OBJECTIVE To study the improving mechanism of Buyang huanwu decoction （BYHW） on idiopathic pulmonary fibrosis （IPF） model rats. METHODS Ninety-six Wistar rats were randomly divided into blank group， model group， positive control group， and BYHW low-dose， middle-dose and high-dose groups， with 16 rats in each group. Except for the blank group， the IPF model was induced in other groups by intratracheal instillation of bleomycin （5 mg/kg）. Starting from the day of modeling， the blank group and model group were given normal saline （10 mL/kg） intragastrically， while the rats in the positive control group were given dexamethasone solution （5 mg/kg） intragastrically， BYHW low-dose， middle-dose and high-dose groups were treated with BYHW （2.5， 5， 10 g/kg， by crude drug） intragastrically， once a day， for 28 consecutive days. The body mass of rats in each group was measured on days 0， 7， 14， 21 and 28 after modeling. The number of adherent white blood cells in pulmonary veins was observed by a dynamic visualization system. The contents of TNF-α and IL-6 in serum and TNF-α， IL-6， HYP and TGF-β1 in lung tissue were detected； the protein expression of ZO-1 was also detected. The pathomorphological changes in lung tissue were observed. RESULTS Compared with the model group， the body weight of rats all increased significantly in BYHW high-dose and middle-dose groups， positive control group， while the number of adherent white blood cells in pulmonary veins was decreased significantly； the contents of TNF-α （except for serum in BYHW middle-dose group） and IL-6 in serum and lung tissue， the contents of HYP and TGF-β1 in lung tissue were decreased significantly， while the protein expression of ZO-1 in the lung tissue was increased significantly （P＜0.05 or P＜0.01）. The pathological changes of lung tissue were improved to varying degrees. CONCLUSIONS BYHW may play anti-pulmonary fibrosis role by improving leukocyte adhesion， anti-inflammatory， anti-fibrosis， and other aspects of pulmonary microcirculation.

Endoscopy, Gastrointestinal ; Anesthesia ; Surveys and Questionnaires ; Anesthesiology ; Hospitals, Public ; China ; Endoscopy

Objective:To analyze the expression and significance of interleukin-17 (IL-17), IL-23 and IL-22 in Klebsiella pneumoniae (KPN) pneumonia in rats. Methods:A total of 40 male SPF rats were randomly divided into the control group and the experimental group according to the simple number random table method, with 20 rats in each group. The control group was simultaneously dropped with 2 mL normal saline, while the experimental group was inoculated with a 2 mL suspension of 0.9×10 9 CFU/mL. The lung tissue was taken for pathological and bacteriological examination. Arterial partial pressure of oxygen (PaO 2), serum IL-17, IL-23 and IL-22 levels were detected after surgery for 4 h, 1 d, 3 d and 5 d. White blood cell count (WBC) and absolute neutrophil count (ANC) were performed in bronchoalveolar lavage fluid (BALF), and the relevance between IL-17, IL-23, IL-22 and PaO 2, and WBC, ANC in BALF was analyzed. Results:After surgery for 4 h, 1 d, 3 d and 5 d, the CFU count of lung tissue in experimental group rats decreased over time. PaO 2 in experimental group was significantly lower than that in the control group after surgery for 4 h, 1 d, 3 d and 5 d ( P<0.05), while WBC and ANC in BALF in the experimental group were significantly higher at the same time ( P<0.05). The levels of IL-17 and IL-23 in serum in the experimental groups were significantly higher than those in the control group after surgery for 4 h, 1 d, 3 d and 5 d ( P<0.05), and the levels of IL-22 in serum in the experimental groups were significantly lower than those in the control group at the same time ( P<0.05). Pearson analysis showed that IL-17 and IL-23 were negatively correlated with PaO 2 ( P<0.05) and positively correlated with WBC and ANC ( P<0.05). IL-22 was positively correlated with PaO 2 ( P<0.05), and negatively correlated with WBC and ANC ( P<0.05). Conclusions:Serum IL-17, IL-23, and IL-22 levels were significantly altered during the course of KPN rats, and serum IL-17, IL-23, and IL-22 levels were correlated with severity of illness.

To investigate the clinical efficacy and safety of Wei nasal jet tube (WNJT) in painless gastroscopy in patients over age of 60, 80 patients aged 60 years or older scheduled for gastroscopy under propofol mono-sedation in Beijing Friendship Hospital were divided into WNJT group ( n=40) and nasal cannula group ( n=40) according to the random number table method from January to June 2021. The main observation indicator was the difference in the incidence of hypoxemia between the two groups, the secondary observation indicators included the lowest pulse blood oxygen saturation (SpO 2), interventions related to hypoxemia, adverse events such as body movement, cough, epistaxis, sore throat, and the satisfaction of physicians, anesthetists and patients. The results showed that the procedure time and total dosage of propofol were no significant differences between the two groups ( P>0.05). Compared with the nasal cannula group, the incidence of hypoxemia in the WNJT group was significantly lower [2.5% (1/40) VS 25.0% (10/40), χ2=8.538, P=0.003], the lowest SpO 2 was significantly higher (97.7%±2.5% VS 92.6%±5.8%, t=5.093, P<0.001), and the use of jaw lift was reduced [5.0% (2/40) VS 35.0% (14/40), χ2=11.250, P=0.001]. The adverse events were not significantly different between the two groups ( P>0.05), but no case of epistaxis and sore throat occurred in the nasal cannula group. The two groups were comparable in terms of the satisfaction of patients, anesthetists and physicians ( P>0.05). In conclusion, WNJT can be used safely during gastroscopy with propofol mono-sedation in patients over 60 years old, with less incidence of hypoxemia and the number of airway interventions. But violent operation should be avoided to reduce the incidence of epistaxis and sore throat.

