Nevin Manimala

Zhonghua Yan Ke Za Zhi. 2022 Jun 11;58(6):433-440. doi: 10.3760/cma.j.cn112142-20210809-00372.

ABSTRACT

Objective: To analyze the etiological changes of children with infectious keratitis. Methods: Retrospective study. Data of patients diagnosed as bacterial, fungal, and amoebic keratitis from 2007 to 2016, aged no more than 14 years old, were collected in the Department of Ophthalmology, Beijing Tongren Hospital. A total of 649 samples were obtained for routine laboratory culture identification and drug sensitivity tests. There were 361 males and 278 females, aged (5.6±4.4) years. The data were analyzed according to age ≤3 years, 4 to 7 years and>7 years. The qualitative data were analyzed by the Chi-square test. Results: Among 649 samples, 140 were culture positive, and the positive rate was 21.6%. Bacteria were the main pathogens, accounting for 81.4%. The positive rate was 31.0% among bacterial samples (114/368), and the bacterial flora was mainly Gram-positive cocci, followed by Gram-negative bacilli. Streptococcus (34.2%) ranked first, followed by Staphylococcus (27.2%) and Pseudomonas (7.9%). For children no more than 7 years old, Streptococcus pneumoniae was the most common bacterial species, while Staphylococcus epidermidis was most common in those aged 8-14 years. Gram-positive cocci were sensitive to vancomycin. Most bacteria were more sensitive to fluoroquinolones and less sensitive to cephalosporins and aminoguanidine. The detection rate of methicillin-resistant Staphylococcus was 68% (17/25). Gatifloxacin had the highest sensitivity, while the difference between gatifloxacin and moxifloxacin, levofloxacin, ofloxacin were not statistically significant (χ²=0.836,0.358, 1.490; P=0.361,0.550,0.222). A total of 254 specimens were cultured for fungi, of which 22 were positive, and the positive rate was 8.7%. The isolated fungi included Fusarium (34.8%, 8/22), Aspergillus (26.1%, 6/22) and Candida (13.0%, 3/22). The positive rate of fungal culture was 9.2% (11/119) from 2007 to 2011, and 8.1% (11/135) from 2012 to 2016, no significant difference was found between two period (χ²=0.096, P=0.757). Fusarium showed a relatively high sensitivity to terbinafine, but it was not sensitive to fluconazole and itraconazole. The sensitivities of Aspergillus to terbinafine and voriconazole were high, followed by amphotericin. Candida had high sensitivities to amphotericin, fluconazole, itraconazole and voriconazole. In 27 specimens for Acanthamoeba culture, 4 specimens were positive, and the positive rate was 14.8%. Risk factors of Acanthamoeba infection included wearing orthokeratology lenses and trauma. Conclusions: Bacteria are the main pathogenic agent of infectious keratitis in children. Streptococcus pneumoniae is the most common in children aged 7 and below, and Staphylococcus epidermidis is the most common in children aged 8-14. Fungal infection was significantly lower than that of bacteria, mainly Fusarium, Aspergillus and Candida.

PMID:35692025 | DOI:10.3760/cma.j.cn112142-20210809-00372

Zhonghua Yi Xue Za Zhi. 2022 Jun 14;102(22):1648-1652. doi: 10.3760/cma.j.cn112137-20211124-02622.

