Objective:To evaluate the influence of the implant-supported porcelain bridges made from non-precious metals using spark erosion techniques, and to discuss the feasibility and details of making the implant restoration by spark erosion technique.Methods: The study included 12 patients ( 9 males and 3 females) with 92 units implant-supported non-precious porcelain bridge from Sep.2011 to Feb. 2013.All the patients received implant treatment in Department of Oral Implantology, Peking University School and Hospital of Stomatology.The total of 52 implants, were from Nobel Biocare implant system, Camlog implant system and Ankylos implant system.The implant analogs were connected in sequence with a copper wire to guarantee conductivity.The implant electrodes represented one electrode and the superstructure the other.During spark-erosion machining, the cast holding the implant electrodes and the prosthetic framework were moved toward one another, causing an electrical erosion of the protruding ele-ments.Results:After the spark-erosion machining, the minimum gap between the framework and abut-ment was 0.21 mm, which was two units bridge.The maximum was 2.59 mm, which was 11 units bridge with 6 implants.The average gap was 0.68 mm.After the spark-erosion machining, the bridge fitted well with the passive position stability.Conclusion: The method of making implant-supported non-precious porcelain bridge reduces costs on patients.Spark erosion has the potential to provide implant framework with an excellent fit.The patients are satisfied with the clinical results.

OBJECTIVETo evaluate the bond strength and durability of a self-adhesive resin cement with a zirconia ceramic pretreated by a zirconia primer.

METHODSZirconia ceramic (Vita Inceram YZ) plates with a thickness of 2.5 mm were fired, polished, and then cleaned. Half of the polished ceramic plates were sandblasted with 50 μm alumina particles at 0.3 MPa for 20 s. The surface compound weight ratios were measured via X-ray fluorescence microscopy. The polished and sandblasted ceramic plates were directly bonded with self-adhesive resin cement (Biscem) or were pretreated by a zirconia primer (Z Primer Plus) before bonding with Biscem. The specimens of each test group were divided into two subgroups (n=10) and subjected to the shear test after 0 and 10,000 thermal cycles. The data were analyzed via three-way ANOVA.

RESULTSAfter air abrasion, 8.27% weight ratio of alumina attached to the zirconia surface. Compared with air abrasion, primer treatment more significantly improved the primary resin bond strength of the zirconia ceramic. The primary resin bond strength of the zirconia ceramic with no primer treatment was not affected by thermocycling (P>0.05). However, the primary resin bond strength of the zirconia ceramic with primer treatment was significantly decreased by thermocycling (P<0.05).

CONCLUSIONPrimer treatment can improve the primary resin bond strengths of zirconia ceramics. However, the bond interface of the primer is not stable and rapidly degraded during thermocycling.

Adhesives ; Aluminum Oxide ; Ceramics ; Dental Bonding ; Dental Porcelain ; Dental Stress Analysis ; Materials Testing ; Resin Cements ; Surface Properties ; Zirconium

Objective To investigate the relation between anormalities of fetal abdominal great vessels and heterotaxy, the clinical significance of screening fetal heterotaxy by the abnormalities of fetal abdominal great vessels. Methods 6532 fetuses from our hospital were scanned and the fetuses with abdominal great vessels abnormalities were included. Parameters of fetal growth, abdominal great vessels and anatomical survey were detected. Results Forty-five cases (0.7%) of fetal abdominal great vessels abnormalities were detected prenatally. Forty-two cases were confirmed postnatally, including 35 cases of heterotaxy syndrome and 7 cases of situs inversus totalis and 3 cases missed. The incidences of the abnormal fetus,heterotaxy syndrome and situs inversus totalis of the fetuses with abnormal abdominal great vessels were higher than that of the fetuses with normal abdominal great vessels, the differences were statistically significant( P＜ 0.001). The incidence of both type Ⅰ and type Ⅱ of the heterotaxy syndrome were significantly higher than that of type Ⅳ (P＜0.001). There was a high incidence of left isomerism in abnormal type Ⅰ and of right isomerism in abnormal type Ⅱ , the differences were statistically significant (P＜ 0.001). Conclusions Abnormal great vessels abnormalities have strong relations to heterotaxy and situs inversus which can be used as effective and simple indicator in screening heterotaxy syndrome.

Objective To investigate the relationship between the abnormalities in the area behind the heart in the four-chamber view and fetal defects, the clinical significance of assessment of area behind the heart in fetal screening.Methods 7062 fetuses were scanned.Area behind the heart in the four-chamber view and anatomical survey were detected.Results Fifty-three cases (0.8％, 53/7062) with abnormal sonographic findings in the area behind the heart in the four-chamber view were detected prenatally.Thirtyseven cases were confirmed by autopsy postnatally.Among these cases, 73.0％ (27/37) had heterotaxy syndrome,8.1％(3/37) had situs inversus totalis,18.9％ (7/37) had heart defects.Conclusions There is close relationship between the abnormalities in the area behind the heart and the fetal defects.This can be used as an effective and simple indicator in screening situs inversus and cardiovascular abnomalities.

