Evaluating high power laser therapy (HPLT) as treatment for chemotherapy-induced oral mucositis in paediatric patients with oncohematological diseases.

BACKGROUND: Oral mucositis (OM) is one of the most debilitating side effects of chemotherapy. Among the current methods used in OM management, the feasibility of high power laser therapy (HPLT) has been proposed but not fully evaluated. AIM: The aim of this study was to evaluate the efficacy of HPLT in the treatment of OM in paediatric patients. DESIGN: Fourteen oncohematological paediatric patients treated with chemotherapy and/or hematopoietic stem cell transplantation and affected by OM at different grades were enrolled in this study. All patients were treated with a class IV laser device in four sessions for four consecutive days, OM was evaluated with the WHO-OTS scale. The perception of pain was assessed by the visual analog scale. Photographs of and information about lesions and patient questionnaires were taken and collected, respectively. Descriptive analyses and the Wilcoxon signed-rank test (nonparametric test) were used, with a statistical significance of α = .05. RESULTS: After a week into the treatment, 57% of patients were completely healed, whereas the whole cohort experienced a drastic decrease in pain, from an average value of 5.8-1.1 (p = .0016). The average number of injuries per patient decreased from 7.4 to 3.1 (p = .008). CONCLUSION: High power laser therapy appears to be a safe and efficacious method for managing OM. It reduces pain and severity of oral cavity injuries. Further studies are needed to determine the optimal parameters useful in OM treatment and to evaluate the relative effectiveness of HPLT to other treatments like LLLT.

[Effective delivery of quality markers in alcohol precipitation of Pudilan Xiaoyan Oral Liquid].

Taking Pudilan Xiaoyan Oral Liquid as a demonstration, the effective delivery of quality markers in alcohol precipitation of Chinese medicine oral liquid preparations was studied. With the transfer rates of adenosine, corynoline, cichoric acid, baicalin, and wogonin as evaluation indexes, the effect of the density of concentrate before alcoholic precipitation, volume fraction of ethanol, stirring speed, temperature of concentrated solution, stirring time, alcohol concentration, alcohol precipitation time, alcoholic precipitation temperature, alcohol addition rate, and the pH of concentrate on the alcohol precipitation process was investigated by Plackett-Burman trial design, thus obtaining the key factors that influenced the alcohol precipitation process. The key factors were further optimized by Box-Behnken design to determine the optimal alcohol precipitation conditions. When the density of concentrate before alcoholic precipitation was 1.12 g·mL~(-1), the pH of concentrate was 6.86, and the alcohol concentration was 50.00%, the transfer rates of baicalin and wogonin were 91.86% and 87.78%, respectively. When the density of concentrate before alcoholic precipitation was 1.13 g·mL~(-1), the concentration of alcohol was 74.50%, and the alcoholic precipitation temperature was 17.0 ℃, the transfer rates of adenosine, corynoline, and cichoric acid were 85.95%, 71.62% and 83.19%, respectively. The method of optimizing alcohol precipitation techniques and determining the parameters of Pudilan Xiaoyan Oral Liquid by response surface methodology is reasonable and feasible, which provides guidance and experience for the effective delivery of quality markers in Chinese medicine oral liquid preparations.

Traditional Chinese Medicine Oral Liquids Combined With Azithromycin for Mycoplasma pneumoniae Pneumonia in Children: A Bayesian Network Meta-Analysis.

Background: Mycoplasma pneumoniae pneumonia (MPP) causes flu-like symptoms in children, increasing the burden on the health and education systems. In China, traditional Chinese medicine oral liquids (TCMOLs) combined with azithromycin (TCMOLs + Azithromycin) is commonly used to treat MPP in children. However, TCMOLs with the optimal clinical applicability remain unknown. Here, we evaluated the clinical effectiveness and safety of TCMOLs + Azithromycin in children with MPP. Methods: We searched PubMed, Embase, Cochrane Library, Ovid, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and VIP information resource integration service platform databases for eligible randomized controlled trials (RCTs) published from database inception to October 2020. Two reviewers independently performed data extraction and risk of bias assessment. After Bayesian random effect modeling and surface under the cumulative ranking curve (SUCRA) scoring, we ranked each intervention. We assessed heterogeneity using multivariate meta-regression for potential modifiers and used the Grading of Recommendations, Assessment, Development, and Evaluation to rate pooled evidence's certainty. Results: In the 63 included RCTs with 6,410 children, five different TCMOLs were combined with azithromycin. TCMOLs + Azithromycin had significantly better primary outcomes than did azithromycin alone. Of all TCMOLs, Xiaoer Xiaoji Zhike (XEXJZK)+Azithromycin showed the best effectiveness with respect to the response rate (odds ratio [OR] = 6.5, 95% credible interval [CrI] = 4.3-10; low certainty) and pulmonary rales disappearance time (mean difference [MD] = -2.1, 95% CrI: -2.9 to -1.2; low certainty) with SUCRA 85 and 80%, respectively. Pudilan Xiaoyan + Azithromycin showed the highest effectiveness with respect to cough disappearance time (MD = -2.6, 95% CrI: -3.4 to -1.7; very low certainty) and fever disappearance time (MD = -1.8, 95% CrI: -2.3 to -1.3; very low certainty) with SUCRA 87 and 87%, respectively. The difference in the adverse effects between TCMOLs + Azithromycin and azithromycin alone was nonsignificant. Conclusion: Of the different TCMOLs, XEXJZK may be the best option to combine with azithromycin to treat children with MPP. However, our results should be interpreted with caution due to the low certainty of evidence. In general, TCMOLs' safety remains unclear because of a lack of evidence. More high-quality RCTs are needed to further evaluate efficacy and safety of these TCMOLs.

