Analysis of the causes of long-standing pelvic anterior sacral space infection and discussion of management techniques / 中华肿瘤杂志

Objective: To investigate the causes and management of long-term persistent pelvic presacral space infection. Methods: Clinical data of 10 patients with persistent presacral infection admitted to the Cancer Hospital of Zhengzhou University from October 2015 to October 2020 were collected. Different surgical approaches were used to treat the presacral infection according to the patients' initial surgical procedures. Results: Among the 10 patients, there were 2 cases of presacral recurrent infection due to rectal leak after radiotherapy for cervical cancer, 3 cases of presacral recurrent infection due to rectal leak after radiotherapy for rectal cancer Dixons, and 5 cases of presacral recurrent infection of sinus tract after adjuvant radiotherapy for rectal cancer Miles. Of the 5 patients with leaky bowel, 4 had complete resection of the ruptured nonfunctional bowel and complete debridement of the presacral infection using an anterior transverse sacral incision with a large tipped omentum filling the presacral space; 1 had continuous drainage of the anal canal and complete debridement of the presacral infection using an anterior transverse sacral incision. 5 post-Miles patients all had debridement of the presacral infection using an anterior transverse sacral incision combined with an abdominal incision. The nine patients with healed presacral infection recovered from surgery in 26 to 210 days, with a median time of 55 days. Conclusions: Anterior sacral infections in patients with leaky gut are caused by residual bowel secretion of intestinal fluid into the anterior sacral space, and in post-Miles patients by residual anterior sacral foreign bodies. An anterior sacral caudal transverse arc incision combined with an abdominal incision is an effective surgical approach for complete debridement of anterior sacral recalcitrant infections.

Case-control study on Scarf and double metatarsal osteotomy of the first metatarsal for the treatment of hallux valgus deformity / 中国骨伤

OBJECTIVE@#To compare clinical efficacy of scarf osteotomy and double metatarsal osteotomy(DMO) in treating moderate to severe hallux valgus.@*METHODS@#Fifty patients (81 feet) with moderate to severe hallux valgus deformity were treated from January 2017 to December 2019, and were divided into Scarf osteotomy (SO) group or DMO group according to different osteotomy methods. There were 26 patients (44 feet) in SO group, including 1 male and 25 females, aged from 48 to 65 years old with an average of (55.5±4.67) years old;18 patients (30 feet) with moderate and 8 patients (14 feet) with severe. There were 24 patients(37 feet) in DMO group, including 1 male and 23 females, aged from 45 to 62 years old with an average of (52.1±6.8) years old;there were 14 patients (24 feet) with moderate and 10 patients (13 feet) with severe. Hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA) and relative length of the first metatarsal(RLFM) on weight-bearing anteroposterior radiographs before and after operation were compared. American Orthopaedic Foot and Ankle Society (AOFAS) hallux, metatarsal, and interphalangeal joint scores was used for evaluate clinical effects. Weight bearing time and complications were observed.@*RESULTS@#Fivty patients were followed up. The follow-up time in SO group ranged from 12 to 36 months with an average of(20.50±6.22) months and from 16 to 28 months with an avaerge of(19.80±2.44) months in DMO group while there was no significant difference between two groups(P>0.05). All incision healed at stage I, and osteotomy healed at (20.31±3.17) months after operation. One patient occurred hallux adduction deformity, without transferred metatarsalgia;2 patients occurred metastatic metatarsalgia in DMO group. There were no significant difference in HVA, IMA, DMAA, and AOFAS scores between two groups(P>0.05) before and after operation. There was no significant difference in RLFM between two groups(P>0.05), while had significant difference in RLFM between two groups at final follow-up (P<0.05). Partial weight-bearing time and full weight-bearing time in SO group were significantly earlier than those in DMO group (P<0.05).@*CONCLUSION@#Both of Scarf osteotomy and the first metatarsal biplane osteotomy could effectively treat moderate to severe hallux valgus deformity, with similar imaging and clinical evaluation. However, the relative length of the first metatarsal bone in SO group was longer than that in DMO group after operation, and the time of weight bearing in Scarf osteotomy is earlier than that of double metatarsal osteotomy of the first metatarsal.

