Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children.

BACKGROUND: The detection rate of peptic ulcer in children is improving, with development of diagnostic procedures. Gastroscopy is the gold standard for the diagnosis of peptic ulcer, but it is an invasive procedure. Gastrointestinal contrast-enhanced ultrasonography (CEUS) has the advantages of being painless, noninvasive, nonradioactive, easy to use, and safe. AIM: To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children. METHODS: We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022. All children were examined by routine ultrasound, gastrointestinal CEUS, and gastroscopy. The pathological results of gastroscopy were taken as the gold standard. Routine ultrasonography was performed before gastrointestinal CEUS. Conventional ultrasound showed the thickness of the gastroduodenal wall, gastric peristalsis, and the adjacent organs and tissues around the abdominal cavity. Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall; the size, location and shape of the ulcer; gastric peristalsis; and adjacent organs and tissues around the abdominal cavity. The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS. All children received informed consent from their guardians for CEUS. This study was reviewed and approved by the hospital medical ethics committee. RESULTS: Among the 43 children, 17 (15 male, 2 female) were diagnosed with peptic ulcer by gastroscopy. There were 26 children with nonpeptic ulcer. There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound. The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1% (34/43), which was significantly different from that of gastroscopy (P = 0.033). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low. Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS. The diagnostic coincidence rate of peptic ulcer in children was 95.3% (41/43). There was no significant difference between CEUS and gastroscopy (P = 0.655). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high. CONCLUSION: Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children, and can be used as a preliminary examination method.

Differential expression and significance of 5-hydroxymethylcytosine modification in hepatitis B virus carriers and patients with liver cirrhosis and liver cancer.

BACKGROUND: The relationship between hepatitis B surface antigen (HBsAg)-positive carrier status and liver cancer has been extensively studied. However, the epigenetic changes that occur during progression from HBsAg-positive carrier status or cirrhosis to liver cancer are unknown. The epigenetic modification of DNA hydroxymethylation is critical in tumor development. Further, 5-hydroxymethylcytosine (5hmC) is an important base for DNA demethylation and epigenetic regulation. It is also involved in the assembly of chromosomes and the regulation of gene expression. However, the mechanism of action of 5hmC in HBsAg-positive carriers or patients with cirrhosis who develop liver cancer has not been fully elucidated. AIM: To investigate the possible epigenetic mechanism of HBsAg-positive carriers and hepatocellular carcinoma (HCC) progression from cirrhosis. METHODS: Forty HBsAg-positive carriers, forty patients with liver cirrhosis, and forty patients with liver cancer admitted to the First People's Hospital of Yongkang between March 2020 and November 2021 were selected as participants. Free DNA was extracted using a cf-DNA kit. cfDNA was extracted by 5hmC DNA sequencing for principal component analysis, the expression profiles of the three groups of samples were detected, and the differentially expressed genes (DEGs) modified by hydroxymethylation were screened. Bioinformatic analysis was used to enrich DEGs, such as in biological pathways. RESULTS: A total of 16455 hydroxymethylated genes were identified. Sequencing results showed that 32 genes had significant 5hmC modification differences between HBsAg carriers and liver cancer patients, of which 30 were upregulated and 2 downregulated in patients with HCC compared with HBsAg-positive carriers. Significant 5hmC modification differences between liver cirrhosis and liver cancer patients were identified in 20 genes, of which 17 were upregulated and 3 were downregulated in patients with HCC compared with those with cirrhosis. These genes may have potential loci that are undiscovered or unelucidated, which contribute to the development and progression of liver cancer. Analysis of gene ontology enrichment and Kyoto Encyclopedia of Genes and Genomes showed that the major signaling pathways involved in the differential genes were biliary secretion and insulin secretion. The analysis of protein interactions showed that the important genes in the protein-protein interaction network were phosphoenolpyruvate carboxykinase and solute carrier family 2. CONCLUSION: The occurrence and development of liver cancer involves multiple genes and pathways, which may be potential targets for preventing hepatitis B carriers from developing liver cancer.

