>

A PC-based 3D stereoscopic medical visualization system / 中国医疗器械杂志

In this paper, a low-cost PC-based, high-quality and interactive 3D stereoscopic medical visualization system is presented, which can be clinically used for diagnosis and surgical planning. The algorithms of direct volume rendering have been improved for realization with the programmable graphics hardware under PC environment. Local illumination, classification and non-polygonal iso-surface rendering are also incorporated into the system in appropriate consideration of both high-quality rendering and real-time interaction. The medical visualization system has been applied to the neurosurgical and orthopedic planning and the effectiveness has been clinically proved.

Buffering effects of plaque solid, Streptococcus mutans and glucans / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the buffer capacity of insoluble plaque mass including bacteria and glucans matrix.</p><p><b>METHODS</b>Plaque samples (starved or incubated 1 h with 10% sucrose), Streptococcus mutans (S. mutans) mass, and insoluble/soluble glucans were titrated with 1 mmol/L HCl. Meanwhile, the density of bacteria was counted and related to buffer capacity.</p><p><b>RESULTS</b>The bacteria density had significant effects on acid buffer capacity in dental plaque, but the effect reduced with consuming sugar. S. mutans mass with no sucrose incubating contributed to the buffer capacity of (0.609 +/- 0.202) mmol/L, and S. mutans mass with 2% sucrose had only the buffer capacity of (0.099 +/- 0.047) mmol/L. In the mean time, glucans had no effect on acid buffering (0.028 - 0.032 mmol/L).</p><p><b>CONCLUSIONS</b>The bacteria including S. mutans may be the main contributor to acid buffering in plaque solid.</p>

Development and study of three-dimensional CT scanning system for dental cast measurement and analysis / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To develop a computer assisted CT scanning system for 3D dental cast measurement and to study its reliability.</p><p><b>METHODS</b>20 dental stone casts were scanned by helical CT and captured a series digital sliced radiographs of them. The program which was developed by Visual C 6.0 language and run under the Windows surroundings rebuilt the 3D graphics and measured the coordinate of the dental cast. These dental casts were scanned and measured to test the reliability of the system, contrasting with manual measurement.</p><p><b>RESULTS</b>There was no significant difference between 3D CT scanning and manual measurement (P > 0.05).</p><p><b>CONCLUSION</b>The system is a valuable computer assisted system for clinical diagnosis and treatment of malocclusion.</p>

The 3D PACS image system based on pipeline framework / 中国医疗器械杂志

We put forward an image rendering system based on pipeline framework for processing and displaying medical images. Compared to original computer graphics algorithms divided into volume rendering and surface rendering, this framework can effectively comprehend methods of computer graphics and image processing, import some new concepts such as vertex buffer, pixel buffer and texture buffer. We implement Shaded Surface Display, Maximum Intensity Projection, Digitally Reconstructed Radiography, Multi planar Reformation, Curved Planar Reformation and Interactive Virtual Endoscopy in our new developed PACS image system.