Although traditional tooth preparation techniques (e.g., depth-groove-guided and index-guided techniques) are designed to improve preparation precision, the results are unsatisfactory because of the lack of proper estimating tools. This study proposed a novel technique, in which relevant details for preparation of drilling holes are provided and corresponding depth is estimated using a quantitive bur under a microscope. This technique offers a viable option for precise tooth preparation.
Humans ; Microscopy, Confocal ; Tooth Preparation ; methods

Objective To investigate the effects of OB built-in tampon indwelled in anus combined with acupoint massage in ICU patients with incontinence-associated dermatitis (IAD). Methods 100 patients with incontinence hospitalized in ICU were randomly assigned to control group (n=50) versus combined therapy group (n=50). The patients in the control group accepted routine nursing while the patients in the combined therapy group were treated with OB built-in tampon indwelled in anus combined with acupoint massage besides the routine nursing care. The two groups were compared in terms of incidence rate of IAD, IAD occurrence time, severity of IAD and incontinence-related nursing workload. Results The incidence rate of IAD and the severity of IAD in the combined therapy group were lower than those of the control group.The IAD in the combined therapy group occurred later than in the control group. Thetime for incontinence-related nursing and the frequency of perineum washing in the combined therapy group were shorter and lower than in the control group. Conclusions The application of OB built-in tampon indwelled in anus combined with acupoint massage in ICU patients with incontinence can not only reduce the incidence rate and severity of IAD but also lower the workload of nursing.The therapy is worthy of clinical application.

Objective:To investigate the clinical value of three-dimensional arterial spin marker imaging(3D-ASL) for evaluating collateral circulation compensatory status in patients with cerebral infarction.Methods:A total of 24 patients with cerebral infarction who were treated at Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Chinese Medicine from September 2017 to January 2019 were examined by 1.5-T high-field MR scanner.The changes of cerebral blood flow(CBF) between the infarcted area and the contralateral normal area were compared when the labeled delay time(PLD)=1.5s and PLD=2.5s, and the patients were divided into the group with strong collateral circulation compensation and the group with weak collateral circulation compensation according to the difference in lesion area measured by 3D-ASL(PLD=1.5s and 2.5s). The changes of national institutes of health stroke scale(NIHSS) score and Bathel index at admission and 15 days after admission were compared.Results:3D-ASL measurement of PLD=1.5s showed that the CBF value in the infarcted area was (33.70±20.83)mL/(100g×min), which was significantly lower than that in the contralateral normal area(PLD=1.5s)[(49.93±13.13)mL/(100g×min)]( t=3.229, P<0.05). When PLD=2.5s, ASL measurement results showed that the CBF value in the infarcted area increased significantly[(58.26±23.50)mL/(100g×min) vs.(33.70±20.83)mL/(100g×min)]( t=3.831, P<0.05), and the CBF value in the contralateral normal area also increased significantly[(68.29±14.03)mL/(100g×min) vs.(49.93±13.13)mL/(100g×min)]( t=4.681, P<0.05). At this time, the CBF value in the infarcted area was still significantly lower than that in the contralateral normal area[(58.26±23.50)mL/(100g×min) vs.(68.29±14.03)mL/(100g×min)]( t=1.795, P<0.05). On the day of admission, the BI index of patients in the weak collateral circulation compensation group(12 cases) was significantly higher than that in the strong collateral circulation compensation group(12 cases)[(90.42±10.50) vs.(67.92±27.57)]( t=2.642, P<0.05), and the NIHSS score was significantly lower than that in the strong collateral circulation compensation group[(1.25±1.01) vs.(3.83±3.62)]( t=2.378, P<0.05). After 15 d of admission, there were no significant differences in BI index and NIHSS score between the two groups(all P>0.05). Conclusion:3D-ASL with different delay time can effectively and intuitively reflect collateral circulation compensation of patients with cerebral infarction, and it has very important reference value for the evaluation of patients' disease and the formulation of clinical treatment plan.