Efficacy and safety of erector spinae plane block for postoperative analgesia in breast cancer surgery-A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: We aim to evaluate the analgesic efficacy and safety of erector spinae plane block (ESPB) for postoperative analgesia in breast cancer surgeries. METHODS: PubMed, Web of Science, CBM, Embase, Cochrane, Wanfang, VIPP, and CNKI were searched to identify published eligible randomized controlled trials. The primary results were the postoperative 24 h morphine consumption and pain scores, while the secondary outcomes included pain scores at other times, press times of patient-controlled intravenous analgesia (PCIA), times to request for first rescue analgesia, the incidence of request for rescue analgesia, opioid-related complications, nerve blocks related complications and patient satisfaction. RESULTS: We included 20 studies meeting the inclusion criteria, which involved 1293 participants. The morphine consumption and the pain scores during 24 h postoperatively were significantly decreased in the ESPB group versus the control group (p < 0.00001). Furthermore, ESPB also reduced pain scores at other time points, press times of PCIA, and times to first rescue analgesia requirement. Meanwhile, there was a lower incidence of postoperative nausea and vomiting, and skin pruritus in the ESPB group than in the control group. CONCLUSIONS: Compared to general anesthesia alone, ESPB combined with general anesthesia can effectively reduce the postoperative pain intensity within 48 h and opioid consumption within 24 h after breast cancer surgery, and reduce the incidence of opioid and nerve blocks related complications.

The Error-Prone Operational Steps and Key Sites of Self-Contamination During Donning and Doffing of Personal Protective Equipment by Health Care Workers.

OBJECTIVE: This study aims to identify error-prone operational steps and key sites of self-contamination during donning and doffing of personal protective equipment (PPE). METHODS: A total of 56 health care workers, including 37 nurses and 19 physicians, were recruited to don and doff the PPE recommended by the Chinese Center for Disease Control and Prevention. Operational errors and sites of self-contamination were recorded using UV-fluorescent labeling and video surveillance. RESULTS: Three main errors during donning were identified: choosing a loose-fitting coverall that was difficult to handle; ignoring to inspect the seal of N95 respirator or gloves; and forgetting to pull up the zipper completely. Four main errors during doffing were identified: removing the N95 respirator in a wrong way; touching the scrubs with contaminated hands and elbows; touching contaminated external surfaces of the goggles; and performing insufficient hand hygiene. Key sites that were easily contaminated during the doffing of PPE included left hand and wrist, left lower leg, chest, and left abdomen. CONCLUSION: Identifying the steps prone to errors and key sites of self-contamination in the process of PPE donning and doffing can facilitate the training of PPE use and provide detailed evidence for optimizing standardized protocols to reduce contamination.

Comparison of the diagnostic value of virtual touch tissue quantification and virtual touch tissue imaging quantification in infants with biliary atresia.

OBJECTIVE: This study aimed to compare the diagnostic performance of vital touch tissue quantification (VTQ) and virtual touch tissue imaging quantification (VTIQ) in diagnosing infants with biliary atresia (BA) from jaundiced infants. METHODS: In this study, 26 jaundiced infants with BA, 33 jaundiced infants without BA, and 40 normal infants were enrolled. The hepatic shear wave velocity (SWV) of each infant was determined by VTQ and VTIQ examinations, respectively. Then, the receiver operating characteristic (ROC) curves were drawn and the area under the curve (AUC) and optimal cut-off values were calculated to evaluate the sensitivities and specificities of VTIQ and VTQ for BA. RESULTS: The mean values of SWV of the control group measured by VTQ and VTIQ were (1.09 ± 0.18) m/s and (1.36 ± 0.21) m/s, respectively. The mean values of SWV of the non-BA group measured by VTQ and VTIQ were (1.30 ± 0.28) m/s and (1.52 ± 0.29) m/s, respectively. The mean values of SWV of the BA group measured by VTQ and VTIQ were (2.36 ± 0.36) m/s and (2.43 ± 0.29) m/s, respectively. The diagnostic threshold of VTQ and VTIQ to diagnose BA was 1.77 and 1.92 m/s. The sensitivities of VTQ and VTIQ to diagnose BA were 90.9% and 95.5%. The specificities of VTQ and VTIQ to diagnose BA were 68.4% and 78.9%. CONCLUSION: Vital touch tissue quantification and VTIQ could help distinguish infants with BA from jaundiced infants by measuring the liver SWV values. VTIQ has higher sensitivity and specificity than VTQ.

