Determinants of poor sleep quality in adults during the coronavirus disease pandemic: COVID-Inconfidentes, a population-based study

ABSTRACT BACKGROUND: The coronavirus disease (COVID-19) pandemic has adversely affected the health of the global population, with sleep quality being one of the affected parameters. OBJECTIVES: To evaluate sleep quality and its associated factors in adults during the COVID-19 pandemic in Brazil. DESIGN AND SETTING: A population-based cross-sectional serological survey of 1,762 adults in the Iron Quadrangle region of Brazil. METHODS: The Pittsburgh Sleep Quality Index was used to assess sleep quality. Sociodemographic variables, health conditions, health-related behaviors, anxiety, vitamin D levels, weight gain/loss, and pandemic characteristics were assessed using a structured questionnaire. Univariate and multivariate analyses using Poisson regression with robust variance were performed to identify factors associated with sleep quality. RESULTS: More than half of the participants reported poor sleep quality (52.5%). Multivariate analysis revealed that the factors associated with poor sleep quality included living alone (prevalence ratio [PR] = 1.34; 95% confidence interval [CI]: 1.04-1.73), anxiety disorder (PR = 1.32; 95% CI: 1.08-1.62), 5.0% weight loss (PR = 1.21; 95% CI: 1.02-1.44), 5.0% weight gain (PR = 1.27; 95% CI: 1.03-1.55), vitamin D deficiency (PR = 1.16; 95% CI: 1.01-1.35), and COVID-19 symptoms (PR = 1.29; 95% CI: 1.10-1.52). CONCLUSIONS: Our study revealed that more than half of the participants experienced poor sleep quality during the COVID-19 pandemic. Factors associated with poor sleep quality included vitamin D deficiency and weight changes related to the pandemic.

Effects of Amarogentin on Residual Liver Cancer Stem Cells After Insufficient Thermal Ablation and Related Mechanism / 肿瘤防治研究

Objective To observe the effects of amarogentinon liver cancer stem cells (LCSCs) after insufficient thermal ablation and its mechanism. Methods A insufficient thermal ablation model of HepG2 cells was established by water bath method.The percentage of CD133-positive LCSCs and the mRNA and protein levels of CD133 were detected by flow cytometry, qRT-PCR and Western blot.The insufficient thermal ablation model of HepG2 cells was treated with variable doses of amarogentin for 24 h; the percentage of CD133-positive LCSCs, the proliferation and apoptosis of liver cancer cells, and the mRNA and protein levels of CD133, TBC1D15, and p53were detected by flow cytometry, qRT-PCR and Western blot. Results The percentage of CD133-positive HepG2 cells and the mRNA and protein levels of CD133 and TBC1D15in the insufficient thermal ablation model were significantly higher than those in the normal HepG2 cells.Amarogentin then markedly decreased the percentage of CD133-positive LCSCs, the proliferation rate of HepG2 cells, and the mRNA and protein levels of CD133 and TBC1D15 in the insufficient thermal ablationresidual model (all P < 0.05);inversely, the apoptosis rate of HepG2 cells and the phosphorylated levels of p53 in the insufficient thermal ablation model were significantly increased (all P < 0.05). Conclusion Amarogentin could reduce the proportion of LCSCs after insufficient thermal ablation, inhibit the proliferation, and promote the apoptosis of LCSCs, which maybe associated with increasing the phosphorylation of p53 and inhibiting the expression of TBC1D15.

Nerve electrical stimulation treatment of xerostomia / 口腔疾病防治

@#Patients with impaired quality of life associated with xerostomia need long-term treatment, and a nerve stimulator has the advantage of providing natural saliva and long-term management for patients with xerostomia by electrically stimulating the relevant secretory nerves to promote saliva production. A number of clinical trials have preliminarily demonstrated the efficacy of nerve electrical stimulation in the treatment of xerostomia. However, electrical stimulation has not yet become the mainstream treatment for xerostomia. Large prospective randomized controlled clinical trials are still needed to confirm its long-term effectiveness and safety. In addition, the design of nerve stimulators is of great significance for clinical application. The large volume and inconvenient treatment associated with the extra oral nerve stimulator and the first generation intraoral nerve stimulator hinder their clinical application and popularization. The second- and third-generation intraoral nerve stimulator devices are small, convenient to use and have great application prospects. Research on electrical nerve stimulators for xerostomia treatment is mainly concentrated in European and American countries, while there is very little domestic research. It is urgent to master the core technology for the research and development of electrical nerve stimulators. The innovation of miniaturization, efficient power supply, data feedback and packaging will be the key issues of electrical nerve stimulators in the future. In this paper, the treatment and research of electrical nerve stimulation for xerostomia are reviewed to provide a reference for related basic research and the clinical application of electrical stimulators treating xerostomia in China.

