Efficacy of caries and gingivitis prevention strategies among children and adolescents with intellectual disabilities: a systematic review and meta-analysis.

BACKGROUND: Dental caries and periodontal diseases are the most common oral diseases among human beings. Individuals with intellectual disabilities (IDs) have poor oral health and limited access to dental care. The aim of this study was to investigate the efficacy of strategies in caries and gingivitis prevention among children and adolescents with ID. METHODS: Four electronic databases (PubMed, Cochrane Library, Web of Science and Scopus) were searched from their commencement date to 17 April 2017. Randomised or non-randomised controlled trials evaluating the efficacy of interventions in caries and gingivitis prevention were included if the participants were children and adolescents with ID. Gingival index and caries experiences were reported in the format of mean difference and standard error. Meta-analysis was conducted if data could be pooled from two or more studies using similar outcome measurements and intervention. RESULTS: A total of 1455 articles published in English were identified. Fourteen studies formed the basis of qualitative analysis; six studies were feasible to perform quantitative analysis. Meta-analysis favoured fluoride to placebo in caries prevention [Z = 2.02, P < 0.05, 95% CI: -0.71 (-1.40, -0.02)], while the effectiveness of chlorhexidine remained elusive. CONCLUSIONS: Both mechanical and chemical approaches had been applied to caries and gingivitis prevention among children and adolescents with ID. Insufficient evidence supported the efficacy of chlorhexidine nor powered toothbrush, while fluoride was suggested to be an effective caries preventive strategy in fluoride-deficient areas. More well-designed randomised controlled trials using integration strategies are encouraged in further studies.

[Utility of the type 3 portable monitor for the diagnosis of patients with obstructive sleep apnea].

Objective: To evaluate the utility of a portable monitor at home for diagnosis of obstructive sleep apnea (OSA) in Chinese adults. Methods: Eighty nine patients suspected of OSA underwent overnight, unattended home sleep apnea testing (HSAT) with a portable monitor (Nox-T3, Nox Medical Inc. Iceland)followed by an in-laboratory polysomnogram (PSG) with simultaneous portable monitor (PM) recording within one week. PSG and PM recorder were scored according to recommended guidelines by independent technicians. The correlation between PSG apnea hypopnea index (AHI) and PM respiratory disturbance index (RDI) were evaluated. Results: Sleep testing showed RDI was (30.0±20.9) events/h on HSAT, and (33.4±22.4) events/h on in-laboratory PM recording. Apnea-hypopnea index (AHI) on PSG was (35.1±23.7) events/h. There was significantly statistical difference among the three group (P<0.001). Both RDI on HSAT and RDI on in-laboratory PM correlated significantly with AHI on PSG (r=0.877, P<0.001 and r=0.962, P<0.001, respectively). Bland-Altman analysis of AHI on PSG versus RDI on HSAT showed a mean difference of 4.4 events/h; limits of agreement was -17.6 to 26.5 events/h. Closer agreements were present when comparing the simultaneous recordings, with AHI on PSG versus RDI on in-laboratory PM showing a mean difference of 1.4 events/h, and limits of agreement was -11.3 to 14.2 events/h. Based on a threshold of AHI≥5 events/h, RDI on HSAT had 98.8% sensitivity, 40.0% specificity. Using an AHI ≥ 15 events/h, RDI on HSAT had 91.5% sensitivity, 76.5% specificity. Conclusion: Type 3 PM has a good diagnostic value for adult OSA patients and there is close agreement between the Type 3 portable monitor and PSG.

Association between HLA-DRB1 alleles and tuberculosis: a meta-analysis.