Improvement of continuous subcutaneous insulin infusion on patients with type 2 diabetes mellitus by 3-dimensional speckle tracking echocardiography.

Three-dimensional speckle tracking echocardiography (3D-STE) was used to evaluate the improvement of continuous subcutaneous insulin infusion on the left ventricular (LV) systolic function of patients with type 2 diabetes mellitu (T2DM). We recruited T2DM patients (38 cases, diabetic group) and healthy volunteers (35 cases, control group) to collect LV full volume imaging. TomTec software was used for calculating LV global longitudinal strain (LVGLS), global circumferential strain (LVGCS), peak twist (LVTW), peak apical rotation (LVPAR), ejection fraction (LVEF), and torsion (LVT). All indices were re-tested 2 weeks later after intensive treatment of insulin pump. LVGLS, LVGCS, LVTW and LVPAR in diabetic group were significantly decreased than control group. LVGLS and LVGCS in pre-treatment diabetic group were significantly increased than post-treatment. LVGLS, LVGCS, LVTW and LVPAR had correlations among control, pre-treatment and post-treatment diabetic groups. There were no significant differences in LVEDV, LVESV, LVEF, LVT and R-R. LV systolic function of patients with T2DM complicated with microangiopathy was improved after treatment of continuous subcutaneous insulin infusion. In addition, therapeutic effect could be accurately evaluated by 3D-STE which had vital clinical application.

[Study of the effect of fluoride removal agent and microabrasion technology in LED teeth whitening of dental fluorosis].

PURPOSE: To evaluate the effect of fluoride removal agent and microabrasion technology in LED teeth whitening of dental fluorosis. METHODS: One hundred and twelve patients with moderate dental fluorosis treated from August 2012 to July 2015 were divided into experimental group and control group according to random number table, with 61 cases in each group. In addition to pretreatment for all patients, patients in the control group were given combined treatment of Beyond LED whitening and fluoride removal agent; while patients in the experimental group were given microabrasion before LED whitening, with the same subsequent treatment process as that in the control group. The whitening effect and tooth sensitivity during whitening were compared between the two groups at the completion of treatment, 1 month and 6 months after treatment. SPSS 19.0 software package was employed for statistical analysis. RESULTS: There were no ineffective or lost patients in 2 groups. The effective rate of whitening for patients in the experimental group at completion of treatment, 1 month and 6 months after treatment was significantly higher than that in the control group (P<0.05). There was no case with tooth sensitivity during treatment. There was no significant difference in non-significant sensitivity rate or significant sensitivity rate between the 2 groups (P>0.05). CONCLUSIONS: Combined treatment with fluoride removal agent and microabrasion technology in LED teeth whitening for dental fluorosis can significantly improve the whitening effect and will not interfered by significantly increased tooth sensitivity.

[Temporal and spatial distribution of rice drought in Southwest China].

Considering the characteristics of rice production and climate conditions in Southwest China, an agricultural drought monitoring model based on wetness index anomaly rate (Mp) by calculating the variation of deviation from average values of relative humid index was established, and was used to analyze the spatial-temporal distribution characteristics of the rice drought during the growth season in Southwest China in the past 50 years (1961-2010). The applicability of the Mp model in Southwest China was verified by using this model to monitor the rice drought. The result showed there was a decreasing trend in the frequency of rice drought in term of the decadal variability. The areas with high drought risk mainly concentrated in northwestern and mid-eastern Yunnan Province, eastern Sichuan Basin, northeastern Chongqing City, and southeastern Guizhou Province. The drought frequency was highest at the stage from transplanting to tasseling, followed by the stage from grain filling to maturity, and was lowest at the stage from tasseling to grain filling. Mp was suitable for monitoring the rice drought in Southwest China, and could be used as a reference for the rice planting areas without irrigation data.

