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1.
Chinese Journal of Digestion ; (12): 522-527, 2021.
Article in Chinese | WPRIM | ID: wpr-912206

ABSTRACT

Objective:To investigate the overlapping prevalence and risk factors of gastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) among rural adults in Shaanxi Province.Methods:From February 1 to October 31 in 2019, 12 villages in Shaanxi Province were randomly selected for household questionnaire survey through multistage stratified cluster sampling. A total of 2 423 subjects were enrolled, including 1 037 males and 1 386 females, with age of (45.3±16.9) years old. GERD was diagnosed according to the Montreal criteria, FD and IBS were diagnosed according to the Rome Ⅳ criteria. The overlapping prevalence of the three diseases were calculated. The risk factors for the overlapping of GERD, FD and IBS were analyzed. Multivariate logistic regression was used for statistical analysis.Results:Among the 2 423 subjects, 624 cases had GERD (302 cases), FD (377 cases) or IBS (167 cases), of which 30.77% (192/624) patients had overlap of ≥two diseases. The overlap rates of GERD and FD, GERD and IBS, FD and IBS, GERD, FD and IBS were 2.56% (62/2 423), 1.61% (39/2 423), 2.52% (61/2 423) and 1.24% (30/2 423), respectively. The results of Multivariate analysis showed that female and migraine without aura were positively correlated with the overlap of GERD and FD, FD and IBS, and GERD and IBS (odds ratio ( OR)=3.08, 2.68, 3.66, 7.37, 5.91 and 4.46, 95% confidence interval ( CI) 1.35 to 7.01, 1.35 to 5.30, 1.52 to 8.83, 3.97 to 13.69, 1.78 to 19.60 and 2.01 to 9.92; all P<0.05). Heavy drinking (alcohol intake≥50 g/d (male) or≥30 g/d (female)) was positively correlated with the overlap of FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=3.69, 4.20 and 4.91, 95% CI 1.19 to 11.48, 1.01 to 17.50 and 1.23 to 19.52; all P<0.05). Heavy smoking (smoking≥20 cigarettes per day) was positively correlated with the overlap of GERD and FD, FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=3.44, 6.25, 8.27 and 7.04, 95% CI 1.07 to 11.01, 1.60 to 24.44, 1.80 to 38.07 and 1.76 to 28.12; all P<0.05). The educational level of junior or senior high school and age≥60 years old were negatively correlated with the overlap of GERD and FD, FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=0.47, 0.29, 0.20, 0.05, 0.23, 0.10, 0.37 and 0.16, 95% CI 0.23 to 0.93, 0.09 to 0.95, 0.09 to 0.42, 0.01 to 0.19, 0.09 to 0.60, 0.02 to 0.65, 0.15 to 0.87 and 0.03 to 0.81; all P<0.05). Conclusions:The overlap of GERD, FD and IBS is common and affected by many factors. Female, age≥60 years old, heavy smoking, heavy drinking, low education level and history of migraine without aura are associated with multiple overlaps of GERD, FD and IBS.

2.
Chinese Journal of Urology ; (12): 485-490, 2021.
Article in Chinese | WPRIM | ID: wpr-911055

ABSTRACT

Objective:To evaluate the safety and efficacy of Toumai ? endoscopic robotic system in radical prostatectomy. Methods:This study was a single-center phase Ⅲ randomized controlled study. From June 2020 to January 2021, patients with prostate cancer who met the inclusion criteria in Changhai Hospital Affiliated to Naval Military Medical University were divided into the experimental group and the control group by random table method. Inclusion criteria included aged 18 to 80 years, pathologically diagnosed as prostate cancer, clinical stage ≤T 2N 0M 0. Exclusion criteria included patients requiring emergency surgery, having serious cardiovascular diseases and cannot tolerate surgery, having participated in other investigational drug or device clinical trials within the last 3 months. The experimental group used Toumai ? laparoscopic robotic system, and the continence group used the Da Vinci robotic system. The patients in both groups underwent radical prostatectomy via a transabdominal approach, which was performed by two surgeons. The clinical characteristics between the two groups were compared, related adverse events were recorded, and PSA and urinary continence were followed up one month after the operation. Results:A total of 44 patients were enrolled in this study, including 22 cases in the experimental group and 22 cases in the control group. The mean age of patients in the trial group and the control group was (67.7±7.5) years and (66.4±6.3) years, respectively. The median PSA at diagnosis was 10.5 (7.7, 23.7) ng/ ml and 13.5 (8.9, 24.7) ng/ ml, respectively. Biopsy Gleason score of 6, 7, 8 and 9 in experimental group were 13.6% (3/22), 68.2% (15/22), 4.5% (1/22) and 13.6% (3/22), respectively, and in the control group were 4.5% (1/22), 59.1% (13/22), 22.7% (5/22) and 13.6% (3/22) respectively. The middle risk and high risk group in the experimental group was 50.0% (11/22), 50.0% (11/22), and the control group was 36.4% (8/22), 63.6% (14/22). There was no statistical difference between the two groups.The operations in both groups were successfully performed. There were no conversions to open or laparoscopic surgeries, and no Clavien-Dindo grade Ⅲcomplications. There was no significant difference in the estimated blood loss during the operation [(109.1±51.6)ml vs.(94.5±51.6)ml] and the blood transfusion rate [9.1%(2/22)vs. 4.5%(1/22)] in both groups. The operation time was significantly higher in the experimental group than that in the control group [164.5(130.5, 214.3) min vs. 88.0(65.3, 110.5)min, P<0.001]. The positive rate of surgical margin was 13.6% (3/22) in the experimental group and 36.4% (8/22) in the control group, respectively, showing no significant difference. The pathologic stages of pT 2, pT 3a and pT 3bin experimental group were 63.6% (14/22), 13.6% (3/22) and 22.7% (5/22), respectively, while those in control group were 36.3% (8/22), 40.9% (9/22) and 22.7% (5/22), respectively, showing no significant difference. The recovery rates of urine control in the experimental group and the control group were 22.7% (5/22) and 22.7% (5/22), respectively. The median PSA in the experimental group and the control group were 0.055 (0.021, 0.103) ng/ ml and 0.032 (0.010, 0.089) ng/ ml, respectively, with no statistical difference. Conclusions:The Toumai ? endoscopic robotic system can successfully perform radical prostatectomy, based on insignificant difference from Da Vinci robotic system in safety and efficacy. The short-term follow-up showed that tumor control and urinary continence have recovered well in the test group. The long-term effect of the new system on tumor control and functional recovery after radical prostatectomy needs further multi-center studies.

