Objective By observing the incidence of postoperative hyperalgesia in patients with total intravenous anesthesia,to study the effects of different anesthesia depth on postoperative hyperalgesia.Methods Forty gynecologic patients undergoing open lower abdominal operation were randomized into two groups (n=20): group B1 with BIS 40-49 and the group B2 with BIS 50-59.Anaesthesia was induced and maintained with intravenous anesthetics.The threshold of haphalgesia and the range of mechanical hyperalgesia were measured before operation.The consumption of the intravenous anesthetics,the emergence time and the extubation time were recorded.The vital signs were recorded at eight time points: pre-aneasthesia (T0),abdominal exploration (T1),the end of operation (T2)and 1 h (T3),4 h (T4),12 h (T5),24 h (T6),48 h (T7) after extubation.The VAS scores at T3-T7 were recorded.The PCA dosage of analgesic and superaddition in postoperative 24 h and 48 h were recored.The Von Frey Hairs were used to assessed the threshold of haphalgesia and the range of mechanical hyperalgesia at T6 and T7.Results The MAP at T6 and T7 and the VAS scores at T6 of the group B1 were lower than those of the group B2 (P<0.05).The range of mechanical hyperalgesia at T7 of the group B1 was narrower than that of the group B2 (P<0.05).Conclusion Maintaining the anesthesia depth within BIS 40-49 can reduce the body′s stress reaction,decrease the incidence of postoperative hyperalgesia and accelerate the recovery time of mechanical hyperalgesia in postoperative 48 h.

BACKGROUND:Interproximal contact loss is a complication of posterior crown/bridge restorations with a higher incidence, and it is induced by a variety of factors, such as age, tooth position, occlusal contact, tooth loss time, whether there is a repair on the free end.OBJECTIVE:To study and analyze the loss of interproximal contact between posterior crown/bridge restorations and adjacent teeth.METHODS: This was a single-center, prospective, observational clinical trial which has been completed at the Stomatology Hospital Affiliated to Southwest Medical University, China. Totaly 82 patients who had underwent posterior crown/bridge restorations from June 2015 to June 2016 in the Stomatology Hospital Affiliated to Southwest Medical University were selected. The time of denture wearing was 1-40 months, and the interproximal contact loss was defined by a 30 μm adjacent contact check or a flossing that can pass through the detection area with no resistance. Single-factor analysis and multiple correlation analysis were performed to analyze the interproximal contact loss at 1, 3, 6 months after posterior crown/bridge restorations. The study protocol was approved by the Ethics Committee of the Stomatology Hospital Affiliated to Southwest Medical University of China with an approval number of 2016024. All protocols were in accordance with Declaration of Helsinki, formulated by the World Medical Association. All patients and their relatives were informed of study protocols and provided a written informed consent prior to the beginning of the trial.RESULTS AND CONCLUSION:Of the 82 patients enroled, there were 41 adjacent contact zones with the emergency of interproximal contact loss, including 20 maxillary and 21 mandibular. It indicated that the interproximal contact loss had no association with the upper and lower jaw. Single-factor analysis showed that the time of denture wearing, tooth loss time and repair of the free end were confirmed as independent influencing factors for the complications (P < 0.05). Multiple correlation analysis found that free end repair and short-term tooth loss were independent factors of the interproximal contact loss. To conclude, free end repair and tooth loss time should be considered in the posterior crown/bridge restorations in order to minimize the occurrence of interproximal contact loss.

