Age at menopause,body mass index,and risk of type 2 diabetes mellitus in postmenopausal Chinese women: The Henan Rural Cohort study

Background and aimThe present study was conducted to explore the stratified and joint effects of age at menopause and body mass index (BMI) with the risk of type 2 diabetes mellitus (T2DM) in Chinese rural adults.Methods and resultsA total of 15,406 postmenopausal Chinese women were included in this study. Multivariable logistic regression analysis was used to quantify the stratified and joint effects of age at menopause and BMI on T2DM. Overall, the mean age at menopause and BMI was 48.8 ± 4.7 years and 25.1 ± 3.6 kg/m², respectively. In general, data suggest that: 1) women with BMI ≥ 24 had a higher risk of T2DM, irrespective of age at menopause; 2) in women with BMI < 24, later menopause had a higher risk of T2DM (OR, 1.52; 95% CI, 1.16–2.01); 3) the risk of T2DM was higher only in patients with early or normal age at menopause and BMI ≥ 24, with 0R (95% CI) of (1.58, 1.28–1.94) and (1.48, 1.31–1.67), respectively.ConclusionOur findings suggest that: 1) women with BMI ≥ 24 had a higher risk of T2DM, irrespective of age at menopause; 2) in women with BMI < 24, a higher risk of T2DM was found only in those with later menopause; 3) women with later menopause had a higher risk of T2DM, irrespective of BMI; 4) in patients with early or normal age at menopause, a higher risk of T2DM was found only in patients with BMI ≥ 24.The Chinese Clinical Trial RegistrationChiCTR–OOC–1500669(URL:http://www.chictr.org.cn/showproj.aspx?proj=11375)     

Early menarche and premature natural menopause in Indonesia

Background: An association has been suggested between early menarche and premature natural menopause. However, existing studies in developed countries show mixed findings.

Aim: This study examined whether early menarche (first menstrual period ≤11 years old) is a factor for premature natural menopause (final menstrual period <40 years old) in the context of a developing country.

Subjects and methods: Data came from the Indonesia Family Life Survey (IFLS) 2014, which consists of 1608 post-menopausal women.

Results: Results of hierarchical logistic regression show that women who experienced early menarche (first menstrual period ≤11 years old) were found to be at higher risk of premature natural menopause (β?=?0.94, p?<?0.01, CI?=?0.24–1.63). The results are robust against potential confounding factors including individual reproductive history, lifestyle and sociodemographic characteristics, as well as unobserved factors at the household and community levels.

Conclusion: The findings support early monitoring of women with early menarche, especially those who have no children, for preventive health interventions aimed at mitigating the risk of adverse health outcomes associated with premature natural menopause.     

Combined medical therapy and neurosurgical revascularization preventing stroke in post-varicella angiopathy: Case report and review of literature

BackgroundPost varicella angiopathy (PVA) is an underdiagnosed but potentially severe disease in both pediatric and adult settings. No guidelines are available for the medical and neurosurgical management of this condition. We report the first pediatric case with headache and PVA who was treated with surgical revascularization before the onset of ischemic events.MethodsThis case report was conducted via retrospective chart review. A literature review was also completed, in order to identify previously described PVA undergone to revascularization.ResultsWe report on a 9-year-old boy presenting with a long history of headache and PVA involving the distal left middle cerebral artery. The arterial lesion rapidly worsened over a 10 months’ period with formation of focal moyamoya-like collaterals, despite an adequate intravenous antiviral treatment. The pattern of headaches significantly changed with a clear left-side lateralization and a “re-build-up” phenomenon on EEG. The patient was treated with left superficial temporal artery - middle cerebral artery (STA-MCA) bypass and encephalo-duro-arterio-myo-pericranial-synangiosis. This combined treatment resulted in an immediate and persistent improvement of brain perfusion, accompanied by prompt resolution of neurological symptoms.Two cases who presented with Suzuki stage III (unilateral or bilateral) moyamoya PVA and recurrent strokes or transient ischemic attacks despite adequate pharmacological prophylaxis have been surgically treated using both indirect and direct revascularization technique. The outcome was good in both cases.ConclusionSurgical revascularization may have a role in the treatment of PVA and may prevent stroke. Given the lack of standardized treatment algorithms, individualized regimens should be formulated on a case-specific basis.     

一种新型数字化桩核修复技术

桩道信息获取不完整、数字化程度低等诸多缺陷限制了全数字化和半数字化桩核制造技术应用于临床。本文旨在介绍一种新型桩核数字印模采集技术,该技术利用计算机辅助设计和计算机辅助制造（computer-aided design/computer-aided manufacturing,CAD/CAM）来制作桩核,能生产出精度更高、外形更合理的定制桩核。     

