spectrophotometry

分光光度法
  • 文章类型: Journal Article
    背景:评估染色饮料对树脂浸润的人工白斑病变(WSLs)颜色变化的影响。
    方法:通过pH循环在扁平牛牙标本上创建了35个人造WSL。WSL用树脂渗透处理,并根据染色饮料分为五组:人工唾液,咖啡,葡萄酒,绿茶,还有可口可乐.使这些样本暴露于相应的饮料28天。使用分光光度计在不同时间点评估颜色稳定性:基线,暴露7、14、21和28天后,和重新抛光。计算每个时间点与基线之间的色差(ΔE)。使用双向测量ANOVA进行统计学分析,显著性水平为p=0.05。
    结果:所有暴露于染色饮料7天的树脂浸润标本比暴露于人工唾液的标本表现出更明显的颜色变化。颜色变化模式基于饮料的类型而变化。随着长时间沉浸在葡萄酒和可口可乐集团中,颜色的变化加剧了,而在咖啡和绿茶组中浸泡28天后,标本的颜色没有显着差异。然而,用浮石粉清洗后,与浸泡28天后观察到的颜色变化相比,所有标本均显示出明显减少的颜色变化,除了那些沉浸在咖啡中的人。
    结论:将树脂浸润的牛牙样本暴露于染色的饮料会随着浸泡时间的增加而导致明显的颜色改变。然而,通过用浮石粉清洗可以将染色效果降至最低,除了咖啡集团。
    结论:树脂渗透处理后,应建议患者尽量减少有色饮料的消费,以防止可能影响美学外观的染色。
    BACKGROUND: To evaluate the effect of staining beverages on the color-changing of resin-infiltrated artificial white spot lesions (WSLs).
    METHODS: Thirty-five artificial WSLs were created by pH cycling on flat bovine teeth specimens. The WSLs were treated with resin infiltration and were divided into five groups based on staining beverages: artificial saliva, coffee, wine, green tea, and Coca-Cola. These specimens were subjected to a 28-day exposure to the respective beverages. Color stability was assessed using a spectrophotometer at different time points: baseline, after 7, 14, 21, and 28 days of exposure, and repolishing. The color difference (∆E) between each time point and the baseline was calculated. Statistical analysis was performed using two-way measures ANOVA with a significance level of p = 0.05.
    RESULTS: All resin-infiltrated specimens exposed to staining beverages for 7 days exhibited more significant color changes than those exposed to artificial saliva. The color change patterns varied based on the type of beverage. The color alterations intensified with extended immersion in the wine and Coca-Cola groups, while there were no significant differences in the color of specimens after 28 days of immersion in the coffee and green tea groups. However, after cleaning with pumice powder, all specimens showed significantly reduced color changes compared to those observed after 28 days of immersion, except those immersed in coffee.
    CONCLUSIONS: Exposure of resin-infiltrated bovine tooth specimens to staining beverages resulted in a significant color alteration as the immersion time increased. However, the staining effect could be minimized by cleaning with pumice powder, except for the coffee group.
    CONCLUSIONS: After resin infiltration treatment, patients should be advised to minimize the consumption of colored beverages to prevent staining that could impact esthetic appearance.
