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Objective:To evaluate the medium and long term clinical effect of three bone graft materials on periodontitis after periodontal regeneration.Methods:Initially, 16 patients with periodontitis after periodontal regeneration in Tianjin Stomatological Hospital from July 2017 to November 2018 were divided into three groups: Bio-Oss ( n=6), Bio-Gene ( n=5) and Bone 3(n=5) according to the differences in bone materials. Clinical and radiological results were evaluated at pre-surgery, post-6 months, and post-4 years. Results:The 6-month and 4-year clinical follow-up showed that, the depth of exploration (PD) and clinical attachment loss (CAL) of patients in the three groups were lower than those before operation (all P<0.05), and the changes of PD (ΔPD) and CAL (ΔCAL) were not statistically significant (all P>0.05). There was no statistically significant difference in gingival recession (GR) between the three groups (all P>0.05), and there was no statistically significant difference in the change of GR (ΔGR) between the groups (all P>0.05). From 6 months to 4 years after operation, there was no significant difference among ΔGR, ΔPD and ΔCAL groups (all P>0.05). At 6 months and 4 years after operation, the residual alveolar bone height (RBH%) of the three groups was significantly higher than that before operation (all P<0.05), and there was no significant difference between the two groups (all P>0.05); From 6 months to 4 years after operation, there was no significant difference in RBH% between the groups (all P>0.05). Conclusions:Three kinds of bone graft materials have significant clinical effects on periodontitis after periodontal regeneration, which can provide a reference for the selection of clinical regeneration materials.
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OBJECTIVE To provide reference for improving the professional identity of clinical pharmacists and the quality of pharmaceutical care ，and promoting the effects of clinical pharmaceutical intervention. METHODS A questionnaire survey was conducted among clinical pharmacists in secondary and tertiary hospitals in 31 provinces（autonomous regions and municipalities ） in 2019 by stratified semi-random sampling. Through descriptive analysis of survey data ，their job satisfaction status was evaluated ； χ 2 test and Logistic regression analysis were used to analyze the influential factors of job satisfaction ；the robustness test of study results by propensity score matching method and replacement regression model ，and grouping Logistic regression of samples from hospital on different levels. Targeted improvement measures were put forward according to the results of survey . RESULTS There was statistical significance in the difference of job satisfaction among pharmacists of different professional titles （P＜0.05）. Results of Logistic regression showed that whether to participate in standardized training ，whether to obtain communication and support from patients ，whether the pharmaceutical management rules and regulations were sound ，whether to set up economic compensation means such as pharmaceutical service fee ，whether to work overload ，and whether to smoothly perform pharmaceutical care duties were significant influential factors for job satisfaction of clinical pharmacists （P＜0.05）. These results showed good robustness as tested by propensity score matching method and replacement regression model. Heterogeneity analysis results showed that the job satisfaction of clinical pharmacists in tertiary hospitals was more significantly affected by economic compensation ，while clinical pharmacists in secondary hospitals were more concerned about training opportunities and workload conditions （P＜0.05）. CONCLUSIONS The job satisfaction level of Chinese clinical pharmacists remains to be improved. Accordingly ，it is compulsory to continue the promotion of standardized training courses ，consummate the pharmaceutical management system ，and fair remuneration structure in order to improve the job satisfaction of clinical pharmacists and build a high-level clinical pharmacist team.
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Objective:To explore any correlation between knee muscle strength and walking ability after an incomplete lumbar spinal cord injury and the factors influencing walking ability.Methods:Twenty-seven persons with an incomplete lumbar spinal cord injury were tested. Their bilateral quadriceps and hamstring muscle strength and peak torque during knee extension and flexion were assessed. They completed the 10m walking time test (10MWT) and each person′s WWISCI II spinal cord injury walking index was evaluated. Spearman correlations among the data were computed and stepwise regression was used to analyze the factors significantly influencing the 10MWT and WISCI II results.Results:The average hamstring strength was significantly negatively correlated with the 10MWT times and WISCI II ratings. Hamstring torque also was negatively correlated with the 10MWT times, but positively correlated with the WISCI II ratings. The 10MWT times and WISCI II ratings were significantly inter-correlated. Hamstring strength was the best predictor of 10MWT times (accounting for 63% of the variance) and WISCI II ratings (64%), but quadriceps strength was also a secondary predictor.Conclusions:Knee muscle strength is a useful predictor of 10MWT times and WISCI II ratings after incomplete lumbar spinal cord injury. It can predict early walking ability to some extent.
