Objective To introduce the experience of treating high energy P il on fractures with an articulated external fixator. Methods From March to June 20 01, twelve patients (13 fractures) suffered from high energy Pilon fractures wer e treated with an articulated external fixator (Orthofix, Italy). The fixators w ere placed medially across the ankle joint, if necessary, fixation of fracture w as enhanced with combination of limited internal fixation. The main injury was c aused by traffic accident and high altitude dropping. The distal two pins were i nserted into the neck of the talus and the tuberosity of the calcaneus so that s ubtalar joint was treated as an axis during ankle movement. At approximately pos toperative two weeks, the articular hinge was released and the patient began ank le exercises. The clinical outcomes and complications were investigated and the postoperative of X-ray examination of ankle were also evaluated. Results Twelve patients were followed up with a mean period of 12 months. No infections of woun d and pin sites and no neurovascular complication was found. According to Teeny & Wiss ankle joint scoring system, the symptom and functional evaluation of the ankle was scored from 74 to 94 (average 87). Clinical results demonstrated 2 exc ellent, 7 good, 4 fair. Quality of reduction of the articular surface showed 7 g ood and 6 fair using system of Marsh classification of reduction of the articula r surface of the ankle. Conclusion External fixation with an articulated fixator combined with limited internal fixation is a satisfying technique to treat high energy Pilon fractures. This technique helps to effectively decrease both wound and bone healing complications. With advantage of restoring anatomical articula r surface and enabling early ankle joint motion, this technique also helps to pr event ankle joint stiffness after fixation. The short term result of the above-m entioned fixation is encouraging.

Objective To evaluate the clinical efficacy and safety of sibutramine (Reductile )in Chinese obese patients. Methods Obese adults (BMI 27～45 kg/m 2) in six research centers received sibutamine 10 mg or placebo one tablet each day with a controlled-energy diet for 24 weeks by randomized, double-blinded, placebo-controlled study. Results For intent-to-treat analysis, 125 sibutramine-treated subjects and 126 placebo-treated subjects were evaluated. After 24 weeks, sibutramine-treated patients lost more weight (6.52?3.95)kg than placebo-treated patients (3.18?3.59)kg(P

Objective To observe the molecular mechanism of adaptive response of the kidney and skeleton and brain issues in the high altitude hypoxia; To discuss the unity of yin and yang oscillation relationship of kidney and brain marrow.Methods SPF KM mice were randomly divided into control group and model group according to random number table method. Mice in the model group were exposed to high altitude hypoxia cabin for successive 21 d. On the 22nd day, mice got out of the cabin and their body weight was measured, and then they were put to death through eyeball blood sampling. The activities of lactic LDH and Na+-K+-ATPase in brain tissue were detected by spectrophotometric colorimetry. The PFK activities of brain and skeletal muscle were detected by ELISA. Meanwhile the contents of EPO and EPOR in the kidney were measured by ELISA. The mRNA expressions of HIF-1α and AQP-4 in brain were assessed by RT-PCR. At the same time, the protein expressions of HIF-1α and AQP-1 in brain and the protein expression of Mb in skeletal muscle were detected by Western blot.Results Compared with the normal group, the LDH and PFK in brain tissue and the content of EPO in kidney tissue were all raised in the model group(P<0.05). Meanwhile the mRNA expressions of HIF-1α and AQP-4 and the protein expressions of HIF-1α and AQP-1 in brain were all increased in the mice from the model group; the activities of PFK and the protein expression of Mb in skeletal muscle were also raised in the model group. But the activity of Na+-K+-ATPase in brain tissue and the content of EPOR in kidney tissue both decreased in the model group (P<0.05,P<0.01).Conclusion Adaptive response and the unity of yin and yang oscillation relationship between kidney, skeleton and brain tissue happen in high altitude hypoxia.

We report the intrauterine treatment of a case of fetal persistent supraventricular tachycardia complicated by heart failure. The ultrasound findings at 32 +1 weeks of gestation showed fetal tachycardia of 242 beats/min, fetal generalized edema, ascites, and visible pulsation spectrum in the intra-abdominal segment of the umbilical vein. Fetal cardiac arrhythmia persisted after maternal oral digoxin for 46 hours. In view of the continuous deterioration of the fetal condition with the persistent umbilical vein pulsation spectrum and worsening edema, fetal intramuscular injection of cedilanid under ultrasound guidance was performed, resulting in successful cardioversion. The pregnant woman gave birth to a baby girl by cesarean section due to premature rupture of membranes and oligohydramnios at 34 +6 weeks of gestation, with normal functions of heart and other organs. During a follow-up to 8 months, no obvious abnormalities were found.

