A cost-effectiveness analysis of fluoride varnish application in preventing Root caries in elderly persons: a Markov simulation study.

BACKGROUND: Root caries are prevalent issues that affect dental health, particularly among elderly individuals with exposed root surfaces. Fluoride therapy has shown effectiveness in preventing root caries, but limited studies have addressed its cost-effectiveness in elderly persons population. This study aimed to evaluate the cost-effectiveness of a fluoride treatment program for preventing root caries in elderly persons within the context of Chinese public healthcare. METHODS: A Markov simulation model was adopted for the cost-effectiveness analysis in a hypothetical scenario from a healthcare system perspective. A 60-year-old subject with 23 teeth was simulated for 20 years. A 5% sodium fluoride varnish treatment was compared with no preventive intervention in terms of effectiveness and cost. Tooth years free of root caries were set as the effect. Transition probabilities were estimated from the data of a community-based cohort and published studies, and costs were based on documents published by the government. The incremental cost-effectiveness ratio (ICER) was calculated to evaluate cost-effectiveness. Univariate and probabilistic sensitivity analyses were performed to evaluate the influence of data uncertainty. RESULTS: Fluoride treatment was more effective (with a difference of 10.20 root caries-free tooth years) but also more costly (with a difference of ¥1636.22). The ICER was ¥160.35 per root caries-free tooth year gained. One-way sensitivity analysis showed that the risk ratio of root caries in the fluoride treatment group influenced the result most. In the probabilistic sensitivity analysis, fluoride treatment was cost-effective in 70.5% of the simulated cases. CONCLUSIONS: Regular 5% sodium fluoride varnish application was cost-effective for preventing root caries in the elderly persons in most scenarios with the consideration of data uncertainty, but to a limited extent. Improved public dental health awareness may reduce the incremental cost and make the intervention more cost-effective. Overall, the study shed light on the economic viability and impact of such preventive interventions, providing a scientific basis for dental care policies and healthcare resource allocation.

[Investigation and analysis of the current situation of dental technical professionals in Shanghai medical institutions].

PURPOSE: To investigate the current situation of dental technical personnel team in medical institutions in Shanghai, and to provide reference for the construction of dental technical discipline and development of dental personnel team in the National Center for Stomatology (Shanghai). METHODS: Random sample questionnaire and expert interviews were used to find out the awareness, satisfaction and improvement suggestions of dental technicians among physicians, nursing and medical technicians in medical institutions in Shanghai. RESULTS: Among the positions engaged in by dental technicians, dental prosthetic technician, dental radiology technician and laboratory technician were the three most important positions at present, 62.3% of doctors and nurses were satisfied with the work of dental technicians, while 56.2% of dental medical technicians were generally or relatively unsatisfied with their current work. CONCLUSIONS: It is necessary to increase training and education opportunities for dental technicians, improve the talent echelon, introduce high-level talents, improve the working environment and treatment, broaden promotion channels, strengthen communication and exchange with medical care, and build a first-class medical technical personnel team that is compatible with the clinical level of stomatology.

Integrative Proteome Analysis Revels 3-Hydroxybutyrate Exerts Neuroprotective Effect by Influencing Chromatin Bivalency.

3-hydroxybutyrate (3OHB) has been proved to act as a neuroprotective molecule in multiple neurodegenerative diseases. Here, we employed a quantitative proteomics approach to assess the changes of the global protein expression pattern of neural cells upon 3OHB administration. In combination with a disease-related, protein-protein interaction network we pinpointed a hub marker, histone lysine 27 trimethylation, which is one of the key epigenetic markers in multiple neurodegenerative diseases. Integrative analysis of transcriptomic and epigenomic datasets highlighted the involvement of bivalent transcription factors in 3OHB-mediated disease protection and its alteration of neuronal development processes. Transcriptomic profiling revealed that 3OHB impaired the fate decision process of neural precursor cells by repressing differentiation and promoting proliferation. Our study provides a new mechanism of 3OHB's neuroprotective effect, in which chromatin bivalency is sensitive to 3OHB alteration and drives its neuroprotective function both in neurodegenerative diseases and in neural development processes.

Roles of oral microbiota and oral-gut microbial transmission in hypertension.