牙冠延长术后桩核修复在牙体缺损至龈下残根残冠患者中的应用观察

目的观察牙冠延长术后桩核修复在牙体缺损至龈下残根残冠患者中的应用效果。方法选取我院2016年10月~2019年11月期间接收的牙体缺损至龈下残根残冠患者140例,根据随机数字表法分成研究组(70例)与对照组(70例),其中对照组接受直接桩核冠修复治疗,研究组接受牙冠延长术后桩核修复治疗。比较两组临床疗效、美观满意度、治疗前与治疗后龈沟液中炎性因子[一氧化氮(NO)、白细胞介素-1β(IL-1β)、前列腺素E2(PGE2)]水平以及治疗前、治疗6周、3个月牙周状况[探诊深度(PD)、龈沟出血指数(SBI)]。结果研究组总有效率97.14%(68/70),较对照组80.00%(56/70)高(P<0.05);治疗6周、3个月研究组PD浅于对照组,SBI少于对照组(P<0.05);治疗3 d,研究组NO、PGE2、IL-1β水平低于对照组(P<0.05);与对照组88.57%(62/70)对比,研究组美观满意度98.57%(69/70)明显较高(P<0.05)。结论牙冠延长术后桩核修复应用于牙体缺损至龈下残根残冠患者中,可增强治疗效果,改善牙周恢复状况,减轻龈沟液中炎性因子,并提高美观度。     

汶川地震救援人员创伤后应激障碍状况调查

目的调查汶川地震救援人员创伤后应激障碍(post-traumatic stress disorder,PTSD)状况,为救援人员心理应激的防治提供依据。方法采用随机抽样的方式对17 132名救援人员进行心理应激相关量表调查。结果 1汶川地震救援人员PTSD的发生率高于常模,震后2年救援人员PTSD发病率下降;2救援人员震后PTSD早期症状突出表现为再体验,后期主要表现为强烈的心理痛苦烦恼、回避或麻木和警觉性增高的症状。结论 PTSD影响救援人员心理健康,需及时进行有效的团体和个体心理干预。     

成人全麻患者术后早期少量饮水安全性和可行性分析

目的：探讨成人全麻患者术后早期少量饮水的安全性和可行性。方法将200例麻醉后监测治疗室全麻患者按随机数字表法分为观察组和对照组各100例。观察组患者实施麻醉后监测治疗室常规护理的同时给予早期少量饮水;对照组患者实施麻醉后监测治疗室常规护理。分别评价两组患者口干程度变化、复苏满意度、呕吐误吸发生率和再次饮水人数。结果观察组患者口干评分为(7.51±1.48)分,明显高于对照组口干评分(1.39±1.20)分,差异有统计学意义(t=32.12,P<0.05);观察组发生误吸4例,对照组6例,两组比较差异无统计学意义(χ2=0.42,P>0.05);观察组复苏满意度评分为(92.35±2.64)分,明显高于对照组的(67.94±7.46)分,差异有统计学意义( t=30.85,P<0.05);观察组有再次饮水意愿者96例,对照组为91例,两组比较,差异有统计学意义(χ2=2.06,P>0.05)。结论全麻患者术后早期饮水具有安全性和可行性。     

How to manage osteoporosis after the menopause

Many women seek advice about bone health at the time of the menopause. Although fracture probability is low in the majority, treatment may be cost-effective if targeted at those at highest risk. Optimal selection of individuals for intervention is based on a case-finding approach, fracture probability being estimated using a combination of bone mineral density and clinical risk factors. A variety of therapeutic interventions is available for the prevention of osteoporotic fractures in postmenopausal women. Hormone replacement therapy (HRT) is a second-line option in most, although it has a place in the management of perimenopausal women with menopausal symptoms who are at risk from fracture and in other postmenopausal women who express a preference for HRT over other options, after being fully informed about known risks and benefits.     

Influence of antimicrobial solutions in the decontamination and adhesion of glass-fiber posts to root canals

Objective

This study evaluated the effect of root canal disinfectants on the elimination of bacteria from the root canals, as well as their effect on glass-fiber posts bond strength.

Material and Methods

Fifty-three endodontically treated root canals had post spaces of 11 mm in length prepared and contaminated with E. faecalis. For CFU/ml analysis, eight teeth were contaminated for 1 h or 30 days (n=4). Teeth were decontaminated with 5% NaOCl, 2% CHX, or distilled water. As control, no decontamination was conducted. After decontamination, sterile paper points were used to collect samples, and CFU/ml were counted. For push-out, three groups were evaluated (n=15): irrigation with 2.5% NaOCl, 2% CHX, or sterile distilled water. A bonding agent was applied to root canal dentin, and a glass-fiber post was cemented with a dual-cured cement. After 24 h, 1-mm-thick slices of the middle portion of root canals were obtained and submitted to the push-out evaluation. Three specimens of each group were evaluated in scanning electron microscopy (SEM). Data were analyzed with one-way ANOVA and Dunnett’s T3 test (α=0.05).

Results

The number of CFU/ml increased from 1 h to 30 days of contamination in control and sterile distilled water groups. Decontamination with NaOCl was effective only when teeth were contaminated for 1 h. CHX was effective at both contamination times. NaOCl did not influence the bond strength (p>0.05). Higher values were observed with CHX (p<0.05). SEM showed formation of resin tags in all groups.

Conclusion

CHX showed better results for the irrigation of contaminated root canals both in reducing the bacterial contamination and in improving the glass-fiber post bonding.