Objective To investigate the risk factors and prognosis influential factors of acute kidney injury (AKI) after cardiac surgery.Methods The clinical data of patients who were hospitalized and underwent cardiac surgery from April 2009 to May 2011 were collected prospectively.Demographic characteristics,types of surgeries,preoperative renal function,pre-and intra-operative conditions and clinical outcomes,etc were recorded.Results A total of 4007 patients underwent cardiac surgery were recruited.The overall incidence of AKI was 31.2％ (1250/4007).The incidence of AKI requiring renal replacement treatment (AKI-RRT) was 2.6％ (104/4007).The overall hospital mortality was 1.9％ (77/4007),and was significantly higher in AKI group than in non-AKI group (5.4％ vs 0.3％,P ＜0.01).The hospital mortality of AKI-RRT group was 36.5％ (38/104).Grouped by type of surgery,cardiac transplantation had the highest AKI incidence (73.0％) and highest in-hospital mortality (18.9％),followed by coronary artery bypass grafting (CABG) combined with valve surgery (AKI incidence 57.8％,in-hospital mortality 6.1％) and aneurysm surgery (AKI incidence 52.0％,in-hospital mortality 5.5％).Multivariate logistic regression analysis showed that man,age,BMI,hypertension,chronic heart failure,pre-operative serum creatinine (SCr) ＞ 106.0 μmol/L,intra-operative cardiopulmonary bypass time,intra-operative hypotension and aneurysm surgery were the risk factors of AKI after cardiac surgery.Multivariate logistic regression analysis showed that pre-operative SCr ＞ 106.0 μmol/L and intra-operative hypotension were independent risk factors of renal recovery after cardiac surgery while recovery of urine output was the favorable factor.Conclusions Cardiac surgery usually induces high AKI incidence and poor prognosis,which closely associated with many risk factors in peri-operative stage.The incidence of AKI is related to a number of perioperative risk factors.Heart transplantation,aneurysm surgery,CABG combined valve surgery are high risk surgeries.

PURPOSE: . To compare the sagittal condylar inclination (SCI) in dentate individuals measured by the different methods with mechanical articulator (MA), virtual articulator (VA), and a jaw tracking device (JTD) system. MATERIALS AND METHODS: . A total of 22 healthy dentate participants were enrolled in this study. For MA workflow, the SCI was obtained by a semi-adjustable articulator with protrusive interocclusal records. The SCI was also set on a VA by aligning intraoral scan (IOS) with cone beam computed tomography (CBCT) and facial scan (FS), respectively. These virtual workflows were conducted in a dental design software, namely VAIOS-CBCT and VAIOS-FS . Meanwhile, a JTD system was also utilized to perform the measurement. Intraclass correlation was used to assess the repeatability within workflows. The bilateral SCI values were compared by Wilcoxon matched-pairs signed rank test for each workflow, and Kruskal-Wallis test and post hoc p-value Bonferroni correction were used to compare the differences among four workflows. The agreement of VAIOS-CBCT , VAIOS-FS , and JTD compared with MA was evaluated by Bland-Altman analysis. RESULTS: . Intraclass correlation of the SCI revealed a high degree of repeatability for each workflow. There were no significant differences between the left and right sides (P > .05), except for VAIOS-CBCT (P = .028). Significant differences were not found between MA and VAIOS-FS (P > .05). Bland-Altman plots indicated VAIOS-CBCT , VAIOS-FS , and JTD were considered to substitute MA with high 95% limits of agreement. CONCLUSION . The workflow of VAIOS-FS provided an alternative approach to measure the SCI compared with MA.

PURPOSE: . The purpose of this in vitro study was to assess whether scanning strategies of virtual interocclusal record (VIR) affect the accuracy of VIR during intraoral scanning. MATERIALS AND METHODS: . Five pairs of reference cubes were added to the digital upper and lower dentitions of a volunteer, which were printed into resin casts. Subsequently, the resin casts were articulated in the maximal intercuspal position in a mechanical articulator and scanned with an industrial computed tomography system, of which the VIR was served as a reference VIR. The investigated VIR of the upper and lower jaws of the resin master cast were recorded with an intraoral scanner according to 9 designed scanning strategies.Then, the deviation between the investigated VIRs and reference VIR were analyzed, which were measured by the deviation of the distances of six selected reference points on the upper reference cubes in each digital cast to the XY-plane between the investigated VIRs and reference VIR. RESULTS: . For the deviation in the right posterior dentitions, RP group (only scanning of right posterior dentitions) showed the smallest deviation. Besides, BP group (scanning of bilateral posterior dentitions) showed the smallest deviation in the left posterior dentitions. Moreover, LP group (scanning of left posterior dentitions) showed the smallest deviation in the anterior dentitions. For the deviation of full dental arches, BP group showed the smallest deviation. CONCLUSION . Different scanning strategies of VIR can influence the accuracy of alignment of virtual dental casts. Appropriate scanning strategies of VIR should be selected for different regions of interest and edentulous situations.

