Comparison of Medical Dispute Resolution Mechanisms in China and Abroad / 法医学杂志

Medical disputes are one of the common problems concerned by the whole world. All countries and regions have established their own medical dispute resolution mechanisms, in accordance with their own national conditions. Medical dispute identification opinions, as one of the important bases for identifying the responsibilities of both doctors and patients, play a pivotal role in the process of dispute settlement. A reasonable medical dispute resolution mechanism and standardized medical dispute identification model can help resolve disputes flexibly and reduce the conflict between doctors and patients. This paper briefly compares the medical dispute resolution mechanism and identification mode of China and several other representative countries (the United States, Britain, France, Germany, Italy, Japan, etc.), and discusses their respective characteristics and shortcomings, to bring some enlightenment to the medical dispute resolution and identification in our country.

Research progress on immunogenicity evaluation of serogroup B meningococcal vaccine / 中华预防医学杂志

Epidemic cerebrospinal meningitis (meningococcal meningitis) is an acute respiratory infectious disease with high mortality and serious sequelae. Meningococcal vaccine is an effective measure to prevent and control meningococcal meningitis. At present, group B meningococcal meningitis has become the main prevalent serum group in the world, including China. Meningococcal ACYW and other vaccines are mainly composed of capsular polysaccharides, while the main component of group B meningococcal vaccine is protein, including outer membrane vesicles (OMV) and recombinant protein vaccine. The methods for evaluating the immunogenicity of group B meningococcal vaccine include hSBA and alternative methods such as meningococcal antigen typing system (MATS), flow cytometric meningococcal antigen surface expression assay (MEASURE), genetic meningococcal antigen typing system (gMATS) and bexsero antigen sequence type (BAST). The evaluation of vaccine immunogenicity is the basis of vaccine development and clinical trial research, However, at present, there is no group B meningococcal vaccine in China. Therefore, in this paper, the research progress of immunogenicity evaluation of group B meningococcal vaccine has been reviewed, in order to provide technical guidance for the research and development of group B meningococcal vaccine, immunogenicity evaluation and clinical trial research in China.

Characteristics and Forensic Identification of Blunt Vertebral Artery Injury / 法医学杂志

Blunt vertebral artery injury occurs frequently in forensic practice. However, injuries of the vertebral artery are easily ignored or overlooked because of its relatively deep location. Through literatures review, this paper finds that the manners of blunt vertebral artery injury are varied and one or more injury mechanisms may be involved simultaneously. Patients often undergo immediate or delayed cerebral apoplexy as well as compression and injury of surrounding structures, due to direct injury or secondary aneurysm or dissection, resulting in disability or death. Diseases such as, vertebral atherosclerosis and dysplasia can increase the disability and death risk and the difficulty of forensic identification. In forensic identification, the details of the case should be considered. For cases of suspected vertebral artery injury, in addition to routine examination of intracranial segment, attention should be paid to the examination of extracranial segment. If conditions permit, angiography can be used prior to or during the autopsy to improve the identification efficiency and accuracy of opinions.

Comparison of head-down lithotomy position and Trendelenburg position on cardiac output in patients undergoing gynecological laparoscopic surgery / 复旦学报（医学版）

Objective To compare the changes in cardiac output (CO) and other hemodynamic parameters in patients undergoing gynecological laparoscopic surgery in head-down lithotomy position and Trendelenburg position. Methods Sixty patients were divided into head-down lithotomy group and Trendelenburg group. CO was recorded as baseline by a noninvasive cardiac output monitor NICOM? system after the placement of patients. These measurements were also acquired when the patients were placed in the 30° head-down tilt(T0)following pneumoperitoneum establishment.Stroke volume(SV), heart rate(HR)and CO were monitored at 1-minute intervals thereafter for a total of 10 minutes(T1-T10),and mean arterial pressure(MAP)and total peripheral resistance(TPR)were monitored every 5 minutes. Results The reduction of CO in head-down lithotomy group was greater than that in Trendelenburg group(T0:-31％±19％ vs.-9％±34％;T1:-32％±18％ vs.-16％±38％;T2:-33％± 19％vs.-16％±26％;T3:-32％±22％vs.-16％±28％;T4:-31％±18％vs.-12％±38％;T5:-30％± 17％vs.-14％±37％;T6:-31％±17％ vs.-14％±33％,all P<0.05)during the first 6 minutes. MAP at baseline in head-down lithotomy group was significantly higher than that in Trendelenburg group[(97±11) mmHg vs.(85±6)mmHg,P<0.05].MAP decreased in head-down lithotomy group at T0(-8％±16％) and increased in Trendelenburg group at T5 and T10(T5:9％±15％,T10:12％±18％). Conclusion CO reduction was greater in patients in head-down lithotomy position than that in Trendelenburg position group during the first 10 minutes after adjusting the position following pneumoperitoneum establishment.

