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RESUMEN Introducción: Diversos autores mencionan que una correcta planificación de una dentadura parcial removible incrementa la satisfacción de los pacientes, en cuanto a estética y función. En casos donde la estética es prioritaria, se plantea un diseño sin retenedores visibles. En estos casos, la elaboración de la dentadura no demanda mayores costos, basta con establecer el diagnóstico correspondiente valorando los pilares, eje de inserción, áreas retentivas entre otros y establecer el diseño más conveniente según sea el caso. Objetivo: El objetivo fue realizar una revisión sistematizada sobre la percepción de la calidad de vida y satisfacción en pacientes portadores de dentaduras parciales removibles. Materiales y métodos: Se incluyeron 13 artículos científicos mediante la metodología PRISMA para la identificación, revisión e inclusión de los textos que formaron parte del estudio. Se seleccionaron tomando en cuenta el título, resumen y objetivo. Fueron considerados: revisiones sistemáticas, metaanálisis, estudios comparativos y revisiones de literatura que evaluaran diferentes criterios acerca de la satisfacción en pacientes portadores de dentadura parcial removible. Los artículos fueron leídos íntegramente, se analizaron objetivos, metodología y conclusión de cada uno de ellos, y posteriormente fueron analizados. Resultados: La queja más común fue el resultado estético, seguida del dolor durante la masticación. Se recomienda ofrecer un control periódico de la prótesis parcial removible para evaluar el correcto funcionamiento y ajuste de esta. Conclusión: El éxito del tratamiento con dentaduras parciales removibles se puede optimizar mediante el diagnóstico preciso del caso, considerando experiencias previas del paciente y teniendo en cuenta sus expectativas. Asimismo, comprender ciertos factores como su estilo de vida, nivel socioeconómico, estado de salud periodontal, personalidad, puede disminuir el riesgo de fracaso futuro del tratamiento con dentaduras parciales removibles.
ABSTRACT Introduction : Various authors mention that correct planning of a removable partial denture can offer adequate satisfaction in terms of aesthetics and function. In cases where aesthetics is a priority, a design without visible clasps is proposed. In addition, this elaboration does not demand higher costs, if the practitioner reaches the corresponding diagnosis and establishes the most convenient design for each specific case. Objective: The objective was to carry out a systematic review on the perception of quality of life and satisfaction in patients with removable partial dentures. Materials and methods: Thirteen scientific articles were included using the PRISMA methodology for the identification, review and inclusion of the texts that were part of this study. The articles were selected considering the title, abstract and objective. Systematic reviews, meta-analyses, comparative studies, and literature reviews that included criteria about satisfaction in patients with removable partial dentures where evaluated. The articles were read in their entirety: the objectives, methodology and conclusions of each one of them were analyzed. Results: The most common complaint was the aesthetic result, followed by pain during chewing. It is recommended to offer periodic control of the removable partial denture to evaluate its correct functioning and fit. Conclusion: The success of the treatment with removable partial dentures can be evaluated through the precise diagnosis of the case, considering previous experiences and taking into account the expectations of the patient. Also, understanding the patient's lifestyle, socioeconomic level, periodontal health status, and personality, may be factors that allow the practitioner to reduce the risk of future failure for the treatment with removable partial dentures.
Subject(s)
Humans , Quality of Life , Denture, Partial, Removable/psychology , Dental Prosthesis/psychologyABSTRACT
Introducción: Diversos autores mencionan que una correcta planificación de una dentadura parcial removible incrementa la satisfacción de los pacientes, en cuanto a estética y función. En casos donde la estética es prioritaria, se plantea un diseño sin retenedores visibles. En estos casos, la elaboración de la dentadura no demanda mayores costos, basta con establecer el diagnóstico correspondiente valorando los pilares, eje de inserción, áreas retentivas entre otros y establecer el diseño más conveniente según sea el caso. Objetivo: El objetivo fue realizar una revisión sistematizada sobre la percepción de la calidad de vida y satisfacción en pacientes portadores de dentaduras parciales removibles. Materiales y métodos: Se incluyeron 13 artículos científicos mediante la metodología PRISMA para la identificación, revisión e inclusión de los textos que formaron parte del estudio. Se seleccionaron tomando en cuenta el título, resumen y objetivo. Fueron considerados: revisiones sistemáticas, metaanálisis, estudios comparativos y revisiones de literatura que evaluaran diferentes criterios acerca de la satisfacción en pacientes portadores de dentadura parcial removible. Los artículos fueron leídos íntegramente, se analizaron objetivos, metodología y conclusión de cada uno de ellos, y posteriormente fueron analizados. Resultados: La queja más común fue el resultado estético, seguida del dolor durante la masticación. Se recomienda ofrecer un control periódico de la prótesis parcial removible para evaluar el correcto funcionamiento y ajuste de esta. Conclusión: El éxito del tratamiento con dentaduras parciales removibles se puede optimizar mediante el diagnóstico preciso del caso, considerando experiencias previas del paciente y teniendo en cuenta sus expectativas. Asimismo, comprender ciertos factores como su estilo de vida, nivel socioeconómico, estado de salud periodontal, personalidad, puede disminuir el riesgo de fracaso futuro del tratamiento con dentaduras parciales removibles.
