BACKGROUND:Compared with the conventional composite resin materials, large pieces of filing composite resin materials have the features of increasing light-curing depth, decreasing the polymerization shrinkage rate and streamlining operational procedures; however, the properties of different types of large pieces of filing composite resin materials are different. OBJECTIVE:To analyze the hardness and bond strength of four kinds of composite resin materials. METHODS: Large pieces of filing composite resin Tetric EvoCeram Bulk Fil, SDR, as wel as conventional composite resin P60, Z350 were obtained. The vickers microhardness of these four kinds of composite resin materials under the light-curing depth of 2, 3, 4, 5 mm was detected. The shear bond strength between these four kinds of composite resin materials and the dentin was also detected. RESULTS AND CONCLUSION:The hardness order under different light-curing depths was: P60 composite resin > Z350 composite resin > Tetric EvoCeram BulkFil composite resin > SDR composite resin, there was a significant difference between these four groups (P < 0.05). The light-cured hardness of Tetric EvoCream BulkFil and SDR composite resins was not significantly decreased with the increased cured depth. The shear bond strength of Tetric EvoCeram BulkFil and SDR composite resins was significantly higher compared with the P60 and Z350 composite resins (P < 0.05). These results demonstrate that large pieces of filing resinous materials, Tetric EvoCeram BulkFil and SDR, show better comprehensive mechanical properties and have a higher shear bond strength.

Objective To evaluate the effect of trimetazidine(TMZ) and metoprolol combining the other regular medicine on the stable angina peetoris patients with type 2 diabetes mellitus. Methods 78 patients with type2 diabetes mellitus and the patients with no less than two months stable and revoked-angina pectoris by effort were colleeted. They were divided into two groups. In one group,20mg of TMZ was used three times a day. In the other group,25mg metoprolol was used and two times a day. The two groups all combined with the regular medicine,bamyl, caleiume-antagonist and long-efficency nitrate and rutine antilipemic, antidiabefie agents for ten weeks and analyzed the statistical difference of two groups. Meanwhile some parameter were observed including the heart rate,blood pressure, blood glucose, TG, TC, HDL-C and LDL-C during the treatment. Results In two groups, cardiac pectoris frequency and lasting-time and the used-nitroglycerin decreased significantly, while the time of next angina outcome and left ventrieular ejection fraction(EF% ) increased significantly. The therapy hasen't great differene(P>0.05) in two groups. But in TMZ group, HR, bllod pressure, blood glucose and blood fat haven't great difference(P > 0.05) before ad after thereapy. In metoprolol group the difference is significant(P < 0.05, P < 0.01) and twogroups have great difference(P < 0.05). Conclusion The results suggest that the TMZ is effect and safe on the sta-ble angina peetoris patients with type 2 diabetes mellitus.

Objective To evaluate the application effect of psychological intervention of husband and wife for the center to patients with in vitro fertilization and embryo transfer. Methods Eighty infertile couples with in vitro fertilization and embryo transfer were selected and divided into intervention group and control group with 40 cases in each group according to the document order numbers, the two groups were given conventional health education of in vitro fertilization and embryo transfer, in addition,the patients in the intervention group received psychological intervention of husband and wife for the center, the intervention time was 5 weeks. Questionnaire investigation about Self- rating Depression Scale (SDS), Self- rating Anxiety Scale (SAS),Coping Style Scale and Subjective Feeling of Marriage Scale were conducted before and after the intervention. Results The scores of SDS and SAS were (30.43±8.92), (33.48±9.92) points after the intervention in the intervention group, and (40.26±9.54), (41.51±7.24) points in the control group,and there were significant differences (t=7.611, 6.245, P<0.01).The scores of help seeking, self- accusation, fantasy, wince and rationalization in Coping Style Scale were (0.63±0.19), (0.25±0.21), (0.41±0.22), (0.43±0.24), (0.42±0.21) points after the intervention in the intervention group, and (0.51±0.21), (0.38±0.22), (0.51±0.19), (0.55±0.23), (0.55±0.22) points in the control group, and there were significant differences(t=3.008-3.668, P < 0.05). The scores of subjective feelings of marriage and family relationship were (64.79±9.75), (34.37±5.12) points after inntervention in the intervention group, and (58.09±11.42), (29.23±4.97) points in the control group, and there were significant differences (t=7.212, 3.463, 15.234, P < 0.05). Conclusions Applying psychological intervention of husband and wife for the center to patients with in vitro fertilization and embryo transfer can improve the psychological state, reduce depression and anxiety, adopt positive coping style, increase the quality of marriage.

Codnopsispilosula polysaccharides (CPP) , which administered intra-peritoneally 200mg/kg?d-1 for 5 d or 8 d in mice, enhanced thephagocytic activity of peritoneal macrophages on chiken RBC, the erythrocyte (E)rosette formation of thymus T lymphocyte and the clearance rate of charcoal particles in normal mice and antagonized the inhibition of E rosette formation and of peritoneal phagocytic activity caused by cyclophosphamide ( CY ) or hydrocortisone ( HCT ) . It inhibited the delayed type hypersensitivity ( DT H ) induced by DNCB and enhanced DT H induced by dexamethasons ( DMS ) . It has regulatory important signification in resisting decrepitude.

