Progress of research on bone grafts for implant dentistry / 口腔医学

@#With the development of dental implant techniques, dental rehabilitation of partially or totally edentulous patients with oral implants has become a common practice. Adequate bone volume in the implant area is a key factor for the success of implant restoration. However, insufficient bone volume in the implant area is very common in clinical practice, which jeopardizes the structural, functional, and esthetic outcomes of implant treatment. Bone augmentation with bone grafts is one of the methods commonly used in clinical practice to meet the requirements of implantation. Properties of bone grafts, such as biocompatibility,osteoconduction, osteoinduction and osteogenesis, are important to the success of bone augmentation. This paper reviews current research on dental bone grafts about their clinically relevant capabilities, classification and their potential development in the future, in order to provide theoretical reference for clinical application of bone grafts and successful implant restoration.

Epidemiological characteristics and spatial clustering analysis of brucellosis in Shandong Province from 2015 to 2020 / 中华地方病学杂志

Objective:To learn about the epidemiological and spatial clustering characteristics of brucellosis in Shandong Province, and to provide a reference for scientific prevention and control of brucellosis.Methods:The epidemic data of human brucellosis in Shandong Province from January 2015 to December 2020 were collected from the Infectious Disease Reporting Information Management System of China Disease Control and Prevention Information System, and the data were analyzed by descriptive epidemiology and spatial clustering analysis.Results:A total of 18 811 cases of human brucellosis were reported in Shandong Province from 2015 to 2020, and the average annual incidence rate was 3.16/100 000. Human brucellosis occurred in every month of the year, and the peak incidence was from March to August, accounting for 66.31% (12 474/18 811). The top 5 counties (districts) with average annual incidence rates were Lijin County (32.39/100 000), Kenli District (11.02/100 000), Wudi County (10.35/100 000), Zhanhua District (9.59/100 000) and Shanghe County (8.80/100 000). There were 13 436 males and 5 375 females, with a male-female sex ratio of 2.50 ∶ 1.00; the age was mainly concentrated in 30-69 years old, accounting for 83.23% (15 656/18 811); farmer was the main occupation, accounting for 85.82% (16 144/18 811). The results of global spatial autocorrelation analysis showed that the annual incidence rates of brucellosis in Shandong Province showed a spatial clustering distribution from 2015 to 2020; and the local spatial autocorrelation analysis showed that the high incidence of human brucellosis was mainly concentrated in the north of Shandong Province.Conclusions:The incidence of brucellosis in Shandong Province is mainly concentrated in spring and summer, most of them are farmers, and the high incidence areas have spatial clustering. Key prevention and control measures should be taken for high incidence seasons, high-risk population and northern high clustering areas to reduce the incidence of brucellosis.

Safety and efficacy of left atrial appendage closure combined with patent foramen ovale closure for atrial fibrillation patients with patent foramen ovale / 中华心血管病杂志

