Objective To construct a temporomandibular joint (TMJ) model including mandible by means of three-dimensional finite element methods and to investigate the stress distribution of the condyle during clenching of edentulous jaw with complete denture.Methods The three-dimensional model (3-DFEM) of TMJ including mandible of edentulous jaw patient was constructed by helix-CT scanned transverse sections.The stress distribution of the condyle was analyzed under load.Results The three-dimensional finite element model of TMJ including mandible of edentulous jaw was established,then loaded and calculated on the corresponding situs of posterior tooth of the model.Analytic results showed the stress on the neck of condyle obviously surpassed that on the top of condyle.The stress decreased from external to interior on anterior and posterior incline,and decreased from anterior to posterior on interior and external incline of the condyle.Compressive stress was dominant in the anterior incline and upper 12 of lateral part (near the top of the condyle),and tensile stress was dominant in the inferior 12 (near the neck),so the lateral inferior part was featured by high stress distribution.In the posterior and interior part,tensile stress occupied the upper 12 and compressive stress was main in inferior 12.Conclusion The edentulous jaw of patients had the compressive stress and tensile stress simultaneously on the whole condyle.But the stress is different in level and feature of distribution.The external anterior incline is featured by the highest stress distribution,and it is consistent with the feature of the TMJ of healthy people.

Objective To assess the adequacy of decompression immediately in anterior cervical surgical procedures with epidurography, and to prevent from leaving compressive materials. Methods After completing primary decompression of anterior cervical intervertebral space by discectomy or corpectomy, posterior longitudinal ligaments were incised or resected, 5-10 ml Omnipaque 300 contrast medium was injected into upper and lower segments of decompressed area through a soft 18# injection needle. Distribution of the contrast medium in front of dura mater was observed by fluoroscopy so as to identify whether the spinal cords were decompressed completely. 64 patients suffered from cervical spondylotic myelopathy, and spinal cords were compressed respectively by giant intervertebral disc prolapse, osteophyte or short segmental OPLL. Intraoperative epidurography was performed after primary anterior decompression. If contrast medium in front of dura mater was discontinued by fluoroscopy, incomplete decompression was judged. 39 of 64 patients were followed up after operation, and in 18 patients of them MRI were taken within 1-12 weeks after operation. Neurological function was compared between preoperation, immediate postoperation and final follow-up by means of JOA scores. Results After completing primary decompression, epidurographs showed that the contrast medium were continuous in front of dura mater in 49 cases(77%), 11 patients of them were examined by MRI during follow-up and the images indicated that cervical cords were free of compression. In 15 cases (23%), the contrast medium was not continuous in front of dura mater, then decompression was performed further until the contrast medium no any interruption. 7 patients of them were confirmed by MRI that cervical cords were no more compressed. 39 patients were followed up postoperatively with a mean follow-up of 13 months. Neurological function was recovered immediately after operation by 52% and 61% at final follow-up. No neurological deficit progressed in all of them. Conclusion Intraoperative epidurography is effective and safe for assessment of decompression during anterior cervical surgical procedures.

