Clinical Characteristics and Drug Resistance Characteristics of Staphylococcus Aureus Causing Bloodstream Infections in Children / 中山大学学报(医学科学版)

@#【Objective】To study the clinical characteristics，predisposing factors，prognosis and drug resistance of Staphylococcus aureus（SA）blood influenza infection in children，so as to provide basis for reasonable control and treatment of this disease.【Methods】182 cases of Staphylococcus aureus positive in blood culture from January 2016 to June 2018 were analyzed in terms of department distribution，infection type，basic diseases，clinical characteristics，antibiotic resistance，treatment outcome and prognostic factors. 【Results】 Staphylococcus aureus in blood culture was positive in 182 cases，mainly from neonatal SA（63 cases，34.6%）orthopaedics（22 cases，12.1%），PICU（20 cases，11.0%）， hematological oncology（15 cases，8.3%），rheumatic immunology（15 cases，8.3%），and respiratory medicine（13 cases，7.1%）；source of infection：community infection（109 cases，59.9%），hospital acquired infection（73 cases，40.1%）；there were 103 cases with underlying diseases （56.6%）；the most common initial symptoms were fever in 148 cases（81.8%），and methicillin-resistant staphylococcus aureus（MRSA）was found in 141 cases（77.5%）；all staphylococcus aureus were resistant to penicillin ，ampicillin ，ampicillin/sulbactam ，ceftriaxone and clindamycin ，but no serious drug resistance was found. Prognosis：161 cases（88.5%）were cured and improved，21 cases（11.5%）were not cured and 21 cases（11.5%）died. The adverse prognostic factors were severe sepsis（χ2 = 35.613，P = 0.000）and mechanical ventilation（χ2 = 39.13，P = 0.000）.【Conclusions】Patients with underlying diseases and newborns are the predisposing factors of blood stream infection of staphylococcus aureus，while those with severe sepsis and mechanical ventilation have poor prognosis. MRSA accounts for a high proportion of blood stream infection of staphylococcus aureus，and nosocomial infection is higher than community acquired infection. When empirical treatment of severe staphylococcus aureus bloodstream infection is ineffective，the treatment should be adjusted in time to take account of MRSA infection.

Three-dimensional reconstruction of the nasomaxillary complex and upper airway following rapid maxillary expansion by cone-beam CT / 中国组织工程研究

BACKGROUND:Two-dimensional radiographs and plaster models are used to evaluate the changes in the maxillary bone and airway after rapid maxillary expansion,but the shortcomings like distortion,one-sidedness,and overlapping appear.Cone-beam CT can effectively solve the above problems and achieve the three-dimensional reconstruction and measurement of the maxillary bone and airway.OBJECTIVE:To investigate the morphological changes of nasomaxillary complex and upper airway in adolescent patients with malocclusion after rapid maxillary expansion by cone-beam CT and Dolphin software.METHODS:Thirty adolescent patients with malocclusion were enrolled to receive rapid maxillary expansion.All patients underwent cone-beam CT examination before and after treatment,and Dolphin software was used for image processing,three-dimensional reconstruction,fixed point and measurement,to evaluate the morphological changes of the nasomaxillary complex and upper airway.RESULTS AND CONCLUSION:After treatment,the nasal cavity and maxillary width was increased by (2.13±1.80) and (4.12±2.15) mm,respectively (P ＜ 0.05);the coronal diameter and area of the airway on the hard plate was increased by (3.30±2056) mm and (75.37±53.92) mm2,respectively (P ＜ 0.05),and all above indexes showed significant difference compared with baseline.While the sagittal diameter of the airway on the hard plate showed no significant changes.After treatment,the upper airway showed a significant increase in the area and volume at the nasopharynx,which was increase by (33.57±57.10) mm2 and (1 009.59±1 350.91) mm3,respectively (P ＜ 0.05).The upper airway showed no significant changes in the area and volume at the velopharynx and glossopharynx,as well as the height at each part.To conclude,in the growing patients with malocclusion after rapid maxillary expansion,the nasomaxillary complex and area and volume of upper airway at the nasopharynx showed a significant increase,but the airway at the velopharynx and glossopharynx reveal no significant changes.

