BACKGROUND:Amount of debris extruded apicaly is an important indicator to evaluate the effect of root canal preparation instrument. Studies have shown that debris extruded apicaly can cause post-treatment pain, and thus, reducing the amount of debris extruded apicaly can decrease the incidence of post-treatment pain. OBJECTIVE:To compare the root canal cleanness and the amount of apicaly extruded debris during root canal preparation with Self-adjusting files, ProTaper Next and ProTaper Universal. METHODS:Forty-five premolars with single canal were divided into three groups randomly, and then prepared by Self-adjusting files, ProTaper Next and ProTaper Universal, respectively. Debris extruded apicaly was colected, dried and weighed. Then roots were longitudinaly sectioned and observed under scanning electronic microscope to evaluate the cleanness of the root canal. RESULTS AND CONCLUSION:The amount of apicaly extruded debris in the ProTaper Universal group was significantly higher than that in the Self-adjusting files group and ProTaper Next group (P < 0.05), but there were no statisticaly significant differences between the groups of Self-adjusting files and ProTaper Next in apicaly extruded debris (P > 0.05). Scores on debris and smear layer were lower in the group of Self-adjusting files than the groups of ProTaper Next and ProTaper Universal (P < 0.05), but there was no difference between the latter two groups (P > 0.05). These findings indicate that the Self-adjusting files and ProTaper Next can extrude less debris beyond the apical foramen, which may decrease the incidence of post-treatment pain. Cleaning ability of Self-adjusting files is better than ProTaper Next and ProTaper Universal.

BACKGROUND:Currently, the nickel-titanium file has no uniform international standards for clinical use, and several nickel-titanium systems have unique designs in terms of cross-sectional shape, taper change,
composition number, central steel volume, and cutting edge angle, so there are some differences in cleanup
capability, security, and cutting efficiency. ProTaper Next is developed based on the ProTaper Universal, and its composition number, blade cross-sectional shape, contact point with the root canal wal and the tip tapers are al improved.
OBJECTIVE:To compare the shaping ability between ProTaper Next and ProTaper Universal Ni-Ti rotary endodontic instruments by preparing the simulated root canals.
METHODS: Two groups of resin blocks were prepared by ProTaper Next and ProTaper Universal respectively. Preparation time and incidence of canal aberration and instruments failure were recorded. After preparation, the images taken before and after preparation were superimposed and analyzed by software Adobe Photoshop v7.0. We measured the amount of resin removed at the inner and outer canal wals. The centering ability was also assessed.
RESULTS AND CONCLUSION:There was no difference in the incidence of canal aberration. ProTaper Next was faster than ProTaper Universal to prepare canals (P < 0.05). Both instruments caused apical transportation. 
ProTaper Universal F2 removed more materials than ProTaper Next X2 at the inner canal wals (P < 0.05). ProTaper Next showed better centering ability than ProTaper Universal in most levels (P < 0.05). Two instruments showed good performance in preparation but both created some apical transportation. However, the ProTaper Next was better in maintaining the original form of curved canal with safety and higher efficiency.

Objective To summarize the clinical experiences and efficacy of laparoscopic total extraperitoneal repair(TEP) for inguinal hernia.Methods From April 2004 to August 2006,294 TEP operations was performed on 269 patients with inguinal hernia by using laparoscopy under epidural or general anesthesia.Among the patients,175 had indirect hernia,40 direct hernias,25 bilateral hernias,and 29 recurrent hernias.Results The operation was completed without converting to open surgeries in all the cases.The mean operation time was(63.1?37.5) min,blood loss(12.3 ?8.2) ml,and hospital stay(3.7 ?1.4) d.Of the patients,24 had peritoneal tearing(8.2%,24/269),4 had groin hematoma(2.4%,4/269),and 2 had foreign body sensation(0.7%,2/269).The patients were followed up for 6-12 months(median,9 months),the recurrence rate was 1.0%(3/294). Conclusion Laparoscopic TEP is safe and effective for patients with inguinal hernia.