Application of a metal occlusal surface and split framework in the treatment of a patient with mandibular distal extension absence and insufficient occlusogingival distance / 口腔疾病防治

Objective@# To investigate the effect of a metal occlusal surface and stress interruption design on minimally invasive prosthodontics for patients with distal extension absence and insufficient occlusal gingival distance.@*Methods @# We retrospectively studied the case of minimally invasive prosthodontic (Vitallium 2000) combined with a metal occlusal surface for distal extension absence in a patient with insufficient occlusal gingival distance; the stress breaking design and pressure impression technology are examined, and relevant articles are reviewd. @*Results@#The design effectively solves the problems of insufficient occlusal gingival distance, large occlusal force and easy denture fracture. Reviewing the relevant literature, stress interruption design can effectively protect abutment teeth, but the behavior of stress interruption design and stress conduction phenomena in the mouths of patients has not been reported. The T-scan test results of this study showed that before and after wearing the denture, the occlusal force distribution ratio of the patient changed from 77.5% on the left and 22.5% on the right to 61.3% on the left and 38.7% on the right. The occlusal force distribution ratio of the right dentition to the total occlusal force increased by 16.2%, and the occlusal force became better distributed. Further analysis showed that the occlusal forces on the left and right sides were nearly the same in the initial occlusion stage. As the occlusal force was further increased, the proportion of the occlusal force on the right side decreased in the middle of the occlusion stage and further decreased in the final occlusion stage until it reached a dynamic balance. The above T-scan test and literature review results suggest that this dynamic balance phenomenon of bite force is related to the stress interruption design and the stress conduction effect of the split framework.@* Conclusion @#The composite of stress interruption design and metal occlusal surface allows for minimally invasive prosthodontics for the treatment of distal extension absence in patients with insufficient occlusal gingival distance.

Correlations of long working hours and shift work with sleep of migrant workers / 环境与职业医学

Background Long working hours (LWH) and shift work are harmful to the physical and mental health of occupational groups. Objective To understand the status quo of LWH and shift work of migrant workers in Shanghai, and to analyze the influence of the above two factors on sleep of the population. Methods From July to September 2018, a cross-sectional survey using questionnaires was conducted among 3215 in-service employees at seven workplaces with more than 300 employees in six selected districts of Shanghai using multi-stage random sampling method. A total of 2976 valid questionnaires were collected, with a valid response rate of 92.6%. The questionnaires included general demographic characteristics, personal health behavior, work-related factors, weekly working hours, shift work, and sleep. Univariate analysis and logistic regression analysis were used to investigate the relationships of LWH and shift work with sleep, and an interaction item was included to evaluate potential interaction between LWH and shift work. Result The average age of the subjects was (30.98±9.49) years old, the male to female ratio was 1∶1.20, and 2382 workers were reported without local residency (80.0%). Among the migrant workers, the average weekly working hours was (57.23±13.14) h, the proportions of LWH (weekly working hours>40 h), extra LWH (weekly working hours>55 h), and shift work were 80.6% (1919/2382), 60.3% (1436/2382), and 25.4% (600/2366), respectively, all above were significantly higher than those of local workers. The prevalence rates of insomnia and lack of sleep among the migrant workers were 46.3% (1091/2356) and 25.4% (597/2354), respectively. The results of logistic regression model showed that after adjusting demographic characteristics such as gender, age, education level, and monthly income, as well as occupation and personal health behavior, compared with working hours ≤40 h per week, working 55-60 h per week was a risk factor for insomnia of migrant workers (OR=1.33, 95%CI: 1.02-1.72), while working >60 h per week was a risk factor for both insomnia (OR=1.37, 95%CI: 1.05-1.78) and insufficient sleep (OR=1.73, 95%CI: 1.28-2.35) of migrant workers. Shift work was only associated with insomnia (OR=1.37, 95%CI: 1.11-1.69). Meanwhile, working hours>60 h per week and shift work had an interaction effect on insomnia of migrant workers (OR=2.35, 95%CI: 1.20-4.60). Conclusion LWH and shift work are prominent among migrant workers, and there is an interaction between LWH and shift work with insomnia.

