OBJECTIVETo evaluate the aesthetic outcomes of all-ceramic restorations by using four different porcelain materials on mimic-tetracycline pigmentation backgrounds.

METHODSThe translucency parameters (TP) of four different all-ceramic restorations (IPS e.max, Cercon, Lava, and Girrbach) were measured under white and black back grounds by using Datacolor 600, and the TP of each group (n = 8) was calculated. Five different mimic-tetracycline pigmentation teeth were printed with different colors by using a colorized printer as the prepared teeth backgrounds, under which the color parameters of each group were measured. The color differences with a standard 2M2 sample were calculated.

RESULTSThe TP values of the all-ceramic restorations were 15.67 +/- 0.58 for IPS e.max, 9.73 +/- 0.43 for Girrbach, 9.55 +/- 0.25 for Lava, and 7.56 +/- 0.43 for Cercon. The TP value of the IPS e.max group was significantly higher than those of the other three groups (P < 0.001). The deltaE of the IPS e.max group was 1.33 national bureau of standards (NBS) on the yellow background, and the deltaE of the Lava and Girrbach groups were 0.75 NBS to 1.47 NBS on the mimic-tetracycline pigmentation backgrounds of gray, dark gray, dark red, and light red.

CONCLUSIONThe IPS e.max group has favorable TP. IPS e.max shows better aesthetic effects than the others when restoring mimic-tetracycline pigmentation teeth (on yellow background). Lava and Girrbach show better aesthetic effects on mimic-tetracycline pigmentation teeth (on gray, dark gray, dark red, and light red backgrounds).

Objective To explore the effects of the integrated teaching," teaching,studying and doing",which designed according to the nurse's core competency. Methods The integrated teaching of "teaching,studying and doing" was applied to the experimental class. The basal portions of the integrated teaching were as follows:searching for the Internet information,Sharing information between groups,per-forming cleaning care for the elders living in welfare agency according to nursing process,writing Nursing History or reflections. Results Comparison of mean scores between the experimental class and the con-trol one predicted significant differcences on theoretical and practical test,and the former was better than the Last. Conclusions The integrated teaching designed according to the nurse's core competency was more effective than the traditional teaching method,since the students from the experimental class valued the knowledge and skills immanently,and were involved in applying,reviewing them in time.

ObjectiveTo explore the importance and significance of classification diagnosis and treatment of chordee among hypospadias in children.MethodsA random sample review and controlled study was made in patients with hypospadias and chordee from 1989 to 2011 in First Affiliated Hospital of Sun Yat-Sen University,and the patients were divided into 2 groups.There were 232 cases in group A,who were all diagnosed as chordee only on the basis of clinical symptoms or an erection induced by artificial stimulation before operation.All the 232 cases were corrected empirically without objective assessment by degloving the penis,dissecting superficial and deep fascia,and cutting off the urethral plate,and so on during operation.There were 25 cases in group B,who were all strictly implemented on classification diagnosis and treatment of chordee,in sponge saline injection test during operation and correction effect evaluation after operation.Chordee was classified according to different etiology and pathology:skin type,fascia-type,urethra type,sponge type and the glans of penis type.There were different operating methods in different ways of folding tunica albuginea.ResultsIn group A,86 patients (37％) had postoperative recurrence of chordee,25 patients ( 11％ ) had pain during erection after surgery,183 patients were satisfied with correction of chordee (79％).In group A,25 patients were in their adulthood when followed up,and 7 patients had IIEF-5 score ＜21 points.In group B,the single type of chordee among hypospadias were 7/25 (28％),merged type were 18/25 (72％).All patients were followed up without chordee recurrence or painless erection,and 100％ patients or families were satisfied with correction of chordee.The efficacy difference were statistically significant between the two groups in chordee correction.In folding tunica albuginea group in group B,the penile erection length was (4.58 ± 1.59) cm before the correction,and (6.16 ±2.54) cm after correction.In non-folding tunica albuginea group,penile erection length was (4.O1 ± 1.18 ) cm before correction,and (5.82 ± 1.51 ) cm after correction.The difference was not significant between the 2 groups in penile erection length (P ＞ 0.05 ).ConclusionsSurgeon should pay more attention to the correction,effect evaluated,classified etiology and pathological diagnosis of hypospadias and chordee.And the targeted selection of the correct treatment of chordee can further improve the therapeutic effect.Chordee of hypospadias can exist in single or merged according to the pathological classification.Chordee correction surgery can increase length of penis,and dorsal tunica albuginea plication had no significantly different effect on the length of the penis compared to other chordee corrective surgery.

