Category: Nevin Manimala

Zhonghua Yi Xue Za Zhi. 2024 Apr 9;104(14):1184-1187. doi: 10.3760/cma.j.cn112137-20230905-00390.

ABSTRACT

The clinical data of 23 patients undergoing real-time echocardiography-guided infusion port implantation in the Breast Center of Tsinghua Changgung Hospital in Beijing from January to July 2021 were analyzed. The length of catheter insertion L1 was initially estimated using surface measurement method in all patients. Intraoperatively, transthoracic echocardiography was applied using the parasternal four-chamber view to visualize the catheter image within the right atrium, and the length of catheter insertion L2 was recorded under the guidance of echocardiography. Postoperatively, chest radiographs were taken in the upright position to observe the position of the catheter tip. According to chest CT scans, the ideal length (L) for catheter tip placement was calculated when it was located at the junction of superior vena cava and right atrium. Bland-Altman scatter plot analysis and linear regression fitting test were used on L1 and L2 respectively with L to evaluate the consistency. A total of 23 patients were included in this study, among which one case of left breast cancer patient undergoing breast-conserving surgery had difficulty in identifying the catheter tip position due to residual pleural effusion obscuring the imaging of the cardiac apex four-chamber view. In 22 patients, the results of intraoperative ultrasound imaging were good, including 1 case of catheter ectopic to azygos vein, and 21 cases of right atrial catheter could be detected by ultrasound. Statistical analysis showed that there was a good consistency between L1 and L, L2 and L, and the difference between them was d=0.28 cm (95%CI:-1.76-2.31 cm) and d=0.20 cm(95%CI:-0.84-1.23 cm), respectively, with no statistical significance (P>0.05). In the linear regression model, L2 and L had a higher fit than L1, and the difference was statistically significant (R²=0.954, P<0.001). This study found that real-time echocardiographic localization technique can be applied in adult port surgery to replace X-ray-guided real-time catheter tip detection and adjustment to the optimal position.

PMID:38583051 | DOI:10.3760/cma.j.cn112137-20230905-00390

Zhonghua Yi Xue Za Zhi. 2024 Apr 9;104(14):1160-1167. doi: 10.3760/cma.j.cn112137-20231110-01055.

ABSTRACT

Objective: To study the effect of hepatitis B virus (HBV) infection on the occurrence of liver damage, HBV reactivation (HBVr) and the influence of HBVr on the prognosis of patients with advanced hepatocellular carcinoma (HCC) receiving systemic therapy. Methods: The clinical data of 403 patients with HBV-related HCC at the Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University et al, from July 2018 to December 2020 were collected. The incidence of liver damage and HBVr during systematic therapy, and the influence of HBVr on survival prognosis were analyzed. Results: Of the 403 patients, 89.1% were male (n=359), with a median age of 51 years (51.5±12.1). Before propensity score matching (PSM), the proportion of patients with cirrhosis, TNM and advanced BCLC stage was higher in high HBV-DNA (baseline HBV-DNA>1000 U/ml, n=147) group comparing with the low HBV-DNA (baseline HBV DNA≤1000 u/ml, n=256) group (P<0.05). There was no significant difference in baseline indexes between the two groups after PSM. In 290 patients after PSM, there was no significant difference in the incidence of liver damage and HBVr between high HBV-DNA group and low HBV-DNA group (P>0.05). Survival analysis was performed on 169 patients with survival data, the median overall survival (OS) was found to be 11.49 months (95%CI: 7.77-12.89) and 16.65 months (95%CI: 10.54-21.99, P=0.008) in the high and low HBV-DNA groups, respectively. And median progression-free survival (PFS) was 7.41 months (95%CI: 5.06-8.67) and 10.55 months (95%CI: 6.72-13.54, P=0.038), respectively, with a statistically significant difference. There were no differences in overall survival (OS) and progression-free survival (PFS) between patients with and without HBVr and those with or without liver damage (P>0.05). Conclusions: HBV-DNA levels above 1 000 U/ml before systemic therapy do not increase the risk of liver damage or HBVr during systemic therapy in patients with HBV-related hepatocellular carcinoma, and such patients can safely receive systemic therapy.

PMID:38583047 | DOI:10.3760/cma.j.cn112137-20231110-01055

Zhonghua Yi Xue Za Zhi. 2024 Apr 9;104(14):1155-1159. doi: 10.3760/cma.j.cn112137-20230824-00295.

