Objective: To evaluate dimensions of the nasopalatine canal and the relationship between the canal and the central incisors, and the canal and the crest, by using cone-beam computed tomography ( CBCT) . Methods:This study included 129 CBCTs, and the sagittal slices were used to measure the lower diameter ( Sda) , median diameter ( Sdb) , and higher diameter ( Sdc) , for calculating the average sagittal diameter ( Sd ); the coronal slices through canals were used to measure the lower diameter ( Hda) , median diameter ( Hdb ) , and higher diameter ( Hdc ) for calculating the average horizontal diameter ( Hd) , length ( H);the sagittal slices were used to measure the buccal bone thickness off the canal ( Bt) , and the distance to the crest off the lowest point ( At) , the horizontal slices were used to measure the distance between the canal and the central incisors ( Id) . These subjects were divided into two groups by gender;and divided into three groups by ages: (1) ≤30 years old, (2) 31 -50 years old, and (3) ≥51 years old. SPSS 17. 0 statistical software was used for statistical analysis. Results:The overall Sd was (3. 41 ± 0. 87) mm, the Hd was (5. 16 ± 0. 93) mm, and the difference was statisti-cally significant. The H was (14. 29 ± 3. 27) mm, the Bt was (7. 49 ± 1. 05) mm, the At was (8. 25 ± 1. 71) mm, and the Id was (2. 71 ± 0. 89) mm. Of the male and female, the Sd were (3. 64 ± 0. 90) mm and (3. 28 ± 0. 82) mm, P=0. 017; the Hd were (4. 98 ± 0. 89) mm and (5. 27 ± 0. 94) mm, P=0. 081;the H were (15. 47 ± 2. 75) mm and (13. 59 ± 3. 32) mm, P=0. 001;the Bt were (7. 90 ± 0. 96) mm and (7. 25 ± 1. 03) mm, P=0. 001; the At were (7. 41 ± 1. 86) mm and (8. 44 ± 1. 90) mm, P=0. 001; the Id were (2. 71 ± 0. 87) mm and (2. 72 ± 0. 91) mm, P =0. 983. Among the groups, no statistically significant differences were detected of the Sd (P =0. 325), of the Hd (P =0 . 636 ) , of the H ( P=0 . 292 ) , and of the Bt ( P=0 . 116 );statistically significant differences were de-tected of the At ( P=0 . 010 ) , and of the Id ( P<0 . 001 ) . Conclusion:The nasopalatine canal anatomy is highly variable. Gender is related to the nasopalatine canal length, Bt width, and At distance. While age was related to At, and Id, but no effect on nasopalatine dimensions. The CBCT is a useful device for studying the nasopalatine canal in three dimensions, prior to dental implant placement.

[Objective]To classify fractures of posterior malleolus by computed tomography and guide its clinical treatment.[Method]From January 2003 to October 2006,eighty-eight patients who had been treated surgically for the posterior malleolar fractures were reviewed.There were 53 males and 35 females.The mean age was 42.3 years(ranged,18～75 years).All the patients' preoperative radiograph and computed tomographic scans were reviewed,and each fracture was categorized according to the size,location and fracture line of the major fragment and the stable state of mortise.The classification was applied to treat 88 patients.[Result]On the basis of the computed tomographic images,the posterior malleolar fractures were categorized into four types.There were type Ⅰ(stable) in 23 cases,type Ⅱ(borderline) in 26 cases,type Ⅲ(big unstable posterolateral oblique) in 18 cases and type Ⅳ(medial-extension) in 21 cases.Type Ⅰ included type Ⅰ1(small shell)in 5 cases and type I2(small posterolateral oblique) in 18 cases.Type Ⅱ included type Ⅱ1(moderate posterolateral oblique without lateral-posterior dislocation of talus)in 15 cases and type Ⅱ2(moedrate postero-lateral oblique with lateral-posterior dislocation of talus)in 11 cases.All patients were followed up for an average of 31months(ranged from 12 to 48 months).According to the Baird-Jackson scoring system,the results were rated as being excellent in 62 cases,good in 13 cases,moderate in 8 cases,and poor in 5 cases,with the good-excellent rate being 85.2%.[Conclusion]Computed tomographic scans can demonstrate the pathoanatomy of the posterior malleolar fracture and provided guidance for clinical treatment.

