China ; Dental Prosthesis ; Humans ; Tooth Loss ; surgery

AlM:To determine the changes of regional macular retinal thickness ( RT ) with spectral domain optical coherence tomography ( SD-OCT ) after successful pars plana vitrectomy ( PPV ) surgery with inner limiting membrane ( lLM ) peeling in patients with idiopathic macular hole.
METHODS:A non-randomized retrospective case study on 17 patients ( 17 eyes ) who were hospitalized between March 1, 2011 and June 30, 2013. All 17 eyes had been diagnosed with idiopathic macular hole and thereafter underwent 25G-PPV surgeries performed by the same surgeon with lLM peeling and short - term gas tamponade. ln the 6mo-plus follow-up after surgery, these eyes were found to have successful closure in the macular hole. The macular RT of the nine areas in the Early Treatment Diabetic Retinopathy Study was measured by SD-OCT. All patients were applied by SD-OCT with linear scan of the macular. At least four examinations on the operated eye were conducted in contrast to the other normal eye: before the surgery, 3~5wk after the surgery (stage A), 2~3mo after the surgery (stage B), and >6mo after the surgery (stage C).
RESULTS:ln stage A, the macular RT of operated eyes in the areas of C, lS, ll, lN, OS, Ol, ON (263. 00±39. 48, 313. 92±18. 35, 311. 00±18. 02, 335. 67±19. 91, 280. 83±33. 74, 269. 92 ± 23. 32, 307. 00 ± 28. 40 ) were significantly thicker than the corresponding areas of the normal fellow eyes (220. 51 ± 23. 94, 292. 08 ± 21. 93, 282. 50 ± 20. 30, 288. 33 ± 20. 76, 251. 25±17. 60, 247. 75±21. 48, 265. 17±24. 76ü m) (P<0. 01) with the exception of the lT (291. 58±18. 97, 280. 33± 20.82üm) and OT (250.83±21.21, 242.08±24.02üm) (P>0. 01). ln Stage B, the macular RT in the areas of ll, lN, OS (335.67±19.20,319.75±19.20, 273.50±16.89üm) were significantly thicker than the corresponding areas of the normal fellow eyes (286. 33±20. 46, 293. 42±17. 64, 252. 50± 16.32üm) (P<0. 01). However, the macular RT of the operated eyes in the areas of C, lS, lT, Ol and OT had no statistically significant difference compared with the corresponding areas of the normal fellow eyes (P> 0. 01). ln Stage C, the macular RT of operated eyes with the areas of lN (321. 17 ± 19. 71ü m) were significantly thicker than the corresponding areas of the normal fellow eyes (296.25±19.57üm) (P<0.01). Meanwhile the other areas of the operated eyes were not significantly different from the normal fellow eyes (P>0. 01). Moreover, the macular RT of operated eyes in the areas of ON, lT (307. 00±28. 40, 291. 58 ± 18. 97ü m ) in stage A significantly decreased compared to that of the corresponding areas in stage C (276. 08±32. 39, 278. 75±10. 19ü m) (P<0. 01).
CONCLUSlON: SD-OCT is a convenient tool for the observation of macular regional changes after macular hole surgery. Macular RT had persistent changes after vitrectomy on eyes with macular hole by SD-OCT. lLM peeling may have caused microstructural changes in wide areas of the macular region after PPV surgery. More support and evidence were provided to the further study of the long - term observation for the structural and function of macular after macular hole surgery.

Objective To study the morbidity rule of community trauma and pre-hospital care mea-sures so as to improve the pre-hospital care performance. Methods 962 cases who received pre-hospital care by "120" commanding center in our hospital were retrospectively analyzed by means of self-designed questionnaires. Results The features of community trauma were mainly multiple trauma caused by traffic accidents, the main pre-hospital care measures included bandaging, hematischesis, pexia, aspiration of oxy-gen,intravenous injection, cardiopulmonary resuscitation,tracheal intubation and cricothyroid puncture,a-mong which bandaging, hematischesis and pexia accounted for 92.7 per cent. Conclusions Early and rapid treatments to the wounded patients, and correct medical rescue are very important. They are the two key factors to promote the success rate of rescue. At the same time, sound nursing management, correct medical treatment and nursing coordination are also critical aspects.