3.
Chinese Journal of Urology ; (12): 233-236, 2021.
Article in Chinese | WPRIM | ID: wpr-884996

ABSTRACT

In recent years, with the development of sequencing technology and research on molecular changes in different races of prostate cancer, it has been found that the pathogenesis of prostate cancer showed obvious ethnic differences. This article reviewed the research progress of ETS fusion genes, FOXA1, SPOP, IDH1 and other driver genes in prostate cancer. And the research of molecular typing of prostate cancer showed different patterns of molecular changes in Chinese and western populations. The molecular changes of prostate cancer in western populations were dominated by ETS fusion gene, while those in Chinese populations were dominated by gene mutations, mainly FOXA1 and SPOP mutations. Moreover, the dominant fusion gene in Chinese prostate cancer was not ETS fusion gene, but SCHLAP1-UBE2E3.

4.
Chinese Journal of Urology ; (12): 26-31, 2020.
Article in Chinese | WPRIM | ID: wpr-798858

ABSTRACT

Objective@#To investigte the efficacy of docetaxel combined with androgen deprivation therapy for the treatment of metastatic hormone-sensitive prostate cancer based on Chinese population.@*Methods@#A total of 497 patients were enrolled from January 2004 to July 2018 in the Changhai Hospital. 459 patients received androgen deprivation therapy alone and 38 patients received androgen deprivation therapy combined with docetaxel. The mean age was (72.1±8.7)years. The median PSA level was 100.0 ng/ml, ranging 42.3-999.0 ng/ml. Patients of clinical T2, T3, T4 stage were 213(42.9%), 160(32.2%), 124(24.9%), respectively. Patients of clinical N0, N1, Nx stage were 319(64.2%), 144(29.0%), 34(6.8%), respectively. Patients of clinical M0, M1a, M1b, M1c, Mx stage were 100(20.1%), 51(10.3%), 332(66.8%), 9(1.8%), 5(1.0%), respectively. Gleason scores of biopsy showed that 146(29.4%) patients was ≤7, 103(20.7%) was 8 and 248(49.9%)was ≥9. Propensity score matching was used to match the baseline between groups. Caliper value was set at 0.02. SPSS 22 software was used to achieve a 1∶1 match between the two groups. There were no statistical difference in the age(P=0.102), PSA(P=0.713), T stage(P=0.113), N stage(P=0.226), M stage(P=0.514), Gleason score(P=0.612), tumor loading(P=0.812)between the two groups. The castration resistance-free rate and cancer specific survival rate of the two groups were compared by log-rank and breslow-wilcoxon test. Furthermore, forest plots were used to display the analysis results of different subgroups such as age, PSA, clinical stage, Gleason score, tumor load, whether patients had received palliative resection, and the differences in castration resistance-free rate were compared between the subgroups with high tumor load.@*Results@#The median follow-up time was 22.6 months in the androgen deprivation therapy group and 13.7 months in the combined therapy group. The number of patients with castration resistance in the two groups was 23 and 17, respectively. There were 3 and 6 deaths, respectively. There was no statistically significant difference in the overall progression time to castration resistance between the two groups (10.3 m vs. 16.5 m, P>0.05), and no statistically significant difference in the prostate cancer specific survival rate (21.9 m vs.14.8 m, P>0.05). When subgroup analysis was performed, it was found that patients in the high-metastasis-volume subgroup who received the combination therapy had a significantly longer castration resistance free lifetime (10.6 m vs. 7.2 m, P=0.044), but there was no significant difference in the low- metastasis-volume subgroup(10.5 m vs.12.6 m, P>0.05).@*Conclusion@#Docetaxel combined with androgen deprivation therapy can improve the castration resistance free rate in patients with high metastasis volume, but not in low metastasis volume group.