Objective: The aim of this study was to evaluate the effect of chemotherapy combined with radiotherapy for the treatment of the patients with advanced nasopharyngeal carcinoma. Methods: Between June,1992 and January,1995, 110 patients with Stage Ⅲ , Ⅳ a nasopharyngeal carcinoma ( 92 stage system) at random received one course of chemotherapy [cisplatin 20 mg· (m2· d)-1 iv on days 1-5 and 5-fluorouracil 500 mg· (m2· d)-1 iv on days 1-5.] before radiotherapy (which started 3 days after the first cycle of chemotherapy ) and three to five cycles of postradiotherapy chemotherapy (chemotherapy/radiotherapy: including 55 patients) or radiotherapy alone (radiotherapy group:including 55 patients). The methods and time/dose schedule of radiotherapy were similar in the two groups. Results: The 5-year survival rate was 65.5％ in the chemotherapy/radiotherapy as compared with 34.5％ in the radiotherapy group (P=0.0012). The primary lesion control rates were 69.1％ (chemotherapy/radiotherapy) and 43.6％ (radiotherapy group), respectively(P=0.0071). The cervical lymph node control rates were 67.3％ (chemotherapy/radiotherapy) and 45.4％ (radiotherapy group), respectively (P=0.021). The distant metastatic rate was 21.8％ (chemotherapy/radiotherapy) versus 41.8％ (radiotherapy group), respectively (P=0.0243). There was no significant difference in the incidence and severity of acute mucositis between the two groups during radiotherapy. Conclusion:This prospective study has demonstrated that alternating cisplatin/5-fluorouracil chemotherapy and early administration of locoregional radiotherapy can improve the survival and local disease control , and delay the distant metastasis in the patients with advanced nasopharyngeal carcinoma.

OBJECTIVETo establish a model of intracellular infection of human dental pulp fibroblast (HDPF) by Porphyromonas gingivalis in vitro.

METHODSHDPF was incubated with live Porphyromonas gingivalis with a multiplicitas of infection (MOI) from 100 for 0.5, 1.0, 2.0 hours. HDPF infected with live Porphyromonas gingivalis were observed by inverted microscope. Metronidazole, Penicillin, Streptomycin were added to the medium to kill any extracellular bacteria. Then the cells were lysed by sterile distilled water, dilutions of the lysates of cells were cultured anaerobically. Colony of invasive bacteria were then observed. HDPF exposed live Porphyromonas gingivalis with a MOI 50 and 100 for 1.0 hour, then cells survival rate were detected by MTT assay.

RESULTSAfter infected with Porphyromonas gingivalis 2.0 hours, cells were eumorphism. Porphyromonas gingivalis of incubation for 1.0, 2.0 hours was invasive cells. MTT assays indicated 99.07% cells survival rate with a MOI from 50 and 74.43% cells survival rate with a MOI from 100.

CONCLUSIONA model of HDPF intracellular infection with Porphyromonas gingivalis was successfully established in vitro.

Dental Pulp ; Fibroblasts ; Humans ; Metronidazole ; Porphyromonas ; Porphyromonas gingivalis

Chemical constituents of ethyl acetate extract of Illicium burmanicum were isolated and purified by various chromatographic methods,including Silica gel, Sephadex LH-20, C18 reverse-phased silica gel, Preparative TLC and Preparative HPLC. Their structures were identified by spectral analysis including NMR and MS data. Fourteen compounds were separated from I. burmanicum and their structures were identified as 7S,8R-erythro-4,7,9,9'-tetrahydroxy-3,3'-dimethoxy-8-O-4'-neolignan (1), 7R,8R-threo-4,7, 9,9'-tetrahydroxy-3,3 '-dimethoxy-8-O-4'-neolignan(2) ,polystachyol(3), (-) -massoniresinol(4), angustanoic acid F (5), trans-sobrerol(6), (3S,6R) -6,7-dihydroxy-6,7-dihydrolinalool (7), (3S, 6S) -6,7-dihydroxy-6,7-dihydrolinalool (8), 2,6-dimethoxy-4-allyl-phenol (9), 3,5-dihydroxy4-hydroxy benzaldehyde (10), 3-hydroxy4-methoxybenzaldehyde (11), methyl vanillate (12), shikimic acid ethylester (13) and beta-sitosrerol (14). Except compound 14, the rest thirteen compounds were separated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Illicium ; chemistry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

