Laparoscopic middle-hepatic-vein-guided anatomical hemihepatectomy in the treatment of hepatolithiasis: a 10-year case study.

BACKGROUND: This retrospective 10-year case study evaluated the perioperative results and long-term efficacy of laparoscopic middle-hepatic-vein-guided hemihepatectomy (L-MHV-H) and traditional anatomical hemihepatectomy (TAH) in the treatment of hepatolithiasis (HL). METHODS: From January 2010 to December 2019, 99 patients with regional HL underwent laparoscopic anatomical hemihepatectomy (LAH) at our centre, including 43 patients in the L-MHV-H group and 56 patients in the TAH group. RESULTS: All patients in both groups were Child-Pugh grade A before operation. No significant between-group differences in general information, stone distribution, comorbidities, history of previous abdominal surgery or co-occurrence of gallstones and common bile duct stones were observed. The L-MHV-H group exhibited a higher intraoperative stone clearance rate (95.3% vs. 75.0%, p = 0.014) and a lower postoperative complication rate (10.1% vs. 48.2%, p = 0.005) compared with the TAH group. In the median follow-up time of 60 months (range 6-125 months), the L-MHV-H group had lower stone recurrence (2.3% vs. 19.6%, p = 0.013) and cholangitis recurrence (2.3% vs. 17.9%, p = 0.034) rates. No significant between-group differences in the other results were observed. CONCLUSIONS: L-MHV-H is safe and feasible for HL with certain advantages over TAH in improving the intraoperative stone clearance rate, reducing postoperative complication incidence and reducing stone and cholangitis recurrence rates.

A survey of the awareness and knowledge of oral cancer among residents in Beijing.

BACKGROUND: The present study aimed to investigate oral cancer awareness and its related knowledge among residents in Beijing. METHODS: A questionnaire survey was conducted among Beijing residents concerning their knowledge of oral cancer, and its prevention and treatment. RESULTS: A total of 3055 questionnaires were completed, 45.8% by males and 54.2% by females. The ages of the respondents ranged from 15 to 93 years; 12.4% were smokers, 1.1% chewed betel nuts, and 82.5% brushed their teeth at least twice a day. Lung cancer was heard of by the most respondents, followed by gastric cancer and liver cancer; oral cancer was the least heard of. More than 60% of respondents were unaware of the risk factors and early signs of oral cancer. CONCLUSIONS: This survey demonstrated a general lack of public awareness and knowledge about oral cancer. Specific measures should be taken to improve public awareness of oral cancer and its prevention and treatment.

Laparoscopic anterior hepatic transection for resecting lesions originating in the paracaval portion of the caudate lobe (with videos).

BACKGROUND: The paracaval portion of the caudate lobe is located in the core of the liver. Lesions originating in the paracaval portion often cling to or even invade major hepatic vascular structures. The traditional open anterior hepatic transection approach has been adopted to treat paracaval-originating lesions. With the development of laparoscopic surgery, paracaval-originating lesions are no longer an absolute contraindication for laparoscopic liver resection. This study aimed to evaluate the safety and feasibility of laparoscopic anterior hepatic transection for resecting paracaval-originating lesions. METHODS: This study included 15 patients who underwent laparoscopic anterior hepatic transection for paracaval-originating lesion resection between August 2017 and April 2020. The perioperative indicators, follow-up results, operative techniques and surgical indications were retrospectively evaluated. RESULTS: All patients underwent laparoscopic anterior hepatic transection for paracaval-originating lesion resection. The median operation time was 305 min (220-740 min), the median intraoperative blood loss was 400 ml (250-3600 ml), and the median length of postoperative hospital stay was 9 days (5-20 days). No conversion to laparotomy or perioperative deaths occurred. Six patients had Clavien grade III-IV complications (III/IV, 5/1). Two patients developed tumor recurrence after 13 months and 8 months. CONCLUSION: Although technically challenging, laparoscopic anterior hepatic transection is still a safe and feasible procedure for resecting paracaval-originating lesions in select patients.