Prospective cohort 3D study of dental arches in children with bilateral orofacial cleft: Assessment of volume and superimposition.

BACKGROUND: Cohort studies have evaluated dental arches of children. AIM: To evaluate the volumetric, linear, palatal surface area, and the dental arch superimposition of participants with bilateral complete cleft lip (BCL) and bilateral cleft lip and palate (BCLP) surgically treated in a specialized hospital. DESIGN: One hundred and thirty six digitized dental models evaluated before cheiloplasty (T1), after cheiloplasty (T2), and after palatoplasty (T3). The stereophotogrammetry software analysed the volume, palate superimposition, linear, and area measurements. RESULTS: In BCL group, at T2, C-C', T-T', area, and volume significantly increased (P = .000, P < .000, P = .010 e P = .003, respectively). In BCLP group, the comparison T3 × T1 showed that C-C' decreased, whereas T-T' and the area increased (P < .000, P < .000, P = .000). The volume increased at T2, but decreased at T3 (P < .000) in participants with BCLP. The intergroup analysis revealed that C-C', T-T', I-C', and I-C were significantly smaller in participants with BCLP (P < .000, P = .016, P = .001 e P = .020, respectively), whereas the volume, superimposition, and area were statistically similar between groups (P > .05). CONCLUSION: The comparison between bilateral orofacial clefts showed reduction in the transversal and anteroposterior linear measurements, but not in the area and volume, which was confirmed by the superimposition of the dental arches.

[Improvement of compliance of Pudilan Xiaoyan Oral Liquid based on comprehensive analysis of bad taste of traditional Chinese medicine oral liquid preparation].

From "good efficacy with a bad taste" to "good efficacy with no bitterness" and then to "good efficacy with a good taste" is the only way to develop oral liquid preparations of traditional Chinese medicine, and "good medicine is beneficial to disease" is the only way for the development of oral liquid preparations of traditional Chinese medicine. Based on the analysis of the causes, the sources of bitterness, the formation principles and their solutions of traditional Chinese medicine oral liquid preparations, we explored the causes of the bad taste and the material basis of bitterness of Pudilan Xiaoyan Oral Liquid, and applied the solutions in improving the taste of Pudilan products. The overall taste of Pudilan Xiaoyan Oral Liquid was improved by modifying the original product taste, enhancing the process and changing the dosage form, which improves the compliance of the patients who take the medicine, and better serve the clinical medication.

Design principle and application prospect of a novel Chinese medicine oral instant powders / 中草药

Excellent taste is of great significance to ensure the clinical efficacy of traditional Chinese medicine. Aiming at the deficiency of traditional Chinese medicine powder preparation and the demand of children and elderly people with insufficient swallowing function, a novel dosage form called Chinese medicine oral instant powders was proposed. The introduction of this concept was inspired by the characteristics of ancient Jujube Instant Beverage, Longjiao Powders from Japan and freeze-dried tablets. It was also based on the understanding of the structure-property-function of traditional Chinese medicine powder, and integrated powder modification technology, taste masking technology, and the pretreatment technology of raw materials. In this manuscript, the concept, basic characteristics, composition of raw materials and accessories, design principle, process route, core equipment, quality evaluation methods and technical advantages of Chinese medicine oral instant powders were introduced in detail. It is hoped that the development of Chinese medicine oral instant powders will help to meet the needs of special population. Meanwhile, it will provide new ideas and technologies for the innovation of powder decoctions, hospital preparations and Chinese patent medicine powders in new era.

A Modified QuEChERS Method for Determination of Pyrethroid Residues in Traditional Chinese Medicine Oral Liquids by High-Performance Liquid Chromatography.

