Computational Medicine: Past, Present and Future / 中国结合医学杂志

Computational medicine is an emerging discipline that uses computer models and complex software to simulate the development and treatment of diseases. Advances in computer hardware and software technology, especially the development of algorithms and graphics processing units (GPUs), have led to the broader application of computers in the medical field. Computer vision based on mathematical biological modelling will revolutionize clinical research and diagnosis, and promote the innovative development of Chinese medicine, some biological models have begun to play a practical role in various types of research. This paper introduces the concepts and characteristics of computational medicine and then reviews the developmental history of the field, including Digital Human in Chinese medicine. Additionally, this study introduces research progress in computational medicine around the world, lists some specific clinical applications of computational medicine, discusses the key problems and limitations of the research and the development and application of computational medicine, and ultimately looks forward to the developmental prospects, especially in the field of computational Chinese medicine.

Narrative evidence-based medicine:a strategy for evaluation of clinical efficacy of Chinese medicine / 中国中药杂志

Rich experience of clinical diagnosis and treatment has been accumulated in the developmental history of Chinese medicine, and the efficacy has been increasingly accepted by the public. However, the evaluation of clinical efficacy is currently based more on scientific evidence instead of merely the changes of patient symptoms. In Chinese medicine, the changes of major disease indicators, patient symptoms, and pathogenesis are the major criteria for the evaluation of clinical efficacy. The lack of well-accepted and uniform criteria and the uncertainty of subjective evaluation limit the development of clinical Chinese medicine. Evidence-based medicine combines clinical skills with the current best evidence. Narrative medicine, utilizing people's narratives in clinical practice, emphasizes patient feelings, willingness, and value orientation. The introduction of both evidence-based medicine and narrative medicine into the evaluation of clinical efficacy refers to the construction of the clinical efficacy evaluation system in a paradigm of participatory diagnosis and treatment. It can fully reflect the characteristics of Chinese medicine, respect the values of patients, and achieve universal clinical evidence. Therefore, it helps to improve the diagnosis and treatment, the relationship between doctors and patients, patients' life quality and decision-making awareness, and finally the new evaluation model of clinical efficacy of Chinese medicine.

Digital workflow coupling conic retention for the immediate restoration of adjacent posterior implants / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the digital workflow coupling conic retention for the immediate restoration of adjacent posterior implants.@*METHODS@#The patients with adjacent teeth missing in the posterior jaw seeking for implant restoration in the Department of Implantology, Peking University School and Hospital of Stomatology from March, 2017 to February, 2018 were recruited. After implant placement and commercial conic retention coping delivery, the patient had an intraoral scan for digital impression, and the computer-assisted design/computer-assisted manufacturing (CAD/CAM) technology was used for the fabrication of the immediate splinted prosthesis, which was made of polymethyl methacrylate (PMMA) and loaded immediately after delivery. Six months later, all the temporary prostheses were replaced by the permanent ones made of monolithic zirconia with CAD/CAM technology as well. The parallel periapical films were taken for the temporary and permanent prostheses post-delivery. The clinical effect of this workflow was evaluated by indices including the survival rates of implants and prostheses, the change of marginal bone level, and the implant-related and prosthesis-related complications; before the final restoration, the Visual Analogue Score (VAS) was used to evaluate the satisfaction of the patients.@*RESULTS@#Ten patients (4 males and 6 females, 55.5 years old for average) were recruited. Totally 34 implants were placed; 14 prostheses were fabricated, temporary and permanent, respectively. After an observation period from 4 to 14 months, the survival rate for implants and prostheses were both 100%; the marginal bone level of the implants were (1.06±0.97) mm and (0.96±0.82) mm, immediate post-operation and 6 months later, respectively. The difference was not statistically significant (P>0.05). Neither implant- nor prostheses- related complications were observed. And the VAS of the patients' satisfaction was 87.2.@*CONCLUSION@#For the adjacent posterior implants, the immediate prostheses manufactured by digital workflow, coupling conic retention, were clinically feasible and patient-satisfactory.

