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Objective@#To propose a digitally modified and guided bone regeneration technique supported by a nonabsorbable titanium plate and explore its effect on vertical bone regeneration.@*Methods@#A total of 8 patients with severe vertical bone defects in the edentulous area who wanted to be treated with implants were included in this study. A digitally modified and guided bone regeneration technique supported by a nonabsorbable titanium plate (fence technique) was used for bone augmentation. The patient's jaw, dentition, and soft tissue data were obtained for prosthetically guided implantation and bone regeneration. After virtual bone augmentation, a model of the jaw was obtained through 3D printing technology, and the titanium plate was bent accordingly. The virtual design was transformed through the template (including the base template and the attachment of a periosteal screw and bone block), so the actual osteogenesis space consistent with the design could be realized in the operation. Guided bone regeneration was performed according to the improved procedure and technical process. After 6 ~ 8 months of bone augmentation, cone beam CT was taken to evaluate the effect of bone augmentation. The implant was implanted according to the initial implant design, and bone tissue was obtained for HE and Masson staining. @* Results@#After 6 ~ 8 months of bone augmentation, the vertical linear bone increment reached (5.44 ± 1.73) mm. The implant was implanted according to the initial implant design, and the bone tissue was obtained for histological examination to show the formation of new bone.@*Conclusion@#Digital improved fence technique can simplify the preoperative and surgical procedures, and obtain good vertical bone augmentation results. In short, it is a kind of vertical bone augmentation technique worth popularizing and applying.
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Abstract@#As an important part of the social psychological service system, social organizations provide collaborative support for the management of mental health in primary and middle schools. Based on a case of Wuhan psychological service center, the significant contributions were made by social organizations, including system building,technique provides,field supervision and resource aggregation. Social organizations efforts include improving school psychology service system, exploring school based curriculum in respond to needs, seeking solutions of the crisis, and collaborating with social resources to guide multilateral support. The path of social organizations in participating in the mental health management, the limitations and needed support would be explored.
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Saikosaponins (SSs) are the main active components extracted from Bupleuri Radix (BR) which has been used as an important herbal drug in Asian countries for thousands of years.It has been reported that the intestinal bacteria plays an important role in the in vivo disposal of oral SSs.Although the deglycosylated derivatives (saikogenins,SGs) of SSs metabolized by the intestinal bacteria are speculated to be the main components absorbed into the blood after oral administration of SSs,no studies have been reported on the characteristics of SGs for their intestinal absorption,and those for SSs are also limited.Therefore,a rapid UHPLC-MS/MS method was developed to investigate and compare the apparent permeability of three common SSs (SSa,SSd,SSb2) and their corresponding SGs (SGF,SGG,SGD) through a bidirectional transport experiment on Caco-2 cell monolayer model.The method was validated according to the latest FDA guidelines and applied to quantify the six analytes in transport medium samples extracted via liquid-liquid extraction (LLE).The apparent permeability coefficient (Papp) determined in this study indicated that the permeability of SGs improved to the moderate class compared to the corresponding parent compounds,predicting a higher in vivo absorption.Moreover,the efflux ratio (ER) value demonstrated an active uptake of SSd and the three SGs,while a passive diffusion of SSa and SSb2.
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Objective@#To discuss the application of digital technology in the education of implant dentistry.@* Methods@#According to the teaching method that combines case-, problem- and team-based learning, a course on implant theory was carried out in a class of 20 students. Then, all the students in this class were divided into two groups to receive two clinical operation training courses. The first was the training of a free-hand implant, and the second was an implant operation under a digital template. The courses introduced digital technology into preclinical education and simulated implant training. After the two courses, students were organized to analyze the accuracy of the implant, the operation time and the experiences of these two courses. Through the comparison of students′ operations of free-hand and template implants, students could analyze their own faults and propose a method of improvement. The students scored the two classes. @*Results @# Through the two classes, all the students completed the implant operation under the guidance of a template and free-hand method and found their own problems and solutions. The combination of theory and practice deepened the students′ understanding of the teaching content. Finally, the classes were graded comprehensively by students, showing that the students′ satisfaction with the digital template class was higher than that with the free-hand class (P < 0.05).@*Conclusion@#The addition of a digital implant technology class significantly improved students′ comprehensive assessment, improved the teaching effect and was more acceptable to students in terms of gaining additional professional skills.
