Anorectal malformations (ARM)comprise a broad spectrum of congenital disorders that account for 25 ％ of gastrointestinal malformations.Despite numerous technical advances for treatment of ARM,complications such as fecal incontinence and constipation still occur and can greatly deteriorate patients' quality of life.It is recognized that lumbosacral spinal cord anomalies in ARM has been an important factor affecting the fecal function after procedure.Researchers have found that lumbosacral myelodysplasia is the common seen complication of ARM and neural cells decreased in lumbosacral spinal cord by the study on animals and human.Due to numerous factos affecting nerve innervation on annrectus and pelvic floor muscle,this review summarizes the nervous system complications and abnormal intervention of human and rats ARMs.The developments of study on ARM complications and intervention are detailed.Then the new direction of the research about the anorectal malformation nervous system is put forward,and the new strategy of improving the prognosis of anorectal malformation surgery is explored.

Objective:To investigate the changes of serum sex hormones, 25-hydroxyvitamin D3, 25 (OH) D3] levels and islet function in patients with gestational diabetes mdlitus (GDM) , and to analyze their intrinsic relationships.Methods:50 GDM patients admitted to the Department of Clinical Medicine of Wuhan Traditional Chinese Medicine Hospital from Mar. 2018 to Sep. 2019 were selected as the study group, and 50 healthy pregnant women were selected as the control group. Serum level of sex hormones, 25 (OH) D3 level, islet function [Fasting insulin (FINS) , Insulin resistance index (HOMA-IR) , Islet β cell function index (HOMA-β) ], the correlations between serum sex hormones, 25 (OH) D3 levels, and islet function changes were analyzed using Person, and the influencing factors of GDM were analyzed using binary logistic.Results:The estrogen level, progesterone level, FINS level and HOMA-IR of the observation group were significantly higher than those of the control group[ (6525.28±2095.51) vs (2259.02±717.75) pg/ml, (554.34±32.85) vs (385.34±24.59) ng/ml, (12.69±3.93) vs (9.68±3.19) mU/L, (3.06±1.06) vs (2.01±0.63) ]. 25 (OH) D3 and HOMA-β in the observation group were significantly lower than those in the control group[ (17.46±5.59) vs (21.51±7.14) ng/ml, (137.31±32.11) vs (281.76±54.02) ], the differences were statistically significant ( P<0.05) . According to Pearson analysis, sex hormones were positively correlated with FINS and HOMA-IR ( P<0.05) and negatively correlated with HOMA-β ( P<0.05) ; 25 (OH) D3 was positively correlated with HOMA-β ( P<0.05) and progestin was negatively correlated ( P<0.05) ; FINS was positively correlated with HOMA-IR ( P<0.05) , and HOMA-IR was negatively correlated with HOMA-β ( P<0.05) . 25 (OH) D3 and HOMA-β were risk factors for GDM ( P<0.05) , and FINS and HOMA-IR were protective factors for GDM ( P<0.05) . Conclusions:GDM patients have higher levels of sex hormones, lower levels of25 (OH) D3, HOMA-β, vitamin D deficiency or deficiency, and decreased insulin secretion. There is a correlation between 25 (OH) D3 and HOMA-β.

BACKGROUND:As the rapid development of oral implantation and restoration techniques, as wel as the increasing enlargement of indications, angulated abutments have been widely used. Posterior teeth region, as the weight-loading region of occlusion, can bear great force from the implants, the assessment of angulated abutments in posterior teeth region has clinical value.
OBJECTIVE:To evaluate the short-term clinical efficacy of angulated abutments on the implant denture in posterior teeth region.
METHODS:From January 2008 to January 2013, 114 patients with 175 ITI implants in the posterior teeth region were included in this study and they al underwent single-crown restoration. The involved patients were divided into angulated abutment group and straight abutment group. Periodontal probing depth, modified plaque index, modified sulcus bleeding index and peri-implant crestal bone loss in two groups were recorded at 6 months and 2 years after restoration. Cumulative survival rate of the implant denture was calculated by life-table analysis.
RESULTS AND CONCLUSION:There was no significant difference in periodontal probing depth, modified plaque index, and modified sulcus bleeding index between two groups (P>0.05). The annual crestal bone loss showed no significant difference between two groups (P>0.05). Moreover, the 5-year cumulative survival rate with 15° and 20° abutments was 95.6%, and that with straight abutment was 96.4%. The angle of abutments has no correlation with peri-implant soft tissue and peri-implant crestal bone loss, implant restorations with 15° and 20° angulated abutments may be successful y used in the posterior region, whereas the long-term effects need further research.