Role of Epithelium Sodium Channel in Bone Formation / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the recent developments in the mechanisms of epithelium sodium channels (ENaCs) induced bone formation and regulation.</p><p><b>DATA SOURCES</b>Studies written in English or Chinese were searched using Medline, PubMed and the index of Chinese-language literature with time restriction from 2005 to 2014. Keywords included ENaC, bone, bone formation, osteonecrosis, estrogen, and osteoporosis. Data from published articles about the structure of ENaC, mechanism of ENaC in bone formation in recent domestic and foreign literature were selected.</p><p><b>STUDY SELECTION</b>Abstract and full text of all studies were required to obtain. Studies those were not accessible and those did not focus on the keywords were excluded.</p><p><b>RESULTS</b>ENaCs are tripolymer ion channels which are assembled from homologous α, β, and γ subunits. Crystal structure of ENaCs suggests that ENaC has a central ion-channel located in the central symmetry axis of the three subunits. ENaCs are protease sensitive channels whose iron-channel activity is regulated by the proteolytic reaction. Channel opening probability of ENaCs is regulated by proteinases, mechanical force, and shear stress. Several molecules are involved in regulation of ENaCs in bone formation, including nitride oxide synthases, voltage-sensitive calcium channels, and cyclooxygenase-2.</p><p><b>CONCLUSION</b>The pathway of ENaC involved in shear stress has an effect on stimulating osteoblasts even bone formation by estrogen interference.</p>

Initial CT-guided percutaneous biopsy of vertebral lesions: Evaluation of its diagnostic accuracy and clinical value / 华中科技大学学报（医学）（英德文版）

This study aimed to examine the diagnostic accuracy and clinical efficacy of initial CT-guided percutaneous biopsy of the vertebral lesions. A total of 305 percutaneous biopsies of the vertebral lesions were performed under either CT guidance (n=127) or C-arm guidance (n=178). The diagnostic accuracy rate was evaluated by comparing the histopathological diagnosis with the ultimate diagnosis. The histopathological diagnosis was consistent with the ultimate diagnosis in 108 (85.0%, 108/127) cases of CT-guided biopsy and in 135 (75.8%, 135/178) cases of C-arm guided biopsy and there was a significant difference. The accuracy of diagnosis based on biopsies varied with different diseases, including primary benign or malignant tumors, metastatic tumors, inflammatory lesions and fractures. A second biopsy or further examinations were required for patients with negative result obtained in the initial biopsy. The complication rate was 3.1% (4/127) in CT-guided biopsy and 7.3% (13/178) in C-arm guided biopsy. In conclusion, CT-guided percutaneous biopsy is an accurate and safe technique for biopsy of the vertebral lesions.

Development of expert diagnostic system for common respiratory diseases / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To develop an internet-based expert diagnostic system for common respiratory diseases.</p><p><b>METHODS</b>SaaS system was used to build architecture; pattern of forward reasoning was applied for inference engine design; ASP.NET with C# from the tool pack of Microsoft Visual Studio 2005 was used for website-interview medical expert system.The database of the system was constructed with Microsoft SQL Server 2005.</p><p><b>RESULTS</b>The developed expert system contained large data memory and high efficient function of data interview and data analysis for diagnosis of various diseases.The users were able to perform this system to obtain diagnosis for common respiratory diseases via internet.</p><p><b>CONCLUSION</b>The developed expert system may be used for internet-based diagnosis of various respiratory diseases,particularly in telemedicine setting.</p>