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  • 文章类型: Journal Article
    食品污染物对食品生产者和消费者构成了挑战。由于其在加热和储存过程中自发形成,羟甲基糠醛(HMF)是富含碳水化合物和蛋白质的食品中普遍存在的污染物。比色法测定,比如Seliwanoff测试,为HMF定量提供快速且经济有效的方法,但需要仔细优化以确保准确性。我们通过系统地评估参数,如孵育时间,温度,和间苯二酚或盐酸浓度,以及干扰碳水化合物的存在。使用UV-Vis分光光度计在扫描模式下分析样品,并使用HPLC验证获得的数据,这也使得未反应的HMF能够定量以评估方案的准确性。孵育时间和盐酸百分比对比色测定有积极影响,随着间苯二酚浓度的增加,观察到相反的效果。通过降低工作试剂中的酸含量来消除碳水化合物的干扰。HPLC分析证实了分光光度计数据,并证实了所提出方法的有效性。香醋样品中的平均HMF含量为1.97±0.94mg/mL。分光光度法证明可以有效地确定复杂食品基质中的HMF。在香脂醋中检测到的HMF水平明显超过了为蜂蜜建立的最大限度。这一发现强调了迫切需要限制各种食品中污染物水平的法规。
    Foods contaminants pose a challenge for food producers and consumers. Due to its spontaneous formation during heating and storage, hydroxymethylfurfural (HMF) is a prevalent contaminant in foods rich in carbohydrates and proteins. Colorimetric assays, such as the Seliwanoff test, offer a rapid and cost-effective method for HMF quantification but require careful optimization to ensure accuracy. We addressed potential interference in the Seliwanoff assay by systematically evaluating parameters like incubation time, temperature, and resorcinol or hydrochloric acid concentration, as well as the presence of interfering carbohydrates. Samples were analyzed using a UV-Vis spectrophotometer in scan mode, and data obtained were validated using HPLC, which also enabled quantification of unreacted HMF for assessing the protocol\'s accuracy. Incubation time and hydrochloric acid percentage positively influenced the colorimetric assay, while the opposite effect was observed with the increase in resorcinol concentration. Interference from carbohydrates was eliminated by reducing the acid content in the working reagent. HPLC analyses corroborated the spectrophotometer data and confirmed the efficacy of the proposed method. The average HMF content in balsamic vinegar samples was 1.97 ± 0.94 mg/mL. Spectrophotometric approaches demonstrated to efficiently determine HMF in complex food matrices. The HMF levels detected in balsamic vinegars significantly exceeded the maximum limits established for honey. This finding underscores the urgent need for regulations that restrict contaminant levels in various food products.
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  • 文章类型: Journal Article
    叶绿素荧光是一种行之有效的估算叶片叶绿素含量的方法。一种流行的基于荧光的仪表,Opti-SciencesCCM-300叶绿素含量仪(CCM-300),利用荧光比F735/F700和使用阔叶物种的实验得出的方程,用于许多应用的叶绿素含量的快速估计。我们试图量化CCM-300相对于更密集的方法的性能,跨植物功能类型和使用年限。我们联系了CCM-300阔叶的测量,针叶树,并在2018年和2019年对同一片叶子进行高效液相色谱(HPLC)和/或分光光度(Spec)分析。我们观察到CCM-300和HPLC/Spec之间存在显着差异,但不在HPLC和Spec之间。与HPLC相比,CCM-300在阔叶(r=0.55,RMSE=154.76)中的表现优于针叶树(r=0.52,RMSE=171.16)和类是(r=0.32,RMSE=127.12)。我们观察到仪表性能在几年之间略有下降,可能是由于仪表校准。我们的结果表明,CCM-300可以可靠地证明叶绿素的粗略变化,但可能仅限于跨植物功能类型研究和跨年比较。
    Chlorophyll fluorescence is a well-established method to estimate chlorophyll content in leaves. A popular fluorescence-based meter, the Opti-Sciences CCM-300 Chlorophyll Content Meter (CCM-300), utilizes the fluorescence ratio F735/F700 and equations derived from experiments using broadleaf species to provide a direct, rapid estimate of chlorophyll content used for many applications. We sought to quantify the performance of the CCM-300 relative to more intensive methods, both across plant functional types and years of use. We linked CCM-300 measurements of broadleaf, conifer, and graminoid samples in 2018 and 2019 to high-performance liquid chromatography (HPLC) and/or spectrophotometric (Spec) analysis of the same leaves. We observed a significant difference between the CCM-300 and HPLC/Spec, but not between HPLC and Spec. In comparison to HPLC, the CCM-300 performed better for broadleaves (r = 0.55, RMSE = 154.76) than conifers (r = 0.52, RMSE = 171.16) and graminoids (r = 0.32, RMSE = 127.12). We observed a slight deterioration in meter performance between years, potentially due to meter calibration. Our results show that the CCM-300 is reliable to demonstrate coarse variations in chlorophyll but may be limited for cross-plant functional type studies and comparisons across years.