Although a number of studies have reported that human leukocyte antigen (HLA)-DRB1 alleles may be correlated with tuberculosis (TB), most were based on small samples or inconsistent and unclear results. Here, we present a meta-analysis to investigate the relationship between HLA-DRB1 alleles and TB susceptibility. We gathered relevant information from published studies on the association between HLA­DRB1 alleles and TB susceptibility through a systematic research. Data from eligible fifteen studies were included in the meta-analyses. Each dataset was statistically analyzed to evaluate the HLA­DRB1 alleles by calculating the respective odds ratios (ORs) and 95% confidence intervals (CIs). The results revealed that frequencies of two DRB1 alleles were significantly decreased in TB: DRB1*03 (P = 0.016, OR = 0.78, 95%CI = 0.67­0.95) and DRB1*07 (P = 0.017, OR = 0.81, 95%CI = 0.68­0.96). Thus, our data indicate that DRB1*03 and DRB1*07 may provide protective effects against TB susceptibility. However, well­designed studies with large sample sizes are required for better understanding of this association.

[Craniofacial anatomical Characteristics of patients with catathrenia].

Objective: To analyze whether the upper airway of patients with catathrenia has obstructive manifestations using nasal resistance, craniofacial, and upper airway imaging methods, which could benefit the exploration of the etiology and treatment options. Methods: From August 2012 to September 2019, a total of 57 patients with catathrenia in the Department of Orthodontics at Peking University Hospital of Stomatology were included in the study, including 22 males and 35 females, aged (31.1±10.9) years, with a body mass index of (21.7±2.7) kg/m2. All the patients were diagnosed by full-night polysomnography at the Sleep Division, Peking University People's Hospital, of which 10 patients were combined with obstructive sleep apnea hypopnea syndrome (OSAHS). The median groaning index of patients was 4.8 (1.8, 13.0) events/h. Nasal resistance and cone-beam CT were conducted on the patients, and measurements were performed on the craniofacial structures, upper airway, and surrounding soft tissues, compared with non-snoring normal occlusion individuals' references published by the same research team (144 college students recruited at Peking University and 100 non-snoring young adults with normal occlusion recruited at six universities in Beijing). Results: The total nasal resistance of patients with catathrenia was (0.26±0.08) Pa·cm-3·s-1. The patients had overall well-developed mandibular hard tissues. However, the patients were found with increased FH/BaN (steep anterior cranial base plane), increased MP/FH (forward rotation of the mandible); increased U1/NA and L1/MP (proclined upper and lower incisors). The sagittal diameter of the velopharynx [(19.2±4.5) mm] was significantly larger than the normal reference (t=8.44, P<0.001), while the sagittal diameter at the hypopharynx [(17.4±6.4) mm] was statistically smaller than the normal reference (t=-2.79, P=0.006). Catarhrenia patients combined with OSAHS presented longer soft palate, tongue, and lower hyoid bone than those with primary catathrenia. Conclusions: In patients with catathrenia, the overall craniofacial characteristics are well-developed skeletal structures, lower nasal resistance, proclined upper and lower incisors, wide upper sagittal development of the upper airway and narrow hypopharynx. Groaning sounds might be related to the narrowing of the hypopharynx during sleep.

Hmong participants' reactions to return of individual and community pharmacogenetic research results: "A positive light for our community".

Pharmacogenetic research has historically lacked racial and ethnic diversity, limiting the application of findings to minority populations. Recent studies, including the Hmong, have gauged communities' interest in participating in genomic research and receiving their individual results. This study was conducted to create a culturally and linguistically appropriate format to return pharmacogenomic results and identify Minnesota Hmong research participants' reactions to their personal and collective results. Using a community-based participatory research approach, researchers collaborated with Hmong community members to format the pharmacogenetic disclosure process. Three focus groups were completed with 24 Hmong participants and three major themes emerged using thematic analysis. Many Hmong focus group participants viewed the results positively, finding them useful for themselves and their community as a means to optimize responses to and avoid harms from medicines. However, some participants expressed concerns about harms that the pharmacogenetic information could bring, including anxiety, misunderstanding, discrimination, exploitation, and lack of a clinician involvement in interpreting and applying the result. Many participants interpreted their results through an experiential lens, trusting their experience of medicines more than trusting genetic information, and through a cultural lens, expressing the belief that environmental factors may influence how people's bodies respond to medicines by influencing their inherited flesh and blood (roj ntsha). Lastly, participants stressed the importance of disseminating the information while acknowledging the complex linguistic, educational, and cultural factors that limit understanding of the results. Researchers, genetic counselors, pharmacists, and healthcare providers should strive to return results in meaningful ways to all members of society.

