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Objective:To compare the efficacies of arthroscopic modified Brostr?m procedure combined with or without peroneal tendon debridement in the treatment of chronic lateral ankle instability (CLAI) concomitant with fibular tendinitis.Methods:A retrospective cohort analysis was conducted on the clinical data of 31 patients with CLAI concomitant with fibular tendinitis, who were treated in Beijing Tongren Hospital, Capital Medical University between March 2019 and December 2021. The patients included 17 males and 14 females, aged 16-57 years [(32.8±9.6)years]. The anterior drawer test and talar tilt test were positive in all patients preoperatively. Diagnosis was confirmed by physical examination and MRI, and calcaneofibular ligament rupture was excluded. Eleven patients received arthroscopic modified Brostr?m procedure combined with peroneal tendon debridement (modified Brostr?m procedure+tendon debridement group), and 20 underwent pure arthroscopic modified Brostr?m procedure (modified Brostr?m procedure group). The operation time, intraoperative blood loss and length of hospital stay were documented. The visual analogue score (VAS) in peroneal tendon area was assessed before operation and at postoperative 2, 6 and 12 weeks. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and foot and ankle outcome score (FAOS) were assessed before operation and at postoperative 6 and 12 weeks. The anterior drawer test was performed at the last follow-up. The foot and ankle ability measure (FAAM) score was assessed before operation and at the last follow-up. Postoperative wound healing and complications were also observed.Results:All the patients were followed up for 4-19 months [(11.3±3.5)months]. The operation time was (66.0±4.2)minutes in the modified Brostr?m procedure+tendon debridement group, which was significantly longer than (61.5±3.4)minutes in the modified Brostr?m procedure group ( P<0.05). There was no significant difference in intraoperative blood loss or length of hospital stay between the two groups (all P>0.05). Compared with the preoperation, the value of VAS was significantly lowered, and the values of AOFAS ankle-hindfoot score, FAOS and FAAM score were significantly increased at different postoperative timepoints (all P<0.01). No significant differences in the values of VAS, AOFAS ankle-hindfoot score, FAOS or FAAM score were seen between the two groups before operation (all P>0.05). The value of VAS was 3.0(3.0, 4.0) points in the modified Brostr?m procedure+tendon debridement group, being markedly different from 4.0(4.0, 4.0)points in the modified Brostr?m procedure group at 2 weeks postoperatively ( P<0.05). The value of VAS was 2.0(1.0, 3.0)points in the modified Brostr?m procedure+tendon debridement group, being markedly different from 3.0(2.3, 3.0)points in the modified Brostr?m procedure group at 6 weeks postoperatively ( P<0.05). At 12 weeks postoperatively, there was no significant difference in the value of VAS between the two groups ( P>0.05). There were no significant differences in the values of AOFAS ankle-hindfoot score and FAOS between the two groups at 6 or 12 weeks postoperatively (all P>0.05). The anterior drawer test was negative in all patients at the last follow-up. No significant difference was seen in the value of FAAM score between the two groups at the last follow-up ( P>0.05). All incisions were healed well in the first stage after operation, without the occurrence of joint infection, impaired joint motion, nerve injury or deep vein thrombosis. Conclusions:Arthroscopic modified Brostr?m procedure combined with or without peroneal tendon debridement can both improve the foot function in CLAI patients concomitant with fibular tendinitis. However, the combined treatment allows for early pain relief, without increasing the risk of complications, and can therefore contribute to a faster postoperative recovery.
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Osteochondral lesions of the talus (OLT) frequently manifest following ankle joint trauma, causing ankle pain, swelling and impaired mobility, thereby significantly impeding daily activities of the patients. Presently, clinical treatment approaches encompass both conservative management and surgical intervention. Conservative management endeavors to alleviate symptoms, while patients experiencing persistent symptoms resort to surgical intervention. Commonly employed surgical treatments encompass bone marrow stimulation, autologous osteochondral transplantation, and allogeneic osteochondral transplantation. Bone marrow stimulation is employed as a therapeutic approach for the management of smaller OLT, demonstrating favorable short-term effectiveness; however, the long-term prognosis remains uncertain. Autologous osteochondral transplantation is a viable option for larger OLT lesions, albeit it carries the potential of complications at the donor site. Conversely, allogenic osteochondral transplantation exhibits a diminished success rate. In recent times, the utilization of cell transplantation techniques has garnered escalating interest in the treatment of OLT due to their capacity to regenerate cartilage resembling hyaline and their diverse range of cellular origins. The authors reviewed the progress of cell transplantation in the treatment of OLT, providing a reference for the clinical treatment.