Application of hypobaric ropivacaine spinal anesthesia and nerve block anesthesia in hip surgery ofelderly patients / 中国组织工程研究

BACKGROUND: The rational choice of anesthesia for the elderly patients with hip surgery not only ensures the smooth operation, but also significantly reduces the incidence of postoperative complications. OBJECTIVE: To compare the clinical anesthetic effects between combined lumbar plexus-sciatic nerve block and hypobaric ropivacaine spinal anesthesia in hip joint surgery of elderly patients. METHODS: Forty patients who were scheduled for hip joint surgery, at the age of 65-99 years old, American Society of Anesthesiologists grades II-III, were enrolled and randomly allocated to two groups: nerve block (n=20) and spinal anesthesia (n=20). In nerve block group, combined lumber plexus-sciatic nerve block was performed directed by a nerve stimulator under the guidance of ultrasound. In spinal anesthesia group, patients received single-dose hypobaric ropivacaine spinal anesthesia at L3-4interspace. Hemodynamic changes, anesthetic effects and perioperative adverse effects were recorded in both groups before and after anesthesia. RESULTS AND CONCLUSION: (1) The patients' heart rate and mean artery pressure in each group did not change significantly before and after anesthesia in the nerve block and spinal anesthesia groups (P > 0.05). (2) The onset time of anesthesia in spinal anesthesia group was significantly faster than that in nerve block group (P < 0.01). Hypobaric ropivacaine spinal anesthesia had a better analgesic effect during the surgery, which did not need extra intravenous anesthetics. The duration of motor and sense block was significantly longer in nerve block group than in spinal anesthesia group (P < 0.01). However, five patients in spinal anesthesia group needed extra intravenous anesthetics to finish the surgery. (3) No side effects were found in both nerve block and spinal anesthesia groups. (4) These indicated that compared to combined lumbar plexus-sciatic nerve block, hypobaric ropivacaine spinal anesthesia can provide a better analgesic effect during the hip joint surgery with stable hemodynamics. Moreover, hypobaric ropivacaine spinal anesthesia dose not increase the incidence of complications and has very good clinical application prospects.

Studies on Composition of Soil Organic Matter by Fourier Transform Infrared Spectroscopy Differential Analysis / 分析化学

Fourier transform mid-infrared spectroscopy (FTIR) method was used to analyze the soil organic matter (SOM) composition of a black soil under different management types. Spectral subtraction method was used for eliminating the interference of soil mineral to the absorption peak. Peaks at 2920,2850,1630 and 1420 cm-1were selected as a range of organic functional groups, and relative areas of these peaks were calculated by integral method. The correlation between peak areas and the content of SOM fractions were analyzed. Positive correlations between carbon (C) in fractions representing labile SOM (water-soluble organic carbon,hot water-soluble organic carbon, free light fraction carbon, occluded light fraction carbon) and the peak area at 2920 cm-1in the bulk soil indicated that this aliphatic peak corresponded to the more labile C compounds. Negative correlations between the same fractions and the area of the predominantly aromatic peak at 1630 cm-1in the bulk soil suggested a relationship with more stable SOM compounds. The ratio of the peaks at 1630 and 2920 cm-1was positively correlated with the ratio of stable C(heavy fraction) to labile C (light fraction) and thus taken as an indicator of SOM stability. This method was convenient, low cost and less sample usage,and could be used to analyze the organic carbon composition of soils which has the same mineral composition.

Identification of Hypotensive Drugs Illegally Added to Flower Buds of Panax Notoginseng by Laser Raman Spectroscopy / 中国药师

Objective:To fast detect hypotensive drugs illegally added to the flower buds of Panax notoginseng. Methods:A laser Raman spectrometer was used to detect several chemical drugs added to the flower buds of Panax notoginseng, and the spectrum was qualitatively analyzed. Results:Raman spectroscopy could detect chemical antihypertensive drugs added to the flower buds of Panax notoginseng, and the test results were in accordance with those of the traditional method. Conclusion: Raman spectroscopy can be used for the determination of illegal additives in the flower buds of Panax notoginseng.

