Objective To assess the clinical effectiveness of vacuum-formed versus Hawley retainers in the period of retention. Methods PubMed, The Cochrane Library, EMbase, CBM, CNKI, VIP, and WanFang Data were searched from the date of their establishment to December 31, 2011, to collect the randomized controlled trials (RCTs) about the clinical effectiveness of vacuum-formed versus Hawley retainers. The quality of the included studies was evaluated by two reviewers independently, and meta-analysis was performed by using RevMan 5.1.4 software. Results Six RCTs including 935 patients were identified. The results of meta-analyses showed significantly fewer changes in irregularity of the maxillary incisors (MD=0.13, 95%CI 0.04 to 0.21) and mandibular incisors (MD=0.29, 95%CI 0.24 to 0.33) in the vacuum-formed group than in the Hawley group. There were no significant differences between the two groups in maxillary intercanine width (MD=?–0.01, 95%CI –0.03 to 0.01), mandibular intercanine width (MD=0.04, 95%CI –0.02 to 0.10), maxillary intermolar width (MD=?–0.01, 95%CI –0.03 to 0.00) and mandibular intermolar width (MD=?–0.02, 95%CI –0.08 to 0.04). The results of qualitative analysis were consistent with the results of meta-analysis and there were no significant differences in overjet and overbite. Conclusion Vacuum-formed retainers are more effective than Hawley retainers at maintaining position of incisors in the period of retention. In other aspects, they are similar. In consideration of the factors such as the limited quality and incomplete measure index of primary studies, RCTs of higher methodological quality are needed.
According to system reform of the current medical insurance diagnosis related groups, quality control of rehabilitation medicine and requirements of information management, this paper constructs a rehabilitation information system by using the theoretical framework and core sets of International Classification of Functioning, Disability and Health (ICF). Then, the constructed system is embedded into the work of rehabilitation medicine team. By the four processes of ICF items evaluation, rehabilitation goal setting, team cooperation scheme formulation and reevaluation, the operation process of rehabilitation information management based on ICF is formed, which strengthens comprehensively the rehabilitation diagnosis and treatment standards and improves the efficiency of quality control management. The big data mining and multi-dimensional analysis in this platform can provide support of medical insurance payment, achieve exchanging and sharing rehabilitation medical quality control data among hospitals at different levels in different regions, assist tertiary referral and remote rehabilitation, improve the rehabilitation medical service system, and enhance the level of rehabilitation medical care. This paper will summarize the application experience of constructing ICF rehabilitation information management system.
ObjectiveTo investigate the causal relationship between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA) with its typical symptoms (snoring and daytime sleepiness) by using Mendelian randomization (MR). MethodsThe inverse-variance weighted method was used as the main analysis method to assess the causal effect. Sensitivity and pleiotropy analyses were carried out using leave-one-out and MR-Egger analysis, and then heterogeneity tests were conducted. ResultsIn the MR analysis, genetically predicted GERD was associated with a greater risk of OSA (IVW: OR=1.528, 95%CI 1.374 to 1.699, P=5.315E?15). Additional MR results were consistent with the IVW results, and no pleiotropy or heterogeneity was found. We also discovered a significant causal relationship between GRED and snoring (IVW: OR=0.959, 95%CI 0.949 to 0.969, P=1.507E?15), and daytime sleepiness (IVW: OR=1.024, 95%CI 1.021 to 1.036, P=4.580E?5), with no evidence of pleiotropy. ConclusionThe MR study supports a causal effect between GERD and OSA with its typical symptoms (daytime sleepiness and snoring).