Low expression of lncRNA MGC27345 is associated with poor prognosis in gastric cancer patients.

OBJECTIVE: A series of evidence showed that long non-coding RNAs (lncRNAs) play an essential regulatory role in the occurrence and development of human cancer, and is a potential biological target in the fight against cancer. PATIENTS AND METHODS: In this research, we investigated the role of lncRNA MGC27345 in gastric cancer (GC), the expression of MGC27345 in GC was detected by quantitative Real-Time PCR in GC tissue from 235 patients. The correlations between MGC27345 expression and clinicopathological variables and survival were evaluated by the Chi-square test. Kaplan-Meier method (log-rank test), univariate and multivariate Cox regression assays were carried out for the identification of the survival and independent risk factors for GC. RESULTS: MGC27345 expression levels were significantly decreased in GC tissues than in adjacent normal specimens. Lower expression of MGC27345 was found in advanced tumor stages. GC patients with low-expression of MGC27345 had a poorer overall survival compare to those with high-expression of MGC27345. Furthermore, MGC27345 was an independent protective prognosis factor in GC development. CONCLUSIONS: Our data indicated that MGC27345 may have a diagnostic and prognostic value for patients with advanced gastric cancer and assist to improve clinical outcomes for GC patients.

Factors associated with subsequent nontuberculous mycobacterial lung disease in patients with a single sputum isolate on initial examination.

Very few studies have focused on the outcome and management of patients with a single sputum isolate of nontuberculous mycobacterium (NTM) on initial examination. Patients with a single isolate of Mycobacterium avium complex (MAC), M. chelonae-abscessus, M. kansasii, or M. fortuitum from at least three sputum samples collected within 1 month were retrospectively identified. Those with follow-up sputum samples within 1 year were included in the analysis. Among the 202 patients included, M. fortuitum (n = 71, 35.1%) and MAC (n = 70, 34.7%) were the most common NTM species isolated, followed by M. chelonae-abscessus (n = 40, 19.8%) and M. kansasii (n = 21, 10.4%). The mean clinical follow-up period was 26.2 months. Forty-four patients (21.8%) had subsequent positive cultures of the same NTM species, while eight (4.0%) had bronchiectasis and developed NTM lung disease (NTM-LD). Neither patients without bronchiectasis nor those with M. fortuitum subsequently developed NTM lung disease. Among bronchiectatic patients with NTM other than M. fortuitum, age ≤65 years (p 0.006, OR 32.13), malignancy (p 0.048, OR 14.35), and initial radiographic score >2 (p 0.027, OR 20.06) were associated with subsequent NTM-LD. In all of the NTM patients, bronchiectasis (p <0.001, OR 5.46) and age ≤65 years (p 0.002, OR 3.29) were significantly associated with subsequent positive NTM culture. In patients with a single isolation of NTM from respiratory specimens, the presence of bronchiectasis and younger age indicates higher risk of subsequent culture-positivity and NTM-LD. Single isolation of M. fortuitum is of little clinical significance. Other patients with NTM, younger age, and more severe radiographic pulmonary lesion also warrant further attention.

Repeated noise exposure affects muscarinic cholinergic receptors in the rat brain.

We examined the effect of repeated exposure to 100-dB white noise (10 daily 45-min sessions) on muscarinic cholinergic receptors in different regions of the rat brain. Twenty-four hours after the last exposure session, increase in concentration (Bmax) of [3H]quinuclidinyl benzilate ([3H]-QNB) binding sites was observed in the hippocampus, but no significant change was seen in the striatum, frontal cortex, and hypothalamus. No significant effect of noise on receptor binding affinity (Kd) was found. Pretreating the rats with naltrexone (1 mg/kg, IP) before exposure blocked the noise-induced increase in cholinergic receptors in the hippocampus.