Trend on dental caries status and its risk indicators in children aged 12 years in China: a multilevel analysis based on the repeated national cross-sectional surveys in 2005 and 2015.

BACKGROUND: This study aimed to explore the trend and risk indicators for dental caries of children aged 12 years in China based on national oral health survey data in 2005 and 2015. METHODS: Research data were from the two latest national oral health surveys conducted in mainland China, including 30 and 31 provinces, autonomous regions, and municipalities in 2005 and 2015, respectively. Children aged 12 years were clinically examined for dental caries and dental fluorosis according to the World Health Organization criteria. Sociodemographic characteristics and oral health-related behaviours were collected using questionnaires. Multilevel zero-inflated negative binomial regression model was used to investigate the association between dental caries severity and dental fluorosis, sociodemographic characteristics, and oral health-related behaviours. RESULTS: The final analyses included 12,350 and 27,818 children surveyed in 2005 and 2015, respectively. The standardized prevalence of dental caries increased from 27.05% (95% confidence interval [CI], 24.25-28.85) in 2005 to 37.92% (95% CI, 34.94-40.90) in 2015, and the respective standardized mean decayed, missing, filled teeth (DMFT) index scores increased from 0.50 (standard deviation [SD], 1.04) to 0.83 (SD, 1.45) (P < 0.001). Fujian province had the highest increase in dental caries, followed by Liaoning, Heilongjiang, Hainan, and Yunnan. Results revealed that children who were girls, more frequently experienced dental pain, and had more recent dental visits, had significantly higher DMFT scores after adjusting for the survey year and other variables (all P < 0.05). CONCLUSIONS: Dental caries of 12-year-old children in China deteriorated from 2005 to 2015, particularly in the northeast and southwest regions. Dental caries was associated with sex, dental pain, and dental service utilization.

The relationship between different types of caries and periodontal disease severity in middle-aged and elderly people: findings from the 4th National Oral Health Survey of China.

BACKGROUND: The relationship between dental caries and periodontal disease is still controversial. The objective of this study was to explore the relationship between different types of caries and periodontal disease severity in middle-aged and elderly people in China. METHODS: The study population consisted of 4407 middle-aged and 4117 elderly subjects. Caries were divided into the following three types: type A, crown caries; type B, lesions involving both the crown and root, representing mixed-type caries; and type C, root caries. These three types together represent the overall caries situation, which we call type ABC. Caries were quantitated by decayed and filled teeth (DFT index). Periodontitis was evaluated by clinical attachment loss. RESULTS: Middle-aged people with periodontitis had a significant association with DFT type B (OR: 1.21, 95% CI 1.17-1.25) and type C (OR: 1.40, 95% CI 1.24-1.56). Elderly people with periodontitis had a significant association with DFT type C (OR: 1.28, 95% CI 1.21-1.35). CONCLUSIONS: In China, caries types B/C were positively correlated with periodontitis in the middle-aged group, and only caries type C was positively correlated with periodontitis in the elderly group.

Dental expenditure, progressivity and horizontal inequality in Chinese adults: based on the 4th National Oral Health Epidemiology Survey.

BACKGROUND: The financial burden of oral diseases is a growing concern as the medical expenses rise worldwide. The aim of this study was to investigate the dental expenditure, analyze its progressivity and horizontal inequality under the general health finance and insurance system, and identify the key social determinants of the inequality for Chinese adults. METHODS: A secondary analysis used the data of 13,464 adults from the 4th National Oral Health Epidemiological Survey (NOHES) in China was undertaken. The dental expenditure was collected and divided into out-of-pocket and health insurance payments. Horizontal inequality index and Kakwani index were used to analyze the horizontal inequality and progressivity, respectively. The decomposition model of the concentration index was set up to explore the associated socioeconomic determinants. RESULTS: The results showed that a mean dental expenditure per capita of Chinese adults was $20.55 (95% Confidence Interval-CI: 18.83,22.26). Among those who actually used dental service, the cost was $100.95 (95%CI: 93.22,108.68). Over 90% of dental spending was due to out-of-pocket expenses. For self-reported oral health, the horizontal inequality index was - 0.1391 and for the decayed tooth (DT), it was - 0.2252. For out-of-pocket payment, the Kakwani index was - 0.3154 and for health insurance payment it was - 0.1598. Income, residential location, educational attainment, oral hygiene practice, self-reported oral health, age difference were the main contributors to the inequality of dental expenditure. CONCLUSION: Dental expenditure for Chinese adults was at a lower level due to underutilization. The ratio of payments of dental expenditure and utilization was disproportional, whether it was out-of-pocket or insurance payment. Individuals who were more in need of oral care showed less demand for service or not required service in time. For future policy making on oral health, it is worth the effort to further promote the awareness of the importance of oral health and utilization of dental service.