[Objective] To establish a method for the determination of ferulic acid and salvianolic acid B contents in Yixin Tablets. [Methods] High pressure liquid chromatography (HPLC) was adopted. The chromatographic conditions were: 100-fold methanol as solvent, Bonification for 30min, gradient elution on C18 comlumn with acetonitrile and phosphoric acid as mobile phase, the detection wavelength being 320nm. [Results] Ferulic acid had a good linearity in the range of 0.024 32 - 0.729 60 ?g and r=0.999 9; salvianolic acid B had a good linearity in the range of 0.416 8-12.504 0?g and r = 0.9999; the average recovery rate was 100.95% in ferulic acid and 99.35% in salvianolic acid B respectively. [Conclusion] This method is simple, accurate and with good reproducibility.

Purpose: To study the clinical treatment and prognosis of gastric cancer in elderly patients. Methods: From 1984 to 1995, 110 old patients with malignant tumor in stomach were treated in this hospital. All 110 patients received surgery with radical resections in 60 cases, palliative resections in 22 cases, laparotomy in 24 cases, and gastrojejunostomy in 4 cases. Results: Postoperative complication was 16. 36%, mortality was 1. 8%. The overall 3- and 5- year survivals for radical resections were 68. 4%, 55. 08%, respectively. Multivariate analyses showed that the favorable factors for prognoses were stage and radical resection. Conclusions: It is recommended that radical resection should be performed for malignant tumors of stomach in old patients. Although the risks of complication morbidity and surgery mortality are more likely to be higher after surgery for the elderly, the outcome would be better if more attention were paid, to improve patients general condition, and correct management after surgery.\;

Purpose:To investigate the effects and side- ef fects of thalidomide in the treatment of relapsed and refractory multiple myelom a (MM).Methods:There were thirteen men and two women aged 33～7 6 (median 58) years in thalidomide alone group. Two cases were newly diagnosed my eloma; twelve of them were refractory myeloma, including three relapsed cases wh o had experienced autologous peripheral blood stem cell transplantation (AutoPBS CT); another one is primary plasma cell leukemia. The starting dose was 100mg/d, escalating up to a maximum of 800mg/d. The combination group included twenty me n and seven women aged 40～81 (median 56) years of which case was newly diagnose d myeloma; twenty-five cases were refractory myeloma, two of whom relapsed after AutoPBSCT; another one was primary plasma cell leukemia. Dexamethasone 40mg/d w as used at d 1-4 , d 9-12 , d 17-20 when the dose of thalidomide increased to 400mg/d. Each cycle lasted for one month.Results: The total response rate was 42.9% and 57.7% in thalidomide alone group and in co mbination group, respectively. The response rate in refractory patients was 33.3 % and 44.0% in thalidomide alone group and in combination group, respectively. T here was no difference between the two groups in response rates. Both of the two groups had side effects of constipation and skin rash, etc. in different degree s but usually tolerable. Conclusions:Both thalidomide alone and thalidomide combined with dexamethasone was effective in the treatment of relap sed and refractory MM.

Objective: To observe curative effect of thoracic sympathetic block on patients with diabetes mellitus (DM) complicated cardiac chamber enlargement and heart failure (HF). Methods: A total of 76 DM patients with cardiac chamber enlargement and HF were randomly divided into routine treatment group (n=36) and epidural nerve block group (nerve block group, n=40, received thoracic epidural nerve block based on routine treatment), and four weeks were a course of treatment. Changes of left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd), left atrial diameter (LAD), levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), brain natriuretic peptide (BNP) and glycosylated hemoglobin (HbA1c) were observed in two groups. Results: There were no significant difference in all indexes between two groups before treatment (P>0.05). After treatment, total effective rate of cardiac function improvement in nerve block group was significantly higher than that of routine treatment group (95% vs. 66.7%, P<0.05). Compared with before treatment, there were significant decrease in LVEDd [(71.63±9.26)mm vs. (65.4±8.12)mm] and LAD[(45.62±7.10)mm vs. (37.14 ±6.28)mm] (P<0.05 both), significant increase in LVEF [(31.3±11.46)% vs. (42.12± 10.42) % , P< 0.01], and significant decrease in levels of TNF-α [(73.55±16.36)ng/L vs. (28.35±10.08) ng/L], IL-6 [(17.62±5.47) ng/L vs. (7.88±2.29) ng/L], BNP[(13.49±2.94) ng/L vs. (6.28±2.28) ng/L] and HbA1c [(7.9±2.6) % vs. (6.8±1.9) %] in nerve block group after treatment, P<0.05 or <0.001; and levels of LVEF, TNF-α, IL-6 and BNP in nerve block group after treatment were significantly improved than those of routine treatment group, P<0.05 or <0.01. Conclusion: Thoracic sympathetic block can significantly decrease levels of neuroendocrine and inflammatory factors, improve cardiac function, and elevate quality of life in patients with diabetes mellitus complicated heart failure.

