To investigate the reason of extraction, length, number and transverse morphology of the root and root canals of first permanent mandibular molars. 100 extracted first permanent mandibular molars were collected. The length of mesial and distal root of the first permanent mandibular molars was 13.00 mm and 13.51 mm separately. 75% double roots and 25% three roots were observed under the stereomicroscope. Difference of root number and shape of transverse morphology in mesial root were more obvious than those in distal roots of the same first mandibular molars in this study.

Objective:To investigate the root length,number and the transverse shape of first maxillary molars using root sectioning technique. Methods:100 isolated first permanent maxillary molars from above 20 years old patients were collected. The roots were cross-sectioned in three parts(superior 1/3,middle 1/3 and apex 1/3) after measuring the length of roots. The transverse shape of root canals were observed under the stereomicroscope.The number and shape of root in three parts of roots were recorded. Results:The length of lingual root,MB and DB of the first maxillary molar is (13.82?1.51) mm;(13.06?1.12) mm and (11.64?0.85) mm respectively; complex degree of MB and DB of the first marxillar molar is very high. 51% double roots in superior 1/3 of MB were found. Above 50% dual roots in the middle 1/3and apex 1/3 in the mesiobuccal root of first maxillar molar were recorded. Conclusion:Root number and transverse configuration in MB and DB of first maxillary molar varied in different parts of roots; There may be double root canals in medium 1/3 and apex 1/3 in MB of first maxillary molar when one line type canal in superior 1/3 was found.

To investigate the reason of extraction,length,number and transverse morphology of the root and root canals of first permanent mandibular molars.100 extracted first permanent mandibular molars were collected.The length of mesial and distal root of the first permanent mandibular molars was 13.00 mm and 13.51 mm separately.75% double roots and 25% three roots were observed under the stereomicroscope.Difference of root number and shape of transverse morphology in mesial root were more obvious than those in distal roots of the same first mandibular molars in this study.

Objective To assay the early quality of life and posttraumatic stress disorder (PTSD) and relating influential factors in patients with severe blunt chest trauma (sBCT).Methods Demographic and clinical data of sBCT patients treated between January 2011 and December 2011 were collected.Early quality of life and PTSD symptom level at posttraumatic months 1,3,and 6 were analyzed by using short form 36 health survey (SF-36) and impact of event scale-revised (IES-R) respectively.Furthermore,logistic regression analysis was performed to identify the risk factors associated with quality of life of the patients.Results A total of 107 patients were included in the study.Ultimately,83 patients were available to the 6-month follow-up.A low score for SF-36 remained at posttraumatic 6 months and one-third of the 83 patients sustained mild or severe PTSD symptoms.Major influential factors to posttraumatic quality of life included age,ISS ≥ 20,combined craniocerebral injury,combined spinal and pelvic injuries,posttraumatic complications,and PTSD.Conclusions Early quality of life in sBCT patients is poor.Therefore,the early intervention with identification of specific risk factors is contributive to better quality of life.

Objective To investigate the distribution status of Pseudomonas aeruginosa (PA) in children in Suining area and the changes of drug-resistance spectrum to provide the basis for clinical antibacterial drugs selection .Methods The ATB microbiologi-cal system was adopted to identify the bacteria and the K-B method was used to conduct the drug sensitivity test .The detection situ-ation of PA in our hospital from January 2010 to December 2012 was performed the statistical analysis on the distribution in various specialties of pediatrics and drug resistance .Results Among 46 isolated strains of PA ,39 strains were mainly distributed in the specialties of respiration ,neonatology and pediatric intensive care unit (PICU) ,which accounted for 84 .8 % ,22 strains were isolated from sputum specimens ,which accounted for 47 .83% .The isolation rate in last three years showed the rising trend year by year , and the resistance to antibiotics was increased year after year .Conclusion PA is one of the main pathogens of clinical infection .We should strengthen its drug-resistance monitoring and use antibacterial drugs reasonably .

Objective To investigate clinical effect of damage control surgery (DCS) in treatment of patients with flail chest combined with severe multiple injuries.Methods A total of 187 cases of flail chest combined with severe multiple injuries treated by fixation of floating chest wall were enrolled and divided into three groups on the basis of different treatments:DCS group (66 cases) underwent early suspension traction of ribs and delayed internal fixation of the ribs ; Group A (70 cases) underwent rib suspension traction alone; Group B (51 cases) underwent initial internal fixation of rib.Complications,mortality,and main parameters before and after operation in each group were analyzed and compared.Results Complications including pulmonary infection (32 cases),atelectasis (38 cases),and acute lung injury (ALI)/ARDS (39 cases) were found.Twenty-two cases died,including 13 deaths from ARDS,two from tension pneumothorax,one from massive hemoptysis,three from cardiac shock,two from craniocerebral injury,and one from liver trauma and thus the overall death rate occupied 11.8％.Oxygenation index (OI) had significant rise postoperatively both in the DCS group and Group A (P ＜ 0.01),but the change of OI was inappreciable in Group B.Mortality,complication rate,cases treated with mechanical ventilation,tracheotomy or fiberoptic bronchoscopy,and average length of ICU and hospital stay were the lowest in the DCS Group,followed by a relatively higher result in Group B and a much higher result in Group A (P ＜ 0.01).Conclusion DCS decreases mortality and complications dramatically when appolied to treat flail chest combined with severe multiple trauma.

