Mandibular molar loss, which is in a high ratio, is found accompanying with alveolar bone resorption frequently while being restored in clinic. Therefore, due to the existence of mandibular neural canal, the success ratio of implant denture in this area can be directly affected by the height reduction of alveolar bone. In clinic, there are some achievements obtained to improve the survival rate of implant denture, such as increasing the implant support area, enhancing alveolar bone height through surgery, optimizing the design of the superior part of implant. This article summarizes the research progress on the mandibular molar implant denture with alveolar bone absorbed and aims to search a selective design of mandibular molar implant denture under the high absorption of alveolar bone.

OBJECTIVE: To investigate the clinical features and operation treatment of the congenital middle ear cholesteatoma. METHOD: A retrospective review of clinical and surgical records of 10 patients with congenital middle ear cholesteatoma were performed. All patients were treated by surgeries,5 of 10 cases deal with one-stage tympanoplasty after drum exploration by external auditory meatus, 3 cases dealed with closed mastoidotympanectomy and tympanomastoidectomy, 2 cases dealed with open mastoidotympanectomy and tympanomastoidectomy. RESULT: The cholesteatomas were located at or around the posterior tympanum or mesotympanum in 5 patients, confined to the tympanic cavity and attic in 3 patients, advanced cholesteatoma that extended from the tympanic cavity into the mastoid antrum was seen in 2 patients. The mean postoperative PTA was 30 dB HL, the mean ABG was within 20 dB, after six months. No residual or recurrence of cholesteatoma was found. CONCLUSION The congenital cholesteatoma often originates from the posterior or anterior of the middle ear, with hiding lesion, thus result in severe conductive hearing loss. Imaging examination plays an important role in diagnosing and treating of congenital cholesteatoma. Early stage surgical treatment can obtain a good hearing reconstruction effect.
Adolescent ; Adult ; Child ; Child, Preschool ; Cholesteatoma ; congenital ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Tympanoplasty ; methods ; Young Adult

Objective To investigate the protective effects of insulin like growth factor 1(IGF-1) on cortical neurons under condition of hypoxia and the possible mechanism. Methods Cerebral cortical neurons from newborn rats were cultured under the condition of oxygen and glucose deprivation (OGD) . On day 7, neurons were treated with IGF-1 or IGF-1 plus LY294002 or PD98059 under condition of OGD or normal condition. MTT assay was used to analyze the viability of neurons in each group. The expression of total Akt and p-Akt were analyzed by Western blot. Results Compared with the control, the neuron viability was significantly higher in IGF-1 treated group under normal or OGD condition (P＜0.05). The protective effects of IGF-1 were attenuated in the presence of LY294002 but not PD98059. The result of Western blot showed IGF-1 upregulated the expression of p-Akt, which was inhibited by LY294002. Conclusion PI3K pathway may play an important role in neuroprotection afforded by IGF-1.

OBJECTIVE To explore the precaution against nosocomial fungal infections of lower respiratory tract(NFILRT).METHODS A retrospective analysis on eighty-seven cases who catched NFILRT during the years 2002 to 2004 was done.RESULTS 80.46% Cases were over 60 and the average age was 67.95 and the average in-hospital days were 46.95;most of the NFILRT patients had serious underlying diseases.Before the NFILRT,immunosuppressive agents had been injected to 47.13% cases and 42.53% patients had taken anti-acid medicine;94.25% cases had received antimicrobial agents and the average days of using antimicrobial agents were 11.01 days,and among these patients 62.20% had received more than two kinds of antimicrobial agents.About 32.18% of the NFILRT cases were associated with tracheal intubation,incision of trachea and mechanical ventilation;some patients had no clinical symptoms referred to the respiratory tract;the mortality rate was 26.44% and it couldn′t be obviously cut down by using antifungal agents.CONCLUSIONS It is very important to prevent NFILRT by using antimicrobial agents reasonably and enhancing immunity in these patients.

0.05);the main infection site was lower respiratory tract(61.97%),followed by surgical site infection(SSI)(23.94%).CONCLUSIONS In order to reduce postoperation nosocomial infection rate,we should take following measures:Improve pulmonary function,remove tracheal intubation as early as possible,shorten lasting time of surgery and days before operation,keep aseptic technique,strengthen nursing,enhance immunity,and use antimicrobial agents reasonably.

OBJECTIVE To investigate the surgical site infection(SSI)in clean surgical sites and the perioperative antibiotic usage.METHODS The incidence of SSI and the antibiotics usages in 842 cases during perioperative were analyzed retrospectively in 32 hospitals.RESULTS One case with nosocomial infection was found(0.12%).The use rate of antibiotics was 98.57%.Among 802 cases using prophylactic antibiotics,the antibiotics were given in 181 cases thirty minutes to two hours before operation.136 cases were given 24 h before operation.And 485 cases were given after operation;195 cases stopped using antibiotics after 24 h,472 cases stopped using antibiotics after 4-6 days and 135 cases stopped to use antibiotics after 7 days.CONCLUSIONS The major problem is excessive use of antibiotic in clean surgical site during perioperation,long duration of antibiotics prophylaxis,more expensive antibiotics and unnecessary combination of antibiotics,suggesting that it be important to strengthen the management of antibiotics.

