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Trueness of maxillary complete dentures duplicated by using conventional and 3D printing techniques: A comparative in vitro study

J Prosthet Dent. 2024 Dec 18:S0022-3913(24)00790-X. doi: 10.1016/j.prosdent.2024.12.004. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Duplicating complete dentures and achieving accurately fitting prostheses poses a challenge. Conventional methods are often time-consuming and susceptible to human error. Advancements in digital technology for denture fabrication offer a promising alternative to conventional duplication techniques, but studies comparing the methods are lacking.

PURPOSE: The purpose of this in vitro study was to compare the trueness of duplicated complete dentures using 3-dimensional (3D) printing technology with that of dentures duplicated using the conventional method.

MATERIAL AND METHODS: A typodont was used to construct a maxillary complete denture using the conventional method. The denture was scanned using a desktop scanner, and the standard tessellation language (STL) file was considered the reference file. Each denture was duplicated using 3 techniques (10 in each group). In the first group, the denture was duplicated using the conventional technique; in the second group, the denture was printed as a single unit (monolithic) from a tooth-colored resin, and the denture flange was then veneered with pink resin; in the third group, the denture base was printed separately from the pink resin, and the teeth were printed as a single unit using tooth-colored resin. The denture base and the teeth were co-related using a positioning device. The duplicate dentures in the 3 groups were scanned, and the STL files were imported into a surface-matching software program to evaluate their trueness. Statistical analysis was done using 1-way ANOVA followed by the Tukey post hoc test (α=.05).

RESULTS: A significant difference (P<.001) was found in the trueness of the 3 duplication techniques, with the highest overall deviation recorded in the conventional denture group (0.73 ±0.06 mm) and the least deviation recorded in the monolithic denture group (0.21 ±0.04 mm). Deviations in the canine, first molar, and maxillary tuberosities were the lowest in the monolithic denture group (0.13 ±0.01 mm), (0.11 ±0.03 mm), (0.27 ±0.05 mm), respectively.

CONCLUSIONS: Using 3D printing technology for complete denture duplication has a promising outcome with the highest trueness reported with the monolithic denture. Comparative clinical studies are needed.

PMID:39701842 | DOI:10.1016/j.prosdent.2024.12.004

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Mandibular tongue-shaped flap reconstruction for lip defects following lip tumor surgery

J Craniomaxillofac Surg. 2024 Dec 18:S1010-5182(24)00342-1. doi: 10.1016/j.jcms.2024.12.010. Online ahead of print.

ABSTRACT

Lip defects due to lip tumor surgery need proper reconstruction to preserve their function. Traditional methods offer various options for lip repair, but each has limitations, and can lead to deformity, asymmetry, or functional impairment. This study aimed to investigate the clinical application of mandibular tongue-shaped flap reconstruction for postoperative defects following lip tumor surgery. A retrospective analysis was conducted on the clinical data of 29 patients with lip tumors treated between February 2018 and August 2024. Patients were divided into two groups based on the surgical method: the tongue-shaped flap group (group T, n = 17) and the Abbe flap group (group A, n = 12). Preoperative indicators (preoperative pathology, tumor location), intraoperative and postoperative indicators (operation time, intraoperative blood loss, hospitalization duration, defect repair range), follow-up indicators (scar hyperplasia at 1, 6, and 12 months postoperatively, flap color difference, lip function, patient satisfaction), and complications (postoperative bleeding, flap necrosis, microstomia, incomplete closure, salivation) were compared and analyzed between the two groups. Group T had a significantly shorter operation time, less intraoperative blood loss, and shorter hospitalization duration compared with group A (all p < 0.05). The tongue-shaped flap was suitable for repairing defects ranging from half to the full length of the lip, while the Abbe flap was suitable for defects ranging from one-third to half the length of the lip. Group T demonstrated a wider repair range compared with group A. At 1 month postoperatively, group A showed a statistically significant difference in eating difficulty compared with group T (p < 0.05), while no statistically significant differences were found at 3, 6, and 12 months postoperatively (p > 0.05). There were no statistically significant differences between the two groups in terms of scar hyperplasia, flap color difference, or overall patient satisfaction (p > 0.05). The incidence of microstomia was significantly lower in group T compared with group A (p < 0.05). There were no statistically significant differences between the two groups in the rates of postoperative bleeding, flap necrosis, incomplete lip closure, or salivation (p > 0.05). Mandibular tongue-shaped flap reconstruction is a novel method for repairing postoperative defects following lip tumor surgery. This technique simplifies the surgical procedure while achieving both functional and aesthetic preservation. It offers advantages such as a wider repair range, minimal trauma, shorter operation time, faster postoperative recovery, shorter hospitalization duration, and a lower incidence of microstomia. Patients demonstrate good tolerance, making it particularly suitable for elderly and high-risk patients. This method may become a new option for repairing defects following lip tumor excision.

