Standard internal limiting membrane peeling versus internal limiting membrane abrasion technique for primary epiretinal membrane surgery / Remoção padrão da membrana limitante interna versus técnica de abrasão da membrana limitante interna em cirurgia primária de membrana epirretiniana

ABSTRACT Purposes: The purpose of this study is to compare the standard inner limiting membrane peeling technique to the inner limiting membrane abrasion technique with respect to visual outcomes and central retinal thickness in the primary epiretinal membrane surgery. Methods: A total of 59 eyes from 57 epiretinal membrane patients were separated into two groups including the standard inner limiting membrane peeling group and the inner limiting membrane peeling with abrasion technique group. At 6, 12, and 24 months of follow-up, the mean alteration in best-corrected visual acuity and central retinal thickness were assessed for each group. Results: The study includes 32 (54%) standard inner peeling and 27 (46%) inner limiting membrane peeling with abrasion technique patients. The mean preoperative logMAR best-corrected visual acuity for the standard inner limiting membrane peeling and inner limiting membrane peeling with abrasion groups was 0.73 (±0.29) and 0.61 (±0.3) respectively. At 6, 12, and 24 months of follow-up, the best-corrected visual acuity improved significantly in each group. At each period of observation, the alteration in best-corrected visual acuity was not statistically significant (p=0.54, p=0.52, p=0.67). When comparing the alterations between the standard inner limiting membrane peeling and inner limiting membrane peeling with abrasion technique groups at 6 months (p=0.26) and 24 months (p=0.06), no statistically significant differences were observed, but they were statistically different at 12 months (p=0.03), reflecting a greater reduction in central retinal thickness for the inner limiting membrane peeling with abrasion technique group after one year. Conclusion: Abrasion of the inner limiting membrane with a diamond-dusted membrane scraper during epiretinal membrane surgery demonstrates similar effectiveness to the standard inner limiting membrane peeling technique. At 12 months, retinal thinning was found to be more significant in inner limiting membrane peeling with abrasion technique patients in terms of central retinal thickness values. As a result, it may be argued that the inner limiting membrane abrasion technique eliminates the inner limiting membrane and related structures more effectively while inflicting less retinal damage.

RESUMO Objetivo: Este estudo tem como objetivo comparar a técnica padrão de peeling da membrana limitadora interna com a técnica de abrasão da membrana limitadora interna com relação aos resultados visuais e à espessura central da retina na cirurgia primária de membrana epirretiniana. Métodos: Cinquenta e nove olhos de 57 pacientes com membrana epirretiniana foram divididos em dois grupos, incluindo o grupo de remoção padrão da membrana limitante interna e o grupo de remoção da membrana limitante interna com técnica de abrasão. A alteração média da melhor acuidade visual corrigida e da espessura central da retina foram medidas para cada grupo aos 6, 12 e 24 meses de acompanhamento. Resultados: O estudo incluiu 32 (54%) de padrão de membrana limitante e 27 (46%) de membrana interna com técnica de abrasão. A média de logMar pré-operatório de melhor acuidade visual corrigida foi de 0,73 (±0,29) e 0,61 (±0,3) para os grupos de remoção padrão da membrana limitante interna e de remoção da membrana limitante interna com técnica de abrasão, respectivamente. A melhor acuidade visual corrigida melhorou significativamente em cada grupo aos 6, 12 e 24 meses de acompanhamento. A alteração na melhor acuidade visual corrigida não foi estatisticamente significante (p=0,54, p=0,52, p=0,67) em cada período de observação. Quanto à espessura central da retina, diferenças estatisticamente significativas não foram observadas aos 6 meses (p=0,26) e 24 meses (p=0,06), mas foram estatisticamente diferentes aos 12 meses (p=0,03) quando comparadas às alterações entre os grupos de remoção padrão da membrana limitante interna e de remoção da membrana limitante interna com técnica de abrasão, refletindo uma maior redução da espessura central da retina para o grupo de remoção da membrana limitante interna com técnica de abrasão após um ano. Conclusão: A abrasão da membrana limitante interna com um raspador de membrana com pó de diamante em cirurgia de membrana epirretiniana demonstra eficácia semelhante com a técnica de remoção padrão de membrana limitante interna. Em relação aos valores de espessura central da retina, o afinamento da retina foi mais significativo em pacientes com remoção da membrana limitante interna com técnica de abrasão aos 12 meses. Assim, pode-se argumentar que a técnica de abrasão da membrana limitante interna remove a membrana limitante interna e as estruturas relacionadas de forma mais eficaz sem causar danos significativos à retina.

Fracture healing, the diamond concept under the scope: Hydroxyapatite and the hexagon / Consolidación de fractura, una mirada al concepto diamante: Hidroxiapatita y el hexágono

Abstract Bone healing after a fracture has many intercalated steps that depend on the host, type of injury, and often the orthopedist. The diamond concept since 2007 has outlined 4 main facets that have to be considered as a model by the treating surgeon at the time of injury and when nonunion develops: osteogenic cells, osteoconductive scaffolds, osteoinduction, and the biomechanical environment. All of these foment fracture healing in optimal circumstances. Yet, this work proposes other facets, such as osteoimmunology and vascularity, to be considered as well in the model. These are as important as the original four, though their correlation to the original work has been less noted until more recent literature. The mindset of the orthopedist must thoroughly analyze all these facets and many more when dealing with nonunion. This work presents, probably the most sig nificant ones, parting from the original 4-corner diamond model and expanding it to a more representative hexagon integrated model. Metaphorically, just like the strongest inorganic constituent of the bone: hydroxyapatite.

