BACKGROUND:At present, the confrontation of CAD/CAM systems and the lost wax casting method for marginal adaptation has been widely concerned, but the results are controversial. OBJECTIVE:To compare the marginal adaptation of single cobalt-chromium PFM crowns produced by 3 Shape CAD/CAM systems and the lost wax casting method. METHODS: A maxilary first premolar was prepared according to the standards. 50 resin-generation models were created by bi-color silicone rubber method and randomly divided into two groups: CAD/CAM group (A1-A25) and cast group (B1-B25). Al the models were cast in plaster. In CAD/CAM group, the digital impressions were obtained by optical scanning, then designed through computer and cut directly by NC miling machine. In cast group, metal ceramic crowns were made by the lost wax casting method. When crowns were al seated on the working dies, the marginal gaps were copied with light silicone rubber and then embedded with occlusal silicone rubber. The thickness of crown marginal gap was measured with a stereo microscope. RESULTS AND CONCLUSION:The average vertical clearance was (34.67±7.48)μm of CAD/CAM group, while (53.70±9.64)μm of the cast group; the difference was statisticaly significant between two groups (P < 0.05). The average level clearance was (37.61±7.63)μm of CAD/CAM group, while (53.02±10.65)μm of the cast group, and the difference was statisticaly significant between two groups (P < 0.05). Experimental findings suggest that, the marginal adaptation of single cobalt-chromium PFM crowns cast produced by 3 Shape CAD/CAM systems is clinical acceptable (< 120μm), and CAD/CAM systems of metal casting is obviously better than the lost wax casting in building metal based crowns with adaptable margin.

Objective To explore a suitable method to estimate the quantity of removing skin in double-fold eyelid operation.Methods Upper eyelid skin gently pulled towards eyebrows was flattened with the eyelash being slightly curved,the double-fold eyelid line that was parallelled to blepharitis was marked at 6-7 mm far from blepharitis.Then opening eyelid and looking upwards,the suprapalpebral fold was formed,and several dots were marked on the fold margin. After slightly closing eyelid the suprapalpebral fold margin line was formed through connecting the dots.The skin between the two line was the quantity to remove in operation.If the two line overlaped,removing skin did not need.Results A total of 89 cases were enrolled in this study.The patients were followed up from three months to one year,and the results showed that 67 cases were satisfactory,22 cases were basically satisfatory,and no one was not satisfactory.Conclusions The designing method for removing skin according to double-fold eyelid line and suprapalpebral fold margin line is a good method to estimate the quantity of removing skin in double-fold eyelid operation.

Objectives To explore the decade-feature of military personnel' s psychosomatic health and Its Influence factors.Methods By random cluster sampling,a total of 11362 military personnel ( including army,navy and air-force) were tested by Chinese Psychosomatic Health Scale (CPSHS) from 80' ( n=1100),90' ( n=8000),2000' ( n =2262)then employing SPSS statistic 17.0 program for data analysis by using ANOVA,LSD multiple-comparison,and stepwise regression analysis.Results The factor of eye-ear( 80s' ( 1.17 ± 1.68),90s'( 1.19 ± 1.64 ),2000s' ( 1.12 ± 1.48 ) ) had no significant difference in three decades (P ＞ 0.05 ) ; military personnel' s respiratory system,cardiovascular system,alimentary system,bone-muscle,skin,reproductive-endocrine system,nervous system,anxiety,depression,psychotic traits,family history,mental heath,physical health,and total psychosomatic health psychosomatic health had significant differences in the three decades (P＜ 0.05 ～0.01 ).The stepwise regression analysis revealed that decade,length of military service,urban-rural,marital state had significant effect on total psychosomatic health( decade:t =- 12.452,length of military service:t =-0.024,urban-rural:t=-0.066,marital status:t=0.119,P＜0.012 ～0.000).Conclusions The level of military personnel's psychosomatic health is improved from 80' s,90' s of last century to the year of 2000; the influenced factors of military personnels' psychosomatic health are including decade,length of military service,rural-urban,and marital status.

