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OBJECTIVES@#Currently, the research results regarding the bilateral temporomandibular joint symmetry in patients at different ages with unilateral complete cleft lip and palate (UCLP) are still controversial. In this study, the position of condyle in the articular fossa and morphology of condyle in UCLP patients at different developmental stages was measured and analyzed to explore the asymmetry difference, which can provide a new theoretical basis for the sequential therapy.@*METHODS@#A total of 90 patients with UCLP were divided into a mixed dentition group (31 cases), a young permanent dentition group (31 cases) and an old permanent dentition group (28 cases) according to age and dentition development. Cone beam computed tomography (CBCT) images were imported into Invivo5 software for 3D reconstruction, and the joint space, anteroposterior diameter, medio-lateral diameter, and height of condylar were measured, and its asymmetry index was calculated.@*RESULTS@#The asymmetry index of condylar height and anteroposterior diameter among the 3 groups, from small to large, was the mixed dentition group<the young permanent dentition group<the old permanent dentition group (both P<0.05). There was no significant difference in condylar anteroposterior diameter and asymmetry index between the mixed dentition group and the young permanent dentition group (both P>0.05), all of them were lower than those in the old permanent dentition group (both P<0.05). Compared with the normal side, the height of fracture condyle was smaller among the 3 groups (all P<0.05), and the anterior joint space was smaller (P<0.05) and the posterior joint space was larger (P<0.05) in the mixed dentition group.@*CONCLUSIONS@#In patients with UCLP, the asymmetry of condylar morphology increases with age, but the condylar position tends to normal. These results suggest that early treatment has important clinical significance for the morphologic development of temporomandibular joint in UCLP patients.
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Humans , Cleft Lip/diagnostic imaging , Cleft Palate/diagnostic imaging , Temporomandibular Joint/diagnostic imaging , Clinical RelevanceABSTRACT
Objective:To study the facial aesthetic effect of different periodontal splints combined with orthodontic treatment for patients with sector displacement of periodontitis teeth.Methods:A total of 186 patients with sector displacement of periodontitis teeth admitted to Hunan Second People′s Hospital from April 2018 to April 2020 were prospectively selected as the research objects. 186 patients were divided into observation group and control group by random number table method, with 93 cases in each group. Both groups were treated with orthodontic correction. The observation group was treated with orthodontic combined with super fiberglass periodontal splint, while the control group was treated with orthodontic combined with conventional periodontal splint. The treatment effect, serum inflammatory factors [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6) ], periodontal pocket depth, bleeding index and plaque index before and after treatment were compared between the two groups, and the satisfaction of the two groups was compared.Results:At half year and 1 year after treatment, the effective rate of the observation group was 91.40%(85/93) and 100%(93/93), which were significantly better than those of the control group [84.95%(79/93), 95.70%(89/93), all P<0.05]. The levels of serum TNF-α, CRP and IL-6 in the two groups at half year and 1 year after treatment were significantly lower than those before treatment (all P<0.05); the levels of serum TNF-α, CRP and IL-6 in the observation group was significantly lower than the control group, with statistically significant difference (all P<0.05). The periodontal pocket depth, bleeding index and plaque index of the two groups after treatment were also significantly lower than those before treatment (all P<0.05); the periodontal pocket depth, bleeding index and plaque index of the observation group was significantly lower than the control group, with statistically significant difference (all P<0.05). At half year and 1 year after treatment, the patients′ satisfaction in the observation group reached 91.40%(85/93) and 94.62%(88/93), respectively, which was also significantly better than that in the control group [81.72%(76/93), 89.25%(83/93), all P<0.05]. Conclusions:Compared with the conventional periodontal splint, the combination of super fiberglass periodontal splint can significantly improve the treatment effect and patient′s satisfaction.
