Efficacy assessment of laser Doppler imager in diagnosing the pulp vitality after dental trauma.

Background/purpose: This is the first paper evaluating the efficacy of laser Doppler imager in diagnosis of pulpal vitality. The purpose of this study was to evaluate and compare the diagnostic benefits of laser Doppler imaging and electric pulp test (EPT) in dental trauma. Materials and methods: Seven patients were selected for pulp vitality evaluation in Kaohsiung Medical University Hospital between 2018 and 2019. EPT and laser Doppler imager evaluation were performed for patients with traumatic injury to teeth. Statistical methods included the Kappa consistency test and the chi-square test. In addition, the receiver operating characteristic (ROC) curve, and the area under the curve (AUC) were used. Results: There was a significant difference in Doppler flow values between the severe trauma group and the mild trauma group, regardless of patient self-reported symptoms (P = 0.043) or physicians' diagnostic classification (P = 0.018). For an EPT instrument, the Kappa coefficient was 0.67 and 1-year pulpal status findings were highly consistent (P < 0.001). Using a Doppler instrument, the Kappa coefficient was 0.85. According to the ROC curve, the AUC for EPT was 0.94, the AUC for Doppler was 1, and the optimal cut-off value was 31.55, indicating that both were superior diagnostic tools. Conclusion: Both laser Doppler imager and EPT can be used as tools for diagnosing traumatic pulp necrosis. Doppler imaging instruments allow for a more timely and accurate assessment of pulp vitality in dental trauma. In the future, ongoing research and related training are necessary for interpretation of Doppler data.

An evaluation of the investment for child development in China.

OBJECTIVE: This study estimated the investment in child development from three aspects-public health, public education, and family investment to establish the level of investment, to provide reference information for government decision making and to provide international comparisons. METHODS: Public investment in health was measured with macro data related to public health spending and child development in government expenditure. Public education investment was based on basic education data. Family investment evaluation was based on per capita family consumer spending data in different age groups to estimate the input for child development. RESULTS: Both public health investment level and the proportion of GDP rose for all age groups over time, but the overall investment level was still insufficient. Public investment in children's education has increased year by year, but the trends in all age groups are unbalanced with much lower investment in early childhood education. Private investment in children has increased over the period, but has declined as a percentage of GDP. International comparisons show that Chinas investment in child development is much lower than OECD countries. CONCLUSION: The private investment in child development was the main way in China, with public finance contributing only a small proportion. Given the poor international comparisons, the government needs to review the balance of public investment to redirect more towards the development of children under the age of six to their health and education.

Assessment of the related factors of blood loss and blood ingredients among patients under hypotensive anesthesia in orthognathic surgery.

OBJECTIVE: The objective of the study was to understand the factors associated with presurgical and postsurgical blood loss and blood ingredients among patients in the treatment of mandibular prognathism by intraoral vertical ramus osteotomy combined genioplasty. METHODS: Preoperative and postoperative values of blood loss and blood ingredients were collected from 30 mandibular prognathic patients who underwent orthognathic surgery. The linear regression models and correlation coefficients were used to identify factors with respect to patients' blood loss level and 3 types of blood ingredients (ie, red blood cells, hemoglobin, and hematocrit). RESULTS: The mean blood loss and operation time were 179.2 mL and 311.7 minutes, respectively. No blood transfusion was received by our patients. After adjusting for potential factors, the regression models showed that no significant factor was found to be associated with blood loss and reduce blood ingredients. Moreover, female patients were found to be more likely to have a low level of presurgical blood ingredients (ß = -0.293 to -3.551; P < 0.05), whereas female sex (ß = -1.606 to -4.008; P < 0.001), a high blood loss level (ß = -0.003 to -0.009; P < 0.05), and long operation time (ß = -0.005 to -0.018; P < 0.05) were associated with a low level of postsurgical blood ingredients (ie, hemoglobin and hematocrit). CONCLUSIONS: No significant factor was associated with blood loss and reduced blood ingredients among patients in orthognathic surgery with hypotenstive anesthesia. Improvements in anesthesia provided surgeons with more time to promote hemostasis during surgery. Hypotensive anesthesia was a well-accepted method to reduce blood loss during orthognathic surgery.