The dynamic observation of corneal nerve regeneration by laser scanning confocal microscope after femtosecond laser in situ keratomileusis / 中华实验眼科杂志

Background Femtosecond laser in situ keratomileusis (LASIK) inevitably injury keratocytes and corneal nerve fibers.The research report about postoperative morphological changes of corneal nerve regeneration and keratocytes in femtosecond LASIK is still rare.Objective The aim of this study was to observe the kinetic changes of keratocytes and corneal nerve in corneal flap after femtosecond LASIK.Method Femtosecond laser manufacture corneal flap of LASIK surgery was performed on 60 eyes of 30 patients with refractive error using both femtosecond laser system and excimer laser treatment system.The repair of corneal wound was examined by slit lamp microscope,and the morphology of keratocytes and corneal nerve were observed with confocal microscope 1 week,1month,3 months after surgery,respectively.Results No haze or flap folds were found under the slit lamp microscope from 1 week through 3 months after operation.One week after surgery,the corneal stromal cells at the interface of the corneal flap appeared to be a mild activation status in 42 eyes (70％),but the activated cells gradually reduced with lapse of time.Three months after surgery,mild activation state still was found in 7 eyes (12％).One week after surgery,independent,short (＜50 μm),curved subbasal nerve fibers were exhibited in 7 eyes (12％),and curved filamentous nerve fibers were discovered in 48 eyes (80％) one month after surgery.The nerve fiber length of subbasal nerve was ＞200 μm in 27 eyes (45％) and classes beaded structure appeared 3 months after operation but were still different with preoperative subbasal nerve fibers.One week after the operation,filaments or discontinuous nerve fibers could been seen in 46 eyes (77％) at theinterface,and long nerve fibers or filamentous nerves were visible around the terminal or periphery of nerve fibers in 49 eyes (82％) one month after surgery,and long nerve fibers or filaments of nerve fibers were visible in 57 eyes (95％) 3 months after the surgery.Conclusions Femtosecond LASIK cause wound reaction at cellular level.Corneal nerve fibers recover with the extension of time,but there are still some morphological differences 3 months after surgery from preoperation.

Evaluation of the therapeutic efficiency of mandibular anterior implant-supported fixed bridges with cantilevers / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Dental implant technology has developed rapidly in recent years. However, the use of implant-supported fixed bridges with cantilevers has been controversial. The purpose of this study was to evaluate the clinical results of the mandibular anterior implant-supported fixed bridges with a cantilever. Method Thirty-three patients (15 males, 18 females; mean age, 42.6 years; range 20-54 years) with two missing anterior mandibular teeth had single implant-supported fixed bridges with a cantilever. Clinical examination was recorded and radiographs were taken. The mean duration of follow-up was 30 months (15-44 months).</p><p><b>RESULTS</b>All implants survived. Loosening or fracture of the prosthesis was not observed. All patients were satisfied with the treatment. The mean bone resorption values after 12, 24, and 36 months of implant loading were 0.94, 1.18 and 1.35 mm respectively. The changes of gingival papilla height ranged from 0 to 0.5 mm. There was significant difference between 1-year and 2 or 3 years restoration groups regarding the average gingival height changes (P < 0.05).</p><p><b>CONCLUSION</b>After careful and precise selection of patients, restoration with a single implant-supported fixed bridge with a cantilever can be recommended if two anterior mandibular teeth are missing.</p>

The Effect Evaluation of Highly Active Antiretroviral Therapy to Patients with AIDS in Hubei Province of China / 华中科技大学学报（医学）（英德文版）

The effects of highly active antiretroviral therapy (HAART) to patients with AIDS in Hubei province of China were investigated in order to provide scientific evidence to reinforce the management of HAART. Self-made questionnaires and descriptive method of epidemiology were used to collect and describe the changes of clinical symptoms, HIV RNA concentration, and immune function of patients with AIDS. After HAART, the effective rate of fever, cough, diarrhea, lymphadenectasis, weight loss,tetter, debility and fungous infection was 92.4%, 90.85%, 92.91%, 90.73%, 93.69%, 89.04%, 92.34%,and 83.1%, respectively. Of 117 patients with detected HIV RNA concentration, 41.03% had declined over 0.5 log, and 52.99% less than 0.5 log. CD4+T cell count was obviously increased: the average number after HAART for 3 or 6 months was 237/μL (26-755/μL) and 239/μL (17-833/μL), respectively.HAART can improve AIDS patients' clinical symptoms, reduce HIV RNA concentration, and maintain immune function. It is very important for the effectiveness of HAART to raise clinical adherence of pa-tients with AIDS and have a persistent surveillance.

