Clinical investigation and research on Axis Ⅱ evaluation of patients with temporomandibular disorders / 中华口腔医学杂志

Objective: To screen the physical, psychological and behavioral factors related to patients with temporomandibular disorders (TMD) by using Axis Ⅱ assessment instruments of diagnostic criteria for TMD(DC/TMD). And to provide a reference to establish personalized diagnosis and treatment plans for TMD patients so as to prevent TMD and reduce predisposing factors. Methods: A total of 141 TMD patients, who were admitted in the Department of Oral and Maxillofacial Surgery in School and Hospital of Stomatology, Wuhan University from October 2018 to February 2021 were selected. There were 121 females and 20 males, with an average age of 30 years. A total of 90 healthy people were included as controls. A full-time psychologist conducted relevant questionnaire surveys. The questionnaires include general clinical survey forms and TMD symptom questionnaire. In addition, Axis Ⅱ assessment instruments include graded chronic pain scale, jaw functional limitation scale, oral behaviors checklist, patient health questionnaire-9 (depression), generalized anxiety disorder scale, patient health questionnaire-15 (physical symptoms), etc. The main observational indicators include: pain level, pain impact rates, overall classification of chronic pain, limited chewing function score, limited motor function score, limited communication function score, total jaw function restricted score, depression score, anxiety score, somatic symptom score and oral behavior score.The survey data were imported into SPSS 22.0 software for statistical analysis. Results: In the TMD group 60.3% (85/141) patients had various degrees of pain, 24.1% (34/141) of those with pain effect grades from 1 to 3 and 61.0% (86/141) showed chronic pain overall grades from Ⅰ to Ⅳ. The chewing function restricted score was 2.67(1.17, 4.25), motor function restricted score was 4.25(1.75, 6.12), communication function restricted score was 1.13(1.00, 2.25) and total jaw function restricted score was 2.56(1.47, 4.15) respectively. Patients with mild depression or above accounted for 59.6%(84/141), patients with mild anxiety or above accounted for 56.7%(80/141), 46.1%(65/141) patients had somatization symptoms. Statistical differences (P<0.05) were determined between TMD group and control group in various scores of jaw function, oral behavior grading, depression, anxiety, and physical symptoms. Physical symptoms had significantly statistical difference between different diagnostic classification(P<0.05). Meanwhile, among the different chronic pain levels in the TMD group, there were statistical differences in the various scales of mandibular dysfunction, depression, anxiety, and somatization. In the TMD group, other significant differences were noticed between males and females in terms of the average score of mouth opening, verbal and facial communication, the total score of mandibular dysfunction as well as physical symptoms (P<0.05). Conclusions: Compared with the healthy people, patients with TMD had more abnormal oral behaviors, different restriction of the mandibular functional activities. At the same time, depression, anxiety, and somatization were more serious. Patients with osteoarthritis and subluxation of temporomandibular joint were more likely to suffer physical symptoms. TMD patients suffering from pain had more severe mandibular dysfunction and symptoms of depression, anxiety, and somatization.

Safety destruction of tetramethylene disulfotetramine and its medical waste / 中华预防医学杂志

<p><b>OBJECTIVE</b>To develop suitable methods for safety destruction of tetramethylene disulfotetramine (TETS) and the medical wastes polluted by TETS.</p><p><b>METHODS</b>The chemical stability of TETS was evaluated under the conditions of acid, alkali and high temperature. TETS was treated with sodium hydroxide, hydrochloric acid, sulfuric acid and nitric acid under various treatment conditions, i.e. concentration, temperature and time, followed by determining remaining TETS using gas chromatograms to estimating the degradation efficiency of TETS. TETS was put into ampoule and heated under the different conditions of temperature and time. After heat treatment, TETS residue was determined. For evaluating the absorption factor of active carbon to TETS in water and blood, active carbon was added into the water and blood with content of TETS, incubated at room temperature for 24 hours, and then determined the remaining TETS in water and blood.</p><p><b>RESULTS</b>The complete degradation of TETS was achieved by one of the following treatments: heating with 6.0 mol/L hydrochloric acid at 100 degrees C for half an hour, heating with 3.0 mol/L hydrochloric acid or 6.0 mol/L sodium hydroxide at 100 degrees C for 3 hours, mixing with concentrated sulfuric acid or nitric acid at room temperature for 24 hours, and dry heating at 300 degrees C for 4.5 hours. Active carbon showed a marked effectiveness in absorbing the TETS in blood and water, with the mean absorption efficiency of over 90%.</p><p><b>CONCLUSIONS</b>The results of this study suggest that TETS powder should be degraded by acid or alkali, and that the solid medical wastes polluted by TETS should be destroyed at high temperature. For the blood and water having contents of TETS, the active carbon should be used as to absorbing the TETS and then be destroyed at high temperature.</p>