Expansive type of hepatocellular carcinoma (HCC) is a subtype of HCC. Correlation between the preoperative sonography and postoperative pathology was studied in 35 cases of HCC. According to the classification of nakashima, 21 cases belonged to the expansive type whereas the other 14 cases the infiltrative type. Different from the infiltrative type. the expansive type of HCC had four specific sonographic appearances: hypoechoic ring, hypoechcic halo, pedunculated and small nodular echo which had different pathological bases. Expansive tyje of HCC was not so commonly seen as infiltative type but its rate of surgical resection was mu~h higher than that of infiltratine type (JP< 0. 01). Thus, it is the kind of HCC with significant clinical importance. Preoperative ultrasonographic diagnosis help to decide the way of treatment.

Objective To analyze the clinical effects, as well as its advantages and disadvantages, of laparoscopic surgery for appendicitis in obese patients. Methods Clinical data of 80 obese patients receiving appendectomy, including 38 cases of open appendectomy and 42 cases of laparoscopic appendectomy, were analyzed retrospectively.The operative time, blood loss, analgesic and antibiotic use, postoperative fever, postoperative complications, length of hospital stay, and hospitalization cost were compared between the two operative methods. Results Conversions to open surgery were required in 2 patients in the laparoscopic group. There was no significant difference in operative time between the 2 groups (P >0.05).Compared with the open group, the laparoscopic group had less blood loss [(14.98 ±12.77) ml vs.(31.58 ±19.00) ml, t=-4.550, P=0.000], shorter time of postoperative antibiotic use [(2.7 ±1.0) d vs.(4.1 ±1.2) d, t=-5.470, P=0.000], less postoperative analgesics needed [5.0%(2/40) vs.26.3%(10/38),χ2 =6.802, P=0.009], less drainage [2.5% (1/40) vs.18.4% (7/38), χ2 =5.367, P=0.021], less postoperative fever [5.0%(2/40) vs.23.7%(9/38),χ2 =5.616, P=0.018], less postoperative wound healing [5.0%(2/40) vs.21.1%(8/38),χ2 =4.493, P=0.034], and shorter hospital stay [(5.9 ±3.2) d vs.(8.7 ±4.1) d, t=-3.345, P=0.001], but the higher cost of hospitalization [(7800 ±396) yuan vs.(4914 ±434) yuan, t=30.716, P=0.000]. Conclusion For obese patients with appendicitis, laparoscopic appendectomy has less surgical trauma, faster recovery, less postoperative pain, fewer complications,and shorter hospital stay, being a preferred method of treatment.

OBJECTIVETo evaluate the influence of eugenol-containing and resin-containing endodontic sealers on the bond strength of fiber posts using different strategies of root canal irrigation.

METHODSForty-eight mandibular premolars were endodontically treated. The specimens were randomly assigned into two groups according to different endodontic sealers. Group A used Endofil (eugenol-containing endodontic sealer), and group B used AH-plus (resin-containing endodontic sealer). After post space preparation, each group was randomly assigned into three subgroups according to the strategies of root canal irrigation (eight premolars in each subgroup). Group Al and B1: 0.9%NaCl irrigation; Group A2 and B2: 17% ethylene diamine tetraacetic acid (EDTA)+5.25%NaClO+0.9%NaCl irrigation; Group A3 and B3: ultrasonic agitation associated with 1 7%EDTA+5.25%NaClO+0.9%NaCl. One week after the cementation of fiber posts using RelyX™ Unicem, a push-out test was performed to measure the bond strength of the posts. The microstructure of the root canal surface was examined under scanning electron microscope (SEM).

RESULTSThe bond strengths of the six groups were as follows: Al (7.96±2.23) MPa, A2 (9.95±2.89) MPa, A3 (18.88±3.69) MPa, B1 (11.41±3.71) MPa, B2 (14.00±4.04) MPa, and B3 (19.14±3.27) MPa. Statistical analysis revealed a significant interaction between the different endodontic sealers and the strategies of root canal irrigation (P<0.05). Lower bond strength was found in group Al but not in group BI (P<0.05), and the same result was revealed when comparing group A2 and B2. No significant difference was observed between group A3 and B3 (P>0.05). SEM showed that the root canal in group A3 and B3 achieved the cleanest surface with nearly all dentine tubules opened.

