Objective To investigate the imaging diagnosis and surgical treatment of intestinal malrotation in adult patients. Methods The clinical data of 11 adult patients with intestinal malrotation who had been admitted to General Hospital of PLA from January 2003 to December 2007 were retrospectively analyzed. Multiple imaging modalities, including barium enema, gastrointestinal radiography, B sonography, computed tomography (CT) scan and mesenteric angiography were applied for diagnosis. All patients received Ladd procedure. Results Two patients were diagnosed by gastrointestinal radiography +B sonography, 4 by gastrointestinal radiography +CT scan, 1 by angiography, 1 by B sonography + CT scan, 1 by iodine radiography + CT scan and 2 by intraopera-tive examination. After the operation, 2 had renal insufficiency, 1 had intestinal fistula and 1 had short bowel syndrome and died at the third month after operation. Conclusion Combined application of multiple imaging modalities can improve the diagnostic rate, and Ladd procedure is effective and safe for adult patients with intes-tinal malrotation.

Objective To investigate the effect on electrical restitution of β1-adrenergic receptor antagonist esmolol administered during cardiopulmonary resuscitation in the porcine ventricular fibrillation model. Method Ventricular fibrillation untreated for four minutes was induced by dynamic steady state pacing protocol in 40 healthy male pigs, in which local unipolar electrograms were recorded using one 10-electrode catheter that was sutured to the left ventrieular epicarditan. During CPR, animals were randomized into two groups to receive saline as placebo or esmolol after two standards doses of epinephrine. At postresuscitation 2-hour, six pigs were randomly selected from each group and the second VF induction was performed. Local activation-recovery intervals (ARI) restitutions and the VF inducibility between control group and esmolol group were compared. Western blotting was performed to determine cardiac ryanodine receptor (RyR2) protein expression, and their phosphorylation status. Results No sig-nificant differences were observed at the restoration of spontaneous circulation between two groups. Higher postre-suseitation 2-hour survival rate was observed in the esmolol group. Esmolol significantly flattened ARI restitution slope, lessened regional difference of ARI restitution, decreased the VF inducibility, and alleviated RyR2 hyper-phosphorylation. Conclusions Esmolol given during CPR significantly improved postresuscitation 2-hour survival rate. Its effects on modulating electrical restitution property and intracellular calcium handling make up the most important reasons why β1-blockade significantly reduced the onset and maintenance of VF.

Objective:To observe the clinical efficacy of Ba-pulling and Qian-traction manipulation with neck suspension and movement for acute cervical radiculopathy. Methods: A total of 85 patients who met the inclusion criteria were randomized into an observation group and a control group by random numbers, with 43 cases in the observation group and 42 cases in the control group. The observation group was treated with Ba-pulling and Qian-traction manipulation with neck suspension and movement;while the control group was treated with Bashen-pulling and stretching manipulation in a supine position. The treatment was performed once a day, 10 times as a treatment course. The therapeutic efficacy was evaluated after 1 treatment course, and the changes in the scores of visual analog scale (VAS) and neck disability index (NDI) were observed. Results: The total effective rate was 97.7% in the observation group, and 83.3% in the control group, and the difference between the two groups was statistically significant (P＜0.05). After treatment, the VAS and NDI scores of both groups were significantly decreased (both P＜0.01), and the differences in the VAS and NDI scores between the two groups were statistically significant (both P＜0.01). Conclusion: Both Ba-pulling and Qian-traction manipulation with neck suspension and movement and Bashen-pulling and stretching manipulation in a supine position can relieve pain and improve cervical function in patients with acute cervical radiculopathy, and Ba-pulling and Qian-traction manipulation with neck suspension and movement can produce more significant efficacy than Bashen-pulling and stretching manipulation in a supine position.

The multi-piece post-crown technique is more effective in restoring residual root than other restoration techniques. Various types of adhesives have different material properties that affect restoration. Therefore, the choice of adhesive is particularly important for patients. However, the effect of different kinds of adhesives was not too precise by experimental methods when concerning about individual differences of teeth. One tooth root can only be restored with one type of adhesive in experiment. After the mechanical test, this tooth root cannot be restored with other adhesives. With the help of medical imaging technology, reverse engineering and finite element analysis, a molar model can be reconstructed precisely and restored using different types of adhesives. The same occlusal and chewing loads were exerted on the same restored residual root models with different types of adhesives separately. Results of von Mises stress analysis showed that the adhesives with low Young's modulus can protect the root canal effectively. However, a root canal concentration is apparently produced around the root canal orifice when chewing. Adhesives with large Young's modulus can buffer the stress concentration of the root canal orifice. However, the root canal tissue may be destroyed because the adhesive is too hard to buffer the load.
Crowns ; Dental Bonding ; Dental Cements ; Dental Pulp Cavity ; Dental Stress Analysis ; methods ; Elastic Modulus ; Finite Element Analysis ; Humans ; Post and Core Technique ; Tooth, Nonvital

