Objective To evaluate the relevant systematic reviews/meta-analyses that focused on the prevention and treatment of complications after impacted tooth extraction. Methods The systematic reviews/meta-analyses on the prevention and treatment of complications after impacted tooth extraction were searched in PubMed, The Cochrane Library, CBM, CNKI and WanFang Data from inception to September 30th, 2012, and a total of 15 professional journals and the references of included studies were also retrieved manually. Two reviewers screened the literature according to the inclusion criteria and extracted the data. Then the AMSTAR was used to evaluate the quality of the included studies, and the GRADE system was used to evaluate the quality of evidence. Results A total of twelve relevant systematic reviews/meta-analyses were included, of which five focused on the prevention and treatment of dry socket, six on the prevention of swelling, seven on the prevention and treatment of pain, six on the prevention of limitation of mouth opening, two on the prevention of infection, three on the prevention of bleeding, and one on the treatment of nerve damage after tooth extraction. Based on AMSTAR, seven studies were minor limitations and five studies were moderate limitations. Based on GRADE system, two was high quality of evidence, twelve were moderate, nine were low, and seven were very low. Conclusion Currently, the systematic reviews/meta-analyses on the prevention and treatment of complications after impacted tooth extraction can provide some references for clinical practice, which should be combined with the real condition by clinical doctors when making an evidence-based decision. However, it also suggests performing more high quality and large sample studies to prove this conclusion.
Objective To observe the histomorphology and the biocompatibil ity of acellular nerve prepared by different methods, to provide the experimental evidence for the selection of preparation of acellular nerve scaffold. Methods Forty-eight adult Sprague Dawley rats, male or female, weighing 180-220 g, were selected. The sciatic nerves were obtained from 30 rats and were divided into groups A, B, and C (each group had 20 nerves). The acellular sciatic nerves were prepared by the chemical methods of Dumont (group A), Sondell (group B), and Haase (group C). The effect to remove cells was estimated by the degree of decellularization, degree of demyel ination, and intergrity of nerve fiber tube. The histocompatibil ity was observed by subcutaneous implant test in another 18 rats. Three points were selected along both sides of centre l ine on the back of rats, and the points were randomly divided into groups A1, B1, and C1; the acellular nerve of groups A, B, and C were implanted in the corresponding groups A1, B1, and C1. At 1, 2, and 4 weeks after operation, the rats were sacrificed to perform the general observation and histological observation. Results The histomorphology: apart of cells and the dissolved scraps of axon could be seen in acellular never in the group A, and part of Schwann cell basilar membrane was broken. In group B, the cells in the acellular never were not removed completely, the Schwann cell basilar membrane formed bigger irregular hollows, part of the Schwann cell basilar membrane was broken obviously. But in the group C, the cells were completely removed, the Schwann cell basilar membrane remained intactly. Group C was better than group A and group B in the degree of decellularization, degree of demyel ination, integrity of nerve fiber tube and total score, showing significant differences (P lt; 0.05). The subcutaneous implant test: there were neutrophils and lymphocytes around the acellular nerve in 3 groups at 1 week after implant. A few of lymphocytes were observed around the acellular nerve in 3 groups at 2 weeks after implant. The inflammation was less in groups A1, B1, and C1 at 4 weeks after implant, part of the cells grew into the acellular nerve and arranged along the Schwann cell basilar membrane. The reaction indexes of the inflammational cells in group A1 and group B1 were higher than that in group C1 at 1, 2, and 4 weeks after implant, showing significant differences (P lt; 0.01), but there was no significant difference between group A1 and group B1 (P gt; 0.05). Conclusion The acellular sciatic nerves prepared by Haase method has better acellular effect and the histocompatibil ity than those by the methods of Dumont and Sondell.