The reoperation strategy after laparoscopic sleeve gastrectomy / 中华消化外科杂志

At present, laparoscopic sleeve gastrectomy (LSG) has become the most popular bariatric surgery worldwide. LSG is simple to operate, with few complications and favorable short-term weight loss results. However, with massive LSG performed, its disadvantages have become increasingly prominent. More and more patients require revisional surgery due to insufficient weight loss, weight regain and reflux esophagitis. Based on clinical experience and existing clinical evidence, the author reviews the reoperation strategies after LSG.

Analysis of reasons of insufficient blood collected in Guangzhou during 2018~2020 / 中国输血杂志

【Objective】 To retrospectively analyze the reasons of insufficient blood collected, to provide evidences for further taking targeted measures, to reduce the discard of insufficient whole blood and prevent the loss of blood donors. 【Methods】 Calculate the total number of whole blood donors and the number of whole blood donors donating insufficient blood during 2018~2020 annually in Guangzhou Blood Center Information System, and the data was analyzed in SPSS (22.0) software for χ2test and linear trend test. 【Results】 During 2018~2020, the incidence of insufficient blood collected was 0.066 4%(531/799 439), and the incidence of insufficient blood collected because of poor blood flow, needle-sickness and other reasons were 0.048 7%(389/799 439), 0.010 6%(85/799 439) and 0.007 1%(57/799 439). Furthermore, the incidence of insufficient blood collected of the three above reasons had statistically significant difference between the years respectively (P<0.05), meanwhile the incidence of insufficient blood collected because of poor blood flow was in a general rising trend significantly (0.036 3%<0.038 2%<0.072 7%, P<0.05). 【Conclusion】 The incidence of insufficient blood collected because of poor blood flow was in the rising trend and further precautions should be considered. Under the normalization of the novel corona-virus pneumonia (COVID-19), the professional knowledge of epidemic prevention and control should be learned and trained, in addition the puncture technique, the ability of offering psychological care and dealing with adverse events during blood collection should be also improved among nurses continually, so as to provide high quality services for blood donors.

Analysis and process improvement concerning adverse events to insufficient plasma transfusion / 中国输血杂志

【Objective】 To analyze the root causes of adverse events to insufficient plasma transfusion, so as to explore improvement measures, optimize the transfusion strategy and avoid such adverse events. 【Methods】 The root causes of insufficient plasma transfusion were analyzed by health care failure mode and effect analysis, the targeted improvement measures were formulated and the effect was evaluated. 【Results】 After the improvement, the incidence of adverse events to insufficient plasma transfusion decreased significantly.The risk priority value affecting the safety of blood transfusion decreased from 70 to 8, and the proportion of coagulation function test after blood transfusion increased from 44.61%(1 309/2 934)in 2012 to 80.55% (2 187/2 715)in 2019, and plasma transfusion volume per capital increased from 300 mL to 528 mL. PT and APTT values after plasma transfusion in 2019 significantly increased compared with those in 2012. Meanwhile, the proportion of plasma transfusion in hospitalized patients decreased from 3.16% (2 934/92 838)to 2.12%(2 715/128 352). 【Conclusion】 Risk management of quality and safety of blood transfusion by combing healthcare failure mode, effect analysis and root cause analysis(RCA) can improve the risk awareness of clinical blood transfusion, optimize the proportion of plasma transfusion, and is essential to ensure the safety and effectiveness of blood transfusion and improve the prognosis of transfused patients.