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    文章类型: Journal Article
    目的:本研究的目的是评估,在体外,三种批量填充复合树脂的颜色稳定性和漂白响应-Activa™,Tetric®-N-Ceram散装填料,和Filtek™一种散装填充和一种常规复合树脂,Filtek™Z250,浸泡在通常消耗的碳酸饮料中,随后用15%过氧化脲进行家庭漂白。方法:将96个样品(2毫米和4毫米厚)的材料浸入麦芽饮料中,能量饮料,可乐,或一天的蒸馏水,一个星期,还有两个月.两个月后,样品用15%过氧化脲凝胶进行家庭漂白。分光光度分析测得的颜色和白度变化,浸泡后,和漂白后。使用因子混合方差分析(ANOVA)确定统计显著性,三因素方差分析,和Bonferroni事后检验(P<0.05)。结果:所有测试的复合树脂在碳酸饮料中两个月后表现出不可接受的变色(颜色变化大于3.3)。Filtek™OneBulk-Fill和Filtek™Z250显示出最显著的变色,特别是浸入麦芽饮料时(P<0.05)。相比之下,Activa™样品在麦芽和可乐饮料中仅一周内达到不可接受的变色。家庭漂白产生有限的白度恢复,用可乐和能量饮料染色后,Activa™在漂白后呈现可接受的白度。结论:这项研究强调了长时间消耗碳酸饮料的美学风险以及使用15%过氧化脲的评估家庭漂白技术的局限性。这些发现表明,增强了牙科教育对某些饮料对修复材料的饮食影响。
    Purpose: The purpose of this study was to assess, in vitro, the color stability and bleaching response of three bulk-fill composite resins-Activa™, Tetric®-N-Ceram Bulk-Fill, and Filtek™ One Bulk-Fill???and one conventional composite resin, Filtek™ Z250, after immersion in commonly consumed carbonated beverages and subsequent home bleaching with 15 percent carbamide peroxide. Methods: Ninety-six samples (two- and four-mm thick) of the materials were immersed in malt drink, energy drink, cola, or distilled water for one day, one week, and two months. After two months, samples underwent home bleaching with 15 percent carbamide peroxide gel. Spectrophotometric analysis measured color and whiteness changes pre-immersion, post-immersion, and post-bleaching. Statistical significance was determined using factorial mixed analysis of variance (ANOVA), three-way ANOVA, and Bonferroni post hoc tests (P<0.05). Results: All tested composite resins exhibited unacceptable discoloration (color change greater than 3.3) after two months in carbonated beverages. Filtek™ One Bulk-Fill and Filtek™ Z250 displayed the most significant discoloration, particularly when immersed in the malt drink (P<0.05). In contrast, Activa™ samples reached unacceptable discoloration within just one week in malt and cola drinks. Home bleaching yielded limited whiteness recovery, with Activa™ presenting acceptable whiteness post-bleaching after staining with cola and energy drinks. Conclusions: This study highlights the aesthetic risks of prolonged carbonated beverage consumption and the limitations of the assessed home bleaching technique using 15 percent carbamide peroxide. Enhanced dental education on the dietary effects of some beverages on restorative materials is indicated by these findings.