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Objective:To evaluate the value of cardiac MR feature tracking (CMR-FT) on the early assessment of left ventricular subclinical myocardial dysfunction in patients of hypertensive heart disease (HHD).Methods:From October 2018 to November 2019, 16 HHD patients with left ventricular hypertrophy (HHD-LVH), 24 HHD patients without left ventricular hypertrophy (HHD-nonLVH) and 24 age-and gender-matched normotensive controls who underwent 3.0 T CMR examination were retrospectively enrolled. Imaging protocol included cine sequence and late gadolinium enhancement. Left ventricular function variables were measured using Argus software, mainly including left ventricular end-diastolic volume index (LVEDVI), left ventricular mass index (LVMI), left ventricular maximal wall thickness (LVMWT), the ratio of left ventricular mass to left ventricular end-diastolic volume (M/V). CMR-FT was performed using commercial software CVI 42, with parameters including global radial, circumferential, longitudinal strains (GRS, GCS, GLS), peak systolic radial, circumferential, longitudinal strain rate (SRSR peak, SCSR peak, SLSR peak) and peak diastolic radial, circumferential, longitudinal strain rate (DRSR peak, DCSR peak, DLSR peak) derived. One-way analysis of variance with scheffe correction or Kruskal-Wallis test was performed for multiple comparisons. Pearson or Spearman analysis was used for linear or monotonic nonlinear correlations. Results:HHD-LVH group had higher LVEDVI, LVMI, LVMWT and M/V than HHD-nonLVH group and control group ( P<0.05). Compared with control group, GRS, GCS and GLS were statistically impaired in HHD-LVH group, and DRSR peak, DCSR peak and DLSR peak were statistically reduced in HHD-LVH group and HHD-nonLVH group(all P<0.05). Correlation analysis showed that LVMI correlated linearly with GRS ( r=-0.384, P=0.002), GCS ( r=0.392, P=0.001) and GLS ( r=0.491, P<0.0001),LVMWT correlated nonlinearly with GRS ( r=-0.362, P=0.003), GCS ( r=0.384, P=0.002) and GLS ( r=0.422, P=0.001), LVEDVI correlated nonlinearly with GRS ( r=-0.295, P=0.018) and GCS ( r=0.264, P=0.035). Conclusion:CMR-FT derived left ventricular strain parameters could be served as early indicators for the assessment of subclinical myocardial dysfunction in HHD patients, which have great potential in guiding appropriate intervention therapy and improving cardiac remodeling.
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Objective@#To explain the true experience of death anxiety in elderly inpatients with chronic diseases, and provide a theoretical basis for hospice care.@*Methods@#The phenomenological study method was used to deeply interview the true feelings of death anxiety in 13 elderly inpatients with chronic diseases.@*Results@#Through analysis, collation and refinement, the five themes of death anxiety, life regret, death attitude, death reminder and final decision power.@*Conclusions@#As clinical medical workers, we must always pay attention to the death anxiety of elderly inpatients with chronic diseases and strengthen the assessment of death anxiety. In particular, patients with cancer and patients at the end of life are provided with personalized care to remind them of the meaning of life and reduce the anxiety level of death.
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Objective@#The purpose of the research was to draw up the questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly and to provide elderly people with a effective tool for evaluating the needs of medicine, pension, rehabilitation and care.@*Methods@#The theoretical framework of the questionnaire was based on the qualitative interview results of 12 community elderly and community health care workers. A preliminary draft was formed through two rounds of expert consultation and a preliminary survey of 102 elderly people in 3 communities in Taian. Construct validity was used to evaluate the validity of the questionnaire, and Cronbach's alpha coefficient and split half reliability were used to evaluate the reliability of the questionnaire.@*Results@#Sixteen experts were invited to conduct two rounds of consultation on 61 items of the questionnaire. The authoritative coefficient of experts was 0.881, and the positive coefficient of experts was 100%. In the first round, items I-CVI, S-CVI/UA and S-CVI/Ave were 0.68-1.00, 0.72 and 0.83, respectively. Seven items were modified, six items were deleted and three items were added. In the second round, one item was deleted and one item was added, and a questionnaire consisting of seven dimensions and 58 items was formed.7 common factors were extracted from exploratory factor analysis, and the cumulative contribution rate was 63.078%. Finally, 7 dimensions and 51 item questionnaires were formed. Each dimension is the community public health service and general services, health education, pension services, rehabilitation services, family beds, service charges The total Cronbach's alpha coefficient was 0.919, the Cronbach' s alpha coefficient of each dimension was 0.615-0.808, the retest reliability coefficient of the total questionnaire was 0.862.and the Guttman half coefficient is 0.865. The total questionnaire CVI was 0.85 and the item CVI was 0.80-1.00. Item analysis showed that the correlation coefficients of the 7 items were lower than 0.3, and the rest were all between 0.3~0.7, and were significantly correlated at P<0.05 level.@*Conclusion@#The questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly had good reliability and validity, and it could be used to evaluate the needs of medicine, pension, rehabilitation and care in the elderly.
