Percepción de la calidad de vida y satisfacción en pacientes portadores de dentadura parcial removible: Revisión de Literatura Sistematizada / Perception of quality of life and satisfaction in patients with removable partial denture: Systematized Literature Review

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.

Percepción de la calidad de vida y satisfacción en pacientes portadores de dentadura parcial removible: Revisión de Literatura Sistematizada / Perception of the

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.

Accuracy of Digital Impression Taking in Partial Dentures: an in Vitro Study on the Degree of Adaptation of Rests / Precisão da Tomada de Impressão Digital em Próteses Parciais: um Estudo in Vitro sobre o Grau de Adaptação de Apoios

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)

The use of fiberglass posts in dentistry: a literature review / O uso de pinos de fibra de vidro na odontologia: uma revisão de literatura

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.

Vertebral fractures combined with prolonged activated partial prothrombin time:A case report / 北京大学学报(医学版)

With the development of modern medical standards,autoimmune diseases and their associ-ated successive osteoporosis have received increasing attention in recent years.Patients with autoimmune diseases,due to the characteristics of the disease and the prolonged use of glucocorticoid hormone thera-py,may affect the bone formation and bone absorption of the patient,followed by severe successive osteo-porosis,thereby increasing the risk of osteoporotic vertebral fractures.Vertebral compression fractures of the spine are common fracture types in patients with osteoporotic fractures.Osteoporosis is a common complication after glucocorticoid therapy in patients with autoimmune diseases.Percutaneous vertebro-plasty(PVP)and percutaneous kyphoplasty(PKP)are minimally invasive operation and are commonly used surgical methods for the treatment of osteoporotic vertebral compression fractures.However,due to the operation of spinal puncture during the operation,there are serious surgical risks such as bone cement leakage,spinal epidural hemorrhage,subdural hemorrhage,and subarachnoid hemorrhage in both PVP and PKP.As a result,it is necessary to evaluate the patient's body before surgery carefully,especially in the case of blood coagulation.This article reports a case of autoimmune disease patient admitted to Peking University People's Hospital due to lumbar 4 vertebral compression fracture combined with Sj?gren's syn-drome.The patient's preoperative examination showed that the activated partial thromboplastin time(APTT)was significantly prolonged.After completing the APTT extended screening experiment and lu-pus anticoagulant factor testing,the multi-disciplinary team(MDT)of Peking University People's Hospi-tal jointly discussed the conclusion that the patient's test results were caused by an abnormal self-immuni-ty anti-copulant lupus(LAC).Based on the results of the laboratory examination,the patient was con-sidered to be diagnosed with combined antiphospholipid syndrome(APS).For such patients,compared with the patient's tendency to bleed,we should pay more attention to the risk of high blood clotting in the lower limbs of the patient,pulmonary clots and so on.With timely anti-coagulation treatment,the patient safely passed the peripheral period and was successfully discharged from the hospital.Therefore,for pa-tients with autoimmune diseases with prolonged APTT in the perioperative period,doctors need to careful-ly identify the actual cause and carry out targeted treatment in order to minimize the risk of surgical and perioperative complications and bring satisfactory treatment results to the patients.

Study on consistency of traditional decoction and formula granules of Sangju Decoction based on fingerprint printing and chemical pattern recognition / 国际中医中药杂志

