Objective This study aimed to compare the clinical efficacy and impact on masticatory function of lithium disilicate ceramic onlays fabricated using CAD/CAM technology versus conventional impression techniques for restoring pulpless posterior tooth defects.Methods A prospective randomized controlled trial was conducted from February 2021 to February 2023,enrolling 104 patients requiring lithium disilicate ceramic onlay restoration for posterior teeth.Patients were randomized into two groups using a random number table:52 patients in the study group received lithium disilicate ceramic onlays fabricated with CAD/CAM technology,and 52 patients in the control group received onlays fabricated via conventional impression.The two groups were compared in terms of gingival index,tooth mobility,plaque index,masticatory efficiency,patient satisfaction with aesthetics,and incidence of adverse reactions.Results After restoration,the study group showed lower scores of tooth mobility,gingival index,and plaque index than the control group(P<0.05).One year after restoration,the masticatory efficiency of the study group was higher than that of the control group(P<0.05).The incidence of adverse reactions in the study group was 5.77%,which was significantly lower than 25.00%in the control group(P<0.05).The aesthetic satisfaction rate in the study group was 94.23%,which was significantly higher than that in the control group(P<0.05).Conclusions Compared with conventional impression techniques,CAD/CAM technology provides better restoration fit and masticatory efficiency,and improves patient satisfaction when restoring pulpless posterior tooth defects.These findings indicate that CAD/CAM technology has significant advantages in posterior tooth onlay restoration and is worthy of clinical promotion.

Objective This study aimed to compare the clinical efficacy and impact on masticatory function of lithium disilicate ceramic onlays fabricated using CAD/CAM technology versus conventional impression techniques for restoring pulpless posterior tooth defects.Methods A prospective randomized controlled trial was conducted from February 2021 to February 2023,enrolling 104 patients requiring lithium disilicate ceramic onlay restoration for posterior teeth.Patients were randomized into two groups using a random number table:52 patients in the study group received lithium disilicate ceramic onlays fabricated with CAD/CAM technology,and 52 patients in the control group received onlays fabricated via conventional impression.The two groups were compared in terms of gingival index,tooth mobility,plaque index,masticatory efficiency,patient satisfaction with aesthetics,and incidence of adverse reactions.Results After restoration,the study group showed lower scores of tooth mobility,gingival index,and plaque index than the control group(P<0.05).One year after restoration,the masticatory efficiency of the study group was higher than that of the control group(P<0.05).The incidence of adverse reactions in the study group was 5.77%,which was significantly lower than 25.00%in the control group(P<0.05).The aesthetic satisfaction rate in the study group was 94.23%,which was significantly higher than that in the control group(P<0.05).Conclusions Compared with conventional impression techniques,CAD/CAM technology provides better restoration fit and masticatory efficiency,and improves patient satisfaction when restoring pulpless posterior tooth defects.These findings indicate that CAD/CAM technology has significant advantages in posterior tooth onlay restoration and is worthy of clinical promotion.

Objective To investigate the types and incidence of bifid mandibular canal using cone beam computed tomography(CBCT)technology so as to enhance our understanding of these anatomical features and help reduce complications caused by trauma to the neurovascular bundle within them.Methods CBCT data of 803 patients from College of Stomatology,Xi'an Jiaotong University,were collected,and the types and incidence of bifid mandibular canal were statistically analyzed according to the Naitoh classification method.Results The incidence of bifid mandibular canal was 54.05％,with the occurrence rates for the retromolar canal and forward canal being 26.40％ and 32.75％,respectively.Conclusion To ensure the safety of treatments,it is recommended that oral clinical practitioners use CBCT to obtain three-dimensional images for precise assessment of bifid mandibular canal,thereby avoiding potential complications during the perioperative period.

