Objective To find out the effect of NO on the stroke of periodic paralysis.Methods Blood potassium,NO and NOS were measured in patients with hypokalemic periodic paralysis during paralysis stroke and after muscle power recovered.The relationship between NO and NOS and paralysis in the different phase was observed.Results NO and NOS decreased obviously in the phase of paralysis,which tended to be normal with recovering of blood potassium and muscle power after treatment.The change of NO was positively correlated with the decreasing degree of blood potassium(r=0.3511,P

BACKGROUND: It is very important to explore an optimal loading force that can both allow effective intrusion and cause no damage to the teeth.OBJECTIVE: To investigate the optimal loading conditions, including loading force values and directions, in the intruding mechanics of maxillary anterior teeth.METHODS: A three-dimensional finite element model (3D FEM) of the maxillary anterior teeth was constructed to include the periodontal ligament (PDL), alveolar bone, and appliance (brackets and wire). The initial stress distribution and force of the maxillary anterior teeth were analyzed when the 3D FEM was loaded with different intruding force values and directions. RESULTS AND CONCLUSION: The optimal value of the intruding force for 6 anterior teeth fell within the range from 0.5 N to 1.0 N. The maximum stress was detected at the distal cervical level of the lateral incisor, and a relatively even distribution of initial stress was observed at 20° palatal deviation to the Y axis. The results suggest that using mini-screw implants at the labial region between the canine and lateral incisor and a combined 0.5-1.0 N intruding force with a distal force could be an optimal intrusion force system by which patients with normal occlusion could obtain a pure intrusion of anterior teeth.

[Objectives]This study was designed to evaluate the treatment effects of a new movable molardistalization appliance for distal movement of maxillary first molars on Angle's Class Ⅲ malocclusion adolescence patients with the second premolar crowded.[Methods]Sixteen patients were treated by a new movable molardistalization appliance.Cephalometric analysis and model measurement was carried out before and after the treatment.Data were analyzed by paired t-test.[Results]The molars were distalized 5 mm during an average time of 3.8 months.There were significant increases in the Angle SNA and A-NPg(P ＜0.05).[Conclusion]it was a effective way to get space and improve patient's profiles on Angle's Class Ⅲ malocclusion adolescence patients with the second premolar crowded by the new movable molardistalization appliance.It was also conducive to patient's oral hygiene.

Objectives To study the changes of hard tissue before and after orthodontic treatment for Angle's class Ⅲ malocclusion adolescence patient with maxillary front traction. Methods 20 cases of Angle's class Ⅲ malocclusion adolescence patients were treated by front traction in maxilla, while there were 20 cases of Angle's class Ⅰ malocclusion adolescence patients as the control group. Cephalometric a-nalysis was carried out before and after the treatment. Data were analyzed by SPSS11.0 system using paired t-test. Results There were significant increases in the length, anteroposterior diameter and thick-ness of maxillary sinus (P<0.05), while there was no significant differences in the site and central point of maxillary sinus(P>0.05). Conclusions It is a effective approach to change the hard tissue after ortho-dontic treatment for Angle's class Ⅲ malocclusion adolescence patient with front traction in maxillary area.

BACKGROUND:Distraction osteogenesis applied in patient’s canine distal movement, can greatly improve the speed of tooth movement, and protect the molar anchorage. But the researches on the traction rate, canine pulp vitality, canine periodontal tissue remodeling and the biological mechanisms of the technology are rare recently. OBJECTIVE:To evaluate the feasibility of rapid canine retraction through distraction osteogenesis of the periodontal ligament in adult patients and to monitor the pulp vitality, root resorption and periodontal remodeling of the canine. METHODS:Nine malocclusion patients were selected, and the bilateral maxil ary canine in adult patients were rapidly retracted and moved to the scheduled position using modified distraction devices. The canine distal movement distance, anchorage loss, root resorption and alveolar interval alterations were measured through intraoral radiographs, and lateral cephalograms. The pulp and periodontal of canine were mointrored. RESULTS AND CONCLUSION:The canines could be rapidly retracted to the schedualed position through distraction osteogenesis of the periodontal ligament in 12-16 days, the average amount of retraction was 7.18 mm and the canines tipped distal y (13.24±2.87)°. The anchorage loss was 0.5 mm. There was no obvious root resorption and periodontal tissue loss. The pulp vitality of the canines was decreased significantly right after distraction, but it recovered significantly after 3 months. The results indicated that periodontal ligament distraction osteogenesis can significantly accelerate canine movement speed, shorten treatment time, while protecting the molar anchorage;there was no significant adverse reaction of root resorption, loose teeth, pulp necrosis and loss of periodontal tissue. Indcating that distraction osteogenesis of periodontal ligament can move canines rapidly and effectively.