Objective To evaluate the alteration of labial bone mass one year after immediate implant or delayed implant placement in esthetic zone.Methods From June 2009 to June 2012,22 patients with 11 immediate implant and 11 delayed implant in the maxillary anterior region were followed up.CBCT images were obtained immediately after surgery and one year after implant placement,the horizontal and vertical alterations of the labial bone were evaluated by image analysis software.Results The 1-year vertical reduction of labial bone after immediate implant placement was statistically significant (P＜0.05),and no significant difference in delayed implant (P＞0.05).The 1-year horizontal reduction of labial bone was statistically significant at coronal and middle of implant,without significant difference at apical of implant.Conclusions Immediate implant can not stop the physical absorption of labial alveolar ridge,and the study can provide reference to achieve esthetics in the anterior region.

This paper selects the bag-type infusion sets for single use as samples, which are produced by different manufacturers and based on the ethylene oxide sterilization. The ethylene oxide sterilization residues in different parts of samples are detected by colorimetric analysis. Combined the comparison of the ethylene oxide residues testing results in the different parts of the same sample with the actual situation in clinical use, more reasonable sampling positions are found to detect the ethylene oxide sterilization residues. The result of this experiment will play a guiding role in the detection of the actual samples.
Disposable Equipment ; Equipment Contamination ; prevention & control ; Ethylene Oxide ; analysis

Objective To evaluate the effect of transforming growth factor-β (TGF-β) on the expressions of epithelial-to-mesenchymal transition (EMT)-related molecules in human A431 epidermal squamous cell carcinoma cells.Methods Cultured A431 cells were classified into two groups:TGF-β group treated with TGF-β of 7.5 μg/L for 72 hours,and control group remaining untreated.Subsequently,cell morphology was observed under an inverted microscope,and real time-PCR and Western blot were performed to quantify the mRNA and protein expressions of EMT-related molecules including E-cadherin,N-cadherin,vimentin and β-catenin respectively.Results After TGF-β treatment,the cells became dispersed and spindle in shape.The mRNA expression levels of E-cadherin,Ncadherin,vimentin,and β-catenin in TGF-β group were 0.317,2.475,11.340 and 2.615 folds those in the control group respectively.Western blot showed a marked increase in the expression of N-cadherin,vimentin,and β-catenin proteins but a notable decrease in that of E-cadherin in the TGF-β group compared with the control group.Conclusions TGF-β can induce EMT in A431 cells,and increased expression of TGF-β may contribute to the invasion and metastasis of SCC.

Objective To evaluate the relationship between the anesthesia factor and myocardial injury in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Eightyeight patients of both sexes,aged 42-71 yr,weighing 59-83 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective coronary artery bypass grafting with CPB,were divided into 4 groups (n =22 each) using a random number table:routine anesthesia control group (group C),dexmedetomidine-based anesthesia group (group D),sevofluranebased anesthesia group (group S) and dexmedetomidine combined with sevoflurane anesthesia group (group DS).After tracheal intubation,0.2％-2.1％ sevoflurane was inhaled until the beginning of CPB in S and DS groups.In D and DS groups,dexmedetomidine was intravenously infused as a loading dose of 1 μg/kg over 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until the end of surgery.Before induction of anesthesia,before CPB,after the end of CPB,immediately after the end of surgery and at 24 h after surgery,venous blood samples were collected for determination of plasma creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) concentrations by immunofluorescence.The restoration of spontaneous heart beat and adverse events such as hypotension,malignant arrhythmia,cardiac arrest and respiratory depression during surgery and within 24 h after surgery were recorded.Results Compared with group C,the plasma concentrations of CK-MB and cTnI were significantly decreased in the other three groups (P＜0.05).The plasma eoncentrations of CK-MB and eTnl were significantly lower in group DS than in S and D groups (P＜0.05).There were no significant differences in the rate of restoration of spontaneous heart beat among the four groups (P＞ 0.05).No adverse events were found during surgery and within 24 h after surgery in the four groups.Conclusion Dexmedetomidine combined with sevoflurane anesthesia is helpful in reducing myocardial injury and provides better efficacy than either alone in the patients undergoing cardiac surgery with CPB and is more suitable for cardiac surgery with CPB.