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Objective:To investigate the relationship between interleukin-35 (IL-35) level in peripheral blood and disease progression and prognosis in newly diagnosed esophageal cancer (EC) patients.Methods:68 newly diagnosed EC patients treated in the People′s Hospital Affiliated to Ningbo University from June 2014 to December 2019 were selected as the observation group and 36 healthy volunteers as the control group. Peripheral blood was collected. The levels of IL-35 were detected by enzyme-linked immunosorbent assay (ELISA). P35 and EBI3 mRNA were detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR); the relationship between IL-35 and clinicopathological features and prognosis of newly diagnosed EC patients was analyzed.Results:The levels of IL-35 [(104.46±34.78)pg/ml vs (36.35±16.34)pg/ml], P35 mRNA [(43.79±7.28) vs (20.62±6.76)] and EBI3 mRNA [(18.68±3.86) vs (7.76±2.83)] in newly diagnosed EC patients were significantly higher than those in the control group (all P values <0.05). The level of IL-35 in tumor node metastasis (TNM) stage Ⅲ -Ⅳ patients was significantly higher than that in stage Ⅰ-Ⅱ patients [(115.85±28.85)pg/ml vs (96.19±36.27)pg/ml], with statistically significant difference ( t=2.479, P<0.05); The level of IL-35 in EC patients with lymph node metastasis was significantly higher than that in patients without lymph node metastasis [(119.83±29.74)pg/ml vs (92.23±33.65)pg/ml], and the difference was also statistically significant ( t=3.512, P<0.01); After radical esophagectomy, the level of IL-35 in 28 EC patients decreased significantly [(102.65±15.51)pg/ml vs (43.28±12.93)pg/ml; t=11.551, P<0.01]. The level of IL-35 in EC patients was negatively correlated with overall survival (OS) ( r=-0.45, P<0.01); the OS in EC patients with high level of IL-35 was significantly shorter than that in low level patients ( P<0.01). The results of univariate analysis showed that TNM staging, lymph node metastasis and IL-35 level were the unfavorable factors affecting the OS in EC patients ( P<0.01). Multivariate analysis showed that TNM staging, lymph node metastasis and IL-35 level were independent risk factors affecting OS in EC patients ( P<0.05). Conclusions:IL-35 is highly expressed in patients with EC, which closely related to disease stage and lymph node metastasis.
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Objective To compare the clinical effects of guided tissue regeneration (GTR) combined with different bone graft materials, including Bio-Gene, Bone3 and Bio-Oss, in the treatment of periodontal intra-bony defects. Methods Eighteen patients with chronic periodontitis with periodontal intra-bony defects were randomly divided into the Bio-Gene group, the Bone3 group and Bio-Oss group. After periodontal debridement, periodontal bone grafting combined with GTR surgery was performed in all patients. The clinical and radiographic parameters of patients were collected before surgery, suture removal (2 weeks after surgery), and 6 months after surgery, including periodontal exploration depth (PD), clinical attachment loss (CAL), gingival recession (GR), and residual alveolar bone height (RBH). Results The wounds healed well in all patients when the suture was removed. The stage Ⅰ healing was obtained without infection or wound dehiscence, and the postoperative discomfort was acceptable. At 6 months after periodontal bone grafting combined with GTR treatment, the PD and CAL indexes in the three groups were significantly improved compared with those before surgery (all P<0.05), and there was no significant difference in PD and CAL between the three groups (all P>0.05). Imaging results showed that new bone formation was observed in the original bone defect area in all three groups after 6 months of the treatment, the bone density was similar to the surrounding bone tissue. Besides, the RBH％increased significantly compared with that before the treatment (all P<0.05), and there was no significant difference in RBH％among the three groups (all P>0.05). Conclusions Bio-Gene, Bone3 and Bio-Oss are all reliable bone graft materials for the treatment of alveolar bone defects caused by periodontitis, which can significantly improve the osteogenesis effect.
