Tag: statistics

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Feb 7;57(2):142-152. doi: 10.3760/cma.j.cn115330-20210504-00250.

ABSTRACT

Objective: To detect the percentages of CD8⁺Treg cells in the nasal mucosa and peripheral blood of chronic rhinosinusitis (CRS) and to explore their correlation with eosinophilic infiltration. Methods: Thirty-three chronic rhinosinusitis with polyp (CRSwNP), 26 chronic rhinosinusitis without polyp (CRSsNP) and 27 control patients who were collected with the nose mucosal tissue and peripheral blood in the Third Affiliated Hospital of Sun Yat-sen University from March 2017 to October 2018 were selected, including 59 males and 27 females, aging from 18 to 72 years. Hematoxylin and eosin (HE) staining was used to observe the number of eosinophils in the nasal tissues and to classify the CRS into eosinophilic CRS (ECRS) and non-eosinophilic CRS (Non-ECRS). Flow cytometry was used to detect the percentages of CD4⁺ and CD8⁺T cells in lymphocytes of nasal mucosa and peripheral blood. The percentages of CD8⁺Foxp3⁺Treg cells, CD8⁺Foxp3^–IL-10⁺Treg cells, CD8⁺IFN-γ⁺T cells (Tc1), CD8⁺IL-4⁺T cells (Tc2) and CD8⁺IL-17A⁺T cells (Tc17) in lymphocytes of nasal mucosa and peripheral blood were also tested. Besides, the percentages of Foxp3⁺TGF-β⁺Treg cells and Foxp3⁺IL-10⁺Treg cells in CD8⁺T cells were determined. All data were represented by M (IQR). GraphPad 7.0 and SPSS 16.0 were used for illustration and statistical analysis. Results: The percentage of CD8⁺T cells (37.75%(17.35%)) was higher than that of CD4⁺T cells (4.72%(4.29%)) in nasal mucosa (Z=-5.70, P<0.001), while lower (23.60%(9.33%)) than that of CD4⁺T cells (44.05% (10.93%)) in peripheral blood (t=9.72, P<0.001). CRSwNP patients possessed the highest Tc2 (1.82% (1.22%)) and Tc17 (1.93% (2.32%)) percentages than CRSsNP (Tc2: 0.84% (0.79%); Tc17: 0.54% (1.04%)) and control (Tc2: 1.09% (0.92%); Tc17: 0.47% (0.51%), both P<0.05) patients. While, CRSwNP patients possessed the lowest CD8⁺Foxp3⁺Treg cells percentage (0.10% (0.32%)) than CRSsNP (0.43% (1.45%)) and control (0.48% (0.83%), Z value was -2.24, -2.22, respectively, P value was 0.025, 0.027, respectively). The percentages of Foxp3⁺TGF-β⁺Treg cells and Foxp3⁺IL-10⁺Treg cells of CD8⁺T cells in nasal mucosa in CRSwNP were also lower than controls (Z value was 1.46, 0.49, respectively, both P=0.001). Moreover, the percentage of CD8⁺Foxp3^–IL-10⁺Treg cells of CD8⁺T cells was decreased in nasal mucosa of CRSwNP patients (0.14% (0.28%)) when compared with that of CRSsNP (0.89% (0.81%), Z=0.61, P=0.03). ECRS patients had the lower percentages of CD8⁺Foxp3⁺Treg cells (0.07% (0.44%)) and CD8⁺Foxp3^–IL-10⁺Treg cells (0.13% (0.21%)) than Non-ECRS patients (CD8⁺Foxp3⁺Treg cells: 0.53% (0.75%); CD8⁺Foxp3^–IL-10⁺Treg cells: 0.29% (0.76%), t value was 2.14, 2.78, respectively, both P<0.05). The percentage of CD8⁺Foxp3⁺Treg cells and the ratio of CD8⁺Foxp3^–IL-10⁺T per CD8⁺T cells were negatively correlated with the percentage of eosinophils in CRS patients(R² value was 0.56, 0.78, respectively, both P<0.001). There was no significant difference in the distribution of CD8⁺Fxop3⁺Treg cells and CD8⁺Fxop3^–IL-10⁺Treg cells in peripheral blood among different groups. Conclusion: The percentages of CD8⁺Treg cells decrease in CRSwNP patients, especially in ECRS patients, which are opposite to that of Tc2 and Tc17, and negatively correlate with the eosinophils percentage. This indicates that the decrease in the ratio of CD8⁺Treg cell may be associated with the immune-imbalance and eosinophilic infiltration in nasal mucosa of CRS patients.