Intra-bone marrow injection of fetal liver mononuclear cells to reconstruct the hematopoietic system in mice / 上海交通大学学报（医学版）

Objective:To observe the effect of intra-bone marrow injection (IBMI) of fetal liver mononuclear cell suspension on reconstructing the hematopoietic system in mice. Methods : The fetal liver mononuclear cells from the mice with gestational age of 13.5 days were obtained by Ficoll separation technique, and then the hematopoietic stem cells (HSCs) were obtained by magnetic bead sorting. The fetal liver mononuclear cells were injected into the tibias of 137Cs irradiated mice by IBMI. The recipient mice were observed for reconstitution of the hematopoietic system by routine blood examination, blood smear and bone marrow smear. The donor HSCs in the bone marrow of the recipient mice was subjected to flow cytometry 1 year after transplantation. Results: HSCs accounted for 0.171% in the mouse fetal liver mononuclear cells. One week after transplantation of mouse fetal liver mononuclear cells, blood cells derived from donor cells were detected from peripheral blood; in the third week after transplantation, peripheral blood leukocytes, red blood cells and hemoglobin of recipient mice were restored to the pre-irradiation levels; the percentage of donor-derived blood cells in peripheral blood in the fifth week was stable; the HSCs in the bone marrow of recipient mice were derived from donor cells 1 year after transplantation. Conclusion: The murine fetal liver mononuclear cells can efficiently reconstruct the hematopoietic system of mice by IBMI.

Application of Intravascular Imaging in Forensic Autopsy / 法医学杂志

With the emergence of new technologies and devices including minimally invasive catheters and rotary couplers, the application of imaging technology such as traditional ultrasound and optical coherence tomography （OCT） is gradually expanded. In recent years, intravascular ultrasound （IVUS） and OCT have become increasingly mature as coronary intravascular imaging techniques, and therefore become an important complementary means of coronary angiography. Although studies on feasibility of clinical applications of IVUS and OCT have been confirmed in the evaluation of previous cadaver studies, these techniques have been neglected in forensic autopsy. This paper reviews the application value of IVUS and OCT in forensic autopsy, especially in the adjuvant evaluation of coronary artery disease. Including the characteristics of IVUS and OCT imaging technology, the problems of coronary examination in traditional autopsy and the specific application of new intravascular imaging technology in forensic autopsy.

Correlated Secondary Ion Mass Spectrometry-Laser Scanning Confocal Microscopy Imaging for Single Cell-Principles and Applications / 分析化学

Secondary ion mass spectrometry ( SIMS) as a powerful surface analysis technique has been widely applied in semiconductor industry and geology research. Recently, with the development of instrumental technology, SIMS is attracting more and more attention in life sciences. SIMS can provide surface MS spectra, 2D/3D chemical images and depth profiling of substances simultaneously. The minimal lateral resolution of 2D SIMS imaging is 80 to 100 nm, and the longitudinal resolution of 3D SIMS imaging is about 1-5 nm. However, due to lack of specific ions to render the structures of organelles, SIMS imaging for single cells still has great challenges. Optical microscopy, in particular laser scanning confocal microscopy ( LSCM) , has been emerged to be an indispensable technique for single cell imaging and can obtain high spatial 2D/3D imaging to visualize the structures of organelles. Thus, the combinational use of SIMS and LSCM, which takes advantages of SIMS for molecular imaging and LSCM for morphological imaging, has greatly extended the application of SIMS imaging and ensured its accuracy at single cells level, providing novel insights into better understanding of the biological events inside cells. In this review, we focus on the development and application of SIMS imaging and the correlated SIMS and LSCM imaging in the research of cell biology and drug discovery. We anticipate that the combinational use of SIMS and LSCM imaging has promising future in biomedicine and life sciences.

