高危型人乳头瘤病毒DNA检测在宫颈癌筛查中的作用

目的:探讨高危型人乳头瘤病毒(HPV)DNA检测在宫颈癌筛查中的作用。方法:2005年4月~2006年4月在我院妇科门诊就诊2 340名妇女进行宫颈癌前病变筛查,采用第2代杂交捕获试验(HC-Ⅱ)检测高危型HPV DNA联合薄层液基细胞学检查,同时进行阴道镜检查,并以宫颈活检的组织病理学为确诊标准。结果:筛查并经病理诊断为HPV感染365例,宫颈上皮内瘤变(C IN)Ⅰ级71例,C INⅡ48例,C INⅢ55例,宫颈浸润癌31例。以组织病理学为确诊标准,高危型HPV DNA检测C INⅡ、C INⅢ的敏感度是91.33%,特异度是74.51%,阳性预测值是5.21%,阴性预测值是99.79%。宫颈细胞学筛查C INⅡ、C INⅢ,以未明确诊断意义的不典型鳞状上皮细胞(ASCUS)为分界点的敏感度、特异度、阳性预测值、阴性预测值分别是90.80%、80.45%、12.30%、99.50%;以高度鳞状上皮内病变(HSIL)为分界点的敏感度、特异度、阳性预测值、阴性预测值分别是98.90%、73.98%、4.90%、100.00%。高危型HPV DNA在不同宫颈病变中的阳性率分别是:宫颈癌88.57%(31/35),C INⅢ91.67%(66/72),C INⅡ87.50%(56/64),C INⅠ42.00%(21/50)。结论:高危型人乳头瘤病毒DNA检测在宫颈癌前病变的筛查中有很高的敏感度和阴性预测值,高危型HPV DNA联合细胞学检查可使敏感度和阴性预测值有提高,但特异度未能提高。     

The efficacy of Salvadora persica extract in the elimination of the intracanal smear layer: A SEM study

AimTo evaluate the efficacy of an ethanolic Salvadora persica extract in removing the smear layer following a root canal procedure.MethodsSixty extracted, single-rooted human teeth were cleaned, shaped, and divided into four groups. Experimental groups 1 (n = 20) and 2 (n = 20) were irrigated with 1 mg/ml and 5 mg/ml of S. persica, respectively. The positive controls (n = 10) were irrigated with 17% ethylenediaminetetraacetic acid (EDTA), while the negative controls (n = 10) were irrigated with saline. Approximately 5 ml of the irrigating solution was delivered into the root canals for 5 min, and the final rinse was performed with 5 ml of 1% sodium hypochlorite. Scanning electron microscopy was used to evaluate the endodontic smear layer removal at the coronal, middle, and apical thirds of the specimens.ResultsA significant difference in smear layer removal between groups 1 and 2 at the coronal and middle thirds of the canal was observed, and no significant difference was seen between group 2 and the positive control at the coronal third. At the apical third, both concentrations of S. persica had similar effects and were less effective than the positive control in removing the smear layer.ConclusionThe 5 mg/ml S. persica solution was significantly more effective than the 1 mg/ml solution. In addition, the 5 mg/ml S. persica solution was as effective as 17% EDTA in removing the smear layer from the coronal third of the canal wall.     

National cervical cancer prevention program in the Arab States: Strategies and cost-minimization study of the Tunisian case

BackgroundThe Arab states geographic region is marked by a low to moderate cervical cancer screening coverage rates and the absence of national human papillomavirus (HPV) vaccination programs, except for the United Arab Emirates. Knowing that the HPV prevalence among Tunisian woman is estimated to 4.9/100 000 according to the “HPV Center” data, this study aims to estimate the cost of a national cervical cancer prevention program in Tunisia using either the primary prevention method (the two-dose schedule anti-HPV vaccine according to the WHO recommendation for young adolescents) or the secondary prevention method (the Pap smear test according to three time-lapse periodicity).MethodsThe mean incremental cost of one avoided cervical cancer case was calculated for each prevention scenario.ResultsThe ascending incremental costs by avoided cervical cancer case are: 1- the national vaccination program through the GAVI support ($ 1803), 2- the cervical cancer screening according to 10-year periodicity ($ 8219), 3- the cervical cancer screening according to 5-year periodicity ($ 14,567), 4- the cervical cancer screening according to 3-year periodicity ($ 20,479), 5- and finally the national vaccination program according to the manufacturer marketed price ($ 36,854).ConclusionCurrently, the anti-HPV national vaccination program combined with cervical cancer screening according to 5-year periodicity present the best cost-effective strategy for cervical cancer prevention in Tunisia. This study gives Tunisian decision makers a basis for structured planning and cost apportionment to ensure effective roll-out of the cervical cancer prevention strategies.     

