DH Group Research Articles

Evaluation of Preheating Methods for Bulk-Fill Thermoviscous Composite in Non-Carious Cervical Lesions: A 24-month Randomized Controlled Trial

This 24-month, double-blind, split-mouth randomized equivalence clinical trial compared the retention rates of a bulk-fill thermoviscous composite resin using two different preheating methods for the restoration of non-carious cervical lesions (NCCLs). A total of 120 NCCLs were randomized into two groups (n = 60 each). In one group, a bulk-fill thermoviscous composite resin (VisCalor bulk, Voco GmbH) was preheated using a dispenser heater (DH, VisCalor Caps dispenser/warmer), while in the other group, the same resin was preheated with a bench heater (BH, Caps Warmer). In the BH group, the composite underwent preheating at 68°C using a heating bench for 3 min while in the DH group, the composite was preheated at the same temperature for 30 s using a dispenser heater. Subsequently, the preheated bulk-fill thermoviscous composite resin was directly applied to the NCCLs. The restorations were evaluated at baseline, and after 6, 12, 18, and 24 months of clinical service using the FDI criteria. The total working time was recorded. The study used TOST-P to assess groups equivalence, Kaplan-Meier analysis for retention/fracture rate, log-rank test for secondary outcomes' survival distributions, and paired t-tests for comparing time per clinical step between groups (α = 0.05). After 24 months, 106 restorations were evaluated. Four restorations were lost-two from the DH group and two from the BH group-resulting in similar retention rates for both groups (96.1%, 95% CI 86.8 - 98.9, p > 0.05). The hazard ratio was 0.83 (95% CI 0.26 to 2.72), indicating no significant difference between the groups (p > 0.05). All other FDI parameters were deemed clinically acceptable. However, the total working time for the BH group was significantly longer than that for the DH group (p < 0.001). Both preheating protocols employed for the bulk-fill thermoviscous composite resin demonstrated high and equivalent retention rates after 24 months, the other FDI parameters were deemed clinically acceptable over the same period. Clinicians can choose either method for heating the thermoviscous composite resin for restoration of non-carious cervical lesions, as they do not impact important clinical outcomes after 24 months. The total working time for the bench heater is higher than that for the dispenser heater due to the need for preheating of the bench heater.

Hybridization promotes growth performance by altering rumen microbiota and metabolites in sheep.

Hybridization can substantially improve growth performance. This study used metagenomics and metabolome sequencing to examine whether the rumen microbiota and its metabolites contributed to this phenomenon. We selected 48 approximately 3 month-old male ♂Hu × ♀Hu (HH, n = 16), ♂Poll Dorset × ♀Hu (DH, n = 16), and ♂Southdown × ♀Hu (SH, n = 16) lambs having similar body weight. The sheep were fed individually under the same nutritional and management conditions for 95 days. After completion of the trial, seven sheep close to the average weight per group were slaughtered to collect rumen tissue and content samples to measure rumen epithelial parameters, fermentation patterns, microbiota, and metabolite profiles. The final body weight (FBW), average daily gain (ADG), and dry matter intake (DMI) values in the DH and SH groups were significantly higher and the feed-to-gain ratio (F/G) significantly lower than the value in the HH group; additionally, the papilla height in the DH group was higher than that in the HH group. Acetate, propionate, and total volatile fatty acid (VFA) concentrations in the DH group were higher than those in the HH group, whereas NH3-N concentration decreased in the DH and SH groups. Metagenomic analysis revealed that several Prevotella and Fibrobacter species were significantly more abundant in the DH group, contributing to an increased ability to degrade dietary cellulose and enrich their functions in enzymes involved in carbohydrate breakdown. Bacteroidaceae bacterium was higher in the SH group, indicating a greater ability to digest dietary fiber. Metabolomic analysis revealed that the concentrations of rumen metabolites (mainly lysophosphatidylethanolamines [LPEs]) were higher in the DH group, and microbiome-related metabolite analysis indicated that Treponema bryantii and Fibrobacter succinogenes were positively correlated with the LPEs. Moreover, we found methionine sulfoxide and N-methyl-4-aminobutyric acid were characteristic metabolites in the DH and SH groups, respectively, and are related to oxidative stress, indicating that the environmental adaptability of crossbred sheep needs to be further improved. These findings substantially deepen the general understanding of how hybridization promotes growth performance from the perspective of rumen microbiota, this is vital for the cultivation of new species and the formulation of precision nutrition strategies for sheep.

