OBJECTIVETo clarify the related factors of marginal bone loss (MBL) around tissue level implants in the posterior part of the mandible.

METHODSA total of 116 tissue level implants were implanted in the mandibular posterior region of 76 patients. Patients' information, including general characteristics, implant characteristics, implant site characteristics, and prosthesis characteristics, was recorded. Their cone beam computed tomography data were measured immediately after implant placement, 3 months later, and 3 and 12 months after prosthesis loading. The measurement of MBL was conducted by One Volume Viewer software. SPSS 20.0 was used for statistic analysis.

RESULTSSmoking, cortical bone thickness (CBT), collum angle (CA), and implant local sanitation showed significant differences with body mass loss (P<0.05). No significant differences were found among sex, age, length of implant, diameter of implants, implant systems, bone height, prosthesis type, and MBL (P>0.05).

CONCLUSIONThe risk factors that caused MBL were smoking, thicker CBT, larger CA, and poor implant local sanitation. Among them, poor implant local sanitation had the highest correlation with MBL.

Alveolar Bone Loss ; epidemiology ; etiology ; Cone-Beam Computed Tomography ; Dental Implants ; adverse effects ; Dental Prosthesis Design ; Dental Prosthesis, Implant-Supported ; Follow-Up Studies ; Humans ; Mandible ; Mandibular Prosthesis ; statistics & numerical data ; Oral Hygiene ; Postoperative Complications ; Smoking ; adverse effects ; Treatment Outcome

Objective To investigate and summarize the clinical and high-resolution computed tomography(HRCT) characteristics of invasive pulmonary fungal infections(IPFIs)in children.Methods Clinical and HRCT data of 35 cases with IPFIs admitted in our hospital between March 2007 and July 2015 were retrospectively analyzed.The clinical and HRCT characteristics were summarized.Results Thirty-five patients consisted of 23 boys and 12 girls with mean age of(3.2±1.9) years.Host factors included acute leukemia (n=12),primary immunodeficiency disease (n=4),congenital heart disease (n=2),cerebral palsy (n=2),severe influenza A infection (H1N1) (n=2),ichthyosis (n=1),acquired immunodeficiency syndrome(n=1),systemic lupus erythematous (n=1),tubercular meningitis(n=1),mechanical ventilation(n=2).All patients were treated with broad-spectrum antibiotic,ranking by descending order:third-generation cephalosporins (28 cases),carbapenems(19 cases)and vancomycin (18 cases).Seventeen cases were treated with corticosteroids systemically and 12 cases with acute leukemia took antineoplastic medicine.The symptoms of IPFIs were intermittent or persistent fever,cough and rales.HRCT results:nodules (n=25,71.4％),subpleural patchy opacities (n=24,68.6％),mass (＞3cm) (n=4,11.4％),halo sign (n=27,77.1％),cavities (n=8,22.9％),air crescent sign (n=4,11.4％),miliary nodules (n=2,5.7％),pleural effusion (n=14,40％).Conclusion There are certain specific characteristics of IPFIs in children in clinical and HRCT aspects.The possible diagnosis of IPFIs can be made based on clinical and HRCT features.

Purpose To explore the effect of Levothyroxine on spatial working memory in patients with subclinical hypothyroidism (SCH) using blood oxygenation level dependent-functional MRI (BOLD-fMRI). Materials and Methods Sixteen patients with SCH before and after 6 months levothyroxine (LT4) treatment and 16 matched euthyroid volunteers underwent n-back task fMRI scanning. AFNI software was used for localization and quantification. Results All the subjects demonstrated activated areas including bilateral dorsolateral prefrontal cortex (DLPFC), bilateral premotor area (PreMA), supplementary motor area/anterior cingulate cortex, bilateral parietal area (PA) and right caudate nucleus/thalamus, with right hemisphere dominance. Quantitative analysis of regions of interests showed that all these regions had load effect related to memory load in the control group (P<0.001), whereas only left DLPFC, left PA, bilateral PreMA and right caudate nucleus/thalamus showed the same effect in SCH group. After 6-month treatment with LT4, BOLD signal change was observed in SCH patients within the right DLPFC, right PA and anterior cingulate/supplementary motor cortex (P<0.001). The activation intensity of working memory related brain regions was lower in SCH group compared with that of the control group. Conclusion Spatial working memory impairments in SCH patients are likely related to decreased right DLPFC and right posterior parietal function. LT4 replacement therapy is important to improve and reverse the memory impairment.