ABSTRACT

Objective: To explore the efficacy and effective node of short-term personalized vestibular rehabilitation (ST-PVR) in treating acute unilateral vestibulopathy (AUVP). Methods: A randomized controlled trial was carried out. The AUVP patients who were admitted to the First Affiliated Hospital of Zhengzhou University from July 2022 to March 2023 were selected and randomized to the vestibular rehabilitation (VR) group and control group via computer-generated randomization. Standard care was the medical treatment with betahistine and prednisolone. Meanwhile, the VR group received ST-PVR. All the patients completed the baseline assessment and underwent follow-up assessments at 1 month and 3 months after the treatment. The assessments were consisted of spontaneous nystagmus (NYS), Romberg test (ROM), head thrust test (HTT), visual analogue scale (VAS) for vertigo, dizziness handicap inventory scale (DHI), activities-specific balance confidence scale (ABC), caloric test using video-electronystagmograph (VNG), and video-head impulse test (vHIT). The measurement data that did not conform to normal distribution were represented by M (Q₁, Q₃). Generalized estimating equation (GEE) was used to analyze the influence of the ST-PVR on the values of these clinical indicators and the VR grading score. The values of clinical indicators and the VR grading score were compared between the two groups at each follow-up point. Results: Seventy-one AUVP patients were included, with 35 cases in the VR group [14 males and 21 females, aged 51 (33, 55) years] and 36 cases in control group [17 males and 19 females, aged 46 (34, 59) years]. There were statistically significant differences in the impact of ST-PVR on the values of clinical indicators between the two groups (ABC: β=10.89, P<0.001; VAS: β=-1.64, P<0.001; DHI: β=-8.70, P<0.001; NYS: β=26.73, P<0.001; vHIT: β=1.41, P=0.047; the VR grading score: β=1.03, P=0.045). The assessments of the VR group in the positive rate of NYS [14.3% (5/35) vs 50.0% (18/36), P<0.001], ROM [48.6% (17/35) vs 55.6% (20/36), P<0.001], directional preponderance (DP) [34.3% (12/35) vs 75.0% (27/36), P<0.001] and DHI [26 (22, 32) vs 36 (30, 60), P=0.001] were significantly lower than that of the control group at 1 month after the treatment. The results showed a statistically significant difference in ABC [88 (80, 90) vs 76 (61, 88), P<0.001], VAS [2 (1, 3) vs 3 (2, 5), P<0.001] at 3-months after the treatment. The VR grading score of the VR group was improved significantly than those of the control group at 1 month after treatment [21 (17, 21) vs 16 (13, 20), P=0.001]. Conclusion: ST-PVR could improve the results of clinical indicators and VR grading score of the AUVP patients effectively after 1 month of the systematical treatment, and alleviate the symptoms and signs of dizziness in the acute phase as early as possible.

PMID:38583046 | DOI:10.3760/cma.j.cn112137-20230824-00295

Zhonghua Yi Xue Za Zhi. 2024 Apr 9;104(14):1143-1148. doi: 10.3760/cma.j.cn112137-20231111-01067.

ABSTRACT

Objective: To develop a simple screening questionnaire for persistent postural-perceptual dizziness (PPPD) and evaluate its screening ability. Methods: A convenience sample of 296 individuals who met the inclusion criteria between November 2021 and January 2023 were prospectively selected for three rounds of screening at the Vertigo Specialty Clinic of the Department of Otorhinolaryngology-Head and Neck Surgery in the First Hospital of Shanxi Medical University. In conjunction with expert opinion and statistical analysis, the first and second rounds of screening were used to modify and finalize the questionnaire entries, and the third round of screening was used to evaluate the questionnaire’s screening ability. Independent sample t-test was used for inter group comparison, reliability and validity indicators were employed to screen and evaluate questionnaire entries, and the receiver operating characteristic (ROC) curve was plotted to determine the optimal cut-off value and corresponding sensitivity and specificity. Results: The final PPPD screening questionnaire entries included 21 items. In evaluating the reliability of this questionnaire, the Cronbach’s alpha coefficient was 0.831, the half folding coefficient was 0.742, the content validity was 0.86, and the Kaiser-Meyer-Olkin (KMO) value in the structural validity was 0.811. Additionally, there were six factors with characteristic root>1 and a cumulative contribution rate of 62.62%. The area under the ROC curve of the screening questionnaire was 0.935 (95%CI: 0.877-0.992), and the optimal cut-off value was 8.5, with a sensitivity of 85.0%, a specificity of 85.5%, and a Kappa value of 0.653. Conclusion: The PPPD simple screening questionnaire designed in this study has a high sensitivity and specificity, making it a useful tool for identifying PPPD patients.

