Emergency tracheal intubation peri-operative risk factors and prognostic impact after esophagectomy.

BACKGROUND: Emergent endotracheal intubation (ETI) is a serious complication after Oesophagectomy. It is still unclear that perioperative risk factors and prognosis of these patients with ETI. METHODS: Between January 2015 and December 2018, 21 patients who received ETI after esophagectomy were enrolled (ETI group) at the department of thoracic surgery, Fujian Union hospital, China. Each study subject matched one patient who underwent the same surgery in the current era were included (control group). Patient characteristics and perioperative factors were collected. RESULTS: Patients with ETI were older than those without ETI (p = 0.022). The patients with history of smoking in ETI group were significantly more than those in control group (p = 0.013). The stay-time of postanesthesia care unit (PACU) in ETI group was significantly longer than that in control group (p = 0.001). The incidence of anastomotic leak or electrolyte disorder in ETI group was also higher than that in control group (p = 0.014; p = 0.002). Logistic regression analysis indicated history of smoke (HR 6.43, 95%CI 1.39-29.76, p = 0.017) and longer stay time of PACU (HR 1.04, 95%CI 1.01-1.83, p = 0.020) both were independently associated with higher risks of ETI. The 3-year overall survival (OS) rates were 47.6% in patients with ETI and 85.7% in patients without ETI (HR 4.72, 95%CI 1.31-17.00, p = 0.018). COX regression analysis indicated ETI was an independent risk factor affecting the OS. CONCLUSION: The study indicated that history of smoking and longer stay-time in PACU both were independently associated with higher risks of ETI; and ETI was an independent risk factor affecting the OS of patients after esophagectomy. TRIAL REGISTRATION: This trial was retrospectively registered with the registration number of ChiCTR2000038549.

[Application of CAD in custom tray design for teaching of dental postgraduates].

PURPOSE: To evaluate the teaching effect of making custom trays via CAD in dental postgraduates. METHODS: Twenty-seven dental postgraduates from first to third grade at the School and Hospital of Stomatology, Tongji University, Shanghai were given an informed consent to explain and request participation in the study. First, a lecture about the theory and process of fabricating custom tray via traditional hand-made method and CAD technique was given, then the students fabricated custom trays via the two methods and completed an online survey. The working time, margin extension and students' preference were analyzed with SPSS 22.0 software package. RESULTS: The working time was shorter, the margin extension was superior, and students' preference was higher via CAD than traditional method, the difference was significant(P＜0.05). CONCLUSIONS: CAD is more conducive to enhance students' understanding of custom tray manufacturing process and relevant theoretical knowledge. It is recommended to integrate digital technology into dental curriculum.

Restoration of critical defects in the rabbit mandible using osteoblasts and vascular endothelial cells co-cultured with vascular stent-loaded nano-composite scaffolds.

The success of large bone defect repair with tissue engineering technology depends mainly on angiogenesis and osteogenesis. In this study, we prepared poly-caprolactone/nano-hydroxyapatite/beta-calcium phosphate (PCL/nHA/ß-TCP) composite scaffolds loaded with poly-(lactic-co-glycolic acid)/nano-hydroxyapatite/collagen/heparin sodium (PLGA/nHA/Col/HS) nanofiber small vascular stent by electrospinning and hot press forming-particle leaching methods. Supramolecular electrostatic self-assembly technology was used to modify the surfaces of small vascular stents to aid in hydrophilicity and anticoagulation. The surfaces of composite scaffolds were modified with an Arg-Gly-Asp (RGD) short peptide by physical adsorption to supply cell adhesion sites. The scaffolds were then combined with rabbit bone marrow-derived osteoblasts (OBs) and rabbit bone marrow-derived vascular endothelial cells (RVECs) to construct large, biologically active vascularized tissue-engineered bone in vitro; this bone was then used to repair critical bone defects in rabbit mandibles. Mechanical and biocompatibility testing results showed that PCL/nHA/ß-TCP composite scaffolds loaded with small vascular stents had good surface structure, mechanical properties, biocompatibility, and bone-regeneration induction potential. Twelve weeks after implantation, histological analysis and X-ray scans showed that the use of osteoblasts and vascular endothelial cells co-cultured with PCL/nHA/ß-TCP scaffolds was sufficient to repair critical defects in rabbit mandibles.

Emergency tracheal intubation during off-hours is not associated with increased mortality in hospitalized patients: a retrospective cohort study.