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  • 文章类型: Journal Article
    目的:为了研究不同表面处理和厚度对颜色的影响,透明度,和超透明氧化锆的表面粗糙度。
    方法:根据厚度(0.3、0.5和0.7mm)和表面处理(对照,空气中的颗粒磨损[APA],二硅酸锂涂层,和釉上)。使用数字分光光度计计算色差(ΔE00)和相对半透明参数(RTP00)。表面粗糙度(Ra,Rq,Sa,和Sq)使用非接触式轮廓扫描仪测量。使用钨丝扫描电子显微镜观察了样品的表面形貌和微观结构。通过单向和双向方差分析(ANOVA)进行统计分析,然后进行事后多重比较和Pearson相关性(α=0.05)。
    结果:结果表明,表面处理,陶瓷厚度,它们的相互作用对ΔE00和RTP00有显著影响(p<0.001)。表面处理显着改变了陶瓷样品的微观形态并增加了表面粗糙度。APA表现出最低的透明度,最大色差,和最高的表面粗糙度。厚度为0.3mm和0.7mm的氧化锆在Sa和RTP00之间显示出强的负相关。
    结论:三种内表面处理显著改变了表面粗糙度,色差,和超透明氧化锆的透明度。随着厚度的增加,内表面处理对氧化锆的色差和透明度的影响降低。
    结论:对于新的氧化锆内表面处理技术,除了考虑对粘结性能的增强作用外,还应考虑对高透明度氧化锆的颜色和半透明性的潜在影响。适当增加氧化锆修复体的厚度有助于最小化表面处理对光学性质的影响。
    OBJECTIVE: To investigate the effects of different surface treatments and thicknesses on the color, transparency, and surface roughness of ultra-transparent zirconia.
    METHODS: A total of 120 Katana ultra-translucent multi-layered zirconia specimens were divided into 12 groups according to the thickness (0.3, 0.5, and 0.7 mm) and surface treatment (control, airborne particle abrasion [APA], lithium disilicate coating, and glaze on). Color difference (ΔE00) and relative translucency parameter (RTP00) were calculated using a digital spectrophotometer. The surface roughness (Ra, Rq, Sa, and Sq) was measured using a non-contact profile scanner. The surface morphologies and microstructures of the samples were observed using a tungsten filament scanning electron microscope. Statistical analyses were performed by one-way and two-way analysis of variance (ANOVA) followed by post hoc multiple comparisons and Pearson\'s correlation (α = 0.05).
    RESULTS: The results showed that the surface treatment, ceramic thickness, and their interactions had significant effects on ΔE00 and RTP00 (p < 0.001). The surface treatment significantly altered the micromorphology and increased the surface roughness of the ceramic samples. APA exhibited the lowest transparency, largest color difference, and highest surface roughness. Zirconia with 0.3 mm and 0.7 mm thicknesses showed strong negative correlations between Sa and RTP00.
    CONCLUSIONS: The three internal surface treatments significantly altered the surface roughness, color difference, and transparency of ultra-transparent zirconia. As the thickness increased, the influence of the inner surface treatment on the color difference and transparency of zirconia decreased.
    CONCLUSIONS: For new zirconia internal surface treatment technologies, in addition to considering the enhancement effect on the bonding properties, the potential effects on the color and translucency of high-transparency zirconia should also be considered. Appropriately increasing the thickness of zirconia restorations helps minimize the effect of surface treatment on the optical properties.
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  • 文章类型: Journal Article
    背景:患者倾向于使用美白漱口水,因为它们易于使用且价格合理。这项研究旨在评估过氧化氢与木炭基美白漱口水对颜色的影响,表面粗糙度,和搪瓷的颜色稳定性。在目前的研究中,由于其白色密封技术,使用的美白漱口水能够阻止未来的污渍。
    方法:本研究共使用21颗因牙周原因而拔除的中切牙。将牙根切片,并将牙冠安装在自固化的丙烯酸树脂块中。根据测试的美白漱口水将标本随机分为三组(n=7):对照组“DW”(蒸馏水),“OW”组:基于过氧化物的漱口水(高露洁光学白)和“CP”组:基于木炭的漱口水(高露洁®Plax木炭)。关于“OW”和“CP”组,将样本浸入每个相应组的20ml测试漱口水中1分钟,每天两次(早晨和晚上),共12周不间断。使用VITAEasyshade分光光度计评估颜色变化,并且使用白光干涉仪测量表面粗糙度(Ra)。使用红茶溶液对样品进行染色,并在浸渍24小时后测量颜色以评估颜色稳定性。
    结果:颜色变化结果表明,两种美白漱口水都能够恢复与对照组相当的颜色,两者之间没有显着差异。关于表面粗糙度,对照组表现出最高的平均Ra值,其次是“OW”组,而“CP”组显示最低的平均Ra值。虽然染色后颜色稳定,对照组显示的值明显高于“CP”和“OW”组。
    结论:过氧化氢和基于木炭的美白漱口水改善了牙釉质的颜色,对表面粗糙度没有不利影响。两种美白漱口水都有利于保持染色后的颜色并防止将来的牙釉质污渍。
    BACKGROUND: Patients tend to favor the whitening mouthwashes as they are easily applied and affordable. This study aimed to evaluate the effect of hydrogen peroxide versus charcoal-based whitening mouthwashes on color, surface roughness, and color stability of enamel. In the current study, the whitening mouthwashes used have the ability to stop future stains due to their white seal technology.
