Clinical features of autoimmune encephalitis secondary to epidemic encephalitis B in 5 children / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features of children with autoimmune encephalitis (AE) secondary to epidemic encephalitis B (EEB).@*METHODS@#A retrospective analysis was performed on the medical data of five children with EEB with "bipolar course" who were treated in Children's Hospital Affiliated to Zhengzhou University from January 2020 to June 2022.@*RESULTS@#Among the five children, there were three boys and two girls, with a median age of onset of 7 years (range 3 years 9 months to 12 years) and a median time of 32 (range 25-37) days from the onset of EEB to the appearance of AE symptoms. The main symptoms in the AE stage included dyskinesia (5/5), low-grade fever (4/5), mental and behavioral disorders (4/5), convulsion (2/5), severe disturbance of consciousness (2/5), and limb weakness (1/5). Compared with the results of cranial MRI in the acute phase of EEB, the lesions were enlarged in 3 children and unchanged in 2 children showed on cranial MRI in the AE stage. In the AE stage, four children were positive for anti-N-methyl-D-aspartate receptor antibody (one was also positive for anti-γ-aminobutyric acid type B receptor antibody), and one was negative for all AE antibodies. All five children in the AE stage responded to immunotherapy and were followed up for 3 months, among whom one almost recovered and four still had neurological dysfunction.@*CONCLUSIONS@#EEB can induce AE, with anti-N-methyl-D-aspartate receptor encephalitis as the most common disease. The symptoms in the AE stage are similar to those of classical anti-N-methyl-D-aspartate receptor encephalitis. Immunotherapy is effective for children with AE secondary to EEB, and the prognosis might be related to neurological dysfunction in the acute phase of EEB.

Influence of thread shapes of custommade root-analogue implants on stress distribution of peri-implant bone: A three-dimensional finite element analysis / 北京大学学报(医学版)

OBJECTIVE@#To explore the effects from the thread shapes of custom-made root-analogue implant (RAI) on distributions of von Mises stress around the peri-implant bone.@*METHODS@#Five one-stage RAI three-dimensional finite element (FE) models with different thread shapes (V-shaped design, square design, buttress design, reverse buttress design and none thread design) and congruent bone were created through reverse engineering technology. The data of the five models were imported into the FE analysis software to calculate. A force of 100 N was applied parallelly and of 45° to the implant axis respectively. Analysis was performed to evaluate the von Mises stress distributions at the peri-implant regions with the help of the Ansys 16 software.@*RESULTS@#The von Mises stresses distributed mostly at the implant cervical regions and the tip ends of the threads on the cortical bone under oblique loading, while on the cancellous bone, the stresses concentrated mostly on the implant lateral cervical regions, the tip ends of the threads and the apical regions. When under vertical loading, the von Mises stresses distributed mostly at the implant cervical regions on the cortical bone while at the tip ends of the threads and the lateral apical regions on the cancellous bone. The von Mises stresses were better distributed on the thread groups under both kinds of loadings compared with no thread design. But there was no obvious difference among the different thread groups. The concentrations of the von Mises stresses on the cancellous bone in the thread groups were mostly at the tip ends of the threads while less in the apical area. The von Mises stresses were better distributed on the cancellous bone on the other three thread designs than on square design.@*CONCLUSION@#Thread designs are advocated for the reason that adding thread designs to the RAI standard design will have a positive effect on stress distributions at the peri-implant regions and it will reduce the concentrations of von Mises stresses on the cortical bone. From the standpoint of the stress distribution, V-shaped design, buttress design and reverse buttress design are more suitable for RAI than square design. There is no difference of the distributions of the von Mises stresses in the RAI between different thread designs.