PMID:38583044 | DOI:10.3760/cma.j.cn112137-20231111-01067

Zhonghua Yi Xue Za Zhi. 2024 Apr 9;104(14):1138-1142. doi: 10.3760/cma.j.cn112137-20231107-01032.

ABSTRACT

Objective: To compare the clinical efficacy of personalized vestibular rehabilitation and otolith reposition in treating atypical benign paroxysmal positional vertigo (BPPV). Methods: A randomized controlled trial was carried out. Fifty patients diagnosed with atypical BPPV in the Vertigo Clinic of the First Affiliated Hospital of Shandong First Medical University from October 2022 to September 2023 were recruited and randomly divided into manual reduction group (25 cases) and vestibular rehabilitation group (25 cases) according to the random number table. All patients were given flunarizine. Patients in the manual reduction group were treated by Epley maneuver and (or) Barbecue maneuver, while the vestibular rehabilitation group was given personalized vestibular rehabilitation therapy. After two weeks’ treatment, the clinical symptoms (positional vertigo/nystagmus) and total dizziness handicap inventory (DHI) score, DHI physical (DHI-P), DHI emotional (DHI-E), and DHI functional (DHI-F) of the two groups were evaluated and compared. Results: A total of 50 patients diagnosed with atypical BPPV were included, including 23 males and 27 females, with an average age of (48.8±14.5) years. There was no statistically significant difference between the two groups in age, gender, disease severity, Romberg, position test abnormality ratio (Dix-hallpike/Roll test), temperature test, and video head impulse test baseline test results (all P>0.05). After 2 weeks of treatment, the effective rates of the treatment in the manual reduction and vestibular rehabilitation groups were 56.0% (14/25) and 88.0% (22/25), respectively, with a statistically significant difference (P=0.025). The total DHI score, DHI-P, DHI-E, and DHI-F scores in both groups were significantly decreased after treatment (all P<0.001). Compared with the manual reduction group, the total DHI score (23.2±2.7 vs 36.4±15.7, P=0.002), DHI-P (10.2±4.6 vs 13.7±5.3, P=0.016) and DHI-F (6.5±6.4 vs 13.0±7.2, P=0.002) in the vestibular group were lower, however, there was no significant difference in DHI-E score between the two groups (6.6±4.8 vs 9.6±7.3, P=0.087). Conclusion: Compared with otolith reposition, personalized vestibular rehabilitation therapy plays a better role in improving the symptoms and decreasing DHI score for patients with atypical BPPV.

PMID:38583043 | DOI:10.3760/cma.j.cn112137-20231107-01032

Shanghai Kou Qiang Yi Xue. 2024 Feb;33(1):101-105.

ABSTRACT

PURPOSE: Through questionnaire survey, parents’ cognition of children’s bad oral habits and their related influencing factors were explored, in order to provide a reference for science popularization and education in future work.

METHODS: With a self-designed questionnaire, 247 parents of children at first visit were surveyed on basic information and problems related to bad oral habits. Descriptive statistics were used for the counting data. Logistic regression analysis was used for the relevant factors affecting the parents’ cognition of children’s bad oral habits with SPSS 26.0 software package.

RESULTS: Among 247 parents of preschool children, 17.4% of the parents took their children to the hospital for treatment because of bad oral habits. The prevalence of oral unhealthy habits was 44%. Parents’ knowledge of bad oral habits was not high, less than half of the parents (46.6%) knew about bad oral habits, of which 82.6% of the parents thought that bad oral habits would affect the development of children’s teeth, jaws, face and mental health, including facial contour (62.1%), dentition (34.7%), masticatory function (48.4%), and mental health (21.1%). 78.3% of the parents thought that bad oral habits needed to be corrected; 69.6% of the parents thought that they needed to go to the hospital for treatment, and 30.4% of the parents thought that it was ok as long as their children giving up bad oral habits. 61.7% of the parents would seek medical treatment in time when their children had bad oral habits. The ways for parents to obtain knowledge about bad oral habits were hospital education (61.5%). Parents with different characteristics had different cognition of bad oral habits. Logistic regression analysis showed that parents’ education background was a risk factor affecting parents’ cognition of bad oral habits(P=0.009).

