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Objective:To evaluate the clinical effects of modified everStick C&B fiber resin bonded bridge in the restoration of inci-sor missing teeth in senile patients.Methods:32 patients over 65 years with incisor loss old were included.13 of them were with missing maxillary incisors and 19 with missing mandibular incisors.13 had 1 missing tooth,11 had 2,5 had 3 and 3 had 4 missing teeth.The abutment was loose in 24 cases and not loose in 8 cases.All patients were treated with modified everStick C&B fiber resin bonded bridge repair.Re-examination was conducted at 6,12 and 18 months after completion of repair.The re-examination includ-ed 6 indexes including prosthesis debonding,fracture,color change,defect,abutment loosening and periodontal tissue inflamma-tion.The patients'satisfaction was investigated 6 months after the repair was completed.The investigation included 3 indexes:whether the treatment was comfortable,whether the aesthetic effect was satisfactory,and whether the pronunciation and chewing were comfortable after the repair.Results:The 32 patients were reexamined 6 months after completion of the repair,and all 6 indexes were grade A.Reexamination at 12 months showed that 1 case of treated defect was grade B,2 cases of abutal periodontal tissue in-flammation was grade B,and the rest indexes were grade A.Reexamination at 18 months showed that 1 case of treated defect was grade B,3 cases of abutal periodontal tissue inflammation was grade B,and the rest indexes were grade A.All the 2 cases of grade B defects reached grade A after resin filling.All the 5 cases of abutal periodontal tissue inflammation grade B reached grade A 5-7 days after periodontal cleaning.All 3 indicators in the patient satisfaction survey were graded A.Conclusion:The modified ever-Stick C&B fiber resin bonded bridge is effective in the restoration of incisor missing teeth in senile patients.
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Objective:To assess the left ventricular (LV) myocardial mechanical dysfunction in patients with cirrhosis using ultrasonic layer-specific strain imaging and to explore its value in clinical application.Methods:A total of 80 consecutive cirrhosis patients without cardiovascular diseases were prospectively enrolled from October 2020 to March 2021 in Sichuan Provincial People′s Hospital, 39 of whom were assigned to the compensated group and 41 were assigned to the decompensated group according to the occurrence of portal hypertension. Forty-three healthy volunteers during the same period were randomly recruited as the control group. Transthoracic echocardiography was performed to assess the LV configuration and functional parameters. LV global longitudinal strain in endocardial, middle and epicardial myocardium (GLSendo, GLSmid, GLSepi), and longitudinal strain (LS) in basal, middle and apical segments, and peak strain dispersion (PSD) were obtained using ultrasonic layer-specific strain imaging. ΔLS was calculated by the formula of GLSendo-GLSepi. Then, the differences of related parameters among three groups were compared.Results:①Conventional echocardiography: compared with the control group, the interventricular septum end-diastolic thickness (IVSTd), left ventricular posterior wall end-diastolic thickness (LVPWd), left ventricular mass (LVM) and LVM index (LVMI) were increased in compensated and decompensated groups (all P<0.05), while no significant differences in conventional echocardiographic parameters were identified between the two cirrhosis groups (all P>0.05). ②Global layer-specific strain: compared with the control group, GLSendo, GLSmid, GLSepi and ΔLS were decreased and PSD was increased in compensated and decompensated groups (all P<0.05); Moreover, the decompensated group showed a more impaired GLSendo, GLSmid and GLSepi than compensated group (all P<0.05), whereas there were no significant differences of ΔLS and PSD between the two groups(all P>0.05). ③Segmental layer-specific strain: compared with the control group, LS values of three layers in compensated and decompensated groups were reduced at basal, middle and apical levels (all P<0.05); Compared with the compensated group, LS values of three layers in decompensated group tended to be reduced at above there levels, but only apical segments had significant differences (all P<0.05). Conclusions:There are different degrees of LV mechanical dysfunction in patients with variable severity of cirrhosis. Ultrasonic layer-specific strain imaging has the potential to quantitatively assess the state of cardiac involvement in patients with cirrhosis and to provide visual evidence for the early and accurate diagnosis of myocardial injuries.
