Tag: pubmed

Thorac Cancer. 2024 Apr 10. doi: 10.1111/1759-7714.15307. Online ahead of print.

ABSTRACT

BACKGROUND: This study investigated the role of the thoracic skeletal muscle mass as a marker of sarcopenia on postoperative mortality in pleural empyema.

METHODS: All consecutive patients (n = 103) undergoing surgery for pleural empyema in a single tertiary referral center between January 2020 and December 2022 were eligible for this study. Thoracic skeletal muscle mass index (TSMI) was determined from preoperative computed tomography scans. The impact of TSMI and other potential risk factors on postoperative in-hospital mortality was retrospectively analyzed.

RESULTS: A total of 97 patients were included in this study. The in-hospital mortality rate was 13.4%. In univariable analysis, low values for preoperative TSMI (p = 0.020), low preoperative levels of thrombocytes (p = 0.027) and total serum protein (p = 0.046) and higher preoperative American Society of Anesthesiologists (ASA) category (p = 0.007) were statistically significant risk factors for mortality. In multivariable analysis, only TSMI (p = 0.038, OR 0.933, 95% CI: 0.875-0.996) and low thrombocytes (p = 0.031, OR 0.944, 95% CI: 0.988-0.999) remained independent prognostic factors for mortality.

CONCLUSIONS: TSMI was a significant prognostic risk factor for postoperative mortality in patients with pleural empyema. TSMI may be suitable for risk stratification in this disease with high morbidity and mortality, which may have further implications for the selection of the best treatment strategy.

PMID:38597111 | DOI:10.1111/1759-7714.15307

Circulation. 2024 Apr 10. doi: 10.1161/CIRCULATIONAHA.123.065277. Online ahead of print.

ABSTRACT

BACKGROUND: In the BEST-CLI trial (Best Endovascular Versus Best Surgical Therapy for Patients With Chronic Limb-Threatening Ischemia), a prespecified secondary objective was to assess the effects of revascularization strategy on health-related quality of life (HRQoL).

METHODS: Patients with chronic limb-threatening ischemia were randomized to surgical bypass (Bypass) or endovascular intervention (Endo) in 2 parallel trials. Cohort 1 included patients with single-segment great saphenous vein; cohort 2 included those lacking suitable single-segment great saphenous vein. HRQoL was assessed over the trial duration using Vascular Quality-of-Life (VascuQoL), European Quality-of-Life-5D (EQ-5D), the Short Form-12 (SF-12) Physical Component Summary (PCS), SF-12 Mental Component Summary (MCS), Utility Index Score (SF-6D R2), and numeric rating scales of pain. HRQoL was summarized by cohort and compared within and between groups using mixed-model linear regression.

RESULTS: A total of 1193 and 335 patients in cohorts 1 and 2 with a mean follow-up of 2.9 and 2.0 years, respectively, were analyzed. In cohort 1, HRQoL significantly improved from baseline to follow-up for both groups across all measures. For example, mean (SD) VascuQoL scores were 3.0 (1.3) and 3.0 (1.2) for Bypass and Endo at baseline and 4.7 (1.4) and 4.8 (1.5) over follow-up. There were significant group differences favoring Endo when assessed with VascuQoL (difference, -0.14 [95% CI, -0.25 to -0.02]; P=0.02), SF-12 MCS (difference, -1.03 [95% CI, -1.89 to -0.18]; P=0.02), SF-6D R2 (difference, -0.01 [95% CI, -0.02 to -0.001]; P=0.03), numeric rating scale pain at present (difference, 0.26 [95% CI, 0.03 to 0.49]; P=0.03), usual level during previous week (difference, 0.26 [95% CI, 0.04 to 0.48]; P=0.02), and worst level during previous week (difference, 0.29 [95% CI, 0.02 to 0.56]; P=0.04). There was no difference between treatment arms on the basis of EQ-5D (difference, -0.01 [95% CI, -0.03 to 0.004]; P=0.12) or SF-12 PCS (difference, -0.41 [95% CI, -1.2 to 0.37]; P=0.31). In cohort 2, HRQoL also significantly improved from baseline to the end of follow-up for both groups based on all measures, but there were no differences between Bypass and Endo on any measure.