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Osteochondral lesion of talus (OLT) is a foot and ankle disease characterized by ankle pain, which may impact the joint function and life quality. If managed improperly, it may lead to a further ankle arthritis, severely compromising the prognosis. The therapeutic effect of conservative treatment for OLT is still uncertain. Surgery is still the main treatment modality for OLT with various techniques. However, the optimized surgical technique is still inconclusive, furthermore, regeneration and repair of cartilage after debridement is also a great challenge for the treatment of OLT. Platelet-rich plasma (PRP) with good repair effect on cartilage injury is gradually applied in the treatment of OLT. However, there still lacks the unified understanding of the technique and specification of PRP for the treatment of OLT. Therefore, National Orthopedics Center of Shanghai Sixth People′s Hospital allied Foot Ankle Basic Research & Orthopedics Group, Chinese Association of Orthopedic Surgeons; Foot and Ankle Committee of Chinese Association of Sports Medicine Physicians; and Foot and Ankle Group of Orthopedic Specialized Branch of Shanghai Medical Association to organize related experts to formulate the Expert consensus on platelet- rich plasma treatment for osteochondral lesion of talus ( version2023). Fifteen recommendations were put forward upon PRP preparation, indications, contraindications and treatment methods of PRP for OLT, so as to standardize the PRP treatment for OLT.
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Objective@#To explore the influence of music training on the response inhibition ability of children with developmental dysplasia, and to provide a theoretical basis for improving the response inhibition ability of children with developmental dyslexia.@*Methods@#From September to October 2020, students from grades 3-6 in a primary school in Shenyang, Liaoning Province were selected. A total of 27 children with dyslexia were selected through literacy test and intelligence test, and 23 children with matched reading level were selected. The Go/No-go experimental paradigm was used to investigate the changes of response inhibition in children with developmental dyslexia before and after ALF music training, induding solfeggio, physical rhythm, music scene performance and chorus.@*Results@#The results before and after music training showed that the main effect in the test stage was significant among two groups[ F(1,48)=6.13, P<0.05, η-p 2=0.11], and The accuracy of post-test [(91.80±0.80)%] was significantly higher than that of pre-test [(89.10±0.90)%]; the accuracy of the children with developmental dyslexia in response to the symbolic stimulus No-go was significantly higher in the post-test [(81.81±10.97)%] than in the pre-test [(73.78±15.26)%]( t =-2.33, P = 0.03 ); the accuracy of reading matched children s response to Chinese characters stimulation No-go was significantly better in the post-test [(85.59±12.11)%] than in the pre-test [(78.33±12.98)%]( t = -2.20, P <0.05). In terms of response time, the post-test scores of developmental dyslexia children [(444.06±77.49)ms] were significantly better than those of pre-test children [(519.01±70.75)ms], and there was no significant difference between symbol stimulus and Chinese stimulus in developmental dyslexia children ( P>0.05). @*Conclusion@#Response inhibition is deficient in children with developmental dyslexia. Compared with symbols, the response inhibition ability of Chinese characters is impaired; Music training significantly improved the inhibitory ability of signs in children with developmental dyslexia.