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Objective To explain the true experience of death anxiety in elderly inpatients with chronic diseases, and provide a theoretical basis for hospice care. Methods The phenomenological study method was used to deeply interview the true feelings of death anxiety in 13 elderly inpatients with chronic diseases. Results Through analysis, collation and refinement, the five themes of death anxiety, life regret, death attitude, death reminder and final decision power. Conclusions As clinical medical workers, we must always pay attention to the death anxiety of elderly inpatients with chronic diseases and strengthen the assessment of death anxiety. In particular, patients with cancer and patients at the end of life are provided with personalized care to remind them of the meaning of life and reduce the anxiety level of death.
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Objective The purpose of the research was to draw up the questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly and to provide elderly people with a effective tool for evaluating the needs of medicine, pension, rehabilitation and care. Methods The theoretical framework of the questionnaire was based on the qualitative interview results of 12 community elderly and community health care workers. A preliminary draft was formed through two rounds of expert consultation and a preliminary survey of 102 elderly people in 3 communities in Taian. Construct validity was used to evaluate the validity of the questionnaire, and Cronbach 's alpha coefficient and split half reliability were used to evaluate the reliability of the questionnaire. Results Sixteen experts were invited to conduct two rounds of consultation on 61 items of the questionnaire. The authoritative coefficient of experts was 0.881, and the positive coefficient of experts was 100% . In the first round, items I-CVI, S-CVI/UA and S-CVI/Ave were 0.68-1.00, 0.72 and 0.83, respectively. Seven items were modified, six items were deleted and three items were added. In the second round, one item was deleted and one item was added, and a questionnaire consisting of seven dimensions and 58 items was formed.7 common factors were extracted from exploratory factor analysis, and the cumulative contribution rate was 63.078%. Finally, 7 dimensions and 51 item questionnaires were formed. Each dimension is the community public health service and general services, health education, pension services, rehabilitation services, family beds, service charges The total Cronbach's alpha coefficient was 0.919, the Cronbach' s alpha coefficient of each dimension was 0.615-0.808, the retest reliability coefficient of the total questionnaire was 0.862.and the Guttman half coefficient is 0.865. The total questionnaire CVI was 0.85 and the item CVI was 0.80-1.00. Item analysis showed that the correlation coefficients of the 7 items were lower than 0.3, and the rest were all between 0.3~0.7, and were significantly correlated at P<0.05 level. Conclusion The questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly had good reliability and validity, and it could be used to evaluate the needs of medicine, pension, rehabilitation and care in the elderly.
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Objective To explore the status and influencing factors of the integrated service needs of medicine, pension, rehabilitation and care of the community elderly in order to provide a theoretical basis for the construction of an old-age service model in line with the national conditions. Methods A total of 330 elderly people from three communities in Tai'an were selected and investigated by self-made questionnaire of the integrated services needs for medicine, pension, rehabilitation and care of community elderly. Results Nearly 83.54％(259/310) of the elderly had moderate and above pension needs, and the first three were rehabilitation services, family beds and community public health services. Age, educational level, self-rated health and number of chronic diseases were the influencing factors of the integrated service needs of medicine, pension, rehabilitation and care(t =2.374-4.844, all P<0.05). Conclusions The majority of elderly people have the moderate and above health care integration service demand, the elderly have the highest demand for rehabilitation services. Age, education, self-rated health status and the number of chronic diseases have different influence on the needs of the elderly;government, society, education and medical treatment institutions interdisciplinary multi linkage, and strengthen the professionals training of health, rehabilitation, health care, in order to explore the best old-age service model in line with national conditions.
