Anemia as a risk factor for restenosis in femoropopliteal arterial disease after drug-coated balloon angioplasty.

OBJECTIVE: This study aimed to investigate the relationship between anemia and restenosis in patients with femoropopliteal arterial disease following drug-coated balloon (DCB) angioplasty. METHODS: 194 patients treated with DCB for femoropopliteal lesions were retrospectively analyzed for up to 12 months of follow-up between January 2017 and September 2020. Baseline clinical and procedural characteristics were compared between the anemia and non-anemia patients, and predictors of restenosis were identified using logistic regression. RESULTS: 32.5% of the patients undergoing DCB angioplasty had anemia. Patients with anemia were significantly older, with higher rates of hypertension, coronary artery disease, chronic renal insufficiency, and diabetes, and with lower rates of smoking and male gender. In the multivariate analysis, anemia was independently and significantly associated with a higher risk of restenosis (OR, 3.872; 95% CI, 1.556-9.638; P = 0.004). CONCLUSION: Anemia is independently associated with restenosis in patients treated with DCB for femoropopliteal arterial disease. Patients with lower baseline hemoglobin might have more chances to develop restenosis at follow-up.

Serum M2BPGi level is a novel predictive biomarker for the responses to pegylated interferon-α treatment in HBeAg-positive chronic hepatitis B patients.

Serum Mac-2-binding protein glycosylation isomer (M2BPGi) level was found to be a useful prognostic marker for hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients treated with nucleoside/nucleotide analogs (NUCs) therapy, and the aim of our study is to evaluate the clinical implementation of M2BPGi level in the prediction of antiviral responses to pegylated-interferon-α (PEG-IFN-α) treatment in HBeAg-positive CHB patients. Ninety-six CHB patients who received PEG-IFN-α treatment for at least 48 weeks were recruited. The serum M2BPGi, alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), HBeAg, and HBV DNA levels at baseline, weeks 4, 12, and 24 after PEG-IFN-α treatment were determined and their associations with antiviral responses were evaluated and the virological response (VR) rate and serological response (SR) rate after 48 weeks of treatment were 65.6% and 35.4%, respectively. Baseline serum M2BPGi level was significantly different between VR and non-VR (P = 0.002) or SR and non-SR groups (P = 0.012). Multivariate analyses suggested that baseline serum M2BPGi level was independently associated with VR and SR of PEG-IFN-α treatment at week 48. The area under the ROC curve (AUC) of baseline M2BPGi was 0.682 in predicting VR, which was superior to HBsAg (AUC = 0.566) or HBV DNA (AUC = 0.567). The AUC of baseline M2BPGi in predicting SR was 0.655, which was also higher than that of HBsAg (AUC = 0.548) or HBV DNA (AUC = 0.583). These results suggested that baseline serum M2BPGi level was a novel predictor of VR and SR for PEG-IFN-α treatment in HBeAg-positive CHB patients.

Patterning Electrospun Nanofibers via Agarose Hydrogel Stamps to Spatially Coordinate Cell Orientation in Microfluidic Device.

A straightforward, inexpensive, and reliable approach to pattern electrospun nanofibers via solvent-containing agarose hydrogel stamps is reported. Complex hierarchical microstructures can be further constructed via appropriate multistep permutation of microcontact patterning and electrospinning. As a proof-of-concept application, the patterned electrospun nanofibers are employed to spatially coordinate cell orientation in microfluidic devices.

Overcoming ABC transporter-mediated multidrug resistance: Molecular mechanisms and novel therapeutic drug strategies.

