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OBJECTIVES@#The objectives of this study were to assess the quality of prosthetic prescriptions of removable partial dentures (RPDs) and to analyze the current situation of the communication and information delivery between clinicians and technicians.@*METHODS@#All RPD prosthetic prescriptions received by a major dental laboratory in 4 weeks were involved in a quality audit, and the prescriptions were divided into three groups in accordance with the grades of clients. The filling of prosthetic prescriptions was recorded. The items in the prescriptions for audit included the general information of the patient, the general information of the clinician, the design diagram information, other detailed information, and the return date. The prescriptions were categorized into four levels on the basis of their quality by two quality inspectors who have been working for more than 10 years.@*RESULTS@#A total of 916 prescriptions were collected and assessed. The names in the general information of the patient and the clinician were filled out best, both at the rate of 97.6% (n=894). The return date was filled out worst, only at the rate of 6.4% (n=59). Of those prescriptions, 86.8% (n=795) exhibited inadequate design diagram information. The results of the quality assessment demonstrated that 74.2% of prescriptions were assessed as noncompliant ones and failed to meet the acceptable clinical quality standard.@*CONCLUSIONS@#At present, the overall quality of RPD prosthetic prescriptions is poor. The responsibilities of clinicians and technicians are unclear, and the communication between them is not ideal.
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Humanos , Diseño de Dentadura , Dentadura Parcial Removible , PrescripcionesRESUMEN
Objective:To investigate the clinical effect of esophagofundostomy combined with pericardial devascularization in the treatment of upper gastrointestinal hemorrhage caused by portal hypertension.Methods:The clinical data of 108 patients with portal hypertension admitted to the Affiliated Hospital of Inner Mongolia Medical University from Feb 2009 to Feb 2015 were analyzed. Among them 42 patients underwent esophagofundostomy combined with pericardial devascularization as the study group, and 66 patients underwent pericardial devascularization only as the control group. All patients presented with splenomegaly or hypersplenism; the spleen was routinely removed during the operation.Results:The difference of operation time between the study group and the control group was statistically significant [(157±41) min vs. (143±27) min, t=2.81, P<0.05]. The improvement in the esophagogastric varices in the study group within 6 months was significantly better than that in the control group( Z=2.47, P<0.05). In addition, the rebleeding rates of varicose veins within 1, 3 and 5 years in the study group was 2%, 5% and 10%, while that in the control group was 15%, 21% and 26% (χ 2=5.49, 4.27, 4.31, all P<0.05). Conclusions:Esophagofundostomy combined with pericardia devascularization achieves complete devascularization and low rebleeding rate.
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Vision formation is classically based on projections from retinal ganglion cells (RGC) to the lateral geniculate nucleus (LGN) and the primary visual cortex (V1). Neurons in the mouse V1 are tuned to light stimuli. Although the cellular information of the retina and the LGN has been widely studied, the transcriptome profiles of single light-stimulated neuron in V1 remain unknown. In our study, in vivo calcium imaging and whole-cell electrophysiological patch-clamp recording were utilized to identify 53 individual cells from layer 2/3 of V1 as light-sensitive (LS) or non-light-sensitive (NS) by single-cell light-evoked calcium evaluation and action potential spiking. The contents of each cell after functional tests were aspirated in vivo through a patch-clamp pipette for mRNA sequencing. Moreover, the three-dimensional (3-D) morphological characterizations of the neurons were reconstructed in a live mouse after the whole-cell recordings. Our sequencing results indicated that V1 neurons with a high expression of genes related to transmission regulation, such as Rtn4r and Rgs7, and genes involved in membrane transport, such as Na/K ATPase and NMDA-type glutamatergic receptors, preferentially responded to light stimulation. Furthermore, an antagonist that blocks Rtn4r signals could inactivate the neuronal responses to light stimulation in live mice. In conclusion, our findings of the vivo-seq analysis indicate the key role of the strength of synaptic transmission possesses neurons in V1 of light sensory.