Objective: To analyze the safety and efficacy of combined left atrial appendage (LAA) and patent foramen ovale (PFO) closure in adult atrial fibrillation (AF) patients complicating with PFO. Methods: This study is a retrospective and cross-sectional study. Seven patients with AF complicated with PFO diagnosed by transesophageal echocardiography (TEE) in Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences from June 2017 to October 2020 were selected. Basic data such as age, gender and medical history were collected. The atrial septal defect or PFO occluder and LAA occluder were selected according to the size of PFO, the ostia width and depth of LAA. Four patients underwent left atrial appendage closure(LAAC) and PFO closure at the same time. PFO closure was performed during a one-stop procedure of cryoablation combined with LAAC in 2 patients. One patient underwent PFO closure at 10 weeks after one-stop procedure because of recurrent transient ischemic attack (TIA). All patients continued to take oral anticoagulants. TEE was repeated 8-12 weeks after intervention. In case of device related thrombus(DRT), TEE shall be rechecked 6 months after adjusting anticoagulant and antiplatelet drug treatment. Patients were follow-up at 1, 3, 6, 12, 24 months by telephone call, and the occurrence of cardio-cerebrovascular events was recorded. Results: Among the 7 patients with AF, 2 were male, aged (68.0±9.4) years, and 3 had a history of recurrent cerebral infarction and TIA. Average PFO diameter was (3.5±0.8)mm. Three patients were implanted with Watchman LAA occluder (30, 30, 33 mm) and atrial septal defect occluder (8, 9, 16 mm). 2 patients were implanted with LAmbre LAA occluder (34/38, 18/32 mm) and PFO occluder (PF1825, PF2525). 2 patients were implanted with LACbes LAA occluder (24, 28 mm) and PFO occluder (PF2525, PF1825) respectively. The patients were followed up for 12 (11, 24) months after operation. TEE reexamination showed that the position of LAA occluder and atrial septal defect occluder or PFO occluder was normal in all patients. DRT was detected in 1 patient, and anticoagulant therapy was adjusted in this patient. 6 months later, TEE showed that DRT disappeared. No cardiovascular and cerebrovascular events occurred in all patients with AF during follow-up. Conclusions: In AF patients complicated with PFO, LAAC combined with PFO closure may have good safety and effectiveness.

Relationship between postoperative pulmonary complications and preoperative malnutrition in elderly patients undergoing thoracoscopic and laparoscopic radical esophagectomy / 中华麻醉学杂志

Objective:To evaluate the relationship between preoperative malnutrition and postoperative pulmonary complications (PPCs) in elderly patients undergoing thoracoscopic and laparoscopic radical esophagectomy.Methods:The elderly patients who underwent elective thoracoscopic and laparoscopic radical esophagectomy in the Affiliated Hospital of Jiangnan University were enrolled.The general clinical data and nutritional status, Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score, tumor pathological stage and operation-related variables based on the Gobal Leader Initiative on Malnutrition criteria were recorded.The patients were divided into 2 groups according to whether PPCs occurred during hospitalization, and the differences between the variables were compared.Logistic regression analysis was used to identify the risk factors for PPCs in elderly patients undergoing thoracoscopic and laparoscopic radical esophagectomy.The accuracy of the ARISCAT score and ARISCAT score combined with malnutrition in predicting the occurrence of PPCs was evaluated by receiver operating characteristic curve.Results:A total of 256 elderly patients undergoing thoracoscopic and laparoscopic radical esophagectomy were included, and the incidence of PPCs was 23.8%.There were no significant differences between patients with and without PPCs in FEV 1/FVC, age, American Society of Anesthesiologists physical status, chronic obstructive pulmonary disease ratio, malnutrition ratio and ratio of patients with high ARISCAT score ( P<0.05). The results of logistic regression analysis showed that increasing age, chronic obstructive pulmonary disease, malnutrition and high ARISCAT score were independent risk factors for PPCs.The area under the receiver operating characteristic curve of ARISCAT score and malnutrition combined with ARISCAT score in predicting the occurrence of PPCs was 0.722 and 0.777, respectively, and the difference was statistically significant ( P<0.05). Conclusions:Preoperative malnutrition is an independent risk factor for the occurrence of PPCs in elderly patients undergoing thoracoscopic and laparoscopic radical esophagectomy, which is helpful in improving the accuracy of ARISCAT score in predicting the occurrence of PPCs.

Efficacy of Watchman occlusion of the left atrial appendage in patients ≥85 years with atrial fibrillation / 中华老年医学杂志

