Objective: To compare influences of different retention attachments on stress among supporting structures .Methods: By 3-dimensional laser scanner and reverse engineering computer aided design ( CAD) software , a basic partially edentulous digital model with mandibular premolar and molar missing was established .Implant attachment and removable partial dentures ( RPD) were added into the basic model to build three kinds of models: RPD only, RPD +implant +Locator attachment , and RPD +implant +Magfit attachment .Vertical and inclined loads were put on artificial teeth unilaterally . By means of 3-dimensional finite element analysis , the stress distribution and displacement of the main supportive structures were compared . Results: A complete 3-dimensional finite element model was established , which contained tooth structure , and periodontal structures .The displacement of the denture was smaller in Locator (9.38μm vertically, 45.48μm obliquely) and Magfit models (9.54μm vertically, 39.45 μm obliquely) compared with non-implant RPD model (95.27 μm vertically, 155.70 μm oblique-ly) .Compared with the two different attachments , cortical bone stress value was higher in Locator model ( Locator model 10.850 MPa vertically , 43.760 MPa obliquely;Magfit model 7.100 MPa vertically , 19.260 MPa obliquely).The stress value of abutment periodontal ligamentin Magfit model (0.420 MPa vertically) was lower than that in Locator model (0.520 MPa vertically).Conclusion:The existence of implant could reduce maximum von Mises value of each supportive structure when Kennedy Ⅰpartially edentulous mandible was restored .Comparing the structure of Magfit and Locator attachment , the contact of Magfit attachment was rigid , while Locator was resilient .Locator attachment could improve stability of the denture dramatical -ly.Locator had stronger effect on defending horizontal movement of the denture .

Objective To examine clusters of anti-nuclear antibodies (ANA) and their associations with clinical features in patients with systemic lupus erythematosus (SLE).Methods It was a retrospective study.113 SLE patients were reviewed from March 2010 to May 2012 in Department of Rheumatology,Jinhua Central Hospital.ANA and specific autoantibodies to 15 kinds of nuclear antigens were tested by indirect immunofluorescence assay (IIF) and line immunoassay (LIA) respectively.Hierarchical clustering method was performed to analyze specific clusters of ANA profiles in SLE.Chi-square tests were used to investigate relationship between antibody clusters and clinical features of SLE.Results The positive rate of LIA for ANA was 97.3％,consistent with IIF method,and the total accordance rate of the both methods was 98.2％.Thirteen kinds of antigen-specific antibodies were detected in SLE patients by LIA.Clustering analysis for these antibodies showed three specific clusters in SLE,Nuc/His/dsDNA cluster (C1),low-Ro/low-La cluster (C2),and Ro/Sm/RNP cluster (C3),accounting for 36.3％,24.8％,38.9％ of the total cases respectively.There were significant difference of AST levels among three clusters [(32.62 ± 21.92)U/L,(25.56 ± 16.63) U/L,(50.41 ± 60.86) U/L respectively for C1,C2 and C3].High incidences of chronic cutaneous lupus,abnormal renal indicators and inflammatory synovitis were found in all three clusters.Besides,there were significant differences among three clusters for the incidences of chronic cutaneous lupus (39.0％,39.3％,63.6％ respectively for C1,C2,C3) and leukopenia/lymphopenia (56.1％,25.0％,56.8％ respectively for C1,C2,C3) (P ＜ 0.05).Patients in Ro/Sm/RNP cluster showed higher incidences of lupus nephritis (43.2％/26.8％ or 39.3％); patients in low-Ro/low-La cluster showed low risk of hypertension (7.1％/19.5％ or 22.7％) ; patients in Nuc/His/dsDNA cluster showed high incidences of thrombocytopenia (41.5％/21.4％ or 25.0％) and high risk of lung or upper respiratory tract infection (46.3％/28.6％ or 29.5％),but low incidence of neurologic symptoms (0％/ 3.6％ ％ or 11.4％).Conclusion Three characterized ANA clusters are identified in SLE patients in this pilot study.Different clusters are associated with certain clinical features and complications ofSLE.However,the correlations found in this study need to be investigated further in larger populations.