Objective:To compare the chemical composition of decoction and granules of Sangju Decoction; To provide a method for quality evaluation of Sangju Decoction.Methods:HPLC was used to establish fingerprints, and a comprehensive comparative study was conducted on the traditional decoction and formula granules of Sangju Decoction from four aspects: chemical composition type, fingerprint similarity, chemical pattern recognition analysis, and representative index component content.Results:The fingerprint similarity of the 10 batches of traditional decoction was >0.988. 35 peaks were identified and 12 peaks were identified as common peaks (neochlorogenic acid for peak 7, chlorogenic acid for peak 10, cryptochlorogenic acid for peak 11, 1,3-dicaffeoylquinic acid for peak 13, rutin for peak 17, lenoside A for peak 19, lignan for peak 20, isochlorogenic acid B for peak 24, ammonium glycyrrhizate for peak 25). The fingerprint similarity of the formulation pellets was >0.983, and 29 characteristic peaks were identified. Compared with the traditional decoction, some batches of the granules lacked peaks 14, 26, 27, 30, 32 and 34, and clustering analysis (CA), principal component analysis (PCA), and orthogonal partial least squares discriminant analysis (OPLS-DA) could distinguish between the two. The contents of the 10 index components neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, 1,3-dicaffeoylquinic acid, forsythia ester glycoside A, grass glycosides, isochlorogenic acid B, 3,5-O-dicaffeoylquinic acid, forsythia glycosides, monkshood glycosides in the traditional soup were higher than that in the granules, and the contents of rutin and ammonium glycyrrhizate in the granules were higher than that in traditional decoction.Conclusions:The content and composition of traditional decoction and formula granules of Sangju Decoction are significantly different. The combination of fingerprinting and chemical pattern identification effectively can effectively evaluate the difference between traditional decoction and formula granules of Sangju Decoction, which can lay a foundation for the quality control and rational clinical application of formula granules of Sangju Decoction.

Comparison of different atomizing inhalation times on noninvasive ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease / 中国实用护理杂志

Objective:To compare the dynamic changes of transcutaneous partial pressure of carbon dioxide (PtCO 2) and treatment effect of non-invasive intermittent nebulization and non-invasive simultaneous nebulization in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods:This was a randomized parallel controlled trial study. A total of 70 patients with acute exacerbation of COPD in Changzhou First People′s Hospital from October 2021 to September 2022 were selected by convenience sampling method, and divided into control group and experimental group by randomized digits table method with 35 cases in each group. The control group was given non-invasive intermittent oxygen-driven nebulization, and the experimental group was given non-invasive simultaneous oxygen-driven nebulization. The PtCO 2 values at 0, 5, 10, 15 min (the end point of atomization) of the 2 groups were observed, the daily arterial blood gas analysis indexes (mainly including PaCO 2, PaO 2 and pH) were recorded, and the clinical pulmonary infection score and the self-assessment score of COPD patients were recorded before treatment, on the 4th and 7th day of treatment. Results:Finally, 33 patients were included in both the control group and the experimental group. There were 25 males and 8 females in the control group, aged (75.33 ± 8.24) years old. There were 25 males and 8 females in the experimental group, aged (72.39 ± 8.56) years old. The PtCO 2 values at 0, 5, 10, 15 min in the control group were (63.83 ± 12.47), (64.40 ± 12.57), (65.42 ± 13.77), (66.62 ± 14.59) mmHg (1 mmHg=0.133 kPa). There were statistically significant differences in PtCO 2 at all time points ( F=8.05, P<0.01). Further pairwise comparison by Sidak method showed that there were statistically significant differences in PtCO 2 at 15 min compared with 0, 5, 10 min (all P<0.05). The PtCO 2 values at 0, 5, 10, 15 min in the experimental group were (67.62 ± 11.89), (67.15 ± 12.12), (67.82 ± 12.22), (68.15 ± 12.09) mmHg. There was no statistically significant difference in PtCO 2 at all time points ( F=2.00, P>0.05). The PaCO 2 and pH value of the two groups were improved with the treatment time, the control group had a statistically significant difference on the 4th day of treatment compared with before treatment ( P<0.05), while the experimental group on the second day of treatment compared with before treatment ( P<0.05). Conclusions:Both kinds of nebulization have achieved good therapeutic effects, but non-invasive simultaneous nebulization can better maintain the stability of PtCO 2 in the process of nebulization with higher safety, and can improve the arterial blood gas index PaCO 2 and pH value of patients earlier, which is a more suitable nebulization method for the combination of non-invasive ventilation and nebulization, especially for patients with hypercapnia.