ObjectiveTo evaluate the mid- and long-term efficacy of subfascial endoscopic perforator surgery (SEPS)in the treatment CEAP classification C4 - C6 of primary chronic venous insufficiency(CVI). MethodsClinical data of 82 cases of chronic venous insufficiency were analysed retrospectively. According to operative method adopted,patients were divided into group A in which perforator veins were ligated under subfascial endoscopic surgery (SEPS group ),and group B in which perforator veins were not ligated (non-SEPS group).Diagnosis was established by clinical symptoms,color Doppler or ascending venography in all patients.Postoperatively patients were followed up regularly.The clinical outcomes between different surgicalmethods in two groups were assessed byCEAP clinical classification,CEAP clinical symptom scores,cumulative ulcer healing rate and cumulative ulcer recurrence rate.ResultsNo significant differences were found in CEAP clinical classification,CEAP clinical symptom scores between the two groups preoperatively ( P ＞ 0.05 ). There were significant differences in CEAP clinical classification such as edema,lipodermatosclerosis,venous ulceration between the two groups on 2 years postoperatively (P ＜ 0.05 ).The amount of swelling limbs,healed ulceration,active ulceration in group A was less than group B (P ＜ 0.05 ) on 3' and 5' years postoperatively.Significant differences were found postoperatively in total clinical symptom scores between group A and B.Clinical symptoms such as swelling,lipodermatosclerosis,ulcer healing in group A relieved more markedly than group B ( P ＜ 0.05 ).The median healing time of ulcers was 2.3 and 3.7 months respectively in group A and B.Log-rank test on group differences was sensitive to long-term cumulative ulcer healing rate ( x2 =4.063,P =0.044).But Breslow test on group differences was sensitive to early cumulative ulcer healing rate ( x2 =5.471,P =0.019).Cumulative ulcer healing rate in group A was significantly higher than in group B postoperatively (P ＜ 0.05 ).The cumulative ulcer recurrence rate in group A was significantly lower than group B (P ＜ 0.05).ConclusionsSuperficial vein resection combined with perforator vein ligation significantly enhanced clinical efficacy,accelerated ulcer healing and decreased mid- and long-term ulcer recurrence rate.

Objective: Sampledrawing is an important procedure in the study of allergic airway inflammation.The authors investigate the methods of drawing samples from the animals with allergic airway inflammation.Methods: We included in this study 20 Guinea pigs,10 rats and 20 mice,which underwent trachea incision,followed by bronchoalveolar and rhinal lavage and collection of the lavage fluids.Then we collected blood samples via the heart from the guinea pigs and rats and via both the heart and the eyes from the mice,and obtained the tissues of the nasal cavities and lungs by different methods.Results: All the samples were satisfactorily obtained from the animals,and 80% of the bronchoalveolar and rhinal lavage fluids were collected.Conclusion: Different methods should be adopted to suit different sampledrawing from the animal models of allergic airway inflammation.

Objective:To investigate the clinical characteristics and pathogenic mutations of propionic acidemia.Methods:Clinical data of two patients with propionic acidemia admitted to the Obstetrics and Gynecology Hospital of Nanjing Medical University from May 2017 to June 2018 were collected. Genomic DNA was extracted from the peripheral blood of the patients and their parents. Inherited disease panel based on Ion Torrent semiconductor sequencing technology was performed to detect gene mutations, and those with suspected pathogenic mutations were verified by Sanger sequencing. Descriptive statistical analysis was used for data analysis.Results:Case 1 was suspected of sepsis and admitted to the Obstetrics and Gynecology Hospital of Nanjing Medical University due to "drowsiness and milk rejection" on the second day after birth. Tandem mass spectrometry suggested the level of propionyl carnitine and its ratios to acetylcarnitine and free carnitine were increased. Urine gas chromatography-mass spectrometry showed elevated 3-hydroxypropionic acid and methylcitric acid. Genetic analysis revealed that the infant carried c.331C>T (p.R111X)/c.1228C>T (p.R410W) compound heterozygous mutations in the PCCB gene. The infant was diagnosed with propionic acidemia and treated with a special diet with an L-Carnitine supplement but died of sudden coma and vomiting without precipitating factors at three months of age. Case 2 presented with sudden vomiting, drowsiness, and anergia on the admission at five-months old. Tandem mass spectrometry showed increased propionyl carnitine level and its ratios. Compound heterozygous mutations of c.146delG (p.G49EfsX16)/c.1253C>T (p.A418V) in the PCCB gene were identified in the patient, of which c.146delG (p.G49EfsX16) was a de novo mutation and was evaluated as a pathogenic mutation. The patient was on a special diet with an L-Carnitine supplement, but with disobedience. Followed up to the age of three years and eight months, the child was severely underdeveloped. Conclusions:Neonates with clinically suspected sepsis may have propionic acidemia, and tandem mass spectrometry and genetic testing should be performed as soon as possible to confirm or rule out the diagnosis. Further investigations on the pathogenesis and function of the new mutation are still needed.