Objective To observe the effect of four-handed technique in light cured resin veneer in the treatment of dental fluorosis. Methods Eighty outpatients with dental fluorosis in our hospital from January 2011 to January 2014 were randomly divided into two groups: 40 in the study group were treated with four-handed technique and another 40 in the control group with one-doctor manual operation. The two groups were compared in terms of treatment duration and curative effect. Result The treatment duration in the study was significantly shorter than that of the control group and the curative effect was significantly better than that of the control group (all P<0.05). Conclusion As for the light cured resin veneer in the treatment of patients with dentalfluorosis in the process , the four-handed technique is better than one-doctor manual operation.

Breast malignant lymphoma refers to occur in the breast malignant tumor of the lymphoid tissue.Breast malignant lymphoma which belongs to outside of lymph tissue malignant tumor can be divided into two categories:one category is the secondary breast lymphoma (SBL),another kind is the primary malignant lymphoma of the breast (PBL).Because the rate of PBL was low and the difficulty of preoperative diagnosis,illness development is rapid and high malignant degree,we should improve the attention of clinicians.Based on the discussion of primary breast lymphoma pathological changes,histological types,clinical manifestations,this article focuses on the progress of diagnosis and treatment of the PBL.

Humanized medical service should take Benevolence as the goal and run throughout the whole process of diagnosis and treatment of rheumatic immune diseases.Through the discussion on improving doctors' medical skills and paying attention to patients' mental health and physiological needs in the department of rheumatology and immunology,this paper put forward that it should improve the patient's disease control rate,prolong the survival,improve the quality of life and build a harmonious relationship between doctors and patients through the humanized treatment program,health education and follow-up.

Objective To investigate the clinical value of endoscopic transnasal dacryocystorhinostomy ( ET-DCR) by suture techniques.Methods 85 patients of 98 eyes with chronic dacryocystifis were randomly divided into the two groups:control group ( without suture) and observation group ( by suture) .All cases were followed up for more than 12 months.The cure rates and occurrence of granulation tissue were compared between the two groups. Results The cure rate of the observation group ( 96.00%, 48/50 ) was higher than that in the control group (81.25%,39/48) (χ2 =5.35,P<0.05). During process of following up,the occurrence of granulation tissue at the ostium margins accounted for 14.00%(7/50) in the observation group and 31.25%(15/48) in the control group (χ2 =4.19,P<0.05).Conclusion ET-DCR by suture techniques reduces the formation of granulation tissue and improves the cure rate.Especially, ET-DCR by suture techniques for the small lacrimal sac of patients may have special advantages.

Objective To explore the effect of endoscopic transnasal dacryocystorhinostomy(ET-DCR) by suture in the treatment of acute dacryocystitis(AD) as early as possible.Methods The clinical data of 32 patients with unilateral AD who underwent ET-DCR by suture as early as possible were retrospectively analyzed.Results All patients presented clear anatomic structure,intraoperative hemorrhage increased in 3 cases,swelling and pain was rapidly relieving in all patients in the first day of postoperation,the mean resolution time of congestion and swelling in the middle canthus was average 3 days(range 1-6 days),no spread of infection occurred,no facial scar appeared in all patients except one case of abscess rupture.Complete complaint relief in 26 cases,slight epiphora presented in 6 patients who confirmed for lacrimalduct obstruction and cured by intubation,and all ostial patency with no AD recurrences at the mean follow-up of 2 years (range 12 months-5 years).Conclusion ET-DCR by suture as early as possible can be used to cure acute dacryocystitis and it is effective safe and economy.

Objective To investigate the clinical characteristics of patients with polymyositis(PM) and dermatomyositis (DM), and compare the differences of PM/DM to help the understanding of clinical diagnosis and treatment. Methods One hundred and forty-five hospitalized PM/DM patients from Department of Rheumatology of the First Affiliated Hospital of Xiˊan Jiaotong University were collected from May 2008 to December 2014, and the clinical manifestations, muscle enzymes, electromyogram, muscle biopsy, treatment outcome were retrospectively analyzed. Mann-Whitney U test and χ2 test were used for statistical analysis. Results The most common initial symptom of PM was muscle weakness, accounted for 51.2%, while rash was the initial presentation in most DM patients(43.1%). The incidence of interstitial lung disease (ILD) (62.7% vs 39.5%, χ2=11.009, P=0.001), and the elevation of CRP (48.9% vs 26.8%, χ2=10.272, P=0.001) were all higher in DM than PM, while the elevation of level of CK (85.4% vs 61.8%, U=-2.668, P=0.008) and CKMB (82.9%vs 41.2%, U=-3.303, P=0.001) were more common in PM compared with DM. The pathological study showed degeneration of muscle fiber, connective tissue hyperplasia in most PM patients, and perimysium atrophy, vacuoles degeneration, muscle bundles, perivascular inflammatory cell infiltration were observed in most DM patients. During the follow-up, the clinical remission rate was 57.5%, the relapse rate and the mortality rate was 7.5%and 31.1%respectively. The mortality rate was higher in DM than PM (34.6% vs 21.4%, χ2=4.861, P=0.027). Infection and tumors were the major causes of death, and the lung was the most common site of infection. Conclusion Differences in the clinical features, muscle enzymes, CRP level, pathology and the mortality rate between PM and DM are evident, while ILD, infection and the higher mortality rate are more common in DM than in PM.