ABSTRACT

Objective: To evaluate the efficacy and safety of laparoscopic surgery for perivascular epithelioid cell tumor (PEComa). Methods: The clinical data of 42 patients with hepatic PEComa diagnosed by pathology in Hunan Provincial People’s Hospital from September 2012 to September 2021 were retrospectively analyzed. The patients were divided into the endoscopic group and the open group according to surgical methods. Statistical software was used to compare the differences in operation time, intraoperative blood loss, postoperative hospital stay, postoperative pathological data and incidence of complications between the two groups. Results: There were 27 cases in the endoscopic group and 15 cases in the open group. In the endoscopic group, there were 5 males and 22 females, aged (40.0±10.4) years. In the open group, there were 5 males and 10 females, aged (44.5±12.6) years. The operative time of the endoscopic group and the open group was (239±156.2) min and (348±103.0) min, and the postoperative hospital stay was (8.2±2.4) d and (13.7±4.9) d, respectively, the endoscopic group was significantly better than the open group, and the difference was statistically significant (P<0.05). There was no significant difference in intraoperative blood loss, tumor benign and malignant, tumor site, tumor diameter, Ki67 index, postoperative complications such as biliary leakage, incision infection and pleural effusion (P>0.05). During the follow-up period of 2-103 months, one case was lost to follow-up, two cases died in the endoscopic group,one case died in the open group. The 5-year overall survival rate (OS) and disease-free survival rate (DFS) were 80.8% and 83.0%, respectively. Meanwhile,. The 5-year OS and DFS were both 92.3%, the difference was not statistically significant (P>0.05). Conclusions: Laparoscopic treatment of hepatic PEComa has the advantages of short operation time and short postoperative hospital stay, and the incidence of complications, 5-year OS and DFS are not significantly different from that of the open group.

PMID:35692016 | DOI:10.3760/cma.j.cn112137-20211124-02622

Zhonghua Kou Qiang Yi Xue Za Zhi. 2022 Jun 9;57(6):618-624. doi: 10.3760/cma.j.cn112144-20211019-00469.

ABSTRACT

Objective: To evaluate the in vivo osteogenic activity of titanium implants with strontium loaded TiO₂ nanotubes (NTSr). Methods: The strontium loaded titanium nanotubes were formed on pure titanium implants through anodization and hydrothermal treatment, and the unmodified titanium (Control) and sheer TiO₂ nanotubes (NT) were set to be control groups and treatment group. Inductively coupled plasma mass spectrometry (ICP-MS) was used to evaluate the Sr release at 28 days. Field emission scanning electron microscopes (FE-SEM) was used to view the micro-topography, atomic force microscope was used to exam the surface roughness, and nano-indenter was used to evaluate the hardness of three groups (n=3). Three groups of implant samples were inserted into the distal femoral metaphysis of New Zealand rabbits (n=4 at each time point). After 4 weeks and 12 weeks, samples were harvested. Micro-CT scanning, immunofluorescent and histological examinations were carried out. Results: The strontium ions could be released slowly for at least 28 days [the Sr concentration at 28 Day was (2.6±1.5) ng/ml]. NTSr coating exhibited a nanoscale tube array (the diameter was about 70 nm), and the surface roughness of implant was increased with the nanobube coating [Control (34.8±5.3) nm, NT (66.2±4.3) nm, NTSr (85.7±10.6) nm, F=37.59, P<0.001]. The surface roughness (Ra) of NT and NTSr groups was higher than the control group (P<0.05). Comparing to Control implants, NTSr implants exhibited a better osteogenic ability [the bone volume/total volume (BV/TV) value was Control (24.7±1.1)% vs. NTSr (37.7±1.9)% at 4 weeks (P<0.05), and Control (40.7±0.9)% vs. NTSr (51.9±2.1)% at 12 weeks (P<0.05)]. The fluorescent examination revealed that NTSr coating can also accelerated the generation of new bone tissue (bone tissue area% labelled by alizarin red at day 7 was Control (19.2±2.9)% vs. NT (35.4±3.7)% vs. NTSr (40.9±0.9)% (F=42.74, P<0.01). The results in the NT and NTSr group were statistically higher than that in the control group (P<0.05). Conclusions: The strontium loaded TiO₂ nanotubes can enhance new bone formation around titanium implants.

PMID:35692006 | DOI:10.3760/cma.j.cn112144-20211019-00469

Zhonghua Kou Qiang Yi Xue Za Zhi. 2022 Jun 9;57(6):611-617. doi: 10.3760/cma.j.cn112144-20210716-00332.