CONCLUSIONS: Among patients with chronic limb-threatening ischemia deemed eligible for either Bypass or Endo, revascularization resulted in significant and clinically meaningful improvements in HRQoL. In patients with an available single-segment great saphenous vein for bypass, but not among those without one, Endo was statistically superior on some HRQoL measures; however, these differences were below the threshold of clinically meaningful difference.

PMID:38597097 | DOI:10.1161/CIRCULATIONAHA.123.065277

Hua Xi Kou Qiang Yi Xue Za Zhi. 2024 Apr 1;42(2):234-241. doi: 10.7518/hxkq.2024.2023346.

ABSTRACT

OBJECTIVES: This study proposes a chairside digital design and manufacturing method for band and loop space maintainers and preliminarily validates its clinical feasibility.

METHODS: Clinical cases of 10 children requiring space maintenance caused by premature loss of primary teeth were collected. Intraoral scan data of the affected children were also collected to establish digital models of the missing teeth. Using a pediatric band and loop space maintainer design software developed by our research team, a rapid personalized design of band and loop structures was achieved, and a digital model of an integrated band and loop space maintainer was ultimately generated. A chairside space maintainer was manufactured through metal computer numerical control machining for the experimental group, whereas metal 3D printing in the dental laboratory was used for the control group. A model fitting assessment was conducted for the space maintainers of both groups, and senior pediatric dental experts were invited to evaluate the clinical feasibility of the space maintainers with regard to fit and stability using the visual analogue scale scoring system. Statistical analysis was also performed.

RESULTS: The time spent in designing and manufacturing the 10 space maintainers of the experimental group was all less than 1 h. Statistical analysis of expert ratings showed that the experimental group outperformed the control group with regard to fit and stability. Both types of space maintainers met clinical requirements.

CONCLUSIONS: The chairside digital design and manufacturing method for pediatric band and loop space maintainers proposed in this study can achieve same-day fitting of space maintainers at the first appointment, demonstrating good clinical feasibility and significant potential for clinical application.

PMID:38597083 | DOI:10.7518/hxkq.2024.2023346

Hua Xi Kou Qiang Yi Xue Za Zhi. 2024 Apr 1;42(2):227-233. doi: 10.7518/hxkq.2024.2023277.

ABSTRACT

OBJECTIVES: This clinical study aimed to assess the trueness of three intraoral scanners for the recor-ding of the maximal intercuspal position (MIP) to provide a reference for clinical practice.

METHODS: Ten participants with good occlusal relationship and healthy temporomandibular joint were recruited. For the control group, facebow transferring procedures were performed, and bite registrations at the MIP were used to transfer maxillary and mandibular casts to a mechanical articulator, which were then scanned with a laboratory scanner to obtain digital cast data. For the experimental groups, three intraoral scanners (Trios 3, Carestream 3600, and Aoralscan 3) were used to obtain digital casts of the participants at the MIP following the scanning workflows endorsed by the corresponding manufacturers. Subsequently, measurement points were marked on the control group’s digital casts at the central incisors, canines, and first molars, and corresponding distances between these points on the maxillary and mandibular casts were measured to calculate the sum of measured distances (D_A). Distances between measurement points in the incisor (D_I), canine (D_C), and first molar (D_M) regions were also calculated. The control group’s maxillary and mandibular digital casts with the added measurement points were aligned with the experimental group’s casts, and D_A, D_I, D_C, and D_M values of the aligned control casts were determined. Statistical analysis was performed on D_A, D_I, D_C, and D_M obtained from both the control and experimental groups to evaluate the trueness of the three intraoral scanners for the recording of MIP.

RESULTS: In the control group, D_A, D_I, D_C, and D_M values were (39.58±6.40), (13.64±3.58), (14.91±2.85), and (11.03±1.56) mm. The Trios 3 group had values of (38.99±6.60), (13.42±3.66), (14.55±2.87), and (11.03±1.69) mm. The Carestream 3600 group showed values of (38.57±6.36), (13.56±3.68), (14.45±2.85), and (10.55±1.41) mm, while the Aoralscan 3 group had values of (38.16±5.69), (13.03±3.54), (14.23±2.59), and (10.90±1.54) mm. Analysis of variance revealed no statistically significant differences between the experimental and control groups for overall deviation D_A (P=0.96), as well as local deviations D_I (P=0.98), D_C (P=0.96), and D_M (P=0.89).

