Dental caries status and related factors among 5-year-old children in Shanghai.

BACKGROUND: Dental caries in young children is a difficult global oral health problem. In the last decade, China has put a great deal of effort into reducing the prevalence of dental caries. This study, which is part of the China Population Chronic Disease and Nutrition Surveillance 2021, aimed to investigate the prevalence of dental caries among children aged 5 in Shanghai, China, and its associated factors. METHODS: A total of 1281 children aged 5 years from 6 districts in Shanghai were selected by a stratified sampling method. The survey consisted of an oral health questionnaire and an oral health examination. The questionnaire included questions on oral health knowledge, attitudes, and behaviours. The oral health examination used WHO standards. After screening, the data were input and analysed. Chi-square tests and logistic regression analyses were used to study the relevant factors affecting dental caries. RESULTS: The prevalence of dental caries among 1281 children was 51.0%, the dmft index score was 2.46, the Significant Caries Index (SiC) score was 6.39, and the SiC10 score was 10.35. Dental caries experience was related to the frequency of sweet drink consumption, the age of starting tooth brushing, eating habits after brushing, whether the children had received an oral examination provided by the government (p < 0.05), and the mother's education level but was not related to sex, the use of fluoride toothpaste, the frequency of brushing, whether the parents assisted brushing, or the frequency of flossing (p > 0.05). Logistic regression analysis showed that the region of residence, eating after brushing and the age of starting brushing were associated with dental caries. CONCLUSIONS: Dental caries remained prevalent among 5-year-old children in Shanghai, China. Prevention strategies that target the associated factors including region of residence, eating after brushing, and the age of starting brushing should be considered.

[Study on digital models of normal deciduous dentition in 189 children from Shanghai].

PURPOSE: To study the gender difference and the regulation of growth and development in normal deciduous dentition． METHODS: A total of 189 children with normal deciduous dentition aged 3 to 6 years in several kindergartens in Xuhui District in Shanghai were selected. The three-dimensional(3D) digital dental models were reconstructed by intraoral scanning. Geomagic Studio, a 3D reverse engineering software, was employed to extract the data, such as the dental arc perimeter of C(APC), the dental arc perimeter of E(APE), the dental arc length of C(LC), the dental arc length of E(LE), the dental arc width of C(C-C), the dental arc width of E(E-E), the mesiodistal width of the deciduous crown, the maxillary and mandibular space. SPSS 22.0 software package was used for data analysis. RESULTS: Parameters of deciduous dentition in boys were significantly elevated than in girls(P＜0.05). All the boys and girls were divided into 4 groups by age. In 3-year-old group, significant differences were observed in maxillary APC, C-C, E-E(P＜0.05) between boys and girls. In 4-year-old group, all boys' parameters were significantly greater than girls'(P＜0.05) except maxillary LC. In 5-year-old group, there were significant differences in all the parameters between boys and girl(P＜0.05) except maxillary APE and mandibular APC, LC, LE, C-C. No significant difference was observed in all the parameters except mandibular APE in 6-year old group. The significant difference between boys and girls were observed in the mesiodistal width of each deciduous crown except that of the maxillary lateral incisor and mandibular central incisor (P＜0.05). There were significant differences in maxillary LE and E-E among children of different ages(P＜0.05).The maxillary space was significantly greater than the mandibular space(P＜0.01). CONCLUSIONS: There was gender difference in children's normal deciduous dentition, especially when they were 4 years old.

[Oral health behavior and parental cognition of first-grade children in urban and suburban areas of Shanghai].

