Oral health status of 12-year-old children in Lisu minority ethnic group in China: a cross-sectional study.

BACKGROUND: Lisu is an ethnic minority group and most of them are living in Yunnan, China. This study investigated the oral health status among 12-year-old Lisu children in Yunnan. METHOD: This survey employed a multistage sampling method to recruit 12-year-old Lisu children. Two calibrated dentists performed the oral examinations in the primary schools. They examined dental caries, gingival bleeding and dental fluorosis using the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed to the children to collect their sociodemographic background information and oral health-related behaviours. A chi-square test, the Mann-Whitney U test, zero-inflated negative binomial (ZINB) regression and multivariate logistic regression were used for statistical analysis. RESULTS: This survey invited 512 children, and 482 children (48% boys) participated in the study (response rate: 94%). Their caries prevalence was 35% and their caries experience in mean (SD) DMFT scores was 0.63 (0.10). The mean (SD) DT score was 0.60 (1.10), consisting 95% of the mean DMFT scores. No dental fluorosis was observed; whereas 426 children (88%) had gingival bleeding. Results of ZINB model indicated sex and sugary-snacking habits were related to the dental caries experience (p < 0.05). The gingival-bleeding prevalence was associated with the mother's education level, the child's monthly-pocket money and daily toothbrushing frequency (p < 0.05). CONCLUSION: Dental caries and gingival bleeding were prevalent among 12-year-old Lisu children in the Yunnan province in China, and most of the decayed teeth were unrestored. Dental fluorosis was not observed in the children.

Two-year follow-up of a randomized multicenter study comparing a drug-coated balloon with a drug-eluting stent in native small coronary vessels: The RESTORE Small Vessel Disease China trial.

OBJECTIVES: To report the clinical outcomes of the RESTORE drug-coated balloon (DCB; Cardionovum, Bonn, Germany) for treatment of de novo small vessel disease (SVD) beyond 1 year. BACKGROUND: Previous reports have demonstrated the noninferiority of the RESTORE DCB to the RESOLUTE Integrity drug-eluting stent (DES; Medtronic, Minneapolis, Minnesota) in terms of 9-month in-segment percent diameter stenosis. METHODS: In the prospective, multicenter, noninferiority RESTORE SVD China trial, 230 patients with visually-estimated reference vessel diameter (RVD) ≥2.25 and ≤2.75 mm were randomized to DCB or DES in a 1:1 ratio stratified by diabetes and number of lesions treated. Furthermore, 32 patients with RVD ≥2.00 and <2.25 mm were enrolled in a nested very small vessel (VSV) registry. Clinical follow-up were performed at 2 years to evaluate target lesion failure (TLF) in both groups and the VSV cohort. RESULTS: Overall, 256 (97.7%) patients (115 and 109 in the DCB and DES groups, respectively, and 32 in the VSV cohort) completed 2 years of follow-up. There was no significant difference in TLF between the DCB and DES groups (5.2 vs. 3.7%, p = .75). Target lesion revascularization was acceptable at 1 month, 1 year, and 2 years, and did not differ significantly with DCB from that in the DES group (0.9 vs. 0%, p = 1.0, 4.4 vs. 2.6%, p = .72, 5.2 vs. 2.8%, p = .50, respectively). CONCLUSIONS: Compared to the second-generation DES, the RESTORE DCB did not increase the risk of clinical outcomes. Late catch-up phenomen requiring revascularization was not significant in this study.

Hyaluronic acid-coated polymeric micelles with hydrogen peroxide scavenging to encapsulate statins for alleviating atherosclerosis.

Inflammation and oxidative stress are two major factors that are involved in the pathogenesis of atherosclerosis. A smart drug delivery system that responds to the oxidative microenvironment of atherosclerotic plaques was constructed in the present study. Simvastatin (SIM)-loaded biodegradable polymeric micelles were constructed from hyaluronic acid (HA)-coated poly(ethylene glycol)-poly(tyrosine-ethyl oxalyl) (PEG-Ptyr-EO) for the purpose of simultaneously inhibiting macrophages and decreasing the level of reactive oxygen species (ROS) to treat atherosclerosis. HA coating endows the micelle system the ability of targeting CD44-positive inflammatory macrophages. Owing to the ROS-responsive nature of PEG-Ptyr-EO, the micelles can not only be degraded by enzymes, but also consumes ROS by itself at the pathologic sites, upon which the accumulation of pro-inflammatory macrophages is effectively suppressed and oxidative stress is alleviated. Consequently, the cellular uptake experiment demonstrated that SIM-loaded HA-coated micelles can be effectively internalized by LPS-induced RAW264.7 cells and showed high cytotoxicity against the cells, but low cytotoxicity against LO2 cells. In mouse models of atherosclerosis, intravenously SIM-loaded HA-coated micelles can effectively reduce plaque content of cholesterol, resulting in remarkable therapeutic effects. In conclusion, the SIM-loaded micelle system provides a promising and innovative option against atherosclerosis.

