Objective To explore the curative effect of fibular flap with limbs composite soft-tissue.Methods From February,2013 to February,2016,13 cases with body severe trauma patients were treated,which including 5 cases of upper limbs and 8 cases of lower limbs,and all existed bone defect,soft tissue defect and trunk vessel defect.Three cases with limbs distal non blood supply were emergency treated with debridment and flow-through fibular flap transplantation renovation,peroneal artery repairing defective blood vesscls to rcstorc limbs distal blood supply,fibular flap repairing bone defect,skin flap repairing soft tissue defect.The limb blood supply for other 10 cases were in good condition,but one case with main artery defect did the second phase of fibular flap transplantation and repaired defective blood vessels,bone and skin soft tissue synchronously according to wound condition.According to the postoperative observation for flap survival and appearance,X-ray films to observe fracture healing after 6 weeks,three months and 6 months of operation as well as evaluating limb function recovery,then analyzed the results.Results Flaps survived successfully for 11 cases,and flaps for the other 2 cases were partial necrosis.One Case was edge flap necrosis,heal scabby after dressing,and the other case was necrosis for 1/3 of the area,but the deep fascia survival,and the skin graft healing after dressing.One case with forearm rolling was in vascular crisis after operation,but tbe crisis was relieved after detection,and fingers blood supply was recovered.All the patients were followed up for 6 to 36 months(mean,14 months).All flaps were survived,fractures healed well and limbs distal blood supply was good.Bone healing time was 8 to 24 weeks,and patients with lower limbs injury could bear load after 3 to 8 months.Lower limbs restored walking function.Upper limbs and hands restored rotation function.Transplant flapshad good elasticity and satisfactory appearance.Conclusion Using fibular flap to repair defective blood vessels,bone and soft tissue synchronously,not only can rescue the limbs on the verge of amputation,but also can repair defective composite tissue and get a good prognosis.It is an effective method for open injuries severely treatment in clinic.

OBJECTIVETo investigate the durability of self-etch adhesives bonded to dentin in vitro.

METHODSForty-two extracted human molars were selected and occlusal dentin surfaces were exposed. The teeth were randomly distributed into three groups based on adhesives applied. The one-step self-etch adhesive B(Adper Prompt) and C(G-Bond) and two-step self-etch adhesive A (Clearfil SE bond) were used. After application of the adhesives to the dentin surfaces, composite crowns were built up, after 24 h water storage, the teeth were sectioned longitudinally into sticks (1.0 mm×1.0 mm bonding area) for microtensile testing or slabs (1 mm thick) for scanning electron microscopec (SEM) observation. Bonding strength (mTBS) and nano-leakage were evaluated immediately after cutting or after 6 months in water. The mTBS was analyzed using one-way ANOVA (SPSS 13.0). The nanoleakage was observed by SEM with a backscattered electron detector.

RESULTSBoth adhesives and water storage time affected the mTBS. All adhesives showed decreased bond strength after six-month water aging [A dropped from (40.60 ± 5.76) MPa to (36.04 ± 3.15) MPa; B dropped from (19.06 ± 1.50) MPa to (11.19 ± 1.97) MPa; C dropped from (17.75 ± 1.10) MPa to (9.14 ± 1.15) MPa] (P < 0.05). B and C showed lower mTBS than A after aging (P < 0.05). Compared to A, nanoleakage was more obvious after aging for B and C.

CONCLUSIONSAll self-etch adhesives tested were probably influenced by water aging, however, the two-step adhesive showed better durability than the one-step adhesives.

Adhesives ; Dental Bonding ; Dentin ; Humans ; Materials Testing ; Tensile Strength

OBJECTIVETo evaluate the microtensile bond strength of one-step self-etching adhesives to dentin in vitro.

METHODSThree commercially available one-step self-etching bonding systems (group A: Adper Prompt, group B: Clearfil S(3) Bond, group C: Xeno III) were compared with two-step self-etching adhesive (group D: Clearfil SE Bond) in this study. The microtensile bond strength was determined with microtensile tester and the fractured bonding surfaces were observed under stereomicroscope and scanning electronic microscope (SEM). The mean bond strengths were analyzed using one-way ANOVA test (P < 0.05).

RESULTSMean microtensile bond strengths of group C, B, A and D were (34.59 +/- 3.46), (30.46 +/- 3.82), (23.36 +/- 2.55) and (45.06 +/- 5.29) MPa, respectively. Group D showed the highest bond strength (P < 0.01).

