IPS-Empress2 is a successful all-ceramic restoration system. To lower its cost, and promote its application, a kind of homemade fast investment material has been developed. The aim of this study was to evaluate the expansion properties of this investment material. The setting expansion, thermal expansion and total expansion of the homemade fast investment material were tested. The same properties of the IPS special fast investment material were also tested as control. Then the SPSS statistics software was used to evaluate the differences between the homemade material and the special material. The results show that the setting expansion rate, thermal expansion rate and total expansion rate of the special investment material for IPS-Empress2 are 0.858%, 1.11% and 1.17% respectively, while the same parameters of the homemade investment material are 0.798%, 1.09% and 1.16% respectively. There is no statistically significant difference in these expansion properties between the two investment materials. In conclusion, the expansion properties of homemade fast investment material are comparable to those of the special fast investment material, so it can compensate for the cast contraction of IPS-Empress2 castable ceramic precisely.
Aluminum Silicates ; chemical synthesis ; chemistry ; Crowns ; Dental Materials ; chemical synthesis ; chemistry ; Dental Porcelain ; chemical synthesis ; chemistry ; Lithium Compounds ; chemical synthesis ; chemistry ; Surface Properties ; Tensile Strength

The aim of this study is to evaluate the physical and mechanical properties of our homemade investment material for the IPS-Empress2 castable ceramic. The IPS specific investment material was taken as control. Results show that the setting time, density before heating, density after heating, rate of open hole, compressive strength at 2 hours after setting and the compressive strength after heating to 920 degrees C of the homemade investment material are 9 minutes, 1.813 g/cm3, 1.402 g/cm3, 38.1%, 5.42 MPa and 8.37 MPa respectively, which are comparable or even better than the specific material. Under the SEM, the crystals of the phosphate hydrate in our homemade material are smaller than those in the special material. Since the physical and mechanical properties of our homemade investment material are comparable or superior to those of the specific material, a conclusion is drawn that it has a promising prospect of future clinical application.
Aluminum Silicates ; chemistry ; Crowns ; Dental Casting Investment ; chemical synthesis ; chemistry ; Dental Materials ; chemical synthesis ; chemistry ; Dental Porcelain ; chemistry ; Lithium Compounds ; chemistry ; Microscopy, Electron, Scanning ; Shear Strength ; Surface Properties ; Tensile Strength

Objective In order to optimize the Fontan circulation,a technique for direct total cavopulmonary connection was devised.To evaluate its surgical feasibility as well as surgical outcomes,our clinical experience was retrospectively reviewed.Methods From August 2005 to March 2012,23 consecutive patients underwent modified extracardiac Fontan operation with direct total cavopulmonary connection.Clinical profile of the patients,and procedural variables were examined and analyzed.Results All patients had adequately developed main and branch pulmonary arteries.Inferior caval vein was contralateral to the pulmonary trunk main pulmonary artery in 7 cases,ipsilateral in 8,and others in 8.There was 1 hospital death.The other 22 patients remained hemodynamically stable postoperatively.Prolonged effusions (n =13,62％) was a challenging problem.No obvious stenosis was found at the direct cavopulmonary anastomosis.Conclusion we are convinced that a direct total cavopulmonary connection is feasible in select subset of patients.This modified Fontan procedure retains the advantage of extracardiac connections together with the avoidance of prosthetic materials.