Multidrug resistance is a key determinant of cancer chemotherapy failure. One of the major causes of multidrug resistance is the enhanced efflux of drugs by membrane ABC transporters. Targeting ABC transporters projects a promising approach to eliminating or suppressing drug resistance in cancer treatment. To reveal the functional mechanisms of ABC transporters in drug resistance, extensive studies have been conducted from identifying drug binding sites to elucidating structural dynamics. In this review article, we examined the recent crystal structures of ABC proteins to depict the functionally important structural elements, such as domains, conserved motifs, and critical amino acids that are involved in ATP-binding and drug efflux. We inspected the drug-binding sites on ABC proteins and the molecular mechanisms of various substrate interactions with the drug binding pocket. While our continuous battle against drug resistance is far from over, new approaches and technologies have emerged to push forward our frontier. Most recent developments in anti-MDR strategies include P-gp inhibitors, RNA-interference, nano-medicines, and delivering combination strategies. With the advent of the 'Omics' era - genomics, epigenomics, transcriptomics, proteomics, and metabolomics - these disciplines play an important role in fighting the battle against chemoresistance by further unraveling the molecular mechanisms of drug resistance and shed light on medical therapies that specifically target MDR.

Determination of a Newborn with Lethal Type II Osteogenesis Imperfecta and Other Anomalies Using Autopsy and Postmortem MSCT--A Case Report.

A case of a stillbirth with lethal type II osteogenesis imperfecta (OI) was reported. The fetus had skull fractures and craniocerebral injuries during pregnancy. Postmortem multi-sliced computed tomography (MSCT) and 3D-reconstruction were performed, followed by a medico-legal autopsy. The autopsic findings showed the typical features of type II OI, including a soft calvarium, deformed extremities, flexed and abducted hips, and uncommon features, such as white sclera, coxa vara, absence of several bones and organs, a cleft lip, and asymmetric ears. The radiologic images revealed such anomalies and variations as a cleft palate, mandibular dysplasia, spina bifida, costa cervicalis, and fusion of the ribs and vertebrae, which were difficult to detect during conventional autopsy. The paper investigated the classification, causative mutation, cause of death, and the differentiation of OI from child abuse, coming to a conclusion that OI knowledge can be of great importance to forensic pathologists and that the merits of postmortem MSCT should be emphasized in forensic pathologic examinations.

Effective Spatial Separation of PC12 and NIH3T3 Cells by the Microgrooved Surface of Biocompatible Polymer Substrates.

Most organs and tissues are composed of more than one type of cell that is spatially separated and located in different regions. This study used a microgrooved poly(lactic-co-glycolic acid) (PLGA) substrate to guide two types of cocultured cells to two spatially separated regions. Specifically, PC12 pheochromocytoma cells are guided to the inside of microgrooves, whereas NIH3T3 fibroblasts are guided to the ridge area in between neighboring parallel microgrooves. In addition, the microgrooved structures can significantly promote the proliferation and neural differentiation of PC12 cells as well as the osteogenic differentiation of NIH3T3 cells. Therefore, the microgrooved PLGA surface with separated PC12 and NIH3T3 cells can serve as a potential model system for studying nerve reconstruction in bone-repairing scaffolds.

Paclitaxel liposome, cisplatin and 5-fluorouracil-based induction chemotherapy followed by de-escalated intensity-modulated radiotherapy with concurrent cisplatin in stage IVA-IVB childhood nasopharyngeal carcinoma in endemic area: a phase II, single-arm trial.

Background: Previous studies demonstrated that induction chemotherapy (IC) followed by de-escalated chemoradiotherapy adapted to tumor response was effective in treating childhood nasopharyngeal carcinoma (NPC), but the toxicity profile of this treatment strategy, and whether childhood patients with advanced stages can obtain enough benefits from it requires further investigation. Methods: We conducted a single-center phase II trial (NCT03020329). All participants received 3 cycles of paclitaxel liposome, cisplatin and 5-fluorouracil (TPF)-based IC. Patients who showed complete or partial response received de-escalated radiotherapy of 60 Gy with 3 cycles of concurrent cisplatin, and those who showed stable or progressive disease received standard-dose radiotherapy of 70 Gy with concurrent cisplatin. The primary endpoint was the complete response (CR) rate at the end of concurrent chemoradiotherapy (CCRT). Findings: From November 2016 to March 2021, 44 patients were recruited in the cohort. The CR rate was 80% (35/44, 95% CI, 65-90) of the whole cohort. All patients achieved CR 3 months after CCRT. By the last follow-up, the 3-year progression-free survival and overall survival were 91% (95% CI, 82-99) and 100% respectively. Dry mouth was the most common late toxicity, with an incidence of 41% (18/44), followed by skin fibrosis and hearing impairment. No patient suffered from severe late toxicity and growth retardation. Interpretation: Our results proved the efficacy and safety of TPF regimen followed by de-escalated radiotherapy with concurrent cisplatin in treating stage IVa-b childhood NPC patients. Funding: A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.