5.
Article in Chinese | WPRIM | ID: wpr-827523

ABSTRACT

OBJECTIVE@#To observe the changes of forward displacement of maxillary complete denture during centric occlusion, three different methods were used to record the changes of vertical overlap and the comfort level of patients before and after the selective grinding of the three dentures made according to maxillo-mandibular horizontal relationship record.@*METHODS@#Twelve edentulous patients with normal stomatognathic system were recruited in this study. Three types of complete dentures for these 12 edentulous patients were made according to their different maxilla-mandibular horizontal relationship record methods. The amount of displacement of the maxillary complete denture, the vertical overlap of the anterior teeth as well as patient comfort level were recorded before and after selective grinding. Statistical analysis was performed using the SPSS 17.0 software package.@*RESULTS@#Before selective grinding, the amount of displacement of denture A was significantly larger than those of dentures B and C (P0.05). During selective grinding, the vertical overlap variation of denture A was significantly greater than those of dentures B and C (P0.05). After selective grinding, no statistical difference was found among the three dentures (P>0.05).@*CONCLUSIONS@#Among the complete dentures with anatomical teeth, the dentures whose horizontal relationship was recorded at 1 mm before the apex of the Gothic arch apex and with checkbite are more in line with clinical repair requirements. Complete dentures whose horizontal relationship was recorded at the apex of Gothic arch need to be adjusted with selective grinding to meet the clinical restoration requirements.


Subject(s)
Dental Occlusion, Centric , Denture, Complete , Humans , Mandible , Maxilla , Mouth, Edentulous
6.
Chinese Medical Journal ; (24): 127-133, 2020.
Article in English | WPRIM | ID: wpr-781623

ABSTRACT

BACKGROUND@#The role of local treatment in oligometastatic prostate cancer (PCa) is gaining interest with the oligometastases hypothesis proposed and the improvement of various surgical methods and techniques. This study aimed to compare the short-term therapeutic outcomes of robotic-assisted laparoscopic radical prostatectomy (RALP) for oligometastatic prostate cancer (OPC) vs. localized PCa using propensity score matching.@*METHODS@#Totally 508 consecutive patients underwent RALP as a first-line treatment. The patients were divided into two groups according to oligometastatic state: the OPC group (n = 41) or the localized PCa group (n = 467). Oligometastatic disease was defined as the presence of two or fewer suspicious lesions. The association between the oligometastatic state and therapeutic outcomes of RALP was evaluated, including biochemical recurrence (BCR) and overall survival (OS). A Cox proportional hazards model was used to assess the possible risk factors for BCR.@*RESULTS@#Totally 41 pairs of patients were matched. The median operative time, the median blood loss, the overall positive surgical margin rate, the median post-operative hospital stays, and the post-operative urinary continence recovery rate between the two groups showed no statistical significance. The 4-year BCR survival rates of the OPC group and localized PCa group were 56.7% and 60.8%, respectively, without a significant difference (P = 0.804). The 5-year OS rates were 96.3% and 100%, respectively (P = 0.326). Additionally, the results of Cox regression showed that oligometastatic state was not an independent risk factor for BCR (P = 0.682).@*CONCLUSIONS@#Our findings supported the safety and effectiveness of RALP in OPC. Additionally, oligometastatic state and sites did not have an adverse effect on BCR independently.

7.
Chinese Journal of Urology ; (12): 205-209, 2020.
Article in Chinese | WPRIM | ID: wpr-869629

ABSTRACT

Objective:To establish a nomogram model for predicting positive resection margins after prostate cancer surgery, and to perform the corresponding verification, in order to predict the risk of positive resection margins after surgery.Methods:A total of 2 215 prostate cancer patients from The First Affiliated Hospital of Naval Medical University, Hospital, Peking University First Hospital, Peking University Third Hospital, Peking University, and First Affiliated Hospital of Xi′an Jiaotong University were included in the PC-follow database from 2015 to 2018, and a simple random sampling method was used. They were divided into 1 770 patients in the modeling group and 445 patients in the verification group. In the modeling group, the age (<60 years, 60 to 70 years, >70 years), PSA (<4 ng/ml, 4-10 ng/ml, 11-20 ng/ml, >20 ng/ml), pelvic MRI (negative, suspicious, positive), clinical stage of the tumor (T 1-T 2, ≥T 3), percentage of positive needles (≤33%, 34%-66%, >66%), Gleason score of biopsy pathology (≤6 points, 7 points, ≥8 points). Univariate and multivariate logistic analysis were performed to screen meaningful indicators to construct a nomogram model. The model was used for validation in the validation group. Results:The results of multivariate analysis showed that preoperative PSA level ( OR=2.046, 95% CI 1.022 to 4.251, P=0.009), percentage of puncture positive needles ( OR=1.502, 95% CI 1.136 to 1.978, P=0.002), Gleason score of puncture pathology ( OR=1.568, 95% CI 1.063 to 2.313, P=0.028), pelvic MRI were correlated ( OR=1.525, 95% CI 1.160 to 2.005, P=0.033). Establish a nomogram model for independent predictors of positive margin of prostate cancer. The area under the receiver operating characteristic (ROC) curve of the validation group is 0.776. The area under the ROC curve of the preoperative PSA level, percentage of puncture positive needles, puncture pathology Gleason score, pelvic MRI, postoperative pathology Gleason score were 0.554, 0.615, 0.556, 0.522, and 0.560, respectively. The difference between the nomogram model and other indicators was statistically significant ( P<0.05). Conclusions:The constructed nomogram model has higher diagnostic value than the preoperative PSA level, percentage of puncture positive needles, Gleason score of puncturing pathology, pelvic MRI, and postoperative pathological Gleason score in predicting positive margin.

