Objective To measure the anatomical parameters of the first maxillary molars in children of different age groups and evaluate the age-related changes in dental crowns.Methods A retrospective analysis was conduc-ted on cone beam computed tomography(CBCT)images of 4-8-year-old children.NNT software was used to ana-lyze multiple important indicators of maxillary first molar.Results A total of 308 first maxillary molars,including 154 pediatric patients,were evaluated in this study.The thickness of the pulp apex H1(left,P=0.01;right,P=0.02)and the thickness of the pulp chamber floor H3(left and right P＜0.01)were positively correlated with age,while the height of the pulp cavity H2(left and right P＜0.01)and the height of the palate tip D1(left P=0.003,right P=0.002)showed a negative correlation with age.There was no significant correlation between the height of the buccal tip and age(P＞0.05).There were significant differences in H1 and H3 between the 4-year-old and 5-year-old age groups between the 8-year-old age group(P＜0.05),as well as significant differences in H2 and D1 between the 4-year-old and 5-year-old between the 6-year-old,7-year-old and 8-year-old age groups(P＜0.05).Conclusion The age-related changes in the crowns of the first maxillary molars are important references for the clinical treatment,and can be accurately measured through CBCT data.

Objective:To translate and culturally adjust Decisional Fatigue Scale (DFS) , and test its reliability and validity.Methods:The Chinese version of DFS was formed through the method of double translation, back translation and expert consultation. Using the convenient sampling method, 247 medical staffs from 16 departments in 76 wards of Xiangyang No.1 People's Hospital Affiliated to Hubei University of Medicine were selected as the research objects. Content validity, criterion validity and structure validity were used for validity evaluation, and internal consistency reliability, split half reliability and retest reliability were used for reliability evaluation. A total of 247 questionnaires were sent out in this study and 247 were effectively received, with effective recovery of 100.00%.Results:The total Cronbach's α coefficient of Chinese DFS was 0.933, the half-reliability coefficient was 0.849 and the retest reliability coefficient was 0.838 ( P<0.01) . Both the item content validity index and scale content validity index were 1.00, and the correlation coefficient with the total score of SRF-S was 0.729 ( P<0.01) . One common factor was extracted by exploratory factor analysis and 65.64% of the variation was explained cumulatively, which was consistent with the dimensions of the original scale. Confirmatory factor analysis showed that all fitting indexes were up to standard and the fitting degree was good. Conclusions:The reliability and validity of the Chinese version of DFS in medical staffs is good, which can be used to evaluate the degree of decision-making fatigue of Chinese medical staffs.

To analyze the endoscopic ultrasonography (EUS) and histopathological features of esophageal epithelial malignant tumors misdiagnosed as esophageal submucosal tumors (SMT), data of patients diagnosed as having esophageal SMT preoperatively but confirmed as esophageal epithelial malignant tumor by pathology after operation in Nanjing Drum Tower Hospital from January 2012 to December 2020 were retrospectively analyzed, and the clinical data including age, gender, size and location of the lesion, origin and echo of the lesion under EUS, endoscopic treatment and postoperative pathology were recorded. Among the 11 patients, there were 9 males and 2 females, aged (65.5±6.2) years. The length diameter of 9 lesions was ≤2 cm, and 8 lesions were located in the middle thoracic esophagus. Among the 11 patients, 10 underwent EUS before operation. The lesions originated from submucosa in 6 cases, muscularis propria in 2 cases and muscularis mucosa in 2 cases. The echo of the lesions was hypoechoic in 9 cases and isoechoic in only 1 case. Of the 11 patients, 3 underwent endoscopic mucosal resection, 6 underwent endoscopic submucosal dissection, and 2 underwent submucosal tunneling endoscopic resection. The histopathological types included 3 cases of moderately to poorly differentiated squamous cell carcinoma, 3 cases of basaloid squamous cell carcinoma, 2 cases of adenoid cystic carcinoma (including 1 case of adenoid cystic carcinoma colliding with squamous cell carcinoma), 2 cases of adenocarcinoma, and 1 case of esophageal sarcomatoid carcinoma with basaloid squamous cell carcinoma. Endoscopic manifestations of submucosal eminence in esophageal epithelial malignant tumors are extremely rare. EUS is helpful for differential diagnosis, and diagnostic treatment can make a definite diagnosis.