INTRODUCTION: Considerable evidence has linked periodontitis (PD) to hypertension (HTN), but the nature behind this connection is unclear. Dysbiosis of oral microbiota leading to PD is known to aggravate different systematic diseases, but the alteration of oral microbiota in HTN and their impacts on blood pressure (BP) remains to be discovered. OBJECTIVES: To characterize the alterations of oral and gut microbiota and their roles in HTN. METHODS: We performed a cross-sectional (95 HTN participants and 39 controls) and a 6-month follow-up study (52 HTN participants and 26 controls) to analyze the roles of oral and gut microbiota in HTN. Saliva, subgingival plaques, and feces were collected for 16S rRNA gene sequencing or metagenomic analysis. C57BL/6J mice were pretreated with antibiotics to deplete gut microbiota, and then transplanted with human saliva by gavage to test the impacts of abnormal oral-gut microbial transmission on HTN. RESULTS: BP in participants with PD was higher than no PD in both cross-sectional and follow-up cohort. Relative abundances of 14 salivary genera, 15 subgingival genera and 10 gut genera significantly altered in HTN and those of 7 salivary genera, 12 subgingival genera and 6 gut genera significantly correlated with BP. Sixteen species under 5 genera were identified as oral-gut transmitters, illustrating the presence of oral-gut microbial transmission in HTN. Veillonella was a frequent oral-gut transmitter stably enriched in HTN participants of both cross-sectional and follow-up cohorts. Saliva from HTN participants increased BP in hypertensive mice. Human saliva-derived Veillonella successfully colonized in mouse gut, more abundantly under HTN condition. CONCLUSIONS: PD and oral microbiota are strongly associated with HTN, likely through oral-gut transmission of microbes. Ectopic colonization of saliva-derived Veillonella in the gut may aggravate HTN. Therefore, precise manipulations of oral microbiota and/or oral-gut microbial transmission may be useful strategies for better prevention and treatment of HTN.

Kinase inhibit region of SOCS3 attenuates IL6-induced proliferation and astrocytic differentiation of neural stem cells via cross talk between signaling pathways.

AIMS: Efficiency of neural stem cells (NSCs) therapy for brain injury is restricted by astrogliosis around the damaged region, in which JAK2/STAT3 signaling plays a key role. The SOCS3 that can directly inhibit JAK/STAT3 pathway. Here, we investigated the effects of a fusion peptide that combined kinase inhibitory region (KIR) of SOCS3 and virus trans-activator of transcription (TAT) on biological behavior of cultured NSCs under inflammatory conditions. METHODS: NSCs were isolated from embryonic brain of SD rats, TAT-KIR was synthesized, and penetration rate was evaluated by flow cytometry (FACS). CCK8, immunostaining, and FACS were used to detected of TAT-KIR on the proliferation of NSCs. The expressions of GFAP and ß tubulin III positive cells induced by IL6 with/without TAT-KIR were examined by immunostaining and Western blotting to observe the NSCs differentiation, and the effect of TAT-KIR on signaling cross talk was observed by Western blotting. RESULTS: Penetration rate of TAT-KIR into primary cultured NSCs was up to 94%. TAT-KIR did not affect the growth and viability of NSCs. It significantly reduced the NSCs proliferation that enhanced by IL-6 stimulation via blocking the cell cycle progression from the G0/G1 to S phase. In addition, TAT-KIR attenuated astrocytic differentiation and kept high level of neuronal differentiation derived from IL-6-induced NSCs. The fate of NSCs differentiation under inflammatory conditions was affected by TAT-KIR, which was associated with synchronous inhibition of STAT3 and AKT, while promoting JNK expression. CONCLUSION: TAT-KIR mimetic of SOCS3 could be a promising approach for brain repair via regulating the biological behaviors of exogenous NSCs.

Periodontitis aggravates renal inflammatory response in a mouse model of renal fibrosis.

OBJECTIVES: To assess the effects of periodontitis on renal interstitial fibrosis in a mouse model. MATERIALS AND METHODS: Thirty C57BL/6 male mice were divided into control, periodontitis (PD), unilateral ureteral ligation (UUO) and PD+UUO groups. Unilateral ureteral ligation was performed 6 days after periodontitis. After 2 weeks, all mice were sacrificed, and samples were collected for the assessment of gene expression, immune cells, biochemical indicators and renal pathology. RESULTS: Expression of tumour necrosis factor-α, interleukin-1ß, and Ly6G in the kidneys in the PD+UUO group was significantly greater than in the UUO group. The percentage of CD11b+ Ly6G+ cells was significantly higher in the PD+UUO than in the UUO group. Fibrotic areas in the kidneys in the PD+UUO group were slightly, but not significantly, greater than those in the UUO group. Kidneys from the PD+UUO group showed markedly higher gene expression of matrix metalloproteinase-9, but not α-smooth muscle actin or collagen I, than those in the UUO group. There were no significant differences in blood urea nitrogen, serum creatinine and uric acid between the PD+UUO and UUO groups. CONCLUSIONS: Periodontitis increases the renal inflammatory response without showing a significant influence on renal interstitial fibrosis or renal function in the UUO mouse model.

