Preparation and Formation Mechanism Study of Antibiofilm Coating Based on Phase Transition of Glutenin.

The surface of food processing equipment is easily affected by biofilm-forming bacteria, leading to cross-contamination and food safety hazards. The critical issue is how to endow the surface of contact materials with antibacterial and antibiofilm abilities. A sustainable, stable, and antibiofilm coating was prepared by phase transition of glutenin. The disulfide bonds in glutenin were reduced by tris(2-carboxyethyl)phosphine, triggering the phase transition of glutenin. Hydrophobic interactions and intermolecular disulfide bonds may be the primary forces. Furthermore, the phase-transited products formed a nanoscale coating on the surface of stainless steel and glass under their own adhesion force and gravity. The coating exhibited good stability in harsh environments. More importantly, after 3 h of direct contact, the colony of Escherichia coli and Staphylococcus aureus decreased by one logarithm. The amount of biofilm was observed to be significantly decreased through optical microscopy and scanning electron microscopy. This article provides a foundational module for developing novel coatings.

Reversible pH-Gated MXene Membranes with Ultrahigh Mono-/Divalent-Ion Selectivity.

Artificial ion channel membranes hold high promise in water treatment, nanofluidics, and energy conversion, but it remains a great challenge to construct such smart membranes with both reversible ion-gating capability and desirable ion selectivity. Herein, we constructed a smart MXene-based membrane via p-phenylenediamine functionalization (MLM-PPD) with highly stable and aligned two-dimensional subnanochannels, which exhibits reversible ion-gating capability and ultrahigh metal ion selectivity similar to biological ion channels. The pH-sensitive groups within the MLM-PPD channel confers excellent reversible Mg2+-gating capability with a pH-switching ratio of up to 100. The mono/divalent metal-ion selectivity up to 1243.8 and 400.9 for K+/Mg2+ and Li+/Mg2+, respectively, outperforms other reported membranes. Theoretical calculations combined with experimental results reveal that the steric hindrance and stronger PPD-ion interactions substantially enhance the energy barrier for divalent metal ions passing through the MLM-PPD, and thus leading to ultrahigh mono/divalent metal-ion selectivity. This work provides a new strategy for developing artificial-ion channel membranes with both reversible ion-gating functionality and high-ion selectivity for various applications.

Preventing dentin erosion with silver diamine fluoride and salivary pellicle: an in vitro study.

OBJECTIVES: To investigate the preventive and discoloring effects of a single and two weekly applications of 38% silver diamine fluoride (SDF) against dentin erosion. MATERIALS AND METHODS: 180 dentin blocks were divided into four groups. Group 1 (SDF2) received two weekly applications of 38% SDF. Group 2 (SDF1) received a single application of 38% SDF. Group 3 (SNF) received a daily application of stannous chloride/amine fluoride/sodium fluoride (standard of care for dental erosion). Group 4 (DW) received a daily application of deionized water. The treated blocks were subjected to a 14-day erosive challenge. Crystal characteristics, elemental composition, surface morphology, percentage of surface microhardness loss (%SMHL), surface loss, and color change (ΔE) were investigated using X-ray diffraction (XRD), energy-dispersive spectrometry (EDS), scanning electron microscopy (SEM), hardness testing, profilometry, and digital spectrophotometry, respectively. RESULTS: XRD and EDS showed dentin surfaces had silver compounds in SDF2 and SDF1, and stannous chloride in SNF. SEM revealed less dentin demineralization with tubular occlusion in SDF2, SDF1, and SNF, but severe demineralization in DW. The %SMHL of SDF2, SDF1, SNF, and DW were 10.8 ± 2.1, 15.7 ± 2.1, 17.9 ± 2.1, and 28.7 ± 2.0 (SDF2 < SDF1 < SNF < DW, p < 0.05). Surface loss (µm) of SDF2, SDF1, SNF, and DW were 5.0 ± 0.6, 6.0 ± 0.6, 6.0 ± 0.7, and 9.0 ± 0.5 (SDF2 < SDF1 = SNF < DW, p < 0.001). ΔE of SDF2, SDF1, SNF, and DW were 26.0 ± 3.4, 12.1 ± 3.8, 6.9 ± 3.5, and 3.9 ± 3.6 (SDF2 > SDF1 > SNF = DW, p < 0.001). CONCLUSION: 38% SDF with two weekly applications provided better preventive effects against dentin erosion, but it might discolor dentin. CLINICAL RELEVANCE: The increased 38% SDF application showed a better anti-erosive potential against dentin erosion. However, SDF caused black staining on the dentin.

