Fused teeth are usually formed by the partial or complete fusion of two normal tooth germs during the development process and belong to dental developmental abnormalities. Fused teeth are relatively rare clinically, and those occurring in the posterior tooth area are even rarer. This article reports a case of fused teeth between the first permanent molar and the second permanent molar in the right mandible. This fused tooth had a complex root canal anatomical structure (seven root canals). The number and location of the root canals were analyzed by cone beam computed tomography, and root canal treatment was successfully completed with the assistance of microscope.
Humans ; Molar/diagnostic imaging* ; Mandible ; Dental Pulp Cavity/abnormalities* ; Cone-Beam Computed Tomography ; Root Canal Therapy/methods* ; Fused Teeth/surgery*

Objective To investigate the lung protection effect of remazolam under lung protection ventilation strategy in elderly patients undergoing laparoscopic upper abdominal surgery.Methods A prospective randomized controlled study was conducted on 60 patients aged 60 years or older who were scheduled to undergo laparoscopic upper abdominal surgery,including cholecystectomy,common bile duct choledocholithotomy,partial hepatectomy,and subtotal gastrectomy from October 2023 to October 2024.The patients were divided into 2 groups by random number table method:30 patients in the observation group received lung protective ventilation strategy and remazolam administration,and 30 patients in the control group received lung protective ventilation strategy and propofol administration.The inflammatory response indexes(TNF-α,IL-6,and hs-CRP),stress indexes(SOD,NE,and Cor),anesthesia quality(VAS score and Ramsay score),lung function(FVC,FEV1,and MVV％),blood gas indexes(pH,Lac,PaO2,and PaCO2),recovery quality(tracheal tube extubation time,respiratory recovery time,and awakening time),and pulmonary complications were compared between the two groups.Results In the observation group,the serum levels of inflammatory markers of TNF-α,IL-6,and hs-CRP at 2,12,and 24 h postoperatively were all lower than those in the control group(all P=0.000).Regarding stress response indicators,the serum SOD levels in the observation group were higher than those in the control group at 2,12,and 24 h postoperatively,while the NE and Cor levels were lower(all P=0.000).The VAS scores at 24 h postoperatively,and the Ramsay scores at 2 and 24 h postoperatively in the observation group were lower than those in the control group(all P=0.000).In the observation group,the FVC,FEV1,and MVV％were all higher than those in the control group at 48 h postoperatively(P＜0.05).The PaO2 level in the observation group was higher than that in the control group at 24 h postoperatively,and the Lac level was lower(P＜0.05).The respiratory recovery time and awakening time in the observation group were both shorter than those in the control group(P＜0.05).There were no significant differences between the two groups in extubation time and pulmonary complications(P＞0.05).Conclusions The lung protection effect of remazolam under lung protection ventilation strategy is better than that of propofol in elderly patients undergoing laparoscopic upper abdominal surgery.The lung protective effects may be achieved by alleviating perioperative stress response,improving oxygenation function,effective sedation,and reducing inflammatory response.

Objective To investigate the lung protection effect of remazolam under lung protection ventilation strategy in elderly patients undergoing laparoscopic upper abdominal surgery.Methods A prospective randomized controlled study was conducted on 60 patients aged 60 years or older who were scheduled to undergo laparoscopic upper abdominal surgery,including cholecystectomy,common bile duct choledocholithotomy,partial hepatectomy,and subtotal gastrectomy from October 2023 to October 2024.The patients were divided into 2 groups by random number table method:30 patients in the observation group received lung protective ventilation strategy and remazolam administration,and 30 patients in the control group received lung protective ventilation strategy and propofol administration.The inflammatory response indexes(TNF-α,IL-6,and hs-CRP),stress indexes(SOD,NE,and Cor),anesthesia quality(VAS score and Ramsay score),lung function(FVC,FEV1,and MVV％),blood gas indexes(pH,Lac,PaO2,and PaCO2),recovery quality(tracheal tube extubation time,respiratory recovery time,and awakening time),and pulmonary complications were compared between the two groups.Results In the observation group,the serum levels of inflammatory markers of TNF-α,IL-6,and hs-CRP at 2,12,and 24 h postoperatively were all lower than those in the control group(all P=0.000).Regarding stress response indicators,the serum SOD levels in the observation group were higher than those in the control group at 2,12,and 24 h postoperatively,while the NE and Cor levels were lower(all P=0.000).The VAS scores at 24 h postoperatively,and the Ramsay scores at 2 and 24 h postoperatively in the observation group were lower than those in the control group(all P=0.000).In the observation group,the FVC,FEV1,and MVV％were all higher than those in the control group at 48 h postoperatively(P＜0.05).The PaO2 level in the observation group was higher than that in the control group at 24 h postoperatively,and the Lac level was lower(P＜0.05).The respiratory recovery time and awakening time in the observation group were both shorter than those in the control group(P＜0.05).There were no significant differences between the two groups in extubation time and pulmonary complications(P＞0.05).Conclusions The lung protection effect of remazolam under lung protection ventilation strategy is better than that of propofol in elderly patients undergoing laparoscopic upper abdominal surgery.The lung protective effects may be achieved by alleviating perioperative stress response,improving oxygenation function,effective sedation,and reducing inflammatory response.

Objective To observe the effects of early rehabilitation on the serum neuron specific enolase (NSE) levels of patients with acute cerebral infarction.MethodsSixty patients with acute cerebral infarction were randomly divided into a rehabilitation group and a control group. All received routine treatment at the acute stage, including anti-platelet aggregation medication, drugs for improving microcirculation, neurotrophic agents and prompt treatment of any complications. Patients in the rehabilitation group also received systemic rehabilitation training beginning immediately after their vital signs had been stabilized. NSE in serum was assayed before treatment and after 3, 7and 14 days. National Institutes of Health stroke scale (NIHSS) scores were evaluated at each time point, and the two groups were compared.ResultsThere was no significant difference in serum NSE or NIHSS scores between the two groups pre-treatment. Both groups improved to a certain extent, but the improvements in the rehabilitation group were significantly better than in the control group, as their NSE levels at 7 days and NIHSS scores at 14 days were both significantly better.ConclusionsEarly rehabilitation intervention contributes to reducing serum NSE levels after acute cerebral infarction, lessening brain injury, and thereby promoting the recovery of damaged neural function.That may be one of the mechanisms by which early rehabilitation promotes functional recovery in patients with acute cerebral infarction.

ObjectiveTo observe the clinical effection of acupuncture using Xingnao Kaiqiao needling method and rehabilitation training on patients with stroke.Methods70 patients with stroke were randomly divided into the observation group(n=35)and the control group(n=35), both groups receiving routine treatment and early rehabilitation training, while acupuncture using Xingnao Kaiqiao needling method was given additionally to the observation group, 4 weeks for a course. The Fugl-Meyer Assessment, assessment of neurological deficit, the Barthel Index and the clinical effect were compared among two groups.ResultsThe neurological deficit decreased obviously, and the Fugl-Meyer Assessment and Barthel Index increased significantly in two groups after the treatment(P<0.05). The theraputic effect was significantly better in the observation group than in the control group(P<0.05).ConclusionAcupuncture using Xingnao Kaiqiao needling method combined with rehabilitation training can more effectively promote the recovery of nerve function, enhance motor function, and significantly improve the quality of life and the prognosis of patients with stroke.