Introduction : Various authors mention that correct planning of a removable partial denture can offer adequate satisfaction in terms of aesthetics and function. In cases where aesthetics is a priority, a design without visible clasps is proposed. In addition, this elaboration does not demand higher costs, if the practitioner reaches the corresponding diagnosis and establishes the most convenient design for each specific case. Objective: The objective was to carry out a systematic review on the perception of quality of life and satisfaction in patients with removable partial dentures. Materials and methods: Thirteen scientific articles were included using the PRISMA methodology for the identification, review and inclusion of the texts that were part of this study. The articles were selected considering the title, abstract and objective. Systematic reviews, meta-analyses, comparative studies, and literature reviews that included criteria about satisfaction in patients with removable partial dentures where evaluated. The articles were read in their entirety: the objectives, methodology and conclusions of each one of them were analyzed. Results: The most common complaint was the aesthetic result, followed by pain during chewing. It is recommended to offer periodic control of the removable partial denture to evaluate its correct functioning and fit. Conclusion: The success of the treatment with removable partial dentures can be evaluated through the precise diagnosis of the case, considering previous experiences and taking into account the expectations of the patient. Also, understanding the patient's lifestyle, socioeconomic level, periodontal health status, and personality, may be factors that allow the practitioner to reduce the risk of future failure for the treatment with removable partial dentures.
Subject(s)
Humans , Costa RicaABSTRACT
The objective of the study is to assess the precision of digital impressions in removable partial dentures through an in vitro study on the degree of abutment adaptation. A Kennedy Class III model with a prosthetic space between elements 43 and 47, featuring niches in the mesio-occlusal and cingulum regions, respectively. Conventional impressions were performed in subgroups CONC and CONM, while digital scanning was conducted in subgroups DIGC and DIGM. Simplified cobalt-chromium alloy frameworks were manufactured using the lost-wax technique on plaster and resin models. The degree of adaptation of the structures was evaluated by impressing the niches with condensation silicone, qualitatively assessing perforations, and quantitatively measuring the mold thickness under a stereomicroscope after cross-sectioning. Regular adaptation was more prevalent among the experimental groups. CONC showed a higher mean degree of abutment adaptation, while CONM had a lower mean. The study factors, impression technique, and type of abutment seat, were not statistically significant, with no interaction among the variables. Occlusal and cingulum abutment measurement points, in both impression techniques, showed no statistically significant difference. Digital scanning yielded better results in terms of abutment adaptation, with smaller average gaps between the abutment seat and the metal structure, making it clinically acceptable. The type of abutment seat and the impression technique did not have a statistically significant impact on abutment adaptation. The impression technique does not represent a factor influencing the adaptation of occlusal and cingulum abutments at different measurement points. (AU)
O Objetivo do estudo é valiar precisão da impressão digital em próteses parciais removíveis, por meio de um estudo in vitro sobre o grau de adaptação dos apoios. Um modelo Classe III de Kennedy com espaço protético entre o elemento 43 e 47, nichos na região mésio-oclusal e na do cíngulo. Foram realizadas impressões convencionais nos subgrupos CONC e CONM, e digitalização nos subgrupos DIGC e DIGM, onde estruturas simplificadas de liga de Co-Cr foram fabricadas usando a técnica de fundição perdida nos modelos de gesso e resina. O grau de adaptação das estruturas foi avaliado pela impressão dos nichos com silicone de condensação, qualitativamente as perfurações e quantitativamente a espessura do molde em um estereomicroscópio após seção transversal. A adaptação regular foi mais prevalente entre os grupos experimentais. CONC maior média do grau de adaptação do apoio, enquanto CONM menor média. Os fatores do estudo, técnica de impressão e tipo de assento de apoio, não foram estatisticamente significativos, sem interação entre as variáveis. Pontos de medição de apoio oclusal e de cíngulo, em ambas as técnicas de impressão, sem diferença estatisticamente significativa. A digitalização mostrou melhores resultados em relação ao grau de adaptação dos apoios, com menores lacunas médias entre o assento de apoio e a estrutura metálica, sendo clinicamente aceitável. O tipo de assento de apoio e a técnica de impressão não interferem estatisticamente na adaptação dos apoios. A técnica de impressão não representa um fator que influencie a adaptação de apoios oclusais e de cíngulo em diferentes pontos de medição. (AU)
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Este estudo objetiva apresentar a experiência do componente curricular Prótese Parcial Removível (PPR) da Universidade Federal da Paraíba com a implementação de metodologias ativas, como gamificação, sala de aula invertida e case-based learning(CBL), no ensino à distância, visando sedimentar o aprendizado quanto ao planejamento de arcos parcialmente desdentados. As atividades foram realizadas de forma síncrona e assíncrona, utilizando como casos os esquemas bidimensionais e fotografias de arcosparcialmente desdentados, baseando-se no conceito de sala de aula invertida, no qual os alunos apresentavam os casos e os professores atuavam como mediadores nas discussões. Observou-se um grande engajamento e participação ativa dos alunos na construção do seuconhecimento. A inserção dessas metodologias no ensino remoto funcionou como um eixo motivacional para os alunos, fomentando a aprendizagem e estimulando o desenvolvimento de competências no planejamento em PPR previamente ao atendimento clínico (AU).
Este estudio tiene como objetivo presentar la experiencia del componente curricular Prótesis Parcial Removible de la Universidade Federal da Paraíba con la implementación de metodologías activas, como gamificación, aula invertida y aprendizaje basado en casos, en educación a distancia, con el objetivo de consolidar el aprendizaje sobre la planificación de arcadas parcialmente edéntulas. Las actividades se realizaron de forma sincrónica y asincrónica, utilizando diagramas bidimensionales y fotografías de arcos parcialmente edéntulos como casos, basados en el concepto de aula invertida, en la que los estudiantes presentaban los casos y los docentes actuaban como mediadores en las discusiones. Hubo un gran compromiso y participación activa de los estudiantes en la construcción de su conocimiento. La inclusión de estas metodologías en la enseñanza a distancia funcionó como eje motivacional de los estudiantes, favoreciendo el aprendizaje y estimulando el desarrollo de habilidades en la planificación de la Prótesis Parcial Removible previa a la atención clínica (AU).
