Objective: To develop a computer-aided three-dimensional design software and laser scanning technique for the restoration of unilateral orbital defect. Method: By laser scanning apparatus plaster face model and the acquired primitive face point data were scanned; with the three-dimensional design software the point data were reconstructed to one smooth face surface image and the data of the defect of the orbital tissue were obtained from the normal contralateral tissue data by software. Results: The face-model data obtained by laser scanning apparatus was distinct and precise; the Digisurf retrograde engineer software succeeded to fulfill the computer-aided design for restoration of unilateral orbital defect. Conclusion: The laser scanning technique and three-dimensional design software can be used in the computer-aided design of the unilateral orbital defect restoration.

Objective:To investigate the three-dimensional accuracy of four impression materials for fixed denture:silicone(OX),hydrocolloid(HT) and two kinds of alginate impression(FC and ZS).Methods:Ten plaster replication models for each impression materials were made on the same metal master cast respectively, vertical and horizontal dimensions between landmarks on the masters and plaster casts were measured with an optical microscope. ANOVA was used to compare the measurements among the materials.Results:The difference between the masters and casts in horizontal distances measured on ZS produced models was bigger than that on other impression material produced ones (P<0.01) and beyond clinical requirment.The difference between the masters and casts in all measured dimensions on OX produced models was the smallest.Conclusion:Alginate paste is not accurate enough for denture model,while silicone is.The hydrocolloid material is relatively accurate.

The endoscopic findings of 884 cases of colonic polyps with different pathological types were retrospectively analyzed.Among all cases,there were 418 cases of tubular adenoma (47.3％ ),92 cases of fluff tubular adenoma ( 10.4％ ),334 cases of inflammatory polyps ( 37.8％ ) and 40 cases of hyperplastic polyps (4.5％ ).There were significant differences in age,location,polyp surface morphology and Yamada grouping among colonic polyps with different pathological types (P ＜0.05).The average age of fluff tubular adenoma group [ (64 ± 12)y] was the highest among all patients; and the average diameter of polyps was the largest [ ( 1.38 ± 1.09 ) cm ],lobulated and mulbenry,polyps were the most common forms; and the majority of fluff tubular adenoma was Yamada type Ⅲ or Ⅳ.The results indicate that fluff tubular adenoma was associated with higher age,larger polyp size,surface morphology and Yamada grouping (P ＜0.05).

Objective To explore the effect of silver needle thermo-conduction on cervical spondylosis of vertebral artery type (CSA). Methods 82 patients with CSA were randomly divided into control group (n=41) and treatment group (n=41). The control group was treated with cervical traction combined with microwave diathermy, and the treatment group was treated with silver needle thermo-conduction combined with cervical traction. Both groups were evaluated with Evaluation Scale for Cervical Vertigo (ESCV) and transcranial Doppler before and 1 course after treatment. Results The ESCV score, the peak blood flow velocity of period of contraction of left vertebral artery, right vertebral artery and basilar artery in both groups were significantly higher after treatment than before (P<0.01), the treatment group was better than the control group after treatment (P<0.01). Conclusion Silver needle thermo-conduction combined with cervical traction therapy can accelerate the blood flow of patients with CSA and improve their clinical symptoms

BACKGROUND: Studies have shown that osteoporosis often leads to a failure in pedicle screw fixation. Considering that the use of ordinary pedicle screw fixation cannot achieve a strong and stable fixation of the osteoporotic vertebra,special measures to strengthen the internal fixation is indispensable.OBJECTIVE: To evaluate the effect of bone cement augmentation combined with expandable pedicle screw fixation on the fixation strength of osteoporotic thoracolumbar vertebrae.METHODS: Twenty osteoporotic thoracolumbar vertebral specimens were randomly divided into four groups: conventional pedicle screw group implanted with normal pedicle screw, and the other three groups implanted with expandable pedicle screw. Bone cement augmentation with polymethylmethacrylate (PMMA) and calcium sulfate was done in the PMMA group and calcium sulfate group, respectively, followed by expandable pedicle screw implantation. No bone cement was used in the expandable pedicle screw group. The maximum axial pull-out strength and yield energy absorption value of the unilateral pedicle were detected, and the maximum removal torque of the contralateral pedicle was determined. Bone cement leakage after augmentation was observed.RESULTS AND CONCLUSION: Compared with the conventional pedicle screw group, the other three groups showed a significant increase in the maximum pull-out strength, maximum removal torque and yield energy absorption values (P < 0.05). Moreover, these parameters were significantly higher in the PMMA and calcium sulfate groups than the expandable pedicle screw group and conventional pedicle screw group (P < 0.05), but there was no significant difference between the PMMA and calcium sulfate groups (P > 0.05). No leakage of bone cement was found in all the groups. To conclude, the combined use of expandable pedicle screw and can significantly enhance the stability of the osteoporotic thoracolumbar vertebrae, and the PMMA and calcium sulfate cements have similar effects.

