BACKGROUND: Along with the emergence of porcelain-fused-to-metal (PFM) technique, Ni-Cr alloy has been shown to be the most available non-novel metal alloy used for preparation of PFM materials. The metal margin of Ni-Cr based PFM crown possibly produces some effects on periodontal tissue for it is primarily contacted with gingiva. OBJECTIVE: To investigate the influences of Ni-Cr alloy PFM crown on periodontal tissue. DESIGN, TIME AND SETTING: A retrospective case analysis was performed. All cases were from Department of Stomatology, the 476 Hospital of Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA between January 2006 and January 2007.PARTICIPANTS: Totally 23 maxillary incisors were included from 19 patients who averaged (32.5±10.8)years old and received tooth restoration using Ni-Cr based PFM crowns. Healthy contralateral corresponding teeth were used as controls. METHODS: All clinical operations were conducted by one dentist. Dental restoration principles should be strictly followed during preparation of dental prosthesis. A routine tooth preparation was performed. Specifically, gingival retraction cords were used for gingival recession, with a shoulder prepared 0.5 mm below the labial gingiva and concave shoulder thickness 0.5 mm. A temporary crown was made using silicon rubber. The normal physiological anatomical profile of complete crown should be recovered as possible while preparation. Dental axial crown overcontour should be increased within 0.2 mm. Finally, a permanent sticking was followed.MAIN OUTCOME MEASURES: At 6-9 months after wearing Ni-Cr alloy PFM crown, the gingival crevicular fluid was collected from affected and control teeth for quantitation and laboratory examinations (C reactive protein and tumor necrosis factor- a included),PARTICIPANTS: Alter placement of Ni-Cr alloy PFM crown which was clinically accepted, plaque index of affected tooth did not alter significantly, but gingival crevicular fluid volume, probing depth, sulcus bleeding index, and levels of C reactive protein and tumor necrosis factor-α were significantly greater in affected teeth than in control teeth (P < 0.05).CONCLUSION: Ni-Cr alloy PFM crown produces some harmful effects on periodontal tissue.

objective To evaluate the clinical implications of perioperative serum albumin (ALB),pre-albumin(PA)and high-sensitivity C-reactive protein(hs-CRP)changes in surgical patients.Methods This study included 103 surgical cases undergoing major,moderate or minor surgery respectively.Perioperative serum ALB.PA and hs-CRP levels were measured.Results were compared with 56 normal controls. Results Pre-and postoperative ALB was(43.6±5.1)g/L and(35.8±5.3)g/L in major surgery patients compared with that of(45.0±3.7)g/L and(38.3±5.7)g/L in moderate or minor surgery patients,both were significantly lower than that of(46.7±2.9)g/L in control group(F=54.07,P＜0.05);Pre-and postoperative PA level was(246±68)mg/L in major surgery patients while that was (270±53)mg/L and(207±70)mg/L respectively in moderate or minor surgery group,that in both groups were lower than that(279±40)mg/L in control group(F=41.18,P＜0.05),Pre-and postoperative hsCRP level was(5.3±5.1)mg/L and(12.7±4.2)mg/L in major surgery patients compared with that of (4.5±3.6)mg/L and(11.1±4.3)mg/L in moderate or minor surgery patients,again both that in the two groups were much higher than that of(1.0±0.7)mg/L in control group(F=69.87,P＜0.05).Conclusions Combined detection of serum ALB,PA and hs-CRP levels is a measure of surgical trauma especially for these patients suffering from postoperative infections.

Objective To explore effect of Medicinal carbon on serum calcium, phosphorus and parathyroid hormone on chronic renal failure dialysis patients.Methods 82 case with chronic renal failure dialysis were selected and divided into two groups.41in control group were treated with conventional therapy, 41 in experiment group were with medicinal carbon 0.3 g, 3 times per day.Serum calcium, phosphorus and parathyroid hormone were compared before and after the treatment.Results Compared with control group, serum creatinine, urea nitrogen and uric acid of the experiment group were lower(P<0.05).The total effective rate of clinical symptoms was higher than control group(P<0.05).Serum calcium, serum phosphorus and parathyroid hormone were lower(P<0.05),the incidence of adverse reactions was lower than the control group(P<0.05).Conclusion Medicinal charcoal can decrease levels of serum calcium, serum phosphorus and serum intact parathyroid hormone in chronic renal failure patients, has good clinical curative effect, with less adverse reaction.