Docosahexaenoic acid-enriched diet improves the flesh quality of freshwater fish (Megalobrama amblycephala): Evaluation based on nutritional value, texture and flavor

Docosahexaenoic acid (DHA) is a potential regulatory substance for flesh quality of fish, while the related evaluation is still barely. In this study, the effects of DHA-enriched diets on the flesh quality of freshwater fish (Megalobrama amblycephala) were investigated systematically. The sub-adult M. amblycephala were randomly fed with control diet (CON), 0.2% DHA diet (DL) or 0.8% DHA diet (DH). After 12-week feeding trial, the DH group flesh had higher concentrations of essential amino acids and polyunsaturated fatty acids compared to the CON group. Meanwhile, the hardness, springiness, shear force and moisture-holding capacity, as well as the values of umami, richness and sweetness were also improved by DH. The non-targeted metabolomics analysis revealed the key metabolites that may have significantly positive influence on flavor. Collectively, the diet supplementation with 0.8% DHA could achieve the improvement of the flesh quality in terms of nutritional value, texture and flavor in freshwater fish.

Proteomics Clustering Research of ITRAQ Markers in Plasma of AIDS Patients with Different Chinese Medicine Syndromes.

We aimed to distinguish the different Chinese medicine (CM) syndromes of acquired immune deficiency syndrome (AIDS) patients at the proteomics level. We collected AIDS patients diagnosed with different CM syndromes from Weishi County, Kaifeng City, Henan Province, China, including Qi-deficiency syndrome (named QD group) and dampness-heat syndrome (named DH group). Healthy people were collected as controls from Weishi County, Kaifeng city, Henan Province, China. The plasma from three groups were labeled with ITRAQ, LC/MC was used for protein quantitative analysis. Finally, sequence search and cluster analysis were performed. Overall, 27 different proteins were found. Three proteins were up-regulated and 2 proteins down-regulated in the QD group, 11 proteins up-regulated and 13 proteins down-regulated in the DH group. Compared with DH group, there were 7 different proteins in QD group, among which 5 proteins were down-regulated and 2 proteins were up-regulated. When the target protein of DH group was up-regulated, the protein of HC group was down-regulated correspondingly. The significance analysis and clustering of protein results showed that DH group was significantly different from QD group and HC group at the protein level (P<0.05). However, the QD group could not be effectively distinguished from the HC group. AAT, PF4, C-reactive protein and c4bp may be used as potential biomarkers in DH group. Mass spectrometry based on feature selection can be used to classify different CM syndromes.

Laser hemorrhoidoplasty versus LigaSure™ hemorrhoidectomy versus diathermy hemorrhoidectomy in treatment of grade III and IV Hemorrhoids: A non-randomized prospective trial

BackgroundThrough the past decades, various surgical methods have been introduced as new modalities for the management of grade III and IV hemorrhoidal disease HD, to provide an effective and less invasive operation in comparison with conventional haemorrhoidectomy which is the gold standard surgical treatment. MethodsThis study was conducted at Alexandria Main University Hospital. Ninety three patients with grade III and IV HD were enrolled in our study, thirty-one patients treated with diathermy hemorrhoidectomy DH (group A), thirty-one patients with LigaSure™ hemorrhoidectomy LH (group B),and thirty-one patients with Laser hemorrhoidoplasty LHP (group C). Assessment of postoperative pain, intra and postoperative bleeding, operative time, time to return to work, quality of life using Hemorrhoidal Disease Symptom Score HDSS, and Short Health Scale for hemorrhoidal disease SHSHD and patient satisfaction were recorded and analyzed. ResultsThe postoperative pain according to Visual analogue scale VAS scores from the evening of the procedure till the fourth week postoperatively were significantly higher in group A patients compared to group B and C patients, however, no significant statistical difference was found between group B and C patients. There was significant statistical difference between each group for intra-operative bleeding, operative time, and time to return to work with advantage for LHP. LH led to significant improvement in both HDSS, SHSHD when compared with LHP (p = 0.015*and p = p3<0.001*respectively) and when compared with DH, however, only SHSHD was statistical significance (p = 0.001*). The median score for patient satisfaction was 6 in the 3 groups (range: 3–7 group A, 3–7 group B and 2–6 group C) with no statistical significance. ConclusionLH and LHP are associated with significantly less postoperative pain and give superior results than DH in terms of less operative time, intraoperative blood loss, postoperative complications, and faster recovery time, with significantlys better health-related quality of life after LH.

Dendrobium huoshanense Improves Lipid Metabolism Disorder by Restoring Gut Flora and Metabolites in Mice Fed a High-Fat Diet

