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Objective:To report the experience of using CT-guided cochlear implant surgery in difficult cases such as severe inner ear deformities and anatomical abnormalities, and to discuss the application value of intraoperative CT-assisted localization in difficult cases of cochlear implant surgery. Methods:Retrospectively analyzed the clinical data of 23 cases of difficult cochlear implant surgery cases completed by our team with the assistance of intraoperative CT, and collected their medical data, including preoperative imaging manifestations, surgical conditions, and intraoperative imaging images for evaluation. Results:During the study period, 23 difficult cases（27 ears） underwent cochlear implantation under the guidance of intraoperative CT, and 4 cases were bilaterally implanted. Including 6 cases of incomplete segmentation type Ⅰ（IP-Ⅰ）, 1 case of incomplete segmentation type Ⅱ（IP-Ⅱ）, 10 cases of incomplete segmentation type Ⅲ（IP-Ⅲ）, 3 cases of common cavity deformity（CC） and 3 cases of cochlear ossification after meningitis. Facial nerve anatomy was abnormal in 9 cases, cerebrospinal fluid "blowout" was serious in 14 cases, electrode position was abnormal in 3 cases requiring intraoperative adjustment of electrode position, anatomical difficulties required intraoperative CT to assist in finding anatomical landmarks in 2 cases, and electrodes were not fully implanted in 3 cases. Conclusion:When faced with difficult cases with challenging and complex temporal bone anatomy, intraoperative CT can accurately evaluate the electrode position and provide intraoperative anatomical details, allowing immediate adjustment of the electrode position if necessary, providing safety guarantee for difficult cases of cochlear implant surgery and ensure accurate implantation of electrodes.
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Humans , Cochlear Implantation/methods , Retrospective Studies , Tomography, X-Ray Computed/methods , Cochlea , Cochlear ImplantsABSTRACT
ABSTRACT The carapace of the tortoise Chinemys reevesii is an ingredient of "Guijia", a traditional Chinese medicine. However, C. reevesii is difficult to raise in aquaculture and is rare in the wild. Counterfeit tablets are made from carapaces of other species. In addition to C. reevesii, other species including Mauremys sinensis, Indotestudo elongate and Trachemys scripta have been used in Plastrum Testudinis as well. After processing, these carapaces are difficult to identify on the basis of morphological characteristics, which impedes law enforcement. Our study used DNA barcoding technology to identify C. reevesii and its substitutes. We extracted concentrated genomic DNA for PCR amplification. Based on the analysis of 61 full-length COI sequences, we designed four pairs of mini-barcode primers: Tu-A, Tu-B, Tu-C and Tu-D. The Tu-B primers sequenced genomic DNA with a success rate of 76.47%, and the Tu-D primers sequenced genomic DNA with a success rate of 88.24%. The identification efficiency of these two mini-barcodes was 70.59% and 64.71%, and the overall identification efficiency was approximately 76.47%. Similarly, a set of mini barcode systems was generated, which may provide an effective and low-cost method for the identification of authentic tortoise shells.
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@#The pathogenic mechanisms by which oral microbial communities affect the occurrence and development of dental caries remain unclear. Applications that make use of high-through put sequencing technologies and metaomics approaches to research dental caries etiology can provide new ideas about disease prevention and treatment. In this article, we review advanced research presented in metaomics studies, including genomic, metagenomic, metatranscriptomic, metaproteomic and metabolomics studies of dental caries.
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@#The microorganisms in a healthy child’s oral environment survive in certain proportions and form a stable dynamic balance with the host. If this balance is disrupted, some of the microorganisms become cariogenic microbes and cause early childhood caries (ECC). The changes of cariogenic microbes in this process could be used as biomarkers to assess the caries risk of children and forecast the development of ECC. The relative indices of Streptococcus mutans and the closely related Candida albicans, Bifidobacterium and Streptococci sanguinis may be used as biomarkers to diagnose the susceptibility of children to caries. The detection rate and detection level of Lactobacillus may provide a reference for judging the rate of ECC development.
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Objective:To analyze therapeutic effect of amiodarone combined RAS inhibitors on hypertensive patients with atrial fibrillation(AF),and its influence on serum levels of uric acid(SUA)and silent information regulator 2-related enzymes 1(SIRT1).Methods:A total of 186 hypertensive patients with AF were selected from our hospital. They were randomly and equally divided into amiodarone group(group A),amiodarone + telmisartan group(A+T group)and amiodarone + ramipril group(A+ R group).Left atrial diameter(LAD),P wave dispersion(Pd),lev-els of high sensitive C reactive protein(hsCRP),brain natriuretic peptide(BNP)and SUA,SIRT1 mRNA and pro-tein expression and blood pressure variability(BPV)were observed and compared among three groups before and 45d after treatment.Results:Compared with before treatment,there were significant improvement in all index ex-cept SUA after treatment in three groups,P=0.001 all;compared with group A after treatment,there were signif-icant reductions in 24hSBPV[(0.112 ± 0.022)vs.(0.092 ± 0.020)vs.(0.091 ± 0.021)],24hDBPV[(0.143 ±0.031)vs.(0.130 ± 0.040)vs.(0.129 ± 0.039)],levels of hsCRP[(8.3 ± 0.3)mg/L vs.(5.3 ± 0.6)mg/L vs. (3.6 ± 0.4)mg/L],BNP[(64.9 ± 9.4)ng/dl vs.(61.1 ± 7.6)ng/dl vs.(58.2 ± 8.3)ng/dl]and SUA[(498.85 ± 89.54)μmol/L vs.(298.54 ± 56.12)μmol/L vs.(278.32 ± 54.09)μmol/L],SIRT1 mRNA[(2.20 ± 0.34)%vs.(1.87 ± 0.30)% vs.(1.76 ± 0.31)%]and protein[(29.54 ± 8.12)% vs.(26.31 ± 7.43)% vs.(23.21 ± 6.90)%]expression in A+T group and A+ R group,P<0.05 or <0.01. Compared with group A,there were sig-nificant rise in Pd[(39.3 ± 4.2)ms vs.(40.9 ± 4.1)ms,(41.2 ± 5.1)ms],and significant reduction in LAD [(37.8 ± 3.4)mm vs.(35.1 ± 4.6)mm,(35.7 ± 4.5)mm]in A+T group and A+R group,P<0.05 or <0.01. Conclusion:Amiodarone combined RAS inhibitors can significantly improve blood pressure variability,and reduce inflammatory factor,SUA and serum SIRT1 level in hypertensive patients with AF.
