A double-blind comparative study of Chinese herbal medicine Jinlianqingre Effervescent Tablets in combination with conventional therapy for the treatment of uncomplicated hand, foot, and mouth disease.

Chinese herbal medicine Jinlianqingre Effervescent Tablets (JET) are the recommended control measure for uncomplicated hand, foot, and mouth disease (HFMD) by the Ministry of Health of China. However, high-quality evidence to support this recommendation is limited. A total of 288 patients ranging in age from 1 to 13 years were randomly assigned to JET in combination with conventional therapy (mainly including the reduction of temperature by applying physical cooling paste or warm bathing), or conventional therapy with placebo group for 7 days. The objective was to test the hypothesis that JET combination therapy is more effective than conventional therapy for uncomplicated HFMD. A randomized, double-blind, placebo-controlled trial was designed. Our study showed that, compared with conventional therapy, the median time to fever resolution was significantly shorter in the JET combination therapy (8 vs. 80 h; p < 0.0001); the risk of fever resolution increased in the JET combination therapy [hazard ratio, 19.8; 95% confidence interval (CI), 12.8 to 30.7]; the median healing time of rash or oral ulcer was significantly shorter in the JET combination therapy (14 vs. 74 h; p < 0.0001); and the median symptom score for skin or oral mucosa lesions improved more rapidly in the JET combination therapy during the follow-up period. The median duration of hospital stay was 6 days in the JET combination therapy and 7 days in the conventional therapy (p < 0.0001). No significant adverse events and complications were found in both groups. The addition of JET to conventional therapy reduced fever clearance time, healing time of skin or oral mucosa lesions, and duration of hospital stay in children with uncomplicated HFMD.

An intubation method for mono-pulmonary ventilation in patients with difficult airway.

OBJECTIVE: This study aimed to compare the clinical effect between thermal softening PVC double-lumen tube (DLT) and single-lumen tube (SLT) guided by laryngoscope and bronchoscopy in patients with difficult airways. PATIENTS AND METHODS: 72 patients with chest surgery in need of mono-pulmonary ventilation, aged 20-70 years old, with ASA rating I-III and Arné scoring ≥ 11, were enrolled. Patients were categorized randomly into two groups with 36 patients in each: the D group (DLT was used) and the S group (SLT was used). Bronchoscopy was used for guiding the intubation and aligning in both groups. Laryngoscope would also be used immediately after failure in two trials of intubation. Intubation resistance, intubation success rate, laryngoscopy assist rate, time for intubation, time for alignment, incidence of catheter dislocation, VAS score for post-operative throat pain, and the damage extent of vocal cord were recorded. RESULTS: No significant differences were seen between two the groups in terms of intubation resistance, intubation success rate, laryngoscopy assist rate, time for intubation, VAS score for post-operative throat pain, and the damage extent of vocal cord. However, shorter time for alignment and lower incidence of catheter dislocation were observed in the D group than in the S group (both p < 0.05). CONCLUSIONS: For intubation in patients with difficult airway, the thermal softening DLT was as safe as the SLT, but simpler in alignment and had a lower dislocation incidence. Meanwhile, video laryngoscope could increase the success rate of intubation with either tube.

[Epidemiological characteristics of hand, foot and mouth disease among people aged 6 and over in Beijing, 2011-2020].

