Dental treatments for children and adolescents have unique clinical characteristics that differ from dental care for adults in terms of children's physiology, psychology, and behavior. These differences impose specific requirements on the application of local anesthesia in pediatric dental procedures. This article presents expert consensus on the principles of local anesthesia techniques in pediatric dental therapies, including the use of common anesthetic drugs and dosage control, safety and efficacy evaluation, and prevention and management of complications. The aim is to improve the safety and quality of pediatric dental treatments and offer guidance for clinical application by dentists.
Humans ; Child ; Anesthesia, Local/methods* ; Consensus ; Anesthesia, Dental/methods* ; Adolescent ; Anesthetics, Local/administration & dosage* ; Dental Care for Children

Objective To evaluate the difference in dose distribution calculated using X-ray voxel Monte Carlo(XVMC)algorithm and ArcherQA Monte Carlo(MC)algorithm in preoperative radiotherapy for rectal cancer,thus providing reference for the planning and evaluation of XVMC algorithm in clinical practice.Methods For 10 patients with rectal cancer undergoing preoperative radiotherapy,the XVMC algorithm in MONACO planning system was used to develop the plan.The CT,tissue structure,and field information from the prepared plan were transmitted to Monte Carlo software,and the MC algorithm was used for the secondary dose calculation.The dose differences between XVMC algorithm and MC algorithm in the target area and organs-at-risk dose calculations were analyzed.Results The differences in Dmin and Dmean of the planning target volume(PTV),V40 of the small intestine,V45 and Dmean of the bladder,and Dmeanof the femoral head calculated by XVMC and MC algorithms for isocenter dose were all within 2%.The differences in the Dmax of PTV,spinal cord expansion,and small intestine between two algorithms were 3.43%,3.59%,and 3.62%,respectively;and the difference in the V5040 of PTV was 2.87%.Conclusion XVMC algorithm underestimates the planned maximum dose and overestimates the prescription dose coverage in the target area as compared with MC algorithm,but the dosimetric differences between the two algorithms are within a clinically acceptable range(within 5%).When evaluating the plan,attention should be paid to the dose calculation errors caused by the algorithm.

NDFIP1 has been previously reported as a tumor suppressor in multiple solid tumors, but the function of NDFIP1 in NSCLC and the underlying mechanism are still unknown. Besides, the WW domain containing proteins can be recognized by NDFIP1, resulted in the loading of the target proteins into exosomes. However, whether WW domain-containing transcription regulator 1 (WWTR1, also known as TAZ) can be packaged into exosomes by NDFIP1 and if so, whether the release of this oncogenic protein via exosomes has an effect on tumor development has not been investigated to any extent. Here, we first found that NDFIP1 was low expressed in NSCLC samples and cell lines, which is associated with shorter OS. Then, we confirmed the interaction between TAZ and NDFIP1, and the existence of TAZ in exosomes, which requires NDFIP1. Critically, knockout of NDFIP1 led to TAZ accumulation with no change in its mRNA level and degradation rate. And the cellular TAZ level could be altered by exosome secretion. Furthermore, NDFIP1 inhibited proliferation in vitro and in vivo, and silencing TAZ eliminated the increase of proliferation caused by NDFIP1 knockout. Moreover, TAZ was negatively correlated with NDFIP1 in subcutaneous xenograft model and clinical samples, and the serum exosomal TAZ level was lower in NSCLC patients. In summary, our data uncover a new tumor suppressor, NDFIP1 in NSCLC, and a new exosome-related regulatory mechanism of TAZ.
Humans ; Carcinoma, Non-Small-Cell Lung/metabolism* ; Carrier Proteins/metabolism* ; Cell Line ; Cell Proliferation ; Exosomes/metabolism* ; Lung Neoplasms/genetics* ; Membrane Proteins/metabolism* ; Transcriptional Coactivator with PDZ-Binding Motif Proteins/metabolism*