Pyrethroid residues in traditional Chinese medicines have been a serious threat to the health and treatment of patients. However, because of the matrix complexity of traditional Chinese medicine, the detection of pyrethroid residues remains a challenge. Therefore, we developed a QuEChERS method coupled with high-performance liquid chromatography and ultraviolet detection (HPLC-UV) for the determination of pyrethroid pesticides in three kinds of traditional Chinese medicine oral liquid preparations, and we investigated and optimized the extraction conditions. The matrix effect was estimated in the organic solvent and the actual samples by comparing the slopes of calibration curves, and the results showed that the matrix effect is not significant when using the modified QuEChERS method. The pyrethroid pesticides could be completely separated in 30 min. The linear correlation coefficients were more than 0.999, and the recoveries of all the pyrethroid pesticides ranged from 87.2% to 104.8%. The intra-day precisions (n = 5) were 2.44-4.62%, and the inter-day precisions (n = 5) were 1.06-3.02%. Moreover, the limits of detection were in the range of 0.007-0.018 ng mL-1, while the limits of quantitation were in the range of 0.022-0.057 ng mL-1. This simple, low-cost, and highly sensitive analytical method can be a potential tool for the analysis of pyrethroid residues in traditional Chinese medicine oral liquid preparations.

Management of compromised first permanent molars in children: Cross-Sectional analysis of attitudes of UK general dental practitioners and specialists in paediatric dentistry.

BACKGROUND: It is unclear on how children with compromised first permanent molars (cFPMs) are currently managed in the UK by either general dental practitioners (GDP) or specialists in paediatric dentistry (SPD). AIM: Explore the current attitudes to the management of compromised first permanent molars amongst UK general dental practitioners and specialists in paediatric dentistry. DESIGN: Self-completed online questionnaire including three clinical vignettes of 7, 9, and 15 years old with cFPM. All registered SPDs (n = 236), as of May 2017, 500 randomly selected GDPs from England, selected from a national performers list, and 52 Scottish GDPs, part of Scottish dental practice research network, were invited to complete the questionnaire. RESULTS: About 71.6% (n = 53) of SPDs agreed that children with cFPM should be referred to a paediatric specialist for treatment planning, whereas the reverse for GDPs is true, as 86.8% (n = 138) believe they have a responsibility to treat these teeth. Responses to clinical vignettes suggest a slight preference amongst GDPs to restore cFPM, including root canal treatment, whereas SPDs have a slight preference towards extraction. CONCLUSION: Current pathways for cFPM, amongst UK general dental practitioners and specialists in paediatric dentistry, vary greatly between and within each professional group.

Comparative analysis of curative effect of combination therapy of acupuncture and medicine in the treatment of knee osteoarthritis / 中国基层医药

Objective To study the clinical effect of combination therapy of acupuncture and medicine in the treatment of knee osteoarthritis.Methods 500 cases of knee osteoarthritis were studied.250 patients from January to June 2015 were selected as the control group with using moxibustion and Chinese medicine for oral treatment;150 patients from July to December 2015 were selected as observation group with using acupuncture and Chinese herbal medicine for oral treatment.The clinical effect of the two groups of patients were compared.Results The total effective rate of clinical treatment in the observation group was 93.60％,which was significantly higher than 76.80％ the control group,the difference between the two groups was statistically significant (x2 =27.98,P ＜ 0.05).At the same time,the total score of Lequesne and the individual score of the observation group were significantly better than those of the control group (P ＜ 0.05).Conclusion Acupuncture combined with traditional Chinese medicine for oral osteoarthritis in patients with clinical treatment has a significant clinical effect,can effectively improve the patient's knee function,ease the clinical symptoms of patients,and it has the exact effect,it is worthy of clinical promotion.

Estudo epidemiológico das lesões bucais no período de 05 anos / Epidemiological study of oral lesion in the period of 05 years

Introdução: Os estudos epidemiológicos perfazem uma grande área da pesquisa desempenhando um importante papel, pois revelam a prevalência de inúmeras doenças, e particularizam a sua distribuição dentro de características próprias do ambiente onde estão sendo executados. Métodos: Este estudo tem como o principal objetivo avaliar os prontuários dos pacientes da disciplina de Semiologia da Universidade Cidade de São Paulo entre os anos de 2003 a 2008, avaliando as informações referentes à ocorrência das lesões; isoladamente e por grupos de classificação; características como: idade, gênero, etnia; tipo de biópsia e diagnóstico histopatológico. Conclusões: Entre as lesões diagnosticadas através de anátomo-patológico, a hiperplasia fibrosa inflamatória ocorreu com mais frequência e o gênero mais acometido foi feminino entre a 5ª e 6ª década.

Introduction: Epidemiological studies make up a large area of research and play an important role, highlighting the prevalence of various diseases, and specify the distribution of characteristics in the environment they are running. Methods: This study evaluates the main patients? charts of Semiology University of São Paulo City between the years 2003 to 2008, evaluating the information related to the occurrence of injuries, isolation and classification groups; characteristics such as age, gender, race, type of biopsy and histopathological diagnosis. Conclusions: Among the lesions studied inflammatory fibrous hyperplasia was the most frequent diagnosis, the most affected gender was female between the 5th and 6th decade.