Lipid metabolism disorders are widely acknowledged as crucial risk factors for a range of metabolic diseases, including hyperlipidemia, obesity, nonalcoholic fatty liver disease, and atherosclerosis. Dysbiosis of the gut microbiota is considered a potential mechanism of action in lipid metabolism disorders. Dendrobium huoshanense C.Z. Tang et S.J. Cheng (DH), an important edible and medicinal Chinese herb, has been shown to regulate the gut flora disorders and improve intestinal health. However, DH inhibits lipid metabolism disorders by regulating the gut flora remains unclear. Therefore, we aimed to explore the effect of the gut flora on improving blood lipid levels in mice that fed a high-fat diet supplemented with DH. Mice were randomly divided into normal control (CTR), high-fat diet (HFD), 2.25 mg/kg/day simvastatin (SIM), 300 mg/kg/day DH (LD-DH), and 600 mg/kg/day DH (HD-DH) groups for 14 weeks. Changes in serum and liver lipid levels and liver function were analyzed. Changes in intestinal microbiota and fecal metabolites were assessed using 16S rRNA gene sequencing and untargeted metabolomics. The relationships among lipids, intestinal microbiota, and fecal metabolites were analyzed using Pearson’s correlation analysis to reveal the mechanism of action of DH against lipid metabolism disorders. The results indicated that DH effectively improved the lipid profiles in both the serum and liver of HFD mice. DH was also found to alter the structure of the gut flora, especially the relative abundances of Bifidobacterium pseudolongum and B. animalis, which dramatically increased with DH. Pearson’s correlation analysis indicated that DH may mainly alter metabolites (amino acid metabolites, bile acid metabolites, lipid metabolites, etc.) to regulate lipid metabolism via the metabolic ability of the gut flora. B. pseudolongum and B. animalis may be the dominant bacterial species in the gut microbiota and play key roles in the alleviation of lipid metabolism disorders caused by HFD.

Retrospective Evaluation of Risk Factors for Ischemic Heart Disease in Patients with Dermatitis Herpetiformis

Background and Purpose: Some have proposed that the cardiovascular risk among individuals with DH differs from that of the general population. This study aimed to analyze cardiovascular risk factors in DH patients and compare them to a matched control group without DH or celiac disease.&#x0D; &#x0D; Methods: This was a retrospective hospital-based study involving patients diagnosed with DH, both clinically and histopathologically, along with age- and sex-matched control subjects without the disease. The presence of ischemic heart disease, and the risk factors including laboratory values, treatment and comorbidity histories were evaluated comparatively. (SPSS version 28.0). &#x0D; &#x0D; Results: Thirty-five patients with DH and 49 controls were included. No significant difference was found between the DH patients and controls regarding the prevalence of ischemic heart disease (22.9% vs. 14.3%, p:0.312). Diabetes mellitus was significantly higher and HDL cholesterol levels were significantly lower in the DH group (respectively, p: 0.044 and p: 0.018). Celiac autoantibodies, the laboratory values, or treatments did not show any significant correlation with heart disease in DH.&#x0D; &#x0D; Conclusion: This study revealed that HDL cholesterol were significantly lower in DH patients compared to general population. More research is needed to optimize the cardiovascular health of DH patients.

L4/5 Disc Herniation: Not Unusually Accompanied with L5/S1 Low-Grade Spondylolytic Spondylolisthesis.

Isthmic spondylolisthesis (IS) is distinguished by a congenital defect or acquired fracture of the pars interarticularis. Numerous studies on L5 low-grade IS have been carried out; however, there is a paucity of data regarding the condition of L5 IS concomitant with L4/5 disc herniation. This study aimed to identify the incidence rate and to illustrate the possible risk factors for L4/5 disc herniation in L5 low-grade IS patients. A total of 268 consecutive patients diagnosed as L5/S1 low-grade IS between May 2017 and May 2022 were retrospectively enrolled in this study. Depending on the presence of L4/5 disc herniation or not, patients were divided into an L4/5 disc herniation group (L4/5 DH) and an L4/5 non-disc herniation group (L4/5 non-DH). Radiographic parameters were measured, and the ratios of L4-S1 segmental lordosis (SL) to lumbar lordosis (LDI), L4 inferior endplate (IEP) to L5 superior endplate (SEP) (L4 IEP/L5 SEP), and L5 IEP to S1 SEP (L5 IEP/S1 SEP) were compared between groups. The Pfirrmann grade of the L4/5 disc and the L5/S1 disc, and Roussouly classifications of each patient were also recorded. Univariate analysis (including independent-samples t-test and χ2 -test) and multiple logistic regression analysis were performed to analyze the data. There were 40 patients (14.9%) in the L4/5 DH group. The Roussouly classification differed significantly between groups. As demonstrated by the Pfirrmann grade, the L4/5 DH group showed more advanced disc degeneration at L4/5 than the L4/5 non-DH group. In contrast to the L4/5 non-DH group, the L4/5 DH group had a significantly larger L4 IEP, L4 IEP/L5 SEP, S1 SEP, and LDI while smaller L4/5 disc angle, L4/5 disc height, slip percentage, lumbar lordosis, and sacral slope. Multivariate logistic regression analysis revealed that higher L4/5 disc Pfirrmann grade (p = 0.004), decreased L4/5 disc height (p < 0.001), and lower L5 slip percentage (p = 0.022) were significantly associated with the occurrence of L4/5 DH. L4/5 disc herniation is not unusually accompanied by L5/S1 low-grade IS. Advanced L4/5 disc degeneration, decreased L4/5 disc height, and lower L5 slip percentage might be significantly associated with L4/5 disc herniation.