Objective: To analyze the epidemiological characteristics of hand, foot and mouth disease (HFMD) among people ≥6 years old in Beijing from 2011 to 2020. Methods: The incidence data of HFMD cases from 2011 to 2020 were collected from the National Notifiable Infectious Disease Reporting System of China Information for Disease Control and Prevention and the etiological surveillance of HFMD in 29 sentinel hospitals from 16 districts of Beijing. Descriptive epidemiological methods were used to analyze the distributions, pathogen constituents, and changes of HFMD cases in Beijing people ≥6 years old. Results: From 2011 to 2020, a total of 38 183 cases of HFMD were reported among people ≥6 years old in Beijing, of which 46 (0.12%) cases were severe. The average annual reported incidence was 19.04/100 000. The ratio of males to females were 1.37∶1(22 064∶16 119). The proportion of HFMD in people ≥6 years old increased from 7.56%(2 606/34 488) in 2011 to 24.54% (546/2 225) in 2020. The average incidence of HFMD was higher in Shunyi district, Yanqing district, and Tongzhou district than in other districts in Beijing. The positive rate of enterovirus in sentinel surveillance was 66.78% (1 976/2 959), the proportion of enterovirus group A 71 (EV-A71) was 45.29% (101/223) in 2014, no EV-A71 positive was detected in 2020, and the proportion of Coxsackievirus A 6 (CV-A6) increased from 15.11% (34/225) in 2016 to 81.08% (60/74) in 2020. Conclusions: From 2011 to 2020, the proportion of cases with HFMD in people ≥6 years old in Beijing increased yearly, and the proportion of EV-A71 positive patients decreased basically. Since 2016, CV-A6 has gradually become the dominant pathogen. More attention should be paid to the epidemic situation and dynamic pathogen changes of hand foot mouth disease in people ≥6 years old.

[Summary of research in economic burden of hand, foot, and mouth disease in China].

Since 2010, the incidence of hand, foot, and mouth disease (HFMD) has ranked top in notifiable infectious disease in China, causing economic losses to many families and the society of China. This paper summarizes the related methods, results and problems systematically in the research of economic burden of HFMD in China to provide reference for the better estimation of the economic burden caused by HFMD. Many studies showed that HFMD, especially severe and fatal cases, had posed heavy economic burden on the society. To mitigate the burden caused by HFMD, it is necessary to decrease the risk of severe and fatal cases, as well as to reduce the incidence of mild cases.

[Trans-oral robotic submandibular gland removal].

Submandibular gland excision was performed on two patients using trans-oral robotic surgery (TORS). Complications such as the injury of marginal mandibular branch of facial nerve, ranula in the floor of the mouth, and postoperative hemorrhage were not observed. Visible cervical scar can be avoided and esthetic outcome can be expected by using this surgical modality.

Preparation and properties of biodegradable polymeric blends from poly(propylene carbonate) and poly(ethylene-co-vinyl alcohol).

Biodegradable blends of poly(propylene carbonate)/ethylene-vinyl alcohol copolymers (PPC/EVOH) were melt prepared. The mechanical strength, crystallization and melting behavior, morphologies, and thermal properties of these blends were fully investigated using tensile tester, modulated differential scanning calorimetry, scanning electron microscopy, and thermogravimetric analysis, respectively. The results indicated that the thermal stability of blends could be enhanced by increasing EVOH content. No change was observed for the tensile strength when EVOH content was lower than 30 wt %. The tensile strength, however, increased obviously with increasing EVOH content when EVOH content was higher than 30 wt %. The crystallization behavior of the PPC/EVOH blends was studied accordingly. The degradability test showed that the weight loss of PPC/EVOH blends increased with increasing EVOH content because of the strong moisture sorption of EVOH. Morphology observation indicated that the PPC/EVOH blends exhibited a two-phase microstructure. The blends with EVOH contents ranging from 40 to 60 wt % showed the best comprehensive properties as biodegradable thermoplastic for many applications.

[The application of laser in endodontics].

Since laser was introduced in the field of medicine in 1970's, its application range has continuously expanded. The application of laser in endodontics also increased due to its safety and effectiveness in dental treatments. The majority of the laser application researches in dentistry focused on dentin hypersensitivity, removal of carious tissues, tooth preparations, pulp capping or pulpotomy, and root canal treatment. In this article, we reviewed literature on the effects of laser in the treatments of dental and pulp diseases.

A favorable impact of preoperative FPLC chemotherapy on patients with gastric cardia cancer.

