Objective To investigate the cause of vertical root fracture in pulpless teeth, and advance the measures of prevention. Methods The clinical data of 20 vertical root fracture in pulpless teeth (17 patients) were collected. The status of the teeth and periodontium before therapy were reviewed, the position and direction of the root fracture were observed, the type and position of the restoration and the occludent station of the teeth were analyzed. Results It was revealed that vertical root fracture frequently occurred in the molars (16/20). Vertical root fracture were frequently found in front teeth(4/20) and premolars (5/20)among those with coronal integrity. Decrease of alveolar level of various degrees was found in 19 cases, among which 8 were mild, 7 moderate and 4 severe. Vertical root fracture mainly took place in molars after coronal restoration (6/7). Vertical root fracture would likely to occur no matter whether they would be worked as the abutment teeth of the removable partial denture or fixed prostheses. Early contact occurred in lateral bite (6 cases) was more susceptible to vertical root fracture than that occurred in centric bite (1 case). Conclusion The causes of vertical root fracture in pulpless teeth are complicated. Due to unfavorable outcomes, it is important to take precautions for vertical root fracture.

Objective To explore the impact of different anesthesia methods and anesthesia-related factors in initial bladder cancer patients with partial cystectomy, and to provide a reference for clinical anesthesia choice and the questions that should be concerned. Methods Ambispective cohort study was performed in consecutive case of illness with initial occurrence bladder cancer patients treatedwith partial cystectomy from 2009 to 2012. A historical cohort was from January 5, 2009 to January 4, 2011. A prospective cohort was from January 5, 2011 to December 31, 2011. Follow-up was terminated in December 31, 2012. All cases were followed up to one full year after surgery. The 402 cases who were diagnosed of initial occurrence bladder cancer and partial cystectomy patients, according to different anesthesia method, were divided into general anesthesia group and intraspinal anesthesia group. Postoperative recurrence was determined within 1 year of follow-up. Multivariate analysis was carried out based on univariate analysis to analyze the causal connection factors for one year recurrence in initial occurrence bladder cancer patients with partial cystectomy. Variables included gender, age, blood type, smoking history, drinking history , number of tumors, tumor size, pathologic TNM stage, anesthesia method, duration of anesthesia, postoperative visual analog scale (VAS) score at 12 h, tumor-associated factor Ki67, P53, CK20, VEGF (whether two or more positive). Tumor recurrence was considered the dependent variable (outcome). Univariate analysis used χ2 or rank sum test, and multivariate analysis used Logistic regression model fitting analysis and the maximum likelihood method. SPSS 16.0 software package was used for data analysis and processing. Results Four hundred and two patients were followed up and got a result of 396 cases (98.51％). Two hundred and eleven cases showed recurrence within one year (53.28％). Univariate analysis showed that age, smoking history, drinking history, duration of anesthesia, pathologic stage, postoperative VAS scores at 12 h less than 3 scores, blood type, tumor-associated factor Ki67, P53, CK20, VEGF (two or more positive) were associated with one year recurrence in initial occurrence bladder cancer patients (P < 0.01) with partial cystectomy, while the difference of two anesthesia methods was not shown (P>0.05). Multivariate Logistic regression model analysis showed that the following factors were associated with postoperative recurrence within a year in initial occurrence bladder cancer patients with partial cystectomy: age (RR = 0.371, 95％ CI 0.183-0.752), drinking history (RR=0.348, 95％CI 0.161-0.752), postoperative VAS scores at 12 h less than 3 scores (RR=0.023, 95％CI 0.011-0.050), duration of anesthesia (RR=3.042, 95％CI 1.495-6.192), and tumor-associated factor Ki67, P53, CK20, VEGF of two or more positive(RR=8.676, 95％CI 4.018-18.733). Among these, duration of anesthesia and tumor-associated factors Ki67, P53, CK20, VEGF of two or more positive were risk factors, and drinking history, age, and postoperative VAS scores at 12 h less than 3 scores were protection factors. Conclusions The impact of general anesthesia and intraspinal anesthesia on one year recurrence in initial occurrence bladder cancer patients with partial cystectomy is not statistically significant. Duration of anesthesia depends on the part of the surgical time which is associated with the postoperative recurrence within a year. Postoperative analgesic perfect (VAS score at 12 h less than 3 scores) is the protective factor. Age and drinking history are also the protective factors for one year recurrence in initial occurrence bladder cancer patients of partial cystectomy.