Progression risk factors in glaucoma patients with disc haemorrhage

Aims/Purpose: In this study, we investigated the clinical characteristics of disc haemorrhage relating to hemodynamic factors and their impact on glaucoma progression.Methods: This was a retrospective cohort study, including 81 eyes with open angle glaucoma accompanying DH. Eyes were classified as non‐recurrent DH and recurrent DH. Eyes with recurrent DH were sub‐classified into three groups according to the location of DH. Visual field progression was determined by event‐based analysis using the Guided Progression Analysis (GPA) software. The coefficient of variation (CV) of systolic and diastolic blood pressure (BP) was used to measure visit‐to‐visit variability. Kaplan–Meier survival analyses were used to compare the cumulative risk ratio of progression between groups.Results: Recurrent DH group showed a significantly higher systolic and diastolic BP (p = 0.014 and 0.021, respectively), with higher proportion of VF progression (p = 0.019), compared to non‐recurrent DH group. Particularly, female with recurrent DH showed highest cumulative probability of VF progression (p = 0.047, Log‐rank test). Recurrent DH at a different quadrant showed a greater cumulative probability of VF progression than non‐recurrent DH group (p = 0.038, Log‐rank test). In the Cox regression analyses, higher visit‐to visit variability of diastolic BP, female gender, recurrence DH in a different quadrant significantly contributed the progression of glaucoma.Conclusions: The presence of recurrent DH was associated with elevated systolic and diastolic BP, while increased visit‐to visit variability in diastolic BP was linked to the progression of glaucoma. Our study emphasize the role of hemodynamic factors in the pathogenesis of DH in glaucoma.

Desipramine ameliorates fine particulate matter-induced hepatic insulin resistance by modulating the ceramide metabolism in mice

Recent research has highlighted a correlation between exposure to ambient fine particulate matter (PM2.5) and the development of systemic insulin resistance (IR) along with an elevated risk of diabetes. Ceramide has emerged as one of the pathogenic mechanisms contributing to IR. The inhibition of acid sphingomyelinase (ASMase) activity by desipramine (DES) has been shown to effectively reduce ceramide levels. In the present study, 24 female C57BL/6 N mice were randomized into one of the four groups: the filtered air exposure (FA) group, the concentrated PM2.5 exposure (PM) group, the concentrated PM2.5 treated with low-dose DES (DL) group, and the concentrated PM2.5 treated with high-dose DES (DH) group. The PM, DL and DH groups were exposed to PM2.5 for an 8-week period within a whole-body exposure system. The study encompassed extensive examinations of glucose homeostasis, liver lipid profile, ceramide pathway, and insulin signaling pathway. Our results demonstrated that PM2.5 exposure caused impaired glucose tolerance, elevated ceramide levels, increased phosphorylation PP2A, reduced Akt phosphorylation, and hindered GLUT2 expression. Remarkably, DES administration mitigated PM2.5-induced IR by effectively lowering ceramide levels. In conclusion, the reduction of ceramide levels by DES may be a promising therapeutic strategy for coping PM2.5-induced IR.

Expanding eligibility for intracranial electroencephalography using Dexmedetomidine Hydrochloride in children with behavioral dyscontrol