    METHODS: A total of 21 permanent central incisor teeth extracted for periodontal reasons were used in the present study. Teeth roots were sectioned and crowns were mounted in self-cured acrylic resin blocks. The specimens were randomly divided into three groups (n = 7) according to the tested whitening mouthwash: Control group ‟ DW\" (Distilled water), ‟OW\" group: Peroxide-based mouthwash (Colgate Optic White) and ‟CP\" group: Charcoal-based mouthwash (Colgate® Plax Charcoal). Regarding ‟OW\" and ‟CP\" groups, the specimens were immersed in 20 ml of the tested mouthwash in each corresponding group for 1 min twice daily (morning and evening) for a total of 12 uninterrupted weeks. Color change was assessed using VITA Easyshade spectrophotometer and surface roughness (Ra) was measured using a white light interferometer. The specimens were stained using black tea solution and color was measured after 24 h of immersion for assessment of color stability.
    RESULTS: Color change results revealed that both whitening mouthwashes were able to restore color comparable to the control group with no significant difference between them. Regarding surface roughness, the control group showed the highest mean Ra value, followed by ‟OW\" group while ‟CP\" group showed the lowest mean Ra value. While color stability after staining, the control group showed a significantly higher value than the ‟CP\" and ‟OW\" groups.
    CONCLUSIONS: Hydrogen peroxide and charcoal-based whitening mouthwashes improve the color of enamel with no adverse effect on the surface roughness. Both whitening mouthwashes were beneficial to maintain the color after staining and prevent future enamel stains.
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  • 文章类型: Journal Article
    通过MTT测定对细胞代谢活性进行定量已经成为真核细胞研究中的广泛实践,并且正在逐步扩展到细菌细胞研究。这项研究开创了MTT测定法在评估纳米纤维材料上细菌生物膜内生物膜形成细胞的代谢活性的应用。聚己内酯(PCL)静电纺丝纳米材料对金黄色葡萄球菌和大肠杆菌生物膜的形成,聚乳酸(PLA),并检查聚酰胺(PA)。系统研究了MTT测定的各种参数,包括(i)形成的甲的溶解时间,(ii)添加葡萄糖,和(iii)分光光度测定的最佳波长。根据中期调查结果,设计了一种适用于纳米纤维材料的精细协议。我们建议2小时的溶解,葡萄糖的应用,并在595nm处进行分光光度测量以获得可靠的数据。与参考CFU计数方案的比较分析揭示了测试的细菌和所有测试的纳米材料的相似趋势。提出的MTT方案是评估PCL上细菌生物膜代谢活性的合适方法,PLA,和PA纳米纤维材料。
    The quantification of cellular metabolic activity via MTT assay has become a widespread practice in eukaryotic cell studies and is progressively extending to bacterial cell investigations. This study pioneers the application of MTT assay to evaluate the metabolic activity of biofilm-forming cells within bacterial biofilms on nanofibrous materials. The biofilm formation of Staphylococcus aureus and Escherichia coli on nanomaterials electrospun from polycaprolactone (PCL), polylactic acid (PLA), and polyamide (PA) was examined. Various parameters of the MTT assay were systematically investigated, including (i) the dissolution time of the formed formazan, (ii) the addition of glucose, and (iii) the optimal wavelength for spectrophotometric determination. Based on interim findings, a refined protocol suitable for application to nanofibrous materials was devised. We recommend 2 h of the dissolution, the application of glucose, and spectrophotometric measurement at 595 nm to obtain reliable data. Comparative analysis with the reference CFU counting protocol revealed similar trends for both tested bacteria and all tested nanomaterials. The proposed MTT protocol emerges as a suitable method for assessing the metabolic activity of bacterial biofilms on PCL, PLA, and PA nanofibrous materials.