Synchronous fluorescence determination and molecular modeling of 5-Aminosalicylic acid (5-ASA) interacted with human serum albumin.

In this paper, we proposed a new method for the determination of either human serum albumin (HSA) or 5-Aminosalicylic acid (5-ASA) by synchronous fluorescence spectra and examined the interaction between them using the molecular modeling method under simulative physiological conditions. The optimum conditions of synchronous fluorometric determination of HSA were investigated and the method was successfully applied to the determination of 5-ASA added to serum, urine, and saliva samples. The linear range of the determination of HSA and 5-ASA were 1.60 - 414 microg mL(-1) and 0.76 -22.95 microg mL(-1), the detection limits were 0.552 microg mL(-1) and 0.38 microg mL(-1), respectively. In addition, the effect of various common ions on the determination of HSA with 5-ASA was also discussed at room temperature.

[Shaping ability of two nickel-titanium rotary systems in simulated S-shaped canals].

OBJECTIVE: To evaluate the shaping ability of two nickel-titanium rotary systems (ProTaper and Hero642) in simulated S-shaped canals. METHODS: Thirty simulated S-shaped canals were randomly divided into three groups and prepared by ProTaper, Hero642, ProTaper combined with Hero642 respectively. All the canals were scanned before and after instrumentation, and the amount of material removed in the inner and outer wall and the canal width after instrumentation were measured with a computer image analysis program. RESULTS: There was significant difference in the amount of material removed at the inner side of apical curvature and outer side of apex between ProTaper combined with Hero642 and ProTaper files (P < 0.05) at the same tip size. The inner and outer wall of the canals were evenly prepared by ProTaper combined with Hero642, and the taper of canals were better than those prepared by Hero642. CONCLUSIONS: ProTaper combined with Hero 642 had better shaping ability to maintain the original shape and could create good taper canals in the simulated S-shaped canal model.

The shaping effect of the combination of two rotary nickel-titanium instruments in simulated S-shaped canals.

This study aimed to analyze the ability of ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) combined with Hero642 (MicroMega, Besancon, France) to shape the simulated S-shaped canals. Thirty simulated canals with double curvatures, 30 degrees coronally and 20 degrees apically, were randomly divided into three groups and prepared with different instruments: ProTaper in group 1, Hero642 in group 2, and a combination of ProTaper and Hero642 in group 3. All canals were scanned pre- and postoperatively. Each postinstrumentation image was superimposed with the preoperative one in a computer. The amount of material removed from canal wall after every instrument was measured at 14 points. Statistical analysis was performed by using an analysis of variance test at alpha = 0.05. Canals prepared with rotary ProTaper were straightened progressively after the use of F1, and great transportation was created. Hero642 and the combination instruments maintained the original shape of canal with a little transportation. However, the taper of canals prepared with Hero642 was relatively poor.

[Shaping ability of multi-taper nickel-titanium files in simulated resin curved root canal].

OBJECTIVE: To compare the shaping ability of ISO standard stainless steel K files and multi-taper ProTaper nickel-titanium files in simulated resin curved root canals. METHODS Thirty simulated resin root canals were randomly divided into three groups and prepared by stainless steel K files, hand ProTaper, rotary ProTaper, respectively. The amount of material removed from inner and outer wall and canal width after canal preparation was measured, while the canal curvature before and after canal preparation and canals aberrations were recorded. RESULTS: The stainless steel K files removed more material than hand ProTaper and rotary ProTaper at the outer side of apex and inner side of curvature (P < 0.05). The mean degree of straightening in stainless steel K files group was significantly bigger than in ProTaper group (P < 0.05). The canals prepared by ProTaper had no evident aberration. CONCLUSION: The shaping ability of ProTaper is better than stainless steel K files.

[Root canal curvature in chinese mandibular permanent incisors].