Jaw reconstruction with vascularized fibular flap: The 11-year experience among 104 patients.

BACKGROUND: A vascularized fibular osteomyocutaneous flap with severe vascular crisis often results in serious consequences. This study aims to examine the clinical effect of non-vascularized fibular graft on patients with severe vascular crisis after reconstruction of the defect jaw with vascularized fibular osteomyocutaneous flap. MATERIALS AND METHODS: From December 2007 to December 2018, a total of 104 patients with jaw neoplasms that underwent reconstruction with free vascularized fibular flap were retrospectively analyzed; seven of these cases had postoperative vascular crisis during mandibular reconstruction. RESULTS: Of the seven cases with postoperative vascular crisis, the vascularized fibular flaps in three patients survived completely, thanks to early detection; two cases were completely necrotic and removed in the end, and the remaining two cases had severe vascular crisis after the removal of the soft tissue attached to the fibular flap. The non-vascular fibular grafts were retained regardless of the severe absorption after follow-ups for 25 and 69 months, respectively. CONCLUSIONS: If vascular crisis occurs following jaw reconstruction with a vascularized fibular osteomyocutaneous flap, early re-surgical exploration effectively improves the salvage rate. In addition, when a severe vascular crisis occurs, the vascularized fibular flap can be changed to a non-vascular fibular graft to reconstruct the mandibular defect, thus avoiding the serious consequences resulting from the complete failure of fibular graft.

Effect of technetium-99 conjugated with methylene diphosphonate (99 Tc-MDP) on OPG/RANKL/RANK system in vitro.

BACKGROUND: RANKL and RANK play an important role in jaw resorption during the development of the ameloblastomas. Therefore, the aim of this study was to explore the effect of 99 Tc-MDP on OPG/RANKL/RANK system on RAW264.7 and MC3T3-E1 cell lines in vitro and provide the theoretical basis for the clinical treatment of the jaw ameloblastoma. METHODS: Different concentrations of 99 Tc-MDP were used to treat RAW264.7 and MC3T3-E1 cell lines. The cell proliferative inhibition rate was analyzed by CCK-8. Cell apoptosis and cell cycle were detected by flow cytometry. Western blot was used to detect the expression of OPG, RANKL, and RANK. RESULTS: Treatment of RAW264.7 cell lines with different concentrations of 99 Tc-MDP had inhibitory effects and decreased the expression of RANK protein. The cell proliferation of 99 Tc-MDP on MC3T3-E1 cell lines was stronger at 48 hours than at 24 hours except for 100 µg/mL concentration group. Compared with the concentration of 0.01 µg/mL, the treatment of MC3T3-E1 cells with 100 µg/mL 99 Tc-MDP showed that the cell proliferative effect decreased at 24 hours and 48 hours (P < 0.05). After treatment with 0.01 µg/mL 99 Tc-MDP, the expression of OPG in MC3T3-E1 cells was significantly increased (P < 0.05). Compared with 0.01 µg/mL, the expression of RANKL was decreased after treatment with 100 µg/mL 99 Tc-MDP (P < 0.05). CONCLUSION: 99 Tc-MDP can induce apoptosis of RAW264.7 cells and inhibit the expression of RANK protein. The effect of 0.01 µg/mL of low concentration of 99 Tc-MDP can promote the proliferation of MC3T3-E1 cells and increase the expression of OPG and RANKL protein. 99 Tc-MDP may have adjuvant therapeutic effects on the treatment of jaw ameloblastoma.

Transmasseteric Anterior Parotid Approach for Treatment of Mandibular Subcondylar Fractures.

This study demonstrated the application of transmasseteric anterior parotid approach for open reduction of mandibular subcondylar fractures depending on the basis of the anatomical study of the temporomandibular joint and parotid gland area. The anatomical study was performed on 5 Chinese adult cadavers fixed by 10% formalin. The temporomandibular joints and parotid regions were studied. In the clinical study, 26 patients with mandibular subcondylar fractures were recruited between July 2014 and December 2017. All 26 patients with mandibular subcondylar fractures received satisfactory occlusions and normal mouth opening: no postoperative facial paralysis occurred in these patients. It is crucial to know the anatomy of both temporomandibular joint and parotid region for reducing significantly the surgical trauma and complications. Transmasseteric anterior parotid approach is a feasible approach for the surgical treatment of the mandibular subcondylar fractures. This method can provide adequate exposure, minimal facial nerve injury, open reduction easily, and inconspicuous scarring.

