Objective:To compare the efficacy on root canal debridement of three ultrasonic units Odontoson-M, P-MAX and Spartan. Methods: Extracted healthy premolars with one single straight canal were used. The canals were prepared by step-down technique. After preparation, the canals were received ultrasonic irrigation and split longitudinally. Debris scores were calculated after photographing with a digital camera. The number of visible open dentinal tubules were evaluated by SEM. Results: At middle third of the canals, when irrigated with 5 g/L NaOCl, the debris score in group Odontoson-M was significantly lower than that in other groups(P

Objective To investigate the effectiveness and safety of intranasal different dose of dexmedetomidine for pediatric echocardiography sedation and to discuss the factors concerning recovery.Methods In a single-blinded randomized clinical trial,183 children were studied with a range of 2months and 33 months of age,and American Society of Anesthesiologists(ASA) physical status Ⅰ to Ⅱ.Those children were divided randomly into one of three groups.Groups D1,D2,and D3,which were received intranasal dexmedetomidine 1.0,1.5,and 2.0 μg/kg,respectively.The induction time,recovery time,examination time,and total sedation time were compared.The success rate of sedation and the occurrence of any side-effects with the drug were compared.Sex,age,weight,dose,induction time,and examination time were used as independent valuations,the recovery time was used as dependent valuation,and then the multiple linear regression analysis was performed to filtrate and formulate the valuable factors influencing recovery time.Results The induction time had no significantly difference among groups (P ＞ 0.05).The recovery time of group D3 was longer than group D1 and group D2 (P ＜ 0.05).The total sedation time of group D3 was longer than group D1 (P ＜ 0.05).The success rate of sedation and the incidence of sideeffects had no significantly difference among groups (P ＞0.05).Children's weight and medicine dose were found to affect recovery time.Conclusions Intranasal dexmedetomidine 1 ～ 2 μg/kg could be used effectively and safely in children undergoing echocardiography examination.Weight and dose were considered as key indexes to predict recovery time.

Environmental Monitoring ; methods ; Inhalation Exposure ; Occupational Exposure ; analysis ; Workplace

To discuss bacteria of urine infection reoccurrence , the routine culture and L-form bacteria culture of urine tract infection on 850 cases were adopted and clinica l watching and analysis of the bacteria plasmid were held ．Result: of the l28 cases, re-infec tion rate l5.0%．,the positive rate of the routine bacteria culture for those initial diagnosis patie nts was 58.3% while that of the re-infection patients was 34.0% P<0.0l ．The initia l diagnosis L-form inspected rate 5.6%yet that of re-infection was up to 32.0 % P<0.01 ．The analysis of the pla smid bacteria of re- infection were of the same origins ．Conclusion: the first infection dont nee d L-form culture but re- infection should have L-form culture ．Analysis: plasmid positive bacteria of r e-infection was the result of the first infection not completely cured．

Objective To study decompression and internal fixation combined with interbody fusion for degenerative lumbar spinal ste-nosis. Methods One hundred cases with degenerative lumbar spinal stenosis from January 2012 to June 2012 were researched. They were randomly divided into observation group and control group. Fifty patients in the control group,they were given treatment of interbody fusion. The observation group had 50 patients,using decompression and internal fixation on the basis of the control group. The back pain VAS score, leg pain VAS score,disc height,Cobb angle,ODI score of patients 3 months and 2 years after treatment were compared with each other. Re-sults After 3 months of treatment,back pain VAS score, leg pain VAS score,ODI scores of the observation group were lower than those of the control group,the difference was significant (P<0. 05). Intervertebral height of observation group was higher than that of control group, the difference was significant(t=4. 110 0,P=0. 000 1). After 2 years of treatment,back pain VAS score,leg pain VAS score and ODI score of the observation group was still lower than those of the control group, the difference was significant(P<0. 05). Intervertebral height of the observation group still higher(P<0. 05). The change of Cobb angle was not obvious. Conclusion Decompression and internal fixation com-bined with interbody fusion for degenerative lumbar spinal stenosis has a good effect,which is worthy of promotion in clinic.

