BACKGROUND:As the rapid development of oral implantation and restoration techniques, as wel as the increasing enlargement of indications, angulated abutments have been widely used. Posterior teeth region, as the weight-loading region of occlusion, can bear great force from the implants, the assessment of angulated abutments in posterior teeth region has clinical value.
OBJECTIVE:To evaluate the short-term clinical efficacy of angulated abutments on the implant denture in posterior teeth region.
METHODS:From January 2008 to January 2013, 114 patients with 175 ITI implants in the posterior teeth region were included in this study and they al underwent single-crown restoration. The involved patients were divided into angulated abutment group and straight abutment group. Periodontal probing depth, modified plaque index, modified sulcus bleeding index and peri-implant crestal bone loss in two groups were recorded at 6 months and 2 years after restoration. Cumulative survival rate of the implant denture was calculated by life-table analysis.
RESULTS AND CONCLUSION:There was no significant difference in periodontal probing depth, modified plaque index, and modified sulcus bleeding index between two groups (P>0.05). The annual crestal bone loss showed no significant difference between two groups (P>0.05). Moreover, the 5-year cumulative survival rate with 15° and 20° abutments was 95.6%, and that with straight abutment was 96.4%. The angle of abutments has no correlation with peri-implant soft tissue and peri-implant crestal bone loss, implant restorations with 15° and 20° angulated abutments may be successful y used in the posterior region, whereas the long-term effects need further research.

Objective To evaluate the alteration of labial bone mass one year after immediate implant or delayed implant placement in esthetic zone.Methods From June 2009 to June 2012,22 patients with 11 immediate implant and 11 delayed implant in the maxillary anterior region were followed up.CBCT images were obtained immediately after surgery and one year after implant placement,the horizontal and vertical alterations of the labial bone were evaluated by image analysis software.Results The 1-year vertical reduction of labial bone after immediate implant placement was statistically significant (P＜0.05),and no significant difference in delayed implant (P＞0.05).The 1-year horizontal reduction of labial bone was statistically significant at coronal and middle of implant,without significant difference at apical of implant.Conclusions Immediate implant can not stop the physical absorption of labial alveolar ridge,and the study can provide reference to achieve esthetics in the anterior region.

Objective To compare the therapeutic effects of continuous veno-venous hemofiltration (CVVH) versus repeated intermittent veno-venous hemofiltration (RIVVH) on patients with severe acute pancreatitis (SAP).Methods Fifty-six patients with SAP were randomly divided into the CVVH group (n =28) and the RIVVH group (n =28).The clinical symptoms and signs,the APACHE Ⅱ and MODS scores,the result of biochemistry including amylase and lipase,and the plasma levels of TNF-α,IL-6,IL8 before and after treatment,the duration of mechanical ventilation,boosting drug application time,the length of stay in ICU,the surgical intervention rate and the mortality were compared between the two groups.Results The clinical symptoms improved in the two groups after treatment (P ＜ 0.05).The APACHE Ⅱ and MODS scores were all reduced in the two groups after treatment (P ＜ 0.05).When compared with the RIVVH group,the result of biochemistry including amylase and lipase,and the plasma levels of TNF-α,IL6,IL-8 were significantly decreased (P ＜ 0.05).The duration of mechanical ventilation,the length of stay in ICU and the mortality were also significantly decreased in the CVVH group (P ＜ 0.05).Conclusions CVVH was more efficacious than RIVVH in the treatment of SAP.

Objective To evaluate the effect of different blood purification modes on patients with hyperlipidemic pancreatitis (HLP).Methods 28 patients with HLP in our department were enrolled into this study from January 2010 to June 2013.The patients were randomly divided into the HP/CVVH group (15 patients) and CVVH group (13 patients).The clinical symptoms and signs of the two groups were observed.The plasma levels of TNF-α,IL-6,IL-8,blood triglyceride and APACHE Ⅱ score before and after treatment were compared between the two groups.The duration of mechanical ventilation,ICU stay and mortality rate were compared between the two groups.Results The clinical symptoms improved in the two groups after treatment.The plasma levels of TNF-α,IL-6,IL-8,blood triglyceride and APACHE Ⅱ score were all reduced.However,the plasma levels of TNF-o,IL-6,IL-8,blood triglyceride and APACHE Ⅱ score in the HP/CVVH group were lower than the CVVH group at the same time points,showing significant differences (P ＜ 0.05).The duration of mechanical ventilation,ICU stay and mortality rate decreased in the HP/CVVH group (P ＜ 0.05).Conclusions HP/CVVH was more efficacious in the treatment of HLP.