Symptom burden survey and symptom clusters in patients with cervical cancer: a cross-sectional survey.

PURPOSE: The purpose of this study is to determine the incidence and severity of symptoms of patients with cervical cancer within 6 months after radiotherapy and chemotherapy, form a symptom burden report, evaluate the distribution characteristics of symptoms, identify symptom clusters, and provide a basis for clinical doctors and nurses to improve the symptom management of patients with cervical cancer after radiotherapy and chemotherapy. METHODS: The patients with cervical cancer within 6 months after radiotherapy and chemotherapy were recruited to investigate their symptom burden. Exploratory factor analysis was used to identify symptom clusters. RESULTS: A total of 250 patients participated in the study. The study found that the most common symptom among the 40 symptoms was fatigue, and the most serious symptom was nocturia. Based on the occurrence rate and severity of symptoms, nine symptom clusters were identified, including psycho-emotion-related symptom cluster, pain-disturbed sleep-related symptom cluster, menopausal symptom cluster, tinnitus-dizziness-related symptom cluster, urinary-related symptom cluster, dry mouth-bitter taste-related symptom cluster, intestinal-related symptom cluster, memory loss-numbness-related symptom cluster, and emaciation-related symptom cluster. The three most serious symptom clusters are pain-disturbed sleep-related symptom cluster, urinary-related symptom cluster, and memory loss-numbness-related symptom cluster. CONCLUSION: The symptoms of patients with cervical cancer within 6 months after radiotherapy and chemotherapy are complex, and nine symptom clusters can be identified according to the incidence and severity of symptoms. We can find the potential biological mechanism of each symptom cluster through the discussion of previous mechanism research and clinical research. The number of symptom clusters and the number of symptoms within the symptom cluster are closely related to the symptom evaluation scale selected for the study. Therefore, the symptom cluster study urgently needs a targeted symptom evaluation scale that can comprehensively reflect the patient's condition.

Three-dimensional assessment of facial asymmetry in class III subjects, part 2: evaluating asymmetry index and asymmetry scores.

OBJECTIVES: To evaluate the outcomes of corrective surgical treatment for craniofacial asymmetry using four different methods with the aim of developing the best technique for craniofacial asymmetry assessment. MATERIALS AND METHODS: CBCT images of twenty-one class III subjects with surgically corrected craniofacial asymmetry and twenty-one matched controls were analyzed. Twenty-seven hard tissue landmarks were used to quantify asymmetry using the following methodologies: the asymmetry index (AI), asymmetry scores based on the clinically derived midline (CM), Procrustes analysis (PA), and modified Procrustes analysis (MPA). RESULTS: Modified Procrustes analysis successfully identified pre-operative asymmetry and revealed severe asymmetry at the mandibular regions compared to controls, which was comparable to the asymmetry index and clinically derived midline methods, while Procrustes analysis masked the asymmetric characteristics. Likewise, when comparing the post-surgical outcomes, modified Procrustes analysis not only efficiently determined the changes evidencing decrease in facial asymmetry but also revealed significant residual asymmetry in the mandible, which was congruent with the asymmetry index and clinically derived midline methods but contradictory to the results shown by Procrustes analysis. CONCLUSIONS: In terms of quantifying cranio-facial asymmetry, modified Procrustes analysis has evidenced to produce promising results that were comparable to the asymmetry index and the clinically derived midline, making it a more viable option for craniofacial asymmetry assessment. CLINICAL RELEVANCE: Modified Procrustes analysis is proficient in evaluating cranio-facial asymmetry with more valid clinical representation and has potential applications in assessing asymmetry in a wide spectrum of patients, including syndromic patients.