Objective:To analyze the safety and efficacy of left atrial appendage closure(LAAC)with Watchman in patients ≥85 years with atrial fibrillation(AF).Methods:515 elderly patients with atrial fibrillation, including 73 patients aged 85 years or older(85~91), who had undergone Watchman LAAC at Zhoupu Hospital affiliated to Shanghai Health Medical College from August 2016 to December 2020, were retrospectively analyzed.Of those ≥85 years, 44(60.3%)with transesophageal echocardiography records were assigned to the elderly group.Fifty-three patients aged 60 to 65 were selected as the control group.Differences in baseline data, intraoperative conditions, antithrombotic treatment plans and 1-year follow-up prognosis were compared between the two groups.Results:Compared with the control group, there was no difference in AF types, history of ischemic stroke/transient ischaemic attack(all P>0.05), but there were higher incidences of coronary heart disease and renal insufficiency, more severe heart failure, higher CHA 2DS 2-VASC(6.0±1.5 vs.3.6±1.5), HAS-BLED(3.2±1.2 vs.2.3±1.3)scores( t values were 7.682 and 3.871, respectively, P<0.05), and a lower one-stop surgery rate(6 cases or 13.6% vs. 27 cases or 50.9%, χ2=10.517, P<0.05)in the advanced age group.There was no difference in the diameter of the Watchman device, rate of device replacement, compression percentage and residual flow between the two groups during the perioperative period.The incidences of device-related thrombosis were 4.5%(2/44)and 3.8%(2/53)for the advanced age group and the control group, respectively, but the difference was not statistically significant( P>0.05). During the 12-month follow-up, there were no cases of ischemic stroke or intracerebral hemorrhage.Three died of heart failure and 1 died of cancer. Conclusions:LAAC with Watchman is safe and effective for patients over 85 years with AF, but the decision on the procedure should be based on careful assessment of patients' cardiac and renal function and general health.

Mechanism of Combination of Pungent Dispersing Bitter Evacuant in Treatment of Asthma Based on Theory of Five Flavor Compatibility / 中国实验方剂学杂志

Bronchial asthma， a chronic inflammatory airway disease， belongs to the category of wheezing disease in the system of traditional Chinese medicine （TCM）. The wheezing symptom of this disease is mainly caused by the imbalance of lung Qi. According to the theory of five flavor compatibility， the Chinese medicinal materials with five different flavors （pungent， bitter， sour， sweet， and salty） can be combined to produce new functions. The pungent medicinal materials have dispersing effect and the bitter medicinal materials have discharging effect， which are important components in the theory of five flavor compatibility. Pungent herbs and bitter herbs can relieve the adverse lung Qi， occupying an important position in the current medication for the treatment of asthma. However， there is still a lack of in-depth analysis of the TCM theory and mechanism of the compatibility of pungent herbs and bitter herbs in the treatment of asthma. The molecular mechanisms of action of pungent herbs and bitter herbs are closely related to transient receptor potential （TRP） channels and bitter taste receptors （TAS2Rs）， respectively. Ca2+ signaling has been recognized in the process of asthma and is involved in the development of multiple symptoms of asthma. The TRP channels and TAS2Rs located on the cell membrane have been proved to directly regulate the intracellular Ca2+ signal and play a role in the treatment of asthma. Therefore， the dispersing effect of pungent herbs and the discharging effect of bitter herbs may be realized through the Ca2+ signaling pathway mediated by TRPs/TAS2Rs. We summarized the theoretical understanding and modern studies of pungent herbs dispersing lung Qi and bitter herbs discharging lung Qi， aiming to explain the internal relationship and mechanism of the compatibility of pungent herbs and bitter herbs in the treatment of asthma from the perspective of TCM theory and modern medicine. The compatibility of pungent herbs and bitter herbs based on the theory of five flavor compatibility for the treatment of asthma has a solid theoretical basis of TCM， and its mechanism can be verified by modern research. Therefore， it may be a main research direction in the treatment of asthma by Chinese medicinal herbs in the future.