Clinical data of 26 patients with proton pump inhibitor dependent gastroesophageal reflux disease (GERD) who underwent anti-reflux mucosectomy (ARMS) in Nanjing Drum Tower Hospital from July 2017 to December 2020 were reviewed, and the GERD questionnaire (GERD-Q) score, the short-form reflux-qual (RQS) score, esophageal motility and 24 h esophageal pH parameters before and after ARMS were compared. With a median follow-up period of 18.4 months (6-27 months), 23 (88.5%) patients reported symptomatic improvement and 15 (57.7%) patients discontinued the use of proton pump inhibitors. After ARMS, the mean scores of GERD-Q (6.23 VS 13.19, P=0.004) and RQS (26.67 VS 10.98, P<0.001) were significantly improved, the mean DeMeester score (10.69 VS 53.15, P<0.001), the mean acid exposure time percentage (3.56% VS 9.92%, P<0.001) and the mean number of acid reflux episodes (36.9 VS 139.9, P=0.001) were lower, and the mean rest pressure at lower esophageal sphincter (LES) (25.19 mmHg VS 13.63 mmHg, P<0.001) and the mean distal contractile integral (1 819.15 mmHg·s·cm VS 1 007.67 mmHg·s·cm, P<0.001) were significantly increased compared with those before surgery. ARMS has significant short-term efficacy in the treatment of proton pump inhibitor dependent GERD, which can effectively improve reflux symptoms and life quality of patients, and strengthen the rest pressure of LES and peristalsis of the esophageal body.

OBJECTIVES: Idiopathic intracranial hypertension (IIH) is a syndrome that excludes secondary causes such as intracranial space-occupying lesion, hydrocephalus, cerebrovascular disease, and hypoxic ischemic encephalopathy. If not be treated promptly and effectively, IIH can cause severe, permanent vision disability and intractable, disabling headache. This study aims to explore the clinical and image features for IIH, to help clinicians to understand this disease, increase the diagnose rate, and improve the outcomes of patients. METHODS: We retrospectively analyzed 15 cases of IIH that were admitted to Xiangya Hospital, Central South University, during January 2015 to September 2020. The diagnosis of IIH was based on the updated modified Dandy criteria. We analyzed clinical data of patients and did statistical analysis, including age, gender, height, weight, medical history, physical examination, auxiliary examination, treatment and outcome. RESULTS: There were 10 females and 5 males. Female patients were 22 to 42 years old with median age of 39.5. Male patients were 27 to 52 years old with the median age of 44.0. The BMI was 24.14-34.17 (28.71±2.97) kg/m CONCLUSIONS IIH primarily affects women of childbearing age who are overweight. The major hazard of IIH is the severe and permanent visual loss. Typical image signs have high specificity in IIH diagnosis. Prompt diagnosis and effective treatment are significantly important to improve the outcomes of patients.
Adult ; Anemia, Iron-Deficiency ; Female ; Humans ; Intracranial Hypertension ; Male ; Middle Aged ; Pseudotumor Cerebri/diagnostic imaging* ; Retrospective Studies ; Ventriculoperitoneal Shunt ; Young Adult

Objective:To prepare the egg yolk immunoglobulin Y ( IgY) against human Sucrase and study its stability,in vitro activity. Methods:Hy-line laying hens were immunized with human Sucrase protein,IgY was isolated and purified from egg yolks of im-munized hens using water dilution and salting out method. Indirect ELISA was used to evaluate the titer and stability of IgY. The purity and specificity of IgY were analysed by SDS-PAGE and Western blot respectively. The inhibitory effects of IgY on α-glucosidase was studied by PNPG method. Results:Indirect ELISA results showed IgY could be detected on the tenth day after the first immunization, and the peak titer of IgY was 1:12 800 after the 40th day of immunization. SDS-PAGE showed that the heavy chain and light chain of IgY were 65 kD and 25 kD respectively, and the IgY against human Sucrase could specifically recognize the protein of human Sucrase. The IgY maintained primary titer when it was kept between 29-69℃ for 15 min,and pH 4-7,37℃,4 h. The titer of IgY was maintained 50% after digestion by pepsin and trypsin respectively for 2 hours. IgY had a higher resistence to pepsin than trypsin after longer digestion time. IgY showed an inhibitory effect on α-glucosidase in concentration dependent manner. The half inhibitory concentration (IC50) was 0. 540 mg/ml. Conclusion:The IgY against human Sucrase has been successfully obtained,which established foundations for its study of Type 2 diabetes mellitus rat models in vivo.

