The procedure of occlusal treatment involves improving the morphology and the stomatognathic function.Several practical methods and morphological endpoints have been described in occlusal rehabilitation.We made a selection of these (mandibular position,oc-clusal plane,occlusal guidance,occlusal contact,face-bow transfer,use of an adjustable articulator and occlusal support)and performed a literature review to verify the existence of compelling scientific evidence for each of these.A literature search was conducted using Medline /PubMed in March 2011.Over 400 abstracts were reviewed,and more than 50 manuscripts selected.An additional hand search was also con-ducted.Of the many studies investigating stomatognathic function in relation to specific occlusal schemes,most studies were poorly designed and of low quality,thus yielding ambiguous results.Overall,there is no scientific evidence that supports any specific occlusal scheme being superior to others in terms of improving stomatognathic function,nor that sophisticated methods are superior to simpler ones in terms of clini-cal outcomes.However,it is obvious that the art of occlusal rehabilitation requires accurate,reproducible,easy and quick procedures to re-duce unnecessary technical failures and /or the requirement for compensatory adjustments.Therefore,despite the lack of scientific evidence for specific treatments,the acquisition of these general skills by dentists and attaining profound knowledge and skills in postgraduate training will be necessary for specialists in charge of complicated cases.

Objective　To analyze the influence of multiple variable factors on the occurance rate of pneumothorax associated with transthoracic needle aspiration biopsy of the lung. Methods　Fluoroscopically guided lung biopsies were performed in 46 patients. Variable factors were analyzed including lesion size, location, number of puncture, presence of emphysema and patients position after needle biopsy of the lung. Results　Pneumothorax occurred at 9 (19.6%) of 46 patients and that occurred at 4 (44.4%) of 9 emphysematous patients. Among them 2 necessitated chest drainage tube placement. The pneumothorax occurance rate was 30% (3/10) for lesions of diameter 3cm or less in size. In the dependent group, pneumothorax occurred in 4 of 20 patients (20%). In the nondependent group, pneumothorax occurred in 5 of 26 patients (19.2%). Conclusion　The correlation showed that increasing frequency of pneumothorax with decreasing size of lesions. An increased rate of pneumothorax was correlated with presence of emphysema. Patients with emphysema are more likely to have a symptomatic pneumothorax. No significant differences were found in the incidence of pneumothorax between patients placed with the puncture site dependent after biopsy and those placed with the puncture site nondependent.

Centric Relation ; Dental Occlusion, Centric ; Humans ; Orthodontics

Objective:To investigate the effects of nanoscale titanium dioxide(Nano-TiO2) on gap junctional intercellular communication(GJIC) between human lung fibroblasts.Methods: Human lung fibroblasts were exposed to two different sizes Nano-TiO2(25 nm and 80 nm) for 24 hours at the concentrations of 0,10,20,40 and 80 mg/L,respectively.The GJIC between cells was measured by using fluorescence redistribution after photobleaching(FRAP) assay.Results: The results showed that GJIC between cells was significantly inhibited both by 25 nm and 80 nm Nano-TiO2 in a dose-dependent manner.The fluorescence recovery rate was 20.81%?1.93% in control group,7.26%?0.91%(P

Objective To explore the nonenhanced CT images,mechanism and clinical application of perinephric edema associated with acute ureterolithiasis.Methods Nonenhanced CT images in 73 patients with acute ureterolithiasis were retrospectively reviewed.Results Of 73 patients with acute ureterolithiasis,eight had no perinephric edema at CT,41 had limited edema and 24 had extensive edema.Conclusion Perinephric edema is a important CT finding of ureteral obstruction in patients with acute ureterolithiasis.

The paper presented a reform program jointly launched by China National Health Development Research Center(CNHDRC) and the UK National Institutes of Health and Care Excellence (NICE) for integrated care pathway and payment reform in China,and its theory basis and framework as well.Intervention measures of the program in Shanxi,Chongqing,Shandong and Henan proved the program theory design as reasonable and implementation outcomes as successful.These two measures,though proven,fall far short of a total solution to overcome roadblocks in the ongoing healthcare reform,and further reforms are expected in the future.

A description of the intervention measures of the reform program for integrated care and payment in pilot areas,covering such diseases as chronic obstructive pulmonary disease and cerbral stroke.The reform aims at exploring impacts on both medical behaviors and medical costs.Authors of the paper hold that the practice of packaged ceiling payment for a single disease is a two-edged sword for clinical pathway management,and joint efforts by the government,medical insurers,medical workers and patients at large are required to regulate medical behaviors over time.They also see the total growth of medical costs as an objective rule,and the correct way out for optimal use of medical insurance funds is to focus on makeup of such costs.

Objective To explore the effect of applying problem-based learning(PBL)in clin-ical anesthesiology demonstration for clinical undergraduates. Methods Eighty-nine 2009 clinical undergraduates were divided into two groups:experimental group and control group. Students in ex-perimental group received PBL while those in control group received traditional teaching. The effect was evaluated according to the results of case examination and investigation table. The results were analyzed by X2 test. Results Most students (42/45) answered questions correctly in experimental group while only 30 of 44 students(30/44)did in control group(P<0.05). Concerning the results of investigation,PBL had more advantages than traditional teaching method in the following 5 aspects:self-studying ability(86.7%,39/45),clinical thinking ability(73.3%,33/45),information seeking ability (75.6%,34/45),expressing ability (82.2%,37/45),communicating between students (75.6%, 34/45)(P<0.05). Conclusions PBL has evident advantages in anesthesiology clinical demonstration. It can inspire students,cultivate abilities,enhance critical thinking and finally improve teaching effect.

Objective To compare the efficacy of weight loss,metformin and rosiglitazone in women with polycystic ovary syndrome(PCOS).Methods A randomized controlled trial(RCT)was carried out in Peking Union Medical College Hospital(PUMCH),one hundred and six women with PCOS were assigned to three intervention groups:weight loss,weight loss and metformin,weight loss and rosiglitazone group.Patients were treated with weight loss(diet and exercise),weight loss and mefformin (500 mg three times daily),weight loss and rosiglitazone(4 mg once daily)for three months.Sixty patients completed treatments.Basal body temperature(BBT),total testosterone as well as fasting serum insulin levels and lipid were measured and compared in all patients before and after weight loss.Results No significant differences were found in the baseline characteristics among three groups.In weight loss group 51%(22/43)patients completed treatment,and 23%(5/22)patients resumed ovulation.In weight loss and mefformin group 58%(21/36)patients completed treatment,and 43%(9/21)patients resumed ovulation.In weight loss and rosiglitazone group 63%(17/27)patients completed treatment,and 59% (10/17)patients resumed ovulation.Ovulation rate was significantly higher in weight loss and rosiglitazone group than in weight loss group.There was no significant difference among three groups in body mass index (BMI),waist circumference,waist-hip ratio(WHR),sex hormone,serum fasting insulin and lipid level after treatment.Conclusion Weight loss,metformin and rosiglitazone all can improve ovulation each.