8.
Chinese Journal of Geriatrics ; (12): 1059-1062, 2020.
Article in Chinese | WPRIM | ID: wpr-869528

ABSTRACT

Objective:To investigate the risk factors for Gleason score upgrading after radical prostatectomy in clinical low-risk prostate cancer patients aged≥65 years.Methods:A total of 485 clinical low-risk prostate cancer patients aged≥65 years at five centers of the national multi-center PC-follow database from January 2015 to March 2019 were retrospectively analyzed.Data including age at diagnosis, prostate-specific antigen(PSA), MRI prostate imaging, puncture Gleason score, operation method, puncture method, positive incision margin and capsule penetration were collected.Differences in Gleason scores before and after operation were compared, and the risk factors for Gleason score upgrading after radical resection were evaluated by univariate and multivariate Logistic regression analysis.Results:Of 485 patients with a puncture Gleason score of 3+ 3=6, 261(53.8%)cases had postoperative pathological upgrading, in whom 228(87.4%)cases had Gleason score upgrading of 7, 22(8.4%)had Gleason score upgrading of 8, and 11(4.2%)had Gleason score upgrading of 9 or more.The rate of Gleason score upgrading was elevated with increased preoperative PSA levels, positive pelvic MRI, and higher positive rates of puncture biopsy.The incidences of postoperative capsule penetration(27.2% vs.12.5%, P<0.001)and positive incision margin(25.2% vs.17.4%, P=0.036)had statistically significant differences between the pathologically upgraded group and the pathologically non-upgraded group.Multivariate analysis showed that preoperative PSA level, percentage of positive puncture biopsies, biopsy Gleason score and pelvic MRI were independent predictors of prostate cancer. Conclusions:For clinical low-risk prostate cancer patients aged≥65 years with high risk factors for Gleason score upgrading, repeated biopsies should be carried out when necessary and the treatment plan should be adjusted accordingly.

9.
Article in Chinese | WPRIM | ID: wpr-743835

ABSTRACT

BACKGROUND: It has been pointed out that perioperative hypothermia can increase the incidence of coagulation, acidosis, stroke, sepsis, pneumonia and myocardial infarction, so it is of great significance to monitor and maintain normal body temperature during perioperative period. OBJECTIVE: To design a medical carbon fiber thermostatic heating pad to prevent perioperative hypothermia and reduce complications. METHODS: The carbon fiber heating technology and medical equipment standard are combined and integrated into many advanced technologies. The system mainly consisted of power supply conversion, operation system, computer control system, PWM control and output, various heating pads and temperature controlling measurement system. A total of 200 patients undergoing epidural anesthesia in Zhengzhou First People's Hospital were randomly divided into two groups: the observation group (n=100) was treated with the medical carbon fiber thermostatic heating pad (adjusting temperature 38-40 oC), and the control group (n=100) with common quilt. The body temperature and shivering were monitored before operation, 10, 30 and 60 minutes after anesthesia, and 2 hours after operation. RESULTS AND CONCLUSION: (1) The heating pad had the characteristics of explosion proof, power purification, shielding isolation, output protection, computer control, and PWM modulation. (2) In clinical application, there was no skin irritation and skin allergy reaction in the observation group. (3) During operation, the body temperature of the observation group was relatively stable, and there was no significant difference in the body temperature in the observation group before and at 2 hours after operation (P> 0.05). However, the fluctuation of body temperature in control group was visible and showed a downward trend, and the body temperature in the control group showed a significant difference before and 2 hours after operation (P < 0.05). The body temperature of 10, 30, 60 minutes after anesthesia and 2 hours after operation was significantly higher in the observation group than the control group (P < 0.05). (4) The postoperative incidence of shivering in the control group was significantly higher than that in the observation group (18% vs. 5%, P < 0.05). To conclude, the medical carbon fiber thermostatic heating pad is advanced in technology, safe and reliable in use, providing a new way for the prevention of perioperative shivering.

10.
Chinese Journal of Urology ; (12): 596-600, 2019.
Article in Chinese | WPRIM | ID: wpr-755494

ABSTRACT

Objective This retrospective study compared the detection rates of prostate cancer between freehand transperineal biopsy (FTPB) and template-guided transperineal biopsy (TYPB) in the patients with PSA levels < 20 ng/ml.Methods From April 2017 to April 2019,768 patients with PSA levels < 20 ng/ml were included into this study.Of these patients,406 underwent FTPB procedures and 362 underwent TTPB procedures.There were no significant differences of median age [66.00(61.00,70.00)vs.66.00 (61.00,71.25) years],height [170.00 (165.00,172.00) vs.170 (165.00,173.00) cm],weight [70.00 (63.88,75.00) vs.70.00 (63.75,75.00) kg],BMI [24.22 (22.22,25.95) vs.24.22 (22.49,25.82) kg/m2],PSA [8.75 (6.49,12.40) vs.8.69 (6.49,11.96) ng/ml],fPSA [1.18 (0.33,2.15) vs.1.15(0.76,1.88)ng/ml],prostate volume [39.79(25.55,53.94)vs.39.88(24.46,55.11)ml] between two groups.Patients' biopsy results were recorded,the differences of prostate cancer detection rates between these two groups were analyzed,specifically including the cancer with Gleason score ≥ 7 and the anterior zone cancer.Results The total prostate cancer detection rates were 33.7% (137/406) and 39.0% (141/362,P =0.134) in FTPB group and TTPB group respectively,and the detection rates of cancer with Gleason score≥7 were 23.9% (97/406) and 32.0% (116/362,P =0.012) respectively.The detection rates of anterior zone prostate cancer were 15.5% (63/406) and 27.3% (99/362,P <0.001).Moreover,in thepatients with PSA < 10 ng/ml,the prostate cancer detection rates were 29.8% (74/248) and 36.2% (81/224,P =0.144) respectively,while the detection rates of cancer with Gleason score ≥7 were 19.4% (48/248) and 29.9% (67/224,P =0.008) respectively.Conclusions There was no significant difference in the total prostate cancer detection rates between 12-core TTPB group and 20-core FTPB group in the patients with PSA < 20 ng/ml,but for the detection rate of cancer with Gleason score ≥ 7,TTPB group was significantly higher than FTPB group,especially in the patients with PSA < 10 ng/ml.In addition,for anterior zone prostate cancer,the detection rate of TrPB group was also higher than FTPB group.

