The Prevalence of Dental Anxiety Associated with Pain among Chinese Adult Patients in Guangzhou.

Background: Anxious people appear to exaggerate the severity of aversive experiences such as anxiety and pain. Anxiety towards dental procedures is a common difficulty that may be experienced by dental patients all over the world. The goal of the study is to find out the prevalence of dental anxiety and its associated factors in Chinese adult patients. Methods: A cross-sectional study was conducted on 183 dental adult patients whose age ranged from 18 to 70 years. Demographic details, first and most recent dental visits with experience, the MDAS, and the Visual Analogue Scale for Anxiety (VAS-A) were obtained. Data were analyzed by frequency analysis, chi-square test, and Spearman correlation test. Results: Most of the respondents were female (68.9%) and 30-45 years age group. The mean total score for dental anxiety on the MDAS was 13.63 (3.1). 80.3% of participants suffered from moderate or high dental anxiety. Age must show a strong association with dental anxiety among the participants (p=0.011). The first dental visit experience, the frequency of the dental visit, most recent dental experience, length of time since the most recent dental visit, and postponement of the dental visit are strongly associated with the MDAS score (p=0.001). Conclusions: The MDAS score exhibits that Chinese adult patients have significant dental anxiety and phobia. Identifying patients with dental anxiety as soon as possible is essential to providing better dental care.

Lidocaine suppresses the malignant behavior of gastric cancer cells via the c-Met/c-Src pathway.

The present study was designed to investigate the role and mechanism of action behind the action of lidocaine in gastric cancer cells. Lidocaine was tested for its potential role in affecting the viability of cells using Cell Counting Kit-8 (CCK-8) assays. It was found that there was a decreased MKN45 cell viability upon lidocaine treatment in a dose-dependent manner. Phosphorylated c-Met, phosphorylated c-Src, c-Met and c-Src levels were detected using western blotting following lidocaine or hepatocyte growth factor (HGF) intervention. It was found that the phosphorylation levels of c-Met and c-Src were markedly reduced by lidocaine treatment, with this effect being further relieved by the addition of HGF. Subsequently, whether lidocaine repressed the malignant biological properties of gastric cancer cells through the c-Met/c-Src axis was further investigated through the detection of epithelial-mesenchymal transition markers (N-caderin and vimentin), wound healing and transwell assay analysis. In addition, cell apoptosis and the levels of apoptosis-related proteins were determined using TUNEL and western blot assays, respectively. The results demonstrated that the malignant behavior of cells were notably repressed upon lidocaine treatment, but the addition of HGF markedly reversed these effects, indicating that the effects of lidocaine on supressing the malignant behaviour of cells could be mediated through the c-Met/c-Src axis. Subsequently, whether lidocaine affected the sensitivity of cells to cisplatin or 5-FU was analyzed using a CCK-8 assay. Enhanced sensitivity of cells to cisplatin or 5-FU was observed when treated in combination with lidocaine. The present study concluded that the involvement of the c-Met/c-Src pathway in the biological behaviour of MKN45 cells was mediated by lidocaine. Therefore, lidocaine may have the potential to suppress the malignant behaviour and proliferation of gastric cancer cells.

Tu-San-Qi (Gynura japonica): the culprit behind pyrrolizidine alkaloid-induced liver injury in China.

Herbs and dietary supplement-induced liver injury (HILI) is the leading cause of drug-induced liver injury in China. Among different hepatotoxic herbs, the pyrrolizidine alkaloid (PA)-producing herb Gynura japonica contributes significantly to HILI by inducing hepatic sinusoidal obstruction syndrome (HSOS), a liver disorder characterized by hepatomegaly, hyperbilirubinemia, and ascites. In China, G. japonica has been used as one of the plant species for Tu-San-Qi and is often misused with non-PA-producing Tu-San-Qi (Sedum aizoon) or even San-Qi (Panax notoginseng) for self-medication. It has been reported that over 50% of HSOS cases are caused by the intake of PA-producing G. japonica. In this review, we provide comprehensive information to distinguish these Tu-San-Qi-related herbal plant species in terms of plant/medicinal part morphologies, medicinal indications, and chemical profiles. Approximately 2156 Tu-San-Qi-associated HSOS cases reported in China from 1980 to 2019 are systematically reviewed in terms of their clinical manifestation, diagnostic workups, therapeutic interventions, and outcomes. In addition, based on the application of our developed mechanism-based biomarker of PA exposure, our clinical findings on the definitive diagnosis of 58 PA-producing Tu-San-Qi-induced HSOS patients are also elaborated. Therefore, this review article provides the first comprehensive report on 2214 PA-producing Tu-San-Qi (G. japonica)-induced HSOS cases in China, and the information presented will improve public awareness of the significant incidence of PA-producing Tu-San-Qi (G. japonica)-induced HSOS and facilitate future prevention and better clinical management of this severe HILI.