The effects of biologically oriented preparation technique on periodontal plaque colonization and inflamma-tory factor expression in gingival crevicular fluid / 实用口腔医学杂志

Objective:To study the effects of biologically oriented preparation technique(BOPT)on periodontal plaque colonization and inflammatory factor expression in gingival crevicular fluid(GCF).Methods:102 patients with chronic periodontitis were randomly divided into 2 groups(n=51).The subjects in control group received traditional tooth preparation,while those in observation group re-ceived BOPT.The probing depth,modified plaque index,gum papillary index,marginal bone resorption and modified gingival groove bleeding index were measured and compared between the 2 groups.The GCF was collected at the restoration site before and after 6 month restoration,the levels of tumor necrosis factor-α,interleukin-6 and matrix metalloproteinase 8 were measured at different time periods.Results:6 months after surgery,there was no significant difference in near-middle,far-middle and mean bone resorption be-tween the 2 groups(P＞0.05).The restoration periodental indexes were decreased in both groups(P＜0.05),and the modified gingival hemorrhage index,probing depth,gum papilla index and modified plaque index in the observation group were obvious lower than in the control(P＜0.05).The inflammatory factor expression in GCF was significantly decreased in both groups(P＜0.05),and in the obser-vation group was obvious lower than in the control(P＜0.05).Patient comfort,retention function,aesthetics and total score in the ob-servation group was obvious higher than in the control(P＜0.05),but there was no statistically significant difference in chewing func-tion,language function between the 2 groups(P＞0.05).Conclusion:BOPT may improve the restoration level,eliminate the inflamma-tory response of GCF and improve satisfaction in patients with chronic periodontitis.

Influence of heat treatment technology on mechanical properties of 3D printed titanium alloy specimens / 中国组织工程研究

BACKGROUND:In recent years,additive manufacturing(also known as 3D printing)has gradually become the mainstream method for producing titanium alloy brackets for removable partial dentures.Heat treatment,as an important method to improve the mechanical properties of 3D printed titanium alloys,has become a current hot topic of attention.OBJECTIVE:To summarize the main heat treatment technologies currently applied to 3D printed titanium alloy specimens(including annealing,solution aging,hot isostatic pressing,and other heat treatments)and their effects on the mechanical properties and microstructure of 3D printed titanium alloy specimens,providing a theoretical basis for improving the heat treatment technology of removable partial denture titanium alloy supports.METHODS:A computer search was conducted on research materials related to 3D printed titanium alloy heat treatment in databases such as CNKI,PubMed,and ScienceDirect.The search period was from 2012 to 2023.A total of 61 articles were selected based on inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Using conventional annealing techniques to treat 3D printed titanium alloy specimens,keeping them at 500-900 ℃ for 2-4 hours,can effectively increase the elongation of 3D printed titanium alloy specimens.(2)Compared to conventional annealing techniques,solid solution aging treatment is more complex,and the titanium alloy specimens after solid solution aging treatment exhibit outstanding yield strength and better corrosion resistance.However,the 3D printed titanium alloy specimens after solid solution aging treatment have no advantage in terms of ductility.(3)Hot isostatic pressing treatment can reduce the internal defects of 3D printed titanium alloy specimens,significantly increase the elongation of 3D printed titanium alloy specimens,and increase their fatigue life.(4)Rapid heat treatment can significantly improve the elongation of 3D printed titanium alloy specimens,and the speed is faster.In terms of elongation improvement and heat treatment efficiency,it has more advantages than conventional annealing in the past.(5)The improvement of elongation of 3D printed titanium alloy specimens by cyclic heat treatment exceeds that of conventional annealing.Cyclic heat treatment can significantly improve the grain structure of 3D printed titanium alloy specimens,but the heat treatment time is too long and the efficiency is low.