CONCLUSIONSTwo-step self-etching adhesive had a higher bond strength than one-step self-etching adhesive systems, although all of them can satisfy the clinical requirements.

Bisphenol A-Glycidyl Methacrylate ; Composite Resins ; Dentin-Bonding Agents ; Humans ; Organophosphates ; Resin Cements ; Tensile Strength

OBJECTIVETo investigate the effects of application time and rubbing action of self-etching adhesives on resin-dentin bond strength and interface morphology in vitro.

METHODSCaries-free human third molars were wet ground to expose dentin surface. Three self-etching bonding agents were applied with varying application time and with/without rubbing. The microtensile bond strength and interface morphology were evaluated.

RESULTSWhen etching time was shortened, normal and prolonged, the bond strength was bonding agent 1 (Adper Prompt): (16.30 +/- 2.59), (23.13 +/- 2.56), (22.28 +/- 2.83) MPa, bonding agent 2 (Xeno III): (15.17 +/- 6.07), (34.50 +/- 3.64), (24.87 +/- 7.01) MPa, bonding agent 3 (Clearfil SE Bond): (29.92 +/- 3.32), (42.21 +/- 6.28), (41.07 +/- 3.93) MPa. When etching was applied with and without rubbing, the bond strength was bonding agent 1 (23.13 +/- 2.56), (12.53 +/- 3.73) MPa, bonding agent 2 (23.98 +/- 3.86), (34.50 +/- 3.64) MPa, bonding agent 3 (48.37 +/- 4.95), (42.21 +/- 6.28) MPa.

CONCLUSIONSShortening application time decreased bond strength of self-etching adhesives, while prolonging application time did not increase bond strength of self-etching adhesives. Not all self-etching adhesives applied with rubbing showed increased bond strength to dentin, which is product-dependent. Manufactures' instructions should be followed to achieve optimum bonding.

Acid Etching, Dental ; methods ; Dental Bonding ; methods ; Dental Cements ; classification ; Humans ; Molar, Third

Objective To observe the brain activation of interictal epiletiform discharges(IEDs) and to localize the epileptogenic foci of epilepsy.Methods The electroencephalogram(EEG)and functional MRI data of 12 focal epileptic patients were acquired using a combination of EEG and functional MRI simultaneously.The IEDs onset time detected with EEG were set as the time parameters in an event- related paradigm of functional MRI analysis.The spatial and temporal characters of IEDs activation were analyzed in detail.In order to confirm the consistency of this method,all patients were scanned repeatedly and the results were correlated with clinical evaluation.Results Of the 12 patients,valid data from EEG- fMRI were obtained from 10 patients in a total of 18 sessions..Compared with the structural foci,the epileptic foci localization results of eleven sessions were good,five sessions were fairly good,and two sessions were poor.The results obtained from six patients in two separate sessions were concordant.respectively.Moreover,thalamic activation was detected in ten sessions,cerebellar activation was detected in all sessions,and the deactivation was found in the default mode loci in nine sessions. Conclusion The method of performing EEG and fMRI simultaneously can potentially be a useful tool in epilepsy research.

OBJECTIVETo explore the influence of Kingsbrain (GETO) on the learning memory impairment of rats with cerebral ischemia.

METHODRats with cerebral ischemia were administered GETO orally once a day for one month. The ability of spatial-learning memory of rats was evaluated by Morris Water Maze (MWM). Duxil was used as a positive control.

RESULTthe results of place navigation of MWM showed that at the 3rd time of swimming training, the escape latency of rats of the GETO group, Duxil group and Sham group were shorter than that of model group. The escape latency were (54.1 +/- 43.94), (55.9 +/- 43.49), (50.4 +/- 34.99) and (85.4 +/- 42.8) s, respectively; but there was no significantly difference. After the 6th time of swimming training, the escape latency of rats of the GETO group (37.8 +/- 38.69) s, the Duxil group (37.4 +/- 38.03) s and the sham group (26.9 +/- 21.63) s were significantly shorter than that of model rats (77.5 +/- 47.59) s, P < 0.05, respectively. Comparison of the swimming distance among groups were similar to the escape latency among groups. In the test of spatial probe, results of the ratio of the swimming time of platform quadrant (tP) vs the total swimming time (tT) and the ratio of the swimming distance of platform quadrant (dP) vs the total swimming distance (dT) indicated that the ratios of the GETO group (0.347 +/- 0.0662, 0.344 +/-0.055 1), the Duxil group (0.345 +/- 0.0984, 0.34 +/- 0.0934) and the sham group (0.35 +/- 0.0662, 0.349 +/- 0.0589) were significantly higher than those of the Model group (0.261 +/- 0.0689, 0.274 +/- 0.0544), P < 0.05, respectively.

