Objective To evaluate the clinical effect of the procedure that involves drilling and inserting a motility peg at the time of hydroxyapatite orbital implant.Methods 89 patients who needed hydroxyapatite orbital implant were divided into groups A and B.The patients in group A were drilled and inserted a motility titanium peg when hydroxyapatite implantation.The patients in group B were drilled and inserted a motility titanium peg 6 months after hydroxyapatite implantation.Data were recorded.including the rate of postoperative pain and conjunctive edema,postoperative facial appearance,motility of the artifieial eye,the rate of hydroxyapatite exposure,excursion and extrusion of titanium peg and other complications.Results The mobility of the prosthesis was 44.97%in group A,and 45.34%in group B.There was no difference in appearance and the motility of their artificial eye between the two groups.The rate of excursion of titanium peg was 4.2% in group A and 7.3%in group B and no statistical difference was found between the two groups.There were no prosthesis exposure,extrusion of titanium peg,secondary infeetion and other complication in one-year follow-up.There were no difference in the rate of postoperative pain and eonjunctive edema in first operative stage.The postoperative reaction in group A was lighter than that in group B in secondary operanve stage.Conclusion The hydroxyapatite orbital implant primary procedure drilling is simple,safe,convenient and effective.It is worth to recommend that procedure that involves drilling and inserting a motility peg at the time of hydroxyapatite orbitaI primary implant.

Objective To evaluate the application of the polymethyl methacrylate (PMMA) artificial eye in acquired ophthalmostewesis. Methods We summarized the experience in the application of PMMA in prosthesis for 8 years. 1155 patients were involved in the artificial eye custom-made program. The artificial eye was individually prepared based on the patient's condition and characters of the healthy eye.Results PMMA artificial eye associated with hydroxyl apatite implantation gave good cosmetic results with good motility, and there was no rejective reaction. The artificial eye was almost same to the real one in color and transparency. Conclusion It is suggested that PMMA is one of the best materials for manufacture of artificial eye at present.

Objective To investigate the effects of hepatocyte growth factor(HGF) on proliferation and collagen synthesis induced by angiotensin Ⅱ(AngⅡ)in SD rat cardiac fibroblasts(CFbs),and determine the role it plays in hypertensive ventricular remodeling.Methods CFbs in SD rat were cultured in vitro and treated with different concentrations of AngⅡ and/or HGF.Collagen type Ⅰ synthesis of CFbs was measured by Western blotting,and proliferation of CFbs was detected by MTT assay. Results AngⅡ promoted collagen synthesis and proliferation in CFbs in a certain concentration range,which can be significantly inhibited by HGF. ConclusionHGF can inhibit the proliferation and collagen synthesis induced by AngⅡin SD rat CFbs,and may protect against hypertensive ventricular remodeling.

Objective To investigate the CT perfusion imaging and the pathological features on the disturbance of regional cerebral microcirculation in a pre-infarction period, and to evaluate the relationship between the astrocytes and regional cerebral microcirculation. Methods Dynamic CT perfusion imaging of the models with regional cerebral hypoperfusion and astrocytic swelling in rats was performed to assess the presence or absence of the disturbance of regional cerebral microcirculation. Then, the histopathologic examination was made for both models, respectively. The ratios of side-to-side were measured at hypoperfusion areas in the models of regional cerebral ischemia. Results Regional hypoperfusion was revealed by regional cerebral blood flow (rCBF) and mean transit time (MTT) maps in the group of hypoperfusion for 6 hours. Regional cerebral blood volume (rCBV) and time-to-peak (TTP) maps were normal in that group. The ratios of rCBF, rCBV, MTT and TTP were 0 39-0 55, 0 92-1 00, 1 20-1 50 and 1 00-1 00 respectively. Astrocytic swelling pressing the capillary wall was obvious and subtle neuronal reversible degeneration was occasionally found. TTC stain was normal. In the tACPD group of astrocytic swelling, the abnormal hemodynamic regions on rCBF and MTT maps were found. The rCBV maps of 3 rats in the tACPD group showed the area of reduced rCBV. In 2 rats of tACPD group, the areas of delayed TTP were also found. The ratios of rCBF, rCBV, MTT and TTP were 0 25-0 44, 0 70-1 01, 1 20-2 00 and 1 02-1 45 respectively. TTC stain was negative. Electron microscope study revealed remarkable swelling of astrocytes, especially endfoot processes of astrocytes around capillaries. The abnormal hemodynamic region on rCBF and MTT maps matched with abnormal extent on histopathologic examination. The rCBV and TTP maps appeared normal. Conclusion The astrocytes can react in a way faster than the neurons in the pre-infarction period, viz. astrocytic swelling. The swelling of astrocytic foot, which pressed capillary vessel, induced the disturbance of regional cerebral microcirculation, and then aggravated hypoxic ischemic state in regional brain parenchyma. Perfusion CT and its parameters' analysis may play an increasing role to delineate the reversible hypoperfusion areas in pre-infarction period. Analyzing the relationship of rCBF and rCBV is very helpful to know the status of the capillary vessels in regional cerebral hypoperfusion area.

