Objective To evaluate pancreatic duct stenting for acute biliary pancreatitis with difficult endoscopic cannulation. Methods From January 2005 to December 2009, in patients with acute biliary pancreatitis who needed intervention of emergency ERCP, a total of 81 cases were found to be with difficult cannulation and were randomly divided into either treatment group (n = 35 ) to receive pancreatic duct stenting, or control group (n =46) to receive the procedure without pancreatic duct stenting. All patients were treated with same medication, and the pancreatic stents were removed after stabilization at a mean time of 11days after ERCP. All patients were followed up for 3 months after discharging from the hospital. Results There was no significant difference between two groups in regarding of mean age, the time from onset to endoscopy, Glasgow scores and relevant biochemical parameters, but the occurrence of postoperative complications was significantly higher in control group than that of the treatment group ( 17. 39% vs. 5. 71%*, P ＜0. 01 ). Conclusion Pancreatic duct stenting is a safe and bridging procedure for patients with acute billiary pancreatitis, which can also reduce complications.

Objective To investigate the effects of hyperbaric oxygen preconditioning (HBOP) on brain edema, inflammatory reaction and neuronal cell apoptosis induced by experimental hemorrhage in rats. Method Eighteen male Spraque-Dawley rats, weighing 300 - 350 g,received five successive sessions of HBOP with 3 atmosphere absolute pressure and 100% O2 one hour daily for five successive days, and other eighteen rats received five successive sessions of pretreatment with one atmosphere absolute pressure, air, one hour daily for five successive days. Twenty-four hours after the final pre-conditioning, rats received an infusion of 100 μL autologous blood into the basal ganglion. Seventy-two hours later, rats were sacrificed for brain edema measurements in 12 rats of each group. The histopathological changes around the hematoma were observed microscopically, and the neuronal cell apoptosis was detected by using the terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) in six rats of each group. Data of brain water content were analyzed by using Stata 7.0 software and statistical analysis was carried out by two-tailed Student t -test. Results Compared with the control group, HBOP significantly attenuated brain edema 72 hours after intra-cerebral hemorrhage in experimental rats (81. 6± 0. 7% vs. 82. 8± 0.9%, P < 0.01). Inflammatory cell infiltration and neuronal cell apoptosis were also significantly decreased in the HBOP group. Conclusions HBOP protects the rats against brain edema formation, and quells inflammatory reaction and neuronal cell apoptosis following intra-cerebral hemorrhage in experimental rats.

Objective To evaluate therapeutic effects of metformin on the expression of serum cytokines,balance of splenic Th17/regulatory T cells (Treg) and expression of splenic AMPK-mTOR in collagen-induced arthritis (CIA) rats,and the mechanism thereof.Methods The rat model of CIA was established by injecting bovine type Ⅱ collagen.Forty rats were randomly divided into five groups:the CIA model group(sterile water by gavage),Met-30 mg/kg group (metformin 30 mg ·kg-1 ·d-1 by gavage),Met100 mg/kg group(metformin 100 mg ·kg-1 ·d-1 by gavage),Met-300 mg/kg group(metformin 300 mg ·kg-1 ·d-1 by gavage) and control group (sterile water by gavage).The hind paw volume was recorded once a week.The serum level of cytokines,tumor necrosis factor (TNF)-α,interleukin (IL)-1β,IL-6,and IL-17,were measured by enzyme linked immunosorbent assay (ELISA) 35 days after the initial immunization.The quantity of Th17 and Treg cells were examined by flow cytometry.The expression of AMPK,p-AMPK,mTOR and p-mTOR were examined by western blotting.One-way analysis of variance was used to evaluate the experimental data.Results The values of hind paw volume were decreased on the 35 d of the initial immunization in the Met100 mg/kg [(2.43±0.37) ml,t=2.97,P＜0.05] and Met-300 mg/kg groups [(2.58±0.21) ml,t=2.96,P＜0.05] than those of CIA model group (2.97±0.23) ml.The serum levels of TNF-α,IL-1β,IL-6 and IL-17 on the 35-d after the initial immunization were significantly lower in the metformin therapeutic groups [Met-300 mg/kg group TNF-α (104±8) pg/ml,t=42.77,P＜0.05;IL-1β (183±24) pg/ml,t=60.457,P＜0.05;IL-6 (19.3±2.8) pg/ml,t=53.62,P＜0.05;IL-17 (64.5±6.7) pg/ml,t=47.92,P＜0.05] than those of the CIA model group [TNF-α (246±8) pg/ml;IL-1β (1 336±40) pg/ml;IL-6 (87.0±5.1) pg/ml;IL-17 (282.3±6.8) pg/ml].The quantity of Th17 and Treg cells were significantly different in the Met-300 mg/kg group than those of the CIA model group 35 d after the initial immunization [Th17(6.57±0.39) vs (9.89±0.53),t=8.74,P＜0.05;Treg (7.60±0.45) vs (3.94±0.61),t =8.37,P＜0.05].The expression of p-AMPK on the 35 d after the initial immunization in the metformin therapeutic groups was significantly higher than in the CIA model group(P＜0.05),and the expression of p-mTOR was significantly lower (P＜0.05).Conclusion Metformin can significantly inhibit the serum levels of TNF-α,IL-1β,IL-6 and IL-17 in CIA model rats,and regulate the balance of Th17/Treg through AMPK-mTOR signaling pathway.

