[Development of a novel absorbable nanofiber chitosan-collagen membrane by electrospinning and the preliminary study on guided bone regeneration]

Objective: To evaluate the application effect of nanofiber chitosan-collagen membrane (NCM) on guided bone regeneration (GBR). Methods: The mixture of collagen, chitosan, polyethylene oxide was used to make up the NCM by electrospinning, then the NCM was crosslinked by glutaraldehyde vapor. The physical property of the NCM was measured by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). MC3T3-E1 osteoblasts were cultured on NCM to characterize the biocompatibility. The effectiveness of four groups [contrast group, Bio-gide membrane (BGM), compressed chitosan-collagen menbrane (CCM), NCM/CCM] on bone regeneration were evaluated in critical-sized defects (diameter=5 mm) in SD rats. Results: When the mixed solution consists of 4.0% collagen, 1.0% chitosan and 3.5% polyethylene oxide, the NCM could be validly fabricated by electrospinning. After cross-linking by glutaraldehyde vapor, the tensile strength and the stability of NCM in damp was enhanced. No cytotoxicity of the NCM was detected on MC3T3-E1 osteoblasts. In vivo study showed that the new bone regeneration ratio of NCM/CCM group was [(43.10±1.49)%], and this was similar to that of the group of BGM [(41.36±2.60)%] (P>0.05), but higher than that of the CCM group [(33.10±1.41)%] and the contrast group [(7.22±2.46)%] (P<0.05). Conclusions: The NCM can promote new bone regeneration effectively in GBR procedure.

[Anatomy and histology characteristics of lymph node in nude mice]

OBJECTIVE

To compare the differences of anatomical and histological characteristics of lymph nodes between BALB/c nude mice and BALB/c mice.

METHODS

Firstly, twenty BALB/c nude mice and twenty BALB/c mice were dissected by using a surgical microscope. Secondly, the differences of T cells and B cells at the lymph node were compared by the expressions of CD₃ and CD₂₀ immunohistochemistry dyes.

RESULTS

There were, on average, 23 nodes per mouse contained within the large lymph node assembly in the BALB/c nude mouse. The anatomical features of the lymph node distribution in the nude mice were mainly found in the neck with relatively higher density. There were two lymph nodes both in the submandible lymph nodes group and in the superficial cervical lymph nodes group (the constituent ratios were 95% and 90%, respectively) in the BALB/c nude mice, but there were four lymph nodes (the constituent ratios were 95% and 90%, respectively) in the BALB/c mice. There were significant difference between the BALB/c nude mice and the BALB/c mice. Mostly there were two lymph nodes of deep cervical lymph nodes both in the BALB/c nude mice and the BALB/c mice (the constituent ratios were 95% and 100%, respectively). There were no significant difference between the BALB/c nude mice and the BALB/c mice. We confirmed that the number of CD₃-positive T lymphocytes in lymph nodes of the nude mice decreased greatly as compared with the BALB/c mice. Expressions of CD3 in T cells were 95% and 100% in the BALB/c nude mice and in the BALB/c mice, respectively. There were significant differences between the BALB/c nude mice and the BALB/c mice. Expressions of CD20 in B cells were 95% and 100% in the BALB/c nude mice and in the BALB/c mice, respectively. There was no significant difference between the BALB/c nude mice and BALB/c mice.

CONCLUSION

The anatomical pictures of lymph node distribution in the nude mouse will be benefit to those who are interested. The anatomical features of the lymph node local higher density in neck of the nude mouse and lack of CD3-positive T lymphocytes would be useful for obtaining a better understanding of localized lymph node metastasis of oral transplant tumors.

