Superior vena cava syndrome and pulmonary artery stenosis in a patient with lung metastases of bladder cancer / 复旦学报（医学版）

Superior vena cava syndrome(SVCS)is a group of clinical syndromes caused by obstruction of the superior vena cava and its major branches from various causes.Pulmonary artery stenosis(PS)is a complication of lung cancer or mediastinal tumours.SVCS combined with PS due to pulmonary metastases from bladder cancer is extremely rare and has not been reported in the literature.Here we reported an old male patient with pulmonary metastases from bladder cancer presenting with swelling of the head,neck and both upper limbs.SVCS combined with PS was clarified by pulmonary artery computed tomography angiography(CTA)and digital subtraction angiography(DSA).Endovascular stenting was used to treat SVCS.Angiography also showed that PS had not caused pulmonary hypertension and did not need to be treated.The swelling of the patient's head,neck and upper limbs was gradually reduced after the procedure.

Research progresses of different material endovascular stents and imaging follow-up after stent implantation / 中国介入影像与治疗学

Endovascular stent implantation had become a major therapeutic option for heart,brain and peripheral vascular diseases.After stent implantation,CT angiography(CTA)and MR angiography(MRA)were often performed during follow-up to diagnose or predict relative complications as early as possible.The research progresses of different material endovascular stent and imaging follow-up after stent implantation were reviewed in this article.

Screwdriver aspiration during implant surgery: case report and literature review / 口腔疾病防治

Objective @#To discuss and summarize the preventive measures and treatment methods for aspiration/ingestion during dental procedures.@*Methods @# One case of aspiration during an implant operation was reported, and the literature on aspiration/ingestion during oral procedures was reviewed.@*Results@#An implant screwdriver accidentally slipped into the mouth of the patient during implant surgery. The patient experienced no obvious discomfort except a few coughs. The surgeon and assistant paused the procedure immediately to search for the screwdriver, but it was not found. The patient declared that there was no special abnormality, such as breathing disorder or chest distress, so we considered that the foreign body was ingestion. After the implant surgery was completed, no foreign body was found in the stomach via gastroscopy. Chest X-ray and CT showed a dense metal shadow in the lower lobe of the left lung. Under local anesthesia, bronchoscopy and biopsy forceps were used by respiratory physicians to clip out the foreign body. After removal of the foreign body, the patient had no obvious discomfort but a slight cough. Cephalexin and metronidazole were given for three days to prevent infection. Three days later, the patient had no complaints of respiratory discomfort. After reviewing the literature, we found that the operation should be paused immediately after aspiration/ingestion occurs during dental procedures and that the dental chair should be laid down to prevent the foreign body from descending deeper, which may increase the difficulty of removal and cause gastrointestinal and respiratory tract injury. The position of the foreign body should be determined by imaging examination, and the corresponding means to remove the foreign body should be performed.@*Conclusion @# Patients may have no obvious symptoms after aspiration/ingestion during dental procedures, and the foreign body can be removed after imaging examination.

Factors affecting the clinical success rate of miniscrew implants for orthodontic treatment / 中国组织工程研究

BACKGROUND: During the orthodontic treatment, the results of related reports on potential risk factors affecting the clinical success rate of miniscrew implants are inconsistent. The influential factors that clinicians concern are not all included in this study, and the conclusions from animal experiments are difficult to apply to clinical practice directly. Therefore, what factors affect the clinical success rate of miniscrew implants need further thorough and systematic research. OBJECTIVE: To investigate the factors that influence the clinical success rate of miniscrew implants used as orthodontic anchorage. METHODS: A total of 114 patients with oral implants, including 42 males and 72 females, aged (19. 26±9. 19) years were included in this study. A total of 253 miniscrew implants were implanted as orthodontic anchorage. The following influential factors were included: Gender, age, vertical skeletal facial pattern, implant site, implant arch, soft tissue type at the implant site, oral hygiene status, diameter and length of the miniscrew implants, implantation method, implantation angle, stress loading timing and intensity, and clinical use. Logistic regression analysis was used to study the correlation between success rate and all variables. Analysis of variance was used to test the effect of each variable on clinical success rate. This trial protocol was approved by the Medical Ethics Committee of Sichuan University. RESULTS AND CONCLUSION: Among 253 successful miniscrew implants, the overall success rate was 88. 54% with an average loading period of 9. 5 months. The average loading period of the 29 failed miniscrew implants was 2. 3 months. The chi-square test, Fisher exact test and Logistic regression revealed that age, oral hygiene, vertical skeletal facial pattern, and implant site were significantly correlated with clinical success rate (P 0. 05). These results suggest that to minimize the failure of miniscrew implants, proper oral hygiene instruction and effective supervision should be given to patients, in particular to those young (< 12 years) high mandibular plane patients.