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Objective To explore value of CT features in diagnosis of traumatic diaphragmatic rupture.Methods A retrospective analysis was performed on totally 256 patients with suspected traumatic diaphragmatic rupture,among them 128 were confirmed after surgery.All patients underwent CT scan before surgery.The prevalence of CT findings were recorded,including diaphragm discontinuity or segmental non-recognition of diaphragm," collar" sign," intrathoracic herniation of abdominal contents" sign," dependent viscera" sign," dangling diaphragm" sign and " thickness of the diaphragm" sign.The sensitivity and specificity of each sign were calculated.Results The sensitivity of diaphragm discontinuity or segmental non-recognition of diaphragm,"collar" sign,"intrathoracic herniation of abdominal contents" sign,"dependent viscera" sign,"dangling diaphragm" sign and "thickness of the diaphragm" sign of diaphragmatic rupture was 75.00％ (96/128),84.37％ (108/128),78.13％ (100/128),76.56％ (98/128),54.68％ (70/128) and 46.87％ (60/128),respectively.The specificity was 93.75％ (120/128),98.43％ (126/128),98.43％ (126/128),99.21％ (127/128),93.75％ (120/128) and 84.38％ (108/128),respectively.The sensitivity and specificity of overall MSCT signs was 92.18％ and 100％,respectively.Conclusion CT features have high value in diagnosis of traumatic diaphragmatic rupture.
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Objective To explore the application of MR diffusion weighted imaging (DWI)in the prognosis evaluation of liver cancer after treatment of transcatheter arterial chemoembolization(TACE).Methods Forty-five patients with primary hepatocellular carcinoma and treated with TACE were included in the study.Digital subtraction angiography(DSA)was used as the gold standard to evaluate the value of DWI in the prognosis evaluation.Results The average apparent diffusion coefficient (ADC)value of tumor necrosis tissue was (1.89±0.22)×10-3mm2/s,which was significantly different from that of tumor residual tissue of (1.39±0.27)×10-3mm2/s (P<0.05).Receiver operating characteristic curve showed that the sensitivity and specificity of diagnosing the necrotic tissue were 82.6% and 85.3% respectively with the ADC threshold of 1.68×10-3mm2/s.The sensitivity,specificity and positive likelihood ratio of traditional MRI enhancement were 86.9%,87.8% and 7.12,respectively.The sensitivity,specificity and positive likelihood ratio of MRI enhancement combined with DWI were 95.7%,82.9% and 5.59,respectively.Conclusion DWI can distinguish tumor necrosis from tumor residual in the prognosis evaluation of liver cancer treated with TACE.Traditional MRI enhancement combined with DWI are better in detecting tumor residual and recurrence of liver cancer treated with TACE.
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Objective To explore the effect of surface electromyographic biofeedback (SEMG-BFT) combined with electrical stimulation on the swallowing function of stroke survivors with dysphagia,and to evaluate the electromyographic activity of the submental muscles in swallowing various foods so as to provide a basis for future rehabilitation of such patients.Methods Sixty patients were randomly divided into a treatment group and a control group,each of 28.Both groups were given low-frequency electrical stimulation and conventional swallowing training.The treatment group was additionally provided with SEMG-BFT.Before the treatment as well as after 2 and 4 weeks of treatment,the swallowing function of both groups was evaluated using the Kubota drinking water test (KDWT) and a Gugging swallowing screen (GUSS).Surface electromyographs of the submental muscles were recorded during empty swallowing,swallowing 10 ml of dilute liquid and swallowing 10 ml of paste.Results After two and four weeks of treatment,the average KDWT and GUSS scores of both groups had improved significantly,but that of the treatment group was significantly higher than that of the control group at each time point.After 2 and 4 weeks of treatment,significant differences were found in swallowing duration and the average amplitude of the sEMGs compared with before the treatment in both groups.The difference between the groups was significant at each time point.Conclusions SEMG-BFT combined with electrical stimulation can significantly improve swallowing function.Paste food can be used safely in the early evaluation and treatment of swallowing dysfunction.
