Objective:To evaluate the influence of the implant-supported porcelain bridges made from non-precious metals using spark erosion techniques, and to discuss the feasibility and details of making the implant restoration by spark erosion technique.Methods: The study included 12 patients ( 9 males and 3 females) with 92 units implant-supported non-precious porcelain bridge from Sep.2011 to Feb. 2013.All the patients received implant treatment in Department of Oral Implantology, Peking University School and Hospital of Stomatology.The total of 52 implants, were from Nobel Biocare implant system, Camlog implant system and Ankylos implant system.The implant analogs were connected in sequence with a copper wire to guarantee conductivity.The implant electrodes represented one electrode and the superstructure the other.During spark-erosion machining, the cast holding the implant electrodes and the prosthetic framework were moved toward one another, causing an electrical erosion of the protruding ele-ments.Results:After the spark-erosion machining, the minimum gap between the framework and abut-ment was 0.21 mm, which was two units bridge.The maximum was 2.59 mm, which was 11 units bridge with 6 implants.The average gap was 0.68 mm.After the spark-erosion machining, the bridge fitted well with the passive position stability.Conclusion: The method of making implant-supported non-precious porcelain bridge reduces costs on patients.Spark erosion has the potential to provide implant framework with an excellent fit.The patients are satisfied with the clinical results.

Objective To investigate the accuracy of functional magnetic resonance imaging(fMRI) and contrast-enhanced ultrasound on evaluation of the breast cancer patients after neoadjuvant chemotherapy.Methods Forty-eight patients with breast cancer who were confirmed by biopsy,undergoing 4 cycles weekly dose-concentrated programs (wPC) neoadjuvant chemotherapy,evaluated the efficacy by fMRI and contrastenhanced ultrasound.Results In pathology,complete remission was 12 cases (25.0％,12/48),non remission was 13 cases (27.1％,13/48).In contrast-enhanced ultrasound,complete remission was 20 cases (41.7％,20/48),non remission was 10 cases (20.8％,10/48).In fMRI,complete remission was 17 cases (35.4％,17/48),non remission was 11 cases (22.9％,11/48).The P values more than 0.05 showed no statistically significant among three methods,the Kappa test showed that fMRI were superior to contrastenhanced ultrasound on evaluating the efficacy of neoadjuvant chemotherapy.Conclusions fMRI and contrast-enhanced ultrasound can be used in evaluating the efficacy of neoadjuvant chemotherapy,however,the data shows fMRI is superior to contrast-enhanced ultrasound.Contrast-enhanced ultrasound must be as the supplementary method.

Objective To investigate the clinical application of the fine needle aspiration on spleen by ultrasonic guidance.Methods The fine needle aspiration by ultrasonic guidance was performed on 36 patients with spleen diseases.Among them,29 patients underwent diagnostic puncture,and the other 7 patients underwent remedial puncture.The definite diagnosis rate of the diagnostic puncture group was calculated by organism pathology and cytology result,as well as final diagnosis after the operation,while the curative effect of the remedial puncture group was appraised by re-examination after the operation.Results The definite diagnosis rate of the diagnostic puncture was higher,and the definite diagnosis rate of histology biopsy group(85.7%)was higher than that of cytology aspiration group(62.5%).All the patients who took remedial puncture were cured.Conclusion The fine needle aspiration on spleen by ultrasonic guidance has very important practical value in identifying the diagnosis of spleen disorders and treating fluidity processes of spleen.

Objective To evaluate the value of 18F-FDG PET/CT in early in vivo monitoring of tumor response to cisplatin,and analyze the relationship between 18F-FDG uptake in tumor and the corresponding pathological changes.Methods Thirty VX2 rabbits were divided into 5 groups by random number table with 6 in each group,including 4 treatment groups and 1 control group.18F-FDG PET/CT were performed before and after (6,12,24 and 36 h post-injection respectively) intravenous administration of cisplatin (7 mg/kg) in the treatment groups,respectively.The control group was injected with physiological saline followed by 18F-FDG PET/CT.The ROI was drawn and the SUVmax and T/NT ratio were calculated.The tumor necrosis rate and apoptosis index were observed by histopathologic examination.Paired t test,GamesHowell test and arcuation correlation analysis were used to analyze the data.Results Significant differences were found in SUVmax and T/NT of the control group before and after injection of physiological saline (6.58±1.67 vs 9.77±2.45,52.93±3.90 vs 29.34±3.31;t=-5.480,17.593,both P＜0.05).18F-FDG uptake decreased after 6 h post-injection of cisplatin,with the mean SUVmax decrease rate of (11.83±8.89) ％ and the mean T/NT decrease rate of (59.00±8.22)％.In the 24 h treatment group,18F-FDG uptake decreased most,and the mean SUVmax decrease rate was (42.33±33.80)％,the mean T/NT decrease rate was (83.50± 7.69) ％.The SUVmax and T/NT of those 2 groups were significantly different from those of the control group,and no difference was found between the 2 treatment groups(all P＜0.05).The changes of SUVmax and T/NT were positively correlated with apoptosis index and tumor necrosis rate (r=0.750,0.794,0.804,0.874,all P＜0.05).Conclusion 18F-FDG PET/CT is a sensitive method for monitoring early response to tumor chemotherapy in VX2 tumor-bearing rabbits at 24 h after treatment.

