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Objective · To observe the clinical outcomes of a modified laterally moved and coronally advanced flap combined with a connective tissue graft (CTG) for the treatment of severe Miller class Ⅱ or class Ⅲ isolated recession defects. Methods · Three patients with initial defect depths of more than 5 mm and malposition in some teeth were enrolled and underwent a modified laterally moved and coronally advanced flap combined with CTG. Recession depth (RD), keratinized tissue height (KTH) of both donor and adopted site, pocket depth (PD), and clinical attachment loss (CAL) at baseline and follow-up one-year after treatment were documented. Root coverage rate (RC) was calculated and visual analogue scale (VAS) was used to evaluate patient's satisfaction degree. Results · The mean RDs at baseline and followup were (5.3±0.5) mm and (0.3±0.5) mm. The mean RC at follow-up was (93.3±9.4)% and two cases had complete root coverage. The KTHs at adopted and donor sites were (0.3±0.5) mm and (6.0±0.8) mm at baseline and (4.3±0.5) mm and (5.7±1.3) mm at follow-up, respectively. PD and CAL were decreased from (1.7±0.5) mm and (7.0±0.8) mm at baseline to (1.3±0.5) mm and (1.3±1.2) mm at follow-up, respectively. The VAS value was 9.0±0.8 and subjective evaluation of patients was improved significantly at one-year follow-up, including root sensitivity and aesthetics. Conclusion · The modified laterally moved and coronally advanced flap with CTG has ideal clinical outcomes and satisfaction degree for the treatment of patients with severe recession defects that lack keratinized tissue and combine with buccal malposition.
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Objective To discuss the clinical efficacy of surgical treatment of pathologic vertebral surgery for thoracic and lumbar tuberculosis. Methods All of 322 cases of thoracic and lumbar spinal tuberculosis patients from December 2003 to June 2014 were retrospectively analyzed in our department. All patients were underwent debridement, fusion and nerve decompres?sion surgery. According to different fixed methods, patients were divided into pathologic vertebral surgery group (fixation complet?ed within lesions invaded motion unit) including 91 males and 100 females, with an average age of 41.53 years, and non?pathologic vertebral surgery group (long segments or short segment fixation) including 61 males and 70 females, with an average age of 42.72 years. We observed the tuberculosis cure rate, degrees of deformity, pain and neurological recovery, operative time, blood loss and complications by follow?up. Results The average follow?up time was 75.52 months in pathologic vertebral surgery group and 76.21 months in non?pathologic vertebral surgery group. The total number of pathologic vertebras in pathologic vertebral surgery group and non?pathologic vertebral surgery group were 277 and 218 respectively, and the average was 1.45 and 1.66. The total number of fixed segments was 277 in pathologic vertebral surgery group and 485 in non?pathologic vertebral surgery group, and the average fixed segments was 1.45 and 3.70. The cure rate was 85.86%in pathologic vertebral surgery group and 85.49%in non?pathologic vertebral surgery group at 6 months postoperatively, and 98.95%and 98.47%at the last follow?up time, with no signifi?cant difference between groups. Graft fusion rate was 89.00%in pathologic vertebral surgery group and 89.31%in non?pathologic vertebral surgery group 6 months postoperatively, 98.38%and 98.47%at the last follow?up time, without significant difference. In lumbar spine, the average correction of Cobb's angle was 12.4° in pathologic vertebral surgery group and 13.1° in non?pathologic vertebral surgery group, and the average angle loss was 1.3 and 1.4°, with no significant difference. In thoracolumbar, the average correction of Cobb’s angle was 10.9°in pathologic vertebral surgery group and 11.1°in non?pathologic vertebral surgery group, and the average angle loss was 1.7°and 1.5° respectively, without significant difference. However, in thoracic, the average correction of Cobb's angle was 10.2° in pathologic vertebral surgery group and 12.7° in non?pathologic vertebral surgery group, and the average angle loss was 3.6° and 2.5°respectively, with significant difference. The mean operation time was 210.45 min in pathologic verte?bral surgery group and 210.45 min in non?pathologic vertebral surgery group, with significant difference. The average blood loss was 726.12 ml in pathologic vertebral surgery group and 726.12 ml in non?pathologic vertebral surgery group, with significant dif?ference. The complication rate was 11.51%in pathologic vertebral surgery group and 11.45%in non?pathologic vertebral surgery group, with no significant difference. Conclusion Pathologic vertebral surgery surgery is a safe, effective and feasible method of operation for treatment of thoracic and lumbar tuberculosis, which can effectively preserve adjacent normal vertebral motion unit features. The thoracic surgery was less satisfactory than the lumbar and thoracolumbar surgery.