Tripterygium polyglycosid attenuates the established airway inflammation in asthmatic mice / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of Tripterygium polyglycosid on establishing airway eosinophil infiltration and related airway hyperresponsiveness of asthmatic mice.</p><p><b>METHODS</b>A mature murine asthmatic model was made with ovabulmin sensitized and challenged C57BL/6 mice. Forty mice were divided into four groups with 10 mice in each group: mice sensitized and challenged with saline (WS group), mice sensitized and challenged with ovalbumin (WO group), mice sensitized and challenged with ovalbumin and treated with Tripterygium polyglycosid (TP group) and Dexamethasone (DXM group). The mice were intraperitoneally injected with 20 μg chicken ovabulmin emulsified in injected alum on days 0 and 14, then were challenged with an aerosol generated from 1% ovabulmin on days 24, 25 and 26. Tripterygium polyglycosid was injected intraperitoneally at 50 mg/kg on days 25, 26 and 27 after ovabulmin challenge. Dexamethasone was administrated to mice at 2 mg/kg on day 21, 23 before ovabulmin challenge. The airway hyperresponsiveness, mucus production, eosinophils in parabronchial area and bronchoalveolar lavage fluid and the level of interleukin-5, granulo-macrophage clone stimulating factor in bronchoalveolar lavage fluid were measured as indexes of inflammation.</p><p><b>RESULTS</b>Tripterygium polyglycosid treatment after ovabulmin challenge completely inhibited eosinophil infiltration in bronchoalveolar lavage fluid [(0.63 ± 0.34)× 10(4) vs. (75.0 ± 14.8)× 10(4), P<0.05] and the peribrochial area (12.60 ± 3.48 mm(2) vs. 379.0 ± 119.3 mm(2), P<0.05), mucus overproduction in airway (2.8 ± 1.7 vs. 7.1±5.6, P<0.05), and increased interleukin-5 levels in bronchoalveolar lavage fluid (28.8 ± 2.8 pg/mL vs. 7.5 ± 3.5 pg/mL, P<0.05). Meanwhile, Tripterygium polyglycosid treatment after ovabulmin challenge also partially inhibited airway hyperresponsiveness. The level of granulo-macrophage clone stimulating factor in bronchoalveolar lavage fluid didn't change with drugs intervention.</p><p><b>CONCLUSIONS</b>The administration of Tripterygium polyglycosid could inhibit the established airway inflammation and reduce the airway hyperresponsiveness of allergic asthmatic mice. It provides a possible alternative therapeutic for asthma.</p>

Promotion of chondrogenesis of marrow stromal stem cells by TGF-β3 fusion protein in vivo. corrected / 华中科技大学学报（医学）（英德文版）

The purpose of this study was to investigate the repair of the osteoarthritis(OA)-induced cartilage injury by transfecting the new TGF-β3 fusion protein (LAP-MMP-mTGF-β3) with targeted therapy function into the bone marrow-derived mesenchymal stem cells (MSCs) in rats. The recombinant of pIRES-EGFP-MMP was constructed by combination of DNA encoding MMP enzyme cutting site and eukaryotic expression vector pIRES-EGFP. LAP and mTGF-β3 fragments were obtained from rat embryos by RT-PCR and inserted into the upstream and downstream of MMP from pIRES-EGFP-MMP respectively, so as to construct the recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3. pIRES-EGFP-LAP-MMP-mTGF-β3 was transfected into rat MSCs. The genetically modified MSCs were cultured in medium with MMP-1 or not. The transfected MSCs were transplanted in the rat OA models. The OA animal models were surgically induced by anterior cruciate ligament transaction (ACLT). The pathological changes were observed under a microscope by HE staining, Alcian blue, Safranin-fast Green and graded by Mankin's scale. pIRES-EGFP-LAP-MMP-mTGF-β3 was successfully constructed by means of enzyme cutting and sequencing, and the mTGF-β3 fusion protein (39 kD) was certified by Western blotting. Those genetically modified MSCs could differentiate into chondrocytes induced by MMP and secrete the relevant-matrix. The transfected MSCs could promote chondrogenesis and matrix production in rat OA models in vivo. It was concluded that a new fusion protein LAP-MMP-mTGF-β3 was constructed successfully by gene engineering, and could be used to repair the OA-induced cartilage injury.