Impact of iatrogenic biliary injury during laparoscopic cholecystectomy on surgeon's mental distress: a nationwide survey from China.

BACKGROUND: Iatrogenic biliary injury (IBI) following laparoscopic cholecystectomy (LC) is the most serious iatrogenic complications. Little is known whether LC-IBI would lead to surgeon's severe mental distress (SMD). METHODS: A cross-sectional survey in the form of electronic questionnaire was conducted among Chinese general surgeons who have caused LC-IBI. The six collected clinical features relating to mental distress included: 1) feeling burnout, anxiety, or depression, 2) avoiding performing LC, 3) having physical reactions when recalling the incidence, 4) having the urge to quit surgery, 5) taking psychiatric medications, and 6) seeking professional psychological counseling. Univariable and multivariable analyses were performed to identify risk factors of SMD, which was defined as meeting ≥3 of the above-mentioned clinical features. RESULTS: Among 1466 surveyed surgeons, 1236 (84.3%) experienced mental distress following LC-IBI, and nearly half (49.7%, 614/1236) had SMD. Multivariable analyses demonstrated that surgeons from non-university affiliated hospitals (OR:1.873), patients who required multiple repair operations (OR:4.075), patients who required hepaticojejunostomy/partial hepatectomy (OR:1.859), existing lawsuit litigation (OR:10.491), existing violent doctor-patient conflicts (OR:4.995), needing surgeons' personal compensation (OR:2.531), and additional administrative punishment by hospitals (OR:2.324) were independent risk factors of surgeon's SMD. CONCLUSION: Four out of five surgeons experienced mental distress following LC-IBI, and nearly half had SMD. Several independent risk factors of SMD were identified, which could help to make strategies to improve surgeons' mental well-being.

Robotic-assisted laparoscopic surgery for complex hepatolithiasis: a propensity score matching analysis.

BACKGROUND: The indication for laparoscopic treatment of hepatolithiasis is early-stage regional hepatolithiasis. Open surgery (OS) is the traditional treatment for complex hepatolithiasis. Robotic-assisted laparoscopic surgery (RLS) overcomes the limitations of the traditional laparoscopic approach in terms of the visual field, instruments, and operational flexibility. RLS is thus theoretically indicated for the treatment of complicated hepatolithiasis. This study aimed to evaluate the safety, efficacy, and feasibility of RLS for the treatment of complicated hepatolithiasis. METHODS: From October 2010 to August 2017, 26 consecutive patients who underwent RLS and 287 consecutive patients who underwent OS for the treatment of complicated hepatolithiasis at our center were included in this study. We performed a propensity score matching (PSM) analysis between patients who underwent RLS and patients who underwent OS at a ratio of 1:2. Twenty-six patients were included in the RLS group, and 52 patients were included in the OS group. RESULTS: The groups exhibited no differences with respect to age, sex, location of stones, liver function, history of previous surgery, or Child-Pugh classification. There were no differences in the postoperative complication rates (46.2% vs. 63.5%, p = 0.145), intraoperative stone clearance rates (96.2% vs. 90.4%, p = 1.000), or final stone clearance rates (100% vs. 98.1%, p = 0.652) between the two groups. The RLS group had less blood loss (315.38 ± 237.81 vs. 542.88 ± 518.70 ml, p = 0.037), a lower transfusion rate (15.4% vs. 46.2%, p = 0.008), shorter oral intake times (3.50 ± 1.30 vs. 5.88 ± 4.00 days, p = 0.004), and shorter postoperative hospital stays (13.54 ± 6.54 vs. 17.81 ± 7.49 days, p = 0.016) than the OS group. At a median follow-up of 48 months (range 7-90 months), there were no differences in stone recurrence rate (3.8% vs. 13.5%, p = 0.356) or recurrent cholangitis rate (3.8% vs. 3.8%, p = 1.000) between RLS and OS patients. CONCLUSION: RLS for complicated hepatolithiasis is safe and feasible with advantages over OS in terms of intraoperative blood loss, transfusion rate, duration of hospital stays, and postoperative recovery.

