Fracture of multiple implants is rare.This report describes 1 case with the fracture of multiple implants related to occlusal over-load,bruxism,periodontitis and other factors in the posterior position.The fractured implants were removed and immediate reimplantation was performed.The panoramic film showed that the implants were integrated successfully 12 months after prosthesis.

Objective To analyse the location of the mandibular canal,providing the theoretical basis for implanting and bone grafting. Methods Mandibular data of 83 Chinese people obtained by cone-beam computed tomography examination were collected. Results The distance from the mandibular canal to mandibular buccal wall was (5.32 ± 1.29)~(7.24 ± 1.29) mm. And the average distance from mandibular canal to mandibular lingual wall or inferior margin were respectively (3.43 ± .99) ~ (3.93 ± 1.17) mm and (8.81 ± 1.90) ~ (10.02 ± 2.19) mm. Significant differences between males and females were found in groups. The anterior loop was observed in 70.9%of all sides. The accessory mental foramen was observed in 10.84% of all sides. Conclusion For the remarkable mutation of the location of the mandibular canal in Chinese people, clinicians should be careful before implant or bone surgery procedures to minimize the risk of inferior alveolar nerve injury.

Objective:To investigate the association between single nucleotide polymorphisms (SNPs) in microRNAs (miRNAs) and the risk of chronic spontaneous urticaria (CSU) .Methods:A case-control study was conducted. A total of 98 patients with CSU (CSU group) were collected from Department of Dermatology, Affiliated Hospital of Jining Medical University from January to June in 2019, and 148 health checkup examinees (control group) were collected at the same time, all of whom were of Han nationality from Shandong province. Genomic DNA was extracted from venous blood samples, and polymorphic sites rs2431697 (miRNA-146a) , rs57095329 (miRNA-146a) , rs3746444 (miRNA-499) , rs11614913 (miRNA-196a2) and rs895819 (miRNA-27a) were analyzed for SNP genotyping by multiplex PCR amplification and single-base extension. Chi-square test was used to analyze differences in the distribution of alleles, genotypes and genetic models between the two groups, and unconditional logistic regression to analyze the relationship between gene SNPs and the risk of CSU.Results:All samples were successfully genotyped by analysis of the 5 polymorphic sites. The alleles of the miRNA-196a2 SNP rs11614913 were T/C, and the absolute frequency of T allele was 110 (56.1%) in the CSU group and 131 (44.3%) in the control group; there was a significant difference in the T/C allele frequency distribution between the two groups ( χ2 = 6.64, P = 0.010) , and the T allele might be a risk factor for CSU ( OR=1.61, 95% CI: 1.12-2.32) . In addition, the absolute frequencies of CC, CT and TT genotypes of rs11614913 were 16 (16.3%) , 54 (55.1%) , 28 (28.6%) in the CSU group, and 48 (32.4%) , 69 (46.6%) , 31 (20.9%) in the control group respectively, and there was a significant difference in the genotype distribution between the two groups ( χ2 = 8.16, P = 0.017) ; the distribution of the dominant genetic model (TT + CT vs. CC) also significantly differed between the two groups ( χ2 = 7.95, P = 0.005) , which might increase the risk of CSU ( OR=2.46, 95% CI: 1.30-4.65) . Conclusion:The miRNA-196a2 SNPs may be associated with the risk of CSU in the Han population in Shandong, China, and the rs11614913 polymorphism may increase the risk of CSU.

Objective: To investigate clinical characteristics and treatment of phytophotodermatitis due to ingesting Chenopodium album. Methods: This study included 11 patients with phytophotodermatitis caused by ingesting Chenopodium album collected from Department of Dermatology, Affiliated Hospital of Jining Medical University from 2013 to 2017. The patients′ general information, clinical manifestations, laboratory test results, treatment and prognosis were retrospectively analyzed. Results: All the 11 patients were female, and their age ranged from 45 to 62 years. They all had a history of ingesting Chenopodium album and exposing to sunlight within 1 - 2 days prior to the disease onset. Clinical manifestations included symmetrically distributed, painful and pruritic, nonpitting, swelling erythema on the face and back of both hands and at sunexposed sites of forearms, with a tense and bright surface. Increased white blood cell counts were observed in 6 patients, and increased eosinophil counts in 1. All of the 11 patients were treated with systemic methylprednisolone, loratadine, ebastine, spironolactone, furosemide and omeprazole as well as topical agents, 2 also received human immunoglobulin treatment, and 3 were also treated with oral ibuprofen and codeine for painful lesions. Ten patients received obvious improvement and were discharged after 7 - 10 days of treatment, and no pigmentation or scars were observed after 1-year follow-up. Skin necrosis occurred on the back of both hands in 1 patient after 7-day treatment, and scars remained in the patient after follow-up of half a year. Conclusions Chenopodium album-induced phytophotodermatitis commonly manifests as swelling erythema on the exposed body sites. After confirmed diagnosis, Chenopodium album ingestation and sunlight exposure should be avoided, and timely antianaphylactic treatment should be considered to effectively control the disease.