Research Progress on Dysemenorrhea of Essential Oils of Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

Dysmenorrhea is a common gynecological disease in clinic， with primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea is usually not accompanied by organic lesions in genital organs， which is mainly related to the increase of prostaglandin content in endometrium during menstruation. Secondary dysmenorrhea is accompanied by organic lesions of reproductive organs， often associated with local lesions of reproductive organs， but also with patients' mental factors and neuroendocrine factors.The incidence of dysmenorrhea is as high as 73.8%， and there is no radical cure method， which has a great impact on the life， work and learning of patients. Chinese medicine essential oil widely exists in aromatic Chinese medicine， with antibacterial， antioxidant and anticancer activities. It can regulate neuroendocrine function， anti-inflammatory and analgesic effects， and improve mood by regulating the levels of prostaglandins， oxytocin and other hormones in the body and regulating the emotions of patients， there by alleviating dysmenorrhea to a certain extent. In recent years， many scholars have made more in-depth research on Chinese medicine essential oil in alleviating dysmenorrhea， but there is a lack of comprehensive collation of such studies. In this regard， the author has systematically sorted out the generation and classification of dysmenorrhea， the mechanism of action of essential oil of traditional Chinese medicine to alleviate dysmenorrhea and the application of essential oil of traditional Chinese medicine in the field of dysmenorrhea by consulting relevant literature in Chinese and foreign languages in recent years， so as to provide reference for the treatment of dysmenorrhea.

Exploration and practice of innovative model of ability-oriented training for general practitioners / 中华医学教育探索杂志

Objective:To explore an innovative model of ability-oriented training for general practitioners and to evaluate its implementation effectiveness.Methods:A total of 49 general practitioners who participated in the training in 2015 were selected as the research objects, and they were trained in a new mode with innovative teaching and training system and comprehensive assessment mode as the main content. The results of theoretical examination and self-assessment scores of post competency were compared before and after the training. SPSS 19.0 was used for t test. Results:The theoretical examination results of the first year of training were higher than those before training [(77.23±0.55) scores vs. (69.14±4.63) scores], with significant differences ( t=12.15, P=0.001); and the results of the second year of training were also higher than those of the first year of training [(83.72±0.45) scores vs. (77.23±0.55) scores], with significant differences ( t=8.12, P=0.001). The self-assessment questionnaire showed that there were significant differences in such five abilities of the students' competency as medical knowledge and clinical skills, autonomous learning, interpersonal communication, teamwork, core values and doctor professionalisms through the comparison of systematic training ( t=2.76, 4.53, 12.09, 2.33, 2.40, all P<0.05). Conclusion:The innovative training model for general practitioners is effective, and the practice of the new model could provide reference for continuously improving the training and education of general practitioners in China.

Effectiveness of induction therapy with exclusive enteral nutrition in pediatric Crohn's disease / 中国当代儿科杂志

OBJECTIVES@#To evaluate the effectiveness of induction therapy with exclusive enteral nutrition (EEN) in pediatric Crohn's disease (CD).@*METHODS@#A retrospective analysis was performed on the medical data of 62 children with CD who received EEN in Children's Hospital, Zhejiang University School of Medicine, from March 2013 to August 2021. The medical data included general information and height, weight, Pediatric Crohn's Disease Activity Index (PCDAI), Crohn's Disease Endoscopic Index of Severity, C-reactive protein, erythrocyte sedimentation rate, and serum albumin level before treatment and after 8 weeks of treatment. The changes in the above indicators were compared before and after treatment.@*RESULTS@#Among the 62 children with CD, there were 39 boys (63%) and 23 girls (37%), with a mean age of (11.9±3.0) years at diagnosis. Among the 55 children who completed EEN treatment for at least 8 weeks, 48 (87%) achieved clinical remission at week 8. PCDAI at week 8 was significantly lower than that before treatment (P<0.001). Except for 17 children with involvement of the small intestine alone and 3 children with involvement of the colon who did not receive colonoscopy reexamination, the remaining 35 children with involvement of the colon received colonoscopy reexamination after the 8-week EEN treatment. Of the 35 children, 29 (83%) achieved mucosal healing. As for the 48 children who achieved clinical remission at week 8, there were significant improvements in height-for-age Z-score and body mass index-for-age Z-score at week 8 (P<0.01). As for the 7 children who did not achieve clinical remission at week 8, there were no significant changes in height-for-age Z-score and body mass index-for-age Z-score at week 8 (P>0.05).@*CONCLUSIONS@#The 8-week EEN treatment has a good effect on clinical remission and mucosal healing in children with CD. For the children with CD achieving clinical remission, EEN can improve their height and body mass index.