Which clinical and laboratory procedures should be used to fabricate digital complete dentures? A systematic review.

STATEMENT OF PROBLEM: Digital workflows for digital complete denture fabrication have a variety of clinical and laboratory procedures, but their outcomes and associated complications are currently unknown. PURPOSE: The purpose of this systematic review was to evaluate the clinical and laboratory procedures for digital complete dentures, their outcomes, and associated complications. MATERIAL AND METHODS: Electronic literature searches were conducted on PubMed/Medline, Embase, and Web of Science for studies published from January 2000 to September 2022 and screened by 2 independent reviewers. Information on digital complete denture procedures, materials, their outcomes, and associated complications was extracted. RESULTS: Of 266 screened studies, 39 studies were included. While 26 assessed definitive complete dentures, 7 studies assessed denture bases, 2 assessed trial dentures, and 4 assessed the digital images only. Twenty-four studies used border molded impression technique, 3 studies used a facebow record, and 7 studies used gothic arch tracing. Only 13 studies performed trial denture placement. Twenty-one studies used milling, and 17 studies used 3D printing for denture fabrication. One study reported that the retention of maxillary denture bases fabricated from a border-molded impression (14.5 to 16.1 N) was statistically higher than the retention of those fabricated from intraoral scanning (6.2 to 6.6 N). The maximum occlusal force of digital complete denture wearers was similar across different fabrication procedures. When compared with the conventional workflow, digital complete dentures required statistically shorter clinical time with 205 to 233 minutes saved. Up to 37.5% of participants reported loss of retention and up to 31.3% required a denture remake. In general, ≥1 extra visit and 1 to 4 unscheduled follow-up visits were needed. The outcomes for patient satisfaction and oral health-related quality of life were similar between conventional, milled, and 3D-printed complete dentures. CONCLUSIONS: Making a border-molded impression is still preferred for better retention, and trial denture placement is still recommended to optimize the fabrication of definitive digital complete dentures.

Accuracy of artificial intelligence-designed single-molar dental prostheses: A feasibility study.

STATEMENT OF PROBLEM: Computer-aided design and computer-aided manufacturing (CAD-CAM) technology has greatly improved the efficiency of the fabrication of dental prostheses. However, the design process (CAD stage) is still time-consuming and labor intensive. PURPOSE: The purpose of this feasibility study was to investigate the accuracy of a novel artificial intelligence (AI) system in designing biomimetic single-molar dental prostheses by comparing and matching them to the natural molar teeth. MATERIAL AND METHODS: A total of 169 maxillary casts were obtained from healthy dentate participants. The casts were digitized, duplicated, and processed with the removal of the maxillary right first molar. A total of 159 pairs of original and processed casts were input into the Generative Adversarial Networks (GANs) for training. In validation, 10 sets of processed casts were input into the AI system, and 10 AI-designed teeth were generated through backpropagation. Individual AI-designed teeth were then superimposed onto each of the 10 original teeth, and the morphological differences in mean Hausdorff distance were measured. True reconstruction was defined as correct matching between the AI-designed and original teeth with the smallest mean Hausdorff distance. The ratio of true reconstruction was calculated as the Intersection-over-Union. The reconstruction performance of the AI system was determined by the Hausdorff distance and Intersection-over-Union. RESULTS: Data of validation showed that the mean Hausdorff distance ranged from 0.441 to 0.752 mm and the Intersection-over-Union of the system was 0.600 (60%). CONCLUSIONS: This study demonstrated the feasibility of AI in designing single-molar dental prostheses. With further training and optimization of algorithms, the accuracy of biomimetic AI-designed dental prostheses could be further enhanced.

