Objective:To evaluate the clinical efficacy between preparation porcelain veneer(PPV)and no-preparation porcelain veneer(NPPV).Methods:44 patients with 97 PPVs and 23 patients with 57 NPPVs were followed up for 3 years.Mental tension, postoperative dentin sensitivity and satisfaction of the patients,survival rate of the veneers,sulcus bleeding index(SBI)of preopera-tive and postoperative 3 years were evaluated.A comparative analysis was taken to examine the clinical indicators of 2 groups accord-ing to the modified CDA /Ryge criteria.Results:Survival rates of PPVs and NPPVs were 96.91 % and 96.49%(P >0.05),satisfac-tion rates of the 2 group patients were 95.45% and 95.65%(P >0.05),respectively.Mental tension and the postoperative dentin sensitivity of patients in PPV group was higher than those in NPPV group.Preoperative and postoperative SBI were not statistically dif-ferent between the 2 groups(P >0.05).Marginal adaptation in PPV group was better than that in NPPV group.Color matching, Porcelain surface and Marginal stain were not statistically different between 2 groups.Conclusion:Preparation porcelain veneers and no-preparation porcelain veneers both are effective in clinical application.

OBJECTIVE: To evaluate the efficacy and safety of proximal femoral nail antirotation(PFNA) vs InterTAN nail in treating the elderly intertrochanteric femoral fractures. METHODS: Data of the randomized controlled trials(RCTs) about PFNA vs InterTAN for the treatment of the elderly intertrochanteric femoral fractures were searched in as the Cochrane Library, PubMed, EMbase, Wanfang, CNKI, CBM and VIP from their establishment to January 2018 for collecting. After study selection, assessment and data extraction conducted by two reviewers independently, meta-analyses were performed by using the RevMan 5.3 sofware. The level of evidence was assessed by using the GRADEpro system. RESULTS: Twelve studies involving 1 015 patients were included. The results of meta, analyses showed that: (1)safety indicator: compared with the InterTAN, PFNA had shorter operation time, and less intraoperative bleeding. But InterTAN had less total postoperative complications and internal fixation failure, but there was no significant difference in the operative incision lengths, fracture healing time and other postoperative complications. (2)efficacy indicator: compared with the InterTAN, the Harris hip score was lower after 3 months, but Harris hip score had no significant difference between the two groups after 6, 12 months. Based on GRADEpro system, all the evidence was at level C and weak recommendation(2C). CONCLUSIONS The current evidence indicates that PFNA had a similar effect compared with the InterTAN. But InterTAN could provide better stability against rotation and axial pressure effect, can allow patients do functional exercise early such as ambulation to recovery the hip function. It also had less total postoperative complications and internal fixation failure for the poor quality of the original studies and the limited number of studies, a prudent choice is suggested and more high-quality, large-sample studies are need.
Aged ; Bone Nails ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; Fracture Fixation, Intramedullary ; Humans ; Treatment Outcome

OBJECTIVETo observe electrophysiological changes of severe N-hexane neuropathy getting active therapies and discuss its prognosis.

METHODSA follow-up study involved 16 adult severe N-hexane neuropathy patients who got active therapies was performed. EMG in right muscle of thenar, tibial muscle, and vastus medialis, NCV in right median nerve, common peroneal nerve, and sural nerve were determined and analyzed before treatment and in the first, the third, the ninth, and the twenty-fourth month after treatment.

RESULTSThe electrophysiology in severe N-hexane neuropathy patients showed that the voluntary potential during muscle relaxation increased by 25.0%; the motor unit potential time limit prolonged by 20.8%, and the amplitude increased by 12.5%, and multiphasic wave increased by 16.5% during mild contraction; the raise decreased by 25.0% during strong contraction. In control group, the MCV, SCV, SNAP, DML, and CMAP of median nerve were (54.63 +/- 5.33) m/s, (59.25 +/- 6.45) m/s, (26.53 +/- 6.32) microV, (3.96 +/- 0.65)ms, and (9.89 +/- 2.30) mV respectively, the MCV, CMAP, DML of common peroneal nerve were (48.49 +/- 3.25) m/s, (5.47 +/- 1.77) mV, (5.20 +/- 1.27) ms respectively, and the SCV, SNAP of sural nerve were (63.21 +/- 9.30) m/s, (4.63 +/- 1.29) microV respectively. Severe N-hexane neuropathy patients presented significantly different abnormalities in the NCV and EMG (P < 0.01). The MCV, SCV, SNAP, DML, CMAP of median nerve were (46.00 +/- 4.32) m/s, (40.66 +/- 2.65) m/s, (7.98 +/- 1.05) microV, (4.28 +/- 0.63) ms, and (6.32 +/- 1.54) mV respectively. The MCV, CMAP, DML of common peroneal nerve were (48.49 +/- 3.25) m/s, (3.21 +/- 1.99) mV, (7.32 +/- 1.65) ms respectively. The SCV, SNAP of sural nerve were (36.48 +/- 5.20) m/s, (2.15 +/- 1.22) microV respectively. These parameters gradually recovered to normal levels in 24 months after treatment.