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Background: The aim of the study is to evaluate the technique, safety, efficacy, and clinical value of computed tomography (CT)-guided percutaneous coaxial biopsy combined with microwave ablation (MWA) therapy for pulmonary tumors. Materials and Methods: CT-guided percutaneous coaxial biopsy combined with MWA was performed on 27 tumors in 23 patients who received treatment at our hospital from August 2014 to November 2017. The patients were followed up from 2 to 42 months. The outcomes were evaluated with plain and contrast spiral CT scans. Results: After treatment, lower density and lower CT values than baseline values were observed in the ablated area. The positive rate of biopsy was 81.48%. Seventeen patients had complete remission, four had partial remission, and two had progressive disease, with an effective rate of 91.3%. Until February 2018, 14 patients survived. Seven patients with metastatic lung cancer died of primary tumor progression. Two patients with primary lung cancer also died; one died of a lung infection and the other of cerebral hemorrhage. The 1-year local control rate was 88.9%, and the median progression-free survival was 33 months. The 1-, 2-, and 3-year survival rates were 91.3%, 69.6%, and 60.9%, respectively. Conclusion: CT-guided percutaneous coaxial biopsy combined with MWA can improve the quality of life of patients, prolong survival, and improve the survival rate. It is currently one of the most promising interventional treatments
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@#Objective To explore the possible factors which influence the survival time of elderly patients with esophageal cancer. Methods We retrospectively analyzed the data of patients with esophageal cancer treated in the First Hospital of Lanzhou University, Gansu Province Tumor Hospital from January 2012 to October 2016. Kaplan-Meier method was used to estimate and analyze the single factor, survival curve with log-rank test. The Cox regression model was used for multivariate prognostic analysis． Results According to the inclusion and exclusion criteria, 302 patients were eventually collected, including 231 males and 71 females, with an average age of 66.0±6.0 years. The univariate analysis showed that age, tumor stage, tumor site, Karnosfsky performance satus (KPS) score, and treatment were prognostic factors (P<0.05). Multivariate analysis showed that the patient age and treatment were independent factors for overall survival (OS) and progress-free survival (PFS) (P<0.05). The OS and PFS of the patients with age≤70 years were better than those of the patients more than 70 years. Chemotherapy alone and surgery alone was better for survival situation than radiotherapy alone. Conclusion Age and treatment are independent prognostic factors in survival time of the elderly patients with esophageal cancer.
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@#Objective To evaluate the effect of fast track surgery (FTS) after esophageal cancer surgery. Methods The randomized controlled trial (RCT) and observational studies about FTS for esophageal cancer in PubMed、EMbase、The Cochrane Library、Web of Science、CBM、CNKI and WanFang databases were searched up to May 2017. Then the studies were screened according to the inclusion and exclusion criteria by two researchers. Data were analyzed by Stata12.0 software. Results Totally 13 RCTs and 5 observational studies with 2 447 patients were eligible for analysis. Compared with the control group, incidence of postoperative complications (OR=0.53, 95%CI 0.40 to 0.71, P<0.05) significantly reduced in the FTS group, but there was no significant difference between the two groups in readmission rate (OR=1.21, 95%CI 0.83 to 1.76, P=0.313) and 30 d mortality rate (OR=0.72, 95%CI 0.43 to 1.20, P=0.207). Conclusion FTS can safely and effectively accelerate the recovery of patients with esophageal cancer and it owns important clinical values.
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This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).A total of 35 ISSNHL patients (including 21 patients with vertigo) were enrolled.All of the patients underwent audiometry,sensory organization test (SOT),caloric test,cervical vestibular-evoked myogenic potential (cVEMP) test and ocular vestibular-evoked myogenic potential (oVEMP) test.Significant relationship was found between vertigo and hearing loss grade (P=0.009),and between SOT VEST grade and hearing loss grade (P=0.001).The abnormal rate of oVEMP test was the highest,followed by the abnormal rates of caloric and cVEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo (compared with patients without vertigo).Significant relationship was found between presence of vertigo and SOT VEST grade (P=0.010).We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.
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Although metoprolol is used to treat hypertension, clinical responses are variable and unpredictable. Evidence suggests that adrenergic 1 receptor (ADRB1, designated Adrb1 in rodents) gene polymorphisms influence the level of blood pressure response to this drug therapy, but their presence can not predict the response of the individual patient. The question exists whether epigenetic modifications, such as DNA methylation could cause changes in the gene’s expression that are a determining factor in metoprolol’s efficacy. The aim of this study was to verify whether DNA methylation could change the expression of the ADRB1 gene, and epigenetic modification could explain why individuals with identical ADRB1 gene polymorphisms have different antihypertensive responses to metoprolol. H9c2 rat myocardial cells in vitro were randomly divided into 5-aza-2'-deoxycytidine (decitabine)-treated (0.5 to 10.0 μM) and control groups. For the in vivo experiments, 45 spontaneously hypertensive rats (SHRs) were divided into metoprolol-treated and control groups, and after a 4-week intervention myocardia were harvested. Genomic methylation-sensitive PCR was used to assess the methylation status of the Adrb1 promoter after DNA extraction from H9c2 cells and SHR myocardia. Real-time fluorescent quantitative RT-PCR was used to determine levels of Adrb1 mRNA. In H9c2 cells, the least degree of methylation was observed in the 5.0 μM decitabine treated group. Prolonged exposure of cells to 5.0 μM decitabine resulted in downregulating methylation of the Adrb1 promoter. Increased levels of Adrb1 mRNA of the 5.0 μM group demonstrated that this concentration resulted in the highest expression. Accordingly, DNA methylation resulted in the downregulation of Adrb1 transcription. In vivo, the lower level of methylation of the Adrb1 promoter from SHR myocardial samples demonstrated a better antihypertensive effect by metoprolol. The expression of Adrb1 mRNA in the effective group of SHRs was significantly upregulated. In conclusion, as shown in both H9c2 cells and SHRs, downregulated methylation of the Adrb1 promoter is likely to improve the antihypertensive efficacy of metoprolol.