Objective To discuss the consequences of CT image quality in two different contrast enhancement ways of high pressure syringe. Methods 100 cases by using high-pressure syringes of Lightspeed 16-raw spiral CT and Stellant D-type high-pressure syringe of Medrad, the dose of constrast medium was 4.0 ml/s and the total dose was 80 ml, which was divided into A and B group enhancement scanning. The canalis singularis high pressure syringe was used in 50 cases of A group that no isotonic Na chloride flush, in contrast to 50 samples of B group that were underwent the double isotonic Na chloride flush. The method of evaluation is double-blind observation. Results The number of positive is 40 samples which has radioactive constructed defect in A group. The masculine proportion is 80%. The number of the negative is 10 samples. The proportion is 20%. Correspondingly, the number of radioactive constructed defect in the B group is 24 samples(48%), and the negative number is 26 samples(52%, P

Mandibular molar loss, which is in a high ratio, is found accompanying with alveolar bone resorption frequently while being restored in clinic. Therefore, due to the existence of mandibular neural canal, the success ratio of implant denture in this area can be directly affected by the height reduction of alveolar bone. In clinic, there are some achievements obtained to improve the survival rate of implant denture, such as increasing the implant support area, enhancing alveolar bone height through surgery, optimizing the design of the superior part of implant. This article summarizes the research progress on the mandibular molar implant denture with alveolar bone absorbed and aims to search a selective design of mandibular molar implant denture under the high absorption of alveolar bone.

Adult ; Branchio-Oto-Renal Syndrome ; diagnosis ; Child, Preschool ; Craniofacial Abnormalities ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Male

AIM　To study the apoptosis and characterizati on of cultured vascular smooth muscle cells (VSMCs) induced by cholestan-3β,5 α,6β-triol(Triol) and compared with 25-hydryoxycholestrol(25-OH). M ETHODS　The culture of vascular muscle smooth cells (VSMCs), light and e lectron transmission microscopy and TdT-mediated dUPT nick-end labeling (TUNEL ) technique. RESULTS　After being treated with oxyterols, VSMCs showed apoptosis of ultrastracture change including shrinkage, condensation of nuclear chromatin, fragmentation nuclei and formation of apoptotic body. TUNEL r evealed that Triol-induced apoptosis in VSMCs was in a concentration-dependent manner. The effect of Triol and 25-OH at a 30 μmol*L-1 concentration i n culture medium induced apoptosis of VSMCs, the former was not but the latter was inhibited by cholesterol at a 50 μmol*L-1 concentration. CO NCLUSION Triol can induce VSMCs apoptosis in vitro and oxysterol-i nduced apoptosis in VSMCs may be mediated through various pathway and different mechanism. Oxysterol-induced apoptosis in VSMCs may play an important role in t riggering atherosclerosis plaque rupture and result to the onset of the acute co ronary syndromes.

Objective To investigate the expression level of antisense non-coding RNA in the INK4 locus (ANRIL) in hepatocellular carcinoma (HCC) tissues and to evaluate its relation to clinicopathological features and prognosis of HCC.Methods Quantitative real-time polymerase chain reaction (qRT-PCR) method was used to detect the expression of ANRIL in HCC tissues and adiacent tissues (n =90) and to analyze its relationship with clinicopathological data.Kaplan-Meier curves and multivariate Cox proportional models were used to study the impact on clinical outcome.Small interfering RNA (siRNA) was used to silence ANRIL and to explore the effects of reduced ANRIL expression on cell growth and metastasis.Results ANRIL expression in HCC tissues was significantly higher than in the adjacent non-tumor tissues (t =13.083,P ＜ 0.05).The expression of ANRIL was remarkably associated with the histologic grade (x2 =40.724,P ＜ 0.05) and TNM stage (x2 =43.245,P ＜ 0.05).The mean survival time of the patients with high ANRIL was 18.2 months (95％ CI:14.9-21.5 months),shorter than 39.4 months (95％ CI:35.5-43.4 months) in low expression (x2 =47.590,P ＜0.05).Multivariate analysis suggested that high ANRIL expression was an independent predictor of poor prognosis (HR =2.143,95％ CI:1.083-4.243,P ＜ 0.05).Decreased expression of ANRIL could suppress the cell proliferation,migration and invasion of HCC cells.Conclusion Positive ANRIL expression is negatively correlated with the prognosis of HCC patients.