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Objective:To compare minimally invasive treatment with versus without a 3D printed guide plate for Sanders type Ⅱ calcaneal fractures.Methods:A retrospective analysis was done of the 74 patients with Sanders type Ⅱ displaced intra-articular calcaneal fracture who had been treated at Foot and Ankle Surgery Center, Beijing Tongren Hospital Affiliated to Capital Medical University from January 2018 to January 2020. They were divided into 2 groups according to whether a 3D printed guide plate was used or not. In the 3D printing group of 38 patients treated by minimally invasive surgery assisted by a 3D printed guide plate, there were 22 males and 16 females with an age of (41.5±3.5) years; in the control group of 36 patients treated by traditional minimally invasive surgery, there were 24 males and 12 females with an age of (40.3±7.2) years. The 2 groups were compared in terms of operation time, intraoperative fluoroscopy, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analog scale (VAS), Short Form 36 (SF-36), B?hler angle, Gissane angle, calcaneal length, width and height and postoperative complications.Results:There was no significant difference in the preoperative demographic data between the 2 groups, indicating comparability between groups ( P>0.05). All patients were available for a follow-up of (12.6±3.6) months (from 6 to 24 months) after surgery. The operation time [(55.3±7.1) min] and intraoperative fluoroscopy [(8.1±2.6) times] in the 3D printing group were significantly less than those in the control group [(71.2±8.7) min and (21.2±8.7) times] ( P<0.01) while the AOFAS score in the former group (81.4±6.3) was significantly higher than that in the latter (77.9±6.2) ( P<0.01). There were no statistically significant differences between the 2 groups in VAS, SF-36, B?hler angle, Gissane angle, calcaneal length, calcaneal width or calcaneus height ( P>0.05). In the control group, 4 screws were found to be too long with possible impingement on the medial structures of the foot, and 3 screws to penetrate the subtalar joint; in the 3D printing group, there were no too long or off-target screws in the sustentaculum tali. Conclusion:The minimally invasive treatment of Sanders type Ⅱ calcaneal fractures assisted by a 3D printing guide plate can reduce operation time, intraoperative fluoroscopy and potential complications, improving the clinical efficacy.
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OBJECTIVE To conduct a c omprehensive clinical evaluation method of Chinese patent medicine ，and to provide reference for rational clinical drug use. METHODS Taking the top 10 Chinese patent medicine injections for promoting blood circulation and removing stasis in Shandong province from 2016 to 2020 collected by the National Rational Drug Use Monitoring Network as an example ，the method combining health technology assessment with objective judgement analysis is used to construct the comprehensive evaluation index system ；based on evidence-based medical evidence and pharmacoeconomic model ，the safety ， effectiveness and economy of the drug were evaluated comprehensively ，and the scores were quantified. RESULTS & CONCLUSIONS The final scores of the 10 kinds of Chinese patent medicine injections were between 26 and 37 scores. Safflower yellow for injection scored the highest score in the treatment of cerebral infarction and angina pectoris of coronary heart disease ， while Ginkgo diterpene lactone meglumine injection and Shuxuening injection had the highest scores in the treatment of coronary heart disease. The clinical comprehensive evaluation method of Chinese patent medicine based on evidence-based medical evidence and pharmacoeconomic model can clarify the comprehensive value of Chinese patent medicine in clinic ，promote rational drug use in clinic ，and provide basis for the next adjustment of medical insurance catalogue and essential medicine catalogue ，decision-making of centralized procurement of related drugs.
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Objective:To determine the 50% effective dose (ED 50) of sugammadex for rapid recovery of the signal of intraoperative neuromonitoring of recurrent laryngeal nerve in radical thyroidectomy. Methods:American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of either sex, aged 18-64 yr, weighing 40-90 kg, scheduled for elective radical thyroidectomy under intraoperative neuromonitoring of recurrent laryngeal nerve, were enrolled in this study.Sufentanil and propofol were intravenously injected, and muscle relaxation monitoring was performed after the patients lost consciousness.Rocuronium 0.6 mg/kg was intravenously injected, and tracheal intubation was performed when the twitch ratio was 0.The infusion rate of rocuronium was adjusted to maintain twitch ratio 0-10%.When the signal needed to be detected, rocuronium infusion was stopped, sugammadex was injected intravenously using up-and-down sequential method, with the initial dose of 2 mg/kg.If a stable signal was detected within 3 min, the concentration decreased by 0.2 mg in the next patient, otherwise the concentration increased by 0.2 mg in the next patient.The Dixon and Massey formula was used to calculate the ED 50 and 95% confidence interval of sugammadex. Results:The ED 50 of sugammadex for the rapid recovery of the signal of intraoperative neuromonitoring of recurrent laryngeal nerve was 0.98 mg/kg, and the 95% confidence interval was 0.94-1.02 mg/kg during radical thyroidectomy. Conclusion:The ED 50 of sugammadex for rapid recovery of the signal of intraoperative neuromonitoring of recurrent laryngeal nerve is 0.98 mg/kg in radical thyroidectomy.