Objective: To discuss the application of failure mode and effect analysis to improve the hand hygiene compliance of medical staff in eye hospital. Methods: To form failure mode and effect analysis (FMEA) quality control team. By using FMEA method of risk management, to analyze the risk factors of hand hygiene compliance of medical staff in eye hospital. By performing analysis, to determine the high risk factors, develop and implement the improvement measures to reduce the risk of these factors. Results: the awareness rate of hand hygiene knowledge was increased significantly after the implementation of failure mode and effect analysis (P<0.01) , the correct rate of hand-washing method, and the implementing rate of 5 hand hygiene were increased significantly (P<0.05) . After the implementation of FMEA, the usage amount of hand washing liquid and quick hand disinfectant was increased from 13 292 ml to 28 390 ml, and difference of the hand hygiene qualification rate was statistically significant (P<0.05) . Conclusion The application of FMEA contributes to analyze the causes of hand hygiene failure, and guide the development of improvement measures, which can effectively improve the hand hygiene compliance of medical staff, thereby reducing nosocomial infection.

This study was performed to investigate the chemical constituents in the twigs and leaves of Harrisonia perforate. Six compounds were isolated from the 95% EtOH extract of the twigs and leaves of Harrisonia perforate by silica gel, ODS, Sephadex LH-20 column chromatographies and preparative HPLC. On the basis of chemical properties and spectra data, these compounds were identified as harriperfin E (1), kihadanin A (2), kihadanin B (3), 6α-acetoxyobacunol acetate (4), gardaubryone C (5), and β-sitosterol methyl ether (6), respectively. Compound 1 is a new chromone, and compounds 2-6 are isolated from this plant for the first time.

Objective To study the effects of the rehabilitation robot-assisted task-oriented training on the hand function in patients after stroke. Methods From June, 2015 to September, 2016, 35 inpatients suffering from stroke were randomly allocated to control group (n=17) and trial group (n=18). Based on the routine rehabilitation, the trial group accepted robot-assisted task-oriented training, while the control group accepted therapist-assisted task-oriented training, for two weeks. They were measured the active range of motion (AROM) of fingers, assessed with fingers motor of Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) invovled with hands before and after train-ing. Results The inpatients dropped three in the control group, two in the trial group. AROM of extension and flexion of all the fingers, the AROM of extension and total of three fingers of thumb, index and middle, and the total AROM of each finger improved in the trial group af-ter training (t>2.937, P<0.05), while the AROM of extension and flexion of all the fingers, AROM of extension, flexion and total of the fin-gers of thumb, index and middle, total AROM of the fingers of thumb, index and little improved in the control group after training (t>2.528, P<0.05);the AROM of extension and total of the fingers of thumb, index and middle, and the total AROM of fingers of thumb and index im-proved more in the trial group than in the control group (t>2.535, P<0.05). The scores of mass flexion, mass extension, opposition, cylinder grip, spherical grip and total score of FMA improved in the trial group after training (Z>2.000, P<0.05), while the scores of mass extension, opposition and the total score of FMA improved in the control group after training (Z>2.000, P<0.05). There was no significant difference between the two groups on the items and total scores after training (P>0.05). The scores of feeding, dressing, toilet transfers, bathing, groom-ing of MBI and the total score of them improved in the trial group after training (Z>2.041, P<0.05), while the total score of MBI improved in the control group after training (Z=-2.527, P<0.05). There was no significant difference between the two groups in the items and total scores after training (P>0.05). Conclusion The rehabilitation robot-assisted task-oriented training can improve AROM of hemiplegic fingers and grip function.

The paper described the professional approach of Shanghai Hospital Development Center(SHDC)in developing a professional team of public hospital directors by such means as operation and management-autonomy,fixed tenures system,performance appraisal,part-time job control and income distribution. Recommendations raised include an organic unity of management functions of investors and power of management of the directors to motivate them in their management;building a comprehensive investor management system and strict cadre management mechanism to enhance supervision of the directors.

