Restoring function and cosmetics are both the goals of dental prosthesis. We discuss the principles of medical morality in the process of dental prosthesis. On the view of medical ethics, we also propose some methods to avoid the dissension between doctor and patient in the process.

Objective TO compare the effect of early postoperative intraperitoneal chemotherapy (EPIC) with that of intravenous chemotherapy (IVC)on the immunity of patients with gastrointestinal carcinoma (GC).Methods 36 patients were divided into two groups each with 18 cases, one group received EPIC and the other IVC, then determined the serum T-lymphocyte subsets (T LS) and sIL-2R before and after the chemotherapy.Results Serum CD3, CD4 and sIL 2R in GC patients after the chemotherapy decreased more significantly than those of before the chemotherapy (P0.1),but mean sIL 2R level in EPIC group was lower than that in IVC (0.05

Objective To investigate the method of cardiopulmonary bypass(CPB) for the repair of atrial septal defect with thoracoscopy. Methods Thirty-six patients with atrial septal defect were operated on.The artery channel and one venous channel were placed in the right femoral artery and femoral venous,the other venous channel was placed in the superior venous cave to set up CPB.The thoracoscope was put into thoracic cavity by the seventh interspace;the other two holes in the fourth interspace were used for operative procedure.The atrial septal defect was closed by thoracoscopy with the help of CPB. Results Except one patient whose incision was extended to stanch bleeding so as to avoid accidents when CPB stopped resulting in low oxygen saturation operation for other patients was successful.After operation,thirty-five patients recovered well and no complication occurred. Conclusions It is safe and reliable to repair atria septal defect with thoracoscopy with the help of CPB.

Objective To observe the clinical efficacy of acupuncture at Shixuan (EX-UE11) plus rehabilitation in improving the upper-limb spasticity and hand function after cerebral stroke. Method Sixty patients with upper-limb spasm due to cerebral stroke were randomized into two groups. The observation group was intervened by conventional acupuncture plus needling Shixuan and rehabilitation training, while the control group was by conventional acupuncture plus rehabilitation training. The Modified Ashworth Scale (MAS) and Modified Barthel Index (MBI) were evaluated before and after the intervention. The effects of the two methods in improving the upper-limb spastic intensity, hand function, and activities of daily living after cerebral stroke were evaluated based on the scores before and after the intervention. Result After treatment, the upper-limb spastic intensity and muscle tension decreased in both groups, and there was a significant difference in comparing the MAS score between the two groups (P<0.05); the improvement of MBI in the treatment group was more significant than that in the control group (P<0.05). Conclusion Acupuncture at Shixuan plus rehabilitation can produce a more significant efficacy in treating upper-limb spasm, improving hand function and activities of daily living after cerebral stroke, compared to the conventional acupuncture plus rehabilitation.

Objective To investigate the clinical feature,pathologic characteristics and prognosis of non-muscle invasive urothelial bladder tumor in young and old patients.Methods From January 2000 to March 2011,the clinicial data of 48 young patients (age ≤ 40 years) with non-muscle invasive urothelial bladder tumor and 50 patients randomly selected with non-muscle invasive urothelial tumor (age ≥ 60 years) were analyzed and compared retrospectively.There were 38 male and 10 female with a median age of 35.4 years (range,18 to 40).There were 34 male and 16 female with a median age of 68.5 years (range,68.5 to 87).All patients had postoperative intravesical instillation for one year.Young patients presented with gross hematuria mostly,which were similmar with old patients.Solitary tumor were 45 cases and 40 cases,and the multiple tumors were 3 cases and 10 cases in the young and old groups,respectively.Of the young group,40 patients were treated by transurethral resection of bladder tumor,and 8 patients by partial cystectomy.Of the old group,35 patients were treated by transurethral resection of bladder tumor,and 15 patients by partial cystectomy.Results According to 2004 WHO classification of papillary urothelial tumor,lower grade tumor were more frequentto occur in young group than in old group.There was significant difference in incidence of PUNLMP between young group and old group (16/48,33.3％ and 8/50,16.0％,P ＜ 0.05).There was significant difference in incidence of high grade bladder cancer between young group and old group (7/48,14.6％ and 17/50,34.0％,P ＜0.05).The incidence of PTa tumor was 70.8％ and 44.0％ in the young and old groups,respectively (P ＜ 0.05).Median follow up was 34 months (range,6 to 132) in young group and 35 months (range,6 to 130) in old group,respectively.Five-year recurrence rate was 36.7％ and 64.3％ respectively (P ＜ 0.05).Conclusions Non-muscle invasive urothelial bladder tumor in young patients had a better prognosis than those in the old group,with lower grade and stage at diagnosisand lower recurrence rate.

