Current views of diabetic peripheral neuropathic pain comorbid depression - a review.

Diabetic peripheral neuropathic pain (DPNP) is defined as a pain directly caused by the abnormal somatosensory system in diabetics according to the International Association for the Study of Pain (IASP). The pain has a great impact on the quality of life of diabetic patients. It results in a decline of patients' personal ability to live, which may even cause depression. Over time, the decline in both physical and psychosocial function caused by neuropathic pain may lead to further aggravation of depressive symptoms. This article mainly reviews the prevalence rate, medical expenditure, clinical characteristics, neurobiological features and the treatment of DPNP comorbidity depression, hoping to find the research directions for further study in the future.

[Radiography study on osteotome sinus floor elevation with placed implant simultaneously with no graft augmentation].

OBJECTIVE: To investigate the change of endo-sinus bone height and bone volume in osteotome sinus floor elevation (OSFE) without bone graft but placing implants simultaneously by using cone beam computed tomography (CBCT) and three dimensional analysis, and to find the impacting factors on endo-sinus bone augmentation. METHODS: OSFE was performed in 38 edentulous patients with missing teeth at posterior maxillary region, and 44 implants were placed and referred for OSFE using no graft materials. CBCT was performed pre-surgery and 9－68 months post-surgery when the patients encountered another implant surgery. The gained bone height at mesial, distal, buccal and palatal sites around the implant in sinus were measured, volumetric measurements of the endo-sinus gained bone volume (ESGBV) in the elevated region were calculated by Mimics software. Univariate analysis and multiple linear regression were performed to investigate the impacting factors on the gained bone height and ESGBV. Marginal bone loss was recorded according to the periapical radiography after implant restoration. RESULTS: The mean residual bone height (RBH) pre-surgery was (3.41±1.23) mm, the mean protruded length (PL) into sinus of implant post-surgery was (3.41±1.28) mm, the mean endo-sinus gained bone height was (2.44±1.23) mm at distal sites, (2.88±1.20) mm at mesial sites, (2.83±1.22) mm at buccal sites and (2.96±1.16) mm at palatal sites, the mean endo-sinus gained bone height at distal sites was significantly lower than the other three sites (P < 0.05). The average endo-sinus gained bone height was (2.78±1.13) mm. The mean ESGBV was (122.15± 73.27) mm3. Univariate analysis showed the more RBH, the less bone height gained in sinus, which existed at buccal, lingual, mesial and distal sites (P < 0.001), and the more RBH, the smaller ESGBV gained (P=0.012). The ESGBV was significantly higher in the subjects whose bone generation period was more than 24 months than those whose bone generation period less than 24 months (P=0.034). The more PL, the more bone height and ESGBV gained (P=0.008). Multivariate analysis showed after adjusting factors of gender, age, smoking, width of sinus floor, thickness of sinus membrane pre-surgery, diameter and length of the implant, PL and bone generation period was positively correlated with mean endo-sinus gained bone height and ESGBV, while RBH negatively correlated with mean endo-sinus gained bone height. During the follow-up, the mean marginal bone loss was 0 (0－1.41) mm and all the implants loaded successfully. CONCLUSION: OSFE without bone graft but with placed implant simultaneously can increase endo-sinus gained bone height and ESGBV. RBH, PL and bone generation period are the significant factors impacting endo-sinus bone augmentation.

[Influence of thread shapes of custommade root-analogue implants on stress distribution of peri-implant bone: A three-dimensional finite element analysis].