BACKGROUND: The prognosis of hospitalized patients after emergent endotracheal intubation (ETI) remains poor. Our aim was to evaluate the 30-d hospitalization mortality of subjects undergoing ETI during daytime or off-hours and to analyze the possible risk factors affecting mortality. METHODS: A single-center retrospective study was performed at a university teaching facility from January 2015 to December 2018. All adult inpatients who received ETI in the general ward were included. Information on patient demographics, vital signs, ICU (Intensive care unit) admission, intubation time (daytime or off-hours), the department in which ETI was performed (surgical ward or medical ward), intubation reasons, and 30-d hospitalization mortality after ETI were obtained from a database. RESULTS: Over a four-year period, 558 subjects were analyzed. There were more male than female in both groups (115 [70.1%] vs 275 [69.8%]; P = 0.939). A total of 394 (70.6%) patients received ETI during off-hours. The patients who received ETI during the daytime were older than those who received ETI during off-hours (64.95 ± 17.54 vs 61.55 ± 17.49; P = 0.037). The BMI of patients who received ETI during the daytime was also higher than that of patients who received ETI during off-hours (23.08 ± 3.38 vs 21.97 ± 3.25; P < 0.001). The 30-d mortality after ETI was 66.8% (373), which included 68.0% (268) during off-hours and 64.0% (105) during the daytime (P = 0.361). Multivariate Cox regression analysis found that the significant factors for the risk of death within 30 days included ICU admission (HR 0.312, 0.176-0.554) and the department in which ETI was performed (HR 0.401, 0.247-0.653). CONCLUSIONS: The 30-d hospitalization mortality after ETI was 66.8%, and off-hours presentation was not significantly associated with mortality. ICU admission and ETI performed in the surgical ward were significant factors for decreasing the risk of death within 30 days. TRIAL REGISTRATION: This trial was retrospectively registered with the registration number of ChiCTR2000038549 .

A genome-wide study of DNA methylation modified by epigallocatechin-3-gallate in the CAL-27 cell line.

In order to gain greater understanding of the mechanisms underlying the effect of epigallocatechin-3-gallate (EGCG) on DNA methylation and its chemopreventative action in oral squamous cell carcinoma (OSCC), a genome­wide methylation and mRNA expression screen was performed in the CAL­27 cell line with and without EGCG (100 µM) treatment. A total of 761 differentially methylated gene loci were identified following treatment with EGCG. Comparison of gene expression profiling in OSCC samples revealed 184 transcripts with a significant difference (P<0.05) and a fold change difference >2 compared with controls. Gene ontology analysis of differentially methylated loci and functional annotation of the differentially expressed genes indicated that the main pathways involved were metabolic, mitogen­activated protein kinase (MAPK), wnt, and cell cycle pathways. In conclusion, the present study indicates that EGCG can affect the methylation status and gene expression in the CAL­27 cell line. Additionally, the changes in several important signaling pathways may reveal the antitumor mechanism of EGCG.

[The effect of epigallocatechin gallate (EGCG) on the surface properties of nickel-chromium dental casting alloys after electrochemical corrosion].

PURPOSE: To investigate the effect of epigallocatechin gallate (EGCG) on the surface properties of nickel-chromium dental alloys after electrochemical corrosion. METHODS: The surface morphology and surface structure of nickel-chromium dental alloys were examined by stereomicroscope and scanning electron microscopy before and after electrochemical tests in 0 g/L and 1.0 g/L EGCG artificial saliva. The surface element component and chemical states of nickel-chromium dental alloys were analyzed by X-ray photoelectron spectrograph after electrochemical tests in 0 g/L and 1.0 g/L EGCG artificial saliva. RESULTS: More serious corrosion happened on the surface of nickel-chromium alloy in 1.0 g/L EGCG artificial saliva than in 0 g/L EGCG. The diameters of corrosion pits were smaller, and the dendrite structure of the alloy surface was not affected in 0 g/L EGCG. While the diameters of corrosion pits were larger, the dendritic interval of the alloy surface began to merge, and the dendrite structure was fuzzy in 1.0 g/L EGCG. In addition, the O, Ni, Cr, Be, C and Mo elements were detected on the surface of nickel-chromium alloys after sputtered for 120 s in 0 g/L EGCG and 1.0 g/L EGCG artificial saliva after electrochemical corrosion, and the surface oxides were mainly NiO and Cr(2)O(3). Compared with 0 g/L EGCG artificial saliva, the content of O, NiO and Cr(2)O(3) were lower in 1.0 g/L EGCG. CONCLUSIONS: The results of surface morphology and the corrosion products both show that the corrosion resistance of nickel-chromium alloys become worse and the oxide content of corrosion products on the surface reduce in 1.0 g/L EGCG artificial saliva.

[Self-cleaning and antimicrobial properties of methacrylic acid coupled TiO(2)/PMMA denture base resin].