Insufficient radiofrequency ablation promotes epithelial–mesenchymal transition mediated by interleukin-6/signal transducer and activator of transcription 3/Snail pathway in the H22 cells

Context: Radiofrequency ablation (RFA), an established and minimally invasive therapy for hepatocellular carcinoma, has become an important treatment strategy. However, tumor aggressiveness remains a common problem. The epithelial–mesenchymal transition (EMT) is thought to play an important role in this process. Design and Aims: Due to limited sample volumes harvested from patients, we established a heat-treated cell line and a mouse model to investigate the mechanisms of incomplete ablation in EMT. Materials and Methods: We heat-treated H22 and HepG2 cells using a water bath to determine a suitable temperature for incomplete RFA. Male BALB/c mice were orthotopically transplanted with H22 cells and then subjected to incomplete ablation. Changes in the EMT biomarkers were detected by real-time polymerase chain reaction, western blotting, and immunofluorescence. Statistical Analysis: The experimental results are expressed as means ± standard deviations. Results: Incomplete RFA promoted EMT, downregulated E-cadherin, upregulated vimentin and Snail, and enhanced the phosphorylation of signal transducer and activator of transcription 3 (STAT3) both in vivo and in vitro. Moreover, interleukin (IL)-6 secretion increased after heat treatment in the H22 cells. AG490, an IL-6 inhibitor, inhibited the occurrence of EMT. Conclusions: Insufficient ablation performed at low temperature successfully induces EMT and promotes tumor aggressiveness, which is mediated by the IL-6/STAT3/Snail pathway in both cell and mouse models.

Clinical application and complications of short implants (≤6 mm) / 口腔疾病防治

@#Short implants can be used as an alternative in cases of insufficient vertical bone volume after dentition defect or absence of dentition to simplify or avoid bone augmentation procedures. Short implants (≤ 6 mm) are reported to have a mean survival rate of 96% after a period of 1-5 years in function and have been widely used in cases of dentition defects or absence of dentition. Compared with conventional implants (≥ 10 mm) combined with bone augmentation procedures, short implants have fewer surgery-related complications, less marginal bone loss, shortened treatment times and reduced costs, and are preferred by patients. Due to a lack of evidence, a high crown-implant ratio should not be an obstacle for the use of short implants. In addition, most of the current literature has not enough follow-up time, the long-term implant survival data of short implants remain unclear. To improve the clinical outcomes of short implants, attention should be paid to the implant site, bone quality, and occlusal force as well as to the presence of oral health maintenance, periodontal diseases and habits through a careful intraoral and radiographic examination. The choices of wider implant use and splint restoration are recommended, occlusal force should be paid attention during implant maintenance. Inappropriate stress on restorations should be avoided. Future studies should be focused on the long-term clinical outcomes of short implants.

Analysis on the rule of clinical acupoint selection in treatment of puerperal insufficient lactation with acupuncture and moxibustion / 中国针灸

The rule and characteristics of clinical acupoint selection were explored in treatment of puerperal insufficient lactation with acupuncture and moxibustion. The clinical articles on the treatment of puerperal insufficient lactation with acupuncture and moxibustion were retrieved from the databases of CNKI, VIP and Wanfang from the date of establishment to June 1, 2019. The articles were screened in accordance with the inclusion and exclusion criteria. The prescriptions of acupuncture and moxibustion were extracted and normalized. Using Microsoft Excel 2016 software, the use frequency, meridians involved and acupoint distributions were analyzed. Using SPSS Statistics 21.0 software, the cluster and factor analyses were conducted. Totally, 102 articles were included,108 acupoint prescriptions were extracted, 65 acupoitns were designed and the total use frequency was 654 times. The top three acupoints used in treatment of puerperal insufficient lactation were Danzhong (CV 17), Rugen (ST 18) and Shaoze (SI 1). The most frequently involved meridians were the stomach meridian, the conception vessel, the small intestine meridian and the liver meridian. The acupoints were mainly distributed in the chest and four extremities. It was showed in cluster analysis that Rugen (ST 18), Shaoze (SI 1), Zusanli (ST 36) and Danzhong (CV 17) represent 3 clusters and a total of 7 common factors were extracted. The acupoint selection is based on syndrome differentiation in treatment of puerperal insufficient lactation with acupuncture and moxibustion, of which, the local acupoints are predominated and the distal acupoints are combined.