Objective To investigate the mRNA expression of β‐catenin and PTEN in hepatocellular carcinoma exposed to hepa‐titis B virus(HBV) and aflatoxin B1(AFB1) .Methods 108 HCCs came from different districts of Guangxi province were labeled as four categories based on their biomarkers of HBV and AFB1 exposure .Group A :HBV(+ )/AFB1(+ ) ,48 cases ,group B :HBV (+ )/AFB1(-) ,27 cases ,group C :HBV(-)/AFB1(+ ) ,19 cases ,group D :HBV(-)/AFB1(-) ,14 cases .And normal hepatic tissue from 20 cases of hepatic hemangioma ,liver resection and liver transplant donor were chosen as normal control group .And the mRNA expression of β‐catenin and PTEN were detected by RT‐PCR .Results The mean expression level of β‐catenin gene mRNA in group A ,B ,C ,D and control group were(1 .13 ± 0 .14) ,(1 .06 ± 0 .12) ,(1 .16 ± 0 .18) ,(1 .01 ± 0 .13) and(0 .085 ± 0 .13) respec‐tively .There were significant differences between group A and C ,A and D .And there were significant differences between these four groups and control group(all P<0 .05) .The mean expression level of PTEN gene mRNA in four subgroup A ,B ,C ,D and con‐trol group were(0 .54 ± 0 .13) ,(0 .59 ± 0 .16) ,(0 .97 ± 0 .16) ,(0 .92 ± 0 .13) and(1 .10 ± 0 .16) respectively .There were significant differences between group A and D ,C and D .And there were significant differences between group A and C (P=0 .002) ,A and D(P=0 .032) ,B and C(P<0 .001) and B and D(P=0 .011) .And there were significant differences between subgroup A ,B and D and control group(all P<0 .05) .Conclusion The over expression β‐catenin of HCC cases may be associated with the exposure to AFB1 while the loss of gene PTEN may relate to the exposure to HBV .

Objective To explore the changes on the value of CVP with different body postures after upper abdominal surgery in order to provide accurate basis for better monitoring of central venous pressure(CVP). Methods The CVP, blood pressure,pulse,respiration of 43 patients after upper abdom-inal surgery with indwelling central venous catheter were measured under supine position, 15°dorsal ele-vated position and 30°dorsal elevated position.The data were collected for correlation and regression analysis. Results The CVP value increased with the elevation of body postures,the CVP value under supine position was linearly positively correlated with the other two positions(P<0.01).The regression e-quation of supine position and 15°dorsal elevated position was:Y=1.009X1+0.811; the regression equation of supine position and 30°dorsal elevated position was:Y=1.005X2+1.630. Conclusions Through moni-toring the CVP value under 15°dorsal elevated position and 30°dorsal elevated position,and substitute it in equation,we can evaluate the CVP value under supine position.

Objective To compare the accuracy of real-time myocardial contrast echocardiography (RT-MCE) with DISA-SPECT in detecting hibernating myocardium. Methods Fourteen hospitalized patients with regional wall motion abnormalities (RWMA) underwent RT-MCE, DISA-SPECT, coronary angiography and percutaneous coronary intervention(PCI). Every left ventricular myocardial segment image was acquired and evaluated according 16-segment model of American Society of Echocardiography. The Motion of every segment was observed by echocardiography after 1,3,6 months. The gold standard is that the motion of ventricular segment get better after PCI. The images of RT-MCE and DISA-SPECT were analyzed semi-quantitatively. Results The sensitivity,specificity,accuracy of RT-MCE and DISA-SPECT in detecting hibernating myocardium were 74.60%, 91.7%, 81.3% and 93.3%, 75.0%, 86.2%, respectively. RT-MCE had more value in specificity while DISA-SPECT had more value in sensitivity. The correlation between two methods was good in detecting hibernating myocardium. Conclusions RT-MCE and DISA-SPECT can be used as valuable methods to detect hibernating myocardium, the correlation between two methods is good and they have more value in specificity and sensitivity respectively.