Objective To establish a stable and controllable model of acute regional cerebral ischemia in rats, and to evaluate it by CT perfusion imaging and histological study. Methods Twenty eight male Wistar rats were randomly divided into 4 groups, and there were 7 rats in each group. The sham operation rats were defined as the first group, rats suffered from cerebral ischemia for 15 minutes were classified as the second group, rats suffered from cerebral ischemia for 30 minutes and then reperfusion for 1 hour as the third group, and rats suffered from hypo perfusion for 6 hours as the fourth group. Cerebral ischemia or hypo perfusion were induced by inserting a nylon thread of different diameter into right middle cerebral artery (MCA) of rats under the monitoring of regional cerebral blood flow (rCBF) by the Laser Doppler Blood Perfusion Monitor (BPM). rCBF was also examined by dynamic CT perfusion imaging. At the end of the observation time, rats were decapitated, and three rats of each group were performed 2,3,5 triphenyltetrazolium chloride (TTC) staining and four rats were performed histological study. Results In the second group, rCBF was controlled within 5% to 22% under the monitoring by BMP and CT perfusion imaging showed the decreased rCBF in 7 rats, but TTC staining showed red appearance indicating no infarction focus formed. Electronic microscopic study revealed astrocytic swelling and a few of neuronal degeneration. In the third group, rCBF was controlled within 4% to 23% under the monitoring by BMP. There were more severe astrocytic swelling and a lot of neuronal degeneration. The abnormal areas in CT perfusion images were the same as TTC staining. In the fourth group, in accordance with less decrease ment of rCBF (from 38% to 55%) in 7 rats, there were obvious astrocytic swelling and subtle neuronal degeneration. TTC stain did not show ischemia area. All these abnormal changes were not observed in the sham operation rats. Conclusion The controllable acute regional cerebral ischemic model in rats is very stable and repeatable. It can be simulated into the ischemic state of different perfusion level. This model is suitable for the research of acute cerebral infarction and regional cerebral ischemia. The facts that parallel changes existed among BMP measurement, CT perfusion imaging, and brain histology indicated that CT perfusion imaging is accurate and sensitive in evaluating acute regional ischemia.

Objective To investigate the effects of pioglitazone on angiotensin Ⅱ(AngⅡ) -induced proliferation and collagen typeⅠ expression of adventitial fibroblasts (AF). Methods The AFs were isolated from rat thoracic aorta. MTT colorimetry and flow cytometry were used to study the effects of pioglitazone on proliferation and cell cycles of AF. The expression of collagen typeⅠ regulated by pioglitazone was examined by the method of Western blot. Results Pioglitazone inhibited the proliferation of AF in a dose-dependent manner, and the most marked effect could be observed at the concentration of 10?10-6 mol/L for pioglitazone (P

Abstract Falls are the leading cause of accidental injury deaths among the elderly. Currently, the incidence and disease burden of falls among the elderly remain high. By understanding the influencing factors of falls among the elderly and formulating targeted preventive measures, the risk of falls can be effectively reduced. Studies have found that falls among the elderly are results of the interaction of multiple factors. When formulating fall prevention strategies, attention should be paid to fall risk assessment and stratification, fall prevention exercise support and health education, living environment improvement, and primary healthcare service enhancement. Reviewing publications pertaining to the epidemiological studies of falls from January 2004 to January 2024, this article summarizes the epidemiological characteristics, risk factors, prevention and control strategies of falls among the elderly, aiming to provide the reference for prevention and control.