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Objective:To investigate the expression, prognostic value and potential mechanism for the role of SNHG4 in gastric cancer.Methods:The expression of SNHG4 in gastric cancer was analyzed by UALCAN database. The relationship between SNHG4 and prognosis of gastric cancer was analyzed by Kaplan-Meier Plotter. SNHG4-miRNA-mRNA regulatory network was constructed by StarBase, Targetscan, microT-CDS and Cytoscape. The target genes were analysis GO and KEGG pathway enrichment by DAVID database.Results:The expression of SNHG4 in gastric cancer was significantly higher than that in normal tissues ( P=8.882E-16) . The overall survival time of patients with high SNHG4 expression was lower than that of patients with low expression ( P=8.900E-05) . Through the construction of RNA regulatory network, we found that hsa-let-7a-5p ( P=1.02E-03) , hsa-miR-152-3p ( P=4.51E-06) , hsa-miR-204-5p ( P=6.68E-04) and hsa-miR-363-3p ( P=8.06E-03) could be used as the binding sites of SNHG4 in gastric cancer, and these four miRNAs further regulated 250 downstream target genes. Through GO and KEGG enrichment analysis of the target genes, we found that these target genes played roles in the biological process of protein phosphorylation regulation, transcription negative regulation, RNA polymerase II promoter transcription, and participated in the occurrence and development of gastric cancer by blocking or activating Wnt and other signal pathways. Conclusions:SNHG4 can be used as a potential tumor marker for gastric cancer to judge the prognosis of gastric cancer. By constructing a SNHG4-miRNA-mRNA regulatory network, the pathogenesis of gastric cancer can be studied at the molecular level. This provides a clear direction for experimental and clinical research.
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Objective To evaluate the transmural myocardial strain in three specific layers of the left ventricle at the papillary muscle level in short-axis view in SD rats before and after doxorubicin administration usmg myocardial layer-specific strain imaging based on two-dimensional ultrasound speckle tracking imaging (2D-STI),and to demonstrate the myocardial mechanical characteristics of doxorubicininduced early-stage acute cardiac toxicity in rats.Methods Thirty-two SD male rats weighing 300-350 g were randomly divided into a doxorubicin group (DOX group,n=16) and a control group (n=16).In the doxorubicin group,doxorubicin hydrochloride (concentration,2 mg/ml) was injected intraperitoneally at a single dose of 12 mg/kg,while the control group was given equal volume of 0.9% sodium chloride solution.LVEDD,LVESD,IVSd,LVPWd,FS,and LVEF were measured and derived using two-dimensional gray-scale echocardiography at the left ventricular papillary muscle level in short-axis view at three time points (before administration and 24 and 48 hours after administration).The circumferential strain in the subendocardium,medium,and subepicardium at the left ventricular papillary muscle level in short-axis view were obtained using ultrasonic 2D-STI.The values of FS,LVEF,and the global myocardial circumferential strain in different layers of the left ventricular wall at the papillary muscle level in short axis view at three time points were compared between the two groups.After echocardiographic examinations at 48 h and 72 h,the hearts of three rats in each group were randomly selected,sliced,and HE-stained for myocardial pathological observation.Results In both groups,there was a circumferential strain gradient of the left ventricular wall at the papillary muscle level in the short-axis view:subendocardium > medium > epicardial myocardium.In the DOX group,the circumferential strain in the subendocardial myocardium decreased at 48 hours after DOX administration;the difference was statistically significant between the two groups (-25.13± 10.6 vs -17.04± 2.89,t=2.3,P < 0.05).There was no significant difference in myocardial circumference strain in the three layers,as well as LVEDD,LVESD,IVS,LVPW,FS,or LVEF at three time points between the control group and DOX group (P > 0.05).The pathological changes were mainly myocardial cell edema,vascular degeneration,myocardial nucleus atrophy,dissolution,interstitial edema,and capillary dilatation in the doxorubicin group,which were especially obvious in subendocardial cardiomyocytes.Conclusion 2D-STI technology based layer-specific strain imaging could be used to detect and quantitatively evaluate the deformation damage of the transmural left ventricular wall in SD rats.