OBJECTIVETo explore the clinical effect of the lobulated medial sural artery perforator flap in repairing soft tissue defect in hand or foot.

METHODSSince March 2012 to September 2014, 6 cases with soft tissue defects in hands or feet were treated by lobulated medial sural artery flaps pedicled with 1st musculo-cutaneous perforator and 2st musculo-cutaneous perforator of the medial sural artery. The size of the flaps ranged from 4.5 cm x 10.0 cm to 6.0 cm x 17.0 cm.

RESULTS5 cases of lobulated flap survived smoothly, only 1 lobulated flap had venous articulo, but this flap also survived after the articulo was removed by vascular exploration. All flaps had desirable appearance and sensation and the two-point discrimination was 6 mm in mean with 4 to 12 months follow-up (average, 7 months). Linear scar was left in donor sites in 3 cases and skin scar in 3 cases. There was no malfunction in donor sites.

CONCLUSIONSLobulated medial sural artery perforator flap is feasible and ideal method for the treatment of soft tissue defect in hand or foot with satisfactory effect.

Arteries ; Cicatrix ; Follow-Up Studies ; Foot Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Perforator Flap ; transplantation ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Time Factors ; Wound Healing

Objective To investigate neurological function, volume of cerebral infarction, changes of lipid peroxidation, and the intervention effect of compound angelica injection (CAI) on rats with focal cerebral ischemia injury. Methods Models of rat with cerebral ischemia were reproduced by middle cerebral artery occlusion (MCAO). All animals were randomly divided into sham-operation group, model group, CAI group, and edaravone group. 1 hour after the models were established, rats in the sham-operation group and model group received intraperitoneal injection with normal saline, while rats in CAI group and edaravone group received intraperitoneal injection with relevant medicine for continuing 7 days. Volume of cerebral infarction was detected by Tetrazole staining method, neurologic function were detected by neuroethology, and concentration of MDA in brain tissue was also detected. Results After 7-day cerebral ischemia, compared with the model group, volume of cerebral infarction in CAI group was significantly reduced (P<0.05), and the concentration of MDA was a little lower. Conclusion CAI has significant protective effects which can significantly improve neurological function, reduce volume of cerebral infarction, and alleviate the effects of lipid peroxidation of rats with focal cerebral ischemia injury.

Objective To describe a novel pubovesical complex preserving technique for laparoscopic radical prostatectomy and to evaluate its postoperative outcomes.Methods From January 2011 to May 2017,168 patients who underwent laparoscopic radical prostatectomy were enrolled and analyzed retrospectively.Their mean age were 62.8 (46-74) years,preoperative PSA 11.3ng/ml,Gleason score 6.7,preoperative prostate volume 46.5 ml.They all got preoperative potency (IIEF-5 score ≥ 15 score).TNM clinical stage:cT1 123 cases,45 cases cT2.There were 59 patients with pubovesical complex preserving technique for laparoscopic radical prostatectomy (group A):without pelvic fascia cut and deep vein complex suture.The preservation of the periprostatic anatomy was kept by preserving the pubovesical complex,including detrusor apron with pubovesical ligaments,DVC and NVB.There were 46 patients with conventional intrafascial laparoscopic radical prostatectomy (group B) and 63 patients with interfascial laparoscopic radical prostatectomy(group C).No differences were found between the three groups in terms of preoperative age,clinical staging,prostate-specific antigen (PSA) values,Gleason score at biopsy and preoperative good potency (IIEF-5 score)(P ＞0.05).Continence was defined as zero to one security pad per day.The three groups were compared for perioperative variables,PSM (positive surgical margin,PSM)rate,postoperative urinary continence functional and potency (IIEF-5 score).Biochemical recurrence-free survival was by Kaplan-Meier and log-rank.Results No differences were found in the three groups in terms of operative times,blood loss,catheterization time and postoperative stay and histologic status (PSM was similar to that of the groups (8.5％ in group A,13.0％ in group B vs.11.1％ in group C).Urinary incontinence:group A,the continence rate was 71％,82％,92％ and 100％ at 1,3 and 6 months after catheter removal,respectively;group B,the continence rate was 63％,80％,89％ and 96％ respectively;group C,it was 24％,54％,79％ and 86％ respectively.The group A showed a significantly earlier recovery from incontinence compared with that in the group C at immediately after catheter removal and 1 month after catheter remove (x2 =27.47,P ＜ 0.001;x2 =15.20,P ＜ 0.01).The group B showed a significantly earlier recovery from incontinence compared with that in the group C at immediately after catheter removal and 1 month,(x2 =17.00,P ＜ 0.01;x2 =8.20,P ＜ 0.05).No differences were found between the A and B groups at immediately after catheter removal and 1 month,(P ＞ 0.05).Regarding sexual function,at the postoperative 1,3,6 months,median IIEF-score was 10,11,16 in the group A,respectively,8,9,13 in the group B respectively,and 7,8,12 in the group C respectively.No differences were found in the three groups in potency (IIEF-5 score).Baseline IIEF-score was reached by 53％,35％ and 21％ at postoperative 6 months.There were significant differences between the A and the C groups.(x2 =13.45,P ＜0.01).There were no significant differences between the A and the B groups.(x2 =3.30,P ＞ 0.05).Follow-up was 31.6 (6-69) months.Biochemical recurrence-free survival at 3 years was 79.3％,76.3％ and 76.4％ by A,B and C group,respectively.Conclusions The pubovesical complex preserving technique for laparoscopic radical prostatectomy provides early recovery from incontinence,faster recovery of sexual function preoperative levels.