Risk factors for unintentional injury among children in rural areas of Liling, Hunan Province, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the risk factors for unintentional injury among children in the rural areas of Liling, Hunan Province, China, as a basis for developing prevention and intervention measures for unintentional injury in rural children.</p><p><b>METHODS</b>A total of 3 257 students, aged between 5 and 16 years from 4 middle schools and 2 primary schools in eastern and western rural areas of Liling were recruited in October 2013 by stratified sampling and cluster sampling. The general personal information and data on family backgrounds, living environment, and incidence of unintentional injury were collected from all subjects through a self-designed questionnaire. The risk factors for childhood unintentional injury were assessed by an unconditional multiple logistic regression analysis.</p><p><b>RESULTS</b>Out of the 3 257 subjects, 356 (10.93%) were injured during the 12-month period prior to the study. The univariate analysis showed that unintentional injury in these subjects was related to sex, left-behind status, times of internet surfing in internet bars per week, parent companion or not, age of guardian, degree of harmony of parents' marital relationship, employment status of one or both parents as a migrant worker, storage of fireworks and firecrackers at home or not, violence in residential areas, and participation or not in violence in residential areas. The unconditional multiple logistic regression analysis showed that the major risk factors for unintentional injury in these subjects were male gender (OR=0.751, P=0.013), left-behind status (OR=1.779, P<0.001), storage of fireworks and firecrackers at home (OR=1.337, P=0.028) and violence around residential areas (OR=1.517, P<0.001).</p><p><b>CONCLUSIONS</b>Risk for unintentional injury is multifactorial among children in the rural areas of Liling, Hunan. To reduce the incidence of unintentional injury in children in Liling, particular attention should be paid to boys, left-behind children, children who have home storage of fireworks and firecrackers and children who are living in areas with frequent violence.</p>

Clinical study of immediate post-extraction implant and immediate function in edentulous patients / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the outcomes of immediate post-extraction implant and immediate function according to All-on-4 immediate concept in edentulous patients.</p><p><b>METHODS</b>The study included 46 patients with hopeless teeth. A total of 254 implants were immediately inserted after extraction and 56 fixed complete-arch all-acrylic prostheses finished and functioned on the day of extraction from June 2008 to March 2012 in Peking University School of Stomatology. At time of abutments connection, a panoramic radiograph was taken, and radiographic assessment of the marginal bone level was performed in every 6 months. Marginal bone level, integrity of the restoration, survival of the implants and degree of satisfaction of the patients were evaluated.</p><p><b>RESULTS</b>A total of 254 implants were immediate loading. Thirteen implants were lost 6 - 8 weeks after immediate loading and the survival rate of 94.9% (241/254). The marginal bone absorption was (0.7 ± 0.3) mm on average. All patients were satisfied with the clinical results.</p><p><b>CONCLUSIONS</b>Immediate post-extraction implant and immediate function technique can be a predictable technique. Further study is needed to determine the long-term results of the technology.</p>

Clinical study of prosthetic gingival reconstruction in vertical bone defect patients / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the preliminary clinical results of prosthetic gingival reconstruction in vertical bone defect patients.</p><p><b>METHODS</b>The study included 31 partial or edentulous patients (male 22, female 9) with 152 implants supporting fixed prostheses from February 2002 to January 2011 in Peking University School and Hospital of Stomatology. The implant-supported fixed prostheses with artificial gingival material to compensate for vertical defect were delivery after implant healing period. At time of prostheses delivery, a panoramic radiograph was taken. The results were evaluated according to California Dental Association by two prosthodontists. Clinical observation included survival of the implants, integrity of the restoration, complication of prosthesis and degree of satisfaction of the patients.</p><p><b>RESULTS</b>A total of 152 implants supported fixed prostheses with artificial gingival materials to compensate vertical bone defect were delivered. No implants lost, and the survival rate was 100% during the follow-up period. The sore of acceptance of prosthesis was 96.8%. All patients were satisfied with the clinical results.</p><p><b>CONCLUSIONS</b>The artificial gingival reconstruction technique is feasible for vertical bone defect patients.</p>

Clinical study of "All-on-4" implant immediate function in edentulous patients / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the preliminary clinical results of application of All-on-4 immediate function in edentulous patients.</p><p><b>METHODS</b>Twenty nine edentulous patients with 140 immediately loaded implants supporting fixed complete-arch all-acrylic prostheses from April 2008 to October 2009 in Peking University School of Stomatology were included. The implant-supported fixed complete-arch all-acrylic prostheses were delivery on the operation day. At time of abutments connection, a panoramic radiograph was taken. And radiographic assessment of the marginal bone level was performed in every 2 months. Clinical observe items included marginal bone level, integrity of the restoration, survival of the implants and degree of satisfaction of the patients.</p><p><b>RESULTS</b>A total of 140 implants were immediate loading. Eight implants were lost during 6 - 8 weeks after immediate loading, giving survival rate of 94.3%. The marginal bone level was (0.8 ± 0.4) mm. The All patients were satisfied with the clinical results.</p><p><b>CONCLUSIONS</b>The data and the experience described in this study indicate that All-on-four immediate function technique can be a predictable technique for edentulous patients. Further study is needed to determine the long-term result of the technology.</p>