PMID:35196757 | DOI:10.3760/cma.j.cn115330-20210504-00250

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Feb 7;57(2):153-160. doi: 10.3760/cma.j.cn115330-20210829-00579.

ABSTRACT

Objective: To compare the clinical characteristics and plasma inflammatory markers levels in different endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP), and to explore the plasma biomarkers associated with endotypes of CRSwNP. Methods: A total of 74 CRSwNP patients (male/female: 41/33; average age: 40 years) and 40 control subjects underwent septoplasty in Tongji Hospital from January 2015 to December 2017 were enrolled in this study. The demographic and clinical features of all subjects including age, gender, past history, visual analogue scale (VAS) and CT scores were recorded. Patients with CRSwNP were divided into Eos^highNeu^high, Eos^highNeu^low, Eos^lowNeu^high and Eos^lowNeu^low four endotypes according to the eosinophil (Eos) percentage and neutrophil (Neu) count of nasal polyps tissue. Preoperative blood routine was performed and the levels of 27 biomarkers in plasma were measured by Bio-Plex suspension chip method. The clinical characteristics and the level of serum biomarkers of patients with different endotypes were compared. SPSS 18.0 software was used for statistical analysis. Results: There was no difference in the clinical features including gender ratio, age, course of disease, VAS score, endoscopy and CT score among Eos^highNeu^high, Eos^highNeu^low, Eos^lowNeu^high and Eos^lowNeu^low CRSwNP patients. Compared with Eos^lowNeu^high and Eos^lowNeu^low CRSwNP patients, patients with Eos^highNeu^high and Eos^highNeu^low endotype demonstrated a higher prevalence of atopy, allergic rhinitis and asthma comorbidity, and increased peripheral blood eosinophil absolute count and percentage (all P<0.05). However, there was no significant difference between Eos^highNeu^high and Eos^highNeu^low CRSwNP. Plasma levels of all 27 mediators including type 1 cytokines (IL-12 and IFN-γ), type 2 cytokines (IL-4, IL-5 and IL-13), type 3 cytokines (IL-17A), pro-inflammatory cytokines (IL-6 and TNF-α) and tissue remodeling-related markers (bFGF, VEGF and PDGF-BB) demonstrated no significant difference among all endotypes of CRSwNP (all P>0.05). Conclusions: Eos^high and Eos^low CRSwNP patients display significant differences regarding the prevalence of atopy, allergic rhinitis and asthma comorbidity, peripheral blood eosinophil absolute count and percentage, but the clinical characteristics, blood cellular and biological markers can not effectively distinguish four endotypes of CRSwNP. Further studies are warranted to dig out the potential objective, convenient and reliable markers associated with endotypes in patients with CRSwNP.

PMID:35196758 | DOI:10.3760/cma.j.cn115330-20210829-00579

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Feb 7;57(2):136-141. doi: 10.3760/cma.j.cn115330-20210730-00500.

ABSTRACT

Objective: To explore the types and clinical characteristics of chronic rhinosinusitis with nasal polyps (CRSwNP) based on artificial intelligence and whole-slide imaging (WSI), and to explore the consistency of the diagnostic criteria of the Japanese epidemiological survey of refractory eosinophilic chronic rhinosinusitis (JESREC) in Chinese CRSwNP patients. Methods: The data of 136 patients with CRSwNP (101 males and 35 females, aging 14 to 70 years) who underwent endoscopic sinus surgery from 2018 to 2019 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analysed retrospectively. The preoperative clinical characteristics of patients were collected, such as visual analogue scale (VAS) of nasal symptoms, peripheral blood inflammatory cell count, total immunoglobulin E (IgE), Lund-Kennedy score and Lund-Mackay score. The proportion of inflammatory cells such as eosinophils, lymphocytes, plasma cells and neutrophils were calculated on the WSI of each patient through artificial intelligence chronic rhinosinusitis evaluation platform 2.0 (AICEP 2.0), and the specific type of nasal polyps was then obtained as eosinophilic CRSwNP (eCRSwNP) or non-eosinophilic CRSwNP (non-eCRSwNP). In addition, the JESREC diagnostic criteria was used to classify the nasal polyps, and the classification results were compared with the current gold standard for nasal polyps diagnosis (pathological diagnosis based on WSI). The accuracy, sensitivity and specificity of the diagnostic criteria of JESREC were evaluated. The data were expressed in M (Q₁, Q₃) and statistically analyzed by SPSS 17.0. Results: There was no significant difference between eCRSwNP and non-eCRSwNP in age distribution, gender, time of onset, total VAS score, Lund-Kennedy score or Lund-Mackay score. However, there was a significant difference in the ratio of nasal polyp inflammatory cells (eosinophils 40.5% (22.8%, 54.7%) vs 2.5% (1.0%, 5.3%), neutrophils 0.3% (0.1%, 0.7%) vs 1.3% (0.5%, 3.6%), lymphocytes 49.9% (39.3%, 65.9%) vs 82.0% (72.8%, 87.5%), plasma cells 5.1% (3.6%, 10.5%) vs 13.0% (7.4%, 16.3%), χ² value was 9.91, 4.66, 8.28, 5.06, respectively, all P<0.05). In addition, eCRSwNP had a significantly higher level of proportion of allergic symptoms (nasal itching and sneezing), asthma, peripheral blood eosinophil and total IgE (all P<0.05). The overall accuracy, sensitivity and specificity of the JESREC diagnostic criteria was 74.3%, 81.3% and 64.3%, respectively. Conclusions: The eCRSwNP based on artificial intelligence and WSI has significant high level of allergic symptoms, asthma, peripheral blood eosinophils and total IgE, and the percentages of inflammatory cells in nasal polyps are different from that of non-eCRSwNP. The JESREC diagnostic criteria has good consistency in our research.

