BACKGROUND: Cone-beam CT (CBCT) and orthopantography are two imaging methods mostly used in the preoperative evaluation of dental implantation. CBCT has high cost and low penetration rate, but orthopantography can result in a larger error in the measurement of bone quantity.OBJECTIVE: To compare the accuracy of bone quantity measurement using CBCT and orthopantography, and to evaluate the clinical effect of simulation in posterior implant region. METHODS: 115 implants from 72 patients undergoing implantation of posterior teeth in the Eye & ENT Hospital of Fudan University were selected. The horizontal heights from the top of the alveolar bone to the important anatomic structures (mandibular nerve or maxillary sinus floor) were measured using CBCT and orthopantography and then analyzed statistically. The implantation simulations were performed using Planmeca Romexis3.8 (for CBCT) and Cliniview9.3 (for orthopantography) to compare the differences in stimulated and postoperative horizontal heights.RESULTS AND CONCLUSION: There were significant differences in the measured data between CBCT and orthopantography (P < 0.05), especially in the maxilla (P < 0.01). There were significant differences between the simulated and postoperative results of the two methods (P < 0.05). The average error and standard deviation in orthopantography were larger than those in CBCT. The average error of implantation simulation using CBCT in the maxilla was smaller than that using orthopantography, whereas the error was similar in mandibular simulations. To conclude, CBCT is more accurate for assessing the quantity of bone in posterior implant region, especially in the maxilla. The accuracy of CBCT and orthopantography in implantation simulation needs to be improved.

Objective In order to know preoperative gastrointestinal cancer patients' quality of life and the related factors. Methods A cross-sectional study was conducted in 356 preoperative gastrointestinal cancer patients. The data were analyzed using descriptive, linear correlation and multiple regression analysis. Results The total number of valid return was 323, and the valid usable return rate was 90.7%.The preoperative gastrointestinal cancer patients' quality of life reached the middle level and varied with gender, age, residence, income and psychological state. Emotional function, physical function and fatigue were influencing factors of total quality of life. Conclusions Anxiety and emotional function were the main influencing factors of preoperative gastrointestinal cancer patients' quality of life.

Objective To observe high residual platelet reactivity in patients with acute coronary syndrome and diabetes mellitus receiving dual antiplatelet therapy with clopidogrel or ticagrelor and its influence on prognosis. Methods A total of 175 patients with acute coronary syndrome and diabetes mellitus in Wuhan Asia Heart Hospital were included in this retrospective study, and all patients were divided into two groups : ticagrelor group ( n = 22 ) and clopidogrel group ( n = 153 ) . The platelet aggregation function was tested by light transmission platelet aggregation (LTA). The high residual platelet reactivity was defined as maximum platelet aggregation rate ﹥46. 0%. The differences of high residual platelet reactivity and the effect of high residual platelet reactivity on cardiovascular events were compared between the two groups. Results The number of patients with high residual platelet reactivity in the clopidogrel group were 99 patients (64. 7%), and 8 patients(36. 4%) in the ticagrelor group (P=0. 011) . For stent thrombosis developed in three months, 3 patients were from the high residual platelet reaction group ( n=107 ) , none from the normal residual platelet reaction group ( n =68 ) ( P =0. 016 ) . For bleeding events at 3 months, there were 2 patients (1. 9%, 2/107) from the high residual platelet reaction group and 2 patients (2. 9%, 2/68) were from the normal residual platelet reaction group (P=0. 631). Conclusions Ticagrelor significantly decreases high residual platelet reactivity than clopidogrel. High residual platelet reactivity increases stent thrombosis risk for ACS and type 2 diabetes mellitus.