Validation of the SOS/Umu test with mutagenic complex mixtures.

The SOS/Umu test, a rapid system for detecting genotoxic agents by monitoring SOS responses, was evaluated with the extracts of 8 mutagenic complex mixtures (airborne particles, coal dust, tobacco snuff, fried beef, fried shredded pork, airborne particles from polyurethane plants). In this system, the SOS function induced by genotoxicants is detected by a colorimetric measurement of beta-galactosidase in tester cells carrying a umuC-lacZ-fused gene on the plasmid. Results from the study show that a higher beta-galactosidase activity was found when the enzyme substrate and treated cells were added simultaneously into the enzyme reaction mixture and post-treatment dilution (10 X dilution with fresh medium) and incubation (for 2 h) were incorporated. The post-treatment dilution is necessary to reduce a possible false positive due to the color of test substances. The extracts of all mutagenic complex mixtures tested were found to induce dose-related SOS responses, indicating that the SOS/Umu test is potentially useful for the detection of mutagenic complex environmental mixtures.

[Therapeutic angiogenesis with the use of vascular endothelial growth factor 165 gene in the myocardium of miniature swine].

The purpose of the present study was to examine whether adenovirus-mediated vascular endothelial growth factor l65 (VEGFl65) can enhance collateral vessel formation of coronary artery and improve regional myocardial perfusion and function. Using a miniature swine model of chronic myocardial ischemia, the replication-deficient recombinant adenovirus vector containing complementary deoxyribonucleic acid (cDNA) for human VEGFl65 (Ad-VEGFl65) or for beta-galactosidase (Ad-Gal) was administered directly into the ischemic myocardium in the left circumflex (LCX) distribution. Myocardial perfusion and function were assessed by electrocardiogram-gated single photon emission computed tomography (SPECT) imaging and collateral vessel development of coronary artery was assessed by ex vivo coronary angiography (CAG). Four weeks after Ad-VEGF165 administration, SPECT imaging demonstrated a significant reduction in ischemic area (P<0.01) and ischemic severity (P<0.01), and a substantial improvement in left ventricular ejection fraction (P<0.01) and regional wall motion in the LCX distribution (P<0.05), as compared with that of control animals and that before administration of Ad-VEGFl65. Collateral vessel development with Rentrop Grading was also significantly greater in Ad-VEGF165 animals than in the Ad-Gal control animals (P<0.05). It's concluded that Ad-VEGFl65 can induce collateral vessel development in ischemic myocardium and result in significant improvement in myocardial perfusion and function.

[Eosinophil response in albino rats to infection with Angiostrongylus cantonensis (author's transl)].

Five male Wistar rats (200 grams each) were infected with 100 third stage larvae of Angiostrongylus cantonensis by gastric intubation. After 42 days of infection, a large number of first stage larvae was found in the feces of all infected rats. Blood examination revealed that the number of eosinophil increased substantially, when compared to controls, at 6, 36, and 46 days after infection. The percentages of eosinophils in blood obtained at day 6, 36, and 46 was about 4 to 6-fold of control group. However, the total number of white blood cells increased only at the late period or after 36 days of infection.

[Development of Angiostrongylus cantonensis in the lung of Achatina fulica (author's transl)].

Twenty-four Achatina fulica from Pai-sha of the Pescardores Islands, where no Angiostrogylus cantonensis has been found in A. fulica(4), were inoculated with the first stage larvae of A cantonensis. One snail was killed every day after 24 days following inoculation. The lung of each snail was separated and examined for larvae under microscope. The same lung was then digested with pepsin. The larvae recovered after pepsin digestion were examined for more detailed morphology. This study confirmed that the first stage larvae of A. cantonensis passed through the respiratory pore to the lung of A. fulica and developed into infectious form (3rd stage larvae) in the lung. The second and third stage larvae were found in the lung on the 7th and 17th day respectively after inoculation. Worm capsules were found in the lung on the 12th day after inoculation and the size of capsule was in proportion to the duration of the infection.

