Enamel pearl is an ectopic enamel, which usually occurs in the root bifurcate or approaching enamel-cementum site of the first maxillary molar. A case of multiple enamel pearls on the left maxillary third molar is reported in this paper, and relevant literature was reviewed.
Dental Cementum ; Dental Enamel ; abnormalities ; Humans ; Molar ; Molar, Third ; Tooth Root

Objective:To study the clinical effect of corticosteroids (C S) with small dosage in the recurrence control of pemphigus. Methods: 25 cases of pemphigus were diagnosed by clinical and pathological examinati on.They were treated with CS at 60-80 mg/d in acute stage for symptom control.Th en,the dosage of CS was decreased by 5 mg in each following 2 weeks untill it re ached 2.5 mg/2 d. The treatment of 2.5 mg/2 d was continued for 1 year and was a ssisted with tripterygium polyglycoside, compound thalidomide, compound cyclopho sphamide (compounded with total saponins of ginseng), dapsone, and/or some kidne y-supplementing herbs. The patients were followed-up for 9~16 years.Re sults:No recurrence was observed in 16 cases(64%).Recurrence was found i n 9 cases(36%),among them 7(28%) were with light symptom and 2(8%) severe. Sever e side-effect was not found in all cases. Conclusion:The recurr ence of pemphigus may be controlled without severe side-effect by long-term us e of small dosage of CS assisted with proper immuno-inhibitors, immuno-regulat ors and/or some kidney-supplementing herbs.

The currently used heart valve prosthesis are still far from the ideal one in anticoagulation and longevity. The construction of tissue engineering heart valve leaflets are carried out recently. This article reviews the progress of tissue engineering heart valve leaflets in implanting materials, seeded cells, animal experiment and basic research. It also discusses the benefits and feasibility of tissue engineering heart valve leaflets.

Forms and Records Control ; methods ; Humans ; Pathology, Clinical ; methods

Objective To compare the biomechanical properties between the two-level fixation by im- plantation of pedicle-screws into the adjacent upper and lower vertebrae of the fractured vertebra and the three-level fixation by implantation of pedicle screws into the fractured vertebra and its adjacent upper and lower vertebrae in the treatment of thoracolumbar burst fractures.Methods Eight fresh frozen calf spines were used in this study.Each specimen was tested in four models:intact model as the control,L1 burst fracture model,two-level fixation model, and three-level fixation model.The L1 burst fracture model was created on a biaxial material testing machine (MTS858 Bionix test system,America).During the experiment,the flexion,extension,bilateral bending and axial rotation loadings were applied to the specimens and the range of motion(ROM)was measured with a three-dimensional laser analysis apparatus and the stiffness was calculated subsequently.One-way statistical analysis was used.Results The ROMs under six different loadings in the fracture model became larger obviously(P＜0.05)and the stiffness decreased(P＜0.05).The ROMs in both fixation models were smaller than those in the other models(P＜0.01)and the stiffness increased distinctly(P＜0.05).There were no significant differences in ROMs and stiffness between the two-level fixation and three-level fixation models(P＞0.05).Conclusion Two-level fixation provides similar biomechanical stability as three-level fixation does in the reconstruction of unstable thoracolumbar fractures.

Humans ; Interferons ; administration & dosage ; therapeutic use ; Lymphoma, Mantle-Cell ; drug therapy ; Male ; Middle Aged ; Thalidomide ; administration & dosage ; therapeutic use

Objective To explore the relevance between fasting plasma glucose (FPG) level in early pregnancy and gestational diabetes mellitus (GDM). Methods Clinical data of 5299 singletonpregnant women accepted antenatal examination and delivered in the Department of Obstetrics and Gynecology, Peking University First Hospital from January 1, 2008 to December 31, 2009 were retrospectively analyzed. Results (1) The pregnant women were divided into 3 groups according to their FPG levels at early stage of gestation: Group A, FPG ＜5. 1 mmol/L (n= 4565); Group B,FPG≥5.1, but ＜5.8 mmol/L (n=701); Group C, FPG≥5.8 mmol/L, but ＜7.0 mmol/L(n=33). The incidence of GDM in Group A, B and C was 10. 69% (488/4565), 26. 11% (183/701)and 54. 55% (18/33). (2) The incidences of large for gestational age (LGA), cesarean section,premature birth, preeclampsia, neonatal hyperbilirubinemia, neonatal hypoglycemia, neonatal polycythemia, and neonatal infection were compared between Group A and B. The cesarean section rate [54. 63% (282/518)]and neonatal hypoglycemia rate [1.54% (8/518)]of those who were not diagnosed as GDM in middle and late term in Group B were higher than those of Group A [49.03%(1999/4077) and 0. 61% (25/4077)] (P＜0. 05); while there were no differences between the other six index of Group A and Group B (P＞0. 05). The prognosis of the GDM patients who did not accept gestational glucose management in two groups were similar (P＞0. 05), so did the prognosis of the GDM patients who accepted gestational glucose management in two groups. After combining the patients of the two groups who were not diagnosed as GDM as a new group, they were compared with those who did not accept gestational glucose management of the two groups (Group A2 and B2)respectively. The incidence of LGA rate of the new group was lower than that of Group A2 (12. 00%va 4. 94 %, x2=21. 4159, P＜0. 05) and Group B2 (18. 39 % vs 4. 94%, x2 = 28. 7189, P＜0. 05).Cesarean section rate of the new group was lower than that of Group A2 (57. 78% vs 49.64%,x2 =5. 6806,P＜0.05) and Group B2 (66. 67% vs 49.64%, x2 =9. 9003, P＜0. 05). And there were no differences between the other six index between the new group and the other two groups (P＞0. 05). Conclusions The diagnosis criteria of GDM set as FPG≥5.1 mmol/L at early stage of gestation, recommended by International Association of Diabetes and Pregnancy Study Group, is not applicable in China yet. Oral glucose tolerance test in middle and late term is still the most important diagnostic tool for GDM.

