Objective:To analyze the influencing factors related to the prognosis of delayed replantation of avulsed permanent teeth.Methods:A retrospective study was conducted on the clinical data of 35 patients with 38 affected teeth underwent delayed replantation of permanent teeth.According to the prognosis after 12 to 108 months of follow-up,the replantation results of the cases were divided into-success,survival and failure groups.Survival curves were plotted using Kaplan-Meier method,Log-Rank test was used for univariate analysis,and Cox proportional risk regression models were used for multivariate analysis to assess the effects of gender,age,degree of tooth development,mode of tooth preservation and mode of endodontic treatment on the survival rate of replanted teeth.Results:Of the 38 replanted teeth,3 were successful,28 remained and 10 failed.The 9-year cumulative survival rate of the replanted teeth was 34.7％.The results showed that there were no statistically significant differences in the survival rate of the replanted teeth in the groups with different sex,age,degree of tooth development and the mode of preservation of avulsed teeth(P＞0.05).There were statistically significant differences in the cumulative survival rate of the replanted teeth among the groups with different endodontic treatment(P＜0.01),which showed that the cumulative survival rate in the root canal filling group＞continuous root canal sealing group＞pulp preserva-tion treatment group.Conclusion:For the delayed replantation of avulsed premanent teeth,survival prognosis of the teeth treated with pulp preservation is poor,early pulp extraction and root canal filling are recommended.

BACKGROUND:Studies have shown that both Panax notoginseng saponins and concentrated growth factor can promote fracture healing,but there are few studies addressing their combined effects on fracture healing.Panax notoginseng saponins may accelerate fracture healing by promoting the release of concentrated growth factor-related factors over a certain period of time. OBJECTIVE:To study the effect of Panax notoginseng saponins on concentrated growth factor release and fracture healing in rats. METHODS:Eighteen 8-week-old Sprague-Dawley rats were numbered and randomly divided into three groups:Panax notoginseng saponins group,model control group and blank group.Panax notoginseng saponins group was fed with Panax notoginseng saponins for 2 weeks.Model control group was given 2 mL of normal saline for 2 weeks and blank group was fed normally.Concentrated growth factor was obtained by the centrifugation method both from the Panax notoginseng saponins group and model control group.After 1 week of normal feeding,all animals underwent modeling for femoral fracture.The Panax notoginseng saponins group and the model control group were implanted with autologous concentrated growth factor,and then the release concentration of growth factors at different time points(1 hour,1,3,5,7,9 and 11 days)were measured by ELISA.Fracture healing was assessed based on postoperative X-ray and hematoxylin-eosin staining of bone tissues. RESULTS AND CONCLUSION:Compared with the model control group,the Panax notoginseng saponins group had higher release concentrations of vascular endothelial growth factor A and transforming growth factor β at 7,9,and 11 days,Platelet-derived growth factor BB at 5,9,and 11 days,and basic fibroblast growth factor at 1-11 days(P<0.01).X-ray examinations indicated that fracture healing in the Panax notoginseng saponins group was better than that in the model control group,and fracture healing in these two groups was better than that in the blank group at 2 months after surgery.Hematoxylin-eosin staining results found that the constituent osteocyte density in the Panax notoginseng saponins group was greater than that in the model control group,and the constituent osteocyte density in these two groups was better than that in the blank group.These findings indicate that Panax notoginseng saponins can increase the concentration of concentrated growth factor-related factors.After intervention with Panax notoginseng saponins,concentrated growth factors are more advantageous in promoting fracture healing in rats.

Objective To determine the risk factors for postoperative hyperactive-type delirium (PHTD) in elderly patients undergoing orthopedic surgery.Methods A total of 7 171 elderly patients of both sexes,aged more than or equal to 65 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅳ,who underwent orthopedic surgery from January 2008 to December 2012 in Second Affiliated Hospital of Wenzhou Medical University,were retrospectively analyzed.Data such as gender,age,preoperative electrolytes,blood glucose,hemoglobin,albumin,senile dementia and use of benzodiazepines,type of operation,anesthesia methods,operation time,intraoperative use of anticholinergic agents and benzodiazepines and hypotension (decrease more than 20％ of the baseline),and postoperative electrolyte,hemoglobin,albumin and hypotension were collected.The patients were divided into postoperative PHTD group (group PHTD) and postoperative non-PHTD group (group non-PHTD) according to whether PHTD developed within 7 days after operation.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression to stratify the risk factors for postoperative PHTD.Results Ninety-nine patients developed PHTD,and the incidence was 1.38％.The results of logistic regression analysis showed that age more than or equal to 80 yr,hip surgery and preoperative anemia were independent risk factors for postoperative PHTD (P＜0.05).Conclusion Age more than or equal to 80 yr,hip surgery and preoperative anemia are independent risk factors for postoperative PHTD in elderly patients undergoing orthopedic surgery.