Reduced-dose radiotherapy for Epstein-Barr virus DNA selected staged III nasopharyngeal carcinoma: A single-arm, phase 2 trial.

BACKGROUND: Radiotherapy-related toxicities of nasopharyngeal carcinoma (NPC) caused by a standard dose of 70 Gy remain a critical issue. Therefore, we assessed whether a radiotherapy dose of 60 Gy was non-inferior to the standard dose in patients with low-risk stage III NPC with a favourable response to induction chemotherapy (IC). PATIENTS AND METHODS: We did a single-arm, single-centre, phase II clinical trial in China. Patients with low-risk (Epstein-Barr virus [EBV] DNA level <4000 copies/ml) stage III NPC were treated with two cycles IC. Patients with complete/partial response and undetectable EBV DNA level were assigned 60 Gy intensity-modulated radiotherapy concurrently with three cycles of cisplatin. The primary end-point was 2-year progression-free survival (PFS). This trial is registered with ClinicalTrials.gov, number NCT03668730. RESULTS: One patient quit because of withdrawal of informed consent after IC. In total, 215 patients completed two cycles of IC, after which 116 (54.0%) and 99 (46.0%) patients were assigned 60 and 70 Gy radiotherapy, respectively. For 215 patients, the 2-year PFS was 90.7% (95% CI, 86.8%-94.6%) with a median follow-up of 43.9 months (interquartile range [IQR], 39.8-46.2). For patients treated with 60 Gy radiotherapy, the 2-year PFS rate was 94.8% (95%CI 90.7%-98.9%) with a median follow-up of 43.9 months (IQR 40.2-46.2). The most common late toxicity was grade 1-2 dry mouth (incidence rate: 54.3%). No grade 3+ long-term adverse event was observed, and most quality-of-life items, domains, and symptom scores returned to baseline by 6 months. CONCLUSION: Reduced-dose radiation (60 Gy) is associated with favourable survival outcomes and limited treatment-related toxicities in patients with low-risk stage III NPC sensitive to IC.

Supramolecular aggregation/disaggregation-based molecular sensing: a review focused on investigations from China.

Supramolecular aggregation and disaggregation induced by external stimuli can impact the optical or electrical signals of the aggregates/constituting units (receptors). Therefore, manipulating supramolecular aggregation/disaggregation has recently been employed to construct novel and promising photoluminescence (PL)-based sensing and recognition systems. The sensing systems were capable of substantially enhancing the sensitivity, relying on cooperative interactions occurring in the assembly/disassembly processes (mostly operating in emission turned-on or emission-enhanced mode). This review focuses mainly on recent advances in the new emerging PL-based sensing platforms, based on manipulating the behaviours of supramolecular aggregation/disaggregation, including aggregation-induced emission (AIE), metallophilic interactions-related sensing (metallophilic interactions-induced aggregation/disaggregation), metal coordination polymers-related sensing, and other sensing systems involving supramolecular aggregation/disaggregation. In particular, those sensing systems developed by scientists in China are summarized and highlighted.

Pulmonary hemorrhagic infarction due to fat embolism and thromboembolism after maxillofacial plastic surgery: a rare case report.