11.
Article in Chinese | WPRIM | ID: wpr-781672

ABSTRACT

OBJECTIVE@#To investigate the long-term effect of posterior lumbar pedicle screw fixation combined with isthmus bone grafting and fusion in young patients with spondylolysis.@*METHODS@#A retrospective study was carried out, consisting of 16 young patients with lumbar spondylolysis without spondylolisthesis treated by lumbar posterior pedicle screw fixation combined with isthmic bone grafting fusion from January 2006 to July 2014. There were 11 males and 5 females, aged from 18 to 21 years old, with an average age of 19.3 years old, and the course of disease ranged from 12 to 26 months, with an average of 22 months. All the patients suffered from lumbar pain and difficulty in getting out of bed. Preoperative CT confirmed 12 cases of L₅ isthmus fissure and 4 cases of L₄ isthmus fissure. Bone graft fusion was confirmed and internal fixation was removed after operation. Lumbar spondylolysis was evaluated by lumbago visual analogue scoring method at preoperative and postoperative time points. Lumbar isthmic fusion was evaluated by lumbar CT, and degeneration of fixed and adjacent segments of lumbar intervertebral disc was evaluated by lumbar MRI.@*RESULTS@#Of the 16 patients, 13 patients (26 sides) were followed up, with a mean duration of 96 months. The operation time ranged from 80 to 105 minutes, with an average of 95 minutes. The intraoperative bleeding volume ranged from 150 to 300 ml, with an average of 225 ml. All the patients were successfully operated without any complications related to the operation. VAS scores at each time point after operation were improved compared with those before operation(<0.01). Postoperative CT scans of lumbar spine showed osseous fusion at 6 to 14 months, with an average of 12 months. There were no changes of adjacent segment degeneration, fixed segment disc degeneration and protrusion on lumbar spine MRI, and no symptomatic recurrence or recurrent spondylolysis in the long term.@*CONCLUSIONS@#The posterior lumbar pedicle screw fixation combined with isthmic bone grafting and fusion is safe and effective in the treatment of young spondylolysis. The fusion rate is high and the interference of normal physiological range is reduced. The long-term effect is satisfactory.


Subject(s)
Adolescent , Bone Transplantation , Female , Humans , Lumbar Vertebrae , Male , Pedicle Screws , Retrospective Studies , Spinal Fusion , Spondylolysis , General Surgery , Treatment Outcome , Young Adult
12.
Article in Chinese | WPRIM | ID: wpr-781363

ABSTRACT

OBJECTIVE@#This study evaluates the effects of different endodontic access methods and full-ceramic crown on the stress distribution in the maxillary central incisor by using three-dimensional finite element analysis.@*METHODS@#Computed tomography scans of the maxillary central incisor were used to construct a three-dimensional finite element model of the maxillary central incisor. According to the different methods of endodontic and the prosthetic treatments, four models were established, namely, group A (traditional access cavity preparation with resin filling), group B (traditional access cavity preparation restored full-ceramic crown), group C (minimally invasive endodontics with resin filling) and group D (minimally invasive endodontics restored full-ceramic crown). A static force of 100 N and a direction of 45° was applied to the long axis of the tooth at the junction of the incisal section one-third and middle section one-third. The maximum principal stress, the von Mises stress and the modified von Mises stress of the tooth tissue were analyzed using the finite-element analysis software.@*RESULTS@#1) Stress peaks: the stress peaks of the maximum principal stress, the von Mises stress and the modified von Mises in group A were the largest, except that the stress peak of von Mises stress in group D was slightly lower than that in group C. The stress peaks of the maximum principal stress and the modified von Mises in group C were the lowest. The stress peaks of the maximum principal stress and the modi-fied von Mises stress in group D were lower than those in groups A and B. 2) Stress distribution: compared with group A, the stress distribution of cervical dentin and the area of stress concentration in group C was lower and smaller. In the root dentin, the stress distribution in group C was more uniform than that in group A, and the stress was dispersed to several areas of the root apex. After crown restoration, no significant difference was observed in stress distribution between groups B and D in the root region. The stress distribution state of group B was not significantly different from that of group A. No significant difference was observed in the stress distribution state between groups D and C.@*CONCLUSIONS@#1) From the perspective of biomechanics, the minimally invasive access was adopted for the maxillary central incisor. 2) Full crown restoration is recommended after traditional access cavity preparation. No obvious advantage is observed in stress analysis for minimally invasive endodontics-restored full-ceramic crown.