Induction of chondrogenesis of adipose-derived stem cells by novel recombinant TGF-β3 fusion protein / 华中科技大学学报（医学）（英德文版）

A new type of TGF-β3 fusion protein with targeted therapy function was constructed, and its feasibility and target specificity of inducing chondrogenesis were investigated by transfecting LAP-MMP-mTGF-β3 gene into adipose-derived stem cells (ADSCs). The recombinant pIRES-EGFP-MMP was constructed by inserting the sense and antisense DNA of encoding the amino acid of the synthetic MMP enzyme cutting site into the eukaryotic expression vector pIRES-EGFP. LAP and mTGF-β3 fragments were obtained by using RT-PCR and inserted into the upstream and downstream of MMP from pIRES-EGFP-MMP respectively, and the recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3 was constructed, which was transferred to ADSCs. The ADSCs were cultured and divided in three groups: experimental group (MMP group), negative control group (no MMP) and non-transfection group. The morphological changes were observed microscopically, and the expression of proteoglycan and type II collagen (ColII) was detected by using Alcian blue staining and immunohistochemistry staining at 7th, 14th and 21st day after culture. The recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3 was correctly constructed by methods of enzyme cutting and sequencing analysis. The mTGF-β3 fusion protein was successfully expressed after transfection, and in the presence of the MMP, active protein mTGF-β3 was generated, which significantly promoted differentiation of ADSCs into chondrocytes and the expression of cartilage matrix. The novel fusion protein LAP-MMP-mTGF-β3 can targetedly induce differentiation of ADSCs into chondrocytes, which would open up prospects for target therapy of cartilage damage repair in future.

Evaluation of the therapeutic efficiency of mandibular anterior implant-supported fixed bridges with cantilevers / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Dental implant technology has developed rapidly in recent years. However, the use of implant-supported fixed bridges with cantilevers has been controversial. The purpose of this study was to evaluate the clinical results of the mandibular anterior implant-supported fixed bridges with a cantilever. Method Thirty-three patients (15 males, 18 females; mean age, 42.6 years; range 20-54 years) with two missing anterior mandibular teeth had single implant-supported fixed bridges with a cantilever. Clinical examination was recorded and radiographs were taken. The mean duration of follow-up was 30 months (15-44 months).</p><p><b>RESULTS</b>All implants survived. Loosening or fracture of the prosthesis was not observed. All patients were satisfied with the treatment. The mean bone resorption values after 12, 24, and 36 months of implant loading were 0.94, 1.18 and 1.35 mm respectively. The changes of gingival papilla height ranged from 0 to 0.5 mm. There was significant difference between 1-year and 2 or 3 years restoration groups regarding the average gingival height changes (P < 0.05).</p><p><b>CONCLUSION</b>After careful and precise selection of patients, restoration with a single implant-supported fixed bridge with a cantilever can be recommended if two anterior mandibular teeth are missing.</p>

Promotion of chondrogenesis of marrow stromal stem cells by TGF-β3 fusion protein in vitro / 华中科技大学学报（医学）（英德文版）

The purpose of this study was to investigate the repair of the osteoarthritis(OA)-induced cartilage injury by transfecting the new TGF-β3 fusion protein (LAP-MMP-mTGF-β3) with targeted therapy function into the bone marrow-derived mesenchymal stem cells (MSCs) in rats. The recombinant of pIRES-EGFP-MMP was constructed by combination of DNA encoding MMP enzyme cutting site and eukaryotic expression vector pIRES-EGFP. LAP and mTGF-β3 fragments were obtained from rat embryos by RT-PCR and inserted into the upstream and downstream of MMP from pIRES-EGFP-MMP respectively, so as to construct the recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3. pIRES-EGFP-LAP-MMP-mTGF-β3 was transfected into rat MSCs. The genetically modified MSCs were cultured in medium with MMP-1 or not. The transfected MSCs were transplanted in the rat OA models. The OA animal models were surgically induced by anterior cruciate ligament transaction (ACLT). The pathological changes were observed under a microscope by HE staining, Alcian blue, Safranin-fast Green and graded by Mankin's scale. pIRES-EGFP-LAP-MMP-mTGF-β3 was successfully constructed by means of enzyme cutting and sequencing, and the mTGF-β3 fusion protein (39 kD) was certified by Western blotting. Those genetically modified MSCs could differentiate into chondrocytes induced by MMP and secrete the relevant-matrix. The transfected MSCs could promote chondrogenesis and matrix production in rat OA models in vivo. It was concluded that a new fusion protein LAP-MMP-mTGF-β3 was constructed successfully by gene engineering, and could be used to repair the OA-induced cartilage injury.