Objective To investigate the of dural reconstruction plates for treatment of humeral intercandylar fracture.Methods The 52 cases with humeral intercandylar fracture were treated with dural reconstruction plates internal fixation.Watched the clinical efficacy Postoperative in outpatient,and guide early exercise of elbow.Result Using Elbow Scoring Standard System to assess:16 cases of C1,excellent and good in 14 cases,fair in 2 cases,and 87.5％ excellent and good results were obtained.Twenty-four cases of C2,excellent and good in 20 cases,fair in 4 cases,and 83.3％ excellent and good results were obtained.Twelve cases of C3,excellent and good in 6 cases,fair in 2 cases,and poor in 4 case,and 50.0％ excellent and good results were obtained.Fifty-two cases were followed up,excellent and good in 40 cases,fair in 8 cases,and poor in 4 case,and 76.9％ excellent and good results were obtained.Conclusion Dural reconstruction plates internal fixation was the relatively effective method for treatment of humural intercandylar fracture.

Golgi protein 73(GP73) was closely correlated with primary hepatic carcinoma(PHC). GP73 had a higher sensitivity and specificity than alpha fetal protein(AFP), so GP73 had a great diagnostic value for early PHC. Although there were many related research reports in the domestic and foreign, their conclusions were inconsistent. This article reviewed these studies results.

Objective To summarize the clinical characteristics and investigate the prognostic factors of primary duodenal carcinoma.Methods The clinical data of 122 patients with primary duodenal carcinoma who were admitted to the Shengjing Hospital Affiliated to China Medical University from November 2007 to May 2013 were retrospectively analyzed.All the patients received different operations according to the characteristics of tumors.Primary duodenal carcinomas of patients were confirmed by the postoperative pathological diagnosis.All the patients were followed up by outpatient examination, telephone interview and correspondence till November 30,2014.The treatment process, results of imaging examination and laboratory examination and postoperative survival were recorded.The clinical features, diagnostic criteria, therapeutic regimens and prognostic factors were analyzed.The survival rate and survival curve were analyzed and drawn by the Kaplan-Meier method.The univariate analysis was done using the Log-rank test, and multivariate analysis was done using the COX regression model.Results Among the 122 patients with primary duodenal carcinoma, jaundice as the first symptom was detected in 57 patients, abdominal pain and upper abdomen discomfort in 37 patients, gastrointestinal obstruction in 14 patients,anorexia and reduction of body weight in 4 patients, gastrointestinal hemorrhage in 3 patients, diarrhea in 3 patients, pyrexia in 3 patients and abdominal mass in 1 patient.The positive rates of CT examinations, endoscopic examinations, magnetic resonanced cholangio-pancreatography (MRCP), B-ultrasound examinations and upper gastrointestinal contrast examinations were 69.67％ (85/122), 85.56％ (77/90), 79.76％ (67/84), 12.73％ (7/55) and 75.00％ (36/48), respectively.Among the 122 patients, anemia was detected in 48 patients,positive fecal occult blood test in 94 patients, increasing level of CA19-9 in 71 patients, increasing level of CEA in 22 patients and increasing level of AFP in 9 patients.The tumors located at the descending part of duodenum,duodenal bulb and horizontal part of duodenum were detected in patients of 86.07％ (105/122), 7.37 ％ (9/122) and 6.56％ (8/122), respectively.The mean diameter of tumors was 2.3 cm (range, 1.0-15.0cm).All the 122 patients received operation.Pancreaticoduo-denectomy was performed in 100 patients, including combined with jejunostomy in 17 patients, pylorus-preserving pancreatoduodenectomy in 7 patients, segmental resection of duodenum and gastrojejunostomy in 5 patients, local resection of duodenal papilla in 6 patients and palliative gastrojejunostomy in 11 patients.Nineteen patients with complications were cured by symptomatic treatment.Of the 122 patients, adenocarcinoma, carcinoid tumor, lymphoma, small cell carcinoma, intraepithelial neoplasm combined with differentiated rhabdomyoma and with undifferentiated rhabdomyoma were detected in 116, 2, 1, 1,1 and 1 patients, respectively.The Ⅰ , Ⅱ , Ⅲ and Ⅳ stage of tumors were detected in 10, 4, 74 and 34 patients.There were 100 patients without lymph node metastasis, 13 patients with 0 ＜ metastatic lymph node ratio (MLR) ≤0.2, 4 patients with 0.2 ＜ MLR≤0.4 and 5 patients with MLR ＞ 0.4.One-hundred and twelve of 122 patients were followed up for 1-70 months with a median follow-up time of 20 months.The postoperative survival time, a median of survival time, postoperative 3-and 5-year survival rates were 1-70 months, 18 months, 36.6％ and 13.5％ , respectively.The results of univariate analysis showed that the lymph node metastasis, differentiated grade of tumor, MLR and with invasion of pancreas were risk factors affecting the prognosis of patients (x2 =8.465, 57.355, 16.232, 20.112, P ＜ 0.05).The multivariate analysis showed that the low-differentiation of tumor, invasion of pancreas, lymph node metastasis and MLR ＞ 0.4 were independent risk factors affecting the prognosis of patients (RR =3.330, 3.718, 2.623, 95％ confidence interval: 1.861-5.956, 1.292-10.696,1.624-4.236, P ＜ 0.05).Conclusions Most of the primary duodenal carcinomas are located at the descending part of duodenum without specific clinical symptoms in the early stage.The joint usage of assistant examinations can improve the diagnostic rate of primary duodenal carcinoma, and surgery is mainly therapeutic method.The low-differentiation of tumor, MLR ＞ 0.4 and invasion of pancreas are independent risk factors affecting the prognosis of patients.