CONCLUSIONThe eugenol-containing endodontic sealer can impair the bond strength of fiber posts compared with the resin-containing sealer when the root canal is irrigated by 0.9% NaCl or 17%EDTA+5.25%NaClO+0.9%NaC. No difference was observed between the two sealers when using 17%EDTA+5.25% NaCIO+0.9%NaCl combined with ultrasonic irrigation.

Bicuspid ; Cementation ; Dental Bonding ; Dental Pulp Cavity ; Dental Stress Analysis ; Dentin ; Humans ; Post and Core Technique ; Root Canal Filling Materials ; Root Canal Irrigants ; Root Canal Therapy

The etiology of rotated maxillary central incisor is unclear, but it has a clear familial tendency. Except for the environmental factors, gene expression directly influences craniofacial growth and the types of malocclusion deformity. In this article, a case of 180° rotated left maxillary central incisor of a male with family history of the deformity was reported. Relevant literature was also reviewed.
Humans ; Incisor ; Male ; Malocclusion ; diagnosis ; Maxilla

OBJECTIVETo evaluate the effect of different auxiliary resistance forms on the resistance and marginal fitness of complete crowns for short molar preparations.

METHODSA total of 70 Nissin resin teeth were prepared with 20° total occlusal convergence, 2.5 mm of occlusocervical height, and a shallow finish line on a milling machine. The milled preparations were then randomly assigned to 7 groups of 10. The first group was used as the control group. A total of 30 dies were modified by preparing interproximal grooves with angles of 0°, 6°, and 20° centered on the mesial and distal surfaces of the dies. The rest of the teeth were prepared with occlusal holes in the center of the occlusal surface milled with the same burs to form 0°, 6°, and 20° holes. Cobalt-chromium copings were fabricated for all specimens. The marginal gap of specific points on the axial surface was measured before and after cementation. The resistance of each specimen was evaluated by applying an external force at an angle of 45° to the long axis of the die by using a universal testing machine in a lingual to buccal direction. The maximum force applied before crown dislodgement was measured. Data were analyzed using the SAS 9.2 software.

RESULTSThe results showed that the 0° groove, 0° hole, and 6° hole were effective in improving the resistance of the complete crowns (P<0.05). The 0° groove, 6° groove, 0° hole, 6° hole, and 20° hole had significant difference with the control group in terms of marginal discrepancies (P<0.05).

CONCLUSIONAuxiliary resistance forms with less degree indicate greater resistance force but worse marginal fitness. In clinical practice, if the resistance of a preparation is enough, the auxiliary resistance forms should be avoided from being used.

Cementation ; Crowns ; Dental Prosthesis Design ; Dental Prosthesis Retention ; Humans ; Molar ; Tooth Crown

Objective To investigate the expression of KLF4 in cervical carcinoma and its significance. Methods Immunohistochemistry and tissue microarray were used to examine the expression of KLF4 in 39 cases of carcinoma, 30 cases of normal cervical epithelial tissues and 28 cases of cervical cancer in situ. Results Moderate to strong nuclear staining for KLF4 was found in normal tissues and cervical cancer in situ. Interestingly, KLF4 expression was lost in 16 (P<0.05) of 39 carcinoma cases. However, KLF4 expression was not associated with clinicopathologic parameters, including tumor stage and differentiation. Conclusion Our observations indicate that KLF4 may function as a tumor suppressor in the pathogenesis of cervical cancer.