The aim of this study is to evaluate the effects of preoperative chemotherapy with fluorouracili polyphase liposome composita pro orale (FPLC) on the tumour cells and the survival rate of the patients with gastric cardia cancer. Sixty patients with gastric cardia cancer were randomly divided into two groups. Thirty patients were treated with FPLC prior to surgical resection, the other 30, as controls, did not receive the preoperative chemotherapy. Pathological responses of the tumours to the FPLC chemotherapy were determined by gross and microscopic assessments of tumour size, tumour emboli, cell degeneration and necrosis. Expressions of nm23 and CD44 were detected by flow cytometry. All patients were followed up to 5 years. In the FPLC-treated patients, the tumour size (p<0. 01), the number of tumour emboli (p=0.04) and the intensity of CD44 expression (p<0.001), were significantly reduced, while cell degeneration (p<0.001), necrosis (p<0.01) and the expression of nm23 (p<0.001) were increased, when compared with those observations seen in the controls. The postoperative 5-year survival rate was 40% in the FPLC-treated group and 23% in the controls (p=0.17). Preoperative FPLC chemotherapy might improve the survival rate of patients with gastric cardia cancer by inhibiting tumour proliferative, invasive and metastatic activities, and stimulating the patient's immune system.

PLGA/TCP composite scaffold incorporating bioactive phytomolecule icaritin for enhancement of bone defect repair in rabbits.

Bone defect repair is challenging in orthopaedic clinics. For treatment of large bone defects, bone grafting remains the method of choice for the majority of surgeons, as it fills spaces and provides support to enhance biological bone repair. As therapeutic agents are desirable for enhancing bone healing, this study was designed to develop such a bioactive composite scaffold (PLGA/TCP/ICT) made of polylactide-co-glycolide (PLGA) and tricalcium phosphate (TCP) as a basic carrier, incorporating a phytomolecule icaritin (ICT), i.e., a novel osteogenic exogenous growth factor. PLGA/TCP/ICT scaffolds were fabricated as PLGA/TCP (control group) and PLGA/TCP in tandem with low/mid/high-dose ICT (LICT/MICT/HICT groups, respectively). To evaluate the in vivo osteogenic and angiogenic potentials of these bioactive scaffolds with slow release of osteogenic ICT, the authors established a 12 mm ulnar bone defect model in rabbits. X-ray and high-resolution peripheral quantitative computed tomography results at weeks 2, 4 and 8 post-surgery showed more newly formed bone within bone defects implanted with PLGA/TCP/ICT scaffolds, especially PLGA/TCP/MICT scaffold. Histological results at weeks 4 and 8 also demonstrated more newly mineralized bone in PLGA/TCP/ICT groups, especially in the PLGA/TCP/MICT group, with correspondingly more new vessel ingrowth. These findings may form a good foundation for potential clinical validation of this innovative bioactive scaffold incorporated with the proper amount of osteopromotive phytomolecule ICT as a ready product for clinical applications.

Comparative study of osteogenic potential of a composite scaffold incorporating either endogenous bone morphogenetic protein-2 or exogenous phytomolecule icaritin: an in vitro efficacy study.

A local delivery system with sustained and efficient release of therapeutic agents from an appropriate carrier is desirable for orthopedic applications. Novel composite scaffolds made of poly (lactic-co-glycolic acid) with tricalcium phosphate (PLGA/TCP) were fabricated by an advanced low-temperature rapid prototyping technique, which incorporated either endogenous bone morphogenetic protein-2 (BMP-2) (PLGA/TCP/BMP-2) or phytomolecule icaritin (ICT) (PLGA/TCP/ICT) at low, middle and high doses. PLGA/TCP served as control. In vitro degradation, osteogenesis and release tests showed statistical differences among PLGA/TCP/ICT, PLGA/TCP and PLGA/TCP/BMP-2 groups, where PLGA/TCP/ICT had the desired slow release of bioactive icaritin in a dose-dependent manner, whereas there was almost no BMP-2 release from the PLGA/TCP/BMP-2 scaffolds. PLGA/TCP/ICT significantly increased more ALP activity, upregulated mRNA expression of osteogenic genes and enhanced calcium deposition and mineralization in rabbit bone marrow stem cells cultured on scaffolds compared with the other two groups. These results indicate the desired degradation rate, osteogenic capability and release property in PLGA/TCP/ICT composite scaffold, as icaritin preserved its bioactivity and structure after incorporation, while PLGA/TCP/BMP-2 did not show an initially expected osteogenic potential, owing to loss of the original bioactivity of BMP-2 during its incorporation and fabrication procedure. The results suggest that PLGA/TCP composite scaffolds incorporating osteogenic ICT might be a promising approach for bone tissue bioengineering and regeneration.

