Adult ; Crown Lengthening ; Dental Prosthesis ; Dental Prosthesis Design ; Esthetics, Dental ; Female ; Gingiva ; Humans ; Incisor ; Smiling

In the past two decades,with the development of electron optics,computer and imaging,hip arthroscopy surgery has become the best effective method in the diagnosis and treatment of the hip discord,as a method integrates less invasive and invisible characteristics.The indication of hip arthroscopy gradually expands and has become the gold standard in the diagnosis and therapy of hip discord.Recent research shows hip arthroscopy can provide early diagnosis and treatment hip unexplained pain,such as femoroacetabular impingement(FAI),labral tears,chondral lesions,furthmore hip arthroscopy shows good prospects in the treatment avascular necrosis of femoral head,synovial abnormalities,post hip arthroplasty discomfort.

Objective To evaluate the outcomes of meniscal injures treated by Ho∶YAG laser using arthroscopy.MethodsA total of 31 patients with meniscal injury were treated with holmium∶YAG laser by arthroscopy from January 2006 to March 2008 in our hospital.Among the cases,11 had flap tear,8 had horizontal tear,6 showed bucket-handle tear,and 6 were found with longitudinal tear.The pre-and post-operative Lysholm score,and compilations in the patients were recorded.Results The operation was completed successfully in all the cases with a mean operation time of 44 min(rang,22-55 min).No injuries to the vessels and nerves occurred in the surgery.The patients got out of bed in 1 to 4 days after the surgery(mean,2.1 days).All the surgical wounds achieved primary healing.Follow-up was carried out in the patients for 9 to 28 months(mean,14.5 months).The patients showed significantly lower Lysholm score at 6 months during the follow-up than that determined before the operation(92?6 vs 57?13,t=13.61,P=0.00).Among the cases,21 showed excellent outcomes,7 were good,and 3 were improved.The rate of excellent and good results was 90.3%(28/31).Conclusion Ho∶YAG laser is a safe,simple,and effective tool in cutting menisci under a arthroscope.

Objective To investigate the therapeutic value of endoscopic implantation of metal stents for obstruction caused by left-sided malignant colorectal tumor.Methods Data of 29 patients with left-sided malignant colonic obstruction who underwent stenting from May 2007 to May 2011 were retrospectively analyzed.Results Self-expanding metal stents were successfully implanted in 27 patients.Symptoms of abdominal distention and vomiting subsided in these patients.The procedure failed in 2 patients (2/29,6.9％ ),because the guidewire failed to pass the colonic stricture due to edema and the length of the diseased colon.Technical success was achieved in 27 of total 29 patients (27/29,92.6％ ).Out of the 27 patients,stage Ⅰ primary left-sided colonic resection and anastomosis were successfully performed in 24 patients.Colonic perforation was found intraoperatively in 1 patient ( 1/27,3.7％ ) who subsequently recovered after operation.There was no death during the perioperative period with the average hospital stay of 11.7 days.A mean colonic stent patency for 5 months was observed in 3 patients who underwent palliative stenting only.Conclusion Endoscopic implantation of metal stents is effective for left-sided malignant colorectal obstruction.As a bridge to surgery,it facilitates sufficient bowel preparation for elective radical operation.

Objective To evaluate the effective treatment for and prevention of complications. Methods The diagnosis and treatment of 32 patients with acute arterial ischemia of the lower extremity were analyzed (retrospectively). 4 cases were treated with thrombolytic therapy, 28 cases underwent emergency operation, of which 3 cases underwent amputation after embolectomy, and 25 cases were treated by arteriotomy of femoral artery and embolectomy with Fogarty catheter(7 cases underwent concomitant arterioplasty).Results One (patient) in the nonoperative group died; but there was no mortality in the operated group. Limb amputation was done in 3 cases, and limbs were saved in 28 cases. Conclusions For acute arterial ischemia of the lower (extremity), emergency arteriotomy of femoral artery plus embolectomy is the treatment of choice. This (therapeutic) approach can lower mortality and limb amputation rate.

Objective To explore the relationship among the sense of coherence,empowerment and self-efficacy in peritoneal dialysis patients.Methods General information,the Sense of Coherence Scale,the Peritoneal Dialysis Empowerent Scale-Short Form and the Self-Efficacy for Managing Chronic Disease Scale were used to investigate a total of 160 peritoneal dialysis patients in a third-class hospital in Tianjin from March to June,2015.Results The mean score of the sense of coherence,empowerment,self-efficacy were (62.01±11.94) points,(4.09±0.68) points and (6.08±2.19) points.Both the sense of coherence and empowerment could positively influence the self-efficacy of peritoneal dialysis patients directly (r=0.429-0.571,P ＜ 0.01),and the sense of coherence could also indirectly influence the self-efficacy through the mediation of empowerment (β decreased from 0.429 to 0.172,P ＜ 0.01),the mediation effect accounted for 60.1％ of the total effect.Conclusions Medical staff should take different actions to improve the sense of coherence and empowerment to improve the self-efficacy of peritoneal dialysis patients.