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Vision formation is classically based on projections from retinal ganglion cells (RGC) to the lateral geniculate nucleus (LGN) and the primary visual cortex (V1). Neurons in the mouse V1 are tuned to light stimuli. Although the cellular information of the retina and the LGN has been widely studied, the transcriptome profiles of single light-stimulated neuron in V1 remain unknown. In our study, in vivo calcium imaging and whole-cell electrophysiological patch-clamp recording were utilized to identify 53 individual cells from layer 2/3 of V1 as light-sensitive (LS) or non-light-sensitive (NS) by single-cell light-evoked calcium evaluation and action potential spiking. The contents of each cell after functional tests were aspirated in vivo through a patch-clamp pipette for mRNA sequencing. Moreover, the three-dimensional (3-D) morphological characterizations of the neurons were reconstructed in a live mouse after the whole-cell recordings. Our sequencing results indicated that V1 neurons with a high expression of genes related to transmission regulation, such as Rtn4r and Rgs7, and genes involved in membrane transport, such as Na/K ATPase and NMDA-type glutamatergic receptors, preferentially responded to light stimulation. Furthermore, an antagonist that blocks Rtn4r signals could inactivate the neuronal responses to light stimulation in live mice. In conclusion, our findings of the vivo-seq analysis indicate the key role of the strength of synaptic transmission possesses neurons in V1 of light sensory.
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Objective To evaluate the significance of double pancreatico-jejunostomy in preventing pan-creatic fistula after central pancreatectomy (CP). Methods The clinical data of 10 patients who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from Feb. 2012 to Dec. 2018 were analyzed retro-spectively. Results All the 10 patients underwent CP, closure of the proximal pancreatic stump, and end-to-side invaginated pancreaticojejunostomy; At the same time, invaginated pancreaticojejunal anastomosis or duct-to-mu-cosa pancreaticojejunostomy was performed to the distal pancreatic remnant. The duration of the operation was (240±60) min, and the average intraoperative blood loss was 300 ml. Incidence of pancreatic fistulas was 30％(3/10). There were no grade B or C pancreatic fistulas, or perioperative deaths. The duration of postoperative hospital stay varied from 9 to 25 days. Endocrine and exocrine functions were well maintained during the follow-ups of 7 months to 5 years, and no tumors recurred. Conclusions Although operation time and technical diffi-culty increase, central pancreatectomy using double pancreaticojejunostomy is safe, feasible, and appears to be as-sociated with a low rate of postoperative pancreatic fistulas.
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Objective@#To evaluate the significance of double pancreatico-jejunostomy in preventing pancreatic fistula after central pancreatectomy (CP) .@*Methods@#The clinical data of 10 patients who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from Feb. 2012 to Dec. 2018 were analyzed retrospectively.@*Results@#All the 10 patients underwent CP, closure of the proximal pancreatic stump, and end-to-side invaginated pancreaticojejunostomy; At the same time, invaginated pancreaticojejunal anastomosis or duct-to-mucosa pancreaticojejunostomy was performed to the distal pancreatic remnant. The duration of the operation was (240±60) min, and the average intraoperative blood loss was 300 ml. Incidence of pancreatic fistulas was 30% (3/10) . There were no grade B or C pancreatic fistulas, or perioperative deaths. The duration of postoperative hospital stay varied from 9 to 25 days. Endocrine and exocrine functions were well maintained during the follow-ups of 7 months to 5 years, and no tumors recurred.@*Conclusions@#Although operation time and technical difficulty increase, central pancreatectomy using double pancreaticojejunostomy is safe, feasible, and appears to be associated with a low rate of postoperative pancreatic fistulas.
