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Dens invaginatus is a rare developmental anomaly of the teeth that is caused by the infolding of enamel organs or the penetration of their proliferations into dental papillae before calcification has occurred. The presence of double dens invaginatus is extremely rare. This paper describes the use of cone beam computed tomography in the evaluation of a maxillary lateral incisor with double dens invaginatus and periapical periodontitis. The tooth was treated through microscopic root canal therapy. The tooth was free of clinical symptoms, and the periradicular lesion narrowed during the follow-up period of 1 year.
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Humans , Dental Pulp Cavity/abnormalities , Dens in Dente/pathology , Incisor/pathology , Root Canal Therapy , Periapical Periodontitis/pathologyABSTRACT
@#Objective To investigate the effectiveness and safety of robotic lobectomy in clinical N0 lung malignant tumor≥3 cm. Methods We retrospectively analyzed the clinical data of 182 patients with lung malignant tumor≥3 cm receiving robotic or thoracoscopic lobectomy at Shanghai Chest Hospital in 2019. The patients were divided into a robotic surgery group (RATS group) and a thoracoscopic surgery group (VATS group). There were 39 males and 38 females with an average age of 60.55±8.59 years in the RATS group, and 51 males and 54 females with an average age of 61.58±9.30 years in the VATS group. A propensity score matching analysis was applied to compare the operative data between the two groups. Results A total of 57 patients were included in each group after the propensity score matching analysis. Patients in the RATS group had more groups of N1 lymph node dissected (2.53±0.83 groups vs. 2.07±0.88 groups, P=0.005) in comparison with the VATS group. No statistical difference was found in operation time, blood loss, postoperative hospital stay, number of N1 and N2 lymph nodes dissected, groups of N2 lymph node dissected, lymph node upstage rate or postoperative complications. The hospitalization cost of RATS was higher than that of VATS (P<0.001). Conclusion In contrast with thoracoscopic lobectomy, robotic lobectomy has similar operative safety, and a thorough N1 lymphadenectomy in patients with clinical N0 lung malignant tumor≥3 cm.
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Objective:Based on the current medical environment, to learn about cognition status of doctor-patient relationship among medical students and analyze causes of the tension between doctors and patients.Methods:Using the self-designed questionnaire "Clinical Medical Students' Cognition Survey on Occupational Status and Doctor-Patient Relationship", a cross-sectional survey was conducted on 527 medical students from 5-year and 7-year clinical program in Batch 2014 in a medical university in Heilongjiang Province. The survey mainly analyzed the causes of the tension between doctors and patients from the level of medical staff, patients and their families, hospitals and society. SPSS 22.0 was used for descriptive statistics and chi-square test.Results:The results showed that 93.7% of the medical students believed that the current doctor-patient relationship was not harmonious. There were cognitive differences among medical students in different gender ( P=0.029), first contact clinical grade ( P=0.003) and professional identity ( P<0.001). Conclusion:Medical students have a poor evaluation towards the current doctor-patient relationship. In order to construct harmonious doctor-patient relationship in the future, we can try to take measures such as carrying out relevant courses of doctor-patient communication, improving the medical students' communication skills and enhancing their professional identity.
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Objective:To explore the present situation of medical students' professionalism cognition and provide reference for medical personnel training and medical education.Methods:A cross-sectional survey was conducted on medical students among 2 affiliated hospitals of a medical university in H province by cluster sampling. Exploratory factor analysis and reliability and validity test were carried out and a descriptive analysis of the present situation of professionalism was conducted by SPSS 20.0. Amos21.0 software was used for a confirmatory factor analysis on the samples.Results:The measurement scale had good reliability and validity, and the Cronbach alpha coefficient of the scale was 0.901. The average professionalism score of the medical students was about 80 points. The score of "physical and mental status and self-development ability" was the highest (83.65 points), and the lowest score was "academic ability" (72.21 points). There was a little difference in the professionalism cognition between the two hospitals, with significant differences between the dimension "respect and care" and "responsibility".Conclusion:This study has initially formed a medical professionalism measurement scale with good reliability and validity. The professionalism of medical students in the 2 affiliated hospitals of a medical school in Province H is in good condition as a whole. In the future, medical education should pay more attention to the combination of basic professional knowledge and clinical practice of medical students, and change the training model of medical students in order to improve the academic ability of medical students and medical students' overall cognition of professionalism.
