OBJECTIVEThe purpose of this study is to analyze the incidence and the type of the bifid mandibular canal (BMC) by using cone beam computed tomography (CBCT) images.

METHODSA total of 216 patients (104 female and 112 male) who underwent CBCT were included in this study. The CBCT images were evaluated for the incidence and the type of the BMC.

RESULTSBMC was observed in 39 (18.06%) of 216 patients and 50 (11.57%) of 432 sides, female 18 (17.31 %) and male 21 (18.75%). BMC were classified into four types: type I 17 sides (3.94%), type II 11 sides (2.55%), type III 20 sides (4.63%), and type IV 2 sides (0.46%).

CONCLUSIONBMC is detected at a high rate by using CBCT. When doctors perform surgical procedures in the mandible, they should pay attention to the anatomical variations of BMC of the mandibular canals.

OBJECTIVE:To investigate the effect of Saccharomyces boulardii adjuvant with aluminium phosphate on symp-toms and signs disappearance time,immune function and inflammatory factors in children with acute diarrhea. METHODS:Totally 110 children with acute diarrhea were chosen from our hospital during Mar. 2013-Mar. 2016,and then randomly divided into con-trol group and observation group according to random number table,with 55 cases in each group. Control group was given Alumini-um phosphate gel 2.5 g,po,qd,on the basis of conventional treatment. Observation group was additionally given S. boulardii cap-sules 0.25 g,po,bid,on the basis of control group. Both groups were treated for 3 d. Clinical efficacies,symptoms and signs(di-arrhea,abdominal pain,vomiting,abnormal stool routine)disappearance time as well as stool frequency,stool character scores, immune function indexes(CD3+,CD4+,CD8+,CD4+/CD8+),inflammatory factors(IL-6,IL-10,TNF-α)before and after treat-ment,the occurrence of ADR were compared between 2 groups. RESULTS:The total response rate of observation group (90.91%)was significantly higher than that of control group(70.91%);the symptoms and signs disappearance time was signifi-cantly shorter than control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in stool frequency,stool character scores,immune function indexes or inflammatory factor levels between 2 groups(P>0.05). After treatment,stool frequency,stool character scores and inflammatory factor levels of 2 groups were significantly lower than before, and the observation group was significantly lower than the control group;the levels of CD3+,CD4+,CD4+/CD8+ were significantly higher than before treatment and control group,and the level of CD8 + was significantly lower than before treatment and control group,with statistical significance(P<0.05). There was no significant difference in immune function indexes of control group be-fore and after treatment(P>0.05). Total incidence of dry mouth and constipation was 5.45% in control group and 9.09% in obser-vation group,without statistical significance(P>0.05). CONCLUSIONS:S. boulardii adjuvant with aluminium phosphate in the treatment of pediatric acute diarrhea can efficiently improve symptoms and signs,shorten disease duration,improve immune func-tion and reduce inflammatory reaction with good safety.

Objective　To study the predictability, stability and safety of laser in situ keratomileusis (LASIK) for myopia.Methods　 Five hundred and Sixty-five eyes ( 293 patients ) were treated with the SCMD corneal shaper and laser sight Compak - 200 excimer laser and followed up for more than 6 months. These eyes were divided into 4 groups according to the degrees of myopia: Group Ⅰ:-1.50～-5.75D,120 eyes; Group Ⅱ:-6.00～-9.75D,230 eyes; Group Ⅲ:-10.00～-14.75D,148 eyes and croup Ⅳ:-15.00～-26.00D,67 eyes.Results　Six months post-operatively, mean uncorrected visual acuity of each group was 1.15±0.20, 0.92±0.22, 0.69±0.24 and 0.44±0.22 respectively; The uncorrected visual acuity of 0.5 or better was 100%, 94.6%, 85.8% and 47.7% respectively; And 1.0 or better was 91.7%, 56.7%, 18.0% , 0% respectively. Mean spherical equivalent of each group was -0.14D±0.61D, -0.43D±1.20D, -0.57D±1.47D and -1.79D±2.57D respectively. There were no serious complications. Conclusion　 LASIK is an effective and safe method for reducing myopia. But the potential complications should be noticed.

Objective To observe the clinical effects of dermis combined autologous transplants in patients with abnormal scar thickness skin graft.Methods 13 cases of scar deformity were selected during August 2011 to December 2014 in our hospital.In stage 1 procedure,the scars that affected the function and induced deformities were resected and then the artificial dermis covering the wound was placed;in stage 2,two weeks after the artificial dermis vascularization,autologous skin grafts were removed to repair the wound edge.Meanwhile,therapy of inhibiting scar after conventional treatment was conducted with funcitional exercise.Results 13 cases were scheduled to repair scar wounds,underwent surgery with more than 6 months follow-up observation.The dysfunctions caused by scar contracture and deformity were significantly improved;appearance,elasticity and appearance of the skin grafts were similar to autologous skin graft with the desired clinical effect.Conclusions Artificial dermis combined autologous skin graft treatment of patients with scar deformity can achieve similar clinical effects to traditional treatment methods.

Objective To investigate a method of repairing complex tissue defects one stage in one finger or several fingers for more fine recipient site repairing and less donor area traum. Methods From August 2007 to August 2010,eight cases of 20 fingers were reconstructed according to the state of complex tissue defects in a hand,second toes (right or left side) were split into two or three parts as complex tissue flaps that may including joints,tendons,skin,nail beds,et al.These flaps then were translated to hand to repair complex tissue defects by anastomosing vessels.Results Twenty fingers in 8 cases were successfully reconstructed.Follow-up ranged from 3 months to 36 months,external appearance were fine.According to the Trial Evaluation Standard of Reconstructed Finger Function of Handsurgery Society of China,sixteen fingers were excellent,three fingers were good,one finger was fine.And there was no effect on foot.Conclusion Spliting single second toe is a good method for repairing more complex tissue defects in a hand.