Risk factors of early childhood caries (ECC) among children in Beijing - a prospective cohort study.

BACKGROUND: Early childhood caries (ECC) was a serious oral health concern with high prevalence and a low treatment rate in China, and few researches have focused on preschool children. This study aimed to explore the risk factors of ECC in Beijing, China. METHODS: Totle of 712 children (mean age: 46.37 ± 5.44 months) participated in this prospective cohort study. Questionnaires and the levels of mutans streptococci in dental plaques and non-stimulated saliva, assessed using Dentocult SM strips, were collected at baseline, respectively. Two calibrated examiners checked for dental caries according to the WHO 1997 criteria at baseline and 1-year follow-up. Negative binomial regression was used for multivariate analysis of factors related to caries development. RESULTS: For caries-free children at baseline, only plaque mutans streptococci (PMS) levels were associated with caries development (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 1.08-2.61, P = 0.02). Children with high PMS levels (scored 2 and 3) had higher caries incidence (46.2% vs. 33.8%) and more caries increment (1.87 ± 3.17 vs. 0.90 ± 1.89) than those with low levels (scored 0 and 1). Among all participants, PMS (OR = 1.69, 95% CI: 1.32-2.23, P < 0.001) and previous caries experience (OR = 2.80, 95% CI: 2.20-3.56, P < 0.001) were related to caries increment. CONCLUSIONS: For caries-free children, the only significant risk factor for ECC was high PMS levels. For all participants, besides high PMS levels, previous caries experience was another significant risk factor for caries development. TRIAL REGISTRATION: The study design, protocol, and informed consent forms were undertaken with the understanding of Declaration of Helsinki and were approved by the Human Research Ethics Committee of the School of Stomatology, Peking University, China (PKUSSIRB-2012042).

Laparoscopic anatomical segmentectomy of liver segments VII and VIII with the hepatic veins exposed from the head side (with videos).

BACKGROUND: The reported protocol was difficult to expose the hepatic veins for laparoscopic anatomical hepatectomy of segments VII and VIII. We introduce a new, convenient, applicable approach with the hepatic vein exposed from the head side. METHODS: This study included 10 patients who underwent laparoscopic liver resection for HCC in the segments VII and VIII between October, 2014 and November, 2015. Their perioperative course and operative techniques were retrospectively evaluated. RESULTS: All patients underwent laparoscopic anatomical segmentectomy of segments VII and/or VIII of the liver with the hepatic vein exposed from the head side. None of the cases was converted to open surgery. The average procedure duration was 326.20 ± 51.13 min, and the average blood loss volume was 375.0 ± 166.42 ml. No postoperative complications were observed. The average postoperative hospital stay was 6.7 ± 0.82 days. No recurrence or metastasis was observed. CONCLUSIONS: Laparoscopic anatomical segmentectomy of liver segments VII and VIII, with the hepatic vein exposed from the head side, may be safe, convenient, and applicable to perform. J. Surg. Oncol. 2016;114:752-756. © 2016 Wiley Periodicals, Inc.

[Sesamin Preconditioning Attenuates Myocardial Ischemia Reperfusion Injury in Rats Through Activation of Akt/eNOS Signaling Pathway].