PMID:39701837 | DOI:10.1016/j.jcms.2024.12.010

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Viral Acute Lower Respiratory Tract Infections (ALRI) in Rural Bangladeshi Children Prior to the COVID-19 Pandemic

Influenza Other Respir Viruses. 2024 Dec;18(12):e70062. doi: 10.1111/irv.70062.

ABSTRACT

BACKGROUND: Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh.

METHODS: We enrolled 3- to 23-month-old children with ALRIs attending a subdistrict hospital outpatient clinic in Sylhet district in Bangladesh. Trained study physicians ascertained the cases and obtained nasopharyngeal swabs to detect 19 respiratory viruses by multiplex PCR using the Luminex Integrated System NxTAG Respiratory pathogen panel.

RESULTS: Between August 2016 and September 2017, we enrolled 1477 children. Median age was 10 months; 58.1% were male. Forty-seven percent presented during autumn (mid-June to mid-October). About a third had temperature ≥ 101°F, 95.4% had cough in the previous 3 days, 72.0% had fast breathing, and 80.0% had chest indrawing. Alveolar consolidation occurred in 23.9%, and 4.4% were hypoxemic (saturation < 90% on room air). Nineteen percent required hospitalization; 79.1% of them were discharged within 48 h. A respiratory virus was identified in 81.8%, majority (75.8%) with single virus isolation. Rhinoenterovirus was most commonly identified (HRV/HEV, 37.9%), followed by respiratory syncytial virus (RSV, 20.2%) and human metapneumovirus (hMPV, 11.7%). Rhinoenterovirus was detected year-round; RSV was detected during August-November and hMPV during December-March.

CONCLUSIONS: Respiratory viruses were identified in a majority (82%) of children under 2 years of age presenting with ALRI in rural hospitals of Bangladesh. These findings have implications for future study and potentially for surveillance, antimicrobial stewardship, vaccine program planning, and policy.

PMID:39701824 | DOI:10.1111/irv.70062

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Quality assessment of animal experimental studies on traditional Chinese medicine treatment of cervical radiculopathy

Zhongguo Zhong Yao Za Zhi. 2024 Nov;49(21):5686-5694. doi: 10.19540/j.cnki.cjcmm.20240620.402.

ABSTRACT

This study aims to assess the methodological and reporting quality of animal experimental studies on the treatment of cervical radiculopathy(CR) with traditional Chinese medicine(TCM), analyze the deficiencies during the experimental process, and develop the methods to enhance the quality of such studies. The related articles were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, and Web of Science. The methodological quality and reporting quality of the included studies were evaluated according to the risk of bias tool of the Systematic Review Centre for Laboratory Animal Experimentation(SYRCLE) and the Animal Research: Reporting of in vivo Experiments(ARRIVE) 2.0 guidelines, respectively. A total of 4 086 articles were initially screened, in which 71 articles met the inclusion criteria. The SYRCLE’s risk of bias tool revealed selection bias, performance bias, detection bias, and attrition bias of the included studies. The aspects for improvement were identified in the randomization of animal grouping, experimental implementation and outcome assessment, blinding, reporting baseline characteristics, and handling incomplete data. The essential item assessment of the ARRIVE 2.0 guidelines showed high risks in sample size determination, inclusion and exclusion criteria, randomization, blinding, outcome assessment, statistical methods, experimental procedures, and results reporting. Additionally, there were high risks in items recommended by ARRIVE 2.0 guidelines, including study background, ethical statements, animal care, interpretation/scientific implications, generalizability/translation, experimental protocol registration, data availability, and conflict of interest declaration. The existing animal experimental studies about the TCM treatment of CR exhibited methodological and reporting deficiencies. We recommend that researchers refer to the SYRCLE’s risk of bias tool and the ARRIVE 2.0 guidelines to rigorously design, implement, and report experiments in a standardized manner, thereby enhancing the scientific, authentic, and reproducible properties of the experiments.