PURPOSE: To study the influence of TiO2 and methacrylic acid on self-cleaning and antimicrobial properties of denture base resin. METHODS: TiO2 (2%, 4%, 6%) and methacrylic acid were respectively added into two makers' denture base resins. The self-cleaning property was assayed with measuring the decomposition of methylthioninium chloride. The antimicrobial property was tested with the pellicle-sticking method. The data were analysed by SPSS 12.0 software package for two-way ANOVA. RESULTS: The self-cleaning and antimicrobial properties of samples were improved as TiO2 increased. Methacrylic acid had no significant influence on self-cleaning and antimicrobial properties of the samples. The decomposition ratio and antimicrobial ratio of MTi4% (Rijin) were 53.96% and 71.42%, respectively. CONCLUSION: Methacrylic acid coupled TiO2/PMMA denture base resin enjoys good self-cleaning and antimicrobial properties.

[Influence of surface roughness of titanium implant on core binding factor alpha 1 subunit of osteoblasts].

OBJECTIVE: To determine whether the roughness of titanium implant can influence its osseointegration by affecting the growth, alkaline phosphatase (ALP) production and expression of core binding factor alpha 1 subunit (Cbfα1) of osteoblasts. METHODS: Totally 48 titanium disc specimens, 15 mm in diameter and 2 mm in thickness, were included in the study and divided equally into 4 groups with 12 specimens in each group. Specimens were coarsened by sandblasting with carborundum granula and acid etching with mixing liquid of hydrochloric acid and sulphuric acid under diverse conditions. In the four groups, three were treated with different surface roughness: micro-roughness [(1.00 ± 0.20) µm], midrange roughness [(1.67 ± 0.08) µm] and severe roughness [(2.40 ± 0.20) µm], while the group untreated with surface roughness [(0.12 ± 0.03) µm] was set as control. Scanning electron microscope, acridine orange fluorescence staining and coomassie brilliant blue staining were used to observe morphology and growth of osteoblasts incubating on these specimens. Enzyme linked immunosorbent assay (ELISA) and fluorescence quantitative real-time polymerase chain reaction were used to evaluate ALP production and gene expression of Cbfα1 of osteoblasts among different groups. RESULTS: Growth, ALP production and Cbfα1 mRNA expression of osteoblasts in experimental groups were higher than those in control group (P < 0.05). Significant differences of these data were also found among three experimental groups (P < 0.05). Midrange roughness group showed the highest level of gene expression of Cbfα1 mRNA, which was 0.93 ± 0.03. While that in the micro-roughness group (0.50 ± 0.03) came second, and the severe roughness group had the lowest data, which was 0.37 ± 0.07. CONCLUSIONS: Results indicated that rough surface was more suitable for the adherence and propagation of the osteoblasts than smooth one did. Surface with roughness of 1-2 µm may be a better choice for osseointegration between osteoblasts and dental implants than others are.

[Expression of Ki67 and P53 proteins in gingival tissue after wearing casting alloy crowns].

OBJECTIVE: The aim of the study was to detect the expression of Ki67 and P53 proteins in the gingival tissue before and after wearing three kinds of dental casting alloy crowns. METHODS: The three kinds of dental casting alloys (58% golden alloy, NiCr alloy, NiCr alloy excluding Be) were used to make full crowns for 3 dogs in each group. Another 3 dogs were taken as control. The immunohistochemistry Envision method was used to measure the expression of Ki67 and P53 proteins in the gingival tissue before wearing the crowns, 2 weeks, 1 month, 2 months, 3 months after wearing the crowns. RESULTS: The expression of Ki67 and P53 proteins in gingival tissue increased 1 month after wearing NiCr alloy and NiCr alloy excluding Be, then decreased gradually. And the expression of Ki67 and P53 proteins in 58% golden alloy group was similar to that in control. No pathological change was observed in all samples. CONCLUSION: Two kinds of NiCr alloy crowns both can increase the expression of Ki67 and P53 proteins in gingival tissue, but 58% golden alloy crowns can not. So compared with NiCr alloy crowns, 58% golden alloy crowns have better biological properties. And none of three kinds of dental alloy crowns may induce long-term abnormal proliferation in gingival tissue.

[Study on cytotoxicity of three kinds of dental ceramic alloys on L929 mouse fibroblasts in vitro].

PURPOSE: To investigate the cytotoxicity in vitro of three kinds of dental ceramic alloys on L929 mouse fibroblasts. METHODS: CCK-8 assay was a quick method to study the cell relative proliferation rate or cytotoxicity. L929 mouse fibroblasts were used to detect the cell relative proliferation rate of the three kinds of dental ceramic alloys(NiCr,CoCr and golden alloys containing 58% of gold) by CCK-8 assay. The DNA damage of L929 mouse fibroblasts was determined by single cell gel electrophoresis(SCGE). The data was statistically analyzed with SAS 9.0 software package. RESULTS: The relative growth rate induced by NiCr, CoCr and golden dental ceramic alloys was (75.9510+/-7.6244)%, (84.8920+/-8.2660)% and (88.5420+/-12.3611)%, respectively. NiCr ceramic alloys caused the most marked cytotoxicity(P<0.05), and there was no difference between CoCr ceramic alloys and 58% golden ceramic alloys(P>0.05). The cytotoxicity of the three kinds of metal ceramic alloys was all grade 1, i.e. mild cytotoxicity. The DNA damage of L929 mouse fibroblasts induced by NiCr ceramic alloys was most serious(P<0.05). There was no difference in the DNA damage between CoCr ceramic alloys and 58% golden ceramic alloys(P>0.05). CONCLUSIONS: NiCr ceramic alloys can suppress the proliferation of the L929 mouse fibroblasts and promote DNA damage. While CoCr ceramic alloys which are similar to 58% golden ceramic alloys show less cytotoxicity than NiCr ceramic alloys. CoCr or 58% golden ceramic alloys should be used as crown and bridge for patients instead of NiCr ceramic alloy clinically.

