Objective To investigate the clinical efficacy and mechanism of minocycline hydrochloride ointment adjuvant therapy for chronic periodontitis.Methods86 patients of chronic periodontitis who received therapy from August 2013 to June 2015 in our hospital were selected.According to random number table, those patients were divided into the experimental group (n=43) and the control group (n=43).The control group was treated on the basis of the foundation treatment with tinidazole Oral Sticking Tablets and the experimental group were treated on the base of the foundation treatment with Minocycline hydrochloride sustained-release ointment, the levels of hs-CRP, TNF-a, IL-8 and IL-10 in gingival sulcus fluid were measured before and after treatment, the indexes of PLI, PD, SBI and AL were recorded,at the same time the clinical curative effect between two groups was compared.ResultsThe effective rate of the experimental group(95.35%) was higher than the control group(81.40%),the difference was statistically significant (P<0.05);Compared with before treatment, two groups general situations and inflammation factors changed after treatment,plaque index, periodontal pocket probing depth, gingival sulcus bleeding index and adhesion levels of the experimental group were lower than the control group after treatment, the PD, SBI, AL and PLI in the experimental group were significantly lower than that of the control group, and the hs-CRP, TNF-a and IL-8 levels were lower than the control group, IL-10 was higher than the control group after treatment(P<0.05).ConclusionMinocycline hydrochloride ointment is well for chronic periodontitis,which can effectively relieve periodontal chronic inflammation, improve clinical efficacy, the underlying mechanism may be related to the reduction of IL-8 and TNF-α levels in gingival crevicular fluid.

Objective To compare the contents of main compounds and the composition of volatile oil from the new hybrid of Amomum villosum Lour. Spring No.1-F4 with those in its female parent Longfruit No.2. Methods Steam distillation, gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) methods were used for analyzing the content differences of main compounds and compositions of volatile oil between Spring No.1-F4 and Longfruit No.2. Results The contents of volatile oil and bornyl acetate from Spring No.1-F4 and Longfruit No.2 met the standard required by Chinese Pharmacopoeia. The content of volatile oil from Spring No.1-F4 was higher than that of Longfruit No.2, and there were some differences between the two in the composition of volatile oil and their relative contents. Conclusion The effective constituents in Spring No.1-F4, a new hybrid species of Amomum villosum, has reached the standard required by Chinese Pharmacopoeia, which is expected for solving the problems of difficulty in pollination and for improving the yield and quality of Amomum villosum.

Objective To optimize the processing condition of the extraction of Baphicacanthis cusiae ( Nees) Bremek. roots polysaccharides ( BCP) by ultrasound technology, and to provide the basis for the further development and study of BCP. Methods The extraction temperature, extraction time, liquid-solid ratio were used as the influence factors, and the yield of polysaccharides from Baphicacanthis cusiae roots was used as the evaluation index. On the basis of single-factor test, 3-factor and 3-level Box-Behnken test was designed for quadratic polynomial regression equation of the yield of polysaccharides. And then the response surface methodology was used for the optimization of process condition. Results The optimum extraction condition was as follows: extraction temperature was 60℃, extraction time was 35 min, and liquid-solid ratio was 24.5∶1 (V∶m, mL·g-1). Under the optimal condition, the yield of polysaccharides was 83.7 mg·g-1. Conclusion The method is simple, rapid and highly efficient, which will provide experimental basis for the development and application of Baphicacanthis cusiae roots polysaccharides.