Objective To measure the angular velocity and perpendicular ground reaction force of the ankle joint under different heights with half-squat jumping in parachute training simulation,providing a reliable experiment basis for the preventing of ankle injury.Methods A total of 18 volunteers participated in this study.The experimental group included 9 male with experience of parachute landing,while the other 9 male without experience of parachute landing were assigned to the control group.Each subject was instructed to jump off a platform with a height of 30 cm and 60 cm and land on a hard surface in a half-squat posture.The dynamic landing process was recorded with a high speed camera and the biomechanical data was collected and analyzed,including perpendicular ground reaction force,angular displacement,velocity and acting time.Results From 30 cm's height,the ankle angular displacement of the control group was significantly larger than the experimental group (25.73°± 8.13° vs 20.05°± 12.27°,P ＜ 0.05).The perpendicular ground reaction force of the control group was significantly smaller than the experimental group (3 372.4±748.6 N vs 5 181.5±1 726.2 N,P ＜ 0.05).The acting time of the control group was significantly longer than the ex perimental group (0.049±0.015 s vs 0.012±0.004 s,P ＜ 0.05).The buffer time of the control group was significantly shorter than the experimental group (1.397±0.746 s vs 1.737±0.451 s,P ＜ 0.05).From 60 cm's height,the ankle angular velocity of the control group was significantly higher than the experimental group (25.45± 15.01 °/s vs 16.51 ±4.18 °/s,P ＜ 0.05).The perpendicular ground reaction force of the control group was significantly smaller than the experimental group (4 616.0±1 124.7 N vs 7 119.5±2 307.4 N,P ＜ 0.05).The acting time of the control group was significantly longer than the experimental group (0.048±0.013 s vs 0.015±0.006 s,P ＜ 0.05).The buffer time of the control group was significantly shorter than the experimental group (0.922±0.347 s vs 1.617±0.547 s,P ＜ 0.05).Conclusion Jumping from different heights,the experinental group was larger in perpendicular ground reaction force but smaller in the angular velocity and displacement than the control group.There was a shorter acting time and a longer buffer time in the experimental group than the control group.

Objective Currently,pediatric 18F-FDG dose and acquisition durations are generally based on coarse extrapolation from adult guidelines.This study sought to determine whether shorter acquisition durations or a lower 18F-FDG injected activity could be used during pediatric 18F-FDG PET/CT examinations while maintaining diagnostic utility.Methods Thirty-six whole-body 18F-FDG PET/CT examinations were performed on 36 patients (weight,13-89 kg,(46.51±5.63) kg; age range,3-14 years old,(9.22±3.16) years old) with a weight-based injected activity (5.3 MBq/kg (0.144 mCi/kg)),fixed acquisition durations 180 S/FOV,VIP record acquisition mode using Discovery STE.For each examination,the Vip-mode data was truncated to form multiple datasets with shorter acquisition durations down to a minimum of 60 s/FOV (i.e.,60,80,100,120,140,160 s/FOV data were formed from single 180 s/FOV acquisition).168 image volumes were generated,randomized,and reviewed in a masked manner with corresponding CT image volumes by 6 radiologists.Overall,subjective adequacy and objective lesion detection accuracy by body region were evaluated.Results All examinations with maximum acquisition duration were graded as adequate and were used as the reference standard for detection accuracy.For patients more than 30 kg,when acquisition duration was more than 120 s/FOV,all PET/CT examinations were graded as adequate for clinical tasks,whereas,when acquisition duration was reduced to less than 120 s/FOV,lesion detection became less accurate.For patients less than 30 kg,lesion detection accuracy was perfect for acquisition times between 140 s/FOV and 180 s/FOV for all regions of the body.However,lesion detection became less accurate when imaging acquisition time was reduced less than 140 s/FOV.Conclusions When GE Discovery STE PET/CT was applied during pediatric PET/CT examination,using decreased acquisition times as a surrogate for 18F-FDG dose,18F-FDG dose can be reduced by approximately 33.33％ when patients weigh over 30 kg were scanned for 180 s/FOV.For patients less than 30 kg,18F-FDG dose can be reduced by approximately 22.22％ without losing diagnostic quality.Reduction of overall scan time potentially reduces motion artifacts,improves patient comfort,and decreases length of sedation.Alternatively,decreased 18F-FDG dose minimizes radiation risk.

