Objective To study the effect of the procedure of oral care on the oral implantology.Methods This study was designed to compare two groups:the experimental group and the control group applied with different nursing procedure,each group comprised with 30 patients.The effect of the nursing procedure on the success rate of implantation,the degree of patient satisfaction,nursing efficiency and the maintenance of equipments were observed and compared.Results The Success rate of implantation of both the experimental group and the control group had no significant difference but the degree of patient satisfaction and the nursing efficiency of the experimental group was significantly better than the control group,the experimental group had advantages in the maintenance of equipments compared with the control group.Conclusions Nursing procedure has an important impact on the oral implantology and is worthy of clinical promotion and reference.

Objective To analyze the consistency of transcutaneous perianal ultrasonography (TPUS) and pelvic magnetic resonance imaging (MRI) in diagnosing perianal lesions of Crohn's disease (CD), and to evaluate the value of transcutaneous perianal ultrasonography in detecting perianal lesions of CD. Methods A cohort of 102 patients diagnosed as Corhn's disease were enrolled from August 2008 to August 2010. Perianal abscess and fistula of these CD patients was diagnosed by ultrasonography and MRI system. Statistics was performed with SPSS 11.5 software for X2 test. The consistency was analyzed with Kappa test. Results The mean onset time of perianal lesions in CD was -0.443 year (95％CI:-1.659～0.773 year) before typical symptoms showed up. There was no significant difference in detecting perianal lesions of CD between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging (P ＝ 0.706, Kappa ＝ 0.541). If pelvic magnetic resonance imaging was considered as the golden standard in detecting perianal lesions of CD,the sensitivity (Sen), specificity (Spe), Youden's index, positive predictive value (PPV) and negative predictive value (NPV) of TPUS were 72.73％, 82.61％, 0.55, 66.67％ and 86.36％ respectively.Furthermore, there was no significant difference between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess ( P ＝ 0.706, Kappa ＝ 0.496) and fistula (P＝0.655, Kappa＝0.546) of CD. Conclusions Perianal lesions occur in the entire course of CD. There was favorable consistency between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess and fistula of CD. Transcutaneous perianal ultrasonography can be used as an additional method in detecting and evaluting perianal lesions of CD.

Objective To evaluate the efficacy and safty of antiviral treatment for chronic hepatitis B ( CHB ) patients in second trimester of pregnancy.Methods Seventy-nine CHB patients in second trimester of pregnancy were collected from Hangzhou First People’ s Hospital and Xixi Hospital of Hangzhou during January 2010 to December 2013.Patients were divided into antiviral treatment group ( n=47) and the control group (n=32) according to their own wishes.Patients in antiviral treatment group were given lamivudine or telbivudine treatment plus hepatoprotective medication, while those in control group were only given hepatoprotective medication.All pregnant women were observed for 12 weeks after childbirth and the neonates were followed-up for 6 months after birth.The liver function, HBV DNA loads, HBV serological markers were measured;adverse effects during pregnancy, blocking rates of mother-to-child transmission and the growth of neonates were documented.t test or Chi-square test was used for statistical analysis.Results Alanine aminotransferase ( ALT) normalization rate and HBV DNA negative rate in antiviral treatment group before childbirth were 88.6%(39/44) and 84.1%(37/44) , while those in the control group were 60.0%(18/30) and 0 (χ2 =8.27 and 50.46, P<0.05).After 12 weeks of childbirth, ALT normalization rate and HBV DNA negative rate in antiviral treatment group were both 100.0% (44/44), which were higher than those in control group (90.0%and 0) (χ2 =4.59 and 74.00, P<0.05).HBeAg seroconversion was observed in 1 (2.8%) and 4 (11.1%) patients in antiviral treatment group before and 12 weeks after childbirth, but it was not observed in the control group.The difference in HBeAg seroconversion rate bwteen two groups was not of statistical significance (P>0.05).No patient in antiviral treatment group terminated pregnancy due to abnormal liver function or adverse effect of drugs, while 2 out of 30 patients (6.7%) in the control group terminated the pregnancy, but the difference between two groups was not of statistical significance (χ2 =1.01, P >0.05).Mother-to-child transmission of HBV was successfully blocked in antiviral treatment group, while 3 cases (11.5%) in control group were failed (χ2 =5.19, P<0.05).No significant differences in gestational age, body mass, body length, Apgar score between two groups were observed (t=0.65, 0.84, 0.25 and 0.77, P>0.05).Conclusion Antiviral treatment can improve liver function, inhibit HBV replication and reduce the risk of mother-to-child transmission, and is safe for CHB patients in second trimester of pregnancy.