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  • 文章类型: Journal Article
    提出了通过与考马斯亮蓝G(CBBG)反应智能比色测定氯化十六烷基吡啶和十二烷基硫酸钠的条件。已研究了CBBG水溶液的吸收和荧光光谱随酸度的变化。已经证明了多种试剂形式和与离子表面活性剂的缔合。已经建立了CBBG-阳离子表面活性剂体系中形成的缔合物的组成。已证明在非离子表面活性剂TritonX-100的有组织介质中的反应过程中,阳离子表面活性剂的分析信号增加,系统的胶体化学状态稳定。这些作用是通过在前胶束溶液中缔合以及在TritonX-100胶束溶液中溶解成分而实现的。向试剂中添加长链阳离子表面活性剂是在取代杂原子质子的情况下发生的。CBBG-阳离子表面活性剂缔合溶液的吸收随着阳离子表面活性剂烃链的长度而增加。乙醇添加剂降低了CBBG的聚集。阳离子表面活性剂测定技术已在药物分析中进行了测试。结果表明,分析信号配准的简单性以及令人满意的正确性和可接受的高灵敏度是所开发技术的优势。
    The conditions for the smart colorimetric determination of cetylpyridinium chloride and sodium dodecyl sulfate by reaction with Coomassie brilliant blue G (CBBG) have been proposed. The nature of the absorption and fluorescence spectra of aqueous solutions of CBBG as a function of acidity has been investigated. A variety of reagent forms and associations with ionic surfactants have been demonstrated. The composition of the associates formed in the CBBG-cationic surfactant system has been established. The increase in the analytical signal of the cationic surfactant and the stabilization of the colloid-chemical state of the system during reactions in the organized medium of the nonionic surfactant Triton X-100 has been demonstrated. These effects are realized through association in premicellar solutions and as a result of the solubilization of components in Triton X-100 micellar solutions. The addition of long-chain cationic surfactants to the reagent occurs with the replacement of the heteroatom proton. The absorption of CBBG-cationic surfactant associates solutions increases with the length of the cationic surfactant hydrocarbon chain. Ethanol additives decrease the aggregation of CBBG. The technique of cationic surfactant determination has been tested in the analysis of the pharmaceutical. The results show that the simplicity of analytical signal registration with satisfactory correctness and acceptably high sensitivity of determination is an advantage of the developed technique.
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  • DOI:
    文章类型: Journal Article
    目的:本研究的目的是研究不同牙组的解剖特征与过氧化氢(H2O2)的扩散和漂白作用之间的关系。
    方法:使用来自五名患者的计算机断层扫描(CT)图像来评估四个牙齿组的硬组织厚度和牙髓体积(PV):下(下颌)切牙(LI),上颌切牙(UI),犬科动物(C),和前磨牙(PM)。此外,将80个牛齿盘分成四组(n=20)以匹配所研究的每个牙齿组的厚度。所有样品都暴露于35%H2O2漂白凝胶中,在第一次期间施加50微升45分钟,第二,和第三次会议。使用过氧化物酶酶法评估扩散。颜色变化分析(ΔE,ΔE00和ΔWID)在三个施用阶段后和漂白处理后7天使用分光光度计进行。
    结果:PM组显示更大的厚度和PV,其次是C,UI,和LI组(P<0.001)。与PM组相比,LI组的H2O2扩散增加了6倍(P0.001),而PM组的PV比LI组大9倍。此外,LI和UI组比C和PM组少一个会话实现了色彩饱和度。
    结论:特定牙齿组具有解剖学特征,在H2O2的扩散和增白作用方面会干扰漂白治疗。此外,H2O2的扩散能力与牙组厚度成反比。
    The objective of the present study was to investigate the association between the anatomical characteristics of different tooth groups and the diffusion and bleaching effect of hydrogen peroxide (H2O2).