Objective To investigate the clinicopathological features and risk factors of lymph node metastasis of gastrointestinal neuroendocrine neoplasms (GI-NENs).Methods The retrospective case-control study was conducted.The clinicopathological data of 467 patients with GI-NENs who were admitted to the Fourth Hospital of Hebei Medical University from January 2006 to December 2015 were collected.Observation indicators:(1) occurrence sites and pathological classification of GI-NENs;(2) pathological characteristics of surgical specimens of GI-NENs;(3) univariate analysis and multivariate analysis affecting lymph node metastasis of GI-NENs:sex,age,tumor location,tumor diameter,pathological classification,pathological stage and tumor invasive depth.The univariate analysis and multivariate analysis were respectively done using the chi-square test and Logistic regression model.Results (1) Occurrence sites and pathological classification of GI-NENs:of 467 patients with GI-NENs,tumors of 304,15,7,14 and 127 patients were located at stomach,duodenum,small intestine,colon and rectum,respectively.Tumor diameter was 0.3-12.0 cm,with an average diameter of 2.2 cm.Of 467 patients with GI-NENs,G1 and G2 of neuroendocrine tumors (NETs),G3 of neumendocfine carcinomas (NECs) and mixed adenoneuroendocfine carcinomas (MANECs) were respectively detected in 209,64,146 and 48 patients.Lymph node metastasis rate of GI-NENs was 31.48％ (147/467).(2) Pathological characteristics of surgical specimens of GI-NENs:NETs were high-differentiated NENs.Ceils of NETs were solid and nest-,trabeculum-and tubular-shaped,and consisted of small or medium cells,with moderate amount or massive cytoplasms,round or oval nucleus,particle-shaped chromatin,unobvious nucleolus and positive endocrine markers.There were abundant of small blood vessels and surrounding fibrous stroma in peripheral tumor cell nests.NECs were low-differentiated NENs and included small cell carcinoma and large cell NEC.Cells of small cell carcinoma were small round or oval and looked similar to lymphocytes,with few amount cytoplasms,fine granularshaped or hyperchromatic nucleus and common mitosis figures.Cells of large cell NEC were large and greater than 3 lymphocytes,arrayed in organoid-or chrysanthemum-shape,with massive cytoplasms,coarse particle-shaped chromatin,obvious nucleus,clear mitosis figures and large laminar-shaped necrosis.There were different positive expressions of endocrine markers between small cell carcinoma and large cell NEC.MANECs had the characteristics of glandular cavity formation of traditional adenocarcinoma and NENs.Results of immunohistochemical staining in 467 patients showed that Ki-67 of 467 patients was positive;CD56 in 379 of 428 with CD56 test was positive;synaptophysin (Syn) in 416 of 422 with Syn test was positive;cytokeratin (CK) in 354 of 396 with CK test was positive;chromogranin (CgA)in 264 of 388 with CgA test was positive;neuron specific enolase (NSE) in 287 of 346 with NSE test was positive.(3) Univariate analysis and multivariate analysis affecting lymph node metastasis of GI-NENs:results of univariate analysis showed that sex,tumor location,tumor diameter,pathological classification,pathological satge and tumor invasive depth were related factors affecting lymph node metastasis of patients with GI-NENs (X2 =20.654,18.182,26.788,184.709,163.738,195.391,P＜ 0.05).Results of multivariate analysis showed that pathological classification and pathological stage were independent influenced factors affecting lymph node metastasis of patients with GI-NENs (HR =2.129,7.171,95％ confidence interval:1.273-3.561,-2.327-22.098,P＜0.05).Conclusions GI-NENs are mostly located on the stomach and rectum.Results of immunohistochenical staining could help diagnosis of GI-NENs.Pathological classification and pathological stage are independent influenced factors affecting lymph node metastasis of patients with GI-NENs.

Objective To analyze the effect of clinical pathway management for capillary bronchitis in Department of Pediatrics.Methods 75 children with capillary bronchitis after the implementation of clinical pathway management were selected as the observation group,and 68 children with capillary bronchitis before the implementa-tion of clinical pathway management were selected as the control group.The hospitalization cost,average hospital stay, antibiotic use rate,cure rate,nonsocomial infection rate,rehospitalization rate within two weeks,service satisfaction and other comprehensive indices were compared.Result The total cost of drug of the observation group[(1 198.49 ± 397.48)yuan]was lower than (1 324.05 ±376.57)yuan of the control group(Z =2.00,P <0.05).The average hospital stay of the observation group[(6.99 ±2.39)d]was shorter than (8.01 ±2.22)d of the control group(Z =2.62,P <0.05).The service satisfaction rate of the observation group(95%)was higher than 82% of the control group(χ2 =5.44,P <0.05).The antimicrobial use rate of the observation group(49%)was apparently lower than 95% of the control group (χ2 =27.59,P <0.01).There were no statistically significant differences between the two groups in cure rate(hospital discharge rate),nosocomial infection rate and rehospitalization rate within two weeks(all P >0.05).Conclusion Clinical pathway management for capillary bronchitis in Department of Pediatrics of primary hospital can play a role in standardizing medical practice,reducing average hospitalization days,controlling medical cost,and improving service satisfaction under the precondition of ensuring medical quality.