IntroductionInvasive intracranial electroencephalography (IEEG) is advantageous for identifying epileptogenic foci in pediatric patients with medically intractable epilepsy. Patients with behavioral challenges due to autism, intellectual disabilities, and hyperactivity have greater difficulty tolerating prolonged IEEG recording and risk injuring themselves or others. There is a need for therapies that increase the safety of IEEG but do not interfere with IEEG recording or prolong hospitalization. Dexmedetomidine Hydrochloride’s (DH) use has been reported to improve safety in patients with behavioral challenges during routine surface EEG recording but has not been characterized during IEEG. Here we evaluated DH administration in pediatric patients undergoing IEEG to assess its safety and impact on the IEEG recordings. MethodsA retrospective review identified all pediatric patients undergoing IEEG between January 2016 and September 2022. Patient demographics, DH administration, DH dose, hospital duration, and IEEG seizure data were analyzed. The number of seizures recorded for each patient was divided by the days each patient was monitored with IEEG. The total number of seizures, as well as seizures per day, were compared between DH and non-DH patients via summary statistics, multivariable linear regression, and univariate analysis. Other data were compared across groups with univariate statistics. ResultsEighty-four pediatric patients met the inclusion criteria. Eighteen (21.4 %) received DH treatment during their IEEG recording. There were no statistical differences between the DH and non-DH groups’ demographic data, length of hospital stays, or seizure burden. Non-DH patients had a median age of 12.0 years (interquartile range: 7.25–15.00), while DH-receiving patients had a median age of 8.0 years old (interquartile range: 3.00–13.50) (p = 0.07). The non-DH cohort was 57.6 % male, and the DH cohort was 50.0 % male (p = 0.76). The median length of IEEG recordings was 5.0 days (interquartile range: 4.00–6.25) for DH patients versus 6.0 days (interquartile range: 4.00–8.00) for non-DH patients (p = 0.25). Median total seizures recorded in the non-DH group was 8.0 (interquartile range: 5.00–13.25) versus 15.0 in the DH group (interquartile range: 5.00–22.25) (p = 0.33). Median total seizures per day of IEEG monitoring were comparable across groups: 1.50 (interquartile range: 0.65–3.17) for non-DH patients compared to 2.83 (interquartile range: 0.89–4.35) (p = 0.25) for those who received DH. Lastly, non-DH patients were hospitalized for a median of 8.0 days (interquartile range: 6.00–11.25), while DH patients had a median length of stay of 7.00 days (interquartile range: 5.00–8.25) (p = 0.27). No adverse events were reported because of DH administration. ConclusionsAdministration of DH was not associated with adverse events. Additionally, the frequency of seizures captured on the IEEG, as well as the duration of hospitalization, were not significantly different between patients receiving and not receiving DH during IEEG. Incorporating DH into the management of patients with behavioral dyscontrol and intractable epilepsy may expand the use of IEEG to patients who previously could not tolerate it, improve safety, and preserve epileptic activity during the recording period.

Overview and Prevention of Complications During Full-Endoscopic Cervical Spine Surgery

Objective: Posterior full-endoscopic cervical foraminotomy/discectomy (PECF) is used to treat medically intractable cervical radiculopathy. PECF has many potential advantages; however, despite its minimally invasive nature, complications of PECF are possible, including hemorrhage, infection, injury to neural tissue, damage to the facet joint and musculature, loss of cervical lordosis, and subsequent progression to cervical kyphosis. We examined complications following PECF and reviewed the relevant literature.Methods: We retrospectively reviewed 101 patients who underwent PECF for either disc herniation (DH, 59 patients) or foraminal stenosis (FS, 42 patients). After surgery, the patients were encouraged to ambulate and were discharged 2–3 days later without the use of a neck collar. Events occurring during hospitalization were documented in the hospital information system. Patients were followed-up for a mean period of 21±26 months (range, 1–110 months).Results: Clinical parameters improved from 1 month postoperatively and were maintained throughout the follow-up period, with no significant differences between the DH and FS groups (p&gt;0.05). Complications occurred in 14 patients (14%) with no significant difference between the DH (8 of 59, 14%) and FS (6 of 42, 14%) groups (p&gt;0.05). The most common complication was dural tear, followed by motor weakness, sensory changes, hematoma collection, incomplete decompression, reoperation, and wrong-level surgery. Two patients underwent reoperation due to symptomatic hematoma collection and symptom recurrence 3 years postoperatively.Conclusion: The incidence of complications following PECF was 14%. Although most were transient, an understanding of both reported and unreported complications, along with thorough preparation, could reduce the occurrence of PECF-associated complications.

Dynamics of oxidative stress and immune responses in neonatal calves during diarrhea

Oxidative stress is the imbalanced redox status between oxidant production and their scavengers leading to intestinal physiological dysfunction. However, the role of systemic and local oxidative status during neonatal calf diarrhea is not known. This study assessed systemic (serum) and local (fecal) oxidative status when calves either naturally developed diarrhea or naturally recovered. Healthy calves were enrolled in the study at d 18 of age, and their health status was monitored from the enrollment. Based on their enteric health status on d 21 and 28, calves were grouped as continuous diarrhea from d 21 to 28 (n = 14), diarrhea at d 21 but recovered at d 28 (DH group, n = 19), healthy at d 21 but developed diarrhea at d 28 (HD group, n = 15), and healthy throughout the study (HH group, n = 16). Serum and fecal samples were collected at d 21 and 28 from all calves in the morning 2 h after feeding. Dynamics of oxidative stress indicators including reactive oxygen species (ROS), malondialdehyde (MDA), H2O2, 8-hydroxy-2'-deoxyguanosine (8-OHDG), glutathione peroxidase, superoxide dismutase, catalase (CAT), and total antioxidant capacity and inflammatory indicators TNF-α, IL-1β, IL-4, IL-6, IL-10, and IFN-γ were evaluated using serum samples. In addition, fecal oxidative stress indicators ROS and MDA were measured. Serum ROS, MDA, 8-OHDG, as well as fecal ROS and MDA, were higher, whereas serum CAT and H2O2 were lower in diarrheic calves than those of healthy calves. Serum ROS, MDA, and 8OHDG and fecal ROS and MDA increased in the HD group from d 21 to 28 as they developed diarrhea. In contrast, all these oxidative stress markers decreased in the DH group from d 21 to 28 as they recovered. However, serum H2O2 had an opposite changing trend, which became lower in the HD group and higher in the DH group at d 28. In conclusion, both systemic and local oxidative stress markers and cytokine profiles altered as calves moved from being healthy to having diarrhea or vice versa. Serum ROS, MDA, and 8-OHDG can be used to develop biomarkers to screen calves prone to enteric infections during the preweaning period.