Pulmonary fat embolism (PFE) and pulmonary thromboembolism (PTE) are common post-operative complications of orthopedic surgical procedures, but are reported less often following maxillofacial plastic surgical procedures, especially with respect to PFE. Thrombi, or together with fat emboli in pulmonary vessels can induce hemorrhagic infarction and cause death. Herein this report introduced a death due to pulmonary hemorrhagic infarction following maxillofacial plastic surgery. The female patient underwent several osteotomies of the mandible, zygomas and autologous bone grafting within a single operation. The operative time was longer than normal and no preventive strategies for pulmonary embolism were implemented. The patient died 20 days after hospital discharge. The autopsy confirmed pulmonary hemorrhagic infarction. The fat emboli and thrombi were also noted in the pulmonary vessels, which were thought to have resulted from the maxillofacial osteotomy. Suggestions were offered to forensic pathologists that risk factors of PFE and PTE, such as the type and length of surgery, the surgical sites, and the preventive strategies, should be considered when handling deaths after maxillofacial operations.

Dynamic Nanocomposite Microgel Assembly with Microporosity, Injectability, Tissue-Adhesion, and Sustained Drug Release Promotes Articular Cartilage Repair and Regeneration.

Owing to the lack of blood vessels, nerves, and lymph, articular cartilage defect is difficult to self-repair. Although several cartilage tissue engineering products have been authorized for clinical use, there are still some problems such as large surgical wounds, weak adhesion with the host tissue, and the limited source of autologous chondrocytes. In this paper, a novel dynamic nanocomposite microgel assembly with excellent microporosity, injectability, tissue-adhesion, and sustained kartogenin (KGN) release is reported. Specifically, KGN-loaded cyclodextrin nanoparticles are synthesized through nanoemulsification and incorporated into bone marrow mesenchymal stem cell (BMSCs)-laden microgels via droplet-based microfluidics and photo-crosslinking, which are then bottom-up assembled via dynamic crosslinking between dopamine-modified hyaluronic acid and phenylboronic acid groups on microgel surface. Results reveal that the microgel assembly can avoid the cell endocytosis of nanoparticles, ensure the high BMSC viability during the regular cell culture, cryopreservation and injection process, promote the chondrogenic differentiation of BMSCs. In addition, animal expriment proves the newborn cartilages present the typical characteristics of articular cartilage. In brief, this microgel assembly not only offers convenience for clinical use (injectability, tissue adhesion) but also provides good microenvironments for chondrogenesis (controlled drug release, interconnected micropores), indicative of its promising application for cartilage repair and regeneration.

Co-transplantation of Islets-Laden Microgels and Biodegradable O2-Generating Microspheres for Diabetes Treatment.

Pancreatic islets transplantation is an optimal alternative to exogenous insulin injection for long-term effective type 1 diabetes treatment. However, direct islets transplantation without any protection can induce cell necrosis due to severe host immune rejection. Insufficient O2 supply induced by the lack of capillary network at the early stage of islets transplantation is another critical constraint limiting islets survival and insulin-secretion function. In this paper, we design a novel co-transplantation system composed of islets-laden nanocomposite microgels and O2-generating microspheres. In particular, nanocomposite microgels confer the encapsulated islets with simultaneous physical protection and chemical anti-inflammation/immunosuppression by covalently anchoring rapamycin-loaded cyclodextrin nanoparticles to microgel network. Meanwhile, O2-generating microspheres prepared by blending inorganic peroxides in biodegradable polycaprolactone and polylactic acid can generate in situ O2 gas and thus avoid hypoxia environment around transplanted islets. In vivo therapeutic effect of diabetic mice proves the reversion of the high blood glucose level back to normoglycemia and superior glucose tolerance for at least 90 days post co-transplantation. In brief, the localized drug and oxygen codelivery, as well as physical protection provided by our co-transplantation system, has the potential to overcome to a large extent the inflammatory, hypoxia, and host immune rejection after islets transplantation. This new strategy may have wider application in other cell replacement therapies.

