OBJECTIVETo compare the accuracy of mesiodistal tooth angulation measurements by using traditional panoramic radiographs and cone beam CT (CBCT) panoramic images.

METHODSPlaster models of 15 volunteers with individual normal occlusions were collected. The functional occlusal plane and tooth long axis on the plaster models were marked from the right first molar to the left first molar in the upper and lower dental arches. A radiographic stent, which contains radiopaque markers near the functional occlusal plane and approximating the root axis, was fabricated for each model. Traditional panoramic radiographs and CBCT scan images were obtained from each patient, with the radiographic stent seated on the dentition. A panoramic image reconstruction was made from the CBCT volumetric data by using related software. The CBCT panoramic image data were oriented parallel to the maxillary or mandibular functional occlusal plane containing all the radiopaque markers when measuring the maxillary or mandibular teeth, respectively. The mesiodistal tooth angulations of the plaster model, traditional panoramic radiographs, and CBCT panoramic images were measured and compared. Multivariate analysis of variance and Dunnett-t test were performed to compare the differences among the three methods.

RESULTSThe difference among the three methods was statistically significant (P = 0.00). Significant differences compared with the model measurement were found in two teeth (upper second premolar and lower second premolar) among twelve teeth (P = 0.00) in traditional panoramic measurement. CBCT panoramic measurement was not significantly different to model measurement.

CONCLUSIONTraditional panoramic radiographs do not provide a more reliable measure of mesiodistal tooth angulation, whereas CBCT panoramic image is an tool for evaluating mesiodistal tooth angulation.

Bicuspid ; Cone-Beam Computed Tomography ; Dental Arch ; Dental Occlusion ; Humans ; Image Processing, Computer-Assisted ; Maxilla ; Molar ; Radiography, Panoramic ; Tooth ; Tooth Root

According to content of ‘lipid metabolism’,we crafted a effective case for problem based learning (PBL) and practiced it in biochemistry course.In group discussion,students participated in discussion with great enthusiasm and initiative.During the discussion,students got a better understanding about lipid metabolism and clinical application of the knowledge.As teachers,we maily guided students during PBL,and at the same time,we also summed up the experience and explored how PBL be implemented for freshmen and sophomores who lack clinical practice.

OBJECTIVETo discuss the clinical effect on swelling and pain after total knee arthroplasty treated with acupoint massage, mild moxibustion and routine detumescence.

METHODSOne hundred and twenty patients of knee osteoarthritis (KOA) after total knee arthroplasty (TKA), were randomized into an observation group and a control group, 60 cases in each one. In the control group, after TKA, the routine detumescence was applied, including elastic bandage compression, the operated limb raising exercise, knee joint braking, local ice compress, intermittent pneumatic compression, active ankle pumping and quadriceps contraction exercise, continuous passive mechanical exercise, using stretch socks, oral administration of rivaroxaban tablets, 10 mg, once a day, continuously for 21 to 24 days. In the observation group, on the basis of the routine detumescence as the control group, 1 h after operation, acupoint massage was done at Zusanli (ST 36) and Sanyinjiao (SP 6) till soreness and distension presented, twice a day; 48 h after operation, mild moxibustion was intervened at Zusanli (ST 36) and Sanyinjiao (SP 6), avoiding burning pain, once a day, continuously till the 7th day after operation. Before and after operation, the limb swelling condition and the scores of visual analogue scale (VAS) and HSS (hospital for special surgery) knee joint function were observed in the patients of the two groups.

RESULTSOn the 1st, 3rd, 5th, 7th and 14th days after operation, the swelling incidence in the observation group was apparently lower than that in the control group (P < 0.05, P < 0.01). On the 1st, 3rd, 5th and 7th days after operation, the scores of VAS in the observation group were lower than those in the control group (all P < 0.05). On the 7th and 14th days after operation, the scores of HSS in the observation group were better than those in the control group (all P < 0.05).

CONCLUSIONThe combined intervention of acupoint massage and mild moxibustion reduces the incidence of lower limb swelling, alleviates pain and promotes knee joint function recovery of TKA and the effects are better than those achieved by the simple routine detumescence therapy.

