Objective:To evaluate the clinical efficacy between preparation porcelain veneer(PPV)and no-preparation porcelain veneer(NPPV).Methods:44 patients with 97 PPVs and 23 patients with 57 NPPVs were followed up for 3 years.Mental tension, postoperative dentin sensitivity and satisfaction of the patients,survival rate of the veneers,sulcus bleeding index(SBI)of preopera-tive and postoperative 3 years were evaluated.A comparative analysis was taken to examine the clinical indicators of 2 groups accord-ing to the modified CDA /Ryge criteria.Results:Survival rates of PPVs and NPPVs were 96.91 % and 96.49%(P >0.05),satisfac-tion rates of the 2 group patients were 95.45% and 95.65%(P >0.05),respectively.Mental tension and the postoperative dentin sensitivity of patients in PPV group was higher than those in NPPV group.Preoperative and postoperative SBI were not statistically dif-ferent between the 2 groups(P >0.05).Marginal adaptation in PPV group was better than that in NPPV group.Color matching, Porcelain surface and Marginal stain were not statistically different between 2 groups.Conclusion:Preparation porcelain veneers and no-preparation porcelain veneers both are effective in clinical application.

Objective To study the effect of the extract of total flavonoids of Chrysanthemum indicum(TFC) on adjuvant arthritis(AA) synoviocytes.Methods Totally 0.1ml of the complete Freund's adjuvant was subcutaneously injected into the right hind feet pads of 20 SD rats.24 days after immunity synoviocytes in the knee joint were treated with TFC.Cell morphology was examined with electron microscopy.Protein level of caspase-3 cleaved fragments was analyzed by Western blotting.The annexin V stain assay was applied to explore the effect of caspase-3 inhibitor on the amelioration in synovial cells apoptosis of AA rats.Results Typical morphology and biochemical feature of apoptosis in synovial cells of AA rats were observed with TFC.The protein level of caspase-3 cleaved fragments increased obviously and was related with the concentration of TFC in synovial cells of AA rats.The apoptotic cells positively stained with annexin V were markedly reduced by caspase-3 inhibitor.Conclusion TFC can induce apoptosis in AA rats synoviocytes,which may achieve therapeutical effects in AA.The activation of caspase-3 may be one of the main causations.

Abstract： Objective　To analyze the species distribution of microorganisms in culture tubes reported positive byBACTEC™ MGIT960 (hereafter referred to as "MGIT960") after species identification using matrix-assisted laser desorption/ionization time of flight massspectrometry (MALDI-TOF MS) technique. Methods　From 2021 to 2022, a total of 2 662 positive tubes reported by the MGIT 960 instrument at Tuberculosis Reference Laboratory of Tianjin Center for Tuberculosis Control were collected. Liquid cultures were independently inoculated to blood plate and neutral L-J medium, and the resulting isolate strains were identified using the MALDI-TOF MS method. According to the MALDI-TOF MS results, the non-repetitive results of the same patient on the same culture medium were analyzed for the composition ratio of strain distribution. For the strains not identified by MALDI-TOF MS, 38 strains were selected for 16S rRNA gene sequencing. Results　A total of 605 isolates were obtained from blood plates, and 501 of those were analyzed. Among them, Mycobacterium accounted for 17.76% (89/501), predominant by Mycobacterium abscess 10.18% (51/501) and Mycobacterium fortuitum 3.19% (16/501). Bacteria other than Mycobacterium accounted for 68.06% (341/501), with the main ones being Nocardia farcinica 15.57% (78/501), Gordonia sputa 9.38% (47/501) and Gordonia bronchialis 7.58% (38/501). There were 71 unidentifiable strains, making up 14.17% (71/501). A total of 2 378 strains were isolated from neutral L-J mediums, 1 748 of which were used in the incoming analysis. Among these, 78.72% (1 376/1 748) were Mycobacterium, 60.53% (1 058/1 748) were Mycobacterium tuberculosis (MTB), 4.69% (82/1 748) were Mycobacterium chimaer intracellulare group and 3.55% (62/1 748) were Mycobacterium Lentiflavum. Bacteria other than Mycobacterium accounted for 17.11% (299/1 748) in neutral L-J medium isolates, with Nocardia farcinica 4.35% (76/1 748), Gordonia sputa 2.69% (47/1 748) and Gordonia bronchialis 2.12% (37/1 748) as the main species. There were 73 strains that couldn't be identified, comprising 4.18% (73/1 748). The 38 strains that not identified by MALDI-TOF MS were all found to be Actinobacteria and Firmicutes by sequencing. Conclusions　A variety of nontuberculous Mycobacterium and bacteria other than Mycobacterium were found in the positive culture tubes reported by the MGIT960 instrument, most of which could be quickly identified by mass spectrometry. Bacteria other than Mycobacterium are mainly Nocardia and Gordonia, which should be paid attention to in differential diagnosis.