Objective To investigate the effect of cardiac resynchronization therapy on improving heart function and reversing left ventricular remodeling in chronic heart failure patients. Methods Eleven patients with NYHA class Ⅲ to Ⅳ heart failure, ejection fraction ≤35% and QRS duration ≥130 ms were implanted synchronous biventricular pacemaker. Serial assessment was performed before and up to 1-36 months after pacing. Results There were significant improvement of LVEF、 LVFS; and decrease in MR、 LVED and QRS duration. The NYHA class of heart function was improved from Ⅲ-Ⅳ to Ⅰ-Ⅱ. Six-minute hall walk distances were also improved. Conclusion For patients with NYHA class Ⅲ to Ⅳ heart failure and ventricular conduction delay, cardiac resynchronization therapy could reverse left ventricular remodeling and improve heart function.

Objective To investigate the effectiveness and methodology of percutaneous transluminal septal myocardial ablation (PTSMA). for hypertrophic obstructive cardiomyopathy (HOCM). Methods PTSMA with Sigwart's Method were performed in 57 patients with symptomatic HOCM from September 1999 to January 2005. Improvements were made about pressure monitoring, echocardiography guiding, the ablation procedure and the evaluation criteria of the operation. Results About 0.6-9.0 mL of absolute alcohol were consumed during PTSMA in each patient with 1-5 target septal branchs ablated per case. The resting and provoked left ventricular outflow tract pressure gradient monitored by catheter was reduced over 50% compared with preoperation level in all 57 cases. Two out of four cases with ECT exam had septal myocardial radioactive absence. During the follow-up of 2 weeks to 5 years, the clinical symptoms such as syncope, diziness, angina, palpitation and dyspnea, disappeared or were relieved in 54 cases compared with preoperation status. Two cases regained the above symptoms not long after the operation. One patient showed improvement in clinical symptoms and echocardiographic examination in 6 monthes, but she died of dilated congestive cardiomyopathy at 18 monthes after PTSMA. Follow-up echocardiographic examination was completed in 43 cases at 6 monthes and in 34 cases at 12 monthes after PTSMA. Further improvement was shown on UCG compared with 2 weeks after the operation. Some patients had transient or nonsustained ventricular tachycardia and atrioventricular block. Anteroseptal myocardial infarction was observed in 4 patients and 1 of them was accompanied by inferior myocardial infarction. Conclusion Percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy is safe and effective. Improvements have to be made for more satisfactory results of PTSMA.

Objective To study the clinical features of cardiac arrest patients and the influence factors of effective resuscitation. Methods The clinical data of 76 patients in our hospital who underwent cardiac arrest and resuscitation were analyzed retrospectively. Results The effective resuscitation were observed in forty-seven patients (47/76, 61.8%), 28 patients completely survived(28/76,36.8%), and the total death rate was 63.2%. The successful rate of resuscitation was positive relation to the starting time of resuscitation, the way of cardiac arrest, and the structure and function of heart, but was negative relation to the times of cardioversion. The successful rate of resuscitation had indefinite relation with the patients age and gender. Conclusion The immediate cardioversion was the key factor of successful resuscitation.The successful resuscitation was dependent on the continuous and effective cardio-press. Basical cardio-disease was the major factor affecting prognosis.

Background The early diagnosis and treatment is vital for the age-related macular degeneration (AMD).Previous examining methods were fundus fluorescein angiography(FFA)and optical coherence tomography (OCT).However,a new diagnostic technique,fundus autofluorescence(FAF),is applying in ophthalmology.objective This study was to observe the FAF characteristics of atrophic AMD. Methods Thirty-nine eyes of 28 patients with atrophic AMD were diagnosed and collected in our hospital and classified based on the criteria of Chen Song.FAF was performed by a confocal scanning laser ophthalmoscope(Heidelberg Retina Angiograph 2,HRA2).Characteristics of FAF images were compared with FFA images or color fundus photographs.Written informed consent was obtained from each patient prior to the examination. Results Areas with abnormal increased or decreased FAF signals were consisted or unconsisted with funduscopically visible alterations.Seven manifestations of FAF were found in the eyes with preatrophic stage of atrophic AMD,including slight change,focal increase pattern,patchy pattern,linear pattern,lacelike pattern,reticular pattern,and speckled pattern.In atrophic stage of atrophic AMD,geographic atrophy showed a well-defined hypoautofluorescence area;while non-geographic atrophy showed a ill-defined hypoautofluorescence area.There were three abnormal FAF patterns(focal,band and diffuse)in the junctional zone of geographic atrophy and diffuse pattern in the junctional zone of non-geographic atrophy. Conclusion FAF imaging is helpful for the diagnosis of atrophic AMD as a new non-invasive technique.

