Carcinoma, Squamous Cell ; diagnosis ; Humans ; Maxilla ; pathology ; Maxillary Neoplasms ; diagnosis ; Neoplasm Metastasis ; Spinal Neoplasms ; secondary

Adult ; Crown Lengthening ; Dental Prosthesis ; Dental Prosthesis Design ; Esthetics, Dental ; Female ; Gingiva ; Humans ; Incisor ; Smiling

BACKGROUND:Now a correspondingly stable project was performed in the rehabilitative treatment for patients with chronic heart failure in China,but it was difficult to be carried out on the wide range because of difficulties in adjusting movement capacity,lower compliance and so on,especially for the elder patients or those with severe chronic heart failure.The movement project will be required with the advantages of good compliance,moderatemovementcapacityandreproducibilityin clinic.OBJECTIVE:To investigate the change of exercise tolerance and cardiac function after the intervention in movement training in patients with chronic heart failure.DESIGN: Randomized and controlled observation.PARTICIPANTS:Seventy inpatients with stable chronic heart failure were chosen from the Department of Gerontology in Wuhan Union Hospital of Hubei Province from August 2002 to October 2003.All patients agreed to this test. Functional class of New York Heart Association (NYHA)was (2.69±0.13).Chronic heart failure duration of all patients was over six months. Seventy patients were randomly divided into movement group(n=34) and control group(n=36).In the movement group with 19 males and 15 females,functional class was(2.68±0.12).In the control group,there were 19 males and 17females.METHODS:Thepatientsinthemovementgroupunderwentthree weeks of movement training (bicycle ergometer,treadmill walking and walking on foot). The patients in the control group underwent three weeks of activity restriction. All patients received the 6-minute walking test under the condition of the same rating of perceived exertion before and after the test. Totally 5 mL of venous blood was drawn without eating anything in the morning before and after the test.The levels of interleukin-6 and norepinephrine were evaluated and left ventricle ejection fraction was observed and determined.MAIN OUTCOME MEASURES:Comparison of walking distance,interleukin-6,norepinephrine,l.eftventricleejectionfractionandcardiac functional class before and after the intervention in all patients.RESULTS:Seventy patients with chronic heart failure were involved in the statistical analysis at last. After the intervention,walking distance covered during 6minutes and left ventricle ejection fraction in the movement group were obviously longer and higher than those before the intervention and in the control group [(385±30)m,(43±5)％;(324±35)m,(39±6)％;(292±30)m,(35±4)％,P＜ 0.05].After the intervention,the levels of plasma interleukin-6 and norepinephrine and cardiac functional class in the movement group were lower than those in the control group and before the intervention[(0.86±0.25) pmol/L,(2.05±0.48) nmol/L,(1.89±0.11);(1.00±0.25)pmol/L,(2.21 ±0.47)nmol/L, (2.45 ±0.12);(1.12±0.23) pmol/L,(2.46 ±0.53) nmol/L,(2.68±0.12),P＜ 0.05-0.01].CONCLUSION:Theprojectof movementtrainingdesignedinour study can improve exercise tolerance and ameliorate cardiac function in patients with chronic heart failure. This project has the advantage of better compliance designed according to oneself.

Objective To investigate the effect of skeletal muscle training on exercise tolerance in patients with chronic heart failure(CHF). MethodsSeventy patients with CHF were divided into group A( n =34),undergoing 3 weeks of exercise training(bicycle ergometer, treadmill walking and walking on foot),and group B( n =36), undergoing 3 weeks of activity restriction. Before and after exercise training and after activity restriction, 6 minutes of walking test was performed and levels of interleukin-6(IL-6), norepinephrine(NE) and left ventricle ejection fraction(LVEF) were evaluated. ResultsAfter exercise training in group A, the maximum distance walked was (385?30.12)m. The levels of LVEF, plasma IL-6 and NE were (43?5.23)%,(0.86?0.25)pmol/L and (2.05? 0.48 )nmol/L,respectively. All the above parameters were significantly ameliorated when compared with group B ( P 0.05). ConclusionThe skeletal muscle training could improve exercises tolerance and ameliorate cardiac function in patients with chronic heart failure,which was beneficial for the rehabilitative treatment.

Objective To explore the effects of physical training on serum activity of some peripheral inflammatory markers associated with endothelial dysfunction, such as granulocyte macrophage-colony stimulating factor (GM-CSF), macrophage chemoattractant protein-1 (MCP-1), soluble intercellular adhesion molecule-1(sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in patients with chronic heart failure. Methods Forty-eight patients were enrolled and randomly divided into two groups: a training group and a rest group. The patients of both groups were both given conventional internal medicine therapy, and the patients of the training group were given physical training in addition. The serum levels of GM-CSF, MCP-1, sICAM-1 and sVCAM-1 in patients of the two groups were determined with stable chronic heart failure before and after 12 weeks of programmed physical training. At the same time, the motor functional status of chronic heart failure patients was evaluated by using the 6-minute walking test. Results It was shown that the physical training produced a significant reduction in serum GM-CSF, MCP-1, sICAM-1 and sVCAM-1 as well as a significant improvement in performance of the 6-minute walking test. Conclusion The physical training could significantly alleviate the inflammation reaction and improve the motor function of patients with chronic heart failure.

