106 patients with liver fibrosis, 58 men (54.72%) and 48 women (45.28%), were treated with Xinganbao. All of these cases were diagnosed as portal hypertension of advanced schistosomiasis. The drug was given in a daily dose of 2.25g (250mg/capsule) 3 times a day for a succession of 2 months.The result of our study suggests that Xinganbao therapy can relieve and/or eliminate the clinical symptoms of advanced schistosomiasis with liver function recovered, serum albumin raised, ?-globulin decreased, immune function adjusted and caliber of portal and spleen vein much diminished. The total rate of efficacy was 89.62%, of which, 14.15% (15 cases) markedly improved while 75.47% (80 cases) moderately.

Objective To compare different dose of remifentanil combined with propofol for painless abortion and approach to an appropriate dose of remifentanil.Methods Ninety pregnant women with ASA 1 were randomly divided into three groups(n=30)before administrating remifetanil,a bolus midazolam 1 mg was injected inminutes later.These two drugs did not stop administration until three minutes before the end of negative suction.MAP,HR,SpO2,BIS,RR,VT,PET CO2 were monitored.The onset,operation and recovery time,sedation score and adverse reaction were recorded.Results Sedation scores were significantly different between group A and C [(3.90±0.97)and(4.90±0.85),t=4.24,P＜0.01].Three cases in group A were found moving.MAP,HR,BIS decreased as compared witll baseline.HR reduced significantly in group C(P＜0.05,P＜0.01).Respiratory movement was lower and shallower.RR,VT decreased compared to preoperative one.PET C02 increased gradually (P＜0.05,P＜0.01).There were two cases of respiratory depressing in group A,four cases in group B and ten cases in group C(five cases apnea more than three minutes).All patients used oxygen mask to maintain SpO2＞95%.Incidence of adverse reactions such as chest titanic,nausea and vomiting,itching were of no difference among three groups(P＞0.05).All patients were satisfied with anesthesia.Conclusion The appropriate infusing dose of remifetory devices such as oxygen mask and monitoring life signs are very important to prevent respiratory depress and bradycardia during operation.

