Objective:To evaluate the clinical effect of galvano-ceramic bridges made by Ni-Cr pontic fired bonding galvano caps with highly temperature-resistant adhesive based on three-year clinical trials. Methods : A total of 29 galvano-ceramic bridges made by Ni-Cr pontic fired bonding on the galvano caps were used for 26 patients. Abutment teeth plaque indices (PI) were compared according to Silness and Loe standards and their papillary bleeding indices ( FBI) according to Mazza standards before restoration and after 36 months' restoration. At the same time, the integrity and marginal fitness of galvano-ceramic bridges were observed. Results:The FBI at abutment teeth were higher than those before restoration, Wilcoxon test revealed significant difference. Their PI were lower than those before restoration, Wilcoxon test revealed significant difference. All the galvano-ceramic bridges were perfect in marginal fitness and color. The rate of integrity was 89. 7% in the period of observation. Conclusion:Galvano-ceramic bridges made by Ni-Cr pontic fired bonding galvano caps with highly temperature-resistant adhesive hold out good prospects for clinical use in fixed restoration.

Objective:To analyze the biomechanics trait of one-piece computer aided design and com-puter aided manufacture ( CAD/CAM ) zirconia post and core by the three-dimensional finite element . Methods:The three-dimensional finite element models of three upper central incisors restored with one -piece CAD/CAM zirconia post and core ( group 1 ) , refabricated zirconia post and hot-pressed porcelain core ( group 2 ) , and cast gold alloy post and core ( group 3 ) were built by geometry method respectively . 100 N vertical loading through the central incisor models long axis and 100 N loading along directing at an angle of 45°with the models long axis were used to imitate the central incisor stress state in biting and mandible physiological protraction movement .Results:Under vertical loading , the restored teeth without dentin ferrule, the maximum Von-Mises stress value of the tooth root in group 1 was the least(11.02 N), which was the largest (13.17 N)in group 2.The stress became weaker from the upper to the lower of the tooth root.The maximum Von-Mises stress value of the tooth root , post and core became smaller while the restored teeth with the 2.0 mm high dentin ferrule.Under directing at an angle of 45°loading, without the design of dentin ferrule in the restored teeth , the maximum Von-Mises stress value of the post and core in group 1 was the greatest(20.45 N), while that stress of post and core in group 3 was the smallest (13.61 N).With 2.0 mm high dentin ferrule design in the restored teeth , the tooth root stress became weaker.The maximum Von-Mises stress value of the tooth root was the greatest (14.10 N) in group 3, but which was the lowest (13.38 N) in group 1.Conclusion:The results of the three-dimensional finite element analysis infers that one-piece zirconia post and core restoration is more beneficial to disperse the bite force than the prefabricated zirconia post and the cast gold alloy post and core .The one-piece of zirconia post and core is good to protect the teeth and keep the restoration intact .

Objective: To measure the fracture strength of the posterior galvano-ceramic bridges made by Ni-Cr pontic fired bonding galvano caps with highly temperature-resistant adhesive and to provide re-ference data for clinical application. Methods: A standard low dental cast was achieved with 46 missing. Five posterior galvano-ceramic bridges made by Ni-Cr pontic fired bonding galvano caps, with abutments being 47 and 45 . The low dental cast was fixed on the panel of the universal testing machine, vertical load given on the central of the pontic as the velocity of 2 mm/min. Results: The fracture strength of the posterior galvano-ceramic bridges made by Ni-Cr pontic fired bonding galvano caps was (877.00?126.53) N, the fracture strength of the metal frame was (1 448.94?51.02) N. Conclusion: Posterior galvano-ceramic bridges made by Ni-Cr pontic fired bonding galvano caps could endure the normal human occlusal force.

OBJECTIVETo evaluate the safety and efficacy of the perineal rectosigmoidectomy (Altemeier procedure) in the treatment of full thickness rectal prolapse.

METHODSClinical and follow-up data of 52 patients with full thickness rectal prolapse undergoing Altemeier procedure in 9 hospitals from September 2010 to July 2016 were analyzed retrospectively. Of which 38 cases were from Zhongnan Hospital of Wuhan University, 1 case from Suizhou Central Hospital of Hubei province, 1 case from Jingzhou Second People's Hospital of Hubei province, 3 cases from Wuxue First People's Hospital of Hubei province, 1 case from Jingmen First People's Hospital of Hubei province, 1 case from Tuanfeng County Hospital of Hubei province, 4 cases from Jingzhou Central Hospital of Hubei province, 2 from PLA Rocket Army General Hospital, 1 case from the Affiliated Hospital of Xuzhou Medical University in Jiangsu province. Altemeier operation steps: The line shaped teeth, the prolapsed rectum is first exposed to the anus. In the dentate line proximal 1-3 cm with ultrasonic knife or Ligasure ring outer rectal incision, using electric knife to mark pre resection line in rectal mucosa. Open down in front of the pelvic peritoneum. Incision of the outer intestine and the reduction of the internal rectum and part of sigmoid colon. To free and remove excess pelvic retroperitoneal, pelvic peritoneum and be at the top of the colon or rectum anterior pelvic reconstruction suture. The rear of the levator ani muscle forming rectum. Pull gently to the anus and rectum and sigmoid, in the absence of tension, 2-3 cm outside the anus was selected as the proximal inner bowel pre resection line, along the line of pre transection of proximal bowel resection, again the broken end of intestine full-thickness end-to-end anastomosis. Postoperative complication and recurrence were summarized. Gastrointestinal quality of life index (GIQLI), Wexner constipation score and Wexner fecal incontinence score were used to evaluate the efficacy.

RESULTSAll the 52 patients were beyond moderate full thickness rectal prolapse. Thirty-one were male and 21 were female with age ranging from 22 to 83 (average 53) years. The length of prolapsed rectum was 6 to 20 (average 9) cm and course of disease was 0.5 to 46(average 19.5) years. No perioperative death. Five patients (9.6%) had postoperative complications, including 2 anastomotic bleeding, 1 wall portion dehiscence of anastomosis, 1 anastomotic stenosis, and 1 malnutrition. Recurrence rate was 9.6%(5/52) within the long-term follow-up of 5 to 71 (median 40) years. Compared with the preoperative results, Wexner constipation score and Wexner fecal incontinence score decreased obviously (2.1±1.4 vs. 4.6±3.4, 4.8±4.1 vs. 6.8±4.1), and GIQLI significantly increased from 99.6±8.0 to 103.0±9.1 (all P<0.05) at 6-month after operation. Above 3 scores were sustained and continuously improved at 12-, 24-, and 36-month during the follow-up (all P<0.05).

CONCLUSIONAltemeier procedure possesses good efficacy with low morbidity of complication and recurrence in the treatment of full thickness rectal prolapse.