Sustained Release of Minocycline From Minocycline-Calcium-Dextran Sulfate Complex Microparticles for Periodontitis Treatment

It is important to address the periodontitis-associated bacteria in the residual subgingival plaque after scaling and root planing to successfully treat periodontitis. In this study, we explored the possibility of exploiting the ion pairing/complexation of minocycline, Ca²⁺, and sulfate/sulfonate-bearing biopolymers to develop an intrapocket delivery system of minocycline as an adjunct to scaling and root planing. Minocycline-calcium-dextran sulfate complex microparticles were synthesized from minocycline, CaCl₂, and dextran sulfate. They were characterized using Fourier-transform infrared spectroscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. An in vitro release study was conducted to evaluate the release kinetics of minocycline from these microparticles. Agar disk diffusion assays and biofilm-grown bacteria assays were used to assess antibacterial capability. High loading efficiency (96.98% ± 0.12%) and high loading content (44.69% ± 0.03%) for minocycline were observed for these complex microparticles. Mino-Ca-DS microparticles achieved sustained release of minocycline for at least 9 days at pH 7.4 and 18 days at pH 6.4 in phosphate-buffered saline, respectively. They also demonstrated potent antimicrobial effects against Streptococcus mutans and Aggregatibacter actinomycetemcomitans in agar disk diffusion and biofilm assays. These results suggested that the ion pairing/complexation of minocycline, Ca²⁺, and sulfonate/sulfate-bearing biopolymers can be exploited to develop complex microparticles as local delivery systems for periodontitis treatment.     

消癌平片联合SOX方案治疗胃癌的临床研究

目的探讨消癌平片联合SOX方案治疗胃癌的临床疗效。方法选取2013年1月—2017年5月洛阳市第六人民医院收治的胃癌术后化疗患者300例为研究对象,根据随机数字表法将所有患者随机分为对照组和治疗组,每组各150例。对照组采用SOX方案辅助化疗,即第1天静脉滴注注射用奥沙利铂,130 mg/m2加入到5%葡萄糖注射液500 m L中,滴注2 h以上,1次/3周;并口服替吉奥胶囊,2～3粒/次,2次/d,连续治疗14 d,停药7 d,3周为1个周期。治疗组在对照组治疗的基础上口服消癌平片,6～8片/次,3次/d,连续治疗14 d,停药7 d,3周为1个周期。两组患者均连续治疗4个周期。观察两组的临床疗效,比较两组的视觉模拟评分法(VAS)评分、生命质量测定量表(QLQ-C30)评分、T细胞亚群和不良反应。结果治疗后,对照组和治疗组的总有效率、疾病控制率分别为44.00%、56.67%,74.67%、88.67%,两组比较差异有统计学意义(P0.05)。治疗后,两组VAS评分显著降低,QLQ-C30评分显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些指标明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组CD3+、CD4+、CD4+/CD8+均显著升高,CD8+水平显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组T细胞亚群指标明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组Ⅲ度和Ⅳ度骨髓抑制、恶心呕吐、便秘腹泻、肝肾功能损害发生率显著低于对照组,两组比较差异有统计学意义(P0.05)。结论消癌平片联合SOX方案治疗胃癌具有较好的临床疗效,能减轻疼痛,提高免疫功能,改善生活质量,安全性高,具有一定的临床推广应用价值。     

Oral health literacy among adult patients seeking dental care

BACKGROUND: This study examined the association of knowledge, dental care visits and oral health status with oral health literacy in dental patients. METHODS: The authors administered to adult patients in two private dental offices the short version of the Rapid Estimate of Adult Literacy in Dentistry-30 (REALD-30), a word-recognition test. An interview provided primary predictor variables for REALD-30 and variables that would serve as controls in multivariate logistic regression analyses. RESULTS: About 29 percent of the sample scored below 22 on the 30-point test, a score that the authors defined as a low literacy level. Those with incorrect knowledge (odds ratio [OR] = 5.98; P < .01) and fair-to-poor oral health status (OR = 3.08; P = .06) were more likely to have a low literacy level than were their reference groups. Not having had a dental care visit in the last year was not associated with literacy (OR = 2.26; P = .17). A change from an unfavorable to favorable category for the primary predictor variables would decrease the probability of having a low literacy level by 35 to 61 percent. CONCLUSIONS: A significant number of patients may have a low level of oral health literacy, which possibly interferes with their ability to process and understand oral health information. PRACTICE IMPLICATIONS: Providers should identify patients who are having difficulty understanding and using dental health information and address their needs.     

Predictive Risk Factors for 30-day Readmissions Following Primary Total Joint Arthroplasty and Modification of Patient Management

The Centers for Medicare and Medicaid have begun to publically publish statistics on readmissions following primary total hip (THA) and total knee arthroplasty (TKA). Our study retrospectively assesses 30-day readmissions rates following THA and TKA, performed by a single surgeon at a tertiary care medical center between 2007 and 2012. Results of a univariate analysis and logistic regression model indicated female gender, high ASA class, and increased operative time to be significantly associated with higher rates of readmission (OR 4.646, OR 1.257, and OR 5.323, respectively). Readmissions most often occurred within the first week of patient discharge. Surgical complications and gastrointestinal discomfort were the most common causes for readmission. Using readmission risk we can stratify patients into tiered critical care pathways to reduce readmissions.     

