Electromyographic features and efficacy of orofacial myofunctional treatment for skeletal anterior open bite in adolescents: an exploratory study.

BACKGROUND: Due to the multifactorial aetiology and unpredictable long-term stability, skeletal anterior open bite (SAOB) is one of the most intractable conditions for orthodontists. The abnormal orofacial myofunctional status (OMS) may be a major risk factor contributing to the development and relapse of SAOB. This study is aimed at evaluating the OMS and the efficacy of orofacial myofunctional therapy (OMT) alone for SAOB subjects. METHODS: Eighteen adolescents with SAOB (4 males, 14 females; age: 12-18 years) and eighteen adolescents with normal occlusion (2 males, 16 females; age: 12-18 years) were selected. The electromyographic activity (EMGA) associated with mastication and closed mouth state was measured. Lateral cephalography was used to evaluate craniofacial morphology. Wilcoxon signed rank tests and t-tests were performed to evaluate myofunctional and morphological differences. Pearson or Spearman correlation analysis was used to investigate the correlations between EMGA and morphological characteristics. SAOB subjects were given OMT for 3 months, and the EMGA was compared between before and after OMT. RESULTS: During rest, anterior temporalis activity (TAA) and mentalis muscle activity (MEA) increased in SAOB subjects, but TAA and masseter muscle activity (MMA) decreased in the intercuspal position (ICP); and upper orbicularis activity (UOA) and MEA significantly increased during lip sealing and swallowing (P < 0.05). Morphological evaluation revealed increases in the FMA, GoGn-SN, ANS-Me, N-Me, L1-MP, U6-PP, and L6-MP and decreases in the angle of the axis of the upper and lower central incisors and OB in SAOB subjects (P < 0.05). TAA, MMA and anterior digastric activity (DAA) in the ICP were negatively correlated with vertical height and positively correlated to incisor protrusion. MEA was positively correlated with vertical height and negatively correlated with incisor protrusion; and the UOA showed a similar correlation in ICP, during sealing lip and swallowing. After SAOB subjects received OMT, MEA during rest and TAA, MMA and DAA in the ICP increased, while UOA and MEA decreased (P < 0.05). CONCLUSION: SAOB subjects showed abnormal OMS features including aberrant swallowing patterns and weak masticatory muscles, which were interrelated with the craniofacial dysmorphology features including a greater anterior facial height and incisor protrusion. Furthermore, OMT contributes to OMS harmonization, indicating its therapeutic prospect in SAOB.

A meta-analysis of locoregional anesthesia versus general anesthesia in endovascular repair of ruptured abdominal aortic aneurysm.

OBJECTIVE: To conduct a meta-analytic review of studies investigating the effect of the anesthesia modality on perioperative mortality in endovascular repair of ruptured abdominal aortic aneurysms (REVAR). METHODS: The present meta-analysis was performed in accordance with the PRISMA guidelines. Multiple electronic databases were comprehensively searched from database inception to January 2020. Eligible studies included cohort studies that reported the 30-day/in-hospital mortality rate or the multivariate adjusted odds ratio (OR) or hazard ratio of the mortality risk for patients who underwent emergency REVAR under locoregional anesthesia (LA) vs general anesthesia (GA). A random effects model was used to estimate the ORs by pooling the related data from individual studies. RESULTS: A total of eight studies were included in this analysis. The first meta-analysis of seven studies that reported the 30-day/in-hospital mortality with a total of 3116 patients (867 in the LA group and 2249 in the GA group) revealed that LA was associated with a lower 30-day/in-hospital mortality than GA (16.4% vs 25.4%; unadjusted OR, 0.47; 95% confidence interval [CI], 0.32-0.68). The second meta-analysis of three of these seven studies (including 586 patients in the LA group and 1945 in the GA group) that reported the perioperative variables revealed comparable baseline characteristics but a lower 30-day/in-hospital mortality in the LA group (unadjusted OR, 0.55; 95% CI, 0.42-0.71). The third meta-analysis of the adjusted ORs or hazard ratios that were reported from four studies (including 501 patients in the LA group and 1136 in the GA group) showed a similar trend (adjusted OR,0.37; 95% CI, 0.19-0.75). CONCLUSIONS: REVAR under LA is associated with a lower 30-day/in-hospital mortality than REVAR under GA. However, because the included studies may have had some observation bias, further randomized controlled trials are warranted to validate the present results.

A systematic review and meta-analysis on the efficacy and safety of traditional Chinese patent medicine Jinqi Jiangtang Tablet in the treatment of type 2 diabetes.

INTRODUCTION: At present, a large number of people in the world are suffering from type 2 diabetes (T2DM), so it is urgent to develop effective treatment measures of T2DM. In China, many clinical studies have shown that Jinqi Jiangtang Tablet (JQJTT), a traditional Chinese patent medicine (TCPM), has a good effect in the treatment of T2DM. This systematic review and meta-analysis is intended to assess the efficacy and safety of JQJTT plus conventional therapy in the treatment of T2DM. METHODS: Seven electronic databases were searched to include in eligible studies published from inception to May 24, 2018. Randomized controlled trials (RCTs) of JQJTT in combination with the conventional therapy versus conventional therapy alone or combined with placebo were included. The two reviewers independently conducted data extraction and quality assessment. For different variable types, the outcome measures were expressed as risk ratios (RRs) or mean differences (MDs). According to the value of I2, a fixed or random effect model was used for statistical analysis. RESULTS: Seventeen studies conducted in China were identified in this systematic review, which included 1,425 participants. The meta-analysis on the effective rate of the comparison groups showed a significant difference in favor of the JQJTT group (RR 1.34; 95%CI [1.02, 1.75]; p = 0.04). In addition, the results showed a statistically significant reduction in FBG (MD -0.85; 95%CI [-1.03, -0.68]; p < 0.00001), 2hPG (MD -1.95; 95%CI [-2.33, -1.56]; p < 0.00001), HbA1c (MD -0.76; 95%CI [-1.03, -0.49]; p < 0.00001), FINS (MD -3.05; 95%CI [-3.69, -2.42]; p < 0.00001), PINS (MD -10.22; 95%CI [-13.93, -6.50]; p < 0.00001), HOMA-IR (MD -1.11; 95%CI [-1.55, -0.68]; p < 0.00001), LDL-C (MD -0.37; 95%CI [-0.63, -0.11]; p = 0.006), TC (MD -0.46; 95%CI [-0.85, -0.08]; p = 0.02), TG (MD -0.34; 95%CI [-0.47, -0.20]; p < 0.00001) with JQJTT plus conventional therapy versus conventional therapy alone. There was no statistical difference between the two comparison groups in HDL-C, total incidence of adverse events and incidence of hypoglycemia. CONCLUSION: The available evidence indicates that JQJTT combined with conventional therapy for treating T2DM has a good performance in regulating glycolipid metabolism and improving insulin resistance. However, due to the limitations of this systematic review, the results should be interpreted with caution.