A 77-year-old male patient received amiodarone 0.2 g twice daily orally for arrhythmia. After 15 months of amiodarone treatment, he developed some symptoms such as poor appetite, reduced diet, nausea and vomiting, and dysphagia. After 22 months of amiodarone treatment, laboratory tests showed white blood cell count 13.5×10 9/L, neutrophil 0.78, C-reactive protein 117.4 mg/L, erythrocyte sedimentation rate 32 mm/1 h, alanine aminotransferase (ALT) 286 U/L, aspartate aminotransferase (AST) 215 U/L, alkaline phosphatase (ALP) 107 U/L, γ-glutamyl transferase (γ-GT) 45 U/L, total bilirubin (TBil) 14.8 μmol/L, direct bilirubin 9.3 μmol/L, and albumin 30 g/L. After treatments with anti-infection, hepatoprotection, and albumin supplementation, the above symptoms were improved and amiodarone was continued. After 40 months of amiodarone treatment, laboratory tests showed ALT 87 U/L, AST 106 U/L, ALP 308 U/L, γ-GT 1 242 U/L, and TBil 11.2 μmol/L. According to the results of liver biopsy, it is suspected that the patient was alcoholic liver fibrosis. After excluding alcoholic liver disease, viral hepatitis, autoimmune liver disease, and tumors by imaging and liver biopsy, it was considered to be associated with long-term use of amiodarone. Amiodarone was withdrawn, but the patient died 3 months later because of ascites and jaundice.

A 77-year-old male patient received amiodarone 0.2 g twice daily orally for arrhythmia. After 15 months of amiodarone treatment, he developed some symptoms such as poor appetite, reduced diet, nausea and vomiting, and dysphagia. After 22 months of amiodarone treatment, laboratory tests showed white blood cell count 13.5×10 9/L, neutrophil 0.78, C-reactive protein 117.4 mg/L, erythrocyte sedimentation rate 32 mm/1 h, alanine aminotransferase (ALT) 286 U/L, aspartate aminotransferase (AST) 215 U/L, alkaline phosphatase (ALP) 107 U/L, γ-glutamyl transferase (γ-GT) 45 U/L, total bilirubin (TBil) 14.8 μmol/L, direct bilirubin 9.3 μmol/L, and albumin 30 g/L. After treatments with anti-infection, hepatoprotection, and albumin supplementation, the above symptoms were improved and amiodarone was continued. After 40 months of amiodarone treatment, laboratory tests showed ALT 87 U/L, AST 106 U/L, ALP 308 U/L, γ-GT 1 242 U/L, and TBil 11.2 μmol/L. According to the results of liver biopsy, it is suspected that the patient was alcoholic liver fibrosis. After excluding alcoholic liver disease, viral hepatitis, autoimmune liver disease, and tumors by imaging and liver biopsy, it was considered to be associated with long-term use of amiodarone. Amiodarone was withdrawn, but the patient died 3 months later because of ascites and jaundice.

Objective: To construct a three-dimensional (3D) finite element model and analyze the biomechanical characteristics during mandibular second molar mesialization using customized lingual appliances and mini-implant. Methods: One adult student volunteer from The First Affiliated Hospital of Zhengzhou University with lower left first molar extraction was selected. After CT scanning, Mimics, Geomagic, ANSYS were employed to develop a 3D finite element model including customized lingual brackets, stainless steel lingual arch wire, buccal buckles, lower dentition, periodontal ligaments and alveolar bone. Four different loading methods (1. the force of 1.470 N loaded at the lingual side only; 2, 3, 4. the forces of 0.490, 0.735 and 0.980 N loaded at both buccal and lingual sides, respectively.) were included. The initial displacements of the lower second molar and stress distribution in the periodontal ligaments were analyzed. Results: More uniform stress distributions in the periodontal membrane of mandibular left second molar were found when the mesial force were loaded at both buccal and lingual sides than the force loaded at lingual side only. More inclination of the second molar was observed when force loaded at both sides than at lingual side only. With the values of the force increased, the mesial inclination potential of the second molar, the initial movement of the second molar and the stress distribution in the periodontal membrane increased. Under the force of 0.735 N at both buccal and lingual sides, mesially inclined initial displacements of the mandibuar second molar were observed and the stress values of von Mises was in the suitable area. Conclusions Less second molar rotation was found when the force loaded at both buccal and lingual sides than loaded at lingual side only. However, force loaded at both sides would increase the measial inclination potential of the second molar.