Objective To explore the function of infliximab in inducing remission in Crohn's disease and the effect of the inducing remission were followed up. Methods Ten patients with Crohn's disease received a infliximab, 5-aminosalicylic acid (5-ASA) and Azathioprine (AZA) therapy for inducing and maintenance remission. Crohn' s disease activity index (CDAI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine aminotransferase (ALT), apartate aminotransferase, (AST), total bilirubin (TBil), conjugated bilirubin, (CB), creatinine (Scr) were evaluated at week 0, 10, 22 and 50. Simple endoscopic score for Crohn's disease (SES-CD) were evaluated at week 0, 10 and 50. Adverse reactions were also evaluated. Results At week 10, all patients achieved remission. The indicators of CDAI, CRP, ESR and SES-CD were significantly declined than those at week 0 (P＜0.01). The follow-up was terminated in one patient due to the relapse at week 30. At week 50, the indicators of CDAI, CRP, ESR and SES-CD in six patients a little bit increased compared with those at week 10, but no statistic significant (P=0. 2001、0. 0600、0. 1328、0. 4230 respectively), but significantly declined compared with those at week 0 (P =0.0005、0.0087、0.0054、0. 0163 respectively). No severe adverse reaction was observed in all patients.Conclusions Infliximab showed an exact efficacy in inducing remission in Crohn's disease. And 5-ASA and AZA were effective for maintenance remission in part of the patients after infliximab induced remission.

Objective To construct Z-score models for normal fetal heart size measurements derived from fetal echocardiography.Methods Fetal echocardiography were performed in 910 normal singleton fetuses from 14th to 40th gestational weeks.Fetal transverse heart diameter (HD),heart length (HL),heart circumference (HC) and heart area (HA) were derived from a standard four-chamber view during end diastole.Using fetal somatic sizes as independent variables and heart sizes as dependent variables,the regression analyses of the mean (M) and the standard deviation (SD) for each parameter were calculated separately.A group of fetal heart diseases were assessed using these models.Results Strong correlations were found between fetal heart sizes and somatic sizes.Linear-cubic regression equations were each fitted to the models of the means of the heart sizes,whereas linear-quadratic equations were fitted to the models of the SDs.HD (r =0.984-0.986) was a dependent variable that provided the highest correlation coefficient with all of the fetal sizes,followed by HL (r =0.981-0.984),HC (r =0.981-0.982) and HA (r =0.978-0.979).All fetuses with Ebstein' s anomaly and most with homozygous α thalassemia-1 demonstrated Z scores reflective of increased heart sizes.Conclusions The fetal heart sizes Z-scores models had been constructed.The calculation of Z-scores for heart sizes as a function of fetal somatic size is feasible and simple.They might be useful for quantitative assessment of some cardiac diseases and used as new predictive indicators for homozygous α-thalassemia-1 particularly.

Objective To investigate the expression of CD27-CD70 co-stimulatory pathway in peripheral circulation and intestinal mucosa of patients with inflammatory bowel disease, and to find the difference between the expression of CD27-CD70 in patients with inflammatory bowel disease and in healthy controls. Methods A total of 62 patients with Crohn's disease, 64 patients with ulcerative colitis and 56 healthy controls were enrolled. Enzyme-linked immunosorbent assay was applied to evaluate plasma CD27-CD70 protein expression in patients with inflammatory bowel disease and healthy controls. SYBR-green real time PCR was applied to access CD27-CD70 mRNA expression in peripheral blood mononuclear cells in patients with inflammatory bowel disease and healthy controls.And CD27-CD70 protein expression in intestinal mucosa was determined by immunohitochemistry.Results Plasma levels of CD27 (P=0. 025) and CD70 (P=0. 000) were significantly higher in patients with Crohn's disease than in healthy controls. However, CD27 (r= 0. 055, P= 0. 673) and CD70 (r= 0. 024, P = 0. 852) were not significantly associated with endoscopic disease activity in patients with Crohn's disease. Similarly, CD27 (P=0. 001) and CD70 (P=0. 000) were significantly higher in patients with ulcerative colitis than in healthy controls. And CD27 (r=0. 077, P=0. 547)and CDT0 (r=0.021, P=0. 869) were not significantly associated with endoscopic disease activity in patients with ulcerative colitis. Moreover, CD27 and CD70 mRNA expression in peripheral blood mononuclear cells were significantly higher in patients with Crohn's disease and ulcerative colitis than in healthy controls (all P=0. 000), and immunostaining indicated that CD27 and CD70 expression in intestinal mucosa were significantly higher in patients with Crohn's disease and ulcerative colitis than in healthy controls (all P=0. 000). Conclusions CD27-CD70 pathway activated in plasma, peripheral blood mononuclear cells and intestinal mucosa of patients with inflammatory bowel disease. However,plasma levels of CD27 and CD70 can not reflect endoscopic disease activity.

