Objective:To explore and compare the perfusion pattern of oral mucosa on Han Chinese and Caucasian by laser-doppler flowmetry.Methods:A cross-sectional study was carried out,in 20 healthy Han Chinese adult subjects (average age:28.4 years)and 20 healthy Caucasian (average age:25.3 years)adult subjects,either gender with 10 subjects.Gingival perfusion was evaluated at 8 points (including upper incisor labial gingival,lower incisor labial gingival,palatal mucosa,cheek mucosa) using a laser-doppler flowmetry(O2C,Medizintechnik GmbH,Germany).Each measurement was car-ried out 25 seconds consisting 5 seconds of foreperiod and 20 seconds of work period,without pressure. The measurements were taken by two well-trained doctors,each measurement was exammed 3 times by an examiner,and the average value was recorded as final data.Each measurement has 4 parame ters:SpO2 (oxygen saturation),rHB (relative amount of hemoglobin),flow (the blood flow of unit interval),and velocity (blood flow velocity).We compared the data by different sites,different genders,and different races.Results:For palatal gingival,the average SpO2 was 77.1% ±10.9%,the average rHB 67.8 ± 11.1,and the average flow 194.1 ±63.7,which presented significant lower values than other oral muco-sa.There was no significant difference among other sites.There was some significant difference between the Caucasian and the Han Chinese:the maxillary central incisor oxygen saturation (SpO2)which were averages of 75.6% ±8.2% and 70.4% ±7.6%;buccal mucosa hemoglobin (rHB)averages of 79.9 ±5.8 and 83.5 ±6.6,which had statistical differences.For most measurement points,the oxygen saturation on men was lower than that on women,which had significant difference.Conclusion:To inves-tigate microcirculation pattern,oral mucosa can be the good observation site.Laser-doppler flowmetry is a well-documented instrument to survey on microcirculation.There may be differences between the genders in hemoglobin oxygen-binding capacity,which may have some impact on the ability of soft tissue healing. Oral mucosa display more blood perfusion than attached gingival.As the recipient site of gingival graft, maxilla and mandible have slight difference in blood supply.

Objective To explore the change characteristics of physiological indexes between infants and children during living-donor liver transplantation and discuss methods of regulation and control.Method In this study,42 patients were selected and assigned into two groups according to age:infants group (＜1 year,n =25),and children group (1-16 years,n =17).The preoperative and peri-operative characteristics,intra-operative operation conditions,internal environment changes before and after re-perfusion,postoperative mechanical ventilation time,ICU time,hospital time,infection rate,additional surgery,complications and survival were analyzed.Result PELD (MELD) score,historical surgery rate and hematokrit were lower in children group than in infants group (P＜ 0.05).Serum creatinine and lactate concentrations increased significantly in children group as compared with infants group (P＜0.05).Intra-operative an-hepatic phase and cold ischemia time were shortened significantly (P ＜ 0.05),and incidence rate of re-perfusion syndrome was reduced in children group as compared with infants group (P＜0.05).As compared with pre-re-perfusion,blood lactate concentrations were significantly raised only in infants group and glucose concentrations significantly raised only in children group (P＜0.05).The blood levels of K + were decreased after reperfusion in both two groups,and those in infants group were lower than in children group (P＜ 0.05).Postoperative intensive care unit time was longer in children group than in infants group (P＜ 0.05),and there was no significant difference in survival rate between two groups.Conclusion There are many differences and change characteristics to physiological indexes between infants and children during the operation of living-donor liver transplantation.Timely management and regulation are critical for the success of surgery according to the differences.