Objective To explore the integration of the digital imaging medical records system and the hospital information system ( HIS), for a hospital-wide information platform for digital medical records management. Methods All the medical records were classified as " to copy and not to copy" by sampling, and an item corresponding table was developed for both HIS medical record files and imaging records copying types. The imaging copying system for paper-based medical records only covers those must-copy ones, while those medical record files without need to be copied were directly transcoded via the interface to the imaging medical records system from the HIS system. This makes digital imaging medical records complete. Results The digital imaging medical record system is thus integrated, and the cost of making imaging medical records was sizably reduced without compromising the quality and integrity of medical records. Conclusions Imaging medical records produced by copying paper-based ones are integrated with those directly sent via the interface to the imaging medical records system, forming complete digital imaging records, at a much lower cost.

Objective : The present study observed the clinical effects on reattachment and pulpotomy of young crown-fractured and pulp-exposed permanent incisors. Methods : In a one-year retrospective clinical observation study, 30 traumatic intact segments of permanent incisors with crown fracture and pulpal exposure were treated using a pulpotomy and reattachment technique with an enamel-dentin luting agent and composite resin. Results : The number of subsequent visit teeth was 30, 29, 25 at 1, 3, 6 months follow-up respectively. The pulpotomy success rates were 100% at 1 month, 93.1% at 3 months, 93.1% at 6 months. The retention rates using the reattachment technique were 100% at 1 month, 100% at 3 months, 100% at 6 months. Conclusion Pulpotomy is the preferred method of preserving live pulp after pulpal exposure of young permanent incisors, and the clinical effect is prominent. The fragment reattachment technique is an effective middle- and short-term method for temporary restoration of young crown-fractured permanent incisors.

Objective To explore the effect of telomerase reverse transcriptase(TERT) gene transfected bone marrow stem cell(BMSC)on the memory function and hippocampal CA1 region synaptic plasticity in vascular dementia rat.Methods A total of 60 rats were randomly divided into the negative control group(group A),model group(group B),conventional BMSC group(group C) and transfected BMSC group(group D).The related indicators in each group were detected by using the Morris maze test,RTPCR and Western blot respectively.Results The escape latency period in the group C and group D was significantly longer than that in the group B,which in the group D was significantly longer than that in the group C.Compared with the group A,the expressions of brain-derived neurotrophic factor(BDNF)mRNA,TERT mRNA,SYP mRNA and protein in the group B,group C and group D were significantly decreased.The synaptic cleft arrange in group A was clear with more SYN positive ceils.The synaptic cleft in the group D was clearer,and the number of SYN positive cells was close to that in group A.Conclusion TERT transfected BMSC has obvious therapeutic effect on vascular dementia rats and its mechanism may be related to the promotion of BDNF,TrkB expression and the improvement of synaptic plasticity.

Objective:To evaluate the clinical effect of the revaseularization procedure for immature teeth with necrotic pulp and apical periodontitis.Methods:12 immature teeth with necrotic pulp and apical periodontitis in 12 patients(9-13 years old) were treated with revascularization protocol.The patients were followed up for 21-24 months.Results:All teeth were cured.4 types of responses were observed:①Increased thickening of the canal walls and continued root maturation;②Severe calcification of the canal space beneath MTA;③Partial pulp canal obliteration;④Continued root development with an open apex.Conclusion:Revascularization procedure may the formation of the root apex but not in all the cases.Excessive deposition of hard tissue might caused calcification in canal space.