Objective:To observe and analyze the pathogenic gene types and clinical phenotypes of Leber congenital amaurosis (LCA).Methods:A retrospective clinical study. Six patients with LCA confirmed by genetic testing and 18 family members were included in the study. The patients came from six unrelated families. The family was investigated with a specific hereditary eye disease enrichment panel which contained 463 known pathogenic genes and based on targeted exome capture technology first to indentify the potential pathogenic genes and mutations. Then the TULP1 , RPGRIP1 , GUCY2D pathogenic mutations were conformed by Sanger sequencing. The pathogenicity of the gene variation was searched through relevant databases and PubMed literature, and its function was explained by protein prediction software. Results:Of the 6 patients, 3 were males and 3 were females; the age was from 3 to 33 years. Nystagmus, finger pressing eyes, photophobia, and night blindness were seen in 5 cases; electroretinogram showed 3 cases of extinction or near extinction; and 4 cases of retinopathy. The results showed patients with compound heterozygous mutation of c.1318C> T and c.1142T> G, homozygous mutation ofc.1318C> T and compound heterozygous mutation of c.1153G> A and c.1561C> T of TULP1 in Family 1, Family 2 and Family 5, respectively. There were compound heterozygous mutations of RPGRIP1 c.391delG and c.1468-2A> G in Family 3 and c.715delA and c.1765C> T in Family 6, respectively. Homozygous mutation of c.3177_3178delAC of GUCY2D was found in Family 4.The parents of all six patients were carriers of corresponding heterozygous mutations. TULP1 gene c.1142T> G, RPGRIP1 gene c.391delG, c.715delA and c.1765C> T and GUCY2D gene c.3177_3178delAC mutations were novel mutations and unreported. The 381th amino acid locus of product protein of TULP1 gene was highly conserved among species. The protein prediction software predicted that the mutation pathogenic. The c.391delG, c.715delA and c.1765C> T mutations of RPGRIP1 gene and c.3177_3178delAC mutation of GUCY2D gene can lead to early translation termination of their product proteins, which are pathogenic variants. Conclusion:The pathogenic mutations of TULP1, RPGRIP1 and GUCY2D genes led to LCA 15, LCA 6 and LCA 1 in six families.

Objective To investigate short-term effect of percutaneous discectomy combined with radiofrequency ablation with Disc-FXon contained lumbar disc herniation. Methods 36 patients were reviewed and followed up with Japanese Orthopaedic Association score(JOA score), the Visual Analogue Score (VAS) and Oswestry score for 12 months. Results The scores of JOA score, VAS and Oswestry improvedsignificantly (P<0.01) after operation. Conclusion Percutaneous discectomy combined with radiofrequency ablation with Disc-FXis effective on contained lumbar disc herniation.

ObjectiveTo investigate the relationship between the degenerative mechanisms of lumbar intervertebral disc (LID) and apoptosis.MethodsThe total RNAs were isolated from human LID tissues. Both the mRNAs from the degeneration and normal LID were reversely transcribed to the cDNAs. The cDNAs were labeled with the incorporations of fluorescent dUTP, for preparing the hybridization probes. The mixed probes were then hybridized to the cDNA microarray. After high-stringent washing, the cDNA microarray was scanned for the fluorescent signals and analyzed by computer image analysis. The apoptotic status and the expression of Bcl-2 and Bax in 12 cases of degenerative LID and 10 cases of normal LID were detected with TdT-mediated dUTP-biotin nick end labeling (TUNEL) and immunohistochemistry methods.ResultsAmong the 4096 targets, there were 10 genes related to apoptosis. The expression related to Bax protein gene was up-regulated and it was down-regulated for Bcl-2 protein. In group of normal LID, the average apoptotic index (AI) was (24.897±3.620); percentage of Bcl-2 positive cells was (31.440±4.150)%; percentage of Bax positive cells was (29.372±2.588)%, average optical density (OD) values of positive particles were (0.183± 0.010 ), ( 0.203 ±0.012) and (0.169±0.005) respectively. In group of degenerative LID, the average AI was (49.232±3.440); percentage of Bcl-2 positive cells was (18.239±2.470)%; percentage of Bax positive cells was (52.349±3.764)%; average OD values of positive particles were (0.152±0.003), (0.310±0.008) and (0.262±0.014) respectively. There were significantly differences in AI and expressions of Bcl-2 and Bax proteins between normal LID and degenerative LID (P<0.05).ConclusionCell apoptosis plays an important role in the process of LID degeneration. Both Bcl-2 and Bax take part in the occurrence and progression of LID.