OBJECTIVE: To investigate the root canal curvature in Chinese mandibular permanent incisors. METHODS: Two hundred and ninety nine Chinese mandibular permanent incisors were included in this study. The root canals were inserted with stainless steel 15# K files, and then taken radiography from the facial and proximal view by X-ray paralleling technique. Canal curvatures were evaluated by measuring the angle, the radius of the curvatures, and the length of the curved part of the canal. Based on the curved angle and the shape of curved canals, the root canals were classified. RESULTS: The curved angle, radius, and the curved canal length was 5.28 degrees +/- 5.52 degrees, 16.19 mm +/- 12.38 mm, 4.10 mm+/-2.01 mm, respectively in the facial view; 9.99 degrees +/- 5.84 degrees, 18.86 mm +/- 9.71 mm, 3.27 mm +/- 2.39 mm, respectively in the proximal view. The prevalence of straight, light, moderate, and serve curved root canals in mandibular permanent incisors was 15.7%, 66.9%, 16.7%, and 0.7%, respectively (P<0.05) based on the curved angle. The prevalence of straight, L shape, and S shape curved root canals was 7.7%, 50.5%, and 41.8%, respectively (P < 0.05). CONCLUSION: Most of the root canals in mandibular permanent incisors are curve.

[Radiographic anatomy of pulp chamber of Chinese permanent anterior teeth].

OBJECTIVE: The aim of this study was to measure and analyze the anatomic characteristics of the pulp chamber of Chinese permanent anterior teeth radiographically. METHODS: There were 137 human permanent anterior teeth to be used. The crown length, crown width and crown thickness were measured by vernier caliper. Labial-lingual and mesial-distal radiographs were obtained by parallel technique and Photoshop 8.0 was adopted for measuring the largest labial-lingual length, the largest mesial-distal length, the pulp chamber height and the distance between the lingual surface of the crown and the corresponding wall of the pulp chamber; the ratios of the largest labial-lingual length to the crown thickness, the largest mesial-distal length to the crown width and the pulp chamber height to the crown length were calculated. Finally the coefficients of variance were caculated. RESULTS: (1) The ratios of the largest mesial-distal length to the crown width of maxillary and mandibular canines were statistically different from those of the other anterior teeth. There was not statistically significant difference for those ratios either between maxillary and mandibular canines or among incisors. (2) Indexes of the pulp chamber had higher variance than those of the external morphology. (3) The distance between the lingual surface of the crown and the corresponding wall of the pulp chamber had the smallest coefficient of variance. (4) The largest mesial-distal length of the pulp chamber had the largest coefficient of variance, except for the mandibular canines. CONCLUSION: This study provided anatomical basis for clinical work; the distance between the lingual surface of the crown and the corresponding wall of the pulp chamber could be used as a depth reference for the endodontic access, and the access should not be extended excessively in mesial-distal direction.

[Colonization relationship between Porphyromonas gingivalis and Bacteroides forsythus in the infected root canals with chronic apical periodontitis].

PURPOSE: To detect the distribution of P. gingivalis and B. forsythus in the infected root canals from Chinese chronic apical periodontitis, and investigate the colonization relationship between them in the root canals. METHODS: P. gingivalis and B. forsythus in the root canal samples of thirty-eight teeth with chronic apical periodontitis from 31 subjects who were referred to the Sichuan University West China Dental Hospital for dental treatment were studied with a 16S rDNA-directed polymerase chain reaction method. Fisher's exact tset was used to detect B. forsythus in the infected root canals with or without P. gingivalis. OR was used to analyse the relationship between them. RESULTS: The prevalence in 38 teeth was 39.5% for P. gingivalis, and 26.3% for B. forsythus, respectively. Significant positive relationship was shown in the combination of P. gingivalis and B. forsythus (OR=12, P<0.05). CONCLUSION: Both P. gingivalis and B. forsythus colonized in the root canals with chronic apical periodontitis and there was a positive relationship between P. gingivalis and B. forsythus in the infected root canal flora.