Objective To evaluate the relationship between excitability of neurons in hypothalamic paraventricular nucleus (PVN) and central nervous regulatory mechanism of myocardial ischemia-reperfusion (I/R) injury in rats.Methods Clean-grade healthy adult male Sprague-Dawley rats,in which PVN catheters were successfully implanted,aged 6-8 weeks,weighing 260-300 g,were divided into 4 groups (n =6 each) using a random number table method:sham operation group (S group),myocardial I/R group (I/R group),γ-aminobutyric acid group (GABA group) and L-glutamic acid group (L-Glu group).Myocardial ischemia was induced by occlusion of the left anterior descending coronary artery for 30 min followed by 120-min reperfusion.Normal saline 2.4 μl/h was infused for 50 min via the PVN catheter starting from 10 min before ischemia in S and I/R groups.GABA 30 μmol/L and L-glutamic acid 30 μmol/L were infused for 50 min via the PVN catheter at a rate of 2.4 μl/h starting from 10 min before ischemia in GABA and L-Glu groups.The heart rate (HR) and mean arterial pressure (MAP) were recorded at 10 min before ischemia (T0),beginning of ischemia (T1),30 min of ischemia (T2) and 120 min of reperfusion (T3).Rate-pressure product (RPP) was calculated.Blood samples were collected at T3 for determination of plasma cardiac troponin I (cTnI) concentrations by chemiluminescence assay.Rats were then sacrificed and myocardial specimens were obtained for measurement of myocardial infarct size (IS) and area at risk (AAS),and IS/AAR percentage was calculated.PVN tissues were taken to detect the expression of cfos by Western blot.Results No myocardial infarction was found in group S,and myocardial infarction was marked in the other three groups.Compared with group S,the plasma cTnI concentrations were significantly increased,and the expression of c-fos in PVN was up-regulated in I/R,GABA and L-Glu groups (P＜0.05),and MAP,HR and RPP were significantly decreased at T1-3 in I/R and GABA groups and at T3 in group L-Glu (P＜0.05).Compared with group I/R,IS and IS/AAR percentage were significantly decreased,the plasma cTnI concentrations were decreased,the expression of c-fos in PVN was down-regulated,and HR,MAP and RPP were decreased at T1,2 in group GABA,and IS and IS/AAR percentage were significantly increased,the plasma cTnI concentrations were increased,the expression of c-fos in PVN was up-regulated,and HR,MAP and RPP were increased at T1,2 in group L-Glu (P＜0.05).Conclusion Excitability of neurons in hypothalamic PVN is involved in central nervous regulatory mechanism of myocardial I/R injury in rats:decreased excitability can attenuate myocardial I/R injury and increased excitability aggravates myocardial I/R injury.

Objective:To assess the applying value of Chinese shorter version of the Visual Function Index questionnaire (VF-11R-CN) for presenting low-vision cataract pre-operation and post-operation by using minimal clinically important difference (MCID) determined by combination of distribution-based with anchor-based methods, and to compare the improvement rate of vision-related quality of life (VRQol).Methods:A cross-sectional study was performed in this study.Ninety-eight patients with presenting low vision cataract were enrolled at Eye Hospital of Wenzhou Medical University from May 2018 to June 2019.All the patients received a phacoemulsification with intraocular lens implantation.A questionnaire survey was carried out with VF-11R-CN Scale before surgery and 1 month-3 months after surgery, and a complement anchor item was added during the questionnaire after surgery.The applicability of the scale was assessed by floor or ceiling effects, and score difference of the VF-11R-CN over time and effective size was determined.Distribution-based MCID was calculated using 0.5 standard deviation (SD) of score difference and 1.96 standard error of measurement (SEM). Anchor-based MCID was calculated using the slope of the linear regression analysis.In responder analysis, sensitivity and specificity of MCID was reported.The differences of postoperative VRQol improvement rate based-on MCID were compared between male and female, single eye disease and multiple eye diseases, pre-operative and post-operative scores.This study protocol was approved by the Ethics Committee of Eye Hospital of Wenzhou Medical University, and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.Results:A total of 85 patients completed the following up.The mean score difference was 399.51±234.92, and that of the presenting visual acuity (PVA) was 0.65±0.36.Both the minor floor and ceiling effects were 1.18% before surgery, and the ceiling effects were 22.35% after surgery.The score before surgery was significantly higher than that after surgery ( t=15.68, P<0.001). The effective size for the surgery was 1.63.The MCID was 122.23 and 123.10 according to 0.5 SD and 1.96 SEM.The linearity regression analysis showed that score difference reduced 106.17 if anchor item option increased 1.The average MCID estimate was 117.17.A total of 76 patients (89.41%) reported an improvement of VRQol.The sensitivity of MCID for the assessment of VRQol was 96.67% and specificity was 46.67%.No significant differences were found in VRQol improvement rate between gender, single cataract and multiple eye diseases or PVA (LogMAR 1.3 as cutoff value) ( P=0.73, 0.88, 0.27). Conclusions:VF-11R-CN scale is available for Chinese presenting low vision cataract patients undergoing surgery.The MCID value for the cataract surgery is 117.17 scores, with a high sensitivity and a relatively low specificity.