Silver Diamine Fluoride Protocol for Reducing Preventable Dental Hospitalisations in Victorian Children

IntroductionThis study was designed to assess whether a dental caries management protocol combining a single application of 38% silver diamine fluoride (SDF) with comprehensive oral health education will successfully divert high-risk children from dental treatment under dental general anaesthesia (DGA), arrest active caries in primary teeth, and improve parent-reported child oral health–related quality of life (OHRQoL).MethodsChildren aged 2 to 10 years, who attended two public dental agencies in Victoria, Australia, and were unable to tolerate restorative treatments in the clinic setting, elected to participate in either a 38% SDF intervention protocol or, alternatively, referral for DGA. Follow-up examinations were completed at 6 months to assess caries progression, decayed missing filled tooth index, PUFA index (pulpal involvement, ulceration, fistula, abscess), DGA referral rates, and OHRQoL (Early Childhood Oral Health Impact Scale [ECOHIS]).ResultsOf the total sample, 89.5% of children (n = 102) [mean (SD) age, 4.1 (1.0) years] with 401 active carious lesions elected to participate in the 38% SDF protocol; 10.5% (n = 12) of parents opted for referral for treatment under DGA. The proportion of active caries subsequently arrested at follow-up (number of arrested lesions/number of lesions treated) was 0.78 (95% CI, 0.69 to 0.87). There was an 88% reduction in referrals for DGA in eligible children over the 6-month period. The 38% SDF intervention group showed a significant improvement in ECOHIS scores at follow-up (P < .001).DiscussionAdoption of the 38% SDF intervention protocol resulted in a significant reduction in the rate of preventable dental hospitalisations. Most parents opted against referral for DGA. Parent-reported OHRQoL for children improved significantly.     

DTF降茶氟剂降茶氟初步研究

目的探讨DTF制剂降茶氟效果。方法在不同制茶方法程序中加入DTF制剂观察其降氟效果。结果在冲泡或煮沸(1.0g茶叶,200ml水量)沏茶中,0.2gDTF可使茶氟降低约60%,使茶水氟浓度由2.0～4.0mg/L降到1.0mg/L左右,茶液色、味、pH值无改变。结论DTF是1种有效的降茶氟剂。     

过量氟化物导致大鼠腰椎黄韧带退变与骨化

[目的]研究氟化物在黄韧带骨化中可能的作用机理。[方法]36只雄性SD大鼠，实验组饮用含NaF（质量分数为1014）蒸馏水，分别于3个月及6个月时，检测骨密度，血清、骨组织标本中Ca、P^3＋、Mg、Zn、Cu、Fe、F^-含量和血清碱性磷酸酶（ALP）活性；行大鼠腰段标本X线检查后组织病理观察。[结果]3个月实验组10只大鼠中6只出现氟斑牙：6个月实验组均出现氟斑牙，且大鼠中轴骨骨密度显著增加（P〈0．05）。X线检查，6个月实验组中有4只可见黄韧带嵴状骨化影。病理观察，3个月实验组大鼠黄韧带呈退行性改变；6个月实验组部分黄韧带骨化，骨化类型以膜内骨化为主。[结论]过量氟化物可造成SD大鼠腰椎黄韧带的退变、骨化，在黄韧带的骨化中可能起重要作用。     