Occlusal analysis of implant-supported fixed denture in edentulous patients / 华西口腔医学杂志

OBJECTIVE@#This study aims to evaluate the occlusal characteristics of full edentulous patients with implant-supported prostheses and to provide a reference with the occlusal situation for clinicians.@*METHODS@#A Teetester occlusal analysis system was used with 30 full edentulous patients of implant-supported fixed denture (test group) in comparison with 30 natural dentition (control group). The percentage of occlusal force distribution were measured, as well as the occlusal time at the intercuspal, protrusion, and left and right lateral positions.@*RESULTS@#Compared with control group, the occlusion time, maximum occlusal force in intercuspal of test group significantly reduced (P<0.05); while control group was obviously superior to test group in the left and right bit force degree. Disclusion time in protrusion, occlusion times in lateral positions of test group also significantly reduced (P<0.05). There were no significant differences in average occlusion force, percentage of total force in anterior teeth, and lateral occlusion between test group and control group.@*CONCLUSIONS@#The maximum occlusal force in intercuspal of full edentulous patients with implant-supported prostheses reduce. The occlusal force in protrusive occlusion is concentrated in the front teeth, and the group function occlusion is the main lateral occlusal pattern.

Design of points, lines and planes in the reconstruction of occlusion and the risk control in implantation / 中华口腔医学杂志

Occlusion reconstruction involves various factors, such as joints, muscles, teeth and mental states. The relationship between implantation complications and occlusion, especially in the method of reducing the risk of implantation during occlusal reconstruction, is more and more emphasized by clinicians. This article mainly summarized the essentials of occlusal factors, such as mandibular position, cusp inclination and occlusal contacts, Spee's curve, Wilson curve and occlusal plane, in clinical treatment from the perspective of static geometry, dynamic functional movement in points, lines and planes, in order to accomplish precise occlusion reconstruction to achieve a stable and functional occlusion reconstruction, i.e. comfortable mandibular position, reasonable protrusive and lateral guidance, firm retrusive control and stable posterior supports, and to maintain the stability of implant.

Skills, safety and feasibility of long stent implants in the middle cerebral artery / 中国综合临床

Objective To discuss the skills, safety and feasibility of the long stent implants in the middle cerebral artery in brain. Methods One 58-year-old female patient suffered from recurrent right limb dysfunction was chosen as the subjective. The cerebral angiography showed long stenosis lesions (90%-95% )in left middle cerebral artery from M1 to M2, with the length of 13 - 14 mm and the vascular diameter of 2. 5mm. Under local anesthesia a 2. 5 mm × 15.0 mm rapamycin-eluting stent was implanted into left middle cerebral artery. Results The stent was successfully implanted with no residual stenosis, and with TIMI 3 level blood flow. The patient had no adverse events during 14-month follow up. Conclusion With good implanting skills,long stent implantation in middle cerebral artery is safe and feasible.

Comparison of Osteogenic Potential in vivo between Autologous Bone Marrow Mesenchymal Stem Cell Implanting and Fibrin Sealant Combined with Recombined Human Bone Morphogenetic Protein-2 Grafting / 中国康复理论与实践

@#Objective To investigate the osteogenic potential for size-critical bone defect of fibrin sealant combined with recombined human bone morphogenetic protein-2 (rhBMP-2) grafting and varied autologous bone marrow mesenchymal stem cells (BMSCs) implanting in vivo. Methods BMSCs were cultured and induced with osteogenic supplement (OS) medium. BMSCs with and without OS induction were collected and percutaneously autologous injected respectively into the 15 mm bone defect of experimental rabbit model. The grafts were BMSCs, osteo-induced BMSCs, BMSCs and osteo-induced BMSCs, BMP combined with fibrin sealant, 0.9% NaCl solution. Osteogenesis at the defect area was assessed with regular radiography, histology and biomechanics. Results The FS/BMP group and the BMSCs+osteo-induced BMSCs group achieved complete bone healing with medullary cavity united, with the most new bone formation and the maximal load among those groups. Conclusion The osteogenic potential of both osteo-induced BMSCs combined with BMSCs and FS/BMP are similar, which are superior to that of BMSCs or osteo-induced BMSCs along.