Clinical application and new progress of dynamic navigation system in the field of oral implantology / 口腔疾病防治

@#Currently, computer-aided implant surgeries include implant placement surgery under the guidance of a dynamic navigation system. With the use of software inherent in the navigation system, doctors can make a preoperative plan including the ideal position of the implant. Then the plan can be accurately transferred to the surgery, during which the real-time condition of the drill and its relationship with the surgical region will be visualized by the surgeon and the drill can be adjusted in a timely manner. Currently the dynamic navigation system is increasingly widely utilized, especially in cases of esthetic zones or surgical sites with important anatomical structures. However, the clinical workflow of the navigation system is complicated, including CBCT taken after the registration device placement, prosthetic-driven 3D design, calibration, registration, navigated borehole preparation and implant placement surgery. Many details should be considered when the device is applied, including implant position design, fixation of the tracking device, registration, and stable borehole preparation under the guidance of dynamic navigation. Therefore, this article introduces the dynamic navigation system into the clinical workflow and evaluates, the effects of the application and the clinical features. The new progress of the navigation system in the field of implantology is demonstrated at the same time, including navigated surgery in fully edentulous arches and in the zygomatic zone. Further improvements in the navigation system in terms of the accuracy and simplification of the workflow are needed in the future.

Characteristics of blood pressure fluctuation in hemodialysis patients with insufficient effective blood volume and comparison with blood pressure at the beginning of hemodialysis / 中国综合临床

Objective@#To explore the clinical symptoms of effective blood volume deficiency caused by ultrafiltration in hemodialysis patients with chronic renal failure, and to analyze the changes of blood pressure during the formation of symptoms.@*Methods@#From October 2016 to February 2019, 146 patients with maintenance hemodialysis were selected from the Yangquan coalmine group General Hospital for 39 658 hemodialysis.There were 3527 cases of clinical symptoms of definable hypovolemia.The characteristics of clinical symptoms in the early stage of dialysis (>0-≤60 min), medium (>60-≤180 min) and late (>180-≤240 min) were analyzed.To define the hypotension, hypertension and maintenance blood pressure in dialysis, and to count the incidence of various blood pressure when clinical symptoms appear.The mean arterial pressure (mean arterial pressure, MAP) measured at the onset of the disease was compared with (MAP) at the onset of dialysis, and the evolution of (MAP) was classified.The dialysis interval weight gain≥5% or<5%, was counted for the onset of the condition caused by dialysis ultrafiltration.To analyze the clinical symptoms of hemodialysis caused by ultrafiltration speed and excess.@*Results@#The incidence of clinical symptoms was 8.9% (3527/39658). The clinical symptoms caused by the insufficiency of effective blood volume are manifested in each period of dialysis, and have the characteristics of disease.Blood pressure index can not accurately reflect the correlation of clinical symptoms.There were 493 cases of effective blood volume deficiency during dialysis >0-≤60 min.Among them, 341 cases of hypotension, accounting for 69.1% (341/493), 79 cases of hypertension, accounting for 16.1% (79/493), 73 cases of maintaining blood pressure, accounting for 14.8% (73/493). The incidence of clinical symptoms was increased when dialysis was >60-≤180 min, which was related to continuous or excessive ultrafiltration.There were 1306 cases in total, including 1003 cases of hypotension, accounting for 76.8% (1003/1306); 179 cases of hypertension, accounting for 13.7% (179/1306); 124 times of maintaining blood pressure, accounting for 9.5% (124/1306). Dialysis>180-≤240 min is the high incidence period of clinical symptoms, which is related to continuous ultrafiltration and exceeding the setting of dry body mass.There are 1728 cases in total, including 1408 cases of hypotension, accounting for 81.5% (1408/1728); hypertension is reduced, but there are still cases of stubborn hypertension.When the clinical symptoms of hypovolemia occurred, 1989 cases were hypotension, which was easy to attract clinical attention; 763 cases were hypotension, which was stable before the clinical symptoms appeared, and then the blood pressure dropped suddenly; 446 cases were significantly higher than before the clinical symptoms appeared, which made it difficult to judge the clinical symptoms; 329 cases maintained the blood before the dialysis pressure.Excessive water retention in the whole process of dialysis has clinical symptoms, the total number of times increased significantly.The incidence of common water retention was less than that of dialysis>180-≤240 min.The osmotic pressure of plasma colloid and crystal affects the refilling of plasma, the change of ultrafiltration mode and the change of dialysis temperature on blood pressure and blood volume.@*Conclusion@#Because of the characteristics of the disease and the particularity of the treatment, the hemodialysis ultrafiltration process is prone to the related clinical symptoms caused by insufficient effective blood volume.However, the occurrence of clinical symptoms is not synchronous with the change of blood pressure.To improve the understanding of clinical symptoms of insufficient blood volume, to achieve early detection and early treatment is conducive to the safe treatment of follow-up hemodialysis and better completion of ultrafiltration target value.

