Sensory innervation around immediately vs. delayed loaded implants: a pilot study

Although neurophysiological and psychophysical proof of osseoperception is accumulating, histomorphometric evidence for the neural mechanisms of functional compensation following immediate and delayed implant loading is still lacking. For this randomized split-mouth study, six mongrel dogs randomly received one of four treatment protocols at 36 implant-recipient sites over 16 weeks （third maxillary incisor, third and fourth mandibular premolar）： immediate implant placement and immediate loading （liP＋ IL）; delayed implant placement and delayed loading （DIP＋DL）; delayed implant placement and immediate loading （DIP＋IL）; and natural extraction socket healing （control）. Histomorphometry was performed in the peri-implant bone and soft tissues within 300 pm around the implants. Immunocytochemistry and transmission electron microscopy were used to confirm the presence of neural structures and to reveal their ultrastructural characteristics, respectively. Myelinated nerve fibres densely populated the peri-implant crestal gingival and apical regions, although they were also identified in the woven bone and in the osteons near the implant threads. Compared with the control group in the mandible, the group that received IIP＋IL showed a higher innervation （in N.mm^-2, 5.94±1.12 vs. 3.15±0.63, P〈0.001） and smaller fibre diameter （in pm, 1.37±0.05 vs. 1.64±0.13, P=0.016）, smaller axon diameter （in pm, 0.89±0.05 vs. 1.24±0,10, P=0.009） and g-ratio （0.64±0.04 vs. 0.76±0.05, P〈0.001） in the middle region around the implants. Compared with DIP＋IL in the mandible, IIP＋IL had a higher nerve density （in N.mm^-2, 13.23±2.54 vs. 9.64±1.86, P=0.027）, greater fibre diameter （in pm, 1.32±0.02 vs. 1.20±0.04, P=0.021）, greater axon diameter （in μm, 0.92±0.01 vs. 0.89±0.03, P=-0.035） and lower g-ratio （0.69±0.01 vs. 0.74±0.01, P=-0.033） in the apical region around the implants. It may be assumed that the treatment protocol with liP＋ IL is the preferred method to allow optimized peri-implant re-innervation, but further functional measurements are still required.

Study on the Impact of Post-Mastectomy Radiotherapy on Immediate Breast Reconstruction and Complications: A Meta-Analysis

Background and objective:Immediate breast reconstruction not only reduces the number of surgeries for patients after mastectomy but also decreases psychological and physical trauma,making it increasingly popular.However,there is currently no consensus on the integration of post-mastectomy radiotherapy(PMRT)with reconstruction techniques.This review evaluates the impact of PMRT on complications following immediate breast reconstruction,providing guidance for clinical treatment decisions.Methods:PubMed,Web of Science,Embase,and other databases were searched for studies published in the past 15 years on outcomes of implant-based breast reconstruction in the context of radiotherapy to identify articles for analysis.RevMan 5.4 software was used to analyze the risks of seroma,infection,wound dehiscence,flap necrosis,implant exposure,capsule contracture,and reconstruction failure.Results:A total of 1l relevant studies were included,comprising 6323 cases of immediate breast reconstruction.It was found that breasts receiving postoperative irradiation had a significantly increased risk of complications,with statistically significant differences in seroma(P=0.004),infection(P<0.00001),wound dehiscence(P=0.04),implant exposure(P<0.00001),capsule contracture(P<0.00001),and reconstruction failure(P<0.00001).There was no statistically significant difference in flap necrosis(P=0.88).Conclusion:The results indicate that postoperative radiotherapy significantly increases the risk of complications for patients undergoing immediate implant-based reconstruction.Preventive measures may be taken in advance with the assistance of healthcare providers if necessary.

欢迎来到世界上最冷的村庄

在没有暖气的情况下,很多人可能连零度的气温都受不了。但是有这么一个地方,常年零下几十度,一出门睫毛就会结冰,但仍有不少人在这里快乐地生活着。The average people have no idea what a deep freeze feels like. We get hi with a foot of snow or read a thermomete(温度计) that says 22 degrees Fahrenhei(华氏度) and immediately find ourselves barely able to cope.