OBJECTIVE: To explore the effects from the thread shapes of custom-made root-analogue implant (RAI) on distributions of von Mises stress around the peri-implant bone. METHODS: Five one-stage RAI three-dimensional finite element (FE) models with different thread shapes (V-shaped design, square design, buttress design, reverse buttress design and none thread design) and congruent bone were created through reverse engineering technology. The data of the five models were imported into the FE analysis software to calculate. A force of 100 N was applied parallelly and of 45° to the implant axis respectively. Analysis was performed to evaluate the von Mises stress distributions at the peri-implant regions with the help of the Ansys 16 software. RESULTS: The von Mises stresses distributed mostly at the implant cervical regions and the tip ends of the threads on the cortical bone under oblique loading, while on the cancellous bone, the stresses concentrated mostly on the implant lateral cervical regions, the tip ends of the threads and the apical regions. When under vertical loading, the von Mises stresses distributed mostly at the implant cervical regions on the cortical bone while at the tip ends of the threads and the lateral apical regions on the cancellous bone. The von Mises stresses were better distributed on the thread groups under both kinds of loadings compared with no thread design. But there was no obvious difference among the different thread groups. The concentrations of the von Mises stresses on the cancellous bone in the thread groups were mostly at the tip ends of the threads while less in the apical area. The von Mises stresses were better distributed on the cancellous bone on the other three thread designs than on square design. CONCLUSION: Thread designs are advocated for the reason that adding thread designs to the RAI standard design will have a positive effect on stress distributions at the peri-implant regions and it will reduce the concentrations of von Mises stresses on the cortical bone. From the standpoint of the stress distribution, V-shaped design, buttress design and reverse buttress design are more suitable for RAI than square design. There is no difference of the distributions of the von Mises stresses in the RAI between different thread designs.

[Synthesis and in vitro characterization of chitosan microspheres/ceramic bovine bone composite scaffold].

OBJECTIVE: The chitosan microspheres encapsulated with bone morphogenetic protein-2 (BMP-2) were prepared by the emulsion cross-linking method. Then the chitosan microspheres were loaded in the ceramic bovine bone (CBB) to achieve the drug delivery system. METHODS: The chemical structure and surface morphology of the drug delivery system were investigated by Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscope (SEM) observation. Characterization preserved the loading capacity and encapsulation efficiency of the BMP-2. The dynamic immersion method was used to examine the in vitro release characteristic of BMP-2. RESULTS: The chitosan microspheres were successfully encapsulated BMP-2 by cross-linking method. The microspheres were micron-sized (5.982 µm) and spherical in shape with smooth surface morphology. From the release experiments, it was found that 5 mg chitosan/BMP-2 soaked for 21 days with a gradual release of BMP-2. The concentration of BMP-2 was (239.1±20.0) mg/L on Day 21. The in vitro experiment showed that this novel drug delivery system could accelerate MC3T3-E1 cells proliferation and osteogenic differentiation. CONCLUSION: The drug delivery system achieves the biological function of BMP-2 and sustaining slow release in bone repair parts. Also it can provide the basis for repair of bone tissue defect treatment and the selection of bone tissue engineering scaffolds.

Hydrothermal pretreatment of bamboo and cellulose degradation.

A systematic hydrothermal pretreatment of bamboo chips had been conducted with an aim to trace the cellulose degradation. The results showed that cellulose chain cleavage basically occurred when the temperature exceeded 150°C. A slightly higher DP (degree of polymerization) than starting material had been observed at low temperature pretreatment. Treatment at higher temperature (≥ 170°C) caused severe cleavage of cellulose and therefore gave rise to low DP with more soluble species. DP of cellulose declined drastically without additional hemicelluloses dissolution when hemicelluloses removal reached to the limit level. Cellulose degradation under hydrothermal pretreatment generally followed the zero reaction kinetics with the activity energy of 121.0 kJ/mol. Besides, the increase of cellulose crystalline index and the conversion of Iα-Iß had also observed at the hydrothermal pretreatment.

Granulation tissue formation following Dumon airway stenting: the influence of stent diameter.

OBJECTIVES: The present study aimed to determine whether stent diameter influences granulation tissue formation following stent placement for major airway stenosis. PATIENTS AND METHODS: Forty-two stent procedures (32 tracheal stents, 3 carinal stents, and 7 bronchial stents) were performed in 40 patients. Seventy-nine stent edge regions (62 tracheal, 17 bronchial stents) were evaluated in this study. RESULTS: Granulation tissue formation was encountered in 11 patients (28.21%). Of the 34 upper ends of evaluated tracheal stents, granulation tissue formation was observed in 6 (17.65%), whereas granulation tissue formation was observed in 2 (7.14%) of the 28 lower ends of tracheal stents evaluated. Of the 17 bronchial stent edge regions, granulation tissue formation occurred in 3 (17.65%) ( P = 0.4352). The rate of granulation tissue formation was higher in those patients with a stent-to-airway diameter ratio of > 90% ( P < 0.0001). Receiver operating characteristic curve analysis further demonstrated that a cut-off stent-to-airway diameter ratio of 90% was effective in predicting granulation tissue formation (AUC: 0.897, Std. error = 0.036, P < 0.0001, 95% CI = 0827-0.968, n = 79). CONCLUSIONS: A stent-to-airway diameter ratio of 90% was found to be the critical cut-off point for predicting granulation tissue formation. Therefore, the optimal stent-to-airway diameter ratio should be ascertained before stent placement.