This study aims to present the experience of RPD course at the Universidade Federal da Paraíba using active methodologies such as gamification, flipped classroom and case-based learning (CBL) in distance learning, aiming to consolidate learning in planningpartially edentulous arches. Activities were carried out synchronously and asynchronously using two-dimensional schemes and photographs of partially edentulous arches as "cases" and based on the concept of the flipped classroom, where students presented the cases and the teachers acted as mediators in the discussions. Excellent engagement and active participation of students in their knowledge construction were observed. The insertion of these methodologies in remote teaching acted as a motivational axis for the students, promoting learning and stimulating development of competences in RPD planning prior to clinical care (AU).
Subject(s)
Humans , Male , Female , Health Knowledge, Attitudes, Practice , Problem-Based Learning/methods , Education, Distance , Denture, Partial, Removable , COVID-19 , Brazil/epidemiology , GamificationABSTRACT
The choice of retaining material that will replace the lost properties of the tooth, in which it is fragile and with loss of dentin structure, is important. The success of the treatment will depend on the qualities presented in it. Therefore, the objective of this work, through a literature review, is to present the advantages and disadvantages observed in the use of fiberglass post intraradicular retainer. This paper reviews the most relevant articles on the specificities presented in the fiberglass post retaining material, published in the period (2003 to 2020). The bibliographic search was performed in PubMed, Lilacs, Scielo, Google Scholar databases. In view of the selected articles on the subject, it is possible to observe the authors' acceptance of the application of the use of retainers, highlighting that in the treatment of cases with extensive coronary destruction, the aim is to have the functional and retentive capacity returned, in addition to the tension resistance. Therefore, theThe use of fiberglass posts in weakened teeth is effective as the material of choice. In cases that require reconstruction and return of tissue integrity, it has sufficient advantages for its selection. Despite the disadvantages it has, these do not outweigh the benefits to the point of making its use unfeasible. However, knowing when, where and how to treat is always important in any procedure for a satisfactory final outcome.
A escolha do material retentor que irá substituir as propriedades perdidas do dente, no qual este se apresenta de forma fragilizada e com perca de estrutura dentinária é importante. O sucesso do tratamento irá depender das qualidades apresentadas no mesmo. Sendo assim, o objetivo deste trabalho por meio de uma revisão de literatura é apresentar as vantagens e desvantagens observadas no uso do retentor intrarradicular de pino de fibra de vidro. Este trabalho revisa os artigos mais relevantes sobre as especificidades apresentadas no material retentor de pino de fibra de vidro, publicadas no período (2003 até 2020). A busca bibliográfica foi realizada nos bancos de dados PubMed, Lilacs, Scielo, Google Scholar. Diante dos artigos selecionados referentes ao tema, pode-se observar a aceitação dos autores sobre a aplicação do uso de retentores, destacando-se que no tratamento de casos com destruição coronária extensa o intuito é dispor da devolução da capacidade funcional, retentiva, além da resistência a tensão. Portanto, a utilização de pinos de fibra de vidro em dentes fragilizados apresenta efetividade como material de escolha. Em casos que necessitam de reconstrução e devolução de sua integridade tecidual, possui consigo vantagens suficientes para sua seleção. Apesar das desvantagens que possui, essas não se sobrepõem aos benefícios a ponto de tornarem inviáveis ao seu uso. Entretanto, saber quando, onde e como tratar é sempre importante em qualquer procedimento para um desfecho final satisfatório.
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Dental Materials , Dental Pins , Dental Restoration, Permanent , Flexural StrengthABSTRACT
Objective@#To explore an accurate method to obtain an intraoral model of patients with specific limited mouth opening (microstomia) due to systemic scleroderma.@*Methods@#This study followed medical ethics, and informed consent has been obtained from patients. A case of Ken's Type I mandibular dentition defect scleroderma with limited mouth opening was addressed with digital technology as the leading method combined with the traditional impression method of segmental impression. Individual trays were made based on the patient's left and right mandibular dentition, and segmented molds were obtained. Simultaneously, intraoral scanning was performed to obtain the morphological data of both the soft and hard tissues of the upper and lower mandibles. After each part of the model was obtained, the mandibular model was scanned and digitally aligned to form the final denture model, and the final removable partial denture was designed and made by computer aided design/computer aided manufacturing (CAD/CAM) technology. At the same time, combined with the literature, the diagnosis and treatment of removable partial denture in patients with limited mouth opening were retrospectively analyzed.@*Results@#The denture was well retained and achieved a good repair effect. The patients expressed satisfaction with the mastication efficiency and other functions of the denture. The findings of the literature review show that the integration of digital technology with the traditional impression method, along with computer fitting, can accurately obtain the patient's oral model and facilitate successful follow-up repairs. However, when the anterior mandibular dentition of the patient is absent, the margin of error is increased in this procedure, which deserves further exploration.@*Conclusion@#Utilizing digital technology as the leading method, combined with the traditional impression method of segmental impression, for the repair of dental defects in patients with limited mouth opening, has proven to be effective. Thus, patients report a positive medical experience with high satisfaction, indicating that this approach is worthy of clinical promotion.
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Tuberous sclerosis complex (TSC) is an autosomal dominant hereditary disease that affects multiple organs and systems throughout the body. TSC-associated kidney disease is the leading cause of death in adult TSC patients. This article retrospectively analyzed the characteristics of one TSC-related renal giant angiomyolipoma(RAML)treated with surgery. The patient, 25 years old, was diagnosed with tuberous sclerosis complex in 2000 due to multiple maculopapular rashes on both cheeks. At a regular follow-up in July 2019, imaging examinations revealed a tumor in the left lower quadrant with a maximum cross-sectional area of 16 cm×7 cm. Genetic testing showed a loss of heterozygosity in the EX18_ 41 of TSC2. After the diagnosis was confirmed, open left partial nephrectomy was performed, during which multiple tumors were found on the kidney surface and the largest one was located on the ventral side with a diameter of approximately 20 cm. After the renal artery was occluded, kidney tumors were completely enucleate. Postoperative pathological confirmed the diagnosis of angiomyolipoma. This case provides a reference for the treatment of TSC-related renal giant hamartoma.
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Objective:To analyze the application value of thromboelastography (TEG) in the prediction of lower limb deep vein thrombosis (DVT) after high-energy ankle injury surgery.Methods:The clinical data of 62 patients undergoing high-energy ankle injury surgery who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2021 were retrospectively analyzed. Based on the occurrence of lower limb DVT, the patients were divided into a control group (without lower limb DVT, n = 42) and an observation group (with lower limb DVT, n = 20). The conventional coagulation function indicators and TEG parameters were compared between the two groups. The receiver operating characteristic (ROC) curves were used to investigate the value of classic coagulation function indicators and TEG parameters in the prediction of lower limb DVT after high-energy ankle injury surgery. Results:The activated partial thromboplastin time in the observation group was (33.29 ± 3.40) seconds, which was significantly shorter than (35.66 ± 3.36) seconds in the control group ( t = 2.59, P < 0.05). The levels of fibrinogen and D-dimer in the observation group were (3.83 ± 0.46) g/L and (1.77 ± 0.43) g/L, respectively, which were significantly higher than (3.47 ± 0.51) g/L and (1.56 ± 0.35) g/L, respectively, in the control group ( P = -2.68, -.05, both P < 0.05). Prothrombin time and thrombin time showed no significant differences between the two groups (both P > 0.05). Coagulation reaction time and cell agglutination formation time in the observation group were (3.80 ± 0.83) minutes and (3.38 ± 0.51) minutes, respectively, which were significantly lower than (4.49 ± 1.21) minutes and (3.82 ± 0.55) minutes in the control group ( t = 2.30, 2.96, both P < 0.05). The maximum clot strength and coagulation rate (α angle) in the observation group were (78.69 ± 9.22) mm and (83.37 ± 9.30) °, respectively, which were significantly greater than (68.33 ± 9.10) mm and (71.25 ± 8.35) ° in the control group ( t = -4.17, -5.15, both P < 0.05). The ROC curve analysis found that the area under the ROC curve describing the prediction of combined indexes for lower limb DVT was 0.983, which was significantly greater than the area under the ROC curve describing the prediction of a single index for lower limb DVT (all P < 0.05). Conclusion:Activated partial thromboplastin time, fibrinogen, D-dimer, coagulation reaction time, red blood cell agglutination formation time, maximum clot strength, and α angle are significantly different between patients with DVT in the lower limb after surgery for an ankle injury and those without DVT. The combination of these indicators can serve as the basis for preventing and treating thrombosis in patients after high-energy ankle injury surgery, demonstrating remarkable practical advantages.
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Objective To establish a method for simultaneous determination of 11 components of Solanum nigrum from different producing areas,and to evaluate the quality by chemometrics and entropy weight-technique for order preference by similarity to ideal solution(EW-TOPSIS).Methods The 17 batches of Solanum nigrum samples from 8 provinces were collected.The high performance liquid chromatography(HPLC)method was used to simultaneously determine the contents of medioresino,pinoresinol,quercetin,rutoside,solasonine,solamargine,khasianine,solasodine,desgalactotigonin,diosgenin and β-sitosterol,and the multi-components quantitative control mode of Solanum nigrum was established.The quality evaluation model of Solanum nigrum was established by using chemical recognition pattern and EW-TOPSIS method,and the overall quality was evaluated comprehensively.Results When the 11 components were in the 0.78-39.00,0.55-27.50,0.34-17.00,0.21-10.50,41.87-2 093.50,60.95-3 047.50,2.58-129.00,1.02-51.00,0.46-23.00,1.05-52.50 and 0.42-21.00 μg/mL(r>0.999 0),their linear relationships were good.The average recovery was 96.81%-100.28%with the RSD<2.0%(n=9).17 batches of samples clustered into 3 categories.Solamargine,solasonine,desgalactotigonin and medioresino may be the main potential markers affecting the quality of Solanum nigrum.The results of EW-TOPSIS method showed that,the quality evaluation closeness of 17 batches of Solanum nigrum were 0.433 6,0.416 8,0.624 2,0.500 8,0.479 1,0.636 1,0.568 3,0.250 0,0.190 9,0.222 1,0.170 7,0.720 0,0.698 3,0.744 7,0.717 9,0.720 9 and 0.718 3,respectively,indicating that the overall quality of Solanum nigrum from Liaoning,Jilin and Heilongjiang were better,followed by Jiangsu,Henan and Anhui.Conclusion The established HPLC method for simultaneous determination of 11 components in Solanum nigrum is convenient and accurate.Chemometrics and EW-TOPSIS method are objective and comprehensive,which can be used for the overall quality evaluation of Solanum nigrum.