BACKGROUND: Three-dimensional printing to prepare a digital model can improve the accuracy of orbital fracture repair, and has a good clinical prospect.OBJECTIVE: To evaluate the effect of individualized titanium mesh based on the digital model in the reconstruction of orbital fracture.METHODS: Twelve cases of orbital fracture were admitted at the Hospital of Stomatology, Southwest Medical University from January 2014 to October 2015. CT scanning in axial, coronal, sagittal planes and three-dimensional reconstruction were performed routinely in all cases preoperatively. Digital model was designed by 3D printing technology according to the CT data. Individualized titanium mesh was shaped based on the digital model and used to repair orbital fracture. The accuracy of the reconstructed orbit was assessed based on the postoperative CT scan.RESULTS AND CONCLUSION: Postoperative CT scans showed that the implanted individualized titanium meshes were capable of accurately reconstructing the fractured orbit in all the 12 patients, and there was no infection, and titanium mesh loosening, prolapse, and rejection. With healthy eyes as controls, 11 cases of eyeball retraction were corrected completely, and only 1 case was still under correction. Diplopia symptoms disappeared in the 8 of 9 cases, and relieved in the 1 of 9 cases. Seven cases of eye movement limitation recovered postoperatively. To conclude, the individualized titanium mesh has great accuracy to repair orbital fractures in patients without serious complications,which has achieved good clinical outcomes in the orbital reconstruction.

OBJECTIVEThis study aims to evaluate the effect of customized titanium mesh, which was designed by mirror imaging and rapid prototyping technique, with Medpor applied for orbital fracture with enophthalmos.

METHODSOrbital axial, coronal, and sagittal CT scan, and three-dimension CT examination were performed routinely in. 18 cases of orbital fracture with enophthalmos preoperatively. Based on the CT data, prosthesis model was designed by reverse engineering and rapid prototyping technique. The customized titanium mesh and Medpor were applied for orbital reconstruction and enophthalmos correction. Orbital reduction and globe projection were evaluated by postoperative CT scan and clinical follow-up visits.

RESULTSCT scans revealed that the customized titanium mesh with Medpor had great accuracy to reconstruct the orbital fracture and correct the enophthalmos in all patients without serious complications. The eye and facial appearance and function recovered significantly. No serious complication occurred in the operation and after operation.

CONCLUSIONThe customized titanium mesh, based on mirror imaging and rapid prototyping technique, can accurately reconstruct the orbital fractures with enophthalmos. The application of Medpor can effectively correct enophthalmos and eyeball mobility malformation.

Enophthalmos ; therapy ; Facial Bones ; Humans ; Orbit ; Orbital Fractures ; surgery ; Polyethylenes ; Postoperative Period ; Prostheses and Implants ; Reconstructive Surgical Procedures ; Surgical Mesh ; Titanium ; Tomography, X-Ray Computed

Objective To explore the short‐term effect of chronic periodontitis patients after implant treatment .Methods Selected 60 cases of tooth loss in chronic periodontitis patients as research group ,a total of 75 implants were placed ,and 50 cases of periodontal healthy teeth missing patients as control group ,a total of 67 implants were placed .Compared two groups of modification sulcus bleeding index(mBII) ,papilla index score(PIS) ,modification plaque index(mPLI) and probing depth(PD) 6 months after op‐eration ,and detected implant sulcular fluid IL‐2 ,IL‐8 content in two groups before and after operation .Results Research group 75 implants had 2 off on their own ,implant loosening degrees 0 ,implant survival rate was 97 .3% ;the control group had no implant failure ,implant loosening of implant survival rate was 100% ,two groups of implant survival rate was no significant difference(χ2 =2 .737 ,P= 0 .098) .The mSBI ,PIS ,mPLI ,PD in research group and control group had no statistically significant(P > 0 .05) .Re‐search group sulcular fluid IL‐2 ,IL‐8 content was significantly higher than those in control group before and after the operation (P< 0 .05) .Conclusion The short‐term effect of implant treatment in chronic periodontitis patients is satisfactory ,without increas‐ing the risk of peri‐implantitis ,and worth of clinical promotion .

