OBJECTIVEThe aim of this study was to evaluate quantitatively the effectiveness and feasibility of the modified supracrestal fiberotomy (MSF) and the contact point reproximation (CPR) in decreasing the relapse of anterior segments rotating and/or crowding after orthodontic treatment.

METHODSA total of 129 patients with crowding and/or rotated anterior teeth were selected for this study, and the average age was 13.07 years (54 males, 75 females). The modified supracrestal fiberotomy was performed on the anterior segments of patients in the experimental group (48 cases). After the anterior teeth were aligned, 23 of the 48 cases received a further treatment of the contact point reproximation on the anterior segments (the subgroup of MSF + CPR), and the other 25 subjects did not receive this treatment (the subgroup of MSF). The control group consisted of 81 cases. All cases wore Hawley retainers for 1.8 to 2.3 years, and all the patients were revisited 2.4 years postretention. The maxillary and mandibular dental models of all the patients were taken before treatment (T1), at the end of the treatment (T2) and 2.4 years postretention (T3).

RESULTSThe relapse rate in the experimental group [(T3-T2)/T1 x 100%] was 21.6%, lower than that in the control group (P < 0.001). The relapse rate of mandible in the subgroup of MSF + CPR was 6.56% lower than that of the subgroup of MSF (P < 0.05). But the relapse rate of maxillary in the subgroups of MSF + CPR was similar as that of the subgroup of MSF (P > 0.05).

CONCLUSIONThe modified supracrestal fiberotomy can effectively alleviate relapse after orthodontic treatment of the crowding and/or rotation of anterior teeth. The treatment combining MSF and CPR can help maintain the stability of post-retention of mandibular anterior teeth.

Adolescent ; Child, Preschool ; Female ; Humans ; Male ; Malocclusion ; therapy ; Orthodontics, Corrective ; methods ; Risk Factors ; Rotation ; Secondary Prevention ; Sex Factors ; Statistics, Nonparametric ; Tooth Extraction ; Tooth Movement Techniques ; Treatment Outcome

OBJECTIVE: To evaluate the effectiveness and security of posterior percutaneous endoscopic cervical discectomy (PPECD) in the treatment of single level cervical spondylopathy with intraspinal ossification. METHODS: Twenty three patients with single level cervical spondylopathy with intraspinal ossification were treated by posterior percutaneous endoscopic cervical discectomy between August 2017 and July 2019. There were 16 males and 7 females, aged from 29 to 74 years old with an average of (50±13) years.The disease duration were 3 to 120 months with a median of 6 months. There were 9 cases of cervical spondylotic radiculopathy, 6 cases of cervical spondylotic myelopathy, and 8 cases of mixed cervical spondylopathy. According to the characteristics of ossification, 17 cases were osteophytes on the posterior edge of the vertebral body;3 cases were protrusion ossification;3 cases were posterior longitudinal ligament ossification. According to the position of ossification in spinal canal, 14 cases were medial and lateral type, 5 cases were central type, and 4 cases were mixed type. Posterior percutaneous cervical endoscopic cervical discectomy in patients performed by the same surgeon. Japanese Orthopaedic Association (JOA) score and visual analogue scale(VAS) were compared separately before and after operation. At 3 months after operation, clinical effect was assessed according to modified Macnab standard. RESULTS: All operations were successful. The operative time was 30 to 155 (69.1±27.2) min. The bedridden time was 2 to 3(3.0±0.9) h, length of postoperative hospitalization was 2 to 7(4.1± 1.5) d. Three dimensional CT reconstruction of the cervical spine at 3 days after operation showed that ossified tissue of 13 cases were completely removed, and 10 cases were left after operation, and the residual was located at the posterior edge and/or center of the upper vertebral body. VAS score at discharge from hospital was significantly lower than that before operation ( CONCLUSION For an experienced surgeon, percutaneous posterior cervical endoscopic discectomy is safe and reliable in treating single level cervical spondylopathy with intraspinal ossification, and can obtain good clinical results.
Adult ; Aged ; Cervical Vertebrae/surgery* ; Diskectomy ; Diskectomy, Percutaneous ; Endoscopy ; Female ; Humans ; Intervertebral Disc Displacement/surgery* ; Male ; Middle Aged ; Osteogenesis ; Retrospective Studies ; Treatment Outcome

This article reviews the high-risk factors, risk assessment tools, information identification systems, and nursing management strategies of incontinence-associated dermatitis, in order to provide evidence for medical and nursing staff to choose appropriate identification tools and early identify high-risk patients with incontinence-associated dermatitis.