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Objective To evaluate left ventricular myocardial systolic function in patients with obstructive sleep apnea hypopnea syndrome ( OSA HS) with normal left ventricular ejection fraction( LVEF) using three‐dimensional strain echocardiography . Methods One hundred patients with OSA HS were divided into mild group ,moderate group and severe group according to apnea hypopnea index ( A HI) w hile matched with 32 healthy people as control group . T he parameters such as three‐dimensional LVEF ,global longitudinal strain( GLS) ,global circumferential strain( GCS) ,global area strain( GAS) ,global radial strain ( GRS) ,twist and torsion based on standard three‐dimensional echocardiography were measured by three‐ dimensional strain echocardiography , the above parameters among the four groups were compared for difference .Linear correlationship between A HI ,LVEF and the three dimensional strain parameters was analyzed respectively . Results ①T here was no significant difference in three‐dimensional LVEF ,twist and torsion between each groups( P >0 .05 ) . ②GLS ,GAS and GRS were lower in mild ,moderate and severe group compared with control group ,decreasing along with the disease severity ( P <0 .01 or P < 0 .05 ) . GCS in severe group was lower than that in control group ( P <0 .01 ) . ③GLS and GAS in severe group were lower than those in mild group ( all P <0 .05) .GRS in moderate and severe group were lower than that in mild group( all P < 0 .05 ) ,GAS ,GRS in severe group was lower than those in moderate group ( P <0 .05) . ④T here was a mild correlation between GLS and A HI ( r =0 .342 , P <0 .01) ,GAS and A HI ( r=0 .294 , P <0 .01) ,GRS and A HI ( r = -0 .411 , P <0 .01 ) . T here was a mild correlation between GCS and three‐dimensional LVEF ( r= -0 .354 , P <0 .01 ) ,GAS and three‐dimensional LVEF ( r = -0 .326 , P <0 .01) ,GRS and three‐dimensional LVEF ( r =0 .300 , P <0 .01) . Conclusions T he left ventricular myocardial systolic function is impaired in all patients with OSA HS even with normal LVEF and the dysfunction is aggravating with the disease severity . Ultrasonic three‐dimensional strain imaging technology can be used to detect the subclinical myocardial systolic dysfunction quantitatively in the early stage of OSA HS patients .
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Primary splenic angiosarcoma is a rare highly malignant hematologic neoplasms. Based on the combination of PET/CT diagnosis of primary splenic angiosarcoma: 1 case was analyzed. The diagnosis and treatment of primary splenic angiosarcoma and the diagnostic significance of PET/CT in this disease were studied.
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Primary splenic angiosarcoma is a rare highly malignant hematologic neoplasms. Based on the combination of PET/CT diagnosis of primary splenic angiosarcoma: 1 case was analyzed. The diagnosis and treat-ment of primary splenic angiosarcoma and the diagnostic significance of PET/CT in this disease were studied.
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Objective To investigate the current status of overcrowding in emergency departments of Tertiary level A hospitals in order to discover and analyze key factors limiting the performance efficiency of staff to raise a suggestion of improvements.Methods The data regarding the distribution of the total number of available beds and total number of patients registered were collected from 19 tertiary level A hospitals to construct a regression model correlating variables including number of patients waiting,time of appointment and number of patients delivered by ambulances.The national grading system of crowdedness for emergency departments was used to estimate the NEDOCS_ BJ value for Beijing Friendship Hospital.Results Statistical analyses of key factors hampering the work efficiency and correlation between ESI triage and clinical decisions revealed overcrowding in the emergency department in a pattern across hospitals and time periods.The extent of overcrowding can be alleviated by way of increase in performance efficiency.Conclusions The proposed improvements regarding the hierarchical medical system,the development of treatment plans,and working procedure were recommended.
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Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16%.The most common underlying disease were coronary disease (43.27%),hypertension (17.73%),cardiomyopathy (16.07%) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81% (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3% and 32.27%,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64% and 46.89%,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64% vs.49.93%),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43% vs.37.45%) and emergency department mortality(1.58% vs.4.09%).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6% vs.33.2%),cardiovascular disease mortality (20.2% vs.26.0%),aggravated heart failure mortality (22.4% vs.28.8%) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51% vs.28.17%,1.41% vs.9.58%),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.