Objective To evaluate pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated by Cockett syndrome in the left lower limbs.Method Data of 137 cases of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb by interventional therapy from January 2007 to October 2012 were analyzed retrospectively.Inferior vena cava filters were placed in all of the patients.Patients were divided into two groups:Group A (n =81) treated with catheter directed thrombolysis only,Group B (n =56) treated with pigtail catheter mashing thrombosis combined with catheter directed thrombolysis.After operation,patients were treated by anticoagulation with urokinase and heparin calcium,and then warfarin for 6 to 1 2 months.Results The thrombolysis time in group B was significantly shorter than that in group A (P ＜0.01),the dosage of urokinase was significantly less than that in group A(P ＜ 0.01).The venous patency score in group B after therapy was significantly better than in group A (P ＜ 0.01).121 patients were followed up for 10-60 months.There were no pulmonary embolism.Conclusions Pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb can improve thrombolytic efficiency,shorten thrombolysis time,reduce the use of urokinase.

Objective To investigate the expression of lymphotoxin-β and its receptor in the skin of a mouse model of allergic contact dermatitis (ACD).Methods BALB/c female mice at 6 to 8 weeks of age were randomly divided into the experiment group (n =15) and normal control group (n =10).Topical 2,4-dinitrofluorobenzene (DNFB,0.5％) was used to establish a model of ACD in the experiment group followed by challenge with DNFB (0.2％) at the right external ear on the 6th day.The normal control mice remained untreated.The right external ear was resected from all of the mice 24 hours after the challenge and divided into 2 parts for the measurement of mRNA and protein expressions of lymphotoxin-β and lymphotoxin-βreceptor by fluorescence-based real-time quantitative PCR and immunohistochemistry,respectively.Results The median mRNA expression levels of lymphotoxin-β and lymphotoxin-β receptor were 3.630 and 1.148respectively in the experimental mice,with the interquartile range being 1.187 and 0.617 respectively,and were both 1.000 in the control mice with the interquartile range being both 0.000.There was a significant difference between the experimental and control group in the mRNA expression levels of lymphotoxin-β and lymphotoxin-β receptor (P ＜ 0.01 ).Immunohistochemistry showed a significant increase in the expression of lymphotoxin-β and lymphotoxin-β receptor proteins in the experimental group compared with the control group (P ＜ 0.01 ).Conclusion There is an increment in the mRNA and protein expressions of lymphotoxin-β and lymphotoxin-β receptor in the lesions of ACD in mice.

Objective To construct recombinant adenovirus vector containing Rattus norvegicus microtubule-associated protein 4 gene,and transfect it into the rat cardiac myocytes cultured in vitro.Methods A pair of primers were designed,and full length MAP4 DNA was cloned from rat total mRNA by PCR.The PCR product was double-digested with restriction endonucleases NheⅠ and NocⅠ,and inserted orientationally into pShuttle2.The plasmid of pShuttle2-MAP4 was double-digested with restriction endonucleases NheⅠ and NocⅠ,and inserted BD Adeno-X~(TM) Virul DNA,named pAd2-MAP4.The non-recombinant adenovirus was screened out with PacⅠ, pAd2-MAP4 was linerized with SwaⅠ,and the recombinant virus genome was transfected into HEK293 cell line for packaging and amplification of Ad-MAP4 virus.The recombinant adenovirus was transfected into rat cardiac myocytes and MAP4 was identified by immunohistochemistry.Results The recombinant adenovirus-MAP4 was constructed successfully and the titer was about 2.3?10~(8) pfu/ml.The expression of MAP4 was enhanced at 48 h after the transfection.Conclusion We have successfully constructed a recombinant adenovirus Ad-MAP4 that has enforced the expression of MAP4 in vivo.

Objective Based on the experience of the first round cooperation between Jinhua Municipal Central Hospital and School of Medicine,Zhejiang University,to evaluate the effects of this collaboration and provide reference for the next round cooperation.Methods A database of research performance from 2008-2017 was established to compare the scientific research situation of collaborating disciplines and non-collaborating disciplines before and after the cooperation between.Results The quality and quantity of scientific research projects,funds,papers were promoted after cooperation,and the improvement of collaborating disciplines was greater than non-collaborating disciplines.Conclusions The hospital college cooperation was helpful to promote the scientific research situation in a district hospital.It should be paid attention to the balance of disciplines development and improve the quality of scientific research in the next round cooperation.