[Study on the effect of malnutrition and anemia identified among general population in 2002 to the future productivity in China].

OBJECTIVE: To measure the social productivity loss and negative effect to economic development due to malnutrition in view of quantitative analysis. METHODS: Using the data of childhood stunting and population anemia status, collected by 2002 National Nutrition and Health Survey to analyse the effect on present and future productivity. PROFILES model was used to estimate two kinds of productivity losses: "Future productivity loss" was figured out based on the data of stunting and anemia status in 0-5 year-old children while "Current productivity loss" was from anemia data of the adults. RESULTS: If current prevalence levels of malnutrition remained unchange over the next ten years (from 2002 to 2012), the total net present value of future productivity lost would be 281.7 billion Yuan (RMB), equivalent to 2.70 % of the Gross Domestice Product( GDP) in 2002, with the productivity losses due to stunting, anemia in adults and children were 0.15 % , 0.46 % and 2.09% of the 2002 GDP, respectively. All the results of calculation mentioned above was restricted with the same assumption - the ignorance of the real cost. CONCLUSION: The social economic development and the improvement of nutrition program would have a huge effect to population nutritional status. The social benefit and return on investment should be significant.

[Economic burden of coronary heart disease and stroke attributable to hypertension in China].

OBJECTIVE: 1) To estimate annual direct medical costs of coronary heart disease (CHD) and stroke attributable to hypertension among Chinese adults aged 35-74 years in China, 2) to analyze the correlation between the hypertension awareness and hypertension treatment rate. METHODS: 2003 National Health Services Survey (n = 93 018) was used to derive direct medical costs including costs for outpatient visits, physician services, inpatient stays, rehabilitation services, nurses fees, and medications. The medical costs of CHD and stroke attributable to hypertension were estimated by multiplying population attributable risk proportion by corresponding disease costs. Using 2002 National Nutrition and Health Survey (n = 148 804), the prevalence of hypertension awareness and hypertension treatment rate in 132 survey sites were calculated. Correlation was used to analyze the correlation between the two variables. RESULTS: The direct medical costs of hypertension, CHD and stroke were 20.2, 15.7 and 24.3 billion Yuan, respectively. The medical costs attributable to hypertension were estimated at 19.1 billion Yuan (RMB), accounting for 47.7% of the total medical costs of the two chronic diseases. The prevalence of hypertension awareness is highly correlated with hypertension treatment rate (r = 0.9777, P < 0.0001). CONCLUSION: The economic burden of CHD and stroke attributable to hypertension is very high, reaching about 50% of the total medical costs of the two diseases. The prevalence of hypertension awareness could be used as an important indicator to evaluate the effectiveness of hypertension prevention and control at community level.

[Analysis on the changes of nutritional situation in past 15 years (1990 - 2005) in China the 15 - year establishment of Chinese food and nutrition surveillance system( CFNSS)].

OBJECTIVE: To establish a Food and Nutrition Surveillance System as the supplementation to the Nationwide Nutritional Survey conducted in China for every ten years. To understand the changes and trend of child growth during the period in fast economic development in China. To provide the basis for policy-maker. METHODS: Based on 145 National Disease Monitoring Sites and 600 sampling sites of SSB, to sampling 40 sites as Chinese Food and Nutrition Surveillance sites. Using Child growth Reference by WHO to evaluate the Child development. Using SSB data to assess the nutrient intake by China DDp. RESULTS: The results from 5 round surveillance in 15 years are reliable and are consistent with National Nutrition Survey. The results also become national data and the basis for policy-making. CONCLUSION: The big improvement of child growth has been showed in China in past 15 years. We have to pay attention to child complementation feeding as important as breastfeeding, improvement of Anemia situation for mother and his/her child, Improvement of child growth in Western child and Child problem of floating mothers.