Objective To analyze the effect of dominant accessory atrioventricular pathways (AP) on the end vector of ventricular depolarization. Methods All patients had single AP confirmed by radiofrequency cathteter abalation (RFCA) and were free from organic heart disease (including 102 cases of dominant accessory AP and 38 cases of concealed AP). The AP was divided into posterior septal(P3) ,mediate septal (MS) ,anterior septal (AS), left posterior free wall (LP), left anterior free wall (LA), right posterior free wall (RP) and right anterior free wall (RA). Results The end 40 ms vector of QRS wave changed in 102 patients with manifested AP and in 4 patients with concealed AP (P < 0. 05). Conclusion The end 40 ms vector of QRS wave of any site manifested AP can change and the changes have the specihty of leads.

Objective To discuss the technique and value of preoperative reformatting with three-dimensional computed tomography technique for C_2 pedicle screw track.Methods GE Light Speed 16 Pro spinal CT scans of 15 adult dry vertebrae were loaded into an imaging station (software ADW4.2).Two methods of C_2 pedicle screw techniques were analyzed through virtual screw trajectory by VR (volume rendering) and MPR (multiple planar reformatting) techniques,in method A,screw entry point was the intersection between the media-vertical and the cranial line of C_2 inferior facet joint,in method B,the screw track was from the cranial and medial quadrant of the dorsal part of C_2 inferior facet joint.Results The screw track could be observed dynamically from any plane.Two vertebrae were ob- served with smaller height in isthmus and the medial edge of the transverse foramen since no space was a- vailable for the screw.The screw trajectories data were compared between method A and method B,which showed that the angles towards the cephalad (in sagittal plane) and midline (in transverse plane) were bigger in method A than in method B (P＜0.05,0.01),but the safe screw diameter was smaller in method A than in method B (P＜0.05),and there was no difference of the screw length between the two methods(P＜0.05 ).Conclusion In this research,the individual C_2 pedicle screw entry points, screw diameter and security screw angle can be simulated,and the screw track can be observed dynami- cally to make sure if it transits the bone structure completely.Preoperative three-dimensional computed tomography reformatting for pedicle screw track is of great value in clinical and basic researches.

OBJECTIVE To investigate the distribution of bacteria in general ICU then discuss the susceptible factors and the treatment.METHODS A retrospective analysis of clinical information was performed on 123 patients diagnosed infection who stayed in ICU from May 2002 to May 2004.RESULTS Most of bacteria resulted in infection of general ICU were Gram-negative(62.88%) and then Gram-positive(19.65%). Fungal infection accounted for 17.47%.Pseudomonas aeruginosa occupied the highest percentage among Gram-negative bacteria.Most of Gram-positive bacteria were Staphylococcus aureus and all of them were MRS.The infection site in ICU focused on lower respiratory tract(89.09%).The second was urinary tract(11.79%).CONCLUSIONS Most of the bacteria causing infection in general ICU locate in respiratory tract.They are mainly Gram-negative.All of the Gram-positive bacteria are MRS.The risk factors of hospital-acquired infection are related with patient′s age,underlying disease,intensive care time,ventilation time and invasive operation.