CONCLUSIONThe electrophysiological abnormalities in severe N-hexane neuropathy patients can restore after treatment, and clinical prognosis is good.

Adult ; Case-Control Studies ; Electromyography ; Female ; Hexanes ; poisoning ; Humans ; Neural Conduction ; Occupational Exposure ; Peripheral Nervous System Diseases ; etiology ; physiopathology

OBJECTIVE: To evaluate the safety and effectiveness of eyelid margin cleaning using Deep Cleaning Device for the treatment of meibomian gland dysfunction-associated dry eye. METHODS: This was a prospective, randomized, open-label, investigator-masked, and self-controlled study. We randomly assigned one eye of patients with meibomian gland dysfunction-associated dry eye to the treatment group, and the other eye to the control group. Both groups received artificial tears and lid warming; the treatment group received an additional one-time in-office eyelid margin cleaning using Deep Cleaning Device. Non-invasive tear break-up time (NITBUT) and tear meniscus height (TMH) of each eye, and Standard Patient Evaluation for Eye Dryness II (SPEED II) score of each patient were evaluated before and at one week after treatment. RESULTS: Thirty eyes of 15 patients were enrolled. No adverse effects occurred during the treatment. Compared with the baseline values, the SPEED score decreased significantly at one week after treatment (mean±95% confidence interval, 11.00±0.99 vs. 5.67±1.67, P<0.0001), the NITBUT-first in the treatment group increased significantly at one week after treatment ((4.74±1.27) s vs. (7.49±2.22) s, P=0.01). The NITBUT-first was significantly longer in the treatment group ((7.49±2.22) s) than in the control group ((5.17±0.91) s) at one week after treatment (P=0.042). No significant differences were found in other tear film parameters between the two groups. CONCLUSIONS Eyelid margin cleaning using the novel Deep Cleaning Device is a convenient, effective, and safe treatment for patients with meibomian gland dysfunction-associated dry eye.
Adult ; Aged ; Dry Eye Syndromes/therapy* ; Eyelids/physiopathology* ; Female ; Humans ; Hyperthermia, Induced ; Male ; Meibomian Gland Dysfunction/therapy* ; Middle Aged ; Prospective Studies ; Tears

OBJECTIVETo investigate the role of 99mTc-TRODAT-1 SPECT in diagnosis and assessing severity of idiopathic Parkinson's disease (PD).

METHODSThirty-eight patients with primary, tentative diagnosis of PD and eighteen age-matched normal controls were studied with 99mTc-TRODAT-1 SPECT imaging. The regions of interests (ROIs) were drawn manually on cerebellum (CB), occipital cortex (OC) and three transverse plane slice-views of striatums, the semiquantitative BG (background)/[(OC+CB)/2] were then calculated.

RESULTSA lower uptake of 99mTc-TRODAT-1 in striatums were displayed in thirty-six out of thirty-eight PD patients by visual inspection, compared to controls. In twenty-four PD cases with (Hoehn and Yahr scale) HYS stage I, a greater loss of DAT uptake was found in striatum and its subregions contralateral striatum to the affected limbs than in the same regions of the controls, although the striatal uptake was bilaterally reduced. Using Spearman correlation analysis showed that the reduction of the uptake ratios significantly correlated with the UPDRS in striatum and all its subregions in the PD group (P<0.05), a similar change was also found in the putamen by using the rating scale of Hoehn and Yahr (P<0.05). However, analysis of variance (ANOVA) did not show any relationship between the decreasing uptake of 99mTc-TRODAT-1 and increasing severity of PD patients, although the specific uptake of 99mTc-TRODAT-1 was continuously decreased in the striatum by visual inspection with the progress of PD from HYS stage I to III.