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Objective To summarize the features of computed tomography (CT) and magnetic resonance imaging (MRI) of autoimmune pancreatitis (AIP) and investigate the key points of diagnosis and identification.Methods The retrospective and descriptive study was conducted.The clinical data of 21 patients with AIP who were admitted to the Affiliated Hospital of Inner Mongolia Medical University between February 2012 and February 2015 were collected.All the patients underwent plain and enhanced scans of CT and MRI,and magnetic resonanced cholangio-pancreatography (MRCP),and then received hormone therapy.Eleven patients with pancreatic cancer and 11 normal subjects who were diagnosed by MRI in the same period were selected,and apparent diffusion coefficient (ADC) was calculated and compared.Observation indicators:(1) situation of imaging examination:① pancreatic manifestations:density,signal,atrophy,calcification and enlargement of pancreas,change of pancreatic duct,② manifestations out of pancreas:changes of biliary tract system and kidney,③ diffusion weighted imaging (DWI) and ADC:comparisons of ADC among AIP,pancreatic cancer and normal pancreas;(2) diagnosis;(3) treatment and follow-up.The follow-up using outpatient examination and telephone interview was performed to detect the clinical symptoms and signs up to February 2016.Measurement data with normal distribution were represented as (-x)-± s.Comparisons among groups were done using one-way ANOVA.Pairwise comparison was analyzed by Dunnett'T3 test.Results (1) Situation of imaging examination:Of 21 patients,17 received scan of CT and 11 received scan of MRI (7 combined with scan of CT).① Pancreatic manifestations:14 patients had diffuse enlargement of pancreas,with full edge and “sausage-like” change.Plain scan of CT showed uniform isodense shadow,and enhanced scan showed that reduced enhancement in arterial phase and gradually homogenous enhancement in portal vein phase and lag phase with no enhancement in edge of pancreas.Plain scan of MRI showed lesions were manifested as slight hypointensity on T1 weighted imaging (T1WI),slight hyperintensity on T2WI and hyperintensity on DWI.Enhanced scan of MRI showed delayed enhancement,edge of lesions was manifested as slight hypointensity on T1WI and T2WI,without enhancement.Atrophy and calcification of pancreas:3 patients had atrophy of pancreatic parenchyma in which scattered calcification were seen.Enlargement of pancreas:4 patients had localized enlargement of pancreas showing “false tumor-like” change,including 2 with localized enlargement in head of pancreas.Change of pancreatic duct:MRCP showed that diffuse stenosis,local stenosis and local dilatation of pancreatic ducts were respectively detected in 4,3 and 1 patients.② Manifestations out of pancreas:11 patients had changes of biliary tract system,showing intrahepatic bile duct and common bile duct dilation,partial stenosis and extensive bile duct wall thickening.Enhanced scan of MRI showed there was obvious enhancement of bile duct wall.MRCP of 4 patients showed that the beak-like stenosis was seen in the distal common bile duct.Three patients had kidney changes,enhanced scan of CT showed that kidney demonstrated patch-shape hypodense shadow in arterial phase and homogenous enhancement of patch-shape hypodense shadow in lag phase,and plain scan of MRI showed that kidney lesions demonstrated equal signal on T1WI fat suppression (FS) and patch-shape low signal on T2WI FS.Lesions had gradually homogenous enhancement in substance phase and lag phase.③ DWI and ADC:lesions in patients with AIP and pancreatic cancer demonstrated high signal on DWI (b =1 000 s/mm2) compared with adjacent tissues (no involvement in pancreas or normal pancreatic parenchyma),ADC of pancreas in patients with AIP,with pancreatic cancer and with normal population was (0.001 30 ± 0.000 35)mm2/s,(0.000 80 ± 0.000 14) mm2/s and (0.001 60-± 0.000 24) mm2/s,respectively,with a statistically significant difference (F =30.409,P ＜ 0.05).There were statistically significant differences between patients with pancreatic cancer and patients with AIP or normal population (P ＜ 0.05) and no statistically significant difference between patients with AIP and with normal population (P ＞ 0.05).(2) Diagnosis:11 patients were diagnosed by CT examination,with a diagnostic accuracy of 11/17.Eight patients were diagnosed by MRI examination,with a diagnostic accuracy of 8/11.One patient was misdiagnosed as cancer of pancreatic head by CT and MRI examinations,and 1 was misdiagnosed as cancer in the distal common bile duct.(3) Treatment and follow-up:21 patients underwent regular hormone therapy,and 40 mg prednisolone was given orally a daily for 3-4 weeks and then gradually reduced to 5 mg up to complete relief of the symptoms.All the 21 patients were followed up for 12-45 months.Of 17 patients with abdominal pain and distension,symptoms of 7 patients disappeared and symptoms of 10 patients decreased or occasionally occurred.Of 10 patients associated with jaundice,symptoms of 7 and 2 patients disappeared and decreased,respectively,and symptoms of 1 patient subsided.Conclusion CT and MRI examinations of pancreas demonstrate “sausage-like” and “false tumor-like” changes,the non-neoplastic bile and pancreatic duct stenosis combined with IgG4 related diseases in other organs is an important imaging evidence for diagnosis and differential diagnosis of AIP.