    Computed tomography (CT) images from five patients were used to assess the hard tissue thickness and pulp volume (PV) of four tooth groups: lower (mandibular) incisors (LI), upper (maxillary) incisors (UI), canines (C), and premolars (PM). Additionally, 80 bovine tooth disks were divided into four groups (n = 20) to match the thickness of each tooth group studied. All the specimens were exposed to a 35% H2O2 bleaching gel, with 50 µL applied for 45 min during the first, second, and third sessions. Diffusion was evaluated using the peroxidase enzyme method. Color change analyses (∆E, ∆E00, and ∆WID) were performed after the three application sessions and 7 days after the bleaching treatment using a spectrophotometer.
    The PM group showed greater thickness and PV, followed by the C, UI, and LI groups (P 0.001). The LI group had six times greater H2O2 diffusion compared with the PM group (P 0.001), while the PM group exhibited a PV nine times larger than the LI group. Furthermore, the LI and UI groups achieved color saturation with one fewer session than the C and PM groups.
    Specific tooth groups have anatomical characteristics that interfere with bleaching treatment in terms of the diffusion and whitening effect of H2O2. Furthermore, the diffusion capacity of H2O2 was inversely proportional to the thickness of the tooth groups.
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  • 文章类型: Journal Article
    目的:关于是否常规使用分光光度法检测脑脊液(CSF)中的黄色症或目视检查是否足够,仍存在分歧。我们旨在评估这些方法在检测突发性严重头痛患者的动脉瘤性蛛网膜下腔出血中的诊断准确性。
    背景:当患者出现怀疑蛛网膜下腔出血的头痛时,排除这一点的金标准是,如果入院时的头颅非对比计算机断层扫描(CT)检查结果为阴性,则在有或没有分光光度法的情况下对黄色症进行CSF分析.
    方法:应用黄金标准后,我们回顾性纳入了2002-2020年期间在我院接受了CT扫描和CSF分光光度法测定的急性头痛患者.如果头颅CT被解释为阳性,则排除患者,有血淋淋的脑脊液,或无法获得CSF的视觉评估数据。我们仔细检查了患者的病历,并评估了分光光度法与目视检查相比的益处。支持蛛网膜下腔出血的净胆红素吸光度截止值设定为>0.007吸光度单位。如果净胆红素吸光度≤0.007并且净氧合血红蛋白吸光度≥0.1吸光度单位,则分光光度法也被认为是阳性。我们计算并比较了CSF分光光度法和目视检查CSF的敏感性和特异性。
    结果:总计,769名患者,平均年龄为42.3±(标准偏差[SD]=17.3)岁,包括在内。41.5%的头痛发作被归类为雷击性头痛,4.7%的人突然失去知觉。15例患者(2%)最终被诊断为蛛网膜下腔出血,6人(0.8%)有动脉瘤性蛛网膜下腔出血,7人(0.9%)有中脑周围出血,一个(0.1%)有皮质脑静脉窦血栓形成,1人(0.1%)有脊髓硬膜外血肿。4例(0.5%)蛛网膜下腔出血,目测未检出,两个是动脉瘤破裂引起的.这两名患者中有一人在干预前死亡,另一个接受了前交通动脉瘤的盘绕。腰椎穿刺检测蛛网膜下腔出血所需的数量为51,但检测动脉瘤出血所需的数量为128。CSF分光光度分析所需的相应数字分别为192和385。31例患者(4.0%)分光光度法阳性,其中18人(2.3%)也目测黄色症(11人真阳性)。在视觉上清晰的CSF的13个样品中,平均净胆红素吸光度为0.0111±(SD=0.0103)吸光度单位,用阴性分光光度法与脑脊液中的0.0017±(SD=0.0013)进行比较。相应的氧合血红蛋白净吸光度为0.0391±(SD=0.0522)对0.0057±(SD=0.0081)。分光光度黄色症检测的灵敏度为100%(95%置信区间[CI],78-100),相比之下,视觉黄色症检测为73%(95%CI,45-92)。分光光度黄色症检测的特异性为98%(95%CI,97-99),而视觉黄色症检测的特异性为99%(95%CI,98-100)。两种方法均具有较高的阴性预测值:100%(95%CI,99.5-100)与99.5%(95%CI,98.6-99.9),分别。
    结论:目测和分光光度法对脑脊液黄色症的检测都有很高的诊断准确性,但是较低的视觉评估灵敏度使其不可靠,我们建议在临床实践中使用分光光度法。
    OBJECTIVE: There is still disagreement about whether to routinely use spectrophotometry to detect xanthochromia in cerebrospinal fluid (CSF) or whether visual inspection is adequate. We aimed to evaluate the diagnostic accuracy of these methods in detecting an aneurysmal subarachnoid hemorrhage in patients with sudden onset severe headache.
