BRTO assisted endoscopic Histoacryl injection in treating gastric varices with gastrorenal shunt.

AIMS: We evaluated the feasibility, efficacy and safety of a novel technique of balloon-occluded retrograde transvenous obliteration (BRTO) assisted endoscopic Histoacryl (N-buthyl-2-cyanoacrylate) injection. MATERIAL AND METHODS: A total with 11 patients were enrolled and analyzed in this single center, open-label, prospective study. Patients with high-risk gastric varices (defined as fundal varices, large GV (>5 mm), presence of a red spot, and Child-Pugh score C) and concurrent gastrorenal shunt underwent endoscopic Histoacryl injection while the gastrorenal shunt was temporarily occluded with an occlusion balloon. Feasibility, hemostatic effect, intra- and postoperative complications, and varices recurrence were evaluated. RESULTS: All procedures were successfully done per protocol. Except for one patient who underwent rescue Histoacryl injection due to residual varices, single therapy was sufficient to eliminate gastric varices in ten patients. Intra-operative hemorrhage occurred in one case and was stopped after additional Histoacryl injection. One patient was confirmed to have treatment-related fungemia. No death or major complications occurred, including ectopic embolism, worsening of hepatic and renal function, etc. No recurrence of the varices was found during a median follow-up time (mean ± SD) of 228 ± 153 days. CONCLUSIONS: BRTO assisted endoscopic Histoacryl injection is effective and safe for patients with high-risk gastric varices and concurrent gastrorenal shunt.

Mechanical properties of thin films of laser-welded titanium and their associated welding defects.

The aim of this study was to evaluate the mechanical properties of thin films of laser-welded cast titanium using an interference strain/displacement gauge (ISDG) and to analyze factors that affect laser welding. Dog-bone-shaped small specimens of cast titanium were prepared by wire cutting after they were laser-welded. The specimens were divided into three groups according to the gap distance of the laser weld; the control was non-welded titanium. Small specimens without cast defects detected by X-ray screening were measured by a tensile test machine using ISDG, and stress-strain curves were drawn. Finally, the fracture texture was analyzed. The ultimate tensile strengths (UTSs) of specimens with a gap distance of 0.00, 0.25, and 0.50 mm were 492.16 ± 33.19, 488.09 ± 43.18, and 558.45 ± 10.80 MPa, respectively. There were no significant differences in UTS between the test groups and the control group (p > 0.05). However, the plastic deformation and the percent elongation increased as the gap distance increased. Incomplete penetration defects appeared in groups that had small gap distances, which may have affected the properties of the laser-welded titanium. However, the welding material was still pure titanium. These results suggest that an appropriate gap distance should be maintained to improve the application of dental laser welding.

Construction of a competency framework of dental hygienists: A Delphi study.

AIM: To explore the basic and core competencies of dental hygienists, construct a systematic and scientific competency framework for dental hygienists taking into account China's national conditions and provide a theoretical basis for the future training in China and other countries that have not yet established the competencies of dental hygienists. BACKGROUND: The establishment of dental hygienists role is essential for the public to improve the dental health level. Currently, more than 50 countries around the world have established the role of dental hygienists and defined the core competencies needed by dental hygienists. However, studies on developing a standardized and unified consensus of competencies of dental hygienists are lacking in China. METHODS: Based on the literature review and theoretical research, this study explored the theoretical basis and fundamental principle of constructing the competency framework for dental hygienists. Moreover, a correspondence questionnaire on dental hygienists' competency framework was initially constructed to clarify the specific content of each competency. Finally, the Delphi method was adopted to establish the indicators of the dental hygienists' competency framework according to the principle of expert selection and inclusion criteria. RESULTS: The three rounds of Delphi consultation experts were from nursing, stomatology and management and other fields. Three rounds of Delphi results showed that the expert authority, enthusiasm and coordination coefficients were high. Thereafter, a competency framework of dental hygienists with 4 primary indicators, 15 secondary indicators and 50 tertiary indicators was constructed, which included theoretical knowledge, professional skills, professional abilities and occupational qualities. CONCLUSION: Literature and theoretical research methods along with Delphi expert consultation were used to construct the competency framework of dental hygienists based on the onion model. The competency framework of dental hygienists was scientific, reasonable and practical, which is consistent with the current health situation in China and has distinct Chinese characteristics. Some of our findings, offer ideas for other developing countries that have not yet set up the role of dental hygienists or are in an initial stage.

A species of the genus Panophrys (Anura, Megophryidae) from southeastern Guizhou Province, China.

Herein, we describe Panophrys congjiangensis sp. nov. obtained from the Yueliangshan Nature Reserve, Congjiang County, Guizhou Province, China. Phylogenetic analyses based on the mitochondrial genes 16S rRNA and COI indicated that this new species represented an independent lineage, closely related to P. leishanensis. The uncorrected genetic distances between the new species and its closest congener, P. leishanensis, were 3.0% for 16S rRNA and 8.4% for COI. The new species is distinguished from its congeners by a combination of the following morphological characteristics (1) medium body size (SVL 28.6-33.4 mm in males and 38.4-40.2 mm in females); (2) a small horn-like tubercle at the edge of each upper eyelid; (3) the tympanum distinctly visible (TD/ED ratio 0.47-0.66); (4) vomerine teeth absent; (5) the tongue not notched behind; (6) a narrow and unobvious lateral fringe on toes; (7) relative finger lengths II < I < V < III; (8) rudimentary webs on toes; (9) hindlimbs slender, heels overlapping when thighs are positioned at right angles to the body; (10) two metacarpal tubercles on the palm, with the inner metatarsal tubercle long and oval-shaped; (11) the tibiotarsal articulation reaching the nostril when the leg is adpressed and stretched forward; (12) dorsal skin rough with numerous orange-red granules, ventral surface smooth; (13) a single internal subgular vocal sac present in males; and (14) in breeding males, weak gray-black nuptial pads with black nuptial spines present on the dorsal surface of the bases of the first and second fingers. To date, the new species is only known from the type locality.

