[Establishment of contralateral arteriovenous fistula by using the waste vein on the side of central venous lesion: a case report].

Central venous lesion is a difficult problem in the vascular access complications of hemodialysis, which can cause serious clinical symptoms and affect the quality of hemodialysis and life of patients. We established arteriovenous fistula of the contralateral graft blood vessel with the used vein on the diseased side of the central vein of the patient. The arteriovenous fistula of the graft blood vessel was successfully punctured and hemodialysis was performed 2 weeks later. In this way, we not only solved the problem of venous hypertension and subsequent vascular access in the patient, but also reserved more vascular resources.

[Effects of the resin base and retention depth on fracture resistance of molars restored with nano-ceramic endocrowns].

OBJECTIVE: To compare the effects of resin base and different retention depth on the fracture resistance of mandibular molars restored with nano-ceramic endocrowns. METHODS: Forty mandibular molars selected and randomly divided into 5 groups: ① The control group which was consisted of intact teeth, ② the non-resin base group, ③ the 2 mm retention depth group, ④ the 3 mm retention depth group, ⑤ the 4 mm retention depth group, respectively. After tooth preparation, in vitro root canal therapy was conducted, which was followed by endocrown design, production and adhesive of groups ②-⑤. All the samples were under load (N) of the universal mechanical testing machine after embedding. The fracture pattern of each sample was observed under stereomicroscope. Then the microstructure of the fracture surface was observed by scanning electron microscopy. RESULTS: The fracture loads of each group were respectively: the control group fracture load was (3 069.34±939.50) N; experimental groups: fracture load of (2 438.04±774.40) N for the group without resin base; fracture load of (3 537.18±763.65) N for the group with 2 mm retention depth. The fracture load of the retention depth 3 mm group was (2 331.55±766.39) N; the fracture load of the retention depth 4 mm group was (2 786.98±709.24) N. There was statistical significance in the effect of resin base and different retention depth on the fracture loads of molars restored with nano-ceramic endocrown (P < 0.05). Repairable fractures in each group were as follows: control group 2/8, non-resin base group 1/8, retention depth of 2 mm group 1/8, retention depth of 3 mm group 2/8, and retention depth of 4 mm group 0/8. The effects of the retention depth and the presence of resin base on the fracture resistance of the resin nano-ceramic endocrowns were statistically significant (P < 0.05). Scanning electron microscopy showed more arrest lines and small twist hackles on the fracture surface of the restorations with resin base (retention depths of 2 mm, 3 mm, and 4 mm), with cracks extending towards the root. In addition to the characteristics above, more transverse cracks parallel to the occlusal surface, pointing outwards from the center of the pulp cavity retention, were also observed on the fracture surface of the non-resin base restorations. CONCLUSION: When molar teeth with nano-ceramic endocrowns are restored, resin base and the retention depth of 2 mm help the teeth to obtain optimal fracture strength.

[Influence of trueness for local finish lines of a full crown preparation on that of complete finish line].

