Objective To investigate the influence of blood pressure level on carotid intima‐media thickness (CIM T ) and plaque in elderly patients with coronary heart disease(CHD) .Methods 100 elderly CHD patients with hypertension admitted in our hospital from Jan .to Dec .2012 was collected .an epidemiological investigation was applied ,and blood pressure was measured .carotid CIMT and plaque were determined by colored Doppler ultrasound .multivariate linear regression model or Logistic regression model was used to analyze the effect of blood pressure on CIMT and plaque .Results A total of 100 subjects were enrolled .CIMT and plaque prevalence were (0 .7 ± 0 .1)mm ,45 .8% in 48 males and (0 .7 ± 0 .1)mm ,34 .6% in 52 females .the difference was statisti‐cally significant(χ2 =5 .609 ,P=0 .018) .multiple regression models showed that ,after adjusting relevant factors ,CIMT increased 0 .001 14 mm with SBP 1 mm Hg increase and CIMT increased 0 .001 18 mm with pulse pressure 1 mm Hg increase in males .Lo‐gistic regression model showed that the risk of plaque number >1 was higher in grade Ⅲhypertension compared to grade 1 hyper‐tension(OR= 2 .115 ,95% CI= 1 .128~ 3 .966 ,P= 0 .020) .Conclusion Elderly CHD patients with hypertension ,especially in males ,carotid CIMT increase while systolic BP and high pulse are high ,which cause the high risk of carotid artery plaque;hyperten‐sion is a independent risk factor for atherosclerosis in elderly CHD patients .

Objective To compare the outcomes of Yang-Monti channels and appendix in the practice of catheterizable continent urinary conduits.Methods Retrospective analyses were conducted in 27 cases with neurogenic bladder from July 2009 to December 2015,including 8 male and 19 female patients whose average age at surgery was 7.6 years old (range:1.5-16 years).The average bladder volume is (203.8 ± 126.0) ml.The bladder compliance values of 24 cases are lower than 20 ml/cm H2O.Seventeen cases had urinary infection combined with fever before surgery,while 6 cases had stress urinary incontinence and 17 cases had dysuria.Seven cases including 2 male patients underwent urinary diversion with YangMonti channels (YM group) and the average age at surgery for patients was 6.7 years old (range:4-16years).Twenty cases including 6 male patients underwent urinary diversion with appendix (AP group) and the average age at surgery for patients was 8.0 years old(range:1.5-14 years).The 3-day urinary diaries were collected in all cases including their records of average catheterization interval,average catheterization volume,stoma stenosis and stoma leakage.The data between the two groups was compared and the statistical analysis was performed.Results Of the 7 patients undergoing Yang-Monti channels,2 cases underwent open surgery and 5 cases underwent laparoscopic surgery in which 2 cases transferred to open surgery.The stoma stenosis occurred in 1 case and the stoma leakage occurred in 1 case.The average catheterization volumc is (239.3 ± 76.2) ml and the average catheterization interval is (2.8 ± 0.9) h.Six patients in the group were followed up less than 3 years,of which the average catheterization interval is (2.6 ± 0.8) h.Of the 20 patients undergoing appendix channels,3 cases underwent open surgery and 17 cases underwent laparoscopic surgery in which 1 case transferred to open surgery.The stoma stenosis occurred in 1 case and the stoma leakage occurred in 2 cases.The average catheterization Volumee is (257.0 ± 67.4) ml and the average catheterization interval is (3.9 ± 0.9)h.Six patients in the group were followed up less than 3 years,of which the average catheterization interval is(3.5 ± 1.0) h.There was no difference in stoma stenosis and stoma leakage and average catheterization volume between the two groups (P ＞ 0.05).There was no difference in average catheterization interval between the patients of two groups who were followed up less than 3 years (P ＞ 0.05).Conclusions Yang-Monti conduits are durable and reliable,which was similar with appendix conduits.

OBJECTIVE:To recommend a monitoring system,Prescription Automatic Screening System(PASS)for rational drug use in clinic in order to improve the rationality of drug use.METHODS:1 200 hospitalization case files were randomly selected,96 800 medical orders of medications were monitored by PASS,and the results were analyzed statistically.RESULTS:The total rate of irrational drug use was 2.28%,among which the drug interaction counted for 88.46%and drug incompatibility 11.54%.CONCLUSION:PASS can efficiently monitor the irrational drug use in medical order,hence prevent and reduce adverse drug reactions,therefore it should be widely used in clinic.However,PASS has some limits and needs further improvement.