Objective: To investigate the status of occupational health examination institutions in Zhejiang Province, so as to provide suggestions for quality control of occupational health examination institutions. Methods: The 312 occupational health examination institutions in Zhejiang Province that have completed filing before September 30, 2023 were selected. The comprehensive capability, service quality, technical capability, and information reporting status were surveyed and evaluated through on-site inspection and skill assessment. Results: There were 161 public hospitals (51.60%), 147 private organizations (47.12%), and 4 centers for disease control and prevention (CDCs)/ occupational disease prevention and control institutes (1.28%). The pass rates of comprehensive capability, service quality, technical capability and information reporting were 90.02%, 69.89%, 84.07% and 86.78%, respectively. Among the indicators of comprehensive capability, the compliance rate for staffing was the highest at 95.06%, while the qualification rate of quality control in occupational health examinations was the lowest at 84.83%. Among the indicators of service quality, the compliance rate of the physical examination report format was the highest at 95.83%, while the accuracy rate of the audiometry examination was the lowest at 76.60%. In terms of technical capabilities, the qualification rates for blood lead testing, pneumoconiosis reading, and audiogram diagnostic ability were 87.92%, 89.42% and 75.34%, respectively. In terms of information reporting, the qualification rates for reporting completeness, reporting timeliness, suspected occupational disease reporting timeliness, and reporting accuracy were 89.10%, 81.09%, 96.47% and 80.45%, respectively. Among the three types of institutions, private institutions had the lowest average qualification rates for comprehensive capability, service quality, and technical capability, which were 89.83%, 69.06% and 80.00%, respectively. Conclusions Public hospitals and private organizations were the main types of occupational health examination institutions in Zhejiang Province. However, there were deficiencies in quality control, audiogram examination and diagnosis, and the accuracy of information reporting among occupational health examination institutions.

Objective This is the first study to explore clinical application value of serum Dickkopf-1 (DKK-1) detection in diagnosis of heptocellular carcinoma (HCC) by magnetic solid phase chemiluminescent immunoassay.Methods The level of serum DKK-1 and AFP in 205 cases of HCC,40 cases of liver cirrhosis,and 200 cases of healthy control were quantitatively detected by Magnetic solid phase chemiluminescent immunoassay.The area under ROC curve,sensitivity and specificity of DKK-1 and AFP for diagnosing HCC were calculated.Results The serum level of DKK-1 in HCC group was significantly higher than those of the liver cirrhosis group and healthy control group (P<0.01).DKK-1 maintained diagnostic sensitivity for patients with HCC who were alpha-fetoprotein (AFP) negative (66.3%).ROC curves showed optimum diagnostic cut-off value was 2.4 ng/mL,area under curve (AUC) was 0.822 (95% CI:0.783-0.856),sensitivity 65.9%,and specificity 87.5%).Moreover,measurement of DKK1 and AFP together improved diagnostic accuracy for HCC versus all controls compared with either test alone [AUC 0.915,95%CI:0.886-0.940),sensitivity 81.5 %(P<0.05)].Conclusion Serum DKK-1 detection has an important clinical value for diagnosis of HCC,especially for HCC with AFP negative.The combined detection of serum DKK-1 and AFP can greatly increase sensitivity and accuracy for diagnosing HCC.

Objective To observe the immediate hemodynamic effects of the intercoronary ischemic preconditioning on the coronary perfusion pressure.Methods The observational study recruited 17 patients who were hospitalized for stable coronary disease and had severe stenosis lesions (70％ ～ 85％ ) in one or two vessels per coronary angiography.They were randomized into ICPC ( n =8 ) group ( receiving two cycles of 1-min balloon inflation and 5-min reperfusion) and control group (n =9).Before interventional treatment,the ICPC group was given 2 cycles of intercomary ischemic preconditioning.The occlusive and non-occlusive pressures proximal and distal to the stenosis were collected before and after ICPC.Fractional flow reserve (FFR) was calculated upon the following equation:FFR =Pd/Pa ( Pa:hyperemic mean aortic pressure,Pd:hyperemic coronary pressure distal to the stenosis).Results Before and after ischemic preconditioning,coronary wedge pressure and FFR of ICPC group were significantly increased ( coronary wedge pressure was from [ 22.08 ± 19.14 ]mm Hg to [25.46 ±19.04]mm Hg,P=0.011;FFR.was from [70.30±16.05]％ to [77.53 ±13.42]％,P=0.001).The collateral flow was increased significantly.Coronary wedge pressure and FFR of control group did not improved obviously.There were significant differences in FFRs and coronary wedge pressures between ICPC and control groups.Conclusion Coronary ischemic preconditioning can improve coronary perfusion pressure,and rapidly increase the coronary pressure distal to the severe stenosis lesions.