Hidden Antipolar Order Parameter and Entangled Néel-Type Charged Domain Walls in Hybrid Improper Ferroelectrics

Hybrid improper ferroelectricity (HIF) denotes a new class of polar instability by the mixture of two octahedral-distortion modes and can feature the coexistence of abundant head-to-head and tail-to-tail polar domains, of which the domain walls tend to be charged due to the respective screening charges with an opposite sign. However, no such coexisting carriers are available in the materials. Using group-theoretical, microscopic, and spectroscopic analyses, we establish the existence of a hidden antipolar order parameter in model HIF (Ca,Sr)_{3}Ti_{2}O_{7} by the condensation of a weak, previously unnoticed antipolar lattice instability, turning the order-parameter spaces to be multicomponent with the distinct polar-antipolar intertwining and accompanied formation of Néel-type twinlike antipolar domain walls (few nanometers) between the head-to-head and tail-to-tail domains. The finite-width Néel walls and correlated domain topology inherently lift the polar divergences between the domains, casting an emergent exemplification of charged domain-wall screening by an antipolar ingredient.

[Relationship between carotid plaque and diabetic retinopathy in type 2 diabetes mellitus patients]

Objective: To analyze the relevant factors for diabetic retinopathy. Methods: The data of type 2 diabetes mellitus patients undergoing general examination and ophthalmology specialist consultation were collected from the inpatients of Department of Endocrinology in Beijing Airport Hospital between 2013 and 2016, and the relevant factors of diabetic retinopathy were retrospectively analyzed. Results: A total of 432 cases were analyzed, including 168 cases of non-diabetic retinopathy and 264 cases of diabetic retinopathy. In the non-diabetic retinopathy group, there were 88 cases of male and 80 cases of female, with an mean age of (57.0± 13.6) years old. Meanwhile, the diabetic group had 142 cases of male and 122 cases of female, with an mean age of (62.7±10.4) years old. Univariate logistic regression analysis showed that age and glycosylated hemoglobin value were significantly higher in the diabetic retinopathy group than those of the non-diabetic retinopathy group, and the incidence of diabetic peripheral neuropathy, carotid plaque and central retinal thickness was significantly higher than that of the non-diabetic retinopathy group. Multivariate logistic regression analysis displayed that carotid plaque (OR=9.922, 95%CI: 3.700-26.603, P<0.001) and thinning of central retinal thickness (OR=9.639, 95%CI: 3.604-25.781, P<0.001) were independently associated with diabetic retinopathy. Conclusions: Carotid plaque is an independent risk factor for diabetic retinopathy, and thinning of central retinal thickness may indicate the progression of retinopathy. Therefore, patients with these two signs need to be observed more closely in clinical practice.

Analysis on application timing of IABP in emergency PCI treatment of patients with combined acute myocardial infarction and cardiac shock

OBJECTIVE

To study the application timing and effect of intra-aortic balloon pump (IABP) in the emergency PCI treatment of patients with combined acute myocardial infarction (AMI) and cardiogenic shock (CS).

PATIENTS AND METHODS

84 cases of patients with combined AMI and CS under PCI in emergency treatment were randomly divided into the control group (n=42) and observational group (n=42). The control group underwent IABP again, after the invalidation of internal medicine drug treatment, while the observational group underwent IABP before the operation. We compared the effects of treatment.

RESULTS

After the intervention, the averages of arterial pressure and urine volume were increased in both groups than before (p <0.05). The average of heart rate was decreased, and the improvement in the observational group was more significant (p <0.05). However, the mortality rate in the observational group during the perioperative period was decreased than the control group as well as, the success rate of off-respirator was significant (p <0.05). The comparison of IABP complication occurrence rate as well as the survival rate after 1-year follow-up between both groups was not significantly different. Additionally, whereas the NYHA grouping in two groups was gradually improved, the difference was not statistically significant between both groups. However, in the observational group, the LVEF after one-month follow-up was significantly higher than in the control group (p <0.05), but not when comparing 1-year. VEDd at each time point in two groups were also similar.

CONCLUSIONS

The early IABP can improve hemodynamics of patients with combined AMI and CS under emergency PCI. It can reduce perioperative mortality rate, improve the success rate of off-respirator, but cannot increase IABP complication incidence rate while having little influence on the long-term survival rate and cardiac function indicator.