Analgesic and Antibiotic Prescription Pattern among Dentists in Guangzhou: A Cross-Sectional Study.

Aim: To assess the rational use of drugs and the pattern of prescribing of analgesics and antibiotics for dental management and the information given by dentists in Guangzhou to their patients about the use of these drugs. Methods: A questionnaire was distributed to 225 dentists working in Guangzhou. The questionnaires consisted of open-ended questions and were given to dentists about analgesic and antibiotic use in dentistry. The questionnaires were analyzed, and absolute frequencies were expressed in the answers to each question. The cases, the analgesics, and the antibiotics recommended by the dentists for each case were determined by the frequency analysis method of descriptive statistics. Results: Responses to the questionnaire were received from 164 (72.9%) dentists. Paracetamol and diclofenac were the most widely prescribed analgesics. It is also estimated that selective COX-2 inhibitors or opioid analgesics have not been administered by dentists. The antibiotics primarily used for treatment were amoxicillin and metronidazole, and amoxicillin was used for prophylaxis. While more than 80% of dentists indicated that they provided their patients with information on the use of antibiotics, the quality of the information was limited. Patients were primarily instructed by dentists to observe the dosage and dose intervals of the prescription drugs. Conclusions: The results of the present study demonstrated that dentists most commonly prescribe paracetamol and diclofenac as analgesics, amoxicillin, and metronidazole for the therapy of periodontal, endodontic, and surgical procedures. The results also showed that dentists informed their patients inadequately about analgesic and antibiotic use.

Treatment planning of implants when 3 mandibular posterior teeth are missing: a 3-dimensional finite element analysis.

PURPOSE: To analyze the biomechanics of 3 designs of implant treatment for 3 teeth missing in posterior low arch quadrants. MATERIAL AND METHODS: A posterior portion of the human mandible missing 44, 45, 46 and three 4.1 × 10 mm threaded ITI implants with crowns were used to construct the finite element model. According to 3 implants being single, splinted or 2 implants support fixed partial denture (FPD) fixed in bone segments. Three implant support conditions were prepared with ANSYS 10.0. A load of 100 N was applied at the central fossa of the occlusal surfaces of the crowns at 45 degrees buccolingually along the triangular ridge of the buccal cusp. The von Mises stress and strain distributions in periimplant bone were observed. RESULTS: The results demonstrated that the von Mises stress in the supporting bone of the 2-implant supported FPD significantly increased compared with that in the 3-implant replacement. Meanwhile, when 3 implants were splinted, only the median implant had a decreased and more homogenous stress distribution, and the other implants did not exhibit significant differences when splinted. CONCLUSION: This study suggests that when space and cost permit, a 2-implant supported FPD should not be used, and 1 implant for each missing tooth being single is recommended.

A case report and DSA findings of cerebral hemorrhage caused by syphilitic vasculitis.

Syphilis is now rare and easily misdiagnosed because of the wide use of antibiotics in the clinical. We report a case of cerebral hemorrhage in a patient with hypertension who was first diagnosed as hypertensive cerebral hemorrhage. However, treponema pallidum particle agglutination and rapid plasma regain tests of cerebrospinal fluid revealed the existence of neurosyphilis. Interestingly, digital subtraction angiography (DSA) showed severe stenosis in both middle cerebral arteries and right anterior cerebral artery. The case reminded us to pay attention to syphilitic vasculitis in patients with cryptogenic stroke. DSA sometimes may play a critical role in differential diagnosis of neurosyphilis.

Influence of masticatory fatigue on the fracture resistance of the pulpless teeth restored with quartz-fiber post-core and crown.

To investigate whether masticatory fatigue affects the fracture resistance and pattern of lower premolars restored with quartz-fiber post-core and full crown, 44 single rooted lower premolars recently extracted from orthodontic patients were divided into two groups of 22 each. The crowns of all teeth were removed and endodontically treated and then restored with quartz-fiber post-core and full crown. Twenty-two teeth in one group were selected randomly and circularly loaded at 45° to the long axis of the teeth of 127.4 N at a 6 Hz frequency, and the other group was not delivered to cyclic loading and considered as control. Subsequently, all teeth in two groups were continually loaded to fail at 45° to the long axis of the teeth at a crosshead speed of 1 mm⋅min(-1). The mean destructive force values were (733.88±254.99) and (869.14±280.26) N for the experimental and the control group, respectively, and no statistically significant differences were found between two groups (P>0.05). Bevel fracture and horizontal fracture in the neck of root were the major fracture mode of the specimens. Under the circumstances of this study, it seems that cyclic loading does not affect the fracture strength and pattern of the quartz-fiber post-core-crown complex.