Biodegradable CaMgZn bulk metallic glass for potential skeletal application.

A low density and high strength alloy, Ca65Mg15Zn20 bulk metallic glass (CaMgZn BMG), was evaluated by both in vitro tests on ion release and cytotoxicity and in vivo implantation, aimed at exploring the feasibility of this new biodegradable metallic material for potential skeletal applications. MTT assay results showed that the experimental CaMgZn BMG extracts had no detectable cytotoxic effects on L929, VSMC and ECV304 cells over a wide range of concentrations (0-50%), whereas for MG63 cells concentrations in the range ~5-20% promoted cell viability. Meanwhile, alkaline phosphatase (ALP) activity results showed that CaMgZn BMG extracts increased alkaline phosphatase (ALP) production by MG63 cells. However, Annexin V-fluorescein isothiocyanate and propidium iodide staining indicated that higher concentrations (50%) might induce cell apoptosis. The fluorescence observation of F-actin and nuclei in MG63 cells showed that cells incubated with lower concentrations (0-50%) displayed no significant change in morphology compared with a negative control. Tumor necrosis factor-α expression by Raw264.7 cells in the presence of CaMgZn BMG extract was significantly lower than that of the positive and negative controls. Animal tests proved that there was no obvious inflammation reaction at the implantation site and CaMgZn BMG implants did not result in animal death. The cortical thickness around the CaMgZn BMG implant increased gradually from 1 to 4 weeks, as measured by in vivo micro-computer tomography.

Effect of water-soluble P-chitosan and S-chitosan on human primary osteoblasts and giant cell tumor of bone stromal cells.

Water-soluble phosphorylated chitosan (P-chitosan) and disodium (1 → 4)-2-deoxy-2-sulfoamino-ß-D-glucopyranuronan (S-chitosan) are two chemically modified chitosans. In this study, we found that P-chitosan significantly promotes cell proliferation of both human primary osteoblasts (OBs) and the OB like stromal cell component of the giant cell tumor of bone (GCTB) cells at the concentration from 125 to 1000 µg ml⁻¹ at all time points of 1, 3, 5 and 7 days after treatment. Further investigation of the osteogenic effect of the P-chitosan suggested that it regulates the levels of osteoclastogenic factors, receptor activator of nuclear factor kappa B ligand and osteoprotegerin expression. An interesting finding is that S-chitosan at lower concentration (100 µg ml⁻¹) stimulates cell proliferation while a higher dose (1000 µg ml⁻¹) of S-chitosan inhibits it. The inhibitory effect of S-chitosan on human primary GCT stromal cells was greater than that of OBs (p < 0.05). Taken together, our findings elucidated the osteogenic effect of P-chitosan and the varying effects of S-chitosan on the proliferation of human primary OBs and GCT stromal cells and provided us the rationale for the construction of novel bone repair biomaterials with the dual properties of bone induction and bone tumor inhibition.

Regulation of bone-related genes expression by bone-like apatite in MC3T3-E1 cells.

Bone-like apatite on HA/TCP ceramics sintered at 1,100 degrees C (HT1) and 1,200 degrees C (HT2) could be obtained via immersing substrates into simulated body fluid (SBF) for 3 days. When MC3T3-E1 preosteoblastic cells cultured on the surface of the bone-like apatite for 3 days, SEM observations revealed cell membrane features with secreted crystals very similar to in vivo bone formation during intramembranous ossification with a direct bone apposition on the ceramics. According to semi-quantitative RT-PCR method, mRNA expressions of osteocalcin (marker of late-stage differentiation) and type 1 collagen were increased in cultures with HT1S and HT2S when compared to HT1 and HT2 after cultured for 6 days. The results indicated that bone-like apatite had the ability to support the growth of osteoblast-like cells in vitro and to promote osteoblast differentiation by stimulating the expression of major phenotypic markers. Taken together, our findings will be helpful in understanding the mechanism of osteoinductivity of calcium phosphate ceramics and in constructing more appropriate biomimetic substrate.

