Impact of anterior occlusal conditions in the mixed dentition on oral health–related quality-of-life item levels:: A multivariate analysis

ObjectivesTo evaluate the impact of anterior occlusal conditions in the mixed dentition on item-level analysis of oral health–related quality of life (OHRQoL).Materials and MethodsA population-based cross-sectional study of 787 children aged 8 to 10 years was conducted. The Child Perceptions Questionnaire (CPQ_8-10) was used to evaluate OHRQoL, and the analysis of item levels was performed on CPQ_8-10 domains. Anterior occlusal characteristics were diagnosed according to the Dental Aesthetic Index criteria. Individual analyses were performed relating the outcome as independent variables. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI).ResultsNo associations were found with regard to anterior occlusal characteristics (P < .001) after the variables of the previous determinants were adjusted for multivariate analysis. However, the following variables were significantly associated with negative impact on OHRQoL item levels: sex, in oral symptoms (OR = 1.42; CI, 1.07–1.89) and emotional well-being (OR = 1.34; CI, 1.00–1.79); race, in oral symptoms (OR = 1.48; CI, 1.10–1.98), emotional well-being (OR = 1.54; CI, 1.14–2.06), and social well-being (OR = 1.34; CI, 1.00–1.80); and family income in functional limitation (OR = 1.46; CI, 1.06–2.02), emotional well-being (OR = 1.71; CI, 1.21–2.42), and social well-being (OR = 1.59; CI, 1.14–2.21).ConclusionsAnterior occlusal conditions did not affect the levels of OHRQoL items.     

Professional identity in nursing: A mixed method research study

Professional identity is developed through a self-understanding as a nurse along with experience in clinical practice and understanding of their role. Personal and professional factors can influence its development. A recent integrative literature review synthesised factors that influenced registered nurse’s perceptions of their professional identity into three categories of the self, the role and the context of nursing practice. This review recommended that further research was needed into professional identity and how factors and perceptions changed over time. The aims of this study were to explore registered nurses’ understanding of professional identity and establish if it changed over time. A mixed-methods study using a two-stage design with an on-line survey and focus groups was implemented with registered nurses who were studying nursing at a postgraduate level in Australia or Scotland. The reported influences on professional identity related to the nurse, the nursing role, patient care, the environment, the health care team and the perceptions of nursing. Professional development and time working in the profession were drivers of changes in thinking about nursing, their role and working context and their professional identity. Additionally, participants sought validation of their professional identity from others external to the profession.     

Tetra-allelic SNPs: Informative forensic markers compiled from public whole-genome sequence data

Multiple-allele single nucleotide polymorphisms (SNPs) are potentially useful for forensic DNA analysis as they can provide more discrimination power than normal binary SNPs. In addition, the presence in a profile of more than two alleles per marker provides a clearer indication of mixed DNA than assessments of imbalanced signals in the peak pairs of binary SNPs. Using the 1000 Genomes Phase III human variant data release of 2014 as the starting point, this study collated 961 tetra-allelic SNPs that pass minimum sequence quality thresholds and where four separate nucleotide substitution alleles were detected. Although most of these loci had three of the four alleles in combined frequencies of 2% or less, 160 had high heterozygosities with 50 exceeding those of ‘ideal’ 0.5:0.5 binary SNPs. From this set of most polymorphic tetra-allelic SNPs, we identified markers most informative for forensic purposes and explored these loci in detail. Subsets of the most polymorphic tetra-allelic SNPs will make useful additions to current panels of forensic identification SNPs and ancestry-informative SNPs. The 24 most discriminatory tetra-allelic SNPs were estimated to detect more than two alleles in at least one marker per profile in 99.9% of mixtures of African contributors. In European contributor mixtures 99.4% of profiles would show multiple allele patterns, but this drops to 92.6% of East Asian contributor mixtures due to reduced levels of polymorphism for the 24 SNPs in this population group.     

Myoepithelial Neoplasms of Soft Tissue: An Updated Review of the Clinicopathologic,Immunophenotypic, and Genetic Features

Myoepithelial tumors in skin and soft tissue are uncommon but have been increasingly characterized over the past decade. Men and women are equally affected across all age groups and lesions arise most frequently on the extremities and limb girdles. Approximately 20 % of cases occur in pediatric patients, in whom they are frequently malignant. Similar to their salivary gland counterparts, myoepithelial tumors of soft tissue demonstrate heterogeneous morphologic and immunophenotypic features. Tumors are classified as mixed tumor/chondroid syringoma, myoepithelioma, and myoepithelial carcinoma; in soft tissue, tumors having at least moderate cytologic atypia are classified as malignant. Mixed tumor and myoepithelioma show a benign clinical course, with recurrence in up to 20 % (typically secondary to incomplete excision), and do not metastasize. In contrast, myoepithelial carcinoma shows more aggressive behavior with recurrence and metastasis in up to 40–50 % of cases. The majority of myoepithelial neoplasms typically coexpress epithelial antigens (cytokeratin and/or EMA) and S-100 protein; GFAP and p63 are frequently positive and a subset of malignant neoplasms lose INI1 expression. Up to 45 % of myoepitheliomas and myoepithelial carcinomas harbor EWSR1 gene rearrangements, unlike mixed tumor/chondroid syringoma which is characterized by PLAG1 gene rearrangement. While mixed tumor/chondroid syringoma are likely related to primary salivary myoepithelial tumors, soft tissue myoepithelioma and myoepithelial carcinoma appear to be pathologically distinct neoplasms.     