Objective: To investigate the protective effect of sesamin on myocardial ischemia reperfusion injury in rats, and to study the possible mechanism. Methods: 50 SD rats were randomly divided into control group, sham operated group, model group, high-dose sesamin group( 160 mg / kg) and low-dose sesamin group( 80 mg / kg),with 10 rats in each group. Rats in sesamin groups were administered intragastrically with sesamin for 7 d. Then all rats except those in sham operated group were subjected to myocardial ischemia-myocardial ischemia reperfusion injury model by coronary artery ligation for 40 min and subsequent reperfusion for 120 min. Serum cardiac troponin Ⅰ( c TnⅠ) and lactate dehydrogenase( LDH),levels of total antioxidant capacity( TAOC) and nitric oxide( NO) in serum and myocardial tissues,Caspase-3 activity in myocardial tissues were detected by colorimetric assay. Cardiomyocyte apoptosis was evaluated by TUNEL assay. Phosphorylation level of endothelial nitric oxide synthase( eNOS) and Protein kinase B( Akt), protein expression of superoxide dismutase( SOD) in cardiac tissue were determined by Western blot. Results: Pretreatment with sesamin significantly ameliorated myocardial injury in rats which induced myocardial ischemia and reperfusion injury by reduced levels of serum c TnⅠand LDH( P <0. 05 or P < 0. 01). Supplementation with sesamin resulted in a significant increasing of total antioxidant capacity and NO level in serum and myocardial tissues and cardiomyocyte apoptosis( P < 0. 05 or P < 0. 01),and remarkable decrease the Caspase-3 activity in myocardial tissues and cardiomyocyte apoptosis( P < 0. 05 or P < 0. 01). Sesamin significantly up-regulated the protein expression of SOD in cardiac tissues, and the levels of phosphorylated eNOS and Akt increased notably( P < 0. 05 or P < 0. 01). Conclusion: Pretreatment with sesamin effectively ameliorated myocardial ischemia reperfusion injury in rats, and the mechanism might be related to enhancing its antioxidant capacity and the activation of Akt / eNOS signaling pathway and subsequent increase of NO synthesis and suppression of cardiac myocyte apoptosis.

[The effect of Salvianolic Acid B on the Apoptosis of HUVECs Induced by Intermittent High Glucose].

Objective: To investigate the effect of Salvianolic acid B (Sal B) on the apoptosis of human umbilical vein endothelial cells (HUVECs) induced by intermittent high glucose and to explore the possible mechanisms. Methods: HUVECs were preincubated with Sal B for 24 h, followed by incubation with intermittent high glucose (IHG, 5.5 mmol/L 12 h, 33.3 mmol/L 12 h) for 72 h. The viability of the HUVECs was determined by MTT assay, and the cells apoptosis was measured flow cytometry, respectively. The levels of nitric oxide (NO), total antioxidant capacity (T-AOC), malondialdehyde (MDA), and Caspase-3 activity were determined by colorimetric method. Intracellular ROS was evaluated by fluorescent microscopy. The protein levels of NOX4, p-eNOS, BAX, and BCL-2 were determined by Western-blot. Results: Pretreatment with Sal B significantly ameliorated IHG-induced cells injury as was manifested by increased cell viability, up-regulated eNOS activation, and promoted the release of NO in HUVECs (P < 0.05 or P < 0.01). Sal B evidently suppressed IHG-induced cell apoptosis, down-regulated the expression of BAX protein and up-regulated the expression of BCL-2 protein. The activity of Capase-3 was also significantly reduced. Pre-incubation with Sal B led to a significant enhancement of antioxidant capacity and a reduction of NOX4 protein expression, accompanied by a remarkable decrease of intracellular ROS and MDA content (P < 0.05 or P < 0.01). Conclusion: Sal B is capable of suppressing IHG-induced injury and apoptosis in HUVECs, which might be attributed to the attenuation of oxidative stress, regulation of BCL-2/BAX protein expression, and subsequent suppression of Caspase-3 activity.

Totally laparoscopic ALPPS in the treatment of cirrhotic hepatocellular carcinoma.

BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a breakthrough in the field of hepatobiliary surgery [1], resulting in the growth of remnant liver volume by 74-87.2% in 9-13 days [2, 3]. However, patients required to undergo two open operations in a short period of time [2-5]. To our knowledge, this video is the first description of the technical aspects of totally laparoscopic ALPPS for the treatment of cirrhotic hepatocellular carcinoma (HCC). METHODS: A patient with 6-cm cirrhotic HCC in the right liver was referred for surgical treatment. Preoperative examination confirmed that the remnant liver volume to standard liver volume ratio was 27%. Therefore, a totally laparoscopic ALPPS was planned. In the first stage of the operation, the right portal vein was ligated after laparoscopic cholecystectomy. A tape was passed along the retrohepatic avascular space and the liver was suspended during parenchymal transection, resulting in the successful completion of liver partition using the anterior approach, which conformed to the "No Touch" principle. Thirteen days after the first stage, the ratio had reached 40.6%. The second stage involved the transections of the right hepatic pedicle and the right hepatic vein. RESULTS: The operative times were 255 min for the first stage and 210 min for the second stage. Pathology confirmed the diagnosis of HCC. A complication, pleural effusion, occurred after the second stage. Following pleural puncture drainage, the patient was discharged 9 days postoperatively. Follow-up 4 months after surgery was uneventful. Comparing with our open ALPPS results in two patients, the laparoscopic approach reduced the rate of postoperative complications and peritoneal adhesions, which often complicate the second stage of the operation, thus contributing to more rapid recovery. CONCLUSION: Totally laparoscopic ALPPS is feasible, with satisfactory short-term efficacy, conforming to the "No Touch" principle. ALPPS may be safe for the treatment of HCC in cirrhotic patients, but the interval between the two stages may be extended.

Laparoscopic versus open liver resection for hepatocellular carcinoma in posterosuperior segments.

BACKGROUND: Traditional open liver resection remains the classic procedure for hepatocellular carcinoma (HCC) located in the posterosuperior segments of the liver (segments I, IVa, VII, and VIII). This study compared the perioperative and oncologic results for laparoscopic versus open liver resection of HCC located in the posterosuperior segments, especially in patients with cirrhosis. METHODS: This study included 41 patients who underwent laparoscopic liver resection (LLR) and 86 who underwent open liver resection (OLR) for HCC in the posterosuperior segments between January 1, 2010, and December 31, 2012. There perioperative course and oncologic outcomes were retrospectively evaluated. RESULTS: There were no significant differences between the LLR and OLR groups in length of operation (242.41 ± 73.69 vs. 235.38 ± 65.80 min), transfusion rate (7.3 vs. 14.0 %), R0 resection rate (100 vs. 97.7 %), or tumor size (4.22 ± 2.05 vs. 4.30 ± 1.49 cm). In contrast, postoperative hospital stay (9.44 ± 2.72 vs. 14.53 ± 6.03 days) was significantly shorter, and postoperative complication rates (17.1 vs. 37.2 %) and intraoperative blood loss (272.20 ± 170.86 vs. 450.12 ± 344.70 mL) significantly lower in the LLR than in the OLR group. In addition, there was no significant difference between the two groups (LLR vs. OLR) regarding 1-year overall survival rate (95.1 vs. 89.5 %), 3-year overall survival rate (78 vs. 76.7 %,), 1-year disease-free survival rate (87.8 vs. 82.6 %,), and 3-year disease-free survival rate (70.7 vs. 68.6 %). CONCLUSIONS: LLR for selected patients with HCC in the posterosuperior segments may offer the same oncologic outcomes as conventional procedures, while being associated with such advantages as lower blood loss, fewer postoperative complications, and shorter hospital stay.

[Effects of crocetin on VCAM-1 expression in human umbilical vein endothelial cells and monocyte-endothelial cell adhesion].