Induction of chondrogenesis of adipose-derived stem cells by novel recombinant TGF-β3 fusion protein / 华中科技大学学报（医学）（英德文版）

A new type of TGF-β3 fusion protein with targeted therapy function was constructed, and its feasibility and target specificity of inducing chondrogenesis were investigated by transfecting LAP-MMP-mTGF-β3 gene into adipose-derived stem cells (ADSCs). The recombinant pIRES-EGFP-MMP was constructed by inserting the sense and antisense DNA of encoding the amino acid of the synthetic MMP enzyme cutting site into the eukaryotic expression vector pIRES-EGFP. LAP and mTGF-β3 fragments were obtained by using RT-PCR and inserted into the upstream and downstream of MMP from pIRES-EGFP-MMP respectively, and the recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3 was constructed, which was transferred to ADSCs. The ADSCs were cultured and divided in three groups: experimental group (MMP group), negative control group (no MMP) and non-transfection group. The morphological changes were observed microscopically, and the expression of proteoglycan and type II collagen (ColII) was detected by using Alcian blue staining and immunohistochemistry staining at 7th, 14th and 21st day after culture. The recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3 was correctly constructed by methods of enzyme cutting and sequencing analysis. The mTGF-β3 fusion protein was successfully expressed after transfection, and in the presence of the MMP, active protein mTGF-β3 was generated, which significantly promoted differentiation of ADSCs into chondrocytes and the expression of cartilage matrix. The novel fusion protein LAP-MMP-mTGF-β3 can targetedly induce differentiation of ADSCs into chondrocytes, which would open up prospects for target therapy of cartilage damage repair in future.

Problems to pay attention to in taking patient-reported outcomes as clinical outcomes assessment / 中国中西医结合杂志

Patient-reported outcomes (PROs) provide clinical researchers with a good means to assess patient-based outcomes. Yet there are still some problems to pay attention to while using PROs as an effectiveness assessment index, including the selection of an appropriate scale of PRO, quality control in PRO data collection, and the interpretations and application ranges of the PRO results.

Effects of mice body temperature on pressure inside plethysmograph / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To observe temperature and pressure changes inside plethysmograph produced by body temperature of anesthetized mice.</p><p><b>METHODS</b>The temperature and pressure changes inside whole body plethysmograph generated from anesthetized mice were compared with those from dead mice. The temperature and pressure changes inside body chamber and head chamber of double-chamber with anesthetized mice in body chamber were synchronously measured. The respiratory frequencies and amplitudes of mice inside two kinds of head-out plethysmographs were synchronously measured. One of these two plethysmographs kept sealed all the time and the other was opened to the atmosphere for 1 min every 2 min.</p><p><b>RESULT</b>Temperature and pressure of air in the anesthetized mice chamber increased 1.18 degree and 2.710 mmHg within 6 min, and data from dead mice were 1.17 degree and 2.671 mmHg. There were no significant differences between these two groups. The temperature inside body chamber increased 1.92 degree in 20 min and the pressure was 5.554 mmHg, which were significantly higher than those of head chamber (0.09 degree and 0.627 mmHg). The respiratory frequencies of mice in the sealed head-out plethysmograph increased from 125.04 per min to 168.45 per min, and amplitudes of pressure changes generated from mice breath decreased from 1.090 mmHg to 0.883 mmHg. Significant differences occurred between different observation time points. Meanwhile respiratory frequencies in the open head-out plethysmograph were around 120 per min and amplitude of pressure changes kept about 1 mmHg. There were no significant differences between different time points.</p><p><b>CONCLUSION</b>Increase of temperature and pressure inside pressure whole-body plethysmograph are mainly from body temperature of mice, and the increased pressure significantly influences respiration of mice.</p>