Rapid report of seismic damage to hospitals in the 2023 Turkey earthquake sequences

The seismic performance of medical systems is crucial for the seismic resilience of communities.The report summarizes the observed damage to twelve hospital buildings in the area affected by the MW 7.8 and MW 7.5 earthquakes on February 6,2023 in Turkey.They include five base-isolated buildings and seven fixed-base buildings in southcentral Turkey's seven most heavily affected provinces.By relating the post-quake occupancy statuses of the hospitals with the estimated seismic demands during the earthquake doublet,the report offers the following observations:(1)the base-isolated hospital buildings on friction pendulum bearings generally exhibited superior performance of achieving the goal of immediate occupancy and provided better protection for nonstructural elements than fixed-base counterparts did;(2)the fixed-base hospital buildings of reinforced concrete structures constructed after 2001 successfully achieved the goal of collapse prevention even under very high seismic demands;(3)some fixed-base hospitals also remained operational even if they were very close to the fault rupture and were subjected to higher-than-design-level earthquake ground motions.

Effects of Immediate Dental Loading Implant Therapy on Electroencephalography (EEG) and Stress

Purpose: Implant therapy restores masticatory function by restoring lost tooth morphology. It has been shown that mastication contributes not only to food intake and digestion, but also to the improvement of overall health. However, there have been no studies on the effects of implant treatment on electroencephalography (EEG). In this study, we investigated the effects of restoration of masticatory function by implant treatment on EEG and stress. Methods: 13 subjects (6 males, 7 females, age 64.1 ± 5.8 years) who had lost masticatory function due to tooth loss and 11 healthy subjects (6 males, 5 females, age 47.6 ± 2.4 years) as a control group. EEG (θ, α, β waves, α/β ratio) and salivary cortisol were measured before immediate dental implant treatment and every month of treatment for 6 months. EEG (θ, α, β waves, α/β ratio) was measured with a simple electroencephalograph miniature DAQ terminal (Intercross-410, Intercross Co., Ltd., Japan) in a resting closed-eye condition, and salivary cortisol was measured using an ELISA kit. Results: Compared to the control group, the appearance of θ and α waves were significantly decreased and β waves were increased, and α/β ratio was significantly decreased. The cortisol level of the subject group was significantly higher compared with the control group. With the course of implant treatment, the appearance of θ and α waves of the subject group increased, while β waves decreased. However, no significant difference was observed. The α/β ratio of the subject group increased from the first month after implant treatment and increased significantly after 5 and 6 months (0 vs. 5 months: p < 0.05, 0 vs. 6 months: p < 0.01). The cortisol levels in the subject group decreased from the first month after implant treatment and significantly decreased after 3 or 4 months (0 vs. 3 months: p < 0.05, 0 vs. 4 months: p < 0.01). These results suggest that tooth loss causes mental stress, which decreases brain stimulation and affects function. Restoration of masticatory function by implants was suggested to alleviate the effects on brain function and stress.

Effect of Training Nurses in ICU in Immediate Care Post Cardiac Surgery

The specialty of cardiovascular surgical nursing has advanced patient care significantly both before and after surgery, and it is now a well-established field. The primary goal of cardiovascular surgical nursing is to optimize the patient's recovery and prevent complications. Immediate nursing care for post-operative cardiac patients in a state of controlled shock due to fluid shift and varying vascular tone. Aim of the Study: Assessment of nurse’s knowledge and performance after the training program of nursing care immediately after a patient arrives from cardiac surgery. Methods: This pre and post-intervention study was conducted at cardiac centers in Sudan Alshaab and Ahmed Gasim Cardiac Center. The aim of the study was to evaluate the impact on nurses’ performance after training program post open-heart surgery. In the initial phase of the study, all 98 nurses working in the intensive care units at Alshaab and Ahmed Gasim cardiac centers were designated as the study group and evaluated before the intervention. Subsequently, the same group was reassessed after the intervention (phase 2), allowing for a comparison of the pre- and post-intervention results. The assessment involved the use of a specifically designed questionnaire and an observation checklist developed in accordance with the standards recommended by the American Nurses Association (phase 3). Result: Descriptive analysis was performed using the Chi-square test, the difference in the performance between the study group before intervention and after the intervention was assessed by the mean of chi-square significantly was taken as p < 0.05.