Objective: To investigate the clinical efficacy of enhanced recovery after surgery(ERAS) in atrial caval shunting (ACS) for type Ⅱ Budd-Chiari syndrome(BCS). Methods: The clinical data of patients underwent ACS for type Ⅱ BCS in the Henan Province People′s Hospital from January 2014 to June 2016 were prospectively analyzed.Randomized and single-blind, controlled study was performed among the patients, and all of them underwent ACS and were divided into control group (patients underwent traditional perioperative management) and ERAS group (patients underwent ERAS perioperative management) based on a random number table.Operational and postoperative data, levels of inflammatory cytokines, stress state evaluation and postoperative complications were observed.The comparison between the two groups was evaluated with an independent sample t test.The trend analyses for variables were done using repeated measures ANOVA.The count data were analyzed using the chi-square test or Fisher exact. Results: Eighty-two patients were screened for eligibility, and allocated into the control group (40 patients) and the ERAS group (42 patients). All patients underwent ACS successfully with no death.Comparison of intraoperative status: operation time, volume of intraoperative blood and number of patients receiving blood transfusion were (211.0±12.9) minutes vs. (207.7±10.7) minutes, (167.5±28.3) ml vs. (165.0±28.4) ml and 3 cases vs. 1 case between the control group and the ERAS group, respectively, showing no difference between the two groups (t=0.90, 0.29, χ²=0.32, all P>0.05). Comparison of postoperative status: time of gastric tube removal, time of catheter removal, time of chest tube, time to flatus, time of food intake, duration of postoperative infusion, duration of postoperative hospital stay and numeric rating scale were (3.7±0.5)days vs. (0.0±0.0)days, (2.3±0.7)days vs. (1.4±0.5)days, (3.7±0.7)days vs. (2.3±0.5)days, (75.2±3.8)hours vs. (46.6±4.2)hours, (75.7±4.7)hours vs. (21.4±2.1)hours, (10.0±1.0)days vs. (5.8±0.9)days, (11.4±1.0)days vs. (7.8±0.6)days, 2.9±0.4 vs. 1.9±0.6 between the control group and the ERAS group, respectively, with statistically differences (t=35.03, 4.36, 8.10, 22.89, 47.78, 14.75, 14.22, 6.13, all P<0.05). Stress state evaluation: the levels of IR were (2.7±0.1) vs.(2.7±0.1), (8.8±0.7) vs. (5.2±0.3), (11.0±0.5) vs. (7.3±0.5), (4.9±0.2) vs. (3.9±0.1), and the levels of C-reaction protein were (14.6±1.3)mg/L vs.(14.6±1.1) mg/L, (101.2±13.6) mg/L vs. (89.5±6.9) mg/L, (62.7±8.6) mg/L vs. (56.4±8.4) mg/L, (46.4±6.7) mg/L vs. (40.0±5.6) mg/L from pre-operation to postoperative day 1, 3 and 5 between the control group and the ERAS group, respectively, with statistically significant differences in changing trends(F=136.61, 4.97, both P<0.05). Comparisons of levels of inflammatory cytokines: the levels of IL-6 were (43.1±2.7) ng/L vs. (43.6±3.6) ng/L, (135.1±6.4) ng/L vs. (117.4±5.7) ng/L, (145.4±6.7) ng/L vs. (128.5±5.5) ng/L, (93.3±3.7) ng/L vs. (88.0±3.9) ng/L, and the levels of TNF-α were (10.4±0.3)mmol/L vs. (10.4±0.3) mmol/L, (14.4±0.4) mmol/L vs. (12.6±0.4) mmol/L, (15.6±0.4) mmol/L vs. (13.8±0.4) mmol/L, (12.3±0.7) mmol/L vs. (11.4±0.6) mmol/L from pre-operation to postoperative day 1, 3 and 5 between the control group and the ERAS group, respectively, with statistically significant differences in changing trends (F=15.15, 21.45, both P<0.05). Comparison of postoperative complications: incidence of complications was 30.0%(12/40) in the control group and 11.9%(5/42) in the ERAS group, and the numbers of patients with nausea and vomiting, respiratory complications and cardiovascular complications were 4, 3, 5 cases in the control group and 3, 1, 1 case in the ERAS group, respectively, showing statistically differences in the incidence of complications(χ²=4.08, P<0.05). All the 82 patients were followed up for 2 to 22 months (median time, 12 months), no patients received reoperation or re-admitted to the hospital duo to complications. Conclusion ERAS management in the perioperative period of ACS for BCS is beneficial to postoperative recovery of patients, and can relieve postoperative stress state and inflammatory response, reduce the duration of hospital stay, and incidence of postoperative complications.