Subject(s)
Crowns , Dental Stress Analysis , Dentin , Finite Element Analysis , Incisor , Post and Core Technique , Stress, Mechanical , Tooth Crown
13.
Article in Chinese | WPRIM | ID: wpr-772703

ABSTRACT

OBJECTIVE@#This study aimed to compare the passive fits of implant-supported cement-retained computer aided design/computer aided manufacturing (CAD/CAM) bridges fabricated with different implant superstructure designs from zirconia and titanium.@*METHODS@#A total of 32 cubic clods with the same dimensions and with elastic modulus similar to that of mandibles were used. Each clod received two one-stage implants to simulate a partially edentulous jaw that was missing teeth between the lower left second premolar and second molar. Four linear strain gauges were bonded on the region surrounding each implant on the mesial, buccal, distal, and lingual aspects. A total of 32 identical frameworks were fabricated through CAD/CAM after scanning. The frameworks were allocated into four different groups (n=8) in accordance with material types and superstructure designs. Group A included zirconia ceramic implant-supported fixed prostheses with regular marginal designs. Group B comprised zirconia ceramic implant-supported fixed prostheses with full circumferential zirconia-collar marginal designs. Group C consisted of titanium ceramic implant-supported fixed prostheses with regular marginal designs. Group D included titanium ceramic implant-supported fixed prostheses with full circumferential titanium-collar marginal designs. Strain development before and after ceramic veneering was recorded during cement setting. Data were statistically analyzed by using SPSS software.@*RESULTS@#Before ceramic veneering, material types affected the strains of prostheses, and zirconia frameworks showed lower strain than other frameworks (P0.05). Nevertheless, the full circumferential collar marginal design reduced discrepancies among groups (P<0.01).@*CONCLUSIONS@#The passive fits of zirconia prostheses were better than those of titanium-based porcelain-fused-to-metal restorations. The full circumferential collar marginal design can help reduce fit inaccuracy, as well as the adverse effects of ceramic veneering.


Subject(s)
Computer-Aided Design , Dental Porcelain , Dental Prosthesis Design , Dental Prosthesis, Implant-Supported , Denture, Partial, Fixed , Titanium , Zirconium
14.
Article in Chinese | WPRIM | ID: wpr-838296

ABSTRACT

IN post-human genomic era, the concept of precision medicine has provided opportunities for “reinterpretation” and “new orientation” for cancer therapy including prostate cancer. Prostate cancer is the leading cause of cancer-related death in men, and its traditional treatment meets bottleneck and needs broken through, while the concept of precision medicine is starting to have positive effect. Precision medicine has potential values in optimizing the clinical reclassification of patients, androgen deprivation therapy (ADT), chemotherapy, and radiation therapy strategies for prostate cancer. When traditional treatment of prostate cancer gradually loses efficacy, the prostate cancer molecular subtyping map and the development of targeted therapies are expected to bring new breakthrough. At the same time, precision medicine also prompts new therapeutic concepts for prostate cancer, such as reconstruction of the immune environment, tumor-specific neoantigens prediction, and organoid culture system. The future of precision medicine has been widely embraced and it will have promising application in the diagnosis and treatment of prostate cancer. However, currently the benefit of precision treatment of cancer is still far below the public expectations. Like for many emerging concepts, the potentially huge market behind precision medicine inevitably breeds overheated commercial propaganda. Full communication and cooperation of scientific researchers with clinical doctors and patients, and standardization and guidance of health administration are the keys to ensure that precision medicine benefits for human health.

15.
Article in Chinese | WPRIM | ID: wpr-805914

ABSTRACT

Objective@#To study the intracellular location and characteristic of SFTSV NP protein in different phases using mini singlet oxygen generator (miniSOG) labeling technique.@*Methods@#MiniSOG is a recently-invented genetically-encoded tag for EM. MiniSOG-fused SFTSV NP (NPSOG) gene was cloned by PCR, and inserted into pcDNA3.0 plasmid to form pTPL-NPSOG, which was used to transfect 293 cells. The transfected cells of different phases were fixed in 2.5% glutaraldehyde in situ, stained with DAB through the photooxidation activity of miniSOG, and used to prepare ultrathin sections. Intracellular location and characteristic of SFTSV NP protein in different phases were studied by observing the sections under transmission electron microscope.@*Results@#After transfecting the plasmid with NPSOG to 293 cells, NP protein was expressed in cytoplasm and peri nucleus, and gradually aggregated, which connected with endoplasmic reticulum and Golgi apparatus to form larger volume and irregular inclusion bodies in cytoplasm. No obvious subcellular structure changes were found.@*Conclusions@#The SFTSV nucleoprotein can be expressed separately to form inclusion bodies without the assistance of other viral proteins. The formation of inclusion bodies requires the directional movement and aggregation of a certain number of NP proteins, which may involve the interaction of NP protein and host organelles during this period.