CONCLUSIONS: With standardized scanning protocols, the three intraoral scanners demonstrated comparable trueness to traditional methods in recording MIP, fulfilling clinical requirements.

PMID:38597082 | DOI:10.7518/hxkq.2024.2023277

Hua Xi Kou Qiang Yi Xue Za Zhi. 2024 Apr 1;42(2):207-213. doi: 10.7518/hxkq.2024.2023282.

ABSTRACT

OBJECTIVES: To determine the optimal placement of miniscrews, this study compared adult male and female patients in terms of cortical bone density, cortical bone thickness, and available bone width in the infrazygomatic crest region.

METHODS: The cone beam computed tomography imaging data of 200 patients (20-30 years old; 100 males and 100 females) were collected. The right maxillary posterior teeth in the sagittal plane were divided into six levels from proximal to distal, and three measurement sites were positioned at vertical distances of 8, 10, and 12 mm from the cementum. Cortical bone density, cortical bone thickness, and available bone width were measured in 18 measurement sites in the infrazygomatic crest and analyzed statistically.

RESULTS: The highest cortical bone density, cortical bone thickness, and available bone width in the infrazygomatic crest in adult male and female patients were at the level of the interradicular space between the maxillary second premolar and maxillary first molar. The bone cortical density and thickness increased with vertical height, whereas the available bone width decreased with increasing vertical height. Differences were observed in cortical bone density, cortical bone thickness, and available bone width between adult male and female patients.

CONCLUSIONS: The optimal implantation sites of the micro-implant anchorages in the infrazygomatic crest were at the level of the interradicular space between the maxillary second premolar and the maxillary first molar, and the vertical height of the optimal implantation site in males was appropriately higher than that in females.

PMID:38597080 | DOI:10.7518/hxkq.2024.2023282

Hua Xi Kou Qiang Yi Xue Za Zhi. 2024 Apr 1;42(2):192-206. doi: 10.7518/hxkq.2024.2023280.

ABSTRACT

OBJECTIVES: This study aimed to explore the expression trends of innate immune cells and immune-checkpoint molecules validated by data calculation in the process of oral mucosal carcinogenesis, as well as to explore methods of suppressing oral mucosal carcinogenesis based on immunotherapy by predicting their interactions. Me-thods 1) The cancer genome atlas (TCGA) database comprehensively scores immune cells and immune-checkpoint molecules in the process of oral mucosal carcinogenesis and screens out intrinsic immune cells and immune-checkpoint molecules that interfere with tumor immune escape. 2) Clinical patient blood routine data were collected for the statistical analysis of peripheral blood immune cells during the progression of oral mucosal carcinogenesis. Immune cells in peripheral blood that may affect the progression of oral mucosal carcinogenesis were screened. 3) Immunohistochemical staining was performed on intrinsic immune cells and immune-checkpoint molecules validated based on data calculation in various stages of oral mucosal carcinogenesis. 4) Special staining was used to identify innate immune cells in various stages of oral mucosal carcinogenesis based on data-calculation verification. 5) Survival analysis was conducted on intrinsic immune cells and immune-checkpoint molecules validated based on data calculation during the process of oral mucosal carcinogenesis. The association of intrinsic immune cells and immune-checkpoint molecules with the prognosis of oral squamous cell carcinoma was verified.

RESULTS: The expression of monocytes and neutrophils increased during the process of oral mucosal carcinogenesis. The expression of eosinophils showed a single peak trend of up and down. The expression of mast cells decreased. In the process of oral mucosal carcinogenesis, the expression of the immune-checkpoint molecules cytotoxic T-lymphocyte-associated protein 4 (CTLA4) and programmed cell death-ligand (PD-L1) increased. The expression trends of monocytes, neutrophils, and eosinophils were positively correlated with those of CTLA4 and PD-L1 immune-checkpoint molecules. The expression trend of mast cells was negatively correlated with the expression of CTLA4 and PD-L1. Monocytes, neutrophils, and eosinophils may promote tumor immune escape mediated by CTLA4 and/or PD-L1, thereby accelerating the progression of oral mucosal carcinogenesis. Mast cells may inhibit tumor immune escape mediated by CTLA4 and/or PD-L1, delaying the progression of oral mucosal carcinogenesis.