BACKGROUND: Apical sealing ability is the key to ensure the long-term curative effect of root canal therapy. The post space preparation exposes some inevitable influence on root canal sealing ability, so how to minimize this effect becomes a hot spot.OBJECTIVE: To explore the effects of immediate or delayed post space preparation on the apical sealing ability of different root canal sealers.METHODS: Forty-eight extracted human premolar teeth were obtained, and the tooth crown was cut off. The samples were randomly divided into three groups (n=16 teeth per group). Group A underwent the immediate post space preparation; group B underwent the delayed post space preparation; group C without the post space preparation. Then all groups were subdivided into two groups, and then were filled with the gutta-percha/AH-Plus (groups A1, B1 and C 1)or the gutta-percha/mineral trioxide aggregate (groups A2, B2 and C2). The depth of apical dye penetration was measured using pressure-driven system. RESULTS AND CONCLUSION: There were no significant differences in the apical microleakage between groups A1 and B1, A2 and B2, C1 and C2 (P > 0.05). The apical microleakage in the group A1 was significantly higher than that in the group A2, and the group B1 also showed higher apical microleakage than the group B2 (P < 0.05). Our findings suggest that either immediate or delayed post space preparation exposes little influence on the apical microleakage after root canal filling with gutta-percha/mineral trioxide aggregate, which exhibits better apical sealing ability than the AH-plus.

BACKGROUND: At present, there is no consensus on the timing of post space preparation in the clinical medical treatment. But it can be inferred from some studies that post space preparation may affect coronal microleakage using different fil ing materials. OBJECTIVE: To compare the effects of immediate post space preparation and delayed post space preparation restoration on coronal microleakage using different fil ing materials. METHODS: Forty-eight extracted and single-rooted premolars were randomly divided into six groups (n=8 per group): premolars were fil ed with AH-plus paste and gutta-percha with the immediate post space preparation as group A1; premolars fil ed with mineral trioxide aggregate paste and gutta-percha with the immediate post space preparation as group A2; premolars fil ed with AH-plus paste and gutta-percha with the delayed post space preparation 1 week later as group B1; premolars fil ed with mineral trioxide aggregate paste and gutta-percha with the delayed post space preparation after 1 week later as group B2;premolars fil ed with AH-plus paste and gutta-percha as negative control group; premolars fil ed with gutta-percha as positive control group. Afterwards, al specimens were soaked for 4 weeks under simulated oral environment to measure the length of coronal microleakage by pressurized dye penetration method. RESULTS AND CONCLUSION: No coronal microleakage was found in the negative control group, but serious coronal microleakage occurred in the positive control group involving the entire root canal. And there was no significant difference in the length of coronal microleakage between group A2 and B2, as wel as between group A1 and A2 (P > 0.05); but the length of coronal microleakage in the group A1 and B2 was significantly less than that in the group B1 (P < 0.05). These results show that the delayed post space preparation has overt effect on the coronal microleakage of root canal fil ed with AH-plus paste.

Objective To discover regularities behind critical values in an effort to provide scientific evidences for a better critical value report system.Methods Collection, analysis and statistical assessments for critical value items and ranges appropriate for the hospital Results The occurrence rate of critical values is found to be 0.14%.By means of clinical evaluation, statistic analysis and reference to literature and clinical specialists, the clinical labs revised the ranges of PO2, GLU, PT and APTT, and added ALT, MYO, CTnl and K+ , GLU, BILl for newborns, and canceled AMY.All of these changes were put in practice upon approval of the Medical Department of the hospital Conclusion Regular evaluation and continuous improvement of the critical value report system may help with saving lives, improving quality of care of the labs and doctors" diagnosis as well