Current Status of Forensic Identification for Blunt Injuries of Internal Carotid Arterial System / 法医学杂志

Internal carotid arterial system is the main source of blood supply in brain. In forensic identi-fication practice, blunt injures of internal carotid arterial system usually cause complications such as throm-bus, aneurysm and arteriovenous fistula, etc. The deaths following delayed cerebral infarction or intracra-nial haemorrhage are not rare. At present, literature of deaths caused by blunt injuries of internal carotid arterial system mainly consist of case reports in China. This paper reviews related literature and case re-ports at home and abroad, and summarizes forensic medical features and identification method of the deaths caused by such injuries. The results show that blunt injures of internal carotid arterial system are related to the direct or indirect force on head and neck, which can result in exceed physiological range traction of head and neck, incision following basicranial fracture, etc. Such injuries are common in the cases as mechanical asphyxia, cervical manipulation, traffic accident and fall, etc. The artery should be examined carefully, and the relationship among injury, disease and death should be analysed correctly when no cause of infarction and hemorrhage was found in routine examination of such cases in forensic pratice. Because of the difficulty for exposing the artery completely in autopsy, angiography can be used to infer the location when necessary for improving the scientificity and reliability of the appraisal conclusion.

Quality safety of ultrasonic diagnostic apparatus during clinical application / 医疗卫生装备

Objective To study and analyze the quality safety of the ultrasonic diagnostic apparatus during clinical application to reduce the incidence of adverse events. Methods According to the actual use of ultrasonic diagnostic equipment and the data of quality control, the quality and safety factors of ultrasonic diagnostic apparatus during clinical application were studied by quantitative analysis of the ultrasonic source dose, image quality and etc. Results The factors affecting the quality safety of the ultrasonic diagnostic apparatus included the ultrasonic source dose, image quality, external environment and the operator's ability. Conclusion It is of great significance to understand the basic characteristics of the ultrasonic diagnostic apparatus and execute periodically preventive maintenance and quality control for increasing medical service quality while decreasing the incidence of adverse events.

Polymorphism of the complement 5 gene is associated with large artery atherosclerosis stroke in Chinese patients / O polimorfismo do gene C5 do complemento está associado a acidentes vasculares cerebrais de grandes artérias com aterosclerose em pacientes chineses

ABSTRACT The complement system has been confirmed to play an increasingly important role in ischemic stroke (IS). This study aimed to determine whether the single-nucleotide polymorphism of the complement 5 (C5) gene independently influences the occurrence, severity, and long-term outcome of IS in Chinese patients. Methods C5 rs17611 genetic variants were investigated in 494 IS patients and 330 control individuals .Ischemic stroke was classified into subtypes and patients were assessed 90 days post-stroke with the modified Rankin Scale to determine stroke outcome. Results The presence of C5 polymorphism was associated with the incidence of large artery atherosclerosis (LAA)-subtype IS (n =2 00; p = 0.031), which even persisted after adjustment for covariates (OR = 1.518; 95%CI = 1.093–2.018; p = 0.013). However, no association was found between genotypes and the severity and outcome of stroke (p = 0.978; p = 0.296). Conclusions The C5 polymorphism might contribute to the risk of LAA-subtype IS independently of other known risk predictors.

RESUMO Já se confirmou que o sistema do complemento exerce um papel cada vez mais importante nos acidentes vasculares cerebrais isquêmicos. Este estudo teve o objetivo de determinar se o polimorfismo de nucleotídeo único (SNP) do gene codificador do componente 5 (C5) influencia de forma independente a ocorrência, a severidade e o desfecho em longo prazo do acidente vascular cerebral isquêmico (AVCI) em pacientes chineses. Métodos Variantes genéticas rs17611 do C5 foram investigadas em 494 pacientes com AVCI e em 330 indivíduos controles. O AVCI foi classificado em subtipos e os pacientes foram avaliados 90 dias após o acidente vascular, através da Escala Modificada de Rankin (mRS), para determinação do desfecho do acidente. Resultados A presença de polimorfismo do C5 foi associada à incidência de AVCI do subtipo com aterosclerose de grandes artérias (AGA) (n = 200; p = 0,031), que persistiu mesmo após os ajustes de covariáveis (RP = 1,518; 95% IC = 1,093–2,018; p = 0,013). Entretanto, nenhuma associação foi observada entre os genótipos e a severidade ou o desfecho do acidente vascular (p = 0,978; p = 0,296). Conclusões O polimorfismo do C5 pode contribuir para o risco de AVCI do tipo com AGA, independentemente de outros riscos preditores conhecidos.

