全麻治牙前后龋活跃性的临床观察

目的观察在全身麻醉(全麻)下行龋病治疗的患儿术前、术后3个月、术后6个月龋活跃性(CA)的变化情况。方法 102例行全麻治牙的儿童龋病患儿,在术前、术后3个月、术后6个月采用Cariostat法检测龋活跃性,并进行比较。结果术后3、6个月,患儿Cariostat法分度均低于术前,差异具有统计学意义(Z=11.960、9.007, P<0.05);术后6个月,患儿Cariostat法分度高于术后3个月,差异具有统计学意义(Z=6.087, P<0.05)。结论全麻治牙可在短期内显著降低患儿的龋活跃性,改善患儿的口腔健康。

老年高血压患者监护治牙安全评估及临床对策

观察在心电监护下局麻治疗急性牙髓炎,对老年高血压患者的影响,为其安全治疗提供参考。监测522名老年高血压患者在急性牙髓炎治疗前后及过程中的血压、心率等变化,将测量结果进行分析。患者血压在麻醉即刻及术中比治疗前明显升高(P<0.05),其中收缩压较舒张压变化更为明显。心率在麻醉即刻及治疗中均明显高于治疗前(P<0.05)。病情稳定的老年高血压患者可在心电监护下治牙,Ⅱ、Ⅲ级高血压,可据情况,静脉给药控制性降压,避免高血压危象的发生,严格掌握老年高血压患者治牙适应症,可明显降低治疗中并发症发生的风险,可提高老年高血压患者治牙的安全系数。

MRC功能矫治器的临床研究

目的观察MRC功能矫治器矫治替牙期安氏Ⅱ类Ⅰ分类患儿的临床效果。方法选择江西省惠民医院2018年4月-2018年6月收治的30例替牙期儿童安氏Ⅱ类Ⅰ分类错[牙合]畸形患儿,按照随机数字表法随机分为对照组与实验组各15例,对照组患儿接受Activator肌激动器矫治,实验组患儿接受MRC功能矫治器矫治,以鼻阻力测定及三维锥体束CT(CBCT)为测量手段,观察两组患儿呼吸方式、上气道形态变化情况、治疗舒适度及满意度差异。结果经矫治,两组患儿呼吸方式纠正情况比较差异无统计学意义(P>0.05);矫治后,两组上呼吸道形态指标[上气道容积(Total)、最小截面积(Min)、下咽腔直径(LPW)及舌根后咽腔直径(PAS)]水平均显著提高(P<0.05),鼻咽腔直径(UPW)、口咽腔直径(MPW)与矫治前比较差异无统计学意义(P>0.05),矫治后,实验组患儿Total水平显著高于对照组(P<0.05),两组矫治前后其他上呼吸道形态指标比较无统计学意义(P>0.05);经矫治,两组治疗满意度比较差异无统计学意义(P>0.05),实验组患儿治疗舒适度显著高于对照组(P<0.05)。结论MRC矫治器对替牙期安氏Ⅱ类Ⅰ分类患儿呼吸方式及上气道形态变化具有良好纠正与改善作用,且其舒适度较Activator肌激动器更高,值得临床推广。

Significance of preoperative C-reactive protein as a parameter of the perioperative course and long-term prognosis in squamous cell carcinoma and adenocarcinoma of the oesophagus