Objective To evaluate the feasibility of the posterior C2 pedicle screw placement (C2 PSP) by MPR techniques of helical CT.Methods Totally 250 patients (500 sides) who underwent head and neck CTA examination were enrolled.The bony parameters and the arterial parameters were measured after MPR.The bony parameters included pedicle diameter (D),isthmus height (T),internal height (H),and the arterial parameters included medial shifting:lateral (L),neutral (N),medial (M);and the degree of riding included below (b),within (w),above (a).The prevalence of narrow pedicles,high-riding vertebral arteries (HRVA) and the subtypes of IAVA in the general population were calculated,and the statistical analysis between narrow pedicles,HRVA,IAVA and C2 vertebral arteries groove (C2 VAG) injury were performed.Results The rate of narrow pedicles and HRVA were 14.40％ (72/500) and 24.60％ (123/500;x2=141.984,P＜0.001).When it came to the simulation of the C2 PSP inserting,the incidence of C2 VAG injuries was 19.40％ (97/500).In narrow pedicle and HRVA patients,the C2 VAG injuries incidence were higher than that of without narrow pedicle and HRVA patients (both P＜0.001).In 58 sides (58/500,11.60 ％),the narrow pedicles and HRVA occurred simultaneously.There were statistical significance differences of narrow pedicles and HRVA and the C2 VAG injuries in different types of IAVA (all P＜0.001),the subtypes of IAVA M-a consisted most common,which account for 55.56％ (40/72),46.34％ (57/123) and 48.45％ (47/97),respectively.Conclusion Most of the C2 VAG injuries happened in narrow pedicles,HRVA or IAVA M-a type patients.MPR can be used to comprehensively evaluate osseous and arterial parameters,which will provide anatomy foundation to the screw placement of C2 pedicles.

Objective To evaluate the efficacy and safety of colistimethate sodium (CMS) for the treatment of critical patients infected by pan-drug resistantAcinetobacter baumannii (PDR-AB) or pan-drug resistant Pseudomonas aeruginosa (PDR-PA).Methods 321 isolates of PDR-AB and 204 isolates of PDR-PA from critical patients admitted to 35 intensive care units (ICUs) of grade two or above were collected from the Anhui Antimicrobial Resistance Investigation Net (AHARIN) program from September 2012 to September 2015, while the minimal inhibitory concentrations (MIC) of colistin were determined by the E-test. A series of Monte Carlo simulations was performed for CMS regimens (1 MU q8h, 2 MU q8h, and 3 MU q8h, and MU meant a million of unit), and the probability of achieving a 24-hour area under the drug concentration time curve (AUC24)/MIC ratio > 60 and risk of nephrotoxicity for each dosing regimen was calculated. Each simulation was run over three CLCr ranges: < 60, ≥ 60-90, ≥ 90-120 mL/min. The probability of target attainment (PTA)for the AUC24/MIC ratio was calculated using the partial MIC value, while the cumulative fraction of response (CFR) was determined by integrating each PTA with the MIC distributions, the value greater than or equal to 90% or more than 80% was set as the optimal dosing regimen or suboptimal dosing regimen respectively. The probability of average 24-hour serum concentrations up to 4 mg/L for three dosage regimens was used to predict the risks of nephrotoxicity.Results All 321 isolates of PDR-AB and 204 isolates of PDR-PA were susceptible to colistin, the MIC50/90 against PDR-AB were 0.5mg/L and 1.0 mg/L, and those against PDR-PA were 0.5 mg/L and 1.5 mg/L, respectively. When recommended dose (1 MU q8h) was used for patients with CLCr of < 60 mL/min, high CFR value (89.78% for PDR-AB, 81.06% for PDR-PA) were obtained, but with a high risks of nephrotoxicity (> 32.51%). Moreover, low value of PTA (< 66.56%) was yielded for isolates with MIC of ≥ 1 mg/L. Recommended dose also yielded a low CFR value (56.97%-69.31% for PDR-AB, 44.76%-56.94% for PDR-PA) in patients with CLCr of ≥ 60-120 mL/min. When dose was increased to 2 MU q8h, CFR (77.45%-92.87%) and the risks of nephrotoxicity (< 0.15%) was optimal for patients with CLCr ≥ 60-120 mL/min, but low value of PTA (< 75.36%) was also yielded for isolates with MIC of ≥ 1 mg/L. The most aggressive dose of 3 MU q8h provided high CFR (> 89.24%) even in patients with CLCr ≥ 90-120 mL/min, and PTA was < 76.20% only for isolates with MIC of ≥ 1.5 mg/L, but this dosing scheme was associated with unacceptable risks of nephrotoxicity (> 33.68%).Conclusion Measurement of MIC, individualized CMS therapy and therapeutic drug-level monitoring should be considered to achieve the optimal drug exposure and ensure the safety of CMS.