Assembling Microgels via Dynamic Cross-Linking Reaction Improves Printability, Microporosity, Tissue-Adhesion, and Self-Healing of Microgel Bioink for Extrusion Bioprinting.

Extrusion bioprinting has been widely used to fabricate complicated and heterogeneous constructs for tissue engineering and regenerative medicine. Despite the remarkable progress acquired so far, the exploration of qualified bioinks is still challenging, mainly due to the conflicting requirements on the printability/shape-fidelity and cell viability. Herein, a new strategy is proposed to formulate a dynamic cross-linked microgel assembly (DC-MA) bioink, which can achieve both high printability/shape-fidelity and high cell viability by strengthening intermicrogel interactions through dynamic covalent bonds while still maintaining the relatively low mechanical modulus of microgels. As a proof-of-concept, microgels are prepared by cross-linking hyaluronic acid modified with methacrylate and phenylboric acid groups (HAMA-PBA) and methacrylated gelatin (GelMA) via droplet-based microfluidics, followed by assembling into DC-MA bioink with a dynamic cross-linker (dopamine-modified hyaluronic acid, HA-DA). As a result, 2D and 3D constructs with high shape-fidelity can be printed without post-treatment, and the encapsulated L929 cells exhibit high cell viability after extrusion. Moreover, the addition of the dynamic cross-linker (HA-DA) also improves the microporosity, tissue-adhesion, and self-healing of the DC-MA bioink, which is very beneficial for tissue engineering and regenerative medicine applications including wound healing. We believe the present work sheds a new light on designing new bioinks for extrusion bioprinting.

Deintensified Chemoradiotherapy for Pretreatment Epstein-Barr Virus DNA-Selected Low-Risk Locoregionally Advanced Nasopharyngeal Carcinoma: A Phase II Randomized Noninferiority Trial.

PURPOSE: Cumulative doses of 200 mg/m2 for concurrent cisplatin (DDP) were indicated by retrospective studies as sufficient in conferring survival benefit for locoregionally advanced nasopharyngeal carcinoma (LA-NPC). We performed an open-label, phase II, randomized, controlled trial to test the noninferiority of a two-cycle 100 mg/m2 concurrent DDP regimen over three-cycle in patients with low-risk LA-NPC with pretreatment Epstein-Barr virus DNA levels < 4,000 copies/mL. PATIENTS AND METHODS: Eligible patients were randomly assigned 1:1 to receive two cycles or three cycles concurrent DDP-based chemoradiotherapy. The primary end point was 3-year progression-free survival (PFS). The secondary end points included overall survival, distant metastasis-free survival, locoregional relapse-free survival, etc. RESULTS: Between September 2016 and October 2018, 332 patients were enrolled, with 166 in each arm. After a median follow-up of 37.7 months, the estimated 3-year PFS rates were 88.0% in the two-cycle group and 90.4% in the three-cycle group, with a difference of 2.4% (95% CI, -4.3 to 9.1, Pnoninferiority = .014). No differences were observed between groups in terms of PFS, overall survival, and the cumulative incidences of locoregional relapse and distant metastasis. Patients in the three-cycle group developed significantly more grade 3-4 mucositis (41 [24.8%] v 25 [15.1%]), hyponatremia (26 [15.8%] v 14 [8.4%]), and dermatitis (9 [5.5%] v 2 [1.2%]). The overall all-grade and grade 3-4 toxicity burdens were heavier in three-cycle group (T-scores, 12.33 v 10.57, P < .001 for all grades; 1.76 v 1.44, P = .05 for grade 3-4). Patients in the three-cycle group also showed more all-grade hearing impairment, dry mouth and skin fibrosis, and impaired long-term quality of life. CONCLUSION: Intensity-modulated radiotherapy plus two cycles of concurrent 100 mg/m2 DDP could be an alternative treatment option for patients with low-risk LA-NPC.

Metal-metal-interaction-facilitated coordination polymer as a sensing ensemble: a case study for cysteine sensing.