Objective:To evaluate the bone alteration subject to remodeling and analyze the esthetic result following immediate implant placement of incisors.Methods:In this study,20 patients (1 3 women,7 men)were involved,who needed implants for incisors of maxilla.The patients received 23 im-mediate implants totally.On the day of surgery and 6 months after the implants were placed,Cone beam CT (CBCT)was taken.The thickness of the alveolar ridge and the vertical change of marginal bone levels onthe mesial and distal aspects of theimplants were measured using the computer software (Planme-caRomexis Viewer 3.6.0.R).The evaluation of esthetic result by labial convexity score (LCS)and pa-pilla index score (PIS)were analyzed pre-operation and one year after the final crown was delivered.The statistics with paired-t test for the measurement data and Willcoxon test for rating data were done by SPSS 20.0.Results:The survival rate in the two-year follow-up was 1 00%.The measuring point 1 (MP1 ), MP2,MP3 and MP4 (0,2,4,6 mm apical to the implant platform,respectively)got significant altera-tions after 6 months of the follow-up.These differences were statistically significant (P<0.05 ).The major alteration happened at MP1 and MP4,which got (-0.89 ±2.06)mm and (-0.75 ±1 .28)mm reduction of the alveolar,respectively.The marginal alveolar ridge resorption was (-0.42 ±1 .24)mm and(-0.91 ±1 .96)mm for Ankylos System and Replace System,respectively,and the difference was not statistical significant .The esthetic results were quite acceptable.Before treatment,1 8 incisors rated 3 for LCS,and 2 incisors rated 4 for LCS;after final restoration,only 5 incisors rated 3 for LCS,and 1 4 incisors rated 2 for LCS.Before treatment,1 5 incisors rated 3 for PIS;after final restoration,1 3 incisors rated 3 for PIS.There was no statistically significant difference for the PIS pre-operation and 1 year after final restoration,while there was statistically significant negative change for LCS.Conclusion:Even fol-lowing the proper surgical technique,the alveolar ridge wall still can’t be maintained after immediate im-plant placed in fresh socket of incisors.The inter-dental papilla could be well maintained,while due to the remodeling of labial bone,labial convexity will inevitably collapse.Therefore immediate implant still has esthetic risk.

Objective To evaluate the perioperative blood loss and blood transfusion in liver transplantation patients.Methods Retrospectively selected and classified 119 patients with liver transplantation medical recordsaccording to the clinical diagnosis of age,gender.Analyzed (disease)patients' blood coagulation index 24 h before surgery,intraoperative and postoperative perioperative bleeding,and blood red blood cell suspension,frozen plasma,cold precipitation,coagulation factor injection lossplateletpheresis.Results There were no significant differences in the amount of blood loss and the amount of blood preparations duringthe perioperative period of liver transplantation according to the age and sex of patients (P＞0.05);According to the clinical diagnosis of different groups,the diagnostic group (primary liver cancer group,hepatitis B cirrhosis group and severe hepatitis group) patients with a single platelet transfusion dosewas similar (P＞0.05)withsuspended red blood cells (U) at 8.4+11.9,16.2+15.7,18.1+13.5,frozen plasma (U) at 8.2+7.1,18.1+15.6 and 18.2+ 17.9 respectively andcold precipitation (U) at 9.5+ 8.2,17.1 + 16.318.5 + 16.4 (P＜ 0.05);The diagnosis group surgery before and after immediate PT (s) were 15.6+3.8,24.6+4.1,APTT (s) were 44.3+5.8,84.9+9.2,TT (s) were 20.4 +4.5,40.1+6.2,and Fib(s) were 2.6+0.8 and 1.3+0.9 (P＜0.05);however,there was no significant difference in the 24 h PT,APTT,TT and Fib between the two groups after diagnosis (P＞0.05).Conclusion Ascientific,safe and reasonable selection of perioperative blood preparation for clinical diagnosis for different liver transplantation patients is critical to the success rate and prognosis of liver transplantation;the evaluation of coagulation indexes at each interval can help guiding the blood transfusion during liver transplantation.

Objective To investigate the effect of Iscom matrix on the immunogenicity of recombinant hepatitis B surface antigen containing PreS epitopes(SS1S2). Methods SS1S2+ Al(OH)3 and SS1S2+Iscom vaccines were made by combining purified SS1S2 antigen with Al( OH)3 adjuvant or Iscom matrix.Groups of BALB/c mice were injected i. m or s. c by either of the two vaccines at day 0 and day 14. Half of the mice were sacrificed and sera were taken and spleen cells separated from the mice 14 days after each injection. Anti-S, anti-PreS1, and anti-PreS2 antibody titers were measured, and total IgG1 and IgG2a titers were further detected for each serum sample. IFN-γ ELISPOT assay was performed to detect IFN-γsecreting cells from the pooled spleen cells for each vaccine group. Results The seroconversion rates and geometric mean titers(GMTs) and the numbers of IFN-γ secreting cells were approximately at the same level for the differently formulated vaccines after the first injection except that the ratio of IgG2a to IgG1 in the Iscom group was higher than the Al(OH)3 group. After boost injection, the GMTs of total IgG rise slightly in the Al(OH)3 group but significantly in the Iscom group. The IgG2a to IgG1 ratio in the Iscom group kept balanced while dropped further in the Al(OH)3 group. The number of specific IFN-γsecreting cells triggered by the Iscom vaccine exceeded significantly the number of Al( OH)3 vaccine, showinga stronger cellular response. Conclusion The results in this study shows that Iscom matrix is more potent in enhancing the immunogenicity of recombinant hepatitis B virus surface antigen containing PreS epitopes than Al( OH)3 adjuvant.