ObjectiveTo explore the decade-feature of military personnel' mental maladjustment and its influenced factors.MethodsBy random cluster sampling,a total of 10883 military personnel( including army,navy and air-force) were tested by military mental maladjustment scale (MMMS) in three decades (80s' 90s',2000),then employing SPSS 17.0 for data analysis by using ANOVA,LSD multiple-comparison,and stepwise regression analysis.ResultsThe single scores for behavioral disorders( (2.79 ±2.96),(3.42 ± 2.98 ) vs (2.85± 2.93 ) ),affective disorders ( ( 1.50 ± 1.47 ),( 1.76 ± 1.50 ) vs ( 1.51 ± 1.47 ) ),interpersonal relationship( ( 1.78 ± 1.93 ),( 2.44 ± 2.14) vs (2.30 ± 2.18 ) ),environmental adjustment( (0.63 ± 0.94 ),( 0.89 ± 1.02 )vs ( 1.02 ± 1.18) ),and total score ( ( 6.71 ± 6.01 ),( 8.50 ± 6.20) vs ( 7.69 ± 6.89 ) ) had significant differences in the three decades (P ＜ 0.01 ).The changing disposition of behavior,emotion,interpersonal relationship and total mental maladjustment seemed as reversed V in three decades,but environmental adjustment revealed linear increase; stepwise regression analysis revealed that total scores of mental maladjustment had significant decadeeffect after introducing other four independent variables( t =5.96,P =0.000 ) ; the educational level,urban-rural also had significant influence on military mental maladjustment( t =- 3.15,- 9.02,P =0.002 ～ 0.000 ).ConclusionThe mental maladjustment of military personnel reveale a decreasing disposition from 80s',90s' of last century to the year of 2000 ; the influencing factors are decade,educational level and rural-urban.

OBJECTIVETo explore the correlation between serum hepatitis B surface antigen (HBsAg) level and hepatic tissue pathological staging in patients with chronic hepatitis B (CHB).

METHODSClinical data was collected from our hospital's records for 302 CHB patients with HBsAg-positive status for more than 6 months and who had undergone hepatic biopsy. The HBsAg level,HBV DNA level and other clinical data were measured using commercial diagnostic assays. Liver histology was scored using the GS staging system. Correlation between serum HBsAg quantity, HBV DNA quantity, stage of inflammation and degree of fibrosis was assessed statistically.

RESULTSThe correlation of serum HBsAg level and HBV DNA level was notable. The serum HBsAg level was a variable affecting hepatic tissue pathological stage significantly. Serum HBsAg level appeared to be a highly specific and sensitive diagnostic marker of hepatic fibrosis. As the severity of liver fibrosis increased, the quantitative levels of platelet (PLT), HBsAg and HBV DNA gradually decreased, and the APRI index gradually increased; there were significant differences between the groups (all P<0.001). Serum HBsAg and HBV DNA levels in patients with hepatitis B e antigen-positive (HBeAg(+)) status showed strong correlation (r=0.721, P<0.0001) by Spearman analysis. HBeAg(+) patients with moderate to severe fibrosis (S2-4) exhibited significantly lower serum HBsAg and HBV DNA levels compared with patients with no or mild fibrosis (S0-1; t=5.475 and 4.826, P<0.001). ROC analysis suggested that a serum HBsAg cutoff of 4.46 log 10 IU/mL (28 800 IU/mL) would provide a theoretical sensitivity of 76.3%, with theoretical specificity of 70.5% in HBeAg(+) CHB patients. A serum HBV DNA cutoff of 7.13 log 10 IU/mL (1.35*10(7) copies/mL) would provide a theoretical sensitivity of 71.1%, with theoretical specificity of 73.4% in HBeAg(+) CHB patients. Logistic regression analysis showed that the level of HBsAg was an independent prognostic factor of moderate to severe liver fibrosis, with alanine aminotransferase, aspartate aminotransferase, HBsAg, HBV DNA and PLT (P<0.001).

CONCLUSIONHBsAg and HBV DNA levels decrease gradually along with aggravation of liver fibrosis. The cutoff values of 28800 IU/mL for HBsAg and 1.35*10(7) copies/mL ofHBV DNA provide higher specificity and sensitivity for predicting the degree of liver fibrosis in HBeAg-positive CHB patients, and the former is an independent predictor of severe liver fibrosis.

Alanine Transaminase ; Aspartate Aminotransferases ; Biopsy ; Blood Platelets ; DNA, Viral ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Inflammation ; Liver Cirrhosis ; ROC Curve

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.