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.

[Investigation and analysis on the status of conducting clinical research among oral health professionals].

PURPOSE: To understand oral health professionals' knowledge, attitude, behavior and training needs related to clinical research, and explore relevant factors affecting clinical research knowledge level. METHODS: An online self-designed questionnaire was conducted among oral health professionals from the collaborative innovation network member units of the National Clinical Research Center for Oral Diseases (Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine). The data were processed with SAS 9.4 software package. RESULTS: A total of 281 oral health professionals were enrolled in the study. Most of them had a positive attitude towards clinical research, 80% of them had an idea of carrying out clinical research, while only 22.8% of them implemented finally. The main causes restricting oral health professionals from conducting clinical research were lack of time (68.3%), insufficient teams (63.7%), and short of financial support (60.9%). Participants' mean score of clinical research knowledge was (13.72±7.20) points. Multiple linear regression model showed the type of hospital, clinical research participation in the past five years and epidemiologists' or statisticians' involvement in the latest project were related to participants' knowledge level of clinical research. CONCLUSIONS: Oral health professionals have a positive attitude towards clinical research, while their behavior and knowledge about clinical research were weak. Strengthening the top design of clinical research is inseparable from the cultivation of professionals' clinical research ability. The national clinical research center should give full play to the mission of the "national team", accelerate the establishment of a specialized, normalized and large-scale clinical research training pattern, and provide training opportunities to network member units.

[Characteristics of clinical trials of mucosal melanoma registered in WHO ICTRP].

PURPOSE: To analyze the characteristics of clinical trials of mucosal melanoma (MM) based on WHO international clinical trial registration platform (ICTRP), in order to provide a reference for clinical translational research of mucosal melanoma. METHODS: WHO ICTRP database were searched to collect MM-related clinical trials. Two reviewers independently screened items, extracted data, and descriptive analysis was performed for the included trials, including number of registrations, research phase, country/region, clinical study design, etc. RESULTS: The results showed that there were 51 registered clinical trials involving MM. European and American countries and East Asia were the main study sites, and head and neck MM were mainly investigated in East Asia (11/12). Forty-eight of them were sponsored by investigators, and only 3 were sponsored by biomedical companies. The main clinical trials were single center (42 items) and in stage II (38 items). Interventions were complex, and multiple treatments and drug therapy accounted a dominant position. CONCLUSIONS: In-depth analysis of clinical trials information can help to understand the current situation and development trends in the field of mucosal melanoma. The number of clinical studies of mucosal melanoma is relatively small and has not received much attention.

Prevalence and Associated Factors of Tooth Wear in Shanghai.

OBJECTIVE: To estimate the prevalence and distribution of tooth wear among groups of adolescents and adults in Shanghai, China through an epidemiological survey, and explore the associated factors. METHODS: Multistage, stratified, constant volume and cluster sampling methods were used in an epidemiological survey conducted in Shanghai in 2014. The basic erosive wear examination (BEWE) index was used to screen for tooth wear in different age groups: 12 years, 15 years, 18 to 35 years, 36 to 49 years and 50 to 74 years. A previously published questionnaire collected information including dietary habits, oral hygiene habits and general conditions. RESULTS: This survey reports the results for 1806 participants in Shanghai. The prevalence of tooth wear was 59.7% in adolescents (BEWE ≥ 1) and 93.1% in adults (BEWE ≥ 2). The prevalence and severity of disease increased with age (P < 0.01). The teeth most susceptible to wear were the central incisors and first molars. Multivariate analysis of covariance (ANCOVA) results showed that soft drinks, alcoholic drinks, pickled vegetables and hard food, gastroesophageal reflux disease (GERD), xerostomia and poor tooth brushing habits were statistically correlated with tooth wear in different age groups. CONCLUSION: The prevalence of tooth wear appears to be high in adolescents and adults in Shanghai. Frequent consumption of soft or alcoholic drinks, GERD, xerostomia and poor tooth brushing habits were positively associated with tooth wear in different age groups.