Objective To investigate the effects of amino acid combined with Salvia miltiorrhiza injection on fetal growth restriction.Methods 122 pregnant women diagnosed with fetal growth restriction were chosen,and they were divided into study group(amino acid+Salvia miltiorrhiza injection) and control group(amino acid).The course of treatment was 7d,and the patients were treated for 3 treatment courses.The clinical efficacy,weight increment,uterine height increment,abdominal circumference increment,fetal biparietal diameter (BPD) increment,femur length (FL) increment,umbilical cord blood flow S/D value and neonatal weight between the two groups were compared.Results The total effective rate in the study group was 84.13%,which was higher than 67.79% in the control group (χ2=4.484,P<0.05).In the study group,the body weight gain,the uterine height increment,abdominal circumference increment were (523.21±103.72)g,(2.88±0.52)cm and (3.19±0.75)cm,respectively,which were significantly higher than those in the control group(t=2.215,4.402,2.328,all P<0.05).The uterine height increment and abdominal circumference increment in the intermediate stage of the study group were (2.14±0.27)cm and (2.89±0.52)cm,respectively,which were significantly higher than those of the control group,and the differences were significant(t=1.503,2.097,all P<0.05).In the study group,the BPD increment and FL increment at prophase and intermediate stage were (2.69±1.23)mm and (2.24±0.97)mm,(2.61±1.28)mm and (2.19±1.28)mm,respectively,which were significantly higher than those in the control group (t=2.053 and 2.244,2.038 and 2.128,all P<0.05).The S/D values of umbilical cord blood flow in early stage,middle stage and anaphase of the study group were (2.33±0.19),(2.46±0.17) and (2.12±0.14),which were significantly lower than those of the control group (t=4.040,2.9817 and 4.418,all P<0.05),the differences were statistically significant.The neonatal weight of the study group was (2 576.18±621.04)g,which of the control group was (2 384.09±428.76)g,and there was significant difference between the two groups(t=1.999,P<0.05).Conclusion Amino acid combined with Salvia miltiorrhiza injection can effectively improve the clinical indicators of pregnant woman and fetal growth restriction,with good clinical effects.

OBJECTIVE:To investigate therapeutic efficacy and safety of leosimendan in the treatment of acute left heart failure (ALHF) and its effects on left ventricular function indexes and serum markers.METHODS:A total of 110 patients with acute left ventricular function selected as research objects from No.251 Hospital of PLA during Jan.2014-Dec.2015,and then were divided into control group (53 cases) and observation group (57 cases) according to random number table.Both groups received routine therapy.Control group was additionally given Dopamine hydrochloride injection or Dobutamine hydrochloride injection as cardiotonic on the basis of routine therapy.Observation group was additionally given Levosimendan injection with initial dose of 10 μg/kg+0.9％ Sodium chloride injection 50 mL,ivgtt (10 min),and then with micro pump infusion at the rate of 0.1 g/(kg· min) for continuous 24 h.Both groups were treated for continuous 7 d.Clinical efficacies of 2 groups were observed,and the levels of left ventricular function indexes (PER,PFR,LVEF,LVSF) level,serum marker (NT-proBNP) and galectin-3 (Gal-3) before and after treatment,the occurrence of ADR was recorded.RESULTS:Two cases were withdrawn from the study due to death (one case in each group).Finally,a total of 108 cases were included,involving 52 cases in control group and 56 cases in observation group.Clinical total response rate of observation group (94.64％) was higher than that of control group (86.54％),but without statistical significance (P＞0.05).Before treatment,there was no statistical significance in left ventricular function indexes or serum markers levels between 2 groups (P＞ 0.05).After treatment,the levels of left ventricular function indexes were improved significantly in 2 groups,and LVEF and LVSF of observation group were significantly higher than those of control group,with statistical significance (P＜0.05).NT-proBNP and Gal-3 of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).No obvious ADR was found in 2 groups during treatment.CONCLUSIONS:Leosimendan in the treatment of ALHF have the similor clinical efficacy with dopamine,but helps to strengthen the left heart pump function,reduce heart failure markers levels with good safety.

Objective To explore the mediating effect and moderating effect of positive mental characters in the relationship between childhood abuse and depression among recruits.Methods 1925 recruits aged from 16 ～24 were investigated using the Childhood Trauma Questionnaire-28 item Short Form (CTQ-SF),Self-Rating Depression Scale (SDS) and Positive Mental Characters Scale for Recruits (PMCS-R) through random cluster sampling.Results The scores of emotional abuse,physical abuse,sex abuse,emotional neglect,physical neglect,depression,positive mental characters were 6.11±1.69,5.49±1.32,5.61±1.45,9.15±3.66,9.57±2.93,0.45±0.11,3.80±0.64,respectively.There were correlations among childhood abuse,depression and positive mental characters (P＜0.05).Emotional neglect,physical neglect and emotional abuse could explain 28.6％ of the total variance of depression (F=256.72,P＜0.05).The positive mental characters partially mediated the relationship between emotional neglect,physical neglect,emotional abuse and depression (mediating effect were 0.19,0.15 and 0.09,respectively),and it could only moderate the relationship between emotional neglect and depression (F=24.73,P＜0.05).Conclusion Childhood abuse not only directly but also indirectly affects depression through the positive mental characters;meanwhile the positive mental characters can change the relationship between childhood abuse and depression.