Objective To study deletion mutations and polymorphism of PINK1 gene exons in patients with Parkinson' s disease (PD) in the littoral of Zhejiang Province,and analyze the association between these changes and the etiology of PD.MethodsAll exons of PINK1 gene in 200 PD patients( 112early-onset PD and 88 late-onset PD) and 220 controls (68 young controls and 152 old controls ) were amplified by polymerase chain reaction (PCR). All the positive PCR products were sequenced,and genotypes were detected by dot blot allele and genotype frequencies of PINK1 were compared by the Chisquare test.ResultsNo deletion mutations of the exons were found in all patients and controls.However,a known heterozygote point mutation G12169A in exon 5 was identified in 2 patients with early-onset PD.And G12164A polymorphism and G12101A polymorphism were located on PINK1 gene of exon 5. There were G/G and G/A genotypes in G12164A polymorphism,no A/A genotype.There were G/A and A/A genotypes in G12101A polymorphism,no G/G genotype. The chain relation polymorphism A/A genotype frequency was significantly higher in the PD group 84/200 (42.0％ ) than the control group (52/220,23.6％,x2 =4.034,P =0.045 ).The frequency was also significantly higher in the late-onset PD (40/88,45.5％ ) than the old control (32/152,21.1％,x2 =3.951,P =0.047 ).There were no significant differences in alleles frequencies of other groups.ConclusionThe deletion mutation and point mutation are rare in PD patients in littoral of Zhejiang Province.Chain relation polymorphism at G12164A and G12101A in PINK1 gene might be a susceptible factor for PD patients.

Objective To explore the impact of atrial fibrillation (AF) recognized at primary diagnosis on clinical features and outcomes of patients with AF in emergency service.Methods Data were collected from consecutive patients admitted in resuscitation room in the Department of Emergency (ED) of a major comprehensive teaching hospital,from January 1,2011 through December 31,2015.Patients were checked by electrocardiogram examination and / or monitored in resuscitation room after admission,and were divided into patients with AF recognized at a primary diagnosis and those with AF judged by alternative primary diagnoses in ED.The main criteria of prognosis were the length of resuscitation room stay,number of repeated ED visits,and outcome scale (such as death,transferred to intensive units,transferred to general wards,or direct discharge).Non-paired student t test,x2,and circular distribution analysis were performed using SPSS 10.0 and EXCEL 2007 software.Results A total of 929 patients with mean age of (70.3 ± 12.7) years,and 502 (54.0％) female were enrolled.There were 122 cases with AF not recognized at primary diagnosis but by an alternative primary diagnosis (non-primary group,NPG),and 807 cases with AF recognized at primary diagnosis (primary group,PG).Compared with the PG,the patients were older [(76.9 ±9.3) vs.(68.7 ± 14.4),P ＜0.01],had more comorbidities [(1.75 ± 1.26) vs.(0.08±0.39),P＜0.01],higher APACHE Ⅱ scores [(17.89±8.19) vs.(8.64±4.15),P＜ 0.01],longer resuscitation room stay (P ＜ 0.01),higher mortality (11.5％ vs.0.2％,OR =52.176,95％ CI:11.698-232.710,x2 =78.928,P ＜ 0.01) and a higher percentage of transferring to intensive careunit (14.8％ vs.5.1％,OR=3.234,95％CI:1.791-5.838,x2 =16.674,P＜0.01) in NPG.There were no significant difference in number of repeated-visits in ED between the PG and the NPG.Conclusion Patients with AF in the ED judged by alternative primary diagnosis are older and have more comorbidities,higher mortality and higher probability to be transferred to intensive care unit than patients with AF directly recognized by a primary diagnosis.This cohort of patients with special characteristics should be meticulously cared for and be distinguished from the patients with AF crystal clear at a primary diagnosis.Future studies are needed to examine the specific impact of AF on outcomes in the setting of primarydiagnoses in ED.

Emergency specialist training in our country is still in its infancy and perfecting stage. The United States has perfect emergency specialist training system. From training target, access system, program personnel, training content and assessment and evaluation, this study explores the difference of the emergency physician training program of the University of Michigan and the emer-gency physician training rules of Beijing University. The emergency specialist training program in the United States has a strict elimination mechanism and a more rigorous training system for the training parties, making the training plan can be implemented and worth learning from.