Robot-assisted laparoscopic treatment of horseshoe kidney combined with renal tumor: a case report and literature review / 中国医师进修杂志

Objective:To explore the technical focus of robotic-assisted laparoscopic surgery for the treatment of horseshoe kidney combined with renal tumor.Methods:The clinical data of a patient with horseshoe kidney combined with renal tumor treated by robot-assisted laparoscopic partial nephrectomy in the Second Hospital of Dalian Medical University in September 2021 were retrospectively analyzed. PubMed, CNKI, Wanfang and VIP databases were searched for all the literature on the use of robot-assisted laparoscopic nephrectomy or partial nephrectomy for the treatment of horseshoe kidney combined with renal tumor from the time of establishment to December 2022.Results:A total of 11 patients from 10 articles were retrieved and 12 patients were enrolled. Among the 12 patients, 4 cases used the retroperitoneal approach and 8 cases used the transperitoneal approach. Two cases were operated by traditional laparoscope, and the arteries were searched for and controlled before the robotic arm was placed to perform the partial nephrectomy and suture; and 10 cases were operated with the robotic-assisted laparoscopic approach throughout the whole procedure. Five cases of nephrectomy were performed on one side, and 7 cases were performed in the partial nephrectomy. Postoperative pathological diagnosis was clear cell carcinoma in 8 cases, chromophobe cell carcinoma in 1 case, eosinophilic cell carcinoma in 1 case, renal cell carcinoma in 1 case, and renal abscess in 1 case. The patient in the Second Hospital of Dalian Medical University was 38 years old female who was admitted to the hospital with a fever. After CT arteriography and three-dimensional reconstruction, robotic-assisted laparoscopic partial nephrectomy of right kidney and isthmus dissecting was performed. During the operation, tumor trophoblast vessels were ligated and dissected one by one by using single-use tissue closure clips, and the isthmus was dissected using endoscopic cutting anastomosis on the left side of the tumor, with the tumor edges sharply resected and completely dissected. The operation time was 240 min, without thermal ischemia time, and the bleeding volume was about 300 ml. The patient recovered well after the operation, and the postoperative pathological diagnosis was renal abscess.Conclusions:Robot-assisted laparoscopic treatment of horseshoe kidney combined with renal tumor is safe and effective, and has more advantages than traditional laparoscopic surgery. Preoperative CT arteriography or three-dimensional reconstruction examination should be applied to fully evaluate the variant vessels. The surgical access and plan should be decided according to the size and location of the tumor. The variant vessels should be properly handled during operation. The use of endoscopic cutting anastomosis to deal with the isthmus can be more conducive to the surgical operation.

Application of` the variable angle traction method by using clip with dental in super minimally invasive non full thickness resection of early gastric cancer / 中国医师进修杂志

Objective:Assisted traction technology is effective in increasing the rate of super minimally invasive surgery (SMIS) in patients with early gastric cancer (EGC), and shortening the operator′s learning curve. We adopt the variable angle traction technique of tissue clamp dental floss as a traction technique in this research.Methods:Patients with early gastric cancer who were treated with SMIS - non full layer resection of EGC were enrolled in the First Medical Center of Chinese PLA General Hospital from January 2022 to June 2023. This research was carried out by experts at the same level. It was divided into two groups: traction and non-traction. Submucosal detachment time (SDT), submucosal detachment rate (SDS), lamina propria exposure, muscularis propria defect (MPD), bleeding during operation, block resection, surgical resection, hand operation expenses, and surgical instruments were recorded.Results:Nine patients adopted variable angle traction, and 9 patients did not. The overall resection rate and curative resection rate of both groups were 100%. The mean SDT time was 28.00 (21.00, 34.00) min in traction group and 56.00 (40.00, 85.00) min in non traction group. And it had statistical significance ( P = 0.005). The SDS was (0.58 ± 0.21) cm 2/min in traction group and (0.23 ± 0.10) cm 2/min in non-traction group. And it had statistical significance ( P<0.05). Exposure of intrinsic muscle layer (IML): 8 cases in the traction group and 6 cases in the non-traction group. Intraoperative IML injury: in the traction group, 8 cases were MPD-0 and 1 case was MPD-Ft; in the non-traction group, 4 cases were MPD-0, 1 case was MPD-Pt, and 4 cases were MPD-Ft. There was no statistical difference between the two groups in terms of intraoperative bleeding, hospitalization expenses, surgical expenses, and the total hospitalization time. There were no serious adverse reactions or outcomes. Conclusions:The variable angle traction method accelerates SDT and SDS for SMIS-non full layer resection of EGC. It has the advantages of the sufficient separation of IML and mucosal layer, the deeper dissection depth, the low injury of IML, low intraoperative bleeding, and no additional medical costs. Therefore, this method can become an auxiliary treatment technology for SMIS.