[The effect of chronic kidney disease on periodontitis-related microorganisms in mice].

PURPOSE: To explore the effect of chronic kidney disease on the composition of oral microbial community in mice and find the significant species. METHODS: Twenty C57BL/6 male mice were randomly divided into 4 groups: healthy control group (HC), periodontitis group (PD), chronic kidney disease group (CKD) and chronic kidney disease and periodontitis group (CKD+PD). The periodontitis model was created in the fourth week when the chronic kidney disease model was established, and then the mice were sacrificed in the sixth week. Histopathological analysis of the kidney was performed by H-E staining and Masson's trichrome staining. Alveolar bone resorption of maxilla was analyzed by micro-CT analysis. The third-generation full-length sequencing of 16SrRNA gene was used to analyze the composition of oral microbial community among groups. Statistical analysis was performed using SPSS 24.0 software package. RESULTS: There were significant differences in alveolar bone resorption, the richness of species and the overall composition of the microbial community among the four groups (P＜0.001). In CKD group, Streptococcus azizii had the most significant abundance. Escherichia coli was the most significantly different species among identifiable bacteria in CKD+PD group, while Staphylococcus lentus and Lactobacillus murinus were species with the most significant differences in HC group and PD group, respectively. CONCLUSIONS: The composition of the oral microbial community was significantly different among four groups with significant species.

Relationship between periodontal disease and male infertility: A case-control study.

OBJECTIVES: To compare the prevalence of chronic periodontitis between men who had semen abnormalities and those who had normozoospermia through a case-control study. MATERIALS AND METHODS: Male patients who visited the assisted reproduction clinic of a large general hospital and were diagnosed with semen abnormalities were included in the case group. The control group was composed of patients of the same clinic with normozoospermia. The semen analysis included sperm concentration, count and progressive and total motility, which were measured in the laboratory. A questionnaire and clinical periodontal examination were conducted for all participants. Logistic regression was performed to explore the relationship between chronic periodontitis and male infertility. RESULTS: A total of 192 participants were included: 63 participants (32.8%) had some type of semen abnormality (case group), while 129 participants (67.2%) had normozoospermia (control group). The case group had a significantly higher prevalence of moderate/severe periodontitis than the control group (33.3% vs. 17.8%, p = .012). The logistic regression showed that participants who had moderate/severe periodontitis had a greater chance of having semen abnormalities after adjusting for other confounding factors (OR = 3.377, p = .005). CONCLUSIONS: Periodontitis is associated with semen abnormalities and sperm motility in men.

[Instructions for clinical research of oral diseases under the first level response to public health emergencies].

Corona virus disease 2019(COVID-19) has swept across our country and local governments have successively initiated first level response to public health emergencies. The outbreak of COVID-19 poses a huge challenge to the implementation of various clinical researches including oral diseases. In view of the specialty of oral diseases, it is particularly necessary to protect the health and rights of the participators and related practitioners, and to standardize the implementation of clinical trials. Based on the normative standards issued by the National Health Commission of China, consensus on clinical trial management formulated by the organization of clinical research, and regulations for the diagnosis and treatment of oral diseases during public health emergencies by Chinese Stomatological Association, we drafted the guideline for clinical research of oral diseases, with a view to provide reference for the clinical studies of oral diseases under the first level response to major public health emergencies.

[A comparative study of the relationship of mothers' and infants' risk of dental caries between Shanghai and Kunming].

PURPOSE: To compare the differences of influence of mothers' different socio-demographic background, their oral health status and feeding behavior on their one-month-old infants' risk of dental caries between Shanghai and Kunming, and to explore the factors affecting infants' risk of dental caries in different regions. METHODS: One-month-old infants and their mothers from Huangpu district of Shanghai and Xishan district of Kunming were recruited in the study. Oral plaque samples of mothers and their infants were collected to assess their risk of dental caries. Statistical analysis was performed using SPSS 22.0 software package, and multivariate logistic regression analysis was used to screen the factors affecting the risk of infantile rickets in Shanghai and Kunming. RESULITS: A total of 165 mother-child pairs in Shanghai and 161 mother-child pairs in Kunming participated in the survey, and the proportion of infants who were at high risk of caries was 10.3% and 6.2%, respectively. The result of multivariate logistic analysis indicated that the infants whose mother smoked before pregnancy (OR=6.9, P=0.030) and attained lower education level (OR=6.1, P=0.035) had higher risk of caries in Shanghai; while in Kunming, the infants whose mother had higher DMFS values were at higher risk of caries (OR=1.1, P=0.031). CONCLUSIONS: Factors affecting one-month-old infants' risk of caries in Shanghai and Kunming were pre-pregnancy maternal cigarette smoking, mother's lower education level and mother's dental caries status, respectively.