[Etiological analysis on patients in department of vertigo and dizziness oriented outpatient]

Objective: We aimed to explore the spectrum of causes for patients in department of vertigo and dizziness oriented outpatient, in order to provide a reference for diagnosis and treatment of patients with vertigo or dizziness. Methods: Retrospective analysis were carried out with clinical data of patients in our department of vertigo and dizziness oriented outpatient. The target group under study was diagnosed based on the uniform diagnostic criteria, and re-visiting patients were excluded. Results: This clinical study was conducted on 5 348 cases, who visited our vertigo and dizziness oriented outpatient from December 2012 to July 2015. The ratio of male to female was 1∶1.48, the age range was between 16 and 93. The frequencies of different etiology were: benign paroxysmal positional vertigo 1 902(35.56%), Chronic subjective dizziness 1 329(24.85%), vestibular migraine 624(11.67%), Meniere's disease 378(7.07%), multi-sensory neuropathy 231(4.32%), vestibular paroxysmia 177(3.31%), benign recurrent vestibulopathy 171(3.20%), presyncope 66(1.23%), posterior circulation ischemia 57(1.07%), vestibular neuritis 54(1.01%), sudden deafness complicated vertigo 36(0.67%), other reasons 68(1.27%), unknown 255(4.77%). Conclusions: Our study indicates that the precedent three causes for vertigo or dizziness are benign paroxysmal positional vertigo, chronic subjective dizziness and vestibular migraine, followed by Meniere's disease、multi-sensory neuropathy, vestibular paroxysmia and benign recurrent vestibulopathy. Presyncope, posterior circulation ischemia, vestibular neuritis and sudden deafness complicated vertigo are relatively infrequent. There are still a certain proportion of patients undetermined.

[Misdiagnosis and associated costs of benign paroxysmal positional vertigo]

Objective: The aims of this study were to investigate the misdiagnosis of benign paroxysmal positional vertigo (BPPV) and to estimate the associated costs. Methods: During October 2015 to December 2015, eighty patients were diagnosed with BPPV in the outpatient dizziness clinic of Shanghai Changzheng Hospital and the clinical data of all the 80 patients were collected including the demographic and clinical characteristics, the history of diagnosis, inappropriate diagnostic tests, costs of the medical tests, transportation and accommodation. All the data were investigated to estimate the misdiagnosis of benign paroxysmal positional vertigo and the associated costs in Shanghai, China. Results: This study showed that the misdiagnosis rate of BPPV was 60.0% (48/80) and the common inappropriate diagnostic tests for BPPV included Cranial CT and MRI test, cervical MRI, cervical and cerebrovascular investigations et al. There was no significant difference between the misdiagnosis patients (48) and patients without misdiagnosis (32) in gender, age, duration of symptom, involved canal and type of BPPV.Complications were significantly more frequent in the misdiagnosis group than for those without[81.3%(39 /48) vs 34.4%(11 /32)]. The estimated costs for each misdiagnosed individual were 8 502.98 China Yuan (CNY) and one-year economic burden associated with the misdiagnosis of BPPV in Shanghai was 13.184 7-78.862 1 million CNY. Conclusions: Our study suggests that the misdiagnosis rate of BPPV is high and the financial impact on patients and society with this disease is huge. The cost-effective Dix-Hallpike or supine roll test maneuver should be used before applying other expensive medical tests in order to minimize misdiagnosis and the waste of health care resources.

[Causal analysis and management strategies of 30-day unplanned revision surgery following single-stage posterior vertebral column resection for severe spinal deformity]