Objective:To investigate the effects of CCR3 on Muc5ac in the airway of asthmatic mice.Methods: Fifty clean BALB/c mice were randomly divided into control group,asthmatic group,dexamethasone treatment group,SB328437 treatment group, vehicle-control group.Total cells and differential inflammatory cells were counted in BALF, the levels of IL-4 and TNF-αwere determined by ELISA,lung tissue HE staining the expressions of Mucin5ac(Muc5ac) and CCR3 in lung tissue were detected by immu-neohistochemical staining and RT-PCR.Results:The total cells,eosinophil,monocytes and lymphocyte cells in BALF,the levels of IL-4,TNF-αin BALF ,the goblet cell of airway wall,the expression of Muc5ac and CCR3 positive staining IOD in the airway and the expression of Muc5ac and CCR3 mRNA lung tissue obviously decreased in SB328437 treatment group and DEX treatment group which compared with asthmatic mice model group ( P<0.05 ) .Conclusion: SB328437 can inhibit the expression of CCR3 in pulmonary tissue,furtherly inhibit the expression and secretion of Muc5ac and control the airway inflammation.

Objective To explore the relationship between content of fine particulate matter (PM2.5) in atmospheric and the number of emergency room (ER) visits with acute coronary syndrome (ACS).Methods Daily data of ER visits to Peking University Third Hospital for ACS was collected from December 1st,2013 to November 30th,2014.All patients were resident population of Haidian District,Beijing.The daily meteorological data and contents of air pollutants in Beijing were also collected in the same time period.Generalized Additive Model (GAM) was fitted to estimate the association between the ambient PM2.5 and the ER visits for ACS,under controlling for time trends,holiday effect,day of week effect and weather conditions.Results The annual average amount of PM2.5 was 85.44 μg/m3 over the study period.There were 619 cases with ACS as ER visits.PM2.5 was positive related with PM10,NO2 and SO2.The corresponding correlation coefficients were 0.87,0.48 and 0.67,respectively (P ＜ 0.05).But PM2.5 was negative related with mean temperature (r =-0.04,P ＜ 0.05).In the polluted model,there was positive association between PM2.5 and ER visits with ACS.When each increament in PM2.2 with 10 μg/m3,the relative risk strength of ER visits with ACS was 1.019 (95％ CI:1.000-1.038).PM2.5 concentrations had a delayed effect on the onset of ACS occurred on the next day.This lagged 1 day phenomenon showed the most significant influence of PM2.5 on ER visits for ACS.Conclusions The ambient concentrations of PM2.5 are positively associated with ER visits for ACS.And there is a lag effect.

Objective To observe functional changes of renal tubular epithelial cells stimulated by high mobility group protein box 1 (HMGB1) and associated mechanism.Methods Renal tubular epithelial cells (NRK52E) were divided into control group,HMGB1 group and HMGB1+ lipopolysaccharide from Rhodobactersphaeroides (LPS RS) group.Toll-like receptor 4 (TLR4) expression was detected by immunofluorescence and Western blotting.Apoptosis rate and cell cycle arrest were identified with flow cytometry.The activation of MAPK signaling pathway and NF-κB were detected by Western blotting.The IL-1,IL-6 and tissue inhibitor of metalloproteinases 2 (TIMP2) mRNA levels were measured by real-time PCR.The secretion levels of IL-1,IL-6 and TIMP2 were measured by protein chips assay.Results TLR4 was expressed by NRK52E cells.Compared with the control group,there were increased cell cycle G1 arrest,MAPK signaling pathway and NF-κB activation in HMGB1 group.Furthermore,IL-1,IL-6 and TIMP2 mRNA levels were increased and IL-1,IL-6 and TIMP2 were secreted by NRK52E when stimulated with HMGB1 (all P ＜0.05).However,effects mediated by HMGB1 stimulation could be inhibited by LPS RS (all P＜0.05).Conclusions Inflammatory activation of NRK52E cells can be mediated by the interaction of HMGB1 and TLR4.

Due to a great amount of data in clinical trials, the data cleansing needs to adopt a variety of measures, including the latest developed visual check approach. According to the different types of clinical data and the different stages in the course of clinical data management, this study reviews 8 types of visual graphics that show the relevance and trend among the data. The series of graphics can rapidly detect abnormal data, monitor clinical research in real-time, make the data management process much easier and improve the clinical trial efficiency and data quality.