Sinus floor elevation and simultaneous dental implantation: A long term retrospective study of sinus bone gain / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the sinus bone gains after sinus floor elevation procedures with or without grafts when implants were placed simultaneously.@*METHODS@#The research included 26 edentulous patients in the maxillary posterior region, who were divided into 2 different groups according to the sinus lift procedures employed: group of osteotome sinus floor elevation with bone grafts (group A) and group of osteotome sinus floor elevation without bone grafts (group B). The implants were placed simultaneously, and were followed for a period of 30-50 months after sinus floor elevation as routine and then were observed for sinus bone change.@*RESULTS@#There were 27 implants (13 implants for group A and 14 implants for group B) and the following time was 40.23 (36.20, 48.07) months. The residual bone height (RBH) was (6.64±1.21) mm for group A and ( 6.96±1.36) mm for group B; the difference between the two groups was not statistically significant (P=0.459).The sinus bone gain (SBG) when followed was (2.20±1.71) mm for group A, and 1.77 (0.94, 2.05) mm for group B; the difference between the two groups was not statistically significant (P = 0.583). The quality of apical bone around implant apex was divided into 3 categories which were excellent, fine and fair.The quality of apical bone around implant apex was excellent and fine for 9 implants in group A and 8 implants in group B, and the difference between the two groups was not statistically significant (Fisher exact test, P=0.695).The implant apex when followed was (0.09±1.32) mm below the new sinus floor for group A and (0.03±0.91) mm for group B, and the difference between the two groups was not statistically significant (P = 0.898). The SBG for the total was 1.85 (1.10, 2.20) mm. The SBG was statistically significantly only related to the protrusion height of the implant apex (r=0.383, P=0.049).@*CONCLUSION@#Sinus floor elevation procedures with or without grafts can all gain good results. The SBG is related to the protrusion height of the implant apex significantly.

A Meta-Analysis of the Efficacy of Glucagon-Like Peptide-1 Receptor Agonists on Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus / 中国药学杂志

OBJECTIVE: To evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RA) on nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). METHODS: The randomized controlled trials (RCTs) of GLP- 1 RA, placebo, and anti-diabetes drugs in the treatment of NAFLD in patients with T2DM were collected from PubMed, Embase, CNKI, Wangfang database, VIP, and CBM. The trials were evaluated for the quality and selected, and the results of the studies were reviewed and analyzed using RevMan 5.2 software. RESULTS: Four RCTs were included, involving 154 patients. The Meta-analysis showed that compared with the control group, GLP-1RA could significantly improve the ALT [MD: -8.36, 95% CI(-13.41-3.31), P = 0.001], HbA1c [MD: -0.43%, 95% CI(-0.73-0.31), P = 0.005], FBG [MD: -0.71%, 95% CI(-1. 39-0.03), P = 0.04], BMI [MD: -1.38%, 95% CI(-2.18-0.58), P = 0.000 8], TG [MD: -0.49%, 95% CI(-0.82-0.16), P = 0.004]. CONCLUSION: GLP-1 RA can obviously improve the metabolic index of patients with NAFLD and T2DM. Given the quality and quantity of the literature, large RCTs are still needed in the future.

Accuracy Assessment of Three-dimensional Surface Reconstructions of In vivo Teeth from Cone-beam Computed Tomography / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The accuracy of three-dimensional (3D) reconstructions from cone-beam computed tomography (CBCT) has been particularly important in dentistry, which will affect the effectiveness of diagnosis, treatment plan, and outcome in clinical practice. The aims of this study were to assess the linear, volumetric, and geometric accuracy of 3D reconstructions from CBCT and to investigate the influence of voxel size and CBCT system on the reconstructions results.</p><p><b>METHODS</b>Fifty teeth from 18 orthodontic patients were assigned to three groups as NewTom VG 0.15 mm group (NewTom VG; voxel size: 0.15 mm; n = 17), NewTom VG 0.30 mm group (NewTom VG; voxel size: 0.30 mm; n = 16), and VATECH DCTPRO 0.30 mm group (VATECH DCTPRO; voxel size: 0.30 mm; n = 17). The 3D reconstruction models of the teeth were segmented from CBCT data manually using Mimics 18.0 (Materialise Dental, Leuven, Belgium), and the extracted teeth were scanned by 3Shape optical scanner (3Shape A/S, Denmark). Linear and volumetric deviations were separately assessed by comparing the length and volume of the 3D reconstruction model with physical measurement by paired t- test. Geometric deviations were assessed by the root mean square value of the imposed 3D reconstruction and optical models by one-sample t-test. To assess the influence of voxel size and CBCT system on 3D reconstruction, analysis of variance (ANOVA) was used (μ = 0.05).</p><p><b>RESULTS</b>The linear, volumetric, and geometric deviations were -0.03 ± 0.48 mm, -5.4 ± 2.8%, and 0.117 ± 0.018 mm for NewTom VG 0.15 mm group; -0.45 ± 0.42 mm, -4.5 ± 3.4%, and 0.116 ± 0.014 mm for NewTom VG 0.30 mm group; and -0.93 ± 0.40 mm, -4.8 ± 5.1%, and 0.194 ± 0.117 mm for VATECH DCTPRO 0.30 mm group, respectively. There were statistically significant differences between groups in terms of linear measurement (P < 0.001), but no significant difference in terms of volumetric measurement (P = 0.774). No statistically significant difference were found on geometric measurement between NewTom VG 0.15 mm and NewTom VG 0.30 mm groups (P = 0.999) while a significant difference was found between VATECH DCTPRO 0.30 mm and NewTom VG 0.30 mm groups (P = 0.006).</p><p><b>CONCLUSIONS</b>The 3D reconstruction from CBCT data can achieve a high linear, volumetric, and geometric accuracy. Increasing voxel resolution from 0.30 to 0.15 mm does not result in increased accuracy of 3D tooth reconstruction while different systems can affect the accuracy.</p>