Objective To separate each protein band from the nerve regeneration conditioned fluid(NRCF）and to study whether there are somenew and unknown neurotrophic factors in the protein bands with a relative molecular mass of 220×103. Methods The silicone nerve regenerationchambers were formed in the sciatic nerve of the 25 New Zealand rabbits (weight,1.8-2.5 kg), and NRCF was taken from it at 1 week after operation. The Nativepolyacrylamide gel electrophoresis (Native-PAGE) was used for separating the proteins from NRCF and detecting the relative molecular mass. The Western blot and ELISA were used to observe whether the protein bands ［220×103 (Band a), (20-40)×103(Band c)］ of NRCF could combine with the antibody of the known antibody of neurotrophic factor (NTF):nerve growth factor(NGF), glial cell-derived neurotrophic factor(GDNF), brainderived neurotrophic factor(BDNF), neurotrophin 3(NT-3)， NT-4, ciliang neurotrophic factor(CNTF). Results Separated by Native-PAGE, NRCF mainly contained two protein bands:Band a had a relative molecular mass about 220×103, and Band c had a relative molecular mass about (20-40)×103. Band a could not combine with the antibodies of the NGF, BDNF, CNTF, and NT-3, but could combine with the antibody of NT-4.Band c could combine with the antibodies of NGF, BDNF, CNTF and NT-3, but could not combine with the antibodies of NT-4 and GDNF. Conclusion The protein bands with a relative molecular mass of 220×103 have ber neurotropic and neurotrophic effects than the protein bands with a relative molecular mass of (20-40)×103, which contains NGF,CNTF, etc. NT-4 just has a weak or no effect on the sympathetic neurone. This indicates that there is a new NTF in the protein bands with a relative molecular mass of 220×103, which only combines with the antibody of NT-4.
Objective To compare the efficacy and safety of pars plana vitrectomy (PPV) versus scleral buckling (SB) on rhegmatogenous retinal detachment (RRD) after cataract surgery. Methods A computerized search was conducted in the Cochrane Library, Medline, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biological Medicine Database (CBM) combined with manually searching of related literatures. Randomized controlled trials (RCT) comparing PPV with SB for RRD after cataract surgeries were collected. Best corrected visual acuity (BVCA), reattachment rate after primary surgery, final reattachment rate and complications between the two operations were compared. Results A total of four RCTs were included in this meta analysis, including 690 eyes of 690 patients (331 eyes in the PPV group, 359 eyes in the SB group). There was no difference in reattachment rates after primary surgery between two groups ［odds ratio (OR) =1.68; 95% confidence interval (CI), 0.81-3.49; P=0.16). Final reattachment rate were in favor of PPV (OR=1.97; 95% CI,1.04 -3.73;P=0.04). There was no significant difference in the proportion of BCVA at six months (weighted mean difference=0.06; 95%CI,-0.01- 0.14; P=0.11). PPV was associated with a significantly lower frequency of diplopia/extrocular muscle dysfunction than SB (OR=6.59; 95% CI1.16 - 37.27; P=0.03), whereas other complications, such as proliferative vitreoretinopathy, macular pucker, cystoid macular edema, and choroidal detachment did not differ statistically (P＞0.05). Conclusion Compared with SB, PPV is more likely to achieve a favorable final reattachment rate for RRD after cataract surgery, and with a lower rate of diplopia/extrocular muscle dysfunction.
ObjectiveTo observe the changes of macula in patients with high myopia after phacoemulsification. MethodsIn 20 patients with high myopia with ocular axial length≥27 mm, optical coherence tomography (OCT) was performed on the operative and contralateral eyes 1 week before and after monocular phacoemulsification, respectively, and the OCT images of macula of the operative eyes were observed and compared.ResultsOne week before and after phacoemulsification, the mean macular fovea thickness of the patients with high myopia was (131.6±16.37) μm and (189.75±45.69) μm, respectively, with a significant difference (t=2.805, P=0.01). Simultaneously, the mean macular fovea thickness of the contralateral eyes was (133.5±15.12) μm and (133.5±14.63) μm, respectively, with a non-significant difference (t=1.367, P=0.853). In 20 operative eyes 1 week after phacoemulsification, 3 had vitreous strand around the macula with retinal thickening, 1 had retinoschisis in macular area, and 2 had obvious retinal thickening with slight retinal edema.ConclusionRetinal thickening occurs in the patients with high myopia after phacoemulsification. Traction of retina by vitreous strand or subclinical retinoschisis may occur in some patients.(Chin J Ocul Fundus Dis, 2005,21:90-92)
