Objective To evaluate the alteration of labial bone mass one year after immediate implant or delayed implant placement in esthetic zone.Methods From June 2009 to June 2012,22 patients with 11 immediate implant and 11 delayed implant in the maxillary anterior region were followed up.CBCT images were obtained immediately after surgery and one year after implant placement,the horizontal and vertical alterations of the labial bone were evaluated by image analysis software.Results The 1-year vertical reduction of labial bone after immediate implant placement was statistically significant (P＜0.05),and no significant difference in delayed implant (P＞0.05).The 1-year horizontal reduction of labial bone was statistically significant at coronal and middle of implant,without significant difference at apical of implant.Conclusions Immediate implant can not stop the physical absorption of labial alveolar ridge,and the study can provide reference to achieve esthetics in the anterior region.

BACKGROUND:As the rapid development of oral implantation and restoration techniques, as wel as the increasing enlargement of indications, angulated abutments have been widely used. Posterior teeth region, as the weight-loading region of occlusion, can bear great force from the implants, the assessment of angulated abutments in posterior teeth region has clinical value.
OBJECTIVE:To evaluate the short-term clinical efficacy of angulated abutments on the implant denture in posterior teeth region.
METHODS:From January 2008 to January 2013, 114 patients with 175 ITI implants in the posterior teeth region were included in this study and they al underwent single-crown restoration. The involved patients were divided into angulated abutment group and straight abutment group. Periodontal probing depth, modified plaque index, modified sulcus bleeding index and peri-implant crestal bone loss in two groups were recorded at 6 months and 2 years after restoration. Cumulative survival rate of the implant denture was calculated by life-table analysis.
RESULTS AND CONCLUSION:There was no significant difference in periodontal probing depth, modified plaque index, and modified sulcus bleeding index between two groups (P>0.05). The annual crestal bone loss showed no significant difference between two groups (P>0.05). Moreover, the 5-year cumulative survival rate with 15° and 20° abutments was 95.6%, and that with straight abutment was 96.4%. The angle of abutments has no correlation with peri-implant soft tissue and peri-implant crestal bone loss, implant restorations with 15° and 20° angulated abutments may be successful y used in the posterior region, whereas the long-term effects need further research.

Objective To explore the risk factors of no reflow phenomenon on post-percutaneous coronary intervention(PCI) in patients with acute myocardial infarction (AMI).Methods The clinical data of 268 patients with AMI who performed emergency PCI were collected and divided into normal group(normal flow) and no-reflow group (no flow).The risk factors of predicting the occurrence of no reflow phenomenon were screened by univariate and multivariate analysis.Results Thirty-two cases (11.9％) of 268 patients had flow occurrence and 236 cases(88.1％) were with no flow occurrence.There were significantly statistical differences between the two groups in terms of angina pectoris history before infarction,white blood cell count (WBC),history of oral of stains,administration of 600 mg of plavix before the operation,creatinine kinase,MB isoenzyme (CK-MB),C-reactive protein (CRP),Low density lipoprotein(LDL),time of coronary artery perfusion,numbers of balloons used during PCI and Killip ≥ grade 2 (all P ＜ 0.05).The multivariate logistic regression model analysis displayed that Killip ≥ grade 2 (odds ratio (OR) =1.237,95％ confidence interval (95％ CI) 1.049 -2.264,P=0.021),history of oral of stains(OR=2.355,95％CI 1.547-3.438,P＜0.001),WBC ≥ 12× 109/L (OR =4.139,95％ CI 2.273-8.451,P＜0.001),no administration of 600 mg of plavix before the procedure (OR =2.645,95％CI 1.628-5.246,P＞0.005) and no angina pectoris history before infarction(OR=1.413,95％CI 1.150-2.426,P＜0.001) were independent risk factors regarding of causing no reflow phenomenon.Conclusion The factors including Killip ≥ grade 2,history of oral of stains,WBC ≥ 12× 109/L,no administration of 600 mg of plavix before theoperation and no angina pectoris history before infarction were independent risk factors in terms of causing no reflow phenomenon.