The Univariate and Bivariate Impact of HIV/AIDS on the Quality of Life:A Cross Sectional Study in the Hubei Province-Central China / 华中科技大学学报（医学）（英德文版）

This study is aimed to evaluate the quality of life (QOL) for individuals living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Hubei province-central China by using WHOQOL-BREF instrument (Chinese version).One hundred and thirty six respondents (HIV/AIDS individuals) attending out-patient department of Chinese Center for Disease Control and Prevention (Chinese CDC) were administered a structured questionnaire developed by investigators.QOL was evaluated by using WHOQOL-BREF instrument (Chinese version).The resuits showed that the mean score of overall QOL on a scale of 0-100 was 25.8.The mean scores in 4 domains of QOL on a scale of 0-100 were 82.9 (social domain),27.5 (psychological domain),17.7 (physical domain) and 11.65 (environmental domain).The significant difference of QOL was noted in the score of physical domain between asymptomatic (14.6) and early symptomatic individuals (12) (P=0.014),and between patients with early symptoms (12) and those with AIDS (10.43) (P<0.001).QOL in psychological domain was significantly lower in early symptomatic (12.1) (P<0.05) and AIDS patients (12.4) (P<0.006) than in asymptomatic individuals (14.2).The difference in QOL scores in the psychological domain was significant with respect to the income of patients (P<0.048) and educational status (P<0.037).Significantly better QOL scores in the physical domain (P<0.040) and environmental domain (P<0.017) were noted with respect to the occupation of the patients.Patients with family support had better QOL scores in environmental domain.In our research,QOL for HIV/AIDS individuals was associated with education,occupation,income,family support and clinical categories of the patients.It was concluded that WHOQOL-BREF Chinese version was successfully used in the evaluation of QOL of HIV/AIDS individuals in Chinese population and proved to be a reliable and useful tool.

Clinical follow-up of ceramic bridges with auro-galvanoforming primary coping and Ni-Cr pontic for restoration of dentition defects / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Alternatives to the conventional auro-galvanoforming ceramic bridge need to be evaluated in long-term longitudinal studies before being recommended for restoration of dentition defects. This study aimed to evaluate the clinical performance of a ceramic bridge with auro-galvanoforming primary coping and Ni-Cr pontic for restoration of dentition defects.</p><p><b>METHODS</b>In total, 114 ceramic bridges with auro-galvanoforming (primary coping and Ni-Cr pontic) were placed in 112 patients with dentition defects. Among them, 83 bridges in 82 patients were available for follow-up after 7 years. We evaluated marginal integrity, color match, gingival inflammation, fracture of ceramic bridges, and recurrent caries.</p><p><b>RESULTS</b>Marginal integrity of the ceramic bridges was perfect in all patients. Most ceramic bridges maintained their original color. Fracture was found in three bridges; the rest were free of fracture, breakage, and loosening. Recurrent abutment caries were not found. Ceramic bridges with auro-galvanoforming (primary coping and Ni-Cr pontic) produced satisfactory clinical outcomes - equivalent to the conventional porcelain-fused-to-metal restoration. This technique is especially useful for dentition defects of the molar area and is cheaper than restoration with noble metal bridges.</p><p><b>CONCLUSIONS</b>Ceramic bridges with auro-galvanoforming (primary coping and Ni-Cr pontic) performed well for the restoration of dentition defects during this follow-up period. More studies are warranted to further evaluate this technique as an alternative to the conventional porcelain-fused-to-metal restoration.</p>