Resumen Hay múltiples pasos intercalados en la consolidación de la fractura que dependen del paciente, el tipo de fractura y frecuentemente del ortopedista. Desde su introducción en el año 2007, el concepto del diamante ha delineado 4 facetas o aristas principales que se han de tener en cuenta por el ortopedista en el momento de la lesión y cuando la no-unión de fractura ocurre: células osteogénicas, matrices osteocunductivas, osteoinducción, y el ambiente biomecánico. Otras facetas para tener en cuenta, no menos importantes, son la osteoimmunología y la vascularidad. Estas son tan importantes como las 4 facetas originales, pero la correlación entre las mismas ha sido poco notada o integrada hasta ahora. El ortopedista tratante debe analizar todas ellas en profundidad, especialmente cuando se trata de una no-unión. Este trabajo presenta las más significantes, partiendo del modelo original del diamante de 4 facetas hacia uno más representativo e integrado como el hexágono. Metafóricamente, como el elemento inorgánico más abundante y fuerte en el hueso: la hidroxiapatita.

Persistent Intraocular Residue with the Use of Dexycu® in Cataract Extraction: A Case Series

Purpose: The objective of this article is to report 8 cases of persistent IOL residue associated with the use of Dexycu® in the context of cataract surgery and then to subsequently describe each patients clinical course.Observations and Presentation: Between 2020-2021, persistent residue was noted in 8 eyes of 7 patients who received Dexycu® implants after cataract surgery. The residue was identified an average of 1.63 months after surgery (range 0.20-4.23). A subsequent procedure removed the residue from the intraocular lens; the average time to the follow-up procedure after surgery was 4.71 months (range 1.90-11.20).Conclusions and Importance: The Bausch and Lomb intraocular lenses seem to be predisposed to a Dexycu® persistent opacification, however correlation does not equate with causation. This article documents cases of persistent IOL residue with the use of Dexycu® and the MX60 lenses and its toric varieties. Further evaluation is necessary to elucidate the mechanism and risk factors for this occurrence.

Aplasia medular congénita de serie roja: Anemia de DiamondBlackfan. A propósito de un caso / Marrow aplasia congenital red series: Diamond BlackfanAnemia. About a case

La Aplasia Medular pura de Células Rojas es un trastorno que se caracteriza por anemia con ausencia casi completa de precursores de células rojas en la médula ósea, con contaje de leucocitos y plaquetas normales. La anemia de Diamond-Blackfan es un síndrome de insuficiencia de la médula ósea caracterizada por anemia, reticulocitopenia y disminución de precursores eritroides en la médula ósea. Se presenta el caso de un lactante menor masculino de 2 meses de edad, sin antecedentes familiares ni perinatales de importancia, cuya madre evidencia palidez cutáneo mucosa progresiva asociado a hiporexia; acude a centro de salud donde realizan paraclínicos que reportan hemoglobina en 1,7g/dL. Se realiza frotis de sangre periférica donde se muestra serie eritroide francamente afectada con contaje granulocítico y megacariocítico normales; se realiza biopsia y aspirado de médula ósea concluyéndose aplasia medular de serie roja y en vista de otros hallazgos clínicos, se plantea posible anemia de Diamond-lackfan. Se indica tratamiento con glucocorticoides, sin embargo por respuesta insuficiente, se inicia eritropoyetina aumentando dosis de forma progresiva, a pesar de la administración de la misma, amerita transfusiones sanguíneas de forma regular; se realizan estudios de compatibilidad con familiares de primer grado resultando positivos, actualmente es candidato a trasplante alogénico de médula ósea. Se concluye que a pesar de corresponder a un síndrome poco frecuente, debe sospecharse ante la presencia de anemia severa, sin pérdida sanguínea aguda y descarte previo de otras etiologías, además se plantea que el inicio oportuno del tratamiento es fundamental para la supervivencia de estos pacientes(AU)

Pure red cell aplasia medullary is a disorder characterized by anemia with almost complete absence of red cell precursors in the bone marrow, with leukocyte count and platelets. e Diamond-Blackfan anemia is a failure syndrome characterized by bone marrow anemia, reticulocytopenia and decreased erythroid precursors in the bone marrow. the case of an infant under 2 months of age presented no family or perinatal history major, whose mother progressive skin pallor evidence mucosa associated with hyporexia; go to health center where they perform paraclinical reporting hemoglobin 1.7 g /dL. peripheral blood smear where erythroid frankly affected with normal megakaryocytic granulocytic count shown is made; It biopsied and bone marrow aspirate concluding marrow red cell aplasia; possible anemia Diamond-Blackfan in light of other clinical findings arises. It stays with glucocorticoid treatment, however insufficient response, begins erythropoietin dose progressively increasing, despite it, warrants blood transfusions on a regular basis; compatibility studies performed with firstdegree resulting positive, currently a candidate for allogeneic bone marrow transplantation. It is concluded that despite being a rare syndrome should be suspected in severe anemia where there is acute blood loss, ruling out other etiologies; also timely initiation of treatment is critical to the survival of these patients(AU)