OBJECTIVE: To investigate the factors affecting the trueness of finish lines of full crown preparations in digital impressions. METHODS: A full crown preparation of the right maxillary molar was prepared on the standard resin dentition model, the trueness of the finish lines, the full crown preparation in the whole dentition and the isolated full crown preparation were measured respectively. Detection of scanning trueness of the finish lines of the full crown preparation in the whole dentition: (1) Using Imetric scanner to scan the full crown preparation, obtaining STL (Stereo lithographic) format data as the reference true value; (2) Using CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner to scan the full crown preparation, obtaining all the STL format data, import Geomagic Studio 2013 software, extraction of images and data of the complete finish lines or local finish lines (mesial, distal, buccal, lingual) of the full crown preparation, then using the data to 3D Compare Analysis with the reference true value, outputting RMS (root mean square) values which could evaluate the scanning trueness, the lower RMS value was, the lower the trueness was. The detection of scanning trueness of the finish lines of the isolated full crown preparation: (1) the anterior and posterior adjacent teeth of the preparation were removed to establish the model of the isolated full crown preparation; (2) CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner were used to scan the isolated preparations, and each group was repeated 6 times. Data collection and analysis were the same as the first part, that is, detection of scanning trueness of finish lines of the full crown preparation in the whole dentition. RESULTS: In the whole dentition, (1) the RMS value [(44±7) µm] of CEREC Omnicam oral scanner scanning complete finish lines was greater than that of 3Shape TRIOS oral scanner [(35±6) µm](P < 0.05). (2) the RMS values of the mesial [(45±9) µm], buccal [(38±3) µm] and lingual [(40±3) µm] finish lines in CEREC Omnicam oral scanner scanning were all lower than that in distal [(63±7) µm](P < 0.05), and the RMS values in mesial were higher than that in buccal and lingual (P>0.05). The RMS values of 3Shape TRIOS oral scanner scanning mesial and distal finish lines were significantly higher than those of the buccal and lingual side (P>0.05), in which:(45±8) µm in mesial, (50±10) µm in the distal, (33±8) µm in the buccal and (33±6) µm in the lingual side. The RMS value of CEREC Omnicam oral scanner scanning distal finish line was greater than that of 3Shape TRIOS oral scanner (P < 0.05). Without adjacent teeth, (1) the RMS values of the complete finish lines of CEREC Omnicam oral scanner and 3 Shape TRIOS oral scanner were significantly reduced (P < 0.05), including CEREC Omnicam oral scanner (34±3) µm and 3 Shape TRIOS oral scanner (26±4) µm; (2) the RMS values of the buccal and lingual finish lines of CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner showed no significant changes (P>0.05), among which, CEREC Omnicam oral scanner buccal (44±7) µm, lingual (43±3) µm, 3Shape TRIOS oral scanner buccal (29±5) µm, lingual (40±7) µm. The RMS values of CEREC Omnicam oral scanner and 3Shape TRIOS oral scanner were significantly reduced and there was no significant difference between them (P>0.05). CEREC Omnicam oral scanner (32±8) µm and 3Shape TRIOS oral scanner (32±6) µm. The RMS values of the distal finish lines of CEREC Omnicam oral scanner and 3 Shape TRIOS oral scanner also decreased significantly (P < 0.05), and CEREC Omnicam oral scanner (38±3) µm decreased more significantly, similar to 3Shape TRIOS oral scanner (36±1) µm, P>0.05. CONCLUSION: When adjacent teeth exist in the full crown preparation, the mesial and distal parts of the finish line will be blocked by adjacent teeth, which will affect the trueness of the local finish line, and ultimately reduce the trueness of the complete finish line.

[Curing method affecting the formation of oxygen inhibition layer on the surface of resin cement].

OBJECTIVE: To explore the conversion of resin monomer, the change of inorganic component and the influencing factors on the oxygen inhibition layer formed on the cured surface of resin cement. METHODS: Three kinds of resin cement were divided into three groups: (1) light-cured group: RelyX Veneer, NX3 (light-cured), Variolink N; (2) dual-cured group: RelyX U200 Automix, NX3 (dual-cured), Multilink Speed; (3) chemically-cured group, and the above 3 types of dual-cured resin cement cured without illumination could be used as chemically-cured resin cement. Each sample was provided with and without oxygen exposure of two matching surfaces, cured respectively, and the variables of light intensity and illumination time were set in the light-cured group and the dual-cured group. Scanning electron microscopy was used to observe the samples' surface morphology. Energy dispersive spectrometer was used to analyze the samples' composition of surface elements. Confocal Raman spectroscopy was used to measure the monomer conversion of resin cement and to obtain the thickness of the oxygen inhibition layer. RESULTS: (1) On the surface of cured resin cement, the weight percentage of oxygen element in the aerobic side was higher than that in the anaerobic side (P < 0.05), and the weight percentage of inorganic element was lower than that in the anaerobic side (P < 0.05). (2) The surface monomer conversion of the cured resin cement on the aerobic surface was significantly lower than that on the anaerobic surface (P < 0.05), and the surface monomer conversion on the aerobic surface and the anaerobic surface was the lowest in the chemically-cured group (P < 0.05), the dual-cured group was the highest (P < 0.05), and the light-cured group was between them. With the increase of light intensity or illumination time, the surface monomer conversion increased (P < 0.05). (3) The thickness of the oxygen inhibition layer was the thickest in the chemically-cured group [(40.27±2.81) µm](P < 0.05), the thinnest in the dual-cured group [(21.87±5.42) µm](P < 0.05) and light-cured group [(23.73±3.84) µm] was between them. With the increase of light intensity or illumination time, the thickness of the oxygen inhibition layer of resin cement decreased (P < 0.05). CONCLUSION: When resin cement is exposed to oxygen, it will form an oxygen inhibition layer, its surface's inorganic filler is less, the surface monomer conversion is lower. The surface monomer conversion and the thickness of oxygen inhibition layer are affected by curing mode and illumination factors.