AIM： C-reactive protein （CRP） is an acute-phase reactant and a known indicator of the malignant potential of the tumour. The aim of this study was to investigate the significance of preoperative CRP as a parameter of the perioperative course and long-term prognosis in patients with squamous cell carcinoma and aclenocarcinoma of the oesophagus. METHODS： Serum CRP was determined preoperatively in 291 of 371 patients undergoing oesophagectomy for cancer from December 1989 to March 2004. Median patient age was 59 （28-79） year, 82.5% of patients were males. Squamous cell carcinoma was diagnosed in 151 （51.9%） and aclenocarcinoma in 122 patients. Transhiatal oesophagectomy was clone in 151 （51.9%） patients and 134 （46.0%） patients underwent the abclominothoracic procedure. RESULTS： In 127 （43.6%） patients the preoperative serum CRP concentration was within the normal range （〈 5 mg/clL）, elevated CRP levels were measured in 164 （56.4%） patients. Tumour extension （P 〈 0.0005） and the number of lymph nodes affected by metastatic spread （P = 0.015） were significantly increased in the group with elevated CRP levels. Among the perioperative parameters both the number of blood transfusions （P = 0.006） and the general complication rate （P = 0.002） were higher in patients with elevated preoperative CRP levels. The long-term survival rate of 13.6 （0-109.8） mo was poorer in the group with elevated CRP levels compared to 18.9 （0-155.4） mo in the group with normal CRP levels （log-rank test： P = 0.107）. Multivariateanalysis with backward variables selection identified preoperative CRP as an independent prognostic factor of the long-term prognosis in patients with oesophageal carcinoma, with a hazard ratio of 1.182 （95% confidence interval： 1.030-1.356）. CONCLUSION： The preoperative serum CRP-level is an easily determined independent prognostic marker in patients with squamous cell carcinoma and adenocarcinoma of the oesophagus.

Factors associated with regular dental visits among hemodialysis patients

AIM To investigate awareness and attitudes about preventive dental visits among dialysis patients; to clarify thebarriers to visiting the dentist. METHODS Subjects included 141 dentate outpatients receiving hemodialysis treatment at two facilities, one with a dental department and the other without a dental department. We used a structured questionnaire to interview participants about their awareness of oral health management issues for dialysis patients, perceived oral symptoms and attitudes about dental visits. Bivariate analysis using the χ2 test was conducted to determine associations between study variables and regular dental check-ups. Binominal logistic regression analysis was used to determine factors associated with regular dental checkups.RESULTS There were no significant differences in patient demographics between the two participating facilities, including attitudes about dental visits. Therefore, we included all patients in the following analyses. Few patients(4.3%) had been referred to a dentist by a medical doctor or nurse. Although 80.9% of subjects had a primary dentist, only 34.0% of subjects received regular dental check-ups. The most common reasons cited for not seeking dental care were that visits are burdensome and a lack of perceived need. Patients with gum swelling or bleeding were much more likely to be in the group of those not receiving routine dental check-ups(χ2 test, P < 0.01). Logistic regression analysis demonstrated that receiving dental check-ups was associated with awareness that oral health management is more important for dialysis patients than for others and with having a primary dentist(P < 0.05). CONCLUSION Dialysis patients should be educated about the importance of preventive dental care. Medical providers are expected to participate in promoting dental visits among dialysis patients.

Distalization of maxillary molars for Class Ⅱ malocclusion with Chinese Ni-Ti coil-springs appliance

Objective: To evaluate the effects of the Chinese Ni-Ti coil-springs appliance on distalization of maxillary molars and the reciprocal effects on the anchorage teeth. Methods:Twenty-four adolescent patients(12 boys,12 girls) with Class Ⅱ malocclusion were selected and the coil-springs appliance was used during the treatment. Pre- and postdistalization lateral cephalometric radiographs were analyzed and compared. Results: The average time for the correction of Class Ⅱ molar relationship was 4.6 months. And the mean distance of molar distalization was 4.4 mm. The Chinese Ni-Ti coil-springs also demostrated less tipping and better bodily movement of maxillary molars. Conclusion: This study suggests that the Chinese Ni-Ti coil-springs appliance distalizes the upper molar significantly, while there is no remarkable loss of anchorage because of patients’ wearing headgear with J hooks at night and Class Ⅱ elastics in the day time.

Effectiveness of infliximab after adalimumab failure in Crohn's disease

AIM:To evaluate the effectiveness of infliximab as a second-line therapy in Crohn's disease patients after adalimumab failure. METHODS:A historical cohort study in a community-based gastroenterology practice evaluated Crohn's disease patients treated with infliximab (induction plus maintenance) after adalimumab failure. Patients were identified using a large Spanish database (ENEIDA). RESULTS:We included 15 Crohn's disease patients who received infliximab after adalimumab failure. Five patients discontinued adalimumab due to loss of response, 3 due to adverse events and 7 due to partial response. After infliximab therapy was started, all patients who had interrupted adalimumab due to loss of efficacy regained response. All patients who discontinued adalimumab due to adverse events responded to infliximab and maintained this response; one of these patients had an uneventful course on infliximab, but 2 developed adverse events. None of the 7 patients who interrupted adalimumab due to partial response reached remission with infliximab. CONCLUSION:Switching from adalimumab to infliximab may be useful in patients who develop adverse effects or loss of response, however, the benefit of infliximab in primary nonresponders was not established.