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Objective To analyze the drug resistance of Helicobacter pylori (Hp) strains isolated from teenagers (aged 13 to 19) in Xiaoshan area to metronidazole,clarithromycin,levofloxacin,amoxicillin and furazolidone. Methods A retrospective study was conducted on 1 452 teenagers who had endoscopic examination in the First People′s Hospital of Xiaoshan District from January 2012 to December 2017. Statis-tical analysis was performed to analyze the antibiotic resistance of Hp to various antibiotics. Results Teen-agers who were positive for Hp infection accounted for 16.46% (239). The resistance rates of Hp isolates to metronidazole and clarithromycin were 71.55% and 16.74% with an upward trend in the past two years. Among all Hp isolates, those resistant to levofloxacin, amoxicillin and furazolidone accounted for 5.02%, 0.0% and 0.84%,respectively. No significant change in the antibiotic resistance patterns of Hp was ob-served. There were 15.06% of Hp isolates resistant to both metronidazole and clarithromycin. No statistical-ly significant difference in antibiotic resistance patterns was found between Hp isolates from male and female teenagers in Xiaoshan area. Conclusion This study suggested that the Hp isolates showed high resistance to metronidazole,moderate resistance to clarithromycin and levofloxacin,and low resistance to amoxicillin and furazolidone. Attention should be paid to monitoring the antibiotic resistance patterns in teenagers and pro-moting individualized treatment with regard to the eradication strategy of Hp infection.
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Obj ectiev The purpose of this study is to assess the impact of bone metastasis on survival in non-small cell lung cancer(NSCLC),Which were treated with gefitinib for more than 6 months,and to identify the prognostic factors of patients with NSCLC presenting bone metastasis .Methods We compared the overall survival(OS), progression-free survival(PFS),1-year2,-year and 3-year survival rates between two cohorts based on bone metastasis ,as well as the prognostic factors in the patients with bone metastasis .Results In total, 76 patients were included in the study ,in which there are44 patients with no bone metastasis and32 patients with bone metastasis.The cohorts were similar in OS (19.000 ±3.317 months vs.26.000 ±2.121 months,P =0.625)as well as PFS (14.000 ±1.843 months vs.16.000 ±1.411 months,P=0.328).The 1-year survival rate was 63.6%in no bone metastasis cohort,but was increased to 96.9%in the other cohort.The survival rates at 2 years(34.1%vs.56.3%,P=0.054)and 3 years(18.2%vs.18.4%,P=0.950)were similar.The univa-riate analysis showed that a worse prognosis was more likely existed in elderly patients ( aged >60 years) and with pulmonary progression ,whereby factors including gender ,pathology s,moking index ,brain metastases ,bone related events and the application of radiotherapy ,bisphosphonates might not be independently associated with the surviv -al late.Analysis of multiple variables indicated a favorable prognosis for patients with no pulmonary progression . Conclusion This retrospective study shows that bone metastasis may not shorten the survival in patients whose pulmonary lesion was controlled by gefitinib .On the contrary ,pulmonary progression may be more likely the cause of death in patients with bone metastasis .Non suggestion is given to discontinue gefitinib when the bone metastasis appears.
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As is commonly understood, the root canal morphology of the maxillary molars is usually complex and variable. It is sometimes difficult to detect the distobuccal root canal orifice of a maxillary second molar with root canal treatment. No literature related to the distobuccal root canals of the maxillary second molars has been published. Objective: To investigate the position of the distobuccal root canal orifice of the maxillary second molars in a Chinese population using cone-beam computed tomography (CBCT). Material and methods: In total, 816 maxillary second molars from 408 patients were selected from a Chinese population and scanned using CBCT. The following information was recorded: (1) the number of root canals per tooth, (2) the distance between the mesiobuccal and distobuccal root canal orifice (DM), (3) the distance between the palatal and distobuccal root canal orifice (DP), (4) the angle formed by the mesiobuccal, distobuccal and palatal root canal orifices (∠PDM). DM, DP and ∠PDM of the teeth with three or four root canals were analyzed and evaluated. Results: In total, 763 (93.51%) of 816 maxillary second molars had three or four root canals. The distance between the mesiobuccal and distobuccal orifice was 0.7 to 4.8 mm. 621 (81.39%) of 763 teeth were distributed within 1.5-3.0 mm. The distance between the palatal and distobuccal orifice ranged from 0.8 mm to 6.7 mm; 585 (76.67%) and were distributed within 3.0-5.0 mm. The angle (∠PDM) ranged from 69. 4º to 174.7º in 708 samples (92.80%), the angle ranged from 90º to 140º. Conclusions: The position of the distobuccal root canal orifice of the maxillary second molars with 3 or 4 root canals in a Chinese population was complex and variable. Clinicians should have a thorough knowledge of the anatomy of the maxillary second molars.