Tumor microenvironment and redox dual stimuli-responsive polymeric nanoparticles for the effective cisplatin-based cancer chemotherapy.

The serious side effects of cisplatin hindered its clinical application and the nanotechnology might be the potential strategy to address the limitation. However, rapid clearance in the blood circulation and ineffective controlled drug release from nanocarriers hamper the therapeutic efficacy of the nano-delivery system. We constructed a tumor microenvironment and redox dual stimuli-responsive nano-delivery system PEG-c-(BPEI-SS-Pt) by cross-linking the disulfide-containing polymeric conjugate BPEI-SS-Pt with the dialdehyde group-modified PEG2000via Schiff base. After optimized the cross-linking time, 72 h was selected to get the nano-delivery system.1H NMR and drug release assays showed that under the acidic tumor microenvironment (pH 6.5-6.8), the Schiff base can be broken and detached the PEG cross-linked outer shells, displaying the capability to release the drugs with a sequential pH- and redox-responsive manner. Moreover, PEG-c-(BPEI-SS-Pt) showed more effective anti-tumor therapeutic efficacyin vivowith no significant side effects when compared with the drug of cisplatin used in the clinic. This strategy highlights a promising platform with the dual stimuli-responsive profile to achieve better therapeutic efficacy and minor side effects for platinum-based chemotherapy.

Microleakage assessment of CAD-CAM Cobalt-Chrome and Zirconia abutments on a conical connection dental implant: A comparative in vitro study.

OBJECTIVE: To assess the marginal and bacterial microleakage in zirconia and CAD-CAM or cast Co-Cr implant abutments. METHODS: Sixty-four conical connection implants with their respective abutments were divided into four groups (Co-Cr (milled, laser-sintered, and cast) and Zirconia (milled)). All specimens were subjected to a chewing simulation and thermocycling. After aging process, specimens were submerged in a 0.2% methylene blue solution with Porphyromonas gingivalis (P.g) for 48 h. The marginal microleakage was measured using a 40× optical microscopy at the internal part of the implant, and when positive microleakage was observed, a DNA isolation with a polymerase chain reaction (PCR) test was used. The microbiological assessment was based on colony forming units (CFUs). RESULTS: Thirty (47%) implant-abutments presented microleakage and the PCR was performed on those specimens (1 Zirconia, 1 Co-Cr milled, 14 Co-Cr laser-sintered and 14 cast). Seven specimens (1 Co-Cr laser-sintered and six cast) presented values below the PCR detection limit (< 100 CFUs). The lowest CFUs count occurred in the Co-Cr milled group (5.17E+02 CFUs/ml) followed by zirconia (7.70E+03 CFUs/ml). The Co-Cr cast (9.39E+03 CFUs/ml) and laser-sintered (2.4E+05 CFUs/ml) groups had higher bacterial count. The CFU count comparison performed between Co-Cr cast and laser-sintered resulted in a statistically significant differences in favor of Co-CrCL (p < .05). CONCLUSIONS: The abutment material and fabrication technique affected the implant-abutment microleakage. Although the CAD-CAM abutments presented favorable results, all tested groups presented microleakage.

Antibacterial activity and action target of phenyllactic acid against Staphylococcus aureus and its application in skim milk and cheese.

Phenyllactic acid (PLA) has been demonstrated to possess antibacterial activity and capacity to prolong food shelf life. However, studies on the performance of PLA in inhibiting Staphylococcus aureus and its effectiveness when applied to dairy products are largely lacking. Here, antibacterial activity (planktonic and biofilm states) of PLA against S. aureus CICC10145 (S. aureus_45) were investigated. The results showed that PLA inhibited growth of S. aureus_45 and formation of S. aureus_45 biofilm. Next, the antibacterial action target of PLA was uncovered from both physiological and phenotypic perspectives. The results showed that PLA decreased cell metabolic activity and cell viability, damaged cell membrane integrity, triggered leakage of intracellular contents (DNA, proteins, and ATP), and caused oxidative stress damage and morphological deformation of S. aureus_45. In practical application, the antibacterial activity of PLA against S. aureus_45 cells was further confirmed in skim milk and cheese as dairy food models, and the antibacterial effects can be adequately maintained during storage for 21 d, at least at 4°C. These findings suggested that PLA could be a potential candidate for controlling S. aureus outgrowth in dairy foods.