Objective To compare the dosimetric difference between the two beams formed by low melting-point lead (LML) and multileaf collimator (MLC) in orbit radiotherapy, so as to select the one with a lower lens dose for treatment of Graves' ophthalmopathy. Methods Patients with unilateral and bilateral Graves' ophthalmopathy (10 cases each) suitable for radiotherapy were selected for dosimetric comparison. The identical sketching principle of target volume was employed, and the prescribed dose of planning target volume (PTV) was 2000 cGy/10 times. The distribution of radiation field in unilateral group was 3 fields (2 X-ray fields + 1 electron field), and in bilateral group was 4 fields (2 X-ray fields + 2 electron fields), and LML and MLC were employed to form the radiation field. The conformity index (CI) and dose volume histogram (DVH) were compared between the two formation methods of radiation field; the effective penumbra area of the half radiation field formed by the two methods and its influence on the lens dose were analyzed with flushing-free film and dose analysis software. Results The average dose of the affected side lens in MLC unilateral group was 582 ± 34cGy, and of the lens of uninjured side was 160 ± 22cGy, the CI of target volume was 0.69; the average dose of the left and right lens in MLC bilateral group was 591 ± 47cGy and 585 ± 52cGy, respectively, and the CI was 0.67. The average dose of the affected side lens in LML unilateral group was 252 ± 45cGy, and that of the uninjured side lens was 148 ± 19cGy, and the CI was 0.71; the average dose of the left and right lens in LML bilateral group was 247 ± 44cGy and 256 ± 42cGy, respectively, and the CI was 0.68. When the X-ray energy was setup at 4MV and 8MV, the half radiation field was 5cm X 5cm with a depth of 4cm, and the effective penumbra area of LML was 3mm smaller than that of MLC. Conclusion A small radiation area formed by LML may be more appropriate, and it may not only diminish the penumbra of radiation field, also it significantly reduce the irradiation dose imparted to patients' affected side lens.

Objective To analyse the clinical characteristics,treatments and prognosis of the chemotheray-induced lung injury in malignant hematological diseases patients.Methods 26 malignant hematological diseasespatients with chemotheray-induced lung injury were collected.The clinical characteristics,chemotherapy regimen,treatments and prognosis of the patiants were retrospectively analyzed.Results Among 26 patients,10 patients were male and 16 patients were famale.The dignosis were nonHodgkin's lymphoma (16 cases),leukemia (9 cases) and multiple myeloma (1 case).The chemotherapy regimens inducing lung injure probably were R-CHOP,R-BEACOP and BEACOP in lymphoma,while they were HA,AA,DA and IA in leukemia.The symptoms of lung injury in these patients were fever,cough,hemoptysis,dyspnea,fatigue,or asymptomatic radiological examination revealed.Pulmonary diffuse infiltration and shadows were showed in CT scan.21 cases were cured by hormone therapy,5 cases died of lung injury,2 cases died of tumor recurrence after lung injury cured.There was no effect on the quality of life in most cured patients.Conclusion The lung injury induced by chemotherapy has no specific clinical characteristics and diagnostic criteria,and it could progress rapidly to cause death.But early dignosis and early hormonal treatment can obtain good therapeutic effect.The occurrence regularity and clinical characteristics should be studied furtherly.

Objective To assess the value of combined detection of enterovirus nucleic acid and antibody in early etiological diagnosis for hand-foot-and-mouth disease ( HFMD).Methods A case-control study was conducted.A total of 1 066 cases of children clinically diagnosed with HFMD from Hangzhou Children′s Hospital were involved into the research group from January to June 2014, consisting of 401 common cases and 665 severe cases; Throat swabs and serum samples from these children underwent combined detection for EV71/CA16/EV of enterovirus nucleic acid by fluorescence quantitative RT-PCR and for EV71/CA16-IgM by ELISA.All data were analyzed with SPSS 16.0.Results The total positive rate of enterovirus nucleic acid EV71/CA16/EV by fluorescence quantitative RT-PCR in the 1 066 cases of children clinically diagnosed with HFMD was 75.52%( 805/1 066 ) ( 95%CI: 72.80%-78.05%).But the total positive rate of combined detection was 91.46%( 975/1 066 ) ( 95%CI:89%.58-93.04%).The total positive rate of combined detection is higher than that of RT-PCR test(χ2 =98.338,P=0.000).The positive rate of EV71 type of combined detection was 64.63%(689/1 066)(95%CI:61.67%-67.49%),which is 15.38%higher than that of RT-PCR test 49.25%(525/1 066)(95%CI:46.21%-52.29%)(χ2 =51.453, P=0.000).In 665 severe cases of HFMD, the total positive rate of combined detection was 96.69%(643/665)(95%CI:94.95%-97.87%), which is higher than that of RT-PCR test 79.25%(527/665)(95%CI:75.92%-82.22%)(χ2 =95.607, P =0.000).In the severe cases, the positive rate of EV71 type of combined detection was 87.52%( 582/665 ) ( 95%CI:84.71%-89.89%) , which is 18.95% higher than that of RT-PCR test 68.57%(456/665) (95%CI:64.87%-72.06%) (χ2 =69.665, P=0.000).In the fatal cases, the positive rate of EV71 type of combined detection was 95.92%(94/98) (95%CI:89.28%-98.68%).Conclusions The combined detection of enterovirus nucleic acid and specific IgM antibody can significantly increase the positive rate of HFMD, especially for severe cases.The combine detection increases both the total positive rate and EV71 positive rate.Thus it has a high potential for becoming a new guidelines for laboratory diagnosis of HFMD.