BACKGROUND: The residual root of anterior teeth are usually repaired by means of post and cores plus porcelain fused metal crown in clinic, and the retention force is mainly provided by the post because of the deletion of crown, so the retention force provided by the post is directly correlated with the long-term effect of repair.OBJECTIVE: To analyze the changes of retention of cast metal post and core restorations with different convergence angles, and investigate the influence of convergence angles on retention.DESIGN: A repeated observational measurement.SETTING: Department of Prosthodontics, West China School of Stomatology, Sichuan University.MATERIALS: The experiments were carried out in the building of high polymer material of Sichuan University in May 2005. Fifty-four simulated tooth roots were manufactured by the numerical control machine tools.They were divided into six groups according to the convergence angles of post being 0°, 3.93°, 5.71°, 7.48°, 11.31° and 14.71°, with nine specimens in each group.METHODS: ① Manufacture of the standard specimens: The tooth roots with the convergence angles of 0°,3.93°, 5.71°, 7.48°, 11.31° and 14.71° were prepared with the digital control precision machine. ② Manufacture of the cast post and cores: The post and core wax patterns of the specimens were made in the condition similar to the clinical practice. The post and cores were cast and tried in, necessary grinding was made to ensure the adoption of the posts and the specimens. Then the posts were luted to the specimens with ZPC after the posts and the simulated root canals having een cleaned by alcohol. The posts and the specimens were pressed until the ZPC solidified. ③ Retention Force test: After having been dipped in physiological saline for 24 hours, the bonded castings and specimens were subjected to a tensile testing at the drawing speed of 10 mm per minute.The retention force of post was the load recorded when the post was pulled out from the specimen. ④ Planar bonding strength test: We cut a PMMA stick into the same little cylinders and made angular milling on the flank of the cylinders. The angle between the milled bevel and the central axis of the cylinder was controlled to 0°, 1.9°, 3°, 6°, 9°, 12° and 15°. Afterwards we cut the brass into pieces. Eight wafers were cast with the same diameter of 8 mm and thickness of 1 mm. With the same procedure of bonding the posts to specimens, the brass pieces were bonded to the cylinder bevels and the wafers were adhered to the upside of some unmachinized cylinders.Immerged in physiological saline for 24 hours, their bonding force were tested at the speed of 10 mm per minute, and the load was recorded when the pieces and wafers were separated from the cylinders. ⑤ Calculation of the frictional and interlocking forces: As the post can be regarded as a frustum, the bonding surface area can be calculated with the formula calculating the flank area of frustum, and the area of the occlusal bonding surface is the sum of the annulus part of the root surface and the circular part of the post tip. Some regressions were made to the retention force, frictional strength, bonding strength per unit area, retention force per unit area and frictional force per unit area to convergence angles.MAIN OUTCOME MEASURES: ① Bonding strength of different convergence angles; ② Influence of different convergence angles on the area and bonding strength of the post; ③ Retention force and frictional force of posts with different convergence angles; ④ The results of the one-way analysis of variance (ANOVA) of bonding strength, retention force and frictional force per unit area.RESULTS: ① The bonding strength of different convergence angles: It was 0.309 0 N/mm2 for the occlusal plane, 0.128 3 N/mm2 for the axial plane with a convergence angle of 0°, 0.108 7 N/mm2 for the 1.9°axial plane, 0.107 2 N/mm2 for the 3°axial plane, 0.084 9 N/mm2 for the 6°axial plane, 0.056 7 N/mm2 for the 9°axial plane, 0.046 3 N/mm2 for the 12°axial plane, 0.027 4 N/mm2 for the 15°axial plane. ② Bonding strength and bonding area of posts with different convergence angles: The post with a 0°convergence angle had a total post area of 108.047 mm2 and bonding strength of 19.041 N; The most tapered post with 14.71°had a total post area of 90.245 mm2 and bonding strength of 5.131 N. ③ The retention force of cast post and the bonding strength of ZPC declined with the increasing of convergence angles of the post. For the parallel post (convergence angle=0°), the retention force was 321.60 N, the frictional force was 302.559 N, retention force per unit area was 2.976 N/mm2,frictional strength was 3.885 N/mm2; for the most tapered post (convergence angle=14.71°), the retention force was 9.93 N, frictional force was 54.799 N, retention force per unit area was 0.664 N/mm2, frictional force was 0.681 N/mm2. ④ A one-way ANOVA showed that there were significant differences in the bonding strength, retention force and frictional force per unit area among the groups (P ＜ 0.05).CONCLUSION: The retention force, frictional force and the bonding strength of ZPC decrease with the increasing of convergence angles of posts, so the convergence angles of posts should be reduced as much as possible to obtain greater retention.

Objective To study the sedation and amnesia of midazolam in patients with different ages of lumbar epidural anesthesia . Methods From January to July 2015, 235 patients in the first affiliated of xian jiaotong unniversity,who were implemented abdominal surgery under combined spinal epidural anesthesia and American Society of anesthesiologists (ASA) grade was I-II , were divided into three groups:young group (n=70); middle-aged group (n =82); elderly group (n =83).Intraoperative continuous monitoring of respiratory and circulatory function index,and recorded MAP,SpO2, HR before and 5, 15, 30 min after injection.ResuIts MAP, HR and SpO2 of three groups were compared with the same time points pre-and post used of midazolam, there was no significant difference among indicators.; Compared with the same group at different time points, MAP(FYG =9.2547,FMG =12.8181,FOG =17.77)和 SpO2 (FYG =190.3835,FMG =196.2393,FOG =270.5609),there were significant difference.The difference was not statistically significant between HR group and the same group at different time points and forgetting degree and sedation score , but compared with OG,there were significant difference(P<0.05).The total number of adverse reactions in YG group and MG group was less than that of OG group(X2 =11.2516,X2 =10.4491, P<0.05).ConcIusion The effect of the same dose of midazolam on sedation and amnesia in patients with different ages of lumbar epidural anesthesia is different, and the degree of the effect of the elderly patients is significant,but will produce more adverse reactions.Therefore, in the combined spinal epidural anesthesia,it is necessary to consider the patient's individual differences, rational use of sedative and narcotic drugs.

Objective: To evaluate the clinical application of MBT straight wire. Methods: 41 cases, 11 males and 30 famales aged 12-42 years old, with malocclusion were treated by MBT straight wire appliance in orthodontic clinics, follow-up was carried out. Results: Satisfactory effects were obtained in 11 completely treated cases, preliminary improvement of occlusion was observed in the other 30 cases being still in the treatment. Conclusion: MBT straight wire appliances may be used in the treatment of various malocclusion, but special consideration should be taken according to the type of occlusion in each case.

