BACKGROUND:For on-visit root canal therapy, ultrasound washing can improve the quality of root canal irrigation, and play a synergistic role with ultrasound so that the flushing fluid can reach the area that cannot be completely cleaned up by root canal preparation instruments, such as apical isthmus and col ateral root canal, for removal of the detritus, cleanup and disinfection. ＜br> OBJECTIVE:To evaluate the clinical effect of one-visit root treatment with nickel-titanium rotary instruments and ultrasonic irrigation unit in treatment of chronic apical periodontitis. ＜br> METHODS:A total of 460 patients with il ed 460 teeth were selected. Patients were randomly divided into three groups:Mtwo instrument and ultrasonic technique combined with sodium hypochlorite was utilized in group A;ultrasonic technique combined with active silver ion antibacterial solution was utilized in group B;stainless steel K files with saline and hydrogen peroxide solution were used as irrigations in group C. Twenty-four hours after root canal fil ing, the pain degree was self-assessed by patients with visual analogue scale, and subsequent visit was done 7 days after root canal fil ing. Six and twelve months after root canal fil ing, the therapeutic effect was determined with X-ray examination and clinical assessment. ＜br> RESULTS AND CONCLUSION:The degree of pain and occurrence rate of acute reactions in groups A and B were significantly lower than those in group C (P＜0.05), but there was no significant difference between groups A and B (P>0.05). Six months after root canal fil ing, the cure rate was not significantly different between three groups (P>0.05). But after 12 months, the cure rate in the group C was significantly lower than that in groups A and B (P＜0.05). By using of nickel-titanium rotary instruments and ultrasonic irrigation unit in treatment of chronic apical periodontitis, the short-and long-term effects of one-visit root treatment have been achieved clinical y.

Objective: To investigate the factors influencing total bilirubin elevation and its correlation with UGT1A1 gene polymorphism in the early postoperative period of transjugular intrahepatic portosystemic shunt (TIPS). Methods: 104 cases with portal hypertension and esophageal variceal hemorrhage (EVB) treated with elective TIPS treatment were selected as the study subjects and were divided into a bilirubin-elevated group and a normal bilirubin group according to the total bilirubin elevation level during the early postoperative period. Univariate analysis and logistic regression were used to analyze the factors influencing total bilirubin elevation in the early postoperative period. PCR amplification and first-generation sequencing technology were used to detect the polymorphic loci of the UGT1A1 gene promoter TATA box, enhancer c.-3279 T > G, c.211G > A, and c.686C > A. Logistic regression was used to analyze the correlation of four locus alleles and genotypes with elevated total bilirubin in the early postoperative period. Results: Among the 104 cases, 47 patients were in the bilirubin elevated group, including 35 males (74.5%) and 12 females (25.5%), aged (50.72 ± 12.56) years. There were 57 cases in the normal bilirubin group, including 42 males (73.7%) and 15 females (26.3%), aged (51.63 ± 11.10) years. There was no statistically significant difference in age (t = -0.391, P = 0.697) and gender (χ(2) = 0.008, P = 0.928) between the two groups of patients. Univariate analysis revealed that preoperative alanine transaminase (ALT) level (χ(2) = 5.954, P = 0.015), total bilirubin level (χ(2) = 16.638, P < 0.001), MELD score (χ(2) = 10.054, P = 0.018), Child-Pugh score (χ(2) = 6.844, P = 0.022), and postoperative portal vein branch development (χ(2) = 6.738, P = 0.034) were statistically significantly different between the two groups. Logistic regression analysis showed that preoperative ALT level, total bilirubin level, and portal vein branch development after TIPS were correlated with the elevated total bilirubin in the early postoperative period. The polymorphism of the c.211G > A locus of the UGT1A1 gene correlation had elevated total bilirubin in the early postoperative period of TIPS. The risk of elevated total bilirubin was increased in the population carrying allele A (P = 0.001, OR = 4.049) in the early postoperative period. Allelic polymorphisms in the TATA box promoter region and enhancer c.-3279 T > G and c.686C > A had no statistically significant difference between the bilirubin-elevated group and the normal bilirubin group. Conclusion: The preoperative ALT level, total bilirubin level, and portal vein branch development are correlated with the elevated total bilirubin in early postoperative patients. The polymorphisms of the UGT1A1 gene and enhancer c.211G > A are correlated with the occurrence of elevated total bilirubin in the early postoperative period of TIPS. Allele A carrier may have a higher risk of elevated total bilirubin in the early postoperative period.
Female ; Humans ; Male ; Bilirubin ; Esophageal and Gastric Varices ; Gastrointestinal Hemorrhage/surgery* ; Portasystemic Shunt, Transjugular Intrahepatic ; Postoperative Period ; Retrospective Studies ; Treatment Outcome ; Adult ; Middle Aged ; Glucuronosyltransferase/genetics*