One-year clinical evaluation of two composite materials used for anterior class V restorations

The purpose of the current study was to evaluate the clinical performance of two composite materials used for filling anterior cavity preparations. A total of 100 class V cavities of anterior tooth were restored with two different composite materials (Palfique Estelite and Palfique Toughwell, 50 cavities each, respectively) in combination with the same bonding agent (Mac Bond II). Colour match, cavosurface marginal discolouration, recurrent caries, wear, marginal integrity and surface texture were evaluated clinically for all restorations on the basis of the United States Public Health Service (USPHS) criteria immediately after insertion (baseline), after 6 months and after 1 year. In the comparison of baseline to 1-year evaluation, the Palfique Toughwell material showed significant changes in all factors except recurrent caries. The Palfique Estelite material, however, showed neither significant cavosurface marginal discolouration nor recurrent caries. No significant difference (P > 0b05) was observed between the two materials in clinical performance after 1 year, with the exception of caries rate, which was found to be significantly lower in the Palfique Estelite material. It was concluded that both composites were clinically reliable materials when used for anterior class V restorations.     

Tricalcium silicate cement sealers: Do the potential benefits of bioactivity justify the drawbacks?

BackgroundGrossman described the ideal properties of root canal sealers. The International Organization for Standardization and American National Standards Institute and American Dental Association have codified some of his requirements in ISO 6876 and ANSI/ADA 57, respectively. In this narrative review, the authors combined the ideal Grossman properties and requirements of these standards, emphasizing the newer tricalcium silicate cement sealers. This chemical matrix for such sealers was developed on the basis of the success of bioactive mineral trioxide aggregate–type (tricalcium silicate cement) materials for enhanced sealing and bioactivity.MethodsThe authors searched the internet and databases using Medical Subject Heading terms and then conducted a narrative review of those articles involving the tricalcium silicate cement endodontic sealers.ResultsNinety-four articles were identified that discussed tricalcium silicate cement sealers. Tricalcium silicate cement sealers are partially antimicrobial and have bioactivity, which may presage improved biological sealing of the root canal system. Most other properties of tricalcium silicate cement sealers are comparable with traditional root canal sealers.ConclusionsWithin the limitations of this review, tricalcium silicate cement endodontic sealers met many of the criteria for ideal properties, such as placement, antimicrobial properties, and bioactivity, but limitations were noted in solubility, dimensional stability (shrinkage and expansion), and retrievability.Practical ImplicationsTricalcium silicate–based cements have been commercialized as bioactive, bioceramic endodontic sealers. Warm, cold, and single-cone obturation techniques are usable, depending on the commercial product. Some sealers can cause discoloration and are not easily retrievable, particularly when used to completely obturate a canal.     

Clinical study of indirect composite resin inlays in posterior stress-bearing cavities placed by dental students: results after 4 years

Objectives

This longitudinal randomized controlled clinical trial evaluated the longevity of composite resin inlays in single- or multi-surface cavities up to 4 years.

Methods

21 dental students placed 75 Artglass and 80 Charisma composite resin inlays in class I and II cavities in posterior teeth (89 adult patients) luted with dual-curing resin cements. Clinical evaluation was performed up to 4 years using modified USPHS criteria.

Results

87.2% of Artglass and 76.6% of Charisma inlays were assessed to be clinically excellent or acceptable. Up to the 4-year recall 5 Artglass and 11 Charisma inlays failed mainly because of postoperative symptoms, bulk fracture, and loss of marginal integrity. No significant differences between both composite resin materials could be detected at 4 years for all clinical criteria (Mann-Whitney U-test, p > 0.05). The comparison of restoration performance with time yielded a significant increase in marginal discolouration and postoperative symptoms (p < 0.05), deterioration of surface texture quality, marginal and restoration integrity (p < 0.05) for both inlay systems. However, the changes were mainly effects of scoring shifts from alfa to bravo. Small inlays compared to large inlays and premolar restorations compared to molar restorations showed significant better outcome for some of the tested clinical parameters for the Artglass inlays (p < 0.05). For Charisma inlays no such influences were revealed.

Conclusions

Clinical assessment of Artglass and Charisma composite resin inlays exhibited an annual failure rate of 3.2% and 5.9% that is within the range of published data. Within the limitations of this study indirect composite inlays are a competitive restorative procedure in stress-bearing preparations.     

基于BERT-TextCNN模型的临床试验筛选短文本分类方法

目的：设计一种基于深度学习的BERT-TextCNN模型,用于临床试验筛选短文本的自动化识别与分类。方法：调研文本分类的常见算法,从中国健康信息处理会议开发的临床试验中筛选短文本分类数据集,比较分析BERT-TextCNN模型、BERT模型和TextCNN模型的性能差异。结果：BERT-TextCNN模型的文本分类平均F1值为82.39%,相较于单纯使用BERT模型和TextCNN模型进行文本分类的性能分别提升了1.81％和9.02％。结论：基于BERT-TextCNN模型的临床试验筛选短文本分类方法有效,为今后相关医学领域的研究和临床试验筛选短文文本自动化系统开发提供了一定的参考。     

Assessing cognition and function in Alzheimer's disease clinical trials: Do we have the right tools?