Objective To explore the effectiveness and safety of limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD)for patients with large common duct stones and periampul-lary diverticula (PAD).Methods Data of 40 patients with large common duct stones (diameter ≥10 mm) and PAD who underwent ESBD were retrospectively reviewed.The clinical feature,operation method,suc-cess rates of stone removal and early complications rates during hospitalization were evaluated according to PAD subtypes.Results The stone removal rate in first session was 90.0%(36 /40,with a median time of 29 minutes per procedure.Three patients underwent a second procedure to remove residual stones.The over-all stone removal rate was 97.5% (39 /40).The early complications rate was 15%(6 /40),including mild pancreatitis in two cases(5%),hyperamylasemia in two (5%),postoperative late bleeding in two (5%), which were cured with conservative treatment.No perforation,massive hemorrhage or death occurred.No significant differences in success stone removal rate and early complication rate were found between PAD sub-types.Conclusion ESBD is an effective and safe procedure for removing choledocholithiasis in patients with PAD,regardless of PAD subtypes.

Objective To explore the MRI features about the annular ligament injuries in pediatric patients. Methods The appearance of MRI about annular ligament injuries in 15 pediatric patients diagnosed clinically were retrospectively analyzed. All patients (aged 4 years 8 months to 12 years 11 months) were scanned by MRI in 2-4 days after injury. Patients were divided into three groups according to the annular ligament injuries severity, which were simple annular ligament injuries, annular ligament injuries combined dislocation, annular ligament ruptures combined dislocation. Results Simple annular ligament injuries were showed in 2 cases, which appeared high signal but continuous configuration. Annular ligament injuries combined dislocation were showed 9 cases. Bald head sign, thickening and continuous ligment were found on axial image, together with compression of the radial joint space on sagittal and coronal view. Annular ligament ruptures combined dislocation were showed in 4 cases. The ligment showed"bald head sign", tortuosity and uneven thickening on axial view and compression of the radial joint space on sagittal and coronal view. Combining with the other tissue injuries were detected in 15 cases. Conclusion The annular ligament injuries show some MRI characteristics. Bald head sign is specific in the annular ligament injuries of pediatric patients.

Objective To explore the MRI features about the annular ligament injuries in pediatric patients. Methods The appearance of MRI about annular ligament injuries in 15 pediatric patients diagnosed clinically were retrospectively analyzed. All patients (aged 4 years 8 months to 12 years 11 months) were scanned by MRI in 2-4 days after injury. Patients were divided into three groups according to the annular ligament injuries severity, which were simple annular ligament injuries, annular ligament injuries combined dislocation, annular ligament ruptures combined dislocation. Results Simple annular ligament injuries were showed in 2 cases, which appeared high signal but continuous configuration. Annular ligament injuries combined dislocation were showed 9 cases. Bald head sign, thickening and continuous ligment were found on axial image, together with compression of the radial joint space on sagittal and coronal view. Annular ligament ruptures combined dislocation were showed in 4 cases. The ligment showed"bald head sign", tortuosity and uneven thickening on axial view and compression of the radial joint space on sagittal and coronal view. Combining with the other tissue injuries were detected in 15 cases. Conclusion The annular ligament injuries show some MRI characteristics. Bald head sign is specific in the annular ligament injuries of pediatric patients.