    BACKGROUND: When a patient presents to the emergency department with a headache for which there is suspicion of a subarachnoid hemorrhage, the gold standard to rule this out is to perform a CSF analysis for xanthochromia with or without spectrophotometry if the cranial non-contrast computed tomography (CT) upon admission is negative.
    METHODS: Having applied the gold standard, we retrospectively included patients with acute headache who underwent both CT scan and CSF spectrophotometry at our hospital in the period 2002-2020. Patients were excluded if the cranial CT was interpreted as positive, there was a bloody CSF, or if visual assessment data of the CSF was unavailable. We scrutinized the patients\' medical records and evaluated the benefit of spectrophotometry compared to visual inspection. The net bilirubin absorbance cut-off for support of subarachnoid hemorrhage was set at >0.007 absorbance units. The spectrophotometry was also considered positive if the net bilirubin absorbance was ≤0.007 and net oxyhemoglobin absorbance was ≥0.1 absorbance units. We calculated and compared the sensitivity and specificity of CSF spectrophotometry and visual inspection of the CSF.
    RESULTS: In total, 769 patients, with a mean age of 42.3 ± (standard deviation [SD] = 17.3) years, were included. The headache onset was classified as a thunderclap headache in 41.5%, and 4.7% had a sudden loss of consciousness. Fifteen patients (2%) were finally diagnosed with a subarachnoid hemorrhage, six (0.8%) had an aneurysmal subarachnoid hemorrhage, seven (0.9%) had a perimesencephalic hemorrhage, one (0.1%) had a cortical cerebral sinus venous thrombosis, and one (0.1%) had a spinal epidural hematoma. Four patients (0.5%) had a subarachnoid hemorrhage that was not detected by visual inspection, and two were caused by an aneurysmal rupture. One of these two patients died just before intervention, and the other underwent coiling for an anterior communicating aneurysm. The number needed for lumbar puncture to detect a subarachnoid hemorrhage was 51, but 128 to detect an aneurysmal hemorrhage. The corresponding numbers needed for CSF spectrophotometric analysis were 192 and 385, respectively. Spectrophotometry was positive in 31 patients (4.0%), of whom 18 (2.3%) also had visually detected xanthochromia (11 true positive). The mean net bilirubin absorbance in the 13 samples with visually clear CSF was 0.0111 ± (SD = 0.0103) absorbance units, compared to 0.0017 ± (SD = 0.0013) in the CSF with negative spectrophotometry. The corresponding figures for net oxyhemoglobin absorbance were 0.0391 ± (SD = 0.0522) versus 0.0057 ± (SD = 0.0081). The sensitivity of spectrophotometric xanthochromia detection was 100% (95% confidence interval [CI], 78-100), compared to 73% (95% CI, 45-92) for visual xanthochromia detection. The specificity of spectrophotometric xanthochromia detection was 98% (95% CI, 97-99) compared to 99% (95% CI, 98-100) for visual xanthochromia detection. Both methods had high negative predictive values: 100% (95% CI, 99.5-100) versus 99.5% (95% CI, 98.6-99.9), respectively.
    CONCLUSIONS: Both visual inspection and spectrophotometry have high diagnostic accuracy for detecting CSF xanthochromia, but the lower sensitivity of visual assessment makes it unreliable, and we recommend the use of spectrophotometry in clinical practice.
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