Three-dimensional assessment of facial asymmetry in Class III subjects. Part 1: a retrospective study evaluating postsurgical outcomes.

OBJECTIVE: The present study aimed to determine the site and severity of maxillomandibular asymmetry before and after orthognathic surgery in asymmetric patients. MATERIALS AND METHODS: Presurgery and postsurgery cone beam computed tomography (CBCT) data of 21 facial asymmetry patients (7 males and 14 females, mean age: 23.0 ± 3.36 years) with soft tissue chin deviation ≥ 3 mm who had undergone bimaxillary surgery were evaluated. Seven midline and twenty bilateral hard tissue landmarks were identified for the evaluation of facial asymmetry and outcomes were assessed against age- and gender-matched control subjects. RESULTS: In the asymmetry group, bilateral landmarks exhibited significant deviation in the mandible and midface regions. Before surgery, asymmetry was more severe at the mandibular midline and sites close to it, in the asymmetry group. Bimaxillary surgery proved to be highly effective, with a significant correction of the menton to a clinically normal value (2.90 mm, p < 0.001). After surgery, significant residual asymmetry was observed at the mental foramen (p = 0.001) in the R-L direction. Moreover, significant asymmetry persisted at the sigmoid notch (p = 0.001) in the S-I direction. CONCLUSIONS: Mandibular midline landmarks and chin peripheral regions contribute significantly to overall facial asymmetry characteristics. Despite significant correction after bimaxillary surgery, asymmetry persisted at several sites, thereby requiring secondary correction. Comprehensive 3D presurgical planning is central for asymmetry correction in a single surgery. CLINICAL RELEVANCE: The present study specifies the location of residual asymmetry sites and advocates the correction of those sites during initial surgery.

Dental students' preference and perception on intraoral scanning and impression making.

BACKGROUND: To investigate the preference and perception on intraoral scanning and impression making among dental students. METHODS: Final-year dental students from the 2019 and 2020 cohorts were invited to complete an online questionnaire via Google-Form. Their preference on the intraoral-scanning/impression making techniques and their perception on these techniques including the ease of defect identification, ease of infection control, need of chairside support, ease to master the technique as a beginner, efficiency in their hands and ease to handle the scanner software (yes/no) were collected. The results were analysed using McNemar tests and binary logistic regression test. All tests were performed at significance level α = 0.05. RESULTS: Ninety-seven students participated in this study with a response rate of 96.0 %. Eighty-one students (83.5 %) have tried intraoral scanning on peers. Fifty-three (54.6 %) students preferred intraoral-scanning and were categorized as Pro-scanning group. Forty-four (45.4 %) students either preferred impression-making (n = 21) or not sure (n = 23) were categorized as Others. More than half of students in both groups felt that intraoral-scanning is easier to identify defect, easier in infection control and require less chairside support. Higher proportion of students in the Pro-scanning group felt that intraoral-scanning requires less chairside support, easier to master as a beginner, more efficient in their hands and they can deal well with the scanner software than that in Others (P < 0.05). Regression shown that students preferred a technique that they perceived is more efficient (P = 0.000). CONCLUSIONS: While intraoral scanning has perceived advantages, many students still prefer impression making that works more efficient to them.

Immediate or delayed loading protocols for two-implant mandibular overdentures: A systematic review and meta-analysis of randomized controlled trials.