Clinical study of implant-retained facial prosthesis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate clinical results and technical characteristics of implant-retained facial prosthesis.</p><p><b>METHODS</b>Six patients with facial defects underwent implant retained prosthesis treatment, of which 3 orbita defects (including upper and lower eyelids, eyeball) in 3 cases, 2 ears defects in 2 cases, and a nose defect in one case. Under local anaesthesia 21 extra-oral implant were placed, facial prosthesis were individually made six month postoperatively. Follow up ranged from 6 month to 6 years.</p><p><b>RESULTS</b>All 21 implants osseointegrated well, implant lost and peri implantitis was not found. All 6 cases had individual facial prosthesis and were satisfied with the prosthesis.</p><p><b>CONCLUSIONS</b>Extra oral implants provided excellent retainment for facial prosthesis; result of current silicon with individual color shade is encouragable.</p>

Application of implant-supported telescopic overdenture in edentulous cases / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate clinical results of implant supported telescopic overdenture.</p><p><b>METHODS</b>21 patients with edentulous jaws underwent telescopic overdenture restoration. A total of 28 prostheses were fabricated. Of them, 13 were in the upper jaws, 15 in the lower jaws. Among 139 placed implants, 74 were Camcog, 28 IMZ, and 37 Frialit-2. The secondary crown was fabricated by electroforming technique and wax-lost cast method. Clinical examination and radiographs were conducted. Changes in the marginal bone level around the implants were evaluated with radiograph. The mean follow-up time was 26.5 months (range 12 - 39 months).</p><p><b>RESULTS</b>This type of restoration could provide sufficient stability and maintain peri-implant hygiene easily. Peri-implantitis and prosthetic complications were not observed. Marginal bone around implants was stable. No implant was lost during the loading time.</p><p><b>CONCLUSIONS</b>The preliminary clinical results of this research showed that implant supported telescopic overdentures were predictable for edentulous patients.</p>

Dynamic characteristics of SARA during liver fibrogenesis in rats / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To investigate the dynamic characteristics of Smad anchor for receptor activation (SARA) expression during liver fibrogenesis in rats and the relationship between SARA and liver fibrosis.</p><p><b>METHODS</b>Liver fibrosis was induced in 74 rats by intraperitoneal injection of dimethylnitrosamine (DMN) with a dosage of 10 microl/kg body weight, once a day, 3 days per week for 4 weeks. The model rats were randomly divided into 9 groups for studying the changes: 1 d, 3 ds, 1 week, 2 weeks, 3 weeks and 4 weeks after starting the ip injections (intoxicating phase), and 1 week, 2 weeks and 4 weeks after stopping the injections (5th w, 7th w and 8th w, recovery phase). Each group included 5 to 8 rats. In addition, 10 non-treated rats served as normal controls. The rat liver tissues were examined. Collagen deposition was stained with Sirius red, and hydroxyproline (Hyp) was measured with Jamall' method. SARA spatial expression in the livers was detected by immunohistochemistry, and the expressions of TGFbeta1, alpha-SMA and SARA protein were detected by Western blot. The relationships of SARA with Hyp, TGFbeta1 and alpha-SMA were analyzed.</p><p><b>RESULTS</b>During the intoxicating phase, the rat hepatic collagen production (Hyp content) and deposition increased as DMN intoxication continued, and there was marked fibrous septum and pseudo-lobule formation at the end of the 4th w. During the recovery phase, the rat hepatic collagen deposition and fibrous septum formation were lessened, but the Hyp content in the livers of the model rats at the end of 4th w, 5th w, 6th w and 8th w was still higher than that of the controls (193.04+/-39.15, 188.49+/-39.92, 174.39+/-21.22, 163.59+/-31.47 vs 125.64+/-19.51; t from 3.43 to 4.9, P<0.01). SARA was mainly stained positively in interstitial cells surrounding the hepatic sinusoids in both normal and fibrotic livers, and the number of the positive stained cells decreased as liver fibrosis developed, and gradually returned to normal after stopping the intoxication. The expressions of TGFbeta1 and alpha-SMA were gradually increased, as shown with Western blot, but SARA decreased as liver fibrosis developed. The expressions of TGFbeta1 and alpha-SMA were slightly decreased, SARA expression recovered to the normal level after stopping the DMN intoxication. During liver fibrosis developing and recovery phases, SARA was significantly negatively correlated with TGFbeta1 and alpha-SMA expressions and Hyp contents.</p><p><b>CONCLUSIONS</b>SARA was mainly expressed in the liver interstitial cells, and it was negatively correlated with liver fibrosis formation.</p>