Objective To investigate the effect and safety of urinary kallidinogenase on acute cerebral infarction.Methods One hundred and sixty-four patients with acute cerebral infarction were randomly divided into two groups:treatment group with urinary kallidinogenase(86 cases)and control group (78 cases).According to Chinese guidelines for prevention and management cerebrovascular disease,two groups were treated with basic therapy,such as antiplatelet,neurologic protection,blood pressure control,and so on.On basis of control group,treatment group Was administrated intravenous injection of urinary kallidinogenase 0.15 PNA U per day for 10 days.The primary efficacy Was evaluated by the National Institutes of Health Stroke Scale(NIHSS)score and Barthel index.Results The score of NIHSS and Barthel index at 15 days after treatment in the treatment group were higher than those in the control group[(6.67±3.02)scores vs(7.42±3.02)scores;75.36±23.56 vs 68.36±22.36,P＜0.05].Urinary kallidinogenase could significantly reduce neurological deficits in big artherosclerosis type by TOAST typing.Conclusion Urinary kallidinogenase may be effective and safe in the treatment of acute cerebral infarction.

Objective To study the diagnosis, therapy and prevention of bile duct carcinomas in choledochal cysts. Methods We retrospectively analysed clinico pathologic data, the ways of operation and living time of 11 patients with bile duct carcinomas in choledochal cysts in two hospitals from 1986 to 1997. Results There were complete excision of the choledochal cysts associated with choledochojejunostomy in 4 patients, exploration of bile duct and drainage with T shape tube in 3 patients. And there were also the excision of the wall of bile duct cysts and the tumor and cholangioplasty, choledochocystoduodenostomy, biopsy, pancreaticoduodenectomy and cholangiojejunostomy at the porta hepatis, resection of original rhynchostoma of choledochojejunostomy in one patient, respectively. One patient has lived for 3.6 years after radical resection. Others lived for 13.6 months after operation. Conclusions It is the key of improving and lengthening lives to find this disease in the early stage and to resect radically as early as possible.

The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort (CRBD) after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale: (1) no pain, (2) mild pain (revealed only by interviewing the patient), (3) moderate (a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation) and (4) severe discomfort (agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra). Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD (mild CRBD: 40.5%; moderate or severe CRBD: 44.0%) at day 1, while 31.9% developed CRBD (mild CRBD: 29.3%; moderate or severe CRBD: 2.6%) at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI (1.1-5.6), P<0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI (0.1-0.6), P<0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI (1.2-8.9), P<0.05] and history of catheterization [OR=0.5, 95%CI (0.2-0.9), P<0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP(B)=3.074, 95%CI (1.3-7.4), P<0.05] and the history of catheterization [EXP(B)=2.458, 95%CI (1.1-5.9), P<0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.

BACKGROUND:Streptozotocin-induced diabetic ophthalmopathy is commonly used in animal models, but the pathological changes are local that mainly emphasize on the retina. Little evidence is found about the animal models of the pathology of diabetic ophthalmopathy. OBJECTIVE:To investigate the long-term stability of type 2 diabetic melitus rat models induced by streptozotocin combined with high-fat feeding and to observe the characteristics of eye disease. METHODS: Rats were randomly divided into control group and diabetes group. Control group was given normal feeding, while diabetes group was given intraperitoneal injection of streptozotocin combined with high-fat feeding to establish diabetic models. RESULTS AND CONCLUSION:Compared with the control group, at 1 month after modeling, the fasting blood glucose levels increased, and the insulin sensitivity index decreased in the diabetic group (P < 0.05). Evans blue staining results showed that, at 3 months after modeling, retinal cel lesions exacerbated in the diabetic group; at 5 months after modeling, retinal blood vessels traveled in circuity and disorderly, accompanied by the leakage in the diabetic group, Evans blue content in the retina increased as the time after modeling went by (P < 0.05). Under transmission electron microscopy, at 5 months after modeling, the eye lenses in the diabetes group were flocculent pieces, which were the typical characteristics of cataract. Experimental findings indicate that the rat model of type 2 diabetic melitus induced by streptozotocin combined with high-fat feeding has a long-term stability, and its eye changes are consistent with the characteristics of diabetic ophthalmopathy. Therefore, it is an ideal animal model for diabetic ophthalmopathy.