Objective:To evaluate the effect of the occlusal surface height of a mandibular posterior implant-supported single crown on stress in bone tissues.Methods:Three-dimensional finite element models of the implant-supported single crown replacing the missing right lower second premolar,mesial and distal natural teeth,periodontal membrane,alveolar bone,loaded rigid body and analog food of almond were established.Using the Federation Dentaire International (FDI)system,the first premolar, the second premolar and the first molar were represented with 44,45,46.Three occlusal surface heights of the crown were studied:(1 )normal height;(2)1 5 μm reduction in height;(3)30 μm reduction in height.The models were loaded by independent loading with maximal occlusal force(44 by 280 N,45 by 360 N,and 46 by 480 N)and average occlusal force(44 by 1 40 N,45 by 1 80 N,and 46 by 240 N)on the single crown;combined loading (maximal occlusal force transformed into uniform load of 3 .7 MPa on top of rigid body,in contact with points on the occlusal surface),and analog almond-like food loading (average occlusal force transformed into uniform load of 1 .67 MPa in simulated food chewing,in contact with points on the occlusal surface).Results:For maximal biting force under independent loading,Von Mises stress peak values in bone tissues around 44,45,and 46 were 82.57 MPa,45.26 MPa and 27.79 MPa;For average biting force,peak values were 41 .28 MPa,22.63 MPa and 1 3.89 MPa.Under com-bined loading,compared with the normal occlusal surface height group,Von Mises stress peak values de-creased 4.6 MPa,by 0.84%;increased 7.52 MPa,by 20.04%,and decreased 1 .8 MPa,by 5.84%, for 45,46,and 44 in the 30 μm infra-occlusion group,respectively.Under food loading,Von Mises stress peak values decreased 0.34 MPa,by 1 .62%;increased 1 .1 1 MPa,by 2.66%;and increased 0.06 MPa,by 0.54%,and for 45,46,and 44 in the 30 μm infra-occlusion group,respectively.Con-clusion:Within the limitation of this study,within 30 μm reduction of the occlusal surface height of im-plant-supported single crown,no significant difference of the peak values was observed.

Objective To evaluate the clinical efficacy and outcomes of percutaneous cholecystostomy(PC) under type-B ultrasonic guide as an alternative treatment option for critically ill patients of acute cholecystitis.Methods The clinical data of 53 high-risk patients of acute cholecystitis were retrospectively analyzed,who received PC from January 1999 to August 2005.Results All cases were successfully punctured and intubated,and 4 received reoperation because of blocked tube or fall-off.Fifty-two(97.3%) gained bile drainage effectively.No complications occurred due to the procedures in the cholecystostomy and intubation.One patient required emergency cholecystectomy on day 1 after the procedures because of deteriorating conditions.Forty-one accepted selective cholecystectomy in 2 weeks to 3 months after cholecystostomy.The follow-up period was 6 months to 3 years.Conclusion PC is an effective,convenient and safe method in managing acute cholecystitis in high-risk patients,with high achievement ratio and less complications.

Objective:To observe the changes of lung index,lung function,regulatory T cells and Foxp3,TGF-β1,Smad3,Smad7 protein expression in adjuvant arthritis(AA) rats,and to investigate the possible mechanism of Foxp3 and TGF-β/Smads signal transduction pathway in reducing lung function.Methods: 24 Wistar rats were randomly divided into normal control group and model group,12 rats in each group.The rats were injected with 0.1 ml Freunds'complete adjuvant to induce inflammation at the part of their rightback foot in model group.On the 48~(th) day post-inflammatory,the swelling degree of toe and arthritis index(AI) were observed.Lung index of the rats was calculated,and pulmonary function of the rats was detected.The percentage of regulatory T cells was determined,and pathological changes of the lungs was observed by HE staining.Foxp3,TGF-β1,Smad3,Smad7 protein expression in the lungs of the two groups of rats was examined by immunohistochemistry.Results:①Compared with those of the normal,the swelling degree of toes,AI,and the lung index were increased.The average peak expiratory flow in 1 second (FEV1/FVC),alveolitis points,TGF-β1 and Smad3 protein expression was significantly higher in the AA model group rats(P＜0.01).Forced vital capacity (FVC),25% of vital capacity of the peak expiratory flow (FEF25),50% of vital capacity of the peak expiratory flow (FEF50),75% of vital capacity of the peak expiratory flow (FEF75),maximum mid-expiratory flow (MMF),forced maximal expiratory flow (PEF),pulmonary dynamic compliance (Cldyn),the percentage of CD4~+ T cell,CD25~+ T cell,CD4~+ CD25+~ T cell,Foxp3 and Smad7 protein expression was obviously lower in the AA model group rats(P＜0.01).②FEF50,Cldyn and MMF were negative correlated with the swelling degree of toes,pulmonary coefficient and TGF-β1.FEF50,FEF75,MMF and FEV1/FVC were positiyely correlated with the arthritis index,pulmonary coefficient and Foxp3(P＜0.05 or P＜0.01).Conclusion:The decline in lung function in AA rats.Tip-induced may be sustained after the inflammation,and the development of cause inflammation,to chronic inflammatory response leading to lung injury.Simultaneously,the decline in lung function and Foxp3.Smad3,Smad7,TGF-β1 protein expression was associated.Description transcription factor Foxp3 and TGF-β1/Smads signal transducation pathway may participate in the mechanism.