OBJECTIVETo compare efficacy of unilateral external fixators and locking compression plates in treating type C fractures of the distal radius.

METHODSFrom January 2009 to June 2010, 76 patients with distal radius fracture were treated with LCP and external fixators, 54 patients were followed up. Among them, 29 cases were male and 25 cases were female with an average age of 45.31 (ranged, 24 to 68) years old. There were 29 patients in LCP group. According to AO classification, 8 cases were type C1, 7 cases were type C2 and 14 cases were type C3. There were 25 cases in external fixators group. According to AO classification, 6 cases were type C1, 8 cases were type C2 and 11 cases were type C3. Radial height, volar tilt and radial inclination were compared, advanced Gartland-Werley scoring were used to assessed wrist joint function after 6 and 12 months' following up.

RESULTSTwo cases were suffered from nail infection in external fixators group. Fifty-four patients were followed up from 12 to 24 months with an average of 21.3 months. Radial height was (9.60 +/- 0.72) mm, volar tilt was (9.55 +/- 0.80) degrees and radial inclination was (21.40 +/- 0.78) degrees in LCP group,while those were (9.40 +/- 0.70) mm, (9.47 +/- 0.71) degrees and (21.20 +/- 0.73) degrees in external fixtors group, and with no statistical significance (P>0.05). Advanced Gartland-Werley score after 6 months' following up was 3.31 +/- 1.17 in LCP group, 5.56 +/- 1.58 in external fixtors group, and with significant difference (t=-5.99,P<0.05); after 12 months' following up, advanced Gartland-Werley score was respectively 2.66 +/- 1.01 and 3.08 +/- 1.00, but with no statistical meaning (t=-1.55, P>0.05).

CONCLUSIONLCP and external fixtors can receive good curative effects in treating type C distal radius fracture, and LCP can obtain obviously short-term efficacy, while there is no significant difference between two groups in long-term results. For serious distal radius comminuted fracture which unable to plate internal fixation, external fixators is a better choice.

Adult ; Aged ; Bone Plates ; External Fixators ; Female ; Fracture Fixation, Internal ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius ; surgery ; Radius Fractures ; surgery ; Treatment Outcome ; Young Adult

ObjectiveTo evaluate the clinical efficacy of bladder hydrodistention and intravesical sodium hyaluronate in the treatment of interstitial cystitis (IC).Methods Twenty-one IC patients received intravesical sodium hyaluronate therapy under combined blockage or intravenous anesthesia.Bladders were perfused with normal saline under 100 cm H2O perfusion pressure and expanded for 10 min,the bladders were then injected through a catheter with 40 mg/50 ml sodium hyaluronate which was released after 1 h.Intravesical perfusion was applied once every week four to six times in a course of treatment.Results The average bladder capacity was extended from 191.6 ± 88.7 ml before expansion to 425.3 ± 79.8 ml after bladder expansion ( P =0.000).The extension was done under anesthesia.There were two suspected bladder ruptures after starting the bladder expansion at 6.5 min and 7.2 min.There was significant gross hematuria in 19 cases,10 min after bladder expansion.After treatment,the catheters were removed 24 h after manipulation in 17 patients; the catheters were removed 72 h after manipulation in two cases with hematuria;the catheters were removed four days after manipulation in the two cases of suspected bladder rupture.Pain was significantly reduced after the catheters were removed and the maximum urinary output increased slightly.The day before the second injection of sodium hyaluronate,the urinary frequency decreased significantly than before start of treatment (32.8 vs 18.5 times/24 h).The maximum urinary output increased significantly compared with the output before treatment (86.7 vs 151.9 ml).Pain was reduced significantly after treatment (8.7 vs 3.0).The O'Leary-Sant IC score and the QOL were significantly improved (30.0 vs 17.0,5.9 vs 2.4,respectively) (P =0.000).After the third treatment,the symptoms continued to improve.The treatment results were best in the fifth week at the time of the sixth injection of sodium hyaluronate.Symptoms rebounded at six months.However compared with that before treatment,the difference was still statistically significant ( P =0.000).ConclusionsBladder hydrodistention under anesthesia for severe intractable IC patients produces immediate effectiveness.Sodium hyaluronic infusion can alleviate urinary frequency and pain,and the effectiveness and duration of treatment are positively correlated.