OBJECTIVE To investigate the characteristic of Gram-positive bacteria in general ICU then discuss the susceptible factors and the treatment.METHODS A retrospective analysis of clinical information was performed on patients with Gram-positive infection in ICU from May 2002 to May 2004.RESULTS Most of Gram-positive bacteria resulted in infection in general ICU were Staphylococcus aureus and all of them were MRSA.The infective site focused on lower respiratory tract(84.44%).The second was catheter(8.89%).CONCLUSIONS The risk factors of hospital-acquired infection are relative with patient's age,underlying diseases,stay time in ICU,ventilated time and invasive operation.

Objective To observe the acute pain service for analgesia effect and complications of postopera-tive analgesia and satisfaction after cesarean section.Methods 360 patients undergoing cesarean section and postop-erative continue analgesia were randomly divided into two groups.The control group (group C,n =178)was given with routine postoperative self -control analgesia give guidance.In the observation group (group A,n =182),a group for acute pain was founded,and the patients were explained about PCA self -control analgesia related knowledge before operation,together with the APS analgesia group people,the patients were given with postoperative pain management,observed self -control analgesia efficacy and side effects,and gives the corresponding treatment and guidance.The difference of analgesia incomplete and complication were observed such as nausea and vomiting,calm, itchy skin.Questionnaires that postoperative analgesia satisfaction survey were filled inafter discharged.The satisfac-tion of nurse with the APS were observed.Results Postoperative analgesia complication in group A were significantly lower than that in group C(P <0.01,P <0.05),APS analgesic incomplete in group C was significantly higher than groupA (χ2 =11,P <0.01).The satisfaction of PCA in group A were significantly higher than group C (P <0.01, P <0.05),ward nurses job satisfaction also increased significantly (t =2.63,P <0.05).Conclusion Acute pain service effectively improve analgesic quality and reduce related complications after cesarean section increase patients postoperative analgesia satisfaction,increase the ward nurses job satisfaction.

Objective To explore the feasibility and application of determining the center of the inferior portion of the glenoid on a standard anteroposterior view of the normal glenoid. Methods Seventy shoulders of 35 mature adults were measured in this study. A 64-slice CT 3D reconstruction was performed for each glenoid. A standard anteroposterior view and the scale of glenoid were made at a 3D workstation by one radiologist, and then transferred to software AutoCAD as 2D images. The 2D images were analyzed with AutoCAD respectively by 3 radiologists. The line was drawn between the most anterior and the most inferior points of the glenoid bony rim. On the same image, another line was drawn between the most posterior and the most inferior points of the glenoid bony rim. Two perpendicular bisectors of the 2 lines were drawn. The cross point of the 2 perpendicular bisectors was regarded as the circle center of the inferior part of the glenoid. The distances from the circle center to the anteroinferior and the posteroinferoir rims of the glenoid and the most posterior point were measured. Measurements were expressed as the mean ± standard deviation. Several related samples Friedman rank sum test was used to compare the measurements (the distance from the circle center to the most posterior point) by the 3 radiologists. Paired t tests were used to compare the differences between the left and right glenoids. Results The mean distance from the circle center to the most posterior point was ( 14. 1 ± 1.6) mm, the anteroinferior rim was ( 14. 0 ± 1.7) mm, and the posteroinferoir rim was ( 14. 1 ±1.6) mm. No significant differences were found ( P>0. 05) between measurements by the 3 radiologists. No significant differences were found ( P>0. 05) between the measurements of the both-side glenoids. Conclusions The method of determining the center of the inferior portion of the glenoid based on the most anterior,posterior and inferior points of the glenoid on a standard 3D anteroinferior view of the normal glenoid is easy,practical and highly repeatable. The radius of the left glenoid is comparable to the radius of the right side in normal shoulders. This method can be used to quantify a glenoid bone defect precisely.