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Objective To study the relationship between hypertensive cerebral hemorrhage and microbleeds by analyzing the characteristics of magetic susceptibility-weighted imaging.Methods Fifty-one patients with mild hypertensive cerebral hemorrhage admitted to Shenzhen Nanshan District No.6 People's Hospital for MRI (T1WI,T2WI and T2FLAIR),susceptibility-weighted imaging,and magnetic resonance angiography from June 2016 to June 2017 were included in this study.Their MRI data were analyzed.Results Multiple foci of microbleeds and small vessel hyperplasia were detected in hemorrhage regions of the 51 patients included in this study,including ＞2 foci of microbleeds in intracranial basal area,thalamus,brain stem and cerebellar area of 40 patients (78.4％),and cerebral small vessel hyperplasia and VR space enlargement in 11 patients (21.6 ％).Magnetic resonance angiography showed cerebral middle artery and basal artery atheroclerosis in 15 patients but no vascular dissection,stenosis,aneurysm and vascular malformation in the other patients.Conclusion MRI can show the pathological changes in cerebral blood vessels of hypertensive hemorrhage patients,including cerebral microbleeds,cerebral small vessel hyperplasia and VR space enlargement.
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The professional identity formation and development of medical students is a gradual process.Its aim is to offer a reference for further research of medical students' professional identity and the improvement of medical practice education in the current medical environment by analyzing the aspects at home and abroad in the research method and research content of medical students' professional identity formation and measurement as well as the present intervention measures that can cultivate medical students' professional identity formation.
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Objective To evaluate the application of 3.0 T magnetic resonance angiography (MRA) in follow-up after embolization of intracranial aneurysms with stent-assisted coils.Methods From June 2013 to June 2015,32 consecutive patients with subarachnoid hemorrhage due to ruptured intracranial aneurysms underwent stent-assisted coil embolization at the Department of Neurosurgery,the Sixth People′s Hospital of Shenzhen were enrolled retrospectively,including 12 males and 20 female,their mean age was 56±10 years.All patients were confirmed to be solitary intracranial aneurysms by digital subtraction angiography (DSA) before embolization.They were followed up with 3.0 T time of flight MRA (TOF-MRA) and contrast enhanced MRA (CE-MRA) at 1 to 2 years after embolization.DSA findings were served as the golden standard.The effect of aneurysm embolization (stabilization,further embolization,recanalization/recurrence) and patency of the parent arteries (without stenosis/mild stenosis,moderate to severe stenosis and occlusion) were compared.Results (1) The comparisons of evaluating the aneurysmal effects and consistencies of DSA among TOF-MRA,CE-MRA and TOF-MRA+source images after stent-assisted coil embolization were poor (Kappa=0.039,P=0.002),medium (Kappa=0.582,P<0.01),and higher (Kappa=0.615,P<0.01),respectively.(2) The comparison of the consistencies in the patency of the parent artery after stent-assisted coil embolization between TOF-MRA,CE-MRA and DSA were poor (Kappa=0.171,P=0.211;Kappa=0.376,P=0.010).(3) With the DSA findings as reference,the accuracy rates of TOF-MRA,TOF-MRA+source images and CE-MRA for interpretation of aneurysm embolization were 37.5% (12/32),75.0% (24/32),and 71.9% (23/32),respectively.TOF-MRA compared with TOF-MRA+source images and CE-MRA respectively,there were significant differences in the accuracy rates (χ2=9.04,P=0.003;χ2=7.63,P=0.006);there were no significant differences in the accuracy rates between TOF-MRA+source images and CE-MRA (χ2=0.08,P=0.777).(4) With the DSA findings as reference,the accuracy rates of TOF-MRA and CE-MRA for interpretation of the patency of the parent artery were 37.5% (12/32) and 62.5% (20/32) respectively.There was no significant difference in the accuracy rate (χ2=4.67,P=0.097).Conclusions The accuracy rate of 3.0 T CE-MRA for evaluating the embolization effect of intracranial aneurysms after stent-assisted coil embolization was superior to that of TOF-MRA.It can be used as a preferred non-invasive examination during the follow-up.TOF-MRA+source images are equivalent to CE-MRA,however,TOF-MRA and CE-MRA for the evaluation of the accuracy of patency of the parent arteries are low.For positive or indeterminate results of MRA examinations,the individualized analysis should be performed,if necessary,perform DSA examination.
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Objective To evaluate the application of 3.0T TOF magnetic resonance angiography (MRA) in intracranial aneurysm coiling follow-up retrospectively.Methods In our hospital,48 patients who underwent intracranial aneurysm coiling were followed up for one to two years with radiologic examination,which inclouded 3.0T TOF-MRA and Digital subtraction angiography(DSA) examination.DSA served as the golden standard.The MRA image quality and the results were compared.Results 3.0T TOF-MRA to determine aneurysm recurrence sensitivity was 85.7％,specificity was 95.7％,total accuracy rate was 93.8％,and the accuracy of the patency of the parent arterial was 93.8％.There was no significant difference between the 3.0T TOF-MRA and DSA (P ＞ 0.05).Conclusion In the patients after coiling,3.0T TOF-MRA in the judgment of the aneurysm embolization results and the patency of the parent artery had a high degree of consistency compare with DSA.We can use 3.0T TOF-MRA as a routine means in the follow-up.We should analysis individually for positive results and uncertainties.By optimizing imaging and scanning parameters might obtain better images.Perform DSA if necessary,when MRA was positive or uncertainty.