CONCLUSION99mTc-TRODAT-1 SPECT imaging may serve as a useful method for improving the correct diagnosis of PD. In assessing the role of 99mTc-TRODAT-1 SPECT in disease severity of PD, UPDRS can offer a comprehensive index, although the Hoehn and Yahr assessment may be available in part.

Adult ; Aged ; Corpus Striatum ; diagnostic imaging ; metabolism ; Dopamine Plasma Membrane Transport Proteins ; Feasibility Studies ; Female ; Humans ; Male ; Membrane Glycoproteins ; metabolism ; Membrane Transport Proteins ; metabolism ; Middle Aged ; Nerve Tissue Proteins ; metabolism ; Organotechnetium Compounds ; pharmacokinetics ; Parkinson Disease ; diagnostic imaging ; metabolism ; Radiopharmaceuticals ; pharmacokinetics ; Reproducibility of Results ; Sensitivity and Specificity ; Severity of Illness Index ; Tomography, Emission-Computed, Single-Photon ; methods ; Tropanes ; pharmacokinetics

AIMTo study the relationships between dyspnea and respiratory drive or respiratory muscle function in COPD.

METHODSThirty-one patients with COPD and 26 normal subjects were involved in the study. Routine pulmonary function, pulmonary diffusing capacity, P0.1, PI(max) were measured at rest. Oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE) etc were observed during exercise test. Dyspnea was assessed with Borg Scale (BS) simultaneously. Arterial blood gas measured before and after exercise.

RESULTS(1) PI(max) of COPD (5.33 +/- 1.95) kPa decreased compared with the normal subjects (7.02 +/- 2.53) kPa, P < 0.05, P0.1 of COPD (0.37 +/- 0.12) kPa increased compared with the normal subjects (0.26 +/- 0.09) kPa, P < 0.05, inspiratory drive efficacy (V(T)/P0.1) of COPD (1.6 +/- 0.31) L/kPa decreased than that of the normal subjects (2.1 +/- 0.53) L/kPa, P < 0.05. P0.1/PI(max) of COPD (0.069 +/- 0.021) was higher than that of the normal individuals (0.037 +/- 0.009), P < 0.01. (2) Peak exercise dyspnea was correlated with dyspnea at rest and P0.1/PI(max) (r = 0.41, P < 0.05 and r = 0.48, P < 0.05, respectively), and P0.1/PI(max) was also positively correlated with the change in BS from rest to maximal exercise (deltaBS) (r = 0.44, P < 0.05) in COPD patients.

CONCLUSIONIn COPD, breathlessness during exercise is not simply related to hyperinflation and the damaged gas exchange, but also to the relatively increased respiratory drive and dysfunction of respiratory muscle.

Adult ; Case-Control Studies ; Dyspnea ; etiology ; physiopathology ; Exercise Test ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; Respiratory Function Tests

OBJECTIVETo investigate the effect of phosphorylated protein kinase C epsilon (pPKC epsilon) on apoptosis of 32D cells induced by sera from patients with aplastic anemia (AA).

METHODSThe expression of pPKC epsilon and apoptosis in 32D cells were measured by Western blotting and flow cytometry after incubation with sera from healthy individuals (controls, n = 8), patients with severe AA ( SAA, n = 8)and non severe AA (NSAA, n = 6).

RESULTSAfter incubation for 0, 12, 24, 36 and 48 hours in the presence of serum and for another 4 hours in medium deprived of serum, the levels of pPKC epsilon in cells in SAA and NSAA group increased gradually, peaked at 24 hours, and then declined (P < 0.05). Compared with that in control group (0.54 +/- 0.08), pPKC epsilon was overexpressed in both SAA group (0.90 +/- 0.10) and NSAA group (0.64 +/- 0.08) (P < 0.05) after 24 hours incubation with serum and subsequent 4 hours without serum. pPKC epsilon level was higher in SAA group than in NSAA group (P < 0.05). A greater proportion of 32D cells showed apoptosis after 24 hours incubation with sera from SAA patients [(4.05 +/- 1.05)%] and subsequent 4 hours incubation without serum than that in controls [(2.45 +/- 0.51)%, P < 0.05], which was correlated with the same serum-induced expression of pPKC epsilon (r = 0.869, P < 0.05). Although the mean level of pPKC epsilon expression was higher in NSAA group than in control group, no significant difference of apoptosis was found between the two groups [(2.45 +/- 0.51)% vs (3.24 +/- 0.56)%, P > 0.05].

CONCLUSIONSera from both SAA and NSAA patients could upregulate the expression of pPKC epsilon in 32D cells. The SAA sera induce apoptosis in 32D cells significantly, but the latter do not.