Sialic acid concentrations in the urine of men with and without renal stones

Summary It has been suggested that urinary sialidase may play a role in the formation of renal stones. The present study was therefore undertaken to compare spectrophotometrically the different types of sialic acid concentrations and sialidase activities in fresh first morning urine specimens of men (21–65 years) with (13) and without (9) calcium oxalate renal stones. Although the free urinary sialic acid concentrations of the two groups of men were statistically about the same (P=0.0614), the total (P=0.003) and bound (P=0.0012) urinary sialic acid concentrations differed significantly. Both the total and bound sialic acid concentrations were lower in the urine specimens of the stone patients than in their healthy counterparts. This decrease in urinary sialic acid concentrations was firstly thought to be the result of elevated breakdown enzymes of sialic acid, which would favour the production of pyruvate. However, spectrophotometric determinations of the endogenous pyruvate concentrations of the two types of urine specimens did not differ significantly (P=0.0708). Secondly, the decrease in total urinary total sialic acid concentration of stone patients, could be attributed to less sialic acid synthesis or less renal excretion. Therefore, the same experiments were repeated using serum of 13 patients and 9 healthy men. Conversely, the total (P=0.4425) and bound (P=0.2850) serum sialic acid concentrations were found to be similar in the two types of subjects. However, the free serum sialic acid concentration of stone patients was significantly lower than in the healthy subjects (P=0.0062). This phenomenon is also reflected in the average ratio for serum free: bound sialic acid in healthy and stone patients, 1:7.9 and 1:18.7 respectively (P=0.0009). The lower free serum sialic acid concentration may lead to lower renal excretions of sialic acid. This may explain the decrease in total urinary sialic acid concentration in stone patients. The lower bound urinary sialic acid concentrations in patients was also reflected in the urinary free: bound sialic acid ratio for healthy (1:2.3) and stone patients (1:1.3). The difference between these two groups of men was highly significant (P=0.0001). This phenomenon might be explained by the urinary sialidase activities, which was spectrophotometrically determined at 334 nm at 37°C of 11 patients with stones and 17 healthy men. The ages of both groups of men were the same (P=0.326). An increase in urinary sialidase activity was observed with the stone patients (P=0.00001) when compared to specimens of healthy men. This might explain the decrease in urinary bound sialic acid concentration of the stone group. It seems from these results that the urinary concentration of sialic acid and the activity of urinary sialidase, may play a role in the pathogenesis of the multifactorial disease, urolithiasis.     

Effects of different doses of alkaline citrate on urine composition and crystallization of calcium oxalate

Summary Prophylactic treatment with alkaline citrate in patients with recurrent calcium oxalate (CaOx) stone disease results in reduced CaOx supersaturation and increased urinary citrate. The effects of a single evening dose were compared with those of two and three daily doses in six recurrent CaOx stone formers with hypercalciuria, hypocitraturia or raised calcium/citrate quotients. While on a standardized hospital diet the patients were given 7.5 g (28 mmol) of sodium potassium citrate (URALYT-U) in one, two, and three doses. Fractional urine collections during 24 hours were analyzed for pH, composition, and crystallization risk (CR). All dosage regimens had favourable effects on urinary calcium, citrate, calcium/citrate quotients, and CaOx-CR. The most sustained effect was recorded with three divided doses. Single evening doses resulted in the most pronounced effects between 22.00–06.00 h, thereby counteracting the increased risk of CaOx crystallization during that period. In terms of 24 h urine composition the best effect was recorded with alkaline citrate administered three times daily, but because of the favourable response by a single evening dose between 22.00–06.00 h the assumption was made that this dosage regimen might be sufficient to reduce the risk of CaOx crystallization and stone formation. However, the validity of such an assumption can only be established by long-term clinical studies.     

氟对体外培养人牙乳头间充质细胞合成I型胶原的影响

目的:明确氟对人牙乳头细胞合成 I型胶原的影响。 方法:对人牙乳头细胞进行体外培养 ,分别给予0 .0、0 .2× 10 - 6、1.0× 10 - 6、5 .0× 10 - 6、2 5 .0× 10 - 6 g/ L 氟处理 ,采用免疫细胞化学方法染色 ,图象分析氟对细胞合成 I型胶原的影响。 结果:I型胶原在对照组和 4种氟浓度处理组细胞表达均为阳性。图象分析结果表明 ,4种氟浓度对体外培养的人牙乳头细胞合成 I型胶原量与对照组相比差异无统计学意义 (P>0 .0 5 )。结论:过量氟对牙本质基质 型胶原的影响可能不是通过影响成牙本质细胞内合成实现的     

运动对体内代谢产物排出量的影响

选择年龄15～18岁的体育学校学生23名(男14、女9),随机分为三个不同的运动组进行跑台训练。结果显示:运动可导致尿乳酸,尿蛋白、尿糖和尿素氮含量增加。无氧训练时尿乳酸的增加尤为明显;尿蛋白的增多与尿液乳酸含量呈正相关;尿素氮水平的升高则以有氧耐力运动时为甚。     

尿αl微球蛋白与微量白蛋白联合检测在高血压病肾损伤早期诊断中的临床价值

在原发性高血压中，因肾功能受损导致蛋白尿甚至血清尿素氮、肌酐增高并依赖透析的患者在临床非常多见，然而一旦出现BUN、Cr增高及肾功能不全时，往往已经对临床治疗造成困难，于是，早发现、早治疗，对控制高血压肾病的发生与发展是十分必要的。