[Association of single nucleotide polymorphisms of TBX5 gene and environmental exposure index with susceptibility to oral cancer].

Objective: To explore the association of TBX5 polymorphisms and environmental exposure index with susceptibility to oral cancer. Methods: A case-control study was conducted to collect 300 oral cancer patients hospitalized in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University from September 2010 to December 2016. A total of 445 non-tumor patients were selected as the control group. Questionnaires were used to collect the information of all subjects and 5 ml peripheral blood was collected to detect single nucleotide polymorphisms (SNPs) of the rs10492336 locus of TBX5 gene. According to the environmental exposure index score, subjects were divided into two groups, low risk group (0-2.31) and high risk group (2.32-11.76). To analyze the association of TBX5 gene rs10492336 SNPs, environmental exposure index and oral cancer and its interactions. Results: The age of all subjects in the case group and control group were (56.19±13.10) years and (54.56±12.48) years old. Compared with CC genotype, the OR (95%CI) values of the co-dominant genetic model AC genotype and the dominant genetic model AC+AA genotype were 0.69 (0.49-0.98) and 0.70 (0.51-0.97), respectively. Compared with the low risk group, the OR (95%CI) risk of oral cancer in the high risk group was 3.72 (2.55-5.43). The results of gene-environment interaction analysis showed that compared with the group with CC genotype and high risk of environmental exposure index, the OR (95%CI) value of oral cancer in the group with AC+AA genotype and low risk of environmental exposure index was 0.18(0.10-0.31). Furthermore there was a multiplicative interaction between rs10492336 SNPs and environmental exposure index (ß=-0.405, P<0.001). Conclusion: This study suggests that the TBX5 gene rs10492336 SNPs and environmental exposure index were associated with oral cancer. And there was a multiplication interaction between rs10492336 SNPs and environmental exposure index.

[Pickled food, fish, seafood intakes and oral squamous cell carcinoma: a case-control study].

Objective: To investigate the effects between fish, seafood and pickled food intakes on oral squamous cell carcinoma (OSCC). Methods: A case-control study was carried out in Fujian area during September 2010 to December 2016, in which 604 newly diagnosed primary OSCC cases confirmed by pathological diagnosis were collected from hospital and 1 343 control subjects were enrolled from community and healthy hospital population. Demographic data, history of smoking drinking and tea drinking, oral hygiene status and dietary behaviors (fish, seafood and pickled food intakes) were collected by in-person interviews using a standard questionnaire.Using unconditional logistic regression to estimate adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) to assess the effects of fish, seafood and pickled food intakes on OSCC. Analysis stratified by smoking, alcohol drinking and bad prosthesis to explore the possible difference in association between subgroups. Multiplicative interactions and additive interactions between fish and bad prosthesis, seafood and alcohol drinking, pickled food and bad prosthesis were assessed by unconditional logistic regression, relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). Results: The average age of case group and control group were separately (58.69±13.92) years old and (59.27±11.37) years old (χ(2)=4.75, P=0.191). The people whose fish and seafood intakes ≥3 times/week had the lower risk of OSCC, the adjusted OR (95%CI) values were 0.63 (0.52-0.77) and 0.51 (0.41-0.64); The stratified analysis indicated that the people having bad prosthesis had the lower risk of OSCC if they eating fish ≥3 times/week, and the adjusted OR (95%CI) values was 0.53 (0.39-0.71); the people having bad prosthesis had the higher risk of OSCC if they eating pickled food ≥3 times/week, the adjusted OR (95%CI) values was 1.37 (1.02-1.88). Regularly eating seafood can decrease the risk of OSCC for non-smokers, smokers, non-drinkers, drinkers, people without bad prosthesis and had bad prosthesis, the adjusted OR (95%CI) values were 0.49 (0.36-0.68), 0.52 (0.37-0.73), 0.41 (0.31-0.55), 0.77 (0.51-0.96), 0.49 (0.36-0.67), 0.59 (0.42-0.83). Crossover analysis showed fish and bad prosthesis exist multiplication interaction relationship (adjusted OR=0.66, 95%CI: 0.44-0.97) and additional interaction relationship (RERI=-0.81, 95%CI:-1.43--0.19; AP=-0.76, 95%CI:-1.35--0.17; S=0.08, 95%CI: 0.01-0.98); pickled food and bad prosthesis exist multiplication interaction relationship (adjusted OR=1.63, 95%CI: 1.06-2.51) and addition interaction relationship (RERI=0.65, 95%CI:0.08-1.22; AP=0.36, 95%CI:0.10-0.62; S=5.19, 95%CI:1.32-54.49). Conclusion: Reducing the consumption of pickled food, quitting smoking and limiting alcohol consumption, and regularly eating fish and seafood can prevent the occurrence of OSCC.