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Objective To evaluate the treatment of posterior malleolar two-part fractures complicated with medial and lateral malleolar fractures via a combination of posterolateral and posteromedial approaches.Methods From January 2014 to January 2017,26 patients were operatively treated at Department of Orthopaedics,Tongji Hospital for posterior malleolar two-part fractures complicated with medial and lateral malleolar fractures via a combination of posterolateral and posteromedial approaches.They were 10 men and 16 women,aged from 53 to 67 years(average,61.5 years).The surgery was conducted in prone position via the posterolateral and posteromedial approaches to expose simultaneously the fractures ends at medial,lateral and posterior malleoli for open reduction.The lateral malleolar fractures were fixated with plate,the medial malleolar fractures with screws and posterior malleolar fractures with plate or cannulated screws depending on the size of the fracture blocks.The outcomes were assessed using the ankle-hindfoot scores of American Orthopaedic Foot and Ankle Society(AOFAS) and the visual analogue scale(VAS).Results Of this cohort,22 were followed up for 30 months on average(range,from 18 to 48 months).All the cases healed by the first intension without any infection.Their postoperative X-ray showed bone union after an average of 12.5 weeks(range,from 10 to 15 weeks).No nonunion,loosening or breakage of implants was found.The mean time for walking with full weight-bearing was 13 weeks(range,from 11 to 16 weeks).Their AOFAS ankle-hindfoot scores at the final follow-ups were 85.4(range,from 80 to 92),yielding 13 excellent and 9 good cases with a good to excellent rate of 100%.Their mean VAS scores were decreased significantly from preoperative 8.6±0.6 to postoperative 1.7±0.3(f=153.000,P=0.000).Conclusion In treatment of posterior malleolar two-part fractures complicated with medial and lateral malleolar fractures,a combination of posterolateral and posteromedial approaches in prone position can expose and reduce simultaneously the fractures ends at medial,lateral and posterior malleoli,leading to satisfactory clinical outcomes.
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Objective To determine the minimum alveolar concentration (MAC)of sevoflurane for blunting the responses to surgical incision in 50% adult patients diagnosed as gastric carcinoma and treated with neoadjuvant chemotherapy.Methods Twenty-five ASA physical statusⅠor Ⅱ,and aged 30-50 years patients (14 males and 11 females)diagnosed with gastric carcinoma were enrolled.At least 1 month before the operation,all these patients received 2 cycles (1 chemotherapy cycle was 14 days)of chemotherapy including oxaliplatin and tegafur.At first,the anesthesia induc-tion was started by inhaling 6% sevoflurane.After the patient lost consciousness,the endotracheal in-tubation was performed.And then,the end tidal sevoflurane concentration was adjusted to the target concentration and maintained stable for 15 min.After that,the surgical incision was executed.The Dixon's up-and-down method was used to calculate the MAC.The initial end tidal sevoflurane con-centration was 2.2% and it was increased or decreased by 0.2% in the next patient according to the surgical incision response.If the surgical incision response was positive,the end tidal sevoflurane con-centration was increased;if the surgical incision response was negative,the end tidal sevoflurane con-centration was decreased.The midpoint from negative response to positive response was set as the balance point and the mean value of the concentrations of sevoflurane at all the balance points were calculated as MAC.Results Minor physical activity occurred when the surgical incision started.No body twisting,eye opening or intraoperative awareness occurred.Body moving occurred in 11 patients (44%)when the surgical incision started.The end tidal sevoflurane concentration for blunting the re-sponses to surgical incision in 50% adult patients diagnosed as gastric carcinoma and treated with neo-adjuvant chemotherapy was 1.52%,and the 95% CI was 1.37%-1.65%.Conclusion The MAC of sevoflurane for blunting the responses to surgical incision in 50% adult patients diagnosed as gastric carcinoma and treated with neoadjuvant chemotherapy is 1.52%.