Alcohol Induces More Severe Fatty Liver Disease by Influencing Cholesterol Metabolism.

Objectives. Fatty liver disease (FLD) is a major cause of morbidity and mortality worldwide. Dietary cholesterol and alcohol consumption are important risk factors for the progression of FLD, but whether and how alcohol induces more severe FLD with cholesterol ingestion remain unclear. Herein, we mainly used the Lieber-DeCarli diet to establish the FLD mouse model to investigate the synergistic effects of alcohol and cholesterol metabolism on liver damage. The indices of aspartate transaminase (AST), alanine transaminase (ALT), low-density lipoprotein cholesterol (LDL-c), and total cholesterol (TC) levels, inflammation foci, and pathogenesis by hematoxylin and eosin (H&E) and Oil Red O staining revealed that alcohol induces more severe liver damage by influencing cholesterol metabolism, which might be primarily related to the influence of cholesterol absorption, synthesis, and excretion on the liver or small intestine. Moreover, inhibition of absorption of intestinal cholesterol, but not of fat, sucrose, and alcohol, absorption into the body's metabolism by Ezetimibe, significantly improved FLD in rats fed with the high fat-cholesterol-sucrose and alcohol diet. These results showed that alcohol plays an important role in cholesterol metabolism in FLD.

Two new species of Ceropales (Ceropales) Latreille (Hymenoptera, Pompilidae), with a key to species from China.

Two new species in the Ceropales helvetica species-group are described: Ceropales (Ceropales) longisulcata Lu Li, sp. nov. from Inner Mongolia, China and Ceropales (Ceropales) yunnanensis Lu Li, sp. nov. from Yunnan, China. A key to the species of Ceropales (C.) from China is provided.

The 4th National Oral Health Survey in the Mainland of China: Background and Methodology.

Oral disease patterns change over time and it is important to conduct epidemiological surveillance population surveys regularly to monitor the situation. The overall objectives of the present survey were: (1) to describe the oral health status of Chinese children and adults in the 2015-2016 4th National Oral Health Survey; (2) to investigate the oral health knowledge, attitudes, and behaviours among children and adults; (3) to explore the association among sociodemographic characteristics, oral health behaviours, and the oral health status of Chinese children and adults. A national oral health survey was conducted among a representative sample of Chinese children and adults. Local residents from the five age groups - 3 to 5 years, 12 to 15 years, 35 to 44 years, 55 to 64 years, and 65 to 74 years - were selected. A multi-stage cluster sampling method was adopted for the identification of participants. All 31 provinces, autonomous regions and municipalities of the mainland of China were included. All participants were clinically examined and information on their oral health status, including oral mucosal lesions, dental caries experience, periodontal health status, dental fluorosis, and dental prosthesis status, was collected according to the procedures and criteria recommended by the World Health Organization (WHO). A calibration training programme and quality control procedures were conducted to ensure the reliability of the findings. Information on sociodemographic background, oral health behaviours, knowledge and attitude was also collected from all five age groups through a questionnaire survey.

Simvastatin Attenuates Neurogenetic Damage and Improves Neurocongnitive Deficits Induced by Isoflurane in Neonatal Rats.