Objective The aim of this article is to review and analyze the timing and surgical management of mediate and severe atrioventricular valve regurgitation(AVVR) in single-ventricle patients.Methods Between June 2006 and October 2011,twenty-three cases of single-ventricle patients accompanied with AVVR underwent atrioventricular valve plasty or replacement.There were 17 males and 6 females.Their ages ranged from 2.1 to 22.0 years,and their weight from 12.5 to 59.0 kg.There were 3 cases of A type of single ventricle,17 of B type,2 of C type,and 1 of D type.All cases had one atrioventricular valve except one of D type with 2 groups of atrioventricular valves.There were 18 patients with sever AVVR and 5 with the moderate.Before the management of AVVR,12 patients had undergone the first stage palliation,including B-D Glenn procedure 11 cases and A-P shunt 1 case.The periods between the two stages operations were 7-96 months.Among the all,there were 7 cases of atrioventricular valve replacement ; 3 cases of atrioventricular valve replacement and TCPC ; 5 cases of atrioventricular valve replacement and B-D Glenn procedure ; 2 cases of atrioventricular valve repair and TCPC ; 4 cases of atrioventricula repair and B-D Glenn procedure; 1 case of atrioventricular valve repair,B-D Glenn procedure and TAPVC repair; 1 case of atrioventricular valve repair,B-D Glenn procedure,PA Banding and TAPVC repair.Results In this group,there were 65.2％ patients who underwent atrioventricular valve replacement.The ones with moderate regurgitation underwent atrioventricular valve repair.Only 3 of the 18 cases with severe regurgitation could underwent atrioventricular valve repair(P =0.002).Three cases died.The mortality was 13％.All cases undergone atrioventricular valve repair were alive.The mortality of atrioventricular valve replacement was 20％.All the post-operative alive were followed up.Their follow-up period were between 0.8-6.3 years,withoud a dead case.Conclusion The regurgitation with single ventricle should be managed before the image of myocardium occurred.It is the best time to manage the atrioventricular valve when the regurgitation was moderate.The atrioventricular valve replacement is effective to the cases of single ventricle with severe AVVR.

Objective To evaluate transport efficiency and safety by process management during the handover of patients with tracheal intubation post-operation. Methods Prospective studies were performed between patients with or without process management during the handover. The time of handover were recorded and compared. The difference between systolic and diastolic blood pressure, heart rate, and arterial oxygen saturation were also recorded and compared. The adverse events during the handover were also investigated. Results It costed less time in the handover of patients under process management with significant difference[(4.75±0.54) min vs. (7.05±0.88) min, t=-17.21, P<0.01]. The incidence rate of harmful cases in the handover of patients under process management was significantly declined than that without process management[ 1.67%(1/60) vs. 13.33%(8/60),Χ2=4.324 3,P<0.05 ]. Conclusions Process management may facilitate the handover of patients with tracheal intubation post-operation and improve its safety.

Objective To compare the two different ways of right ventricular outflow tract(RVOT) reconstruction at repair of pulmonary atresia with ventricular septal defect,the direct RV-PA anastomosis and pericardial conduit to find the better way.Methods From Jun.2002 to Oct.2012,66 patients underwent pulmonary atresia with ventricular septal defect repair in our hospital,age at operation from 14 days to 272 months.Patients were divided into 2 groups according to the way of RVOT reconstruction.Group 1:31 of them,using direct RV-PA anastomasis,Group 2:35 of them,using pericardial conduit.Paired t test was used to evaluate the growth of pulmonary arteries.Chi-square test and Kaplan-Meier were used to calculate the postoperative mortality,reopemtion situation and survival time.Results There are 3 early hospital death in group 1 (9.7 ％),and 5 in group 2(14.3％),P =0.71.There is a significant difference between the two groups in restenosis rate of the RV-PA anastomasis and autologous pericardial conduit with pulmonary branch artery(Group 1:22.2％,Group 2:55.6％,P =0.01).The diameters of RV-PA anastomasis and the pulmonary artery branches in follow-up were significantly lager than the earlier diameters(P ＜ 0.05) in group 1.There is no growth on diameters of the pericardial conduit and pulmonary branches except the right pulmonary artery in follow-up in group 2.There is no significant difference between the two groups in later survival(P =0.30).Conclusion Both the direct anastomasis of RV-PA and pericardial conduit are available for RVOT reconstruction in pulmonary atresia with ventricular setal defect repair.There is lower incidence of RVOT and pulmonary stenosis and anastomosis absolutely has the ability for later growth in the former.