[Effect of bite force on the periodontal tissue remodeling of molar with different levels of periodontal attachment ment].

OBJECTIVE: The theory of strain energy density (SED) was combined with finite element analysis to investigate alveolar bone remodeling of the mandibular first molar with different levels of periodontal attachment under mastication loading. METHODS: Three-dimensional finite element models of the mandibular first molar with different levels of periodontal attachment were established. Based on SED theory, the user material subroutine (UMAT) (used by ABAQUS software) was developed by ourselves to simulate the remodeling process of mandibular bone. The stress distributions and bone density changes were analyzed under different mastication loading. The influence of loading magnitude on alveolar bone remodeling with different levels of periodontal attachment was investigated. RESULTS: The results showed that the neck of buccal, lingual regions and root apex area experienced a higher stress. The stress and the density of alveolar bone increased gradually with the enhancing of the bite force at the beginning. Then the density would appear declining when the bite force exceeded the extreme load. The extreme load reduced from 420 N to 240 N with the periodontal attachment falling from normal to 1/2 of root length also. And the remodeling rate of the bone was faster as the loading increasing. CONCLUSION: The capability of the periodontal tissue for supporting the teeth will drop gradually as the periodontal attachment level dropping. And the decline of bone density also appeared in earlier time. The change of density is associated with mastication loading during the bone remodelling. And reducing the occlusal force properly to the molar with different attachment level is benefit for clinical treatment and prognosis of periodontal disease.

The remodeling of alveolar bone supporting the mandibular first molar with different levels of periodontal attachment.

The objective of this study was to investigate alveolar bone remodeling of the mandibular first molar with differing levels of periodontal attachment under mastication loading. Three-dimensional finite element models of the mandibular first molar with differing levels of periodontal attachment were established. The stress distributions and bone density changes were analyzed under mastication loading to simulate the remodeling process of mandibular bone based on the theory of strain energy density. The results showed that the alveolar buccal, lingual ridges and root apex areas experienced higher stresses. The stresses and densities of the alveolar bone increased proportionally to increased mastication loading. Decrease in alveolar bone density under extreme loading indicated bone resorption. The remodeling rate was continual with gradual loading. Periodontal ligament support marginally decreased with an increased remodeling rate under extreme loading. Changes in alveolar bone density can reflect the remodeling process of periodontal tissue under mastication loading. The relationship between the change in density and mastication loading during remodeling can provide useful indicators into clinical treatment and diagnosis of the periodontal disease.

[Numeric simulation of functional remodeling of the anterior alveolar bone].

OBJECTIVE: To study the remodeling of the anterior alveolar bone with parodontium under physiology loading using finite element method (FEM) and theory of bone remodeling. METHODS: A FEM model of the maxillary central incisor with parodontium was established, and the change of bone density during the remodeling of alveolar bone was investigated under physiology loading (60 - 150 N) based on the theory of bone remodeling about strain energy density (SED). The finite element analysis software Abaqus user material subroutine (UMAT) were used. RESULTS: With the increase of physiology loading, the pressure stress on the buccal cervical margin increased gradually while the density was decreased gradually. The cortical bone was lower than its initial density 1.74 g/cm(3), which was 1.74 - 1.63 g/cm(3). The density of cancellous bone was 0.90 - 0.77 g/cm(3), which was lower than its intial density 0.90 g/cm(3). The lingual cervical margin was under tensile stress which also increased with loading, the density had no significant change. When the achieve to 120 N, the density of cortical bone was 1.74 - 1.73 g/cm(3). No significant change was found in the cancellous bone. CONCLUSIONS: The simulation of the perodontium remodeling is achieved and proved to be effective by the relevant research based on the method of the study. And the result will be helpful to form the basis of analysis bone remodeling process and predict the results in the clinical work.

Alpha interferon is a powerful adjuvant for a recombinant protein vaccine against foot-and-mouth disease virus in swine, and an effective stimulus of in vivo immune response.

The adjuvant effect of porcine interferon-alpha (PoIFN-alpha) was examined in swine vaccinated with a recombinant FMD protein vaccine named IgG-FMDV, which contains the swine IgG single heavy chain constant region and an immunogenic peptide of serotype O FMDV. The PoIFN-alpha gene was cloned into pcDNA3 vector and the recombinant plasmid was incorporated into cationic liposomes by a dehydration and rehydration procedure to use as an adjuvant, injected together with low-dose IgG-FMDV. This procedure resulted in strong induction of FMDV-specific neutralizing antibody and significant T-cell-mediated immune responses, whereas only a modest humoral and cellular response was observed with low-dose vaccine alone. As an adjuvant for the protein vaccine, PoIFN-alpha induced strong inflammatory cytokines production in vivo and the results denoted that IFN-adjuvant and our vaccines could drive the immune response toward Th1 type responses. The data of ELISA suggests that the recombinant protein vaccine synergizes with the IFN-adjuvant to produce endogenous IFN in vivo. In response to viral challenge, all control animals developed viremia and lesions, whereas all animals received IFN-adjuvant+IgG-FMDV were protected and nonstructural protein antibody in this group could not be detected by 14 days post-challenge (dpc). Our studies indicate that porcine IFN-alpha is a powerful adjuvant for recombinant FMD protein vaccine and could aid in vaccination against FMDV in swine.