16.
Article in Chinese | WPRIM | ID: wpr-772465

ABSTRACT

OBJECTIVE@#This investigation aimed to develop a novel self-healing and antibacterial dental resin composite. The effects of water immersion on its properties were also evaluated.@*METHODS@#Microcapsules filled with healing agent of triethylene glycol dimethacrylate were synthesized on the basis of previous studies. Antibacterial resin composite contained nano-antibacterial inorganic fillers that were modified by quaternary ammonium salt with long-chain alkyl. Microcapsules were incorporated into antibacterial resin composite at mass fraction of 7.5%. A commercial resin composite named Tetric N-Ceram was used as control. The resin samples were immersed in 37 °C distilled water for different periods. A flexural test was used to measure the mechanical properties of the novel resin composite. A single-edge V-notched beam method was used to measure fracture toughness and self-healing efficiency. A dental plaque microcosm biofilm model with human saliva as inoculum was formed. Colony-forming units (CFU) and lactic acid production of biofilm on the novel resin composite were calculated to test the antibacterial property.@*RESULTS@#Mechanical properties and fracture toughness decreased significantly after the composite was immersed in water for 30 days (P0.05). Water immersion did not weaken the self-healing capability of the composite (P>0.05), and self-healing efficiency of 64% could still be obtained even after 270 days. The antibacterial resin composite showed a strong inhibition effect on the biofilm metabolic activity versus water immersion time from 1 day to 270 days. Therefore, the composite could still have a promising antibacterial property even after being immersed in water (P<0.05).@*CONCLUSIONS@#Water immersion could weaken the mechanical properties of the novel self-healing and antibacterial resin composite, but it insignificantly affected the self-healing and antibacterial properties of the composite.


Subject(s)
Anti-Bacterial Agents , Biofilms , Capsules , Composite Resins , Dental Plaque , Humans , Materials Testing , Methacrylates , Water
17.
Article in Chinese | WPRIM | ID: wpr-688178

ABSTRACT

<p><b>OBJECTIVE</b>To detect potential mutations of PHEX gene in four pedigrees affected with hypophosphatemic rickets (HR) and provide prenatal diagnosis for a fetus at 13th gestational week.</p><p><b>METHODS</b>The coding regions and exon/intron boundaries of PHEX, FGF23, DMP1, ENPP1, CLCN5 and SLC34A3 genes of the probands were analyzed by targeted next-generation sequencing (NGS). Suspected mutations were verified by Sanger sequencing among unaffected relatives and 200 unrelated healthy individuals. Deletions were confirmed by multiplex ligation-dependent probe amplification (MLPA) detection of probands, unaffected relatives and 20 unrelated healthy individuals. Prenatal diagnosis for a fetus with high risk was carried out through MLPA analysis.</p><p><b>RESULTS</b>Four PHEX mutations were respectively detected in the pedigrees, which included c.850-3C>G, exon 11 deletion, exon 13 deletion and c.1753G>A (p.G585R). Among these, exon 11 deletion, exon 13 deletion and c.1753G>A (p.G585R) were novel mutations and not found among unaffected relatives and healthy controls. In pedigree 3, the same mutation was not found in the fetus.</p><p><b>CONCLUSION</b>Mutations of the PHEX gene probably underlies the disease among the four pedigrees. NGS combined with Sanger sequencing and/or MLPA detection can ensure accurate diagnosis for this disease.</p>

18.
Article in Chinese | WPRIM | ID: wpr-688020

ABSTRACT

<p><b>OBJECTIVE</b>This work aims to observe the healing of periimplant mucosal tissue injury in beagle dogs after subgingival retraction cord placement by examining the gingival index (GI), quantity of gingival crevicular fluid (GCF), and the proinflammatory cytokine in the GCF.</p><p><b>METHODS</b>In eight beagle dogs, the fourth mandibular premolars on the left side were extracted (n=8); after two months of healing, bone-level implants were installed. A plaque control regimen was performed throughout the duration of the experiment. After three months, retraction cords were placed subgingivally for 5 min before the cement-retained implant-supported crowns were cemented. GI, GCF quantity, and levels of tumor necrosis factor-alpha (TNF-α) in GCF were assessed before application and on days 1, 3, 7, 14, 28, and 56 after application.</p><p><b>RESULTS</b>GI, quantity of GCF, and TNF-α were significantly increased on days 1, 3, and 7 compared with those at the baseline and on days 14, 28, and 56 (P<0.05), and no statistically significant differences were observed among those on days 14, 28, and 56 and the baseline (P>0.05).</p><p><b>CONCLUSIONS</b>Under the circumstances of good oral hygiene, acute injury caused by placing retraction cord subgingivally in periimplant mucosal tissue of bone-level implant is reversible. GI, the quantity of GCF, and TNF-α on day 14 return to the baseline levels.</p>