Efficacy of Partial Splenic Artery Embolization Versus Splenectomy for Hypersplenism Secondary to Liver Cirrhosis:a Meta-analysis / 医学研究杂志

Objective To systematically evaluate the efficacy of partial splenic artery embolization(PSE)and splenectomy in the treatment of secondary hypersplenism in liver cirrhosis.Methods PubMed,Cochrane Library,Embase,CNKI,Wan Fang were searched to collect randomized controlled trials and cohort studies about the efficacy of PSE versus splenectomy in the treatment of hyper-splenism secondary to liver cirrhosis from inception to October 30,2021.Two reviewers screened the literature,extracted data,and as-sessed the risk of bias of included studies.Meta-analysis was then conducted.Results A total of 14studies were included with 1092 patients.The results of the meta-analysis showed that there was no significant difference in postoperative leukocyte levels at 1 week,1 month,and 1 year after surgery between the PSE group and the splenectomy group.However,6months after surgery,the level of postop-erative leukocyte in the splenectomy group was significantly higher than that in the PSE group.For postoperative platelet counts,there was no significant difference at 1 month and 1 year after surgery between the two groups.However,1 week(MD=-65.46,95％CI:-116.39--14.52,P=0.01)and 6months(MD=-117.99,95％CI:-229.71--6.27,P=0.04)after surgery,the level of postoperative platelet in splenectomy group was significantly higher than that in PSE group.There was no significant difference in postoperative erythro-cyte levels at 1 week,1 month,and 1 year after surgery between the two groups.The level of postoperative natural killer cells in the PSE group was significantly higher than that in the splenectomy group at 1 month(MD=6.02,95％CI:4.27-7.77,P＜0.001)and 1 year(MD=3.53,95％CI:1.68-5.37,P=0.0002)after surgery.Compared with splenectomy group,PSE group exhibited less intraopera-tive bleeding(MD=-73.92,95％CI:-89.39--58.45,P＜0.001),less hospitalization costs(MD=-0.80,95％CI:-1.27--0.34,P=0.0008)and shorter length of stay(MD=-4.08,95％CI:-5.22--2.95,P＜0.001).Conclusion The current evi-dence shows that PSE has certain short-term and long-term effects on hypersplenism.Compared with splenectomy,it has less surgical trauma,less hospital stay and less cost,easy to control complications,and retains some immune function,which is worth spreading in the clinic.Limited by the quantity and quality of the included literature,more high-quality studies are needed to confirm the above conclu-sions.

Comparative analysis of the efficacy of RAPN and LPN in treating tumors in isolated kidney / 中华泌尿外科杂志

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.

The application of percutaneous puncture renal fascia suspension in laparoscopic partial nephrectomy / 中华泌尿外科杂志

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.

Variation rules of main secondary metabolites in Hedysari Radix before and after rubbing strip / 中成药

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.

UHPLC-Q-TOF/MS Analysis of the Active Components of Total Flavonoids Extracts from Sarcandra glabra in Promoting Megakaryocyte Differentiation / 中药新药与临床药理

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.

Compositional Analysis of 11 Nucleosides and Bases in Fritillaria taipaiensis P.Y.Li from Different Origins and the Differences in Their Origin / 中药新药与临床药理

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.

Study on HPLC Fingerprint and Multi-Index Components Contents of Atractylodis Macrocephalae Rhizoma / 中药新药与临床药理

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.

Safety and mid- to long-term efficacy analysis of surgical correction of isolated partial anomalous pulmonary venous connection / 中国胸心血管外科临床杂志

@#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.

Repeatability and Reproducibility of a New Ocular Biometer Based on Partial Coherence Interferometry and Its Agreement with IOL Master 500 / 中山大学学报(医学科学版)

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.