STATEMENT OF PROBLEM: The immediate loading protocol for 2-implant mandibular overdentures has been widely reported. Nevertheless, the clinical effects reported in different articles are quite different. PURPOSE: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to compare the clinical effects of immediate and delayed loading of 2-implant mandibular overdentures. MATERIAL AND METHODS: The review followed the guidelines of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). PubMed, Cochrane Library, Web of Science, Embase, Scopus, ScienceDirect, CBM, CNKI, and Wan Fang databases were searched electronically for RCTs published before March 25, 2020. Two authors independently conducted literature screening, quality assessment, and data extraction. The outcomes of interest were implant failure rate, marginal bone loss (MBL), implant stability quotient (ISQ), periotest value (PTV), and patient satisfaction. RESULTS: A total of 2498 unduplicated records were identified. After full-text analysis, 7 eligible RCTs were included. All studies were followed for at least 12 months, and the meta-analysis was based on this. The meta-analysis showed that the implant failure rate in the immediate group was higher than that in the delayed group, but there was no statistically significant difference (I2=0%; n=7; risk difference [RD]=0.03; 95% confidence interval [CI]=-0.01 to 0.08). The difference of MBL between immediate and delayed loading was not significant (I2=88%; n=6; mean difference [MD]=-0.04; 95% CI=-0.16 to 0.24). Because of the limited articles reporting on ISQ, PTV, and patient satisfaction, no quantitative analysis was conducted for these outcomes. CONCLUSIONS: Although the implant failure rate was more likely to favor the delayed group, available evidence indicates no statistical difference in implant failure and marginal bone loss between immediate and delayed loading protocols.

CpG immunostimulatory oligodeoxynucleotide 1826 as a novel nasal ODN adjuvant enhanced the protective efficacy of the periodontitis gene vaccine in a periodontitis model in SD rats.

BACKGROUND: We previously demonstrated that nasal administration of periodontitis gene vaccine (pVAX1-HA2-fimA) or pVAX1-HA2-fimA plus IL-15 as adjuvant provoked protective immunity in the periodontal tissue of SD rats. This study evaluated the immune effect of pVAX1-HA2-fimA plus CpG-ODN 1826 as an adjuvant in the SD rat periodontitis models to improve the efficacy of the previously used vaccine. METHODS: Periodontitis was induced in maxillary second molars in SD rats receiving a ligature and infected with Porphyromonas gingivalis. Forty-two SD rats were randomly assigned to six groups: A, control without P. gingivalis; B, P. gingivalis with saline; C, P. gingivalis with pVAX1; D, P. gingivalis with pVAX1-HA2-fimA; E, P. gingivalis with pVAX1-HA2-fimA/IL-15; F, P. gingivalis with pVAX1-HA2-fimA+CpG ODN 1826 (30 µg). The levels of FimA-specific and HA2-specific secretory IgA antibodies in the saliva of rats were measured by ELISA. The levels of COX-2 and RANKL were detected by immunohistochemical assay. Morphometric analysis was used to evaluate alveolar bone loss. Major organs were observed by HE staining. RESULTS: 30 µg could be the optimal immunization dose for CpG-ODN 1826 and the levels of SIgA antibody were consistently higher in the pVAX1-HA2-fimA+CpG-ODN 1826 (30 µg) group than in the other groups during weeks 1-8 (P < 0.05, except week 1 or 2). Morphometric analysis demonstrated that pVAX1-HA2-fimA+CpG-ODN 1826 (30 µg) significantly reduced alveolar bone loss in ligated maxillary molars in group F compared with groups B-E (P < 0.05). Immunohistochemical assays revealed that the levels of COX-2 and RANKL were significantly lower in group F compared with groups B-E (P < 0.05). HE staining results of the major organs indicated that pVAX1-HA2-fimA with or without CpG-ODN 1826 was not toxic for in vivo use. CONCLUSIONS: These results indicated that CpG-ODN 1826 (30 µg) could be used as an effective and safe mucosal adjuvant for pVAX1-HA2-fimA in SD rats since it could elicit mucosal SIgA responses and modulate COX-2 and RANKL production during weeks 1-8, thereby inhibiting inflammation and decreasing bone loss.

Risk factors for distal migration of biliary plastic stents and related duodenal injury.