Our previous finding showed that down-regulation of CD3ζ gene was detected in patients with chronic myeloid leukemia (CML). In order to further elucidate the feature of T cell immune status in the signal transduction in CML patients, the expression patterns of all 4 CD3 genes were characterized in peripheral blood of patients, the expression levels of CD3γ, δ, ε and ζ chain genes were detected by real time qPCR with SYBR Green I staining in peripheral blood mononuclear cells (PBMNCs) from 17 cases of de novo CML patients in chronic phase and 17 cases of healthy individuals, the ß₂-microglobulin gene was used as an internal reference, and the mRNA expression level of each CD3 gene was evaluated by the 2(-ΔCt) x 100% method. The results showed that the median expression levels of CD3γ, δ and ε genes (2.344%, 0.515% and 3.516%) in CML patients were not significantly different from healthy individuals (p = 0.072, p = 0.190, p = 0.615, respectively), while the expression level of CD3ζ gene in PBMNCs from CML patients (0.395%) was lower than that from healthy individuals (1.538%) (p < 0.001). The expression patterns of 4 CD3 genes in proper order were CD3ε > CD3γ > CD3δ > CD3ζ in CML group, in contrast, the expression patterns were presented as CD3γ > CD3ε > CD3ζ > CD3δ in healthy group. It is concluded that the present study characterized the expression pattern of CD3γ, δ, ε and ζ chain genes in CML patients, lower expression of CD3ζ is the feature of TCR signal transduction immunodeficiency and the expression patterns of 4 CD3 genes are changed in CML patients.
Adolescent ; Adult ; Aged ; CD3 Complex ; genetics ; metabolism ; Case-Control Studies ; Female ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; blood ; genetics ; Lymphocyte Count ; Male ; Middle Aged ; Signal Transduction ; T-Lymphocytes ; metabolism ; Young Adult

BACKGROUNDThe epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI) is playing an important role in the treatment of non-small cell lung cancer.The acquired resistance of EGFR-TKI has become a hot spot.This study aims to investigate VEGF-D expression level in lung adenocarcinoma with or without acquired resistance to gefitinib and in normal lung,so as to explore the role of VEGF-D in resistance of gefitinib.

METHODSLung adenocarcinoma,normal lung tissues adjacent to the carcinoma and adenocarcinoma with acquired resistance to gefitinib including some metastastic lymph nodes were obtained during operation.SYBR Green real-time PCR with beta actin gene as the endogenous control was performed to examine VEGF-D gene expression semi-quantitatively.After positive expression of VEGF-D was determined,the expression ratio and level in each group was analyzed qualitatively and quantitatively.

RESULTSExact significance was computed to compare VEGF-D expression ratios in groups of lung adenocarcinoma with acquired resistance to gefitinib(1/6,16.7%),lung adenocarcinoma(7/14,50.0%) and normal lung(16/16,100.0%) and the difference was significant(P=0.000 091 7).VEGF-D relative expression level in the seven lung adenocarcinoma cases was significantly lower than its corresponding normal lung tissue by analysis of nonparametric test(P < 0.01).

CONCLUSIONSVEGF-D has a high-level expression in normal lung tissues,while has a decreased expression in lung adenocarcinoma with or without acquired resistance to gefitinib,suggesting that VEGF-D functions in lung adenocarcinoma with or without acquired resistance to gefitinib in a way,which is different from in normal lung.

OBJECTIVEThis study aimed to evaluate the effectiveness of multi-disciplinary treatment approaches in reducing neurological disabilities in premature infants.

METHODSA total of 117 infants who were born premature in our hospital between March 2008 and February 2010 but had no congenital malformations and no severe neonatal complications, were enrolled in this study. They were randomly allocated to a multi-disciplinary treatment group (n=63) and a control group (n=54). While patients in the control group underwent an early conventional treatment, those in the multi-disciplinary treatment group were subjected to regular development monitoring, neurological examination and screening for brain injury, neuro-nutrition and neurodevelopment therapies, and rehabilitation training.

RESULTSThe incidence rates of abnormalities in posture, reflex, sleep, muscle tone and EEG were significantly lower in the multi-disciplinary treatment group than in the control froup (P<0.05) at corrected postnatal ages of 6-12 months. At corrected postnatal ages of 6, 12, 18 and 24 months, both mental development index (MDI) and psychomotor development index (PDI) scores were significantly higher in the multi-disciplinary treatment group than in the control group (P<0.05). At corrected postnatal age of 3 years, incidence rates of cerebral palsy, language barrier, abnormal muscle tone and hearing impairment were significantly lower in the multi-disciplinary treatment group than in the control group (P<0.05).

CONCLUSIONSEarly multi-disciplinary intervention approaches may significantly improve mental and motor developments and reduce the incidence of cerebral palsy-associated neurological disabilities in premature infants.

