Objective To investigate the role of staging nutrition(SN) in the treatment of severe acute pancreatitis(SAP). Methods One hundred patients with SAP treated in our hospital since 1997 were randomly divided into two groups: Total parenteral nutrition group(TPN group,50 cases) and staging nutrition group (SN group,50 cases). The curative effects and complications between two groups were analyzed and compared. Results The incidences of total complications,incubation complication,double infection,hepatic function injury,abdominal cavity infection and hospital stay in SN-group were significantly lower than those in TPN-group(all P

OBJECTIVETo study the differences between amelogenesis imperfecta (AI) teeth and normal human (NH) teeth in wear properties.

METHODSThe ultrastructure of the human tooth enamel from adult patient diagnosed with AI was investigated using atomic force microscope (AFM) and compared with the surface of normal human tooth enamel. The composition of tooth enamel of AI teeth and normal human teeth were analyzed by energydispersive X-ray spectroscopy (EDX). The properties of micro-friction and wear between AI teeth and normal human teeth were compared using nano-scratch technology and scanning electron microscope (SEM).

RESULTSThe AI teeth were found porosity and the loosely packed hydroxyapatite was distributed randomly compared with normal human teeth. The amount of C was higher while the amount of Ca, P were lower in AI teeth than normal human teeth. The friction coefficient of both AI teeth and normal human teeth was increasing with the load increased and the friction coefficient of AI teeth was higher than normal human teeth with the same load. Meanwhile, the destruction of AI teeth was more severe than normal human teeth with the same load.

CONCLUSIONThe AI teeth has significant differences with normal human teeth on micro-structure, composition and micro-friction and wear properties. Thus, we need to have a general consideration of all these results when doing clinical restorations.

Adult ; Amelogenesis Imperfecta ; Dental Enamel ; Humans ; Microscopy, Electron, Scanning ; Tooth

Objective: To explore the relationship between procalcitonin (PCT), C-reactive protein (CRP) and blood glucose (BG) levels and postoperative pancreatic fistula (POPF) in non-diabetic patients after pancreaticoduodenectomy (PD), and evaluate the clinical value of early multi-indicators combined prediction of pancreatic fistula. Methods: The clinical data of 68 non-diabetic patients who underwent PD surgery from April 2016 to June 2018 in the First Affiliated Hospital of Harbin Medical University were retrospectively analyzed, including 42 males and 26 females, with average age of 58 years, age range from 26 to 80 years. According to the diagnostic criteria of POPF, the patients were divided into the pancreatic fistula group (n=17) and the non-pancreatic fistula group (n=51). The surgical related indicators, health economic indicators and PCT, CRP, and BG levels on preoperative and postoperative day 1, 3 and 5(POD1, POD3, POD5) were compared between two groups. Multivariate logistic regression analysis was used to screen out independent risk factors associated with POPF, and a weighted predictive model (wScore M) for predicting pancreatic fistula in non-diabetic patients was established by combining independent risk factors. The receiver operating characteristic (ROC) curves of each independent risk factor and prediction model were plotted to determine the cutoff value, area under the ROC curve (AUC), sensitivity, specificity, positive predictive value, negative predictive value, and individual risk factors were compared. And the predictive value of the multi-indicator combined prediction model. Results: Univariate analysis showed that the pathological types of the tumor, the tumor size, the blood glucose level of POD3, the PCT level of POD1, POD3, POD5 and the CRP level of POD3, POD5 were statistically different (P<0.05). Multivariate analysis showed that PCT (P=0.004), CRP (P=0.031), and BG (P=0.005) levels of POD3 were independent risk factors of POPF. The AUC of the ROC were 0.967, 0.692, and 0.698, respectively. The sensitivity were 0.588, 0.706, and 0.647, respectively. The specificities were 0.863, 0.686, and 0.765, respectively. The positive predictive values were 52.9%, 70.6%, and 64.7%, respectively. The negative predictive values were 88.2%, 70.6%, and 76.5%; the AUC of the wScore M ROC curve was 0.877, the sensitivity was 0.706, the specificity was 0.863, the positive predictive value was 70.6%, and the negative predictive value was 86.3%. Compared with the non-pancreatic fistula group, the patients of the pancreatic fistula group with pancreatic fistula complications had prolonged hospitalization time and increased the total hospitalization cost, which were statistically different (P=0.039, 0.010). Conclusion PCT, CRP and BG are independent risk factors for POPF, and early combined prediction of multiple indicators (POD3)has good predictive value, which has significant clinical reference for optimal and effective interventions at early stage.