CONCLUSIONGETO can significantly improve the spatial learning and memory ability of rats with cerebral ischemia, which provides the pharmacodynamics evidence for its clinical application of improveing the learning and memory ability in poststroke patients.

Animals ; Brain Ischemia ; etiology ; physiopathology ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Infarction, Middle Cerebral Artery ; complications ; Male ; Maze Learning ; drug effects ; Memory ; drug effects ; Panax ; chemistry ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVES: To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia. METHODS: A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis. RESULTS: Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%, CONCLUSIONS Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.
Asphyxia ; Asphyxia Neonatorum/epidemiology* ; Humans ; Hyperglycemia ; Infant, Newborn ; Prognosis ; Retrospective Studies

OBJECTIVETo design ABC damage variable and positioning system for acetabular fracture and explore the feasibility and clinical practical value of the system through the multi-center analysis of 1122 acetabular fractures.

METHODSAccording to acetabular three-column conception, and pelvic ring lesions damage direction caused by acetabular fracture domino effect and injury degree of proximal femur joint, it defined class A as any column acetabular fracture; class B as any two-column acetabular fracture; class C as front, dome and posterior mixture acetabular fracture. Lower case English letters a, m, p represented front, dome, posterior fracture, respectively. Acetabular damage variables: 1 was simple displaced fractures; 2 was comminuted fractures; 3 was compression fractures. Pelvic ring lesions damage variables: alpha was sacroiliac joints or sacroiliac fracture horizontal separation deflection; beta was sacroiliac joints or sacroiliac fracture vertical separation deflection; gamma was pubic symphysis separation/superior and inferior ramus of pubis fracture deflection; alpha beta gamma delta was compound floating damage. Proximal humerus joint damage variables: I was femoral head fracture; II was femoral neck fracture; II was intertrochanteric fractures of femur; IV was I to III compound fracture. The ABC damage variable positioning system for acetabular fracture was made up by the above-mentioned variables. The statistics from March 1997 to February 2010 showed 1122 cases acetabular fractures with 18 cases of double side acetabular fracture and 1140 cases of acetabular fractures. The pelvics anterior-posterior view, ilium and obturator oblique view, and 2/3D-CT materials were analyzed and researched.

RESULTSEach damage variables distribution situation in 1140 cases of acetabular fracture involved A in 237 cases (20.8%), B in 605 cases (53.1%), C in 298 cases (26.1%);front column fracture in 808 cases(70.9%), dome fracture in 507 cases (44.5%), posterior fracture in 1026 cases (90%). Acetabular variables: variabe 1 in 203 cases of simple displaced fracture (17.8%); variabe 2 in 516 cases of comminuted fracture(45.3%); variabe 3 in 421 cases of compression fracture (36.9%); 249 cases of pelvic ring lesions damage (21.8%), 75 cases femoral head fracture (6.6%); 18 cases of double side acetabular fracture and relative pelvic ring and proximal humerus joint variables (1.58%). Key part and curative effect elements of 1140 cases acetabular fracture: 507 cases of dome or posterior acetabular fracture (44.5%); 421 cases of compression fracture (36.9%); 249 cases of pelvic ring variables (21.8%); 75 cases of proximal humerus joint variables (6.6%); 486 cases of simple Aa/pl/2,Bapl/2 acetabular fracture (42.6% ).

CONCLUSIONCompression fracture, especially defected compression fracture, takes important part in acetabular damage variables, and also presents that acetabular fracture with pelvic ring and proximal femoral damage variables are not rare at all. The relationship of the acetabular fracture damage variables, and its percentage shows the key points and elements in clinical treatment: weight-bearing to dome accounts for 44.5%; compression to defects account for 36.9%, pelvic ring to float accounts for 21.8%; dome fracture to double side fracture account for 6.6%. The system has significant guiding effects on clinic in terms of evaluation of injury severity, anatomic localization, difficulty index, alternative strategy, operative approach, effect of treatment,and prognosis. And the most important thing is that the system creates the comparison of damage variables in same type of fracture and the communication of homo-language and explores a new method.