Objective:To compare the outcomes of guide bone regeneration by calcined bovine bone and Bio-Oss graft material in alveolar ridge preservation after tooth extraction.Methods:280 patients were divided into two groups randomly.Each patient had single tooth extracted.The sockets were filled with calcined bovine bone in 140 patients and Bio-Oss graft in another 140 patients. After shaping,all the sockets were covered with Bio-Gide membrane.Buccal mucoperiosteal flap was released and sutured to close the alveolar sockets.The patients were regularly examined at the 1st,12th and 24th week after surgery.Physical examination and X-ray evaluation were applied to compare the outcomes of the two materials in alveolar ridge preservation.Results:No infection and re-jection occurred.The radiographic results showed the width and height of the alveolar bone were preserved well at the 12th and 24th weeks.No statistically difference was found in the two groups at the 1st and 24th weeks(P>0.05).Conclusion:The two graft ma-terials can effectively preserve alveolar bone after tooth extraction.

To facilitate noninvasive diagnosis of anemia, high-performance and portable near infrared (NIR) spectrometer for human blood constituents was designed and fabricated based on linear variable filter (LVF).Meanwhile, the performance of support vector regression (SVR) model for quantitative analysis of human hemoglobin (Hb) was investigated.Spectral data were collected noninvasively from 100 volunteers by self-designed LVF-NIR spectrometer, then divided into calibration set, validation set 1 and 2.To establish a robust SVR model, grid search method was applied to optimize the penalty parameter and kernel function parameter c=5.28, g=0.33.Then, Hb levels in the validation 1 and 2 sets were quantitatively analyzed.The results showed that the root mean square error of prediction (RMSEP) were 10.20 g/L and 10.85 g/L, respectively, and the relative RMSEP (R-RMSEP) were 6.85% and 7.48%, respectively.The results indicated that the SVR model had high prediction accuracy to Hb level and adaptability to different samples, and could satisfy the requirements of clinical measurement.Based on the SVR algorithm, the self-designed LVF-NIR spectrometer has a wide application prospect in the field of non-invasive anemia diagnosis.

OBJECTIVEThe aim of this retrospective study is to present the long-term effects of open healing of keratocystic odontogenic tumors (KCOTs) in the mandible.

METHODSA retrospective case series study was conducted on 41 patients with large KCOTs (the maximum diameter of the tumors exceeded 5 cm) treated at our institution between September 2003 and April 2011. A conservative surgical treatment was applied. The treatment involved enucleation of the primary lesion through narrow unroofing and open packing of the residual osseous defect with iodoform gauze for secondary healing. Bone regenera- tion and surgical complications were observed. The long-term effects of the treatment were followed up.

RESULTSThe inferior alveolar nerve was exposed in the KCOT bone cavity in all cases, and some nerves adhered to the tumor tightly. The post- operative follow-up time was 81.5 months on the average (36 to 127 months). The packing gauze was changed every two weeks after enucleation, and the total duration time for packing was 8.9 months on the average (3 to 15 months). Notable bone regeneration and satisfactory secondary healing were observed clinically and radiographically. The KCOT-affected teeth were reserved, and their chewing functions were restored. Two cases presented recurrences after the initial treatment. The recurrence rate was 4.9% (2/41). No serious complications were observed.

CONCLUSIONEnucleation associated with subsequent open packing is a reliable treatment for patients with large KCOTs in the mandible.

Adult ; Bone Regeneration ; Female ; Humans ; Male ; Mandible ; Mastication ; Neoplasm Recurrence, Local ; Odontogenic Tumors ; Retrospective Studies