Desflurane Protects The Brain Against The Oxidant Activity of Acute Hyperglycemia in Diabetic Rats, Comparison with Sevoflurane

In this study, we investigated the effects of sevoflurane and desflurane administration on the oxidant and antioxidant system in the brain of acute hyperglycemia in diabetic rats. In the study, 30 male Wistar Albino rats were randomly divided into five groups. Diabetes was induced by administering a single dose of intraperitoneal streptozotocin (55 mg/kg) to rats except for the control group (C). To create acute hyperglycemia in diabetic groups, which were hyperglycemia (DH), desflurane (D), and sevoflurane (S) groups, 2.5 g/kg glucose was administered intraperitoneally. After glucose administration, desflurane 6% and sevoflurane 2.3% mixed with 4 L/min oxygen were administered for 2 hours, by which minimal alveolar concentration for rats would be one. Afterward, the animals were sacrificed, and their brain tissues were prepared for biochemical analysis. Catalase (CAT), glutathione-s-transferase (GST), paraoxonase (PON) activities, and TBARS levels were measured to determine oxidant and antioxidant status. GST activity was significantly lower in group D than in group DH (p=0.001). The PON activity was significantly lower in the D group compared with other groups (p&amp;lt;0.001). In the S group, PON activity was significantly lower than in the diabetic control (DC) group and DH groups (p=0.022, p=0.020, respectively). TBARS level was significantly lower in group D than in group DH (p=0.013). As a result, desflurane decreases GST and PON activity and TBARS levels more than sevoflurane. In terms of lipid peroxidation, desflurane shows more protective properties than sevoflurane. Since our study is the first study in this field, it should be supported by other studies to be carried out.

Effectiveness of Class IC Antiarrhythmics in Patients with Paroxysmal Form of Atrial Fibrillation in Absence of Structural Heart Disease

Aim. To study the efficacy of class IC arrhythmic drugs (AAD) and catheter ablation (CA) for paroxysmal form of atrial fibrillation (AF) in patients with without structural heart disease.Material and methods. The study included 122 patients (44 men, 78 women, mean age 63 [55;68] years) with symptomatic AF paroxysms. Patients was divided into the lappaconitine hydrobromide group (LH group; n=26), the propafenone group (P group; n=25) – 25 patients, the diethylaminopropionylethoxycarbonylaminophenothiazine hydrochloride (DH group; n=23), the CA groups: radiofrequency ablation (RFA group; n=24) and cryoballoon ablation (CRYO group; n=24) groups each included 24 patients. The primary endpoint was the AF recurrence within 6 and 12 months from the onset of antiarrhythmic drug therapyand in RFA and CRYO groups – within 6 and 12 months after the end of the blinding period. Additionally, in AAD groups a composite endpoint was assessed: the frequency of recurrence of AF within 6 months and the frequency of side effects requiring drug withdrawal.Results. Within the 6 months AF recurrence was observed in 13 (50%) patients of the LH group, 11 (44%) patients of the P group, and 13 (56.5%) patients of the DH group (p=0.687). Side effects requiring drug withdrawal were observed in the LH group in 2 patients (7.7%), in the P group in 3 patients (12%) and in the DH group in 3 patients (13%) (p=0.801). The difference in frequency of reaching the composite endpoint was not significant (p = 0.581) and the incidence was 57.7%, 56%, 69.5%, respectively in groups LH, P and DH. The efficacy of CA was higher than class IC AADs: 77% vs 39% (that including the withdrawals of AADs due to side effects) (p˂0.001). At the same time, there was no significant difference in the effectiveness of RFA and CRYO: AF recurrences within 6 months after the end of the blinding period were registered in the RFA group in 29% of cases, in the CRYO group – in 16.7% of cases (p=0.247). The overall effectiveness of CA after 12 months was 69%, which was significantly higher than the effectiveness of AADs that was 38% (p˂0.001).Conclusion. Starting the AAD therapy with IC class in patients with paroxysmal AF in the absence of structural pathology, despite acceptable safety, one should take into account that, regardless of the initially prescribed drug, less than half of patients can achieve prevention of AF recurrence within 1 year. CA for AF can be considered as a first line therapy or can be recommended if one of IC class AADs is ineffective.

The effect of drug holiday on preventing medication-related osteonecrosis of the jaw in osteoporotic rat model.

Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with antiresorptive medications managing osteoporosis, such as bisphosphonates (BPs). To date, there is very limited evidence from prospective, controlled studies to support or refute the controversial prevention regimen that if a discontinuation of BPs before dentoalveolar surgery, so called "drug holiday", is effective in reducing the risk of MRONJ development in patients with osteoporosis. We proposed an experimental animal study, aiming to investigate the prevention of MRONJ following tooth extractions in osteoporotic condition, with the implementation of a BP drug holiday. Twenty rats were subjected to bilateral ovariectomy. After establishing the osteoporotic condition, all rats were exposed to weekly injections of zoledronate acid (ZA) for 8 weeks. After ZA treatment, 10 rats were subjected to dental extraction and defined as control group, and the rest 10 rats assigned to the DH group had a drug holiday of 8 weeks prior to dental extraction. Eight weeks after the dentoalveolar surgery, bone turnover biomarker in serum, occurrence of MRONJ-like lesion and histomorphometric assessment of osteonecrosis in mandible, and bone microarchitecture indices in femur, were examined. Eight weeks after dental extraction, the DH group showed a recovered osteoclastic activity, indicated by significantly increased number of osteoclasts in the mandibles and serum level of C-terminal telopeptides of type I collagen, as compared to the control group. No significant differences were observed in the gross-view and histological occurrences of MRONJ-like lesions between the two groups.There was no significant difference in bone microarchitecture in the femur between the control and DH groups before ZA therapy and 8 weeks after dental extraction. Our data provided the first experimental evidence in the osteoporotic animal model that the implementation of a BP holiday in prior to dental extractions could partially recover osteoclastic activity, but could not alleviate the development of MRONJ-like lesion or exacerbate the osteoporotic condition in the femur. Longer-term drug holiday, or combination of drug holiday and other prophylaxes to prevent MRONJ in patients with osteoporosis could be worth exploring in future studies, to pave the way for clinical managements. This in vivo prospective study reported that a recovery of osteoclastic activity by a BP drug holiday for 8 weeks in osteoporosis rats did not alleviate the development of MRONJ-like lesion followed by dental extractions. It contributes to the understanding of regimens to prevent MRONJ.

Jaboticaba (Myrciaria cauliflora) Fruit Extract Suppressed Aberrant Crypt Formation in 1,2-Dimetylhydrazine-Induced Rats.

Early intervention can significantly improve the colorectal cancer survival rate. Foods rich in phenolic compounds, such as jaboticaba (Myrciaria cauliflora), may prevent tumorigenesis. We investigated the effectivity of jaboticaba whole fruit ethanolic extract (FEX) in suppressing aberrant crypt foci (ACF), the earliest lesion of colorectal cancer (CRC), in 1,2-dimethylhydrazine (DMH)-induced rats and the underlying mechanisms related to the gut microbiota composition and short chain fatty acid (SCFA). This study was approved by the Institutional Animal Care and Use Committee (IACUC) of Providence University (Trial Registration Number 20180419A01, registration date: 22 December 2018). The FEX contains gallic acid and an especially high ellagic acid concentration of 54.41 ± 1.80 and 209.79 ± 2.49mg/100g FEX. The highest total ACF number (150.00 ± 43.86) was recorded in the DMH control (D) group. After 56 days of oral FEX treatment, the total ACF number in the low FEX dosage (DL) group was significantly lower compared to the D group (p < 0.05). The large-sized ACF (> 5 foci), which has a higher probability of progressing to later stage, was significantly decreased in the high FEX dosage (DH) group. The 16s rDNA metagenomic sequencing of the cecal material revealed that the CRC biomarker Lachnoclostridium was significantly suppressed in the DH group (p < 0.05), whereas some SCFA-producing taxa and the cecal butyrate concentration were significantly elevated in the DL and DH groups (p < 0.05). This study demonstrated the potential of jaboticaba whole fruit in CRC prevention, especially in the initial stage, by shifting gut microbiota composition and improving cecal butyrate level.

Densidade de incidência de pneumonia associada à ventilação mecânica em dois hospitais

Ventilator-associated pneumonia (VAP) is the main nosocomial infection in patients admitted to the intensive care unit. A strategy to avoid VAP are preventive measures (bundles), which are performed by intensive care professionals. One of the recommendations of the bundles is the oral hygiene protocol for the intubated patient, performed by the nursing technician, which can minimize the incidence of VAP in the ICUs, but which could be better performed by the insertion of the dental surgeon (CD) in the team. The aim of the study was to compare the density of the incidence of VAP (AVIP) in the Intensive Care Units (ICUs) of two private hospitals, named A and B. In hospital A, patients were not followed up by a CD (group 1). In hospital B, there were two collections, one related to patients without DH follow-up (group 2), and another collection of patients who received dental care from a DH (group 3). The incidence densities in groups 1, 2 and 3 were respectively 13.76; 11.96 and 3.63. Although there was no statistical difference between the three groups (p = 0.33), group 3 of patients in hospital B had a considerably lower incidence. The present study concludes by pointing to the importance of including the dentist within the medical-hospital care team for patients using mechanical ventilation, as it contributes to infection control and prevention of searchable diseases that can have consequences on general health.