Objective To investigate and compare predictive diagnostic value of neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio and mean platelet volume,for early-stage diabetic nephropathy (EDN).Methods 245 patients with T2DM were divided into patients with EDN(EDN group,n=120) and patients without DN (T2DM group,n=125).116 healthy people were also enrolled in our study.Their clinical and biochemical data were collected.Results NLR (2.14±0.73 vs 1.78±0.58 vs 1.46±0.48,P＜0.05),PLR (116.11±36.43 vs 100.65±27.83 vs 90.24±26.17,P＜0.05) and MPV (11.29± 1.16 vs 10.37 ± 1.01 vs 9.78 ± 1.28,P＜0.05) were significantly higher in EDN group and T2DM group than those of the control group.NLR,PLR and MPV were significantly higher in EDN group than those of T2DM group.Logistic regression analysis showed that after correction of diabetes duration,blood pressure,lipid,and so on,NLR(OR=3.77,95％ CI 2.12-6.08,P＜0.01),PLR(OR=1.81,95％ CI 1.02-2.89,P=0.04) and MPV (OR=2.08,95％ CI 1.22-5.04,P=0.01) were all positively correlated with EDN.According to the analysis of ROC curves,the value of NLR for predicting EDN was higher than PLR and MPV.The cut off value of NLR for predicting EDN was set at 1.82,with the sensitivity of 79.20％ and the specificity of 68.60％.Conclusion NLR has the greatest diagnostic value for EDN,patients whose NLR is over 1.82 need further test in order to diagnose and therapy DN earlier.

Objective To explore the effect of external diaphragm pacemaker (EDP) in patients with mechanical ventilation after stroke. Methods One hundred patients with mechanical ventilation after stroke, admitted to our hospital from January 2014 and July 201, were assigned to a control group and an observation group (n=50) according to the willing of the patient family. All the patients received routine ICU treatment; patients from the observation group were additionally given external diaphragm pacemaker (EDP). After 30 d of treatment, the incidence of respiratory infections and percentage of total subjects of weaned, diaphragmatic excursion, duration in ICU, and duration of mechanical ventilation were compared between the two groups. Results As compared with those in the control group, the percentage of subjects of weaned and diaphragmatic excursion were significantly increased, and the duration in ICU, duration of mechanical ventilation, and incidence of respiratory infections were significantly decreased in the observation group (P<0.05). Conclusion EDP treatment may increase the percentage of subjects of weaned by improving the diaphragmatic function, which can decrease the duration of mechanical ventilation and incidence of respiratory infections in patients with mechanical ventilation after stroke.

OBJECTIVETo detect the disease-causing mutation in a pedigree affected with autosomal dominant congenital cataract.

METHODSGenomic DNA was extracted and purified from peripheral blood samples from members of the pedigree and 100 healthy controls. Coding regions of 18 candidate genes were screened with PCR and Sanger sequencing. Identified mutations were verified among 100 healthy individuals to exclude single nucleotide polymorphisms.

RESULTSA heterozygous nonsense mutation c.471G>A of the CRYGD gene, which resulted in p.Trp157Term, was identified in all three patients. The same mutation was not found in the two normal individuals from the family and 100 healthy controls. The nonsense mutation was predicted to be "disease causing" by Mutation t@sting program.

CONCLUSIONThe nonsense mutation c.471G>A of the CRYGD gene probably underlies the congenital cataract in the pedigree.

Cataract ; etiology ; genetics ; Child ; Codon, Nonsense ; Humans ; Male ; Sequence Analysis, DNA ; gamma-Crystallins ; genetics

OBJECTIVETo identify potential mutations of PKD1 gene in a family affected with autosomal dominant polycystic kidney disease (ADPKD).

METHODSThe coding regions of the PKD1 gene were subjected to PCR and Sanger sequencing. Reverse transcription-PCR (RT-PCR) was used to determine the relative mRNA expression in the patient.

RESULTSA splicing site mutation, c.8791+1_8791+5delGTGCG (IVS23+1_+5delGTGCG), was detected in the PKD1 gene in all 5 patients from the pedigree but not in 6 phenotypically normal relatives and 40 healthy controls. Sequencing of RNA has confirmed that there were 8 bases inserted in the 3' end of exon 23 of the PKD1 gene.

CONCLUSIONThe novel c.8791+1_8791+5delGTGCG mutation has created a new splice site and led to a frameshift, which probably underlies the ADPKD in the family. Above finding has enriched the mutation spectrum of the PKD1 gene.

Adult ; Female ; Humans ; Male ; Mutation ; genetics ; Pedigree ; Polycystic Kidney, Autosomal Dominant ; genetics ; RNA Splicing ; genetics ; TRPP Cation Channels ; genetics ; Young Adult