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Objective To compare the effect and prognosis outcome of open reduction internal fixation and primary arthrodesis in treatment of Lisfranc injuries combined with the first tarsal jointdislocation.Methods A retrospective case control study was conducted on the clinical data with complete follow up data of 126 patients with Lisfranc injuries combined with the first tarsal joint dislocation in nine ankle surgery centers of China from January 2009 to June 2015.There were 76 males (60.3％) and 50 females (39.7％) with an average age of 45.5 years (range,20-87 years).Among the 126 cases,simple dislocation occurred in 41 cases (32.5％),and fracture dislocation in 85 cases (67.5％).The duration from injury to surgery was 11.7 days (range,4-26 days).According to surgery method,the patients were divided into open reduction internal fixation group (n =92) and primary arthrodesis group (n =34).The outcomes were evaluated by American Orthopedic Foot and Ankle Society(AOFAS) score,36-items short form health survey (SF-36),and visual analogue score (VAS).Complications were also followed up.Results All patients were followed up for 18-80 months,with an average of 29.5 months.Primary union was seen in all the patients.At the last follow up,the mean AOFAS midfoot score was (79.4 ± 6.7) points in open reduction and internal fixation group and (85.1 ±8.3) points in primary arthrodesis group (P ＜ 0.05).The mean VAS was (3.1 ± 0.6) points in open reduction and internal fixation group and (2.2± 0.3)points in primary arthrodesis group(P ＜ 0.05).The physiological function of SF-36 was (80.3 ± 5.3) points in open reduction and internal fixation group and (83.5 ± 6.9) points in primary arthrodesis group(P ＞ 0.05).The body pain score of SF-36 was (76.1 ±4.6) points in open reduction and internal fixation group and (84.6 ± 8.7) points in primary arthrodesis group (P ＜ 0.05).In open reduction and internal fixation group,there were five cases (5％) with internal fixator loosening or fracture,16 cases (17％) with redislocation,36 cases (39％) with obvious pain of the middle foot during walking,and eight cases (6％) with tarsal joint traumatic arthritis which was given phase Ⅱ arthrodesis.In primary arthrodesis group,two patients (6％) reported pain due to internal fixation,and the pain was relieved after fixator removal.No re-dislocation,loosening of internal fixation,or traumatic arthritis were found (P ＜ 0.05).Conclusion For Lisfranc injuries combined with first tarsal joint dislocation,primary arthrodesis can stabilize the first tarsal joint and avoid complications or adverse consequences such as redislocation,pain,internal fixation failure,or reoperation.
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Objective To use real-time three-dimensional echocardiography(RT-3DE) to compare the cardiac function related indicators between before operation and at postoperative 2 months in the patients with left ventricular aneurysm(LVA) undergoing emergency percutaneous coronary intervention(PCI),and to assess the PCI short term effect.Methods RT-3DE was applied to observe the left ventricular end-diastolic volume(LVEDV),end systolic volume(LVESV),cardiac output(CO),end-diastolic volume index(EDVI),end systolic volume index (ESVI),cardiac index (CI),left ventricular ejection fraction (LVEF) and left ventricular spherical index(SPI) before operation and at postoperative 2 months in 31 cases of acute anterior myocardial infarction(AAMI) complicating LVA.The patients were divided into the functional LVA group(A),anatomical LVA group (B) and complicating thrombus LVA group(C).The cardiac function parameters in various groups conducted the intra-group and inter group comparisons.Results Compared with before operation,LVEF at postoperative 2 months in the group A was increased and SPI was decreased(P＜0.05);CO,CI and LVEF before operation and at postoperative 2 months in the group B were increased and SPI was decreased(P＜0.05);SPI at postoperative 2 months in the group C was decreased(P＜0.05);EF and SPI before operation and at postoperative 2 months had no statistical difference among 3 groups(P＞0.05).SPI before operation and at postoperative 2 months was negatively correlated with LVEF and positively correlated with EDV,ESV,EDVI,ESVI,CO and CI.Conclusion The left ventricular morphology and overall systolic function at 2 months after PCI in the patients with functional and anatomical LVA are improved,but the curative effect in the patients with complicating thrombus LVA is unobvious.