Application of professor 's academic thought " is often insufficient, but is often surplus" in heat-sensitive moxibustion for tumor rehabilitation / 中国针灸

Professor has explored the causes of the characteristics of TCM syndromes in modern disease spectrum and pointed out that the TCM syndromes are generally characterized by " is often insufficient, but is often surplus". Based on the clinical experience and the understanding of TCM classics and ancient literature on tumor, professor has proposed that TCM syndromes of patients with advanced tumor are also generally characterized by " is often insufficient, but is often surplus". The heat-sensitive moxibustion has the functions of warming and nourishing eliminating dampness, warming meridians and dispersing cold, activating blood circulation and clearing collaterals, therefore tumor patients with deficiency syndrome (-deficiency, deficiency), cold syndrome, dampness syndrome, phlegm syndrome and blood-stasis syndrome belonging to the indications of heat-sensitive moxibustion. The heat-sensitive moxibustion has unique advantages in treating spleen-stomach dysfunction after chemotherapy and radiotherapy, bone marrow suppression after chemotherapy and radiotherapy, cancerous deficiency, cancerous pain, pleural effusion, ascites, constipation, which has important clinical value in improving the quality of life and prolonging the life time for patients with advanced tumors.

Probable Controversy of Cardiac Resynchronization Therapy on the Adaptive Energy Metabolism of Hypertrophied and Insufficient Heart in Democratic Republic of Congo

Background: It is reported that 20 to 30% of patients are not responders to this treatment (Cardiac Resynchronization Therapy). The reasoning in this merely theoretical paper shows the plausible danger that can be brought by measurements apparatus, in the occurrence the CRT especially when it is sophisticated. Objective: In Physical Cardiochemistry field our overall purpose is to bring a contribution to heart health. It is needful to draw attention for caregivers and manufacturers, especially with respect to the magnetism these apparatuses may exhibit. Methods: The Observation and documentary research are used. It is recalled hereby successively energy metabolism in healthy cardiomyocyte, adaptive energy metabolism of a hypertrophied and insufficient heart, cardiac resynchronization therapy and energy metabolism of the cardiomyocyte with its potential effects on both glucose oxidation and fatty acids oxidation. Results: It is shown a plausible interaction between oxygen magnetic field, paramagnetic by nature, and pacemaker and/or defibrillator electromagnetic field according to the sacral principle of “like dissolves like” with all evil consequences on patients. Conclusion: It will be necessary to evaluate later not only the behavior of the various energetic substrates of a hypertrophied heart as a function of the variation of the magnetic field strength but also the content of the probable substances produced in the presence of a magnetic field and with a potentially harmful effect on cardiac function. Convinced technology has its setbacks, the pacemakers and/or defibrillators manufacturers are invited to a greater rigor, greater caution and sustained care in building these devices. In next publication study of a case (CRT-D), where the diabetes has been observed, will be outlined.

Short-term effect of unilateral recession-resection procedure for intermittent exotropia with insufficient collection / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect and binocular alignment of unilateral recession-resection(R-R)procedure in patients with insufficient convergence intermittent exotropia(IXT).<p>METHODS: Totally 45 patients with insufficient convergence IXT were operated with unilateral R-R procedure. Binocular alignment was accessed 1d postoperative and 2wk postoperative. Statistical analysis was performed on squint at different time points.<p>RESULTS: All 45 patients with insufficient convergence IXT were operated with unilateral R-R procedure. On the 1st day after surgery, an overcorrection of 8.27±7.17PD at distance and 2.40±8.86PD at near were seen. On the 2wk after surgery. An under correction of 1.18±6.98PD at distance and 4.36±7.83PD at near were seen. Within 2wk after surgery, the average exo-drift at distance was 9.45±6.40PD, and at near was 6.77±7.92PD. There was statistically significant difference between exo-drift at distance and near, and a positive correlation was discovered. The difference of near-distance squint at postoperative(3.18±5.60PD)was significantly lower than that of preoperative(7.65±6.55PD), and there was a positive correlation between them.<p>CONCLUSION: Unilateral R-R procedure is appropriate for patients with insufficient convergence IXT. An appropriate increase of medial rectus strengthening can reduce postoperative near-distance squint difference and does not change the tension of medial rectus and lateral rectus. There was a synchronized exo-drift both at distance and near. The postoperative exo-drift at distance was 10PD and we believe a 10PD overcorrection shortly after operation may be beneficial to the long-term binocular alignment.