PMID:35196756 | DOI:10.3760/cma.j.cn115330-20210730-00500

Eur J Dent. 2022 Feb 23. doi: 10.1055/s-0041-1742123. Online ahead of print.

ABSTRACT

OBJECTIVES: There are several hypotheses regarding how chlorhexidine (CHX) digluconate causes staining with the role of beverages, specifically the precipitation of anionic dietary chromogens onto adsorbed cations, the most probable cause. The aim of this study was to investigate and compare the staining potential of common beverages using an in vitro staining and brushing model to better understand the interactions between chromogens from different beverage categories and the teeth.

MATERIALS AND METHODS: Human enamel samples were exposed to a cyclic treatment of artificial saliva and 0.2% CHX mouthwash combined with a range of beverages, with and without brushing, simulating a period equivalent to 2 weeks. Eleven beverages were tested: diet coke, diet lemonade, white wine, red wine, lager beer, black tea, coffee, black tea with milk, coffee with milk, ginger and lemon infusion, and water. Toothbrushing was performed in a brushing simulator with toothpaste and also with water. Colorimetric differences were determined by ΔE using a VITA Easyshade dental spectrophotometer. Statistical analyses were performed by one-way analysis of variance with post hoc Tukey’s honestly significant difference test and Levene’s test.

RESULTS: Black tea and red wine produced highest staining, which agrees with the literature. Significant staining was also observed for a ginger and lemon infusion, coffee, coffee with milk, tea with milk, and lager beer compared with water (p < 0.05). The staining potential of diet coke in combination with brushing appeared to be connected to its low pH. Both white wine and diet lemonade produced stain comparable to the water control. After treatment with high staining beverages, scanning electron microscope evaluation confirmed the formation of a surface layer. The mechanical resistance of the stain differed depending on the beverage, black tea stain was the most resistant. The addition of milk to tea and coffee considerably modified the stain layer and the adhesion to the tooth surface.

CONCLUSION: The data may help demonstrate that appropriate user guidance can avoid stain and in turn help improve user compliance during short-term use of this gold standard antimicrobial treatment.

PMID:35196724 | DOI:10.1055/s-0041-1742123

Eur J Dent. 2022 Feb 23. doi: 10.1055/s-0041-1736417. Online ahead of print.

ABSTRACT

OBJECTIVES: The current trial aimed to compare lithium disilicate (LS2) endocrowns’ clinical performance, gingival health, and parental satisfaction to those of prefabricated zirconia crowns (ZCs) over a 24-month of follow-up.

MATERIALS AND METHODS: This study designed as a spilt-mouth randomized controlled trial. A total of 88 pulpotomized mandibular second primary molars of 44 children were assigned into two equal groups. Forty-four molars were restored with prefabricated primary ZCs (control group) and the same number were restored with LS2 endocrown (intervention group). Clinical performance and gingival status were evaluated using a modified United States Public Health Service criterion, and plaque and gingival indices. Parental satisfaction was assessed using a 5-point Likert-scale questionnaire.

STATISTICAL ANALYSIS: Paired data were analyzed using McNemar’s test, a statistical test used on paired nominal data, and paired t-tests. The significance level was set to 5% at 95% confidence interval.

RESULTS: Both restorations showed comparable gingival health status over the follow-ups. Marginal adaptation of the endocrowns and ZCs at the end of follow-up was 95.5 and 90.9%, respectively (p = 0.68). For marginal integrity and discoloration, both restorations showed similar results at the follow-ups. The overall parental satisfaction of both groups was statistically insignificant (p = 0.07). However, parents were more satisfied with the endocrown color over that of the ZC (p < 0.05).