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OBJECTIVE:To explore the effect of comprehensive intervention mode on the rational use of Ribonucleic acid Ⅱ for injection,and to provide reference for the management of adjuvant drugs for cancer therapy.METHODS:The rational use of ribonucleic acid Ⅱ was interfered by establishing evaluation criteria,reviewing medical record,establishing tumor therapy adjuvant management work group,classifying drug prescription right,examining and approving off-label drug use,strengthening the assessment and training,clinical pharmacists intervention.The utilization of ribonucleic acid Ⅱ was analyzed statistically in our hospital during Apr.-Jun.2015 (before intervention),Jul.-Sept.2015 (after the first intervention),Oct.-Dec.2015 (after the second intervention) and Jan.-Mar.2016 (after the third intervention).RESULTS:The reasonable rate of Ribonucleic acid Ⅱ for injection was 77.34％ before intervention,and 83.25％,83.64％,95.12％ after the first,second and third intervention respectively;the difference was statistically significant compared to before intervention (P＜0.05).The irrational types included inappropriate indications,unsuitable treatment course,inappropriate usage and dosage,and unsuitable drug combination,etc.The percentage of these irrational types decreased from 2.96％,4.93％,13.79％ and 0.99％ before intervention to 1.63％,0,3.25％ and 0 after the third intervention,respectively.The utilization rate of Ribonucleic acid Ⅱ for injection was reduced from 8.81％ before intervention to 3.93％ after the third intervention,the differences were statically significant (P＜0.05).CONCLUSIONS:The comprehensive intervention model combined with multiple intervention methods can promote the rational use of Ribonucleic acid Ⅱ for injection.It is suggested to further study and evaluate the intervention effect of this model on other adjuvant drugs for cancer therapy.
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Objective The mediastinal mass usually posed higher risk of anesthesia and surgery due to its especial anatomical position,and this study aimed to analyze the perioperative anesthetic management of 3 patients undergoing resection of huge mediastinal mass,to identify the potential risks for this type of surgery and to summarize the corresponding perioperative anesthetic management protocol.Methods Three cases recently underwent resection of huge mediastinal mass in our hospital were reviewed.Their preoperative assessment and preparation,intraoperative anesthetic management,postoperative pain management and special interventions needed in the perioperative period were summarized and analyzed retrospectively.The enhanced recovery after surgery (ERAS) protocol was established for this type of surgery based on the analysis mentioned above,evidence reported at home and abroad and currently available ERAS protocols for other surgeries.Results Pleural malignant solitary fibrous tumor,thymus squamous cell carcinoma and malignant mixed germ cell tumor were the three mediastinal masses.The preoperative assessment focused on the impact of tumor on other vital organs within the mediastinum;anesthesiologists focused on massive hemorrhage and severe complications such as cardiac insufficiency and respiratory insufficiency;all the three patients were sent to the intensive care unit after surgery for further treatment,successfully recovered and were discharged;improving postoperative analgesia was helpful for recovery after resection of huge mediastinal mass.Conclusion Perioperative anesthetic management of patients undergoing resection of huge mediastinal mass is related to high risk,and establishing specific ERAS protocol is helpful in reducing complications and in promoting recovery after surgery based on the currently available evidence and characteristics of this type of surgery.
