ObjectiveTo valuate the three-dimensional CT angiography(3DCTA) in diagnosing blood vessel diseases.MethodsCTA findings of 284 patients confirmed with blood vessel diseases were retrospectively analyzed.They were divided into two groups:141 cases of head and neck and 143 cases of trunk and extremities.Scan was performed with the beam collimation of 0.625 ～ 3.0mm,increment of 0.3 ～ 1.4mm,pitch of 1.0 ～ 1.5,with the gross contrast medium of 1.5 ～ 2.0ml/kg.3D imaging methods included volume rendering(VR),multi-planar reformatting (MPR),curved planar reformatting(CPR),surface shade display(SSD),maximum intensity project(MIP) and virtual endoscopy(VE).The diagnostic results of CTA were compared with those of DSA and/or surgery.ResultsIn this study,3D images of vasculature met the diagnostic criterion.The diagnostic sensitivity,specificity and accuracy of CTA was 97.28％,82.35％ and 96.48％,respectively.The size of artery aneurysm shown with CTA and DSA had no significant difference( P ＞0.05 ),both smaller than that in surgery( P ＜ 0.05 ).Conclusion3DCTA could be used in diagnosing the cardiovascular diseases and compensate the limitation of conventional CT.It had the characteristics of non-invasion,high accuracy and could partly substitute DSA.

Objective To evaluate the diagnostic accuracy of transcranial doppler(TCD)as an additional screening tool for intracranial arterial steno-occlusive disease in patients with acute ischaemic stroke(AIS)by comparing with the computed tomography angiography(CTA). Methods Two hundred and twenty-four consecutive patients who were hospitalized within 7 days of the onset of symptoms and fulfilled the criteria for the clinical di-agnosis of AIS between May 2013 and May 2014 were enrolled for the study. Among the 224 patients,there were 118 males and 106 females with an average age of 61.2±12.6 years. High-resolution brain CTA was performed after completion of TCD. Results There was slight distinction of the diag-nostic accuracy of TCD for different arteries. TCD demonstrated the most accurate diagnosis for carotid artery vascular system,with a sensitivity of 96.19%and specificity of 98.60%. For the vertebrobasilar vascular system,TCD diagnosis showed a sensitivity of 71.11%and specificity of 94.31%. TCD findings were complementary to the CTA results(real-time embolization,collateral flow patterns and steal phenomenon). Conclusion TCD shows a high diagnostic accuracy comparing to CTA in evaluating intracranial and extracranial arterial stenosis in patients with AIS,especially for the carotid artery vascular system analysis within a short time interval. TCD can also provide additional real-time dynamic findings complementary to the information provided by CTA.

OBJECTIVETo get aesthetic implant-supported restorations by means of the all-ceramic crown fused to small-size titanium abutment and evaluate the quality of the restorations.

METHODSA small-size titanium abutment that had extremely thin circumferential collar and axial wall was fabricated, while a Cercon all-ceramic crown made with computer aided manufacture (CAM). The crown was fused to the abutment by firing the opaque porcelain. A total of 6 restorations in 5 patients were installed and assessed according to the California Dental Association (CDA) quality evaluation system.

RESULTSAll the restorations were fabricated well and ranked in clinic evaluation excellent for surface, anatomical form, marginal quality, and color at baseline and one year after insertion, respectively.

CONCLUSIONSThe restoration of all-ceramic crown fused to titanium small-size abutment is a new aesthetic alternative for the implant-supported restoration.

Adult ; Crowns ; Dental Abutments ; Dental Implants, Single-Tooth ; Dental Porcelain ; Dental Prosthesis Design ; Dental Prosthesis, Implant-Supported ; methods ; Female ; Humans ; Male ; Titanium

OBJECTIVETo observe the skin regeneration after hair follicle bulb cells were implanted into collagen/chitosan porous scaffolds in vitro.

METHODSThe cultured dorsal hair follicle bulb cells of 4d-old C57BL/6J mice were implanted into collagen/chitosan porous scaffolds in vitro. The skin regeneration was observed.

