Total 1188 subjects aged 35-74 in an urban community of Beijing were recruited by a multistage stratified random sampling procedure. Dental caries were examined by three dentists independently. The prevalence of dental crown caries was 79. 6% (DF), that of DMFS was 24. 39% and the root caries index (RCI) was 3.5% in this group. 22. 3% of the examinees required treatment for the crown caries and 26. 0% for root caries. Bivariate correlation analysis showed that DMFS was significantly correlated with RCI (P <0. 01 ), and there was no significant difference of DMFS and RCI between males and females. The study indicates that dental caries is a common health problem in adults and elderly population of urban Beijing, and the development of community oral health service system is necessary.

OBJECTIVETo investigate the changes of caries susceptibility factors during the transition from caries-free to caries in three-year-old children.

METHODSThe study included 144 caries-free children aged 34-38 months. All participants underwent clinical examination and full-mouth supragingival plaque collection.Survey of children's oral health behaviors involving feeding habits and oral health care was also taken from children's parents of all participants. The children were reexamined 6 and 12 months later. According to the potential changes of caries status in twelve months follow up, all the participants were divided into three groups: caries-free group (caries free children in twelve months follow up), caries at 6-month group (children who were found with caries or cavities fillings at six months review) and caries at 12-month group (children who were caries free at six months but found with caries or cavities fillings at twelve months). Streptococcus mutans (Sm)and Streptococcus sobrinus (Ss) loads were compared among the three groups by real time fluorescence quantitative polymerase chain reaction (FQ-PCR).

RESULTSOne hundred and thirty children completed twelve months review, the dropout rate was 9.7% (14/144). At the end of twelve months follow up, the number of children in caries-free group, caries at 6-month group and caries at 12-month group was 58, 44 and 28 respectively. The changes of oral behavioral habits in caries-free group, caries at 6-month group and caries at 12-month group during twelve months follow up were not significantly different (P > 0.05). At baseline, the frequency of sweets consumption and eating sweets before sleeping in caries-free group was significantly lower than that in caries at 6-month group and caries at 12-month group (P < 0.001). At baseline, the quantity of Sm and Ss in caries at 6-month group[copy number of Sm: (6.33 ± 2.21)×10(3), copy number of Ss: (1.99 ± 0.45)×10(3)] was significantly higher than that in the caries-free group[copy number of Sm: (5.81 ± 2.43)×10(3), copy number of Ss: (1.34 ± 0.53)×10(3)] (P < 0.05). There was no significant difference in the quantity of Sm and Ss in the caries-free group and caries at 12-month group(P > 0.05). At six months, the quantity of Sm and Ss in caries at 12-month group was significantly higher than that in the caries-free group although both groups of children were caries-free at six months (P < 0.05).

CONCLUSIONSThe quantity of Sm and Ss increased six months before the caries onset in three-year-old children.High frequency sweets consumption and eating sweets before sleeping were important susceptibility factors for caries onset in the future.

Child, Preschool ; Dental Caries ; Dental Caries Susceptibility ; Dental Plaque ; Follow-Up Studies ; Humans ; Mouth ; Oral Health ; Real-Time Polymerase Chain Reaction ; Streptococcus mutans ; isolation & purification ; Streptococcus sobrinus ; isolation & purification

OBJECTIVETo determine the quantity of Streptococcus mutans (S. mutans) and the ratio of S. mutans to total bacteria in the dental plaque of different caries-susceptible children.

METHODSDental plaque samples from 26 children aged 3 years old to 4 years old were collected. The quantities of S. mutans and total bacteria were determined by TaqMan real-time fluorescence quantitative polymerase chain reaction (PCR). The ratio ofS. mutans to total bacteria in children with and without caries was calculated and statistically analyzed.

RESULTSIn children with and without caries, the quantities of S. mutans were 1.33 x 10(5) and 1.16 x 10(3) CFU x mg(-1), the total bacteria were 7.17 x 10(7) and 1.01 x 10(8) CFU x mg(-1), and the ratios of S. mutans to total bacteria were 0.058 6 and 0.018 6, respectively. Significant differences were observed in the quantities of S. mutans and the total bacteria as well as in the ratios of S. mutans to total bacteria of the two groups (P = 0.033, 0.418, 0.008).

CONCLUSIONThe quantities of total bacteria of the two groups show negligible difference. However, the quantity of S. mutans and the ratio of S. mutans to total bacteria in caries-susceptible children are higher than those in caries-free children. Therefore, the ratios of S. mutans to total bacteria in plaque are closely associated with the prevalence of dental caries in children.