Objective : To investigate the willingness to receive HIV testing in primary health service institutions (PHSIs) among young students in Wuhan City, so as to provide the evidence for improving the detection of HIV testing among young students. Methods: Fifteen PHSIs were sampled using a stratified random sampling method in 14 districts of Wuhan City, and school students at ages of 15 to 24 years were sampled from each district using a convenience sampling method. Participants' demographics, awareness of AIDS-related knowledge, HIV testing and willingness to receive HIV testing were collected using questionnaires, and factors affecting the willingness to receive HIV testing in PHSIs were identified among school students using a multivariable logistic regression model. Results : A total of 301 questionnaires were allocated, and 299 valid questionnaires were recovered, with an effective recovery rate of 99.34%. The respondents included 143 men (47.83%) and 156 women (52.17%), and had a mean age of (19.36±2.40) years; there were 223 respondents with an educational level of diploma and above (74.58%). The awareness of AIDS-related knowledge was 71.57% among the respondents, and 144 respondents had received AIDS-related health education in PHSIs (48.16%). There were 34 respondents that had received HIV testing (11.37%) and 203 respondents that were willing to receive HIV testing in PHSIs (67.89%). The respondents that were unwilling to receive HIV testing in PHSIs were mainly attributed to considering to be unlikely to get HIV infections (82.29%). Multivariable logistic regression analysis showed that school students who knew AIDS-related knowledge (OR=2.797, 95%CI: 1.583-4.941), knew free HIV counseling and testing services in PHSIs (OR=2.070, 95%CI: 1.123-3.814), and had received AIDS-related health education in PHSIs (OR=2.814, 95%CI: 1.573-5.032) were more willing to receive HIV testing in PHSIs. Conclusions There were 67.89% of school students that were willing to receive HIV testing in PHSIs in Wuhan City, and the willingness to receive HIV testing was correlated with the awareness of risk of HIV infections, and awareness and experience of AIDS control services in PHSIs.

Objective:To analyze the clinical outcomes of tibial bone transport over an intramedullary nail in combination with antibiotic-loaded calcium sulphate for treatment of segmental bone defect.Methods:A retrospective analysis was conducted by enrolling 11 surgically treated patients with tibial segmental bone defect after the debridement for tibial infection or osteomyelitis who were admitted in Lower Limb Surgery Ward of Traumatic Orthopedic Department, Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from Jan. 2018 to Jan. 2020. The collected clinical materials and data included gender, age, injury mechanism, smoke or alcohol, comorbidities, intraoperative bleeding loss, bone defect length, resorption time of calcium sulphate, bone transport time, external fixation time, external fixation index, complications and Paley bone and functional criteria. SPSS 24.0 software was used to analyze the data.Results:Eleven patients were followed up for 8 to 31 months (average 23.2 months). All patients achieved bone healing and the infection was eradicated with no sign of recurrence. The mean length of defect was (8.1±1.6) cm, mean resorption time of calcium sulphate was (6.6±2.6) months, bone transport time was (11.4±2.8) weeks, external fixation time was (4.7±1.2) months, external fixation index was (0.58±0.07) month/cm and full weight bearing time was (6.1±1.4) months. The complication rate was 36.4% including deep vein thrombosis, delayed union of the docking site, pin tract infection and sterile draining of the wound. Paley bone evaluation results were excellent and good in 10 patients (90.9%) and functional results were excellent and good in 11 patients (100%).Conclusion:Tibial bone transport over an intramedullary nail in combination with antibiotic-loaded calcium sulphate is a safe, reliable and successful method for segmental bone defect and eradication of infection which reduces external fixation time and complication rate, allows patients perform weight bearing and return to daily life earlier.

Objective To analyze the factors that influence the articular function after open reduction and internal fixation for ankle fractures.Methods From July 2014 to January 2016,111 ankle fractures received surgery in our hospital.There were 54 males and 57 fenales,with a mean age of 43.5 years (frown 18 to 75 years).By the Broos & Bisschop classification,there were 43 unimalleolar,38 bimalleolar and 30 trimalleolar fractures.The postoperative articular function was evaluated according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring at the final follow-up.Comparisons were made between the patients with excellent functional scores and those with lower than excellent functional scores.The potential influencing factors were analyzed,including age,gender,body mass index,smoking history,primary hypertension history,diabetes history,injured side,fracture cause,Broos & Bisschop classification,combined presence of obvious inferior tibiofibular separation,combined presence of ankle dislocation,combined presence of other injury,time from injury to surgery,physical status classification by the American Society of Anesthesiologists system,operation time,early functional exercise,removal of internal fixation and postoperative complications.The influencing factors were identified using univariate analysis and logistic regression analysis.Results The average follow-up period was 15.5 months (from 8 to 25 months).The clinical union time of the fractures averaged 3.2 months (from 3 to 5 months).The ankle function at the final follow-up was excellent in 58 cases,good in 48,fair in 5 and poor in 0,with an excellent and good rate of 95.5％.Removal of internal fixation (P =0.001),early functional exercise (P =0.002),and postoperative complications (P =0.049) were identified as the independent risk factors influencing the articular function after surgery for ankle fractures.Conclusion For patients with ankle fracture,enhancing intraoperative procedures,reducing postoperative complications,encouraging the patients to do early functional exercise,and removing internal fixation after firacture union can effectively improve their ankle function.