OBJECTIVE: To analyze the marginal roughness and marginal fitness of chairside computer-aided design and computer-aided manufacturing (CAD/CAM) laminate veneers with different materials and thicknesses, and to provide a reference for the clinical application of laminate veneers. METHODS: The butt-to-butt type laminate veneers were prepared on resin typodonts, the preparations were scanned, and the laminate veneers were manufactured by chairside CAD/CAM equipment. The laminate veneers were divided into four groups (n=9) according to the materials (glass-matrix ceramics and resin-matrix ceramics) and thickness (0.3 mm and 0.5 mm) of the veneers, with a total of 36. The marginal topo-graphies of each laminate veneer were digitally recorded by stereomicroscope, and the marginal rough-nesses of the laminate veneers were determined by ImageJ software. The marginal fitness of the laminate veneers was measured by a fit checker and digital scanning and measuring method. At the same time, the mechanical properties of glass-matrix ceramic and resin-matrix ceramic bars (n=20) were tested by a universal testing device. RESULTS: The marginal roughness of 0.3 mm and 0.5 mm glass-matrix ceramic laminate veneers was (24.48±5.55) μm and (19.06±5.75) μm, respectively, with a statistically significant difference (P < 0.001). The marginal roughness of 0.3 mm and 0.5 mm resin-matrix ceramic laminate veneers was (6.13±1.27) μm and (6.84±2.19) μm, respectively, without a statistically significant difference (P>0.05). The marginal roughness of the glass-matrix ceramic laminate veneers was higher than that of the resin-matrix ceramic laminate veneers with a statistically significant difference (P < 0.001). The marginal fitness of 0.3 mm and 0.5 mm glass-matrix ceramic laminate veneers were (66.30±26.71) μm and (85.48±30.44) μm, respectively. The marginal fitness of 0.3 mm and 0.5 mm resin-matrix ceramic laminate veneers were (56.42±19.27) μm and (58.36±8.33) μm, respectively. There was no statistically significant difference among the 4 groups (P>0.05). For glass-matrix ceramics, the flexural strength was (327.40±54.25) MPa, the flexural modulus was (44.40±4.39) GPa, and the modulus of resilience was (1.24±0.37) MPa. For resin-matrix ceramics, the flexural strength was (173.71±16.61) MPa, the flexural modulus was (11.88±0.51) GPa, and the modulus of resilience was (1.29±0.27) MPa. The flexural strength and modulus of glass-matrix ceramics were significantly higher than those of resin-matrix ceramics (P < 0.001), but there was no statistically significant difference in the modulus of resilience between the two materials (P>0.05). CONCLUSION The marginal roughness of CAD/CAM glass-matrix ceramic laminate veneers is greater than that of resin-matrix ceramic laminate veneers, but there was no statistically significant difference in marginal fitness among them. Increasing the thickness can reduce the marginal roughness of glass-matrix ceramic laminate veneers, but has no effect on the marginal roughness of resin-matrix ceramic laminate veneers.
Ceramics ; Computer-Aided Design ; Dental Porcelain ; Dental Veneers ; Materials Testing ; Surface Properties

Background::Post-operative acute kidney injury (AKI) is one of the most common and serious complications after major surgery and is significantly associated with increased risks of morbidity and mortality. This meta-analysis was conducted to evaluate the effects of perioperative dexmedetomidine (Dex) administration on the occurrence of AKI and the outcomes of recovery after non-cardiac surgery.Methods::The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched for studies comparing the effects of Dex vs. placebo on kidney function after non-cardiac surgery, and a pooled fixed-effect meta-analysis of the included studies was performed. The primary outcome was the occurence of post-operative AKI. The secondary outcomes included the occurence of intra-operative hypotension and bradycardia, intensive care unit (ICU) admission, duration of ICU stay, and hospital length of stay (LOS). Results::Six studies, including four randomized controlled trials (RCTs) and two observational studies, with a total of 2586 patients were selected. Compared with placebo, Dex administration could not reduce the odds of post-operative AKI (odds ratio [OR], 0.44; 95% confidence interval (CI), 0.18-1.06; P= 0.07; I2= 0.00%, P= 0.72) in RCTs, but it showed a significant renoprotective effect (OR, 0.67; 95% CI, 0.48-0.95; P = 0.02; I2 = 0.00%, P = 0.36) in observational studies. Besides, Dex administration significantly increased the odds of intra-operative bradycardia and shortened the duration of ICU stay. However, there was no significant difference in the odds of intra-operative hypotension, ICU admission, and hospital LOS. Conclusions::This meta-analysis suggests that perioperative Dex administration does not reduce the risk of AKI after non-cardiac surgery. However, the quality of evidence for this result is low due to imprecision and inconsistent types of non-cardiac operations. Thus, large and high-quality RCTs are needed to verify the real effects of perioperative Dex administration on the occurrence of AKI and the outcomes of recovery after non-cardiac surgery.