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<p><b>OBJECTIVE</b>To determine the effects of estrogen deficiency on the proliferation and osteogenic differentiation of mandibular bone marrow stromal cells (mBMSC).</p><p><b>METHODS</b>Ten 8-week-old female SD rats were randomly divided into two groups, ovariectomized group (OVX, n = 5) and sham-operation group (n = 5). All rats were anesthetized and both ovaries of OVX-rats were gently removed. Sham-operation rats were treated with the same incisions to expose the ovaries but without any hurt to them. One month after the operation, the mandibular bones were gently separated and mBMSC were isolated. Methyl thiazolyl tetrazolium (MTT) assay, alkaline phosphotase (ALP) activity, alizarin red staining, real-time reverse transcription (RT)-PCR and Western blotting were respectively used to examine the proliferative activity and osteogenic potential of mBMSC.</p><p><b>RESULTS</b>MTT results showed that OVX-mBMSC exhibited the decreased proliferative activity as compared with Sham-mBMSC. ALP activity of OVX-mBMSC [(0.710±0.011) Sigma unit/protein] was lower than that of Sham-mBMSC [(1.512±0.021) Sigma unit/protein] (P < 0.01). Alizarin red staining showed that OVX-mBMSC formed less calcified nodules than Sham-mBMSC. Ca(2+) concentration analysis showed Ca(2+) of OVX-mBMSC [(0.433±0.045) µg/g] was less than Sham-mBMSC [(1.453±0.131) µg/g] (P < 0.01). Real-time RT-PCR and Western blotting results showed that the expression of osteogenic markers (Alp, Runx2/RUNX2, Osx/OSX, Ocn/OCN) in OVX-mBMSC was significantly inhibited as compared with Sham-mBMSC (P < 0.05).</p><p><b>CONCLUSIONS</b>Estrogen deficiency significantly inhibits the proliferation and osteogenic capacity of mBMSC.</p>
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Animals , Female , Rats , Cell Differentiation , Estrogens , Mandible , Cell Biology , Mesenchymal Stem Cells , Physiology , Osteogenesis , Ovariectomy , Rats, Sprague-DawleyABSTRACT
To analyze the cause and therapy of hydrops in subcutaneous scalp after repairing skull defect by using silicon-polyester fiber network, a total of 91 patients who were treated with silicon-polyester fiber network to repair skull defect from June 1996 to October 2000 in the Department of Neurosurgery, Nanshan People's Hospital were analyzed retrospectively. And 56 cases of them had hydrops of subcutaneous scalp and treated with suction and pressure dressing, including 11 cases of less than 20 mL hydrop quantity, 27 cases of 20-50 mL, and 18 cases of more than 50 mL. They were observed for 6 weeks averagely after operation and were healed within 4 weeks by simple management. No recurrence of hydrops was found in subcutaneous scalp. It is indicated that silicon-polyester fiber network in repair of skull defect may complicate with hydrops of subcutaneous scalp usually. However, the prognosis will be good by means of drainage, so it can be used as a therapy for skull defect.
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Objective To compare and analysis two different surgical treatments for hypertensive basal ganglia hemorrhage.Methods 68 patients with hypertensive basal ganglia hemorrhage with no brain hernia received small window craniotomy microsurgery and aspiration. 24 patients received conservative treatment as the control group in the same time,who didn't accepted the surgery.Results Two groups of surgical treatments were better than the control group in aspect of effective rate,functional recover and mortality. And the rebleeding rate and complication incidence in acute-time had no difference.There were no difference in aspect of effective rate,average stay,functional recover and mortality between the two groups of surgical treatments. Conclusion Small window craniotomy microsurgery and aspiration had same effect on hypertensive basal ganglia hemorrhage. We can choice the method of operation according to the case.
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Objective To explore the effect of aspiration of hematoma on the serum neuron-specific enolase(NSE)concentration in patients with hypertensive intracerebral hemorrhage and its clinical meaning.Methods 45 cases of intracerebral hemorrhage with hematoma volumes of 30ml to 50ml were selected and divided into operative group(23 cases)and conservative group(22cases).The control group(18 cases)were healthy.Serum NSE was detected with ELISA method.Results ①The concentration of NSE in conservative group was obviously higher than that in control group within 21 days(P0.05).③The concentration of NSE in operative group was no significant difference than that in conservative group with in 7 days,but decreaced rapidly and was obviously lower than that in conservative group respectively in 14 days and 21 days(P