BACKGROUND/AIMS: Isoflurane inhibited neurogenesis and induced subsequent neurocognitive deficits in developing brain. Simvastatin exerts neuroprotection in a wide range of brain injury models. In the present study, we investigated whether simvastatin could attenuate neurogenetic inhibition and cognitive deficits induced by isoflurane exposure in neonatal rats. METHODS: Sprague-Dawley rats at postnatal day (PND) 7 and neural stem cells (NSCs) were treated with either gas mixture, isoflurane, or simvastatin 60 min prior to isoflurane exposure, respectively. The rats were decapitated at PND 8 and PND 10 for detection of neurogenesis in the subventricular zone (SVZ) and subgranular zone (SGZ) of the hippocampus by immunostaining. NSC proliferation, viability and apoptosis were assessed by immunohistochemistry, CCK-8 and TUNEL, respectively. The protein expressions of caspase-3, p-Akt and p-GSK-3ß both in vivo and vitro were assessed by western blotting. Cognitive functions were assessed by Morris Water Maze test and context fear conditioning test at the adult. RESULTS: Isoflurane exposure inhibited neurogenesis in the SVZ and SGZ, decreased NSC proliferation and viability, promoted NSC apoptosis and led to late cognitive deficits. Furthermore, isoflurane increased caspase-3 expression and decreased protein expressions of p-Akt and p-GSK-3ß both in vivo and in vitro. Pretreatment with simvastatin attenuated isoflurane-elicited changes in NSCs and cognitive function. Co-treatment with LY294002 reversed the effect of simvastatin on NSCs in vitro. CONCLUSION: We for the first time showed that simvastatin, by upregulating Akt/GSK-3ß signaling pathway, alleviated isoflurane-induced neurogenetic damage and neurocognitive deficits in developing rat brain.

Herpesviruses in etiopathogenesis of aggressive periodontitis: A meta-analysis based on case-control studies.

OBJECTIVE: Previous studies have found that herpesviruses are associated with aggressive periodontitis (AgP). However, these findings are controversial. This meta-analysis was aimed at clarifying the association between herpesviruses and AgP. METHODS: We identified eligible case-control studies evaluating the association between herpesviruses and AgP from PubMed and Embase databases in October 2015. Original data were extracted and quality assessment was done. Overall odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Random-effects model was determined. The stability was evaluated by sensitivity analysis. Finally, Egger's funnel plot was used to investigate the publication bias. RESULTS: Twelve case-control studies involving 322 patients and 342 controls were included in the present meta-analysis. The included case-control studies were assessed as high quality. The quantitative synthesis results for Epstein-Barr virus (EBV) showed significance (10 studies: p = 0.0008, OR = 6.11, 95% CI = 2.13-17.51); nevertheless, evidence of publication bias for EBV was considerable (EBV: Egger's test, p<0.001). Human cytomegalovirus (HCMV) and Herpes simplex virus type 1 (HSV-1) had significant association with AgP (12 studies for HCMV: p = 0.009, OR = 3.63, 95% CI = 2.15-6.13; 4 studies for HSV-1: p<0.001, OR = 19.19, 95% CI = 4.16-79.06). Sensitivity analyses showed the results yielded consistency, and no significant publication bias was observed for HCMV. The association between Herpes simplex virus type 2 (HSV-2) and AgP was inconclusive (2 studies: p = 0.20, OR = 3.46, 95% CI = 0.51-23.51). CONCLUSION: This meta-analysis suggests that HCMV and HSV-1 are significantly associated with AgP. However, due to the heterogeneity among studies these conclusions should be cautiously interpreted. There is insufficient evidence to draw any conclusion between EBV, HSV-2 and AgP based on the currently limited data.

[A survey on knowledge, attitude and practice related to evidence-based dentistry among dental students].

PURPOSE: To investigate the knowledge, attitude and practice related to evidence-based dentistry among dental students, and to provide a reference for targeted evidence-based dentistry teaching and practice evidence-based dentistry in dental students. METHODS: Dental students who attended the internship in Shanghai Ninth People's Hospital and Pudong People's Hospital were invited to attend this survey. Information on knowledge, attitude and practices related evidence-based dentistry was collected through questionnaires. SPSS 21.0 software package was used for data analysis. RESULTS: A total of 62 dental students attended this survey. Evidence-based dentistry related knowledge and attitude scores were 5.5±1.9 and 5.1±1.0, respectively. Over three quarters of students took courses on evidence-based medicine, while around half of students (56.5%) self-reported that they knew little about evidence-based medicine. 70.5% students practiced evidence-based dentistry less than once in the process of clinical decision making per week. The majority of students (80.3%) used MEDLINE or other databases to search for practice-related literature less than once per week. 63.9% students used practice guideline. The top three barriers to practice evidence-based dentistry were lack of information resources, insufficient time and lack of search skills. CONCLUSIONS: Evidence-based dentistry related knowledge and practice among dental students is deficient, whereas they hold positive attitude on practice. The top three barriers to practice evidence-based dentistry are lack of information resources, insufficient time and lack of search skills.