19.
Article in Chinese | WPRIM | ID: wpr-687310

ABSTRACT

This paper aimed to investigate the hypoglycemic effect and relative mechanism of jatrorrhizine in insulin-resistance (IR)-3T3-L1 adipocytes. The 3T3-L1 preadipocytes were used to induce mature adipocytes, then the stable IR model was established with 1 μmol·L⁻¹ dexamethasone. The adipocytes were divided into normal group, IR model group, rosiglitazone positive group and jatrorrhizine group (0.5, 1, 5, 10, 20 μmol·L⁻¹). After different time points (12, 24, 30, 36, 48 h) treatment, glucose content of 3T3-L1 adipocytes was detected by the glucose oxidase peroxidase method and TG content was measured by glycerol phosphate oxidase method, whereas cell viability was detected by CCK-8 assay. Furthermore, the protein expression levels of insulin receptor substrate 2 (IRS2), phosphinositide-3-kinase regulatory subunit 1(PI3KR1), phosphorylated protein B [p-AKT (Ser473)], phosph-AMP-activated protein [p-AMPK (Thr172)], and glucose transporter type 4/1/2 (GLUT4/1/2) were detected by Western blot assay. The results showed that as compared with the normal group, the glucose consumptionwas significantly decreased in IR model group(<0.01); whereas 0.5, 1, 5, 10, 20 μmol·L⁻¹ jatrorrhizine and rosiglitazone group elevated IR-3T3-L1 cells glucose consumption (<0.01) at 36 h and 48 h administration as compared with IR group. The optimal administration time was 48 h for jatrorrhizine. 1, 5, 10, 20 μmol·L⁻¹ of jatrorrhizine decreased the TG content in 3T3-L1 adipocytes for 48 h administration (<0.05). The protein expression levels of IRS2, PI3KR1, p-AKT (Ser473), p-AMPK (Thr172), GLUT4/1/2 were significantly up-regulated by different concentrations of jatrorrhizine and rosiglitazone (<0.01). The results showed that jatrorrhizine increased glucose uptake with elevated glucose consumption, whereas reduced intracellular TG content in IR-3T3-L1 adipocytes. Moreover, it intervened classic insulin signal pathway IRS2/PI3KR1/p-AKT/GLUT4 and increase AMPK protein phosphorylation level for the activation of GLUT1/4 for insulin sensibility. Thus, jatrorrhizine could effectively regulate the GLUTs with multiple manners for hypoglycemic effect.

20.
Chinese Journal of Urology ; (12): 721-726, 2018.
Article in Chinese | WPRIM | ID: wpr-709587

ABSTRACT

Objective To review the clinical characteristics of prostate mucinous adenocarcinoma cases and update literatures,and recommend the corresponding clinical treatment strategy.Methods From October 2010 to March 2018,36 cases of prostate mucinous adenocarcinoma were involved from 5 urinary centers in China,including 9 cases from Shanghai Changhai Hospital,4 cases from Wuhan Tongji Hospital,13 cases from Shanghai Renji Hospitals,8 cases from the First Affiliated Hospital of Nanjing Medical University,and 2 cases from Sichuan West China Hospitals.The patients' age were (66.8 ±7.2) years (53-83 years) and the median PSA was 22.89 ng/ ml (2.67-1786 ng/ ml).Prostate biopsy confirmed Gleason score 3 + 3 points in 6 cases,3 + 4 points in 9 cases,4 + 3 points in 5 cases,8 points in 11 cases,and 9 to 10 points in 5 cases.According to D'Amico risk stratification,2 patients were in the low-risk group,9 in the intermediate-risk group,and 25 in the high-risk group.Eight cases underwent radical retroperitoneal prostatectomy,13 cases underwent laparoscopic radical prostatectomy,and 12 cases underwent robotic laparoscopic radical prostatectomy.Twenty-three cases underwent pelvic lymphadenectomy,including 12 cases of bilateral obturator lymph node dissection,and 11 cases of bilateral obturator + intraorbital + para-vascular para-aortic lymphadenectomy.Results All 36 operations were completed successfully.Twenty-three cases underwent pelvic lymphadenectomy,including 12 of bilateral obturator lymph node dissection,and 11 of bilateral obturator,intraorbital,and para-aortic lymphadenectomy.Pathological examination showed 9 cases of prostate mucinous adenocarcinoma,26 cases of mucinous adenocarcinoma with acinar adenocarcinoma,and 1 case of mucinous adenocarcinoma with neuroendocrine and immunohistochemical positive of MUC2 (+).Among 33 cases undergoing radical surgery,the pathological stage of ≤T2b in 12 cases (36.3%),T2c in 7 cases (21.2%),T3a in 7 cases (21.2%),T3b in 6 cases (18.2%),and T4 in 1 case (3.0%).Four cases had positive pelvic lymph nodes and 9 cases had positive margin.The median follow-up period was 26 months (6-48 months).The biochemical recurrence occurred in 6 patients one year after surgery,including 3 cases in the intermediaterisk group and 3 cases in the high-risk group.Six cases with postoperative biochemical recurrence and 19 cases with PSA > 0.2 ng/ml after radical or palliative resection underwent adjuvant androgen deprivation therapy(ADT),no postoperative adjuvant radiotherapy or chemotherapy was administered,and 4 cases progressed to castration-resistant prostate cancer.Four cases with CRPC were in the high-risk group and had underwent radical surgery,and the median period progressed to CRPC was 26 months(3-37months)with 2 cases of death.However,there was no significant difference in the rate of biochemical recurrence and the incidence of CRPC in the low-risk group,the intermediate-risk group and the high-risk group.In addition,2 cases had metastases,with pelvic MRI presenting pelvic multiple nodular mass in one case which was consistent with recurrence and metastasis at the 5th month after radical surgery,and pathological examination presenting the mucinous adenocarcinoma being neurosecretory in another case and mestastasis being detected on glans at the 3rd months after radical surgery.The recovery rate of urinary continience at 6 and 12 months after radical surgery was 86.2% (31/36) and 89.7% (32/36) respectively.Conclusions Prostate mucinous adenocarcinoma is a variant of acinar adenocarcinoma.This study clarifies prostate mucinous adenocarcinoma of Chinese patients with high Gleason scores,advanced pathological stage,variant in prognosis,and prone to recurrence and metastasis.For treatment strategy,the low-risk and intermediate-risk mucinous adenocarcinoma is recommended undergoing radical surgery,and the prognosis maybe good.High-risk mucinous adenocarcinoma could treated with radical surgery or palliative surgery with adjuvant ADT,and most high-risk patients can benefite,with a small number of poor prognosis.

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