Construction of evaluation index system of postgraduate education quality of clinical medicine based on SNA / 中华医学教育探索杂志

Objective:To systematically sort out and cluster the existing indicators of key issues in the quality of postgraduate clinical degree education based on the bibliometric study, so as to build a multidimensional quality assessment index system that integrates scientificity, rationality and representativeness, and to provide a scientific measurement tool for assessing clinical professional postgraduate education in China.Methods:By mining the related functions of UCINET6 network analysis integration software and its one-dimensional and two-dimensional data analysis NetDraw program, the social network analysis (SNA) method was used to extract and cluster the education quality problem set of clinical professional degree postgraduates.Results:A three-dimensional evaluation index system was constructed. The first dimension concluded such 8 key issues in the quality of postgraduate education in clinical medicine as ability assessment, teaching system, teaching quality assurance system, professional cognition and career prospects, assessment and evaluation system and organization, and the pulse taking and diagnosis.Conclusion:The clinical graduate education quality evaluation index system is an effective measurement tool for education quality improvement, based on a multidimensional perspective, with key issues as priority areas for intervention, providing an effective evidence-based basis for ensuring the development of professional graduate education efforts from 2020-2025.

Chemical composition and hypoglycemic activity of Edgeworthia gardneri / 药学学报

Seven compounds were isolated from the alcohol extract of Edgeworthia gardneri by various technologies, including silica gel, Sephadex LH-20 and high performance liquid chromatography, and were identified as edgeworthiaside A (1), 2,4,6-trichlorol-3-methyl-5-methoxy-phenol 1-O-β-D-glucopyranosyl-(1-6)-β-D-glucopyranoside (2), 2,6-dimethoxy-4-(2-propen-1-yl)phenyl 6-O-(6-deoxy-α-L-mannopyranosyl)-β-D-glucopyranoside (3), eugenol rutinoside (4), tiliroside (5), edgeworoside C (6), and salicylic acid (7). Compound 1 is a new chlorophenyl glycoside and 2-4 were isolated for the first time from Edgeworthia gardneri. The in vitro inhibition of α-glucosidase showed that the inhibition rate of compounds 1 and 2 were similar to acarbose.

The relationship of osteoporotic vertebral body compression fracture with the degeneration of multifidus muscle and intervertebral disc in lower lumbar spine and the lumbar-pelvic parameters in elderly women / 中华老年医学杂志

Objective:To investigate the relationship of osteoporotic vertebral body compression fracture(OVCF)with multifidus muscle and intervertebral disc degeneration in the lower lumbar spine and the lumbar-pelvic parameters in elderly women.Methods:Clinical data of a total of 108 elderly women with osteoporosis were retrospectively analyzed.They were divided into the fracture group(n=56)and the control group(n=52)according to the presence of vertebral body compression fractures.Age, body mass index(BMI)and bone mineral density(BMD)were collected in two groups.The angle of pelvic incidence(PI), angle of pelvic tilt(PT), low lumbar lordosis(LLL)and sacral slope(SS)were measured by the standing lumbar lateral X-ray photography.The degree of degeneration of intervertebral disc L 3-S 1 and multifidus muscle were detected by using the lumbar MRI.These parameters were compared between the two groups. Results:The age, BMI and BMD had no significant difference between the two groups( P>0.05). The degree of intervertebral disc degeneration of L 3-L 4 and L 4-L 5 was statistically significant higher in the fracture group than in the control group( Z=-4.656 and -2.675, P=0.000 and 0.007), while the degree of intervertebral disc degeneration of L 5-S 1 had no statistically significant difference between the two groups( Z=-1.784, P=0.075). There were statistically significant higher multifidus muscle degeneration of L 3-L 4 and L 4-L 5 in the fracture group than in the control group( Z=-3.248 and -4.073, P=0.001 and 0.000), while no significant difference between the two groups in multifidus muscle degeneration of L 5-S 1( Z=-1.096, P=0.282). No statistically significant differences were found in PI, PT, SS and LLL between the two groups( t=1.162, 0.827, -0.082 and -0.677, P=0.248, 0.410, 0.935 and 0.500). Conclusions:The degeneration of intervertebral disc and multifidus muscle of L 3-L 4 and L 4-L 5 is positively correlated with OVCF in elderly women.