CONCLUSION: Endocrowns’ clinical performance and gingival health were comparable to those of ZCs. For both restorations, parental satisfaction was nearly similar except for the color that showed an advantage in favor of the endocrowns.

PMID:35196722 | DOI:10.1055/s-0041-1736417

Eur J Dent. 2022 Feb 23. doi: 10.1055/s-0041-1742128. Online ahead of print.

ABSTRACT

OBJECTIVE: The current study was designed to assess the bonding strength of EndoSeal MTA and AH Plus sealers after using three irrigation protocols as follows: (1) 17% Ethylenediamine tetraacetic acid, (2) 7% maleic acid, and (3) 37% phosphoric acid.

MATERIALS AND METHODS: Push-out bond strength was evaluated for 60 middle root slices of 1-mm thickness each. They were horizontally cut from freshly extracted single-rooted human teeth. A hole in the root canal was made using a carbide round bur of 1.1 mm in diameter in a middle third root slice. Specimens were dipped in 2.5% NaOCl, and then they were grouped into three groups; G1: 17% EDTA, G2: 7% maleic acid, and G3: 37% phosphoric acid as a final irrigant for 3 minutes. Each group was subdivided into two subgroups, according to the type of sealer, either EndoSeal MTA or AH Plus.

STATISTICAL ANALYSIS: After the full set of the sealer, the bond strength was evaluated with the push-out test by applying a force to each slice using a plunger with a 1-mm diameter. The one-way Tukey’s post hoc test, analysis of variance (ANOVA) test, and Student’s t-test were utilized to gather data and statistically evaluate it.

RESULTS: The irrigation protocol used exhibited significant influence on the bond strength of EndoSeal MTA and AH Plus sealers. AH Plus sealer subgroups showed the highest bond strength with 7% maleic acid, followed by 37% phosphoric acid, and 17% EDTA. While in the EndoSeal MTA sealer subgroups, the highest bond strength was shown with the 17% EDTA followed by 7% maleic acid and 37% phosphoric acid, respectively.

CONCLUSION: The present study revealed that the type of the final irrigant significantly impacts the bond strength of the sealer used. The AH Plus sealer bond strength was improved by using the 7% maleic acid as a final irrigant. In contrast, the EndoSeal MTA sealer showed the best results with the 17% EDTA as a final irrigant.

PMID:35196723 | DOI:10.1055/s-0041-1742128

Eur J Dent. 2022 Feb 23. doi: 10.1055/s-0041-1742124. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to evaluate fatigue resistance of cast-on implant abutment using three alloys.

MATERIALS AND METHODS: Forty specimens of implant-supported crowns were prepared; Group 1 (TA) stock titanium abutments, Group 2 (GS) abutment cast with 40% gold alloy, Group 3 (GP) abutment cast with palladium alloy, and Group 4 (CN) abutment cast with nickel-chromium alloy. Specimens were cyclic loaded at 20 Hz, starting from 200 N (5,000 cycles), followed by stepwise loading of 400, 600, 800, 1,000, 1,200, 1,400, 1,600, and 1,800 N (30,000 cycles/step). Specimens were loaded until failure or reached 245,000 cycles.

STATISTICAL ANALYSIS: The withstand cycles were analyzed using one-way analysis of variance and Weibull survival analysis. Fracture surfaces were examined using scanning electron microscopy.

RESULTS: The results of withstand cycles were TA (189,883 ± 22,734), GS (195,028 ± 22,371), GP (187,662 ± 22,555), and CN (200,350 ± 30,851). The statistical analysis showed no significant difference between the groups (p = 0.673).

CONCLUSION: Although CN has higher Weibull characteristic strength which means greater durability, its lower Weibull modulus demonstrated less structural reliability. Consistent failures at implant fixture level were also found in CN group.

PMID:35196721 | DOI:10.1055/s-0041-1742124

Eur J Dent. 2022 Feb 23. doi: 10.1055/s-0041-1742129. Online ahead of print.

ABSTRACT

OBJECTIVES: There is a lack of information regarding the longevity of prefabricated crowns on primary teeth. Therefore, the objective of the present study was to evaluate the clinical success rate of NuSmile pediatric Zirconia crowns in both primary anterior and posterior teeth up to 2 years in terms of gingival health, levels of plaque, restoration failure, and marginal integrity.