Progress in molecular diagnosis of Diamond-Blackfan anemia / 国际儿科学杂志

Diamond-Blackfan anemia(DBA)is a rare hereditary anemia.About 90% of them have symptoms in infancy, and about 50% are complicated with congenital malformations.Genetic abnormalities were found in 70% to 80% of DBA cases, mainly autosomal dominant inheritance, and a few were recessive or X-linked inheritance.The main gene mutations of DBA are ribosomal protein gene mutations and deletions.More than 20 mutation genes related to DBA have been found in the ribosomal protein(RP)gene encoding ribosome, of which RPS19 gene mutation is the most common.In addition, there are TSR2 genes related to ribosome function and non-RP genes related to DBA like phenotype, such as GATA1, EPO and ADA2 genes.These genes play a key role in the differentiation and proliferation of erythroid cells.Molecular diagnosis is an important criterion to diagnose and distinguish classical DBA from non-classical DBA.This review summarizes the latest research progress in the genetics, gene mutation and molecular diagnosis of DBA.

Recent Progress in Hepatic Involvement in Shwachman-Diamond Syndrome / 罕见病研究

Shwachman-Diamond syndrome is a multisystem autosomal recessive disorder characterized by pancreatic and bone marrow abnormalities with frequent liver involvement.Patients with SDS display aminotransaminase elevation and hepatomegaly in their early childhood. For most of the patients, the syptoms tend to improve as they grow. However, a number of the children with progress into cirrhosis even liver failure, and the prognosis is poor.This paper summarizes advances in the epidemiology, pathogenesis, clinical manifestations, and diagnosis and treatment of hepatopathy in Shwachman-Diamond syndrome.

“To compare the effect of mulligan’s mobilization with mulligan’s taping and diamond taping on grip strength in patients with chronic lateral epicondylitis”: A randomized clinical trial.

Background and objectives: Lateral epicondylalgia or tennis elbow is a prevalent musculoskeletal disorder that is characterized by lateral elbow pain often associated with gripping tasks. This study was done to compare the effect of Mulligan’s mobilization with Mulligan’s taping and Diamond taping in chronic lateral epicondylitis grip strength. Methods: Forty (n=40) participants with chronic lateral epicondylitis were randomly allocated in two groups. Group ‘A’ received Mulligan’s mobilization with Mulligan’s taping and Group ‘B’ received Diamond taping and both the group received stretching exercise of the common extensors muscle of wrist prior to taping technique. The outcome measure was assessed in terms of Pain free grip strength (PFGS) for grip strength. Results: 20 subjects (n=20) were taken in both the groups with a mean age of 39.3 years in Mulligan’s Mobilization group and 41.95 years in Diamond taping group. Comparison of the pre and post values showed significant improvement (p<0.05) in grip strength in both the groups. When comparison of pre-test grip strength were done, there was no significant difference (p>0.05) in both the groups, this proves the fact that both the group started with the same intensity of grip strength while the post intervention comparison showed a significant improvement in grip strength (p<0.05) in both the groups. Conclusion: Mulligan’s Mobilization and Diamond taping intervention were equally beneficial in improvising the grip strength in patients with lateral epicondylitis.

Humberto Fernández-Morán (1924-1999) a pioneer in electron ultra-cryomicroscopy / Humberto Fernández-Morán (1924-1999) pionero en ultracriomicroscopía electrónica

SUMMARY: Humberto Fernández-Morán (1924-1999) a Venezuelan physician and biophysicist research, who developed the diamond knife. Furthermore he focused on improving the mechanical performance, accuracy and reliability of mocrotomes and ultramicrotomes which significantly advanced the development of electromagnetic lenses for electron microscopy based on superconducting technology. Promoter and founded of the Venezuelan Institute for Neurological and Brain Studies. He was a pioneer in electron ultra-cryomicroscopy field. Fernández-Morán taught and researched in University of Stockholm, Massachusetts Institute of Technology, Harvard University, Massachussetts General Hospital and the University of Chicago. He worked with NASA for the Apollo project in the field of physic-chemical analysis of lunar rocks.

RESUMEN: Humberto Fernández-Morán (1924-1999) médico venezolano e investigador biofísico, quien desarrolló el cuchillo de diamante. Además, se centró en mejorar el rendimiento mecánico, la precisión y la fiabilidad de los micrótomos y ultramicrótomos, lo que avanzó significativamente en el desarrollo de lentes electromagnéticos para microscopía electrónica basados en tecnología superconductora. Promotor y fundador del Instituto Venezolano de Estudios Neurológicos y Cerebrales. Fue pionero en el campo de la ultracriomicroscopía electrónica. Fernández-Morán enseñó e investigó en la Universidad de Estocolmo, el Instituto Tecnológico de Massachusetts, la Universidad de Harvard, el Hospital General de Massachussets y la Universidad de Chicago. Trabajó con la NASA para el proyecto Apollo en el campo del análisis físico-químico de rocas lunares.