OBJECTIVE To establish a quantitative analysis of multi-components by single marker （QAMS） method based on a variety of internal reference substances for the content determination of 6 components in Jinlian qingre granules， such as mangiferin， 2″-O-β-L-galactopyranosylorientin， orientin， veratric acid， vitexin， harpagoside. METHODS The determination was performed on Agilent Eclipse Plus C18 column with mobile phase consisted of acetonitrile-0.1% phosphoric acid solution （gradient elution） at the flow rate of 1 mL/min. The column temperature was 30 ℃， and the detection wavelength was set at 270 nm. Taking orientin， vitexin and 2″-O-β-L-galactopyranosylorientin as internal references， the relative correction factors （RCF） of the other 5 components to be determined and internal substances were determined by QAMS. The contents of 6 components in 21 batches of Jinlian qingre granules were calculated and then compared with the results of the external standard method. RESULTS The contents of mangiferin， 2″-O-β-L-galactopyranosylorientin， orientin， veratric acid， vitexin and harpagoside in 21 batches of samples were determined by QAMS in the range of 0.234-0.516， 1.804-2.270， 2.143-2.606， 0.190-0.223， 0.594-0.782， 0.080-0.152 mg/g； the contents of them determined by external standard method were 0.235-0.523， 1.798-2.265， 2.137-2.599， 0.190-0.224， 0.597-0.786， 0.077-0.151 mg/g， respectively. The percentage difference between the results measured by the two methods should not exceed 4.00%. CONCLUSIONS QAMS has been constructed for the simultaneous determination of 6 components in Jinlian qingre granules based on a variety of internal reference substances. The results obtained by this method are not significantly different from those obtained by the external standard method， and can be used for the quality control of Jinlian qingre granules.

【Objective】 To provide data reference for the implementation of the homogenization of pre-donation blood testing by investigating the relevant situation of pre-donation blood testing in various blood services in Chongqing and analyzing their differences. 【Methods】 A questionnaire covering the basic information of pre-donation blood testing items, quality control and the management of deferral donors was developed, and issued to 19 blood services in Chongqing through E-mails by Chongqing Society of Blood Transfusion. The data collected were sorted, revised and analyzed. 【Results】 A total of 19 questionnaires from 19 blood services(including 1 blood center, 1 sub-center, 6 central blood stations and 11 central blood banks) were collected. All of the pre-donation blood test items of 19 blood services met the Blood Donor Health Test Requirements. Hemoglobin, blood group, ALT and HBsAg testing were carried out by 19 blood services, anti-TP testing by 15, and lipid blood testing by 11, using different detection methods and reagents. Significant differences were found in the frequency and rules of internal quality control for quantitative testing items. In addition, the deferral time and re-recruitment strategy of deferral blood donors were also significantly different. 【Conclusion】 There were differences in the management of pre-donation blood testing and blood donor management after blood donation among blood services in Chongqing. Further standardization was needed to realize regional homogenization and guarantee blood safety and the safety of blood donors.

Objective To summarize the key points of nursing care in reservation of catheters in 11 cases of nasopharyngeal carcinoma patients who received concurrent chemo-radiotherapy with symptomatic thrombosis after ultrasound-guided implantation of double-lumen PICCs(PowerPICC).Methods From January,2014 to December,2015,totally 11 cases with symptomatic venous thromboembolism were identified among 109 cases of nasopharyngeal carcinoma patients receiving concurrent radiotherapy and chemotherapy,and observation and nursing care were provided at the early stage of thrombosis and during thrombosis.Results All double-lumen PICCs were reserved,and no recurrence or aggravation of thrombosis was recorded to the end of the treatment.The duration of carrying PICCs was 67～89(77.45±6.65) days.Conclusion With careful treatment and nursing,PICC catheter-related complications can be reduced and the duration of carrying catheters can be prolonged,which leads to accomplishment of the treatment plan for patients.