To investigate the relationship between single-nucleotide polymorphisms (SNPs) of interleukin-10 (IL-10) and syndrome types of traditional Chinese medicine (TCM) in posthepatitis B cirrhosis.

Objective To investigate the expression level of antisense non-coding RNA in the INK4 locus (ANRIL) in hepatocellular carcinoma (HCC) tissues and to evaluate its relation to clinicopathological features and prognosis of HCC.Methods Quantitative real-time polymerase chain reaction (qRT-PCR) method was used to detect the expression of ANRIL in HCC tissues and adiacent tissues (n =90) and to analyze its relationship with clinicopathological data.Kaplan-Meier curves and multivariate Cox proportional models were used to study the impact on clinical outcome.Small interfering RNA (siRNA) was used to silence ANRIL and to explore the effects of reduced ANRIL expression on cell growth and metastasis.Results ANRIL expression in HCC tissues was significantly higher than in the adjacent non-tumor tissues (t =13.083,P ＜ 0.05).The expression of ANRIL was remarkably associated with the histologic grade (x2 =40.724,P ＜ 0.05) and TNM stage (x2 =43.245,P ＜ 0.05).The mean survival time of the patients with high ANRIL was 18.2 months (95％ CI:14.9-21.5 months),shorter than 39.4 months (95％ CI:35.5-43.4 months) in low expression (x2 =47.590,P ＜0.05).Multivariate analysis suggested that high ANRIL expression was an independent predictor of poor prognosis (HR =2.143,95％ CI:1.083-4.243,P ＜ 0.05).Decreased expression of ANRIL could suppress the cell proliferation,migration and invasion of HCC cells.Conclusion Positive ANRIL expression is negatively correlated with the prognosis of HCC patients.

Objective To explore the surgical method and effects of posterior expansive open-door laminoplasty extended to C1,2 levels.Methods 16 cervical spinal stenosis patients with cervical myelopathy were posterior cervical surgery in our hospital from February 2013 to September 2015,including 11 males and 5 females;aged 51-76,average 62.8.4 cases merged C1spinal stenosis,the line which operated by C1～7 spinal posterior open-door expansion of the forming with mini titanium fixation;12 cases merged C2 spinal stenosis,which had the operation of C2～7 posterior open-door laminoplasty with Micro Titanium fixation plate.According to the patient imaging data to assess the stability of the cervical spine,and spinal cord compression fixation position before and after their surgery evaluated;the preoperative and postoperative pain using visual analog scale (VAS);application Japanese Orthopaedic Association (JOA) score spinal cord score was used to evaluated spinal cord function,and calculates the rate of improvement of neurological function;surgery patients before and after application Frankel grading was used to evaluate neurological function.Results All patients were followed up,for an average of 11.58 months (2-33 months).16 patients showed no loosening,fracture fixation and related complications,C1,2 showed no instability;cerebrospinal fluid surrounding the spinal cord with in the C1-7 range of the signal on MRI T2WI showed continuous recovery;preoperative VAS score was 6.7 points,postoperative VAS score was 1.8 points;the first 16 cases of patients with preoperative JOA score average (8.3± 1.6) points,postoperative JOA score was (14.6±1.4) points,postoperative neurological improvement rate was 91.6％;Frankel grade C before operation and grade E in postoperation;postoperative follow-up neurological improvement rate excellent 7 cases,good 7 cases,general 2 cases.Conclusion Treatment of cervical spinal stenosis combined with cervical myelopathy may use a C 1-7 posterior spinal expand within the single door molding fixation with mini titanium plate,which can release the compression of the cervical spinal cord nerve and reconstruct a stable structure of posterior of cervical spine.

Objective:To study the anatomical correlation between dental arch and the volume of upper airway in patients with obstruc-tive sleep apnea hypoventilation syndrome(OSAHS). Methods: Dental arch architecture and upper airway volume were measured by cone beam CT(CBCT) in the subjects with OSAHS(n=22) and without OSAHS(n=19). The correlation between dental arch and the supper airway volume in OSAHS patients was analyzed. Results:The length of the upper dental arch and the height of palate in OSAHS patients were larger than those of the controls(All, P<0. 05). Cross-sectional area of nasopharynx and retropalatal and the total volume of upper airway were negatively correlated with the palatal height and upper dental arch length(P<0. 05), while positively correlated with upper dental arch of molar regions(P<0. 05). Conclusion:The abnormal shape of upper dental arch is related to the airway vol-ume of nasopharynx and retropalatal region in patients with OSAHS.