Maxillary sinus is located in the maxilla bone with the largest volume in all sinuses and is closest to the roots of maxillary posterior teeth, especially the mesiobuccal root of the maxillary second molar. The thickness of the normal maxillary sinus mucosa is about 1 mm. When stimulated or infected, it shows thickening of the mucosa. Periodontitis is one of the most common oral diseases in human beings, and the complex root anatomy of the maxillary molars aggravates the difficulty of inflammation control. Severe periodontitis of maxillary molars without effective treatment can affect the maxillary sinus, increasing the possibility of the mucosa thickening, and is also one of the reasons for the occurrence of odontogenic maxillary sinusitis (OMS). There are many different schemes for the treatment of OMS caused by severe periodontitis of maxillary molars. Extraction of teeth with severe periodontal disease without retention value or successful periodontal treatment can significantly reduce the thickness of maxillary sinus mucosa. For the patients with uncontrollable sinusitis by using drug treatment and eliminating odontogenic causes, or ones with severe symptoms, periodontal treatment and endoscopic sinus surgery can be combined to effectively control the periodontitis related maxillary sinusitis.

End-stage renal disease (ESRD) patients undergoing outpatient hemodialysis (HD) and home peritoneal dialysis (PD) are high risk population of severe and critical types caused by SARS-CoV-2 infection. In order to improve the quality of diagnosis and treatment in dialysis patients with SARS-CoV-2 infection, we wrote this recommendation for primary care clinicians. During the epidemic period of SARS-CoV-2 infection, all patients should be instructed to strengthen self-management. Once the SARS-CoV-2 infection was found in dialysis patients, early stratified management should be carried out within 72 hours after the first positive nucleic acid or antigen test results, which includes early antiviral therapy, early recognition, and transferring severe patients from community or primary hospital to a referral hospital promptly. Guidance for dietary and sports rehabilitation after SARS-CoV-2 infection should also be started as soon as possible.

Objective:To explore the effect of systemic use of amoxicillin and metronidazole during mechanical therapy on the clinical parameters of the first molars and periodontal microorganisms in subgingival plaque and saliva in patients with generalized aggressive periodontitis (GAgP).Methods:A total of 23 GAgP patients were recruited from Peking University School and Hospital of Stomatology from January 2006 to December 2009 and then randomly divided into two groups according to random number table: 12 patients received scaling and root planning (SRP) only and 11 patients received SRP combined with systemic administration of antibiotics (amoxicillin and metronidazole for a week after supragingival scaling). Clinical examination of periodontal parameters and collection of saliva and pooled subgingival plaque samples from mesial-buccal sites of 4 first molars were performed before initial therapy and 2, 4 and 6 months respectively after mechanical therapy, and saliva samples were also collected 2 weeks after therapy. Eight different periodontal microorganisms were detected in these samples by PCR. In addition, semiquantitative analysis of red complex microorganisms [ Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td)] was performed. Results:Both therapies led to significant decrease of the plaque index (PLI), probing depth (PD) and bleeding index (BI) from mesial-buccal sites of first molars. Meanwhile the PD of antibiotics group [(4.21±1.50), (4.00±1.54), (3.84±1.89) mm of 2, 4 and 6 months respectively after therapy] was significantly lower than the SRP group [(5.29±1.27), (5.30±1.34), (4.98±1.36) mm of 2, 4 and 6 months respectively after therapy] at 3 different time points after mechanical therapy ( P<0.05). In the antibiotics group, the quantities of Pg, Tf and Td in subgingival plaque samples (the median quantity decreased to 0.0 ng at 2, 4 and 6 months after therapy) and saliva samples (the median quantity of Tf and Td decreased to 0.0 ng at 2, 4 and 6 months after therapy ( P<0.05), and the median quantity of Pg decreased to 16.3, 59.6 and 22.4 ng at 2, 4 and 6 months respectively after therapy) significantly decreased at 3 different time points after mechanical therapy compared with before therapy ( P<0.05). While in the SRP group, there were no significant changes in the quantities of Tf and Td in saliva at 2, 4 and 6 months after mechanical therapy ( P>0.05) , and the quantities of Tf and Td in subgingival plaque significantly decreased only at 2 months after therapy ( P<0.05). Conclusions:SRP combined with systemic administration of amoxicillin and metronidazole could achieve greater improvement in PD of first molars and better control of the amounts of red complex microorganisms in the saliva and subgingival plaque of GAgP patients over a 6-month period.