PURPOSE: To investigate oral health behaviors of first-grade school children and parents' cognition of oral health in urban and suburban areas of Shanghai, and to analyze and compare the differences between the two areas, so as to provide reference for formulating oral health intervention measures and oral health education. METHODS: A total of 3 312 first-grade school-aged children in Shanghai were included by cluster random sampling method. Relevant data were collected through questionnaire survey of parents' oral health and clinical oral examination of children. Chi-square test was used to compare the differences in oral health behaviors of children and parents' oral health cognition between urban and suburban area with SAS 9.4 software package. RESULTS: The proportion of children who brush their teeth more than twice a day in urban and suburban areas was 72.55% and 44.26%, and the proportion of children who brushed their teeth with fluoride toothpaste was 53.25% and 44.79%, respectively. Compared with the suburban area, the brushing habits of school-aged children in urban area were better, the difference was statistically significant(P＜0.05). In terms of medical habits, the proportion of children with no dental experience in urban and suburban areas was 26.99% and 44.08%, and the proportion of children with toothache in the past year was lower than that in the last dental visit, the difference was statistically significant (P＜0.05). In terms of parents' cognition and attitude towards oral health knowledge, parents in urban areas were more correct than those in suburban areas, with the average correct rate being 82.56% and 70.42%, and the difference was statistically significant (P＜0.05). CONCLUSIONS: There are regional differences in oral health behaviors of first-grade school children and parents' oral health knowledge between urban and suburban area in Shanghai. It is suggested that relevant government departments should strengthen oral health education and oral health behavior guidance for parents, and strengthen oral health investment in non-central urban areas.

Serologic Evidence of Human Exposure to Ehrlichiosis Agents in Japan.

In retrospective analyses, we report 3 febrile patients in Japan who had seroconversion to antibodies against Ehrlichia chaffeensis antigens detected by using an immunofluorescence and Western blot. Our results provide evidence of autochthonous human ehrlichiosis cases and indicate ehrlichiosis should be considered a potential cause of febrile illness in Japan.

Diversity unearthed by the estimated molecular phylogeny and ecologically quantitative characteristics of uncultured Ehrlichia bacteria in Haemaphysalis ticks, Japan.

Ehrlichia species are obligatory intracellular bacteria transmitted by arthropods, and some of these species cause febrile diseases in humans and livestock. Genome sequencing has only been performed with cultured Ehrlichia species, and the taxonomic status of such ehrlichiae has been estimated by core genome-based phylogenetic analysis. However, many uncultured ehrlichiae exist in nature throughout the world, including Japan. This study aimed to conduct a molecular-based taxonomic and ecological characterization of uncultured Ehrlichia species or genotypes from ticks in Japan. We first surveyed 616 Haemaphysalis ticks by p28-PCR screening and analyzed five additional housekeeping genes (16S rRNA, groEL, gltA, ftsZ, and rpoB) from 11 p28-PCR-positive ticks. Phylogenetic analyses of the respective genes showed similar trees but with some differences. Furthermore, we found that V1 in the V1-V9 regions of Ehrlichia 16S rRNA exhibited the greatest variability. From an ecological viewpoint, the amounts of ehrlichiae in a single tick were found to equal approx. 6.3E+3 to 2.0E+6. Subsequently, core-partial-RGGFR-based phylogenetic analysis based on the concatenated sequences of the five housekeeping loci revealed six Ehrlichia genotypes, which included potentially new Ehrlichia species. Thus, our approach contributes to the taxonomic profiling and ecological quantitative analysis of uncultured or unidentified Ehrlichia species or genotypes worldwide.

Growth Characteristics of Rickettsia Species LON Strains Closely Related to Rickettsia japonica Isolated from Haemaphysalis longicornis Ticks in Mouse Derived L929 and Human-Derived THP-1 Host Cell Lines.

Non-pathogenic Rickettsia species LON strains closely related to an agent of Japanese spotted fever (JSF), R. japonica, were isolated in Japan from Haemaphysalis longicornis ticks in 2001. However, the biological properties of LONs in mammalian host cells are poorly understood. In this study, microscopic analysis showed that LONs in a mouse-derived L929 host cell line were rod shaped with sizes of 0.3-0.5 × 0.5-2.0 µm. Molecular analysis revealed the existence of a LON-specific disrupted open reading frame in R. japonica-related group-specific DNA regions. Growth kinetics of LON-2 and LON-13 strains analyzed by a quantitative real-time PCR showed 100-fold or more increment of LONs cultured in L929 host cells at 30°C and slightly less increment at 33°C, and 25-fold increment in human-derived THP-1 host cells at 35°C on day 7 (168 h) post infection. The generation times of the two LON strains cultured in L929 and THP-1 were estimated to be 9.4-12.9 h and 9.6-10.9 h, respectively. To our knowledge, this is the first report on the biological characteristics of Rickettsia sp. LON strains in mammalian cells, which may provide significant information for the experimental approaches for other rickettsiae.