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Objective To investigate the heterogeneity of the left ventricular reference value in echocardiography mesurements by Meta analysis. Methods A literature retrieval in PubMed,Embase, Medline and other databases from January 2005 to September 2017 related to left ventricular normal reference value in healthy adults was performed. Cohrane′s Q test was used to test the heterogeneity,and I2 was used as a statistic for the description of heterogeneity. Subgroup analysis,sensitivity analysis and Meta regression were used to analyze the sources of heterogeneity. Results The Meta analysis enrolled 9 studies including 5 933 normal cases. The heterogeneity test showed that the left ventricular normal reference value of echocardiography was highly heterogeneous among the studies. In subgroup analysis, some measurements′ heterogeneity were significantly reduced. Meta regression analysis showed that the contribution of racial specificity to heterogeneity was relatively high in some measurements. Conclusions The heterogeneity of left ventricle is mainly related to racial specificity,but it cannot fully explain the heterogeneity between studies. Further studies are needed to demonstrate the involved factors of heterogeneity of left ventricular normal reference values.
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Objective To reveal the early elastic dysfunction of common carotid artery may have occurred in systemic lupus erythematosus( SLE) patients ,the circumferential strain parameters of common carotid artery intima in SLE patients at different serum complement levels were quantitatively evaluated by layer-specific strain imaging . Methods Seventy-two patients suffered from SLE without evidence of atherosclerosis were enrolled ,and the results of laboratory examination of serum complement C 3 in patients with SLE were recorded in detail ,49 cases of SLE patients whose serum C3 was lower than the normal reference range(SLE C3+ group) ,23 cases of SLE patients whose serum C3 was in the range of normal reference value(SLE C3 - group) . And a matched healthy control group ( n =38) were selected . Carotid ultrasound were performed in all three groups ,and the common carotid artery conventional parameters ,such as common carotid artery intima-media thickness ( CCA-IM T ) ,peak systolic velocity ( PSV ) ,end-diastolic velocity(EDV) ,resistance index(RI) and circumferential strain related parameters ,such as circumferential strain of common carotid artery intima(CSendo) and circumferential strain rate(CSr) were measured and derived.Therelatedparametersamongthosegroupswerecomparedfordifference.Results ①Therewas no significant difference in RI among the three groups(all P >0 .05) . The values of CCA-IMT in the SLE C3+ group and SLE C3- group were larger than that in the control group( all P <0 .05) . ②The values of CSendo and CSr in the SLE C3+ group and SLE C3 - group were lower than those in the control group ,the values of SLE C3+ group were significantly lower than those in the control group ( P <0 .001) ,and there was no significant difference between the SLE C3- group and control group( P >0 .05) . ③The CSendo and CSr in the SLE C3+ group were lower than those in the SLE C3- group(all P < 0 .05) . Conclusions CSendo which is provided by new ultrasonic technology of layer-specific strain combined with recent changes in serum complement C3 may provide visual evidence for assessing early elastic disfunction of carotid intima in SLE patients .
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Polybrominated diphenyl ethers (PBDEs), a kind of important Brominated Flame Retardant (BFR), are widely used in electronic products, construction materials and textiles. PBDEs have been detected in many environmental media (including air, water, dust, sediment and food), many animal and human tissues. For their environmental persistence, high bioaccumulative and multiple biotoxicitiies, PBDEs have been viewed as one of the most concerned environmental Endocrine Disrupting Chemicals (EDCs) at present. Although detailed mechanisms are not clear, studies have found that PBDEs can induce toxicity to liver, endocrine system, nervous system, reproduction and immune system. What's more, lots of experiments indicate that PBDEs exposure can alter the levels of thyroid hormones. Recently, studies on the impact of PBDEs exposure on thyroid hormones have been quite a few and have not reached an agreement, especially on the alternation of thyroid hormones caused by PBDEs exposure, which has also been a hot issue. This paper reviews from the basic properties, usage, exposure and biotoxicity of PBDEs. We mainly introduce the impact PBDEs have on the thyroid and thyroid hormones in terms of biotoxicity, and attach importance to the endocrine disruption and neurodeveloptoxicity. We also give a preliminary introduction to hydroxylated and methoxylated polybrominated diphenyl ethers, structural analogs of PBDEs, which researchers start late to study. This paper can be a reference for the further research on PBDEs exposure and biotoxicity.