Objective:To explore the correlation and interaction between epidermal growth factor (EGF) rs2237051 and peroxidase proliferators activate receptor-α (PPAR-α) rs4253623 polymorphisms and the susceptibility of generalized aggressive periodontitis (GAgP).Methods:Two hundred and nineteen Chinese patients with GAgP were enrolled from the patients of the Department of Periodontology, Peking University School and Hospital of Stomatology from January 2001 to December 2015. The control group comprised 138 periodontally healthy volunteers recruited from the staff and students of the Peking University School and Hospital of Stomatology. The EGF rs2237051 and PPAR-α rs4253623 polymorphisms were genotyped using time-of-flight mass spectrometry. Logistic regression models were conducted to analyze the correlation between the EGF rs2237051 and PPAR-α rs4253623 variants with GAgP. The likelihood ratio test was used to analyze whether there was an interaction between the two polymorphisms in the susceptibility of GAgP. The interaction model adopted was the multiplication model.Results:The mean ages of GAgP group (male:87; female:132) and control group (male: 53; female: 85) were (27.3±4.5) years and (27.1±4.2) years respectively and there was no significant difference in age and gender distribution between the two groups. For EGF rs2237051, the frequency of AA genotype in the GAgP group [49.5% (107/216)] was significantly higher than that in the control group [37.7% (52/138)], and the frequency of AG/GG genotype in the GAgP group [50.5% (109/216)] was significantly lower than that in the control group [62.3% (86/138)]( P<0.05). Compared with AA genotype, individuals with AG/GG genotype had a 39% lower risk of GAgP after adjustment of age and gender ( OR: 0.61, 95 %CI: 0.40-0.95, P<0.05). For PPAR-α rs4253623, the frequency of AA genotype in the GAgP group [76.2% (160/210)] was significantly higher than that in the control group [65.9%(81/123)], and the frequency of AG/GG genotype in the GAgP group [23.8% (50/210)] was significantly lower than that in the control group [34.1%(42/123)] ( P<0.05). Compared with AA genotype, individuals with AG/GG genotype had a 40% lower risk of GAgP after adjustment of age and gender ( OR: 0.60, 95 %CI: 0.36-0.98, P<0.05). EGF rs2237051 and PPAR-α rs4253623 showed a significant interaction in the susceptibility to GAgP. Compared with AA genotype, the risk of GAgP in individuals with both AG/GG genotypes of EGF rs2237051 and PPAR-α rs4253623 was reduced by 66% ( OR: 0.34, 95 %CI: 0.17-0.66, P<0.01). Conclusions:EGF rs2237051 and PPAR-α rs4253623 are correlated with GAgP susceptibility, and there is a significant interaction between them in the susceptibility of GAgP. The G allele of the two loci has a protective effect on the disease of GAgP.

Objective To explore the treatment experience of acute type-A aortic dissection with lower limb malperfusion.Methods From December 2012 to December 2016,479 cases of acute type A aortic dissection were treated surgically,including 39 patients with lower limb ischemia,including 27 males and 12 females,with mean age of(5 1.4 ± 12.4) years.All patients were treated with deep hypothermic circulatory arrest and were treated with single pump,double-tube and double-injected limbs.According to the patient's lower limb ischemia time,symptoms and signs,limb ischemia was assessed.If necessary,femoral artery-femoral arterial bypass was performed.For patients undergoing femoral arterial-femoral prosthetic bypass during the same period,postoperative follow-up monitoring,if necessary,secondary femoral-femoral arterial vascular bypass or osteofascial decompression.Results Early mortality rate was 17.9％ (7/39).32 cases of postoperative survival.The follow-up rate was 93.8％ (30/32),3 months to 3 years after the operation,the results were satisfactory.The over lower limb malperfusion recovery rate of follow-up patients was 96.7％ (29/30).Conclusion Positive operation for acute type-A aortic dissection with lower limb malperfusion is safe,feasible and effective.Concomitant or secondary bypass procedures are also possible to restore distal perfusion when necessary.Comprehensive evaluation of patient' s status is strongly recommended for optimal surgical decision making.

Objective To investigate the feasibility and clinical effect of tranexamic acid in prehospital emergency care of patients with craniocerebral trauma.Methods A randomized,placebo controlled trial was carried out on 77 craniocerebral trauma patients [Glasgow Coma Scale (GCS) ≤12 points]enrolled between May 2015 and December 2016.There were 45 males and 32 females,with an average age of 36.5 years (range,19-73 years).Among the patients,37 cases were caused by traffic accidents,19 falling from high places,11 falling when walking,and ten by being hit.According to the random number table method,they were divided into control group (39 cases) and treatment group (38 cases).The treatment group received 1 g of tranexamic acid by intravenous injection within ten minutes on the scene and another 1 g of tranexamic acid within eight hours at the hospital.The control group received 0.9％ isotonic saline.The operation and medication followed the routine process.The arrival time of ambulance and the time of first medication use were recorded.The plasma fibrin degradation products (FDP) and D-dimer at admission and 1 d post-trauma,the percentage of cranitomy operation,case fatality rate,red blood cell transfusion,length of stay in the neurosurgical intensive care unit (NICU),and the Glasgow Outcome Scale (GOS) at day 28 were all recorded and analyzed.Results No significant differences were found between the two groups in gender,age,injury causes,GCS,arrival time of ambulance,and the time of first medication use (P ＞ 0.05).The FDP and D-dimer at admission of the two groups were similar (P ＞ 0.05).One day after admission,the expression of plasma FDP was significantly lower in treatment group than that in control group [6758 (4732,13661) μg/L vs.11740 (8516,21756) μg/L] (P ＜ 0.01).The expression of D-dimer was significantly lower in treatment group than that in control group [1074 (849,1414) μg/L vs.1722 (1389,2330) μg/L] (P ＜ 0.01).Between group differences were insignificant in the percentage of craniotomy operation,case fatality rate,and red blood cell transfusion (P ＞ 0.05).However,treatment group showed shorter stay in NICU [4 (1,12)days vs.2 (0,4)days] and higher GOS [4 (3,5)points vs.5 (4,5)points]than control group (both P ＜ 0.01).Conclusions Tranexamic acid can be applied conveniently in pre-hospital emergency care of craniocerebral trauma patients.It can effectively realize the synchronization of pre hospital transport and treatment,eventually reducing the time of NICU treatment as well as improving the prognosis.