Naltrexone pretreatment blocks microwave-induced changes in central cholinergic receptors.

Repeated exposure of rats to pulsed, circularly polarized microwaves (2,450-MHz, 2-microseconds pulses at 500 pps, power density 1 mW/cm2, at an averaged, whole-body SAR of 0.6 W/kg) induced biphasic changes in the concentration of muscarinic cholinergic receptors in the central nervous system. An increase in receptor concentration occurred in the hippocampus of rats subjected to ten 45-min sessions of microwave exposure, whereas a decrease in concentration was observed in the frontal cortex and hippocampus of rats exposed to ten 20-min sessions. These findings, which confirm earlier work in the authors' laboratory, were extended to include pretreatment of rats with the narcotic antagonist naltrexone (1 mg/kg, IP) before each session of exposure. The drug treatment blocked the microwave-induced changes in cholinergic receptors in the brain. These data further support the authors' hypothesis that endogenous opioids play a role in the effects of microwaves on central cholinergic systems.

Application of SOS umu-test for the detection of genotoxic volatile chemicals and air pollutants.

The SOS umu-test has been used for the detection of DNA-damaging agents. In this system the plasmid pSK1002 carrying a fused gene umuC-lacZ was introduced into Salmonella typhimurium TA1535. The SOS function induced by genotoxic agents is detected by a colorimetric measurement of beta-galactosidase activity encoded by the lacZ gene, which is regulated by the Umu operon. This system was used with modifications to study the SOS function inducibility of volatile chemicals (propylene oxide, methyl bromide, and ethylene dibromide) and air pollutants (diesel emission, welding fumes, and cigarette smoke). Tester cells were exposed directly to the test material. The enzyme activity of the treated cells was measured according to the established procedure. Results of the study showed that all chemicals and pollutants tested induced SOS function in a dose-related manner. These results indicate that the SOS umu-test is potentially useful for the in situ detection of genotoxic agents in occupational settings.

A comparison of the care of hypertension in Hunan and Connecticut.

The demographic, clinical, and social characteristics of 300 hypertensive patients (150 seen in the Hypertension Clinic at Yale University and 150 seen in a newly opened clinic at the First Affiliated Hospital of the Hunan Medical College) were compared at their initial visit to the clinic. The mean blood pressure of both treated and untreated patients and the frequency of mild hypertension and rarity of secondary causes of hypertension were similar. Americans drank more alcohol and were more likely to be heavy smokers, and the Chinese were older, had more end organ damage, and had many more symptoms. The majority of patients in China (77%) were being treated most often with combination pills containing multiple agents. We feel that hypertensive patients are similar in the United States and China, though the Chinese patients appeared to have been seen at a later stage of their disease.

A comparison of the treatment of hypertension with Chinese herbal and Western medication.

Forty-five patients with diastolic blood pressure (DBP) greater than or equal to 105 mmHg were randomly assigned to receive Western (group 1, n = 21) or a classical Chinese herbal preparation (group 2, n = 24) to treat their hypertension (HBP). All remained hypertensive after 4 days in the hospital without treatment. Except for baseline Na+ excretion (higher in group 1) and somewhat more evidence of end organ damage in group 1, the patient groups were comparable. Those in group 1 were given a thiazide diuretic and propranolol if needed, and those in group 2, a mixture of 12 herbs. Patients on active therapy in group 1 had a drop in blood pressure (BP) from 172.6 +/- 27.8/107.4 +/- 13.6 to 141.2 +/- 26.2/89.6 +/- 12.0 mmHg, whereas those in group 2 had no change in BP, 168.8 +/- 22.0/107.7 +/- 9.8 mmHg to 165.7 +/- 23.7/106.0 +/- 11.8 mmHg. Although 66% of patients in group 1 had a DBP under 90 mmHg by discharge, only 8% of those in group 2 did. Except for a fall in serum K+ in group 1, there were no significant biochemical or clinical problems in either group. We conclude that standard Western medication is more effective than a classical Chinese herbal preparation used to treat HBP.