OBJECTIVETo Investigate the changes in dentition at each treatment stage and to get some guidelines for clinical work.

METHODSThirty-one cephalometric films of skeletal class III malocclusion patients were analyzed. All the patients were treated by orthodontic and orthognathic surgery.

RESULTSDuring presurgical orthodontic treatment, the lower Incisors were decompensated (labially Proclined by 7 degrees ). The upper incisors were uprighted during surgery following rotation of maxilla. After surgery, the upper anterior teeth kept tipping for ward. While the lower anterior teeth were In stable. The dentition was in good occlusion during observing stage.

CONCLUSIONSLingually tipped lower Incisors were decompensated after presurgical orthodontic treatment in class III malocclusion patients, and lower Incisors kept in stable during observing stage, while the upper incisor had a little bit relapse.

Adolescent ; Adult ; Dentition ; Female ; Humans ; Male ; Malocclusion, Angle Class III ; pathology ; surgery ; Odontometry ; methods ; Orthodontics, Corrective ; methods ; Time Factors ; Treatment Outcome

Objective:To construct a prediction model of psychological distress risk in young and middle-aged patients with gynecologic malignancy based on random forest algorithm and validate its prediction effect, which provided a tool for healthcare professionals to detect patients′ psychological distress in early stage.Methods:This was a cross-sectional study, a total of 385 cases of young and middle-aged patients with gynecologic malignancies admitted to the gynecology and oncology departments of six tertiary hospitals in Tianjin from October 2021 to October 2022 were consecutively included, the study subjects were randomly divided into 270 cases in the training set and 115 cases in the testing set according to 7:3 by R-studio software. After grouping the training set patients according to the presence or absence of psychological distress (positive psychological distress 151 cases and negative psychological distress 119 cases), univariate analysis was performed on each influencing factor. A random forest model for the prediction of psychological distress in young and middle-aged gynecological malignancy patients using R-studio software on the training set, and the prediction effect was verified on the testing set.Results:The prediction accuracy was 94.78%, sensitivity was 96.88%, specificity was 92.16%, positive predictive value was 93.94%, negative predictive value was 95.92%, and AUC was 0.992 (95% CI 0.982-1.000). The top 5 significant predictor variables were ranked according to the average decrease in the Gini coefficient of each influencing factor in the random forest model: General Self-Efficacy Scale score, Herth Hope Index score, Perceived Social Support Scale score, Self-Rating Depression Scale score, Self-Rating Anxiety Scale score. Conclusions:In this study, the prediction model of psychological distress in young and middle-aged patients with gynecologic malignancy constructed by random forest algorithm has high predictive efficacy, which provides reference for healthcare professionals to identify patients′ psychological distress early and formulate interventions.

Quality control of biotech drugs has attracted increasing attentions in recent years. Deamidation reaction is one of the major concerns in quality control of biotech drugs, due to the generation of isoaspartic acid(isoAsp) . This paper describes the deamidation of asparagine(Asn) residues and its effects on the biological drugs. The detection methods currently used in China and overeas for this reaction, including pretreatment protocols and instrumental analysis were described. The identification and determination of isoaspartyl sites were also described in detail, along with the positive impact on the development of biotech drugs in China by the studies on deamidation reactions.