Objective To understand the job stressors, coping style and general self-efficacy of emergency nurses and relationship of them. Methods A cross-sectional study involving 83 emergency nurses were conducted through the Chinese Nurses′ Job Stress Sources Scale, Trait Coping Style Questionnaire, General Self-efficacy Scale. Results Job stress among nurses in emergency department was caused by heavy workloads and time distribution (2.88±0.82), issue of patient care (2.78±0.59). The score of emergency nurses′coping propensity was 3.77, indicating more use of positive coping. Negative coping scored higher than the norm (26.99±4.76 vs.21.25±7.41), the difference was significant (t=10.290, P<0.01). The average score of general self-efficacy was 2.40 ± 0.48, lower than the norm (2.86±0.52), the difference was significant (t=-8.07, P<0.01). Active coping style scores were negatively correlated with job stress (r =-0.294, P < 0.05), negative coping style scores were positively correlated with job stress (r =0.239, P<0.05). General self-efficacy and positive coping scores were positively correlated (r=0.270, P<0.05). Conclusions The job stress among emergency nurses was at high level, self-efficacy was not high, but they still have a positive behavior patterns. Nurse managers should take advantage of the positive psychological characteristics of nurses and give reasonable support and guidance, in order to enhance the confidence of nurses and promote self-efficacy, optimize coping, improve the physical and mental health in emergency nurses.

Objective To investigate the risk factors affecting early mortality in spontaneous rupture in patients with hepatocellular carcinoma (HCC)and explore the effective treatment.Methed A retrospective study of 34 consecutive patients with spontaneous rupture of HCC from January 1998 to January 2008 was conducted.Followup was conducted for more than 3 years.18 clinical ,biochemical and pathological factors influencing 30-day mortality were analyzed.Results 30-day mortality rate was 38% (n=13).Univariate analysis showed that presence of cirrhosis,Child's C status,shock on admission,higher blood transfusion requirement,raised α-fetoprotein (AFP),raised alkaline phosphatase(ALP)and raised aspartate transaminase(AST)were all associated with increased risk early death (P＜0.05).Multivariate analysis displayed that shock was an independent risk factor affecting early death.The median survival time was 14.4 months in 8 patiens receiving emergency curative rescection and 44.4 months in 5 cases underwent delayed curative resection,and the 1-and 3-year survival rate were 63% (5/8)and 13% (1/8)in the former group and 80% (4/5)and 60% (3/5)in the latter group.Conclusion Poor prognosis of spontaneous rupture of HCC is associated with poor liver reservation,advanced disease and large volume of haemorrhage.Shock and blood transfusion requirement are the independent factors affecting early mortality.Curative resection is a definite treatment and delayed curative resection following initial haemostasis has a safer and more effective result.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Facial Injuries ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; therapy ; Retrospective Studies ; Wounds, Penetrating ; therapy ; Young Adult

Objective To investigate the effects of different positions of the patients mechanically ventilated under general anesthesia on respiratory mechanics during one or both lung ventilation before thoracotomy.Methods Twelve ASA Ⅰ or Ⅱ patients of both sexes (8 males, 4 females) aged 33-63 years weighing 62-85 kg scheduled for general thoracic surgery were studied. The preoperative lung function of the patients was normal. The patients were premedicated with intramuscular pethidine, promethazine and atropine. Anesthesia was induced with fentanyl, droperidol, midazolam, propofol and vecuronium. Left-sided double-lumen tube was inserted and correct placement was confirmed using a fiberoptic bronchoscope inserted through the bronchial lumen. Anesthesia was maintained with propofol and vecuronium infusion. The magnitude of neuro-muscular blockade was monitored by stimulation of radial nerve with TOF pulses. T4/T1 was maintained at 0 during study. The patients were placed in supine, left and right lateral position. In each position both lungs, left and right lung were ventilated for 10 min respectively. The non-ventilated bronchial lumen was open to the air during one-lung ventilation. The ventilatory parameters were kept unchanged during the study (VT = 8-10 ml?kg-1 , RR = 12 bpm, I:E = 1:2). Pressure-volume loop (P-V loop), peak airway pressure (Ppeak), airway resistance (Raw), total compliance (CT) (lung and thorax) and PETCO2 were measured and recorded at the end of each 10 min ventilation using S/5 monitor ( Datex-Ohmeda Finland) . Results During both lung ventilation Ppeak was significantly increased and CT was significantly decreased in left and right lateral position as compared with supine position ( P