Objective To conduct an epidemiological investigation on a case of familial arsenic poisoning in Yunnan Province,to find arsenic poisoning source and create a archive of typical cases,in order to raise awareness of endemic arsenicosis and provide scientific materials for prevention and treatment of the disease.Methods In Xiaxiaoying Village of Yunnan Province,all members of a family with arsenic poisoning patients were investigated in 2013,their health examination and epidemiological survey of arsenic poisoning were carried out,and arsenic poisoning family profiles and personal files were established.Drinking water,hair and urine samples were collected for arsenic content determination,blood samples were collected for biochemical detection,excessively keratose skin was collected for pathological biopsy.Results A total of 33 family members were investigated.Among them 15 were exposed to arsenic and 18 were not exposed to arsenic.Fifteen people exposed to arsenic were found to be have skin lesions,and two eldest males died of skin cancer and cerebral hemorrhage in 1994 and 2009,respectively.The survey found out that 15 patients born in 1935-1983 had been drinking arsenic pesticides polluted well water for 5 to 16 years from 1973 to 1989.As of 2013,the arsenic exposure had been stopped for 24 years,the content of arsenic in the polluted wells was 0.624 mg/L,which was 62.4 times the recommended maximum limit (0.01 mg/L) of the World Health Organization.The median of hair and urinary arsenic in arsenic exposed population and non-arsenic exposed population was 4.2,3.7 mg/kg and 60.9,41.0 μg/L,respectively.There was no statistically significant difference in hair arsenic (Z =-1.905,P ＞ 0.05),but the difference of urinary arsenic was statistically significant (Z =-3.002,P ＜ 0.05).The median of aspartate aminotransferase (AST),gammaglutamyltransferase (γ-GT) and 24 hours urinary ereatinine (Cr) in arsenic exposed population and non-arsenic exposed population was 37.5,31.0 U/L,25.5,12.0 U/L,13 834.0,and 6 843.0 μmol/L,respectively.The differences between the two groups were statistically significant (Z =-2.776,-2.311,-2.502,P ＜ 0.05).Twelve cases of arsenic poisoned patients who were conducted health examination and epidemiological investigation showed typical triad of skin,among them 2 cases were moderate and 10 cases were severe.Pathological biopsy results showed 8 cases had basal cell carcinoma or squamous cell carcinoma.Conclusions Drinking arsenical pesticide contaminated water can induce chronic arsenic poisoning,even after the cessation of arsenic exposure.We should pay close attention to its long-term serious harmful effect.

OBJECTIVETo compare the shaping ability of ISO standard stainless steel K files and multi-taper ProTaper nickel-titanium files in simulated resin curved root canals. METHODS Thirty simulated resin root canals were randomly divided into three groups and prepared by stainless steel K files, hand ProTaper, rotary ProTaper, respectively. The amount of material removed from inner and outer wall and canal width after canal preparation was measured, while the canal curvature before and after canal preparation and canals aberrations were recorded.

RESULTSThe stainless steel K files removed more material than hand ProTaper and rotary ProTaper at the outer side of apex and inner side of curvature (P < 0.05). The mean degree of straightening in stainless steel K files group was significantly bigger than in ProTaper group (P < 0.05). The canals prepared by ProTaper had no evident aberration.

CONCLUSIONThe shaping ability of ProTaper is better than stainless steel K files.

Dental Alloys ; Dental Instruments ; Dental Pulp Cavity ; Equipment Failure ; Humans ; Nickel ; Root Canal Preparation ; Stainless Steel ; Titanium

OBJECTIVEThe aim of this study was to measure and analyze the anatomic characteristics of the pulp chamber of Chinese permanent anterior teeth radiographically.

METHODSThere were 137 human permanent anterior teeth to be used. The crown length, crown width and crown thickness were measured by vernier caliper. Labial-lingual and mesial-distal radiographs were obtained by parallel technique and Photoshop 8.0 was adopted for measuring the largest labial-lingual length, the largest mesial-distal length, the pulp chamber height and the distance between the lingual surface of the crown and the corresponding wall of the pulp chamber; the ratios of the largest labial-lingual length to the crown thickness, the largest mesial-distal length to the crown width and the pulp chamber height to the crown length were calculated. Finally the coefficients of variance were caculated.

RESULTS(1) The ratios of the largest mesial-distal length to the crown width of maxillary and mandibular canines were statistically different from those of the other anterior teeth. There was not statistically significant difference for those ratios either between maxillary and mandibular canines or among incisors. (2) Indexes of the pulp chamber had higher variance than those of the external morphology. (3) The distance between the lingual surface of the crown and the corresponding wall of the pulp chamber had the smallest coefficient of variance. (4) The largest mesial-distal length of the pulp chamber had the largest coefficient of variance, except for the mandibular canines.

CONCLUSIONThis study provided anatomical basis for clinical work; the distance between the lingual surface of the crown and the corresponding wall of the pulp chamber could be used as a depth reference for the endodontic access, and the access should not be extended excessively in mesial-distal direction.

Asian Continental Ancestry Group ; China ; Crowns ; Cuspid ; Dental Pulp Cavity ; Dentition, Permanent ; Humans ; Incisor ; Lip ; Maxilla ; Tooth ; Tooth Crown ; Tooth Root