Objective To investigate the effects of growth-discordant twin pregnancies on neonatal thyroid stimulating hormone (TSH) level and congenital hypothyroidism (CH).Methods A total of 3 444 live-birth twin neonates born between January 1,2012 and December 30,2014 in Ningbo City were enrolled.Blood samples via heel puncture were collected and tested.Incidence of CH in singleton and twin neonates was compared.Deviation of birth weight larger than 25％ in twin neonates was set as the criteria for discordant growth.TSH and 17 α-hydroxylase levels in CH twins and normal twins,with or without discordant growth,were compared.Chi-square and non-parametric statistics were performed for data analysis.Results The incidence of CH in twin neonates was 0.56％ (19/3 444),higher than that in singleton neonates [0.09％ (203/225 712),x2=76.225,P＜0.01].Among nineteen CH twins,CH occurred in both twins in eight cases (four twins) and in one of the twins in eleven cases.The gestational age at birth in the eight CH twins were less than 37 weeks,with four males and four females;five were low birth weight infants;one twin were dichorionic,and three twins were monochorionic.In the eleven cases of CH occurring in one of the twins,the gestational age was less than 37 weeks in nine cases,eight were low birth weight infants,six were male and five female;seven were monochorionic and four were dichoronic twins.Five cases of temporary hypothyroidism were all low birth weight infants among the growth-discordant twins.CH cases in growth-discordant group had lower birth weight than their normal twins [M(P25-P75),2 100 (1 800-2 600) vs 2 770 (2 530-2 960) g,Z=4.369],and a higher TSH level [15.4 (11.8-18.5) vs 6.4 (4.8-7.9) mU/L,Z=6.339] (both P＜0.05).In normal twins with or without discordant growth,the neonates with a lower birth weight had a higher TSH level [3.6(2.5-4.7) vs 2.4(1.8-2.9) mU/L,Z=0.962] in weight consistent group,compared with 6.0(4.4-7.8) vs 3.4(1.9-4.1) mU/L in weight inconsistent group (Z=4.369),both P＜0.05.Conclusions In the growth-discordant twins,neonates with a lower birth weight have a higher TSH level and a higher risk of temporary hypothyroidism.

OBJECTIVEBalloon angioplasty is an alternative to surgical repair for coarctation of the aorta in children. However, its role in the treatment of neonates and infants younger than 3 months old remains controversial. The purpose of this study was to evaluate the efficacy and safety of balloon angioplasty for native coarctation by comparing children in different age groups.

METHODThis is a retrospective clinical study including 37 children treated with balloon angioplasty for native coarctation from January 2006 to December 2012. A total of 37 patients consisting of 26 boys and 11 girls underwent the procedure, with median age 10 months (range from 7 days to 6 years) and the mean body weight was 6.3 (2.5-17.0) kg. The indication of the procedure includes discrete native coarctation without aortic arch hypoplasia and a peak-to-peak systolic pressure gradient > 20 mmHg (1 mmHg = 0.133 kPa) across aortic coarctation. During one year follow-up, the approach artery injury, recoarctation and aneurysm formation were particularly assessed.

RESULTWe classified these patients into two groups according to their age. Group A consisted of 25 patients younger than 3 months and Group B of 12 patients older than 3 months. There was no significant difference between the two groups in systolic pressure gradient before balloon angioplasty (P > 0.05). The mean peak systolic gradient decreased from (38 ± 18) mmHg to (12 ± 11) mmHg immediately after angioplasty in group A and from (47 ± 18) to (17 ± 12) mmHg in group B (P = 0.000 for both). Meanwhile, the mean diameter of the coarctation segment increased from (1.8 ± 0.7) to (3.7 ± 1.1) mm after angioplasty in group A and from (2.6 ± 1.5) to (5.5 ± 1.8) mm in group B (both P = 0). The initial successful balloon angioplasty (immediate postangioplasty peak pressure gradient < 20 mmHg) was achieved in all the 37 patients; 32 patients (86.5%) have been followed up for one year. Approach arterial complications occurred in 3 patients (9.4%), all of whom were in Group A (P = 0.537). Two patients had decreased femoral artery pulse and one required surgical repair for a postoperative pseudoaneurysm at left carotid artery. At follow-up, 8 patients (25.0%) developed recoarctation, with 6 cases in Group A and 2 in Group B. There was no significant difference between groups A and B in the recoarctation rate (P = 1.000). Among them, 7 patients underwent repeat balloon angioplasty, and all showed successful relief of coarctation, and one patient required surgical repair. Two patients (2/37, 5.4%) had small aneurysms of the descending aorta immediately after balloon angioplasty, with one patient in each group (12/25 vs.1/12, P = 0.755).Late aneurysm development has not been observed in the 17 patients who have had a follow-up CTA or MRA study.

