Chronic kidney disease is a common and serious life-threatening health condition, often associated with multisystemic complications. In recent years, several studies have found that chronic kidney disease is not only closely associated with the occurrence and development of a variety of oral diseases, such as periodontal disease, oral mucosal disease, dental tissue disease, oral bone tissue disease, and oral carcinoma. Meanwhile, chronic kidney disease is also affected by some oral diseases. This article reviews the research progress on the correlation between chronic kidney disease and oral diseases, in order to prevent the occurrence and progression of oral diseases and maintain oral health status. of patients with chronic kidney disease in a more targeted manner.

Objective:To develop a standardized training model incorporating feedback from a digital assessment tool and to evaluate whether the model provides effective training in tooth preparation.Methods:The study was based on the training data of 53 trainees enrolled between February and June 2018 from multiple institutions in China. The trainees were trained in a standardized training unit on the preparation of right maxillary mesial incisors (11 #) for metal ceramic crowns. Three sessions of practice-assessment-feedback before examination were performed in one day. A digital assessment system was used to obtain total and component scores for the preparation as indicators of observation. The scores of three practice sessions and examination were subjected to analysis of variance. Results:The mean total scores before training, after the first training session, after the second training session, after the third training session, and in the examination were (60.53±12.73), (60.12±12.98), (71.25±13.70), (70.70±11.84), and (69.67±12.85), respectively; the overall difference was statistically significant ( F=19.06, P<0.001). Compared to the total scores before training and after the first training session, the total scores after the second and third training sessions and in the examination were significantly increased ( P<0.001, P<0.001). The score deductions for cutting amount and shoulder were similar, with overall significant differences (score deductions for cutting amount, F=16.20, P<0.001; score deductions for shoulder, F=1.45, P=0.032). Compared to before training and after the first training session, the second and third training sessions and the examination showed significant decreases in score deductions for cutting amount and shoulder ( P<0.001, P=0.048). Conclusions:The feedback-based standardized training process established on a digital evaluation system can rapidly enhance the skills of dentists in tooth preparation through immediate and effective feedback and targeted improvements. The training process enables an independent practice mode and optimizes teaching outcomes.

Chronic kidney disease is a common and serious life-threatening health condition, often associated with multisystemic complications. In recent years, several studies have found that chronic kidney disease is not only closely associated with the occurrence and development of a variety of oral diseases, such as periodontal disease, oral mucosal disease, dental tissue disease, oral bone tissue disease, and oral carcinoma. Meanwhile, chronic kidney disease is also affected by some oral diseases. This article reviews the research progress on the correlation between chronic kidney disease and oral diseases, in order to prevent the occurrence and progression of oral diseases and maintain oral health status. of patients with chronic kidney disease in a more targeted manner.

Objective:To investigate the risk factors for neoplasia in pale lesions of gastric mucosa, and provide clinical clues for early diagnosis.Methods:A total of 402 patients with gastric mucosal pale lesions who underwent gastroscopy at The Seventh Medical Center of Chinese PLA General Hospital from January 2020 to May 2021 were enrolled in the retrospective analysis. Data of gender and age of patients, degree of gastric mucosal atrophy, lesion boundaries, size, location, morphology, narrow band imaging magnifying endoscopy (NBI-ME) findings and histopathological results, etc. were collected for analysis. Multivariate logistic regression was used to analyze the risk factors for diagnosed as tumor.Results:Among 402 cases, 33 cases (8.2%) were diagnosed as neoplasia, and 23 cases (5.7%) were high-risk epithelial neoplasia (high grade dysplasia or early gastric cancer). The age of patients, the degree of gastric mucosal atrophy, lesion size, surface depression, NBI-ME positive findings, surface microvessels and surface microstructures were related to neoplasia of gastric mucosal pale lesion ( P<0.05). While the age of patients, the degree of gastric mucosal atrophy, lesion size, surface depression, surface microstructures were related to high-risk epithelial neoplasia of gastric mucosal pale lesion ( P<0.05). Multivariate logistic regression analysis showed that lesion diameter<20 mm ( OR=4.487, 95% CI: 1.776-11.332, P=0.001) and NBI-ME positive findings ( OR=40.510, 95% CI: 1.610-1 019.456, P=0.024) were independent risk factors for neoplasia, and abnormal surface microstructure of lesion was an independent risk factor for high-risk epithelial neoplasia ( OR=0.003, 95% CI: 0.000-1.587, P<0.001). Conclusion:Abnormal surface microstructure, the lesion size, and NBI-ME positive findings are important clues for the diagnosis of neoplasia in the pale lesions.