全国初治涂阴肺结核病例登记现状分析

目的 分析全国各省初治涂阴肺结核病例登记现状,为评价初治涂阴肺结核病例诊断质量提供依据.方法 根据2004-2005年全国结核病防治规划报表中初治涂阴和初治涂阳肺结核病例登记资料,分析各省2年初治涂阴肺结核病例登记率变化和增长幅度;统计各省及不同地区初治涂阴与初治涂阳肺结核病例登记率;对各省初治涂阴与初治涂阳肺结核病例登记率进行直线回归分析.结果 2005年全国登记初治涂阴肺结核病例316 405例,登记率为24.27/10万,各省登记率在6.01/10万～72.17/10万;2005年登记初治涂阴病例数比2004年增加了19.9%,其中2个省登记数呈负增长,其余各省登记数增长了0.5%～62.3%;2005年全国初治涂阳病例登记率是涂阴病例登记率的1.5倍,其中23个省初治涂阳病例登记率高于涂阴病例登记率,8个省相反;初治涂阴病例占初治涂阳病人登记率的比例,京津沪地区为149.28%,非项目地区为83.6%,项目地区为50.3%;对涂阳和涂阴病例登记率进行直线回归分析,回归方程y=22.342＋0.563 6x.结论 对初治涂阴肺结核患者实行免费政策后,全国涂阴肺结核病例登记率提高.但各省初治涂阴病例登记率和增长幅度以及涂阴病例登记率与涂阳病例登记率的比例悬殊.由于涂阴病例诊断困难,对于涂阴病例登记率高或增长幅度大的地区,特别在DOTS执行时间短和人力资源有限的地区,应对涂阴病例诊断质量予以进一步检查和评价.     

Influence of concentration, time and method of application of citric acid and sodium citrate in root conditioning

Objective

The aim of this study was to establish the parameters of concentration, time and mode of application of citric acid and sodium citrate in relation to root conditioning.

Material and Methods

A total of 495 samples were obtained and equally distributed among 11 groups (5 for testing different concentrations of citric acid, 5 for testing different concentrations of sodium citrate and 1 control group). After laboratorial processing, the samples were analyzed under scanning electron microscopy. A previously calibrated and blind examiner evaluated micrographs of the samples. Non-parametric statistical analysis was performed to analyze the data obtained.

Results

Brushing 25% citric acid for 3 min, promoted greater exposure of collagen fibers in comparison with the brushing of 1% citric acid for 1 minute and its topical application at 1% for 3 min. Sodium citrate exposed collagen fibers in a few number of samples.

Conclusion

Despite the lack of statistical significance, better results for collagen exposure were obtained with brushing application of 25% citric acid for 3 min than with other application parameter. Sodium citrate produced a few number of samples with collagen exposure, so it is not indicated for root conditioning.     

Combined effect of smear layer characteristics and hydrostatic pulpal pressure on dentine bond strength of HEMA-free and HEMA-containing adhesives

Objective

This study evaluated the combined effect of smear layer characteristics with hydrostatic pulpal pressure (PP) on bond strength and nanoleakage expression of HEMA-free and -containing self-etch adhesives.

Methods

Flat dentine surfaces were obtained from extracted human molars. Smear layers were created by grinding with #180- or #600-SiC paper. Three HEMA-free adhesives (Xeno V, G Bond Plus, Beautibond Multi) and two HEMA-containing adhesives (Bond Force, Tri-S Bond) were applied to the dentine surfaces under hydrostatic PP or none. Dentine bond strengths were determined using the microtensile bond test (μTBS). Data were statistically analyzed using three- and two-way ANOVA with Tukey post hoc comparison test. Nanoleakage evaluation was carried out under a scanning electron microscope (SEM).

Results

Coarse smear layer preparation and hydrostatic PP negatively affected the μTBS of HEMA-free and -containing adhesives, but there were no significant differences. The combined experimental condition significantly reduced μTBS of the HEMA-free adhesives, while the HEMA-containing adhesives exhibited no significant differences. Two-way ANOVA indicated that for HEMA-free adhesives, there were significant interactions in μTBS between smear layer characteristics and pulpal pressure, while for HEMA-containing adhesives, there were no significant interactions between them. Nanoleakage formation within the adhesive layers of both adhesive systems distinctly increased in the combined experimental group.

Conclusion

The combined effect of coarse smear layer preparation with hydrostatic PP significantly reduced the μTBS of HEMA-free adhesives, while in HEMA-containing adhesives, these effects were not obvious.

Clinical significance

Smear layer characteristics and hydrostatic PP would additively compromise dentine bonding of self-etch adhesives, especially HEMA-free adhesives.     

结节病与菌阴结核病的鉴别诊断方法研究进展

结节病是一种原因未明的、多系统受累的肉芽肿性疾病,以呼吸系统受累多见.其临床表现多样,缺乏特异性,病理表现为非干酪样坏死性肉芽肿,需排除其他病因后方能确立诊断.在中国这样一个结核病高发的国家,结节病与痰结核菌阴性结核病的鉴别诊断尤其困难,是一个非常值得研究的问题.     

The influence of smear layer in lateral channels filling

This in vitro study evaluated the ability of a warm gutta-percha obturation system Thermafil to fill lateral channels in presence/absence of smear layer. Forty single-rooted extracted human teeth were randomly divided into two groups for which different irrigation regimens were used: group A, 5 ml of 5% NaOCl + 2.5 ml of 3.6% H₂O₂; group B, 5 ml of 5% NaOCl 5% + 2.5 ml of 17% ethylenediamine tetraacetic acid. A conventional crown-down preparation technique was employed. Obturation was performed using epoxy resin-based cement (AH Plus) and a warm gutta-percha plastic carrier system (Thermafil). Specimens were cleared in methyl salicylate and analyzed under a stereomicroscope to evaluate the number, length, and diameter of lateral channels. Lateral channels were identified in both groups at medium and apical thirds. Additional samples were prepared for scanning electron microscopy inspection to confirm the presence of smear layer in group A, and the absence of smear layer in group B. All lateral channels resulted filled in both groups. No statistically significant differences regarding number, length, and diameter were observed between the two groups. Smear layer did not prevent the sealing of lateral channels.