Objective:To presents a new way of constructing post crowns for the anterior maxillary teeth which had the subginginval crown fracture more than 3 mm.To discusse the difficulties in the restoration of the subgingival residual roots and residual crowns of anterior maxillary teeth,and to explore the principles of the new restoration by the casting post-core and the porcelain fused mental crowns with wings. Methods: 23 patients(26 teeth) which had crown fracture more than 3 mm under the gingival were enrolled in this study.After those residual roots and crowns were endodontically treated following the conventional root canal therapy,the casting post-core and the porcelain fused mental crowns with wings were applied to reconstructing those missing crowns. Results: After 3 months to 5 years clinic observation,restored crowns were still stable with good retention and fracture resistance. Conclusion: Those residual roots and crowns can be preserved by this innovative way and can also acquire satisfactory effects in esthetics and functions.

Objective:To evaluate the efficacy of occlusal rehabilitation in old patients with decreased vertical dimensions caused by serious attrition.Methods:Sixty-five patients with decreased vertical dimension caused by serious attrition were divided into 3 groups according to the defect of dentition and/or TMD.Group A included 42 patients with serious attrition and defection of dentition.Group B had 15 patients with heavy tooth wear,defection of dentition and TMD.Group C included 8 patients with serious attrition and functional TMD.All patients were conducted occlusal rehabilitation at increased vertical dimensions in normal intercuspital position(ICP) by removable denture with occlusal pad and removable occlusal splints.The time of follow-up visit of these patients ranged from 1.5 months to 9 years. Results:The masticatory efficacy of the patients was obviously improved,and all the symptoms of TMD were relieved.Furthermore,the symptoms of TMD were not observed after the treatment in patients without TMD.Conclusion:The results achieved by removable occlusal rehabilitation to aged people with serious attrition and decreased vertical dimension are satisfactory,and suggest that the occlusal rehabilitation is necessary for them.Furthermore,the removable occlusal rehabilitation can be acted as a reference and transition to permanent fixed occlusal rehabilitation.

Service quality in the outpatient department reflects the overall capacity of a hospital.It has become the focus of hospital administrators' attention how to improve service quality by following the patients-centered policy,renewing service ideas and innovating the service mode in order to satisfy patients' needs to the best extent.The authors aim to summarize the experience in and explore the effective ways of improving service quality in the outpatient department.

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Objective To explore the effect of different concentrations of ALLN on proliferation and apoptosis of C2C12 myoblasts.Methods After intervention with Ca2+ and ALLN,methyl thiazolyl tetrazolium and flow cytometry were used to determine the effect of Ca2+ and ALLN on the proliferation and apoptosis of C2C12 cells,respectively.The morphological changes of C2C12 myoblasts were observed using Giemsa staining.Results The absorbance of Ca2 + group was significantly lower than that of the control group (P ＜0.05).After 6,12,24,36 hours of intervention,the absorbance in ALLN groups 1 to 7 (cultured in serum-free media containing 16 mmol/L Ca2+ and ALLN at final concentrations of 3.125,6.25,12.5,25,50,100,200 μmol/L) were all significantly higher than that in the 16 mmol/L Ca2+ group (after 6 hours:0.449±0.024,0.472±0.022,0.513 ±0.008,0.540±0.014,0.588±0.016,0.607±0.030,0.700±0.020 vs.0.355 ±0.012,all P =0.000; after 12 hours:0.407 ±0.007,0.414 ±0.006,0.434 ±0.004,0.441 ±0.003,0.460 ±0.010,0.484 ± 0.006,0.525 ± 0.006 vs.0.368 ± 0.027,all P =0.000; after 24 hours:0.436±0.005,0.431 ±0.015,0.441 ±0.006,0.459 ±0.013,0.527 ±0.009,0.581 ±0.005,0.599 ±0.011 vs.0.386 ± 0.007,all P =0.000 ; after 36 hours:0.464 ± 0.022,0.460 ± 0.018,0.461 ± 0.007,0.434 ± 0.020,0.454 ± 0.028,0.479 ± 0.006,0.524 ± 0.011 vs.0.379 ± 0.011,all P =0.000),while no significant differences were observed after 48-72 hours of intervention.After treatment for 36 hours,the apoptosis rate in ALLN 10,50,100,and 200 μmol/L groups were (6.00 ± 1.20) ％,(5.02 ± 1.13) ％,(4.89±1.11)％,and (2.71 ± 1.15)％,all significantly lower than that in the Ca2+ group [(13.70 ±2.30)％] (all P =0.000).Giemsa staining showed apoptotic morphological changes in the Ca2+ group,which were obviously alleviated in the ALLN group.Conclusions Ca2+ at a concentration of 16mmol/L can induce apoptosis of C2C12 cells.In contrast,ALLN can inhibit cell apoptosis and promote proliferation in a time-and dose-dependent manner.