Practices of Maternity’s Care Providers in the Municipality of Kozah 1 Regarding the Administration of Vitamin K1, Eye Care, and Umbilical Cord Care in Immediate Postpartum Newborns

Background: Neonatal mortality is a real public health problem in the world and particularly in countries with limited resources. Essential care remains an effective means of reducing this mortality. Objective: To evaluate the practice of administering of vitamin K1, ocular and cord care in maternity wards in the Kozah 1 municipality. Method: This is a cross-sectional study conducted from March 1st to June 30th, 2022 in all maternity wards in the Kozah 1 municipality. Socioprofessional aspects of providers and those related to the administration of vitamin K1, ocular and cord care were studied. Results: Eighty-five (85) maternity providers were included in this study. The average age of the providers was 36.2 years with extremes of 21 and 55 years. Providers were midwives (51.8%), childbirth attendants (35.3%), and matrons (12.9%). The average length of practice was 9.5 years with extremes of 1 and 28 years. For three out of four providers (75.3%), the postpartum period was defined as a period of 02 hours following delivery. The importance of cord, ocular care, and administration of vitamin K1 in postpartum was known respectively by 84.7%, 98.8%, and 92.9% of the providers. Chlorhexidine gel was used by 81.2% of providers for umbilical cord care. For ocular disinfection, more than half of the providers (52.9%) reported using half-diluted povidone iodine. No center had displayed care protocol. Conclusion: This study highlighted the level of knowledge and practice of three essential postpartum care practices. The products used for the different care practices are consistent with recommendations but vary according to the care providers.

Management of Immediate Postpartum Hemorrhage at the University Hospital Center of the Sino-Central African Friendship

Introduction: Immediate postpartum hemorrhages constitute a frequent maternal complication and remain at the forefront of maternal death in our countries. Objective: Contribute to improving the management of immediate postpartum hemorrhage in our context with a view to reducing maternal mortality. Patients and Methods: We conducted a retrospective descriptive and analytical study over a period of 12 months from January 1st to December 31st 2020. Results: We collected a total of 109 files on a total of 4360 deliveries. The frequency of postpartum haemorrhages was of the order of 2.5%. The most represented age group was between 20 and 24 years old. Pauciparas represented the majority of our study population. 64.5% of patients were uneducated. These hemorrhages occurred in patients who often gave birth outside the department with 63.8%. The main causes of postpartum hemorrhage were cervical tears (51.2%) and partial placental retention (30.7%). The majority of these deliveries (48.8%) were carried out by midwives followed by assistant midwives (33.2%). Active management of the third period of delivery was systematic and immediate followed by the valve examination completed by the infusion of oxytocin in case of uterine atony, tranexamic acid ans misoprostol intrarectally. In the event of persistent hemorrhage, suture of the cervical lesions, ligation of the cervical vessels or even laparotomy either for the selective ligation of the blood vessels or for the hysterectomy for hemostasis were practiced. We do not have a Nalador, nor a Bakry balloon, nor an Interventional Radiology service for embolization of the uterine arteries. We deplore 1.3% of deaths from afibrinogenemia. Conclusion: The frequency of immediate postpartum hemorrhages is lower in our health facility. This is due to the rapid handling of cases. Improving the quality of services offered to women during childbirth can further help reduce the frequency of these hemorrhages.