Objective:To analyze the mistakes in the application of tuina therapy in the rehabilitation of stroke,in order to elevate the clinical effects in the treatment of stroke by tuina.Methods:The issues are found out by searching and analyzing the relevant articles on tuina treatment of stroke.Results:In the tuina treatment of stroke,mistakes exist in the intervening time of the treatment,in the emphasis of tuina with negligence of rehabilitation,in the assessment of therapeutic effects,in the selection of the manual techniques and acupoints,and in the negligence of health education.Conclusion:In the tuina treatment of stroke,it is advisable to start treatment in the early stages,use the manual techniques in different phases,to cooperate with rehabilitation at the proper time and to emphasize health education,in order to avoid or reduce the occurrence of misuse syndrome,and eliminate the appearance of disuse syndrome,for displaying the unique advantage of tuina therapy fully and promoting the innovation and development of TCM rehabilitative techniques.

Twelve patients with maple syrup urine disease were treated with restricted natural protein intake,special nutrition powder,and vitmin B1.The manifestations of these patients were greatly improved after treatment.The blood levels ofleucine and valine were significantly decreased after treatment(P＜0.01).Although the level of branched-chain α-ketoacids in urine was reduced,but not significantly.

Objective To investigate the acid α glucosidase(GAA)gene mutations and clinical features of a Chinese patient exhibiting signs and symptoms of infantile glycogen storage disease type Ⅱ(GSD Ⅱ). Methods Clinical features of the patient were reviewed,and GAA activity in the patient＇s and her parents＇ whole leukocytes were measured. GAA coding regions were amplified by polymerase chain reaction(PCR),and analyzed by direct DNA sequencing. Results The patient showed feeding difficulties,generalized hypotonia and weakness starting at 2 months of age. Cardiomegaly and cardiomyopathy were found at 4 months. She died of cardiorespiratory failure at the age of 6 months. GAA activity in leukocytes was low in the patient(17.3% of the median normal range). Genotyping revealed the patient was a heterozygote for a novel nonsense mutation p.W738X and a previously reported nonsense mutation p.E888X. The reported pseudodeficiency allele c.1726G ＞ A;2065G ＞ Awas found in the patient and her mother. Conclusions Correct diagnosis was made for this patient by combination of GAA activity assay and genetic analysis. From the clinical course,this patient should be classified as infantile type of GSD Ⅱ,suggesting that the novel mutation p.W738X may have a damaging effect on the function of GAA. Pseudodeficiency allele found in this family highlights the importance of genetic analysis of GAA when performing diagnosis and prenatal diagnosis for the affected families,as this allele causes low GAA activity in normal individuals.