Objective To investigate anti-inflammatory effect of recombinant human erythropoietin(rhEPO) on bronchopulmonary dysplasia in newborn rats exposed to hyperoxia.Methods Ninety-six Wistar newborn rats were randomly divided into 4 groups after birth:room air-exposed control group,room air-exposed rhEPO treated group,hyperoxia-exposed group,and the hyperoxia-exposed rhEPO treated group.The last two groups were exposed to oxygen,FiO2 =850 mL/L,room air-exposed rhEPO treated and hyperoxia-exposed rhEPO treated group received rhEPO 2 400 IU/kg subcutaneously at birth,30 minutes' before oxygen exposure and 2 d after birth.The isodose of 9 g/L saline was given in the same way in room air-exposed controls and hyperoxia-exposed pups.Rats from each group were sacrificed on day 3,7 and 10.Lung histology was observed under microscope,and mRNA expression of monocyte chemoattractant protein-1 (MCP-1) and cytokine-induced neutrophil hemoattractant-1 (CINC-1) were determined with reverse transcriotion-polymerase chain reaction(RT-PCR).Results Under microscope,in the hyperoxia-exposed group,inflammatory cell influx was detected in the lungs on the 3rd day and there was marked neutrophlic infiltrate on the 7th day.Alveolar enlargement and fibrosis were evident on the 10th day.At the same time,the histopathological changes were improved greatly in the lungs of hyperoxia-exposed rhEPO treated pups compared with the hyperoxia-exposed pups.MCP-1 and CINC-1 mRNA expression increased in hyperoxia-exposed pups,compared with room air-exposed controls especially on the 7th day [(0.94 ± 0.45) vs (0.21 ± 0.03),P ＜ 0.001 ; (1.26 ± 0.29) vs (0.26 ± 0.06),P ＜ 0.001].MCP-1 and CINC-1 mRNA expression were greatly depressed in the hyperoxia-exposed rhEPO treated pups compared with the hyperoxia-exposed pups especially on the 7th day.[(0.65 ± 0.07) vs (0.94 ± 0.45),P＜0.05;(0.83±0.07) vs (1.26±0.29),P＜0.05].Conclusions The therapy of rhEPO (2 400 IU/kg) therapy can reduce lung inflammatory cell infiltration and alveolar fibrin deposition in newborn rats with hyperoxic lung injury,and it can restrain MCP-1 and CINC-1 mRNA expression.The anti-inflammatory mechanism of rhEPO is related to inhibition of MCP-l and CINC-1 mRNA expression.

Objective To study the effect of injectable osteoinductive materials with fibrin sealant as the vehicle on the reconstruction of segmental radius defect in dog, and to provide an experimental foundation for its clinical application in the future. Methods 20mm bone defects were created in the radius 18 dogs, and in the experiment group b [FS+bFGF+bBMP (bovine BMP)] composite, and in experiment group r (FS+bFGF+rhBMP-2) were injected percutaneously into the defects. A control group (FS) with bone defect only was also included. The reconstruction effect on the segmental dog radius defects was evaluated by radiography, histology, bone mineral density (BMD) at 4, 8, 12, 16, 20 and 24 weeks after operation. Results In the experimental groups with bovine BMP as osteoinductive agent, higher repairing capability and osteogenesis rate were observed in experiment group b (FS+bFGF+bBMP) compared with that of control group (P

Objective To investigate the effect of the injectable osteoinductive material with fibrin glue(FG)as carrier compounded with rhBMP-2 and bFGF on the proliferation and differentiation of marrow matrix cells(MMCs)of rabbit,in order to lay an experimental foundation for clinical application in the future.Method MMCs were isolated and cultured from bone marrow of a 3-day-old rabbit.The effects of the material were investigated in experiment group(group A:FG+bFGF+rhBMP-2),with control groups consisting of control group 1(group B:FG),control group 2(group C:FG+bFGF),control group 3(group D:FG+rhBMP-2)and single control group(group E:free of material).The observation objects included proliferation rate,adhesive rates,expression of type I collagen and alkaline phosphatase,cell growth condition in the material and the ultrastructure of rabbit MMCs with the aid of electron microscopy,histochemistry and cell culturing.The concentration of rhBMP-2 and bFGF in all groups was uniform(1?g/ml).Results The proliferation rates and the adhesive rates of rabbit MMCs in group A was significantly higher than that in group B,group D and group E,but was lower than in group C(P