Objective To evaluate the right ventricular global systolic function by real-time three dimensional echocardiography (RT-3DE) and two dimensional echocardiography (2DE) in normal children,and investigate their correlation with age,height,weight,body surface area (BSA) and cardiac cycle time.Methods In 192 normal children,2DE right ventricular systolic function indexes were obtained at the apical four chamber view,including:tricuspid annular lateral wall peak systolic excursion (TAPSE),tricuspid annular peak systolic velocity (TRV) and right ventricular systolic area shortening (RVa).Full volume imaging of right ventricle was obtained at the parasternal four-chamber view near the apex by RT-3DE.The right ventricular ejection fraction (RVEF) was analyzed by TomTec RV-Function.The correlation analysis was performed between RT-3DE and 2DE indexes.The correlation and regression analysis on RT-3DE and 2DE indexes with above physical development indexes were also studied.At the same time 192 normal children were divided into five groups by age.2DE and RT-3DE indexes were compared with each other among five age groups.Results RVEF had no statistical correlation with all 2DE indexes (P ＞0.05).The correlation analysis on RT-3DE and 2DE indexes with physical development indexes demonstrated that TAPSE,TRV had strong positive correlation with the above indexes (P =0.000),while RVa had no statistical correlation with the above indexes (P ＞0.05).RVEF had weak positive correlation with cardiac cycle time r =0.180,P =0.014),but it had no statistical correlation with the other indexes (P ＞0.05).Stepwise regression analysis showed that the significant factor for TAPSE and TRV was height (R2 =0.508,P =0.000)and BSA (R2 =0.130,P =0.000)separately.In five age groups RVEF and RVa remained constant (P ＞0.05).However for TAPSE and TRV significant difference were found in part of comparisons between groups(P ＜0.05).Conclusions Although RVEF assessed by RT-3DE was slightly influenced by heart rate,it was independent of age,height,weight,BSA.It was a stable index for evaluating right ventricular systolic function among different age and physical development population.

Objective To evaluate right ventricular(RV) global and regional volume and systolic function by real-time three-dimensional echocardiography (RT-3DE) in normal children with different age.Methods One hundred and ninty-two normal children were divided into five groups by age:group Ⅰ,＜1 years old,32 cases;group Ⅱ,≥1 years old-＜3 years old,46 cases;group Ⅲ,≥3 years old-＜6 years old,36 cases;group Ⅳ,≥6 years old-＜9 years old,41 cases;group Ⅴ,≥9 years old-＜14 years old,37 cases.Full volume imaging of RV was obtained at the parasternal four-chamber view near the apex by RT-3DE.RT-3DE data set were analyzed off-line by TomTec RV-Function.RV were divided into three parts:inflow,body,outflow.The measurements were including RV global and regional end-diastolic volume (EDV),end-systolic volume (ESV),ejection fraction (EF) and the ratio of regional parts EDV to RVEDV. The volume and systolic function were compared in three regional parts.RV global and regional parts EF and the ratio of regional parts EDV to RVEDV were also compared in five age groups.Correlation analysis and curve estimation were studied on RV global and regional EDV with age and physical development indexes.Results In the comparison of three regional parts:inflow EDV and EF were higher than outflow and body parts (P＜0.05).No significant different was found between outflow EDV and body EDV (P＞0.05),however,outflow EF was significant higher than body EF(P＜0.05).The comparison of RV global and regional EF in five age groups were no statistical different (P＞0.12). The ratio of regional parts EDV to RVEDV remained constant in five age groups(P＞0.58).Correlation analysis showed the global and regional RV volume were strongly correlated with age,height,weight and BSA (r＞0.77,P=0.000).The best correlation was found with BSA (r＞0.83,P=0.000).Curve estimation demonstrated that the relationship of RV global and regional EDV with age and physical development indexes could be best expressed by power model,the best matched model were found with BSA.Conclusions Among three regional parts of RV,inflow and outflow parts volume contraction were the two main contribution factors for RV function.In childhood RV volume didn't increase linearly with age and physical development indexes,but in an exponential model.

Objective To investigate the correlations of extracellular matrix and hepatic ultramicrostructural changes with clinical manifestations in patients with mild chronic hepatitis B (CHB).Methods Patients with chronic HBV infections were enrolled and were divided into mild CHB group (n=66) and HBV carrier group (n=10).Serum samples were collected from patients, and serum HBV markers, HBV DNA load and liver fibrosis indexes were measured.All subjects received liver biopsy, and the tissue samples were observed by light microscope and electron microscope.T test and χ2 test were performed for measurement data and enumeration data, respectively.Spearman test was used for ranked data.Results The differences on ALT and AST levels between mild CHB group and HBV carrier group were significant (t=12.42, 7.06, P＜0.05), but there was no significant difference on HBV DNA load between two groups (t=0.24, P ＞ 0.05).Serum liver fibrosis indexes (hyaluronic acid, type Ⅲ collagen,type Ⅳ collagen and laminin protein) in mild CHB group were not significantly higher than those in HBV carrier group (t=0.45, 0.95, 0.76 and 1.21, P ＞0.05).In mild CHB group, there were 33 patients with ≥G2 and ≥S2, but in HBV carrier group were only 2 patients (χ2=4.17, P ＜ 0.05).Seventeen patients in mild CHB group were with S3-4, while that was not observed in HBV carrier group (χ2=4.75, P ＜0.05).In mild CHB group, hepatic ultramicrostrutural changes on fat storing cell, collagen protein and portal area were correlated with fibrosis grades, and the correlation coefficients were 0.351, 0.675 and 0.301, respectively (P=0.004, 0.000 and 0.014).Conclusion Electron microscope is of higher sensitivity than light microscope in observing hepatic ultramicrostructural changes, which is effective in evaluating the severity of mild CHB.