Objective To evaluate the effect of various sampling errors on ELISA test results. Methods Standard sample volume,standard sample volume reducing 1,2,3,4 μL or adding 1, 2,3 μL were respectively pipetted into the wells of a microplate,follwed by routine operation of ELISA test. Then the influence of various sampling errors was analyzed on ELISA test results of HBsAg, HCV and TP. Results S/CO value was increased with the increase of sample volume. The statistical difference of mean S/CO value of HBsAg and TP was only found between sample volume adding 3 μL group and control group(P<0.05). For HCV result, there were significant differences between standard sample volume adding 2,3μL or reducing 3,4μL groups and control group(P<0.05), while no obvious differences were found in the other groups(P>0.05). The difference of mean positive rate between ex-perimental groups and control group showed an increasing tendency with the reduction of sample vol-ume,and significant differences in HBsAg, HCV and TP results were also found between sample vol-ume increase groups and reduction groups(P<0.05). Conclusion Various sampling errors influence ELISA test results to different degrees,and the extent increases with the reduction of standard sample volume.

Objective To observe the prevention and treatment of the total flavonoids from Litchi chinensis Sonn( TFL) on hepatic fibrosis induced by dimethylnitrosamine(DMN)in rats, and to explore its mechanism. Methods Ninety SD rats were randomly divided into six groups, normal control group, model control group, colchicine group, high-, medium- and low-dose TFL group(n=15).Expect for normal control group, the other groups were given intraperitoneal injection of 2 mL.kg-1 of 5% dimethylnitrosamine for 4 weeks as the model group. The rats in the normal control group and model control group were given 5 mL.kg-1of 0.9% sodium chloride solution, colchicine group was treated with 0.1 mg.kg-1 colchicine.High-, medium-and low-dose TFL groups were given 200, 100 and 50 mg.kg-1 of TFL.The rats were sacrificed and the livers were harvested and stained with HE and Masson staining to observe pathological changes and liver fibrosis in the same part 6 weeks after all the medicine was given to the rats each day. Immunohistochemistry and Western blotting were used to detect the expression of the transforming growth factor β-Ⅰ/type Ⅱ receptor ( TβRⅠ/Ⅱ) , collagen Ⅰ( Col Ⅰ) and Ⅲ collagen ( Col Ⅲ) . Results Compared with the normal control group, the semiquantitative score of liver fiber and the protein expression of TβRⅠ, TβRⅡ, ColⅠ and Col Ⅲ in the model control group were significantly increased(P<0.01).Compared with the model control group, the protein expression levels of TβR, TβRⅡ, ColⅠand ColⅢwere significantly decreased( P<0.01) in the high-,medium-and low-dose TFL group.The semiquantitative score of liver fiber was significantly decreased( P<0.01) with a dose-effect relationship. Conclusion TFL can inhibit formation of DMN-induced liver fibrosis in rats, which may be related with reduction of expression of TβRⅠ/Ⅱ of hepatic fibrosis promoting factor TGF-β1 , inhibition of the activation and increase of hepatic stellate cells, reduction of the collagen content.

Objective To determine relative risk factors for positive surgical margins in extraperitoneal laparoscopic radical prostatectomy(LRP). Methods From February 2004 to September 2007,33 patients(mean age 70 years old)with prostate cancers underwent extraperitoneal LRP.All patients were diagnosed by pathology preoperatively.Gleason score:3+3 14 cases(43%),3+4 11 cases(33%),4+3 6 cases(18%),4+4 2 cases(6%).Clinical stage:T1a-T1b 4 cases(12%),T1c 14 cases(43%),T2a-T2b 5 cases(15%),T2c10 cases(30%).Logistic regression analyses were performed. Results LRP was successfully performed on 31 cases.There were 2 cases converted to open surgery.Nine cases(27%)had PSMs.There were 6 cases(67%)and 4 cases(17%)of clinical stage T2c in PSM and negative surgical margin(NSM)groups respectively(P=0.010).There were 3 cases(33%)and 0(0)with high Gleason score(higher than 7)in PSM and NSM cases(P=0.015).There were 4 cases(44%)and 5 cases(21%)with t-PSA higher than 20dg/ml in PSM and NSM cases respectively(P=0.178).In these 9 cases,there were 4 cases(44%)positive with DRE.However there were 9 in the 24 NSM cases(38%)(P=0.509).Clinical stage T2c was independently positively correlated with PSM(OR=24.69).High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml were positively correlated with PSM. Conclusions Clinical stage is positively correlated with PSM.It is an independent factor.High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml mignt be the risk factors in predicting PSM and should be used together with clinical stage.Positive DRE findings may be also useful to predict PSM.