Objective:To explore the risk stratification value of HEART score combined with cardiac troponin (cTn) in emergency patients with chest pain.Methods:A total of 11 583 patients with chest pain who visited the Emergency Department of Zhongshan Hospital Affiliated to Fudan University from January to December 2019 were retrospectively collected. Patients who unfinished 0 h high-sensitivity cardiac troponin T (hs-cTnT) or electrocardiogram diagnosed ST-segment elevation myocardial infarction (STEMI) or lost to follow-up were excluded, and 7 057 patients were finally included. The final diagnosis of chest pain and the occurrence of major adverse cardiovascular events within 6 mon (6 m MACEs) were followed up by telephone and medical history. The HEART score of each patient was calculated by two attending physicians, and the patients were divided into the low-risk group (0-3 points), intermediate-risk group (4-6 points) and high-risk group (7-10 points) according to the final score. The risk stratification performance and safety of HEART score were observed and analyzed. A total of 1 884 patients who completed serial hs-cTnT tests were divided into groups according to HEART score (≤3 as low-risk group) and HEART score combined with serial hs-cTnT pathway (HEART score ≤3 and two hs-cTnT measurements <0.03 ng/mL as the low-risk group). The sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) of each diagnostic method were calculated to compare the diagnostic performance of the two predictive values.Results:The patients were divided into 3 groups by HEART score : 2 765 (39.2%) patients in the low-risk group, 3 438 (48.7%) in the intermediate-risk group, and 854 (12.1%) in the high-risk group. The incidence of 6 m MACEs in each group was 1.2%, 18% and 55.3%, respectively. When the low-risk threshold was 2, 23.1% of patients entered the low-risk group and the incidence of 6 m MACEs was 0.9%. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive performance of the HEART score for 6 m MACEs, and the final AUC was 0.831 ( P=0.006, 95% CI: 0.819-0.843). Regarding the occurrence of NSTEMI at the time of this visit, 4 (0.8%) patients were misdiagnosed by using the HEART score alone. Combined with serial troponin detection, the diagnostic SE and NPV were both 100%; at the same time, the diagnostic SE and NPV of 6 m MACEs in patients increased from 98.1% (95% CI: 96.9%-99.1%), 97.9% (95% CI: 96.2%-99%) to 99.1% (95% CI: 97.9%-99.7%) and 98.9% (95% CI: 97.4%-99.6%), the diagnosis SE and NPV of 6 m myocardial infarction and cardiac death in patients increased from 98% (95% CI: 96%-99.2%), 98.6% (95% CI: 97%-99.4%) to 99.2% (95% CI: 97.6%-99.8%) and 99.3% (95% CI: 98.1%-99.9%). Conclusions:The HEART score can be used for risk assessment in emergency patients with chest pain, and a threshold of 2 is recommended for the low-risk group. The diagnostic performance of HEART score combined with serial cTn is better than that of HEART score alone.

Objective:To investigate the clinical characteristics of patients with acute aortic dissection (AAD) through a retrospective and observational study, and to construct an early warning model of AAD that could be used in the emergency room.Methods:The data of 11 583 patients in the Emergency Chest Pain Center from January to December 2019 were retrospectively collected from the Chest Pain Database of Zhongshan Hospital Affiliated to Fudan University. Inclusion criteria: patients with chest pain who attended the Emergency Chest Pain Center between January and December 2019. Exclusion criteria were 1) younger than 18 years, 2) no chest/back pain, 3) patients with incomplete clinical information, and 4) patients with a previous definite diagnosis of aortic dissection who had or had not undergone surgery. The clinical data of 9668 patients with acute chest/back pain were finally collected, excluding 53 patients with previous definite diagnosis of AAD and/or without surgical aortic dissection. A total of 9 615 patients were enrolled as the modeling cohort for early diagnosis of AAD. The patients were divided into the AAD group and non-AAD group according to whether AAD was diagnosed. Risk factors were screened by univariate and multivariate logistic regression, the best fitting model was selected for inclusion in the study, and the early warning model was constructed and visualized based on the nomogram function in R software. The model performance was evaluated by accuracy, specificity, sensitivity, positive likelihood ratio and negative likelihood ratio. The model was validated by a validation cohort of 4808 patients who met the inclusion/exclusion criteria from January 2020 to June 2020 in the Emergency Chest Pain Center of the hospital. The effect of early diagnosis and early warning model was evaluated by calibration curve.Results:After multivariate analysis, the risk factors for AAD were male sex ( OR=0.241, P<0.001), cutting/tear-like pain ( OR=38.309, P<0.001), hypertension ( OR=1.943, P=0.007), high-risk medical history ( OR=12.773, P<0.001), high-risk signs ( OR=7.383, P=0.007), and the first D-dimer value ( OR=1.165, P<0.001), Protective factors include diabetes( OR=0.329, P=0.027) and coronary heart disease ( OR=0.121, P<0.001). The area under the ROC curve (AUC) of the early diagnosis and warning model constructed by combining the risk factors was 0.939(95 CI:0.909-0.969). Preliminary validation results showed that the AUC of the early diagnosis and warning model was 0.910(95 CI:0.870-0.949). Conclusions:Sex, cutting/tear-like pain, hypertension, high-risk medical history, high-risk signs, and first D-dimer value are independent risk factors for early diagnosis of AAD. The model constructed by these risk factors has a good effect on the early diagnosis and warning of AAD, which is helpful for the early clinical identification of AAD patients.