The 6-year clinical comparison of compound galvano-ceramic bridges with gold alloy and Ni-Cr alloy ceramic bridges / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate and compare effects of compound galvano-ceramic bridges with Ni-Cr alloy ceramic bridges and gold alloy ceramic bridges in clinic.</p><p><b>METHODS</b>A total of 105 bridges were made for 103 patients. Of them, 35 were compound galvano-ceramic bridges, 35 Ni-Cr alloy ceramic bridges, and 35 gold alloy ceramic bridges respectively. The marginal fitness and fracture of ceramic bridges were checked and caries or second caries of all abutments were also examined in clinic at 6 years after cementation.</p><p><b>RESULTS</b>The marginal fitness of compound galvano-ceramic bridges was evaluated as good in 100% of the bridges, which was better than the fitness of gold alloy ceramic bridges (91%) and Ni-Cr alloy ceramic bridges (77%) (P < 0.01). There was no difference in fracture of ceramic layer among compound galvano-ceramic, gold alloy ceramic, and Ni-Cr alloy ceramic bridges at 6 years (P > 0.05). None of compound galvano-ceramic bridge was found out caries or second caries of abutments. Two of 35 (6%) gold alloy ceramic bridges was found out second caries of abutments and five of 35 (14%) Ni-Cr alloy ceramic bridges were found out caries or second caries of abutments at 6 years. None of frameworks of all bridges was loose or broken.</p><p><b>CONCLUSIONS</b>The 6-year clinical study on compound galvano-ceramic bridges presents good results in marginal fitness and fracture resistance, which indicates the compound galvano-ceramic bridge can be used in clinic.</p>

Fatigue cyclic loading test of an auro-galvanoforming ceramic bridge / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In dental clinics, dentition defects are commonly restored with conventional porcelain-fused-to-metal fixed bridges. However, Ni-Cr alloy ceramic fixed bridges are known to have several drawbacks such as marginal coloration of the neck, low casting precision and, most seriously, poor biocompatibility. These problems could be circumvented by using noble metal ceramic bridges; however, one negative issue related to the conventional noble metal ceramic bridges is its high price due to the use of a large amount of gold for pontic. Therefore, an auro-galvanoforming ceramic bridge would be ideal to retain the advantages of a conventional material, yet reduce the amount of noble metal used. This study aimed to investigate whether any destructive changes occur to the auro-galvanoforming ceramic bridge under a fatigue cyclic loading test.</p><p><b>METHODS</b>On standard models which the left maxillary first premolar is lost and with the cuspid teeth and the second premolar as the fixed bridge abutment teeth, six maxillary auro-galvanoforming ceramic bridges and six corresponding nichrome ceramic jointed crowns were made as group A, six nichrome ceramic bridges and six corresponding nichrome ceramic jointed crowns were made as group B (control group). And then all specimens were fixed and tested on a fatigue cyclic loading machine; the changes occurring to the surfaces of occlusal contact with large functional area and to the porcelain-metal interfaces of the nichrome primary copings margins were observed through a scanning electron microscope (SEM).</p><p><b>RESULTS</b>In 120 hours' continual observation, none of the specimens had porcelain coating fractures or scraping occurrence and all of the porcelain coatings had been kept intact under sinusoidal cyclic loading with the load range of 120 - 200 N and frequency of 5 Hz.</p><p><b>CONCLUSIONS</b>Auro-galvanoforming ceramic bridges exhibited excellent fatigue strength in the fatigue cyclic loading test and may satisfy the clinical demand in theory, while the practical application shall be evaluated by observations in long-term clinical usage.</p>

The evaluation of the carbon fiber post system on restoration of teeth defect in children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Post and post-core systems are used to restore extensively damaged teeth. Among these systems, cast alloy post and core, prefabricated threaded alloy post and prefabricated simple alloy post are most frequently applied in China nowadays. In Europe and North America a combined application of the fiber post, resin-core and crown has been applied to restore seriously destructed teeth with satisfactory results in recent years. This study was intended to evaluate the clinical effect of carbon fiber post system on restoration of child anterior tooth defect after root canal therapy, based on 3 - 5 years' observation.</p><p><b>METHODS</b>One hundred and six children with incompletely established occlusion were observed and followed for an average of 42 months (ranging from 36 to 60 months). Eighty-five upper teeth and forty-one lower teeth were restored with carbon fiber post system and composite jacket crown. Periodic check-up was conducted for periodontal condition and restoration effect.</p><p><b>RESULTS</b>One hundred and twenty-one (96.2%) restorations were successful. Four jacket crowns (3.0%) were lost. One tooth (0.8%) had slight gingival inflammation. Tooth root or post fracture and gingival stain were not observed. X-ray showed there was no obvious change in aspects including the width of periodontal membrane, the density of alveolar bone and the height of alveolar ridge crest.</p><p><b>CONCLUSIONS</b>Carbon-fiber post system can satisfy the clinical requirements of young patients who have residual anterior crown and root caused by trauma or caries, and have incomplete occlusion and have completed root canal therapy. This system helps realize good esthetic result for patients and easy practice for dentists. Carbon fiber post is safe and convenient, especially for sick children.</p>