Endoscopes ; Humans ; Nasal Cavity ; surgery ; Nasal Septum ; surgery ; Reconstructive Surgical Procedures ; Rhinoplasty ; Surgical Flaps

Objective To assess the value of diffusion tensor imaging(DTI)and susceptibility weighted imaging(SWI)in diagno-sis of acute diffuse axonal injury.Methods The imaging data of 45 cases with acute DAI diagnosed by clinical symptoms were ana-lyzed retrospectively.In all the images of T2 WI,FLAIR ,DTI and SWI we analyzed the characteristic of signal and distribution of all the lesions.The numbers of lesions found in each sequence group were statistically analyzed by chi-square test.Results 497 lesions of DAI we all found.265 lesions were found in FLAIR,the detection rate was 53.3%.313 lesions in DTI,the rate was 62.9%.448 lesions in SWI,the rate was 90.1%.The detection rate of DTI and SWI were significantly higher than FLAIR,they had significant difference(P <0.05).Conclusion DTI combined with SWI,we can find DAI lesions in acute phase more comprehensively.DTI di-mensional diffusion tensor imaging technique can help us visualize discontinuous fibers intuitively in DAI and confirm objectively the existence of DAI lesions.

Objective To study the clinical characteristics of tracheotomy in patients with critical diseases and obesity aged 80 years and over. Methods A total of 120 patients with critical diseases and obesity undergoing tracheotomy from July 2006 to August 2011 were retrospectively reviewed,and divided into advanced age group(aged 80-99 years,n=60) and control group(aged 60-79 years,n=60).Surgery time,operation preparation,surgery skill and complication after surgery were compared between the two groups. Results A total of 60 patients undergoing tracheotomy were successfully performed by relative surgery skills according to characteristics of critical obesity in advanced age group.There was 1 case (1.7％) and 0 case with trachea cannula exodus,3 cases (5.0％) and 4 cases(6.7％) with cuff leak,4 cases (6.6％) and 3 cases(5.0％) with stoma bleeding,5 cases (8.3％) and 7 cases (11.4％) with subcutaneous emphysema in advanced age and control groups,respectively.Total complication rate was similar between the two groups of patients [13 cases (21.7％) vs.14 cases (23.3％),x2 =1.00,P＞0.05]. Conclusions Individualized procedure of tracheotomy may reduce complication of patients with critical diseases and obesity aged 80 years and over.

Objective: To investigate the hyponatremia incidence in patients with ruptured intracranial aneurysms and the correlation with Fisher grading and cerebral vasospasm. Methods: Totally 150 patients with ruptured intracranial aneurysms from March 1998 to May 2001 were divided into anterior communicating artery (ACoA) group,posterior communicating artery (PCoA) group and middle carotid artery(MCA) group according to the sites of aneurysms.The patients were treated with GDCs interventionally and the incidences of hyponatremia were analyzed. Results: The incidences of hyponatremia in 3 groups were 48%(32/67),15%(8/52) and 16%(5/31),respectively; The incidences of severe hyponatremia of 3 groups were 30%(20/67),6%(3/52) and 6%(2/31), respectively. In ACoA group, the incidences of hyponatremia in Fisher grade Ⅲ-Ⅳ and Ⅰ-Ⅱ were 67%(20/30) and 32%(12/37) and the incidences with and without vasospasm were 71%(24/34) and 24%(8/33), respectively. Conclusion: The ACoA group has a significantly higher incidence of common and severe hyponatremia than the other groups. In ACoA group,hyponatremia is significantly more often in Fisher grade Ⅲ-Ⅳ cases and those with vasospasm.

Objective: To investigate the relationship between senile degenerative valvular heart disease (SDVHD) and heart failure. Methods:86 cases of SDVHD consisted of 67 males and 19 females, with the mean age of 60 -93(78?9)yr . 86 cases of controls with comparable gender, age and baseline conditions were include in the control group. Morbidity rate of heart failure were compared between the two groups during 12 years follow-up. Heart function was determined by color Doppler ultrasonography. Results:Prevalence of left heart failure and whole heart failure in SDVHD group were 75. 5% and 22. 0% , respectively, significantly higher than the control group ( 16. 2% and 7. 0% , respectively). Ejection fraction ( Ef) in SDVHD group was significantly lower than the control group [ (43?7 ) % vs (71?6)%,P