A case of colohepatic penetration by a swallowed toothbrush

Although foreign body ingestion is relatively common,toothbrush swallowing is rare. We report a case of a swallowed toothbrush which passed through the ileocecal valve and perforated the proximal transverse colon,then the liver. To our knowledge, this is the first case to be reported,

Hispanic Women＇s Presence in the Actual U.S. Congress

The Hispanic population of the United States has become, in recent times, into a powerful electoral force whose vote is historically oriented towards the Democratic Party of the incumbent US President Barack H. Obama. Obviously, this growing electoral strength is reflected into its political presence in the American life that has been accomplished with their numeric inclusion in the US Congress. Although in the recent decades several studies have arisen on the status of the Hispanic community in the United States from both sides of the Atlantic, these have been primarily focused on casuistic, demographic, developmental or educational aspects. But only a few of them, if any, has focused exclusively on the numerical and symbolical representation of the community in the political arena, and more specifically into the main legislative body of the country, the US Congress. And therein it lays the purpose of this article. We intend to investigate not only the historical presence of Hispanic legislators in Congress but also and especially their political influence in the current U.S. Congress. Finally, and prior to the conclusions drawn throughout the paper, we will analyze the political influence of the Hispanic congresswomen in the current 114th Congress. As we will be breaking down, this group has been changing gradually from a poor oppressed minority into one of the most dynamic groups of the country, introduced at all levels of government.

Rising costs and hospital admissions for hepatocellular carcinoma in Portugal(1993-2005)

AIM:To determine,for hepatocellular carcinoma(HCC),the patient demographic profile and costs of their admissions to the hospitals of the Portuguese National Health System from 1993 to 2005.METHODS:The National Registry(ICD-9CM,Inter-national Classification of Diseases,155.0)provided data from the 97 Hospitals in Portugal.RESULTS:We studied 7932 admissions that progres-sively rose from 292 in 1993 to 834 in 2005,having a male predominance of 78%(6130/7932).The global rate of hospital admissions for HCC rose from 3.1/105 in 1993 to 8.3/105 in 2005.The average length of stay decreased from 17.5 ± 17.9 d in 1993 to 9.3 ± 10.4 d in 2005,P < 0.001.The average hospital mortality for HCC remained high over these years,22.3% in 1993 and 26.7% in 2005.Nationally,hospital costs(in Euros-€)rose in all variables studied:overall costs from €533 000 in 1993,to €4 629 000 in 2005,cost per day of stay from €105 in 1993,to €597 in 2005,average cost of each admission from €1828 in 1993,to €5550 in 2005.In 2005,1.8%(15/834)of hospital admissions for HCC were related to liver transplant,and responsible for a cost of about €1.5 million,corresponding to one third of the overall costs for HCC admissions in that same year.CONCLUSION:From 1993 to 2005 hospital admissions in Portugal for HCC tripled.Overall costs for these admissions increased 9 times,with all variables related to cost analysis rising accordingly.Liver transplant,indicated in a small group of patients,showed a disproportionate increase in costs.

Clinical characteristics and type of antithrombotic treatment in a Spanish cohort of elderly patients with atrial fibrillation according to dependency, frailty and cognitive impairment