Objective To compare the bio-medical parameters in SIV infected Chinese rhesus monkeys with diverse disease progression,by which the pathogenesis of simian AIDS were to be investigated.Methods Sixteen Chinese rhesus monkeys were inoculated intravenously with SIVmac239 and followed-up for 18 months.Based on their progression patterns and plasma viral loads,animals were divided into 3 groups,including 1 rapid progressor( RP),13 normal progressors(NP),and 2 elite controllor(EC).Their parameters of haematology,virology,immunology and pathology were examined and compared. Results Compared with other animals,RM449(RP) showed higher viral load,unresponsive humoral immunity,and higher level of auto-antibodies against lymph node,thymus,and spleen.Additionally,its effector memory CD4 count was lower,with the transformation progress being blocked-like from naive/central memory subsets to effector memory subset,as the flow-cytometry assay showed.Notable decrease in its peripheral B cell was also observed,especially to the sub-population of tissue-like memory B cells and activated memory B cells.Pathological examination showed the depletion of lymphoid tissue,atrophy of spleen and loss of thymus.Moreover,most of these parameters of RM450 and RM453 (EC) changed opposite to that of RP.Conclusion The hallmarks of RM449 were higher viraemia and lower SIV specific IgG level,which may due to the disturbance of T cells and B cells development and differentiation.Moreover,destructions of organs of the immune system may contribute to the disturbance.Our study suggest that the change of micro-environments of thymus induced by SIV infection,which is necessary in T cell and B cell development and differentiation,may contribute at least partially to the AIDS pathogenesis.

Objective To evaluate the efficacy of fetal heart diameter(HD)Z-score as predictors of homozygous α-thalassemia-1.Methods Two hundred and fourteen cases of Single mid-pregnancies(1 5-22 W)at risk of homozygous α-thalassemia-1 were enrolled.Fetal HD were first measured.Next,the Z-scores of HD were calculated separately based on previously constructed Z-score models.Finally,the accuracy of this variable was analyzed and compared with that from the cardiothoracic ratio(CTR)by ROC curves analysis.Results ①A total of 214 singleton pregnancies were recruited in which 57 cases were homozygous α-thalassemia-1 fetuses and the other 157 cases were unaffected.②The affected fetal HD and Z-score were significantly higher than those in the unaffected fetuses(P <0.01).③With the HD Z-score >2.76 as the best cutoff value,the sensitivity and specificity of predicting homozygous α-thalassemia-1 fetuses in 1 5-22 gestational week were 92.98% and 100%;If a best cut-off value of CTR >0.52 was used for prediction,the sensitivity was 87.72% and the specificity was 91.72%.Compared with CTR,the discriminative power of HD Z-score was better(Z value=2.286,P <0.01).Conclusions HD Z-score is a novel,effective and noninvasive predictor of homozygous α-thalassemia-1 in mid-pregnancy.Its prediction efficiency is higher than that of traditional CTR.It can improve the prenatal detection rate of homozygous α-thalassemia-1 fetus,reduce unnecessary invasive operation and save expenses.

Objective:To determine the optimal concentration of inhaled oxygen in pediatric patients undergoing laparoscopic choledochal cyst resection under general anesthesia.Methods:Seventy-five pediatric patients of both sexes, aged 1-3 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with body mass index of 15-18 kg/m 2, with expected operation time≥3 h, scheduled for elective laparoscopic choledochal cyst resection with general anesthesia, were divided into 3 groups ( n=25 each) using a random number table method: C 40 group (FiO 2=40%), C 30 group (FiO 2=30%) and C 21 group (FiO 2=21%). Blood samples were collected from the radial artery for blood gas analysis after operation for determination of oxygenation index (OI), respiratory index (RI), alveolar-arterial oxygen partial pressure difference (PA-aO 2) and arterial-alveolar oxygen partial pressure ratio (PaO 2/PAO 2). The occurrence of high risk events of hypoxia (SpO 2<94%), extubation time, and occurrence of pneumonia and atelectasis at day 7 after operation were recorded. Results:Compared with C 21 group, PaO 2, PAO 2, PA-aO 2 and RI were significantly increased, PaO 2/PAO 2 was decreased, and the incidence of high risk events of hypoxia was decreased in C 30 and C 40 groups, and the incidence of atelectasis in C 30 group and pneumonia and atelectasis in C 40 group was increased at day 7 after operation ( P<0.05). Compared with C 30 group, PaO 2, PAO 2, PA-aO 2 and RI were significantly increased, and PaO 2/PAO 2 was decreased in C 40 group ( P<0.05). Conclusions:The optimal concentration of inhaled oxygen recommended is 21%-30% in the pediatric patients undergoing laparoscopic choledochal cyst resection under general anesthesia.

Orbital fracture often leads to facial collapse, diplopia, enophthalmos, and even blindness. Traditional surgery relies on the experiences of physicians to achieve fracture reduction and orbital wall reconstruction, but the repair effect is not satisfactory. In recent years, with the development of digital technology, technologies such as computer-assisted surgery, 3D printing, surgical navigation systems, and intraoperative CT imaging have become increasingly widespread in the field of orbital reconstruction. Such techniques can avoid dependence on physicians′ experiences and make it easy for estimating and positioning the implantation sites, which subsequently contributes to better surgery efficiency and precise reconstruction of the orbit, improving aesthetics and visual function of patients. To this end, the authors reviewed the recent progress in application of digital technology for orbital fracture reconstruction, so as to provide reference and theoretical basis for clinical practice.