Cardiac pathology after valve replacement by disc prosthesis: A study of 61 necropsy patients

Clinical and necropsy observations are described in 61 patients who had one or more cardiac valves replaced with a discoid prosthesis of the Hufnagel type. The most common (31 percent) cause of death among the 45 patients who died early (less than 65 days after operation) appeared to be prosthetic disproportion; that is, the prosthesis was too big for the aorta or ventricular cavity into which it was inserted so that inadequate space was present between the margins of the disc and the endocardium of ventricle or intima of aorta. Prosthetic thrombosis occurred in only 3 of the 45 patients who died early, but poppet movement appeared considerably altered in each. In contrast, thrombi were observed on a prosthesis in 14 of the 16 patients who died late (4 to 47 months [average 21] postoperatively), but in none did the thrombi appear of sufficient size to alter poppet function. Excessive bleeding occurred in 11 (24 percent) of the 45 early deaths and was primarily related to the insertion of a patch in the root of the aorta. Uncorrected valvular disease either by itself or by its ability to alter function of the prosthesis appeared responsible for death in 6 (13 percent) of the 45 patients who died early and in 2 (6 percent) of the 16 who died late. Insertion of a mitral poppet disc in a patient with uncorrected aortic regurgitation, even of mild degree, may be hazardous because the aortic regurgitant jet stream may interfere with proper function of the mitral disc. Likewise, insertion of a poppet disc only in the aortic valve position in a patient with combined aortic and mitral regurgitation may considerably increase the degree of mitral incompetence because the aortic prosthesis is intrinsically obstructive.Disc wear or variance was observed in all but one prosthesis in place for more than 1 year. Although hemolytic anemia of significant degree was not observed in any of the 16 patients who died late, the occurrence of renal hemosiderosis in 13 of the 16 patients indicates that the poppet disc prosthesis is considerably traumatic to erythrocytes. Thus, this type of prosthesis is not an ideal substitute cardiac valve. It clots, despite anticoagulant therapy, it is intrinsically stenotic, portions of it, that is, the disc, degenerate, and it causes hemolysis to erythrocytes.     

Tracing the Pathogenesis of Type 1 Diabetes: A Report on the 44th Annual Meeting of the European Association for the Study of Diabetes (EASD)

Clinical type 1 diabetes is preceded by autoimmune destruction of the pancreatic beta-cells. However, progression to disease is not uniform. One challenge facing current diabetes research is therefore to identify biomarker profiles that accurately reflect the individual stage of type 1 diabetes pathogenesis and develop new techniques to distinguish between these profiles and associated diabetes risks. This report highlights some of the recent studies on diabetes biomarkers, with a particular focus on zinc transporter ZnT8, presented at the EASD meeting in September 2008 in Rome, Italy.     

Mast cells are critical mediators of vaccine-induced Helicobacter clearance in the mouse model

BACKGROUND & AIMS: Despite the proven ability of immunization to prevent Helicobacter infection in mouse models, the precise mechanism of protection has remained elusive. METHODS: We explored the cellular events associated with Helicobacter clearance from the stomach following vaccination by flow cytometry analysis and histological and molecular studies. RESULTS: Kinetic studies showed that the infection is undetectable in vaccinated mice at day 5 postbacterial challenge. Flow cytometry analysis showed that the percentages of mast cells (CD3 - CD117 + ) increased in the lymphoid cells isolated from the stomach at day 4 postchallenge in urease + cholera toxin (CT)-vaccinated mice in comparison with mice administered with CT alone (9.4% +/- 4.4% and 3.1% +/- 1%, respectively, for vaccinated and CT administered, n = 5; P < .01). Quantitative PCR analysis showed an increased messenger RNA (mRNA) expression of the mast cell proteases 1 and 2 at day 5 postchallenge in the stomach of vaccinated mice. In contrast to wild-type mice, mast cell-deficient mice (W/W v mice) were not protected from H felis colonization after vaccination. Indeed only 1 out of 12 vaccinated W/W v mice showed a negative urease test. Remarkably, vaccinated W/W v mice reconstituted with cultured bone marrow-derived mast cells recovered the ability to clear the infection after vaccination (8 out of 10 mast cell-reconstituted mice showed negative urease tests [ P < .006 as compared with wild-type mice]). CONCLUSIONS: These experiments show that mast cells are, unexpectedly, critical mediators of anti- Helicobacter vaccination.     

Neural correlates of music-syntactic processing in two-year old children

Music is a basic and ubiquitous socio-cognitive domain. However, our understanding of the time course of the development of music perception, particularly regarding implicit knowledge of music-syntactic regularities, remains contradictory and incomplete. Some authors assume that the acquisition of knowledge about these regularities lasts until late childhood, but there is also evidence for the presence of such knowledge in four- and five-year-olds. To explore whether such knowledge is already present in younger children, we tested whether 30-month-olds (N = 62) show neurophysiological responses to music-syntactically irregular harmonies. We observed an early right anterior negativity in response to both irregular in-key and out-of-key chords. The N5, a brain response usually present in older children and adults, was not observed, indicating that processes of harmonic integration (as reflected in the N5) are still in development in this age group. In conclusion, our results indicate that 30-month-olds already have acquired implicit knowledge of complex harmonic music-syntactic regularities and process musical information according to this knowledge.