Implanting operation and normal implanting position of mini-implant / 实用口腔医学杂志

The whole process of mini-implant was introduced, including preparation, operating methods, points for attention during the procedure, post-operation of implanting and the medical orders. Principles of implanting position and eight normal positions of implanting were introduced. These might be useful for clinical application.

Application of problem based learning(PBL) in clicical practice of cardial pacemaker / 中华医学教育探索杂志

To evaluate the effect of problem based learning(PBL)in clinical education of pacemaker implanting,30 postgraduates of clinical medicine were arranged into the PBL education group and 60 into the traditional education group.The results showed that the scores of theory and clinical skill of the PBL group were significantly better than those of the traditional education group. It also showed that PBL teaching method is more helpful and more effective than traditional education in clinical education of pacemaker installing.

Analysis of 42 cases implanting with autoskull stored utra-hypothermia skull bone of oneself / 临床外科杂志

Objective To analyze the superiority of implanting operation with autoskull stored at ultrahypothermia over low temperature's and frozen skull bone of oneself.Methods 42 case were observed and followed up after operation.Results Incision is healing by firct intention.there were many advantages,such as good biological activity,beautiful appearance,no repellent response,no immunoreaction and hard to infection,etc. After storing 1,3,6 and 12 months,the histological structure of frozen skull observed by electronscope was similar to those of fresh skull.Pestroyed skull bone cells were not found.All cases had no complication during the period of 3 to 12 months(mean 6.5 months) follow-up after operation.After 12 months,X ray and CT scan showed that skulls were healed.Conclusions Implanting operation with autoskull stored at ultra-hypothermia is one of the most effective technique for repairing skull defects.

Implanting traffic discipline in children with lessons from the street.

Because the development of character is more easily attained in a child than an adult, a pilot project was launched in Thailand during 1997 with the aim of inculcating traffic discipline in a group of secondary school students. The strategy was to have them witness real traffic in the streets, and the consequences of such actions, anticipating that they would vicariously learn a lesson that would be implanted permanently in their conscience, in the hope that this would help to make them more disciplined citizens when they become adult drivers. From 9 a.m. to noon daily during the period September 26 to October 28, 1997, a cohort of about 10 randomised secondary school students out of a total of 332 students aged 12 to 18 years (median age 14 years) was taken in an air-conditioned van through the streets of Muang district of Nonthaburi Province to observe traffic laws being broken and the legal action taken by an assigned team of traffic police. One or two motor-cycle policemen would take the appropriate action against the violators. Another officer who accompanied the students in the van would describe the action taking place outside, quoting the relevant regulations and penalties (fines, etc.). The students were then required to complete the information sheets they had been provided earlier. After the daily trips, each group of students prepared a summary of their observations. Both the group summary and the information sheets from individual students were to be submitted to the project organizer on the next day. Composite data in those information sheets and the summary notes acquired from 332 students were analysed and put into categeries. Correlations were then assessed in term of the variety of vehicles stopped, the age and sex of the drivers, and the type of offense and the legal action imposed. The enthusiasm of the students was judged from the written expressions in their summary notes as well as from observatory remarks by the project organiser who accompanied them on the daily trips. The results of the project are discussed with regard to the prevalence of traffic law violations, and the discretion of police in enforcing the law and levying of fines. It is not possible to draw firm conclusions from the present data; however, follow up of these particular cohorts of students in the future may provide pertinent evidence on the degree to which the students have become more disciplined as drivers. The authors observed that, despite the relatively limited action of the police involved in this project, fines of approximately 400,000 baht were levied on the traffic violators during the 32-day period in only one district of suburban Bangkok. Thus, it has been estimated that several millions of baht monthly could be made available to the government if the authorities were to energetically enforced traffic rules and additional police to tackle the problem of ubiquitous traffic violations in Bangkok and nationwide. Further, such an approach might assist in solving the problem of unemployment caused by the country’s current economic crisis.

Use and management of medical implanting material / 医疗卫生装备

The use and management of medical implanting material is always the key point of the hospital material management. Questions existing in hospital management were investigated along with some suggestions in further management in the system and the process.