BACKGROUND:Nano-calcium titanate, prepared with different modifiers, have properties of good osteogenesis, bone conductibility and biocompatibility.
OBJECTIVE:To observe the influence of nano-calcium titanate materials on the proliferation and differentiation of osteoblasts.
METHODS:Nano-calcium titanate was prepared with modifiers such as polyethylene glycol, acetyl trim ethyl ammonium bromide and sodium citrate. Meanwhile, nano-calcium titanate without modifier was prepared. Al the four kinds of nano-calcium titanate materials were used to prepare nano-calcium titanate extracts under the concentration of 0.1, 1.0, 10 g/L, respectively. The proliferation of osteoblasts was observed through 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and alkaline phosphatase activity of osteoblasts was observed. Osteoblasts cultured in normal condition served as contrast.
RESULTS AND CONCLUSION:The proliferation of osteoblasts cultured in the calcium titanate extracts prepared with polyethylene glycol, acetyl trim ethyl ammonium bromide and sodium citrate and without modifier was obviously improved under the concentration of 1.0 and 10 g/L. Absorbance value of the cells cultured in the above-mentioned four kinds of calcium titanate extracts 1.0 and 10 g/L) for 3, 6, 9 days exceeded the contrast (P<0.05, P<0.01), as wel as the alkaline phosphatase activity (P<0.05, P<0.01). Calcium titanate prepared with polyethylene glycol, acetyl trim ethyl ammonium bromide and sodium citrate and without modifier has no cytotoxicity effect on osteoblasts, and can promote the proliferation and differentiation of osteoblasts.

Objective To investigate the underlying neural mechanism of left hemiparalexia and left hemialexia in reading Chinese characters. Methods A patient with reading disorders caused by brain infarctions at the left ventralis medialis occipitotemporal lobe and the splenium of the corpus callosum was studied. A series of neuropsychological tests, such as reading Chinese characters presented in the central foveal field or in the left and right half of the foveal field, were conducted with the patient, and neuroimaging techniques including high spatial resolution 3D-MRI and diffusion tensor tractography (DTT) were used to examine whether or not there were lesions of the neural pathway. Results The patient showed left hemiparalexia, which was characterized by making substitution or omission mistakes, mostly in the left parts of Chinese characters, and also left hemialexia(alexia for characters presented in left visual field). 3D-MRI demonstrated infarctions in the left ventral mesial occipitotemporal area and in the left side of the splenium of the corpus callosum. The left lateral mid-fusiform cortex, which has been identified as the visual word form area(VWFA), was almost intact. DTT indicated the major forceps fibers running through the splenium were all disconnected due to the infarction of the left splenium. Conclusion As a result of disruption of the splemium-major forceps pathway, visual character information in the left visual field which is initially projected to the right occipital cortex cannot be transferred from the right visual cortex to the left VWFA. This mechanism of left hemiparalexia and left hemialexia in reading Chinese characters is similar to that in reading English words.