[The changes of the attributable factors of child growth].

OBJECTIVE: To rule out the attributable factors of child growth in China and the changes of the factors in the past 15 years for the planning of future nutrition improvement of children in China. METHOD: The datasets of 1990 - 2005 China Food and Nutrition Surveillance were used and the Multi-factorial Logistic Regression analysis was used. The AR% of these factors and the changes of the attributable factors during the past 15 years were presented. RESULT: The main factors attributed to the growth of children under 5 in year 2005 were low education level of mothers (AR = 40.5%), floating out-for-job mothers (AR% = 35.5%), No egg introduction in the past 24 hours (AR = 24.2%), No milk introduction in the past 24 hours(18.7%) and household income below national poverty line (21.9%). Many of the attributable factors have improved significantly during the past 15 years. However, the increasing number of floating out-for-job mothers will have more impact on the quality of child feeding and child care. CONCLUSION: Social economic development is the direct factors to child growth, while other factors such as feeding and mother care are critical factors could either accelerate or counteract the positive effects of the favorable socioeconomic development. To improve height growth is essential to further enhance health and fitness of children under 5 focused nutrition and dietary intervention should be implemented.

[The current prevalence status of body overweight and obesity in China: data from the China National Nutrition and Health Survey].

OBJECTIVE: To study on the prevalence of body overweight and obesity in China and its distribution in age, sex and economic development status. METHODS: A total of 209,849 in all ages from the 2002 China National Nutrition and Health Survey (NNAHS) database were analyzed. The year 2000 population census data was used for age standardization. 1978 WHO criteria using Z scores was applied to age 0-7 years, criteria recommended by the Working Group on Obesity in China was applied to those aged 7-17 years and criteria in the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults was applied to those aged 18 years and above. RESULTS: The overall prevalence was 17.6% for overweight and 5.6% for obesity. The combined prevalence of overweight and obesity was 23.2%. The prevalence of overweight was 25.0%, 21.6%, 17.4%, 15.1%, 19.2% and 12.8%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. For obesity, the rate was 10.6%, 7.2%, 6.4%, 4.3%, 6.0% and 2.7%, respectively for large city, middle-and-small city, class 1 rural, class 2 rural, class 3 rural and class 4 rural. By age groups, the prevalence of overweight was 3.4% in children age 0-6, 4.5% in adolescents age 7-17, 22.8% in adults age 18 and above; the prevalence of obesity was 2.0% in children age 0-6, 2.7% in adolescents age 7-17, 7.1% in adults age 18 and above. The sex difference in overweight and obesity differed between urban and rural, and among age groups. CONCLUSION: Overweight and obesity should have affected nearly 1 quarter of the country's total population, and became a threatening hazard to resident's health. As the urbanization progress, obesity might doubly increase. Prevention and control of this hazard should be urgently needed.

Effects of malnutrition on economic productivity in China as estimated by PROFILES.

OBJECTIVE: To calculate the effects of malnutrition on economic productivity in China. METHODS: PROFILES was used to quantify the function consequences of malnutrition in term of protein energy malnutrition, iron deficiency and iodine deficiency. RESULTS: Productivity gained due to improved iodine nutrition. The reduction in the TGR in 1992 to 2001 increased the net present value of further economic productivity by yen 142 billion. Reduction of the TGR rate to 5% over next 10 years would result in future productivity gains with value of yen 40 billion. Productivity gain due to reductions in child stunting would result in future economic productivity gains with the value of yen 101 billion. Reducing stunting further over the next 10 years would gain yen 20 billion. Productivity gain due to reduction of iron deficiency anemia reduced by 30% over the next 10 years would gain worth yen 107 billion and if childhood anemia reduced by 30% over next 10 years would gain yen 348 billion. CONCLUSION: These interventions have huge economic payoff. That is likely to exceed their costs many times over.