Three-dimensional evaluation of maxillary tooth movement in extraction patients with three different miniscrew anchorage systems: a randomized controlled trial

ObjectiveTo compare the three-dimensional (3-D) movement of maxillary teeth in response to three common miniscrew anchorage systems in extraction patients with maxillary dentoalveolar protrusion.Materials and methodsThe study employed a randomized controlled single-blinded design with three arms. Thirty extraction patients who required maximum anchorage to retract maxillary anterior teeth were included and randomly allocated into three treatment groups: space closure with direct miniscrew anchorage and low crimpable hooks (DL group), indirect miniscrew anchorage and low crimpable hooks (IL group), and direct miniscrew anchorage and high crimpable hooks (DH group). Cone beam computed tomography (CBCT) images of all included patients were obtained immediately before (T0) and after (T1) space closure. The outcomes were 3-D positional changes of maxillary central incisor, lateral incisor, canine, second premolar, and first molar. The repeated measures analysis of variance with post hoc LSD test was used to evaluate differences among groups.ResultsA significant intrusion (− 1.34 mm; 95% CI, − 1.60 mm, 1.08 mm) and buccal (− 6.92°; 95% CI, − 8.67°, − 5.13°) and distal (4.90°; 95% CI, 3.75°, 6.04°) inclination of the maxillary first molars were observed in the DL group, compared to the other two groups. The mesial movement (− 0.40 mm; 95% CI, − 0.83 mm, − 0.03 mm) of the maxillary first molars was found in the IL group, while the DL (0.44 mm; 95% CI, 0.15 mm, 0.73 mm) and IL (0.62 mm; 95% CI, 0.28 mm, 0.96 mm) groups exhibited distal movement. In the DH group, the lingual inclination changes of maxillary central incisor (5.04°; 95% CI, 2.82°, 7.26°) were significantly lower, which is indicative of good lingual root torque control of the maxillary anterior teeth.ConclusionThree miniscrew anchorage systems produced significantly different 3-D maxillary tooth movement. The maxillary first molars were significantly buccally and distally inclined and intruded in patients using direct miniscrew anchorages with low crimpable hooks. Direct miniscrew anchorages with high crimpable hooks could help to achieve better lingual root torque control of the maxillary incisors.Trial registration The trial was registered at www.chictr.org.cn (ChiCTR1900026960). Registered 27 October 2019.

Diosgenin protects against podocyte injury in early phase of diabetic nephropathy through regulating SIRT6

BackgroundDiabetic nephropathy (DN) is a serious complication of diabetes mellitus. DN is the main cause of end-stage renal disease (ESRD). SIRT6 becomes the important target of DN. Diosgenin (a monomer from Chinese herbs) is probable to bind to SIRT6. PurposeBased on studies presented in the literature on kidney injuries plus screening for the binding effects of the drug to Sirt6, we aimed to carry out the study to assess the effects of diosgenin involved in improving podocyte damage in the early phase of DN.. MethodsDN model was established in spontaneous diabetic db/db mice. Animal experiment was in two parts. The first part includes four groups consisting of control (Con) group, model (Mod) group, low dose of diosgenin (DL) group and high dose of diosgenin (DH) group. The second part includes four groups consisting of control group, model group, DH+OSS_128167 (OSS, inhibitor of SIRT6) group, MDL800 (agonist of SIRT6) group. MPC5 cell line was selected in cell experiment, which was mainly composed of six groups including Con group, palmitic acid (PA) group, PA+DL group, PA+DH group, PA+DH+OSS group, PA+MDL800 group. Some procedures such as transcriptomics, RT-qPCR and so on were used in the study to explore and verify the mechanism. ResultsThe abnormal changes of mesangial matrix expansion, glomerular basement membrane (GBM) thickness, foot process (FP) width, urine albumin/creatinine (UACR), DESMIN, ADRP, NEPHRIN, PODOCIN, SIRT6 in Mod group were alleviated in DH group rather than DL group in the first part of animal experiment. The effect in DH group could be reversed in DH+OSS group and the same effect was observed in MDL800 group in the second part of animal experiment. The same results were also found in cell experiment. Protein level and mRNA expression of pyruvate dehydrogenase kinase 4 (PDK4) and Angiopoietin-like-4 (ANGPTL4) were increased in PA group, which could be alleviated in DH group, MDL800 group rather than DH+OSS group. ConclusionsDiosgenin could protect against podocyte injury in early phase of diabetic nephropathy by regulating SIRT6.