Several lines of evidence from Alzheimer's disease (AD) research continue to support the notion that the biological changes associated with AD are occurring possibly several decades before an individual will experience the cognitive and functional changes associated with the disease. The National Institute on Aging—Alzheimer's Association revised criteria for AD provided a framework for this new thinking. As a result of this growing understanding, several research efforts have launched or will be launching large secondary prevention trials in AD. These and other efforts have clearly demonstrated a need for better measures of cognitive and functional change in people with the earliest changes associated with AD. Recent draft guidance from the US Food and Drug Administration further elevated the importance of cognitive and functional assessments in early stage clinical trials by proposing that even in the pre-symptomatic stages of the disease, approval will be contingent on demonstrating clinical meaningfulness. The Alzheimer's Association's Research Roundtable addressed these issues at its fall meeting October 28–29, 2013, in Washington, D.C. The focus of the discussion included the need for improved cognitive and functional outcome measures for clinical of participants with preclinical AD and those diagnosed with Mild Cognitive Impairment due to AD.     

骨密度测量诊断骨质疏松的临床应用

诊断骨质疏松症（OP）要分析诊断手段、诊断指标、诊断标准及其在人群中的应用。本文重点从骨质疏松历史的回顾、诊断指标、骨密度诊断OP标准、各种OMD测量仪比较以及脆性骨折在骨质疏松诊断中的地位等方面进行介绍。     

糖负荷后2小时血糖在糖尿病诊断中的意义

目的：探讨糖负荷后2小时血糖（2hPG）在糖尿病诊断中的意义。方法：4660例连续的内分泌门诊病人采用口服葡萄糖耐量试验（OGTT），对其血浆葡萄糖结果进行分析。结果：4660例中，2856例（61．3％）2hPG达到糖尿病诊断标准，其中622例（21．8％）空腹血浆葡萄糖（FPG）小于7．0mmol/L；2319例（49．8％）FPG达到糖尿病诊断标准，其中85例（3．7％）2hPG小于11．1mmol/L。1710例FPG小于6．1mmol/L,其中274例（16％）2hPG达到糖尿病诊断标准。631例FPG大鼠或等于6．1mmol/L，且小于7．0mmol/L，以2hPG标准判断达糖尿病标准者348例（55％），糖耐量减低（IGT）213例（34％），空腹高血糖（IFG）70例（11％）。结论：2hPG诊断糖尿病敏感性高于FPG标准，且漏诊率也低于FPG标准，2hPG标准和FPG标准不能相互取代。FPG正常不能排除糖尿病，FPG大于或等于6．1mmol/L且小于7．0mmol/L者，必须核查OGTT，以了解是否为糖尿病或IGT。     

耳甲电针治疗腹泻型肠易激综合征的疗效

目的：观察耳甲电针治疗腹泻型肠易激综合征(IBS)的疗效。方法：选取2018年2月至2020年1月首都医科大学附属北京同仁医院收治的腹泻型IBS患者86例作为研究对象,按照随机数字表法分为对照组和观察组,每组43例,所有患者治疗前后均使用IBS症状评分表、肠易激综合征症状严重程度量表(IBS-SSS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、SF-36生命质量量表评估患者症状的严重程度。并参照肠易激综合征中医诊疗专家共识意见(2017)的疗效评估方法,比较分析观察组与对照组治疗腹泻型肠易激综合征的疗效。结果：观察组与对照组治疗前IBS症状评分表、IBS症状严重程度量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表、SF-36生命质量量表各维度差异无统计学意义（P>0.05）,治疗后观察组与对照组IBS症状评分表、IBS症状严重程度量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表、SF-36生命质量量表差异有统计学意义（P<0.05）。观察组治疗有效率85.4%,对照组治疗有效率58.5%,差异有统计学意义（P<0.05）。结论：耳甲电针对于腹泻型肠易激综合征的各项症状均具有较好疗效且值得推广。     

Nationwide survey of Arima syndrome: Revised diagnostic criteria from epidemiological analysis

Aim: We have never known any epidemiological study of Arima syndrome since it was first described in 1971. To investigate the number of Arima syndrome patients and clarify the clinical differences between Arima syndrome and Joubert syndrome, we performed the first nationwide survey of Arima syndrome, and herein report its results. Furthermore, we revised the diagnostic criteria for Arima syndrome. Methods: As a primary survey, we sent out self-administered questionnaires to most of the Japanese hospitals with a pediatric clinic, and facilities for persons with severe motor and intellectual disabilities, inquiring as to the number of patients having symptoms of Arima syndrome, including severe psychomotor delay, agenesis or hypoplasia of cerebellar vermis, renal dysfunction, visual dysfunction and with or without ptosis-like appearance. Next, as the second survey, we sent out detailed clinical questionnaires to the institutes having patients with two or more typical symptoms. Results: The response rate of the primary survey was 72.7% of hospitals with pediatric clinic, 63.5% of national hospitals and 66.7% of municipal and private facilities. The number of patients with 5 typical symptoms was 13 and that with 2–4 symptoms was 32. The response rate of the secondary survey was 52% (23 patients). After reviewing clinical features of 23 patients, we identified 7 Arima syndrome patients and 16 Joubert syndrome patients. Progressive renal dysfunction was noticed in all Arima syndrome patients, but in 33% of those with Joubert syndrome. Conclusion: It is sometimes difficult to distinguish Arima syndrome from Joubert syndrome. Some clinicians described a patient with Joubert syndrome and its complications of visual dysfunction and renal dysfunction, whose current diagnosis was Arima syndrome. Thus, the diagnosis of the two syndromes may be confused. Here, we revised the diagnostic criteria for Arima syndrome.