Objective: To investigate the causes of 30-day unplanned revision surgery following one-stage posterior vertebral column resection (PVCR) for severe spinal deformity and the methods of prevention and management. Methods: A total of 112 severe deformity patients underwent one-stage PVCR for surgical treatment in the 306(th) Hospital of People's Liberation Army from May 2010 to December 2015 were retrospectively reviewed. Six patients required reoperation within 30 days after PVCR, including 2 males and 4 females with average age of 21 years (ranging from 12 to 38 years). Four cases were congenital kyphoscoliosis, 1 was post-laminectomy kyphoscoliosis and 1 was post-tuberculous angular kyphosis. Three cases associated with preoperative neurologic deficit (Frankel C in 1 patient and D in 2 patients). The causes, management and outcomes of unplanned revision surgery within 30 days after PVCR were recorded. Results: The total incidence of unplanned revision surgery within 30 days following PVCR was 5.4% (6/112). There was 1 case due to cerebrospinal fluid leak, 5 cases with varying degrees of new neurologic deficits, the causes were as followed: dural buckling in 1 case, residual bone compression in 1 case, epidural hematoma compression in 2 cases, spinal subdural hematoma in 1 case. All the 6 cases underwent surgical exploration again, including further dural repair, decompression and hematoma clearance. After unplanned reoperation, 6 cases recovered completely. The average follow-up time after surgery was 30.8 months (ranging from 10 to 60 months). The major curve at coronal plane was improved from preoperative 87.7° to 34.2°, with a mean correction of 61.0% at final follow-up; the sagittal kyphosis curve was improved from preoperative 119.5° to 45.5°, with a mean correction of 61.9% at final follow-up. Two patients' neurological status improved from Frankel D to Frankel E, one patient's neurological status improved from Frankel C to Frankel E. Conclusions: One-stage PVCR could be an effective method for treatment of severe spinal deformity. The causes of 30-day unplanned reoperation after PVCR are as followed: cerebrospinal fluid leak, dural buckling, residual bone compression and hematoma compression. Timely surgical exploration can gain good clinical outcomes.

Superconducting fluctuation effect in CaFe0.88Co0.12AsF

Out-of-plane angular dependent torque measurements were performed on CaFe0.88Co0.12AsF single crystals. Superconducting fluctuations, featured by magnetic field enhanced and exponential temperature dependent diamagnetism, are observed above the superconducting transition temperature T c, which is similar to that of cuprate superconductors, but less pronounced. In addition, the ratio of T c versus superfluid density follows well the Uemura line of high-T c cuprates, which suggests the exotic nature of the superconductivity in CaFe0.88Co0.12AsF.

[Gene diagnosis of four patients with protein C deficiency]

目的

探讨蛋白C缺陷症的分子发病机制。

方法

对4例蛋白C缺陷症患者进行常规诊断和基因分析。

结果

①例1，女，40岁。临床诊断：左下肢深静脉血栓形成。蛋白C活性（PC∶C）48%，蛋白S活性（PS∶C）26.3%，抗凝血酶活性（AT∶C) 75.6%。基因检测结果：蛋白C基因（PROC）启动子C5156T杂合突变、2号外显子区域存在A6578T杂合突变。给予抗凝、溶栓、滤器植入等治疗，症状好转出院。②例2，女，32岁。临床诊断：双下肢深静脉血栓，双上、下肢缺血，双下肢皮肤软组织感染。PC∶C 27%，PS∶C 22.9%，AT∶C 86.7%。基因检测结果：PROC基因启动子C5156T杂合突变、A5045T杂合突变。给予抗凝、抗感染等治疗，因呼吸衰竭、感染性休克、DIC死亡。③例3，女，28岁。临床诊断：右髂静脉及股深静脉血栓。PC∶C 58%，PS∶C 57.3%，AT∶C 80.8%。基因检测结果：PROC启动子C4867T杂合突变，7号外显子12702-12704 AGA (Arg192）或12705-12707 AGA（Arg193）杂合缺失，9号外显子G15240A杂合突变。给予抗凝、溶栓、滤器植入等治疗，症状好转出院。④例4，男，30岁。临床诊断：左下肢深静脉血栓，双下肺动脉栓塞伴双下肺梗死。PC∶C 50%，PS∶C 75.0%，AT∶C 89.1%。基因检测结果：PROC启动子C4867T纯合突变、G4880A纯合突变和A5045T杂合突变，2号外显子T6589C杂合突变。给予抗凝、溶栓、滤器植入等相关治疗，症状好转出院。⑤多态性分析：PROC基因启动子C4867T杂合突变、G4880A纯合突变、C5156T杂合突变为PROC启动子多态性位点。