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Objective To summarize the experience in diagnosis and treatment of popliteal vein entrapment syndrome (PVES). Methods A total of 57 patients with PVES were selected from the Department of Vascular Surgery in Xinxiang Central Hospital from March 2009 to October 2015. Of which 43 patients were severe stenosis of popliteal vein (stenosis degree>90%), and another 14 cases were with stenosis less than 90%. All the patients underwent ascending venography of low limb to confirm the clinical classification after admission. Forty-three cases with severe stenosis of the popliteal vein were treated with releasing popliteal vein of entrapment and stripping varicose veins. The static pressure and dynamic pressure of popliteal vein and foot dorsal vein were measured before and after operation. Another 14 patients were treated with medical circulation driven sock and medical therapy. Results The degrees of popliteal vein stenosis were more than 75% in all patients. The patients were divided into bove-knee stenosis (n=9), knee stenosis (n=18), and below-knee stenosis (n=30) according to the different parts of stenosis. Forty-three patients treated with surgery showed relief of leg swelling and pain, and ulcer healing. And the imaging examination showed that there were no obvious compression and stenosis of popliteal vein, and vascular filling was well. The static pressure and dynamic pressure of the popliteal vein and dorsal vein were lower than those before surgery (P<0.05). The lower limb swelling and pain were relieved, and varicose veins of lower limbs were no longer continued to increase in 14 patients with conservative treatment. Conclusion PVES is easy to be misdiagnosed, which should be paid attention to, and satisfactory clinical results can be achieved by releasing popliteal vein of compression combined with stripping varicose veins in patients with serious symptoms .
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Objective To summarize the features of computed tomography (CT) and magnetic resonance imaging (MRi) of hepatic cystic echinococcosis, and investigate the key points of identification and diagnosis.Methods The clinical data of 58 patients with hepatic cystic echinococcosis who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from August 2011 to August 2014 were retrospectively analyzed.Patients received plain and enhanced scan of CT and MRI.Hepatic cystic echinococcosis was divided into the 5 types according to the literatures, including unilocular echinococcasis in type Ⅰ, multivesicular hydatid cysts in type Ⅱ, anechoic content with detachment of laminated membrane from the cyst wall in type Ⅲ, calcification of lesions in type Ⅳ and mixed echinococcosis in type Ⅴ.Patients who were diagnosed as with definite or suspected hepatic cystic echinococcosis underwent surgery.The follow-up including observing the recurrence of hepatic cystic echinococcosis was performed by outpatient examination and telephone interview at postoperative month 3, 6, 12 for 1 year and then once every year up to August 2015, and was ended if there was no recurrence for more than 5 years.Results (1) The results of CT and MRI examinations: of the 58 patients, 54 received scan of CT and 21 received scan of MRI.Seventeen patients were detected in type Ⅰ with clear-boundary and low-density cystic lesions by CT examination;MRI examinations showed there were single or multiple, round or oval abnormal signal including low T1WI signal, high T2 WI signal and low T1 WI and T2WI signal of cyst wall.Thirteen patients were detected in type Ⅱ, CT examination showed the daughter cysts of multiple sizes were found in the mother cyst, arranged in honeycomb or wheel shape;MRI examination showed there were lower T1 WI signal in the daughter cyst and higher T2 WI signal in the daughter cyst compared with signal in the mother cyst, and low signal in the cyst wall of the daughter cyst and mother cyst.Six patients were detected in type Ⅲ with capsule in capsule sign and water snake sign by CT examination and ribbon sign by MRI examination.Thirteen patients were detected in type Ⅳ, CT examination showed there were irregular high-density calcified shadow with the performances for return sample or sample volume skins changes.Nine patients in type Ⅴ had more than 2 kinds of lesions.