Induction of apoptosis by capsaicin in hepatocellular cancer cell line SMMC-7721 is mediated through ROS generation and activation of JNK and p38 MAPK pathways.

Capsaicin, one of the major pungent ingredients found in red peppers, has been shown to have anti-carcinogenic effect on various cancer cells through multiple mechanisms. In this study, we investigated the apoptotic effect of capsaicin on human hepatocellular cancer cell line SMMC-7721, as well as the possible mechanisms involved. Treatment of SMMC-7721 cells with capsaicin resulted in a dose-dependent inhibition of cell-viability and induction of apoptosis which was associated with the generation of ROS and persistent disruption of mitochondrial membrane potential. These effects were significantly blocked when cells were pretreated with a general antioxidant N-acetyl cysteine (NAC). We also found that capsaicin induced JNK and p38 MAPK phosphorylation. JNK and p38 MAPK inhibitor effectively blocked capsaicin-induced SMMC-7721 cell apoptosis. In addition, NAC completely blocked phosphorylation of JNK and p38 MAPK induced by capsaicin. Our results indicate that capsaicin induced in SMMC-7721 cell apoptosis through generation of intracellular ROS and activation of JNK and p38 MAPK pathways.

[Changing scanning angles on improving finish line trueness of the full crown preparation].

Objective: To explore the effect of scanning methods on finish line trueness of the full crown preparation. Methods: The standard full crown preparation model of the right maxillary first molars was prepared by using the maxillary standard resin dentition model. The standard preparation was scanned by imetric scanner and data were used as the true value. CEREC Omnicam and 3Shape TRIOS were used to scan the standard preparation. According to the scanning methods, they were divided into parallel scanning group, occlusal wave scanning group and buccolingual wave scanning group. Each group was scanned repeatedly 6 times. The data were imported into Geomagic Studio 2013 software, and the local finish line image data of the mesial, distal, buccal and lingual regions of the full crown preparation were extracted respectively. Three-dimensional deviation analysis was performed with the reference true value, and the root- mean-square error (RMSE) was the evaluation index of scanning trueness. The statistical method was one-way ANOVA. Results: Parallel scanning group: in general, the RMSE value of complete finish lines of scanner B [(35±6) µm] was significantly lower than that of scanner A [(44±7) µm](P<0.05). After scanner A occlusal wave scanning, the RMSE values of the mesial and distal finish lines [(33±5) and (50±12) µm] were significantly lower than those of parallel scanning group (P<0.05). After buccal and lingual wave scanning, the RMSE values of local finish lines in the mesial, distal, buccal and lingual regions [(37±3), (50±6), (28±6) and (29±8) µm] were significantly lower than those in parallel scanning group [(45±9), (63±7), (38±3) and (40±3) µm] (P<0.05). No significant difference was found in the RMSE values of the mesial, distal, buccal and lingual regions of scanner B between parallel scanning group, occlusal wave scanning group and buccolingual scanning group (P>0.05). Conclusions: The scanning trueness of the full crown preparation finish line obtained by the active triangulation scanning equipment can be improved by changing the scanning method to wave scanning.