Experimental study on different power CO2 laser for vocal cord injury / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the injury and repair of the subepithelial cordectomy by CO2 laser in different power.</p><p><b>METHODS</b>Thirty dogs were randomly divided into 5 groups according to different laser power such as A(1 W), B(3 W), C(5 W), D(8 W), E(cold instruments), 6 dogs in each group. Subepithelial cordectomy was performed on the dogs and the tissue damage and wound recovery were observed in different time after operation.</p><p><b>RESULTS</b>The mucosa reaction in group C, D was heavier than those in group A, B, E, and the wounds healed slowly with visible pathological scars. The densities of fibroblast and blood capillary were determined with optical microscope. It was found that those in group C, D were higher than those in group A, B, E. The difference was statistically significant (average P < 0.05). Observation by electron microscope showed that the injuries were lighter in group A, B, E and there was no significant difference in vocal cord repair process, while the injuries were more serious in group C, D with few elastic fibers in lamina propria and collagen fibers increased significantly after vocal cord repairing.</p><p><b>CONCLUSIONS</b>The tissue repair after subepithelial cordectomy by CO2 laser with low power (1 - 3 W) was similar to that by cold instrument surgery.</p>

Identification of the new allele D18S1364-10 by sequence analysis / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify a new allele by analyzing the polymorphism of D18S1364 in Power Plex(TM)16.</p><p><b>METHODS</b>An abnormal band was found in paternity test by short tandem repeat-PCR, and collected by gel extraction. Then the DNA was amplified, cloned and sequenced.</p><p><b>RESULTS</b>A fragment containing eight bases less than the minimal allele in the D18S1364 ladder, was found with the core sequence of (ATCT)₆(ATGT)₁(ATCT)₃. The allele was D18S1364-10.</p><p><b>CONCLUSION</b>The D18S1364-10 allele was found and reported for the first time in China.</p>

Aerodynamics study on pressure changes inside pressure-type whole-body plethysmograph produced by flowing air / 生理学报

When using pressure-type plethysmography to test lung function of rodents, calculation of lung volume is always based on Boyle's law. The precondition of Boyle's law is that perfect air is static. However, air in the chamber is flowing continuously when a rodent breathes inside the chamber. Therefore, Boyle's law, a principle of air statics, may not be appropriate for measuring pressure changes of flowing air. In this study, we deduced equations for pressure changes inside pressure-type plethysmograph and then designed three experiments to testify the theoretic deduction. The results of theoretic deduction indicated that increased pressure was generated from two sources: one was based on Boyle's law, and the other was based on the law of conservation of momentum. In the first experiment, after injecting 0.1 mL, 0.2 mL, 0.4 mL of air into the plethysmograph, the pressure inside the chamber increased sharply to a peak value, then promptly decreased to horizontal pressure. Peak values were significantly higher than the horizontal values (P<0.001). This observation revealed that flowing air made an extra effect on air pressure in the plethysmograph. In the second experiment, the same volume of air was injected into the plethysmograph at different frequencies (0, 0.5, 1, 2, 3 Hz) and pressure changes inside were measured. The results showed that, with increasing frequencies, the pressure changes in the chamber became significantly higher (P<0.001). In the third experiment, small animal ventilator and pipette were used to make two types of airflow with different functions of time. The pressure changes produced by the ventilator were significantly greater than those produced by the pipette (P<0.001). Based on the data obtained, we draw the conclusion that, the flow of air plays a role in pressure changes inside the plethysmograph, and the faster the airflow is, the higher the pressure changes reach. Furthermore, the type of airflow also influences the pressure changes.

Measurement of differential values of inhaled volumes and exhaled volumes in mice / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the differential value of inhaled volume and exhaled volume in anesthesia mice, and its effect on the pressure change inside of plethysmograph.</p><p><b>METHODS</b>Pressure and temperature in head chamber of double-chamber plethysmograph were tested when mice were placed in the body chamber. The differential values of inhaled volume and exhaled volume of mice were calculated.</p><p><b>RESULT</b>The baseline pressure in head chamber increased with temperature rising within 12 minutes, then went down though temperature remained high. The inhaled volumes of 8 mice were (0.2842 + or - 0.0173)ml,and the differential value of inhaled volume and exhaled volume was (0.0012 + or - 0.0002)ml.</p><p><b>CONCLUSION</b>The inhaled volume is larger than exhaled volume, which makes pressure baseline of plethysmograph decreased. The differential value may be generated from respiratory quotient.</p>

