Objective: Osteoarthritic lesions of Temporomandibular joint(TMJ) were assessed by dental cone beam computed tomography(CBCT),and compared with conventional radiographic technology. Methods: The study was conducted retrospectively on 511 joints of 350 patients, who had undergone dental CBCT ,panoramic radiography,transcranial projection and transpharygeal projection of TMJ . The results were compared and the accuracy with CBCT was assessed. The types of osseous condylar abnormalities were observed.Results: (1) The occurrence of osteoarthritis in male and female were 59.04% and 69.66%, respectively, with no significant difference. (2) Compared with CBCT, panoramic radiography,transpharygeal projection examination showed no significant difference, with the accuracy being 90.64% and 94.10%,respectively;However, transcranial projection indicated a significant difference in comparison with CBCT and the accuracy was 86.97%. (3) A higher occurrence of osteoarthritic lesions of the condyle was sclerosis (39.86%). Bony proliferation or osteophyte (28.18%) and ill-defined cortical bone (18.90%) were followed. Conclusion: Cone beam CT, which reproduces multiple images including axial, coronal and sagittal planes of the joint, provides a complete radiographic investigation of the bony components of the TMJ. It is one of the best choices of imaging diagnosis of TMJ osteoarthritis. Panoramic radiography and transpharygeal projection examination are also good choices for showing osseous condylar abnormalities in the clinic, but transcranial projection examination is inferior.

Aim To investigate the effect of MTX(included(±)MTX,(+)MTX and(-)MTX)on the proliferation of ECV304 cells and to explore its mechanisms.Methods ECV304 cells were cultured.The cell proliferation was determined by MTT.The morphological changes were inspected by inverted microscope.Cell cycle phases were assayed by propidium iodide staining flow cytometry.Results ECV304 cells were treated with(+)MTX,(-)MTX and(±)MTX at 1～150 μmol·L~(-1) for 24,48,72 h.The results showed that the proliferation of ECV304 cells was significantly inhibited under different conditions.The order of the inhibited efficacy was(+)MTX>(±)MTX>(-)MTX.The morphology of ECV304 cells were changed by(+)MTX,(-)MTX and(±)MTX treatment,which included the cell shrinkage,chromatin condensation.After administration of 10 μmol·L~(-1) of(+)MTX,(-)MTX and(±)MTX for 48 h,the cell cycle phases were assayed by propidium iodide staining flow cytometry.The result showed DNA replication was interfered by(+)MTX,(-)MTX and(±)MTX treatment.Conclusions The proliferation of ECV304 cells has the chiral selective effects by(+)MTX and(-)MTX treatment,and the inhibition on ECV304 cells proliferation of(+)MTX is significantly stronger than that of (-)MTX.

The paper is to report the pharmacokinetics of furosemide in rats living at plain area and high altitude. After intragastric administration of furosemide (2.87 mg x kg(-1)), serial blood samples (0.5 mL) were collected by retro-orbital puncture at 0, 20 min, 40 min, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 h, samples were determined by LC-MS/MS, and plasma concentration-time data were analyzed by DAS 2.0 software to get the related pharmacokinetic parameters. The main pharmacokinetic parameters: area under curve (AUC), mean residence time (MRT), the biological half-life (t1/2) and the peak concentration (C(max)) of furosemide, were significantly increased at high altitude, the time to reach peak concentration (t(max)) and clearance (CL) was significantly decreased. This study found significant changes on the pharmacokinetics of furosemide under the special environment of high altitude. This finding may provide some references for clinical rational application of furosemide at high altitude.

Objective:Living organ transplantation prolongs the life of many dying patients, but there are many disputes, especially the definition ofliving organ transplantation between non relatives. The definition of this ter-minology is closely related to medical students′cognitive ofliving organ transplantation between non relatives. The medical students are the main reserve army of medical staff and the executor of living donor organ transplantation in the future, who directly determine the organ transplantation and affect the doctor-patient relationship. This paper is to investigate and analyze the status of the medical students′recognition of cross transplantation between non rela-tives. Methods:A total of 450 medical students of Qingdao university were selected with cluster method and were investigated using self-designed questionnaire. Data were analyzed by SPSS 22. 0. Results:The overall recogni-tion rate toliving organ cross transplantation between non relatives was relatively low. The difference was statisti-cally significant (P<0. 05), namely that students in higher grade had lower recognition. The difference was statis-tically significant (P < 0. 05) between different specialties, and the recognition degree of students majoring in clinical medicine and ecsomatics was higher. Conclusion:The medical students of Qingdao University understand the concept of living organ cross transplantation between non relativesfuzzily, and the recognition degree is low.

