Congenital absence of major salivary glands is a sort of infrequent salivary glands abnormality.This disease can be diagnosed by nuclide raster display and its anatomy image can be identified by CT or MRI.We reviewed the etiological factor,clinical situation,diagnosis and therapy of this disease,and pointed out that gene and development checks are necessary to classify it as a hereditary disease.

After several thousand years of development,TCM has formed its own sets of research methods.such as observation,comparison,classification,trial and error,and deduction,etc.Based on the unique TCM theory,experiences of clinical diagnosis and treatment of TCM,the author put forward that the research of TCM should combine macrophenomenon and microphenomenon,quality and quantity,and"Zheng"and"Xie",emphasize locality feature for the purpose of promoting the science research level.

Objective:To assess the clinical efficacy of two different diameter Osstem MS one-stage implant restoration of small edentu-lous space in the mandibular anterior region.Methods:85 patients were treated by Osstem MS one-stage implant with the diameter of 2.5 mm(n =66)and 3.0 mm(n =66)respectively for the restoration of small edentulous space in mandibular anterior region.The mesi-al and distal marginal bone level and soft tissue were statistically analyzed after 1 2 and 24 months of functional load.The implant survival rate was evaluated according to Wheeler's survival criteria.Results:The survival rate of the implants was 1 00%.The mean changes in marginal bone level(mm)on the mesial side of 2.5 mm and 3.0 mm diameter implants were 0.275 ±0.638 and 0.098 ±0.31 9,distal aspects were 0.360 ±0.588 and 0.1 09 ±0.323 after 1 2 months of functional load;while 0.299 ±0.672 and 0.099 ±0.31 8,0.381 ± 0.581 and 0.1 07 ±0.31 9 after 24 months of functional load.The mesial and distal marginal bone loss of 2.5 mm diameter implant was greater than that of 3.0 mm after 1 2 and 24 months of functional load(P <0.05).No significant change on the marginal bone level was found aomog the same diameter implants from 1 2 to 24 month observation(P >0.05).No relevant complication of peri-implant soft tissue was shown.Conclusion:Favorable clinical effects including function and aesthetics can be achieved by Osstem MS one-stage implant with the diameter of 2.5 mm or 3.0 mm for the restoration of small edentulous space in the mandibular anterior region,however,the mar-ginal bone loss was greater around 2.5 mm diameter implant.

Objective To explore the value of combining Uniplate anterior cervical plate system with titanium cage to treat single level cervical spondylotic myelopathy. Method Observing the clinical outcome and X-ray results of 32 patients with cervical spondylotic myelopathy undergone anterior decompression, autograft fusion and internal fixation with Uniplate anterior cervical plate system and titanium cage. Results All patients were followed up for 3 to 12 months. According to bony fusion criteria,no implants breakage, dislocation or loosening was found in all cases in 3 months' postoperatively radiological review. According to Odom classification,excellent outcome was 27 patients, good was 5 patients, the excellent and good rate was 100%(32/32). Conclusions Combining Uniplate anterior cervical plate system with titanium cage to treat single level cervical spondylotic myelopathy has advantages of easy manipulation,safe, less complication and higher fusion rate. It is an ideal way for cervical anterior fixation.

Arterio-Arterial Fistula ; complications ; Coronary Artery Disease ; complications ; Coronary Stenosis ; complications ; Female ; Humans ; Middle Aged