Insufficient treatment and over treatment for thyroid nodules / 中华内分泌外科杂志

Thyroid nodules are common diseases with increasing incidence in recent years.Patients undergoing thyroid surgery are increasing.Based on the current national guidelines,this article analyzes the issue of insufficient treatment and over treatment in the process of surgical treatment for thyroid nodules,conducive to individualized and standardized treatment.

Cause analysis and control measures of insufficient blood collection / 中国输血杂志

Objective To analyze the causes of blood deficiency in the process of voluntary blood donation and to adopt targeted control measures,so as to effectively reduce blood scrapping and to better ensure theclinical blood use of the hospital.Methods The data of blood collection from January 2014 to December 2016 and the various reasons of insufficient blood collection were summarized;and according to these data as the object of study,the targeted measures were taken to observe the effect.Results According to the the reasons for the lack of blood collection,the targeted measures,such as organizing staff training,strengthening communication with blood donors and so on,were taken.After the implementation of these measures,the phenomenon of insufficient blood collection from 2014 to 2016 showed declining trend,withthe proportion decreased from 0.29％ to 0.20％.Conclusion To strengthen the staff staining in order to improve them vein collection technology,to publicize further,to communicate with blood donors effectively and improve the blood donation services,to ease the feelings of blood donors and to create a warm,harmonious and orderly blood donation atmosphere;all of these should be helpful for reducing the occurrence of insufficient blood collection.

The Experience in Treating Tinnitus by Acupuncture and Moxibustion / 浙江中医药大学学报

Objective] To explore teacher Zhou Zhiying’s clinical experience in treating tinnitus by using the electric acupuncture with Gongxue point to improve the blood flow of posterior circulation. [Method] By following teacher Zhou ’s clinical diagnosis and treatment as well as organizing previous clinical cases, to sum up teacher Zhou’s academic thoughts and clinical experience on tinnitus by acupuncture and moxibustion, and with proven cases. [Result] Teacher Zhou believes that the treatment of tinnitus must first clear etiology, discern the actual situation, and then find right selected acupuncture prescription with acupoints along meridians and sydrome differentiation. Teacher Zhou considers that tinnitus is related to the cerebral circulatory insufficiency. And Gongxue point has the effect of improving the brain circulation, therefore Teacher Zhou uses the methods of needling Gongxue point to improve posterior cerebral circulation in the clinical treatment of tinnitus, so it can improve inner ear microcirculation, and promote the recovery of neurological function and promote inflammation subsided. Coupled with electric acupuncture, moxibustion and acupuncture for reinforcing and reducing ,it will bring about a significant effect.[Conclusion] The clinical treatment by using the electric acupuncture with Gongxue point to improve the blood flow of posterior circulation for tinnitus curative effect is distinct. Teacher Zhou has unique clinical experience on tinnitus which is worthy our deep study and reference.

Posterior maxillary segmental osteotomy for management of insufficient intermaxillary vertical space and intermolar width discrepancy: a case report / 대한악안면성형재건외과학회지

BACKGROUNDS: Insufficient intermaxillary space is caused by non-restoration following tooth extraction in the past, and this involves eruption of the opposing teeth and changes of the arch structure. Such cases are difficult just by a simple prosthetic approach, and diversified treatment plans should be established. Among these, posterior maxillary segmental osteotomy (PMSO) is an efficient treatment option than extraction of opposing teeth as it surgically repositions multiple erupted teeth and alveolar bone. PMSO can preserve the natural teeth; therefore, it is being regarded as a treatment method which can improve insufficient intermaxillary space significantly. CASE PRESENTATION: In this case report, the first patient received PMSO in order to place an implant in the mandibular edentulous space after decreased vertical dimension is restored, and the second patient received PMSO along with orthodontic treatment to obtain the intermaxillary space and balance the interarch molar width. CONCLUSION: PMSO is the treatment of choice when occlusion is compromised in the presence of decreased vertical dimension or arch length discrepancy.