CONCLUSIONS: Therefore, interference with specific immune cells in innate immunity can regulate the expression of CTLA4 and/or PD-L1 to a certain extent, inhibit tumor immune escape, and delay the progression of oral mucosal carcinogenesis.

PMID:38597079 | DOI:10.7518/hxkq.2024.2023280

Hua Xi Kou Qiang Yi Xue Za Zhi. 2024 Apr 1;42(2):163-171. doi: 10.7518/hxkq.2024.2023245.

ABSTRACT

OBJECTIVES: To investigate the mechanism of circadian clock protein Bmal1 (Bmal1) on renal injury with chronic periodontitis, we established an experimental rat periodontitis model.

METHODS: Twelve male Wistar rats were randomly divided into control and periodontitis groups (n=6, each group). The first maxillary molars on both sides of the upper jaw of rats with periodontitis were ligated by using orthodontic ligature wires, whereas the control group received no intervention measures. After 8 weeks, clinical periodontal parameters, including probing depth, bleeding index, and tooth mobility, were evaluated in both groups. Micro-CT scanning and three-dimensional image reconstruction were performed on the maxillary bones of the rats for the assessment of alveolar bone resorption. Histopatholo-gical observations of periodontal and renal tissues were conducted using hematoxylin-eosin (HE) and periodic acid-Schiff (PAS) staining. Renal function indicators, such as creatinine, albumin, and blood urea nitrogen levels, and oxidative stress markers, including superoxide dismutase, glutathione, and malondialdehyde levels, were measured using biochemical assay kits. MitoSOX red staining was used to detect reactive oxygen species (ROS) content in the kidneys. The gene and protein expression levels of Bmal1, nuclear factor erythroid 2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) in rat renal tissues were assessed using real-time quantitative polymerase chain reaction (RT-qPCR) and immunohistochemical staining.

RESULTS: Micro-CT and HE staining results showed significant bone resorption and attachment loss in the maxillary first molar region of the periodontitis group. Histological examination through HE and PAS staining revealed substantial histopathological damage to the renal tissues of the rats in the periodontitis group. The findings of the assessment of renal function and oxidative stress markers indicated that the periodontitis group exhibited abnormal levels of oxidative stress, whereas the renal function levels showed abnormalities without statistical significance. MitoSOX Red staining results showed that the content of ROS in the renal tissue of the periodontitis group was significantly higher than that of the control group, and RT-qPCR and immunohistochemistry results showed that the expression levels of Bmal1, Nrf2, and HO-1 in the renal tissues of the rats in the periodontitis group showed a decreasing trend.

CONCLUSIONS: Circadian clock protein Bmal1 plays an important role in the oxidative damage process involved in the renal of rats with periodontitis.

PMID:38597076 | DOI:10.7518/hxkq.2024.2023245

Hua Xi Kou Qiang Yi Xue Za Zhi. 2022 Mar 25;40(2):225-231. doi: 10.7518/hxkq.2022.02.015.

ABSTRACT

OBJECTIVES: To evaluate the susceptibility of Streptococcus mutans (S. mutans) to NaF and the effects of Candida albicans (C. albicans) metabolites on the metabolic activity and drug resistance of S. mutans.

METHODS: The minimum inhibitory concentration (MIC) and MIC based on metabolic activity (MIC-MA) of NaF against S. mutans were measured through the broth dilution test and D₂O-labeled single-cell Raman microspectroscopy, respectively, to explore the inhibitory effect of NaF on the growth and metabolism of S. mutans. The effects of different concentrations of C. albicans supernatant on the metabolic activity of S. mutans were evaluated by using D₂O-labeled single-cell Raman microspectroscopy. The correlation between C. albicans and S. mutans was explored throughassessing the drug resistance of S. mutans against NaF in a mixed system containing C. albicans supernatant by using D₂O-labeled single-cell Raman microspectroscopy.

RESULTS: The MIC and MIC-MA of NaF against S. mutans were 0.4 g·L^-1 and 1.2 g·L^-1, respectively. At the MIC level, S. mutans showed completely inhibited growth but retained high metabolic activity. Therefore, S. mutans may regain its virulence. At the MIC-MA level, the metabolic activity of S. mutans was inhibited only when the NaF concentration reached 3×MIC. At the concentration of OD₆₀₀≥0.5, the C. albicans supernatant significantly promoted the metabolic activity of S. mutans at different time points (P<0.05). In the mixed system, the susceptibility of S. mutans to NaF decreased, and statistical differences at different time points were observed (P<0.05). The metabolic activity of S. mutans was inhibited completely only at the concentration of 4×MIC (1.6 g·L^-1).