PMID:39701779 | DOI:10.19540/j.cnki.cjcmm.20240620.402

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Effect of Buzhong Yiqi Decoction on Treg cells in rats with autoimmune thyroiditis through TGF-β/Smad signaling pathway

Zhongguo Zhong Yao Za Zhi. 2024 Oct;49(19):5288-5296. doi: 10.19540/j.cnki.cjcmm.20240712.702.

ABSTRACT

To investigate the effect of Buzhong Yiqi Decoction on regulatory T cells(Treg) in experimental rats with autoimmune thyroiditis(EAT) through the transforming growth factor-β(TGF-β)/Smad signaling pathway. Female SD rats were immunized with iodine-rich drinking water combined with Freund’s adjuvant and porcine thyroglobulin(pTG) to establish the EAT model of rats, and the levels of serum thyroperoxidase antibody(TPOAb) and thyroglobulin antibody(TGAb) were detected. Pathological sections by hematoxylin-eosin(HE) staining were observed. Treg in the rats’ spleen were extracted by immunomagnetic beads after the successful modeling and identified by flow cytometry. The extracted Treg were divided into blank group, Buzhong Yiqi Decoction group, TGF-β group, antagonist(LY3200882), and antagonist(LY3200882)+Buzhong Yiqi Decoction group. After the intervention, the cell counting kit-8(CCK-8) experiment was conducted to detect cell viability. Western blot and quantitative real-time PCR(RT-qPCR) were used to detect the expression of TGF-β/Smad signaling pathway-related proteins and genes. The results showed that the levels of TPOAb and TGAb increased in the rats in the model group compared to the rats in the blank group. HE staining showed that part of the follicles in the thyroid tissue of the rats in the model group were destroyed, and a large number of lymphocytes were infiltrated, indicating that the modeling was successful. After Treg were administered in vitro, CCK-8 results showed that the serum concentration of Buzhong Yiqi Decoction was below 40% to promote cell proliferation. The Buzhong Yiqi Decoction-containing serum group could increase the protein expression of TGF-β1, FoxP3, Smad2, and Smad4 compared with the blank serum group, while the expression of p-Smad2, p-Smad3, and Smad3 increased compared with the blank serum group, but the difference was not statistically significant. Compared with the antagonist group, the protein expressions of p-Smad2, Smad2, p-Smad3, Smad3, Smad4, and Smad7 did not significantly increase or decrease in the antagonist group after adding Buzhong Yiqi Decoction-containing serum. RT-qPCR showed that compared with the blank serum group, the mRNA expression of TGF-β1, FoxP3, Smad2, Smad3, Smad4, and Smad7 in the Buzhong Yiqi Decoction group increased or decreased in the same trend as that in the TGF-β group, but there was no statistical significance. After Buzhong Yiqi Decoction-containing serum was added to the antagonist group, the mRNA levels of TGF-β1, FoxP3, Smad2, Smad3, Smad4, and Smad7 were not statistically significant. In conclusion, Buzhong Yiqi Decoction could promote the stability and activity of Treg cells by promoting the secretion of TGF-β1 and regulating the expression of key signaling molecules TGF-β1, Smad2, and Smad4 in the TGF-β/Smad signaling pathway, thus affecting the immune balance of Th17/Treg and inhibiting the inflammatory response of rats with EAT.