Common Neurological Disorders Involving Inpatient Liaisons at a Secondary Referral Hospital in Taiwan: A Retrospective Cross-Sectional Study

BACKGROUND AND PURPOSE: The requirement for neurology liaison is increasing in accordance with the growing health care demands associated with aging populations. The aim of this study was to characterize the nature of neurological inpatient liaisons (NILs) to help plan for the appropriate use of neurology resources. METHODS: This was a retrospective cross-sectional study of NILs in a secondary referral hospital over a 12-month period. RESULTS: There were 853 neurological consultations with a liaison rate of 3% per admission case. Chest medicine, gastroenterology, and infectious disease were the three most frequent specialties requesting liaison, and altered consciousness, seizure, and stroke were the three most frequent disorders for which a NIL was requested. Infection was the most common cause of altered consciousness. Epilepsy, infection, and previous stroke were common causes of seizure disorders. Acute stroke accounted for 44% of all stroke disorders. Electroencephalography was the most recommended study, and was also the most frequently performed. Ninety-five percent of emergency consultations were completed within 2 hours, and 85% of regular consultations were completed within 24 hours. The consult-to-visit times for emergency and regular consultations were 44+/-47 minutes (mean+/-standard deviation) and 730+/-768 minutes, respectively, and were shorter for regular consultations at intensive care units (p=0.0151) and for seizure and stroke disorders (p=0.0032). CONCLUSIONS: Altered consciousness, seizure, and stroke were the most common reasons for NILs. Half of the patients had acute neurological diseases warranting immediate diagnosis and treatment by the consulting neurologists. Balancing increasing neurologist workloads and appropriate health-care resources remains a challenge.

Distribution of Diatoms in Main Sections of Urban District Rivers with Drowning-prone in Chengdu / 法医学杂志

OBJECTIVES@#To explore the species distribution and constituent ratio of diatoms in main sections of urban district rivers where drowning occurs frequently in Chengdu.@*METHODS@#Total 39 water samples from the sampling points of 5 rivers （Jinjiang, Jinniu, Qingyang, Wuhou and Chenghua districts） in October 2014 were collected. The diatoms smear were made and the species distribution and constituent ratio of diatoms from the water samples were analyzed using biological microscope and acquisition system of digital microscope.@*RESULTS@#Total 21 species of diatoms were detected in main sections of urban district rivers in Chengdu. Significant differences in the dominant diatom species and proportions of the different rivers were observed, and there were different species existed in all sampling points of the upstream, midstream and downstream of the rivers.@*CONCLUSIONS@#The database of species map, species distribution and constituent ratio of diatoms in main sections of urban district rivers in Chengdu are preliminarily established, which has special meaning for the analysis and evaluation of falling location inference using diatoms test in case investigation.

The clinical significance of hepatitis B virus large surface protein in the diagnosis and treatment of patients with hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the sigificance of HBV-LP in the HBV replication and anti-virus treatment efficacy assessment by detect the serum HBV-LP and HBV DNA and Pre-S1 and HBV serum markers.</p><p><b>METHODS</b>Serum HBV-LP, Pre-S1 and HBV serologic markers were measured by enzyme-linked immunosobent assay(ELISA), fluorescent PCR method to detect serum HBV DNA content in the 220 cases infected serum of CHB. Treated with adefovir dipivoxil antiviral therapy, and mesured the setologic indicators after 12 weeks, 24 weeks,36 weeks and 48 weeks.</p><p><b>RESULTS</b>The detection rate of HBV-LP and HBV DNA detection rate no significant difference in patients with chronic hepatitis B, and significantly higher than the Pre-S1 and HBeAg detection rate. HBV-LP positive rate also similar to the HBV DNA positive rate in HBeAg negative CHB patients. In the anti-virus therapy, the declined of HBV-LP similar to HBV DNA.</p><p><b>CONCLUSIONS</b>HBV-LP can reflect the HBV replication, is a good chronic hepatitis B diagnosis and efficacy evaluation index.</p>