Dental and periodontal status of 12-year-old Dai school children in Yunnan Province, China: a cross-sectional study.

BACKGROUND: The Dai people are one of the ethnic minorities in China and have a population of 1,260,000. They have the same origin as one of the main ethnic groups in Laos and Thailand. The study aims to describe the dental caries and gingival status of 12-year-old Dai children in China and to study the factors affecting their oral-health status. METHODS: This cross-sectional oral-health survey was conducted from 2011-2012 with ethics approval. A sample of 12-year-old Dai children living in Yunnan, China, was selected using a multistage and cluster sampling method. One trained examiner performed the clinical examination. Caries experience was measured using DMFT index, and gingival status was assessed with CPI index. A self-completed questionnaire was sent to the children, and they were asked about their backgrounds and oral-health-related behaviors and oral-health knowledge. Binary logistic regression analysis was performed to investigate the factors that affected the caries status. RESULTS: A total of 875 children were invited, and 823 (94 %) joined the survey. The prevalence of caries experience among the participants was 40 %. The mean DMFT and DT scores were 0.9 and 0.8, respectively. Most children (93 %) had gingivitis, and many (46 %) had calculus. Girls and those who had visited a dentist during the previous year had a higher prevalence of caries. CONCLUSION: Dental caries were prevalent among 12-year-old Dai children in China. The periodontal condition of most of the children was poor. Caries were associated with gender and dental attendance.

Biolimus-coated versus paclitaxel-coated balloons for coronary in-stent restenosis (BIO ASCEND ISR): a randomised, non-inferiority trial.

BACKGROUND: The treatment of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation remains challenging in current clinical practice. AIMS: The study was conducted to investigate a novel biolimus-coated balloon (BCB) for the treatment of coronary DES-ISR compared with the best-investigated paclitaxel-coated balloon (PCB). METHODS: This was a prospective, multicentre, randomised, non-inferiority trial comparing a novel BCB with a clinically proven PCB for coronary DES-ISR. The primary endpoint was in-segment late lumen loss (LLL) at 9 months assessed by an independent core laboratory. Baseline and follow-up optical coherence tomography were performed in a prespecified subgroup of patients. RESULTS: A total of 280 patients at 17 centres were randomised to treatment with a BCB (n=140) versus a PCB (n=140). At 9 months, LLL in the BCB group was 0.23±0.37 mm compared to 0.25±0.35 mm in the PCB group; the mean difference between the groups was -0.02 (95% confidence interval [CI]: -0.12 to 0.07) mm; p-value for non-inferiority<0.0001. Similar clinical outcomes were also observed for both groups at 12 months. In the optical coherence tomography substudy, the neointimal area at 9 months was 2.32±1.04 mm2 in the BCB group compared to 2.37±0.93 mm2 in the PCB group; the mean difference between the groups was -0.09 (95% CI: -0.94 to 0.76) mm2; p=non-significant. CONCLUSIONS: This head-to-head comparison of a novel BCB shows similar angiographic outcomes in the treatment of coronary DES-ISR compared with a clinically proven PCB. (ClinicalTrials.gov: NCT04733443).

Chemiexcited Photodynamic Therapy Integrated in Polymeric Nanoparticles Capable of MRI Against Atherosclerosis.

Background: Photodynamic therapy (PDT) has achieved continued success in the treatment of tumors, but its progress in the treatment of atherosclerosis has been limited, mainly due to the low tissue-penetration ability of the excitation light for photosensitizers. Methods: In this study, we designed a chemiexcited system producing singlet oxygen in an attempt to apply PDT for the treatment of atherosclerosis without the irradiation of external light. The system designed was polymeric nanoparticles (NPs) equipped with chemical fuel and photosensitizers, cross-linked with an Fe3+-catechol complex for stabilization and magnetic resonance imaging (MRI). Results: The system (FeCNPs for short) accumulated effectively in plaques, providing persistent and enhanced T 1-weighted contrast ability. FeCNPs also prevented progression of atherosclerosis via macrophage elimination, and obviously reduced plaque size and thickness revealed by T 1-weighted MRI. Expression of CD68, MCP1, and TNFα was significantly reduced after treatment. However, low doses of FeCNPs exhibited better therapeutic efficacy than high doses. Furthermore, low-dose FeCNPs exhibited effective macrophage elimination in aortic arches and abdominal aortae, but inefficiency in the thoracic aorta, aortic hiatus, and aorta-iliac bifurcation. Conclusion: This study provides the first example of a combination of MRI and chemiexcited PDT for atherosclerosis, evidencing the effectiveness of PDT and providing significant pointers for developing nanotherapy on atherosclerosis.