Objective To investigate the clinical outcomes of sternoclavicular hook plate in treatment of the anterior sternoclavicular joint dislocation. Methods A new device named sternoclavicular hook plate was devised by our team. Between May 2002 and Octorber 2009, 66 patients with sternoclavicular joint anterior dislocation were treated with the new device, among whom there were 47 males and 19 females,aged 21-68 years old (average, 32.6 years old). Twenty-one cases were caused by crush injury, 5 cases by falling and 40 cases by traffic accident. Anterior fracture-dislocation was found in 41 cases. According to the Allman system, there were 35 cases of type Ⅱ and 31 cases of type Ⅲ. Patients were evaluated with serial clinical and radiographic examinations. Rockwood score were used after the operation to assess the curative effect. Results The average operative time was 33 min (range, 20-48 min). The mean blood loss was 60 ml (range, 20-90 ml). There were no vascular or peripheral nerve injuries in the patients. All incisions healed smoothly. The X-ray and CT showed that the reduction of sternoclavicular joint and the location of internal fixation were satisfactory. All the 66 patients were followed up for 12-37 months (average, 17 months). There was no internal fixation failure, redislocation or other complications. The sternoclavicular hook plate was removed 12 months after operation. The mean Rockwood's score was 13.2 (8 to 15). There were excellent in 50cases, good in 15 cases, and fair in 1 case. Conclusion The sternoclavicular hook plate is a new, safe and liable technique for sternoclavicular fracture-dislocation. This new technique is helpful for early functional exercises.

Objective To investigate doctor's screening practice for hepatitis B virus (HBV) infection before immunosuppressive therapy for rheumatoid arthritis (RA) patients and clinical management of RA patients with positive surface antigen of HBV (HBsAg).Methods One hundred fifty doctors who treated RA patients in daily clinic were survied with a modified American College of Rheumatology (ACR) questionnaire which was composed of demographic data and 10 multiple-choice questions.Step-forward logistic regression analysis was performed to find out the influencing factors,then receiver operator characteristic curve analysis and area under the curve were performed to confirm the influencing factors.Results One hundred and thirtytwo effective questionnaires were collected.Before immunosuppressive therapy,HBV screening rate in outpatients with RA was significandy lower than that in hospitalized patients (68.7％ vs 94.6％,x2=31.5,P＜0.01).Only 23.7％(31/131) of doctors considered antiviral treatment for all RA patients with positive HBsAg.One hundred and thirteen doctors had clinical experience of antiviral treatment,but only 30.1％(34/113) and 23.9％ (27/113) of these doctors chose entecavir or adefovir as the antiviral drug respectively,59.3％ (67/113) prescribed antiviral drug before or together with immunosuppressive therapy compared with 40.7％(46/113) after HBV reactivation.Only 20.4％(23/113) of doctors would sustain antiviral treatment until the termination of steroid or disease modifying antirheumatic drugs (DMARDs).During immunosuppressive therapy for HBsAg(+) RA patients,11.4％(15/132) and 30.3％(40/132) of doctors reported no regular monitoring of aminotransferase or HBV DNA respectively.Conclusion Our survey shows that HBV screening rate in outpatients with RA is low and low awareness of antiviral treatment for all RA patients with positive HBsAg,and lack of awareness of indication,choosing of antiviral drugs,initiation,monitoring and duration of antiviral treatment during immunosuppressive therapy.Further medical education on the associated information and importance to collaborate with hepatologists should be emphasized.

Targeting to improve clinical thinking and practice skill of interns, modified Team-based learning (TBL) based on seeing real patient was performed for interns from eight-year clinical medicine program. Teachers prepared the corresponding case material before the teaching and made teaching aids. And interns were mobilized and guided to preview and self-study in teams. During modi-fied TBL, in-class application of seeing real patient was performed to assess the effect of self-study in teams, besides individual test and team test deriving from traditional TBL. All teams were assigned one task of seeing real patient by drawing lots, and then finished the task, answered teachers' questions. And the students' performance was given comments and comprehensive scores by the judges. After the completion of teaching, the teaching effectiveness of the modified TBL was assessed from students' performance, their scores and their teaching evaluation. Practice shows that the modified TBL can not only attract students to engage in it, but also elevate their abilities of clinical thinking and practical skill. It can also cultivate their interpersonal ability.

