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 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.

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.

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 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.

Adult ; Branchio-Oto-Renal Syndrome ; diagnosis ; Child, Preschool ; Craniofacial Abnormalities ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Male

OBJECTIVE To understand the sites of nosocomial infection and its pathogenic bacteria. METHODS Infection sites and pathogens of 2134 patients with nosocomial infection were analyzed. RESULTS Totally 2235 infections were occurred. The main site was lower respiratory tract(30.47%),followed by upper respiratory tract(18.20%) and operated wound(12.17%). Among 815 strains,149 were Gram-positive bacteria,456 Gram-negative bacteria and 210 fungi. The rates of main Gram-positive cocci in lower respiratory tract,burned and operated wounds were 42.14%,20.00% and 12.86%,respectively; the rates of main Gram-negative rods in lower respiratory tract,burned wound and urinary tract was 44.14%,29.70% and 10.90%,respectively; the rates of fungi in lower respiratory tract,oral cavity and gastrointestinal tract was 41.90%,18.56% and 18.10%,respectively. CONCLUSIONS According to the main sites and pathogenic bacteria of nosocomial infection,countermeasure should be taken to prevent and control nosocomial infection.

Objective To investigate the development of auditory and speech skills and the safety and stability among the prelingually deaf children with Nurotron Venus cochlear implants.Methods A total of 78 cochlear implant subjects were recruited from the first of affiliated hospital of Zhengzhou university.They were divided into 5 groups according to the ages at the time of implantation: group A(between 13 and 24 months), group B(between 25 and 36 months),group C(between 37 and 48 months),group D(between 49 and 72 months),group E(between 73 and 96 months).Children were evaluated by IT-MAIS(group A and B) and MAIS(group C,D and E) before the surgery and 1 month,3 months,6 months, and 12 months after surgery.All children were evaluated by MUSS questionnaires 1 months, 3 months,6 months,and 12 months after surgery.Post-operative cochlear radiographs determine the position of the CIs.The complications and usage of The CIs were followed up.Results The auditory and speech ability of children with CIs improved constantly.The auditory and speech of different groups were statistically significant.All the surgeries of 78 cases Nurotron-Venus cochlear implants were successful.Post-operative cochlear radiographs showed electrodes in the normal position.2 cases had processor failures.The remaining CIs were implanted completely.Conclusion Within 1 year, the ability of auditory and speech improved gradually.The scores of auditory and speech about the small age groups are lower than older children in the early days.There is no influence on the audition in 12 months.Small children's scores of speech are lower than older children in 12 months.The better ability to integrate auditory information is , the better the ability to speak is.The Nurotron CIs work safety and effectively.

Objective To discuss the clinical characteristic of middle ear malformation with cholesteatoma.Methods From September,2011 to November,2016,23 cases of middle ear malformation with cholesteatoma were collected.Their symptoms,ENT examination,temporal bone high resolution computed tomography (HRCT) and intraoperative findings were analyzed.Results All 23 patients had hearing loss.90.0％ patients had ear discharge and tinnitus.86.96％ patients had perforation in pars flaccida of tympanic membrane.95.7％ patients had poor mastoid gasification.73.9％ patients had undeveloped or dysplastic tympanic antrum.100％ patients had destruction of the ossicular chain.56.5％ patients had malformation of the ossicular chain.52.2％ patients had exposed facial nerve.30.4％ patients had hyperplasia of the attic bone.Conclusion The symptoms and physical examinations of middle ear malformation with cholesteatoma are the same as middle ear cholesteatoma.Poor mastoid gasification can usually be detected on temporal bone HRCT.The most common malformation is dysplastic tympanic antrum,followed by malformation of the ossicular chain,exposed facial nerve and hyperplasia of the attic bone.Temporal bone HRCT can indicate the malformation and destruction quite well.