A detailed investigation of the absorption and CD signals of Ag(I)-cysteine (Cys) aqueous solutions at buffered or varying pH has allowed us to suggest that coordination polymers are formed upon mixing Ag(I) and Cys bearing a Ag(I)-Cys repeat unit. The formation of the coordination polymers are shown to be facilitated by both the Ag(I)···Ag(I) interaction and the interaction between the side chains in the polymeric backbone. The former allows for an immediate spectral sensing of Cys with enantiomeric discrimination capacity with both high sensitivity and selectivity, and the contribution of the side-chain/side-chain interaction serves to guide extended sensing applications by means of modulating this interaction. With our preliminary data on the corresponding Cu(I)-Cys and Au(I)-Cys systems that exhibited similar spectral signals, we conclude that the M(I)-SR coordination polymers (M = Cu, Ag, or Au) could in general function as spectral sensing ensembles for extended applications. This sensing ensemble involves the formation of coordination polymers with practically no spectral background, thus affording high sensing sensitivity and selectivity.

In Situ Formation of Microgel Array Via Patterned Electrospun Nanofibers Promotes 3D Cell Culture and Drug Testing in a Microphysiological System.

A microphysiological system (MPS) is recently emerging as a promising alternative to the classical preclinical models, especially animal testing. A key factor for the construction of MPS is to provide a biomimetic three-dimensional (3D) cellular microenvironment. However, it still remains a challenge to introduce extracellular matrix (ECM)-like biomaterials such as hydrogels and nanofibers in a precise and spatiotemporal manner. Herein, we report a strategy to fabricate a MPS combining both electrospun nanofibers and hydrogels. The in situ formation of microsized hydrogel (microgel) array in MPS is realized by patterning electrospun poly(l-lactic acid) (PLLA)/Ca2+ nanofibers via a solvent-loaded agarose stamp and injecting an alginate solution to trigger the quick ionic cross-linking between alginate and Ca2+ released from patterned nanofibers. The one-on-one integration of electrospun nanofibers and microgels not only provides a 3D cellular microenvironment in designated regions in MPS but also improves the stability of these microenvironments under dynamic culture. In addition, due to the biocompatible properties of an ionic cross-linking reaction, patterned cell array can be achieved simultaneously during the microgel formation process. A breast cancer model is then built in MPS by coculturing human breast cancer cells and human fibroblasts in microgel array, and its application in drug (cisplatin) testing is evaluated. Our data prove that MPS-MA offers a more precise platform for drug testing to evaluate the drug concentration, duration time, cancer microenvironment, etc, mainly due to its successful construction of the biomimetic 3D cellular microenvironment.

Tough thermoplastic hydrogels with re-processability and recyclability for strain sensors.

Tough hydrogels with the ability to be repeatedly processed into various shapes as thermoplastics are highly desired in advanced medical devices and tissue engineering. Here, we have developed a kind of versatile supramolecular hydrogel with a network cross-linked by double hydrogen bonds from poly(N-acryloyl glycinamide) (PNAGA). The resulting PNAGA-30 hydrogels (30 wt% solid content) are tough, re-processable, and recyclable similar to thermoplastics. The hydrogels in the form of fragments can be easily re-processed into various shapes including sheet, filament, cylinder and other complex shapes by using simple stamping and injection methods. The mechanical properties of the re-programed hydrogels are comparable to the properties of the original hydrogels. The re-processability and robust mechanical properties of the PNAGA hydrogels are promising for practical applications in soft materials, tissue engineering and wearable devices. Furthermore, the PNAGA-30&LiCl ionic hydrogels can be fabricated by simply compositing LiCl into thermoplastic hydrogels. The PNAGA-30&LiCl hydrogels can function as multifunctional strain sensors to monitor large human movements and tiny vibrations, thereby showing great application potential in robotics, biomedical prosthetics, personal healthcare monitoring and so on.

[Status of tooth loss, prosthodontic treatment and oral health-related quality of life of Shanghai elderly people].