ObjectiveTo analyze the homology of Citrobacter freundii strains and detect multidrug resistant genes.MethodsThe minimum inhibition concentration was tested with standard agar dilution method and the the homology of C.freundii strains was measured with pulsed field gel electrophoresis (PFGE) and the PCR was used to perform the drug resistant genes such as β-lactamase,disappearing of outer membrane channel protein.ResultsThe four strains ( No.1,2,4,5 ) showed nineteen banding patterns with PFGE.PCR experiment showed that there were 2 strains (No.1,4) with blaCTX-M,3 strains (No.2,3,5 ) with blaDHA,1 strains(No.3) with blaACT/MIR,and 4 strains(No.1,2,4,5) with blaKPC-2.PCR analysis comfirmed that No.2 and No.4 disappearing of OmpF and No.3 disappearing both of OmpC and OmpF.The expression levels of the chromosomal ampC gene of No.3 isolates was 106.7 times higher than the negative isolates.ConclusionThere is high homology in carbapenem-resistant isolates and the mechanism of drug resistance is complex including blaKPC,AmpC,ESBLs,disappearing of outer membrane channel protein.The spreading of drug resistance result from above genes.

This paper is to report our study in which the differences between prosthetic restoration and surgical reconstruction using traditional clasp retention technology were analyzed based on three-dimensional finite element methods in our laboratory. Firstly, the maxillary unilateral defect model was developed using medical image processing software MIMICS. Secondly, the prosthesis was generated by mirroring technology. The clasp was designed according to the methods raised by Aramany. Then, the stress distribution of maxilla was calculated by simulating occlusion. According to the results, after osseointegration of surgical reconstruction, stresses of unaffected abutments were reduced significantly, and less stress of junction occurred near zygoma of affected side, which were all less than stresses of prosthesis restoration. Thus, removing the clasp of surgical reconstruction increased the stresses of unaffected abutments. The stress trends of maxillary components were different between prosthetic restoration and surgical reconstruction. Surgical reconstruction is better than prosthesis restoration in protection of the abutments. Clasp can alleviate the occlusal burden of maxilla. Varieties of retentive technologies can be considered in prosthesis restoration. The surgical reconstruction is more conducive to rehabilitate unilateral maxilla biomechanically in clinic.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Image Processing, Computer-Assisted ; Mandibular Reconstruction ; methods ; Maxilla ; surgery ; Maxillofacial Prosthesis ; Osseointegration ; Zygoma

Objective To discuss the influence of grading nursing care by physician-nurse cooperation decision-making on the quality of patient care and disease outcomes,and evaluate the application feasibility of nursing core system in this nursing mode.Methods 379 patients were admitted to departments of orthopedics and endocrinology from two hospital areas of our hospital from January 2011 to January 2012.Patients were divided into two groups according to nursing process.Patients who were given conventional grading nursing were set as the routine group,and patients receiving physician-nurse collaboration grading nursing were set as the collaboration group.The nursing quality and nursing efficiency,and the disease outcome of patients were compared between the two groups.Results The quality of care,the qualified rate of care plan implementation,the coverage rate of health education of patients and the patient satisfaction rate were higher in the collaboration group than those in the routine group.The performing rate of doctor's orders,the awareness rate of patient disease,the average length of hospital stay,compliance of medical orders and re-admission rate of patients with the same or a related disease within three months were significantly different between two groups.The collaboration group improved the matching degree of nursing grade with disease condition,understanding of professional knowledge,recording of nursing records,deficient nursing process,and communication ability of life knowledge,compared with those of the routine group.Conchusions Nursing grading mode by physician-nurse collaboration decision-making can obviously improve the defmition of grading nursing and the general treatment effect of patients,it significantly improved the quality of grading nursing.