MATERIALS AND METHODS: This interventional study evaluated the clinical performance of NuSmile primary Zirconia crowns on 232 (172 primary incisors and 60 primary molars) pulp-treated primary teeth. Statistical analysis included independent t-test and Kaplan-Meier survival method for which the level of significance was set up at p < 0.05.

RESULTS: Gingival and plaque index of the teeth restored with NuSmile Zirconia crowns (test tooth) compared with adjacent and antagonist teeth (control tooth) showed no statistically significant difference at all time intervals (p > 0.05). The Kaplan-Meier survival graph indicated that only 34% of NuSmile Zirconia incisor crowns and 86% of NuSmile Zirconia molar crowns have survived at the end of 24 months. Of the 172 NuSmile Zirconia incisor crowns placed, only 82 teeth survived at the end of 2 years and the majority of the crowns completely lost the Zirconia crown. The Kaplan-Meier graph also indicated that more than two-thirds of crowns, i.e., 90% incisor crowns and 76% of molar crowns, had good marginal integrity at the end of 24 months.

CONCLUSIONS: Zirconia pediatric crowns preserve and maintain gingival health and have long-term survival rates with good retention and marginal integrity, indirectly preventing secondary caries. Hence, Zirconia pediatric crowns are a well-suited restoration of choice for primary teeth rehabilitation.

PMID:35196720 | DOI:10.1055/s-0041-1742129

Plast Reconstr Surg. 2022 Mar 1;149(3):465e-474e. doi: 10.1097/PRS.0000000000008846.

ABSTRACT

BACKGROUND: An amputation of the upper extremity not only is devastating for the patient’s physical, emotional, and social well-being but also constitutes a financial stress for both the patient and the health care system. The objective of this study was to determine the utility and quality-adjusted life-years of hand allotransplantation versus myoelectric prostheses and to compare these measures in patients afflicted with unilateral versus bilateral amputations.

METHODS: A survey was administered on bilateral amputees, unilateral amputees, replantation patients, and healthy controls. Patient demographics, functional patient-reported outcomes, quality-of-life questionnaires, and utility outcome measures were calculated for four different scenarios: hand transplantation and myoelectric prostheses with or without complications.

RESULTS: Five bilateral amputees, 12 unilateral amputees, nine replantation patients, and 45 healthy controls completed the survey. The highest quality-adjusted life-years were obtained in the replantation patient group for the scenario of myoelectric prosthesis without complications (mean, 34.8 years). Altogether, there was no statistically significant difference between hand transplantation and myoelectric prostheses (p = 0.36). On subgroup analysis, unilateral amputees reported significantly higher quality-adjusted life-years for myoelectric prostheses rather than hand transplantation (6.4; p = 0.0015), whereas bilateral amputees did not demonstrate a significant difference (-2.4; p = 0.299).

CONCLUSIONS: Utility and quality-adjusted life-years do not differ significantly between hand transplantation and myoelectric prostheses, except in unilateral amputees with myoelectric prostheses, who had higher quality-of-life scores. Based on trends from this pilot study, myoelectric prostheses may be considered for unilateral amputees, whereas no superiority can be demonstrated between both treatments in bilateral amputees.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

PMID:35196684 | DOI:10.1097/PRS.0000000000008846

Plast Reconstr Surg. 2022 Mar 1;149(3):496e-499e. doi: 10.1097/PRS.0000000000008818.

ABSTRACT

BACKGROUND: The surgery-first orthognathic approach has been applied at our institution since 2007. However, its indications remain debated. The aim of this study was to investigate the reliability of the surgery-first approach to correct facial asymmetry compared to the traditional orthodontics-first approach using a novel artificial intelligence-based cephalometric analysis.

METHODS: Intervention outcomes of surgery-first (n = 33) and orthodontics-first (n = 26) approaches to correct facial asymmetry were examined. Patients with facial asymmetry who had undergone orthognathic surgery from January of 2006 to January of 2019 were included in the study. In the surgery-first approach, the novel preoperative simulation process on the dental model was performed to determine the final occlusion without presurgical orthodontic treatment. Changes in cephalometric landmarks were compared using the supervised deep learning process developed at our institution.

RESULTS: The surgery-first approach without presurgical orthodontic treatment corrected facial asymmetry and yielded results similar to those of the traditional orthognathic approach. The statistical analysis revealed that changes in skeletal cephalometric landmarks were similar in the two groups.

CONCLUSIONS: The surgery-first orthognathic approach without presurgical orthodontic treatment treated facial asymmetry, possibly suggesting a possible paradigm shift in treatment. In addition, artificial intelligence-based cephalometric analysis was an effective tool.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

PMID:35196690 | DOI:10.1097/PRS.0000000000008818