Background Available data regarding clinical profile and management of elderly patients with atrial fibrillation （AF） according to dependency, fragility and cognitive impairment are scarce. The objective of the study was to analyze the biodemographic data, clinical profile and antithrombotic treatment according to dependency, fragility and cognitive impairment in elderly AF patients. Methods Cross- sectional and multi-center study performed in consecutive AF patients ≥ 75 years treated with oral anticoagulants ≥ 3 months attended in Internal Medicine Departments in Spain. Results A total of 837 patients （83.0 ± 5.0 years; CHA2DS2-VASc： 5.0 ± 1.4; HAS-BLED： 2.1 ± 0.9） were included. 44.4% of patients had some degree of dependency, 43.3% were fragile, and 32.3% had cognitive impairment. Patients with any of these conditions were older, had a worse clinical profile, with more comorbidities and higher risks of thromboembolic and bleeding events. All these conditions were independently associated among them. Overall, 70.8% of patients were taking vitamin K antagonists, the remaining 29.2% direct oral anticoagulants and 9.7% oral antiplatelets. This distribution was independent of the presence of dependency or fragility, but there was a trend to a higher prescription of vitamin K antagonists in those patients with cognitive impairment （75.2% vs. 68.8%; P = 0.05）. Conclusions Approximately 32%-44% of elderly anticoagulated AF patients attended have some degree of dependency, fragility and/or cognitive impairment. Patients with any of these conditions are older and have a worse clinical profile. Ap？proximately 71% of patients are taking vitamin K antagonists, regardless dependency or frailty, but with a trend to higher prescription in patients with cognitive impairment.

The Renascence Party and Union and Socio-Political Organization of Muslims in Spain

This paper presents an overview and analyzes the impact of the Partido Renacimientoy Union de Espana （PRUNE, Renascence Party and Union in Spain） specifying in the socio-political articulation of Muslims in Spain. In particular, it aims to describe and analyze the historical and political context of the emergence of these types of parties in the European Union （EU）; their background in Spain, particularly in the Autonomous Cities of Ceuta and Melilla and their specific impact on socio-political movements. The main hypotheses of work are the heterogeneity of Islamic communities in Spain, its religious references and social integration are difficult and complex, implying that this will provide a strategic impact from PRUNE, which could be very limited, slow, and uncertain.

Power and Architecture in Portuguese Fascism： Political and Artistic Control and Resistance

This paper analyses the system of artistic and ideological conditioning that architects were subject to during the Portuguese fascism, the so-called ＂New State＂, the longest western European dictatorship of the previous century, that lasted from 1933 to 1974, under the uninterrupted leadership of Ant6nio de Oliveira Salazar until 1968. After a concise exposition of the importance of a major public work campaign to the regime affirmation as well as the aesthetic discourse promoted in its architecture, the standard course of a building project evaluation will be described. Crossing varied legislation and taking into consideration the results of a thorough examination to more than one hundred processes of architectural plans approval, the interaction of the various decision-making bodies will illustrate the existence of an efficient apparatus which progressively depurate designs. Prevention and repression of artistic deviation will be demonstrated. Furthermore, the development and importance of self-censorship will be highlighted. Secondly, a characterization of the atmosphere of ideological surveillance and dissident＇s oppression will be provided. Architects＇ participation in opposition＇s initiatives and strategies will be portrayed. As a conclusion, New State practice of a negotiation and inclusion （both artistic and ideological） tactic in the architectural field will be underlined.

A Sustainable Agriculture Production Model of Pampanga State Agricultural University in Central Luzon, Philippines

Alternative Low-Input Agriculture Systems （ALIAS） center advocates organic and sustainable food production system through farm/field demonstration and piloting. The center undertakes activities, including research and development, extension and training, technology dissemination, linkaging and promotional activities. The study established a campus-based demonstration technology showcasing ALIAS to facilitate easy technology diffusion. The objectives of this research were to promote： （1） bio-fertilizers and plant-based pesticides in managing insect pests and diseases of organic vegetables and fruit crops; （2） lotus-tilapia integration as a new modality of farming system in frequently flooded areas; （3） honeybee as pollinators to enhance productivity of organic vegetable and fruit crops; （4） Adlai as intercrop to organic vegetable and fruit crops in support to rice sufficiency; （5） native chicken-coffee integration. The results show that： （1） microbial inoculants and plant-based pesticides are effective in controlling diseases and insect pest, respectively; （2） lotus integration in tilapia production system have no negative effect on the tilapia yield; （3） honeybees as pollinators enhances fruit setting by 42%-68% in different crops; （4） Adlai is a viable intercrop for organic vegetable and fruit crops; （5） native chicken integration was found to be beneficial in terms of soil fertility, insect pest control, natural weeding practices and cultivation in the coffee plantation.