Impact of Behavioural Factors and Living Conditions on Dental Caries Among Pupils from Shanghai and Jiangxi Province in China: A School-based Cross-sectional Study.

PURPOSE: Dental health is associated with the growth and development, physical or psychological, of children. Although numerous preventive measures are available, dental caries among primary schoolchildren remains a public health concern in China. Understanding the disparity of children's dental health between rural and urban areas in China could provide further insight into the prevention of caries. METHODS: A cross-sectional study was conducted to examine the oral health of pupils aged 6-12 years in Pudong District (Shanghai) and Lichuan (Jiangxi Province) in China. A questionnaire survey was performed among children's guardians to identify the potential risk factors for childhood dental caries. RESULTS: A total of 1922 primary schoolchildren were included in this study, with 815 from Pudong and 1107 from Lichuan. The mean age of children from Pudong was 8.57 (SD = 1.61), which was statistically significantly lower than their counterpart from Lichuan (9.36 ± 1.75). The prevalence of caries in Pudong and Lichuan was 63.4% and 75.0%, respectively. Statistically significant differences of demographical and behavioural features were observed between schoolchildren in Pudong and Lichuan. In general, Lichuan children had a higher caries risk compared with their Pudong counterparts (OR = 3.43, 95%CI 2.65-4.28). Moreover, the non-parental caregivers, low family income, low parental educational level, as well as bad dietary habits, were identified as risk factors for caries. CONCLUSIONS: Childhood caries in the rural area was far more severe than that in the urban area. This disparity was determined by several factors such as the high proportion of left-behind children in the rural area (e.g. children who remain in rural regions of China while their parents leave to work in urban areas). Our government should put the prevention of caries among rural children at a higher priority in the near future to narrow the gap between rural and urban areas.

Insight of diagnostic performance using B-cell epitope antigens derived from triple P44-related proteins of Anaplasma phagocytophilum.

Human granulocytic anaplasmosis (HGA) is caused by Anaplasma phagocytophilum. Indirect immunofluorescence assay (IFA) is generally used for HGA serodiagnosis. A. phagocytophilum immunodominant P44 major outer membrane proteins are encoded by p44/msp2 multigene family, responsible for IFA reactivity. However, because multiple P44-related proteins may involve immunoreactivity in IFA, the available diagnostic antigens remain obscure. In this study, we identified 12 B-cell epitopes on triple P44-related proteins using peptide array that reacted with 4 HGA patients' sera. Then, peptide spot immunoassay using 14 synthetic peptides derived from those 12 epitopes as antigens was applied for the detection of antibody to A. phagocytophilum from patients with fever of unknown origin. The sensitivities and diagnostic efficiencies of this immunoassay were higher than those of Western blot analysis using 3 recombinant proteins previously developed. Thus, the immunoassay using our epitope-derived antigens, which has higher diagnostic performances, may have significant benefit for HGA serodiagnosis.

[The effect of fluoride varnish Duraphat in preventing deciduous dental caries in preschool children].

PURPOSE: To evaluate the effect of fluoride varnish Duraphat on preventing caries of primary teeth caries, and provide scientific basis for the establishment of oral health care. METHODS: 1140 preschool children aged 3~4 years old were chosen from 25 public kindergartens in Xuhui district of Shanghai by cluster sampling method, they were divided into 2 groups on a voluntary basis with the informed consent of the child's parents. 762 preschool children in Fluoride Varnish group were taken oral examination and used fluoride varnishes every 6 months, 378 preschool children in the control group were without treatment. Oral health instruction was given to all the children. The data of caries prevalence, mean dmft, caries incidence and mean increments of dmft (decayed, missing and filled teeth) of 2 groups were compared. The results were analyzed using SAS 9.4 software package. RESULTS: After 2 years, caries prevalence, mean dmft, caries incidence and mean increments of dmft of fluoride varnish groups were lower than those of control group and the difference was statistically significant (P＜0.05). CONCLUSIONS: Fluoride varnish Duraphat is effective in decreasing caries incidence and mean dmft increments of primary teeth in preschool children and is worthy to be used widely in Xuhui district.