0),whose mean calcification score was 1935.54(0～9833). Patients with calcification score ≥100 had significantly higher morbidity of cardiovascular diseases, serum phosphate level, calcium-phosphate product, C-reactive potein concentration and lower serum albumin than patients with calcification score

Purpose To investigate the value of dual-source CT with dual-energy virtual non-contrast imaging in the diagnosis of cervical lymph node disease. Materials and Methods The dual-energy scan data of 126 lymph nodes from 50 patients confirmed pathologically were reviewed. The difference of average CT value, signal to noise ratio, contrast to noise ratio, image subjective assessment and lesion detectability between virtual non-contrast imaging and conventional non-contrast scan were analyzed. The radiation dose of virtual non-contrast imaging and real non-contrast imaging of cervical lymph node were also compared. Results ①The consistency of virtual plain scan combined with dual-energy contrast imaging in the diagnosis of six typical pathological types were all satisfactory (Kappa>0.7, P<0.01), and the detection rate of non-specific lymphadenitis, lymphomas and lymph node metastasis of thyroid carcinoma was higher among the six types (93.1%, 86.7% and 100.0%, respectively, Kappa=0.983, 0.893; P<0.01), and had the highest detection rate of lymph node metastasis of thyroid carcinoma (100.0%, Kappa=1.000, P<0.01). ②There was no significant difference among the average CT, signal to noise ratio and contrast to noise ratio of conventional scan and virtual non-contrast imaging during arterial phase and venous phase (H=3.125, 4.374, 4.037;P>0.05).③ Compared with conventional enhanced scan, dual-energy phases reduced radiation dose by about 19%. Conclusion Dual-energy virtual non-contrast imaging combined with contrast imaging can provide clear images in the diagnosis of enlarged cervical lymph nodes and reduce radiation dose of subjects, thus can be expected to replace real scan.

Objective To study the surgical treatment strategy for heamophilic arthropathy and musculoskeletal appara?tus. Methods A total of 120 heamophilic patients underwent 166 primary operations from January 1996 to June 2015 in Pe?king Union Medical College Hospital, with the average age of 29.7±12 years (from 6 to 61 years). Hemophilic type A accounted for 109 patients and hemophilic type B accounted for 11. Eighty?seven patients presented with bleeds within the joints, with 63 cases for knee involved, 29 cases for hip, 11 cases for ankle. Fifteen patients presented with intramuscular bleeds, 21 patients with heamophilic pseudotumors. Strategy of clotting factor replacement therapy was designed according to the different level of opera?tion procedure. The clinical manifestation, operative strategy, clinical outcome and complications were retrospectively recorded. Results 41 cases (34.2%) of patients underwent surgeries for more than one location. Totally, 166 procedures were performed for 120 patients. There were 103 procedures of joint arthroplasty (62.0%, 103/166), 21 procedures of pseudotumor resection (12.7%, 21/166), 15 procedures of tendon lengthening, 12 procedures of ankle arthrodesis, 13 procedures for knee flexion contracture. There were 30 cases of postoperative complications, with the rate of 18.1% (30/166). The coagulation related complication was 4.8%in this group (8/166). The surgical procedure related complication was 7.2%(12/166). All the preoperative symptoms were relieved during the follow?up. Conclusion Surgical treatment was effective for the heamophilic arthropathy and lesion of mus?culoskeletal apparatus, under the reasonable clotting factor replacement therapy. The incidence of perioperative complication in heamophilic patients is higher than that in non?hemophilic patients. Closely inspection was inevitable for perioperative treat?ment in hemophilic patients.

Heat shock protein 27 ( HSP27 ) is an endogenous protein that plays an important role in a great variety of physio-logical and pathological processes. It can express a large number under body stress conditions. Recent studies have shown estro-gen upregulates the expression of HSP27 through a number of ways, playing a perfect “triple protection” role. In the early stage of atherosclerosis, estrogen induces the phosphorylation of HSP27 via PI3K/Akt signaling pathway. Phosphorylation of HSP27 can resist the injury of vascular endothelial cells( VECs) through an antioxidant and anti-apoptotic pathway as well as the inhibition of cytochrome C. In the stage of forming foam cells, estrogen induces the expression and release of HSP27 from mac-rophages by stimulating the estrogen receptor β ( ERβ) , then HSP27 inhibits the LDL uptake and the release of proinflammato-ry cytokine by binding scavenger receptor A ( SR-A) . During the proliferation and migration of vascular smooth muscle cells ( VSMCs) , estrogen induces estrogen receptor α ( ERα) and protein phosphatase 2 ( PP2A) to form a complex that enhances the activity of PP2A, then it can lead to the dephosphorylation of HSP27 and finally inhibit cells proliferation and migration. In summary, the anti-atherosclerotic effect of estrogen is closely re-lated to the role of HSP27. Given the side effects of estrogen re-placement therapy( MHT) , regulating HSP27 may provide a no-vel therapy for the prevention and treatment of cardiovascular dis-eases in menopausal women clinically.

, but the amount decreased significantly. Conclusions Peri-operative nursing can promote the recovery of patients with pelvic floor hernia, rectal prolapse combined with colonic slow transit constipation.