CONCLUSIONS: Parents’ awareness of bad oral habits is not high, and parents’ educational background is a risk factor for parents’ awareness of bad oral habits. It is necessary to improve parents’ awareness of oral habits, strengthen health education of bad oral habits, especially for parents with special signs, and improve the attention to oral health care, to achieve early detection, early prevention, early treatment and timely treatment, so as to prevent the occurrence and development of malocclusion.

PMID:38583034

Shanghai Kou Qiang Yi Xue. 2024 Feb;33(1):85-89.

ABSTRACT

PURPOSE: To study the relationship between the expression of prostaglandin E2 (PGE2) and cyclooxygenase-2 (COX-2) and the osteogenic activity and oxygen level of alveolar bone.

METHODS: The alveolar bones of 56 patients with chronic periodontitis who received dental treatment from March 2021 to March 2023 were collected as the experimental (periodontitis) group, and the healthy alveolar bones of 53 patients who received dental treatment during the same period were selected as the control group. The osteoblasts were cultured by tissue block culture, and modified Kaplow’s alkaline phosphatase (ALP) staining was used to identify the cells. COX-2, PGE2 and osteoclastogenesis inhibitory factor (OPG) receptor activator of nuclear factor-κb ligand (RANKL) and other indicators were determined by ELISA. PGE2, COX-2, OPG, internal oxygen level, ALP, RANKL and their correlation were compared between the two groups. Statistical analysis was performed with SPSS 27.0 software package.

RESULTS: PGE2, COX-2 and RANKL in periodontitis group were significantly higher than those in the control group, but OPG, internal oxygen level and ALP were significantly lower than those in the control group (P＜0.05). PGE2 and COX2 were highly positively correlated with OPG, internal oxygen level and ALP, but were highly positively correlated with RANKL(P＜0.05).

CONCLUSIONS: The expression of PGE2 and COX-2 is highly negatively correlated with ALP and oxygen levels. Clinical treatment may consider increasing oxygen levels, increasing oxygen partial pressure, and regulating ALP levels by drugs, so as to change the inflammatory condition of periodontitis or other dental diseases.

PMID:38583031

Shanghai Kou Qiang Yi Xue. 2024 Feb;33(1):76-79.

ABSTRACT

PURPOSE: To analyze the effect of orthodontic treatment combined with bone level implant in repairing dentition defect.

METHODS: The data of 88 patients with single dental implant in mandibular posterior region who were treated for dentition defect from January 2020 to January 2022 were retrospectively analyzed, including 44 patients with bone level implant repair(control group) and 44 patients with orthodontic treatment combined bone level implant repair (experimental group). The success rate of implant implantation, periodontal health status, masticatory function, implant stability, postoperative complications and implant satisfaction were compared between the two groups. Statistical analysis was performed with SPSS 18.0 software package.

RESULTS: There was no significant difference in the success rate of implant implantation at 3 months and 6 months between the two groups(P＞0.05). The success rate of implant implantation at 12 months in the experimental group was significantly higher than that in the control group (P＜0.05). The gingival sulci bleeding index (SBI) and probing depth (PD) of the experimental group were significantly lower than those of the control group at 12 months after implantation (P＜0.05), and there was no significant different in bone absorption between the two groups at 12 months after implantation(P＞0.05). The EMG activities of masseter muscle and temporal muscle in the two groups were significantly higher than those before treatment(P＜0.05), and those of masseter muscle and temporal muscle in the experimental group were significantly higher than those in the control group (P＜0.05). The implant stability coefficient values of 6 months and 12 months in 2 groups were significantly higher than those of 3 months (P＜0.05), the implant stability coefficient values of 12 months in 2 groups were significantly higher than those of 6 months and 12 months in 2 groups (P＜0.05), and the implant stability coefficient values of 6 months and 12 months in the experimental group were significantly higher than those in the control group(P＜0.05). There was no significant difference in the total complication rate between the two groups (P＞0.05). The implant satisfaction of the experimental group was significantly higher than that of the control group (P＜0.05).

CONCLUSIONS: Orthodontic treatment combined with bone level implants can improve the success rate of implantation and masticatory efficiency, enhance the periodontal health of implants, and increase the patients’ satisfaction with implants.

PMID:38583029

Shanghai Kou Qiang Yi Xue. 2024 Feb;33(1):71-75.