Molecular Detection and Characterization of p44/msp2 Multigene Family of Anaplasma phagocytophilum from Haemaphysalis longicornis in Mie Prefecture, Japan.

Anaplasma phagocytophilum is an obligate intracellular bacterium that causes human granulocytic anaplasmosis (HGA), an emerging tick-borne infectious disease. This bacterium expresses various 44-kDa major outer membrane proteins encoded by the p44/msp2 multigene family to avoid the host immune system. We previously detected A. phagocytophilum p44/msp2 from the tick Haemaphysalis longicornis in Mie Prefecture, Japan in 2008. In this study, we further investigated a total of 483 H. longicornis ticks (220 adults and 263 nymphs) collected from the Mie Prefecture by PCR targeting p44/msp2 to characterize the p44/msp2 multigene family of A. phagocytophilum. Six of the 483 ticks tested were PCR-positive for A. phagocytophilum p44/msp2, and these positive individuals were at the nymph stage of the tick life cycle. Cloning, sequencing, and phylogenetic analyses of the amplicons revealed that the 11 p44/msp2 clones obtained from the positive ticks shared a 54.9%-99.3% amino acid sequence similarity with the 27 previously identified clones from HGA patients in Japan. In particular, 6 p44/msp2 clones displayed the highest similarities (97.2%-99.3%) with 3 previously identified clones (FJ417343, FJ417345, FJ417357). Thus, the data from this study provide important public health information regarding A. phagocytophilum infection transmitted by H. longicornis ticks, especially at the nymph stage.

Predominant Shift of Different P44-Expressing Anaplasma phagocytophilum in Infected HL-60, THP-1, NB4, and RF/6A Cell Lines.

Anaplasma phagocytophilum, an agent of human granulocytic anaplasmosis, is an obligatory intracellular bacterium that dominantly produces P44 outer membrane proteins encoded by the p44/msp2 multigene family, which are major antigens for serodiagnosis. However, A. phagocytophilum antigens from cultures with different cell lines seem to have varying reactivities with sera. In this study, we performed RNA-seq to investigate the P44 expression of A. phagocytophilum propagated in 4 cell lines. In infected HL-60 cells, the P44-2b transcript was predominant in the first RNA-seq analysis (HL-60.1). However, the P44-23 transcript was predominant in the second RNA-seq analysis at 1 month after additional passages (HL-60.2). We further analyzed the P44 expression of A. phagocytophilum cultured in THP-1, NB4, and RF/6A cells through consecutive passages in the same cell lines for 1 year after transferring A. phagocytophilum from infected HL-60 cells to the respective cell lines. In the long-term cultures, P44-18, P44-78, and P44-51 were predominantly transcribed in infected THP-1, NB4, and RF/6A cells, respectively. Therefore, the predominant shifts of different P44-expressing transcripts of A. phagocytophilum might occur during cell culture even in the same cell line at different time points of sample harvest (HL-60.1 and HL-60.2), which may be attributed to host cell adaptation/selection/interaction.

[Analysis of caries and its risk factors of the first permanent molar among primary school students in Pudong, Shanghai and Lichuan, Jiangxi Province].

PURPOSE: To Investigate the current situation of caries of primary school students in Shanghai Pudong and Lichuan, Jiangxi province, and analyze the risk factors of dental caries, in order to provide scientific evidence for prevention and treatment of dental caries. METHODS: A stratified cluster sampling method was applied to choose 10 primary schools from Lichuan and 2 primary schools from Pudong area, respectively. A total of 1922 pupils aging from 6 to 12 were selected. Oral health examination was applied to each student and questionaire survey was conducted among their parents. The results were analyzed with SPASS 21.0 software package. RESULTS： Two hundred and sixty-one caries was found in Lichuan pupils, with the caries rate of 23.6% and DMFT being 0.37±0.766. 96 caries was found in Pudong pupils, with the caries rate of 11.8% and DMFT being 0.19±0.582. There was significant difference between two areas. Analysis of risk factors showed a significant correlation between children's pre-bedtime sweets and other bad habits, as well as low level of education of children's parents and dental caries. CONCLUSIONS: The caries of primary school students in rural areas are significantly worse than those in urban areas; bad living habits are risk factors of caries and the knowledge of caries prevention should be popularized in school students to enhance the awareness of oral health among pupils.