Objective To investigate the effects of phacoemulsification on macula in diabetics． Methods Thirty eyes of cataract in diabetics were chosen randomly for measurement of the thickness of fovea of retina using OCT before phacoemulsification and 1 month after surgery ． The other eyes in these patients and 30 eyes of cataract in nondiabetic pati ents with phacoemulsification were as control． Results In 30 eyes of diabetics with phacoemulsification, the mean fovea thickness were (148．5plusmn;27．7) mu;m preoperatively and (219．4plusmn;68．23) mu;m postoperatively, and the difference was significant (Plt;0．05)． In 30 eyes of diabetics without surgery, the mean foveal thickness were (147.4plusmn;27.5) mu;m preoperatively and (148.2plusmn;27.3) mu;m postoperatively and the difference was not significant (Pgt;0．05)． In 30 eyes of cataract in nondiabetic patients, the mean fovea thickness were (142．37plusmn;12．7) mu;m preoperatively and (151．9plusmn;23．7) mu;m postoperatively and the difference was not significant (Pgt;0．05)． In 30 eyes of diabetic s with phacoemulsification, 11 eyes had new macula edema after surgery and 3 eye s had significant retinal thickening． In 6 eyes with macular edema before surgery, the macular edema were aggravated in 3 eyes after surgery． The macular stru ctural changes were not found in two control groups． Conclusion The thickness of retina is inreased after phacoemulsification in deabetics,and morbidity and its severity of postopevative macular edema are increas ed as well． (Chin J Ocul Fundus Dis, 2001,17:175-177)
Purpose To explore the characteristics of eyes after congenital cataract surgery and to evaluate the methods of different retinal detachment surgery in those eyes． Method We retrospeetively reviewed the cli ncal data of 44 eyes with rhegmatogenous retinal detachment (RRD) after congenital cataract surgery,and compared the surgical results between scleral buckling and vitrectomy in those eyes．The mean interval between the congenital cataract surgery and RRD of the affectde eyes was 14．8 years and most of the techniques of cataract surgery was irrigation-aspiration and capsulotomy was performed in nearly all eyes． The mean axis length in 16 eyes was （26.8plusmn;1.90） mm． Results The success rate was 80．3% in scleral buckling and 85．7% in vitrectomy． Conclusion There is a long interval between congenital cataract surgery and RD．The pupil of these eyes is often small and immobile,causing diffculty in visualizing the peripheral retina ,decreasing the success rate of scleral buckling operation．Vitrectomy is an ideal chocie for such eyes． (Chin J Ocul Fundus Dis，2000，16：71-138)
Objective To systematically review the effectiveness and safety of power chain vs. nickel titanium coil springs in closing dental extraction space. Methods Databases including PubMed, EMbase, The Cochrane Library, Chinese Biomedicine Literature Database, Chinese Scientific Journals Full-text Database, and Chinese Journal Full-text Database were searched to collect the randomized controlled trials (RCTs) on comparing power chain with nickel titanium coil springs published before February 2012. Two reviewers independently screened literature, extracted data and assessed the quality of the included studies. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 4 RCTs involving 122 patients were included. The results of meta-analyses showed that there was a significant difference in the rate of space closure between the two groups (MD=0.30 mm per month, 95%CI 0.17 to 0.44, Plt;0.000 1); The results of subgroup analyses indicated that, both high-quality trials (MD=0.20, 95%CI 0.07 to 0.34, P=0.003) and low quality trials (MD=0.40, 95%CI 0.30 to 0.50, Plt;0.000 01) showed no significant difference in the rate of space closure. Conclusion Current clinical evidence indicates nickel titanium coil spring is superior to power chain in the rate of space closure, but its long-term effect still needs to be proved by more large-scale RCTs.
The data collection form is a bridge in-between the original studies and the final systematic reviews. It’s the basis for data analyses, directly related to the results and conclusions of systematic reviews, and plays an important role in systematic reviews. There are strict requirements of data collection forms in making Cochrane systematic reviews. In this article, the authors introduce their experiences regarding to the design of data collection form.
ObjectiveTo discuss the safety of dental extraction with electrocardiogram (ECG) monitoring for cardiovascular patients. MethodsWe summarized and analyzed the clinical data of 933 cases of dental extraction with ECG monitoring from May 2010 to May 2011. Analysis of the change of heart rate and blood pressure in the process of dental extraction was also carried out. ResultsAll patients underwent the tooth extraction successfully. The heart rate and blood pressure increased after local anesthesia and in the process of tooth extraction without any accident. ConclusionUnder the premise of strict control of indications, dental extraction with the implementation of ECG monitoring has a very high security for patients with cardiovascular diseases or other systemic disorders.