Improved Behavioural Engagement of Students through Low-stakes Online Tests and Immediate Dialogic Feedback

The engagement of students is a recognised challenge for teachers.Technology offers some practical student engagement tools,and this paper examines the use of low-stakes online tests and immediate dialogic feedback to improve behavioural engagement.The academic exploration of low-stakes tests and dialogic feedback has been extensive,and they are credible teaching tools.In this study,we explore the learning benefit of their combination.Postgraduate engineering students’self-reported and learning analytics data shows conclusive evidence of improved behavioural engagement.We measured a 500%increase in the Learning Management System(LMS)page views on the days when we ran the low-stakes tests(each worth 2%of the marks for the subject)and engaged in immediate dialogic feedback.To interpret these results,we draw on theories of behavioural engagement,low-stakes tests,and feedback.We conclude that the combination of low-stakes tests and immediate feedback improves student behavioural engagement.

2035年,全球一半以上人口将肥胖

世界肥胖联合会的一份新报告提醒道,如果不立即采取行动,到2035年,世界上一半以上的人口将肥胖或超重。A new report from the World Obesity Federation has warned that, without immediate action, more than half of the world's population will be obese or overweight by 2035.

MUTATIONAL SPECTRA OF INDUCED MUTATIONS IN THE ad-3 REGION OF Neurospora crassa:EVIDENCE FOR MUTAGEN SPECIFICITY

Specific-locus mutations induced in the ad-3region of two-component heterokaryons ofNeurospora have been compared by means ofMutational Spectra.Genetic characterization ofad-3 mutations has revealed that there are majorclasses:gene/point mutations,multilocus deletionmutations and unknowns (mutants that grow toorapidly alone on minimal medium to be classified).

Condylar and Occlusal Changes after High Condylectomy and Orthodontic Treatment for Condylar Hyperplasia

Condylar hyperplasia（CH） of human temporomandibular joint（TMJ） often occurs unilaterally, and causes occlusal disturbance and facial asymmetry. The purpose of this study was to compare the effects of high condylectomy with and without postsurgical orthodontic treatment. Forty patients were diagnosed as having active CH and treated with high condylectomy. Patients in group A（n=24） took the postsurgical orthodontic therapy immediately after surgery, and those in group B（n=16） did not take orthodontic therapy. For both groups, the mandibular ramus height on the affected side was decreased significantly after surgery. Orthodontic treatment promoted maxillary alveolar remodeling significantly by depressing alveolar bone of the affected side and increasing alveolar bone of the nonaffected side. Better improvement for facial midline deviations was observed in group A than in group B. In both groups, the condylar remodeling was observed and manifested by the smoothening of condylar surface and returning of condyle to normal position in glenoid fossa. It was concluded that high condylectomy in the treatment of active CH of TMJ improved the functional occlusion and facial aesthetic. Postsurgical orthodontic therapy could more effectively enhance maxillary alveolar and condylar remodeling, and more rapidly and meticulously establish the stable occlusal and normal position of condyle than the spontaneous remodeling.

The Romantic Movement in English and American Literature

Ⅰ The Appearance of Romantic Lite-ratureThe Romantic Movement in Eng-lish literature came into being as anew trend at the turn of tlie 18th and19th centuries.It was flowering dur-ing the first half of the 19th centuryin America.During this period,the class con-tradiction and national contradictionwere extremely acute in Europe.In1789,the French Revolution broke out,,which overthrew the feudal power.As a result of this,a new

Flotation techniques to improve viability of Juniperus polycarpos seed lots

The germination of freshly collected Juniperus polycarpos（K. Koch） seeds is very low and attributed to the large proportion of nonviable seeds in the seed lots.Thus, the aim of this study was to improve seed lot quality by removing nonviable seeds using two flotation techniques： incubation-drying-separation（IDS） and modified specific gravity（MSG） separation. We examined different IDS conditions（the specific incubation time, subsequent drying time and sorting media） for effectively sorting out nonviable seeds; and tested the feasibility of modified SG separation, which involved soaking seeds in water for a certain period before sorting in different concentrations of sucrose solution. Viable seeds were expected to absorb and metabolically bind more water during soaking than dead seeds could, and hence be sorted effectively depending on the viscosity of the sucrose solution. The viability of the seeds that floated or sank was determined in a topographical tetrazolium chloride（TTC） test. For the IDS trial,7 days incubation followed by 9 h of drying and sedimentation in pure water or 200 g L-1sucrose solution identified, respectively, 75 and 82 % of the seeds as viable（sunken） seeds. For the MSG trail, 77 % viable seeds were recovered in the sunken fraction when seeds were soaked for 48 h then immediately sorted in 600 g L-1sucrose solution. In both cases, the loss of viable seeds in the discarded floating fraction was only 4 %. The results demonstrate that both IDS and MSG separation techniques substantially improved seed lot viability, but MSG separation is simple and needs no modern seed handling facility, and its efficacy relies on seed mass（due to the initial soaking） and the specific density and viscosity of the flotation medium.