Improving neural network prediction of effluent from biological wastewater treatment plant of industrial park using fuzzy learning approach.

Three types of adaptive network-based fuzzy inference system (ANFIS) in which the online monitoring parameters served as the input variable were employed to predict suspended solids (SS(eff)), chemical oxygen demand (COD(eff)), and pH(eff) in the effluent from a biological wastewater treatment plant in industrial park. Artificial neural network (ANN) was also used for comparison. The results indicated that ANFIS statistically outperforms ANN in terms of effluent prediction. When predicting, the minimum mean absolute percentage errors of 2.90, 2.54 and 0.36% for SS(eff), COD(eff) and pH(eff) could be achieved using ANFIS. The maximum values of correlation coefficient for SS(eff), COD(eff), and pH(eff) were 0.97, 0.95, and 0.98, respectively. The minimum mean square errors of 0.21, 1.41 and 0.00, and the minimum root mean square errors of 0.46, 1.19 and 0.04 for SS(eff), COD(eff), and pH(eff) could also be achieved.

Comparisons of grey and neural network prediction of industrial park wastewater effluent using influent quality and online monitoring parameters.

In this study, Grey model (GM) and artificial neural network (ANN) were employed to predict suspended solids (SSeff) and chemical oxygen demand (CODeff) in the effluent from a wastewater treatment plant in industrial park of Taiwan. When constructing model or predicting, the influent quality or online monitoring parameters were adopted as the input variables. ANN was also adopted for comparison. The results indicated that the minimum MAPEs of 16.13 and 9.85% for SSeff and CODeff could be achieved using GMs when online monitoring parameters were taken as the input variables. Although a good fitness could be achieved using ANN, they required a large quantity of data. Contrarily, GM only required a small amount of data (at least four data) and the prediction results were even better than those of ANN. Therefore, GM could be applied successfully in predicting effluent when the information was not sufficient. The results also indicated that these simple online monitoring parameters could be applied on prediction of effluent quality well.

Lansoprazole reduces ulcer relapse after eradication of Helicobacter pylori in nonsteroidal anti-inflammatory drug users--a randomized trial.

AIM: To study whether prophylaxis with lansoprazole could prevent relapse of ulcers after eradication of Helicobacter pylori in patients with NSAID-related peptic ulcers. METHODS: Patients who presented with peptic ulcers and were found to be infected with H. pylori while receiving NSAIDs were recruited into the study. They received, twice daily, lansoprazole 30 mg, amoxicillin 1 g and clarithromycin 500 mg for 1 week, followed by lansoprazole 30 mg daily for 4 weeks. Patients with healed ulcers and H. pylori eradicated were given naproxen 750 mg daily, and randomly assigned to receive lansoprazole 30 mg daily or no treatment for 8 weeks. The primary endpoint was the cumulative recurrence of symptomatic and complicated ulcers. RESULTS: At the end of the 8-week treatment period, significantly fewer patients (1/22, 4.5%, 95% confidence interval [CI] 0-23) in the lansoprazole group compared with the group that received H. pylori eradication alone (9/21, 42.9%, 95% CI 22-66) developed recurrence of symptomatic and complicated ulcers (log rank test P=0.0025). CONCLUSIONS: Lansoprazole significantly reduced the cumulative relapse of symptomatic and complicated ulcers in patients requiring NSAIDs after eradication of H. pylori.

Soluble E-cadherin is a valid prognostic marker in gastric carcinoma.