[Short-term efficacy of empagliflozin in children with glycogen storage disease type â b].

Objective: To analyze the short-time efficacy of empagliflozin in the treatment of glycogen storage disease type Ⅰb (GSD Ⅰb). Methods: In this prospective open-label single-arm study, the data of 4 patients were collected from the pediatric department in Peking Union Medical College Hospital from December 2020 to December 2022. All of them were diagnosed by gene sequencing and had neutropenia. These patients received empagliflozin treatment. Their clinical symptoms such as height and weight increase, abdominal pain, diarrhea, oral ulcer, infection times, and drug applications were recorded at 2 weeks, 1 month, 2 months, 3 months, 6 months, 9 months, 12 months, and 15 months after treatment to assess the therapeutic effect. The liquid chromatography-tandem mass spectrometry method was used to monitor the changes in 1, 5-anhydroglucitol (1, 5AG) concentration in plasma. At the same time, adverse reactions such as hypoglycemia and urinary tract infection were closely followed up and monitored. Results: The 4 patients with GSD Ⅰb were 15, 14, 4 and 14 years old, respectively at the beginning of empagliflozin treatment, and were followed up for 15, 15, 12 and 6 months, respectively. Maintenance dose range of empagliflozin was 0.24-0.39 mg/(kg·d). The frequency of diarrhea and abdominal pain decreased in cases 2, 3, and 4 at 1, 2 and 3 months of treatment, respectively. Their height and weight increased at different degrees.The absolute count of neutrophils increased from 0.84×109, 0.50×109, 0.48×109, 0.48×109/L to 1.48×109, 3.04×109, 1.10×109, 0.73×109/L, respectively. Granulocyte colony-stimulating factor was gradually reduced in 1 patients and stopped in 3 patient. Plasma 1, 5 AG levels in 2 children were significantly decreased after administration of empagliflozin (from 46.3 mg/L to 9.6 mg/L in case 2, and from 56.1 mg/L to 15.0 mg/L in case 3). All 4 patients had no adverse reactions such as hypoglycemia, abnormal liver or kidney function, or urinary system infection. Conclusion: In short-term observation, empagliflozin can improve the symptoms of GSD Ⅰb oral ulcers, abdominal pain, diarrhea, and recurrent infection, also can alleviate neutropenia and decrease 1, 5AG concentration in plasma, with favorable safety.

[Relationship between selenium and the risk for oral cancer: a case-control study].

Objective: To explore the relationship between selenium and the risk for oral cancer. Methods: We performed a case-control study in 325 cases of newly diagnosed primary oral cancer from the First Affiliated Hospital of Fujian Medical University and 650 controls from the same hospital and community. Unconditional logistic regression and stratification analyses were used to explore the association between selenium and oral cancer. Adjusted OR and corresponding 95%CI were calculated. The analyses on multiple interactions between selenium and smoking or drinking status, and fruit or fish intake frequencies were conducted. Results: The level of serum selenium was 112.42 (80.98-145.06) µg/L in the case group, which was lower than 164.85 (144.44-188.53) µg/L in control group, the difference was statistical significant (P<0.01). There was a negative correlation between serum selenium level and the risk for oral cancer regardless of smoking and drinking status, and fruits and fish intake frequencies (P<0.05). There were multiple interactions between serum selenium level and smoking or drinking status, and fruit and fish intakes. Conclusions: The high level of serum selenium is a protective factor for the incidence of oral cancer, and serum selenium has multiple interactions with smoking or drinking status, and fruit and fish intakes. Therefore, reducing tobacco use and alcohol consumption and increasing the intakes of fruit and fish can reduce the risk for oral cancer to some extent.

[Advantages and disadvantages of endocrown restorations of endodontically treated teeth with large coronal destruction].

The strength of endodontically treated teeth were reduced apparently because of structural damage, therefore further reduction of healthy tissue should be avoided as much as possible in restoration. Endocrown made by chair-side CAD/CAM is some kind of minimal invasive restoration, and the retention of restoration is achieved by reliable bonding and macromechanial retention forces. Without post preparation, the root structure could be resevered. Following the indications and use of biomechanical dentin-like CAD/CAM materials could reduce the adverse effect of tensile stress on cervical part.