Objective:To investigate the clinical features of patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis misdiagnosed as mental disorder, improve the early diagnosis rate and reduce misdiagnosis.Methods:The clinical data of patients with anti-NMDA receptor encephalitis diagnosed at the First Affiliated Hospital of Zhengzhou University from 2012 to 2018 were collected. Patients misdiagnosed as mental disorders were screened out. Their psychiatric symptom characteristics, disease course characteristics, imaging and laboratory findings, treatment and prognosis were retrospectively analyzed.Results:A total of 121 cases of anti-NMDA receptor encephalitis were collected, and 43 cases of mental disorders were screened out. Sixteen of the 43 patients (37.2%) had prodromal symptoms, and all the patients had psychiatric behavioral abnormalities (100%), including 32 cases (74.4%) of seizures, 13 cases (30.2%) of decreased level of consciousness, 21 cases (48.8%) of involuntary movements, 15 cases (34.9%) of decreased memory, 8 cases (18.6%) of speech dysfunction, and 8 cases (18.6%) of other neurological symptoms (central hyperventilation, autonomic dysfunction). Memory loss was observed in 15 cases (34.9%), speech dysfunction in 8 cases (18.6%), other neurological symptoms (central hypoventilation, autonomic dysfunction) in 8 cases (18.6%), and various symptoms may appear simultaneously or successively in the same patient. Thirty-eight cases had complete resolution of symptoms or only minor physical impairment, and 5 cases had recurrent admissions with mental abnormalities and seizures. The recurrence rate accounted for 11.6% (5/43).Conclusions:The clinical manifestations of anti-NMDA receptor encephalitis are complex and varied. Most of them have mental behavior abnormalities as the first symptom, which is easily misdiagnosed as mental disorder and delayed treatment will lead to prolonged disease course and poor prognosis.

Objective To explore the reasons for platform-switching abutment fracture,the treatment and prevention methods.Methods Between March 2009 and December 2014,all of the fractured platform-switching abutments were evaluated.The fracture rate of platform-switching abutments was calculated and the gender,age,implant site,implant size,abutment size,prosthetic type,loading time and crown materials were analyzed.Results A total of 2 487 platform-switching implants were placed during this period and 6 abutments were fractured.The fracture rate was 0.24％ (6/2 487).All of the 6 fractured abutments were placed in molar region.All occlusal planes were made of metal material.Five patients were male.All the fracture abutments could not be removed and the implants had to be removed and reimplanted.Conclusions Without special abutment removing instruments,it is difficult to remove the fractured platform-switching abutment.In molar region,platform-switching implant system should be carefully used.Increasing implants number and splinting crowns with porcelain occlusal planes might reduce the abutment fracture risk.