(2) Diagnosis: 4 patients were misdiagnosed by CT examination including 3 with preoperative diagnosis of hepatic cyst and 1 with preoperative diagnosis of metastatic carcinoma of liver, with an accurate rate of diagnosis of 92.6％ (50/54).Two patients with preoperative diagnosis of hepatic cystic adenocarcinoma were misdiagnosed by MRI examination, with an accurate rate of diagnosis of 90.5％ (19/21).(3) Treatment and follow-up: 58 patients underwent surgery, including 40 undergoing internal capsule removal with external capsule suturing (31 with open operation and 9 with laparoscopic operation), 10 undergoing partial hepatectomy and 8 undergoing external capsule enucleation.Of 58 patients, 3 were complicated with effusion of residual cavity, 2 with unclosed external capsule, 1 with bile leakage and then was cured after 4-8 week drainage.Fifty patients were followed up for 12.0-48.0 months with a median time of 27.1 months and a follow-up rate of 86.2％ (50/58).During the follow-up, 1 patient undergoing internal capsule removal had recurrence at postoperative month 8 and was cured by CT-guided interventional therapy using absolute alcohol, and other patients had no recurrence.Conclusions There was a higher accuracy in CT and MRI examinations for hepatic cystic echinococcosis.Honeycomb and wheel shapes are characteristic findings of hepatic cystic echinococcosis in type Ⅱ.The characteristic performances of CT examination for hepatic cystic echinococcosis in type Ⅲ are capsule in capsuleand water snake signs, and characteristic performances of MRI examination is ribbon sign.The ring-like enhancement of edge by MRI examination is an essential of identification and diagnosis between hepatic cystic echinococcosis and hepatic cyst, and irregular calcification is a differential point between hepatic echinococcosis and hepatic tumor.
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In recent years,liver transplantation donor shortage as one of world medical problems is paid more attention by domestic and overseas scholars.In view of that,heterotopic auxiliary liver transplantation emerges which transplants the whole or some parts of a donor liver outside the original liver position on the condition that some parts or the whole of the original liver were retained.As for the liver transplantation with poor conditions on portal vein,reconstruction of portal vein has become an aporia.Based on this,some scholars put forward the theory——arterialization of portal vein(PVA),namely a method to increase arterial blood supply or replace portal vein blood perfusion of liver by establishing some pathes among artery and portal vein or its branches.The research background and current situation of heterotopic auxiliary liver transplantation with portal vein arterialization,the transplanting position of donor liver,vessel reconstruction,dynamics mechanism after reconstruction and liver regene-ration are summarized in this review.
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Basic surgical skills tralning which belongs to the basic course of surgery, is clini-cal basis for the medical students. The teaching practice of basic surgical skills tralning was explored by the Affiliated Hospital of Inner Mongolia Medical University, the theoretical teaching was combined with skills tralning practice, three kinds of means which contalned the model, animal tissues and or-gans in vitro and animal experiment were used to carry out systemic and standardized tralning. Finally, the basic surgical skills of postgraduate in surgery were improved, and the expected alm of teaching was achieved.
