[Retrospective analysis of the effectiveness of treating multi-space infection combined with descending necrotizing mediastinitis at oral maxillofacial and cervical region via multidisciplinary team collaboration].

Objective: To explore the strategy and experience for treating maxillofacial and cervical multi-space infection combined with descending necrotizing mediastinitis (DNM) via multidisciplinary team (MDT) collaboration. Methods: A total of 36 patients with maxillofacial and cervical multi-space infection complicated with DNM admitted to the First Affiliated Hospital of Zhengzhou University from July 2011 to July 2019 were included in the study. The clinical data of the patients were retrospectively analyzed, including gender, age, symptoms at admission, source of infection, preoperative and postoperative evaluation indicators, MDT strategy and prognosis. Results: There were 26 males and 10 females with an average age of (51.6±17.6) years (8-80 years). The course of disease before admission was (8.9±8.4) days (2-30 days). All patients were admitted with maxillofacial and neck swelling and pain as the main complaints. Odontogenic infection accounted for 39% (14/36), throat floor swelling and pain accounted for 25% (9/36) and unknown maxillofacial swelling accounted for 36% (13/36). There were 28 cases receiving surgical treatment, 26 cases were cured and discharged (72%), 10 cases died (28%). In the patients treated with multidisciplinary therapy (mainly by surgery), the white blood cell count, neutrophil percentage, C-reactive protein and procalcitonin levels were significantly improved compared with those at admission at each observation time point after operation (P<0.05). The length of stay was positively correlated with the levels of C-reactive protein (r=0.545, P<0.05) and procalcitonin (r=0.504, P<0.05). The prognosis of patients treated with surgery (26/28) was better than that of patients without surgery (0/8) (P<0.01). Conclusions: The patients with maxillofacial and cervical multi-space infection combined with DNM might be in critical condition. The surgical based MDT strategy has an important impact on the prognosis of patients. White blood cell count and other inflammatory indicators monitoring can effectively observe the changes of the patient's condition.

[Preliminary study on the elimination of artifacts of five kinds of dental prosthetic materials by energy spectrum CT multi-material artifact reduction technology].

Objective: To investigate the effect of the multi-material artifact reduction (MMAR) algorithm of spectral CT in reducing the beam hardening artifacts in dental restoration material. Methods: Three-unit fixed bridge restorations were fabricated on the first to third molars in pig jaw. Gold alloy, zirconia, cobalt chromium alloy, nickel chromium alloy and pure titanium were used as materials for these fixed bridges. After restoration delivery, the pig jaw was scaned using energy spectrum CT machines. Images in regular 120 kVp scan mode were used as conventional group, and reconstructed single-energy horizontal images of 80, 90, 100, 110, 120, 130 and 140 keV in energy spectrum scanning mode were used as energy spectrum group, and reconstructed images applied MMAR technology in energy spectrum scanning mode were used as energy spectrum MMAR group. Each group was scanned 10 times to measure CT value and noise of muscles around dental prosthetic materials and adjacent non-artifact layers. Artifact index was calculated. Two radiologists scored the image quality of each group subjectively. Kruskal Wallis rank sum test was used to compare the difference of image noise, artifact index and subjective score among the control group and the best keV condition in the energy spectrum group and the energy spectrum MMAR group. Results: The image noise of energy spectrum group and energy spectrum MMAR group decreased gradually with the increase of single energy level. The artifact index of pure titanium restorations in conventional group, energy spectrum group and energy spectrum MMAR group were 71.0±8.0, 21.4±2.7 and 14.7±2.7 respectively, and these values were significantly lower than those of other materials in the same group (P<0.05). The subjective image quality scores in energy spectrum MMAR group were as follows: 3.0±0.2 for gold alloy, 4.3±0.5 for zirconia, 3.0±0.4 for cobalt chromium alloy, 3.1±0.4 for cobalt chromium alloy, and 4.6±0.5 for pure titanium. These scores were significantly smaller than those in the conventional group (P<0.05). There was no significant difference in noise between energy spectrum group and energy spectrum MMAR group (P>0.05), and the noise values in energy spectrum group and energy spectrum MMAR group were significantly lower than that in the conventional group (P<0.05). Conclusions: Artifacts of pure titanium is minimal. Energy spectrum CT combined with MMAR technology can effectively reduce the artifacts of gold, zirconia, cobalt-chromium alloy, nickel-titanium alloy and pure titanium. This technique can be used as an effective method to remove artifacts of dental prosthesis.