Crocetin, a naturally occurring carotenoid, possesses antioxidant and antiatherosclerotic properties, of which the underlying mechanism remains unclear. In the present study, we examined the effects of crocetin (0.1, 1, 10 µmol·L(-1)) on angiotensin II (Ang II, 0.1 µmol·L(-1)) induced expression of vascular cell adhesion molecule-1 (VCAM-1) in human umbilical vein endothelial cells (HUVECs) and monocyte-endothelial cell adhesion. The effects of crocetin on the activation of nuclear factor kappa B (NF-κB) and intracellular reactive oxygen species (ROS) were also observed. The results demonstrated that crocetin notably suppressed Ang II induced NF-κB activation (P<0.01) and VCAM-1 expression (P<0.05, P<0.01) in HUVECs, accompanied by a markedly reduced monocyte-endothelial cell adhesion (P<0.05, P<0.01). In addition, preincubation with crocetin resulted in a significant enhancement of cellular antioxidant capacity (P<0.05, P<0.01), while Ang II induced intracellular ROS decreased markedly (P<0.05, P<0.01). These results indicated that crocetin was capable of suppressing Ang II induced VCAM-1 expression and monocyte-endothelial cell adhesion by suppression of NF-κB activation, which might be derived from the enhancement of antioxidant capacity and subsequent reduction of intracellular ROS.

[Analysis of volatile sulfur compounds production of oral cavity in preschool children and influencing factors].

OBJECTIVE: To investigate the prevalence of volatile sulfur compounds(VSC) in oral cavity of preschool children, and to analyze related factors, thus to provide scientific basis for the prediction and treatment of halitosis. METHODS: The VSC content (hydrogen sulfide, methyl mercaptan, dimethyl sulfide) of 170 preschool children (4 to 6 years old) was detected by a portable gas chromatograph OralChromaTM. The status of the oral health was evaluated. The living habits and other aspects were obtained through questionnaires from the children's parents. A soft package for social statistics version 13.0 (SPSS 13.0) was used in which univariate analysis and multivariate analysis were utilized to analyze the related factors of halitosis in children. RESULTS: In the study, 34.4% of the total subjects had excessive VSC. Hydrogen sulfide (H2S) [(1.59 ± 2.41) ng/10 mL] and total VSC concentration [(2.14 ± 4.42) ng/10 mL] in the girls were significantly higher (P<0.05) than those in the boys. The tongue coating score had a significant positive correlation with H2S [tongue coating area (1.68 ± 2.48) ng/10 mL,tongue coating thickness (2.18 ± 2.69) ng/10 mL] and total VSC concentration [tongue coating area, (2.26 ± 4.31) ng/10 mL,tongue coating thickness (2.41 ± 3.02) ng/10 mL , P<0.01]. The site number of DI-S ≥ 2 had a significant positive correlation with methyl mercaptan (CH3SH) and dimethyl sulfide [(CH3)2S] concentration (P<0.01). The concentration of H2S [(1.19 ± 1.62) ng/10 mL] in children, whose mother had a higher degree of education, was statistically lower (P<0.01). The children who took dessert or sweat drinks more frequently had lower H2S [(1.04 ± 1.55) ng/10 mL, P<0.05] concentration, while CH3SH and (CH32)S concentration [(0.29 ± 1.92) ng/10 mL, (0.37 ± 2.06) ng/10 mL, P<0.05) were higher in the children with mouth-breath habit. CONCLUSION: A high prevalence of halitosis was noted in preschool children. Gender, tongue coating index, debris index-simplified, status of the mother's education, frequency of eating dessert or sweat drinks and dry mouth breath were related with halitosis of preschool children. The different related factors resulted in changes of each VSC concentration.

[Effect of Danzhi Jiangtang Capsule on Myocardial Fibrosis in Diabetic Rats].