Objective:To analyze clinical characteristics of scabies.Methods:The clinical data of 747 patients with scabies who visited Department of Dermatology, Affiliated Hospital of Jining Medical College from January 2018 to December 2019 were retrospectively analyzed.Results:There were more males (73.09%, 546/747) than females (26.91%, 201/747); most of patients had a age of 13-24 year (55.96%, 418/747); students account for 50.33% (376/747) of all patients; there were more patients living in dormitory than those living at home (61.45% (459/747) vs. 38.55% (288/747)). The cases began to rise from October, reaching the peak in December and remaining at relatively high level in January and February, then decreasing to the lowest during March to September. The number of patients living in rural areas is higher than that in urban areas. Patients took average 30 (15, 90) days from onset of disease to seeing a doctor, and itching was the main complain for visiting. The locations of lesion were most common on the abdomen (63.19%, 472/747), fingertips and wrists (53.41%, 399/747), vulva (37.22%, 278/747), and extremities (30.25%, 226/747). The lesions were characterized by erythematous papules (71.62%, 535/747), nodules (47.12%, 352/747), papules (24.50%, 183/747), wheals (6.02%, 45/747), secondary infections (3.61%, 27/747), tunnels (3.08%, 23/747) and small pustules (2.14%, 16/747); the male scrotal nodules were common (48.17%, 263/546). More patients (471/747, 63.05%) first visited non-dermatology outpatient clinics, and less first visited dermatology outpatient clinics (276/747, 36.95%); the misdiagnosis rates were 55.41% (261/471) and 27.54% (76/276), respectively; 127 cases (17.00%) were misdiagnosed as eczema, 54 cases (7.23%) as allergic dermatitis, 41 cases (5.49%) as prurigo nodularis, and 35 cases (4.69%) as urticaria pulosa. Conclusions:There is a certain discrepancy in the incidence of scabies among different populations, regions and seasons, the lesions of scabies are polymorphic involving different parts of the body surface and it is easy to be misdiagnosed.

AIM: To investigate the effect and mechanism of hypoxia inducible factor-1α on intestinal mucosal barrier in sepsis. METHODS: SD rats were randomly divided into 4 groups: sham group, sepsis group, sepsis+HIF-1α stimulant (sepsis+DMOG group), sepsis+HIF-1α inhibitor (sepsis+Bay87-2243 group), 6 rats in each group. Sepsis model was established by cecal ligation and perforation (CLP). The levels of inflammatory markers IL-1β, IL-6, TNF-α, oxidative stress markers MDA and antioxidant factors SOD and CAT were detected by ELISA and the expression of HIF-1α in intestinal mucosa was detected by Western blot. The pathological damage of intestinal mucosa was detected by HE staining. RESULTS: Inflammatory factors, oxidative stress factors and HIF-1α were significantly up-regulated in septic rats (P<0.05). The contents of IL-1β, IL-6, TNF-α and MDA in plasma were significantly decreased by intraperitoneal injection of DMOG (P<0.05); the levels of SOD and CAT in plasma were increased (P<0.05), HIF-1α was up-regulated (P<0.05), and the pathological damage of intestinal mucosa was alleviated, with decreased Chiu's score (P<0.05). Oral administration of Bay87-2243 gave the opposite result. CONCLUSION: HIF-1α has a protective effect on intestinal mucosal injury in sepsis. The mechanism may be related to the alleviation of inflammatory response and inhibition of oxidative stress.

Twenty pediatric patients with kerion were treated in Department of Dermatology, Affiliated Hospital of Jining Medical University from January 2014 to June 2020. The general information, clinical manifestations, laboratory test results, treatment and prognosis were retrospectively analyzed. There were 13 males and 7 females aged from 2 to 10 years. Thirteen patients had a history of contact with animals, 4 had contact with parents with tinea. All patients had alopecia, 6 cases presented with inflammatory mass, 14 presented with abscessus; some patients had regional lymphadenopathy and febrile. Four cases were misdiagnosed as abscesses caused by bacterial infection and underwent incision leading to deep ulcers. A total of 13 fungal strains were isolated, including 4 strains of Microsporum gypseum, 3 strains of Trichophyton rubrum, 2 strains of Microsporum canis, the others were Trichophyton tonsurans and Trichophyton mentagrophytes and Fusarium. All patients were treated with fluconazole, concomitantly with topical antifungals and He-Ne laser, 19 of whom were cured. It is suggested that kerion characterized by inflammatory lesions is likely to be misdiagnosed. Fungal examination can confirm the diagnosis of kerion, and fluconazole is effective for treatment.