BACKGROUND:Hydroxyapatite/gel nano-composite has the same mechanical strength to the natural bone, but its ability to repair bone defects and osteogenic effect need to be confirmed by further studies.
OBJECTIVE:To explore the repair effect of hydroxyapatite/gel bionic composite in skul defects of rabbits.
METHODS: The hole-like calvarium defect models were established in rabbits, and treated with hydroxyapatite/ gel composites (hydroxyapatite/gel group), autologous skul as positive control (autologous bone group) and
nothing as negative control (blank group). The repairing condition in the skul defect areas were observed and analyzed by X-ray and CT at 4, 8, 12 weeks after implantation.
RESULTS AND CONCLUSION: After 8 weeks, X-ray assessment showed that normal-like bone tissue appeared in the defect region of the autologous bone group; in the hydroxyapatite/gel group, dense bone with similar
morphology to normal bone tissue was found in the central site of defect region, and the boundary was slightly blurred. After 12 weeks, the hydroxyapatite/gel showed blurred edge compared with autologous bone, and the center of the composite was disconnected; in the blank group, a clear and regular transmitted shadow was
observed. After 12 weeks, CT examination showed that the hydroxyapatite/gel was connected tightly with the surrounding normal bone tissue. As a new bionic composite, the hydroxyapatite/gel can achieve good effect in repairing skul defects of rabbits.

Objective To investigate the value of transvaginal color Doppler sonography (TVCDS) and magnetic resonance imaging (MRI) in diagnosis for myometrial invasion of eudometrial cancer before surgical operation, in comparison with pathological examinations. Methods TVCDS and MRI were undergone before surgical operation in 34 patients with endometrial cancer confirmed by biopsy to evaluate depth of its myometrial invasion, as compared to those with postoperative pathological examinations. Results Predictive accuracy for myometrial invasion by TVCDS was 85%, with sensitivity, specificity, positive predictive value and negative predictive value of 80%, 9/9, 100% and 9/14, respectively, and predictive accuracy by MRI was 68%, with sensitivity, specificity, positive predictive value and negative predictive value of 60%, 8/9, 15/16 and 8/18, respectively. Resistance index (RI) averaged 0.51 for flow signal to detect superfical myometrial invasion by color Doppler flow imaging (CDFI) and 0.43 for deep myometrial invasion. Conclusions TVCDS and MRI can be used before surgical operation to judge the depth of myometrial invasion for patients with endometrial cancer, particularly more suitable for its screening, which will be helpful to judge the depth of myometrial invasion incorporated with resistance index by color Doppler flow signal.

Objective To evaluate the effects of flapless versus flap implant surgery on the tissues surrounding the implants in the esthetic zone.Methods A controlled study was conducted in 20 patients with a single implant in the anterior esthetic zone,as compared with the flapless and traditional flap implant placement.6 and 12 months after the implant ation,the vertical reduction of labial and lingual bone were assessed by cone beam computed tomography (CBCT);6 and 12 months after the crowns restoration,the peri-implant soft tissues were examined by probing depth (PD),modification sulcus bleeding index (mSBI),papillary index (PPI) and evaluated by pink esthetic score (PES) standard.Results The vertical reduction of the flapless labial and lingual bone was lower than that of the flap,in which the change of labial bone was statistical differences at 6 months after implant surgery between groups (P ＜ 0.05).The differences of PES between two groups were not statistically significant,although PES increased over time in both groups,which the flapless group had a significantly change in PES from crown placement to 12 months (P＜0.05).Conclusions A flapless implant surgery in sufficient bone support may provide a better short-term esthetic result,whereas the longterm effects need further studies.