PMID:39701767 | DOI:10.19540/j.cnki.cjcmm.20240712.702

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Serum metabolomics reveals effects of standard decoction and formula granules of Paeoniae Radix Rubra on rat model of heat toxin and blood stasis

Zhongguo Zhong Yao Za Zhi. 2024 Oct;49(19):5181-5192. doi: 10.19540/j.cnki.cjcmm.20240710.301.

ABSTRACT

This study aims to compare the effects and mechanisms of the standard decoction and formula granules of Paeoniae Radix Rubra in regulating the metabolism in the rat model of heat toxin and blood stasis. SD rats were randomized into control, model, standard decoction, and formula granules groups. After 14 days of administration, the rats in the latter three groups were subjected to subcutaneous injection with carrageenan and intraperitoneal injection with bacterial lipopolysaccharide for the modeling of heat toxin and blood stasis. The anal temperature, coagulation indexes, platelet aggregation(PAG), serum levels of thromboxane B_2(TXB_2), 6-ketone-prostaglondin F1α(6-keto-PGF1α), interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), von Willebrand factor(vWF), endothelial nitric oxide synthase(eNOS), and endothelin-1(ET-1) were measured. The metabolites in rat serum were identified by ultra-high performance liquid chromatography-quadrupole-time of flight mass spectrometry(UPLC-Q-TOF-MS). Multivariate statistical analysis was performed to screen the differential metabolites, which were then subjected to the KEGG pathway enrichment analysis. The results showed that the standard decoction and formula granules of Paeoniae Radix Rubra improved the state of model rats by lowering the body temperature, inhibiting inflammation, reducing PAG, delaying coagulation, and regulating the vascular function. The metabolomics analysis screened out 15 and 65 differential metabolites in the standard decoction and formula granules groups, respectively, compared with the model group. The enrichment analysis of the differential metabolites showed that the standard decoction of Paeoniae Radix Rubra exerted effects by affecting four key metabolic pathways: α-linolenic acid metabolism, primary bile acid biosynthesis, linoleic acid metabolism, and phenylalanine metabolism. The formula granules of Paeoniae Radix Rubra exerted effects by affecting four key metabolic pathways: α-linolenic acid metabolism, citrate cycle(tricarboxylic acid cycle), purine metabolism, and glyoxylic acid and dicarboxylic acid metabolism. This study indicated that the standard decoction and formula granules of Paeoniae Radix Rubra had similar effects on the syndrome of heat toxin and blood stasis and both of them regulated α-linolenic acid catabolism, which provided a scientific basis for the clinical application of the formula granules of Paeoniae Radix Rubra.

PMID:39701756 | DOI:10.19540/j.cnki.cjcmm.20240710.301

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Construction and content introduction of implementation standard of health technology assessment in traditional Chinese medicine

Zhongguo Zhong Yao Za Zhi. 2024 Oct;49(20):5643-5651. doi: 10.19540/j.cnki.cjcmm.20240708.501.

ABSTRACT

This study aims to establish the implementation standard of health technology assessment(HTA) in traditional Chinese medicine(TCM), so as to promote the scientific and standardized implementation and application of HTA in TCM for high-quality decision-making. Based on the published HTA method guidelines, the literature analysis and expert consensus method were used to establish the implementation standard of HTA in TCM with implementation steps, assessment domains, and reporting checklists as the main content. A total of 41 HTA guidelines were included. After statistical induction and 4 consensus meetings, the preliminary standard of HTA in TCM was formed, and a complete TCM HTA implementation standard was established after two rounds of Delphi method, including 10 implementation steps(1 optional step and 9 necessary steps), 7 assessment domains(7 domains, 19 criteria and 37 sub-criteria, with 2 specific criteria and 5 specific sub-criteria for TCM diagnosis and treatment equipment or protocol health technologies), and 16 items in the reporting checklists. This study constructed a universal HTA implementation standard in TCM and incorporated patient perspectives. The implementation standard was normative, scientific, compatible, and considering the particularity of TCM. At the same time, the implementation standard was explained in detail, providing a reference for the practical application of HTA in TCM.