Thermally stable AgI quantum-dot-based room-temperature fast ionic conductors.

AgI quantum dot (QD)-based room-temperature fast ionic conductors are prepared via an aqueous route. New phase behavior and good performance are found in this material. This is a prototype of quantum dot-ionics.

Oral Health Status of 12-Year-Old Hani Children in the Yunnan Province of China: A Cross-Sectional Study.

BACKGROUND: The aim of this cross-sectional study was to investigate the oral health status of Hani 12-year-old children in Yunnan, a province in Southwest China. METHOD: This study employed a multistage sampling method to recruit children from local primary schools. Two calibrated dentists examined the status of dental caries, gingival bleeding and dental fluorosis by adopting the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed. The chi-square test and multivariate logistic regression were conducted. RESULTS: This study invited 480 Hani children, and recruited 413 children (52% boys) (response rate: 86%). The dental caries prevalence was 52%, and the caries experience associated with the mean (standard deviation) decayed, missing and filled teeth (DMFT) score was 1.10 (1.46). Gingival bleeding was diagnosed in 252 children (61%), and dental fluorosis was found in two children (0.5%). The results of the regression model indicated the prevalence of dental caries were associated with sugary snacking habits (p = 0.002). The prevalence of gingival bleeding was related to the mother's education level as well as the child's monthly pocket money (p < 0.05). CONCLUSION: Dental caries and gingival bleeding were prevalent among 12-year-old Hani children in the Yunnan province in China. Dental fluorosis was uncommon.

Drug-Coated Balloon Versus Drug-Eluting Stent for Small-Vessel Disease: The RESTORE SVD China Randomized Trial.

OBJECTIVES: The aim of this study was to evaluate the angiographic efficacy and clinical outcomes of the Restore paclitaxel-coated balloon in a randomized trial designed to enable its approval with an indication for small-vessel disease (SVD). BACKGROUND: Higher rates of restenosis and stent thrombosis limit the effectiveness of drug-eluting stent (DES) treatment of SVD. Whether a drug-coated balloon (DCB)-only strategy is effective in de novo SVD is not yet established. METHODS: In the noninferiority RESTORE SVD China trial, eligible patients with reference vessel diameter ≥2.25 and ≤2.75 mm were randomized to the Restore DCB or the RESOLUTE Integrity DES in a 1:1 ratio stratified by diabetes and number of lesions treated. Patients with RVD ≥2.00 and <2.25 mm were enrolled in a nested very small vessel registry. Angiographic and clinical follow-up were planned at 9 months and 1 year, respectively, in all patients. The study was powered for the primary endpoint of 9-month in-segment percentage diameter stenosis. RESULTS: Between August 2016 and June 2017, a total of 230 subjects at 12 sites were randomized to the DCB group (n = 116) or DES group (n = 114); 32 patients were treated with the DCB in the very small vessel cohort. Nine-month in-segment percentage diameter stenosis was 29.6 ± 2.0% with the DCB versus 24.1 ± 2.0% with the DES; the 1-sided 97.5% upper confidence limit of the difference was 10.9%, achieving noninferiority of the DCB compared with the DES (p for noninferiority < 0.001). The DCB and DES had comparable 1-year rates of target lesion failure (4.4% vs. 2.6%, p = 0.72). CONCLUSIONS: In this multicenter randomized trial, the Restore DCB was noninferior to the RESOLUTE DES for 9-month in-segment percentage diameter stenosis. (Assess the Efficacy and Safety of RESTORE Paclitaxel Eluting Balloon Versus RESOLUTE Zotarolimus Eluting Stent for the Treatment of Small Coronary Vessel Disease; NCT02946307).

[Study on a novel vascular stent material (titanium oxide, Ti-O) coated with albumin and heparin: is it hemocompatible with fibrinogen].