BACKGROUND: Valvular heart disease (VHD) has become increasingly common with the aging in China. This study aimed to evaluate regional differences in the clinical features, management strategies, and outcomes of patients with VHD across different regions in China. METHODS: Data were collected from the China-VHD Study. From April 2018 to June 2018, 12,347 patients who presented with moderate or severe native VHD with a median of 2 years of follow-up from 46 centers at certified tertiary hospitals across 31 provinces, autonomous regions, and municipalities in Chinese mainland were included in this study. According to the locations of the research centers, patients were divided into five regional groups: eastern, southern, western, northern, and central China. The clinical features of VHD patients were compared among the five geographical regions. The primary outcome was all-cause mortality or rehospitalization for heart failure. Kaplan-Meier survival analysis was used to compare the cumulative incidence rate. RESULTS: Among the enrolled patients (mean age, 61.96 years; 6877 [55.70%] male), multiple VHD was the most frequent type (4042, 32.74%), which was mainly found in eastern China, followed by isolated mitral regurgitation (3044, 24.65%), which was mainly found in northern China. The etiology of VHD varied significantly across different regions of China. The overall rate of valve interventions was 32.67% (4008/12,268), with the highest rate in southern China at 48.46% (205/423). In terms of procedure, the proportion of transcatheter valve intervention was relatively low compared to that of surgical treatment. Patients with VHD in western China had the highest incidence of all-cause mortality or rehospitalization for heart failure. Valve intervention significantly improved the outcome of patients with VHD in all five regions (all P  <0.05). CONCLUSIONS: This study revealed that patients with VHD in China are characterized by significant geographic disparities in clinical features, treatment, and clinical outcomes. Targeted efforts are needed to improve the management and prognosis of patients with VHD in China according to differences in geographical characteristics. REGISTRATION ClinicalTrials.gov , NCT03484806.
Aged ; Female ; Humans ; Male ; Middle Aged ; China/epidemiology* ; Heart Valve Diseases/therapy* ; Kaplan-Meier Estimate ; Tertiary Care Centers ; Treatment Outcome

Objective To investigate the types and incidence of bifid mandibular canal using cone beam computed tomography(CBCT)technology so as to enhance our understanding of these anatomical features and help reduce complications caused by trauma to the neurovascular bundle within them.Methods CBCT data of 803 patients from College of Stomatology,Xi'an Jiaotong University,were collected,and the types and incidence of bifid mandibular canal were statistically analyzed according to the Naitoh classification method.Results The incidence of bifid mandibular canal was 54.05％,with the occurrence rates for the retromolar canal and forward canal being 26.40％ and 32.75％,respectively.Conclusion To ensure the safety of treatments,it is recommended that oral clinical practitioners use CBCT to obtain three-dimensional images for precise assessment of bifid mandibular canal,thereby avoiding potential complications during the perioperative period.

Objective: To investigate the clinical significance of serum low-density lipoprotein receptor-related protein 6 (LRP6) level in patients with acute myocardial infarction (AMI). Methods: One hundred and fifty patients with AMI were selected as the AMI group and 150 patients with suspected coronary heart disease without coronary artery stenosis were selected as control group from January 2017 to December 2018 in Quzhou People′s Hospital of Zhejiang. The serum LRP6 levels were determined by Western blot. The serum B-type brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) levels were determined by enzyme-linked immunosorbent assay (ELISA). Results: The levels of total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in AMI group were higher than those in the control group [(4.42 ± 0.79) mmol/L vs. (3.79 ± 0.82) mmol/L, (1.52 ± 0.33) mmol/L vs. (1.37 ± 0.38) mmol/L, (3.15 ± 0.34) mmol/L vs. (2.91 ± 0.28) mmol/L], and the level of high-density lipoprotein cholesterol (HDL-C) was lower than that in control group [(0.95 ± 0.26) mmol/L vs. (1.21 ± 0.33) mmol/L], and there were significant differences (P<0.05). The level of serum LRP6 and left ventricular ejection fractionin in AMI group were lower than those in control group [0.12 ± 0.03 vs. 0.38 ± 0.07, (53.27 ± 6.89)% vs. (66.82 ± 7.35)%], and the BNP and cTnI levels were higher than those in control group [(78.16 ± 5.27) ng/L vs. (7.13 ± 1.24) ng/L, (125.83 ± 3.26) ng/L vs.(0.71 ± 0.24) ng/L], and there were significant differences (P<0.05). The serum LRP6 level was negatively correlated with LDL-C, BNP, cTnI and SYNTAX scores (r=- 0.587, - 0.523, - 0.542, - 0.583, P<0.05), and was positively correlated with left ventricular ejection fraction (r=0.515, P<0.05). Conclusions Serum LRP6 level is decreased in patients with AMI. Serum LRP6 is closely related to the severity of AMI and the extent of coronary artery disease.