Objective To explore the intervention effect of low-dose vitamin D on glucose metabolism of patients with impaired glucose regulation. Methods A total of196 subjects receiving oral glucose tolerance test were enrolled in this study, including individuals with normal glucose tolerance ( NGT group, n=67) and indi-viduals with impaired glucose regulation (IGR group, n=129). The IGR group was divided into intervention group ( n=64) and non-intervention group ( n=65) according to vitamin D intervention ( for 1 year) performed or not. Clinical data and biochemical parameters were collected. Results The level of serum 25(OH)D3 was significantly lower in the IGR group than that of normal control group ( P<0. 05) . After 1 year of low-dose vita-min D intervention, insulin sensitivity increased and insulin resistance decreased in the intervention group as compared with non-intervention group. Diabetes developed less frequently in the intervention group ( 25 of 64 [ 39. 1％] ) compared with non-intervention group ( 30 of 65 [ 46. 2％] ) . But there was no significant differ-ent in diabetes prevalence between the two groups. Conclusions Vitamin D intervention can improve insulin sensitivity and reduce insulin resistance in patients with impaired glucose regulation. Low dose vitamin D can improve the abnormal glucose metabolism outcome in patients with impaired glucose regulation.

Objective:To analyze the molecular characteristics of Echovirus 11 (Echo11) strains isolated in Xiangyang, Hubei Province from 2016 to 2017 based on the sequences of VP1 gene.Methods:Rectal and throat swab specimens were collected from children with hand, foot and mouth disease (HFMD) in Xiangyang from 2016 to 2017. Echo11 strains were detected by real-time reverse transcriptase PCR (RT-PCR) and isolated after cultured in human rhabdosarcoma (RD) cells. The VP1 regions of Echo11 strains isolated from RD cells and the whole genomes of three representative Echo11 strains were amplified by conventional RT-PCR and the sequences were analyzed. DNAStar7.0 (MegAlign) and MEGA6.0 (Data) were used to analyze the homology and mutation sites in nucleotide and amino acid sequences. Neighbor-joining method was used to construct phylogenetic trees. Recombination analysis was performed with SimPlot software (BootScanning).Results:A total of 11 Echo11 strains were isolated from 3 494 HFMD cases, accounting for 0.31%. They were highly homologous in the VP1 gene. These strains shared 98.4%-100.0% homology in nucleotide sequences and 98.3%-100.0% homology in amino acid sequences. The homology between the 11 Echo11 strains and the prototype strain (Echo11/Gregory, X80059) was 73.9%-74.8% in nucleotide sequences and 87.7%-88.7% in amino acid sequences. All of the Echo11 strains circulating in Xiangyang were classified into lineage D, having a similarity to the strains circulating in some regions of mainland China since 2013. In multiple regions of the genome, the Echo11 strains isolated in Xiangyang were highly similar to the Henan Echo1 strains in 2010 and the Hubei Echo6 strains in 2015, suggesting there was recombination within the genome of Echo11 strains in Xiangyang.Conclusions:The Echo11 strains circulating in Xiangyang from 2016 to 2017 belonged to lineage D and were recombinant strains.

Objective To investigate the curative effect of Zhizhukuanzhong capsule combined with Deanxit in the treatment of functional dyspepsia ( FD) of spleen -deficiency and qi -stagnation.Methods Seventy -six patients with FD were randomly divided into three groups .A group (24 cases)_was given Zhizhukuanzhong combined with Deanxit,B group (26 cases) was given Zhizhukuanzhong ,C group (26 cases) received trimebutine dispersible tablets treatment.After treatment for 8 weeks,the symptoms of indigestion,depressive state and therapeutic effect were observed.Results Before treatment,there were no statistically significant differences in the symptoms of dyspepsia (all P>0.05).After treatment,the symptoms of dyspepsia were improved in different degree ,the effective rates of A, B,C three groups were 91.6%,65.4% and 42.3%,respectively,there was no statistically significant difference between A group and B group(χ2 =1.579,P=0.209);there was statistically significant difference between A group and C group(χ2 =13.549,P=0.000);there was no statistically significant difference between B group and C group (χ2 =2.786,P=0.09).The FD patients complicated with varying degrees of anxiety and depression ,there was no statistically significant difference among the three groups before treatment (P>0.05).After treatment,comparison of HAMA and HAMD scores among the three groups:there were statistically significant differences between A group and B group (tHAMA =6.839,tHAMD =4.607,all P<0.05),A group and C group (tHAMA =20.069,tHAMD =15.342,all P<0.01),B group and C group (tHAMA =11.951,tHAMD =12.071,all P<0.01).After treatment,the HAMA,HAMD scores of A group and B group were significantly decreased compared with before treatment ( A group tHAMA =52.758,tHAMD=49.970,B group tHAMA =30.230,tHAMD =17.151,all P<0.01).Those in C group had no statistically significant decline compared with before treatment (tHAMA =7.845,tHAMD =3.530,all P>0.05).The adverse reactions of A group were mainly weakness ,dizziness,drowsiness,which were alleviated within 2 weeks.The adverse reactions of B group were slight stomach disease and stool frequency increased ,which not affected the treatment.The adverse reactions of C group were digestive tract symptoms ,which lasted for more than 2 weeks.Conclusion Zhizhukuanzhong capsule combined with Deanxit in the treatment of FD of spleen -deficiency and qi -stagnation can obtain good curative effect,it is safe,convenient,and with minor side effects,good compliance.