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Objective To study the distribution of intra-articular posterior malleolus fracture lines in ankle fracture of supination-external rotation.Methods Computed tomography scans of a consecutive series of 70 ankle fractures of supination-external rotation were used for this study.The DICOM files were loaded into Mimics 16.0 for 3D reconstruction of distal tibial articular surface.The intra-articular posterior malleolus fracture lines were identified after virtual fracture reduction.All the fracture lines were drawn on one picture of distal tibial articular surface after standardization before a heat map was created based on the frequency of fracture lines.Results Although the distribution of posterior malleolus intra-articular fracture lines varied,most of them were concentrated in an arcuate zone.The ratios of the area of posterior fracture fragment to the total area of articular surface averaged 14.96％ (range,from 2.23％ to 38.45％).They were most likely to enter the articular surface at 20.4％ of the tangent of the posterior edge in a standardized image and exit at 58.7％ of the tangent of the lateral edge.Conclusion In ankle fractures of supination-external rotation,most intra-articular posterior malleolus fracture lines may be distributed regularly in an arcuate zone of the articular surface.
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Objective To investigate the relationship between the bacterial vaginosis and 8 putative periodontal pathogen infection.Methods A total of 48 patients with bacterial vaginosis were collected and 47 healthy female patients were selectedin the control group.Vaginal secretion and subgingival plaque were obtained from the study group and the control group.The presence of Porphyromonasgingivalis (P.g),Tannerella forsythia (T.f),Treponemas denticola (T.d),Prevotell intermedia (P.i),Prevotella nigrescen (P.n),Peptostreptococcus micros (P.m),Fusobacteriumnucleatum (F.n) and Campylobacterrectas (C.r) was detected by DNA extraction and PCR method.Simultaneously,all the patients underwent a clinical periodontal examination of the teeth in community periodontal index,including plaque index (PLI),bleeding on probing (BOP),probing depth (PD) and clinical attachment loss (CAL) Results The prevalence of periodontal disease,PLI,BOP and CAL in the study group was significantly higher than in the control group (P＜0.05) and the PD had no statistically significant difference between the 2 groups (P＞O.05).The 2 groups were both detected 8 putative periodontal pathogens in the vaginal secretion and the subgingival plaque samples.The detection ratio of T.dfrom both the vaginal secretion and subgingival plaque samples was significantly higher in the study group than that in the control group (P ＜0.05),and other 7 pathogens showed no statistically significant difference (P ＞0.05) Conclusion The prevalence of periodontal disease was higher among the bacterial vaginosis patients.The 8 putative periodontal pathogens were normal flora in the subgingival plaque and vaginal secretion.Td might be relevant to the pathogenesis of bacterial vaginosis.
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Objective To evaluate the clinical training outcomes from two clinical practice modes for undergraduate students. Methods Total two grades 2009 and 2010,150 undergraduate students were randomly divided into two groups: 69 students in group A and 81 students in group B. The synthetic teaching mode was applied in group A,and group B received the traditional teaching mode. The Objective Structure Clinical Examination (OSCE)and a written comprehensive examination were used to evaluate the training outcomes by T test analyzed by SPSS 17.0(α= 0.05). Results The theoretical level of 2009 grade students was better than that of 2010 grade (P 0.05). There were no significant differences between two groups in theoretical and clinical training(P > 0.05). Comparing with the 2010 grade,the theoretical level of the 2009 was better,but the clinical skill level was weaker. Conclusion Synthetic teaching mode and traditional teaching mode both achieved good outcomes. In order to obtain better comprehensive progresses,the two teaching modes need to be combined. The orientation by following the requirements of oral practicing qualification examination may enhance the clinical skills of the students.
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BACKGROUND:Autologous micro-skin graft covered with alogeneic skin has become a major means for repair of extremely severe burn wounds. Due to the limitation of the source of alogeneic skin, heterogeneous skin (pigskin) or artificial skin serves as a vector to cover the wound on the clinical use. OBJECTIVE: To observe the curative effect of thin-thickness micro-skin pulping covered with heterogeneous skin for repair of burn wounds in comparison with blade-thickness micro-skin pulping covered with heterogeneous skin. METHODS:A self-control study was performed in 36 patients with severe burns of bilateral limbs. There were 42 pairs of wounds, 32 of which were at joint sites. One or two pairs of III-degree burns treated with escharectomy were selected from each patient for self-control comparison. Covered with heterogeneous skin, thin-thickness micro-skin pulping and blade-thickness micro-skin pulping were used in the trial and control groups, respectively. The expansion ratio was controled at 1:8-1:12 in al patients. Wound healing time, degree of scar hyperplasia within 6 months to 2 years after transplantation, and ratio of reconstruction surgery at joint sites were observed and compared. The removed scars by surgery were analyzed based on the total score of the Vancouver Scar Scale. RESULTS AND CONCLUSION: The average wound healing time was (44.7±1.24) days in the trial group and (49.6±1.41) days in the control group, and there was a significant difference between the two groups (P 0.05). The reconstructive surgery ratio of the trial group was 38%, significantly lower than that of the control group (59.38%;P < 0.01). The total score on the Vancouver Scar Scale was less in the trial group than the control group (P < 0.05). These findings suggest that the thin-thickness micro-skin covered with heterogeneous skin is likely to be a better treatment to repair large ful-thickness skin burn by increasing the thickness of micro-skin, and it can obtain better wound healing quality.