Analysis of the Genome Sequence of Strain GiC-126 of Gloeostereum incarnatum with Genetic Linkage Map

Gloeostereum incarnatum has edible and medicinal value and was first cultivated and domesticated in China. We sequenced the G. incarnatum monokaryotic strain GiC-126 on an Illumina HiSeq X Ten system and obtained a 34.52-Mb genome assembly sequence that encoded 16,895 predicted genes. We combined the GiC-126 genome with the published genome of G. incarnatum strain CCMJ2665 to construct a genetic linkage map (GiC-126 genome) that had 10 linkage groups (LGs), and the 15 assembly sequences of CCMJ2665 were integrated into 8 LGs. We identified 1912 simple sequence repeat (SSR) loci and detected 700 genes containing 768 SSRs in the genome; 65 and 100 of them were annotated with gene ontology (GO) terms and KEGG pathways, respectively. Carbohydrate-active enzymes (CAZymes) were identified in 20 fungal genomes and annotated; among them, 144 CAZymes were annotated in the GiC-126 genome. The A mating-type locus (MAT-A) of G. incarnatum was located on scaffold885 at 38.9 cM of LG1 and was flanked by two homeodomain (HD1) genes, mip and beta-fg. Fourteen segregation distortion markers were detected in the genetic linkage map, all of which were skewed toward the parent GiC-126. They formed three segregation distortion regions (SDR1–SDR3), and 22 predictive genes were found in scaffold1920 where three segregation distortion markers were located in SDR1. In this study, we corrected and updated the genomic information of G. incarnatum. Our results will provide a theoretical basis for fine gene mapping, functional gene cloning, and genetic breeding the follow-up of G. incarnatum.

Clinical effect of alfacalcidol in children with Henoch-Schönlein purpura: a prospective randomized controlled trial / 中国当代儿科杂志

OBJECTIVES@#To study the effects of alfacalcidol on serum 25-(OH)D@*METHODS@#A total of 200 children with HSP were prospectively enrolled from June 2018 to June 2020. According to the random number table method, they were divided into an observation group and a control group (@*RESULTS@#After treatment, the observation group showed a significantly higher serum 25-(OH)D@*CONCLUSIONS@#Alfacalcidol can increase the serum 25-(OH)D

Imaging study of soft tissue swelling after anterior cervical corpectomy / 中国骨伤

OBJECTIVE@#To study the changes of anterior soft tissue swelling after anterior cervical subtotal corpectomy, titanium mesh fusion and internal fixation.@*METHODS@#From November 2015 to July 2018, 151 patients with cervical spondylotic myelopathy were treated with anterior single corpectomy, titanium mesh fusion and internal fixation, including 109 males and 42 females, aged 44 to 81 (59.77±8.34) years. Through postoperative follow up observation, the C@*RESULTS@#All patients were followed up for 15 to 40(28.00±3.52) months. One week after the operation, the swelling of anterior soft tissue reached the peak, and then decreased. At 8 months after the operation, the swelling of anterior soft tissue on C@*CONCLUSION@#Anterior subtotal cervical corpectomy, titanium mesh bone graft fusion and internal fixation can cause swelling of the anterior soft tissue. One week after operation, we should pay more attention to the aggravation of the swelling of the anterior soft tissue to avoid the occurrence of dysphagia, respiratory obstruction, asphyxia and other complications.