A administração no crepúsculo do reino: registros de Saint-Hilaire / Administración en el crepúsculo del reino: los registros de Saint-Hilaire / Administration in the twilight of the kingdom: Saint-Hilaire's records

Resumo O objetivo deste ensaio é analisar a estrutura e a operação da gestão pública no Reino Unido de Portugal, Brasil e Algarves, relacionadas à indústria extrativista de diamantes por meio das obras de Saint-Hilaire, botânico e naturalista francês, que visitou e percorreu o Brasil no século XIX, em viagem realizada em 1817. O autor descreveu aspectos ligados à estrutura organizacional, aos processos da operação de extração de diamantes, aos métodos de gestão pública, de recursos humanos, financeira e contratos no distrito dos diamantes. A análise de seus relatos revelou o alto grau de controle, bem como as condições de trabalho dos escravos e a rígida estratificação social do Brasil Império, com intensa utilização de mão de obra escrava, por meio do que se chamava à época de aluguel. Conclui-se que o autor fez extenso relato da operação, com inestimável contribuição para os estudos dos primórdios do Estado brasileiro.

Resumen El objetivo de este ensayo fue analizar la estructura y la operación de la gestión pública del Reino Unido de Portugal, Brasil y Algarves, relacionadas con la industria de extracción de diamantes a través de las obras de Saint-Hilaire, botánico y naturalista francés, que recorrió Brasil, en un viaje que realizado en 1817. El autor describió en detalles aspectos relacionados con la estructura organizacional, los procesos de la operación de extracción, los métodos de gestión pública, de recursos humanos, financiera y de contratos. El análisis de sus relatos reveló el alto grado de control, así como el uso intensivo del trabajo esclavo, a través de la subcontratación de recursos humanos, las condiciones de trabajo de los esclavos y la rígida estratificación social del reino. Se concluye que el autor presentó una detallada descripción de la operación lo que constituye una invaluable contribución a los estudios de los inicios del Estado brasileño.

Abstract This essay aims to analyze the structure and operation of the public management of the United Kingdom of Portugal, Brazil, and the Algarves, related to the diamond extraction industry through the texts of Saint-Hilaire, French botanist and naturalist. Saint-Hilaire visited and toured Brazil in 1817 in a journey throughout the country's interior offering detailed information on Brazil's organizational structure, operations management structure, the public management processes, and the management of human resources, finances, and contracts. The analysis of Saint-Hilaire's reports revealed a high degree of control, the slaves' work conditions, and the rigid social stratification of Brazil in the early 19th century. The essay concludes that Saint-Hilaire presented a deep and detailed description of the diamond extraction operation, offering a valuable contribution to the studies of the beginning of Brazil as an independent nation.

Síndrome de Pearson en un niño trasplantado debido a anemia de Diamond-Blackfan / Pearson syndrome in a child transplanted for Diamond-Blackfan anemia

El síndrome de Pearson (SP) comparte varias características con la anemia de Diamond-Blackfan (ADB), incluida la anemia grave de inicio temprano, por lo que es importante hacer un diagnóstico diferencial. El diagnóstico diferencial de la ADB y el SP es fundamental, ya que los pacientes con ADB podrían res-ponder al tratamiento con corticoesteroides, presentar remisión o beneficiarse del trasplante de células madre hematopoyéti-cas (TCMH). Sin embargo, los pacientes con SP tienen un pronós-tico diferente, con un riesgo muy elevado de acidosis, problemas metabólicos y disfunción pancreática, y una expectativa de vida menor en comparación con aquellos con ADB. En este artículo, presentamos el caso de un paciente sometido a TCMH para la ADB, pero que luego fue diagnosticado con SP tras desarrollar algunas complicaciones.

Pearson syndrome (PS), shares a number of overlapping features with Diamond-Blackfan anemia (DBA), including early onset of severe anemia, making differential diagnosis important. Differential diagnosis of DBA and PS is critical, since those with DBA may respond to treatment with steroids, may undergo remission, or may benefit from hematopoietic stem cell transplantation (HSCT). However, patients with PS have a different prognosis, with a very high risk of developing acidosis, metabolic problems, and pancreatic dysfunction, and a shorter life expectancy than those with DBA. Here we present a patient who underwent HSCT for DBA but was subsequently diagnosed with PS after developing some complications

RPL5 gene mutation causes Diamond-Blackfan anemia: a case report and literature review / 中华实用儿科临床杂志

Objective:To explore the clinical characteristics of Diamond-Blackfan anemia (DBA) in children caused by RPL5 gene mutation, thus improving the understanding of the etiology of DBA.Methods:The clinical data and sequencing results of a child with DBA caused by RPL5 gene mutation treated in the Children′s Hospital of Fudan University were analyzed.In addition, through literature review of reported DBA cases at domestic and home, summarized the clinical features of DBA.Results:The patient was an 8-year-old male child.Bone marrow puncture examination of the child showed DBA, and a heterozygous mutation of RPL5 gene c. 657C>G, p.Y219X was identified for the first time in the DBA case.A total of 47 cases of DBA were retrieved from the online databases plus the one reported in this study (48 cases in total), and their clinical features were summarized as follows: the incidence of DBA was similar in men and women.The number of DBA patients in Asia was lower than that in Europe and the United States.DBA was mainly a sporadic disease.Among the exon mutations in European and American cases of DBA, 43.0% of them had mutations in Exon3.The malformation rate of DBA patients with RPL5 mutation was 81.3% (39/48 cases, excluding short stature cases), which was higher than that of patients with other mutation types.The response rate of glucocorticoid therapy for DBA was 46.0%, which was lower than that of the overall response rate.Conclusions:chr1: 93303142(c.657 C>G, p.Y219X) is a newly detected mutation of RPL5 gene in the DBA case, which expands the pathogenic gene spectrum of DBA.Patients with RPL5 mutation have higher rates of teratogenicity and multiple teratogenicity, and a lower response rate to hormone therapy.