PMID:39701746 | DOI:10.19540/j.cnki.cjcmm.20240708.501

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Rapid identification of honey-processing degree of Astragali Radix based on intelligent sensory technology and multivariate statistical analyses

Zhongguo Zhong Yao Za Zhi. 2024 Oct;49(20):5451-5459. doi: 10.19540/j.cnki.cjcmm.20240717.301.

ABSTRACT

To analyze the differences and dynamic changes in the color, odor, and major chemical components of Astragali Radix during honey processing, this study used a CM-5 spectrophotometer and Hercules NEO ultra-fast gas phase electronic nose for analysis. High performance liquid chromatography was employed to determine the content of calycosin, calycosin-7-glucoside, formononetin, and ononin in the Astragali Radix decoction pieces processed with honey to different degrees. Multivariate statistical analyses including partial least squares-discriminant analysis(PLS-DA), orthogonal partial least squares-discriminant analysis(OPLS-DA), differential factor analysis(DFA), and Bayesian discriminant analysis were adopted to differentiate the Astragali Radix decoction pieces processed with honey to different degrees and evaluate the correlations between visual characteristics and chemical composition. The results showed that chromatic values c~*, b~*, and L~* were the main color difference variables distinguishing raw and honey-processed Astragali Radix decoction pieces. The reference ranges for the chromatic values of raw and honey-processed Astragali Radix decoction pieces were determined based on these key color parameters. A total of 18 odor components were identified in Astragali Radix during the honey-processing process, with cyclohexane and dimethyl sulfoxide identified as odor markers for distinguishing Astragali Radix decoction pieces with different honey-processing degrees. The content of calycosin had a significant correlation with that of 2-methylfuran and delta-nonalactone, two odor components. This study successfully and rapidly differentiated the Astragali Radix decoction pieces processed with honey to different degrees, providing a reference for the quality control and the quality evaluation of Astragali Radix decoction pieces based on the appearance traits during the process of honey processing.

PMID:39701728 | DOI:10.19540/j.cnki.cjcmm.20240717.301

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Current status of randomized controlled trials of traditional Chinese medicine in treating coronary heart disease with angina pectoris after percutaneous coronary intervention

Zhongguo Zhong Yao Za Zhi. 2024 Nov;49(22):6224-6234. doi: 10.19540/j.cnki.cjcmm.20240815.503.

ABSTRACT

This study systematically reviewed the randomized controlled trial(RCT) of traditional Chinese medicine(TCM) treatment of coronary heart disease patients with angina pectoris after percutaneous coronary intervention(PCI). The basic elements of these RCTs, including sample size and estimation method, randomizing scheme, allocation concealment, blind method implementation, data integrity, statistical method, TCM syndrome, intervention measures, treatment course, follow-up time, and outcome indicators, were analyzed to provide reference for the design of future RCT and the clinical application of TCM in treating angina pectoris after PCI. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, Web of Science, ClinicalTrials.gov, and Chinese Clinical Trial Registry were searched for the RCT about TCM treatment of coronary heart disease patients with angina pectoris after PCI according to pre-defined criteria, with the time interval from inception to January 31, 2024. A total of 188 RCTs were included, of which 184 were clinical research articles and 4 were clinical trial registration schemes. These RCTs involved a total of 15 521 patients, with an average sample size of 83 patients and a maximum sample size of 248 patients. Among them, 126 RCTs reported TCM syndromes, the top three of which were Qi deficiency and blood stasis(38.89%), phlegm combined with stasis(17.46%), and Qi stagnation and blood stasis(9.52%). The control group received guideline-directed medical therapy(GDMT) or GDMT combined with placebo, and the treatment group received GDMT combined with TCM. The treatment mainly lasted for 4-8 weeks, most of the RCTs did not set the follow-up period or the follow-up period was unknown. A total of 160 outcome indicators were used, with the total frequency of 1 348. According to functional attributes, the outcome indicators can be categorized into 6 groups: symptoms/signs(403, 29.90%), TCM syndromes/symptoms(182, 13.50%), physical and chemical examination(468, 34.72%), quality of life(89, 6.60%), long-term prognosis(5, 0.37%), and safety evaluation(201, 14.91%). The clinical trial design of TCM intervention in angina pectoris after PCI of coronary heart disease is becoming more and more rigorous, while it remains to be improved. It is expected that more clinical trial schemes with rigorous design and taking into account the TCM advantages can be adopted in the future to provide a basis for the TCM treatment of angina pectoris after PCI of coronary heart disease.