Value of combined detection of GP73 and alpha-fetoprotein in diagonosis of hepatocellular carcinoma / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the diagnostic value of the measurement of serum Golgi protein 73 (GP73) in the diagnosis of hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum GP73 in the 81 cases of HCC, 71 cases of chronic hepatitis or cirrhosis (CH/LC) and 65 cases of healthy blood donors, and to evaluate the sensitivity and specificity in the diagnosis of HCC through the ROC curves.</p><p><b>RESULTS</b>The average levels of serum GP73 in HCC, CH/LC and Normal groups were (152.67 +/- 33.59) ng/ml, (93.15 +/- 20.02) ng/ml and (58.95 +/- 17.29) ng/ml(o) After calculating through the ROC curves, 120 ng/ml was set as the optimal cut-off point, GP73 has a sensitivity of 77.80% and a specificity of 78.00%.</p><p><b>CONCLUSIONS</b>GP73 as a serum marker in the diagnosis of HCC had a higher sensitivity than AFP, and the combined detection of GP73 and AFP could improve HCC diagnosis.</p>

Clinical study of laparoscopic sphincter-preserving proctectomy for low rectal cancer using transanal telescopic anastomosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the safety, feasibility and clinical outcomes of laparoscopic sphincter-preserving proctectomy for low rectal cancer using transanal telescopic anastomosis.</p><p><b>METHODS</b>Five patients underwent laparoscopic sphincter-preserving proctectomy for low rectal cancer using transanal telescopic anastomosis between March 2011 and April 2011 at the General Hospital of Beijing Military Command. After lymph node dissection around the mesentery using harmonic scalpel, the root of the inferior mesenteric vessel was ligated and transected. Rectal dissection was further carried out until 5 cm distal to the lower margin of the tumor. A circumferential incision was made 1.0 cm above the dentate line using 5 support stitches for exposure. The submucous layer was striped upward to the level of the levator ani, and rectum was transected. Rectum and sigmoid colon were extracted transanally and removed. Finally, colonanal anastomosis was made using telescopic technique.</p><p><b>RESULTS</b>Five patients underwent the procedure successfully. The mean operative time was 178 minutes. The mean intraoperative blood loss was 76 ml. The mean lymph nodes retrieval was 14. Bowel function recovered after a mean of 3 days. There were no postoperative complications. No obvious scars were seen in the abdomen or the anus. The mean hospital stay was 12 days. After one year of follow-up, all the patients survived cancer-free.</p><p><b>CONCLUSIONS</b>Laparoscopic anterior resection with sphincter preservation by transanal telescopic anastomosis for low rectal cancer is feasible and safe. Abdominal incision is minimal. However, the long-term outcomes require further investigation.</p>

Analysis of 61 cases undergoing sphincter-preserving procedure with intersphincteric resection by telescopic anastomosis for ultra-low rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of sphincter-preserving procedure with transabdominal intersphincteric resection for ultra-low rectal cancer.</p><p><b>METHODS</b>Clinical data of 61 cases with ultra-low rectal cancer (distance from anal verge ranged from 4-5 cm) were analyzed retrospectively. The patients underwent sphincter-preserving procedure with intersphincteric resection and telescopic anastomosis.</p><p><b>RESULTS</b>There were 34 males and 27 females. The mean age was 56.7 years. The inferior border of the tumor was 4 cm above the anal verge in 21 cases, and 5 cm in 40 cases. There 55 patients with rectal adenocarcinoma in this cohort. The tumor was well-differentiated in 24 cases, moderately-differentiated in 29 cases, and poorly-differentiated in 2 cases. There were 6 cases with malignant adenoma. The TNM staging was T1N0M0 in 36 cases, T2N0M0 in 23, and T3N1M0 in 2. The ability to control defecation significantly improved in 1-3 months postoperatively, and returned to normal in 6-12 months. Two patients developed anastomotic leak (3.3%), and 3 anastomotic stenosis (4.9%) postoperatively. Fifty-four patients(88.5%) had follow-up. The median follow-up time was 6.2 years. The local recurrence rate was 5.6%, and the 5-year-survival rate was 73.5%.</p><p><b>CONCLUSION</b>Sphincter-preserving procedure with intersphincteric resection and telescopic anastomosis is a safe and effective procedure for ultra-low rectal cancer.</p>