Adolescent ; Adult ; Anemia, Aplastic ; enzymology ; pathology ; Apoptosis ; Case-Control Studies ; Cells, Cultured ; Child ; Female ; Humans ; Male ; Middle Aged ; Phosphorylation ; Protein Kinase C-epsilon ; blood ; Young Adult

OBJECTIVETo investigate the imaging and hemodynamical features of pulmonary artery branches in chronic obstructive pulmonary disease (COPD) with pulmonary artery hypertension (PAH).

METHODSCT pulmonary angiography (CTPA) with ECG-gating was performed in 13 patients with clinical diagnosed COPD and 25 normal subjects. The thin-slice multiple plane reconstruction in systole and diastole phase was conducted, which in turn was used to generate the InSpace reconstructed images with reference frame of the main pulmonary artery and the first two grades branches, the contour of the branches was depicted. On the base of coordinates, the GAMBIT was used to generate nodes and furthermore meshes, then the software Fluent was used for numerical calculation and flow simulation. The velocity and pressure changes in the main pulmonary artery and the first two grades branches during different periods of cardiac cycle were observed in both groups.

RESULTCTPA showed that the diameter of the main pulmonary before bifurcate and proximal of the first two branches was larger in systole period than that in diastole period. The diameter of the second segmental artery of right upper lobe was larger during diastole period. The length of the main pulmonary and the first two branches showed no significant difference in both diastole and systole periods. There was no significant difference in length of pulmonary arteries between COPD and normal groups. The main pulmonary to distal right pulmonary artery appeared larger in diastole period. Compared with normal, in COPD group several arteries increased in diameter including proximal and distal of the proximal right pulmonary artery and the proximal right pulmonary artery during systole and diastole periods. In systole period only the diameter of the main pulmonary before bifurcate got larger and the back basic segmental artery of both lower lobe show smaller than normal. The flow condition analysis in COPD and normal groups suggested higher pressure in pulmonary arteries during systole period than that in diastole period, both groups showed high pressure area below the branching point. In COPD patients the right lower lobe artery endured the most significant pressure fall during the two periods and high pressure distributed larger area than normal. Flow velocity in main branch was faster than lower grade branches and that in systole period was faster than that in diastole period. The trend of diffusion of high pressure area was more prominent in diastole period than normal and the influence more prominent.

CONCLUSIONThe distal part of right pulmonary artery to lower lobe artery may be affected earlier when the pulmonary pressure increased. It is feasible to study the changes of flow condition in pulmonary artery branches though the combination of CTPA image and relevant software.

Adult ; Angiography ; methods ; Case-Control Studies ; Humans ; Hypertension, Pulmonary ; etiology ; physiopathology ; Middle Aged ; Pulmonary Artery ; diagnostic imaging ; physiopathology ; Pulmonary Disease, Chronic Obstructive ; complications ; physiopathology ; Tomography, Spiral Computed

BACKGROUNDLaparoscopic cholecystectomy (LC) has been a standard operation and replaced the open cholecystectomy (OC) rapidly because the technique resulted in less pain, smaller incision, and faster recovery. This study was to evaluate the value of blunt dissection in preventing bile duct injury (BDI) in laparoscopic cholecystectomy (LC).

METHODSFrom 2003 to 2015, LC was performed on 21,497 patients, 7470 males and 14,027 females, age 50.3 years (14-84 years). The Calot's triangle was bluntly dissected and each duct in Calot's triangle was identified before transecting the cystic duct.

RESULTSTwo hundred and thirty-nine patients (1.1%) were converted to open procedures. The postoperative hospital stay was 2.1 (0-158) days, and cases (46%) had hospitalization days of 1 day or less, and 92.8% had hospitalization days of 3 days or less; BDI was occurred in 20 cases (0.09%) including 6 cases of common BDI, 2 cases of common hepatic duct injury, 1 case of right hepatic duct injury, 1 case of accessory right hepatic duct, 1 case of aberrant BDI 1 case of biliary stricture, 1 case of biliary duct perforation, 3 cases of hemobilia, and 4 cases of bile leakage.

CONCLUSIONExposing Calot's triangle by blunt dissection in laparoscopic cholecystectomy could prevent intraoperative BDI.

Adolescent ; Adult ; Aged ; Bile Duct Diseases ; prevention & control ; Cholecystectomy, Laparoscopic ; methods ; Common Bile Duct ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult