Investigation of irrational drug use in elderly patients and analysis of influence factors of potentially inap-propriate medications andinfluence factors analysis of potential inappropriate medication in geriatric patients in senile people / 医学研究生学报

Objective The proportion of multiple drugs and the irrational use of drugs increased significantly in the elderly patients (over 80 years). This study aimed to investigate the occurrence of potentially inappropriate medication (PIM) and analyzed the possible reasons related to PIM in elderly patients. Methods In this study,918 cases from Cadre Ward I of Research Center for Geriatrics of Nanjing General Hospital of Nanjing Military Region were selected from January to December in 2016. According to the Beers Criteria (Version 2015),we evaluated PIM in four subtypes,type 1 that is not related to the state of disease in elderly patients, type 2 that is related to the state of disease in elderly patients,type 3 which should be used carefully,and type 4 which is the inappropriate combination of non-anti-infective Drugs. The PIM influence factors were analyzed by logistic regression analysis. Results There are 521 cases (56.75%) of type 1 PIM. The first 3 drugs are Short and medium acting benzodiazepams,PPI and long acting benzodiazepams. There are 206 cases (22.4%) of type 2 PIM. The first 2 drugs are drugs associated with insomnia (oral hyperemia, stimulants, theo-phylline and caffeine) and drugs associated with dementia or cognitive impairment (anti-cholinergic drugs and H2 receptor antago-nists). There are 834 cases (90.85%) of type 3 PIM,which should be used carefully and 45 cases(4.90%) of type 4 PIM.45 cases (4.90%) of non-anti-infective drugs should be avoid or reduced as much as possible in consideration of renal function. The number of combined drug use(OR=5.331,95% CI:3.549-8.009),the age(OR=1.171,95% CI:1.093-1.249),the Chalson's comorbidity index (OR=1.964,95% CI:1.477-2.450) are risk factors of PIM. Conclusion The incidence of potentially inappropriate use of drugs is high among the elderly patients. Reducing the number of combined drugs is an important measure to avoid the occurrence of PIM in elderly patients.

Histological study about the effect of orthodontic loading time and duration on the periodontal repair in autologous tooth transplantation / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The study established an animal model of autologous tooth transplantation in dogs and aimed to explore the effects of orthodontic loading time and duration on the periodontal repair in autologous tooth transplantation.</p><p><b>METHODS</b>12 Beagle dogs were selected and grouped randomly in this research. Four first premolar teeth in every dog were carried on autologous transplant operation. These teeth were exerted the orthodontic force after the operation in 2, 4, 8 and 12 weeks respectively. The loading duration was 1, 2 and 4 weeks respectively. We examined the dental and periodontal tissue samples in first premolar teeth by histological study, measured root absorption rate and analyzed reconstruction condition of periodontal tissue with statistical methods.</p><p><b>RESULTS</b>Root absorption rates of the experimental group which was exerted the orthodontic force were lower than those of the control group. The difference between two groups had statistical significance (P < 0.05). Root absorption rates in different levels of orthodontic loading time (X) and the duration (Y) had no statistical significance (P > 0.05), but these two factors had interaction effect (P(X x Y) < 0.05).</p><p><b>CONCLUSION</b>Orthodontic force contributes to the improvement of root absorption and reconstruction of periodontal tissue in transplant teeth. The orthodontic loading time and the duration have no obvious effect on root absorption rate of transplant teeth. When X is two weeks and Y is four weeks, it is most beneficial for the reconstruction effect of periodontal tissues in transplant teeth.</p>

Factors influencing subjective orthodontic treatment need and culture-related differences among Chinese natives and foreign inhabitants / 国际口腔科学杂志·英文版

<p><b>AIM</b>The aim of this survey was to compare Chinese natives and foreign inhabitants in Chengdu, China, with respect to: (1) attitudes towards dental appearance, (2) subjective orthodontic treatment need, and (3) the main factors influencing orthodontic treatment need.</p><p><b>METHODOLOGY</b>A total of 522 subjects, including 227 foreign inhabitants and 295 Chinese natives in Chengdu participated in the survey. A simple random sampling method was adopted and a face-to-face interview was conducted at some public sites using a questionnaire. Data was entered by two persons synchronously using Epidata 3.0, and SPSS 13.0 was used to analyze these data.</p><p><b>RESULTS</b>89.0% of foreign inhabitants were satisfied with their teeth compared to only 46.8% of Chinese natives. Females were more dissatisfied with their teeth than males. Chinese natives put improving appearance as the top priority (55.9%) for seeking orthodontic treatment; however, in foreign inhabitants, the main reason for seeking treatment was to improve masticatory function (44.1%), followed by "to be pretty" (35.2%). The importance of well-aligned teeth and self-perception of psychosocial impact of malocclusion were the same two main factors influencing subjective orthodontic treatment need (P < 0.05) in foreign inhabitants and Chinese natives. Subjective orthodontic treatment need between the two target groups was significantly different (P < 0.05).</p><p><b>CONCLUSION</b>(1) It was very common that Chinese natives were dissatisfied with their dental appearance, and their subjective orthodontic treatment needs were high. (2) There were some differences in orthodontic treatment motives between the two target groups. (3) There were differences in subjective orthodontic treatment needs between foreign inhabitants and Chinese natives. However, the prominent influential factors were almost the same. There may be benefit to understanding subjective orthodontic needs of different races.</p>

The technique characteristic and clinical application of HX straight-wire appliance / 华西口腔医学杂志

HX straight-wire appliance (HX-SWA) is designed and adjusted by doctors of Orthodontic Department, West China College of Stomatology, Sichuan University. It is a set of appliance that is constructed according to normal occlusion features of the Chinese people, including the prescription of tip, torque, in/out, counter-tip, counter-rotation and overcorrection in brackets and buccal tubes. Some ingredients of the appliance are different from that of the most popular Roth straight-wire appliance in the world wide. Over a period of the last 10 years, doctors in our hospital kept on summarizing treatment experience with HX-SWA, which will help more doctors promote practice and results in orthodontic clinic.

Angle's class II malocclusion: a report of seven cases in one family / 华西口腔医学杂志

A family with Angle's Class ii malocclusion was identified in West China Stomatological Hospital of Sichuan University. The proband was a 22-year-old woman with Angle's Class II Division 2 malocclusion with congenitally missing teeth. A total of 15 members of the 3 generations in the family were investigated. There were 7 members (3 males, 4 females) with Angle's Class II malocclusion in the family. The results provide the primary basis for further study to localize the virulence gene.

The skeletal regulating mechanisms and concepts in growth and development of cranial-facial bones and orthodontic treatment / 华西口腔医学杂志

There are three kinds of mechanisms regulating the growth and development of skeletal tissue: Bone growth, bone modeling and bone remodeling. However, in the current orthodontics literature, there continues to be substantial confusion regarding the usage of the term "bone remodeling". This article reviews the historical causes for this semantics problem and explains the difference between bone modeling and remodeling, as well as the detailed skeletal regulating mechanisms in the growth and development of cranial-facial bones and orthodontic treatment. At last, this article suggests Chinese orthodontists use the terms "bone modeling" and "bone remodeling" more precisely to avoid scientific confusion and barriers to scientific exchange with other biomedical disciplines.

Effect of asymmetry traction on the expression of type II collagen in adult rat condyle / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The aim of this investigation was to study the expression of collagen type II in the cartilage of mandibular condyle following asymmetric inter-maxillary traction.</p><p><b>METHODS</b>Two hundred and twenty SD rats were used in this study (one hundred and four rats loading 0.39 N elastic force, another one hundred and four rats loading 1.18 N elastic force, while twelve rats for control). The extra-joint device was fixed on the right side by surgery. Half of the experimental group was killed at 3, 7, 14, 28 days. The devices were removed at the 28th day in the rest rats, and the rats were sacrificed at 3, 7, 14, 28 days after removing the device. The type II collagen expression levels of all the joints were measured using immunohistochemical techniques.</p><p><b>RESULTS</b>The positive expression of the type II collagen was mainly observed in the cytoplasm of chondrocyte, especially in maturative and hypertrophic layer. The expression intensity was different in different stages and different sides. Both of the two experimental groups showed the same tendency, while the changes in the light force group were more obviously than the heavy force group. In the right side (force-loading side), the type II collagen expression decreased at the early force-loading period. After the device was removed, the expressions increased immediately but then reach the lowest level. The expression almost recovered to normal level at the end of experiment. In the left side (none force-loading side), the expression remained increasing after force-loading and reached the peak at the 14th day.</p><p><b>CONCLUSION</b>These results suggest that even in the adult individuals, the chondrocyte showed reaction to the mechanical force by altering type II collagen expression patterns and it may be the cause of the cartilage remolding after asymmetric inter-maxillary traction. A forward elastic force showed a depressant effect in matrix synthesis, and heavy force had stronger effect. But the rotation of condyle accelerated the matrix synthesis.</p>

Displacement of impacted mandibular canine: a case report / 华西口腔医学杂志

The long distance displacement of canine is a rare phenomenon in orthodontic clinic. Its related clinical epidemiology, etiology, diagnosis and treatment methods are briefly summarized, and a case of mandibular canine displaced in chin is reported.

Effects of orthodontic tooth movements on insulin-like growth factors expression in periodontal tissues / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To elucidate the regulatory bio-mechanism of estrogen and local stress on the bone remodeling activities in vivo.</p><p><b>METHODS</b>A Wistar rat experimental model was established to apply orthodontic activation during different stages of estrous cycle. In situ hybridization was used to detect the variation of the insulin-like growth factors (IGF) mRNA expression in the periodontal tissues. The data of each group was analyzed with SPSS 11.0 software package for Student-Newman-Keuls (S-N-K) test and one way ANOVA test.</p><p><b>RESULTS</b>Both IGF-I mRNA and IGF-II mRNA level expressed in the periodontal tissues were increased by orthodontic activation during various stages of the estrous cycle. But a similar pattern emerged that the IGF-I mRNA level was the lowest in the estrous stage, whereas its level was the highest in the proestrus stage (P < 0.05). No rhythm of IGF-II mRNA expression found during the estrous cycle.</p><p><b>CONCLUSION</b>It was concluded that local mechanical stimulation directly enhanced the IGF expression. In contrast to the IGF-II, IGF-I was also influenced by the sex hormone rhythm during the estrous cycle.</p>

A bio-mechanism study of differential orthodontic tooth moving speed during the estrous cycle / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The purpose of this article was to investigate the changes of the estrogen and insulin-like growth factors (IGF) level induced by orthodontic tooth movements in order to elucidate the bio-mechanism of orthodontic treatments during the estrous cycle.</p><p><b>METHODS</b>A Wistar rat experimental model was established to apply orthodontic activation during different stages of estrous. The serum and periodontal tissue estradiol level were determined by radioimmunoassay and immunohistochemistry. In situ hybridization was also used to detect the variation of the IGF mRNA expression in the periodontal tissues. The data of each group was analyzed with SPSS 11.0 software package.</p><p><b>RESULTS</b>Both serum and periodontal estradiol level were increased by orthodontic activation during various stages of the estrous. IGF mRNA expression were also enhanced with the same trend. The estradiol and IGF- I level showed in a similar pattern during the estrous cycle and the rhythm was not changed by the orthodontic activation. There was no rhythm of IGF-II expression found in the estrous cycle.</p><p><b>CONCLUSION</b>It was concluded that estrogen and IGF were involved in the remodeling activities induced by the orthodontic activation. The speed of the orthodontic tooth movements was closely related to the estrous cycle.</p>

Improvement on the making process of double splints before orthognathic surgery of skeletal Class III / 华西口腔医学杂志

The conventional methods on making double splints in presurgery of skeletal Class III were complicated. To find an easy method for the improvement of the production of splints and simplify the making process, 17 severe skeletal Class III patients accepted bimaxillary surgery after making double splints were used. According to visual treatment objective (VTO) forecasting on the lateral cephalometric radiograph of ending presurgical orthodontics and analyzing study models, the surgical methods were designed, the mobile osteotomy bone volume was estimated and the maxillary abnormity was classified. For the patients with right midline and without adjusting their occlusion plane, use the single model method (antedisplace maxillary model twice) or double models method (antedisplace maxillary model firstly, and then retrodisplace mandibular model) to make the double splints which guided the fixtion of bimaxillary surgery through their parallel models and simple articulators. The making process of the double splints was simplified and improved, and the postsurgery effects of all patients were satisfied. Therefore, for making the double splints of skeletal Class III bimaxillary surgery, utilizing the proper method on the basis of the specific abnormal conditions of patients can simplify the production process and get twice the result with half the effort.

Early-response of the condylar chondrocyte under cyclic uniaxial compressive stress / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the protein profile after treatment of the cyclic uniaxial compressive stress on the rat condylar chondrocyte in vitro.</p><p><b>METHODS</b>The third-passage chondrocytes were harvested from the mandibular condyles of 2-day-old rats, and a cellular compressive stress device (self-made four-point bending system) was used to apply stress on cells at 2000 microstrain and 4000 microstrain (0.5 Hz frequency) for 60 min. The early effects of cyclic uniaxial compressive stress on the protein profile of the rat mandibular condylar chondrocytes were examined by two dimensional polyacrylamide gel electrophoresis (2D-PAGE) and matrix-assisted laser-desorption ionization time of flight mass spectrometry (MALDI-TOF-MS).</p><p><b>RESULTS</b>The results showed that the protein profile of the condylar chondrocyte did not change statistically in 2000 microstrain group. In 4000 microstrain group, the protein profile of the condylar chondrocyte was changed. Three new proteins appeared. Five proteins disappeared. Twenty-two proteins were down-regulated and 7 proteins were up-regulated (P < 0.05). The eight different protein spots were identified by MALDI-TOF-MS. It included cytoskeleton protein (gamma-actin and vimentin), glycometabolism protein (alpha enolase and stress-70 protein) and signal transduction protein (Raf kinase inhibited protein, RKLP).</p><p><b>CONCLUSIONS</b>There were significant alternations of the protein profile in the rat condylar chondrocyte after the 4000 microstrain cyclic uniaxial compressive stress loading for 60 min. These different proteins might take part in the early response to the cyclic uniaxial compressive stress.</p>

Influence of orthodontic force on osteoprotegerin and osteoprotegerin ligand mRNA expression in the inflammatory periodontal tissues / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore certain principle of how osteoprotegerin (OPG) and osteoprotegerin ligand (OPGL) take part in the periodontal tissues remodeling under the combined influence of inflammation and orthodontic force.</p><p><b>METHODS</b>The positive signals of OPG and OPGL mRNA were measured with in situ hybridzation after orthodontic tooth movement in the experimental periodontitis groups and control ones.</p><p><b>RESULTS</b>The OPG and OPGL mRNA expression intensity in the experimental group showed difference from control. All their optical density index reached a peak in day 2, respectively.</p><p><b>CONCLUSION</b>OPG and OPGL play important roles in the periodontal reconstruction induced by inflammation irritation and orthodontic force, and complex interaction could exist between the two factors.</p>

Early effects of the cyclic uniaxial compressive stress on Actin and Vimentin of the rat condylar chondrocytes / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the early effects of the cyclic uniaxial compressive stress on Actin and Vimentin of the rat condylar chondrocyte.</p><p><b>METHODS</b>The third-passage chondrocyte were harvested from the mandibular condyles of 2-day-old rats, and a cellular compressive stress device was used to apply stress on cells at 4 000 microstrain for 15, 30, 60, 120, 240 min. The early effects of the cyclic uniaxial compressive stress on Actin and Vimentin of the rat mandibular condylar chondrocytes were examined by laser scanning confocal microscope (LSCM), immunofluorescence technique and Western blot.</p><p><b>RESULTS</b>The expression of fluorescent light of cys-toskeleton protein changed obviously with 4000 microstrain compressive stress loading. The expression of Actin significantly decreased in 60 min, and the expression of Vimentin decreased in 30 min. Then the expression of these two protein recovered in 120 min.</p><p><b>CONCLUSION</b>There are time-responsiveness between the 4000 microstrain compressive stress stimulate and Actin, Vimentin. It shows the expression of Actin and Vimentin down-regulated at first under the compressive stress, then increased by feedback. It hints that there are "self-regulate" mechanisms in the cell response to mechanics stimulate.</p>

Periodontal expression pattern of osteopontin mRNA induced by orthodontic tooth movement in pregnant and non-pregnant rats / 华西口腔医学杂志

<p><b>OBJECTIVE</b>Through orthodontic tooth movement in the pregnant and non-pregnant rats, to investigate the osteopontin (OPN) mRNA expression pattern in the periodontal tissues, and to probe its possible roles in orthodontic periodontal remodeling.</p><p><b>METHODS</b>Fixed appliances were used to mesially move the rats' maxillary first molars. In situ hybridization method was used to detect the expression changes of OPN mRNA in periodontal tissues.</p><p><b>RESULTS</b>Compared to the non-pregnant rats, the expression of OPN mRNA in periodontal cells of the pregnant rats was more intensive. During the gestational period, the expression intensity had significant difference at different pregnant stages. The highest expressions occurred at the mid-pregnant stage, less at the late-stage and lest at the early-stage.</p><p><b>CONCLUSION</b>Under the pregnant state, the expression of OPN mRNA in periodontal tissues may be up-regulated by increased serum progesterone level.</p>

Changes in expression of gelatinase in young rat condylar cartilage during functional mandibular advancement / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the changes in expression of gelatinase (MMP-2, MMP-9) in young rat condylar cartilage during functional mandibular advancement.</p><p><b>METHODS</b>Sixty male 5-week old SD rats were divided into experimental and control groups. The mimic functional appliances were used in experimental group rats. The animals were sacrificed after 1, 2, 4 weeks. The immunoreactivity of gelatinase was detected by immunohistochemistry.</p><p><b>RESULTS</b>In normal mandibular condylar cartilage, the immunoreactivity of MMP-2 was rather strong, the immunoreactivity of MMP-9 was very weak. Following functional mandibular advancement, the expression of MMP-9 was significantly increased (P < 0.01), but immunoreactivity of MMP-2 had no significant changes.</p><p><b>CONCLUSION</b>Gelatinase plays an important role in the adaptive remondling of young rat condylar cartilage during functional mandibular advancement.</p>

Differential regulation of P2X3 protein expression in the rat trigeminal ganglion after experimental tooth movement / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the regulation of P2X3 protein expression in the trigeminal ganglion sensory neurons after the nociceptive stimulation by orthodontic tooth movement force.</p><p><b>METHODS</b>Male Sprague-Dawley rats weighing 200-250 g were used. The mimic tooth movement appliance was used in experimental group rats. The animals were sacrificed after 4 h, 1 d, 2 d, 3 d, 5 d, 7 d and 14 d. The semi-quality of P2X3 protein was measured by Western blot. The expression place and strength of P2X3 was detected by in situ hybridization with an oligonucleotide probe in the same time.</p><p><b>RESULTS</b>A major specific protein of 4.5 x 10(4) was found by Western blot in trigeminal ganglion of rats. The expression strength of P2X3 receptor increased after given force to the teeth of rats from 1 day of experiment, 3 day group rats showed peak change. 14 day group had returned to control values. The level change of P2X3 mRNA expression showed the same result.</p><p><b>CONCLUSION</b>The results suggest that the P2X3 receptor expression is transiently upregulated and anterogradely transported in trigeminal primary sensory neurons after orthodontic tooth movement and that P2X3 receptor may play role in the pathomechanism of nociceptive in primary sensory neurons during orthodontic clinic treatment.</p>

Effects of mesenchymal stem cells transplantation on cranial suture distraction osteogenesis in growing goats / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To observe the effects of mesenchymal stem cells (MSCs)on cranial suture under mechanical strain in growing goats.</p><p><b>METHODS</b>10 growing goats were used in this study. A customized distractor was used for distraction of the coronal suture at a rate of 0.4 mm/day for 8 days. The experimental group(5 goats) was injected with autologous MSCs into the distracted region, whereas the control group (5 goats) with injection of physiological saline. All animals were killed at 4 weeks after the end of distraction. Scanning electron microscopy and histological analysis were taken to observe the samples.</p><p><b>RESULTS</b>4 weeks after the end of distraction, the cranial sutures in all animals were separated successfully. The new bone formation at the edge of suture in the experimental group was superior to that in the control group.</p><p><b>CONCLUSION</b>Autologous MSCs transplantation may promote the cranial suture distraction osteogenesis in the growing goats.</p>

Dimensional differences in craniofacial morphologies of prepubescence Class II patients with deep and shallow mandibular antegonial notching / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To identify certain craniofacial characteristics of untreated prepubescence Class II patients with deep and shallow mandibular notching.</p><p><b>METHODS</b>18 untreated preadolescent Class II patients with deep mandibular notching and 17 untreated preadolescent Class II patients with shallow mandibular notching were selected. Each subject's pretreatment lateral cephalogram was traced. Seventeen angular and eleven linear measurements were made. The means and standard deviations were calculated for each parameter. The significance of difference between mean values was evaluated by the Independent-Samples T test. Differences were considered statistically significant when the P value was 0.05 or less.</p><p><b>RESULTS</b>There was no difference in ANB between two groups, but deep notch cases had more retrusive maxillary and mandibles with shorter maxillary and corpus. In vertical direction, subjects with a deep mandibular notch had a longer lower facial height and more vertically directed mandibular plane angle than did shallow notch cases, these may be caused by the increasing of alveolar height of maxillary, smaller ramus height and greater gonial angle.</p><p><b>CONCLUSION</b>There were some differences in the craniofacial morphologies between deep and shallow notching groups of preadolescent Class II patients. Compared with shallow notching group, the mandibles with the deep notching rotated downward and backward and have more vertical directed tendency, but there have no obviously difference in horizontal relationship of maxillary and mandible between two groups.</p>

Seasonal rhythms of parathyroid hormone-related protein (PTHrP) expression in growing rats after functional mandibular protrusion / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study parathyroid hormone-related protein (PTHrP) expression during forward mandibular positioning and compare it with the expression during natural growth in different seasons.</p><p><b>METHODS</b>Sixty-four SD rats were randomly divided into experimental and control groups. Each group were randomly divided into four groups according to seasons. Immunohistochemical (IHC) methods were used to test the protein expression of PTHrP. Macroscopic and microscopic approach were applied to analyze the results.</p><p><b>RESULTS</b>PTHrP expressed in mandibular condylar cartilage (MCC), the expression was accelerated and enhanced when the mandible was positioned forward. Furthermore, there was a seasonal rhythm in the protein expression of PTHrP in both experimental and control groups. The protein expression in spring group rose more than other groups.</p><p><b>CONCLUSION</b>The functional appliance therapy can enhance the protein expression of PTHrP. The enhancement has a seasonal rhythm, which indicates that for the functional treatment better results can be achieved in spring.</p>