Objective This paper summarize peri-operative nursing of minimally invasive surgery on osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma.Methods 47 cases of osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma were operated via nasal endoscope from March 2006 to March 2013.Focused peri-operative psychological support and adequate medical care were given to patients.Strengthened nasal nasopharyngeal cavity nursing,the observation and nursing of complications were carried out after operation and health guidance pre-discharge was given.Results The operations of 47 cases were successful and no major complication of intra-operation and post-operation occurred.Headache and foul odor relieved after operation.The follow-up continued for 3 to 84 months,46 cases were survived,1 case died of nasopharyngeal massive bleeding.Conclusions Effective peri-operative nursing of minimally invasive surgery on osteoradionecrosis of skull base after radiotherapy could ensure patients' cooperation and the smooth implementation of surgery and improve the quality of life.

Objective To summarize the diagnostic and therapeutic experience on chronic pancreatitis characterized by a pancreatic mass. Methods The clinical data of 28 cases of chronic pancreatitis with mass undergoing surgical operations were retrospectively analyzed in our hospital from June1999 to June 2009. Results Among the 28 cases, 19 were diagnosed as carcinoma, 9 cases were diagnosed as chronic pancreatitis respectively before operation. Needle aspiration biopsy and/or postoperative pathology identified chronic pancreatitis in all cases. The symptom included abdominal pain (22 cases),jaundice (15 cases), and obstruction of duodenum (4 cases). Pancreaticoduodenectomy was performed in 17 cases, choledochojejunostomy performed in 3 cases, pancreatojejunostomy performed in 1 case.Duodenum-preserving resection was performed in 4 cases, and resection of body and tail of the pancreas were performed in 3 cases. There was no operative death. Postoperative complications included pancreatic leakage (2 cases), severe gastroplegia (2 cases) and stress peptic ulcer with massive bleeding ( 1 case). All patients got follow-up ranging from 6 months to 5 years. Recurrence of abdominal pain developed in 7 cases after 2 years. Canceration of pancreatic mass was found respectively in 8 months, 1 year after operation in one each cases. Conclusion Preoperative differential diagnosis of chronic pancreas and pancreatic tumor was difficult. Although needle aspiration biopsy is the effective method for diagnosis, there may be still a possibility of missed diagnosis/misdiagnosis.

Objective To evaluate the significance of MRI before surgery to remove polyaeryl-amide hydrogel (PAMHG) which has been used for augmentation mammaplasty. MethodsTwenty female patients with 40 breasts, having been injected PAMHG as augmentation mammaplasty, under-went bilateral breast axial T1WI, T2WI-fat saturation (FS) and sagittal T2WI-FS by 4-channal phased-assay breast coil at 3.0T (Philips) before removal surgery, in which 8 patients underwent axial multiphase contrast-enhanced MRI with THRIVE after Gd-DTPA (2.0 ml/s, 0.1 mmol/kg) adminis- tration. The results of MRI were compared with that of operation and pathology. ResultsPAMHG showed iso-intensity compared with breast gland on T1WI and hyperintensity on T2WI-FS. Low signal septa were noted within PAMHG in 40 breasts (20 patients), 90% (36/40) PAMHG without capsule, 10 % (4/40) with smooth capsule which showing homogenous low signal on T1WI and T2WI-FS. Subcutaneous lump of PAMHG was 70 % (28/40), lump of that in breast gland was 20% (8/40). Diffuse gel along spatium intermusculare of pectoralis major was 100 % (40/40), that along spatium intermusculare of intercostal muscle was 10 % (4/40). All PAMHG in breast of the 8 patients showed no enhancement, an irregular enhanced mass was found in gland of 1 patient. All distributions of PAMHG and appearances of its complications on T2WI-FS were consistent with the results of operation. ConclusionsT2WI-FS can accurately display the distribution of PAMHG and its complication before removal surgery. MRI plane scan combined with muhiphase contrast-enhanced MRI can differentiate PAMHG from the lesions in the gland and find the breast carcinoma, so that it can guide clinicians before surgery to remove PAMHG used for augmentation mammaplasty.