Generalized pulp canal obliteration in a patient on long-term glucocorticoids: a case report and literature review.

BACKGROUND: The calcification of the tooth pulp is a pathological condition that occurs in response to various factors. A uncommon haematological condition known as paroxysmal nocturnal haemoglobinuria (PNH) is characterized by bouts of haemolysis, and it requires long-term use of glucocorticoids (GCs). CASE PRESENTATION: A female patient who was diagnosed with PNH and had a history of long-term use of GCs came to our department for root canal therapy (RCT) for teeth 25, 26, and 27. The radiographs showed generalized pulp canal obliteration (PCO) in most of the patients. None of these teeth (25, 26, or 27) were sensitive to percussion, and they did not respond to thermal or electrical sensitivity tests. A diagnose of pulp necrosis was made for these teeth. RCT was carried out with the help of an oral microscope, and then a prosthodontic procedure was created for the teeth. CONCLUSIONS: Based on the patient's long history use of GCs and a series of related studies, we conclude that the long-term usage of GCs contributes significantly to the onset of PCO.

Analysis of preoperative risk factors of postoperative complications in patients undergoing endovascular repair surgery / 复旦学报（医学版）

Objective To summarize the perioperative outcomes of patients undergoing endovascular repair,and to screen out related preoperative risk factors in order to provide reference for the promotion of postoperative rehabilitation of patients.Methods The clinical data of 2 896 patients undergoing elective endovascular repair in the Department of Vascular Surgery,Zhongshan Hospital,Fudan University from Jan.2013 to Dec.2014 were analyzed to screen out related preoperative risk factors of postoperative complications retrospectively.Results A total of 148 patients had postoperative complications,including 2 cases of death during hospitalization.The incidence of complications in the patients older than 75 years old,with hypertension,diabetic mellitus,renal dysfunction,chronic obstructive pulmonary disease (COPD) or ASA physical status more than grade Ⅱ is 9.7％,8.1 ％,14.3 ％,8.0 ％,29.7 ％,6.3 ％,respectively.The multivariate Logistic regression analysis identified that patients older than 75 years old (P =0.000,OR =43.29,95％CI:22.51-83.28),with hypertension (P=0.000,OR=3.822,95 ％CI:2.37-6.16),diabetic mellitus (P=0.025,OR=1.714,95％CI:1.07 -2.75),renal dysfunction (P =0.017,OR =2.692,95 ％ CI:1.19-6.07) or COPD (P =0.000,OR =7.158,95％CI:3.83-13.37) and ASA physical status more than grade Ⅱ (P =0.000,OR =27.77,95％CI:13.79-55.93) were the independent risk factors with postoperative complications of endovascular repair surgery.Conclusions The patients older than 75 years old,with hypertension,diabetic mellitus,renal dysfunction or COPD and ASA physical status more than grade Ⅱ were the independent risk factors for endovascular repair surgery.

Three-rooted unilateral maxillary first premolar diagnosed by CBCT:A case report / 实用口腔医学杂志

Most of the maxillary first premolar are single-rooted,there are also two-rooted and three-rooted ones.A case of three-rooted maxillary first premolar was diagnosed by CBCT.CBCT has the advantage in the observation of the variation root number,root canal bending and the variation of root canal morphology.

Clinical application of vertebroplasty: a report of 1080 cases / 中华创伤杂志

Objective To analyze the efficacy of vertebroplasty using the patient data in our hospital so as to better serve those clinical patients.Methods A retrospectively review was performed on 1 080 with data integrity out of 1 084 cases undergone vertebroplasty from January 2003 to March 2012.Basic information measured was age,gender,entity,number of operated vertebral bodies,distribution of operated vertebral bodies,postoperative X-ray films,bone cement volume,bone cement leakage into the vertebral canal,cases with balloon kyphoplasty,cases with bilateral or bilateral vertebroplasty,and intraoperative vital signs.Clinical manifestations and quality of life were observed after operation.Results In all,306 cases occupying 28.33％ presented bone cement leaks based on postoperative X-ray films.Volume of bone cement infused in each vertebral body varied from 1.5 ml to 7.5 ml.No bone cement leaked into the vertebral canal during operation.There were 706 cases occupying 65.37％ managed by balloon kyphoplasty and 984 cases occupying 91.11％ by unilateral vertebroplasty.Within 3-5 days after surgery,associated symptoms were found in 23 cases,among which 3 had neurologic symptoms and 20 composing 5 men and 15 women had symptoms related to pulmonary embolism including one severely affected was transferred to the department of pneumology.Among the 23 cases,8 were managed by unilateral vertebroplasty and 15 by bilateral vertebroplasty,including 17 involving thoracic surgery.Conclusion Although various complications relate to the procedure,vertebroplasty may be widely used on condition that techniques and indications iu surgery are correctly mastered.