Phytoestrogens refer to a class of compounds in plants that can bind to and activate estrogen receptors in mammalian organisms,exerting varying degrees of protective and improvement effects on the body.Modern pharmacological studies have found that phytoestrogens have therapeutic effects on the cardiovascular system,nervous system,endocrine system,immune system,and so on.It is worth noting that the binding of phytoestrogens to estrogen receptors in the brain can produce central neuroprotective effects and improve learning and cognitive impairment in Alzheimer's pectients through multiple targeted pathways.This paper describes the research progress and related mechanisms of phytoestrogen-like monomers,Chinese herbal medicine,and compound formulations in Alzheimer's disease.The aim is to provide new drug design ideas and solutions for the effective treatment of senile dementia with traditional Chinese medicine.

Objective To analyze the correlations of D-dimer and the Global Registry of Acute Coronary Events(GRACE)score with long-term heart failure(HF)in patients with acute myocardial infarction(AMI).Methods A total of 398 patients with AMI were selected as research objects and divided into normal D-dimer group(n=309)and elevated D-dimer group(n=89)based on the D-dimer level.Cox proportional hazard model was used to analyze the risk factors for long-term HF in both groups.Time-dependent receiver operating characteristic(ROC)curve was used to analyze the values of D-dimer,GRACE score and their combination in predicting long-term HF.According to the GRACE score and D-dimer level,398 patients were divided into low-value group(181 patients with normal D-dimerand low GRACE score),high-value group(70 patients with elevated D-dimer and high GRACE score),and middle-value group(147 patients did not meet the conditions of the low-value and high-value groups).Kaplan-Meier method was used to analyze the occurrence of long-term HF in the three groups.Point-biserial analysis was used to analyze the correlation between elevated D-dimer and the occurrence of long-term HF.Results The number of patients with long-term HF in the elevated D-dimer group was 2.3 times of the normal group.D-dimer and GRACE score were independent risk factors for long-term HF in patients with AMI(P＜0.05).Both D-dimer and GRACE score had certain predictive values for the occurrence of HF at 5 years after AMI,but the predictive efficiency of GRACE score was better.The incidence of long-term HF in the high-value group was significantly higher than that in the low-value group and the middle-value group(P＜0.01).D-dimer was signif-icantly positively correlated with the occurrence of long-term HF after AMI(P＜0.001).Conclu-sion Both D-dimer and GRACE score are independent risk factors for long-term HF in patients with AMI,and the two indexes have certain predictive value for the occurrence of long-term HF.Patients with both elevated indicators are high-risk groups for long-term HF.

Objective To analyze the correlations of D-dimer and the Global Registry of Acute Coronary Events(GRACE)score with long-term heart failure(HF)in patients with acute myocardial infarction(AMI).Methods A total of 398 patients with AMI were selected as research objects and divided into normal D-dimer group(n=309)and elevated D-dimer group(n=89)based on the D-dimer level.Cox proportional hazard model was used to analyze the risk factors for long-term HF in both groups.Time-dependent receiver operating characteristic(ROC)curve was used to analyze the values of D-dimer,GRACE score and their combination in predicting long-term HF.According to the GRACE score and D-dimer level,398 patients were divided into low-value group(181 patients with normal D-dimerand low GRACE score),high-value group(70 patients with elevated D-dimer and high GRACE score),and middle-value group(147 patients did not meet the conditions of the low-value and high-value groups).Kaplan-Meier method was used to analyze the occurrence of long-term HF in the three groups.Point-biserial analysis was used to analyze the correlation between elevated D-dimer and the occurrence of long-term HF.Results The number of patients with long-term HF in the elevated D-dimer group was 2.3 times of the normal group.D-dimer and GRACE score were independent risk factors for long-term HF in patients with AMI(P＜0.05).Both D-dimer and GRACE score had certain predictive values for the occurrence of HF at 5 years after AMI,but the predictive efficiency of GRACE score was better.The incidence of long-term HF in the high-value group was significantly higher than that in the low-value group and the middle-value group(P＜0.01).D-dimer was signif-icantly positively correlated with the occurrence of long-term HF after AMI(P＜0.001).Conclu-sion Both D-dimer and GRACE score are independent risk factors for long-term HF in patients with AMI,and the two indexes have certain predictive value for the occurrence of long-term HF.Patients with both elevated indicators are high-risk groups for long-term HF.

The idea of disease prevention runs through the traditional medical diagnosis and treatment system,and also plays an important role in the prevention and treatment of gastric precancerous lesions.This article organically combines disease differentiation,syndrome differentiation,symptom differentiation,and constitution differentiation to form a four in one diagnosis and treatment model.Disease differentiation means identifying the name of the disease and grasping the progression stage of the disease;syndrome differentiation means combining the macroscopic and microscopic aspects to accurately grasp the pathogenesis;symptom differentiation means identifying complications and clinical problems that need to be solved urgently;constitution differentiation means predicting syn-drome type bias and disease development.This model not only enables systematic diagnosis and treatment of gastric precancerous le-sions,but also provides targeted diagnosis and treatment plans for patients,with the characteristics of comprehensiveness,full process,and personalization.Therefore,combining the four in one diagnosis and treatment model of disease differentiation-syndrome differentia-tion-symptom differentiation-constitution identification with the disease prevention theory is conducive to the early detection of gastric precancerous lesions,timely tracking of the progress of the lesions,and the adoption of correct,comprehensive,and full-process inter-vention methods to reverse gastric precancerous lesions,which can play a positive role in the diagnosis,treatment,and prevention of gastric precancerous lesions.

OBJECTIVES: This study aimed to compare the effects of virtual adjustment on occlusal interferences in mandibular posterior single crown and three-unit bridge restorations by using the mandibular movement track and the movement parameters of a virtual articulator. METHODS: Twenty-two participants were recruited. Digital casts of the maxillary and mandibular arches were obtained using an intraoral scanner, and the jaw registration system was used to record the data of the mandibular movement track and the movement parameters of the articulator. Four kinds of restorations with 0.3 mm occlusal interferences were designed with dental design software. In particular, single crowns were designed for teeth 44 and 46, whereas three-unit bridges were designed for teeth 44-46 and 45-47, and the corresponding natural teeth were virtually extracted. Virtual adjustment of the restorations was performed using two dynamic occlusal recordings, namely, the mandibular movement track and the movement parameters of the virtual articulator. A reverse-engineering software was used to measure the root-mean-square of the three-dimensional deviation of the occlusal surfaces between natural teeth and the adjusted restorations. The differences between the two methods of virtual-occlusion adjustment were compared and analyzed. RESULTS: For the same group of restorations, the three-dimensional deviation of the mandibular movement track group were lower than those of the virtual articulator group, and the differences were statistically significant (P<0.05). For the four groups of restorations adjusted by the same method, the three-dimensional deviation of the 46-tooth single crown was the largest and the smallest three-dimensional deviation was that of the 44-tooth single crown. Statistical differences existed between the 44-tooth single crown and the other groups (P<0.05). CONCLUSIONS For the occlusal design of posterior single crown and three-unit bridge, the mandibular movement track could be a more effective approach to virtual occlusal adjustment than the movement parameters of the virtual articulator.
Humans ; Mouth, Edentulous ; Occlusal Adjustment ; Jaw Relation Record ; Dental Articulators ; Software

Objective To investigate the effect of sodium-glucose cotransporter 2 inhibitor (empagliflozin, EMPA) on myocardial remodeling in a mouse uremic cardiomyopathy (UCM) model induced by 5/6 nephrectomy, through the phosphatidylinositol 3 kinase (PI3K)/protein kinase B (PKB/AKT)/p65 signaling pathway. Methods The animals were divided into three groups: Sham group (n=6), UCM group (n=8), and UCM＋EMPA group (n=8). A UCM model was established in C57BL/6N mice using the 5/6 nephrectomy. Starting from 5 weeks post-surgery, EMPA or a placebo was administered. After 16 weeks, blood pressure, serum creatinine, blood urea nitrogen, 24-hour urine glucose and urine sodium were measured. Cardiac structure and function were assessed by echocardiography. Hematoxylin-eosin (HE) staining and Masson trichrome staining were used to observe pathological changes in the heart and kidneys. Wheat germ agglutinin (WGA) staining was used to evaluate myocardial hypertrophy. The real-time quantitative PCR (RT-qPCR) was used to detect the expression levels of myocardial hypertrophy- and fibrosis-related mRNAs. Western blotting was used to detect the expression levels of PI3K, AKT and p65 in myocardial tissues. Results After 16 weeks, UCM group exhibited significantly higher blood pressure, serum creatinine, blood urea nitrogen than sham group (P＜0.01); UCM＋EMPA group exhibited lower blood pressure, serum creatinine, blood urea nitrogen, and higher 24 h urine sodium and glucose than UCM group (P＜0.05). Echocardiographic results showed ventricular remodeling in the UCM group, evidenced by left ventricular wall thickening, left ventricular enlargement, increased left ventricular mass, and decreased systolic function (P＜0.05); ventricular remodeling was alleviated (P＜0.05), though there was no significant improvement in systolic function in UCM＋EMPA group. HE and Masson stainings revealed myocardial degeneration, necrosis, and interstitial fibrosis in UCM group (P＜0.01); the myocardial pathology improved with reduced collagen deposition in UCM＋EMPA group (P＜0.01). WGA staining confirmed myocardial hypertrophy in UCM group (P＜0.01), while myocardial hypertrophy was alleviated in UCM＋EMPA group (P＜0.01). RT-qPCR results showed myocardial hypertrophy- and fibrosis-related genes (NPPA, NPPB, MYH7, COL1A1, COL3A1, TGF-β1) were upregulated in UCM group (P＜0.05), but downregulated in UCM＋EMPA group. Western blotting showed PI3K, p-AKT/AKT ratio, and p-p65/p65 ratio were increased in UCM group, but decreased in UCM＋EMPA group (P＜0.05). Conclusion EMPA can improve myocardial hypertrophy and fibrosis in the UCM mouse model, and it may play the role through inhibiting the PI3K/AKT/p65 signaling pathway.