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Distal radius fractures often occur in the elderly.At present,there has not yet reached a consensus on how to take effective measures for the treatment of such fractures in clinical.There are many different therapeutic methods for this fracture with different effect.Based on the summary of the relevant literature,the epidemiological characteristics of fractures of the distal radius,treatment,implant selection,surgical procedure,complications and prevention were summarized,in order to provide references for clinical treatment.
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Objective To understand the relationship between the infants′iron-deficiency anemia and the dependents′KAP (knowledge,attitude,practice)of iron nutrition,and to provide a theoretical support for the prevention and cure of the infants′iron-eficiency anemia.Methods A total of 960 infants,aging from 6 months to 36 months,were randomly chosen as samples at the child care clinics in Wuhan while they were doing their routine health check-up there.Their hemoglobin was examined.Their dependents were asked to fill in questionnaires about KAP of iron nutrition.Results The ratio of anemia in infants in Wuhan is 26.6%.The ra-tio difference of different age groups has statistical significance(P <0.05).The dependents′KAP of iron nutrition is in direct pro-portion to their educational level and family income.The ratio of anemia in infants is in inverse proportion to their dependents′edu-cational level and family income.The dependents′knowledge,attitude and practice of iron-intake were positively related.The aver-age score of guardian nutrition knowledge(K)was (11.96±3.77)points,the average score of attitude(A)was (7.09±2.80)points while the average score of feeding practice(P)was (18.05±3.60)points.Conclusion Much publicity should be given to the knowl-edge of iron nutrition and it should be conducted from various perspectives,in order to improve the cognitive level of the depend-ents′knowledge of iron nutrition and to lower the ratio of anemia in infants.
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Objective To explore the effects of isokinetic training on muscle endurance and the ambulatory capacity of patients with incomplete lumbar spinal cord injury ( SCI ) . Methods Sixty patients were randomly divided into a control group and a treatment group, each of 30. Both groups were given conventional rehabilitation, while the treatment group was additionally provided with isokinetic muscle strength and muscle endurance training for 3 months. The endurance ratio ( RO) of the quadriceps and hamstrings, the mean power frequency of the rectus femo-ris (RF-MPF) and the biceps flexor cruris (BF-MPF), and distance covered in the 6-minute walk test (6MWT) were evaluated before and after the treatment. An index of functional community ambulation was also compared be-tween the 2 groups. Results After the treatment significant differences were observed in all of the measurements compared to before the treatment for both groups. The average RO improvement of the quadriceps and hamstrings, the BF-MPF, the RF-MPF and the 6MWT distance of the treatment group were all significantly higher compared with the control group. After the treatment, 25 patients of the treatment group could demonstrate functional community ambula-tion, significantly better than that of 20 of the control group. Conclusion Isokinetic training can improve muscle endurance and the walking capacity of persons with an incomplete lumbar spinal cord injury.
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Objective Due to the anatomy of the scapula itself is exceptional,fracture is often associated with other damage.So it is particularly important to evaluate the patients,physical examination,as well as the choice of surgical approach during perioperative period.By studing of the relevant literatures,this article reviewed the anatomy and classification of the shoulder blades,patient assessment,surgical indications and approaches,as well as the functional exercise.