Active monitoring of the hospital admissions due to adverse drug reactions in endocrinology ward / 中国药学杂志

OBJECTIVE: To obtain the prevalence of hospital admissions due to adverse drug reactions (ADRs) and study the main features of the ADRs. METHODS: The clinical data of the inpatients of endocrinology ward from January 2011 to December 2013 were collected by clinical pharmacists by interviewing with patients. And the types of ADRs, clinical features, suspicious drugs, hospital stays, cost and turnover were analyzed. RESULTS: Among the 6914 patients, 40 patients (0.58%) were hospitalized due to ADRs, including 13 males and 27 females. The mean age was (54.82±15.85) y. The mean hospital stay was (12.85±1.51) d. The mean cost was (10622.86±6719.48) Yuan. The 40 hospital admissions were attributed to 11 types of ADRs caused by 27 suspected drugs. The ADRs included hypoglycaemia, agranulocytosis (neutropenia), hypokalemic, hypophosphatemic osteomalacia secondary to renal tubular damage, electrolyte disturbances, elevated hepatenzyme, insulin allergy, insulin autoimmune syndrome, hypothyroidism, and hyperthyroidism. The suspicious drugs included antidiabetics(insulin, oral antidiabetics and traditional Chinese medicines), methimazole, adefovir and corticoids. CONCLUSION: The prevalence of hospital admission due to ADRs in the endocrinology ward was 0.47%. The clinical characteristics of the ADRs such as hypoglycaemia, hypokalemic and electrolyte disturbances were similar to the clinical manifestation of some endocrine system diseases, which might affect the diagnosis and delay the therapy. So, we should pay attention to ADRs during the process of diagnosis and therapy.

Pharmaceutical care of five cases of hypophosphatemic osteomalacia secondary to renal tubular damage caused by adefovir / 中国药学杂志

OBJECTIVE: To summarize the outcomes and clinical features of hypophosphatemic osteomalacia secondary to renal tubular damage caused by adefovir and put forword the key points of pharmaceutical care for these patients. METHODS: Literature was retrieved about hypophosphatemic osteomalacia secondary to renal tubular damage caused by adefovir in recent years. Combining the clinical situations of five patients with the named damage, they were treated with complement of phosphorus preparations and monitored for related clinical indicators. RESULTS: The possible mechanisms of adefovir for causing hypophosphatemic osteomalacia secondary to renal tubular damage is gene defect. Hypophosphatemic osteomalacia often occurrs in patients taking small doses (10 mg · d-1) of adefovir for more than one year. The symptoms aggravate over time. By withdrawing adefovir or switching to other antiviral drugs and giving syptomatic treatment with phosphorus, calcium, and vitamin D supplements and other measures, good prognosis was achieved. CONCLUSION: Hypophosphatemic osteomalacia secondary to renal tubular damage caused by adefovir is lack of specific clinical features, which is easy to be misdiagnosed, therefore attention should be paid by clinical professionals.