Evaluation of tongue coating indices

AIM: The purpose of this study was to determine inter-examiner reproducibility of two modified Winkel tongue coating indices and to study the relationship between each of these two indices and the amount of tongue coating as determined by wet weight of scrapings from the dorsum of the tongue. MATERIALS AND METHODS: Twenty-five participants were selected for the study from among dental students. The selection was made to assure that a wide range of degrees of tongue coating were represented. Two independent examiners scored the tongue coatings using the two modified Winkel tongue coating indices (mWTCI 1 + 2 and mWTCI 2). After completion of index recordings, tongue scrapings were performed by one of the examiners. RESULTS: Inter-examiner reproducibility of mWTCI 1 + 2 and mWTCI 2 using Pearson's coefficients of correlation amounted to r = 0.48 and 0.93 respectively. Overall, mWTCI 2 showed higher correlations to wet weight of tongue scrapings than mWTCI 1 + 2. CONCLUSION: The mWTCI 2 was found to be highly reproducible and also valid as related to wet weight of tongue scrapings. This index would seem suitable for further studies on tongue coatings; effect of tongue cleaning; and rate of reformation of coatings after cleaning.     

固本咳喘胶囊联合二羟丙茶碱片治疗缓解期支气管哮喘的临床研究

目的探讨固本咳喘胶囊联合二羟丙茶碱片治疗缓解期支气管哮喘临床疗效。方法选取2015年1月—2016年1月天门市第一人民医院收治的缓解期支气管哮喘患者92例纳入本研究,所有患者采用随机数字表法分为对照组和治疗组,每组各46例。对照组口服二羟丙茶碱片,1片/次,3次/d。治疗组在对照组基础上口服固本咳喘胶囊,3粒/次,3次/d。两组患者均连续治疗3个月。观察两组的临床疗效,比较两组的肺功能、血气指标和炎性因子。结果治疗后,对照组和治疗组的总有效率分别为73.9%、89.1%,两组比较差异有统计学意义(P0.05)。治疗后,两组呼气流速峰值(PEF)、呼气峰流量变异率(PEFR)和一秒用力呼气容积(FEV1)均明显增高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血氧分压(p O_2)、酸碱度(p H)值明显升高,二氧化碳分压(p CO_2)显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-4(IL-4)水平均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论固本咳喘胶囊联合二羟丙茶碱片治疗缓解期支气管哮喘具有较好的临床疗效,可改善患者肺功能,调节血气指标和炎性因子,具有一定的临床推广应用价值。     

Metabolic syndrome: pathogenesis, medical care and dental implications

BACKGROUND: The dental literature contains little information about metabolic syndrome (MetS) and its dental implications. TYPES OF STUDIES REVIEWED: The authors conducted a MEDLINE search for the period 2000 through 2005, using the term "metabolic syndrome" to define its pathophysiology, medical treatment and dental implications. RESULTS: MetS is the co-occurrence of abdominal obesity, hyper-triglyceridemia, reduced high-density lipoprotein cholesterol levels, hypertension and impaired fasting glucose, which results from consumption of a high-calorie diet and decreased levels of physical activity superimposed on the appropriate genetic setting. Components of MetS synergistically promote the development of atherosclerosis, resulting in myocardial infarction and stroke. CLINICAL IMPLICATIONS: Deteriorating oral health status is associated with worsening of the atherogenic profile. Tooth loss often results in chewing difficulties because of inadequate occlusive surfaces and may lead to alterations in food selection and dietary quality. This, in turn, adversely affects body composition and nutritional status, both of which are related to vascular health. Dentists should develop treatment plans that preserve and restore the dentition, thus ensuring maximum masticatory efficiency and affording patients the optimum opportunity to consume food that will not foster atherogenesis.     

外环境中布雷图指数和诱蚊诱卵器指数的差异研究

目的 对外环境布雷图指数法和诱蚊诱卵器法的平行对照研究,比较布雷图指数和诱蚊诱卵器指数的差异,以便明确自然积水对诱蚊诱卵器法监测的影响,为蚊虫及蚊媒传染病防控提供科学依据。方法 2020年5—10月期间每月中旬在上海市静安区各街道（镇）居民区外环境中采用布雷图指数法和诱蚊诱卵器法开展相同区域内的平行对照研究,比较不同监测环境中两监测方法的差异。结果 不同月份中,诱蚊诱卵器指数最高为8月6.86,其次为7月6.74;布雷图指数最高为8月16.24,其次为7月14.56。两监测方法在时间趋势上高度相关（r=0.965,P<0.05）,诱蚊诱卵器指数各月均低于布雷图指数,指数月间分布趋于平缓。诱蚊诱卵器指数老旧公房为5.73,商品房为4.91,差异有统计学意义（Z=12.530,P<0.05）;布雷图指数老旧公房为13.58,商品房为7.14,差异有统计学意义（Z=-4.013,P<0.05）。老旧公房布雷图指数和诱蚊诱卵器指数均高于商品房,老旧公房的布雷图指数为13.58,高于同一地区的诱蚊诱卵器指数5.73,差异有统计学意义（Z=-3.608,P<0.05）。两类型居民区积水构成相近,两类型居民区最多的积水种类依次为盆景、水生植物、闲置容器和储水容器,数量上老旧公房自然积水平均66.43处/居民区,商品房平均49.27处/居民区,随自然积水数量增加,布雷图指数上升。结论 布雷图指数和诱蚊诱卵器指数有较高的一致性,诱蚊诱卵器指数相较于布雷图指数更趋于平缓,不同类型居民区中环境积水数是影响诱蚊诱卵器指数的主要因素,在自然积水较多的环境中,布雷图指数法相较于诱蚊诱卵器指数敏感性更高。     