Objective:To study the pharmacokinetics of propranolol in Wistar rats after acute exposure to high altitude.
Methods:Fourteen male Wistar rats (200±20) g were selected. After administration of propranolol tablets (0.05 g/kg, i.g.), blood samples (3 mL) were collected at 0, 20, 40 min,1, 1.5, 2, 4, 6, 8, 12 and 24 h, respectively. The pharmacokinetic parameters were determined by LC-MS/MS and DAS 2.0 software.
Results:The main pharmacokinetic area under concentration-time curve (AUC), mean retention time (MRT), half-life (t1/2) and peak plasma concentration (Cmax) of propranolol were increased by 442.61%, 47.45%, 73.13%and 352.97%, respectively, whereas Tmax and clearance (CL) were decreased by 80.87%and 68.94%, respectively.
Conclusion:This study displays significant changes in the pharmacokinetics of propranolol under high altitude, which may provide evidence for clinical rational application of propranolol at high altitude.

Objective:To investigate the workload of extracorporeal membrane oxygen(ECMO) patients, estimate the number of hours of care based on the amount of nursing work, and to analyze the status of human resources, improve the quality of care and the effect of nursing.Methods:The Nursing Activity Assessment Scale was used to evaluate the daily workload of ECMO patients in the Intensive Care Unit of Zhejiang Province People′s Hospital, and the relevant factors affecting the workload were analyzed.Results:The average daily workload of ECMO patients was (76.06 ± 7.23) points, the daily nurse care ECMO patients time was 10.31 h, and the number of ideal nurses who needed to participate directly in the daily patients was 2.28. The workload was related to age, whether heparin and vasoactive drugs were used, and prognosis( t values were -3.184-7.291, P<0.05 or 0.01). Conclusions:The workload of ECMO patients is relatively large. At this stage, the ratio of nurse to patient is reasonable in our hospital. The patients′ age, use the heparin, vasoactive drugs and prognosis affect the level of nursing workload of ECMO patients.

Objective:To explore the effect and nursing experience of vein-artery extracorporeal membrane oxygenation (V-A-ECMO) combined with continuous renal replacement therapy(CRRT) in the treatment of fulminant myocarditis.Methods:From January 2014 to October 2019, 15 cases of fulminant myocarditis were treated by V-A-ECMO combined with CRRT in the department of critical care medicine of Zhejiang People′s Hospital. During the operation of V-A-ECMO combined with CRRT, heart rate, blood pressure, coagulation function, troponin, creatinine and other indicators were closely monitored, strict liquid management and extracorporeal circulation pipeline management were implemented, and various complications such as arrhythmia, hypotension, bleeding and acral circulation disorder were timely observed and treated.Results:After 48 hours of treatment with V-A-ECMO and CRRT, the troponin value, lactic acid and creatinine of the patients were (21.53 ± 3.19) μg/L, (2.24 ± 0.37) mmol/L, and (58.13 ± 2.41) μmol/L, which were significantly lower than the start of the machine (79.65 ± 6.08) μg/L, (7.65 ± 1.28) mmol/L, (185.24 ± 5.63) μmol/L, the difference were statistically significant ( t values were -32.784, -15.726, -80.386, P<0.01), except for one dead patient, the left ventricular ejection fraction was significantly increased, reaching 45%-55% within 72 hours, and the left ventricular systolic and diastolic function was normal. Among the 13 patients who successfully withdrew the machine, 11 were cured, 3 were discharged automatically and 1 died. The success rate of withdrawing the machine was 86.67% and the cure rate was 73.33%. Conclusions:V-A-ECMO combined with CRRT can effectively improve cardiac renal function, maintain the stability of internal environment and improve the survival rate of patients. High-quality nursing can effectively improve the healing of patients, clinical need to continue to summarize the relevant nursing experience, improve the level of nursing, prevent various complications, improve the success rate of treatment, promote the recovery of patients.

OBJECTIVETo investigate the changes in hepatic functions and activities of CYP1A2 and CYP3A4 in rats after acute exposure to high altitude.