Objective To analyze CD127 expression on the memory CD8+ lymphocytes from hepatitis B e antigen (HBeAg) positive chronic hepatitis B (CHB) patients treated with peginterferon α-2a (Pegasys). Methods Thirty HBeAg positive CHB patients were treated with peginterferon α-2a 180 μg once a week for 48 weeks and followed up for 24 weeks. The memory CD8+ lymphocytes were characterized by expressing CD45RA and CD27 markers. CD127 expression on cell surface was measured by four-colour flow cytometry. The difference of mean values between groups was evaluated by Mann-Whitney test. Results The CD127 expression on CD8+ T lymphocytes was significantly lower in HBeAg positive CHB patients compared to healthy controls (Z=2.889, P＜0.05), which was negatively correlated with serum hepatitis B virus (HBV) DNA level and HBeAg titers. The CD127 expression increased along with the decrease of HBV DNA and HBeAg after 24-week, 48-week and 72-week treatment in patients showing good response to peginterferon α-2a, while CD127 expression didn't change markedly in non responders (Z24w = 1.954, Z48w = 2.789, Z72w = 2. 989; all P＜0. 05). Conclusion CD127 expression on memory CD8+ lymphocytes increases along with effective anti-HBV treatment in CHB patients, which can be used as a marker for evaluating the effectiveness of anti-viral treatment.

Objective To investigate the effects of levofloxacin,ciprofloxacin,ceftazidime,pip-eracillin,cefoperazone/sulbactam,erythromycin,sulfamethoxazole and gentamycin on the bacterial biofilms of Stenotrophomonas mahophilia.Methotis Biofilm and conventional susceptibilities were determined for S.maltophilia isolates from 42 patients.The model of S.maltophilia biofflms in vitro was developed in the Mueller-Hinton broth--micmtiter inoculator or silica films.After antibiotic challenge plate 20 h,each plate was sonicated and the absorbance value at 620 nm(A620)was measured on a microtiter plate colorimeter be-fore and after incubation for 6 h.Then the biofilm inhibitory concentrations were calculated.Finally,based on the acquired data.the experiments of combinafion effects of erythromycin with the 3 antibiotic agents on the formed biofilms of 5 picked strains were designed and worked out.Results The sensitive rate of 42 S.maltaphilia to levofloxacin.sulfamethoxazole and piperacillin were 83.33%,66.67%and 54.76%,re-spectively.The bilfilm inhibitory concentrations were much higher than the corresponding minimal inhibitory concentrateion after formed biofflms.Conclusion Forty-two S.maltophilia are multi-resistant to antibiotic agent.And levofioxacin may have a better effect against biofilms compared with others.The inhibition effect of combination erythromycin with levofloxacin is more obvious among all the 3 antibiotic agents.

Objective To compare the short-term effects and toxicity of one cycle of TPF regimen induction chemotherapy with that of two cycles of PF regimen induction chemotherapy in the N advanced local nasopharyngeal carcinoma (NPC). Methods A total of 47 patients initially treated with N advanced local NPC without distant metastasis from Jan 2007 to Dec 2008 were enrolled in this study. The TPF chemotherapy regimen was administered as follows: TAX 60 mg/m2, i.v. infusion on day 1st, cisplatin 80 mg/m2, i.v. infusion on day 1st and 5-Fu 800 mg/m2, bolus infusion in 96 hours on day lst-4th. The PF chemotherapy regimen was as follows: cisplatin 100 mg/m2, i.v. infusion on day 1 and 5-Fu 1000 mg/m2, bolus infusion in 96 hours on day lst-4th. Twenty-six patients received one cycle of TPF regimen and 21 patients received two cycles of PF regimen, with 21 days each cycle and a total of 3 courses in each group, then chemoradiotherapy with cisplatin 30 mg/m2 (weekly) was followed. Results The short-term efficacy was no significant difference between two groups, after one cycle TPF chemotherapy, the CR+PR rates of primary site and lymph nodes were 57.7 % and 69.2 %, respectively, while after two cycles PF chemotherapy in control group, those were 66.7 % and 71.4 %, respectively (P>0.05). In 3 months after treatment, the CR rates of primary site and lymph nodes in TPF group were 92.3 % and 88.7 %, respectively, while those in control group were 100.0 % and 90.5 %, respectively (P>0.05). The main adverse reactions were Grade Ⅲ-Ⅳ neutropenia and alopecia in TPF group. Conclusion Short-term effects of induction chemotherapy with one cycle of TPF regimen in the N advanced local NPC is satisfied, and the main toxicity is neutropenia.