ObjectiveTo explore the correlations of simple bladder capacity measurement and urodynamic examination used for assessing the bladder function of patients with spinal cord injury.Methods From December 2011 to September 2013,a total of 37 patients with spinal cord injury were recruited.Their bladder functions were examined by both simple bladder capacity measurement and urodynamics in the first week after admission.The type of neurogenic bladder,residue urine,bladder capacity and the changes of bladder pressure were documented and compared.Results The simple bladder capacity measurement and urodynamics showed no significant differences in the parameters including residual urine,and bladder pressures when inputting 50mL,100mL,300mL and 400mL water(P>0.05). But there were significant differences in the results of bladder capacity and bladder pressure when inputting 200mL water(P<0.05). The intra-class coefficients between the results by the two methods were 0.606~0.919(P<0.01).The Kappa coefficient of the health professionals’judgments according to the two methods was 0.825(P<0.001).Conclusions The results of simple bladder capacity measurement are reliable.It can be used as the supplement for urodynamics to monitor the bladder function of patients with spinal cord injury.

Purpose :To study the effect of bFGF on the idiopathic oligoasthenospermia. Methods:bFGF wasused for 34 patients with idiopathic oligoasthenospermia in the male infertility. The immunohistochemical tech-nique, radioimmunoassay, electromicroscope technique and semen quality analysis were used to investigate thestructure and function of testile of patients. Results: bFGF could promote the proliferation of spermatogenouscells, improve arrangement of cells and ultrastructure of testile. All patients semen were improved. Sexual hor-mones (PRL, FSH, LH, T) in serum araised. The ability of reproduction of patients was increased consequent-ly. Conclusions:bFGF is an effective drug for patients with idiopathic oligoasthenospermia in the male infertility.

OBJECTIVETo study the effects of the superficial venous trunk (SVT) and its nourishing vessels on early revascularization of the reverse-flow random flap in order to provide theoretical evidences for clinical applications.

METHODSThe morphologic changes of micrangium of the reverse-flow random flap with SVT and without SVT were observed at different phases and compared by optical microscopy and stereological methods.

RESULTSThe micrangium density of the flaps with SVT and without SVT showed a tendency of increasing at 3 days after the operation. At 5 to 10 days, the micrangium density of the flap with SVT was much higher than the flap without SVT. There was significant difference between the two groups, which was proved by the optical microscopy observation.

CONCLUSIONSThis study suggests that SVT and its nourishing vessels could promote early revascularization of the flap after transplantation. The SVT can be of benefit to the survival of the reverse-flow random flap.

Animals ; Graft Survival ; Microcirculation ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; blood supply ; Swine ; Swine, Miniature ; Veins ; transplantation

OBJECTIVETo comparatively study the clinical effect of electrical plum-blossom needle on ametropic amblyopia and anisometropic amblyopia.

METHODSSixty children (107 eyes) with ametropic amblyopia or anisometropic amblyopia were randomly assigned to two groups at their first visit on the basis of optometry. They had never received any treatment before. Patients in one group were treated with electrical plum-blossom needle (as the treatment group) and those in the other group were treated with physical comprehensive therapy (as the control group). The 1-month clinical effect was observed.

RESULTSThe 1-month total effective rate was 79.6% (43/54) in the treatment group and 58.5% (31/53) in the control group. Statistical significance was shown in clinical effect after statistical management. The electrical plum-blossom needle showed better effect than the comprehensive therapy.

CONCLUSIONThe electrical plum-blossom needle for treatment of amblyopia in children could initiate faster with good compliance. Its short-term effect was definite with no side effect.

Acupuncture Therapy ; methods ; Amblyopia ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; Needles