Spotted Fever Group Rickettsiae in Inner Mongolia, China, 2015-2016.

We found Rickettsia raoultii infection in 6/261 brucellosis-negative patients with fever of unknown origin in brucellosis-endemic Inner Mongolia, China. We further identified Hyalomma asiaticum ticks associated with R. raoultii, H. marginatum ticks associated with R. aeschlimannii, and Dermacentor nuttalli ticks associated with both rickettsiae species in the autonomous region.

Deciduous dental caries status and associated risk factors among preschool children in Xuhui District of Shanghai, China.

BACKGROUND: This study aims to understand the deciduous dental caries status of preschool children in Xuhui District of Shanghai, China and to analyze the associated risk factors. METHODS: In January of 2016, a cross-sectional investigation was conducted to examine the oral health of all the kindergarten children in Xuihui District of Shanghai, China. Meanwhile, a field questionnaire survey was conducted with the children's guardians to ascertain the potential risk factors associated with deciduous dental caries. RESULTS: Among 11,153 children, the prevalence of deciduous dental caries was 47.02%, and the mean dmft score was 2.21. The first three predilection sites were maxillary central primary incisors, mandible second primary molars, and mandible first primary molars. There were statistically significant differences in caries prevalence and dmft among different age groups and different household registration (Hukou) types (P < 0.001). Multivariate Logistic regression suggested that the possible risk factors for deciduous caries included: older age, drinking sweetened beverages frequently, often or usually eating sweets before sleep compared to rarely/never eat them at this time, exclusive or predominant breastfeeding compared to exclusive or predominant artificial feeding and latter introduction of toothbrushing. On the other hand, Shanghai Hukou families, high educational level of guardians (high school or college education), regular parental support for children's toothbrushing, guardians' oral health knowledge, and a good perception about children's oral health conditions were shown as potential protective factors for deciduous dental caries. CONCLUSIONS: The deciduous dental caries status of preschool children in Xuhui District of Shanghai was still serious. The caries prevalence in Xuhui, China, is associated with children's age, household registration type, oral health habits, feeding habits, guardians' education level, parental perception about children's oral health and knowledge about oral health.

Evaluation of Diagnostic Assay for Rickettsioses Using Duplex Real-Time PCR in Multiple Laboratories in Japan.

Tsutsugamushi disease and Japanese spotted fever are representative rickettsioses in Japan, and are caused by infection with Orientia tsutsugamushi and Rickettsia japonica, respectively. For molecular-based diagnosis, conventional PCR assays, which independently amplify respective rickettsial DNA, are usually used; however, this approach is time-consuming. Here, we describe a new duplex real-time PCR assay for the simultaneous detection of O. tsutsugamushi and spotted fever group rickettsiae, and its evaluation using several PCR conditions in 6 public health laboratories. The detection limit of the assay was estimated to be 102 copies and the sensitivity was almost identical to that of 3 conventional PCR methods. A total of 317 febrile patients were selected as clinically suspected or confirmed cases of rickettsioses. The detection efficiency of this assay for O. tsutsugamushi from blood or skin (eschar) specimens appeared to be almost the same as that of the conventional PCR method, even when performed in different laboratories, whereas the efficiency for spotted fever group rickettsiae tended to be higher than that of the 2 traditional double PCR assays. Our duplex real-time PCR is thus a powerful tool for the rapid diagnosis of rickettsioses, especially at the acute stage of infection.

Case of Human Infection with Anaplasma phagocytophilum in Inner Mongolia, China.