Bacteria ; Child, Preschool ; Dental Caries ; Dental Plaque ; Humans ; Prevalence ; Streptococcus mutans

Objective To enhance the triage efficiency of patients with acute heart failure(AHF)by improving emergency severity index(ESI)score,and to achieve stratified care for patients with AHF.Additionally,the aim is to improve the combination of stratified scores and nursing care in emergency departments to address the limitations of current studies.Methods A retrospective nested cohort study was conducted on 120 patients with AHF admitted to the Affiliated Hospital of Guizhou Medical University from January 1,2019 to December 30,2021.According to the clinical outcomes of the patients,the patients were divided into subgroup A(71 cases,recovered after treatment,no serious complications during treatment),subgroup B[35 cases,discharged after treatment,multiple organ dysfunction syndrome(MODS),acute respiratory distress syndrome(ARDS),shock and other serious complications occurred during treatment],and subgroup C(14 cases,cardiac death during treatment).A prospective randomized controlled study involving 106 patients with AHF admitted to our hospital from January 1 to December 30,2022,was conducted,and the patients were divided into control group(53 cases)and stratified care group(53 cases)according to the random number table method.The control group received routine nursing care,while patients in the stratified care group received stratified care based on the ESI scoring clinical care pathway.The early warning score model of elderly patients with AHF was constructed with risk threshold as warning signal.The improved ESI scoring criteria were used to score AHF patients,with a total score of 25 points.The higher the score,the higher the risk.0-10 is divided into Ⅰ level risk,>10-20 is divided into Ⅱ level risk,>20 is divided into Ⅲ level risk.Implement nuring at grades Ⅲ,Ⅱ,and Ⅰ,respectively.The changes of modified ESI scores in subgroup A,subgroup B and subgroup C were observed,and Spearman correlation coefficient was used to evaluate the correlation between modified ESI scores and clinical outcomes of different severity of disease.Receiver operator characteristic curve(ROC curve)was drawn to evaluate the effectiveness of the risk threshold classification method of different nursing plan designs in the stratified nursing group and the control group,and to compare the efficiency differences of emergency nursing rescue time,rescue success rate,and stay time in the emergency department,and the incidence of complications such as MODS,ARDS,shock and nursing satisfaction during treatment between the stratified nursing group and the control group.Results The modified ESI score in subgroup C was the highest,significantly higher than that in subgroup B and A(19.6±1.7 vs.17.8±1.5,15.3±1.3,all P<0.05).Spearman correlation analysis showed that the modified ESI score was significantly positively correlated with the occurrence of complications,the occurrence of cardiac death,and the recovery after treatment(r values were 0.623,0.635,0.322,P values were 0.004,0.003,0.012,respectively).Therefore,an improved ESI score has a certain early warning effect on complications and cardiac death of patients.ROC curve analysis showed that the area under the ROC curve(AUC)of routine care for stratified care was 0.710 and 0.620,and the 95％ confidence interval(95％ CI)was 0.620-0.750 and 0.580-0.690,respectively,with Pvalues of 0.023 and 0.034.It shows that the difference between the two nursing methods is significant,and further indicates that the risk threshold classification method designed in this study is effective.With the increase of risk,the rescue time and emergency stay time of the two groups were gradually extended,and the success rate of rescue was gradually decreased,the rescue time and emergency stay time of grade Ⅲ risk were the longest and the success rate of rescue was the lowest,and the rescue time and emergency stay time of the stratified nursing group were significantly shorter than those of the control group(minutes:59.6±6.3 vs.76.5±7.2 and 57.6±5.4 vs.68.2±7.1,both P<0.05),the success rate of rescue was significantly increased[(68.7±6.1)％ vs.(54.6±5.2)％,P<0.05],and the difference of rescue time between grade Ⅰ risk and grade Ⅲ risk was the largest.There were significant differences in the success rate of rescue and the duration of emergency stay in grade Ⅲ risk.The incidence of complications such as MODS,ARDS and shock in stratified care group was significantly lower than that in control group[incidence of MODS:13.2％(7/53)vs.18.9％(10/53),incidence of ARDS:15.1％(8/53)vs.22.6％(12/53),incidence of shock:13.2％(7/53)vs.20.8％(11/53),all P<0.05],satisfaction of patients with service attitude,operation technique,comfort and timeliness were significantly improved compared with the control group[service attitude:28.3％(15/53)vs.18.9％(10/53),operation technology:30.2％(16/53)vs.20.8％(11/53),comfort:32.1％(17/53)vs.24.5％(13/53),timeliness:32.1％(17/53)vs.24.5％(13/53),all P<0.05].Conclusion Based on the modified ESI score,early risk warning thresholds are divided and stratified nursing is conducted,which is beneficial for timely intervention in AHF,effectively ensuring the clinical nursing value of patients during the implementation of medical measures,and has broad application prospects.