Objective To investigate the distribution and drug resistance of pathogens in intensive care unit (ICU) so as to provide scientific basis for antibiotic adoption and the prevention and control of nosocomial infections. Methods The various specimens collected from the patients admitted into ICU in the First People's Hospital of Shunde Affiliated to the South Medical University from January 2007 to December 2014 were used to isolate the pathogens that might cause nosocomial infections and retrospectively analyze their clinical distribution and drug resistance. Kirby-Bauer paper diffusion and minimal inhibitory concentration (MIC) methods were applied to test the drug sensitivity, and according to National Committee for Clinical Laboratory Standards/Clinical and Laboratory Standards Institute (NCCLS/CLSI) standard, the results were identified.Results The sputum was the major specimen source in ICU, accounting for 68.8%, followed by urine (12.4%) and blood (6.8%). All together 557 pathogens in ICU causing nosocomial infections were isolated of which there were 377 gram-negative (G-) bacilli (67.7%), 103 gram-positive (G+) cocci (18.5%), and 77 fungi (13.8%). Among G- bacilli, the top three wereAcinetobacter baumannii (34.5%), Klebsiella pneumonia (17.8%), andPseudomonas aeruginosa (13.0%). Beside carbapenem, the drug resistance rates of Acinetobacterbaumannii to other antibiotics were more than 40%. The main G+ coccus causing nosocomial infection wasSaphylococcus aureus (36.9%) in ICU. The drug resistance rates ofSaphylococcus aureus to penicillin, gentamicin and erythromycin were higher than 50%. In 77 fungus strains,Candida albicans was ranked the first, accounting for 41.6%.Conclusion The main infection site in ICU is primarily respiratory tract, the G- bacilli are the predominate pathogens, and the drug resistance to antibiotics found in this report is serious, so clinically, the antibiotics should be properly used to avoid the occurrence of pathogenic strain with drug tolerance.

Objective To investigate the localization,zone and activation intensity of olfactory center in young versus elderly healthy volunteers by functional magnetic resonance imaging (BOLD-fMRI),so as to elucidate the effect of age on olfactory center in healthy population.Methods Thirteen right-handed healthy adult volunteers were recruited and divided into two groups:young group (5 males and 3 females,mean aged 23 years) and elderly group (2 males and 3 females,mean aged 69.2 years).The olfactory stimulus was r-undecalactone,and it was given according to a block design.The fMRI detection was performed on Philips Achieva 3.0 T MR scanner,and data of BOLE-fMRI was processed and analyzed to get cerebration image by using SPM2.Results In groupaveraged maps,both young and elderly group showed significant olfactory activation in right parahippocampal gyrus,left hippocampal sulcus,right and left superior temporal gyrus,etc,subcortical activation in right thalamus,dorsal pons,and cerebellum activation in cerebellar vermis.Activations in right inferior frontal gyrus,right middle frontal gyrus,right medial occipito-temporal gyrus and right fimbria of hippocampus were observed only in young group,while activation in bilateral middle temporal gyrus was observed only in elderly group.Activation area was apparently smaller and activation degree was lower in elderly group than in young group.Activation intensity in right superior parietal lobule and bilateral superior temporal gyri was higher in male group than in female group (t=13.7,6.08,5.36,respectively,all P＜0.001).Conclusions The intensity of activation in olfactory center is lower in the elderly than in the young,and absence of part of the active regions is found in the elderly,which demonstrates the regression of olfactory center in the elderly.The olfactory center shows right-predominant activation,and olfactory activation intensity in some cortical regions is higher in males than in females.

Objective To investigate the clinical efficacy of new-type patent endotracheal tube in difficult endotrachea intubation patients.Methods Seventy-three patients with the abnormal airways were selected as our subjects.Patients were given the traditional endotracheal tube by mouth after anesthesia.The successes patients in terms of endotracheal intubation were as group Ⅰ (n =73).The failed patients were asgroup Ⅱ (n =63),who performed the secondary endotracheal intubation with new type patent endotracheal tube.Analyze the success rate of intubation of the two groups when on use the tube core.Results The first time intubation success rate and intubation success rate was (2.7％ (2/73),13.7％ (10/73) respectively) in Ⅰ group,and 73.02％ (46/63) and 98.41％ (62/63) respectively in the group Ⅱ,and there was the significant difference between two groups (x2 =36.01,31.08 respectively,P ＜ 0.01).Conclusion The new type endotracheal tube was proved with three advamage of good plasticity,without need of auxiliary core intubation with trachealtube and give full play to lead the soft cannula guide tubes leading role.Therefore,the new type patent endotracheal tube has more efficacy over traditional tube.