Acupuncture Points ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; Combined Modality Therapy ; Female ; Humans ; Knee Joint ; surgery ; Male ; Massage ; Middle Aged ; Moxibustion ; Osteoarthritis, Knee ; surgery ; therapy ; Treatment Outcome

Objective To compare the anesthetic effect of sufentanil combined with propofol and remifentanil combined with propofol in hysteroscopic surgery, and to provide a scientific basis for the selection of clinical anesthesia methods. Methods From November 2016 to March 2017, 94 patients in Lishui central hospital underwent hysteroscopic surgery were divided into the observation group and the control group according the anesthesia way, 47 cases in each group. The control group were given remifentanil(1 μg/kg) combined with propofol(2 mg/kg) by intravenous injection, the observation group were given sufentanil(0.2 μg/kg) combined with propofol(2 mg/kg). The mean arterial pressure(MAP), respiration (RR), pulse oxygen saturation (SpO2), heart rate (HR), the onset time of anesthesia, the postoperative recovery time, the recovery time of orientation and Ramsay sedation score in the two groups were recorded and compared before anesthesia, 2 min after anesthesia, 10 min after operation, 10min after operation finished. Results Compared with before anesthesia, MAP, RR, SpO2, HR index decreased significantly after anesthesia, the differences have statistical significance (P<0.05), the control group compared to the index value, the observation group and the control group of convergence and the decline of difference, group showed no statistically significant difference the observation group was more stable; comparison between the 10min group and MAP HR index after surgery, there was significant difference between two groups (P<0.05). The onset time of anesthesia, postoperative recovery time, orientation recovery time, Ramsay score difference between the groups was not statistically significant sedation score difference was statistically significant between group VAS, observation group than in the control group (P<0.05). Conclusion Sufentanil combined with propofol anesthesia were used in hysteroscopic surgery, which can better maintain the vital signs of patients, effectively reduce postoperative pain.

ObjectiveTo investigate the therapeutic effect of acupoint pressing plus gentle moxibustion on lower limb swelling after total knee arthroplasty.MethodOne hundred and twenty patients diagnosed with knee osteoarthritis who required unilateral total knee arthroplasty were allocated, in order of operations, to observation and control groups, 60 cases each. After the operation, all the patients received routine nursing care including elastic bandage pressure dressing, operated-on limb elevation, early knee immobilization, local ice compress, intermittent pneumatic compression, active ankle pump and quadriceps contracting-relaxing exercise, CPM mechanical exercise, use of elastic stockings and oral administration of rivaroxaban. The observation group received postoperative acupoint pressing plus gentle moxibustion additionally. Limb circumferences 10 cm superior and inferior to thepatella were measured and operated-on limb pains were scored (using the VAS) in the two groups of patients before, on the day of and at one, three, five, seven and fourteen days after the operation. Knee joint range of motion (ROM) was measured before and at three,seven and fourteen days after the operation.ResultThe incidence of swelling was 47.46% in the observation group and 67.24% in the control group. The duration of swelling was (7.31±3.19) days in the observation group and (10.92±3.12)days in the control group. There were statistically significant differences in the VAS score and operated-on knee joint range of motion between the two groups of patients at the same time points after the operation (P<0.05).ConclusionAcupoint pressing plus gentle moxibustion can effectively intervene in lower limb swelling and promote the recovery of knee joint function after total knee arthroplasty.

Objective To observe the clinical efficacy of Sha-petechia releasing therapy based on She medicine in treating occipital neuralgia, for proving its effectiveness and advantage. Method Eighty patients were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened by Sha-petechia releasing therapy based on She medicine, while the control group was by Western medications, 10 d as a treatment course, totally for 2 courses. The clinical efficacy and change of Visual Analogue Scale (VAS) score after intervention were observed. Result The total effective rate was 92.5% in the treatment group versus 82.5% in the control group, and the difference was statistically significant (P<0.05). Conclusion Sha-petechia releasing therapy based on She medicine is an effective approach in treating occipital neuralgia.

6 cases of lingually inclined mandibular second molar were treated by ring uprightor,the malposition was corrected in all the ca-ses in 3 months on average.

Objective To compare the accuracy of mesiodistal tooth angulation measurements by using traditional panoramic radiographs and cone beam CT (CBCT) panoramic images. Methods Plaster models of 15 volunteers with individual normal occlusions were collected. The functional occlusal plane and tooth long axis on the plaster models were marked from the right first molar to the left first molar in the upper and lower dental arches. A radiographic stent, which contains radiopaque markers near the functional occlusal plane and approximating the root axis, was fabricated for each model. Traditional panoramic radiographs and CBCT scan images were obtained from each patient, with the radiographic stent seated on the dentition. A panoramic image reconstruction was made from the CBCT volumetric data by using related software. The CBCT panoramic image data were oriented parallel to the maxillary or mandibular functional occlusal plane containing all the radiopaque markers when measuring the maxillary or mandibular teeth, respectively. The mesiodistal tooth angulations of the plaster model, traditional panoramic radiographs, and CBCT panoramic images were measured and compared. Multivariate analysis of variance and Dunnett-t test were performed to compare the differences among the three methods. Results The difference among the three methods was statistically significant (P=0.00). Significant differences compared with the model measurement were found in two teeth (upper second premolar and lower second premolar) among twelve teeth (P=0.00) in traditional panoramic measurement. CBCT panoramic measurement was not significantly different to model measurement. Conclusion Traditional panoramic radiographs do not provide a more reliable measure of mesiodistal tooth angulation, whereas CBCT panoramic image is an effective tool for evaluating mesiodistal tooth angulation.

