Combined glycoprotein IIb/IIIa inhibitor therapy with ticagrelor for patients with acute coronary syndrome.

This study was to compare the efficacy and safety of combined glycoprotein IIb/IIIa inhibitor (GPI) and ticagrelor versus ticagrelor in patients with acute coronary syndrome (ACS). An observational study was conducted using the Improving Care for Cardiovascular Disease in China-ACS project. Totally, 13,264 patients with ACS and received combination therapy or ticagrelor therapy were analyzed. The primary outcome was the composite of major cardiovascular events (MACE: all-cause mortality, myocardial infarction [MI], stent thrombosis, cardiogenic shock, and ischemic stroke), and secondary outcomes included all-cause mortality, MI, stent thrombosis, cardiogenic shock, and ischemic stroke. The multivariable adjusted analysis indicated that combination therapy was associated with an increased risk of major cardiovascular events (MACE) (P = 0.001), any bleeding (P<0.001), and major bleeding (P = 0.005). Moreover, the multivariable adjusted for propensity score-matched (PSM) analysis suggested that combination therapy produced additional risk of MACE (P = 0.014), any bleeding (P<0.001), and major bleeding (P = 0.005). Moreover, PSM analysis suggested that combination therapy was associated with greater risk of stent thrombosis (P = 0.012) and intracranial bleeding (P = 0.020). Combined GPI and ticagrelor therapies did not have any beneficial effects on MACE, stent thrombosis, intracranial bleeding, any bleeding, or major bleeding.

Lack of associations between lactoferrin (LTF) and mannose-binding lectin 2 (MBL2) gene polymorphism and dental caries susceptibility.

OBJECTIVE: With the development of human genomics, the genetic factors associated with dental caries have receiving increasing attention. This study was performed to evaluate the relationship between lactoferrin (LTF) and mannose-binding lectin 2 (MBL2) gene single nucleotide polymorphisms (SNPs) and dental caries susceptibility in Chinese children. METHODS: This prospective case-control study included 360 unrelated children (aged 12-15 years) who received oral health examinations and questionnaire surveys. The children were divided into two groups by counting the numbers of decayed, missing, and filled teeth (DMFT/dmft): case group (n = 162, DMFT/dmft ≥ 1) and control group (n = 198, DMFT/dmft = 0); non-invasive saliva samples were collected to extract genomic DNA. Six SNPs (rs2073495C/G, rs1042073C/T, rs10865941C/T, and rs1126477A/G in LTF; rs7096206C/G and rs7095891G/A in MBL2) were tested by mass spectrometry. RESULTS: The study included 360 individuals with (85 boys and 77 girls) and without a history of caries (96 boys and 102 girls). There were no statistically significant differences in alleles and genotypes among the six SNPs between the two groups. CONCLUSION: There is no evidence that polymorphisms of LTF and MBL2 genes are associated with dental caries susceptibility in populations from northwest China; further confirmation is needed with larger sample sizes.

Several clinical interests regarding lung volume reduction surgery for severe emphysema: meta-analysis and systematic review of randomized controlled trials.

OBJECTIVES: We aim to address several clinical interests regarding lung volume reduction surgery (LVRS) for severe emphysema using meta-analysis and systematic review of randomized controlled trials (RCTs). METHODS: Eight RCTs published from 1999 to 2010 were identified and synthesized to compare the efficacy and safety of LVRS vs conservative medical therapy. One RCT was obtained regarding comparison of median sternotomy (MS) and video-assisted thoracoscopic surgery (VATS). And three RCTs were available evaluating clinical efficacy of using bovine pericardium for buttressing, autologous fibrin sealant and BioGlue, respectively. RESULTS: Odds ratio (95%CI), expressed as the mortality of group A (the group underwent LVRS) versus group B (conservative medical therapies), was 5.16(2.84, 9.35) in 3 months, 3(0.94, 9.57) in 6 months, 1.05(0.82, 1.33) in 12 months, respectively. On the 3rd, 6th and 12th month, all lung function indices of group A were improved more significantly as compared with group B. PaO2 and PaCO2 on the 6th and 12th month showed the same trend. 6MWD of group A on the 6th month and 12th month were improved significantly than of group B, despite no difference on the 3rd month. Quality of life (QOL) of group A was better than of group B in 6 and 12 months. VATS is preferred to MS, due to the earlier recovery and lower cost. And autologous fibrin sealant and BioGlue seems to be the efficacious methods to reduce air leak following LVRS. CONCLUSIONS: LVRS offers the more benefits regarding survival, lung function, gas exchange, exercise capacity and QOL, despite the higher mortality in initial three postoperative months. LVRS, with the optimization of surgical approach and material for reinforcement of the staple lines, should be recommended to patients suffering from severe heterogeneous emphysema.

[Study of dental caries and correlated factors of 12-year-old children in Dongxiang, Baoan and Yugu races].

OBJECTIVE: To investigate the epidemiology of dental caries and its correlated factors of 12-year-old children in Dongxiang, Baoan and Yugu races. METHODS: According to the method of third national oral health epidemiologic investigation, 448 12-year-old children in Dongxiang, Baoan and Yugu races were randomly collected and the epidemiological investigation of dental caries, oral bacteriological detection and oral hygiene behavior were carried out. RESULTS: 1) The caries prevalence rate of Dongxiang, Baoan and Yugu races were 40.52%, 44.29%, 46.45%, respectively. The average caries of Dongxiang, Baoan and Yugu races were 0.92, 0.90, 1.13, respectively. 2) The main ranks of Streptococcus mutans in saliva were class 2 and class 3 in Dongxiang and Baoan races. However, it was class 0 or class 1 in Yugu race. The level of Streptococcus mutans in dental plaque was higher in Dongxiang and Baoan races than in Yugu race. 3) The children's everyday brushing rate was higher in Yugu race than in Dongxiang and Baoan races (P<0.01). But there were no difference between Dongxiang and Baoan races. CONCLUSION: The caries prevalence rates of 12-year-old children in Dongxiang, Baoan and Yugu races are high. The main factors of high caries prevalence rate were low brushing rate and dental plaque couldn't be removed effectively. Oral health education should be strengthened in the three race areas.

[Investigation of oral health status in 3 516 undergraduate university students].

OBJECTIVE: To investigate the oral health status of undergraduate university students and to guide their oral hygiene behaviors. METHODS: 3516 college students in Northwest University for Nationalities were investigated in this study according to the criterion issued by World Health Organization (WHO) on the basic methods of oral health investigation in 1997. RESULTS: The caries prevalence rate among the students investigated was 47.87%. The average decayed teeth were 1.29. The obturation rate of caries was 20.42%. The students came from city showed significant higher caries rate than those from countryside, and so did the female students compared with the male students. Dental calculus rate was 79.78%. The dental segments related were 3.75. The worst situation was among male students and students from countryside. The examined rates were 53.30% of crowded incisor, 42.58% of maximum upper-incisor anomaly, 50.60% of the maximum lower-incisor anomaly and 31.09% of molar malposition, respectively. More rates of dentofacial anomalies showed no differences of significance between different area and gender. CONCLUSION: In general, the oral health status of the college students are not ideal. It is necessary to advocate early examination, early prevention and early treatment among the students in university.