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Objective To evaluate the effect of esophagofundostomy combined with devascularization for the treatment of portal hypertension.Methods From February 2009 to August 2013,30 cases (research group) underwent esophagofundostomy combined with devascularization,while 56 cases (control group) were treated by devascularization only.Splenectomy was performed in all patients.Results There was no perioperative mortality in either group.The difference of postoperative serum bilirubin,albumin and blood platelet was not statistically significant (t =1.13、0.23、1.53,all P ＞ 0.05) ; The incidence of hepatic encephalopathy in research group and control group was 3％ and 11％,respectively,three years mortality was 14％ and 24％,respectively (x2 =0.61、1.22,all P ＞0.05).The rebleeding rate in research group was lower than control group,there was a significant difference (x2 =4.61,P ＜ 0.05).Research group was superior to control group in improving esophageal-gastric varices and there was a significant difference (P ＜ 0.05).Conclusions Compared with devascularization,esophagofundostomy combined with devascularization is more effective in reducing esophageal-gastric varices and prevention of rebleeding.
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Objective To evaluate the value of PET-CT in patients with breast cancer and to determine if the PET-CT can provide additional information to predict early response to neoadjuvant chemotherapy (NAC).Methods NAC was given to 20 patients with breast cancer confirmed by biopsy puncture from September 2009 to March 2012.The PET-CT was carried out for all patients before NAC.TEC program with three weeks for one cycle was selected.After 6 days of the first cycle,the PET-CT was performed again.The changes of standard uptake value before and after the first cycle were compared.At the same time hand palpation was selected to detect the changes in tumor size before and after the first cycle of NAC.The changes of the standard uptake value and in tumor size need to refer to the pathology Miller & Payne classification methods to evaluate the efficacy of the NAC.Results The SUV were (7.51±1.76) Bq/ml and (4.98±1.61) Bq/ml before and after chemotherapy (t =7.916,P ＜ 0.05) the maximum tumor diameters were (9.62±4.38) cm and (8.89±4.08) cm before and after NAC (t =2.154,P＞ 0.05).SUV had highly correlated with pathological MP classification (r =0.725,P =0.000); while for the tumor size there was no significant change (r =0.026,P =0.824).Conclusion PET-CT can predict the efficacy earlier and is more accurate than clinical efficacy standard for the NAC.
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Since portal vein arterialization(PVA) was firstly introduced as a treatment in patients with portal hypertension due to liver cirrhosis, the concept of PVA has drawn much attention. In special situations, in hepatobiliary surgery, this procedure remains useful. However, PVA is unphysiological and there is much controversy on its use.This article reviews the current status of PVA in hepatic artery resection or injury, in acute liver failure and in liver transplantation, and suggests future directions in research in PVA.
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Objective To discuss the diagnostic value of peritoneal effusion detection by emergency-ultrasound in patients with closed abdominal injury. Method From August 2006 to June 2009,212 patients with closed abdominal injury were studied to evaluate peritoneal effusion detection by emergency ultrasound. Results of 212 patients,peritoneal effusion frequency rate was 78.8%( 167/212), meanwhile,abdominal paracentesis confirmation ratio was only 46.2%(98/212). In the follow-up, 13 patients with injuried hollow viscera and 1 patient with rupture of kidney showed peritoneal effusion. The volume of abdominal fluid was increasing in 17 patients,which needed to be managed by surgery. The accuracy rates were respectively 78.3%( 112/143) and 36.1%(13/36) in the solid organs and the hollow organs. Conclusion During the course of diagnosis and treatment in closed abdominal injury,peritoneal effusion monitoring by ultrasound should be used routinely, which can help to decrease the rate of misdiagnosis and avoid delayed treatment.
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Radiological evaluation is a key step for donor's preoperative evaluation in living donor liver transplantation(LDLT).There are many powerful functions in multi-slice computed tomography (MSCT)which can suit all-in-one radiological evaluation before donor's operation.By referring to the articles from home and abroad in recent years,from viewpoint of surgeon,this artical reviews the application status of multi-slice CT for preoperative assessment in LDLT,which can help to provide theory support for choice of radiological examination in LDLT donor.