Objective To evaluate the role of caspase-1 in the spinal cord in a rat model of incisional pain.Methods Eighteen adult male Sprague-Dawley rats,weighing 250-280 g,in which intrathecal catheters were successfully implanted,were divided into 3 groups (n =6 each) using a random number table:incision pain group (group Ⅰ),incision pain plus dimethyl sulfoxide group (group ID) and incision pain plus caspase-1 inhibitor (Ac-YVAD-CMK) group (group IA).At 10 min before establishment of the model,0.9％ normal saline 20 μl was intrathecally injected in group Ⅰ,dimethyl sulfoxide 20 μl was intrathecally injected and then the catheter was washed with 0.9％ normal saline 10 μl in group ID,and Ac-YVAD-CMK 1 nmol/μl (dissolved in 20 μl dimethyl sulfoxide) and then the catheter was washed with 0.9％ normal saline 10 μl in group IA.The mechanical paw withdrawal threshold (MWT) of the ipsilateral hind paw was measured at 2 h before intrathecal catheterization (T0),3 days after intrathecal catheterization (T1) and 2,6,24 and 48 h after establishment of model (T2-5).The rats were sacrificed after the last measurement of pain threshold at T5,and lumbar enlargement segments of the spinal cord were removed for detection of caspase-1 (p20) expression and interleukin-1beta (IL-1β) content by Western blot and enzyne-linked immunosorbent assay,respectively.Results Compared with the baseline at T0,the MWT was significantly decreased at T2-5 in Ⅰ and ID groups (P＜0.05),and no significant change was found in MWT at T1-5 in group IA (P＞0.05).Compared with Ⅰ and ID groups,the MWT at T2-5 was significantly increased at T2-5,and the caspase-1 (p20) protein expression and IL-1β content were decreased in group IA (P＜0.05).There was no significant difference in MWT,expression of caspase-1 (p20) protein or IL-1β content between group Ⅰ and group ID (P＞0.05).Conclusion The activation of caspase-1 in the spinal cord can promote the release of IL-1β and thus is involved in the incision pain in rats.

Objective:To evaluate the relationship between immunoglobulin heavy chain-binding protein (BIP) and Na v1.8 in peripheral nerve in a rat model of neuropathic pain. Methods:Forty-four SPF healthy male Sprague-Dawley rats, weighing 210-260 g, were used in this study.Neuropathic pain was induced by chronic constriction injury (CCI) in anesthetized rats.The experiment was performed in two parts.Experiment Ⅰ Twenty rats were divided into 2 groups ( n=10 each) using a random number table method: sham operation group (group Sham) and group CCI.Experiment Ⅱ Twenty-four rats were divided into 3 groups ( n=8 each) using a random number table method: sham operation group (group Sham), CCI plus normal saline group (group CCI+ NS) and CCI plus BIP inhibitor HA15 group (group CCI+ H). Starting from 4th day after surgery, 0.9% normal saline 1 ml was intraperitoneally injected in group CCI+ NS, and HA15 0.7 mg/kg was intraperitoneally injected in group H, once a day for 3 consecutive days.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before surgery and 3, 5 and 7 days after surgery (T 0-T 4), and the expression of BIP and Na v1.8 in dorsal root ganglion (DRG) and sciatic nerve was detected by Western blot on 7th day after completion of behavioral testing in two groups.The expression and colocalization of BIP and Na v1.8 in DRG and sciatic nerve were determined by immunofluorescence on 7th day after completion of behavioral testing in group Ⅰ, and the interaction between BIP and Na v1.8 was evaluated by co-immuno-precipitation. Results:Experiment Ⅰ Compared with group Sham, the MWT was significantly decreased, and TWL was shortened at T 1-T 4, the expression of Na v1.8 in DRG was down-regulated, the expression of BIP was up-regulated, and the expression of Na v1.8 and BIP in sciatic nerve was up-regulated in group CCI ( P<0.05), and BIP and Na v1.8 on the sciatic nerve were co-localized, BIP could co-precipitate Na v1.8 from DRG, and Na v1.8 could also coprecipitate BIP in group CCI.Experiment Ⅱ Compared with group Sham, the MWT was significantly decreased, and TWL was shortened at T 1-T 4, the expression of Na v1.8 in DRG was down-regulated, the expression of BIP was up-regulated, and the expression of Na v1.8 and BIP in sciatic nerve was up-regulated in group CCI+ NS ( P<0.05). Compared with group CCI+ NS, the MWT was significantly increased, and TWL was prolonged at T 3, 4, and the expression of Na v1.8 in DRG was down-regulated in group CCI+ H ( P<0.05). Conclusion:BIP can mediate the redistribution of Na v1.8 in peripheral nerve and is involved in the pathophysiological mechanism of neuropathic pain in rats.