BACKGROUND:In recent years,artificial cervical disc replacement surgery as a new method for the treatment of cervical disease has gradualy been accepted and understood,but relevant complications have gradualy attracted attention.OBJECTIVE:To investigate the clinical outcomes of artificial cervical disc replacement in the treatment of cervical disease and the range of motion of the replacement segment.METHODS: A total of 25 patients with artificial cervical disc replacement in the treatment of cervical spondylosis,who were treated in the Department of Orthopedics,Air Force General Hospital of Chinese PLA from August 2006 to April 2012,were enroled in this study,including 15 males and 10 females,aged 31-76 years,averagely 51.04 years.There were 6 cases of double segments and 19 cases of single segment.They were folowed up for 24 to 93 months.Clinical results were assessed using the Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores.Imaging was used to observe range of motion,cervical curvature,heterotopic ossification,and degeneration of adjacent segments.RESULTS AND CONCLUSION:Neurological function in al patients was improved to different degrees.One case suffered from mild heterotopic ossification,but no clinical symptoms were found.No significant difference in range of motion of surgical segment,and range of motion of upper and lower adjacent segments was detected between pre-replacement and final folow-up results (P＞0.05).No significant difference in range of motion of C2-C7 was found between pre-replacement and final folow-up results (P＞0.05).Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores were significantly improved during final folow-up compared with pre-replacement (P＜0.05).These results indicated that artificial cervical disc replacement in the treatment of cervical disease can achieve better clinical efficacy,can keep the range of motion of replacement segment and avoid the accelerated degeneration of adjacent segments.

Objective To investigate cyclic mechanical stimulation on expression of connective tissue growth factor (CTGF) in osteoblast-like cells (MG63) and to explore the rote of MAPK involved in the process.Methods Expressions of CTGF protein and mRNA in MG63 cells were detected by Western blot and RT-PCR,respectively. Phosphorylation levels of p38, ERK, JNK were examined by Western blot. Results Cyclic mechanical stimulation upregulated expressions of CTGF protein and mRNA. The levels reached a maximal response of 2-3 fold after 3-6 h. ERK and JNK signal pathways were activated by cyclic mechanical stimulation, the phosphorylated proteins increased within 10 min of stretch, phosphorylated ERK reached maximal levels by 60 min of stretch, phosphorylated JNK reached maximal levels by 15-30 min of stretch, but not for p38 signal pathway.Only the inhibitior of JNK signal pathway (SP600125) markedly suppressed stretch-induced CTGF expression,meanwhile the inhibitors of ERK (PD98059) and p38 (SB203580) did not show such effect. Conclusion Cyclic mechanical stimulation upregulates CTGF expression via JNK-dependent pathway in MG63 cells.

Objective To investigate the influence of size and depth of thyroid carcinoma for diagnostic accuracy of ultrasound-guided fine-needle aspiration (US-FNA).Methods A retrospective review of clinical and preoperative US-FNA data of 87 malignant thyroid nodules confirmed by surgical pathology from 87 patients was performed.According to the the Bethesda System for Reporting Thyroid Cytopathology (BSTC),the grade that higher than grade Ⅳ was the cytologic criteria for diagnosis of thyroid carcinoma.According to the cytopathological data of thyroid carcinoma confirmed by surgical pathology,the patients were divided into group A (cytopathological data was same as the surgical pathology result) and group B (cytopathological data was not same as the surgical pathology result).The longest diameter of malignant thyroid nodules and the distance from the shallow of thyroid nodules to superficial capsule of thyroid gland were analyzed.The ROC analysis was performed to find the optimal cut-off value of the longest diameter of thyroid carcinoma and the distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland.Results The consistent rate between US-FNA and surgical pathologic results was 79.31 ％ (69/87).The longest diameter of thyroid carcinoma of group A and group B was (1.63±0.58)cm and (1.01±0.42)cm respectively,which was statistically different (P＜0.01).The distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland of group A and group B was (4.15±1.83) mm and (7.86±2.08)mm respectively,which was statistically different (P＜0.01).According to the ROC analysis results,the optimal cut-off value of the longest diameter of thyroid carcinoma and the distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland was 1.05 cm and 6.1 mm respectively.Conclusion Diagnosis accuracy of US-FNA could be influenced by size and depth of thyroid carcinoma.

Objective:To systematically evaluate the quality of continuing care services carried out by nursing staff in China, comprehensively integrate the influencing factors of continuing care services, and provide guidance for promoting the development of continuing care in China.Methods:PubMed, EMbase, Web of Science, the Cochrane Library, CMB, SinoMed, CINAHL, CNKI, Wanfang Data and VIP related qualitative studies were searched from the database establishment to March 2022. The NoteExpress software was used to screen and analyze the literature, the 2017 Australian JBI Evidence-based Health Care Center quality research quality evaluation standard was used to conduct qualitative evaluation of the literature, and the Meta-integration method was adopted to carry out pooled integration. The ConQual approach was used to evaluate the quality of the integrated results.Results:A total of 39 results were extracted from 11 studies. Eleven new categories were summarized and four integrated results were obtained, which were: nurses lack relevant cognitive, motivational and behavioral skills; patients have poor compliance and low trust in medical prescriptions; lack of team management, method guidance and system standards; lack of connection sharing, input supply and upper protection. The total evidential quality of the integration results was intermediate.Conclusions:At present, nurses should strengthen their own ability, pay attention to patient education, enhance the sense of trust between doctors and patients. Managers should pay attention to team building, standardize the service standards and systems. The state should increase input, improve social policy support and legal protection; for the orderly development of continuity of care services escort.