Objective: To evaluate the effect of curcumin on the lead burden in lead-exposed rats, and to study whether curcumin can influence the lipid peroxidation caused by lead exposure. Methods: A total of 70 rats of 21-day-old rats were divided randomly to 7 groups, the control group was given normal diet and drinking water, the curcumin group was given curcumin only 1 month after normal drinking water being given; the other 5 lead-exposed groups were given 2 g/L of acetate lead in free drinking water for 1 month and then randomly divided into lead-exposed group, low, medium and high concentration curcumin groups and Dimercaptosuccinic acid(DMSA) group, relatively.Lead levels of lead-exposed rats were determined by using inductively coupled plasma mass spectrometry, and commercial kit was used to detect antioxidant enzymes, and glutathione related enzymes and lipid peroxides. Results: The lead concentrations in the blood, hippocampus, liver and kidney of lead-exposed group increased, the levels of each group were (221.76±12.59) μg/L, (1.10±0.11) μg/g, (1.40±0.12) μg/g, (8.26±0.47) μg/g, and (57.58±6.09) μg/g, respectively; compared with the lead-exposed group, the lead concentrations reduced in the blood, hippocampus, liver and kidney significantly (F=90.67, 39.07, 27.34, 86.04, all P=0.000) in the curcumin-treated group, while the effect of curcumin in the bones showed no significant difference between groups(F=5.65, P=0.230). Lead could significantly improve the level of lipid peroxides in the serum and hippocampus, and curcumin-treated groups could significantly reduce the level of lipid peroxidation(F=58.03, 19.25, 32.27, 24.83, all P=0.000) and (F=28.18, 33.71, 38.95, 32.11, all P=0.000); lead could also reduce the antioxidant enzyme activity in the serum and hippocampus; curcumin-treated groups could significantly increase the antioxidant enzyme activity (F=18.24, 78.65, all P=0.000) and (F=13.68, 17.04, all P=0.000), respectively.The concentration in the curcumin group was better than that of DMSA group (P<0.05). Conclusions Curcumin can downregulate the lead concentrations in the blood, hippocampus, liver and kidney and improve the activity of antioxidant enzymes, inhibit the oxidative stress induced by lead, and thus resist the lead-induced damage.

Objective To investigate the inhibitory effect of Allicin on the apoptosis of hippocampal neurons induced by lead in rats.Methods Sixty male Sprague-Dawley rats aged 3 weeks were randomly divided into 6 groups,10 rats in each group,which were low dose group(A-L),medium-dose group(A-M) and high dose (A-H) Allicin group and lead exposure group (Pb group),dimercaptosuccinic acid (DMSA) group and blank control group.The blank control group animals were treated with ultrapure water,and the other 5 groups received 1.0 g/L lead acetate aqueous solution instead of ultrapure water after 20 days and they were treated them with compounds by oral gavage.The doses of Allicin in group A-L,A-M group and A-H group were 2.7 mg/kg and 5.4 mg/kg,and 10.8 mg/kg,respectively.The DMSA dose was 10.8 mg/kg,and the Pb group was given 9 g/L saline.After the model was established,the rats were sacrificed to collect whole blood and hippocampus.Blood lead and tissue lead concentrations were measured,and the level of apoptosis in hippocampus was observed by TUNEL staining.The levels of cysteine-containing aspartate-specific proteases (caspase)-3,caspase-9,poly adenosine diphosphate-ribose polymerase (PARP) mRNA and caspase-3,caspase-9,PARP activated protein and cytochromes C distribution in the hippocampus cells were detected by using real-time quantitative PCR (qPCR),Western blot,and immunofluorescence staining.Results (1) Lead levels in the blood lead and hippocampus of rats in A-L group,A-M group and A-H group [(190.54±11.33) μg/L,(0.28 ±0.03) μg/L;(159.55 ±16.94) μg/L,(0.22 ±0.06) μg/L;(l16.62 ±8.85) μg/L,(0.19 ±0.01) μg/L] were lower than those in Pb group [(271.34 ±21.23) μg/L,(0.31 ±0.04) μg/L],and there were significant differences (all P ＜ 0.05).The blood lead and hippocampal lead levels in the DMSA group [(50.12 ± 7.44) μg/L,(0.15 ± 0.03) μg/L] were lower than those in the A-L group,A-M group and A-H group.(2) The results of TUNEL staining showed that the apoptosis levels of hippocampus in A-L group,A-M group and A-H group were lower than that in Pb group [(2.81 ±0.17)％,(2.08 ±0.28)％,(1.33 ±0.08)％ vs.(4.23 ±0.17)％],and there were significant differences (all P ＜ 0.05);the apoptosis level of hippocampus in the DMSA group [(2.63 ± 0.32) ％] was higher than that in the A-M group and the A-H group,which was lower than that in the Pb group.(3) qPCR results showed that the levels of caspase-3,caspase-9 and PARP mRNA in A-H group were down-regulated compared with Pb group (1.07 ± 0.05,1.02 ± 0.02,1.11 ± 0.02 vs.1.34 ± 0.02,1.26 ±0.05,1.93 ± 0.07).The differences were statistically significant (P ＜ 0.05).The expression levels of caspase-3 and PARP mRNA in A-L group and A-M group were down-regulated (1.21 ± 0.05,1.43 ± 0.12,1.16 ± 0.02,1.20 ± 0.06 vs.1.34 ± 0.02,1.93 ± 0.07),and there were significant differences (all P ＜ 0.05),and there was no significant change in caspase-9 mRNA;the mRNA levels of caspase-3,caspase-9 and PARP in A-H group (1.07 ± 0.05,1.02 ± 0.02,1.11 ± 0.02) were lower than those in DMSA group (1.14 ± 0.02,1.15 ± 0.08,1.32 ±0.05).(4) Western blot results:compared with Pb group,the expression levels of activated caspase-3,caspase-9 and PARP protein in A-H group were down-regulated (A-H group:0.44 ± 0.15,0.58 ± 0.25 and 0.31 ±0.19,0.23 ±0.07 vs.Pb group:0.69 ±0.13,0.72 ±0.22 and 0.55 ±0.21,0.43 ±0.10),the expression of activated caspase-9 protein in A-M group was lower than that in Pb group (A-M group:0.59 ±0.18 vs.Pb group:0.72 ± 0.22),and there were significant differences (all P ＜ 0.05);the expression of activated caspase-3 and RARP protein in A-H group was lower than that in DMSA group.(5) Fluorescence staining showed that the expression of cytochrome C in cytoplasm of A-L group,A-M group and A-H group were significantly lower than that of Pb group and DMSA group.Conclusion Allicin can inhibit the apoptosis of hippocampus cells in rats with lead poisoning through mitochondrial pathway.The effect of Allicin on apoptosis inhibition may be better than DMSA.