Cerebral Palsy ; prevention & control ; Child, Preschool ; Developmental Disabilities ; prevention & control ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; prevention & control ; Male

Objective:To evaluate the effects of pulmonary rehabilitation on anxiety and depression in patients with chronic obstructive pulmonary disease (COPD) .Methods:The RCTs on application effects of pulmonary rehabilitation in COPD patients were searched in Cochrane Library, Medline, PsycINFO, PubMed, Web of Science, Embase, China Biology Medicine disc, CNKI, Wanfang Database and VIP Database from the establishment of those databases to August 1, 2020. Quality assessment and data extraction were performed for the included articles, and Meta-analysis was performed using Stata 14.0 and RevMan 5.3 software.Results:A total of 14 articles were included, including 1 106 patients. Meta-analysis results showed that pulmonary rehabilitation therapy was helpful to improve the symptoms of depression [ SMD= -0.79, 95% CI (-0.94--0.64) , P<0.01]and anxiety [ SMD=-0.61, 95% CI (-0.82--0.41) , P<0.01]in COPD patients. The results of subgroup analysis showed that the relief degree of depression and anxiety of patients in the intervention group was statistically significantly different from those of the control group ( P<0.01) when the intervention was longer than 3 months or less than or equal to 3 months. Conclusions:Pulmonary rehabilitation can improve the depression and anxiety of COPD patients, and the results of intervention for more than 3 months and less than or equal to 3 months are consistent. Combining the actual clinical situation, the shortest intervention time of 3 months can be used for intervention in order to obtain more ideal intervention effect.

Objective:To evaluate and summarize evidence related to structured skin care for incontinence-associated dermatitis (IAD) in adult inpatients, so as to provide a reference for clinical nursing decision-making.Methods:Clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus related to structured skin care for IAD in adult inpatients were retrieved by computer in British Medical Journal Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Health Care Centre in Australia, Canadian Registered Nurses Association of Ontario, Guidelines International Network, National Guideline Centre, National Institute for Health and Care Excellence, Medlive, the Cochrane Library, PubMed, Web of Science, CINAHL, Embase, WanFang Data, VIP, China National Knowledge Infrastructure, China Biomedical Literature Database. The retrieval time limit was from the establishment of the database to April 30, 2021. Two investigators independently assessed the quality of the included evidence and the level of recommendation.Results:A total of 14 articles were included, involving 2 clinical decisions, 1 practice guideline, 6 evidence summaries, 2 systematic reviews, and 3 expert consensus. A total of 29 best evidence was compiled from 4 aspects of structured skin care assessment, cleansing, moisturizing and isolation.Conclusions:Medical and nursing staff should integrate evidence with clinical scenarios and patient preferences to make optimal clinical decisions on structured skin care and improve the quality of care for adult inpatients with IAD.

BACKGROUNDOveractive bladder (OAB) is a series of symptoms with high prevalence in elderly people. This study was conducted using the overactive bladder symptom score (OABSS) to evaluate the efficacy of solifenacin succinate for the treatment of OAB.

METHODSThis was a prospective, multicenter, single-arm, 12-week study that enrolled 241 OAB patients. The patients received 5-10 mg/day solifenacin. Changes in OABSS, symptoms from voiding diary, perception of bladder condition (PPBC) score, international prostate symptom score (IPSS) and quality of life (QOL) were evaluated at weeks 0, 4, and 12. The relationship between OABSS and PPBC score or parameters of voiding diary was also evaluated.

RESULTSAt baseline, the mean OABSS for all patients was 9.41 ± 2.40, and was reduced significantly at week 12 (-3.76 points; 61.21%, P < 0.0001). The OABSS subscore, PPBC score, IPSS, and QOL were also significantly reduced during the study (P < 0.0001). The overall incidence of adverse events was 19.91% (44 cases). The gastrointestinal system was the most commonly affected (11.31%). Around 5.88% of the cases had adverse events related to the genitourinary system. There was a strong correlation between OABSS and urinary symptoms that was recorded in the 3-day voiding dairy.

CONCLUSIONSWe showed that solifenacin was clinically effective for relieving OAB symptoms, considering the balance between efficacy, patients' well-being, and tolerability. OABSS integrates four OAB symptoms into a single score and can be a useful tool for research and clinical practice.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Muscarinic Antagonists ; therapeutic use ; Prospective Studies ; Quality of Life ; Quinuclidines ; therapeutic use ; Solifenacin Succinate ; Tetrahydroisoquinolines ; therapeutic use ; Treatment Outcome ; Urinary Bladder, Overactive ; drug therapy