METHODSTwelve healthy male Wistar rats were randomly divided into control group and exposure group for acute exposure to normal and high altitude (4010 m) environment. Blood samples were collected from the vena orbitalis posterior for detection of the hepatic function. Hepatic pathologies of the rats were examined microscopically with HE staining. Liver microsomes were extracted by differential centrifugation to assess the activities of CYP1A2 and 3A4 using P450-GloTM kit.

RESULTSIn rats with acute exposure to high altitude, AST, ALT, and ALP all increased significantly by 48.50%, 47.90%, and 103.02%, respectively, and TP decreased significantly by 17.80% as compared with those in rats maintained in normal altitude environment (P<0.05). Pathological examination of the liver revealed edema of the central vein of the liver and hepatocyte karyopyknosis in rats after acute exposure to high altitude, which also resulted in significantly lowered activities of CYP1A2 and 3A4 in the liver (by 96.56% and 43.53%, respectively).

CONCLUSIONAcute exposure to high altitude can cause obvious liver injuries and lowered activities of CYP1A2 and 3A4 in rats to severely affect drug metabolism in the liver and result in increased concentration, prolonged half-life and reduced clearance of drugs.

Altitude ; Animals ; Cytochrome P-450 CYP1A2 ; Cytochrome P-450 CYP3A ; metabolism ; Cytochromes ; metabolism ; Liver ; pathology ; Male ; Microsomes, Liver ; enzymology ; Rats ; Rats, Wistar

OBJECTIVETo study the pharmacokinetics of propranolol and metoprolol in rats after acute exposure to high altitude.

METHODSWistar rats were randomly assigned into 4 groups for treatment with intragastric administration of propranolol or metoprolol after acute exposure to high altitude (4010 m) or normal altitude (50 m). Venous blood samples were collected from the rats at different time points after drug administration to determine the drug concentrations in the plasma and plasma ultrafiltrate using liquid chromatography-mass spectrometry (LC-MS/MS).

RESULTSThe protein binding rate of propranolol was significantly increased but that of metoprolol remained unchanged after acute exposure to high altitude. Compared with the rats exposed to normal altitude, the rats with acute exposure to high altitude showed significant alterations in the pharmacokinetic parameters of the drugs, shown by increased Cmax and AUC, prolonged t1/2 and MRT, and lowered Clz/F of propranolol, and by increased Tmax and prolonged t1/2 and MRT of metoprolol without obvious changes of the parameters of the compartmental model.

CONCLUSIONSignificant changes in the pharmacokinetics of propranolol and metoprolol occur in rats after acute exposure to high altitude possibly in relation to, apart from the changes in plasma protein binding ratio and blood gas, alterations in metabolic enzyme activities, increased blood viscosity, and species and general conditions of the animals.

Altitude ; Animals ; Chromatography, Liquid ; Metoprolol ; pharmacokinetics ; Propranolol ; pharmacokinetics ; Protein Binding ; Rats ; Rats, Wistar ; Tandem Mass Spectrometry

OBJECTIVETo investigate the influence of a sudden increase of altitudes (within 2500 m) in winter on cardiomyocyte functions in rats.

METHODSThirty male Wistar rats were randomly divided into groups A (55 m), B (1520 m), and C (2260 m) and subjected to simulated conditions at the indicated altitudes in winter for 3 days. Blood gas analysis, venous blood biochemistry, and measurements of SOD activity and myocardial concentrations of MDA and NO were performed. Histopathological changes in the left ventricle were observed with HE staining and electron microscopy.

RESULTSBlood pH and PCO2 did not differ significantly between the 3 groups, but PO2 and BE in groups B and C decreased significantly compared with those in group A (P<0.01). Compared with group A, the rats in group C showed obviously increased myocardial enzymes, MYB, Tn-I, and MDA contents (P<0.01) with significantly decreased SOD activity (P<0.05); both groups B and C showed significantly decreased NO content in the myocardium (P<0.01). Histopathologically, the myocardial fiber in group C showed irregular alignment, disruption, and mitochondrial expansion.

CONCLUSIONA sudden increase of altitude to 2260 m in winter can potentially cause hypoxic cardiomyocyte damage as a result of oxidative and environmental stresses.

Altitude ; Animals ; Hypoxia ; pathology ; Male ; Malondialdehyde ; metabolism ; Myocardium ; metabolism ; pathology ; Nitric Oxide ; metabolism ; Oxidative Stress ; Rats ; Rats, Wistar ; Superoxide Dismutase ; metabolism