A Novel Method for Stratification of Major Complication Risk Using Body Mass Index Thresholds for Patients Undergoing Total Hip Arthroplasty: A National Cohort of 224,413 Patients

IntroductionElevated body mass index (BMI) is associated with complications following Total Hip Arthroplasty (THA). Since obese individuals are almost 10 times more likely to require THA compared to non-obese individuals, we need to understand the risk-benefit continuum while considering THA in obese patients. We aimed to determine data-driven thresholds for BMI at which the risk of major complications following THA increases significantly.MethodsPatients were identified in a national database who underwent primary THA from 2010 to 2020. BMI thresholds were identified using the stratum-specific likelihood ratio (SSLR) methodology, which is an adaptive technique that allows for identification of BMI cut-offs, at which the risk of major complications is increased significantly . BMI cutoffs identified using SSLR were used to create a logistic regression model.ResultsA total of 224,413 patients were identified with a mean age of 66 ± 10, BMI 32 ± 6.7, and 7,186 (3%) sustained a major complication. BMI thresholds were defined as 19-31, 32-37, 38-49 and 50+. Overall, the absolute risk of major complications increased from 2.9% in the lowest BMI strata to 7.5% in the highest BMI strata. Compared to patients with a BMI between 19-31, the odds of sustaining a major complication sequentially increased by 1.2, 1.6, and 2.5-times for patients in each higher BMI strata (all, P < .05).ConclusionsWe have identified BMI cutoffs using SSLR that categorizes patients into four categories of risk for major complications in a nationally representative patient sample. These thresholds can be used in the surgical decision-making process between patients and surgeons.     

What Is the Impact of Body Mass Index Cutoffs on Total Hip Arthroplasty Complications?

BackgroundBody mass index (BMI) cutoffs are commonly utilized to decide whether to offer obese patients elective total hip arthroplasty (THA). However, weight loss goals may be unachievable for many, and some patients are thereby denied complication-free surgery. The purpose of this study was to assess the impact of varying BMI cutoffs on the rates of complication-free surgery after THA.MethodsPatients undergoing THA between 2015 and 2018 were identified in the American College of Surgeons National Surgical Quality Improvement Program database using Common Procedural Terminology code 27130. BMI and rates of 30-day complications were collected. BMI cutoffs of 30, 35, 40, 45, and 50 kg/m² were applied to model the incidence of complications if THA would have been allowed to proceed based on BMI.ResultsA total of 192,394 patients underwent THA, and 13,970 (7%) of them had a BMI ≥40 kg/m². With a BMI cutoff of 40 kg/m², 178,424 (92.7%) patients would have proceeded with THA. From this set, 170,296 (95.4%) would experience complication-free surgery, and 11.8% of complications would be prevented. THA would proceed for 191,217 (99.3%) patients at a BMI cutoff of 50 kg/m², of which 182,123 (95.2%) would not experience a complication, and 1.3% of complications would be prevented. Using 35 kg/m² as the BMI cutoff would prevent 28.6% of complications and permit 75.9% of complication-free surgeries to proceed.ConclusionLower BMI cutoffs for THA can result in fewer complications although they will consequentially limit access to complication-free THA. Consideration of risks of obesity in THA may be best considered as part of a holistic assessment and shared decision-making when deciding on goals for weight reduction.     

HIFU治疗骨肉瘤对患儿身高影响的探讨

骨肉瘤的发病率虽然很低,但是患者多为成长期的少儿,尤其是多年来骨肉瘤保肢治疗的5年以上生存率显著提高,因此,患儿骨骺端功能在治疗中的受影响程度直接关系到患儿的生活质量和心理状态,应该重视。本文着重观察骨肉瘤经局部高强聚焦超声(HIFU)治疗后对患儿骨骺生长及身高的影响,现将相关病例总结分析如下:随访统计的所有病例均为2001年至2005年之间系统保肢治疗的少儿患者,所有病例均为本院门诊患者,男患儿3例,女患儿1例,共4例。年龄9~14岁之间,发病部位均在股骨和胫骨,患儿瘤体大小和全身症状无显著差异,全部病例均未手术截肢治疗,而是接受HIFU治疗结合全身综合治疗。HIFU治疗的输出功率和次数均使用临床常规肿瘤消融治疗标准。对所有病例进行HIFU治疗后身高跟踪测量,每年测量1次,对存活3年以上的患儿身高追踪测量,跟踪测量时间均为3年。以首次测量身高为基数,把接受HIFU治疗的患儿与正常同龄儿童年增高身高作比对,其计算方法为:年均身高增长值=3年身高增长总数&#247;3(单位:cm)。观察3年生存期以上的患儿经HIFU合并系统综合治疗者4例。HIFU治疗组患者的身高年增长数值为2.6~5.1cm,平均值为3.9cm。讨论骨...