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Objective To establish the UPLC fingerprint chromatogram combined with chemometric analysis for the quality evaluation of classical formula Linggui Zhugan Decoction.Methods SHIMADZU Shim-Pack GIST C18 column(100 mm×2.1 mm,2.0 μm)was used with acetonitrile-0.1%phosphoric acid aqueous solution as mobile phase,gradient elution;flow rate was 0.2 mL/min;the detection wavelength was 266 nm for the first 30 minutes and 235 nm for the last 36 minutes;the column temperature was 30℃.The UPLC fingerprint of Linggui Zhugan Decoction was established by Similarity Evaluation System for Chromatographic Fingerprint of TCM(2012.130723 version),and the common peak was determined and the similarity evaluation was carried out.Based on the peak area determination results of the common peak of the fingerprint,the quality of different batches of Linggui Zhugan Decoction was evaluated by chemometrics such as clustering analysis and principal component analysis.Results A total of 24 common peaks were confirmed and 14 components were identified by using reference substances.The similarity of 10 batches of Linggui Zhugan Decoction samples was greater than 0.950,which could be divided into two categories by chemometrics,and the principal component 1-4 were the main factors affecting its quality evaluation.OPLS-DA identified 6 differential markers.Conclusion The fingerprint research method established in the study is simple,reliable and reproducible.Through the method of fingerprint combined with chemometrics analysis,the differences between Linggui Zhugan Decoction from different origins of medicinal materials are identified,which provides a reference for the internal quality evaluation of Linggui Zhugan Decoction.
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Objective:To construct a three-dimensional time-dose-response model for dose estimation and validate its feasibility.Methods:Based on a random number table, mice were divided into 0, 2, 4, 6, and 8 Gy groups for whole-body X-ray irradiation, with each group consisting of three mice. Hair follicle cells of whiskers were sampled at 1, 6, and 24 h after the irradiation. After immunofluorescence staining, the numbers of γ-H2AX foci at different time points from 1 to 24 h post-irradiation were observed using a confocal laser scanning microscope. The average numbers of γ-H2AX foci observed were corrected using the Dolphin’s model, followed by the fitting of dose-response curves. Using the R software, the equations and surfaces of the three-dimensional model for partial-body irradiation were established using the irradiation doses, post-irradiation time, and the corrected average numbers of γ-H2AX foci.Results:The average number of γ-H2AX foci increased with dose at fixed time points 1, 6, and 24 h but decreased with irradiation time at fixed doses 2, 4, 6, and 8 Gy. The dose-response curve equations of partial-body irradiation were fitted as follows: YF = 2.853+ 3.775 D, R2= 0.928, at 1 h after the irradiation; YF = 0.144+ 2.775 D, R2= 0.903, at 6 h after the irradiation; YF = 0.066+ 2.472 D, R2= 0.85, at 24 h after the irradiation. The three-dimensional model equation fitted was YF = 6.837 t-1.728+ 3.113 t-0.071D, R2=0.897. Substituting different post-irradiation time points into the three-dimensional surface model appeared as a two-dimensional linear model. By substituting the number of γ-H2AX foci and irradiation time into the linear and the three-dimensional models, both models yielded relative deviations between the estimated and actual radiation doses of 30% or less. Conclusions:The three-dimensional time-dose-response model, established by using the number of γ-H2AX foci to estimate partial-body irradiation doses, can be preliminarily applied for dose estimation at all time points 1-24 h after irradiation.
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Objective:To compare the outcomes of robot-assisted laparoscopic partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) in the treatment of tumors in isolated kidney, and analyze the factors influencing postoperative renal function and long-term survival in patients.Methods:A retrospective analysis was conducted on clinical data of 67 patients with tumors in isolated kidney who underwent surgery at the Chinese PLA General Hospital from November 2010 to January 2022. There were 48 males and 19 females, with an average age of (58.6±10.1) years old. The patients were divided into RAPN group (43 cases) and LPN group (24 cases) based on the surgical approach. The RAPN group had a higher R.E.N.A.L. score than the LPN group [(8.7±1.5) vs. (7.9±1.7), P=0.042]. There were no statistically significant differences between the two groups in terms of age [(57.4±10.2) years old vs. (60.9±9.8) years old, P=0.185], body mass index (BMI) [(25.7±3.5) kg/m 2 vs. (25.1±3.6) kg/m 2, P=0.518], and preoperative serum creatinine [(102.9±31.6) μmol/L vs. (102.3±22.4) μmol/L, P=0.930]. Twelve cases underwent hypothermic treatment during surgery, with 9 cases(20.9%) in the RAPN group and 3 cases(12.5%) in the LPN group( P=0.596). Surgical time, intraoperative