Infinite optical thickness of dentine porcelain of IPS E.max A color series / 南方医科大学学报

<p><b>OBJECTIVE</b>To determine the infinite optical thickness of dentine porcelain of IPS E.max A color series.</p><p><b>METHODS</b>Cylindrical dentine porcelain specimens of the IPS E.max A color series were prepared with a diameter of 13 mm and thickness of 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, and 5.0 mm. The chromatic value of all the specimens was determined with CM-5 spectrometer against standard black and white background. The chromatic aberration (deltaE) was calculated by regression equation.</p><p><b>RESULTS</b>The infinite optical thickness of dentine porcelain of the IPS E.max A color series ranged from 2.341 to 3.333 mm for a deltaE of 1.0, and from 2.064 to 2.904 mm for a deltaE of 1.5. As the chromaticity or thickness increased, the influence by the background color decreased, and the color of specimens became gradually close to the intrinsic color.</p><p><b>CONCLUSION</b>The thickness of the background dentine porcelain specimens must exceed its infinite optical thickness to represent the intrinsic color and avoid the influence by the extrinsic color.</p>

Reposition of coronary sinus lead dislocation only using pre-shaped stylet and guidewire: a case report / 中华医学杂志(英文版)

Technologies associated with cardiac resynchronization therapy (CRT) devices and lead systems have progressed. However, dislocation after coronary sinus (CS) lead placement continues to be a problem. We reported on the patient treated with CRT, in whom dislocation of CS lead occurred. In the case, we tried to reposition the CS lead without the left heart delivery system only using pre-shaped stylet and guidewire, and the dislocated CS lead could be successfully repositioned by the method. The method of only using a pre-shaped stylet and guidewire is easier than the conventional way, and it can shorten procedure duration and fluoroscopy time, as well as reduce the cost of treatment, but it is not always feasible.

Relationship between the increase of fibrous and fatty in atrioventricular node and narrowing of the atrioventricular node artery / 法医学杂志

OBJECTIVE@#To explore relationship between increase of fibrous and fatty in atrioventricular node (AVN) and narrowing of the AVN artery. To analyze the cause of pathological fibrosis and fatty infiltration in AVN.@*METHODS@#One hundred and nineteen cases of sudden cardiac death determined by autopsy were selected and the histological sections were examined with Image-pro plus software to calculate the AVN area, AVN artery inside-diameter, AVN artery lumen area(LA) , AVN artery perimeter area(PA), fibrous area and fatty area. All cases were divided into two groups: narrowing of artery group and normal control group. The changes of the PA/LA value and the fibrous and fatty contents were evaluated.@*RESULTS@#The PA/LA value is the highest in 21-40 age group. The difference of the fatty contents and total interstitial tissue was statistical significance in the two groups under 40 years of age.@*CONCLUSION@#There is some relationship between the narrowing of the AVN artery and the increase of interstitial contents in AVN.

Effects of three types of veneering porcelain on bending strength of KAVO(TM) Y-TZP/porcelain bilayered structure / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of three types of veneering porcelain on the bending strength of KAVO Y-TZP/porcelain layered structure.</p><p><b>METHODS</b>KAVO zirconia ceramics were used as the substructure. To form Y-TZP/porcelain bilayered structure, a leucite-based veneering porcelain was fired on the zirconia substructures by slip-casting technique with dentin washbake, and two nano-fluorapatite-based veneering porcelains were fired on the zirconia substructures by either slip-casting or pressed-on technique with or without liner coverage. The bending strength was tested according to ISO 6872 standard, and the veneered surfaces of the fracture samples were analyzed by scanning electron microscopy (SEM).</p><p><b>RESULTS</b>For covering KAVO zirconia core material, the conventional veneering slurry-porcelain combined with liner or wash firing had significant higher bending strength than pressed-on porcelain. SEM showed that the main failure type at the interface was adhesive failure.</p><p><b>CONCLUSION</b>Thin layer sintering using washbake program or liner on KAVO zirconia surface increases the surface wettability, and this procedure may be indispensable when veneering on the surface of dental zirconia.</p>