Objective To evaluate the effects of flapless versus flap implant surgery on the tissues surrounding the implants in the esthetic zone.Methods A controlled study was conducted in 20 patients with a single implant in the anterior esthetic zone,as compared with the flapless and traditional flap implant placement.6 and 12 months after the implant ation,the vertical reduction of labial and lingual bone were assessed by cone beam computed tomography (CBCT);6 and 12 months after the crowns restoration,the peri-implant soft tissues were examined by probing depth (PD),modification sulcus bleeding index (mSBI),papillary index (PPI) and evaluated by pink esthetic score (PES) standard.Results The vertical reduction of the flapless labial and lingual bone was lower than that of the flap,in which the change of labial bone was statistical differences at 6 months after implant surgery between groups (P ＜ 0.05).The differences of PES between two groups were not statistically significant,although PES increased over time in both groups,which the flapless group had a significantly change in PES from crown placement to 12 months (P＜0.05).Conclusions A flapless implant surgery in sufficient bone support may provide a better short-term esthetic result,whereas the longterm effects need further studies.

Objective To investigate the clinical distribution and change in antimicrobial resistance of Acinetobact-er baumannii (A.baumannii)from a hospital between 2011 and 2013,so as to provide guidance for clinical treat-ment.Methods Sources and antimicrobial susceptibility testing results of A.baumannii from a hospital were ana-lyzed statistically.Results A total of 14 705 bacterial isolates were isolated in 2011 —2013,13.59%(n=1 999)of which were A.baumannii isolates,the percentage of A.baumannii in isolated pathogens in 3 years was 12.74%, 13.05%,and 14.85% respectively,which showed a rising trend (χ2 =9.458,P =0.002).The main specimen was sputum (n = 1 541 ,77.09%),bacteria were mainly isolated from patients in respiratory disease department (21 .71 %),surgical intensive care unit (16.26%),and emergency intensive care unit (8.26%).Antimicrobial re-sistance rates of A.baumannii increased year by year(all P <0.05);multidrug-resistant and extensively drug-resist-ant A.baumannii also increased year by year (all P <0.001).Conclusion Isolation rate and antimicrobial resistance rate of A.baumannii strains increase year by year,multidrug-resistant and extensively drug-resistant A.baumannii strains are obvious,which should be paid more attention in clinical department.

Objective To evaluate the effect of 6% hydroxyethyl starch 130∕0. 4 on acute kidney injury in elderly patients in a prospective, multicenter, randomized, double?blind, controlled clinical tri?al. Methods A total of 120 patients of both sexes, aged 65-82 yr, weighing 56-83 kg, of American So?ciety of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective orthopaedics and hernia surgery, were divided into either hydroxyethyl starch group ( group HES) or lactated Ringer′s solution group ( group LR) , with 60 patients in each group. Hydroxyethyl starch and lactated Ringer′s solution were infused intra?venously at a rate of 7. 5 ml∕kg during 1st hour of surgery in HES and LR groups, respectively. Lactated Ringer′s solution was then infused at a rate of 5 ml∕kg starting from 2nd hour of surgery until the end of sur?gery in both groups. Before surgery, at the end of surgery and at 1, 3 and 5 days after surgery, blood sam?ples and urine specimens were collected for determination of the concentrations of neutrophil gelatinase?asso?ciated lipocalin, interleukin?18 (IL?18), plasma creatinine, urine β2 microglobulin and urine albumin.
The estimated glomerular filtration rate was calculated. Results The level of urine IL?18 was significantly higher at each time point after surgery than before surgery and immediately after the end of surgery ( P<0.05) . There were no significant differences between the two groups in the levels of urine IL?18, plasma creatinine, plasma and urine neutrophil gelatinase?associated lipocalin, plasma IL?18, urineβ2 microglob?ulin and urine albumin and estimated glomerular filtration rate at each time point ( P>0.05) . Conclusion Compared with lactated Ringer′s solution, 6% hydroxyethyl starch 130∕0.4 does not aggravate acute kidney injury in elderly patients.