BACKGROUND: Several studies have demonstrated that the range,thickness and morphology of oral prosthesis directly influence patient's phonetic function,and titanium base and polymethyl methacrylate(PMMA)resin base yield different influences on phonetic function due to different thicknesses of materials.OBJECTIVE: To analyze the phonetic parameters in one complete denture patient who wear titanium base and PMMA resin base simultaneously and investigate the influences of maxillary complete denture base on phonetic function.METHODS: Through the use of computer-based voice analysis software PRAAT4.4.34,frequency value of the first concentrated frequency area when speaking consonant sounds/x,sh,r,zh,ch,j,q/and voice onset time when speaking consonant sounds/g,k,zh,ch,j,q/were statistically analyzed in the same patient who separately wear titanium complete denture base and PPMA resin complete denture base,and spectrogram of velar stops between complete denture bases was compared.RESULTS AND CONCLUSION: MMPA resin complete denture base was to some extent poor in promoting the recovery of phonetic function owing to great base thickness.Titanium complete denture base with less thickness in the tongue or palate region would help recovery of phonetic function.Extraction and analysis of phonological parameters,such as frequency value of first concentrated frequency area and voice onset time,using CSL computer*based voice analysis system,would provide objective evidence for lamprophony analysis after wearing complete denture.Maxillary denture with thinner base in tongue and palate regions better promotes the recovery of patient's phonetic function.

Objective To analyze the clinical features and prognosis of hyperglycemia and the relationship between the blood glucose level and the severity of disease in critically ill children.Methods A total of 349 critically ill children admitted in Pediatric Intensive Care Unit (PICU) from November 2009 to April 2010 were restrospectively analyzed.According to the levels of venous blood glucose within 24 h after admission,they were divided into very high level group (blood glucose ≥11.1 mmol/L,n =67 ),slightly high level group (blood glucose 6.3-11.1 mmol/L,n =134) and normal level group (blood glucose ≤6.3mmol/L,n =148).Blood glucose levels were measured within 24 hours,3 days and 7 days after admission.Electrolytes,inflammatory markers,cardiac enzymes,liver and kidney function as well as other biomarkers related to the severity and the prognosis of the patients were recorded after admission.The categorical variables were analyzed with Chi -squared test,the continuous variables were analyzed with t-test,F-test,U-test andH-test,and the correlation analysis was calculated by using Pearson Coefficients. Results In the very high level group,slightly high level group and normal level group,the average blood glucose levels were 16.98 ±7.08 mmol/L,8.25 ± 1.40 mmol/L and 4.89 ± 0.98 mmol/L ( P ＜ 0.01 ),respectively;and the Pediatric Critical Ⅲ Scores at admission were 81.22 ± 8.25,86.71 ± 6.40 and 86.15 ± 6.99 ( P ＜0.01 ),respectively,and the incidences of sepsis or septic shock were 55.23％,30.59％ and 14.18％,respectively (P ＜0.01 ),and the incidences of MODS were 46.26％,22.39％ and 16.23％,respectively (P ＜0.01 ).The blood glucose levels of patients with one organ failure and two organ failure were 8.27 ± 3.75 mmol/L and 8.88 ± 5.42 mmol/L,respectively ( P ＜ 0.05 ).The blood glucose levels of patients with two organ failure and multiple organ failure were 8.88 ± 5.42 mmol/L and 13.09 ± 8.23 mmol/L,respectively (P＜0.01).The mortality rates of three groups were 47.76％,14.93％ and 10.13％ (P ＜0.01 ),and the blood glucose levels at admission in survival group and death group were 7.57 ±4.11 mmol/L and 12.46 ± 8.17 mmol/L ( P ＜ 0.01 ).Conclusions Patients with hyperglycemia are often found in the PICU.It not only partially reflects the severity of the disease,but also serves as an important indicator for the prognosis.The blood glucose level is positively correlated to the number of compromised organs and the severity of the disease.Dynamic monitoring of blood glucose may be essential for controlling the symptoms and prediction of prognosis.

OBJECTIVEThe purpose of this study is to compare the fracture strengths of custom-fabricated Celay all-ceramic post-core, custom cast metal post-core, and prefabricated stainless steel post (Parapost) plus composite resin core with or without a 2.0 mm dentine ferrule.