Anaplasma phagocytophilum is an obligate intracellular bacterium that causes febrile illness in humans and livestock. A 49-year-old woman was suffering from feverish symptoms, fatigue, arthralgia, general body pain, and anorexia for 2 weeks. Later, she visited the Bayannur Centers for Disease Control and Prevention Hospital in Inner Mongolia, China. Molecular-based diagnostic analysis of the patient's blood revealed that A. phagocytophilum p44 DNA was positive, but Brucella omp31, spotted fever group Rickettsia gltA, Orientia tsutsugamushi 16S rDNA, and Ehrlichia p28 were negative. The amino acid sequences of 9 A. phagocytophilum p44 clones obtained from the patient shared 44-100% similarity among them and were closely related to those of previously identified p44 clones from Canis familiaris (accession no. KJV64194) and from Ixodes persulcatus tick (no. BAN28309). Serological tests using the patient's serum showed that immunoglobulin M (IgM) and IgG titers to A. phagocytophilum antigens were 160 and 20, respectively, determined using indirect immunofluorescence assay, and the reaction to recombinant P44 proteins (rP44-1, rP44-18ES, and/or rP44-47) was confirmed using Western blot analysis. Thus, the results obtained in this study strongly suggest that the patient was infected with A. phagocytophilum. To our knowledge, this is the first case of human anaplasmosis infection in the Inner Mongolia Autonomous Region.

[Evaluation of the effect of one-step self etching adhesives applied in pit and fissure sealing].

PURPOSE: To observe the effect of three one-step self etching adhesive systems used in fit and fissure sealant and explore the feasibility of application in caries prevention in school. METHODS: Seven hundred and twenty completely erupted mandibular first molars in 360 children aged 7 to 9 years old were chosen. The split-mouth design was used to select one side as the experimental group, divided into A1(Easy One Adper), B1(Adper Easy One), and C1(iBond SE).The contra lateral teeth served as A2,B2 and C2 groups (phosphoric acid). The retention and caries status were regularly reviewed .The clinical effect of the two groups was compared using SPSS19.0 software package for Chi - square test. RESULTS: At 3 and 6 months, pit and fissure sealant retention rate in A1 and A2, B1 and B2,C1 and C2 group had no significant difference. At 12 months, sealant retention in A1 and B1 group was significantly lower than A2 and B2 group (P<0.05). No significant difference was found between C1 and C2 groups (P>0.05). At 24 months, sealant retention rate in A1, B1 and C1 group was significantly lower than A2, B2 and C2 group (P<0.05). The caries rate in A1and A2, B1 and B2, C1 and C2 group had no significant difference during different follow-up time (P>0.05). CONCLUSIONS: The clinical anticariogenic effect of three kinds of one-step etching adhesives and phosphoric acid etching sealant was similar .One-step self etching adhesive system was recommended for pit and fissure sealant to improve the students' oral health. The long-term retention rate of one-step self etching adhesive system was lower than the phosphoric acid method to long term observation is needed.

[Investigation of the first permanent molar caries in primary school students in Xuhui District of Shanghai Municipality].

PURPOSE: To investigate the prevalence and current status of caries about the first permanent molars of students in elementary schools in Xuhui District of Shanghai Municipality in order to provide evidence for prevention and treatment strategies of caries. METHODS: Random cluster samples of 5698 students aged from 7 to 12 years old were examined with regard to caries epidemic status of the first permanent molars. The results were analyzed by SPASS13.0 software package. RESULTS: The caries prevalent rate of the first permanent molars was 16.18%.The mean DMFT of the caries patients was 1.80. The females' mean caries prevalent rate and DMFT of the first permanent molars were both significantly higher than males'. The caries rate increased rapidly with aging from 7 to 12(P<0.01).The overall filling rate of the first permanent molars was 56.04%.The prevalence of the first permanent molars in the mandible was significantly higher than that in the maxilla (P<0.01).The caries rate of students, who brushed teeth twice a day or more, was significantly lower than those who brushed teeth once a day or less. CONCLUSIONS: The caries prevalence of the first permanent molars in students of 7 to 12 years old in elementary schools in Xuhui District of Shanghai municipality was less optimistic. Some concrete measures should be taken to prevent and treat caries.