Objective To investigate the feasibility of gene delivery to the ischemic myocardium of rabbits by ultrasound-mediated destruction of microbubbles. Methods A ligation model of left circumflex branch coronary artery was established in 48 rabbits. Three days after ligation, the mixture of gene and microbubbles was infused into the vein of rabbits with or without simultaneous ultrasound. Additional controls included ultrasound of microbubbles that did not contain gene, gene alone, gene plus ultrasound,and blank control. Rabbits were killed after two weeks and examined for the expression of vascular endothelial growth factor(VEGF). Results The hearts of five rabbits that underwent ultrasound-mediated destruction of microbubbles containing gene showed VEGF expression in ischemic myocardium.None of the control animals showed VEGF expression. Conclusions Ultrasound-mediated destruction of microbubbles is a promising method for the delivery of bioactive agents to the heart.

OBJECTIVE:To observe clinical efficacy and safety of paclitaxel or 5-fluorouracil combined with nadaplatin in the treatment of advanced nasopharyngeal carcinoma(NPC). METHODS:42 patients with advanced NPC were randomly divided into observation group and control group(n=21). 2 groups of patients were treated with radiotherapy. Observation group received che-motherapy of paclitaxel(135 mg/m2,d1)and nedaplatin(80 mg/m2,d 2-4);control group received chemotherapy of 5-fluoroura-cil(500 mg/m2,d1-5)and nedaplatin(80 mg/m2,d1-3);a treatment course lasted for 3 weeks,and both groups received 2 courses of treatment. Clinical efficacy, survival rate and ADR were observed in 2 groups. RESULTS:The overall response rate was 95.2%in observation group and 90.5% in control group,with no significant difference between 2 groups (P>0.05). The 3-year overall survival rate and progression-free survival rate were 81.0% and 71.4% in observation group and 76.2% and 66.6% in control group,with no significant difference(P>0.05). The incidence of nausea and vomiting in observation group were lower than in con-trol group,while the incidence of oral mucosa inflammation was higher than control group,with statistical significance(P<0.05). CONCLUSIONS:The chemoradiotherapy of paclitaxel or 5-fluorouracil combined with nadaplatin have similar therapeutic efficacy for advanced NPC. ADR by chemoradiotherapy should be monitored closely and treated timely.

BACKGROUND:The role of minocycline hydrochloride in adjuvant therapy of chronic periodontitis and
periodontal abscess has been widely reported, but detailed study of minocycline hydrochloride for combined periodontal-endodontic lesions is rare at present.
OBJECTIVE:To investigate the effect of minocycline hydrochloride in the treatment of combined periodontal-endodontic lesions.
METHODS:A total of 68 teeth with combined periodontal-endodontic lesions were treated with periodontal mechanical treatment and root canal therapy. According to the patient’s wiling, 68 patients were divided into experimental group (n=24; local injection of minocycline hydrochloride after periodontal mechanical treatment), positive control group (n=24; local injection of iodine glycerol after periodontal mechanical treatment), and
negative control group (n=20; no injection after periodontal mechanical treatment). These three groups were reviewed 1 month after periodontal mechanical treatment, and the differences before and after treatment were compared, including periodontal probing depth, attachment loss and gingival bleeding index.
RESULTS AND CONCLUSION: Probing depth, attachment loss and gingival bleeding index in three groups were significantly improved after 1 month of periodontal mechanical treatment (P< 0.05); both probing depth and
sulcus bleeding index in experimental group and positive control group were better than that of the negative
control group (P < 0.05), and probing depth and sulcus bleeding index in experimental group were better than that
of positive control group (P < 0.05). Experimental findings indicate that, in the clinical treatment of combined
periodontal-endodontic lesions, in addition to periodontal mechanical treatment and root canal therapy, local application of minocycline hydrochloride can effectively reduce the depth of periodontal pocket, improve gingival inflammatory
conditions and consolidate curative effect.

Objective To evaluate the safety and efficacy of endoscopic implantation of self-expandable metallic stent (SEMs) for malignant colorectal obstruction. Methods A total of 108 patients who had undergone endoscopic SEMs implantation for malignant colonic obstruction from January 2011 to May 2014 were enrolled. The clinical suc-cess rates and the complications were reviewed. Results The clinical success rates were 92.59%(100/108). Abdomi-nal pain, perforation and bleeding were the most common post-procedure complications, the rates of which were 16.67% (18/108), 7.41% (8/108), 6.48% (7/108), respectively. The abdominal pain in most patients was self-reliev-ing except for 6 patients with perforation of colon. Patients with perforation were cured by emergency surgery. The 7 patients developing bleeding recovered themselves. Conclusion The success rate of endoscopic SEMs implantation is satisfactory in the study. As a bridge to surgery or a palliative care method, endoscopic SEMs implantation is effec-tive and safe for malignant colorectal obstruction.