This study investigated the effect of cadmium on the telomerase activity, the expression of TERT, c-myc and p53 and the apoptosis of rat hepatocytes. The rats were administrated 5, 10 and 20 μmol/kg cadmium chloride intraperitoneally and sacrificed 48 h after the initial treatment. The telomerase activity of the rat hepatocytes was measured by the telomeric repeat amplification protocol (TRAP), and apoptosis was detected by flow cytometry. The mRNA expressions of TERT, c-myc and p53 were measured by reverse transcription-polymerase chain reaction (RT-PCR). C-myc and P53 proteins were determined by immunochemistry. The results showed that cadmium chloride increased the hepatocellular telomerase activity in a dose-dependant manner and induced the apoptosis of hepatocytes significantly. The value of relative coefficient between the telomerase activity and the apoptosis rate was 0.9398. RT-PCR revealed that specific bands corresponding to the TERT mRNA, c-myc mRNA, and p53 mRNA were displayed at 185, 342 and 538 bp respectively. Cadmium chloride could substantially increase the mRNA expressions of TERT, c-myc and p53 in rat hepatocytes, as compared with control. Moreover, cadmium chloride at the doses of 5, 10 and 20 μmol/kg could increase the content of P53 protein in rat hepatocytes obviously, but only that at the doses of 10 and 20 μmol/kg substantially promoted the c-myc protein level in rat hepatocytes. Our study herein suggested that cadmium may contribute to the carcinogenesis by activating telomerase, and overexpressing the mRNAs of TERT, c-myc and p53, and causing apoptosis of normal cells.

Following rapid social and economic development over the past several decades,pollution by heavy metals has been both serious and widespread in many areas of the world,including China.The situations of heavy metal pollution in China were reviewed,and the health risk and control policy of such pollution were also analyzed and discussed in present paper.

OBJECTIVE: To investigate the diagnosis and treatment of mixed connective tissue disease (MCTD) and myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis, which is a rare clinical entity in medical practice. METHODS: A 35-year-old female of Asian origin was admitted to our hospital due to complaints of Raynaud's phenomenon, myalgia, arthralgia and fatigue. The patient was diagnosed as MCTD in the out-patient department 8 months prior to admission based on Alarcon-Segovia classification criteria of Raynaud's phenomenon, myalgia, arthralgia and a high anti-U1 ribonucleoprotein antibody level. Interstitial lung disease was determined by chest computed tomography. Renal biopsy was performed because of marked proteinuria on 24 h urine collection. Histopathological examination revealed glomerulonephritis with fibrocellular/cellular crescents, in which moderate staining of IgM was shown by direct immunofluorescence. She was tested positive for myeloperoxidase antineutrophil cytoplasmic antibody. RESULTS: High dose of methylprednisolone (500 mg/d for 3 days) was started intravenously when the results of renal biopsy were obtained. Oral prednisone and intravenous cyclophosphamide therapy (0.8 g/month) were continued for 12 months. Daily urinary protein loss decreased dramatically and serum creatinine was maintained at a normal level. CONCLUSION Corticosteroids and cyclophosphamide are effective in the treatment of MPO-ANCA associated glomerulonephritis in MCTD.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Cyclophosphamide ; Female ; Glomerulonephritis ; Humans ; Methylprednisolone ; Mixed Connective Tissue Disease ; Peroxidase ; Proteinuria

AIM:To investigate the mechanism by which wogonin(WOG)induces ferroptosis in collagen-in-duced arthritis rat fibroblast-like synoviocytes(rat CIA-FLS cells)through the nuclear factor E2-related factor 2(NRF2)/heme oxygenase-1(HO-1)signaling pathway.METHODS:Rat CIA-FLS cells were divided into:control group,low,medium,and high dose of(25,50 and 100 μmol/L)WOG group,ferroptosis inhibitor(LIP-1)group,LIP-1+high dose WOG group,HO-1 agonist cobalt protoporphyrin(COPP)group,and COPP+high dose WOG group.CCK-8 assay was used for cell viability.Crystal violet staining was used for for cell morphology.The levels of oxidative stress markers gluta-thione(GSH),malondialdehyde(MDA),and superoxide dismutase(SOD)were measured.DCFH-DA fluorescent probe was used to detect the intracellular reactive oxygen species(ROS)content as well as Western blot to detect the protein ex-pression levels of Kelch-like ECH-associated protein 1(KEAP-1),NRF2 and HO-1.RESULTS:Compared with the nor-mal control group,administration of WOG treatment resulted in a significant decrease in CIA-FLS cell viability(P<0.01),a significant increase in the level of oxidative stress(P<0.01),a significant increase in the content of ROS(P<0.01),a significant decrease in the level of expression of NRF2 and HO-1 proteins(P<0.01),and a significant increase in the level of KEAP-1(P<0.01)in the rat.Compared with the WOG group,the LIP-1-treated group showed a significant increase in cell viability(P<0.01),a significant decrease in the level of oxidative stress(P<0.01),and a significant de-crease in the content of ROS(P<0.01).Compared with the WOG group,the addition of COPP resulted in a significant in-crease in the protein expression levels of NRF2 and HO-1(P<0.01)and a significant decrease in KEAP-1 levels(P<0.01).CONCLUSION:WOG can induce ferroptosis in rat CIA-FLS cells by promoting oxidative stress through the NRF2/HO-1 signaling pathway.