[Flow cytometric analysis of DNA-ploidy in oral squamous cell carcinomas].

In an attempt to evaluate the significance of cellular DNA content as an objective prognostic indicator of oral squamous cell carcinomas, a retrospective analysis of 70 paraffin-embedded specimens using flow cytometry was performed. 41 patients (58.6%) had heteroploid tumors and 29 patients (41.4%) had diploid or nearly diploid DNA distribution pattern. There was significant difference in 5-year disease-free rate between patients with heteroploid and diploid or nearly diploid tumors, and the relationship between heteroploid and cervical metastasis approached statistical significance (0.10 greater than P greater than 0.05). The DNA content had no correlation with histologic grade, clinical stage and tumor size. It is concluded that patients with heteroploidy primary tumors have a significantly poorer prognosis than those with diploid or nearly diploid tumors and have higher risk for regional metastasis.

[Correlation study on acute pericoronitis and the position of the mandibular impacted third molar.].

The clinical study was carried out to determine the correlation factors of acute pericoronitis in mandibular impacted third molars.The results showed that the teeth at greatest risk in relation to acute pericoronitis are vertical unerupted lower third molar (79%),at or below the occlusal plane (66% and 30%),partially covered by soft tissue (>1/2 is 64% and <1/2 is 36% respectively),and existed opposite teeth (66%).The three indexes of vertical impaction had significant difference compared with other impactions(P<0.025).Meanwhile it was also obvious difference(P<0.025) compared with the same indexes within vertical impaction that verified it was easier to suffer acute pericoronitis in such conditions as at or below occlusal plane more than half encapsulated by soft tissue and existed opposite teeth than other conditions.Therefore it may act as an indication of tooth extraction whenever it develops acute inflammation in vertical impaction with three indexes as mentioned above.

[An experimental study on dental pulp histology after the inferior alveolar nerve damage and autogenous nerve graft].

The dental pulpal histology was studied experimentally in rabbits after the inferior alveolar neurovascularity damage and nerve graft. The results revealed that the dental vitality was gradually repaired at different intervals after the inferior alveolar neurovascularity damage. In the early damaged period the pulpal blood vessels were reduced in number and some of them were swollen and permeable, in the late period the structure of the microvascular system became normal and abundant. The pulpal architecture was altered in the initial stage and with the tendency to repair gradually. The pulpal axon degenerated in early stage and reinnervated later. The authors indicate that there are no evident affections for dental pulpal tissues whatever the inferior alveolar neurovascularity is damaged and repaired. This has an important clinical value to define the dental pulp vitality in mandibular subapical osteotomy and tumor resection.

[Clinical evaluation of pulpotomy in the treatment of deciduous teeth with deep dentine caries].

OBJECTIVE: To study the curative effect of pulpotomy in the treatment of deciduous teeth with deep caries. METHODS: 45 deciduous molars with deep caries from 3 8 years old children were selected at random. Pulpotomy was performed on these treated teeth. Clinical examination and X-ray films for the treated teeth were taken to follow up all the teeth at 6 months, one year and two years respectively after treatment. RESULTS: At one year after treatment, 45 cases were followed up, the rate of success in clinical examination and in X-ray photographs both were 100%. While at two years after treatment, 42 cases were followed up and 3 cases were lost, the rate of success in clinical examination was 95% and the rate of success in X-ray photographs was 88%. The reasons of the failure were internal absorption and pulpitis followed by fracture and exfoliation of the obturators in the treated teeth. CONCLUSION: Pulpotomy in deciduous teeth with deep caries was a reliable and effective method. It is necessary to follow up the treated teeth by X-ray at regular intervals after treatment.