Objective:To construct a short hairpin RNA(shRNA) eukaryotic expression vector of the survivin gene,and investigate its inhibitory effect on the survivin expression in human cervical cancer cells.Methods:We designed and synthesized 2 pairs of survivin-specific small interfering RNA primers(s1 and s2),cloned them into the eukaryotic expression vector pSilencer 2.1-U6 neo by DNA recombined techniques after annealing connection reaction,and transfected them respectively into human cervical cancer cell line HeLa using LipofectAMINE2000 after identificationby restrict endonuclease digestion and DNA sequencing.Then we selected the positive clones by G418 and detected the expression of survivin mRNA by semi-quantitative RT-PCR and that of the survivin protein by Western blot.Results:The survivin shRNA eukaryotic expression vectors pSilencer2.1-s1 and pSilencer2.1-s2 were successfully constructed.Positive clones were obtained by screening with G418 for 24 days,the survivin expression in HeLa cells decreased in different degrees after transfected with pSilencer2.1-s1 and pSilencer2.1-s2,and the latter showed a better interference efficiency.Conclusion:The shRNA eukaryotic expression vector of the survivin gene we constructed,with its improved interfering efficiency,has paved the way for further research on its role in regulating the biological behavior of cervical cancer cells.

From the perspective of hospice care， focusing on the entire process before and after the occurrence of a death event， taking the interpretation of the concept of death value in hospice care as the starting point， this paper explored the value connotation implied in the process of death from the perspectives of the terminal person， caregivers， and social culture， as well as summarized the characteristics of the death value. Meanwhile， in the current social context of the difficulty in achieving good death due to the shallow understanding of death， this paper analyzed the great significance of the construction of the death value concept in hospice care for improving the personal death quality of the terminal person， promoting the quality of end-of-life， and accelerating the formation of a social environment of good death， with a view to stimulating academic attention to the construction of the death value of terminal person， and providing conceptual reference for improving the quality of hospice care services.

Focusing on the field of palliative care，the Rodgers evolutionary concept analysis method was used to analyze the literature related to good death in the context of Chinese culture.The development history and application，definition and characteristics，influencing factors and their impacts，measuring indicators and tools of the concept of good death were elaborated，and further discussions were conducted.Good death refers to an individual’s peaceful and painless journey towards death，without subjective pain or concern，and calmness under the premise of sufficient longevity，while receiving care and companionship during the process of death from family，especially children and grandchildren，as well as achieving moral fulfilment and transcendence.The characteristics of good death in the context of Chinese traditional culture include the indirect expression of physical and mental pain being “understood” and properly handled，the construction of dying dignity based on virtue rather than autonomy，the emphasis on filial piety and emotional connections in the family，making after-death arrangements and realizing intergenerational inheritance，as well as the emphasis on achieving the integrity of life at the moment of death，which have distinct Chinese cultural characteristics.In the future，the connotation and extension of the concept of good death should be further explored，so as to assist in the development of localized theory and practice systems of good death.

Objective:Based on the theory of planned behavior (TPB), the exercise intervention program for breast cancer patients undergoing chemotherapy was constructed, and its application effect was preliminarily explored.Methods:A total of 116 patients receiving chemotherapy in the department of breast surgery from June to December 2021 in Shanxi Provincial Cancer Hospital were selected by purpose sampling method. The subjects were randomly divided into control group and experimental group by flipping a coin. The control group was given routine nursing, and the experimental group was given routine nursing on the basis of exercise intervention based on the theory of planned behavior. After three cycles of chemotherapy, the effects of the intervention were evaluated by piper Revised Fatigue Scale (RPFS), Exercise Self-efficacy Scale and Quality of Life Core Scale (EORTC QLQ-C30).Results:In the intervention stage, there were 2 cases in the experimental group and 3 cases in the control group lost. After the intervention, the total score and all dimensions (behavioral, emotional, sensory and cognitive) of cancer-induced fatigue in the experimental group were (2.30 ± 0.58), (2.21 ± 0.85), (2.32 ± 0.70), (2.66 ± 0.71) and (2.03 ± 0.58), which were lower than those in the control group (2.84 ± 0.44), (2.79 ± 0.60), (3.04 ± 0.75), (3.04 ± 0.60) and (2.53 ± 0.56), the differences were significant ( t values were 3.05-5.23, all P<0.05). The total scores of exercise self-efficacy and the dimensions of physical, psychological and social environment were higher than those of the control group ( t values were -7.63 - -3.31, all P<0.05). The scores of overall quality of life, physical function and emotional function were higher than those of the control group ( t = -3.48, -3.14,-2.34, all P<0.05), while the scores of fatigue and insomnia symptoms were lower than those in the control group ( t = 5.13, 3.14, both P<0.05). Conclusion:The exercise program based on the theory of planned behavior can improve the exercise self-efficacy of breast cancer patients undergoing chemotherapy, reduce cancer-related fatigue and improve their quality of life.

Objective To investigate a more pedect method for a nice outward appearance of a reconstructed thumb.Methods A free one-stage plasty second toe transfer for thumb reconstruction by interchanging the whole skin-nail flap from the great toe with another one from the second toe.Results There were 12 cases in this group,following-up 6-9 months in 8 cases,7 cases was excellent and 1 cases was good.The reconstructed thumb got a nice looking and more normal function while no blight to the great toe occurred.Conclusion It is an effective new procedure in ameliorating outward appearance of the reconstructed thumb by transferring the free moulded second toe.