BACKGROUND: The risk factors of duodenal injury from distal migrated biliary plastic stents remain uncertain. The aim of this study was to determine the risk factors of distal migration and its related duodenal injury in patients who underwent placement of a single biliary plastic stent for biliary strictures. METHODS: We retrospectively reviewed all patients with biliary strictures who underwent endoscopic placement of a single biliary plastic stent from January 2006 to October 2017. RESULTS: Two hundred forty-eight patients with 402 endoscopic retrograde cholangiopancreatography procedures were included. The incidence of distal migration was 6.2%. The frequency of duodenal injury was 2.2% in all cases and 36% in cases with distal migration. Benign biliary strictures (BBS), length of the stent above the proximal end of the stricture (> 2 cm), and duration of stent retention (< 3 months) were independently associated with distal migration (p = 0.018, p = 0.009, and p = 0.016, respectively). Duodenal injury occurred more commonly in cases with larger angle (≥ 30°) between the distal end of the stent and the centerline of the patient's body (p = 0.018) or in cases with stent retention < 3 months (p = 0.031). CONCLUSIONS: The risk factors of distal migration are BBS and the length of the stent above the proximal end of the stricture. The risk factor of duodenal injury due to distal migration is large angle (≥ 30°) between the distal end of the stent and the centerline of the patient's body. Distal migration and related duodenal injury are more likely to present during the early period after biliary stenting.

Intubation of non-difficult airways using video laryngoscope versus direct laryngoscope: a randomized, parallel-group study.

BACKGROUND: The video laryngoscope is recommended for intubating difficult airways. The present study aimed to determine whether the video laryngoscope can further improve intubation success rates compared with the direct laryngoscope in patients with non-difficult airways. METHODS: In total, 360 patients scheduled for elective abdominal surgeries were randomly assigned to undergo intubation using either a video laryngoscope (n = 179) or a direct laryngoscope (n = 181). The following parameters were measured: mouth opening; thyromental distance; sternomental distance; shape angle of the tracheal catheter; and glottic exposure grade. RESULTS: The percentage of patients with level I-II of total glottic exposure in the video laryngoscope group was 100% versus 63.5% in the direct laryngoscope group (P < 0.001). The one-attempt success rate of intubation was 96.1% using a video laryngoscope versus 90.1% using a direct laryngoscope (P = 0.024). The intubation success rate using a video laryngoscope was 100% versus 94.5% using a direct laryngoscope (P = 0.004). Immediate oropharyngeal injury occurred in 5.1% of patients intubated using a direct laryngoscope versus 1.1% using a video laryngoscope (P = 0.033). On postoperative day 1, obvious hoarseness was exhibited by 7.9% of patients intubated using a direct laryngoscope versus 2.8% using a video laryngoscope (P = 0.035). The grade of glottic exposure and catheter shape angle were independent risk factors for tracheal intubation failure. Thyromental distance, shape angle, glottic exposure time, and surgical position were independent risk factors for postoperative complications. Thyromental distance and glottic exposure time were independent risk factors for complications lasting > 2 days. CONCLUSIONS: Intubation using a video laryngoscope yielded significantly higher intubation success rates and significantly fewer postoperative complications than direct laryngoscopy in patients with non-difficult airways. TRIAL REGISTRATION: Chinese Clinical Trial Registry. No: ChiCTR-IOR-16009023 . Prospective registration.

[The cardiovascular protection of irisin and its research progress in sports field].

Irisin is a circulating myokine induced by exercise, which is a cleaved version of fibronectin type III domain containing protein 5 (FNDC5). It can promote the browning of white fat tissue, increase energy consumption, and decrease weight. Irisin plays an important role in the regulation of various diseases, such as diabetes and coronary heart disease. Different types of exercise have different effects on irisin level in blood circulation, and moderate exercise can reduce cardiovascular symptoms. In this paper, the cardiovascular protective effect of irisin and its research progress in the field of exercise are reviewed, hoping to provide a new target for the prevention and treatment of cardiovascular diseases.