OBJECTIVETo explore the effect of Xinfeng Capsule (XC) on lipoprotein metabolism of rheumatoid arthritis (RA) patients.

METHODSTotally 180 RA patients were assigned to the experimental group and the control group by random digit table, 90 in each group. Patients in the experimental group took XC (three pills each time, three times daily), while those in the control group took Methotrexate Tablet (four tablets each time, once per week). One month consisted of one therapeutic course and all patients were treated for two therapeutic courses. A healthy control group consisting of 60 patients was also set up. Changes of lipoprotein indices, clinical efficacy, lipid metabolism, joint symptoms and signs, activity indicators were observed, and correlation analyses were performed.

RESULTSCompared with the healthy control group, expression levels of prealbumin (PA), globulin (GLO), high-density lipoprotein (HDL), apolipoprotein Al (Apo-A1) were lowered in RA patients (P <0. 05, P <0. 01). Correlation analyses showed that PA was negatively correlated with joint tenderness, morning stiffness time, disease activity score (DAS-28), C-reactive protein (CRP), interleukin (IL)-6, respectively. Total protein (TP) was negatively correlated with joint tenderness. GLO was negatively correlated with joint tenderness and DAS-28. HDL was negatively correlated with erythrocyte sedimentation rate (ESR) and endothelin (ET)-1. Apo-Al was negatively correlated with joint pain; Apo-B was negatively correlated with CRP; LDL was negatively correlated with morning stiffness time (P <0. 05, P <0. 01). Compared with before treatment, expression levels of PA, HDL, Apo-A1 , Apo-B, and serum IL-10 contents increased, and expression levels of ESR, CRP, IL-6, ET-1 , joint pain, joint swelling, morning stiffness time, and DAS-28 decreased in the experimental group (P <0. 05, P <0. 01). PA increased more after treatment than before treatment in the control group (P <0. 01). There was statistical difference in joint symptoms (except joint tenderness) and activity indices (except ET-1) in the control group (P <0. 05, P <0. 01). Compared with the control group after treatment, PA and HDL increased, ET-1 and duration of morning stiffness decreased in the experimental group (all P <0. 05).

CONCLUSIONSLipoprotein metabolic disorder exists in RA patients, and it is associated with disease activity. XC could obviously improve lipoprotein metabolism and joint symptoms.

Arthritis, Rheumatoid ; drug therapy ; metabolism ; Blood Sedimentation ; C-Reactive Protein ; Capsules ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Interleukin-10 ; Interleukin-6 ; Lipoproteins ; Lipoproteins, HDL ; metabolism ; Methotrexate