CONCLUSIONBalloon angioplasty of discrete native coarctation is effective and safe in children both younger and older than 3 months with similar incidence of approach arterial complication, recoarctation and aneurysm formation.

Angioplasty, Balloon ; Aortic Aneurysm ; epidemiology ; Aortic Coarctation ; therapy ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Heart Septal Defects ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Postoperative Complications ; epidemiology ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To observe the effect of dexmedetomidine combined with goal-directed fluid therapy(GDFT)on hemodynamics and cerebral oxygen supply of patients undergoing cerebral aneurysm clipping.Methods A total of 78 patients undergoing cerebral aneurysm clipping surgery in Jinhua Municipal Central Hospital from January 2021 to December 2022 were selected and divided into control group and observation group according to random number table method,with 39 cases in each group.The patients in control group received conventional fluid therapy,and the patients in observation group received dexmedetomidine pump +GDFT.Mean arterial pressure(MAP),heart rate(HR),cardiac index(CI),brain metabolic markers,neuron specific enolase(NSE),S100β levels and mini mental status examination(MMSE)scores at different time points[before anesthesia induction(T0),immediately after tracheal intubation(T1),beginning of surgery(T2),opening meninges(T3),immediately after aneurysm clipping(T4),end of surgery(T5),24h after surgery(T6),72h after surgery(T7)],and fluid intake and outflow of two groups were compared.Results MAP at T1-T4 and CI at T1-T3 in observation group were significantly higher than those in control group(P<0.05).The colloid volume,total infusion volume and urine volume in observation group were significantly higher than those in control group(P<0.05).The serum levels of NSE and S100β at T5-T7 were significantly higher than those at T0 in both groups(P<0.05).The levels of serum NSE and S100β at T5 and T6 in observation group were significantly lower than those in control group(P<0.05).The oxygen content in jugular venous blood(CjvO2)at T1-T4 was significantly lower than that at T0 in control group(P<0.05).Cerebral oxygen extraction ratio at T1 was significantly higher than that at T0 in both groups(P<0.05).CjvO2 at T3-T4 in observation group were significantly higher than those in control group(P<0.05).At T6 and T7,MMSE scores in two groups were significantly lower than at T0 in this group(P<0.05).MMSE score at T6 of observation group was significantly higher than that of control group(P<0.05).Conclusion Dexmedetomidine combined with GDFT can effectively improve preload and brain function,stabilize intraoperative circulatory function,and improve early postoperative cognitive function in patients undergoing cerebral aneurysm clipping.

Objective To observe the impairment effect of retinol binding protein 4(RBP4) on neurocognitive function in diabetic nephropathy(DN) patients with silent cerebral infarction(SCI) and to explore its mechanism.Methods Sixty patients with newly diagnosed DN and 30 healthy volunteers were selected as the study subjects and the DN cases were divided into the complicating SCI group(SCI,n=30) and non-complicating SCI group(NSCI,n=30) according to the imaging results.The degrees of neurological function deficit and Montreal cognitive assessment(MoCA) were evaluated.Serum RBP4 level was determined by ELISA and expressions of Lp-PLA2 and C-X-C chemokine receptor type 4(CXCR4) were determined by Western blot.Results Compared with the NSCI group,the neurocognitive function in the SCI group was subsided,the expression levels of RBP4,Lp-PLA2 and CXCR4 were increased(P＜0.05).The RBP4 level was positively correlated with the neurocognitive function impairment in SCI patients,moreover,there existed a regression correlation between them.Conclusion Serum RBP4 may serve as the predictive factor of DN complicating SCI and is positively correlated with neurocognitive dysfunction.Lp-PLA2/CXCR4 pathway activation may be one of its pathogenesis.