ABSTRACT

Objective: To analyze the external root resorption of incisors caused by maxillary canine impaction, and to explore the changes of incisor external root resorption after orthodontic treatment. Methods: Twenty-four patients with impacted maxillary canines leading to external root resorption of incisors treated in Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University from July 2011 to January 2019 were selected. The age ranged from 10 to 14 years [(12.3±1.6) years], including 11 males and 14 females. The maxillary incisors with external root resorption before treatment were included in the resorption group (21 central incisors and 22 lateral incisors), and the maxillary incisors without external root resorption were used as the control group (26 central incisors and 21 lateral incisors). Cone-beam CT was taken before treatment, immediately after treatment and one year after treatment. At the one year follow-up 15 patients were collected (10 central incisors and 12 lateral incisors in the resorption group, while 16 central incisors and 12 lateral incisors in the control group). The root length and tooth volume of maxillary incisors were measured and analyzed before canine traction, after canine traction finished and at the one year follow-up. Results: After the treatment of maxillary impacted canines, the root length and volume of the central and lateral incisors in both resorption group and control group were significantly less than that before treatment (P<0.05). At the one year follow-up, the root length and volume of the incisors (central incisors in the resorption group and the central and lateral incisors in control group) were significantly less than those immediately after impacted canine traction (P<0.05). During the canine traction, the difference of the volume change in lateral incisors between the resorption group [(17±6) mm³] and the control group [(12±5) mm³] was statistically significant (t=2.51, P<0.05). During the one year follow-up period, the difference between the changes of the root length in maxillary central incisors in the resorption group [(0.5±0.4) mm] and in the control group [(0.2±0.1) mm] was statistically significant (t=2.35, P<0.05). Conclusions: For maxillary incisors with external root resorption caused by impacted maxillary canines, the external root resorption could not stop immediately after the treatment of impacted canines. The root resorption in maxillary lateral incisors mainly occured during the traction process, while the root resorption in maxillary central incisors existed during the orthodontic treatment and in the follow-up period.

PMID:35692005 | DOI:10.3760/cma.j.cn112144-20210716-00332

Zhonghua Kou Qiang Yi Xue Za Zhi. 2022 Jun 9;57(6):569-575. doi: 10.3760/cma.j.cn112144-20220321-00124.

ABSTRACT

Objective: To explore the effects of periodontitis and inflammatory factors toward the occurrence of gestational diabetes mellitus (GDM). Methods: Pregnant women who came to the Department of Obstetrics, Northwest Women’s and Children’s Hospital for prenatal examinations during March to November of 2021 were invited to participate in this study. Participants with GDM who met the inclusion criteria (n=100) were assigned into the case group; while healthy participants (n=100) were assigned into the control group. Information of participants from the two groups were collected by questionnaires and periodontal statuses were clinically recorded in the meantime. Gingival crevicular fluid (GCF) and venous blood were also collected from participants of two groups to analyze the expression levels of inflammatory factors like C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, IL-8, IL-10 and IL-33. Factors different between the two groups were included in the multivariate regression analysis model to determine the risk factors of GDM. Results: The age of participants was (33.4±5.1) years in case group and (30.5±4.5) years in control group respectively, which had statistical differences (t=4.33,P<0.001). Besides, the body mass index of participants from case group was also significantly higher than control group [(28.11±3.85) kg/m²vs. (23.31±3.15) kg/m², t=9.65, P<0.001]. Participants with GDM had more adverse periodontal clinical parameters. Prevalence of periodontitis in GDM group was 47.0% (47/100) compared with 29.0% (29/100) in control group (χ²=6.88, P=0.009). Multivariate regression analysis results indicated that periodontitis was a critical risk factor for the occurrence of GDM (OR=1.882, P<0.001). Besides, GCF IL-8, serum TNF-α, IL-8 and IL-10 were also risk factors of GDM due to their higher expressions. Among them, TNF-α in serum (OR=2.077) and IL-8 in serum (OR=2.060) had more significant impacts (P<0.001). Conclusions: This study demonstrated that periodontitis was associated with the occurrence of GDM. Up-regulation of serum pro-inflammatory mediators leaded by local periodontal inflammatory microenvironment might play a critical role in this pathological process.

