银杏叶制剂联合地塞米松在老年突聋治疗中对血清炎症指标的影响

目的: 探讨银杏叶制剂联合地塞米松在老年突聋治疗中对血清炎症指标的影响。方法: 按随机数字表法将我院2016年7月-2021年7月收治的102例老年突聋患者分入两组（各51例）。对照组用地塞米松治疗，治疗组加用银杏叶制剂治疗。观察两组治疗前后纯音听阈和血管内皮功能指标[超氧化物歧化酶（SOD）、脂质过氧化物（LPO）、一氧化氮（NO）]、血清炎症指标[肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、白细胞介素-6（IL-6）]，分析其疗效与不良反应。结果: 与对照组比较，治疗组总有效率更高（96.08％vs 82.35％）（χ2=4.993，P=0.025）；两组治疗后各频率点阈值均下降，且相比对照组，治疗组治疗后各频率点阈值更低（P<0.05）；治疗后两组SOD、NO水平均升高，LPO水平降低（P<0.05），且相比对照组，治疗组治疗后SOD、NO水平更高，LPO水平更低（P<0.05）；治疗后两组血清TNF-α、CRP、IL-6水平降低，且相比对照组，治疗组TNF-α、CRP、IL-6水平更低（P<0.05）；治疗组不良反应发生率5.88％，对照组为9.80％，两组比较差异无统计学意义（P=0.543，χ2=0.461）。结论: 银杏叶制剂联合地塞米松治疗老年突聋患者疗效理想，能恢复各频率点听力，安全可靠，推测改善患者血管内皮功能和炎症因子水平是其重要作用机制。     

A customized metal guide for controllable modification of anterior teeth contour prior to minimally invasive preparation

ObjectiveOptimal tooth reduction is a key requirement for aesthetics, function, and the longevity of fixed restorations. Research has demonstrated that controlled and conservative tooth preparation is crucial for the long-term success of adhesive restorations. Different techniques of fabricating reduction guides have been previously reported in literature. The present technical note describes the fabrication technique and clinical application of a customized metal preparation reduction guide.Material and methodPatient presented with tilted maxillary left central incisor. The flared-out part of the tooth was modified prior to veneer restoration preparation. Resin pattern reduction guide was fabricated on the diagnostic cast with a window on the tilted mesial portion of the tooth. After intraoral evaluation, resin pattern guide was casted. Metal reduction guide was place intraorally and reduction was provided on the exposed surface of the tooth. After the removal of the tilted portion, a harmonious arch form allowed the clinician to provide adequate evaluation and preparation for veneer restorations.ResultsThe device demonstrated good practical value, allowing for selective and controlled reduction of tooth structure, and definitive protection of adjacent tooth surfaces from iatrogenic damage. The clinical outcome successfully addressed the patient’s restorative and aesthetic needs, and the veneer was stable 2 years postoperatively.ConclusionUse of a metal guide assists clinicians to provide a more predictable reduction of a desired tooth surface, while decreasing the risk of compromising the other/adjacent tooth surfaces.     

Meeting report: Initial World Health Organization consultation on herpes simplex virus (HSV) vaccine preferred product characteristics,March 2017

The development of vaccines against herpes simplex virus (HSV) is an important global goal for sexual and reproductive health. A key priority to advance development of HSV vaccines is the definition of preferred product characteristics (PPCs), which provide strategic guidance on World Health Organization (WHO) preferences for new vaccines, specifically from a low- and middle-income country (LMIC) perspective. To start the PPC process for HSV vaccines, the WHO convened a global stakeholder consultation in March 2017, to define the priority public health needs that should be addressed by HSV vaccines and discuss the key considerations for HSV vaccine PPCs, particularly for LMICs. Meeting participants outlined an initial set of overarching public health goals for HSV vaccines in LMICs, which are: to reduce the acquisition of HIV associated with HSV-2 infection in high HIV-prevalence populations and to reduce the burden of HSV-associated disease, including mortality and morbidity due to neonatal herpes and impacts on sexual and reproductive health. Participants also considered the role of prophylactic versus therapeutic vaccines, whether both HSV-2 and HSV-1 should be targeted, important target populations, and infection and disease endpoints for clinical trials. This article summarizes the main discussions from the consultation.     

Morphologic Changes of Apical Foramen and Microcrack Formation after Foraminal Enlargement: A Scanning Electron Microscopic and Micro–computed Tomographic Analysis

IntroductionThe aim of the present study was to evaluate the morphologic changes on the apical foramen and the formation of dentinal microcracks after foraminal enlargement in straight and curved root canals using scanning electron microscopic (SEM) and micro–computed tomographic (micro-CT) analyses.MethodsSixty teeth were selected and divided into 2 experimental groups: GI (incisors/straight group, n = 30) and GM (molars/curved group, n = 30). Each group was divided into 2 subgroups (n = 15) according to the analysis performed: SEM or micro-CT analysis. The incisors and mesiobuccal canal of molars were instrumented with Reciproc Blue R25 instruments (VDW, Munich, Germany) using standardized shaping procedures in the apical foramen and 1 mm beyond. The occurrence of foraminal deformation was analyzed by scanning electron microscopy. The z test was used for statistical analysis (P < .05). Micro-CT imaging was used to observe the presence of microcracks in the root apical third. Afterward, pre- and postoperative cross-sectional images were screened to identify the presence of dentinal defects.ResultsThe curvature of the canal did not influence the occurrence of foraminal deformation either for instrumentation in the foramen or for instrumentation beyond the foramen (P > .05). It was also observed that the increase in the working length did not influence the appearance of new deformations in the GI/SEM and GM-SEM groups (P > .05). Qualitative micro-CT analysis showed the presence of dentinal defects in 0.8% (112) and 1.5% (208) of the cross sections of incisors and molars, respectively, from a total of 13,987 slices. All dentinal defects identified in the analysis of any postoperative scans were already present in the corresponding preoperative images. Therefore, no new microcracks were observed after root canal preparation.ConclusionsThe preparation of straight and moderately curved root canals with Reciproc Blue, regardless of the working length, did not influence the occurrence of apical foramen deformations and did not cause the formation of dentinal microcracks.