PMID:39701718 | DOI:10.19540/j.cnki.cjcmm.20240815.503

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Network Meta-analysis of comparative efficacy of Chinese medicine injections for dilated cardiomyopathy

Zhongguo Zhong Yao Za Zhi. 2024 Nov;49(22):6198-6213. doi: 10.19540/j.cnki.cjcmm.20240815.501.

ABSTRACT

Bayesian network Meta-analysis was conducted to assess the efficacy and safety of different Chinese medicine injections for dilated cardiomyopathy(DCM). CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, EMbase, Cochrane Library, ProQuest, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov were searched for the randomized controlled trial(RCT) from the inception to January 2024. The quality of the included RCT was evaluated using the Cochrane’s risk of bias assessment tool, and the quality of evidence for outcomes was assessed by GRADE. Stata 16.0 and RevMan 5.4 softwares were used for Meta-analysis. A total of 57 RCTs involving 4 812 subjects, 6 Chinese medicine injections and 6 outcome indicators were included. Bayesian network Meta-analysis indicated that:(1) In terms of increasing clinical total effectiveness rate, except Shenqi Fuzheng Injection + conventional western medicine, other 5 Chinese medicine injections combined with conventional western medicine outperformed conventional western medicine alone, and Xinmailong Injection + conventional western medicine had the best effect.(2) In terms of improving left ventricular ejection fraction, all of the 6 Chinese medicine injections combined with conventional western medicine were superior to conventional western medicine alone, and Shengmai Injection + conventional western medicine had the highest likelihood of being the best intervention.(3) On account of reducing left ventricular end-diastolic dimension, Shenfu Injection + conventional western medicine, Shenmai Injection + conventional western medicine, Huangqi Injection + conventional western medicine, and Xinmailong Injection + conventional western medicine outperformed conventional western medicine alone except Shengmai Injection + conventional western medicine, and Huangqi Injection + conventional western medicine had the highest probability of being the best treatment.(4) In terms of decreasing BNP, Huangqi Injection + conventional western medicine, Shenfu Injection + conventional western medicine, and Shenmai Injection + conventional western medicine were better than conventional western medicine alone, and Huangqi Injection + conventional western medicine had the highest likelihood of being the best treatment.(5) Considering the improvement in 6-min walk test, Shenmai Injection + conventional western medicine were superior to conventional western medicine alone.(6) In the case of improving cardiac output, Shenmai Injection + conventional western medicine, Shengmai Injection + conventional western medicine, Xinmailong Injection + conventional western medicine, and Shenqi Fuzheng Injection + conventional western medicine outperformed conventional western medicine alone except Shenfu Injection + conventional western medicine, thereinto, Shenmai Injection + conventional western medicine might be the optimal choice for increasing cardiac output level.(7) For safety, no statistically significant difference in adverse events was recorded between the experimental group and the control group(P=0.24). Bayesian network Meta-analysis showed that the addition of Chinese medicine injections to conventional western medicine exerted a more positive effect for DCM, and had advantages in alleviating clinical symptoms and improving cardiac function. However, due to the overall low quality of the included articles, the low inclusion of certain Chinese medicine injections, and the lack of direct comparison between different Chinese medicine injections, the results need to be further confirmed.

PMID:39701716 | DOI:10.19540/j.cnki.cjcmm.20240815.501