ABSTRACT

PURPOSE: To evaluation the effect of modified triangular flap-secondary healing (MTF-S) on the treatment of mandibular impacted wisdom teeth with full or partial bone impaction.

METHODS: A total of 207 patients with mandibular impacted wisdom teeth were selected in Shaoxing Stomatological Hospital from June 2022 to June 2023. Among them, 86 patients had completely impacted wisdom teeth (group A), and 121 patients had partially impacted wisdom teeth (group B). All patients had bilateral impacted wisdom teeth. One of the wisdom teeth was removed first and was sutured with triangular flap-primary healing (TF-P). The other wisdom tooth was removed two weeks later and was sutured with MTF-S. Patients in groups A and B were divided into two subgroups based on suture methods, with TF-P used for group A1 and B1, and MTF-S used for groups A2 and B2. Perioperative indicators, including surgical time, root loss rate, and completeness of extraction sockets were recorded; Postoperative complications of four groups, including pain, swelling, and limited mouth opening were compared. SPSS 22.0 software package was used for statistical analysis.

RESULTS: The surgical time of group A1, A2, B1 and B2 was (17.69±3.28), (18.22±3.06), (12.37±3.72) and (12.64±4.13) minutes, respectively. The surgical time of group A1 and A2 was significantly longer than that of group B1 and B2 (P＜0.05). Seven days after surgery, the VAS scores of group A1, A2, B1 and B2 were (1.17±0.34), (0.93±0.29), (0.48±0.15) and (0.76±0.21), respectively. The VAS scores of group B1 and B2 were lower than those of group A1 and A2, and group A2 was lower than group A1 and B2 was higher than group B1 group(P＜0.05). On the 1st day, 3rd day, and 7th day after surgery, the swelling degree in group A1 was greater than that in group B1, and the swelling degree in group B1 was greater than that in group A2 and B2(P＜0.05); while the limitation of mouth opening mouth in group A2 and B2 was lower than that in group A1 and B1, and the limitation of opening mouth in group B2 was lower than that in group A2(P＜0.05).

CONCLUSIONS: Compared with partially impacted wisdom teeth, the extraction of completely impacted wisdom teeth has a longer surgical time. For completely impacted wisdom teeth, MTF-S is beneficial for reducing postoperative pain, swelling and mouth opening limitations. For partially impacted wisdom teeth, MTF-S is beneficial for reducing postoperative swelling and mouth opening limitations, but the effect is not significant in reducing patient pain.

PMID:38583028

Shanghai Kou Qiang Yi Xue. 2024 Feb;33(1):54-58.

ABSTRACT

PURPOSE: To compare the forming ability of four kinds of nickel-titanium instrument preparation resin for simulated curved root canal.

METHODS: A total of 40 single bend resin simulated root canals were randomly divided into 4 groups with 10 in each group. Four kinds of nickel-titanium instruments (ProTaper, HyFlex EDM, WaveOne Gold and Reciproc Blue) were used for root canal preparation, and divided into group A, group B, group C and group D. The preparation time of the four groups was compared, the root canal images before and after preparation were analyzed by computer image analysis software, and the changes of the preparation time, curvature and curvature radius of the four groups were recorded. With the root tip as the center of the circle, the radius of 1-10 mm was selected as concentric circle arcs. The detection points were overlapping root canal intersection points. The resin removal amount and center positioning force of the inner and outer walls of the root canal at different detection points were recorded. Statistical analysis was performed with SPSS 20.0 software package.

RESULTS: The root canal preparation time in group A was significant longer than that in group B, C and D(P＜0.05), but there was no significant difference in the curvature and curvature radius of the root canal among the four groups (P＞0.05). The removal amount of resin from the root canal wall in group C was significant lower than that in group A, B and D (P＜0.05) when the distance from the detection point to the apical foramina was 5, 6, 8, 9 and 10 mm, respectively. The removal amount of resin from the outer wall of the root canal in group C was significant lower than that in group A, B and D (P＜0.05) when the distance from the detection point to the apical foramina was 5, 6, 7, 9 and 10 mm, respectively. The root tip offset of group A from the detection point to the apical hole of 1, 2, 3, 4, 6, 7, 8, 9 and 10 mm was significant greater than that of group B, C and D(P＜0.05).

CONCLUSIONS: Among the four instruments, ProTaper has the largest apical deviation, HyFlex EDM, WaveOne Gold and Reciproc Blue have better ability of root canal forming.

PMID:38583025