Objective To investigate effect of diabetes mellitus factor on attenuation of myocardial ischemia-reperfusion injury by sufentanil postconditioning in rats.Methods Diabetes mellitus was established by intraperitoneal streptozotocin 50 mg/kg and was confirmed by blood glucose ≥ 16.7 mmol/L.Thirty healthy adult male SD rats,weighing 250-300 g which diabetes mellitus model was successfully established were randomly divided into 3 groups ( n =10 each):diabetic mellitus sham operation group (group DM-S),diabetic mellitus ischemia-reperfusion group (group DM-IR) and diabetic meltitus sufentanil postconditioning group (group DM-SP).Another 30nondiabetic mellitus rats were also randomly divided into 3 group ( n =10 each):nondiabetic mellitus sham operation group (group NDM-S),nondiabetic mellitus ischemia-reperfusion group (group NDM-IR) and nondiabetic mellitus sufentanil postconditioning group (group NDM-SP).Myocardial ischemia-reperfusion was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by reperfusion.Sufentanil postconditioning was induced by iv injection of sufentanil 1.0 μg/kg at 5 min before reperfusion.MAP,SBP,HR and RPP (HR × SBP) were recorded before ischemia,30 min of ischemia and 120 min of reperfusion.Arterial blood samples were collected at 120 min of reperfusion for measurement of plasma cardiac troponin 1 (cTnI) concentration.The animals were then sacrificed for determination of total areas of right and left ventricles ( LV + RV),infarct area (IS),area at risk (AAR) and IS/AAR.Results MAP and RPP were significantly lower,while plasma cTnI concentration was higher during myocardial ischemia reperfusion in diabetic and nondiabetic rats.Sufentanil postconditioning significantly decreased IS,IS/AAR and plasma cTnI concentration in nondiabetic rats during myocardial ischemia reperfusion but had no effect on IS,IS/AAR and plasma cTnI concentration in diabetic rats.The IS,IS/AAR and plasma cTnI concentration were significantly higher in DM-SP group than in NDM-SP gnoup ( P ＜ 0.05).Conclusion Diabetes mellitus factor can negate sufentanil postconditioning induced protection against myocardial ischemia-reperfusion injury in rats.

Objective To evaluate the role of mitochondrial permeability transition pore (mPTP) in attenuation of myocardial ischemia-reperfusion (I/R) injury by sufentanil postconditioning in rats.Methods Sixty male Sprague-Dawley rats,aged 14-15 weeks,weighing 350-420 g,were randomly divided into 4 groups (n =15 each):sham operation group (group S),group I/R,cyclosporin A group (group CP) and sufentanil postconditioning group (group SP).Myocardial I/R was produced by occlusion of left anterior descending branch of coronary artcry for 30 min followed by reperfusion.In groups CP and SP,cyclosporin A 5 mg/kg and sufentanil 1 μg/kg were injected via the jugular vein at 5 min before reperfusion respectively,while the equal volume of normal saline was injected in group I/R.At 10 min of reperfusion,hearts were excised,the myocardial mitochondria were immediately isolated and the activity of mPTP was measured by spectrophotometry.MAP and HR were recorded at 30 min of equilibration,at 30 min of ischemia and at 120 min of reperfusion and rate-pressure product (RPP) was calculated.Arterial blood samples were obtained at 120 min of reperfusion for determination of the plasma cardiac troponin Ⅰ (cTnⅠ) concentration.The animals were then sacrificed for determination of infarct size (IS) and area at risk (AAR),and IS/AAR was calculated.The mitochondrial ultra-structure was examined with electron microscope.Results Compared with group S,the mPTP activity and plasma cTnI concentration were significantly increased,and MAP and RPP were significantly decreased in the other three groups (P ＜ 0.05).Compared with group I/R,the mPTP activity,plasma cTnI concentration and IS/ARR were significantly decreased in groups CP and SP,and MAP was significantly increased in group CP (P ＜ 0.05).Compared with group CP,MAP was significantly decreased (P ＜ 0.05),while no significant change was found in the other indexes in group SP (P ＞0.05).Significant mitochondrial swelling,and disruption and disappearance of cristae were showed in I/R group.The mitochondrial structure was more complete in CP and SP groups than that in group I/R,and the disrupted cristae were found in a small number of mitochondria in CP and SP groups.Conclusion The mechanism by which sufentanil postconditioning reduces myocardial I/R injury is related to inhibition of mPTP opening in rats.