OBJECTIVE: To investigate the effect of Danzhi Jiangtang Capsule on myocardial fibrosis in diabetic rats with fluctuated blood glucose and the possible mechanisms implicated. METHODS: Following induction of diabetes with intraperitoneal injection of streptozotocin (STZ), rats were administered with insulin or glucose at different time during a day to induce blood glucose fluctuation. After treatment with Danzhi Jiangtang Capsule for six weeks, rats were sacrificed and the hearts were collected for the determination of cardiac mass index. Cardiac levels of angiotensin II (Ang II), type I and type III collagens and transforming growth factor-ß1 (TGF-ß1) were assayed by ELISA. Levels of Smad3 phosphorylation and protein expression of matrix metalloproteinase-2 ( MMP-2) and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) were determined by Western blot analysis. Total antioxidant capacity and malondialdehyde (MDA) content in cardiac tissues were measured colorimetrically. RESULTS: Treatment with Danzhi Jiangtang Capsule for six weeks significantly reduced cardiac mass index and cardiac levels of type I and type III collagens (P < 0.05 or P < 0.01). Levels of Ang II, TGF-ß1 and Smad3 phosphorylation in cardiac tissues were also decreased markedly (P < 0.05 or P < 0.01). Supplementation with Danzhi Jiangtang Capsule resulted in an evident up-regulation of MMP-2 protein and down-regulation of TIMP-2 protein expression in cardiac tissues (P < 0.05 or P < 0.01). In addition, Danzhi Jiangtang Capsule significantly enhanced total antioxidant capacity in diabetic rats, while cardiac content of MDA was decreased markedly( P < 0.05 or P < 0.01). CONCLUSION: Danzhi Jiangtang Capsule significantly ameliorated myocardial fibrosis in diabetic rats with fluctuated blood glucose, which might be derived from enhancement of antioxidant capacity, suppression of RAS and TGF-ß1/Smad3 signaling pathway and regulation of MMP-2/TIMP-2 protein expression.

[Effect of Serum Containing Sesamin on Angiotensin II-Induced Apoptosis in Rat Cardiomyocytes].

OBJECTIVE: To investigate the effect of serum containing sesamin on angiotension II (Ang II)-induced apoptosis in rat cardiomyocytes and the possible mechanisms. METHODS: H9c2 rat cardiomyocytes were preincubated with serum containing sesamin or blank serum for 12 h, followed by incubation with Ang II for 24 h. Cell viability was assessed by MTT assay and cell apoptosis was evaluated by flow cytometric analysis. Protein expression of BCL-2, BAX, Caspase-3, p47phox and superoxide dismutase (SOD) was determined by Western blot analysis. Levels of intracellular reactive oxygen species (ROS), total antioxidant capacity (T-AOC) and malondialdehyde (MDA) were measured colorimetrically. RESULTS: Preincubation with serum containing sesamin significantly improved cell viability and suppressed cell apoptosis in H9c2 rat cardiomyocytes exposed to Ang II (P < 0.05 or P < 0.01), with the expression of BAX, Caspase-3 and p47phox protein down-regulated and BCL-2 and SOD protein up-regulated markedly (P < 0.05 or P < 0.01). The levels of T-AOC were effectively increased in serum containing sesamin groups, while the levels of intracellular ROS and MDA contents were decreased significantly (P < 0.05 or P < 0.01). Control serum had no influence on the above mentioned measurements. CONCLUSION: Sesamin is capable of suppressing Ang II-induced apoptosis in H9c2 rat cardiomyocytes, which might be derived, at least partly, from amelioration of oxidative stress, regulation of BAX/BCL-2 protein expression and suppression of Caspase-3 protein expression.

[Identification of Streptococcus mutans in carious patients' saliva samples by MALDI-TOF mass spectrometry].

OBJECTIVE: To identify Streptococcus mutans (S. mutans) in carious patients' saliva using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and to establish a faster and more accurate method to identify S. mutans. METHODS: In this study, a total of 90 carious patients from Department of Endodontics of Peking University School of Stomatology were recruited. All these patients' saliva was collected. After extracting the protein of the samples, they were identified by MALDI-TOF MS. The composite profile was analyzed using BioExplorer 1.0 software. The scores ≥ 25 were considered as S. mutans, whereas the scores <25 were as considered as non S. mutans. Finally, these results were compared with 16S rDNA sequencing to figure out the sensitivity and concordance rate, respectively. RESULTS: The sensitivity of MALDI-TOF MS was 96.0%, and the concordance rate compared with 16S rDNA sequencing was as high as 98.7%. CONCLUSION: MALDI-TOF MS is high throughput, rapid and easy to perform in comparison to other conventional methods. It has a high sensivity and concordance rate. Thus, MALDI-TOF MS can serve as an effective tool for identification of S. mutans.