Objective To understand the compliance of highly active anti-retroviral therapy (HAART) and influencing factors in people living with HIV/AIDS (PLWHA) in Nanjing. Methods PLWHA receiving HAART in No. 2 Hospital of Nanjing during May-June 2014 were recruited in this study. Self-administrated questionnaire was used to collect the data about HAART compliance and socio-demographic characteristics of PLWHA surveyed. Descriptive and multivariate statistical analysis were conducted to examine the effects of the factors on self-reported HAART adherence. Results A total of 276 PLWHA were surveyed,According to the evaluation criterion of Center for Adherence Support Evaluation (CASE),252 cases showed good compliance (91.3%). logistic regression analysis revealed that smoking,progress of the disease and side effects,reminding of taking drug and age were correlated with self-reported HAART adherence. Conclusion It is suggested to strengthen the education about antiviral therapy compliance in PLWHA with mild infection and those who are smokers and young,suffer from side effects,have no reminding methods for taking drug.

OBJECTIVETo understand the economic burden caused by antiretroviral treatment for people living with HIV/AIDS and influencing factors in Nanjing.

METHODSPeople living with HIV/AIDS were divided into two groups, HIV infected patients and AIDS patients. The data about their direct medical expenditure, direct non-medical expenditure and indirect economic loss in the past year were collected. Univariate and multivariate analysis were conducted to identify the potential influencing factors.

RESULTSThe median of direct medical expenditure and total costs for 133 HIV infected patients were 1,200 yuan RMB and 1,972 yuan RMB respectively. The median of direct medical expenditure and total costs for 145 AIDS patients were 1 060 yuan RMB and 2 826 yuan RMB respectively. The differences in direct medical expenditure and total costs between HIV infected patients and AIDS patients showed no statistical significance. The results from univariate analysis indicated that the sample source influenced total costs significantly. Multivariate analysis showed that onset time and CD level were negatively correlated with direct medical expenditure. The patients infected through heterosexual contact had more direct medical expenditure than those infected through homosexual contact. The patients receiving HIV test in hospitals had more direct medical expenditure than those receiving volunteer counseling and testing.

CONCLUSIONFurther efforts should be made to expand HIV testing and treatment coverage in order to detect HIV infections as early as possible. Early antiretroviral treatment should be given to HIV infected patients to maintain their immunity and reduce their medical expenditure.

Acquired Immunodeficiency Syndrome ; drug therapy ; economics ; Anti-Retroviral Agents ; economics ; therapeutic use ; China ; Cost of Illness ; Counseling ; HIV Infections ; drug therapy ; economics ; Health Expenditures ; statistics & numerical data ; Heterosexuality ; Humans ; Mass Screening ; Voluntary Programs

OBJECTIVETo understand the compliance of highly active anti-retroviral therapy (HAART) and influencing factors in people living with HIV/AIDS (PLWHA) in Nanjing.

METHODSPLWHA receiving HAART in No. 2 Hospital of Nanjing during May-June 2014 were recruited in this study. Self-administrated questionnaire was used to collect the data about HAART compliance and socio-demographic characteristics of PLWHA surveyed. Descriptive and multivariate statistical analysis were conducted to examine the effects of the factors on self-reported HAART adherence.

RESULTSA total of 276 PLWHA were surveyed, According to the evaluation criterion of Center for Adherence Support Evaluation (CASE), 252 cases showed good compliance (91.3%). logistic regression analysis revealed that smoking, progress of the disease and side effects, reminding of taking drug and age were correlated with self-reported HAART adherence.

CONCLUSIONIt is suggested to strengthen the education about antiviral therapy compliance in PLWHA with mild infection and those who are smokers and young, suffer from side effects, have no reminding methods for taking drug.

Acquired Immunodeficiency Syndrome ; drug therapy ; Age Factors ; Antiretroviral Therapy, Highly Active ; Antiviral Agents ; adverse effects ; therapeutic use ; China ; Disease Progression ; HIV Infections ; drug therapy ; Humans ; Medication Adherence ; statistics & numerical data ; Reminder Systems ; Smoking ; Surveys and Questionnaires