Objective To investigate the effect of insulin-like growth factor-1(IGF-1 ) on the osteogenic phenotype of fibroblasts. Methods Fibroblasts (Fbs) were derived from an adult New Zealand white rabbit through isolation,purification and cultivation.The experiment was conducted in 3 groups.In the control group,Fbs were cultured in conventional medium without any intervention factors.In the osteogenic induction group,the osteogenic induction medium was composed of conventional medium plus dexamethasone at concentration of 1 × 10-8 mol/L plus vitamin C at 50 mg/L plus sodium glycerophosphate-β at 10 mmol/L.In the experimental group,Fbs were cultured in osteogenic induction medium plus IGF-1 at the final concentration of50 ng/mL.Proliferation of Fbs in each group was detected by methyl thiazolyl tetrazolium (MTT)colorimetric assay.Alkaline phosphatase(ALP) activiiy was detected,osteocalcin 6 days after culture was determined,and the ability of osteogenic differentiation 2 weeks after culture was evaluated by calcium-cobalt staining. Results MTT showed that the cells grew significantly faster in the experimental group than in the other 2 groups( P ＜ 0.05),but there was no significant difference between the control group and the osteogenic induction group in this respect (P ＞ 0.05).The ALP expression in the experimental group was insignificantly higher than in the osteogenic induction group( P ＜ 0.05),but significantly higher than in the control group ( P ＜ 0.05).In osteocalcin secretory activity,the experimental group was significantly superior to the other 2 groups and the osteogenic induction group was significantly superior to the control group ( P ＜0.05).The experimental group had significantly more calcified nodules than the other 2 groups and there were few calcified nodules in the control group 2 weeks after culture. Conclusion IGF-1 can advance proliferation and osteogenic phenotype expression of the Fb stimulated.

Polydimethylsiloxane (PDMS) and hydroxyapatite (HA) were combined in our laboratory to fabricate an elastic porous cell scaffold with pore-forming agent, and then the scaffold was used as culture media for rat bone marrow derived mesenchymal stem cells (rBMSCs). Different porous materials (square and circular in shape) were prepared by different pore-forming agents (NaCl or paraffin spheres) with adjustable porosity (62%-76%). The HA crystals grew on the wall of hole when the material was exposed to SBF solutions, showing its biocompatibility and ability to support the cells to attach on the materials.
Animals ; Biocompatible Materials ; chemistry ; Dimethylpolysiloxanes ; chemistry ; Durapatite ; chemistry ; Mesenchymal Stromal Cells ; cytology ; Porosity ; Rats ; Tissue Scaffolds

OBJECTIVE:To systematically review the effect of ticagrelor versus prasugrel on platelet reactivity,and provide evi-dence-based reference for clinical treatment. METHODS:Retrieved from PubMed,CJFD and Wanfang Database,randomized con-trolled trials(RCT)about the effect of ticagrelor versus prasugrel on platelet reactivity were collected. Meta-analysis was performed by using Rev Man software after data extract and quality evaluation by Cochrane 5.1.0. RESULTS:Totally 17 RCTs were enrolled,involv-ing 2 757 patients. Results of Meta-analysis showed,regardless of Verity Now(VN)detection method [MD=15.43,95%CI(-0.39, 31.25),P=0.06] or vasodilator stimulus phosphoprotein(VASP)detection method [MD=-3.04,95%CI(-8.98,2.90),P=0.32], ticagrelor and prasugrel had the same effects on platelet reactivity under loading dose,the differences were not statistically significant;regardless of VN detection method [MD=-48.94,95%CI(-58.04,-39.84),P<0.001] or VASP detection method [MD=-14.32, 95%CI(-20.45,-8.20),P<0.001],the effects of ticagrelor were better than prasugrel on platelet reactivity under maintenance dose,the differences were statistically significant. CONCLUSIONS:At the loading dose,there was no difference between ticagrelor and prasugrel,but ticagrelor has more benefits than prasugrel under maintenance dose.

From alveolar bone and the complete dentition CT images, a three-dimensionalysis of nonlinear finite element model of mandibular unilateral distal-extension with extracoronal precision attachment was established. The contact elements were used between the denture and alveolar bone. The result shows that, the stress in the second premolar and periodontal tissue decreased obviously as the second abutment was added. However, the stress difference was unapparent as the third abutment was added. Considering various facts, the attachment with two abutments was suggested to be used. With the decrease of the periodontal tissue, the stress in the periodontal tissue increased, however the stress in the tooth changed slightly. Thestress in the periodontal tissue decreased effectively when the third abutment was added, as the tooth root was absorbed by 50%. In this situation, the extracoronal precision attachment can also be used.
Dental Stress Analysis ; Denture Precision Attachment ; Denture, Partial, Removable ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; methods ; Mandible ; diagnostic imaging ; physiology ; Models, Biological ; Tomography, X-Ray Computed