Objective To investigate the main risk factors of respiratory complications in patients with cervical spinal cord injury so as to provide reference for early nursing assessment and personalized nursing intervention model. Methods A retrospective case series study was conducted on the clinical data of 303 patients with cervical spinal cord injury admitted to the Third Hospital of Hebei Medical University between January 2015 and September 2016. There were 248 males and 55 females, aged (44.9 ±13.8)years (range, 14-70 years). There were 109 cases at fracture site C14 and 194 cases at C5-8. According to ASIA classification, 131 cases were grade A, 26 cases grade B, 42 cases grade C, and 104 cases grade D. The duration from injury to operation was (23.2 ± 69.9) hours (range, 6-48 hours). Univariate analysis was performed on the risk factors of respiratory complications, including gender, age (14-54, 55-65, and 66-70 years old), occupation, hospital stay, smoking history, previous history, ASIA grade (grades A to D), injury cause, complications (abdominal distension, hyponatremia, hypoproteinemia, and anemia). Multivariate logistic regression was used to analyze the significant risk factors in the univariate analysis so as to further identify risk factors associated with respiratory complications. Results Univariate analysis showed that age (55-65 and 66-70 years), ASIA grade A, ASIA grade B, smoking history, injury cause, complications (abdominal distension, hyponatremia, hypoproteinemia, and anaemia) were related to respiratory complication of patients with cervical spinal cord injury (P ＜0.05). The gender, occupation, length of hospital stay, and previous history were not associated with respiratory complications of patients with cervical spinal cord injury (P＞0.05). Logistic regression analysis showed that age between 55 and 65 years (OR = 3.989, P ＜ 0.05), age between 66 and 70 years(OR =0.301, P＜0.05), AISA grade A (OR=30.300, P＜0.05), ASIA grade B (OR =5.784, P ＜0.05), smoking history (OR=5.238, P ＜0.05), abdominal distension (OR = 1.975, P＜0.05), hypoproteinemia (OR =6.212, P ＜ 0.05), and hyponatremia (OR =3.233 ＜0.05) were independent risk factors for respiratory complications in patients with spinal cord injury. Except for ASIA classification, other factors might be easily ignored by doctors and nurses, leading to poor prognosis of patients. Conclusions Age (above 55 years), ASIA grades A and B, smoking history, abdominal distention, hypoproteinemia, and hyponatremia are the risk factors of respiratory complications in patients with cervical spinal cord injury. Based on the results, early nursing assessment can be carried out and personalized nursing measures can be taken to reduce the incidence of respiratory complications. It can also provide reference for constructing standardized nursing intervention model.

Objective To compare the clinical efficacy of a new low notch plate system(Carmen synchronous adaptive cervical fusion system)and Zero-p in the treatment of single level cervical spondylotic radiculopathy(CSR).Methods Retrospective analysis was made on 48 patients with single level cervical spondylosis of nerve root type admitted from January 2015 to January 2020,including 26 patients with new low notch steel plate system(observation group)and 22 patients with Zero-P(control group).The operation duration,intraoperative blood loss,incidence of postoperative dysphagia,preoperative and postoperative JOA scores,cervical dysfunction index(NDI)Visual analog score of pain(VAS)and Cobb angle and intervertebral space height of postoperative imaging.Results There was no significant difference between the two groups in terms of operation time,intraoperative blood loss and the incidence of postoperative dysphagia(P＞0.05).All patients were followed up for 12-15 months,with an average of(12.6±0.7)months.There was no significant difference in JOA score,NDI index and VAS score of pain between the two groups before and 3 and 12 months after operation(P＞0.05).Conclusion The clinical efficacy of the new low notch plate system in the treatment of single segment cervical spondylotic radiculopathy is equivalent to Zero-P,and it is a reliable new type of anterior cervical internal fixation system.

Objective The aim of this retrospective study is to present the long-term effects of open healing of keratocystic odontogenic tumors (KCOTs) in the mandible. Methods A retrospective case series study was conducted on 41 patients with large KCOTs (the maximum diameter of the tumors exceeded 5 cm) treated at our institution between September 2003 and April 2011. A conservative surgical treatment was applied. The treatment involved enucleation of the primary lesion through narrow unroofing and open packing of the residual osseous defect with iodoform gauze for secondary healing. Bone regeneration and surgical complications were observed. The long-term effects of the treatment were followed up. Results The inferior alveolar nerve was exposed in the KCOT bone cavity in all cases, and some nerves adhered to the tumor tightly. The postoperative follow-up time was 81.5 months on the average (36 to 127 months). The packing gauze was changed every two weeks after enucleation, and the total duration time for packing was 8.9 months on the average (3 to 15 months). Notable bone regeneration and satisfactory secondary healing were observed clinically and radiographically. The KCOT-affected teeth were reserved, and their chewing functions were restored. Two cases presented recurrences after the initial treatment. The recurrence rate was 4.9% (2/41). No serious complications were observed. Conclusion Enucleation associated with subsequent open packing is a reliable treatment for patients with large KCOTs in the mandible.

Objective To develop a satisfaction scale in orthopaedic inpatient and test the reliability and validity.Methods A research team was founded in March 2015.The primary items were obtained through literature review and semi-structured interview with orthopaedic inpatients.After expert consultation,the pretesting scale was developed.212 patients with orthopedic in the Third Hospital of Hebei Medical University were recruited in the study to finish the questionnaire from May to November 2015.After the test of reliability and validity,the final scale was developed.Results The final scale consisted of five dimensions and forty nine items.The Cronbach's α coefficient was 0.987 for the total scale and the dimensions were ranged from 0.874 to 0.928.The split-half reliability was 0.929.The item-content validity index (I-CVI) was 0.786-1.000.The scale-content validity index (S-CVI) was 0.893.The CVI of dimensions was 0.83-0.93.Exploratory factor analysis totally extracted five common factors,and the load value of each entry factor was 0.480-0.480.The cumulative variance contribution rate was 70.625％.Conclusions The orthopaedic inpatient satisfaction scale has good reliability and validity.It can be used as the evaluation tool for the satisfaction in orthopedic hospitalized patients and it also can provide references for the interventions in effect evaluation of satisfaction.