Objective To investigate the clinical significance and distribution of different rotational displacements on the sagittal plane in unstable pelvic fractures radiologically.Methods We retrospectively reviewed 82 patients with unilateral pelvic fracture who had been treated at our department from June 2005 to June 2015.They were 48 men and 34 women,with an average age of 43 ± 18 years.By Tile classification,there were 48 cases of type B and 34 cases of type C.Their rotational displacements on the sagittal plane of the pelvic ring were determined on the anteroposterior X-ray films of the pelvis by measuring the changed distances from the top of iliac crest to the lowest point of ischial tuberosity and to the pubic tubercle.The data were recorded for analysis of different displacements and their clinical significance.Results Of all the 82 patients,based on the preoperative radiographic evidence,36 (43.9％) showed sagittal plane rotational displacement.Of them,28 (77.8％) showed supination displacement and 8 (22.2％) pronation displacement.The preoperative CT three-dimensional reconstruction confirmed the findings from the X-ray films.Twenty-one of the 48 cases of Tile type B (43.8％) and 15 of the 34 cases of Tile type C (44.1％) showed sagittal plane rotational displacement.The success rate of closed reduction was,respectively,66.7％ (24/36) in the 36 cases with sagittal plane rotational displacement,62.5％ (5/8) in those with pronation displacement and 67.9％ (19/28) in those with supination displacement,all significantly lower than the total success rate of closed reduction in this cohort(84.1％).Conclusions The sagittal plane rotational (pronation and supination) displacement of pelvic fracture can be determined by measuring special points and lines on the anteroposterior radiographs of the pelvis.The supination displacement on the sagittal plane is more common.The unstable pelvic fracture with sagittal plane rotational displacement is more difficult to reduce.

AIM: To investigate the effect of VEGF gene transfer on matrix metalloproteinases(MMPs) and tissue inhibitor of metalloproteinases(TIMPs) expression after vascular balloon injury. METHODS: 90 New Zealand white rabbits were divided into 3 groups randomly: group Ⅰ(balloon injury group), groupⅡ (pAdtrackCMV group) and group Ⅲ(pAdtrackCMV-VEGF165 group). Hypercholesterol diet was given for 7 days before experiment and continued to receive until the animals were killed. Each group were divided into five subgroups according to the sacrifice time. Blood samples and iliac arteries were harvested for further analysis. RESULTS: In group Ⅰ and Ⅱ, MMP2 and TIMP1,2 expressions were detected during the whole process ,while in group III ,MMP1,2,9 and TIMP1,2 could be detected from 3 days after gene transfer and reached the highest level at 1 week and could not be detected at 8 week. CONCLUSIONS: Imbalance expression of MMPs and TIMPs occurred after vascular injury and this may be the reason of pathological remodeling. Local phAdtrackCMV-VEGF165 transfer could specifically change the expression of MMPs and facilitate the positive remodeling process after vascular injury.

Objective To explore the clinical efficacy of medial iliosciatic plating via the Stoppa approach for complex acetabular fractures involving the posterior column.Methods Between February 2015 and February 2016,a total of 16 complex acetabular facture cases treated by the medial iliosciatic plate via the Stoppa approach were retrospectively analyzed in this study.This approach provided good exposure to a large region of the pelvis and acetabulum including pubis symphysis,pubic ramus,anterior and inner wall of acetabulum,quadrilateral surface,inner surface of posterior column,true pelvic margin,greater sciatic notch and sacroiliac articulation.The anterior and column was reduced and fixed by the anterior column plate and the medial ilioseiatie plate.The screw direction and angle were adjusted according to the intraoperative X-ray.Surgical time,amount of bleeding,and relevant complications were recorded.The reduction of the posterior column fracture was evaluated by Matta scoring system on the plain X-ray of the pelvic post-surgery,and functional outcomes of the hip joint affected were evaluated one year post-surgery by the Merle d'Aubigne-Postel scoring system.All the cases were followed for at least 12 months.Results The reduction and fixation of the posterior column was accomplished in all the 1 6 patients.The average surgical time was 165.5 min (range,130-270 min).The average blood loss was 1 245.6 ml (range,600-5 600 ml).Thc intraoperative infusionof concentrated red blood cells averaged 6 units.According to the Matta scoring system,anatomical reduction was achieved in 12 cases,satisfactory reduction in 3,and poor reduction in one.The patients were followed from 12 to 22 months.According to the Merle d'Aubigne-Postel scoring system,there were 11 cases of excellent and 3 cases of good,yielding a good or excellent rate of 87.5％.The average Merle d'Aubigne-Postel score was 15.8 (range,8-18).There were 1 case of external iiiac vein rupture and 1 case of bladder rupture.Both were repaired during surgery.Superior gluteal artery rupture was found in 1 case and surgical ligation of the artery was performed during surgery.Conclusion In the treatment of complicated acetabular fractures involving the posterior column,the medial iliosciatic plating via the Stoppa approach is safe and effective,because it can provide a safe and sufficient operative field for surgeons to reduce and fix the posterior column fractures,and it leads to satisfactory recovery of the patients with limited complications.