Objectives To explore the efficacy of CaNa2EDTA in the treatment of chronic moderate lead poisoning, so as to optimize the chelation therapy for lead poisoning in children. Methods The clinical data of 14 patients with chronic moderate lead poisoning treated with CaNa2EDTA for 3 consecutive courses of lead removal during September 2014 to December 2016 were analyzed retrospectively. Twenty-four hour urinary lead levels during hospitalization were analyzed. The changes of blood lead levels before treatment, 3 days, and 5 days after treatment were also analyzed. Results In the 14 children (4 males and 10 females) average age was 2.35±1.47 years. After treatment with CaNa2EDTA for 3 consecutive courses, the blood lead levels were decreased significantly in all the patients, and the blood lead levels at 3 days after treatment were 0.76, 0.77, 0.72 times those at 5 days after treatment respectively. The decrease of blood lead levels per unit of drug in the first 3 days of treatment were significantly higher than those in 5 days of treatment (P<0.05). The decrease of blood lead levels at 3 days after treatment was 0.65, 0.71, 0.70 times , those in 5 days' treatment respectively. The decrease of urine lead levels per unit of drug in the first 3 days of treatment were significantly higher than those in 5 days of treatment (P<0.05). Conclusions CaNa2EDTA has an obvious effect on removal of lead.The efficiency of lead removal in 3 days of treatment was higher than in 5 days of treatment. Thus, a course of treatment for 3 days may be an altenative for a course of 5 days.

BACKGROUND:Biomechanical compatibility is the necessary condition to ensure the stable osseointegration with implants that then can function over a long period; therefore, it is especialy important to get knowledge about distribution of stress and strain between the maxilary central incisor and its surrounding bone tissue. OBJECTIVE: Based on five different anatomical types of natural teeth, to study the regularity of stress distribution between the maxilary central incisor root and implant.METHODS: According to the five different anatomical types of natural maxilary central incisors, UGNX and ANSYS were used to set up three-dimensional finite element models (B1, B2, M1, M2, P1) for the implant and surrounding structures, which were under 100 N static load at angles of 0o, 30o, 45o, 60o, 90o with the long axis of teeth. Then, the stress distribution between the five kinds of maxilary central incisor roots and implants was analyzed. RESULTS AND CONCLUSION:Among the five different anatomical types, the equivalent stress for both the natural central incisor and implant were increased with the increasing of angles, and the implant had a higher raising trend. The equivalent stress for the natural tooth concentrated upon B1 for the maximum value and M1 for the minimum value; while the equivalent stress for the implant focused on the maximum value at M1 and the minimum value at M2. There was a gap of 2%-31% between the equivalent stresses for the natural tooth roots and a gap of 4%-21% for the implants. The stress distribution range for the implant was just smaler than that for the natural tooth roots. It implies that the bit force of implant and natural tooth is in positive proportion to the bite angles, and the bite force that implant can burden is smaler than that the central incisor can.