OBJECTIVES: With the increase in aging population in China, elderly Crohn's disease (CD) patients need to receive more attention. This study aims to explore the clinical characteristics and disease process of elderly onset CD (EOCD) patients in a single center. METHODS: From January 2002 to January 2022, a total of 221 patients with CD from the Seventh Medical Center of Chinese PLA General Hospital were enrolled. According to the Montreal CD classification standard, the patients were further divided into 4 groups: an EOCD group (≥60 years old, n=25), a middle age onset CD (MOCD) group (40-59 years old, n=46), a young onset CD (YOCD) group (17-40 years old, n=131), and a childhood onset CD (COCD) group (6-16 years old, n=19). We compared the clinical characteristics and long-term prognosis among them. RESULTS: Females were predominant in the EOCD group (15/25, 60%). The number of people without smoking in the EOCD group (80%) was lower than that in COCD group (100%), higher than that in the YOCD group (70.2%) and the MOCD group (69.6%) (all P<0.05). Patients with perianal diseases at diagnosis were rare in the EOCD group (0%), lower than that in the COCD group (21.1%) and the YOVD group (19.8%) (all P<0.05). Stenosis was the most common disease behavior in the EOCD group (63.0%), significantly higher than that in the COCD group (15.8%), the YOCD group (36.6%) and the MOCD group (43.5%) (all P<0.05). The EOCD group was easier to be misdiagnosed as tumor (24%), higher than that in the COCD group (0%), the YOCD group (6.9%) and the MOCD group (19.6%) (all P<0.05). The EOCD group was prone to comorbidities (52%), and 20% of them were complicated with multiple comorbidities (P<0.05). During the follow-up, the all-cause mortality of EOCD was 12%, and the CD-related mortality was 8%, which was significantly higher than the other groups (all P<0.05). The use of immunosuppressants in the EOCD group (4.8%) was lower than that in the COCD group (12.8%), the YOCD group (16.8%) and the MOCD group (16.1%), but there was no statistical significance among the 4 groups (P=0.467). In addition, there was no significant difference in the rate of intestinal resection among the 4 groups (P=0.062). CONCLUSIONS In EOCD patients, females were predominant, smoking was less common, and they were prone to comorbidity. At the initial stage of diagnosis, it is easy to be misdiagnosed as tumor, and the disease behavior mainly showed stricture type, less complicated with perianal diseases. During the follow-up, all-cause mortality and CD-related mortality of EOCD patients were significantly higher than those of the non-elderly onset CD patients.
Female ; Middle Aged ; Humans ; Aged ; Child ; Adult ; Adolescent ; Young Adult ; Crohn Disease/epidemiology* ; Prognosis ; Constriction, Pathologic ; Aging ; Hospitals, General