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Objective:To investigate the effect of BMSC transplantation on the recovery of neurological function in rats with cerebral infarction,and to explore the related mechanism.Methods:90 rats were randomly divided into 3 groups:sham operation group,control group,BMSC transplantation group,30 rats in each group.The control group and BMSC transplantation group established middle cerebral artery occlusion (MCAO) model,the sham operation group only need to separate the cervical tissue of rats,and MCAO model in the MCAO model operation.After 1 days of BMSC transplantation group by intravenous injection of 1 mL 3× 106 BMSC,the control group was injected with the same dose of NS in MCAO after 1 D,3 D,7 d,14 d,21 d,28 d,35 d,42 d,49 D respectively,the neurological function score of rats (mNSS),after 2 months of transplantation BMSC group and control group of brain tissue for immunohistochemical staining,detection of MAP2,TUJ1,Ⅷ factor,the expression of GFAP.Results:In seventh to thirty-fifth days after treatment,BMSC mNSS transplantation group were significantly lower than the control group (P < 0.05).2 months after BMSC transplantation group MAP2,TUJ1,Ⅷ expression level was significantly higher than the control group,while the control group,the expression of GFAP was significantly higher than that of BMSC group (P < 0.01).Conclusion:BMSC transplantation in order to promote the recovery of neurological function in cerebral infarction.
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Objective To discuss MRI manifestations of overlap syndrome of autoimmune liver diseases and the diagnostic value of the MRI .Methods Seven patients of overlap syndrome of autoimmune liver diseases were recruited .The MRI examination (inclu‐ding T1WI ,T2WI ,DWI and MRCP )were underwent on these patients .MR features of overlap syndrome were reviewed by two ra‐diologists by consensus .Two radiologists independently reviewed the studies in a blinded fashion .Results AIH/PBC 4 cases ,AIH/PSC 1 case ,PBC/PSC 1 case ,AIH/PBC/PSC 1 case was collected .MRI of AIH/PBC has the MRI feature of AIH and PBC .MRI of AIH/PSC has the MRI feature of AIH and PSC .MRI of PBC/PSC has the MRI feature of PBC and PSC .MRI feature of AIH/PBC/PSC has the MRI feature of AIH ,PBC and PSC .Conclusion If the patients who sufferd autoimmune liver diseases displayed the MIR images of other autoimmune liver diseases ,the patients were considered that had developed into overlap syndrome of autoim‐mune liver diseases .
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Although digital subtraction angiography (DSA) has been used as the gold standard for the diagnosis of intracranial aneurysms, its clinical use is somewhat limited by its invasiveness, high medical cost and potential risk of nephrotoxicity. For the past three decades, the magnetic resonance angiography (MRA) techniques have been developed rapidly. As a non-invasive technique with high resolution ability, MRA can replace DSA for the diagnosis of intracranial aneurysms in most clinical situations. The time-of-flight MRA (TOF-MRA) carries a diagnostic sensitivity of up to 98.2%-98.7%for tiny intracranial aneurysms ( 5 mm) reaches as high as 100%. All the above mentioned MRA techniques can clearly display the intracranial aneurysms although their imaging characteristics and clinical applications are different from each other. This paper aims to make a brief review concerning the principles, clinical applications and recent progress of some MRA techniques.
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The development and progression of gastric cancer is a multi-factor,multi-gene,multi-stage and multi-approach sequential process.Phosphatase and tensin homologue deleted on chromosome 10 (PTEN)is so far the first discovery of a dual specificity phosphatase activity of the tumor suppressor gene,which regulates the cell cycle and multiple signaling pathways of gastric cancer and plays an important role in the development and progression of gastric cancer.Further studies on PTEN will provide a new way for the early diagnosis,treatment and prognosis of gastric cancer.