结论

PROC启动子多态性位点G4880A、C4867T、C5156T，错义突变A5045T、A6578T、G15240A，缺失突变AGA12702-12704del或12705-12707del可能与蛋白C缺陷症有关。PROC启动子错义突变A5045T、A6578T、G15240A，缺失突变AGA12702-12704del或12705-12706del是国际首次报告。

Surgical complications in zygomatic implants: A systematic review

BACKGROUND

The use of zygomatic implants in the prosthetic rehabilitation of the patient with severe maxillary bone atrophy is another therapeutic alternative, not exempt from complications. The main objective of this review is to analyze and describe the most frequent surgical complications associated with the use of zygomatic implants.

MATERIAL AND METHODS

An electronic database search on PubMed, along with a manual search, without taking into account date nor language, was undertaken by two observers, selecting studies that comprised a study period from 6 to 12 months, any type of clinical trial, and series that included a follow-up and/or review period during the aforementioned margin, that mentioned at least two types of complications.

RESULTS

Out of the initial search that yielded 455 studies, 67 were considered potentially relevant for the present study, out of which 14 were finally selected. Out of the most frequent surgical complications, sinusitis (3,9%) and failure in osseointegration (2,44%) are highlighted.

CONCLUSIONS

The analysis of the results shows that the most frequent complications are sinusitis and failure in osseointegration of the zygomatic implant. However, a standardised data collection system for the data on complications is needed.

Effect of polymorphisms in interleukin-18 gene on the susceptibility to coronary artery disease in a Chinese population

Coronary artery disease (CAD) has a high mortality rate in several countries. Interleukin (IL)-18 has been previously correlated with atherosclerotic plaque rupture. In this case-control study, the relationship between -607A/C and -372C/G promoter polymorphisms in IL-18 and risk of CAD development was investigated. A total of 326 CAD patients were consecutively recruited from the First Hospital of Yulin between March 2013 and May 2015. The IL-18 -607A/C and -372C/G polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism. Patients with CAD had a higher body mass index, a history of hypertension or diabetes (all P < 0.001), cigarette smoking habit (P = 0.002); as well as higher plasma total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels (all P < 0.001) and lower high-density lipoprotein cholesterol (P < 0.001) levels compared to the control subjects. Unconditional logistic regression analysis revealed significant correlation between the CC genotype of IL-18 -607A/C and CAD development, compared to the AA genotype [adjusted odds ratio (OR) = 2.42; 95% confidence interval (CI) = 1.52-3.89; P < 0.001]. The recessive model showed a significant association between the CC genotype of IL-18 -607A/C and an increased risk of CAD, compared to the AA+AC genotype (OR = 2.51, 95%CI = 1.65-3.85). However, IL-18 -372C/G did not contribute to the risk of glioma development in the co-dominant, dominant, and recessive models. Therefore, the IL-18 -607C/A polymorphism was significantly correlated with the risk of CAD development.

Angular dependent torque measurements on CaFe0.88Co0.12AsF

Out-of-plane angular dependent torque measurements were performed on CaFe0.88Co0.12AsF (Ca1 1 1 1) single crystals. In the normal state, the torque data shows [Formula: see text] angular dependence and H (2) magnetic field dependence, as a result of paramagnetism. In the mixed state, the torque signal is a combination of the vortex torque and paramagnetic torque, and the former allows the determination of the anisotropy parameter γ. At T   =  11.5 K, γ (11.5 K ≃ 0.5 T c)  =  19.1, which is similar to the result of SmFeAsO0.8F0.2, [Formula: see text] at [Formula: see text]. So the 11 1 1 is more anisotropic compared to 11 and 122 families of iron-based superconductors. This may suggest that the electronic coupling between layers in 1 1 1 1 is less effective than in 11 and 122 families.