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Objective In clinic, the elderly with femoral intertrochanteric fracture are suggested surgical treatment, with the continuous deepening of the research and technology innovation, the new type of internal fixator for treating this fracture are emerging?At present,a wide variety of internal fixators in clinic,but each has its advantages, disadvantages and indications, and considering?The right choice of internal fixator directly affects patient's prognosis?This article reviewed several common internal fixators in clinic, so as to provide a reference for the clinical selection.
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Objective To explore the neutrophil to lymphocyte ratio (NLR) and its relationship with the effect of chemotherapy and prognosis in patients with diffuse large B-cell lymphoma (DLBCL).Methods The clinicopathological characteristics and outcome of 51 patients with DLBCL diagnosed by pathological biopsy and immunohistochemistry who received CHOP or R-CHOP regimen were collected and reviewed.According to the median of NLR,the patients were divided into low NLR group (NLR≤2.32) and high NLR group (NLR＞2.32).The prognostic influence of the NLR on overall survival (OS) was studied by Kaplan-Meier method and Log-rank test.To evaluate the independent prognostic relevance of NLR,univariate and multivariate Cox regression models were applied.Results The complete response (CR) rates of the low and high NLR groups were 71.4 ％ (20/28) and 39.1％ (9/23),respectively (P =0.02).The OS in the low NLR group was significantly better than that in the high NLR group (1,2 and 3-year OSs were 96.4 ％,90.4 ％ and 72.3 ％ vs 63.9 ％,52.7 ％ and 42.2 ％,respectively,P =0.009).Univariate and multivariate Cox regression models analysis showed that NLR ＞ 2.32 was an independent prognostic factor (P =0.016).Conclusion An elevated NLR before treatment indicates the poor effect of chemotherapy and prognosis of patients.NLR is an independent prognostic factor for DLBCL.
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Objective To evaluate the CT and MR features of renal oncocytoma in order to improve the ability for recognition and ima-gingdiagnosis.Methods The CT and MR findings of renal oncocytoma in 12 patients proved by pathology were retrospectively analyzed.Results CT scans were performed in 12 patients,one of which was accompanied with the contralateral renal angiomyoliptoma.In all lesions, seven were in the right kidney and five in the left.The lesions were round or oval in shape with the diameter 1.5 cm-12.3 cm.On pre-contrast scan,the homogeneous density was found in 3,calcification in 2,and central scar tissue in 5.On post-contrast images,the parenchyma of tumor was obviously enhanced in the cortical phase.However,the enhancement was attenuated in the parenchymal phase.Seven patients underwent MRI at the same time,exhibiting iso-or hypointensity on T1 WI in 4 and heterogenous hyperintensity on T2 WI in 5.Dynamic contrast enhanced MRI demonstrated homogenous enhancement in 1 and heterogenous enhancement in others with delayed enhancement of the central scar.Conclusion Most renal oncocytomas show certain characteristics on CT or MRI, which are helpful for preoperative diagnosis and surgical therapy.