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Objective To study and analyze the perinatal outcomes of different glycosylated hemoglobin levels in gestational diabetes mellitus (DM).Methods 53 pregnant women diagnosed gestational diabetes in our hospital were selected as the observation group,and 53 pregnant women without gestational diabetes were selected as the control group.The two groups were followed up to terminate pregnancy.The glycosylated hemoglobin level was detected by HPLC.The postpartum hemorrhage,pregnancy induced hypertension syndrome and urinary tract infection and other complications were compared between the two groups.And the premature delivery,polyhydramnios,fetal macrosomia,intrauterine distress,premature rupture of membranes and other adverse pregnancy outcomes were compared between the two groups.According to the different HbA1 c levels in the observation group,they were divided into group A (HbAlc ＜ =6％),group B (HbAlc between 6.1％ ～ 6.5％),group C (HbAlc between 6.6％ ～7.0％) and group D (HbAlc ＞ 7％),the incidences of adverse pregnancy outcome were compared among four groups.Results The incidence rates of postpartum hemorrhage,pregnancy induced hypertension and urinary system infection of the observation group (18.86％,13.21％,11.32％) were higher than those of the control group (3.77％,1.89％,3.77％),the differences were statistically significant (x2 =11.356,9.179,4.085,all P ＜ 0.05).The incidence rates of premature delivery,polyhydramnios,fetal macrosomia,intrauterine distress,premature rupture of membranes of the observation group (9.43％,9.43％,11.32％,13.21％,15.09％) were higher than those of the control group (1.89％,1.89％,1.89％,3.77％,5.66％),the differences were significant (x2 =5.323,5.323,7.207,5.735,4.781,all P ＜ 0.05).The higher the level of glycosylated hemoglobin,the higher the incidence rates of adverse pregnancy outcomes,such as premature delivery,polyhydramnios,fetal macrosomia,fetal distress.And the incidence rate of premature rupture of membranes had no significant correlation with glycated hemoglobin levels (r =0.955,P ＜ 0.05).Conclusion Glycosylated hemoglobin as an important index of gestational diabetes,its change has great influence on the outcome of pregnancy,HbAl c level higher,adverse pregnancy outcomes and the high incidence of clinical pregnancy,should strengthen the HbAlc test,in order to take timely and effective measures to reduce the incidence of adverse pregnancy outcomes and ensure the safety of mother and child.
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Objective To observe the effect of capsaicin on lipid deposition in liver cells and the expression of autophagy,to provide new ideas and targets for the study of fatty liver disease.Methods The model of nonalcoholic fatty liver disease (NAFLD) was established by inducing LGF cell line of liver primary cells with oleic acid (40 μg/mL).The experiment was divided into blank control group,oleic acid group,capsaicin group[oleic acid--capsaicin(100 μmol/L)].The level of intracellular lipid was detected by oil red O staining and triglyceride (TG) kit.Western bolt was used to detect the expression level of autophagy marker molecule p62 and LC3,and to calculate the ratio of LC3 Ⅱ/LC3-Ⅰ.Results After treated with 40 μg/mL oleic acid for 24 h,the oil red O staining showed that orange-red lipid droplets were found in the oleic acid group,but there was no obvious orange-red lipid droplet formation in the blank group,which suggesting that the NAFLD cell model was established successfully by using 40 μg/mL oleic acid in vitro.Oil red O staining was observed,the cells in the capsaicin group were significantly less than the oleic acid group,and the content of triglyceride in the liver cells was significantly lower than that in the oleic acid group(P＜0.05).Western bolt test results showed that capsaicin group p62 protein levels were significantly lower compared with the oleic acid group(P＜0.05),while the LC3-Ⅱ/LC3-Ⅰ ratio was higher than that of oleic acid group(P＜0.05).Conclusion NAFLD model was established by inactivating LO2 cell line with oleic acid in vitro.Capsaicin stimulated NAFLD cells,upregulated the autophagy level of NAFLD cells and reduced intracellular lipid deposition,but the specific mechanism need further study.
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Objective To observe effect of abdomen compression on improvement of anal exsufflation for patients after abdomen operation. Methods Patients in the department of general surgery( 120 cases )after abdomen operations were randomly divided into the experimental group and the control group with 60 cases in each group.The control group adopted routine postoperative nursing,The experimental group received abdomen compression baaed upon routine nursing. Anal exsufflation time was compared between the two groups. Sults Anal exsufflation time of the experimental group undergoing different operations was earlier than that of the control group(P < 0.01 ). Conclusions Abdomen compression can bring forward anal exsufflation time,fa-cilitate the recovery of gastrointestinal function and normal diet, thus improve the rehabilitation of patients
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Objective To investigate the feasibility and safety of helix hydro-jet lithotrity in treatment of calculus of intrahepatic duct and to establish its basic parameters.Methods The parameter of hydro-jet Was set at different levels of pressure(5000-9000 kPa)and different nozzle directions,and the effect of different parameter wag observed and analyzed in three groups.including 32 ex vivo intrahapatic gallstones.thirty-two ex vivo swine bile ducts and 31 ex vivo bile ducts obtained from patients with hepatolithiasis.Results Lithotrity was successful in all groups with a jet pressure of 5000-9000 kPa.The multiple regression analysis showed that the time of procedure depended linearly on the minimal stone diameter,stone weight andjet pressure.The time of procedure and the time needed to damage the bile duct decreased with the increase in jet pressure.At same jet pressure,the smaller the angle between nozzle and bile duct,the longer the time needed to cause damage in bile duct.The technique was successfully performed in 60 patients,with no severe complications,including bile duct injury.Conclusion It is feasible to treat hepatolithiasis with hydro-jet lithotrity.The most optimal operation condition was hydro-jet pressure of 6000-7500 kPa and frequency of 1 Hz.