Objective To evaluate the outcomes of surgical repair of typeⅢ pulmonary atresia with ventricular septal de-fect( PA/VSD) .Methods Retrospectively analyzed the clinical data of 98 patients with type Ⅲ PA/VSD who underwent sur-gical repair in the Department of Cardiovascular Surgery , Guangdong Cardiovascular Institute from September 2005 to December 2014.There were 54 males and 44 females at the mean age of(4.2 ±4.8) years and the mean weight of(13.2 ±10.0) kg. There were 67 patients in palliative repair group and 31 patients in radical repair group .There were 85 patients underwent on-pump operation including 9 beating heart cases.Results The mean bypass time was(121.2 ±49.4)min, the mean aorta cross-clamping time was(75.4 ±31.8) min.The overall postoperative mortality was 6.1%(6/98).For the survival patients, the mean ventilation time was(106.7 ±184.3) h, the mean ICU stay was(8.9 ±10.9) days and the mean hospital stay was (33.4 ±17.0)days.During follow-up period, 28 patients were underwent re-operation, the postoperative mortality was 7.1%(2/28).There were no differences in postoperative status between two groups.Conclusion The outcomes of surgical repair for type Ⅲ PA/VSD was good.Preoperative evaluation of the pulmonary development and MAPCAs were helpful for choosing surgical options.Re-operation was recommended to those appropriate patients.

Objective To explore the influence of different methods of bandaging on the postoperative intracranial pressure of patients with severe brain injury patients after decompression craniectomy. Methods The standard decompressive craniectomy was use for the 36 cases of severe traumatic brain injury patients, and the intracranial pressure monitoring sensor probe was indwelled in operaion. Two different dressing methods of elasticity mesh cap and applicator were used for the patients respectively at 0h, 72h, 120h and 168h after operation, and the value of intracranial pressure was monitored and recorded. Result The intracranial pressure of elastic cap were significantly higher than the applicator respectively in operation immediate postoperative 72h, 120h and 168h (P<0.05), the difference was statistically significant. Conclusions The intracranial pressure of elastic cap is significantly higher than the applicator at different times after the surgery group.

Objective To evaluate the right heart function with echocardiography after right ventricle-pulmonary artery (RV-PA) anastomasis for right ventricle outflow (RVOT) reconstruction in patients with different types of pulmonary atresia and ventricle septal defect(PA/VSD).Methods From Nov 2002 to Aug 2013,31 patients with PA/VSD had undergone right ventricle-pulmonary anastomasis to reconstruct RVOT for radical or palliative repair.Related echocardiography indexs including strain/rate etc.were used to evaluate the right heart function and the progress of the right heart valves regurgitation.Results There were 3 early hospital deaths.No later death during follow-up.The echocardiography suggested the pulmonary artery and tricuspid regurgitation were more serious,however,the right heart function was relatively fine.The regurgitation of tricuspid valve was positive correlation with duration of follow-up (P =0.016).Conclusion The right heart function in follow-up keeps relatively well,and tricuspid valve regurgitation needs a long-term follow-up.

Objective To summarize the experience and early outcomes of surgical treatment of adult tetralogy of Fallot (ATOF).Methods We retrospectively analyzed the clinical data of 227 patients with ATOF who underwent surgical repair in the Department of Cadiovascular Surgery,Guangdong Cardivascular Institute from January 2004 to December 2014.There were 112 males and 115 females at a median age of 34 years(range,18 to 58 years) and a mean weight of(49.00 ± 8.27) kg.All patients were underwent one stage repair,including 129 cases with transannular patch and 61 cases with MAPCAs in which 4 cases were underwent hybrid occlusion.Results There were 12 cases died in hospital(5.3％),24 cases with Re-thoratomy for hemaostsis,5 cases with poor wound healing,10 cases with postoperative pneumonia.There were 25 cases with residual VSD including 8 cases caused by surgeon in congenital heart disease department and 17 cases caused by surgeon in adult heart disease department(P ＜ 0.05).The repair with transannular patch required significantly longer bypass time [(87.83 ± 26.02) min vs.(78.47 ± 26.00) min,P =0.009].The cases with MAPCAs had higher cost than that with no MAPCAs [(83 137.01 ±69363.05) RMB vs.(66 184.29 ±44219.38) RMB,P=0.03].Conclusion The early outcomes of ATOF is good.The cases with MAPCAs had higher cost than that with no MAPCAs.The CHD surgeon had lower probability of residual VSD.Preoperative evaluation of MAPCAs by CHD surgeon and perioperative maintain of the right ventricular function were helpful.