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Objective To investigate the feasibility of Antituberculotic?loaded bone cement (ATLBC) prepared by mix?ing the anti?TB drugs Rifampicin (RFP), Isoniazid (INH), Pyrazinamid (PZA), Moxifloxacin (MFX) with Palacos R PMMA bone cement in Total Joint Arthroplasty treatment for Joint Tuberculosis. Methods Forty grams of Palacos R bone cement powder without antibiotics was mixed with 1 or 2 grams of RFP, INH, PZA and MFX respectively. According to ISO 5833:2002 stan?dard, 8 groups of ATLBC standard test specimen were prepared as experiment group and Palacos R PMMA bone cement with?out antibiotics was prepared as control group. Physical properties (such as the average dough time, curing time, maximum tem?perature), mechanical strength (such as the compressive strength, the bending resistance strength, the modulus of elasticity) and the concentrations of eluant drug in different time points of ATLBC were detected. Results In RFP (1 g), RFP (2 g), INH (1 g) and INH (2 g) group, the average dough time and curing time were longer than those in control group, which exceeded the standard scope of ISO, while the average maximum temperature was significantly lower than that in control group. The INH ( 1 g) group and INH (2 g) group hardened after mixing for 14 days. The RFP (1 g) group and RFP (2 g) group hardened after mixing for 30 days. Twenty minutes after mixing and hardening, the compressive strength, bending resistance strength and modulus of elastic?ity were significantly lower than the specified values of ISO standard. The physical properties and mechanical strength in PZA ( 1 g) group, PZA (2 g) group, MFX (1 g) group, MFX (2 g) group and control group were in accordance with the specified values of ISO standard, and they hardened after 20 minutes. In RFP (1 g) group, RFP (2 g) group, INH (1 g) group, INH (2 g) group, PZA (1 g) group, PZA (2 g) group, MFX (1 g) group and MFX (2 g) group, the concentration of eluant could maintain for 3 days, 7 days, 90 days, 90 days, 45 days, 60 days, 60 days and 60 days respectively. Conclusion RFP and INH mixing with Palacos R PMMA bone cement can hinder the aggregation of bone cement so they are unsuitable for preparing ATLBC. PZA and MFX mixing with Palacos R PMMA bone cement do not affect the physical properties of bone cement, with excellent mechanical strength and elu?tion properties. Because the minimal inhibitory concentration of PZA is higher and its antimicrobial activity maintains shorter time, while MFX maintains longer time in antimicrobial activity, it's more suitable for the preparation of ATLBC.
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Objective To investigate the radiation level around Jiangzha hot spring,and to analyze the sources of pollution.Methods The radon and its progeny concentration,γ dose rate in hot spring living district and surrounding area were measured with ATD monitors,radon and WL continuous measurement devices,γ dose rate meter.Results The radon concentration in water was 23 -764 Bq/L.Radon concentration indoors,outdoor and in bathing place were 254 -876 799,688 -709 and 3590-15 299 Bq/m3,respectively.γ dose rate were 205 -28718 nGy/h indoor,4104- 18254 n Gy/h outdoors.Conclusions Jiangzha hot spring is an area with rare high radon and high nature radiation.Its radiation level and health effects are worthy for further attention.
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Objective To monitor the protective qualities of personal protective appliances and to ensure the health and safety of radiological working personnel.Methods The lead-equivalent thickness of personal protective appliances and materials was measured by means of standard lead slices.The lead equivalent thickness represents in terms of mm Pb.Results 77 pieces of products and samples were measured altogether.The results indicate that the specific lead equivalents of lead-rubber plates were between 0.20-0.39 mm Pb/mm for 37 pieces of lead-rubber plates and the values of 6 pieces of samples were less than 0.25 mm Pb/mm,which did not accord with the requirement of the relational standard.27 pieces of personal protection appliances were measured altogether.They were 12 pieces of protective clothes,4 pieces of protective headgears,5 pieces of protective neckpieces,4 pieces of protective gloves and 2 pieces of protective masks.13 pairs of lead-glass spectacles among them were measured altogether.The measured results for personal protective appliances and lead-glass spectacles showed that actually measured lead-equivalent were higher than the nominal lead-equivalent.Conclusions The protective qualities are reliable for personal protection materials and appliances to be made in home and imported abroad.But the protective qualities of interventional protection gloves should be improved and made them better.