METHODSA total of 60 recently extracted human maxillary central incisors were endodontically treated and divided into five groups of 12. They were given the following treatments: Group A: Celay ceramic post-core with 2.0 mm dentine ferrule, Group B: Celay ceramic post-core with no dentine ferrule, Group C: cast metal post-core with 2.0 mm dentine ferrule, Group D: cast metal post-core with no dentine ferrule, and Group E: prefabricated post and composite core with 2.0 mm dentine ferrule. All specimens were stored at 100% humidity at room temperature for 30 days before testing. Each specimen was in a special jig at a 45 degrees angle to the long axis and subjected to a load on MTS 810 universal material testing machine until failure, with crosshead speed of 0.02 cm/min. Analysis of variance followed by the Newman-Keuls pairwise multiple comparison test was used to compare the results of the groups tested.

RESULTSThere was a statistically significant difference between five groups (P < 0.01). Celay ceramic post-core with 2.0 mm dentine ferrule (758.35 N +/- 119.26 N) and cast metal post-core with 2.0 mm dentine ferrule (756.63 N +/- 166.22 N) had a significantly larger mean failure threshold for fracture than the other three groups which had no significant difference between each other. There was a statistically significant difference between the fracture resistance of Celay post-core restored teeth with and without 2.0 mm dentine ferrule.

CONCLUSIONThe custom-fabricated Celay post-core could be a choice for clinical use in endodontically treated tooth when the final restoration is an all-ceramic crown and the preparation has a 2.0 mm dentine ferrule.

Ceramics ; Crowns ; Dental Porcelain ; chemistry ; Dental Restoration Failure ; Humans ; Incisor ; Inlays ; Materials Testing ; Post and Core Technique ; Stress, Mechanical ; Tooth Fractures ; prevention & control

Objective To analyze the clinical features of the hyperamylasemia in critically ill children and investigate the related risk factors in order to provide the basis for prevention and treatment. Methods A total of 1036 critically ill children admitted in pediatric intensive care unit (PICU)from April,2011 to Oct,2012 were studied.They were divided into the high amylase group (n=82)and the normal group (n=954).According to the outcomes,the high amylase group was divided into survival group (n=61 ) and death group (n =21 ).The related risk factors of the occurrence and outcome of hyperamylasemia were analyzed by univariate and multivariate Logistic regression.Results There were statistically significant differences in rates of coagulation disorders, convulsions, disturbance of consciousness,pediatric critical illness score (PCIS)≤80,multiple organ dysfunction (MODS)≥3, sepsis,shock,and lactic acid (LA),procalcitonin (PCT),blood glucose (BG)between the high amylase group and the normal group (P<0.05 ).The differences in the rates of coagulation disorders,convulsions, mechanical ventilation,PCIS≤80,MODS≥3,and LA,PCT,oxygenation index,albumin,C-peptide,BG were statistically significant between the survival group and the death group (P <0.05 ).Multivariate Logistic regression analysis showed that the risk factors of the hyperamylasemia's occurrence were LA,PCT, BG,PCIS<80,MODS>3.Adjusted ORs confidence intervals of them were 1.662 (1.236-2.234),1.042 (1.025-1.060),1.612 (1.411-1.843),3.219 (1.311-7.905),3.411 (1.370-8.494),respectively. The hyperamylasemia's prognostic risk factors were PCT,C-peptide,PCIS ≤80,MODS >3,shock. Adjusted ORs confidence intervals of them were 1.066(1.021-1.113),1.437(1.017 ~2.030),16.137 (1.876-138.836),10.437(1.528-71.925),20.928(1.938-226.009),respectively.Conclusions The severity of the disease,the levels of LA,PCT,BG in critically ill children were positively correlated to the occurrence of hyperamylasemia.The severity of the disease,the incidence of organ failures,the levels of PCT,C-peptide combined shock in children with hyperamylasemia were positively correlated to the prognosis of hyperamylasemia.

Objective To investigate the clinical performance of fiber post restorations in elderly patients with residual root and crown and to analyze the factors affecting the clinical success rate.Methods A total of 66 elderly patients requiring post restoration were selected.They were randomly divided into two groups:the observation group (n=33,restored with fiber post-resin cores) and the control group (n=33,restored with cast metal post-cores).All patients were rechecked 1 year and 2years after the restoration.The clinical efficacy and the failure types were recorded.The differences in clinical performance between the 2 groups were compared by using Fisher's exact test.Results The differences in the gingival index and periodontal index in the 2 groups between the experimental teeth and the control teeth were zero.There were no significant differences in dental morphology,root canal treatment failure,tooth color matching and marginal coloration between the 2 groups (all P＞0.05).1 case with post debonding and 1 case with fiber post fracture were found in the observation group and 1 case with marginal coloration was found in control group.There was no significant difference in clinical success rate between the 2 groups (93.94％ vs.96.97％,P＞0.05).Conclusions The clinical success rate in fiber post-resin core restoration is the same as in cast metal post-cores restoration in elderly patients.