Mixed connective tissue disease with interstitial pneumonia in HTLV-1 carrier: case report and review of the literature

We report on a carrier of human T-lymphotropic virus type 1 (HTLV-1) who developed mixed connective tissue disease (MCTD). This patient suddenly manifested clinical symptoms and interstitial pneumonia ascribable to MCTD following long-term infection with HTLV-1. After initiation of oral prednisolone all manifestations quickly improved in parallel with a decrease in inflammatory reactions. In this patient HTLV-1 infection might have played an important role in the pathogenesis of MCTD. Since HTLV-1 can cause adult T-cell leukemia and HTLV-1-associated myelopathy, and also collagen diseases including MCTD, careful observation is necessary even in a carrier, particularly when autoantibodies are detectable in serum.     

改良单荷包四点牵引PPH在环状混合痔中的应用

目的比较改良单荷包四点牵引法与传统单荷包单点牵引法吻合器痔上黏膜环切术（PPH）治疗环状混合痔中的临床疗效。 方法选取2017年1月至2019年1月联勤保障部队第九〇〇医院普通外科收治的140例环状混合痔患者的临床资料,随机分成改良组和传统组,各70例,改良组采用单荷包四点牵引PPH,传统组采用单荷包单点牵引PPH。对两组临床疗效、术中情况、术后并发症及复发情况进行比较。 结果改良组与传统组治愈率分别为95.71%和82.86%,差异有统计学意义（χ²=6.048,P=0.014）。改良组切除的黏膜环的宽度（t=12.772,P<0.05）、黏膜环均匀程度（χ²=7.368,P<0.05）、痔核完全回缩（χ²=6.048,P<0.05）均优于传统组,差异有统计学意义;术后随访1年,改良组和传统组复发率分别为0.00%和7.14%,差异有统计学意义（χ²=5.185,P<0.05）;两组手术时间（t=1.081,P>0.05）和术中出血（χ²=0.085,P>0.05）差异无统计学意义;术后第1天、第7天的VAS疼痛评分差异无统计学意义（t_1d=0.731,t_7d=1.243;P>0.05）;改良组与传统组术后并发症总体发生率分别为8.57%和20%,差异无统计学意义（χ²=3.773,P>0.05）;两组住院时间差异无统计学意义（t=0.335,P>0.05）。 结论改良的单荷包四点牵引法PPH与传统单荷包单点牵引法PPH相比,术中切除的黏膜环较均匀一致,痔核回缩效果好,治愈率高,复发率低,值得临床应用。     

Impact of Less Invasive Treatments Including Sclerotherapy With a New Agent and Hemorrhoidopexy for Prolapsing Internal Hemorrhoids

Conventional hemorrhoidectomy is applied for the treatment of prolapsing internal hemorrhoids. Recently, less-invasive treatments such as sclerotherapy using aluminum potassium sulphate/tannic acid (ALTA) and a procedure for prolapse and hemorrhoids (PPH) have been introduced. We compared the results of sclerotherapy with ALTA and an improved type of PPH03 with those of hemorrhoidectomy. Between January 2006 and March 2009, we performed hemorrhoidectomy in 464 patients, ALTA in 940 patients, and PPH in 148 patients with second- and third-degree internal hemorrhoids according to the Goligher''s classification. The volume of ALTA injected into a hemorrhoid was 7.3 ± 2.2 (mean ± SD) mL. The duration of the operation was significantly shorter in ALTA (13 ± 2 minutes) than in hemorrhoidectomy (43 ± 5 minutes) or PPH (32 ± 12 minutes). Postoperative pain, requiring intravenous pain medications, occurred in 65 cases (14%) in hemorrhoidectomy, in 16 cases (1.7%) in ALTA, and in 1 case (0.7%) in PPH. The disappearance rates of prolapse were 100% in hemorrhoidectomy, 96% in ALTA, and 98.6% in PPH. ALTA can be performed on an outpatient basis without any severe pain or complication, and PPH is a useful alternative treatment with less pain. Less-invasive treatments are beneficial when performed with care to avoid complications.     

微电极射频电化学疗法治疗内痔60例疗效观察

为观察微电极射频电化学疗法治疗内痔的疗效,将内痔患者120例随机分为治疗组和对照组,每组60例。治疗组采用微电极射频电化学疗法治疗,对照组采用铜离子电化学疗法治疗。结果显示,两组对痔出血疗效相近（P〉0．05）,但治疗组凝固点少,治疗时间短（P〈0．05）。两组对痔脱出近期有效率相近（P〉0．05）。但治疗组术后肛管黏膜溃疡发生率少于对照组（P〈0．05）。结果表明,微电极射频电化学疗法使内痔的手术治疗由微创向无创的方向迈进了一步,其更具有实用性。