Objective:To explore the characteristics of intestinal flora in female patients with type 2 diabetes mellitus (T2DM) with comorbid coronary heart disease.Methods:Female patients with T2DM from September 2019 to November 2020 were enrolled in this study and divided into 2 groups stratified by coronary heart disease: 22 patients with coronary heart disease(T2DM+ CHD group) and 49 patients with simple T2DM group(T2DM group). Thirty-one healthy females were selected as the normal control group(NC group). The abundance of intestinal flora, the difference in intestinal flora and its relationship with indicators such as glycosylated hemoglobin and fasting blood glucose was analyzed by the real-time fluorescent quantitative PCR detection technology in the three groups.Results:The abundance of Prevotella in the T2DM group was lower, and Roseburia inulinivorans and Faecalibacterium prausnitzii in the T2DM+ CHD group were lower, while Bacteroides and Enterococcus spp in the T2DM+ CHD group were higher compared with NC group, respectively( P<0.05). The abundance of Bacteroides and Enterococcus spp in the T2DM+ CHD group was lower than that in the T2DM group( P<0.05). Spearman correlation analysis showed that the abundance of Faecalibacterium prausnitzii and Eubacterium rectale was negatively correlated with obesity while abundance of Bacteroides and Enterococcus spp was positively correlated with HbA 1C and fasting blood glucose. The abundance of Bacteroides was positively correlated with TCH and TG(all P<0.05). Logistic regression analysis showed that Bacteroides and Enterococcus spp were independent influencing factor of the development of female patients with T2DM and CHD. Conclusion:Female T2DM and T2DM with CHD had intestinal flora imbalance, which was related to a variety of glucose and lipid metabolism indicators, and might be closely related to the occurrence of T2DM and CHD. Bacteroides and Enterococcus spp were independent influencing factors of the development of female patients with T2DM and CHD. Regulating the intestinal flora can provide ideas for the prevention and treatment of T2DM with CHD in female.

Objective:To assess the clinical efficacy of low-level laser therapy(LLLT)for the treatment of burning mouth syndrome(BMS)in elderly patients.Methods:As a randomized controlled study, 60 elderly BMS patients treated in the department of stomatology of Beijing Hospital from September 2018 to August 2021 were randomly divided into a laser group and a control group, including 7 man and 53 women, with an average age of(68.27±6.38)years.Patients in the laser group were treated with LLLT, and patients in the control group were treated with non-energy red light and oryzanol.The visual analogue scale and self-rating anxiety and depression scale were used to evaluate the two groups of patients.Results:After LLLT, the effectiveness rate of the laser group was 86.67%(26/30)on the 28th and 90th day, which was significantly higher than 63.33%(19/30)of the control group( χ2=4.356, P=0.037). When data for pre-treatment, the 28th day after treatment and the 90th day after treatment for the laser group were compared, results showed that after LLLT, pain symptoms of BMS patients were relieved and it lasted for some time, and anxiety and depression also improved, but there were episodes of relapse as time went on.Visual analogue scale and self-rating anxiety scores and depression scale scores of BMS patients for pre-treatment, the 28th and 90th days after treatment in the two groups were compared.Only self-rating anxiety scale scores of the laser group was lower than those of the control group on the 28th day, with statistical significance( t=2.622, P=0.011), indicating that LLLT could alleviate anxiety for BMS patients in the short term, but had no significant effect on patient depression.However, in the long term, LLLT had no significant effect on relieving anxiety and depression. Conclusions:LLLT has a certain effect on improving pain symptoms and anxiety in elderly BMS patients.