OBJECTIVETo investigate the influence of post-core structure on the strength of endodontically treated and crowned teeth with or without a 2.0 mm dentine ferrule.

METHODSA total of 60 recently extracted human maxillary central incisors were endodontically treated and randomly divided into five groups of 12. They were given following treatments: Group A, endodontically treated; Group B, endodontically treated and crowned (PFM); Group C, cast metal post-core with 2.0 mm dentine ferrule and crowned (PFM); Group D, cast metal post-core with no dentine ferrule and crowned (PFM); Group E, prefabricated post and composite core with 2.0 mm dentine ferrule and crowned (PFM). All specimens were stored at 100% humidity at room temperature for 30 days before testing. Each specimen was in a special jig on the MTS 810 universal material testing machine and subjected to a load at a 135-degree angle to the long axis until failure, with crosshead speed of 0.02 cm/minute. Analysis of variance followed by the Newman-Keuls pairwise multiple comparison tests was used to compare the results.

RESULTSThere was a statistically significant difference between different restorative methods. The cast metal post-core with 2.0 mm dentine ferrule and crowned teeth had the highest fracture strength (1793.59 +/- 387.93N), followed by endodontically treated intact teeth (1466.68 +/- 240.11N). No significant difference in the fracture strength was found among the other three groups (958.49 +/- 286.02N; 992.98 +/- 291.00N; 994.94 +/- 285.04 N). There was a statistically significant difference in the fracture resistance between crowned teeth with and without 2.0 mm dentine ferrule (P < 0.01).

CONCLUSIONSNot all post-core structure could improve the strength of endodontically treated teeth. The dentine ferrule can effectively improve the fracture resistance of endodontically treated and crowned teeth.

Biomechanical Phenomena ; Crowns ; Humans ; Stress, Mechanical ; Tooth, Nonvital

Objective: To observe the clinical efficacy of photodynamic therapy on oral leukoplakia in elderly patients. Methods: In this prospective study, fifteen elderly patients with oral leukoplakia were treated with 5-aminolevulinic acid-based photodynamic therapy(ALA-PDT). After 2 hours of dressing, patients were irradiated using a 635nm semiconductor laser with the power density of 300mW/cm².Each lesion was irradiated for 6 minutes with energy density of 100J/cm².The curative effect was evaluated and the adverse reactions were recorded based on the observation of lesion changes. Results: Of the 15 lesions in 15 patients, 4 lesions were treated once, 3 lesions were treated twice.And 6 lesions were cured after three treatments, and 2 patients were cured after four treatments.The average treatment frequency was(2.4±1.1)treatment.The postoperative adverse reaction was pain.The average visual analogue scale was(2.2±0.8)scores after operation, and the duration of pain was(2.6±1.1)days after operation.There was no recurrence for 3 to 9 months after operation.No abnormalities of oral sensation and function were found in patients. Conclusions ALA-PDT is an effective method for the treatment of oral leukoplakia in elderly patients.

Objective To study the exocrine pancreatic function in critically ill children with septic shock,sepsis and hyperlactacidemia.Methods A total of 64 critical pediatric patients were admitted from Jan 2009 to Oct 2012,and clinical and laboratory findings including pancreatic function,and histopathological features and score after autopsy were reviewed.Results (1) Compared with non-septic shock children,the pancreatic pathology score and serum lipase in septic shock group were significantly higher and serum calcium was significantly reduced (P ＜0.05) ; (2) The pancreatic histopathology score was significantly increased in patients with elevated plasma lactate ≥2 times (P ＜0.05),but there were no significant differences in serum calcium and blood amylase and lipase between patients with elevated plasma lactate level and patients with normal plasma lactate level; (3) The concentrations of serum amylase,lipase and urinary amylase were significantly increased in patients with pancreatic histopathology score ＞4 points compared with score ≤4 points patients,but there were no significant differences in above three biomarkers between patients with score ≤3 points and patients with score ＞3 points.Conclusions The pancreas is vulnerable to damage easily occurred in septic shock children especially complicated with hyperlactacidemia.The pancreatic histopathology score ＞ 4 points can be as a sensitive and reliable indicator of pancreas damage.