Objective:To assess the influence of age on the safety of propofol mono-sedation for adult patients undergoing painless gastroscopy.Methods:A retrospective study was conducted on data of 321 patients scheduled for painless gastroscopy with propofol mono-sedation. According to the age, patients were divided into youth group (116 cases, 18-44 years), middle-aged group (103 cases, 45-59 years) and elderly group (102 cases, 60-80 years). The procedure time, the total dosage of propofol, the occurrence of airway obstruction or hypoxemia, the use of airway interventions including airway opening maneuvers and facemask ventilation, lowest SpO 2, adverse cardiovascular events (including hypertension, hypotension, tachycardia, and bradycardia), and the use of ephedrine during painless gastroscopy were observed. Results:There was significant difference regarding the total dosage of propofol among youth group (173.2±47.0 mg), middle-aged group (158.8±41.3 mg) and elderly group (137.8±26.3 mg) ( F=21.761, P<0.001). The total dosage of propofol was significantly lower in the elderly group compared with the middle-aged group ( P<0.017) and youth group ( P<0.017), and that in the middle-aged group was significantly lower than that in the youth group ( P<0.017). The incidence of hypoxemia was 12.9% (15/116) in the youth group, 15.5% (16/103) in the middle-aged group and 25.5% (26/102) in the elderly group, with significant difference among three groups ( χ2=5.711, P=0.017). Moreover, the incidence of hypoxemia was significantly higher in the elderly group compared with the middle-aged group ( P<0.017) and youth group ( P<0.017). The incidences of hypotension, bradycardia and total adverse cardiovascular events were 5.2% (6/116), 4.9% (5/103) and 11.8% (12/102), 1.7% (2/116), 2.9% (3/103) and 7.8% (8/102), and 11.2% (13/116), 10.7% (11/103) and 20.6% (21/102) respectively in youth, the middle-aged and the elderly group. There were no significant differences in the above indicators among the three groups ( P>0.05). However, compared with those of the young and the middle-aged patients, the occurrence of hypotension, bradycardia and total adverse cardiovascular events in the elderly patients were on the rise. There were no significant differences among the three groups in other indices( P>0.05). Conclusion:Total dosage of propofol may need to be decreased gradually with the increase of age of patients undergoing gastroscopy with propofol mono-sedation. Compared with young and middle-aged patients, elderly patients have a significantly higher incidence of hypoxemia, with a tendancy of total adverse cardiovascular events increase, so the safety of painless gastroscopy is reduced for these patients.

Mycobacterium abscessus infection is a rare and serious complication of prosthetic breast augmentation. In March 2020, Foshan Huamei Plastic Surgery Hospital treated a 35-year-old female patient with Mycobacterium abscessus infection after breast augmentation mammoplasty. Twenty days post surgery, there was pain and swelling onthe whole left breast, especially the incision, and the main clinical symptoms such asobvious fluctuation, obvious tenderness andhighskin temperature. Then the left breast implant was removed, and bacterial culture and susceptibility testing of the secretions in the operation area were performed. According to susceptibility testing result, antibiotics were used intravenouslyand the cavity of the operation area was flushed. After 9 months flushed treatment, the infection was controlled and followed up for 14 months. There was norecurrence on the left breast. In the whole treatment, it is necessary to ensure the continuity of the treatment, especially the early stage of the infection, in order to ensure the possibility of cure of the disease.

Mycobacterium abscessus infection is a rare and serious complication of prosthetic breast augmentation. In March 2020, Foshan Huamei Plastic Surgery Hospital treated a 35-year-old female patient with Mycobacterium abscessus infection after breast augmentation mammoplasty. Twenty days post surgery, there was pain and swelling onthe whole left breast, especially the incision, and the main clinical symptoms such asobvious fluctuation, obvious tenderness andhighskin temperature. Then the left breast implant was removed, and bacterial culture and susceptibility testing of the secretions in the operation area were performed. According to susceptibility testing result, antibiotics were used intravenouslyand the cavity of the operation area was flushed. After 9 months flushed treatment, the infection was controlled and followed up for 14 months. There was norecurrence on the left breast. In the whole treatment, it is necessary to ensure the continuity of the treatment, especially the early stage of the infection, in order to ensure the possibility of cure of the disease.