A clinical observation of combined application of magnetic attachments and extracoronal attachments / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore the clinical effect of combined application of magnetic attachments and extracoronal attachments in prosthodontics.</p><p><b>METHODS</b>Twenty-two cases of dentition defect with isolated residual root or residual crown were selected. All the cases accepted the restorative treatment combined magnetic attachments with extracoronal attachments. The clinical effect of dentures and the condition of abutment teeth were evaluated by chief complaint of patients and clinical examination. The follow-up time ranged from 2 years to 4 years.</p><p><b>RESULTS</b>Satisfactory functional, stable and esthetic results of dentures were achieved for all the cases. And there was no abutment loosening and no secondary caries. Alveolar bone loss around abutment occurred in 1 case, gingivitis of abutments appeared in 5 cases. Chewing pain occurred in 1 case and unstable state of dentures appeared in 5 cases after the use of denture for 2 years. The dentures of above-mentioned cases were used normally after symptomatic treatment.</p><p><b>CONCLUSION</b>The combined application of magnetic attachments and extracoronal attachments in prosthodontics is an effective treatment option for cases of dentition defect with isolated residual root or residual crown.</p>

Shoulder hemiarthroplasty for the treatment of complex proximal humeral fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the indication, perioperative announcements, selection of prosthesis and clinical results of shoulder hemiarthroplasty for the treatment of complex proximal humeral fractures.</p><p><b>METHODS</b>A total of 55 patients who suffered from complex proximal humeral fractures were treated by shoulder hemiarthroplasty. The mean age was 55.6 years and mean follow-up period was 25.1 months. The scoring system modification for hemiarthroplasty (SSMH) had been adopted for evaluation at the latest follow-up.</p><p><b>RESULTS</b>The pain was obviously relieved in all patients. Fifty patients were painless and 5 patients had slight pain. The mean range of motion was 100 degrees (90 degrees-110 degrees) in abduction, 95 degrees (80 degrees-100 degrees) in forward flexion, 35 degrees (30 degrees-40 degrees) in external rotation and internal rotation was confined at L2 level (L1-L3). The mean SSMH score was 27.9 (24-29). Fifty patients (90.1%) were satisfied with the clinical outcome.</p><p><b>CONCLUSIONS</b>Shoulder hemiarthroplasty is an effective method to treat complex proximal humeral fractures. The proper selection of patients and prosthesis, good operation skill and enough functional exercise are the key points of successful treatment.</p>

Total hip arthroplasty for treatment of elderly patients with comminuted intertrochanteric fracture accompanied by femoral head necrosis / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To assess the curative effect and investigate the indications of total hip arthroplasty for treatment of comminuted intertrochanteric fractures.</p><p><b>METHODS</b>Total hip arthroplasty was carried out in 9 cases of severe intertrochanteric fracture. The patients included two men and seven women. The average age of the patients was 68 years (48-75 years). The period from fracture to operation was 5 days (2-10 days). The mean follow-up period lasted for 11 months (3 months-2 years). There was one patient with comminuted intertrochanteric fracture accompanied by femoral head necrosis and 2 patients with intertrochanteric fracture and stroke. Other 6 patients had severe osteoporosis. The Harris score before operation was 63 points (45-71 points).</p><p><b>RESULTS</b>At the last follow-up, the patients gained 86 points (70-100 points) according to the Harris score. The effects of the 8 cases were good. The Harris score of all patients improved after treatment. Only two hemiplegia patients needed sticks to walk. The others could walk without hip pain. No radiographic evidence of acetabular wear and prosthesis dislocation or other major complications happened during the follow-up.</p><p><b>CONCLUSIONS</b>Prosthetic replacements can well treat unstable intertrochanteric fracture if operative indication is correctly selected. It is suitable for elderly patients and the operation should be performed by experienced surgeons.</p>