The functional hemocompatibility between fibrinogen (FIG) and a novel vascular stent material (Ti-O film fixed with albumin and heparin) was investigated as follows: (1) Preparing the new biologic material (Ti-O) film; (2) Coating albumin and heparin on the Ti-O film; (3) Testing platelets (PL) adsorption; (4) Determining FIG adhesion number by use of enzyme linked immunoassay (ELISA); (5) Implanting the films from the test group of Ti-O film and from the comparison group of stainless steel (SS) film into the left and right femoral arteries respectively in 4 dogs. It was proved that albumin and heparin were fixed on Ti-O film. After 6 months, the femoral arteries of the dogs were resected. In the test group of Ti-O film coated with albumin and heparin, few PL adhered to the coat, their form did not change, and no thrombus was found by scanning electron microscopy; the result was better than that of plain Ti-O film, and was much better than that of SS film. Ti-O maintained normal transformation condition of FIG, and no C terminal of gamma chain in FIG was revealed. As it is known whether the hemocompatibility of a biomaterial is good depends upon its adsorption of FIG, and Ti-O has excellent reaction on albumin and heparin by chemical processes. In this study, the Ti-O film coated with albumin and heparin further reduced the absorption of FIG and PL when compared against the plain Ti-O film. So the Ti-O film coated with albumin and heparin has the insistent and permanent anticoagulant character.

Positive End-Expiratory Pressure Effect of 3 High-Flow Nasal Cannula Devices.

BACKGROUND: High-flow nasal cannula (HFNC) is supposed to provide additional PEEP compared with conventional oxygen therapy. However, the exact determinants of this PEEP effect are unclear. We investigated the factors that might affect the PEEP and compared PEEP performance among 3 HFNC devices. METHODS: Three available HFNC devices were evaluated: the AIRVO 2 device and 2 mechanical ventilators (SV300 and Monnal T75). A device consisting of a test lung (5600i) and an airway model (AMT(IE)) was used to simulate spontaneous breathing. The flows ranged from 0 to their maximum flow with an interval of 10 L/min. The pressures were measured at 4 sites (nasopharynx, supraglottis, carina, and lung) under compliances of 50 and 100 mL/cm H2O and tidal volume of 300, 500, and 700 mL with the mouth closed or open. The influencing factors were determined by multiple linear regression. The sum of squares reduction test was used to compare working curves of PEEP effect among 3 devices. Pairwise comparisons were conducted by using Tukey's multiple comparisons test within an overlap of flow from 0 to 50 L/min. RESULTS: A quadratic curved relationship between PEEP and flow was observed (coefficients were 8.97 × 10-3 for flow and 4.79 × 10-4 for a quadratic element of flow, respectively) but evanished when the mouth was open. The PEEP increased along with lung compliance (coefficient was 2.58 × 10-3). Despite the difference in working curves, both the mechanical ventilators performed slightly better than the AIRVO 2 device at higher flows (40 and 50 L/min). CONCLUSIONS: The mouth status, flow, and compliance were the 3 major influencing factors of PEEP effect, whereas performance of the 2 mechanical ventilators was slightly superior to that of the AIRVO 2 device at higher flows.

[Treatment of mandibular angle fracture through intraoral and extraoral approach: a comparative study].

PURPOSE: To compare the clinical effects of mandibular angle fracture surgery through intraoral and extraoral approach. METHODS: From January 2008 to December 2014, 46 patients with mandibular angle fracture were retrospectively recruited in this study. An intraoral approach was used in 22 cases as group 1 in whom the fractures were fixed by one titanium miniplate alone, the others through an extraoral approach as group 2 in whom the fractures were fixed by two plates. Intermaxillary traction was used in all patients for 3 weeks following the operation. The data was collected in MS Excel 2003 and further analyzed by SPSS13.0 software package. RESULTS: The wound healing was in uneventful group 1, no complication occurred 3 weeks later. On the contrary, 5 cases with postoperative infection and 3 cases with temporary weakness of facial nerve were observed in the group 2. Three months later, postoperative panoramic radiographs showed mandible fractures healed well in group 1; while in group 2, three cases complained of unhealed fractures and unsatisfactory occlusion. CONCLUSIONS: Compared with extraoral approach to manage mandibular angle fracture with 2 miniplates, one miniplate through intraoral approach can provide better outcomes.

One-pot, template-free synthesis of Pd-Pt single-crystalline hollow cubes with enhanced catalytic activity.

Hollow structures have attracted ever-growing interest owing to their various excellent properties. However, a facile strategy for their fabrication is still desired. Herein, Pd-Pt alloy with three different morphologies, that is, cubes, hollow cubes, and truncated octahedrons, is synthesized by using a one-pot, template-free method. The mechanism and dynamics of this system is also studied in detail. In particular, the hollow cubic structure represents enhanced catalytic activity in both coupling reactions and in the electrochemical oxidation of formic acid.