The measurement and comparison of shear fracture strength and shear bond strength between carbon fiber post and some other posts / 中华口腔医学杂志

<p><b>OBJECTIVE</b>The shear fracture strengths of carbon fiber post, IPS-Empress 2 all-ceramic post (without ZrO2 post), cast Ni-Cr alloy post, prefabricated zirconia ceramic post, human dentin and the shear bonding strengths of the first three kinds of post bonded in the human root canals were measured and compared, which are as the reference for dental clinic.</p><p><b>METHODS</b>Standard cylindrical samples were made respectively in each group of carbon fiber post, IPS-Empress 2 all-ceramic post, cast Ni-Cr alloy post, prefabricated zirconia ceramic post, human dentin, three for each group. The shear fracture strengths of these samples were measured by universal testing machine (AUTOGRAPH DCS5000). Standard cylindrical samples were made respectively in each group of carbon fiber post, IPS-Empress 2 all-ceramic post (without ZrO2 post), cast Ni-Cr alloy post, five for each group. They were bonded in extracted human root canals that had been prepared to 3.0 mm length and 2.0 mm diameter with Glass ionomer cement (Japan Shofu). The shear bond strengths were measured by the same universal testing machine.</p><p><b>RESULTS</b>The shear fracture strengths of the carbon fiber post (199MPa), cast Ni-Cr alloy post (210MPa, shear bend strength) and prefabricated zirconia ceramic post (193MPa) were statistically higher than those of IPS-Empress 2 all-ceramic post (109MPa) and human dentin (100MPa). The shear fracture strength of the carbon fiber post was statistically similar to that of cast Ni-Cr alloy post and prefabricated zirconia ceramic post. There were no statistical differences between the shear bond strengths of carbon fiber post (2.4MPa) and cast Ni-Cr alloy post (3.8MPa). IPS-Empress 2 all-ceramic post broke before debonding (2.7, break value).</p><p><b>CONCLUSIONS</b>Carbon fiber post, as well as cast Ni-Cr alloy post and prefabricated zirconia ceramic post, has a comparatively high shear fracture strength. The shear bond strengths of carbon fiber post is similar to cast Ni-Cr alloy post.</p>

Human Brain Mapping of Language-Related Function on 1.5T Magnetic Resonance System: Focused on Motor Language Function

PURPOSE: To investigate the feasibility of functional MR imaging of motor language function and its usefulnessin the determination of hemispheric language dominance. MATERIALS AND METHODS: In order to activate the motorcenter of language, six subjects(5 right-handed, 1 left-handed; 3 males, 3 females) generated words. They wererequested to do this silently, without physical articulation, in response to English letters presented visually.Gradient-echo images (TR/TE/flip angle, 80/60/40o; 64x128 matrix; 10mm thickness) were obtained in three axialplanes including the inferior frontal gyrus. Functional maps were created by the postprocessing of gradient-echoimages, including subtraction and statistics. Areas of activation were topographically analyzed and numbers ofactivated pixels in each region were compared between right and left sides. The reproducibility of functional mapswas tested by repetition of functional imaging in the same subjects. RESULTS: Statistically significant activationsignals were demonstrated in five of six subjects, in whom the distribution of those signals was predominantly inboth frontal lobes. Hemispheric lateralization of activation, when activated pixels were compared between bothinferior frontal gyri, was in all cases on the left. In four subjects, functional maps were reproduced in asimilar fashion. CONCLUSION: Our results suggest that functional MR imaging can depict the activation of motorlanguage function in the brain and can be used as a useful non-invasive method for determining the hemisphericdominance of language.