Objective To explore the clinical feasibility of ambulatory surgery for inguinal hernia in 70 years of age or older patients.Methods The retrospective cohort study was adopted.The clinical data of 675 patients undergoing ambulatory surgery for inguinal hernia and 464 patients (age ≥ 70 years) undergoing inpatient surgery for inguinal hernia who were admitted to the West China Hospital of Sichuan University from January 2015 to May 2016 were collected.Of 675 patients undergoing ambulatory surgery,594 patients with age ＜ 70 years and 81 with age≥70 years were respectively allocated into the under 70 years group and 70 years or older group.Four hundred sixty-four patients undergoing inpatient surgery with age ≥ 70 years were allocated into the inpatient surgery group.Observation indicators included:(1) efficacies of patients undergoing ambulatory surgery:① type of anesthesia,surgical procedures and operation time,② cases with delayed discharge and cases with unplanned readmission,③postoperative complications,including wound infection and dehiscence,edema of scrotum,urinary retention,chronic pain and patch infection.(2) Efficacies of patients with inpatient surgery:①type of anesthesia,surgical procedures and operation time,② postoperative complications,including wound infection and dehiscence,edema of scrotum,urinary retention,chronic pain and patch infection,③ duration of postoperative hospital stay.(3) Follow-up.Patients were regularly followed up using telephone interview at postoperative day 1,2,3,and using outpatient examination and telephone interview at postoperative week 2 and month 3,6,12 up to July 2016.Follow-up included the survival of patients,recurrence of hernia and number of readmission.Measurement data with normal distribution were represented as （x） ± s and comparison between groups was evaluated with the t test.Comparison of count data were analyzed using the chi-square or Fisher exact probability.Results (1) Efficacies of patients undergoing ambulatory surgery:① type of anesthesia,surgical procedures and operation time:patients in the under 70 years group and 70 years or older group underwent tensionfree repair under local anesthesia.The operation time in the under 70 years group and 70 years or older group was respectively (29 ± 11) minutes and (28 ± 10) minutes,with no statistically significant difference between 2 groups (t =0.378,P ＞ 0.05).② The cases with delayed discharge and with unplanned readmission:there were 2 patients with delayed discharge and 1 with unplanned readmission in the under 70 years group and no case in the 70 years older group,with no statistically significant difference between the 2 groups (x2=0.601,0.137,P ＞ 0.05).③ The postoperative complications:wound infection and dehiscence,edema of scrotum,urinary retention and chronic pain were detected in 4,2,1,3 patients in the under 70 years group and 1,0,0,1 patients in the70 years or older group,respectively,showing no statistically significant difference between the 2 groups (P ＞ 0.05).No patch infection occurred.(2) Efficacies of patients undergoing inpatient surgery:① type of anesthesia,surgical procedures and operation time:patients in the inpatient surgery group underwent tension-free repair under local anesthesia and operation time was (29 ± 10) minutes.There was no statistically significant difference in operation time between the inpatient surgery group and 70 years or older group (t =0.806,P ＞ 0.05).② The wound infection and dehiscence,edema of scrotum,urinary retention and chronic pain in the inpatient surgery group were respectively detected in 3,1,1,2 patients,showing no statistically significant difference between the inpatient surgery group and 70 years or older group (P ＞ 0.05).No patch infection occurred.③ Duration of postoperative hospital stay was less than 1 day in 439 patients and more than 1 day in 25 patients in the inpatient surgery group,respectively.(3) Follow-up:625 of 675 patients undergoing ambulatory surgery were followed up for a median time of 9 months (range,2-18 months).One patient in the under 70 years group was complicated with recurrence of hernia and then was cured by reoperation.There was no recurrence of hernia in the 70 years or older group.Of 464 patients in the inpatient surgery group,432 were followed up for a median time of 9 months (range,2-18 months),and 1 patient with recurrence of hernia was cured by reoperation.Conclusion Ambulatory surgery for inguinal hernia is feasible in 70 years or older patients.

ObjectiveTo compare the therapeutic effects of percutaneous cervical discectomy (PCD group),percutaneous cervical disc nucleoplasty(PCN) and the association of them (PCDN) for the treatment of cervical intervertebral disk displacement and instability of cervical vertebral column.Methods From February 2003 to April 2011,171 consecutive patients with cervical disc herniation have presented at the authors' hospital and were retrospectively studied.The average age of patients was 47.8 years(ranged,21-74).Ninety-seven cases were treated with PCD,50 cases with PCN,and the other 24 cases with PCDN.Clinical result and the stability of cervical vertebral column after operation were evaluated and compared among the 3 groups.ResultsAll cases had been followed up for a median of 4.1 years.There was significant difference in the pre- and post-operation the Japanese Orthopaedic Association(JOA) scoring system on within 3groups (PCD:t=21.85,P＜0.05; PCN:t=14.50,P＜0.05; PCDN:t=8.56,P＜0.05).All cases had been successfully operated.There was no significant difference between groups among the 3 groups in terms of the clinical outcomes(The recovery rate of JOA standard evaluation,F=2.19,P=0.12).According to Odom criteria,the excellent and good rate are as follows:81.35％ in PCD,82.44％ in PCN,83.19％ in PCDN,respectively.There was no significant difference between groups among the 3 groups in terms of the clinical success rate (P＞0.05).There was no instability of cervical vertebral column cases in 3 groups after operation(P＞0.05),and no significant difference was found in terms of cervical vertebral column stability in pre- and post-operation in each group.ConclusionAll the three operations including PCN,PCD and PCDN are safe,minimally invasive spine surgery for the treatment of cervical intervertebral disk displacement; they achieve good clinical outcomes and there are no difference on the stability of cervical vertebral column between preoperation and postoperation.