Aim To investigate the up-regulation of miR-22 through Wnt pathway inhibits the proliferation,migration and invasion in human gastric MGC803 cells induced by diallyl disulfide(DADS).Methods The effects of proliferation,migration,and invasion of gastric cancer cells were evaluated by MTT,wound-healing and invasion assays.Online prediction software was applied to search the target gene of miR-22.Luciferase report gene assay was used to assess the target genes Wnt-1 of miR-22.The expressions of Wnt-1,β-catenin and TCF-4 were tested by qRT-PCR and Western blot,respectively.Results MTT showed that DADS and miR-22 notably decreased the proliferation compared with control group(P<0.05).Wound-healing assay showed that DADS and miR-22 could significantly inhibit the migration of MGC803 cells compared with the control group, especially in miR-22+DADS(P<0.05). Invasion assay showed that DADS and miR-22 could markedly inhibit the invasion of MGC803 cells compared with the control group, especially in miR-22+DADS(P<0.05). Online prediction software to search the target gene exhibited that Wnt-1 may be a target gene of miR-22. Luciferase report gene assay disclosed that Wnt-1 was identified as a direct target of miR-22. Qrt-PCR showed that the expression of Wnt-1 Mrna was respectively down-regulated by DADS and miR-22 compared withcontrol group, especially in miR-22+DADS(P<0.05). Western blot exhibited that DADS and miR-22 obviously suppressed the expressions of Wnt-1, β-catenin and TCF-4 proteins, especially in miR-22+DADS(P<0.05).Conclusion Up-regulation of miR-22 through Wnt pathway can remarkably suppress the proliferation, migration and invasion in MGC803 cells by DADS.

Objective To explore the efficacy and safety of low-dose heparin in the treament of children with primary nephrotic syndrome (PNS). Methods It was an open and comparative trial. Eightyeight children with PNS in the hypercoagulable state,on the basis of administrating with glucocorticosteroid,were administrated with low-dose heparin that infused by micro pump oriented to time ( group A). Eighty patients only treated with glucocorticosteroid were chosen as control (group B). Results Serum-albumin and activated partial thromboplastin time (APTT) increased,but fibrinogen (Fib) decreased after therapy in the group A,and they all showed significant differences (P ＜ 0. 01 ). Serum-albumin increased after therapy in the group B and there was significant difference (P＜0. 01 ). However,APTT and Fib in the group B showed no significant difference( P ＞ 0. 05 ) between post-treatment and pretherapy. Post-treatment serum-albumin and APTT in the group A were significantly higher than those in group B, and Fib was significantly lower than that in group B ( P ＜ 0. 01 ). The rate of urine protein remission in group A (82/88) was significantly higher than that in group B (63/80). Urine protein remission time and edema disappearance time were significantly shorter in group A than group B ( P ＜ 0. 01 ). APTT of group A at the peak concentration of heparin after therapy was significantly higher than that of pretherapy ( P ＜ 0. 01 ), and the ratio was 2. 38. However, there was no significant difference in APTT at the valley concentration of heparin between post-treatment and pretherapy ( P ＞ 0.05 ). Conclusion Low dose-heparin infused by micro pump oriented to time in the treatment of children with PNS has an obvious anticoagulative effect. It can improve the rate of urine protein remission and shorten edema disappearance time. Meanwhile it is safety ,requires no laboratory monitor and has few drug side effects,thus it deserves further clinical application.

Adolescent ; Atrial Appendage ; Diagnostic Errors ; Female ; Humans ; Tachycardia, Ectopic Atrial ; diagnosis ; Tachycardia, Sinus ; diagnosis