Is There Such Thing as ＇Populist Constitutionalism＇？ The Case of Hungary

The paper deals with recent deviations from the shared values of con- stitutionalism towards a kind of ＇populist, illiberal constitutionalism＇ introduced by Hungary＇s new constitution in 2011. The populism of FIDESZ was directed against all elites, including the ones that designed the 1989 constitutional system （in which FIDESZ also participated）, claiming that it was time for a new revolution. This is why PM Viktor Orban characterized the results of the 2010 elections as a ＇revo- lution of the ballot boxes＇. His intention with this revolution was to eliminate all checks and balances, and even the parliamentary rotation of governing parties. His vision for a new constitutional order----one in which his political party occupies the centre stage of Hungarian political life and puts an end to debates over values has now been entrenched in the new constitution. The paper argues that this current Hungarian constitutional system was made possible by FIDESZ＇ anti-pluralist nationalist populism, but is not necessarily based on a true commitment to expressing the will of the people via ＇illiberal constitutionalism＇. The populist government rather misuses the country＇s lack of constitutional culture. Adherence to constitutional patriotism would mean that FIDESZ would have to endorse what John Rawls once called ＇constitutional essentials＇. The core of this kind of con- stitutional patriotism is a constitutional culture centred on universalist liberal democratic norms and values. Instead, the current Hungarian constitutional system is confronted with unconstitutional patriotism, a kind of nationalism that violates constitutional essentials in the name of ＇national constitutional identity＇.

Treatment of exfoliative cheilitis with Traditional Chinese Medicine：a systematic review

OBJECTIVE:To systematically review treatments of exfoliative cheilitis based on symptom patterns in terms of Traditional Chinese Medicine.METHODS:Pub Med, Cochrane Central Register of Controlled Trials and Wanfang data were screened for case reports, case series or clinical trials that were published in English or Chinese from January,1973 to September, 2015.The keyword of "exfoliative cheilitis or scaling cheilitis or factitious cheilitis" was used.Effectiveness or ineffectiveness was investigated as outcome for Meta analysis, which is based on effective index in each study.Response to treatment was described for case reports or case series.RESULTS:From 38 screened studies, 17 were randomized controlled trials(RCTs), 5 were single-arm trials, and 16 were case reports or case series.Three RCTs were eligible for Meta analysis and all of them compared managements between Traditional Chinese Medicine and corticosteroids for exfoliative cheilitis, which involved 223 participants.Interestingly, data of Meta analysis showed similar effect of Traditional Chinese Medicine and corticosteroids for patients with exfoliative cheilitis [relative risk ratio:1.10; 95% CI(1.00-1.21), P = 0.06].CONCLUSION:Traditional Chinese Medicine might be a substitute for corticosteroids on exfoliative cheilitis.However, the evidence and recommendation of exfoliative cheilitis managements need to be taken with caution because of the low quality of evidence in the studies obtained.

Acupuncture-moxibustion Theories of Ge Hong

Ge Hong （261-341）, courtesy name Zhichuan, also known as Baopuzi or Ge Ximlweng, born in Jurong of Danyang （present-day Jurong ofJimlgsu Pronce）, was a famous Taoist and physician during the Eastern Jin Dynasty. He had a reputation for broad reading, mad was enthusiastic over Huamg Di Nei Jl＇ng （Yellow Emperor＇s Classic of InternM Mediclhe） and A^J J？hg （Classic of Ditticult Issues）, esoteric arts, mid alchemy. He was once ma official of theEastern Jin Dynasty, but later lived as a recluse on Luofu Mount of Guangdong Province. His one hundred scrolls of Yu Hail FaJlg （PrescripKons Hidden 111 Golden Chambe was supplemented later by Tao Hong-jing and Yang Yong-dao, and became Fu GuaJlg Zhou Hou BeiJi Fang （Supplement Handbook of Prescripgons for Emergenc [Zhou Hou Bei Ji Fang （Handbook of Prescripgons for Emergencies） for short] nowadays, in which, convenient, low-price, and effective treatment methods were included.