PMID:35692000 | DOI:10.3760/cma.j.cn112144-20220321-00124

J Math Biol. 2022 Jun 12;84(7):59. doi: 10.1007/s00285-022-01764-w.

ABSTRACT

The effective degree SIR model describes the dynamics of diseases with lifetime acquired immunity on a static random contact network. It is typically modeled as a system of ordinary differential equations describing the probability distribution of the infection status of neighbors of a susceptible node. Such a construct may not be used to study networks with an infinite degree distribution, such as an infinite scale-free network. We propose a new generating function approach to rewrite the effective degree SIR model as a nonlinear transport type partial differential equation. We show the existence and uniqueness of the solutions the are biologically relevant. In addition we show how this model may be reduced to the Volz model with the assumption that the infection statuses of the neighbors of an susceptible node are initially independent to each other. This paper paves the way to study the stability of the disease-free steady state and the disease threshold of the infinite dimensional effective degree SIR models.

PMID:35691964 | DOI:10.1007/s00285-022-01764-w

Prog Orthod. 2022 Jun 13;23(1):22. doi: 10.1186/s40510-022-00413-8.

ABSTRACT

BACKGROUND: Several semi-automatic software are available for the three-dimensional reconstruction of the airway from DICOM files. The aim of this study was to evaluate the accuracy of the segmentation of the upper airway testing four free source and one commercially available semi-automatic software. A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of the upper airway. The software tested were Invesalius, ITK-Snap, Dolphin 3D, 3D Slicer and Seg3D. The same upper airway models were manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the upper airway model obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the upper airway models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analyzed for software comparisons.

RESULTS: Statistically significant differences were found in the volumetric dimensions of the upper airway models and in the matching percentage among the tested software (p < 0.001). Invesalius was the most accurate software for 3D rendering of the upper airway (mean bias = 1.54 cm³; matching = 90.05%) followed by ITK-Snap (mean bias = – 2.52 cm³; matching = 84.44%), Seg 3D (mean bias = 3.21 cm³, matching = 87.36%), 3D Slicer (mean bias = – 4.77 cm³; matching = 82.08%) and Dolphin 3D (difference mean = – 6.06 cm³; matching = 78.26%). According to the color-coded map, the dis-matched area was mainly located at the most anterior nasal region of the airway. Volumetric data showed excellent inter-software reliability (GS vs semi-automatic software), with coefficient values ranging from 0.904 to 0.993, confirming proportional equivalence with manual segmentation.

CONCLUSION: Despite the excellent inter-software reliability, different semi-automatic segmentation algorithms could generate different patterns of inaccuracy error (underestimation/overestimation) of the upper airway models. Thus, is unreasonable to expect volumetric agreement among different software packages for the 3D rendering of the upper airway anatomy.

PMID:35691961 | DOI:10.1186/s40510-022-00413-8

Lifetime Data Anal. 2022 Jun 13. doi: 10.1007/s10985-022-09556-6. Online ahead of print.

ABSTRACT

The heterogeneous inverse Gaussian (IG) process is one of the most popular and most considered degradation models for highly reliable products. One difficulty with heterogeneous IG processes is the lack of analytic expressions for the Fisher information matrix (FIM). Thus, it is a challenge to find an optimum test plan using any information-based criteria with decision variables such as the termination time, the number of measurements and sample size. In this article, the FIM of an IG process with random slopes can be derived explicitly in an algebraic expression to reduce uncertainty caused by the numerical approximation. The D- and V-optimum test plans with/without a cost constraint can be obtained by using a profile optimum plan. Sensitivity analysis is studied to elucidate how optimum planning is influenced by the experimental costs and planning values of the model parameters. The theoretical results are illustrated by numerical simulation and case studies. Simulations, technical derivations and auxiliary formulae are available online as supplementary materials.