Application of posterior arch of the atlasrch resection for high-level cervical dumbbell schwannoma surgery / 中国骨伤

OBJECTIVE@#To investigate the feasibility and clinical effect of hemi-resection of posterior arch of atlas in the upper cervical spinal dumbbell-shaped schwannomas.@*METHODS@#A retrospective analysis was performed on 13 patients with high level cervical dumbbell schwannomas from January 2005 to December 2018, including 10 males and 3 females, aged 19 to 67 years old. The occipital foramen to the C@*RESULTS@#The operation was successfully completed in 13 cases of this group. No vertebral artery injury or spinal cord injury occurred during the operation. All 13 patients were followed up for more than 12 months. No local recurrence was found. Both the VAS and the JOA score were significantly improved compared with those before surgery. The ASIA classification before operation was:1 case of grade C, 6 cases of grade D, 6 cases of grade E;the latest follow up was 3 cases of ASIA grade D and 10 cases of E.@*CONCLUSION@#The posterior arch of the atlas hemisection can remove the upper cervical dumbbell schwannoma in one stage. The short-term clinical effect is good, and there are no complications such as cervical instability.

Analyzing the abnormal results of personal dose monitoring of medical radiation workers / 中国职业医学

OBJECTIVE: To analyze the abnormal results and their causes of personal dose monitoring on medical radiation workers.METHODS: The medical radiation workers monitored from 2016 to 2019 in the personal dose monitoring room of Guangdong Province Hospital for Occupational Disease Prevention and Treatment were selected as the study subjects using convenient sampling method. The abnormal results and their causes of the medical radiation workers with personal dose equivalent ≥1.25 mSv(investigation level) in a single period were analyzed. RESULTS: The rate of abnormal results of personal dose monitoring was 0.26%(263/102 284). The false result rate was 0.19%(194/102 284), and that of the true result rate was 0.07%(69/102 284). A total of 73.38%(193/263) of medical radiation workers had abnormal results with an personal dose equivalent less than 5.00 mSv. Among different occupational groups, the abnormal results and false results in personal dose monitoring in interventional radiology group were the highest(all P<0.01). The abnormal result rate and false result rate were higher in the Pearl River Delta area than that in the non-Pearl River Delta area(0.27% vs 0.17%, 0.20% vs 0.12%, all P<0.05). The rate of false result of personal dose monitoring in the tertiary hospitals was lower than that in the non-tertiary hospitals(0.18% vs 0.30%, P<0.05). The main reason for the true results of personal dose monitoring was the increase of workload(43.48%), and the main reason for the false results was that the dosimeter was left in the workplace(57.73%). CONCLUSION: The rate of abnormal results of personal dose monitoring in the medical radiation workers is high. Radiological protection should be strengthened with emphasis on medical radiation workers in interventional radiology, Pearl River Delta area hospitals and non-tertiary hospitals.

Diagnosis and surgical treatment of symptomatic lumbar spinal epidural liposis / 中国骨伤

OBJECTIVE@#To explore diagnosis and surgical treatment of symptomatic lumbar spinal epidural lipoplasia.@*METHODS@#A retrospective analysis of 19 patients with symptomatic lumbar spinal epidural hyperplasia treated with hemilaminectomy and interbody fusion and internal fixation from February 2012 to November 2018 were performed, including 7 males and 12 females, aged from 48 to 72 years old with an average of (57.6±1.2) years old;the course of disease ranged from 6 to 60 months with an average of (18.6±5.1) months;plane requiring decompression:L@*RESULTS@#All patients were followed up from 12 to 37 months with an average of (16.3±3.8) months. Ninteen patients were successfully completed operation, and all adipose tissues in the compressed segment of the spinal canal were removed. Operation time was from 125 to 260 min with an average of (186± 15) min, and blood bleeding was from 150 to 500 ml with an average of (280±46) ml. Two patients occurred partial incision fat liquefaction and exudate did not heal, the incision was opened to remove effusion, the dressing was changed and anti-inflammatory treatments were performed. No complications such as cauda equina injury, cerebrospinal fluid leakage, and broken nails occurred. Preopertaive VAS of back pain and leg pain were 5.3±0.7 and 6.8±0.8, respectively, while 2.1±0.4 and 2.3±0.5 respectively at 6 months after opertaion, there were statisticalsignificant difference between 6 months after operation and before operation (@*CONCLUSION@#Patients with symptomatic lumbar spinal epidural lipoplasia undergo hemilaminectomy and internal fixation of compression segment could relieve compression of dura mater and cauda equina, and achieve good clinical results.