Objective:To summarize the practical experience of Jinhua hospital of Zhejiang University in improving the scientific research capacity of medical staff, explore the appropriate training mode of scientific and technological talents suitable for the municipal hospitals.Methods:The SWOT analysis method was used to conduct in-depth discussions on the internal and external environment of the work. Corresponding policies and measures were introduced based on the analysis findings. The implementation effects of the policy were evaluated.Results:Through years of practice, it has effectively enhanced the scientific research consciousness of medical staff, enhanced scientific research capacities, standardized scientific academic ethics, and trained a group of high-level scientific and technological talents. The scientific research volume and quality of hospitals have been greatly improved.Conclusions:Established a training mode in line with the hospital's function. It proposed that systematical planning, accurately implementing, and collaboration among hospital and departments in practice are effective ways to improve the scientific research capacity of medical staff in the municipal hospitals.

Objective:To investigate the feasibility and clinical value of endovascular treatment of iliac vein disease via the great saphenous vein approach.Methods:Eighty-six patients with nonthrombotic left iliac vein compression lesions identified by anterograde lower limb vein angiography were divided into 2 groups: group A ( n=46) was treated via great saphenous vein and group B ( n=40) was treated via femoral vein. The success rate of puncture, time consuming of puncture catheterization, postoperative bed immobilization and complication rate of puncture were observed and compared between the two groups. Results:The puncture success rate was 97.8% (45/46) in group A and 100% (40/40) in group B, there was no significant difference between the two groups（ P>0.05）. The average puncture time was (9.4±2.7) min in group A and (5.5±1.3) min in group B ( P<0.05). The complication rate of group A was lower than that in group B ( P<0.05). The patency rate of iliac vein stent was 100%, as indicated by venous color ultrasound or angiography. Conclusion:Endovascular treatment of iliac vein disease via great saphenous vein approach is a safe and feasible method with less trauma and easier postoperative care.

Objective To evaluate hepato-intestinal anastomosis in the treatment of complex stricture of high bile duct.Methods From Jan 2010 to Dec 2016,43 patients undergoing traditional biliary-intestinal anastomosis were grouped into control,45 patients undergoing hepato-intestinal anastomosis were allocated into study group.Results (1) Control vs study grounp,the operative time was (24 ±3)min vs.(15 ± 3)min,intraoperative blood loss and blood transfusion were (384 ± 51)ml vs.(280 ± 41) ml,(649 ± 3) ml vs.(454 ± 8) ml,number of patients with intraoperative blood transfusion,and liver resection were 10 vs.3,and 8 vs.3 respectively,with statistically differences (t =12.48,10.46,144.65,x2 =43.68,49.50,all P ＜ 0.05).(2) Postoperatively efficacy:fever was in 7 vs.3 cases,incision infection in 5 vs.3 cases,abdominal infection was in 5 vs.2 cases,biliary fistula was in 7 vs.3 cases,number of un-planed readmission was in 7 vs.3 cases,and postoperative hospital stay were (14.3 ± 1.5) d vs.(10.7 ± 0.7) d,respectively,between the control group and the study group,with statistically differences (x2 =52.55,58.91,62.23,52.55,52.55,t =16.28,all P ＜0.05).(3) Follow-up situation:all the 88 patients were followed-up for 6 to 96 months (median time,30 months).Biliary restenosis occurred in 5 vs.1 patients between the control group and the study group,respectively,with statistically differences (x2 =65.64,P ＜ 0.05).Conclusions Hepato-intestinal anastomosis is effective in the treatment of complex stricture of high bile duct.