warm ischemia time, intraoperative blood loss, postoperative fasting time, perioperative complication rate, postoperative serum creatinine, and other indicators were compared between the two groups. Multiple linear regression analysis was used to identify factors affecting postoperative serum creatinine. Kaplan-Meier curves were employed to analyze patient prognosis, and log-rank tests were performed to compare the differences between the two groups. Multiple Cox regression analysis was used to identify factors influencing patient prognosis. Results:All surgeries were completed successfully with negative pathological margins. There were no statistically significant differences between the RAPN and LPN groups in terms of surgical time [(136.6±47.6) min vs. (125.3±34.4) min, P=0.311], intraoperative ischemia time [23.0 (16.0, 30.0) min vs. 19.0 (13.5, 27.5) min, P =0.260], intraoperative blood loss [50.0 (50.0, 100.0) ml vs. 50.0 (22.5, 100.0) ml, P=0.247], postoperative hospital stay [(6.6±3.5) days vs. (7.7±4.2) days, P=0.244], time to drain removal [4(3, 5) days vs. 5(3, 6) days, P =0.175], postoperative fasting time [(2.1±0.7) days vs. (2.2±1.0) days, P=0.729], perioperative complication rate [18.6% (8/43) vs. 16.7% (4/24), P=1.000], postoperative serum creatinine [145.2 (128.3, 191.3) μmol/L vs. 157.8 (136.2, 196.3) μmol/L, P =0.229], and pathological staging [T 1a/T 1b/T 2a/T 3a/T 4 stage: 32/7/1/3/0 case vs. 17/5/0/1/1 case, P=0.804]. Kaplan-Meier survival curves showed that the total survival rates at 1, 3, and 5 years after surgery were 94.7%, 84.9%, and 84.9% for the RAPN group, and 100.0%, 95.5%, and 95.5% for the LPN group, with no statistically significant difference in the log-rank test ( P=0.116). Excluding 10 patients with preoperative tumor metastasis (7 in the RAPN group and 3 in the LPN group), the progression-free survival rates at 1, 3, and 5 years after surgery were 84.8%, 81.1%, and 81.1% for the RAPN group, and 100.0%, 95.0%, and 90.0% for the LPN group, with no statistically significant difference in the log-rank test ( P =0.142). Multiple linear regression analysis showed that the use of hypothermic treatment during surgery significantly reduced postoperative serum creatinine ( B=-72.191, P=0.048). Multiple Cox regression analysis revealed that BMI ( HR=0.743, P=0.044), pathological T stage ( HR=4.235, P=0.018), and preoperative metastasis ( HR=18.829, P=0.035) were independent factors affecting patient overall survival time. A smaller BMI, higher pathological stage, and preoperative metastasis were associated with poorer prognosis. Conclusions:Despite the higher R. E.N.A.L. score and greater surgical difficulty in the RAPN group, RAPN achieved similar perioperative and prognostic results as the LPN, indicating RAPN advantages in treating tumors in isolated kidney. Appropriate intraoperative hypothermic treatment can better protect postoperative renal function. BMI, pathological T stage, and preoperative metastasis are independent factors affecting overall survival time.
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When partial nephrectomy is performed by posterior abdominal approach, the surgical field is poorly exposed, resulting in increased surgical difficulty and risk of injury.In this study, 28 patients with T 1a stage kidney tumors underwent retroperitoneal laparoscopic partial nephrectomy. Intraoperatively, exposure of the surgical field was achieved using the percutaneous puncture of the renal fascia suspension technique. There were no dissatisfactory exposures due to peritoneal damage during the surgery, no additional tubes were inserted, and no conversions to open surgery were needed. The operation time was (76.5±20.3) minutes, blood loss was (92.1±18.7) ml, renal artery clamping time was (19.5±4.3) minutes. Postoperatively, there were no complications such as bleeding, infection, or hematuria.
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AIM To investigate the variation rules of main secondary metabolites in Hedysari Radix before and after rubbing strip.METHODS UPLC-MS/MS was adopted in the content determination of formononetin,ononin,calycosin,calycosin-7-glucoside,medicarpin,genistein,luteolin,liquiritigenin,isoliquiritigenin,vanillic acid,ferulic acid,γ-aminobutyric acid,adenosine and betaine,after which cluster analysis,principal component analysis and orthogonal partial least squares discriminant analysis were used for chemical pattern recognition to explore differential components.RESULTS After rubbing strip,formononetin,calycosin,liquiritigenin and γ-aminobutynic acid demonstrated increased contents,along with decreased contents of ononin,calycosin-7-glucoside and vanillic acid.The samples with and without rubbing strip were clustered into two types,calycosin-7-glucoside,formononetin,γ-aminobutynic acid,vanillic acid,calycosin-7-glucoside and formononetin were differential components.CONCLUSION This experiment clarifies the differences of chemical constituents in Hedysari Radix before and after rubbing strip,which can provide a reference for the research on rubbing strip mechanism of other medicinal materials.