Objective To investigate the role of cyclophilin A (CypA) and CD147 in the process of skin aging. Methods Twenty cases of tissue samples from junior group(＜15 years old), middle age group(30-40 years old)or old age group (＞65 years old) were collected from photophobic and exposal parts of skin, respectively. Immunohistochemistry (IHC) and in situ hybridization (ISH) were carried out to semi-quantitatively detect the expression level of CyPA and CD147. Results IHC demonstrated that both CyPA and CD147 were expressed in both photophobic and exposal parts of normal human skin in all 3 groups. The expression levels of both CyPA and CD147 were increased with increase in age. There were significant differences in both CyPA and CD147 expression among 3 groups (P<0.05). CyPA and CD147 were also positively correlated in all 3 groups. Similar results were achieved by ISH. Conclusion The interaction between CD147 and CyPA might play an important role in the process of skin aging.

Objective To observe the protection of human keratinocyte cell line, HaCaT cell, from UVA damage by resveratrol and its possible mechanism. Methods HaCaT cells were incubated with or without 0.01 mmol/L or 0.1 mmol/L resveratrol after exposure to 5 J/cm2 UVA irradiation. Unirradiated HaCaT cells-without the treatment with resveratrol served as the control. After another 24-hour culture, MTT assay was used to detect the proliferation of cells, RT-PCR and Western-blot to measure the iNOS mRNA and protein expression respectively, electron microscopic technique to observe the changes in cell ultrastructure. Results After irradiation with UVA of 5 J/cm2, the proliferation of HaCaT cells decreased with the absorbance at 490 nm descending from 0.889±0.083 to 0.542±0.004, while a significant increase was observed in the relative expression level of iNOS mRNA and protein in HaCaT cells (1.532±0.041 vs 0.009±0.003, 1.331 ±0.046 vs 0.003±0.001, both P < 0.05) with the presence of typical apoptotic cells. The treatment with 0.01 and 0.1 mmol/L resveratrol significantly promoted the proliferation of irradiated cells with the absorbance at 490 nm being 0.753±0.435 and 0.892±0.173 respectively, but inhibited the mRNA (0.853±0.038 vs 1.532±0.041, 0.392±0.033 vs 1.532±0.041, both P< 0.05) and protein expression level (0.809±0.018 vs 1.331±0.046, 0.412±0.026 vs 1.331±0.046, both P< 0.05) of iNOS in irradiated cells, and the resveratrol of 0.1 mmol/L was more effective than that ofO.01 mmol/L in all tested parameters (P< 0.05). Furthermore, no apoptofic cells or necrotic cells were observed in irradiated ceils incubated with resveratrol. Conclusion Resveratrol effectively protects HaCaT cells from UVA damage, which may be related to the inhibition of UVA-induced iNOS expression by resveratrol.

Objective: Analyze the ecological adaptable regions for the resource reservation and the expanding cultiva-tion of Quisqualis indica L. Methods: The Traditional Chinese Medicine Geographic Information System (TCMGIS) was used to analyze the ecological adaptable region. Results: The 17 provinces (city, municipalities) were the ecolog-ical adaptable region for Q. indica L. The 100% ecology similarity regions are mainly in 16 provinces (city, munici-palities), including Guangxi, Guangdong, Hunan, Fujian etc., which area accounts for 1 012 895.98 km2. Among these, the area in Guangxi province is the largest (195 313.64 km2), the second is Guangdong (150 276.36 km2), the following order is Hunan(128 925.29 km2), Fujian (101 471.16 km2) and Y unnan (100 660.83 km2). The 95%~100%ecology similarity regions is located in 16 provinces (city, municipalities), including Y unnan, Sichuan, Guizhou, Hubei province etc., which area accounts for 362 366.25 km2. The largest area is in Y unnan province (92 399.04 km2), followed by Sichuan(76 122.32 km2), Guizhou (43 902.38 km2), Hubei (31 760.32 km2) and Jiangxi (29 770.09 km2). Conclusion: The results are consistent with the survey results and the previous reports. To promote the develop-ment of Q. indica L. cultivation, the planting scientifically and quality evalution should be further conducted on the basis of the results by system analysis.

ObjectiveTo evaluate the efficacy of rehabilitation associated with local intramuscular injection of botulinum toxic A (BTX-A) on spastic cerebral palsy (CP).Methods60 children with spastic CP were divided into experimental group and control group with 30 cases in each group. Cases of experimental group were treated with rehabilitation associated with local intramuscular injection of BTX-A. Cases of control group were treated only with rehabilitation treatment. The therapeutic efficacies of two groups were evaluated with physician rating scale (PRS) and activities of daily living (ADL) evaluation systems.ResultsImprovement of clinical evaluations index-PRS and ADL in experimental group was much more significant than that of control group (P<0.05). ConclusionRehabilitation associated with local intramuscular injection of BTX-A can improve the efficacy of spastic CP.