Objective To explore the feasibility of establishing an acute pericardial effusion animal model guided by ultrasound. Methods Six experimental pigs were anesthetized. A PTC needle was injected and guided to the right ventricular anterior wall under real-time high frequency ultrasound,40 ml and 80 ml normal saline were respectively infused into the pericardial cavity within 5 minutes. Ultrasonography and pathologic examination were applied to confirm this porcine model. The amount of the fluid was estimated by ultrasound at 1 hour and 8 hours after infusion. Results With ultrasound guidance,the PTC needle smoothly entered the pericardial cavity and the saline was successfully injected. The fluid dispersed from local to the entire pericardial cavity. Pericardial effusion last within 8 hours and no significant change of the fluid amount was found (all P ＞0.05). This acute pericardial effusion model was successfully established with a rate of 100%. Conclusions It is feasible to establish an animal model of acute pericardial effusion under the guidance of ultrasound. This method is safe,rapid and effective. It can provide a suitable animal model for the study of acute pericardial effusion.

Objective: To study the correlation of lifestyle characteristics with thyroid nodules in a population-based sample of centenarians in Hainan. Methods: The study was based on China Hainan Centenarian Cohort Study (CHCCS) conducted in 18 cities and counties in Hainan province from 2014 to 2016. A group of multidisciplinary team interviewed and examined local centenarians with structured questionnaires and ultrasonography procedures. A total of 918 centenarians were analyzed after excluding those who refused ultrasonographic examinations or had relevant missing data. Thyroids of centenarians were examined by 3-year experienced sonographer, details on lifestyle characteristics and dietary habits were collected by standard procedure. Results: Of the 918 centenarians, 683 (74.4%) had thyroid nodules under the ultrasonography procedures. The prevalence of thyroid nodules in different group of areca nut consumption varied significantly (P<0.05). In multivariate logistic regression model, the results showed female and areca nut intake were independently associated with thyroid nodules in centenarians (P<0.05). Conclusions The modifiable variables including areca nut intake as well as non-modifiable such as gender are independent determinants of thyroid nodules in centenarians. Further studies are warranted to explore and verify these associations in populations with different ranges of age.

Objective:To explore the mRNA differential expression and clinical effect of leptin in different kinds of ovarian cancer.Methods: 129 patients with ovarian cancer and 42 controls were collected from Jun.2015 to Jun.2016 in our hospital.We got a small tissue by ovarian biopsy guided under the ultrasonic processing,detected the total RNA,purified mRNA and analyzed the correlation of the expression of leptin in different kinds and clinical stages of ovarian cancer.Results: Compared with the control groups,the mRNA expression of leptin in each group was increased(P<0.05),and the serous adenocarcinoma group increased obviously(P<0.05).Patients with clinical stage FIGO Ⅲ was significantly higher than other stages in serous adenocarcinoma group(P<0.05).Conclusion: Leptin could express in different kinds and clinical stages of ovarian cancer,and may be a new detection index for early diagnosis of ovarian cancer.

Objective This study explored the expression of polyclonal protein SUZ12 in patients with intrahepatic cholangiocarcinoma(ICC),and its role in predicting the survival and treatment of ICC patients.Methods The expression of SUZ12 and p16INK4a was detected by immunohistochemical assay in 207 liver tissue samples including ICC patients,BilIN-1,-2,-3 and non-tumor-like cholangiocarcinoma.The expression of these proteins was assessed to be related to the pathological characteristics of the ICC patients receiving chemotherapy and the outcome of survival as well as the subsequent chemotherapy response.Results The expression level of SUZ12 was gradually increased from non-neoplastic bile duct tissue to BilIN-1,-2,-3 and ICC.The expression of p16INK4a protein was expressed in non-neoplastic-like cholangiocarcinoma,but it decreased gradually in BilIN-1,-2,-3 and ICC tissues.SUZ12 expression was associated with undifferentiated ICC,lymph node metastasis and advanced cancer.Kaplan-Meier curve analysis showed that ICC patients with high expression of SUZ12 had a significant reduction in overall survival and disease-free survival in comparison with ICC patients with the low expression of SUZ12.SUZ12 expression was significantly associated with overall survival of patients receiving adjuvant gemcitabine-based chemotherapy(AGC).Conclusion SUZ12 expression is able to predict the overall survival and disease-free survival of ICC patients with adjuvant gemcitabine-based chemotherapy.