Objective:To evaluate the relationship between breast reconstruction and postoperative complications by meta-analysis.Methods:Through a defined search strategy, related literature was collected in databases from PubMed, MEDLINE, EMBASE, Cochrane, CNKI, Wanfang Database and VIP Database, from January 1990 to November 2017. Data were extracted and each merged data was analyzed using RevMan 5.3 software. The postoperative complications between transverse rectus abdominis musculocutaneous-flap (TRAM) and deep inferior epigastric perforatorflap (DIEP), TRAM and latissimus dorsiflap (LDF), LDF and LDF+ prosthesis, LDF+ prosthesis and simple prosthesis implantation were compared.Results:Twenty-nine papers met inclusion criteria of our study. The Meta-analysis results showed that the risk of local flap necrosis, seroma, infection, fat liquefaction, abdominal wall hernia and abdominal bulging in TRAM group were higher than those in DIEP group, and the differences were significant. There was no significant difference in total flap necrosis, wound dehiscence, venous congestion between the two groups; the risk of total flap necrosis, wound dehiscence and infection in TRAM group were higher than those in LDF group, and the differences were significant. The risk of seroma in TRAM group was lower than that in LDF group, and the differences were significant. There was no significant difference in fat liquefaction between the two groups; there was no significant difference in the postoperative complications between LDF group and LDF+ prosthesis group; the risk of seroma in LDF+ prosthetic group was higher than that in prosthetic group, and the differences was significant. The risk of prosthetic capsular contracture and prosthesis displacement in LDF+ prosthetic group were lower than those in prosthetic group, and the differences were significant. There was no significant difference in prosthesis exposure and infection between the two groups.Conclusions:DIEP has most of the advantages of TRAM and fewer complications. It plays an important role in breast reconstruction in the future. We should make a choice of breast reconstruction methods according to the patient＇s conditions as far as possible in clinical practice.

Objective To investigate the correlation between dose and effect of thioacetamide (TAA) on rat model of intestinal endotoxemia. Methods The models of intestinal endotoxemia were induced by three different doses of TAA by gavage administration of TAA 200, 400, 600mg/kg respectively once per day for two days.The doses were given at same time point every day. Each group included 10 rats. The rats in the control group were administrated with 2 mL 0.9% NaCl saline gavage. The death of the rats was observed at 24 hours and 48 hours after administration. The blood samples of the living rats were drawn from abdominal aorta for determining the plasma endotoxin levels, serum alanine aminotransferase(ALT)and aspartated transaminase (AST) levels. The histopathological changes of liver were examined. Single factor analysis of variance was performed and comparision between groups was done using t test. Results No rat in the control group died. Two rats of 200 mg/kg TAA group, five rats of 400 mg/kg TAA group and eight rats of 600 mg/kg TAA group died during the experiment. The mean serum ALT levels of TAA model groups [(305.09±116.78)U/L,(901.67±274.31)U/L,(1454.84±473.49)U/L] were all significantly higher than that of the control group(47.81±22.61)U/L(t=14.583, 25.896 and 20.596, respectively; all P＜0.05). The mean serum AST levels of TAA model groups [(465.88±139.96)U/L, (884.37±250.90)U/L,(1889.23±159.67)U/L] were all significantly higher than that of the control group (69.33±22.04)U/L(t=12.988,18. 455 and 13.542, respectively; all P＜0.05). The mean plasma endotoxin levels of TAA model groups [(0.436±0.110)EU/mL, (0.550±0.095) EU/mL, (0.620±0.057)EU/mL] were all significantly higher than that of the control group (0.103±0.056)EU/mL(t=7.335, 5.260 and 8.191, respectively; all P＜0.05). The histological results of TAA model groups showed hepatic cell degeneration and necrosis in different degrees. Conclusions TAA with 200-600mg/kg is proper to establish the rat model of intestinal endotoxemia. The death rate of rats in the 200mg/kg TAA group is lower than those of other model groups, which suggests that 200mg/kg TAA may be the best dosage for establishing rat model for further studies.

Adenocarcinoma ; metabolism ; secondary ; surgery ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; secondary ; surgery ; Colectomy ; Colonic Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Keratin-18 ; metabolism ; Liver Neoplasms ; metabolism ; secondary ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; metabolism

Objective To study the clinical and pathological features of primary nephrotic syndrome in elderly patients.Methods Clinical data of patients with primary nephrotic syndrome aged ≥ 60 years underwent renal biopsy were retrospectively analyzed and patients with primary nephrotic syndrome aged ＜60 years were selected as control group.Results Male patients with primary nephrotic syndrome were common in the elderly group and control group,and there was no significant difference in gender composition between the two groups (62.0％ vs.61.5 ％,P＞0.05).The degree of edema and hypertension,levels of blood urea nitrogen,serum albumin,blood IgG and ratio of IgG /IgM were higher while levels of urinary protein and blood cholesterol were lower in elderly group than in control group (all P ＜ 0.05).No significant differences in the incidence of hematuria,serum levels of creatinine,IgA,and complement were found between the two groups (all P＞0.05).The risk of primary nephrotic syndrome was higher in elderly group than in control group (P＜0.01).The level change of blood IgG was positively associated with plasma albumin,while negatively associated with urinary protein and blood cholesterol in both groups (r=0.327,-0.147,-2.860,respectively,all P＜0.05).Membranous nephropathy was the most common type in elderly patients,accounting for 49.77％,while only accounting for 23.6％ in control group,which had a significant difference between the 2 groups (x2 =62.390,P ＜ 0.01).Mesangial proliferative glomerulonephritis was common in both groups,but no significant difference(x2 =62.390,P＞0.05).Conclusions Male patients are more common than female patients in primary nephrotic syndrome.The clinical manifestations including urinary protein and serum albumin are milder but the risk is much greater in elderly patients than in the non-elderly patients.The change of blood IgG level is associated with urine albumin,plasma albumin and plasma cholesterol.Membranous nephropathy is the most common type followed by mesangial proliferative glomerulonephritis in elderly patients with nephrotic syndrome.