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Objective To screen the active components of total flavonoid extracts of Sarcandra glabra to promote megakaryocyte differentiation.Methods(1)A model of megakaryocyte differentiation disorder was established by co-culturing human megakaryocytic leukaemia cells(Dami)with human bone marrow stromal cells(HS-5)as an evaluation system,and the experimental groupings were as follows:the Dami group(Dami),the control group(Dami+HS-5),and the PMA group[Dami+HS-5+5 ng·mL-1 foprolol 12-tetradecanoate 13-acetate(PMA)],and model group[Dami+HS-5+1%rabbit anti-rat platelet serum(APS)+5 ng·mL-1 PMA]were cultured for 48 hours.The expressions of megakaryocyte differentiation and maturation surface marker molecules,CD41a and CD61 were detected by flow cytometry.(2)Forty-nine SD male rats were randomly divided into blank plasma group,15-minute group,30-minute group,60-minute group,90-minute group,120-minute group,and 240-minute group,with 7 rats in each group.The rats in each administration group were gavaged with 1.26 g·kg-1 of total flavonoids extracts of Sarcandra glabra,and blood was collected at six set time points(15,30,60,90,120,240 minutes)for the preparation of time-dependent serum-containing plasma of total flavonoids extracts of Sarcandra glabra.(3)Ultra-high performance liquid chromatography-quadrupole tandem time-of-flight mass spectrometry(UHPLC-Q-TOF/MS)was used to analyze the plasma of the time-dependent serum-containing plasma of the total flavonoids extracts of Sarcandra glabra,and the peak area was used to construct a matrix(X-matrix)of the amount of chemical composition change over time in the time-dependent serum-containing plasma of the total flavonoids extracts of Sarcandra glabra.The collected time-dependent serum-containing plasma of the total flavonoids extracts of Sarcandra glabra at six different time points was used to intervene in the model of megakaryocyte differentiation and maturation disorder,and the expression of cell surface molecules CD41a and CD61 was detected by flow cytometry to construct the matrix of effect of time-dependent serum-containing plasma of the total flavonoids extracts of Sarcandra glabra(Y-matrix).(4)After the data of X and Y matrices were standardized,partial least squares(PLS)was used to calculate and analyze the quantitative and qualitative effect relationship,and variable importance for projection(VIP)>1 was used as the threshold to screen the effect components related to the changes of cell surface molecules CD41a and CD61,and chemical composition identification,as the potential effector components in the total flavonoid extracts of Sarcandra glabra were used to promote the differentiation of megakaryocytes,and finally the regression evaluation system was used to verify the efficacy of its medicinal effect.Results(1)Compared with the Dami group,the expression level of CD41a on the surface of Dami cells in the control group was significantly increased(P<0.05).Compared with the control group,the expression levels of CD41a and CD61 on the surface of Dami cells in the PMA group were significantly increased(P<0.01).Compared with the PMA group,the expression levels of CD41a and CD61 on the surface of Dami cells in the model group were significantly reduced(P<0.01).(2)Compared with the blank plasma group,the expression levels of the molecules CD41a and CD61 on the surface of Dami cells at each time point of 15,30,60,90,120,and 240 minutes were significantly increased(P<0.01),and the expression levels of CD41a and CD61 were both highest in the 30-minute group.The potential effective components with VIP value greater than 1 were screened out in the positive and negative ion mode,and 540.3638@12.25 and 559.2991@11.53 were selected for pharmacodynamic verification.559.2991@11.53 was identified as daucosterol(Dau),540.3638@12.25 was identified as rosmarinic acid 4-O-β-D-glucoside(Ros).After Ros and Dau intervened in the megakaryocyte differentiation and maturation disorder model respectively,the expression levels of CD41a and CD61 on the surface of Dami cells in the low-,medium-and high-dose groups(40,60 and 80 μg·mL-1)of Ros and Dau were significantly increased compared with the model group(P<0.05,P<0.01).Conclusion Ros and Dau may be the active components of the total flavonoids extracts of Sarcandra glabra to promote the differentiation of megakaryocytes.
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Objective The contents of 11 nucleosides and base components in 10 batches of samples from 5 provinces(cities)including Chongqing,Yunnan and Shaanxi were determined,and the differences in nucleosides and base components in Fritillaria taipaiensis were compared by chemometric analysis,and the quality was comprehensively evaluated,so as to provide a reference for the cultivation of excellent varieties and the selection of medicinal materials.Methods Nucleoside and base components were extracted from Fritillaria taipaiensis by ultrasonication in aqueous solutions,and the content of each component was determined by HPLC-DAD method.The origin was classified by principal component analysis(PCA)and hierarchical cluster analysis(HCA).Partial least squares discriminant analysis(PLS-DA)was used to determine the differentiated index components in Fritillaria taipaiensis.Then the differences in the contents of the index components among samples from different origins were compared.Results It was found that 11 nucleoside and base components differed significantly among different origins of Fritillaria taipaiensis.Principal component analysis and hierarchical cluster analysis indicated that all samples could be clustered into 4 categories.Five characteristic components,including uracil,cytosine,uridine,inosine,and adenosine,were identified by PLS-DA.The nucleosides and bases in samples from Chongqing and Hubei were relatively high,and the quality of the samples was comparatively superior.Conclusion This method is simple,reproducible,accurate and reliable.It has screened out the index nucleoside and base components in the identification of Fritillaria taipaiensis of different origins,which can be used to initially elucidate the differences of samples between different origins.Additionally,it can better reflect the quality of Fritillaria taipaiensis,and can provide reference for the selection of procurement origin and the quality control for Fritillaria taipaiensis.
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Objective To establish a method for simultaneous determination of HPLC fingerprint and multi-target ingredients in Atractylodis Macrocephalae Rhizoma(AMR),in order to provide reference for its quality control.Methods HPLC-DAD multi-wavelength switching method was used to establish fingerprint of AMR,similarity evaluation combined with hierarchical clustering analysis(HCA),principal components analysis(PCA)and discriminant analysis of partial least squares(PLS-DA)were used to carry out chemometric study.The contents of differential component such as atractylenolide Ⅰ,Ⅱ,Ⅲ and atractylon were determined simultaneously.Results The HPLC fingerprint of 37 batches of AMR was established.Nine common peaks were marked,and 4 of them were identified as atractylon,atractylenolide Ⅰ,Ⅱ,Ⅲ.The similarity degrees were between 0.539 and 0.996,the quality of AMR from different origin and different batches varies greatly.Atractylon,atractylenolide Ⅰ,Ⅱ,Ⅲ and one unknown component(peak 9)are the important factors affecting the quality of AMR.Conclusion The combination methods of HPLC fingerprint and simultaneous determinations of multiple components are simple,stable,accurate and reliable,which can provide reference for the quality evaluation of AMR and the improvement of quality standard,as well as lay a foundation for the basic research of its pharmacodynamic substances and related compound.