Objective To explore the levels of serum hepatitis B surface antigen (HBsAg) in different clinical stages of hepatitis B virus(HBV) infection and their correlation with serum HBV DNA. Methods Five hundred and seventy-five patients with HBsAg-positive and without antiviral therapy were enrolled in this study. The patients were classified into six group:IT group (immune tolerant phase, 120 patients), EPH group (hepatitis B e antigen positive hepatitis, 110 patients), LR group (low replicative phase, 90 patients), ENH group (hepatitis B e antigen negative hepatitis, 110 patients), LC group (liver cirrhosis stage, 85 patients) and HCC group (hepatocellular carcinoma, 60 patients). Serum HBsAg and HBV DNA levels were quantified and analyzed through statistics. Results The levels of serum HBsAg in IT group, EPH group, LR group, ENH group, LC group and HCC group were (4.58 ± 0.40), (4.12 ± 0.50), (2.60 ± 0.68), (3.31 ± 0.27), (2.82 ± 0.57) and (3.03 ± 0.39) lg U/ml respectively, and there was significantly different among the different phase (P<0.01). The levels of serum HBsAg in IT group, EPH group, LR group, ENH group, LC group and HCC group had positive correlation with serum HBV DNA level, and the correlation coefficients were 0.627, 0.579, 0.134, 0.317, 0.159 and 0.224 respectively. Conclusions The levels of serum HBsAg is significantly different in the different clinical phase of HBV infection, and the tendency of the correlation between serum HBsAg and serum HBV DNA gradually weakens in general.

Objective To characterize the molecular changes and their significance in pathogenesis of esophageal squamous cell carcinomas from the elderly patients (≥60 years old) at high risk area of esophageal cancer in Linzhou, Henan Province. Methods Immunohistochemical method(ABC) and histopathological method were applied to examine the expressions of P53 and Rb proteins in esophageal squamous cell carcinomas and the relationship of the expressions with the lesions and age distribution was analyzed. Results Positive immunostaining rate for P53 was much higher in esophageal cancer tissue of the elderly patients(27/33, 82%) than that of the young patients (10/43, 23%) ( P

Objectives:To observe the characteristics of rocuronium bromide in cirrhotic patients. Methods:Six healthy patients and six patients with hepatic cirrhosis undergoing intraabdominal operation were studied. Rocuronium 0.6 mg/kg was given to all of the patients,and the twitch high of adductor pollicis muscle was recorded using NMT mechanosensor (Datex Ohmeda). The time of onset, T 1 Maximum depression, the clinical duration of initial dose, the clinical duration of repeated maintenance doses and the spontanous recovery index were observed. Results:The time of onset was markedly prolonged in the cirrhotic compared with the healthy group( P

Myasthenia gravis is an autoimmune disease resulting from the production of antibodies against acetylcholine receptors of the endplate. These antibodies impair postjunctional membrane and reduce the number of functional acetylcholine receptors of endplate. Thymectomy is an effective therapeutic method for adult myasthenic patients. In this paper, the author reviewed the pathophysiological characteristics and problems related to anesthesia, such as preoperative evaluation, the effect of preoperative medical treatment on the anesthesia, patients'response to muscle relaxants and postoperative management.

OBJECTIVE To explore the curative effect of budesonide on acute epiglottitis. METHODS Seventy-eight patients with acute epiglottitis were devided into 2 groups randomly. Budesonide and dexamethasone were breathed in respectively with other treatments being the same. The results were processed statistically. RESULTS The effective and apparent effective rate were 98 % and 95 % in the experimental group,81 % and 72 % in control group. The effective rate was significantly different between the 2 groups,the apparent effective rate was very significantly different between the 2 groups. CONCLUSION The budesonide is more powerful than dexamethasone in the treatment of acute epiglottitis. It can decrease the epiglottis edema more quickly and reduce the opportunity of tracheotomy.