Objective To id scuss the role and safety of fiberoptic bronchoscopy for diagnosing and treating respiratory dsi ease in PICU.Methods A total of 95 eil gible children with respri atory diseases admi-tted ni PICU of Hu′nan Prvo inec Children′s Hospital were enroll ed in this retrospectvi e study from January 2013t o December 2013, and the efficacy and complications of fiberoptic bronchoscopy were assessed.Results A total of 95 children underwented bronchoscopy 112 timest, he most common of microscopic examination resutl s was tracheal bronchitis ( 62.1%) , followed by congenital airway abnormality ( 21.1%); 58 times (56.9%) showed becteria positive in 102 times lavage and sputum culture results, including 16 times (27.6%) of Klebsiella pneumoniae bacteria,12 times(20.7%) of Acinetobacter baumannii.After under-wenting bronchoscopy and lavage wash,blood gas analysis of pH value,PaO2 ,PaCO2 ,SaO2 had significant improvement than before( P<0.05 ) , respiratory rate had improved than before ( P<0.05 ) , little effect in heart rate(P>0.05).The inrt aopear tive and postoperative transient comlp ications were obserev d in 38 times (33.9%).Conclusion The appil cation of fiberoptic bronchoscopy for diagnosing and ter ating disease in PICU has a cetr ia n value, its vo erall safety is reliable.

Objective To analyze the clinical value of continuous veno-venous hemofiltration (CVVH) treatment in children with severe hand-foot-and-mouth disease(HFMD) complicated with cardiopulmonary failure,via the prognostic comparison of the general comprehensive treatment and CVVH add-on treatment.Methods Fifty-one cases of severe HFMD with cardiopulmonary failure were divided into a CVVH group (n =19) and a control group(n =32) based on whether CVVH add-on or not.Their physiological and biochemical indicators were recorded and pediatric critical illness score (PCIS) and pediatric risk of mortality score (PRISM Ⅲ) were calculated within 24 hours,when they were diagnosed with neurogenic pulmonary edema (NPE)/pulmonary hemorrhage.Both groups were treated with endotracheal intubation,mechanical ventilation with high PEEP,corticosteroids,ulinastatin,actively lowering the intracranial pressure,fluid resuscitation,milrinone,dopamine and other vasoactive drugs,high-dose intravenous gamma globulin,the CVVH group were added with CVVH treatment(duration ＞ 12 h).Prognosis difference of CVVH add-on treatment after diagnosed with NPE/pulmonary hemorrhage by tracking indicators of the third day.Survival analysis between two groups were compared by 3-day survival rates,7-day survival rates,28-day survival rates and the finally survival rates.Results (1) The overall conditions of two groups were comparable when diagnosed with NPE/pulmonary hemorrhage.PCIS,PRISM Ⅲ,WBC counting,lactic acid,micro-blood sugar,myocardial enzymes and liver enzymes showed no significant difference between two groups.Three days after treatment,WBC and lactic acid decreased,but there was no significant difference (P ＞ 0.05),the remaining indicators had significantly improved in the CVVH group than those in the control group (P ＜ 0.05).(2) The 3-day survival rate,7-day survival rate,28-day survival rate and the finally survival rates in control group and CVVH group were 40.63 ％ vs.84.21％,37.50％ vs.73.68％,25.00％ vs.63.16％,18.75％vs.52.63％,the survival rate in CVVH group were significantly higher(P ＜0.05).(3)The survival curve indicated that the survival time of CVVH group was significantly longer than that of the control group,the median survival time were 17 d and 2 d,respectively,and the difference was statistically significant (P ＜ 0.05).(4)In the CVVH group,15 cases received CVVH after diagnosed with NPE/pulmonary hemorrhage within 12 hours,of which 10 cases(66.67％) ultimately survived,while the other 4 cases received CVVH after 12 h were all end to death,the difference was statistically significant(P ＜ 0.05).Further analysis of the impact of the timing of blood purification on the prognosis of children showed that the mortality rates of children received CVVH within 6 hours,6 to 12 hours,after 12 hours of diagnosis of NPE/pulmonary hemorrhage,were 2/8,3/7,4/4,respectively.Conclusion Continuous hemofiltration can significantly improve the prognosis of children with severe HFMD,and may be preferable to perform in early stage.