Objective To analyze the risk factors for failures of intramedullary and extramedullary internal fixation in surgery of femoral intertrochanteric fractures in elderly patients.Methods A retrospective study was conducted of the 205 elderly patients with osteoporotic femoral intertrochanteric fracture who had accepted closed reduction together with intramedullary and extramedullary internal fixation between September 2005 and August 2014.They were 89 men and 116 women,from 65 to 98 year of age (average,78.8 years).By AO classification,137 cases were of types AI.1-A2.1 (stable fractures),and 68 of type A2.2-A3.3(unstable fractures).The incidence of internal fixation failure and Harris scores at the last follow-up were recorded.The factors possibly contributing to the failure were analyzed using the univariate analysis and multivariate logistic regression analysis.Results Of the patients,192 obtained a mean follow-up of 39 months (from 14 to 60 months),but 13 were lost after a 10-month follow-up.Of the 205 patients,internal fixation failure occurred in 12 (incidence of 5.9％).Five failed cases received DHS fixation and 7 accepted PENA fixation.At the last follow-up when the 13 cases were lost after 10-month follow-up,the mean Harris hip score was 81.6 (from 57 to 92),and the excellent to good rate was 84.9％ (29 excellent cases,145 good ones,10 fair ones and 21 poor ones).The multivariate regression analysis revealed that tip-apex distance (TAD) ＞ 25 mm(OR ＝ 333.33),severe osteoporosis (OR =267.44),AO types A2.2-A3.3 (OR ＝ 22.24),functional reduction of fracture (OR =20.79),and concomitant medical diseases (OR =4.59) were independent risk factors for failures of internal fixation.Conclusions DHS and PFNA fixations are effective treatments for elderly patients with femoral intertrochanteric fractures.TAD＞ 25 mm,severe osteoporosis,unstable factures,functional reduction of fracture,and concomitant medical diseases may lead to internal fixation failure in surgery of femoral intertrochanteric fractures in elderly patients.

Six DNA extraction methods and four DNA purification methods were compared and analyzed in this study to get higher quality DNA from the rhizospheric soil of Fritillaria thunbergii Miq.Results showed that higher purity DNA were harvested by pretreating the soil with 20 mmol/L EDTA(pH 7.5),then isolating soil DNA with CTAB-SDS-frozen-thawing,and further purified by agarose method.The recovery rate of this soil DNA was about 44.00 ?g/g ? 2.65 ?g/g soil,and they were qualified for the microbial diversity analysis in the rhizospheric soil of F.thunbergii Miq based on the 16S rDNA sequence.

BACKGROUND:Development of new coronary thrombolytic agents is hot in the market. A new drug, mutated recombinant tissue-type plasminogen activator (rtPAm), is the product of mutation of tPA by changing binding loci with plasminogen activator inhibitor (PAI)-1 to reduce the degradation. In vitro test has demonstrated that the activity of rtPAm is much higher than rtPA in the absence of PAI. The present study is to observe the efficacy of mutated recombinant tissue-type plasminogen activator (rtPAm) in coronary thrombolytic therapy. METHODS:A total of 30 adult beagles were equally divided into 5 groups after thrombi:vehicle group, urokinase group, rtPAm low-dose group, rtPAm medium-dose group, and rtPAm high-dose group. Thrombolytic effect and myocardial infarction were observed after thrombolytic therapy. RESULTS:In the urokinase group, time to reperfusion was (15.8±3.8) minutes. TIMI 2 flow was demonstrated in 4 beagles, TIMI 3 flow in 2, and re-occlusion in 4 after 90 minutes respectively. In the low-dose rtPAm group, time to reperfusion was (15±4.5) minutes; TIMI 2 flow was demonstrated in 2 beagles, TIMI 3 flow in 4, and re-occlusion in 2 after 90 minutes. In the high-dose rtPAm group, time to reperfusion was (7.5±2.6) minutes. None of the beagles showed re-occlusion after 90 minutes. The infarction areas were (2.1+0.9)％ in the medium-dose rtPAm group and (0.7+0.4)％ in the high-dose rtPAm group, which decreased significantly than those in the low-dose rtPAm group. The aggregation rate in the medium-dose and high-dose rtPAm groups decreased significantly than that in the urokinase group. CONCLUSION:rtPAm may serve as a thrombolytic agent with platelet-targeted fibrinolysis and antiplatelet aggregation activities.