Objective To explore crossed cerebellar diaschisis (CCD) in cerebral gliomas with three dimensional arterialspin-labeling (3D ASL) perfusion MRI.Methods The images of 31 patients with cerebral gliomas and 31 normal subjects were retrospectively analyzed.The cerebral blood flow (CBF) were measured with 3D ASL technology,and the asymmetry index (AI) of cerebellar hemispheric CBF value changes were calculated and compared in patients.And the relationship between the AI values of cerebellar hemispheric and the AI values of tumor region in cerebral hemispheric,tumor histological grade and size were investigated.Results Compared with tumor ipsilateral cerebellar hemisphere of supratentorial glioma,the CBF value of contralateral cerebellar hemisphere significantly reduced (t=5.04,P＜0.01),and the AI values of cerebellar hemispheric in patients obviously increased compared to normal subjects (t=4.13,P＜0.01).But there was no significant difference in the AI values of cerebellum between high grade and low grade gliomas (t=1.31,P＞0.05).In cerebral gliomas patients,there was no significant correlation between the AI values of cerebellar hemispheres and the AI values of cerebral hemisphere (tumor:r=-0.28;tumor parenchyma:r=-0.24;tumor plus edema:r=-0.19,all P＞0.05),and tumor size (r=0.18,P＞0.05).Conclusion Cerebral glioma can cause CCD phenomenon,and 3D ASL is able to quantitatively assess the degree of cerebellar hypoperfusion noninvasively.This phenomenon may not be associated with tumor histological grade,size and the AI values of cerebral hemispheric.

Objective:To investigate the efficacy of intravenous combined with aerosol inhalation of polymyxin B for the treatment of pneumonia caused by multidrug-resistant Gram-negative (G -) bacteria. Methods:A observational study was conducted. The clinical data of 45 patients with pneumonia due to multidrug-resistant G - bacteria admitted to intensive care unit of Fujian Medical University Union Hospital from January to October in 2020 were analyzed. According to the different use methods of polymyxin B, 25 patients who received single intravenous drip (the first dose was 2.0 mg/kg, then 1.25 mg/kg, once every 12 hours) from January to April in 2020 were enrolled in the routine group, and 20 patients who received intravenous drip combined with aerosol inhalation (25 mg once every 12 hours, sputum in the airway was sucked and then sprayed aerosol) from May to October in 2020 were enrolled in the combination group. After the treatment course of polymyxin B, the total bacterial clearance rate, total clinical efficiency rate, recovery time of body temperature, time of bacterial clearance and the change of serum procalcitonin (PCT) level before and after treatment were compared between the two groups. Moreover, the incidence of adverse reactions during treatment in the two groups was observed. Results:The results of sputum culture in the routine group were Acinetobacter baumannii in 13 patients, Klebsiella pneumoniae in 5 patients, Pseudomonas aeruginosa in 6 patients, Enterobacter cloacae in 1 patient; the sputum culture results of the combination group showed that there were 5 patients of Acinetobacter baumannii, 9 Klebsiella pneumoniae and 6 Pseudomonas aeruginosa. There was no significant difference in the results of sputum culture between the two groups ( P > 0.05). The total bacterial clearance rate and the total clinical efficiency rate of the combination group were significantly higher than those in the routine group (total bacterial clearance rate: 70.0% vs. 40.0%, total clinical efficiency rate: 75.0% vs. 40.0%, both P < 0.05). The recovery time of body temperature and the time of bacterial clearance of the combination group were significantly shorter than those in the routine group [recovery time of body temperature (days): 6.0±3.9 vs. 10.2±7.3, time of bacterial clearance (days): 6.1±5.2 vs. 11.5±6.8, both P < 0.05]. No significant difference was found in serum PCT level before treatment between the two group. There was no significant difference in serum PCT level before and after treatment in the routine group [μg/L: 0.85 (0.44, 2.87) vs. 1.43 (0.76, 5.30), P > 0.05]. The serum PCT level after treatment in the combination group was significantly lower than that before treatment [μg/L: 0.27 (0.10, 0.70) vs. 0.91 (0.32, 3.53), P < 0.05], and it was significantly lower than that in the routine group [μg/L: 0.27 (0.10, 0.70) vs. 0.85 (0.44, 2.87), P < 0.01]. The incidence of renal toxicity of polymyxin B between the combination group and the routine group was not significantly different (5.0% vs. 4.0%, P > 0.05). Conclusions:The efficacy of intravenous combined with aerosol inhalation of polymyxin B for the treatment of pneumonia due to multidrug-resistant G - bacteria is better than that of intravenous drip of polymyxin B only. The aerosolized polymyxin B will not increase the risk of renal injury.