Early enteral nutrition compared with parenteral nutrition for esophageal cancer patients after esophagectomy: a meta-analysis.

Early postoperative enteral nutrition (EN) after esophagectomy in esophageal cancer patient has been reported to be correlated with a better rehabilitation than parenteral nutrition (PN). However, a robust conclusion has not been achieved. Therefore, we performed a meta-analysis to compare the postoperative EN and PN in patients with esophageal cancer undergoing esophagectomy. Three electronic databases were searched for eligible studies to be included in the meta-analysis. The summary relative risk/weighted mean difference (RR/WMD) estimates and corresponding 95% confidence interval (CI) were calculated using fixed- and random-effects models. Ten studies met the inclusion criteria. The analysis demonstrated that the early postoperative EN could significantly decrease the pulmonary complications (RR = 0.37, 95% CI = 0.22-0.62, P = 0.00, test for heterogeneity: I(2) = 0.0%, P = 0.89) and anastomotic leakage (RR = 0.46, 95% CI = 0.22-0.96, P = 0.04, test for heterogeneity: I(2) = 0.0%, P = 0.66) compared with PN. On the eighth postoperative day, the EN group had a higher levels of albumin (WMD = 1.84, 95% CI = 0.47-3.21, P = 0.01, test for heterogeneity: I(2) = 84.5%, P = 0.00) and prealbumin (WMD = 12.96, 95% CI = 3.63-22.29, P = 0.01, test for heterogeneity: I(2) = 0.0%, P = 0.63) compared with the PN group. However, there was no difference in digestive complications between these two approaches (RR = 1.30, 95% CI = 0.79-2.13, P = 0.30, test for heterogeneity: I(2) = 0.0%, P = 0.97). For patients with esophageal cancer following esophagectomy, the early postoperative EN support could decrease the morbidity of severe complications, such as pulmonary complications and anastomotic leakage, and maintain patients at a better nutritional status than parenteral nutrion support.

Construction, expression and immunoassay detection of recombinant plasmid encoding fusion protein of Roman chicken complement C3d and Newcastle disease virus F gene.

The terminal degradation product (C3d) of mammalian complement component C3 plays an important role in modulation of the adaptive immune response through the interaction with complement receptor type 2 (CR2) on B cells. In this study, the gene fragment coding for the complement protein C3d (chC3d) from Roman chicken was cloned and expressed as a fusion protein for its application in the vaccine study of chicken, and for in vitro experiments. The chC3d fragment strengthened B-cell responses when complexed with antigen. Three potential vaccine construct units were engineered to contain two, four and six copies of chC3d coding gene linked to the F gene of Newcastle disease virus (NDV), an economically important pathogen of chicken that is classified as a list A contagious disease of poultry by the Office International des Epizooties. The cloned chC3d protein and different repeats of C3d proteins in addition to the F gene of NDV were generated separately in Escherichia coli and chicken embryo fibroblast cells with the help of expression vectors. All recombinant proteins were analysed by SDS-PAGE and Western blotting. Analysis of the immunogenicity of different repeats of C3d revealed that chC3d had an enhancing effect on the immunogenicity of antigens, and that six or more repeats of C3d may be necessary for efficient enhancement of antigen-specific immune responses. To date, published research into the adjuvant activities of C3d has been limited to experiments in mice, rabbits and cattle. The adjuvant properties of C3d have not been assessed in poultry using homologous C3d in association with antigens relevant to the target species. The Roman chicken C3d fusion proteins described in this study is the first report and will provide a basis for immunization trials in chicken, studies of receptor binding and cell activation of chicken lymphocytes, and investigations of new types of vaccines, including recombinant vaccines and DNA vaccines for future use against other pathogens in chicken.

[Xuefu zhuyu decoction in treating blood stasis syndrome of schizophrenia].

The clinical and experimental study of 66 schizophrenics were conducted. Based on mental symptoms, four-diagnostic method of TCM and hemorheology, it presented preliminarily the clinical and experimental criteria for schizophrenia. The combined therapy of Xuefu Zhuyu Decoction and low dosage of antipsychotic drug could relieve the mental symptoms and the abnormal hemorheologic index normalized. Its therapeutic index was higher than that of control group.