Objective:To study the effectiveness of a strategy for detecting early gastric cancer using high-definition gastroscopy.Methods:A total of 849 patients over 35 years old who underwent gastroscopy in the Seventh Medical Center of PLA General Hospital from December 2018 to January 2019 were enrolled to a prospective study. During gastroscopy, biopsies were taken at any suspicious lesions in patients who had never been infected with Helicobacter pylori. In ulcer-type lesions, biopsies were taken at the edge of the ulcer. Outside the atrophic area, biopsies were taken at lesions in the cardia which were reddish under white light, or lesions in the non-cardiac area which were white or showed clear borders under white light. Inside the atrophic area, biopsies were taken at elevated lesions with clear borders or irregular depressions on the top, or flat/depressed lesions with irregular borders or being ocherous under narrow band imaging. In addition, biopsies were performed on any lesion that did not meet the above standard but was considered necessary. The high-risk patients were followed up by gastroscopy to observe the detection and missed diagnosis of neoplasm that meet the above standard, and to determine the sensitivity and positive predictive value of the strategy. Results:A total of 548 patients were biopsied (781 lesions). Among the 327 lesions that met the above standard, 16 lesions (4.9%) were diagnosed as epithelial neoplasm, of which 10 (3.1%) were high-grade neoplasm. Among the 454 lesions that did not meet the standard, only 1 (0.2%) epithelial neoplasm was diagnosed, and there was no high-grade neoplasm. The positive predictive value of this screening strategy for gastric epithelial neoplasm and high-grade neoplasm was higher than those who did not meet the standard (4.9% VS 0.2%, χ2=19.49, P<0.01; 3.1% VS 0, P<0.001). There were 146 patients (17.2%, 146/849) followed up by gastroscopy. During the follow-up, 2 high-grade intramucosal neoplasms were found. 84.2% (16/19) of epithelial tumors and 83.3% (10/12) of high-grade neoplasm were detected during the initial gastroscopy. Conclusion:This screening strategy can efficiently detect early gastric cancer under high-definition gastroscopy.

Objective:To propose a strategy for detecting early gastric cancer (EGC) under high-definition gastroscopy.Methods:Data of 469 lesions of EGC or high grade intraepithelial neoplasia (HGIN) confirmed by pathology detected at The Seventh Medical Center of Chinese People′s Liberation Army General Hospital from January 2013 to January 2020 were collected and gastroscopic images were re-interpreted. The Helicobacter pylori ( HP) infection status, lesion location in the area of atrophy or at the cardia, morphological type of lesions, lesions with/without clear or regular boundary, and lesion color were analyzed for morphological characteristics of EGC and HGIN under high-definition gastroscopy. Results:Among the 469 lesions of EGC or HGIN, HP-negative lesions accounted for 2.1% (10/469) and ulcerative lesions for 7.7% (36/469). Among non-ulcerative lesions of suspected HP infection ( n=423), there were 28 lesions in the cardia outside the atrophic area and 82.1% (23/28) were reddish under white light imaging. There were 29 non-cardiac lesions outside the atrophic area and 82.8% (24/29) were white or showed clear border under white light imaging. Inside the atrophic area, there were 73 elevated lesions, 95.9% (70/73) of which had clear border or irregular depression on the top. There were 293 flat/depressed lesions in the atrophic area, and 90.8% (266/293) had irregular border or were brown under narrow band imaging. Conclusion:According to the status of HP infection, the location and morphological category of lesions, above endoscopic features can be used as clues to detect EGC and HGIN.

Objective:To analyze the endoscopic and histological characteristics of Helicobacter pylori ( HP)-negative early gastric cancer (EGC) and high grade intraepithelial neoplasia (HGIN). Methods:Data of patients diagnosed as having EGC or HGIN confirmed by pathology at the Seventh Medical Center of Chinese People′s Liberation Army General Hospital from January 2013 to January 2020 were collected. Patients were included according to the diagnostic criteria of HP-negative gastric cancer, and their endoscopic features and histopathological characteristics were retrospectively analyzed. Results:Among 469 lesions of EGC/HGIN, HP-negative lesions accounted for 2.1% (10/469), which included 3 signet ring cell carcinomas, 3 fundic gland type carcinomas, 1 foveolar adenocarcinoma, 1 HGIN of the cardia, 1 familial adenomatous polyposis with gastric HGIN, and 1 Lynch syndrome with gastric HGIN. The 3 cases of signet ring cell carcinoma were all whitish flat/depressed lesions and commonly seen in the lower part of the stomach (2/3). Most of the 7 cases of differentiated EGC/HGIN were elevated type (5/7) and commonly seen in the upper and middle stomach (6/7). Conclusion:HP-negative EGCs are usually solitary lesions under gastroscopy. Undifferentiated type mostly appears whitish flat/depressed in the lower part of the stomach, while differentiated type appears elevated in the upper and middle part.