Objective To understand the status of recent infected and newly reported HIV cases in Jiangsu province. Methods Information including general demographic,mode of transmission and sample source of newly reported HIV infected cases was collected. Corresponding serum or plasma samples were collected and tested with BED-CEIA. Proportions of recent HIV infections among different populations were calculated,and associated factors of recent HIV infection calculated. Results Among cases infected through different channels as homosexual,heterosexual and needles sharing,the proportions of recent infections were 29.19%,17.40% and 21.75%, respectively. Statistically significant difference was seen between different populations(P<0.05). Compared with female cases,male cases were more likely to be recent infected(OR=1.569,95%CI:1.168-2.107). Compared with cases older than 35 years of age,the ones that younger than that age were more likely to be recently infected(OR=1.556,95%CI:1.289-1.879). Compared with cases who remained single,those married cases were more likely to be long-term infections(OR=0.789, 95%CI:0.649-0.960). Compared with patients identified by hospitals,the recent HIV infections were more likely to be found through voluntary counseling programs and testing(OR=2.278,95%CI:1.853-2.801),project-based surveillance programs(OR=2.409,95%CI:1.860- 3.120),and unpaid blood donation sites(OR=2.911,95%CI:2.118-4.001)(P<0.05). Conclusion Proportion of MSM ranked 1st in the newly reported HIV cases in Jiangsu province. Related HIV case-finding programs should be strengthened to reduce the secondary transmission.

Objective:To investigate the clinical effect of large medium thickness skin graft on the back and scalp replantation in the back donor area after complete resection of giant congenital melanoma nevus (GCMN) in children′s upper limbs.Methods:From April 2017 to may 2020, 16 pediatric patients with GCMN of upper limbs were treated in the First Affiliated Hospital of Air Force Military Medical University, including 9 males and 7 females, aged from 2 years to 7 months to 12 years. Giant melanoma nevus area 14 cm×11 cm-23 cm×20 cm, the wound after removing the skin of giant melanocytic nevus of the limb was covered with vaseline oil gauze for 2-3 days, and then a large medium thickness skin graft was cut on the back with a drum skin extractor for transplantation. The wound in the back skin donor area was replanted with a blade thick scalp.Results:The effect of excision of giant nevus of upper limb and skin grafting on the wound of back medium thickness donor area in 16 pediatric patients was satisfactory, and there were no serious complications such as skin necrosis and poor survival. Plasma swelling was formed under the skin graft of one child′s limb, which healed after opening and drainage and three dressing changes. Anti-scar and rehabilitation treatment was performed on the limb and donor site.The patients were followed up for 6-18 months. There was no obvious scar hyperplasia and contracture in the skin graft area and donor area. The skin color and elasticity of the back and limb skin graft area were close to the normal skin around the wound, and the activities of elbow joint, wrist joint and interphalangeal joint were not limited. The parents of the pediatric were satisfied with the function and appearance of the limb skin graft area and back skin donor area of giant nevus.Conclusions:The function and appearance of large medium thickness skin graft on the back after excision of congenital giant nevus of upper limb in pediatric are better; There is no obvious scar formation after scalp replantation in the back donor area, and the repair effect is better.

Objective:To explore the clinical effect of composite skin transplantation combined with systemic rehabilitation in the treatment of extensive scar contracture deformity around the popliteal fossa in children after burns.Methods:A retrospective observational research method was adopted. Seventeen children with extensive scar contracture deformities around the popliteal fossa after burns who met the inclusion criteria and were admitted to the First Affiliated Hospital of Air Force Military Medical University from March 2018 to April 2022 were selected. Among them, there were 10 males and 7 females, aged 2-11 years, with scar contracture deformities lasting from 10 months to 9 years, all located around the popliteal fossa, 10 cases of right popliteal fossa, 5 cases of left popliteal fossa, 2 cases of bilateral popliteal fossa, scars around the popliteal fossa result in a knee joint extension angle of only 95° to 115°. The scar contracture during surgery was thoroughly released, joint mobility was restored, so as to form a secondary wound range of 10 cm×8 cm-20 cm×13 cm. In stage Ⅰ, after completely releasing the scar contracture, the wound was covered with negative pressure closure drainage (VSD) for 2-3 days. In stage Ⅱ, a large autologous blade thick scalp and allogeneic decellularized dermal matrix composite graft was performed to repair the wound around the popliteal fossa. After 8-10 days of surgery, the dressing was changed to check the survival of the skin graft. One week after the skin graft survived, a 12 month orderly knee joint function training was conducted under the guidance of a rehabilitation therapist. Postoperative sequential treatment with a combination of strong pulsed light and ultra pulsed carbon dioxide lattice laser for 5-7 courses of significant scar hyperplasia in the skin graft area and edges.Results:15 cases of pediatric patients had good skin graft survival; One patient developed a wound due to partial displacement of the transplanted autologous scalp, and one patient developed a plasma swelling under the limb graft, which was drained through an opening. Two patients underwent dressing changes for 3 weeks before the wound healed. After follow-up for 6 to 36 months, the elasticity and appearance of the skin graft were similar to those of a medium thickness skin graft. Children with knee joint contracture were able to fully extend to 180°, and knee joint function was significantly improved. There was no scar formation or hair loss in the donor skin area.Conclusions:The combination of composite skin transplantation and systematic rehabilitation has a good effect on the treatment of extensive scar contracture around the popliteal fossa in children after burns, avoiding the problem of scars left in the donor area due to autologous skin grafting.