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Sonic hedgehog (Shh) signaling has recently been shown to be involved in the pathological angiogenesis in response to tissue hypoxia and ischemic injury. Hypoxia/ischemia is considered to play an important role in the development of choroidal neovascularization (CNV). This study was aimed to examine the effect of blockade of the Shh signaling pathway on CNV and the underlying mechanism. A total of 64 male Brown-Norway (BN) rats were used in this study. One eye of each rat underwent laser photocoagulation. The other eye served as normal control. After the laser treatment, the 64 rats were divided into four groups (n=16 in each group): Blank control group, in which no intravitreal administration was given; cyclopamine group, recombinant Shh N-terminals protein (rShh) group and phosphate-buffered saline (PBS) group, in which cyclopamine (a Shh inhibitor), rShh (a Shh activator) and PBS were intravitreally injected into the laser-treated eyes respectively every other day for a total of four intravitreal injections immediately after the laser treatment. Fourteen days after the intravitreal administration, the changes of CNV-related variables, including positive CNV lesion percentage, CNV membrane area and CNV membrane thickness, were evaluated by fluorescein angiography, indocyanine green angiography and pathological examinations. The mRNA and protein expression of PTCH1, Gli1, HIF-1(α), VEGF and DLL4 in each group on 14 days of CNV model was detected by real-time quantitative PCR and western blot analysis, and the relationship between the Shh cascade and the HIF-1(α)-VEGF-DLL4 cascade in CNV was analyzed. The results showed that the CNV membrane area and the CNV membrane thickness were decreased by 62.5% and 41.9% in the cyclopamine group and increased by 85.7% and 64.3% in the rShh group in comparison to those in the blank control group (P<0.01 for each). There was no significant difference in the CNV membrane area and thickness between the blank control group and PBS group (P=0.102 and P=0.063, respectively). Real-time quantitative PCR revealed a 5.23-, 4.14-, 2.97-, 2.78- and 2.39-fold up-regulation of the mRNA expression of PTCH1, Gli1, HIF-1(α), VEGF and DLL4 genes in the laser-treated eyes compared with the normal control eyes in the control group. In the cyclopamine group, the mRNA and protein expression of Gli1, HIF-1(α), VEGF and DLL4 was significantly down-regulated (P<0.05 for each) while the expression of PTCH1 showed no significant changes at the mRNA (P=0.293) and protein level (P=0.304). The mRNA expression and protein expression (P=0.001 and P=0.021, respectively) of PTCH1, Gli1, HIF-1(α), VEGF and DLL4 was significantly increased in the rShh group when compared with the control group. The expression level of these genes was related to the severity of the CNV. It was concluded that intravitreal administration of cyclopamine can effectively inhibit the formation of laser-induced experimental CNV by down-regulating the expression of the HIF-1(α)-VEGF-DLL4 cascade in CNV. The Shh signaling pathway as an upstream signaling pathway of HIF-1(α)-VEGF-DLL4 cascade is implicated in the development of experimental CNV.
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Objective To discuss the effects of remifentanfl for delthemte hypotension in intracranial aneurysm clamp operation,evaluating the feasibility and safety.Methods Twenty intracranial aneurysm patients undergoing occlusion surgery were prospectively randomized in to two groups:Group Ⅰ and Group Ⅱ.Group Ⅰ adopted remifentanil for deliberate hypotension and Group Ⅱ adopted sodium nitroprusside.The data were analyzed with SPSS 11.5 for Windows.Results Deliberate hypotension was achieved at the target mean arterial pressure(MAP)for remifentanil and nitroprusside respectively.During deliberate hypotension,HR in Group Ⅰ were lower than that in Group Ⅱ(P<0.01).RPP in Group Ⅰwere lower than that in Group Ⅱ(P<0.01).Blood loss in Group Ⅰ were lower than that in Group Ⅱ(P<0.05).Conclusion For general anesthesia in intracranial aneurysm clamp operation,using remifentanil for deliberate hypotemion is a good choice.
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The role of catecholamine (CA) in the pathogenesis and development of macular edema of central serous chorioretinopathy (CSC) was studied, and its relations with visual acuity were investigated. Plasma concentrations of epinephrine (E) and norepinephrine (NE) were determined in 30 consecutive eyes with CSC. Central macular thickness analysis was done by RTA and all the data were compared with normal eyes and analyzed with SAS software package. Plasma concentrations of E and NE were increased to (569 +/- 123) ng/L and (721 +/- 104) ng/L respectively in active CSC patients, significantly higher than those in normal subjects (P < 0.01), and decreased to normal in convalescent stage. RTA analysis revealed that the retinal thickness of CSC patients was increased at active and recovery stage as compared with normal subjects; and the plasma concentration of E was significantly correlated with central macular thickness (t = 2.173, P < 0.05). Also, central macular thickness measured by RTA was significantly correlated with the visual acuity (r = -0.8046, P < 0.001) in CSC eyes. RTA analysis might be useful to quantitatively detect and evaluate prognosis in CSC patients. The plasma concentration of E, which was highly correlated with macular edema, might play an important role in the early damage and the pathogenesis of CSC.