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Objective To compare the therapeutic effects of cordyceps sinesis (CS) and reduced glutathione on experimental non-alcoholic fatty liver disease (NAFLD) rats and explore the possible molecular mechanisms. Methods After NAFLD rats were induced by high-fat diet and were treated by CS and reduced glutathione. The histopathologic changes of livers were evaluated. The levels of TG and FFA in serum and liver were measured. The levels of SOD and ATP in liver were measured too. Results (1)In the development of NAFLD, extensive adipose degeneration, inflammatory cell infiltration and necrosis, local fibrous tissue hyperplasia were found in the liver. The increase of TG, FFA in the serum and liver and decrease of SOD and ATP in the liver were seen. (2)In CS treated group, adipose degeneration had been alleviated with slightly inflammatory cells infiltration and no necrosis or fibrosis had been found. The concentrations of TG and FFA were decreased in the serum and liver, but SOD and ATP increased. (3)In glutathione treated group, adipose degeneration of liver and inflammatory cells infiltration remained obviously with focus or punctiform necrosis, but without fibrosis. The increase of SOD in liver was distinguished. No changes of TG, FFA, UCP-2 and ATP had been detected. Conclusion Both CS and reduced glutathione have therapeutic effects on NAFLD, by preventing the generation of liver fibrosis. CS has a better therapeutic effects on metabolic disturbance or accumulation of lipid and energy metabolic imbalance of liver cells.
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Objective: To investigate the role of uncoupling protein -2 in development of nonalcoholic fatty liver diseases ( NAFLD) ,and explore the effect of glutathione ( GSH) on NAFLD. Methods: 32 SD rats were randomly divided into basic diet - treated group ( B group) ,model group( M group) , Pathology group( P group) and GSH treated group( G group). The following parameters were determined by biochemical analysis; superoxide dismutase( SOD) , glutathione(GSH) , malondialdehyde (MDA). Liver histopathologic e-valuation was performed by hematoxylin - eosin staining. Serum tumor necrosis factor alpha(TNF?) level was done by enzyme -linked immunoadsordent assay ( ELISA). Ucp2 and TNFaproteins expression in hepatocytes was examined by immunohistochemistry, and UCP2mRNA expression by semi - quantitative reverse transcription - polymerase chain reaction( RT - PCR). Results: ( 1 ) compared with B group, no evident increase in liver MDA,SOD and GSH of M group rats as well as serum TNF?level were observed. Neither marked change in number of hepatocytes with TNF?positive was shown by immunohistochemistry staining, but an increase in UCP2 mRNA and UCP2 protein expression was seen in M group rats. (2) Compared with M group, a significant increase in serum TNF? and MDA levels was found in P group .while a significant decrease in liver homogenate SOD and GSH was observed . An apparent increase in number of hepatocytes with TNF?and UCP2 positive was shown by immunohistochemistry staining, as well as UCP2mRNA level by RT-PCR. (3) Compared with P group, a significant decrease in serum MDA and a significant increase in liver homogenate SOD, GSH levels was found in G group. A little lower level of UCP2 expression was shown in G group than in P group. Conclusion; High level of serum and tissue TNFaand UCP2 over - expression are concomitant with an extreme decrease even depletion in the liver ATP in NAFLED model rats, that cause oxidative stress and lipid super - oxidation in liver, and induce or exacerbate fatty liver disease progression to steatohepatitis even fibrosis. Glutathione seems to be effective to some extent for NAFLD by protection of liver function through replenishment of exogenous antioxidants.