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<p><b>OBJECTIVE</b>To make an animal periodontitis and atherosclerosis compound model, and to study the effects of periodontitis on atherosclerosis.</p><p><b>METHODS</b>36 Japan rabbits were randomly divided into four groups: Including periodontitis model group, periodontitis and atherosclerosis compound model group, atherosclerosis model group and control group. Periodontitis model was initiated by ligating floss around teeth cervical and oral inoculating with Porphyromonas gingivalis (P. gingivalis). Atherosclerosis was established by single iliac artery of balloon-injured rabbit. Histopathological change of injured iliac artery was observed under optical microscope after hematoxylin-eosion stain. Elastica van Gieson-stained sections were used for the morphometric analysis. We measured intimal and medial lesion areas in iliac artery cross-sections as well as the intimal/medial ratio (I/M). We also analyzed P. gingivalis 16S rDNA amplification with nested-polymerase chain reaction (nested-PCR), and detect systemic proinflammatory mediators with enzyme linked immunosorbent assay (ELISA), including C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-1beta (IL-1beta).</p><p><b>RESULTS</b>The serum levels of CRP, IL-6 and IL-1beta increased obviously among the compound model group than other groups (P<0.01). Histopathological observation revealed the compound model group in I/M was bigger than other groups (P<0.01). P. gingivalis 16S rDNA was detected among the periodontitis model group and the compound model group by nested-PCR.</p><p><b>CONCLUSION</b>Periodontitis may accelerate intimal hyperplasia in balloon-injured iliac arteries by upgrade of systemic inflammation factors and local bacterial infection.</p>
Asunto(s)
Animales , Conejos , Experimentación Animal , Aterosclerosis , Proteína C-Reactiva , Modelos Animales de Enfermedad , Ensayo de Inmunoadsorción Enzimática , Interleucina-6 , Periodontitis , Porphyromonas gingivalisRESUMEN
Objective:To assess the effect of basic fibroblast growth factor(bFGF) and chitosan(a water soluble derivation) on human periodontal ligament fibroblasts(HPDLFs). Methods:In vitro cultured HPDLFs of passage 5-7 were in culture medium only(group 1), or exposed to 10 ng/ml of bFGF(group 2), 10 ng/ml of bFGF combined with 0.2 mg/ml chitosan(group 3),10 ng/ml of bFGF combined with 2 mg/ml chitosan(group 4),0.2 mg/ml of chitosan(group 5) or 2 mg/ml of chitosan(group 6) for 5 days respectively. Cell proliferation was examined by MTT assay,alkaline phosphatase activity and osteocalcin synthesis were measured by AMP method and radioimmunoassay respectively.Results:Higher proliferation of HPDLFs was observed in group 2 and 3,higher alkaline phosphatase activity in group 5 and 6, and higher osteocalcin synthesis in group 3 and 4.Conclusions:bFGF combined with chitosan(0.2 mg/ml) may increase the proliferation of HPDLFs, stimulate HPDLFs to differentiate into osteoblasts.
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Process for the industrial production of sodium alginate from Sargassum siliquastrum was reported. The main influential factors in the extraction process were discussed in detail. As a result, the product conformed to British Pharmacopoeia (1968 ) in colour, lustre, purity and heavy matals. The yield was 20%.