Tween-80 and impurity induce anaphylactoid reaction in zebrafish.

A number of recent reports suspected that Tween-80 in injectable medicines, including traditional Chinese medicine injections could cause life-threatening anaphylactoid reaction, but no sound conclusion was drawn. A drug-induced anaphylactoid reaction is hard to be assayed in vitro and in conventional animal models. In this study, we developed a microplate-based quantitative in vivo zebrafish assay for assessing anaphylactoid reaction and live whole zebrafish mast cell tryptase activity was quantitatively measured at a wavelength of 405 nm using N-benzoyl-dl-arginine p-nitroanilide as a substrate. We assessed 10 batches of Tween-80 solutions from various national and international suppliers and three Tween-80 impurities (ethylene glycol, 2-chloroethanol and hydrogen peroxide) in this model and found that three batches of Tween-80 (nos 2, 20080709 and 20080616) and one Tween-80 impurity, hydrogen peroxide (H2 O2 ), induced anaphylactoid reactions in zebrafish. Furthermore, we found that H2 O2 residue and peroxide value were much higher in Tween-80 samples 2, 20080709 and 20080616. These findings suggest that H2 O2 residue in combination with oxidized fatty acid residues (measured as peroxide value) or more likely the oxidized fatty acid residues in Tween-80 samples, but not Tween-80 itself, may induce anaphylactoid reaction. High-throughput zebrafish tryptase assay developed in this report could be used for assessing safety of Tween-80-containing injectable medicines and potentially for screening novel mast cell-modulating drugs.

Arthroplasty in patients with extensive femoral head avascular necrosis: Cementless arthroplasty in extensive femoral head necrosis.

PURPOSE: The purpose of this study was to investigate the outcomes of using cementless femoral stem for extensive osteonecrosis of the femoral head involving the proximal femur. METHODS: A total of 21 patients (27 hips) in the study group defined as extensive ONFH involving proximal femur and 42 patients (52 hips) with the diagnosis of regular osteonecrosis of the femoral head in the control group were enrolled in the study. Clinical and radiographic follow-ups were documented at three, six, 12 and 24 months postoperatively. RESULTS: Results improved for Harris hip score in both groups. In the study group undersized stem implantation and lateralized mal-position were identified. Subsequent subsidence was also found. CONCLUSIONS: Pre-operative templating and intra-operative X-ray confirmation are necessary to avoid complications.

Targeted co-delivery of rapamycin and oxaliplatin by liposomes suppresses tumor growth and metastasis of colorectal cancer.

The activation of tumor cell immunogenicity through oxaliplatin (OXP)-induced immunogenic cell death (ICD) has significant implications in cancer treatment. However, the anti-tumor effect of OXP monotherapy still has many shortcomings, and the systemic administration of OXP leads to low drug concentration at the tumor site, which is susceptible to systemic toxic side effects. In this study, a combined therapeutic strategy using folate-modified nanoliposomes co-delivered with rapamycin (Rapa) and OXP (abbreviated as FA@R/O Lps) is proposed for the treatment of colorectal cancer (CRC). Rapa and OXP can directly inhibit tumor cell proliferation and induce apoptosis. OXP induces ICD by triggering the release of danger signals, such as HMGB1, ATP, and calreticulin. FA@R/O Lps with a particle size of about 134.1±1.8 nm and a small dispersion were successfully prepared. This novel liposomal system can be used to target and increase drug accumulation in tumors. In-vivo experiments showed that FA@R/O Lps successfully inhibit CRC growth and liver metastasis, and simultaneously reduce off-target toxicity. In particular, FA@R/O Lps showed greater therapeutic effects than free Rapa/OXP and R/O Lps. Taken together, this study provides a novel combination of Rapa and OXP, and a nano-delivery system for enhanced anti-CRC efficacy. The results suggest that FA@R/O Lps could be a promising strategy for the treatment of CRC.