Objective To observe the effect of RNA interference binding immunoglobulin protein (BiP) on expression of bone markers and keytranscription factors in osteoblast exposed to fluoride.Methods MC3T3-E1 cells were used as osteoblast model in vitro.The cell viability was test with cell counting Kit-8 after cells were administrated with varying concentrations of fluoride [0.0 (control),0.1,1.0,2.0,4.0,8.0,16.0,20.0,32.0 and 64.0 mg/L] for different duration.Cells transfected with small interfering RNA (siRNA) BiP were exposed to fluoride (2.0,8.0 and 20.0 mg/L) for 2 days.Real-time PCR and Western blotting technique were used to determine the gene and protein levels of BiP.Meantime,the mRNA expression of bone markers and key transcription factors was investigated by real-time PCR.Results The difference of all viability in fluoride-dose groups was statistically significant exposed for 1,3,7 and 14 days (F =46.7,118.6,214.6,325.6,all P ＜ 0.05).Expression of BiP significantly increased in cells exposed to 20.0 mg/L compared to that of control (11.22 ± 3.25 vs.7.94 ± 1.31,P ＜ 0.05).The expression of alkaline phosphatase (ALP) elevated in cells exposed to 2.0 mg/L of fluoride (12.81 ± 3.62 vs.6.86 ± 2.13,P ＜ 0.01);conversely,it significantly reduced in cells exposed to 20.0 mg/L of fluoride (0.89 ± 0.17 vs.6.87 ± 2.14,P ＜ 0.01).Cells transfected with siRNA BiP significantly decreased the ALP expression in cells exposed to fluoride compared to that of cells only exposed to the same concentration of fluorine (12.81 ± 3.62 vs.7.43 ± 2.06;5.92 ± 2.38 vs.3.96 ± 0.21,all P ＜ 0.05).Cells transfected with siRNA BiP and administrated with 2.0 mg/L significantly reduced the osteocalcin expression (4.29 ± 0.99 vs.1.29 ± 0.86,P ＜ 0.01).Similarly,expression of runt-related transcription factor 2 (Runx2) significantly increased in cells exposed to 2.0 mg/L.However,expression of Runx2 significantly decreased in cells transfected with siRNA BiP and administrated with fluoride.Cells transfected with siRNA BiP significantly decreased the Runx2 expression in cells exposed to 2.0 mg/L and 20.0 mg/L compared to that of cells only exposed to the same concentration of fluorine (1.13 ± 0.22 vs.6.61 ± 0.48;0.02 ± 0.02 vs.1.50 ± 0.38,all P ＜ 0.01).As the downstream of Runx2,the expression of osterix in cells treated with different concentrations of fluoride was similar to that of Runx2.Conclusion BiP is not directly involved in the process of osteoblast differentiation induced by fluoride;instead,it affects the expression of bone markers and key transcription factors in osteoblast exposed to fluoride.

176.2,P0.05).Conclusions The tight adherence around catheter is formed in 5 days after PTCD.

Objective To prepare melanoma antigen n(MAGEn)protein vaccine and to investigate the immune responses and anti-tumor effects of MAGE-n protein vaccine accompanied by CpG-containing oligodeoxynucleotide(CpG-ODN)adjuvant.Methods The DH5? containing the MAGE-n prokaryotic expression plasmid pGEX-MAGE-n was induced and the protein was purified as protein vaccine.The CpG-ODN was synthesized as adjuvant and the C57BL/6 mice were inoculated.The cellular and humoral immune responses were detected by ELISPOT,cytotoxicity assay and enzyme linked immunosorbent assay(ELISA).The antitumor effects were detected through tumor volume and life span.Results The MAGE-n protein accompanied by CpG-ODN could induce strong MAGE-n-specific cellular and humoral immune responses.In the MAGE-n positive B16 tumor model of C57BL/6,the growth velocity of tumor was decreased and the life span was prolonged with the treatment of vaccine.Conclusion MAGE-n protein vaccine accompanied by CpG-ODN adjuvant can induce strong immune responses and anti-tumor effects against MAGE-n positive B16 tumor,which provides a new way for tumor therapy.