CONCLUSIONS: D₂O-labeled single-cell Raman microspectroscopy is suitable for evaluating the effects of drugs on bacterial metabolic activity. In the mixed system, the metabolites in the C. albicans supernatant at the concentration of OD₆₀₀≥0.5 significantly promoted the metabolic activity of S. mutans and reducedthe susceptibility of S. mutans to NaF.

PMID:38597057 | DOI:10.7518/hxkq.2022.02.015

Hua Xi Kou Qiang Yi Xue Za Zhi. 2022 Mar 25;40(2):204-209. doi: 10.7518/hxkq.2022.02.012.

ABSTRACT

OBJECTIVES: This study aimed to assess the efficacy and safety of facial artery musculomucosal (FAMM) flap for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer.

METHODS: A retrospective cohort study was conducted and included patients with early-medium stage tongue or floor of mouth cancer and reconstructed by FAMM flap or traditional free or axial flaps. Demographic data and surgery-related data were collected. Patients were followed up for 6 months and evaluated with satisfaction, maximal mouth opening, satisfactory contour and speech, and oral intake function at months 3 and 6.

RESULTS: Forty-five patients were included, with 15 in the FAMM group and 30 in the flap group. All patients finished 3 months follow-up, and 1 in each group was lost to follow-up at month 6. All followed-up patients had no recurrence or metastasis. The FAMM group had a significantly shorter surgical time than the flap group (P<0.05). The flap group had significantly more donor sites that were uncomfortable compared with the FAMM group (P<0.05). There was no statistical significance on satisfaction, but the FAMM group had better outcomes on contour, speech, and oral intake function at month 6 than the flap group (P<0.05). The FAMM group had smaller maximal mouth opening than the flap group (P<0.05) at month 3 but equivalent maximal mouth opening at month 6 (P>0.05).

CONCLUSIONS: FAMM flap has some advantages for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer, and it could be an ideal choice for clinical application.

PMID:38597054 | DOI:10.7518/hxkq.2022.02.012

Hua Xi Kou Qiang Yi Xue Za Zhi. 2022 Mar 25;40(2):183-188. doi: 10.7518/hxkq.2022.02.009.

ABSTRACT

OBJECTIVES: Andrews six elements was used to explore the possible influences of gender, extraction/non-extraction, and different bracket types on the evaluation of orthodontic treatment outcome.

METHODS: Digital data from 320 selected orthodontic cases in Kunming Medical University Affiliated Stomatological Hospital during the period of 2016-2020 were divided into groups in accordance with gender, tooth extraction, and type of orthodontic brackets (DamonQ self-ligating brackets and MBT brackets). Measurement was performed using Andrews six elements as standard. The mean and standard deviation of each individual score and total score for different groups were calculated and statistically tested.

RESULTS: The differences in total scores between female and male cases exhibited no statistical significance (P>0.05). By contrast, the scores in skeletal width change of the maxilla between extraction cases and non-extraction cases presented statistical significance (P<0.05). Moreover, the scores in the anteroposterior change in the position of the maxillary incisors, the bucco-lingual border change of the mandibular arch, and the skeletal width change of the maxilla between the DamonQ self-ligating bracket and MBT bracket cases presented statistical significance (P<0.05). The cases with DamonQ self-ligating brackets had significantly lower scores than the cases with MBT brackets in the bucco-lingual border change of the mandibular arch, the skeletal width change of the maxilla, and the anteroposterior change in position of the maxillary incisors.

CONCLUSIONS: Digital 3D models can be used in the clinical retrospective studies of patients after orthodontic treatment. These models can be measured repeatedly and have clinical application value. For cases with incomplete orthodontic treatment, the control of the anteroposterior position of the incisor and the width of the arch of the upper tooth is crucial. Total treatment efficiency between female and male cases exhibited no difference, but the skeletal width change of the maxilla between extraction and non-extraction cases may exert an effect on cases with complete orthodontic treatment. The group that used DamonQ self-ligating brackets may achieve good adjustment of the bucco-lingual border change of the arch.

PMID:38597051 | DOI:10.7518/hxkq.2022.02.009