This case report presents an extracted maxillary third molar,which have 3 separate roots with 5 canals,the canal configuration in mesiobuccal root are 3 separate orifices and canals,1 apical foramen.The clinician should be aware of this anatomical variation,avoid the missed canals.

Objective To compare cardiovascular responses of intubations by Discopo and Macintosh laryngoscope in elderly patients with hypertension. Methods Sixty elderly hypertensive patients with ASAⅡ~Ⅲundergoing elective surgery were equally randomized into two groups. After induction of general anesthesia , orotracheal intubation was performed with Discopo or Macintosh. The Mean arterial pressure (MBP) and heart rate (HR), as while as Electrocardiogram (ECG) and Blood oxygen saturation (SpO2), were recorded before (baseline values) and at 1,3,5 minutes after intubation(post-induction values). The rate of one-time successive intubation,intubation time and complication were also recorded. Results Compared with the macintosh group, the rate of one-time successive intubation was higher and the intubation time was shorter in the Discopo group (P< 0.05, respectively),with no complications. Compared with T0,MBP and HR at T2 in the two groups and T3 in the Macintosh group increased significantly (P < 0.05). Compared with the Macintosh group,MBP and HR at T2,T3 of the Discopo group decreased significantly (P < 0.05). Conclusion Little effect of tracheal intubation with Discopo on cardiovascular response was observed in elderly hypertensive patients.

Bronchiolitis is the most common lower respiratory tract disease in infants. There is no speciifc treatment for it and the treatment is mainly supportive. The management of bronchiolitis is the clinical hotspot recently. Continuous positive airway pressure (CPAP) has gained more attention in clinical application as it is a safe, effective, and noninvasive method and can effectively relieve symptoms of bronchiolitis and improve prognosis. This paper reviews the clinical application of CPAP in infants with severe bronchiolitis.

[Objective]To investigate the effective method for allergic rhinitis.[Method]58 cases were randomly divided into 2 groups,treatment group 31 take self-made Yiqi Tuomin Decoction,other group 27 take cetirizine hydrochloride.[Result]In treatment group,16 cases had marked effect,12 had effect,3 had no effect,effective rate was 90.3%;for control one,they were 8,10,9 and 66.7%respectively.[Conclusion]Yiqi Tuomin Decoction has obvious effect on allergic rhinitis.

Objective To investigate the effects of puerarin on levels of thromboxane A 2 (TXA 2) and prostaglandin I 2 (PGI 2) in plasma of rats with hyperlipidemia. Methods A total of 48 Wistar juvenile rats were randomly divided into four groups: normal diet, high fat and high cholesterol diet (HFD), HFD supplemented respectively with 1 g/kg puerarin (puerarin group Ⅰ) or 2 g/kg puerarin (puerarin group Ⅱ). After eight weeks of feeding, the rats were sacrificed for detection of the levels of lipid, TXA 2, and PGI 2. Results The blood triglycerol, total cholesterol, LDL C, TXA 2, and TXA 2/PGI 2 were significantly lower in puetarin Ⅰ and puerarin Ⅱ groups than those in HFD group, but the concentration of HDL C was significantly increased in the supplemented group( F =109 163, P =0 000; P

Autoimmune polyendocrinopathy syndrome type Ⅰ( APS-Ⅰ) is a rare autosomal recessive disorder caused by mutations in autoimmune regulator gene( AIRE) . A number of mutations have been described in the AIRE gene of patients with APS-Ⅰ, including nonsense mutation, missense mutation, silent mutation, splice site mutation, insertions and deletions mutation, et al. The mutation characteristics of the APS-Ⅰ pathogenic gene have been reviewed in the article.

Objective To investigate the diagnostic value of serum amyloid A(SAA)in diagnosing acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Methods A total of 86 patients with AECOPD and 46 patients with stable COPD were recruited.SAA determined with ELISA was compared between AECOPD patients and stable COPD patients.The changes of SAA,WBC,the percentage of neutrophils and C-reactive protein (CRP) of AECOPD patients Was compared before and immediately after the last treatment procedure.Results The SAA levels in AECOPD patients were higher than those in stable COPD patients [(182.33±50.12)mg/L vs (6.24±3.05)mg/L,P<0.05].The change of SAA was more evident than that of serum WBC and the percentage of neutrophils before and after the treatment procedure. SAA was more sensitive than CRP in diagnosing lung function severity of AECOPD patients.Conclusion SAA has great diagnostic value in AECOPD diagnosis and evaluation of lung function severity.

Thyroid hormone insensitive syndrome is an inherited disease characterized by decreased target tissue responsiveness to thyroid hormone. Most cases are due to thyroid hormone receptor β gene mutation. Two novel types of thyroid hormone insensitive syndrome were recently identified, which are caused by gene mutations of MCT8, a specific thyroid hormone transporter, and SBP2 in the synthesis of deiodinase.

Urinary tract infection (UTI)is a commonly encountered disease during routine clinical care. In the mean time, it is also a commonly encountered hospital acquired infection. UTI possesses various clinical symptoms, and usually the symptoms are atypical. The detection of leukocyturia and bacteriuria is an essential index for screening and confirmatory diagnosis of UTI. This article summarized the pathogenesis of UTI, diagnostic criteria, clinical significance and application evaluation of detection of the WBC and bacteria in urine.

Objective To analyze the cause of lower limbs swelling after knee arthroscopy operation, and compare the effect of gravity and pump irrigation system on lower limbs swelling after operation. Methods 60 patients after knee arthroscopic surgery were divided into the pump irrigation group and the gravity group with 30 patients in each group. We measured the perimeter of the lower limb pre and post operation and compared the operation time of each group. Results There were no significant differences in the perimeter of the lower limb and operation time between the gravity group and the pump irrigation group. Conclusions During knee arthroscopic surgery which cost less than 1 hour, there was no inlluence on lower limbs swelling whether using gravity or pump irrigation system.