Plant density on yield of Husk tomato (Physalis ixocarpa Brot.) in field and greenhouse / Densidade vegetal no rendimento de tomate Husk (Physalis ixocarpa Brot.) em campo e casa de vegetação

ABSTRACT: Physalis ixocarpa Brot. (tomatillo or Husk tomato) is one of the five major vegetables cultivated in Mexico, but its yield in the field is low. However, greenhouse crops and the enhancement in plant density can promote an increase in yield per area. The aim of this research was to evaluate: yield, water consumption and water use efficiency of variety husk tomato 'Diamante'. The experiment was conducted under field and greenhouse conditions, during the two crop cycles (autumn-winter and spring-summer), with different planting densities (1.5, 2 and 3 plants m-2), in complete random blocks and three replications. The yield was influenced by the planting density and environments. In both environments, the planting density, with 3 plants m-2 increased yield 32 %, and 25% in water use efficiency (WUE). In greenhouse increased 32% yield m-2 and the WUE it was 18.1 kg m-3 while in the field was 16.4 kg m-3. Crop cycle spring-summer produced differences of 27% in plant length and 15% in stem diameter, probably due to the temperature that was 4 ºC higher with respect to autumn-winter.

RESUMO: Physalis ixocarpa Brot. (tomatillo ou tomate de cáscara) é um dos cinco principais vegetais cultivados no México, mas seu rendimento no campo é baixo. No entanto, as culturas em estufa e o aumento da densidade das plantas podem promover um aumento no rendimento por área. O objetivo desta pesquisa foi avaliar: rendimento, consumo de água e eficiência no uso da água do tomate de casca de variedade 'Diamante'. O experimento foi conduzido em condições de campo e casa de vegetação, durante os dois ciclos de cultivo (outono-inverno e primavera-verão), com diferentes densidades de plantio (1,5, 2 e 3 plantas m-2), em blocos aleatórios completos e três replicações. O rendimento foi influenciado pela densidade e pelos ambientes de plantio. Nos dois ambientes, a densidade de plantio, com três plantas m-2, aumentou a produtividade em 32% e em 25% na eficiência no uso da água (WUE). Em casa de vegetação aumentou 32% do rendimento m-2 e o WUE foi de 18,1 kg m-3, enquanto no campo foi de 16,4 kg m-3. O ciclo da safra primavera-verão produziu diferenças de 27% no comprimento das plantas e 15% no diâmetro do caule, provavelmente devido à temperatura 4 ºC maior em relação ao outono-inverno.

Prevalence of novel coronavirus pneumonia in the early stage of transmission and responding strategies in Japan / 上海预防医学

Novel coronavirus pneumonia disease (COVID-19) caused by SARS-CoV-2 was identified in December 2019, and is gradually spreading globally including Japan.The COVID-19 case in Japan began to appear in middle January 2020 and continued to increase over time.The period from middle January to the end of February is considered to be the initial stage of domestic transmission in Japan.The paper descibes the spread of 935 cases of COVID-19 related to Japan by the end of February 2020, including the 15 infected Japanese returned from Wuhan, the 696 infected individuals in the large-scale cruise ship "Diamond Princess" and the 224 infected individuals in Japan.This paper summarizes the measures to control the spread of SARS-CoV-2 in Japan, such as limiting RT-PCR detection for SARS-CoV-2, reducing the number of patients with mild illness who go to medical institutions unnecessarily, formulating guidelines for SARS-CoV-2 infection consultation, canceling large gatherings and temporarily closing schools.This paper further points out the problems encountered in the prevention and control of the spread of SARS-CoV-2 in Japan, such as the slow detection of RT-PCR, the risk of infection faced by medical staff, the regional differences in the domestic health care service system, the confusion of information disclosure and management.The paper allows us to acquire a better understanding of the new coronavirus pneumonia in Japan and the world and may provide reference for the control the epidemic of COVID-19 in worldwide.

Prevalence of novel coronavirus pneumonia in the early stage of transmission and responding strategies in Japan / 上海预防医学

Novel coronavirus pneumonia disease (COVID-19) caused by SARS-CoV-2 began to emerge in Wuhan, Hubei, China in December 2019. It is currently spreading globally including Japan. The COVID-19 case in Japan began to appear in middle January 2020 and continued to increase over time. The period from middle January to the end of February is considered to be the initial stage of domestic transmission in Japan. This article described the spread of 935 COVID-19 cases related to Japan by the end of February 2020, including the 15 infected Japanese returned from Wuhan, the 696 infected individuals in the large-scale cruise ship 'Diamond Princess' and the 224 infected individuals in Japan. This paper summarizes the measures to control the spread of SARS-CoV-2 in Japan, such as limiting RT-PCR detection for SARS-CoV-2, reducing the number of patients with mild illness who go to medical institutions unnecessarily, formulating guidelines for SARS-CoV-2 infection consultation, canceling large gatherings and temporarily closing schools. This paper further points out the problems encountered in the prevention and control of the spread of SARS-CoV-2 in Japan, such as the slow detection of RT-PCR, the risk of infection faced by medical staff, the regional differences in the domestic health care service system, the confusion of information disclosure and management. The above introduction as allows us to acquire a better understanding of the new coronavirus pneumonia in Japan and the world and may provide reference for the control the epidemic of COVID-19 in worldwide.

Effect of different smear layers on the bonding performance and durability of four adhesive systems / 中国组织工程研究

BACKGROUND: When the tooth surface is treated with a rotary or manual instrument, a smudge layer is formed on the enamel and dentin by debris generated by cutting and abrasion. The bonding interface between the adhesive and the dentin is considered as a weak part in the direct repair process. To clarify the effect of smear layer on different kinds of adhesive is significantly important for dentists to select and correctly use the adhesive in clinical treatment. OBJECTIVE: To evaluate the effect of different diamond burs on the dentin bonding performance of four adhesive systems to dentin after 24 hours and 100 days of artificial saliva-storage. METHODS: Adhesive systems were: (1) VSA (Optibond Versa, Kerr); (2) AIO (Optibond All in One, Kerr); (3) SBU (Single bond Universal, 3M); (4) GLU (Bond 5, Gluma, Heraeus). In present study, 80 extracted human molars were randomly divided into four groups and each group is divided into 4 subgroups. Dentin surfaces were prepared by: (1) 600-grit SiC-paper (control group); (2) super-fine diamond bur; (3) regular diamond bur; (4) coarse diamond bur. Bonding agent was applied according to each manufacturer’s instruction. After light-curing, dentin surfaces were built-up with resin composite (A2, CHARISMA, Heraeus). The micro-tensile bond strength was determined after 24 hours and 100 days of storage in artificial saliva at 37 °C. The fractured surfaces on dentin side were observed by scanning electron microscope. RESULTS AND CONCLUSION: (1) Storage for 24 hours: There was no significant difference among groups under VSA and GLU. Under SBU and AIO, the bond strength in the coarse diamond bur group was significantly lower than that in the control group (P 0. 05). Using coarse diamond bur, the bond strength in the VSA group had significant difference compared with the AIO, GLU and SBU groups (P 0. 05). (2) Storage for 100 days, there was no significant difference among groups under VSA and GLU. Under SBU, the bond strength in the coarse diamond bur group was significantly lower than that in the control group (P 0. 05). Using regular diamond bur, the bond strength showed no significant difference in the GLU group compared with the SBU, and VSA groups (P > 0. 05). Using coarse diamond bur, the bond strength had no significant difference between VSA and AIO groups (P < 0. 05). (3) Using VSA, the bond strength in each group at 100 days showed significant difference compared with that at 24 hours (P < 0. 05). (4)Compared with immersed for 24 hours, the ratio of bond interface and combined crack in the VSA, SBU and GLU groups after immersed for 100 days was increased, especially the VSA group. Compared with the other groups, the ratio of bond interface and combined crack in the GLU group after immersed for 24 hours and 100 days both increased by 50%. (5) These results indicate that preparation by different burs produces different smear layers, which has significant effect to self-etching adhesive system and has no significant effect to total-etching adhesive system. Storage time makes effect on different adhesives.

Application of "diamond concept" in treatment of femoral shaft fractures nonunion after intramedullary fixation / 中国修复重建外科杂志

Objective: To investigate the effectiveness of the treatment under the guidance of "diamond concept" for femoral shaft fractures nonunion after intramedullary fixation. Methods: Between January 2014 and December 2016, 21 cases of femoral shaft fractures nonunion after intramedullary fixation were treated with auxiliary plate fixation combined with autogenous iliac graft, and autologous bone marrow concentrate and platelet-rich plasma (PRP) gel under the guidance of the "diamond concept". There were 13 males and 8 females, with an average age of 32.5 years (range, 17-48 years). All fractures were closed femoral shaft fractures. Four patients underwent internal fixation with plate and resulted in nonunion, then they were fixed with intramedullary nails, but did not heal either. The rest 17 patients were fixed with intramedullary nailing. Fracture nonunion classification: 4 cases of hypertrophic nonunion, 17 cases of atrophic nonunion; the length of bone defect was 1-3 mm; the duration from the last treatment to the current treatment was 10-23 months (mean, 14.3 months). The operation time, intraoperative blood loss, the time between operation and full loading, fracture healing time, and complications were recorded. The visual analogue scale (VAS) score and the imaging system of fracture healing of the extremities (RUST) of patients before operation and at last follow-up were recorded to evaluate the fracture healing; the function of the affected limb was evaluated according to the Schatzker-Lambert efficacy score standard at last follow-up. Results: The operation time was 105-160 minutes, with an average of 125.6 minutes; the intraoperative blood loss was 160-580 mL, with an average of 370.5 mL. All incisions healed by first intention, without vascular or nerve injury. All patients were followed up 22-46 months (mean, 26.5 months). All the fractures healed, with a fracture healing time of 3-7 months (mean, 4.8 months). During the follow-up, there was no infection, loosening, implant breakage, re-fracture, and other complications. The VAS score at last follow-up was 0.8±0.3, showing significant difference ( t=7.235, P=0.000) when compared with preoperative score (5.2±3.7); the RUST score was 3.4±0.3, which was significantly higher than the preoperative score (1.5±0.7) ( t=8.336, P=0.000). According to the Schatzker-Lambert effectiveness evaluation standard, the limb function was excellent in 16 cases, good in 4 cases, fair in 1 case, and the excellent and good rate was 95.42%. Conclusion: Nonunion after intramedullary fixation of femoral fracture treated with auxiliary plate combined with autogenous iliac graft, autogenous bone marrow concentration and PRP gel in accordance with the "diamond concept" can not only restore the stability of the fracture ends, but also improves the biological environment of the fracture site, and can improve the rate of fracture healing.

Comparison of Visual Acuity and Retinal Thickness According to Membranectomy in Idiopathic Epiretinal Membrane

PURPOSE: To compare the visual acuity and retinal thickness in patients with an idiopathic epiretinal membrane (ERM) after vitrectomy and membranectomy using two different methods.METHODS: This retrospective observational study included 77 eyes (32 eyes in the diamond-dusted membrane scraper [DDMS] group, and 45 eyes in the intraocular forceps [IOF] group) of 77 patients with idiopathic ERM who underwent pars plana vitrectomy and membranectomy. The main outcome measures were best-corrected visual acuity (BCVA, logMAR) and mean retinal thickness.RESULTS: In the IOF group, the BCVA at postoperative 1 week was significantly lower than at baseline and had improved at 12 weeks after surgery. In the DDMS group, the BCVA at postoperative 1 week showed no significant difference at baseline and had improved at 4 weeks after surgery. The central macular thickness at postoperative 6 months was significantly lower than at baseline (all, p < 0.001); there was no significant difference between the two groups (p = 0.400). The postoperative macular thickness of the DDMS group was significantly lower than that of the IOF group in the inner inferior and outer inferior areas at postoperative 12 weeks and 4 weeks (p = 0.046 and p = 0.039, respectively). Five eyes of the DDMS group and 15 eyes of the IOF group developed cystoid macular edema, 14 eyes of that improved without treatment.CONCLUSIONS: In patients with ERM, the use of DDMS or IOF for vitrectomy and membranectomy both resulted in improved visual acuity and decreased mean retinal thicknesses.

The influence of different surface treatment protocols and bonding agents on the repair microtensile bond strength of six-month' aged composite: An in vitro study / A influência de diferentes protocolos de tratamento de superfície e agentes de união na resistência de união à microtração de reparo de compósito envelhecido por seis meses: um estudo in vitro

Objective: To compare the effect of three surface treatment protocols and two intermediate agents on repairing aged composite, regarding microtensile bond strength (µTBS) and mode of fracture, at two time intervals. Material and methods: Six-monthaged microhybrid composite blocks, were randomly distributed into three groups, subjected to; Fine, Super Fine grit diamond burs or Erbium- Yag Laser surface treatment. Each block had both One Coat bond SL (Bond) and Brilliant Flow flowable composite (Flow) intermediate agents, alongside. Blocks were incrementally repaired using nanohybrid composite, cut into beams, then randomly subjected either immediately (IM) to µTBS test or after thermocycling (TC) for 5000 cycle. Mode of failure was determined using stereomicroscope. Data were analyzed through three-way ANOVA followed by pairwise comparison with Bonferroni correction. Kruskal Wallis test compared groups for failure mode analysis (α=0.05) Results: Super Fine grit showed the highest mean µTBScompared to control for both intermediate agents, IM and after TC at P<0.05. No difference between Fine grit and Laser application for all groups (P>0.05). IM, Bond showed the highest µTBS compared to TC, Flow for all tested groups. Beams roughened with Fine and Super Fine burs showed significantly lower adhesive failures than those roughened with Laser. Flow suffers significantly higher adhesive failure than those with Bond. For TC tested groups; beams with Super Fine bur and Bond showed significantly lower adhesive failure at P=0.029. Conclusion: Super Fine grit and Bond provide the highest µTBS and the least adhesive failure; moreover TC resulted in significant decrease in µTBS (AU)

Objetivo: Comparar o efeito de três protocolos de tratamento de superfície e dois agentes intermediários no reparo de compósito envelhecido, quanto à resistência à microtração (µTBS) e modo de fratura, em dois intervalos de tempo. Material e métodos: Blocos de compósito microhíbrido envelhecidos por seis meses, foram distribuídos aleatoriamente em três grupos, submetidos a; Pontas diamantadas de granulação Fina, Superfina ou tratamento de superfície com laser de Erbio-Yag. Cada bloco tinha ambos os agentes intermediários One Coat bond SL (Adesivo) ao lado de Brilliant Flow (Resina Fluida). Os blocos foram reparados de forma incremental usando compósito nanohíbrido, cortados em palitose, em seguida, submetidos aleatoriamente imediatamente (IM) ao teste de µTBS ou após termociclagem (TC) por 5000 ciclos. O modo de falha foi determinado usando estereomicroscópio. Os dados foram analisados por meio de ANOVA de três fatores, seguida de comparação pareada com correção de Bonferroni. O teste de Kruskal Wallis comparou os grupos para análise do modo de falha (α = 0,05). Resultados: a granulação Super fina apresentou a maior média de µTBS em comparação com o controle para ambos os agentes intermediários, IM e após TC (P <0,05). Não houve diferença entre granulação fina e aplicação de laser para todos os grupos (P> 0,05). IM, Adesivo apresentou a µTBS mais alta em comparação com TC, Resina Fluida para todos os grupos testados. Os palitos asperizados com pontas de granulações Fina e Superfina apresentaram falhas adesivas significativamente menores do que as asperizadas com Laser. Resina Fluida sofreu falhas adesivas significativamente maiores do que aquelas com Adesivo. Para grupos testados TC; palitos tratados com ponta Superfina e Adesivo apresentaram falha adesiva significativamente menor com P = 0,029. Conclusão: a granulação Superfina e o Adesivo fornecem a maior µTBS e o mínimo de falha adesiva; além disso, o TC resultou em uma diminuição significativa da µTBS. (AU)

Effect of dlc films with and without silver nanoparticles deposited on titanium alloy

Abstract Diamond-like carbon (DLC) film is a biocompatible hard coating material that can prevent the leaching of metal ions. This study evaluates the structural characteristics of DLC, with and without silver nanoparticles, deposited by plasma (PECVD) on titanium alloy (Ti-6Al-4V) and bone formation in contact with DLC films. Sixty Ti-6Al-4V samples were used divided in: uncoated, coated with DLC and coated with DLC-Ag. After structural characterization, samples were fixed bilaterally at the rabbit's mandible. After 15 and 90 days, samples were characterized again and bone formation in the area was analyzed by histomorphometry. Statistical analysis was performed by two-way ANOVA. Both the DLC and DLC-Ag films were firmly adhered and showed a high electrical resistance without significant changes in the Raman spectrum after in vivo integration. After 15 days, there were immature bone trabeculae in the interface and partially covering the surface. After 90 days, mature bone filled the interface and coved the surface. There was no statistically significant difference among the three groups in both periods. In conclusion, osseointegration with DLC, DLC-Ag and uncoated Ti-6Al-4V is similar. However, DLC and DLC-Ag coverings have the advantage of electrical insulation and can presumably control bacterial activity and ion leaching.

Resumo O filme de carbono semelhante a diamante (DLC) é um material de revestimento duro e biocompatível que pode impedir a corrosão com liberação de íons metálicos. Este estudo avaliou as características estruturais do filme de DLC, com e sem nanopartículas de prata (Ag), depositadas por plasma (PECVD) em liga de titânio (Ti-6Al-4V) e formação óssea em contato com filmes de DLC. Foram utilizadas 60 amostras de Ti-6Al-4V divididas em: não recobertas, recobertas com DLC e recobertas com DLC-Ag. Após caracterização estrutural, amostras foram fixadas bilateralmente na mandíbula de coelhos. Após 15 e 90 dias, as amostras foram novamente caracterizadas e a formação óssea na área foi analisada por histomorfometria. A análise estatística foi realizada por ANOVA dois fatores. Ambos os filmes DLC e DLC-Ag foram firmemente aderidos e mostraram uma alta resistência elétrica sem alterações significativas no espectro Raman após a osseointegração in vivo. Após 15 dias, havia trabéculas ósseas imaturas na interface e cobrindo parcialmente a superfície. Após 90 dias, o osso maduro preencheu a interface e a superfície. Não houve diferença estatisticamente significante entre os três grupos nos dois períodos. Em conclusão, a osseointegração com DLC, DLC-Ag e Ti-6Al-4V não revestido é similar. No entanto, os revestimentos DLC e DLC-Ag têm a vantagem do isolamento elétrico e podem presumivelmente controlar a atividade bacteriana e a corrosão com liberação de íons.

A novel, new generation drill coating for osteotomy site preparation

Background: Implant success and survival rate ranges from 93% to 97%; however, failures are not very uncommon. These failures can be caused due to a variety of reasons out of which increased heat during drilling of osteotomies is a major contributor.Aim: The aim of this study was to develop a new generation diamond-coated drill and compare the thermal changes between commercially available drills and the experimental diamond coated drill during implant site preparation in artificial bone. Material and Methods: Three types of drills were selected for the study; Group A (Carbide), Group B (Stainless Steel), and Group C (Experimental). A total of 60 implant site preparations were performed with all the drills in artificial bone using a surgical unit linked to a testing device, in order to standardize implant drilling procedures. Bone temperature variations were recorded when drilling at a depth of 10 mm. A constant irrigation of 50 ml/minute and drilling speed of 800 r.p.m. was maintained. Results: The mean temperature of Group A, Group B, and Group C was 35.57°C, 36.83°C and 34.23°C, respectively. The results were assessed and statistically analyzed using ANOVA test and post hoc Bonferroni test. Statistically significant higher temperatures were obtained with stainless steel drill and carbide drill when compared with the experimental diamond coated drill. (P = 0.000). Conclusions: Diamond coated osteotomy drills have shown promising results in reducing heat generation at the osteotomy. Further studies need to be conducted to maximize the potential use of diamond as components of drills in implant dentistry.