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Objective To analyze the treatment outcomes of multidrug-resistant pulmonary tuberculosis (MDR-TB) cases in Hubei Province. Methods From October 2006 to June 2017, a retrospective cohort analysis of treatment outcomes for 1 447 patients with MDR-TB who were included in treatment was performed. Excel worksheet was created to establish database by monthly and quarterly reports. The statistical analysis of data was conducted using SPSS 21.0 software. Results Among 1 447 MDR-TB patients, 1 076 were males and 371 were females, with an average age of 44.44±14.28 years. 798 patients were cured, 63 patients completed the course of treatment, and the overall treatment success rate was 59.50% (861/1 447). The treatment success rate was68.02% (268/394) in newly diagnosed cases, and 56.32% (593/1 053) in relapse cases. There was a significance difference between the two groups (χ²=16.30，P<0.05). The treatment success rate [78.41% (672/857)] in patients with negative sputum culture at the end of 6th month was higher than the rate [38.71% (12/31)] of negative sputum culture at the end of 12nd month, with a statistical significance difference (χ²=26.65，P<0.05). The treatment success rate [12.07% (14/116)] in patients with continued positive sputum culture at the end of 6th month was higher than the rate [4.44% (2/45)] of negative sputum culture at the end of 12th month, with a significance difference (χ²=1.34，P=0.25). Conclusion It is extremely important to screen drug-resistant individuals for smear-positive patients, and to detect and treat drug-resistant patients timely. The negative conversion of sputum bacteria at the end of 6th month had important predictive significance for the treatment outcomes of MDR-TB patients. The patients with continued positive sputum at the end of 6th month should be closely monitored to adjust treatment according to the progress of the patient's condition and to explore a way to shorten the treatment course.

The ongoing pandemic coronavirus disease 19 (COVID-19) remains a significant issue for global health, economics, and society. In order to balance epidemic control and economic recovery, many countries have successively announced the gradual relaxation of some lockdown restrictions. Hospitals and medical staff constitute the backbone in this war against COVID-19. In response to this serious situation, many hospitals went into emergency and impaired healthcare access to patients with conditions other than COVID-19. Therefore, gradually promoting hospital operations and functions back to the new normal is important, especially when this outbreak has been effectively controlled. In this study, we introduce existing and potential problems that could seriously affect people's health. Additionally, we propose that an especial transition phase between the emergency and regular modes of hospitals can be well adapted to the current situation.
Coronavirus Infections ; epidemiology ; Health Policy ; trends ; Hospitals ; standards ; trends ; Humans ; Pandemics ; Pneumonia, Viral ; epidemiology

Objective To retrospectively analyze the prevention and control effect and epidemic characteristics of elderly tuberculosis in Hubei Province from 2016 to 2020, and to provide a scientific basis for the prevention and treatment of elderly tuberculosis in Hubei Province． Methods The data on tuberculosis patients aged 60 and above who registered their current address in Hubei Province from 2016 to 2020 were collected and analyzed. The registration rates and composition ratios were analyzed using χ² test and χ² test for trend. Results A total of 135 976 tuberculosis patients were reported in Hubei from 2016 to 2020. The annual average registration rate of elderly tuberculosis among the elderly registered residence population (referring to the registration rate of elderly registered residence population aged 60 and above as the denominator, and tuberculosis patients aged 60 and above as the numerator) was 263.51/100 000. The highest rate was 300.02/100,000 in 2017, and the lowest was 188.19/100,000 in 2020 (χ²=70,227.603, P<0.001). In terms of composition, the average annual proportion of tuberculosis patients in the 60-70 years old group was 59.60%, which decreased year by year (χ²_trend=40.448，P<0.001 ). The average annual proportion of males was 73.35%, which was significantly higher than that of females (26.65%). The average annual proportion of farmers was 62.03%. From the perspective of case management, the annual average proportion of major epidemic online reports was 85.17%. The classification of cases was mainly based on clinical diagnosis, accounting for 48.33% annually and showing a decreasing trend year by year (χ²_trend=740.911, P<0.001). The proportion of confirmed cases was 25.08%, which showed an increasing trend (χ²_trend=380.557, P<0.001). From 2016 to 2019, the delay rate of diagnosis and treatment of elder tuberculosis patients was 49.42% (67 876/135 967), and the delay rate decreased year by year (χ²_trend=323.764, P<0.001). Conclusion The elderly population with pulmonary tuberculosis in Hubei Province shows a downward trend. It is necessary to focus on the efforts of designated hospitals to proactively identify cases, increase the proportion of confirmed cases, maintain a high tracking in place, reduce medical delays, and ensure the effectiveness of tuberculosis prevention and treatment for the elderly.