Objective To analyze the common respiratory tract infection pathogens distribution and their drug resistance in pedi-atric cardiac intensive care unit(CICU),so as to provide reference for clinical rational use of antibiotics.Methods 1 350 cases of sputum specimens from lower respiratory tract infection patients of pediatric CICU in the medical center between January 2011 and December 2012 were cultivated and drug susceptibilities were tested.The results were retrospectively analyzed.Results 490 patho-genic strains were isolated from 1 350 cases of sputum specimens and identified,including Gram negative bacilli 288 strains (58.78%),Gram positive coccus 140 strains(28.57%),fungi 62 strains(12.65%,mainly Candida albicans ).Gram negative bacilli was given priority to with Klebsiella pneumoniae (62 strains,12.65%),followed by Branhamella catarhalis ,Pseudomonas aerugi-nosa and Escherichia coli .The rates of extended-spectrum beta-lactamases(ESBLs)-producing strains among Escherichia coli and Klebsiella pneumoniae were 73.33% and 66.13%,respectively.Gram positive coccus was given priority to with Staphylococcus aureus (65 strains,13.27%),followed by Streptococcus pneumoniae .Methicillin-resistant Staphylococcus aureus (MRSA)accounted for 24.62%.Conclusion Staphylococcus aureus ,Streptococcus pneumoniae and Klebsiella pneumoniae are main pathogens of re-spiratory tract infection in pediatric CICU.And there is multiple drug-resistant bacteria infection.Rational applicattion of antibiot-ics according to the test results of isolation and drug susceptibility is an effective way to control the infection of critical children and reduce the emergence of resistant strains.

BACKGROUND:At present, vertebroplasty and spinal canal decompression are common methods for treatment of metastatic spinal tumors. Iodine-125 (125 I) radioactive seed implantation has been shown to control the tumor. However, there were few clinical studies on combined therapy using above-mentioned methods. OBJECTIVE:To compare the differences of 125I radioactive seed implantation combined with vertebroplasty and titanium al oy nail-rod fixation and vertebroplasty combined with titanium al oy nail-rod fixation for treating thoracolumbar metastases on pain control, general performance and improvement of the spinal cord function, and to evaluate clinical value of 125 I radioactive seed implantation combined with therapeutic plans. METHODS:Thoracolumbar metastases patients undergoing titanium al oy nail-rod fixation were selected in the Department of Spinal Surgery, Shenzhen Municipal People’s Hospital in China from October 2009 to March 2013. They were assigned to experimental and control groups according to with or without 125 I radioactive seed implantation. Improvement in neurological function was observed before and 2 weeks, 1, 6, and 12 months after titanium al oy nail-rod fixation in both groups. RESULTS AND CONCLUSION:Al patients were fol owed up for 7 to 29 months, averagely 15.8 months. There was no loosening of titanium al oy nail-rod fixation and the position of bone cement was good. No seed migration or radioactive spinal cord injury was observed. No relapse or diffusion in the surgical site was observed during fol ow up. Visual Analogue Scale and Karnofsky Performance Status scores were higher in the experimental group than in the control group (P<0.05). Frankel level was obviously improved after fixation in both groups compared with preoperation. No significant difference in the improvement of neurological function was detected between the two groups (P>0.05). Results indicated that 125 I radioactive seed implantation combined with vertebroplasty and titanium al oy nail-rod fixation for treatment of metastatic spinal tumors showed obvious outcomes in relieving cancer pain.

Objective To compare and analyze the occurrence of delayed cerebral ischemia(DCI)after coiling and clipping of intracranial aneurysms, and explore the risk factors of DCI. Methods A total of 236 patients with aneurysms diagnosed by CT angiography (CTA) or digital subtraction angiography (DSA) in Department of Neurosurgery, Tianjin Medical University General Hospital were enrolled in this study from March 2011 to May 2014. Patients were divided into clipping group(n=135) and coiling group(n=101). The clinical characteristics were compared between two groups, including gender, age, medical history, GCS score, Hunt-Hess grade, Fisher grade, WFNS grade, aneurysm location, prognosis and incidence of DCI. Risk factors for DCI were investigated by Logistic regression analysis. Results DCI was occurred in 36 patients (26.7%) underwent clipping operation while in 11 patients (10.9%) underwent coiling operation. The incidence was significantly higher in clipping group compared with that of coiling group (P <0.01). The patients were followed up for 6 months. The poor prognosis rates were 17.0%and 25.7%in clipping group and coiling group, respectively (P>0.01). The overall mortality was 11.0%, the former had a lower mortality rate (5.9% vs. 17.8%, P <0.01). According to Logistic regression analysis, Fisher Grade 3-4, postoperative pulmonary infection and surgical procedure were independent risk factors for DCI (P<0.01). Conclusion DCI is one of the most significant factors for high fatality and morbidity of postoperative aneurysm patients. There is a low occurrence of DCI after coiling compared with that of clipping. If we pay more attention to risk factors associated with the DCI, it will improve the prognosis of postoperative aneurysm patients greatly.