Acetabulum ; injuries ; Adolescent ; Adult ; Aged ; Child ; Female ; Fractures, Bone ; classification ; diagnostic imaging ; Humans ; Male ; Medical Informatics ; methods ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To evaluate the effect of intrapulpal pressure simulation on the micro-tensile bond strength (μTBS) of resin cement to dentin. METHODS: Thirty extracted human third molars were selected. Occlusal enamel was removed to expose dentine surface and teeth with residual dentin thickness of 0.5-2.5 mm were selected. Dye permeation through dentin tubules with or without intrapulpal pressure (IPP) simulation, or after Single Bond Universal (SBU) application on dentin surface with IPP simulation were observed at the end of 0 min, 5 min, 30 min and 2 h. The teeth with residual dentin thickness of (1.0±0.1) mm were divided into 2 groups with IPP simulation of 15 or 0 cmH₂O (1 cmH₂O=0.098 kPa), which was maintained for 30 min before bonding procedure. SBU was applied on the dentin surface and light cured, then RelyX Ultimate (RLX) cement was heaped on the dentin surface (diameter=10 mm, height=4 mm) and light-cured. After the dentin-resin cement samples were stored in distilled water for 24 h at 37 °C, the samples were cut into beams with cross sectional area of 0.9 mm×0.9 mm for μTSB testing (n=100). The data were analyzed with two independent samples t-test (α=0.05). The fracture mode was observed using scanning electron microscopy (SEM). The results were analyzed with Fisher exact test (α=0.05). The rest of dentin-resin cement samples (five samples for each group) were cut perpendicular to the bonding interface and the morphology of the bonding interface was observed using SEM. RESULTS: The dye permeation through dentin tubules with IPP simulation was faster than those without IPP simulation. The μTSB of RLX to dentin with and without IPP simulation were (26.26±9.78) MPa and (28.70±9.0) MPa, respectively. The most frequent fracture mode was mixed-fracture mode. There was no significant difference between the two groups for neither bond strength nor fracture types distribution (P>0.05). Regarding the morphology of dentin-resin cement bonding interface, both groups showed 4-8 μm finger-like resin tags. CONCLUSION With SBU pretreatment, the IPP simulation had no influence on the immediate bond strength of RLX to dentin.
Composite Resins ; Dental Bonding ; Dentin ; Dentin-Bonding Agents ; Humans ; Materials Testing ; Microscopy, Electron, Scanning ; Resin Cements ; Surface Properties ; Tensile Strength

OBJECTIVE: To investigate influence of setting time on bond strength of different bioactive pulp capping materials with self-etch or etch-and-rinse adhesive. METHODS: Sixty specimens were prepared for each of the three tested capping materials, namely mineral trioxide aggregate (MTA), iRoot BP Plus (BP) and iRoot FS (FS). Specimens of each material were divided into three groups and bonded at three setting time points of the materials respectively: initial setting time (4 h for MTA, 2 h for BP and 20 min for FS), 24 h after application and 7 d after application. The specimen surfaces of each group were treated with self-etch mode or etch-and-rinse mode of one universal adhesive (Single Bond Universal, SBU) (n=10). The bonding area was restricted to a round area with 3 mm diameter, on which composite cylinders were build up with flowable composite and light cured completely. The shear bond strength was tested immediately with a shear strength tester and fracture mode was observed under stereo microscope and recorded. The mean shear bond strength for each group was analyzed with SPSS 19.0 software ANOVA method. The surface morphology of each material was observed after setting and acid treatment under scanning electron microscope. RESULTS: There was no significant difference among the three tested materials at either initial setting point or 7 d after application (P<0.05). The bond strength of MTA was significantly higher than those of BP and FS 24 h after application in both bonding modes (P<0.05). For all the three tested materials, shear bond strength was significantly higher for complete setting group than for initial setting group of the same material (P<0.05). Under scanning electron microscope, the characteristic crystal patterns could be observed on the three bioactive materials surfaces after complete setting, the size of which was bigger for MTA than for BP and FS. These features were lost to some extent after self-etch primer application or phosphoric acid etching. CONCLUSION Based on the present results, adequate bond strength can be obtained for FS at initial setting time, which is comparable with BP and MTA. This implies that clinically composite restoration can be placed over bioactive direct capping materials after shortened initial setting process in one visit.
Acid Etching, Dental ; Composite Resins ; Dental Bonding ; Dental Cements ; Dental Materials ; Dental Pulp Capping ; Dental Stress Analysis ; Dentin-Bonding Agents ; Materials Testing ; Resin Cements ; Shear Strength