[The influence of thickness ratios on the fatigue behaviors of two kinds of dental ceramic].

OBJECTIVE: To investigate the intensity changes of different thickness ratios of Empress II glass ceramic and GI- II glass-infiltrated alumina ceramic before and after Hertzian contact cyclic fatigue. METHODS: Disk-shaped specimens of different thickness ratios of Empress II glass ceramic and GI-II glass-infiltrated alumina ceramic were respectively fabricated. Hertzian contact technique was imposed on the specimens. Critical loads of the specimens before and after 10(5) cycles loading were recorded. RESULTS: The average values of critical loads of all specimens reduced significantly after cycles loading (P < 0.05), and critical loads declined with diminishing thickness of the core ceramic. The critical load of GI-II glass-infiltrated alumina ceramic was significantly higher than Empress II glass ceramic before and after cycle loading(P < 0.05). CONCLUSION: Cycle loading can reduce the strengths of the two kinds of dental ceramic, and the latter is better than the former in the resistance to fracture and cyclic fatigue. Critical loads of the two kinds of dental ceramic are mainly influenced by the core ceramic's strength and thickness.

[The study of the monomer release from four kinds of temporary crown material by infrared spectrum].

PURPOSE: To study the quantity and characteristic of monomer release from four kinds of temporary crown material. METHODS: The experimental animal model was established by temporary prosthesis on dogs' teeth using four kinds of temporary crown materials.The quantity of residual monomer in temporary crown material was measured by infrared spectra at four different periods before and after wearing crowns. The data were analysed with SAS6.12 software package for one-way ANOVA. RESULTS: During the early period after wearing temporary crowns, the quantity of residual monomer from self-curing resin crowns and heat-curing resin crowns was significantly more than that from DMG-TEMP crown material and Shofu SWIFT-TEMP resin. With the time going on, the difference became less. The residual monomer in DMG-TEMP crown material and Shofu SWIFT-TEMP resin remained steady at a low level all the time, without significant monomer release. CONCLUSIONS: There is significant monomer release from self-curing resin crowns and heat-curing resin crowns early after wearing temporary crowns. DMG-TEMP crowns and Shofu SWIFT-TEMP crowns don't release significant residual monomer.

[Compared study of cyclic fatigue behaviors in two kinds of dental ceramic layers structures].

OBJECTIVE: To compare the difference in strength degradation and morphology damage of two dental ceramic materials after Hertzian contact cyclic fatigue. METHODS: Hertzian contact technique was used to investigate the response of Empress II glass ceramic and GI- II glass-infiltrated alumina ceramic to cyclic fatigue. Critical loads of specimens after different fatigue cycles were recorded. RESULTS: For Empress II glass ceramic, critical load had significantly difference between specimens after 10(5) cycles loading. No significant difference of critical load was found in GI- II glass-infiltrated alumina ceramic after cycles loading. CONCLUSION: GI- II glass-infiltrated alumina ceramic has better capability in resistance to cyclic loading. It may attribute to microstructure of material. Empress II glass ceramic shows a brittle damage model.

[Study of DNA damage of buccal mucosal cells after wearing casting alloy crowns].

OBJECTIVE: To test the corrosion behavior of three kinds of dental casting alloys and to investigate the effect of the released metal ions on the DNA damage of dog buccal mucosal cells. METHODS: Three kinds of frequently used dental casting alloys were used to make full crowns for dogs. The concentration of the released metal ions was measured after the restoration of 2 weeks, 1 month, 2 months and 3 months. The DNA damage of buccal mucosal cells was studied by the method of SCGE. RESULTS: The metal ions released from NiCr and NiCrBe were detected in buccal mucosal cells while the amount of the ions released from noble alloy (gold 58%) was too small to be detected. The DNA damage of mucosal cells increased after restoration of NiCr and NiCrBe crowns. CONCLUSION: The noble alloy (gold 58%) is most corrosion resistant of the three alloys and has good biocompatibility. The NiCr and NiCrBe are prone to corrode and have cytotoxicity to cells.