A REPORT OF A CASE OF MALIGNANT INSULINOMA WITH LIVER METASTASIS

A47-year-old man was admitted to our departmentbecause ot progresive cardiopalmus,trumor of hands anddiaphoresis at hunger for two months.Cerebrovasculardisease was diagnosed for two times because of coma at night.and every times.the patient recovered immediately followingdrip treatment. At the beginning CT scan revealed a normalbrain and a doubtful pancreatic lesion In the period of hos-pitalization.the patient repeatedly developed the symptoms ofhypoglycemia,which always relieved in 3—5 minutes aftercating sugar. The blood glucose Was 1.6 mmol/L and Seruminsulin was 160 μu/ml when the hypoglycemia wasdeveloping.Ultrasonic examination displayed abnormal area(2 cm in diameter)in the head and the uncinate process ofpancreas and an enlarged liver and multiple parenchymallesions in the liver. Futher CT scan showed hepaticenlargement and a huge mass at the posterior segnent of thehepatic right lober.and multiple parenchymal lesions in theliver. The CT also showed enlargement of the head ofpancreas with dis

REPORTS ON ILLUSTRATIVE CASES OFVARIOUS DISEASES EFFECTIVELYTREATED WITH MOXIBUSTION

Fleshy Growths Creeping Over the Eyeball Patient Wang, a male cadre of 58, firstvisited on 28 June 1989 with the chief com-plaint of blurred vision in the left eye forhalf a month. For 6 months prior to the visitthe patient felt some discomfort in his lefteye with increase in discharge and tearing,and in the two weeks immediately before thevisit, vision of the left eye became blurred.There was a gritty sensation and

EXPERIENCE IN THE CLINICAL APPLICATION OF ACUPOINT ZHAOHAI (K 6)

The acupoint Zhaohai (K 6) is locatedin the depression immediately below the in-ferior border of the medial malleolus. It be-longs to the Kidney Channel ofFoot--Shaoyin and is one of the eightconfluent points. In ancient medical books,acupoint Zhaohai is referred to as the placewhere the qi of Yinqiao Channel originates.

Experience with pulmonary vein isolation in patients with paroxysmal atrial fibrillation by using a circular cryoablation catheter

Objective This study was to report our early experience with electrical isolation of pulmonary vein (PV) in paroxysmal atrial fibrillation (AF) by using a circular cryoablation catheter. Methods After electroanatomic model of LA/PVs was established by Carto, cryoablation was performed in each PV. If complete isolation of PVs could not be achieved, then additional radiofrequency ablations would be applied to ablate the conduction gaps. Results Cryoablation was performed in totally 58 PVs in 14 cases with paroxysmal AF. Thirty-one PVs (53.4%) were successfully isolated with the single use of the circular cryoablation catheter after 2 to 5 (3.2±1.5) cryoablation, while 2 to 4 additional radiofrequency ablations needed to be applied at gaps on the circular cryoablation lines to achieve completely isolation in 27 PVs (46.6%). After a follow up of 18±7 months, 11 patients (78.6%) remained AF free. Selective pulmonary venography immediately and repeat magnetic resonance imaging (MRI) scan at 3 months post procedure showed there was no PV stenosis. Conclusion The circular cryoablation catheter can be safely used in the isolation of PVs in paroxysmal AF, But the efficacy of this technique needs to be further improved.