RESULTThe skin-like structure was formed on the collagen/chitosan porous scaffolds where were cultured the hair follicle bulb cells before 4th passages.

CONCLUSIONThe skin-like structure is generated in vitro when early passages of cultured hair bulb cells are implanted into collagen/chitosan porous scaffolds.

Animals ; Chitin ; analogs & derivatives ; Chitosan ; Collagen ; Hair Follicle ; cytology ; Mice ; Mice, Inbred C57BL ; Regeneration ; Skin ; cytology ; Tissue Engineering

INTRODUCTION: Timely administration of prophylactic antibiotics within 60 minutes before surgical incision is important for reducing surgical site infections. This quality improvement initiative aimed to work towards achieving 100% compliance with perioperative antibiotic administration. METHODS: We examined the workflow in our Anaesthesia Information Management System (AIMS) and proposed interventions using cause-and-effect analysis of anonymised anaesthetic records from eligible surgical cases extracted from AIMS. This ultimately led to the implementation of an antibiotic pop-up reminder. The overall process was done in a few small plan-do-study-act cycles involving raising awareness, education and reorganisation of AIMS before implementation of the antibiotic pop-up reminder. Data analysis took place from August 2014 to September 2016. Compliance was defined as documented antibiotic administration within 60 minutes before surgical incision, or as documented reason for omission. RESULTS: The median monthly compliance rate, for 33,038 cases before and 28,315 cases after the reminder was implemented, increased from 67.0% at baseline to 94.5%. This increase was consistent and sustained for a year despite frequent personnel turnover. Documentation of antibiotic administration also improved from 81.7% to 99.3%, allowing us to identify and address novel problems that were initially not apparent, and resulting in several department recommendations. These included administering antibiotics later for cases with predicted longer-than-expected preparation times and bringing forward antibiotic administration in lower-segment Caesarean sections. CONCLUSION The use of information technology and implementation of an antibiotic pop-up reminder on AIMS streamlined our work processes and brought us closer to achieving 100% on-time compliance with perioperative antibiotic administration.
Anti-Bacterial Agents ; administration & dosage ; Antibiotic Prophylaxis ; methods ; Documentation ; Drug Administration Schedule ; Electronic Health Records ; Guideline Adherence ; Humans ; Perioperative Period ; Quality Improvement ; Reminder Systems ; Software ; Surgical Procedures, Operative ; standards ; Surgical Wound Infection ; prevention & control

INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, multiple guidelines have recommended videolaryngoscope (VL) for tracheal intubation. However, there is no evidence that VL reduces time to tracheal intubation, and this is important for COVID-19 patients with respiratory failure. METHODS: To simulate intubation of COVID-19 patients, we randomly assigned 28 elective surgical patients to be intubated with either McGrath™ MAC VL or direct laryngoscope (DL) by specialist anaesthetists who donned 3M™ Jupiter™ powered air-purifying respirators (PAPR) and N95 masks. The primary outcome was time to intubation. RESULTS: The median time to intubation was 61 s (interquartile range [IQR] 37-63 s) and 41.5 s (IQR 37-56 s) in the VL and DL groups, respectively ( P = 0.35). The closest mean distance between the anaesthetist and patient during intubation was 21.6 ± 4.8 cm and 17.6 ± 5.3 cm in the VL and DL groups, respectively ( P = 0.045). There were no significant differences in the median intubation difficulty scale scores, proportion of successful intubations at the first laryngoscopic attempt and proportion of intubations requiring adjuncts. All the patients underwent successful intubation with no adverse event. CONCLUSION There was no significant difference in the time to intubation of elective surgical patients with either McGrath™ VL or DL by specialist anaesthetists who donned PAPR and N95 masks. The distance between the anaesthetist and patient was significantly greater with VL. When resources are limited or disrupted during a pandemic, DL could be a viable alternative to VL for specialist anaesthetists.
Humans ; COVID-19 ; Intubation, Intratracheal ; Laryngoscopes ; Laryngoscopy ; Respiratory Protective Devices ; Video Recording