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@#Objective To evaluate the safety and mid- to long-term efficacy of surgical correction of isolated partial anomalous pulmonary venous connection (IPAPVC). Methods We retrospectively collected consecutive patients who were diagnosed with IPAPVC and underwent surgical correction at Fuwai Hospital of Chinese Academy of Medical Sciences and Fuwai Yunnan Cardiovascular Hospital from June 2009 to May 2019, summarized the basic preoperative and intraoperative data of patients, analyzed the postoperative and mid- to long-term follow-up results. Results A total of 54 patients were enrolled, including 29 males and 25 females, with an average age of 16.20±2.40 years, ranging from 1 month to 62 years. There were 28 (51.9%) patients with varying degrees of arrhythmia, 22 (40.7%) patients with cardiac insufficiency, and 39 (72.2%) patients with pulmonary hypertension. According to Bordy's typing, 14 (25.9%) patients were classified as type A, 23 (42.6%) type B, 4 (7.4%) type C, 5 (9.3%) type D and 8 (14.8%) mixed type. Transthoracic echocardiography was performed in the whole group of patients and the accuracy of staging diagnosis was 66.7% (36/54), and cardiac CT angiography (CTA) was performed in 37 patients and the accuracy of staging diagnosis was 94.6% (35/37). All surgical procedures were assisted with cardiopulmonary bypass, aortic cross-clamping time was 0-219 (67.02±5.23) min, cardiopulmonary bypass time was 40-261 (105.09±5.23) min, and there was no serious intraoperative complication. Postoperative tracheal intubation time was 0-230 (13.33±4.20) h, intensive care unit stay was 0-13 (1.89±0.28) days, postoperative hospital stay was 5-18 (7.20±0.38) days, and follow-up time was 16-140 (62.58±5.12) months. There were 2 (3.7%) all-cause postoperative deaths, including 1 in-hospital death and 1 death during the follow-up, and there was no intraoperative death. Among the survivors, there were 3 patients with surgery-related complications: 1 patient had atrial septal defect with the second surgical treatment, 1 early obstruction of the superior vena cava and 1 arrhythmia. Two patients had complications of IPAPVC (atrial fibrillation, collateral circulation) prior to surgery and underwent the second surgery with a poor prognosis, and 1 patient had preoperative cardiac insufficiency and atrial fibrillation, whose symptoms persisted for a long time during the follow-up. Conclusion IPAPVC accounts for a lower percentage of partial anomalous pulmonary venous connection, transthoracic echocardiography combined with CTA improves diagnostic accuracy, and IPAPVC should be treated with elective surgery after diagnosis. The surgical approach should be individualized with imaging features such as disease staging, number of drains and drainage location. Surgical treatment of IPAPVC is safe and effective, and regular follow-up is warranted.
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ObjectiveTo assess the repeatability (intra-operator variability) and reproducibility (inter-operator variability) of a new partial coherence interferometry (PCI)-based ocular biometer, Myopia Master, and its agreement with IOL Master 500 for measuring axial length (AL) and corneal curvature (K) in children aged 8-12 years. MethodsThe same operator measured school children with the Myopia Master and the IOL Master 500 in random order to assess agreement. Additionally, some of these children received measurements from another operator using the Myopia Master to assess repeatability and reproducibility. AL, flat keratometry (Kf), steep keratometry (Ks), mean keratometry (Km), J0 and J45 were analyzed. The repeatability and reproducibility were assessed by the within-subject standard deviation (Sw), test-retest repeatability (TRT), coefficient of variation (CoV) and intra-class correlation coefficient (ICC). The agreement between the Myopia Master and the IOL Master 500 was assessed by Bland-Altman plots and 95% limits of agreement (LoA). ResultsBoth repeatability and reproducibility of the Myopia Master were high for AL measurements (Sw=0.02 mm, ICC=0.999; Sw=0.04 mm, ICC=0.998), but moderate for K measurements (Sw range, 0.04 to 0.12 D, ICC range, 0.861 to 0.991; Sw range, 0.06 to 0.20 D, ICC range, 0.835 to 0.992). There were significant mean differences between the Myopia Master and the IOL Master 500 in measurements of AL (-0.01±0.04) mm, Kf (-0.09 ± 0.15) D, Ks (-0.47±0.40) D, and Km (-0.28±0.23) D, J0 (0.18±0.20) D and J45 (-0.01±0.12) D. ConclusionsThe Myopia Master provided high repeatability and reproducibility for AL measurements in schoolchildren with myopia, but the Myopia Master and the IOL Master 500 cannot be used interchangeably in measuring AL and K.
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【Objective】 To analyze the position of the feeding artery entering the renal cell carcinoma (RCC) with 3D Slicer software, so as to explore the distribution pattern of the tumor artery and to provide an anatomical basis for the accurate surgical resection. 【Methods】 The clinical data of RCC patients who underwent partial nephrectomy in the Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University during Jan.2021 and Jun.2022 were collected.The preoperative renal artery CT angiography data were imported into 3D Slicer software in DICOM format to construct the relative positions of tumor-feeding artery from horizontal, sagittal and coronary planes.The number and distribution of tumor feeding arteries in each plane were analyzed. 【Results】 A total of 112 patients (59 male and 53 female) with single tumor were involved.RENAL score was 4-10.The tumor stages were T1a in 58 cases, T1b in 48 cases, and T2a in 6 cases.Among them, 38 cases (33.93%) had 1 tumor artery, 53 cases (47.32%) had 2 tumor arteries, and 21 cases (18.75%) had 3 tumor arteries.Of these 207 tumor arteries, 22 (10.63%) entered the tumor through the superficial part of the tumor bed, and 185 (89.37%) through the deep part. 【Conclusion】 In localized RCC, nearly 90% of the feeding arteries enter the tumor from deep part of the tumor bed, which provides an anatomical basis for accurate tumor resection and wound suture in partial nephrectomy.