[A novel prognostic index for oral cancer in Fujian province].

Objective: To explore the survival factors and construct a prognostic index (PI) for oral squamous cell carcinoma (OSCC). Methods: From January 2004 to June 2016, a total of 634 patients with pathologically confirmed OSCC were recruited in a hospital of Fujian. The clinical and follow-up data of all the patients with pathologically confirmed OSCC were collected to identify the factors influencing the prognosis of OSCC. All the patients were randomly divided into two groups: modeling group (modeling dataset, n=318) and validation group (validation dataset, n=316). Randomization was carried out by using computer-generated random numbers. In the modeling dataset, survival rates were calculated using Kaplan-Meier method and compared using the log-rank test. Cox regression model was used to estimate the hazard ratio (HRs) and 95% confidence intervals (CIs) of prognosis factors. An PI for OSCC patients prognostic prediction model was developed based on ß value of each significant variable obtained from the multivariate Cox regression model. Using the tertile analysis, patients were divided into high-risk group, moderate-risk group, and low-risk group according to the PI, the Akaike information criterion (AIC) and Harrell's c-statistic (C index) were used to evaluated the model's predictability. Results: Results from the multivariate Cox regression model indicated that aged ≥55 years (HR=2.22, 95%CI: 1.45-3.39), poor oral hygiene (HR=2.12, 95%CI: 1.27-3.54), first diagnosis of lymph node metastasis (HR=5.78, 95%CI: 3.60-9.27), TNM stage Ⅲ-Ⅳ (stage Ⅰ as reference) (HR=2.43, 95%CI: 1.10-5.37) and poor differentiation (well differentiation as reference) (HR=2.53, 95%CI: 1.60-4.01) were the risk factors influencing the prognosis of OSCC. The PI model had a high predictability in modeling group and validation group (AIC and C index were 1 205.80, 0.700 2 and 1 150.47, 0.737 3). Conclusion: Age, poor oral hygiene, first diagnosis of lymph node metastasis, TNM stage and histological grade were factors associated with the prognosis of OSCC, and the PI model has a certain significance in the clinical treatment of OSCC.

Treatment planning optimization by quasi-Newton and simulated annealing methods for gamma unit treatment system.

The gamma unit is used to irradiate a target within the brain. During such a treatment many parameters, including the number of shots, the coordinates, the collimator size and the weight associated with each shot, affect the amount of dose delivered to the target volume and to the surrounding normal tissues. Hence it is not easy to determine an appropriate set of these parameters by a trial and error method. For this reason, we present here an optimization method to determine mathematically those parameters. This method is composed of two steps: firstly, a quasi-Newton method is used to deal with the continuous variables such as position and weight of shots; the result obtained at the end of this step then serves as the initial configuration for the next step, in which a simulated annealing method is applied to optimize all the aforementioned parameters. Application of the proposed methods to two examples shows that our optimization algorithm runs in a satisfactory way.

An orthogonal moment-based method for automatic verification of radiation field shape.

The purpose of this paper is to develop a new method for automated on-line verification of the treatment field shape during radiotherapy. The treatment field boundary is extracted from the digital portal image and is then approximated by a polygon. The proposed procedure used one of the approved field shapes as the reference boundary for automated comparison with subsequent portal field boundaries. The orthogonal moment-based method was applied to align treatment field boundaries that include the translational shifts, scaling factor and rotation angle. Firstly, the moments of order up to one were used to adjust the magnification and translation of the test field boundary related to the reference one; this step created a common coordinate system for the two images. Then a quadratic least-square objective function based on the orthogonal moments (e.g. Legendre moments) of the two field shapes was employed to perform rotational correction. Since moment computation by a straightforward method required a large number of multiplication and addition operations, a fast method for computing Legendre moments was also developed to decrease the calculation time. Application of the method to some simulated cases showed that our alignment procedure has an accuracy of 0.5 mm in detecting translational shift, 0.004 in detecting magnification and less than 0.3 degrees in detecting rotation angle between the test shape and the reference shape. The alignment procedure using the proposed method can be done within 2 s on a Pentium II personal computer. Therefore, our method is potentially useful for automated real-time treatment field shape verification.