BACKGROUND: Gastric cancer remains a major cause of cancer mortality globally but no good prognostic tumour marker is available. Soluble fragment of E-cadherin protein has been reported to increase in the sera of patients with cancer and recently was found to be elevated in 67% of patients with gastric cancer. AIMS: To investigate if serum soluble E-cadherin is a valid prognostic marker in gastric cancer. METHODS: Concentrations of soluble E-cadherin from 116 patients with histologically confirmed gastric adenocarcinoma and 40 healthy subjects were measured using an immunoenzymometric method with a commercially available sandwich ELISA kit based on monoclonal antibodies. RESULTS: The logarithm of the means of soluble E-cadherin concentration was significantly higher in patients with gastric cancers (mean 3.85 (SD 0.28)) than in healthy subjects (3.71 (0.18)) (p=0.001), and in palliative/conservatively treated cancers (3.91 (0.35)) than in operable cancers (3.78 (0.19)) (p=0.015). The logarithm of the concentrations correlated with tumour size (p=0.032) and carcinoembryonic antigen concentrations (p=0.001). The cut off value calculated from discriminant analysis on operability and inoperability/palliative treatment was 7025 ng/ml. Soluble E-cadherin concentrations higher than this cut off value predicted tumour (T4) depth invasion (p=0.020, confidence interval (CI) 1.008-1.668) and palliative/conservative treatment (p=0.023, CI 1.038-2.514). In contrast, the relative risks for lymph node (N2) metastasis, distant metastasis, and stage III/IV disease were 1.41, 1.33, and 1.55 respectively, despite not reaching statistical significance. CONCLUSION: Serum soluble E-cadherin is a potential valid prognostic marker for gastric cancer. A high concentration predicts palliative/conservative treatment and T4 invasion.

Lack of association between obesity and dental caries in three-year-old children.

To investigate whether the obese children are prone to develop dental caries, the cross-sectional data from a Three-year-old Children's Health Survey were evaluated. The body weight, height, body mass index (BMI), and decayed and filled teeth (dft) score were analyzed in 5,133 children. The prevalence of dental caries was not different significantly among different BMI groups. There were no significant differences in the dft score of carious children among different BMI groups. Little or no relationship was found between BMI and dft score. We conclude that there is no relationship between carious deciduous teeth and weight status in three-year-old children.

Candidemia after endoscopic retrograde cholangiopancreatography.

We report a case of candidemia associated with manipulation of the common bile duct during endoscopic retrograde cholangiopancreatography. The patient had received parenteral nutrition and prolonged antibiotic therapy before the procedure and before Candida tropicalis was grown from blood cultures. Antifungal therapy resulted in clinical response.

[Fibrobronchoscopy in the diagnosis of middle lobe syndrome].

236 cases with middle lobe syndrome were examined with fibrobronchoscope. The total rate of positive finding was 92.8% (219/236). Inflammation (167 cases), lung cancer (47 cases), tuberculosis (17 cases) accounted for most of the cases. The diagnostic rate for the three above-mentioned diseases were 97.6%, 87.2% and 58.8% respectively. Fibrobronchoscopy was also of significant diagnostic value in determining other uncommon cases such as broncholithiasis, lipoid pneumonia, lung infiltration in leukemia, etc. The etiology, chest X-ray (including CT) presentations of this middle lobe syndrome and the diagnostic value of fibrobronchoscopy were discussed. Our experience suggests that this procedure is both safe and effective in the diagnosis of patients with middle lobe syndrome.

Effect of cimetidine on isolated rat myocardial reperfusion injury.

The effects of cimetidine (Cim) on ventricular fibrillation threshold (VFT), diastolic excitation threshold (DET), effective refractory period (ERP), and vulnerable period (VP), were determined in both stable perfusion and postischemic reperfusion rat hearts. The results showed that reperfusion after 15 min global myocardial ischemia caused a significant decrease VFT and ERP, and an increase in VP and DET. Cim 1 mmol.L-1 prevented the lowering in VFT, shortening in ERP, and lengthening in VP from the postischemic reperfusion. Cim 0.1 mmol.L-1 attenuated the exacerbation of VFT and VP. Cim 0.01 mmol.L-1 did not exert any noticeable influence on the electrophysiological parameters. It was shown that Cim 1 mmol.L-1 protected myocardium against the aggravation of electrophysiological characteristics induced by postischemic reperfusion.