PMID:35691960 | DOI:10.1007/s10985-022-09556-6

Ann Surg Oncol. 2022 Jun 12. doi: 10.1245/s10434-022-11950-1. Online ahead of print.

ABSTRACT

BACKGROUND: Splenic artery (SpA) involvement heralds poor prognosis in pancreatic ductal adenocarcinoma (PDAC) of the body and tail but is not included in the resectability criteria. This study evaluated the prognostic impact of radiological SpA involvement in PDAC of the body and tail.

METHODS: Preoperative computed tomography images of patients who underwent distal pancreatectomy for resectable PDAC of the body and tail (n = 242) at our hospital between 2004 and 2018 were graded according to splenic vessel involvement status as clear, abutment, or encasement. Clinicopathological prognostic factors and overall survival (OS) and recurrence-free survival (RFS) rates were compared between the three groups. The prognostic value of radiological involvement status was assessed using Harrell’s concordance statistic (C-index) and time-dependent receiver-operating characteristic curve analysis and compared with pathological findings.

RESULTS: The diagnostic concordance rate was 0.87 (weighted κ statistic). Prognosis worsened with progression from clear, abutment, to encasement status. SpA encasement (hazard ratio [HR] 1.97, p = 0.04) predicted poor OS in multivariate Cox hazard regression analysis. SpA abutment (HR 1.77, p = 0.017) and encasement (HR 1.86, p = 0.034) independently predicted poor RFS. Splenic vein abutment and encasement were not significant predictors of poor OS or RFS. SpA encasement without adjuvant chemotherapy had the poorest prognosis because of early distant metastasis. The prognostic value was higher for radiological SpA involvement than for pathological SpA invasion.

CONCLUSIONS: Radiological SpA involvement status is a meaningful and reproducible prognostic indicator that can be used preoperatively for determining the treatment strategy in PDAC of the body and tail.

PMID:35691957 | DOI:10.1245/s10434-022-11950-1

Ann Surg Oncol. 2022 Jun 12. doi: 10.1245/s10434-022-11973-8. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative carcinoembryonic antigen (CEA) has been reported as a prognostic factor in patients with colorectal liver metastasis (CRLM) after hepatectomy. However, the impact of a preoperative “CEA uptrend” on prognosis after hepatectomy in these patients remains unknown. This study assessed the impact of CEA uptrend on prognosis in patients undergoing hepatectomy for CRLM.

METHODS: Consecutive patients with CRLM who underwent hepatectomy between 2009 and 2018 were retrospectively analyzed. Patients with CRLM for whom CEA was measured both around 1 month before (CEA-1m) and within 3 days (CEA-3d) before hepatectomy were enrolled. A CEA-3d higher than both the upper limit of normal (5 ng/ml) and CEA-1m was defined as a CEA uptrend.

RESULTS: Study participants comprised 212 patients with CRLM. Of these, 88 patients (41.5%) showed a CEA uptrend. CEA uptrend indicated better discriminatory ability (corrected Akaike information criteria, 733.72) and homogeneity (likelihood ratio chi-square value, 18.80) than CEA-3d or CEA-1m. Patients with CEA uptrend showed poorer overall survival than those without CEA uptrend (p < 0.001). After adjusting for known prognostic factors, the prognostic significance of CEA uptrend retained (hazard ratio 2.63, 95% confidence interval 1.63-4.26, p < 0.001). In subgroup analyses, the prognostic significance of CEA uptrend was retained irrespective of the status of RAS mutation or response to preoperative chemotherapy.

CONCLUSIONS: CEA uptrend offers better prediction of survival outcomes than conventional CEA measurements in patients undergoing hepatectomy for CRLM.

PMID:35691953 | DOI:10.1245/s10434-022-11973-8