PURPOSE: The aim of the present study was to investigate oral health status of the elderly in Shanghai using Eichner index dental classification system, and to discuss the relations between tooth loss, prosthodontic treatment and the impact on oral health-related quality of life(OHRQoL). METHODS: A total of 747 subjects aging 65-74 years old were selected by multistage stratified cluster sampling method. Clinical examination and questionnaires of the Fourth National Oral Health Survey of China were used for the study, and data of tooth loss, OHRQoL were analyzed using non-parametric test and binary logistic regression with SPSS 19.0 software package. RESULTS: 79.1% of the subjects had problem of missing teeth, while 35% of them never received any kind of dental prosthesis. Grouping by the Eichner index, only A1, A2 and C3 group were scored above the average, while group B had the lowest general oral health assessment index(GOHAI) score. The scores of GOHAI were significantly correlated to dental prosthodontic treatment, overall health status and Eichner index(P<0.05). Except for group C2 due to the small sample size, the scores of GOHAI in most of the untreated subjects were lower than those who had prosthesis. Among the subjects with missing teeth but without prosthesis, 81.2% of the subjects thought they had no problem with their teeth or the problem did not matter. CONCLUSIONS: Tooth loss is a serious problem among the elderly in Shanghai, but only a few of them have received dental prosthodontic treatment. The OHRQoL of the elderly is related to tooth loss, dental prosthodontic treatment and overall health. Oral health education should be strengthened for the elderly people with missing teeth, to replace their missing teeth timely and improve their quality of life.

A medical adhesive used in a wet environment by blending tannic acid and silk fibroin.

A multifunctional and effective medical adhesive with a combination of high toughness and superior adhesion is highly desired in biomedical fields. However, clinical application of medical adhesives is still limited due to their weak adhesion to wet tissue. In this study, a novel medical adhesive called TASK composed of tannic acid (TA) and silk fibroin (SF) based on polyphenol-gel systems was developed. TASK powder was prepared by a simple physical mixture of pyrogallol-rich tannic acid and silk fibroin in aqueous solution and further freeze drying, which was stable and convenient for sterilization before clinical application. The TASK composite gel was formed by just adding water to the TASK powder. TASK showed improved wet-adhesive properties and stability; its adhesion strength after 5 h in water reached 180.9 ± 27.4 kPa. ATR-FTIR results indicated that the plentiful phenolic hydroxyl groups in TA allowed TASK to maintain adhesion to tissue in a wet environment. Furthermore, no chemical modification or covalent cross-linking was required for this wet-adhesive TASK which may facilitate its clinical application.

[Early childhood caries and its related risk factors in 1 296 children aged 3 to 5 years old in Shanghai].

PURPOSE: To investigate the prevelence of early childhood caries (ECC) and its related risk factors in children aged 3 to 5 years old in Shanghai. METHODS: According to the requirements of the Fourth National Epidemiological Survey of Oral Health, multistage, stratified, equal capacity and simple random sampling method was performed. A total of 1 296 children aged 3, 4 and 5 years old in 12 kindergartens in Shanghai were selected to calculate the prevalence and the mean dmft(decayed-missing-filled tooth). Their parents were surveyed with questionnaire on oral hygiene habit and consciousness of oral health and related factors. Statistical analysis were performed using SPSS 21.0 software package. RESULTS: The prevalence of ECC were 58.07% in children aged 3 to 5 years old in Shanghai, with dmft index of 2.99 in average. There were significant differences in the mean dmft and the prevalence between male and female and among different age groups(P<0.05). In multivariate logistic regression analysis, more frequent sweet drinks, eating sweets before sleep, less daily tooth brushing, starting tooth brushing after 2 years old and low level of parents' education and oral health knowledge were risk factors for dental caries. CONCLUSIONS: The prevalence of ECC in children aged 3 to 5 years old in Shanghai is severe. There is an urgent need for implementation of a systematic education on diet habit and oral health behavior, and the parental education on oral hygiene needs to be further improved.