OBJECTIVETo understand the status of recent infected and newly reported HIV cases in Jiangsu province.

METHODSInformation including general demographic, mode of transmission and sample source of newly reported HIV infected cases was collected. Corresponding serum or plasma samples were collected and tested with BED-CEIA. Proportions of recent HIV infections among different populations were calculated, and associated factors of recent HIV infection calculated.

RESULTSAmong cases infected through different channels as homosexual, heterosexual and needles sharing, the proportions of recent infections were 29.19% , 17.40% and 21.75% , respectively. Statistically significant difference was seen between different populations(P < 0.05). Compared with female cases, male cases were more likely to be recent infected (OR = 1.569, 95%CI: 1.168-2.107). Compared with cases older than 35 years of age, the ones that younger than that age were more likely to be recently infected (OR = 1.556, 95% CI:1.289-1.879). Compared with cases who remained single, those married cases were more likely to be long-term infections(OR = 0.789, 95%CI:0.649-0.960). Compared with patients identified by hospitals, the recent HIV infections were more likely to be found through voluntary counseling programs and testing (OR = 2.278, 95%CI: 1.853-2.801), project-based surveillance programs (OR = 2.409, 95%CI:1.860- 3.120), and unpaid blood donation sites (OR = 2.911, 95%CI:2.118-4.001)(P < 0.05).

CONCLUSIONProportion of MSM ranked 1st in the newly reported HIV cases in Jiangsu province. Related HIV case-finding programs should be strengthened to reduce the secondary transmission.

Age Distribution ; China ; epidemiology ; Female ; HIV Infections ; diagnosis ; epidemiology ; HIV Seropositivity ; Heterosexuality ; Homosexuality ; Humans ; Male ; Marital Status ; statistics & numerical data ; Needle Sharing ; adverse effects ; Sex Distribution

Objective : Viral load is becoming more and more important in prevention of HIV/AIDS. Understanding the baseline of viral load before treatment in newly reported HIV/AIDS patients can provide a basis for AIDS prevention. Methods : The viral load of newly reported HIV/AIDS patients in Jiangsu province in 2019 was detected by fluorescence quantitative PCR , the differences of viral load under different demographic characteristics were compared , and the factors of high viral load were analyzed. Results : he mean viral load of 3098 newly reported HIV/AIDS patients in Jiangsu province was 4. 33 ± 1. 05 log/mL , and the proportion of patients with viral load < 5000 copies/mL was 20. 85% (646/3 098) . There were statistically significant differences in viral load among different genders (P < 0. 05) , and male patients had higher viral load. The difference of viral load between HIV⁃infected and AIDS patients was statistically significant (P < 0. 05) , and the viral load value of AIDS patients diagnosed with disease status was relatively high. Unmarried and married spouses were more likely to have higher viral load than divorced or widowed spouses. Higher baseline viral load level was associated with higher rates of virologic failure after antiviral therapy. Conclusion The overall viral load of HIV infected /AIDS patients is high , but there is a certain proportion of low viral load , suggesting that follow⁃up of low viral load should be strengthened in AIDS prevention and treatment. Strengthen interventions aimed at men and unmarried or married people with spouses to reduce the risk of transmission.