Diagnosis, treatment and etiology analysis of nerve compression by bone fragment after lumbar spine surgery / 中国骨伤

OBJECTIVE@#To explore the diagnosis, treatment, cause and prevention of nerve compression by bone fragment after lumbar spine surgery.@*METHODS@#The clinical data of 23 patients with nerve compression by bone fragment after lumbar spine surgery from February 2012 to March 2019 were collected retrospectively, including 9 males and 14 females, aged 42 to 81 years with an average of (62.60±5.70) years. The surgical methods included lumbar interbody fusion in 20 cases and spinal endoscopy in 3 cases. All 23 patients experienced radiating pain on the decompression side or the contralateral limb after operation. The time of occurrence was from immediately after operation to 2 weeks after operation, with an average of (3.2±1.7) days. All patients underwent postoperative examination of lumbar spine CT or MRI to confirm residual ectopic bone fragments, and at the same time, bilateral lower extremity color Doppler ultrasound excluded thrombosis. Sources of ectopic bone fragments:14 cases of residual bone fragments caused by intervertebral fusion bone graft loss or fenestration fusion, 6 cases of fractured upper articular process head, and 3 cases of upper articular process bone remaining during spinal endoscopic surgery.@*RESULTS@#The patient's hospital stay was 10 to 37 (23.4±6.2) days. All patients were followed up for 6 to 25 (13.6±3.4) months. Three patients underwent posterior open nerve root exploration for removing bone fragments on the same day or the second day after surgery, and the symptoms were relieved. Twenty patients underwent conservative treatment firstly, and 13 patients were discharged after pain relieved by conservative treatment, 7 patients failed conservative treatment, the 2 cases of failed 7 cases had undergone nerve root block surgery during conservative treatment. Two patients underwent spinal endoscopy nerve root exploration and bone mass removal, and five patients underwent posterior open nerve root exploration and bone fragmentation removal. All postoperative pain symptoms were relieved. Preoperative CT, MRI and intraoperative bone fragment removal confirmed the shape and location of the bone fragments. The most likely source of bone fragments was the loss of intervertebral fusion bone grafts or residual bone fragments resulting from fenestration fusion (14 cases), fractured upper articular process head (6 cases), and upper articular process bones remaining in endoscopic surgery (3 cases). According to the Macnab criteria in evaluating clinical outcome, 20 cases got excellent results and 3 good.@*CONCLUSION@#After the lumbar spine surgery, the nerve compression by bone fragments is treated with appropriate treatments, and good clinical results can be obtained. Timely removal of residual bone fragments during operation and careful exploration of nerve roots before closing incision can avoid such complications.

Application of biomimetic restoration in oral-maxillofacial hard tissue repair / 华西口腔医学杂志

Oral-maxillofacial hard tissue is the support of maxillofacial structure and appearance, and lays the foundation for functions of oral and maxillofacial system. Once the defect occurs, it will not only affect the physiological functions such as chewing and pronunciation, but also have a significant impact on the psychological and social life of patients. However, the self-repairing capability of the oral-maxillofacial hard tissue is pretty limited, in which case, substitute materials are required for tissue repair. A huge gap exists between the physical, chemical, structural characteristics of conventional substitute materials and those of human hard tissues, resulting in poor repair effect. Based on this, scholars simulated the process of biomineralization in the development of hard tissues, to improve the structure and function of materials through biomimetic mineralization technology and enhance the repair performance of materials. The current understanding of biomineralization theory and the construction of biomimetic repair technology is still in the stage of rapid development. In recent years, a mass of innovative studies are keeping emerging. In this review, the representative advances in the repair of oral-maxillofacial hard tissues of the past five years are reviewed.