Objective To find a selection method system appropriate for China's essential drug list.Methods Collection and analysis of technical paper literature on essential drug list developement,adjustment technical papers,and literature on evidence-based medicine,pharmacoeconomics evaluation,and medical insurance budget analysis from WHO and other countries.On such basis,a method system for selecting China's essential medicine list can be proposed,with its feasibility analyzed and demonstrated.Results The GRADE assessment proposed by WHO was used to evaluate the efficacy and safety of the drug;the pharmacy economics evaluation is added to assess the economic efficiency;these were aided by the pharmacoeconomics evaluation for a comprehensive evaluation of the pharmacoeconomics of the drug in question,supplementing analysis of the medical insurance,and ensuring its affordability of essential medicine so selected.The theory of this system is well developed,and supporting software ready for application.Examples in Zhejiang Province regarding essential medicine for diabetes have proved this method feasible.Data acquisition constitutes a major roadblock for scientific selection due to barriers against medical insurance data sharing.Conclusions Theoretic basis and method tools are fully available for essential medicine selection,and the selection method system as proposed in this study prove feasible to some extent.Decision makers are recommended to scientifically select the essential drugs,and to encourage data sharing,in order to make the list more scientific and pragmatic.

Objective To investigate the protective effect and possible mechanism of adiponectin (ADPN) and its receptors in diabetic nephropathy (DN). Methods A total of 64 Sprague-Dawley female rats were equally divided into diabetes mellitus (DM) group with streptozotocin(STZ) 60 mg/kg injection, and normal control (NC) group with the same dose of citric acid buffer randomly. At the end of 2, 6, 10 and 12 weeks, weight, fast blood glucose, 24-hour urinary albumin excretion, serum creatinine and serum fast blood insulin were measured. The level of adiponectin in urine and serum was examined by ELISA. The pathological change of kidney tissue was studied by periodic acid-Schiff's staining (PAS) and the expression of adiponectin receptor 1 (adipoR1), adiponectin receptor 2 (adipoR2) was determined by immunohistochemistry.The NRK-52E cells were cultured with 5 mmol/L glucose (control group), 30 mmol/L glucose (high glucose group), 30 mmol/L glucose+different concentrations of adiponectin (1 mg/L, 5 mg/L, 10 mg/L, ADPN groups), respectively. The mRNA expression of monocyte chemoattractant protein 1 (MCP-1) was measured by RT-PCR after 12 h. Results (1)Both in urine and serum, the levels of ADPN in DM group were higher than that in NC group after 6 weeks (P＜0.01) and increased gradually during the whole experiment. (2)Compared with NC group, the expressions of AdipoR1 and AdipoR2 in kidney tissues were elevated gradually in DM group. There was a significant positive correlation of ADPN with AdipoR1 and AdipoR2 in DM group(r=0.666, P＜0.01;r= 0.684, P＜0.01). (3)The expression of MCP-1 increased in high glucose group, but decreased in 1 mg/L, 5 mg/L, 10 mg/L adiponectin group. Conclusions The level of ADPN in urine and serum is positively correlated with its receptors and elevates with the process of diabetic kidney disease. High level of serum adiponectin plays a protective role through the direct action of AdipoR and the alleviation of MCP-1 expression in renal tubules.