Objective:To introduce our modified hybrid bone transport technique using hindfoot arthrodesis nails combined with antibiotic-loaded calcium sulfate by comparison with conventional bone transport in the treatment of distal tibial osteomyelitis with bone defects involving the articular surface.Methods:The clinical data of 34 patients were retrospectively analyzed who had been treated at Department of Orthopaedics, Honghui Hospital for distal tibial osteomyelitis with bone defects involving the articular surface from September 2014 to September 2019. They were divided into 2 groups according to their way of repairing bone defects. In the modified group of 14 cases subjected to the treatment using the modified hybrid bone transport technique, there were 9 males and 5 females, with an age of (39.4±7.3) years. In the conventional group of 20 cases subjected to the treatment using conventional bone transport technique, there were 12 males and 8 females, with an age of (41.2±6.6) years. The external fixation time (EFT), external fixation index (EFI), self-rating anxiety scale (SAS) were recorded and compared between the 2 groups. Healing of bone defects and function were evaluated at the last follow-up according to the criteria of Association for the Study and Application of the Method of Ilizarov (ASAMI) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-posterior foot score, respectively. Complications were recorded according to the Paley classification.Results:There was no significant difference in the general data between the modified group and the conventional group, showing they were comparable ( P>0.05). Thirty-four patients were followed up for 18 to 32 months (average, 27 months) after operation. The modified group had significantly shorter EFT [(3.9±1.6) months] than the conventional group [(9.8±2.2) months], and significantly lower EFI [(0.48±0.09) months/cm] than the conventional group [(1.42±0.32) months/cm] ( P<0.05). The SAS [(48.1±4.7) points] in the modified group was significantly lower than that in the conventional group [(61.2±6.2) points], and the number of complications per capita in the former [(0.8±0.4)/case] was significantly smaller than that in the latter [(1.42±0.32)/case] ( P<0.05). There were no significan differences in the healing of bone defects or AOFSA ankle-posterior foot score ( P>0.05). In the modified group and the conventional group, respectively, 13 versus 12 patients were satisfied while 1 versus 8 patients unsatisfied, 1 versus 8 patients had grade-Ⅱ infection while 13 versus 12 patients did not, and 1 versus 9 patients had grade-Ⅲ infection while 13 versus 11 patients did not. There were significant differences between the 2 groups in the above indexes (all P<0.05). Conclusion:In the treatment of distal tibial osteomyelitis with bone defects involving the articular surface, compared with conventional bone transport technique, our modified hybrid bone transport technique using hindfoot arthrodesis nails combined with antibiotic-loaded calcium sulfate may lead to better clinical efficacy due to the advantages of shorter external fixation time, lower external fixation index and fewer complications.

Objective:To evaluate the clinical performance of direct antimicrobial susceptibility test in blood culture-positive broth, and to provide a basis for optimizing the antibiotic use strategy in clinical bloodstream infection.Methods:A retrospective analysis was conducted on 780 blood culture-positive samples collected in Peking University People′s Hospital from May 2017 to December 2021. The direct antimicrobial susceptibility test was performed by disk diffusion method on blood culture-positive broth. The antimicrobial susceptibility breakpoints were in accordance with Clinical and Laboratory Standards Institute (CLSI) M100 S32 edition document.Results:In this study, a total of 331 strains of Gram-negative bacteria (139 strains of Escherichia coli, 79 strains of Klebsiella pneumoniae, 35 strains of Pseudomonas aeruginosa, 21 strains of Acinetobacter baumannii) and 396 strains of Gram-positive cocci (25 strains of Staphylococcus aureus, 316 strains of coagulase-negative staphylococci, 47 strains of Enterococcussp.) were collected, after excluding 53 cases with two or more isolates. Compared with the routine antimicrobial susceptibility test (AST), the rates of category agreement (CA), major error (ME), and very major error (VME) of Gram-negative bacteria were 86.0% (1368/1 591), 8.7% (139/1 591), and 0.5% (8/1 591), respectively. On the other hand, the CA%, ME%, and VME% of Gram-positive cocci were 89.2% (960/1 076), 7.5% (81/1 076), and 1% (11/1 076), respectively. Regarding the individual antimicrobial agents, the CA% of Escherichia coli was 16/17 for imipenem, 90.1% (109/121) for meropenem, and 70.8% (85/120) for cefepime. For Klebsiella pneumoniae, the CA% of was 10/13 for imipenem, 80.9% (55/68) for meropenem, and 80.3% (53/66) for cefepime. The CA% of meropenem in Pseudomonas aeruginosa and Acinetobacter baumannii were 96.0% (24/25) and 16/16. The CA% of linezolid and cefoxitin in Staphylococcus aureus were 100% (25/25) and 100% (24/24), respectively. The CA% of linezolid, cefoxitin and gentamicin in coagulase-negative staphylococci were 98.9% (269/272), 94.5% (277/293) and 71.6% (194/271) respectively. Finally, for Enterococcus sp., the CA% of vancomycin and ampicillin were 91.5% (43/47) and 94.7% (36/38), respectively. Conclusion:Compared with the conventional AST, the blood culture-positive broth direct AST exhibited high category agreement and low error rates for both Gram-negative bacteria and Gram-positive cocci, which can serve a rapid alternative for AST in cases of clinical bloodstream infection.