ObjectiveTo guide fluid management and evaluate the clinical index through monitoring extravascular lung water index(EVLWI) of patients with pulmonary contusion.MethodsThirtyone severe chest trauma patients with pulmonary contusion were selected,performed with central venous catheterization or femoral artery catheterization,and connected to pulse index continuous cardiac output (PICCO).EVLWI after pulmonary contusion were measured by using thermal dilution.The intake and output of patients were recorded in detail,fluid intake was controlled,furosemide was prescribed,and the changes and correlations of oxygenation index,EVLWI and liquid balance difference at different time points were evaluated.ResultsEVLWI after pulmonary contusion at 1st to 7th d after hospitalization was respectively (9.25 ±0.71),(8.98 ±0.61),(8.61 ±0.59),(7.75±0.53),(6.64 ±0.49),(6.22±0.36),(5.59 ±0.39) ml/kg.Comparing with 1st d after hospitalization,EVLWI declined from 3rd d (P ＜ 0.05).Oxygenation index at Ist to 7th d after hospitallzation was respectively( 145.76±23.61 ),( 144.19±20.24),( 146.67±19.25 ),(159.33±15.42),(177.38±14.25),(199.33±19.04),(213.71±18.51) mm Hg(1 mm Hg =0.133 kPa).Comparing with 1st d,oxygenation index from 4th to 7th d had significant difference (P ＜ 0.05 ).The fluid volume at 1st d to 7th d were all negative balance,that of 3rd d to 6th d had significant difference comparing with 1st d [(-431.43±121.17),(-601.43±127.09),(-629.52±140.69),(-320.01 ±93.71) ml vs.(-213.81±63.91 ) ml](P ＜ 0.05 ).Oxygenation index and EVLWI had negative correlation(r =-0.824,P＜0.01).Liquid balance difference and the changes of oxygenation index and EVLWI had no correlation.ConclusionEVLWI effectively monitoring after pulmonary contusion can not only evaluate the changes of pulmonary vascular permeability of patients with pulmonary contusion,but also have important significance to guide fluid management.

Objective: The quality standards for Zhixuan Granule (Rhizoma Alismatis, Rhizoma Atractylodis Macrocephalae, etc.) were studied. Methods: The TLC methods for identification of Rhizoma Alismatis、 Rhizoma Atractylodis Macrocephalae were established. A simple HPLC was established for the determination of 23-acetate alisol B. The mobile phase was acetonitrile-water(70∶30). UV detecting wavelength was at 208nm. Results: Rhizoma Alismatis and Rhizoma Atractylodis Macrocephala could be detected. 23-acetate alisol B showed a linear relationship at the concentration range of 99～1388.8ng, r=0.9999. The average recovery was 103.05% and RSD was 2.41%(n=6). Conclusion: This method is suitable for the quality control of Zhixuan Granule.

Objective To investigate relationship between insulin sensitivity and beta-cell function with body mass index (BMI) and age in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods Totally, 304 patients with T2DM newly-diagnosed at admission to the first hospital affiliated to Nanjing Medical University, Jiangsu province, during 2006 to 2007 were recruited in the study. The patients were divided into three groups based on WHO criteria of obesity in Asia Pacific Region in 2003, 68 cases with normal weight ( 18. 5≤ BMI ＜ 23.0), 69 in overweight (23.0 ≤ BMI ＜ 25.0), and 167 in obesity (BMI≥25.0). Fasting serum glucose, glycesylated hemoglobin Alc (HbAlc) and lipids were measured for all the subjects, as well as oral glucose tolerance test (OGTr), C-peptide releasing tests and determination of serum insulin performed. Homeostasis model assessment of insulin resistance index (HOMA-IR), insulinogenic index (AI30/AG30) and modified beta-cell function index (MBCI) werecalculated to evaluate their insulin sensitivity and beta-cell function of the islets. All these parameters werecompared between the three groups and subgroups. Results HOMA-IR and MBCI were significantly higherin T2DM patients with obesity than those in the groups with normal weight and over-weight ( P < 0. 05 ).AI30/AG30 in obesity group was significantly higher than that in the group with normal weight (P <0. 05).Multiple linear regression analysis showed that BMI independently correlated with HOMA-IR ( P < O. 05 ).Sub-group analysis showed that △I30/△G30 and MBCI were significantly higher in those aged 60 years and over with obesity than those in the groups aged less than 60 years ( P ＜ 0. 05 ). Conclusions Non-obese patients with newly diagnosed T2DM have more severe impaired insulin secretion than that in obese ones,and their insulin resistance increases with BMI. Age has no significant correlation with pancreatic beta-cell function or insulin sensitivity.

Cerebrospinal Fluid Rhinorrhea ; surgery ; Endoscopy ; methods ; Female ; Humans ; Male

Objective To summarize imaging features of Kallmann syndrome (KS) in children and to improve diagnostic level of the disease.Methods The imaging manifestations of 13 patients with clinically proved KS were retrospectively studied.MRI of rhinencephalon and left wrist X-ray examinations were performed in all the 13 children.Ultrasound of abdomen and pelvis was implemented in the 8 of 13 patients.Results All the patients had abnormalities of olfactory system.Bilateral olfactory bulbs and tracts were absent in 9 patients.Unilateral olfactory bulbs and tracts were absent in 4 patients,in which contralateral olfactory bulbs and tracts were hypoplastic.These patients presented 2 aplastic,17 hypoplastic and 7 normal olfactory sulci.Anterior pituitary was hypoplastic in 3 patients.Bone age showed retardation in 6 of 13 patients.Bilateral testicles were small in all the 8 cases by ultrasound.Conclusions Aplastic or hypoplastic olfactory bulbs and tracts and sulci are seen in children with KS.Anterior pituitary dysplasia is present in part of patients and bone age backward happens in approximate half of the children.