Objective:To observe the clinical effect of endodontic therapy and full crown restoration in the treatment of cracked teeth. Methods:The trace and depth of 50 cracked teeth were carefully examined under root canal microscope.According to the depth and scope of the cracks,the cracked teeth were classficated into the degree of Ⅰ,Ⅱ and Ⅲ,treated endodontically and restored with full crown.Results:During 1 year follow-up,34 cases showed successful effect,5 progressive,1 1 failure.The general effectiveness rate was 78.0%.The effectiveness rate of group Ⅰ,Ⅱ and Ⅲ was 93.3%,82.1 % and 28.6% respectively.Group Ⅰand Ⅱ vs Ⅲ,P <0.05,Ⅰvs Ⅱ,P >0.05.Conclusion:The treatment effect of cracked teeth is closely related to the depth and scope of cracks.

Objective To compare the spatial learning and memory function of heat stroke rats in different periods, to explore the long-term impairment. Methods 42 Sprague-Dawley rats were randomly divided into heat stroke 7 days group (HS7, n=21), heat stroke 21 days group (HS21, n=21), and another 18 rats were performed femoral artery intubation as surgery control group (sham, n=18). They were tested with Morris water maze 7 days and 21 days after modeling respectively for 5 days. The escaping latency, the frequency of crossing the platform area and the duration in the target quadrant were recorded. Results Compared with the sham group, the escaping latency prolonged in HS7 group in all the time (P<0.05), and 4th and 5th days in HS21 group (P<0.05). Compared with HS7 group, the escaping latency short-ened in HS21 group on the 3rd, 4th and 5th days (P<0.05). The duration in the target quadrant shortened in HS7 group compared with the sham group (P<0.05), and prolonged in HS21 group compared with HS7 group (P<0.05). The frequency of crossing the platform decreased both in HS7 group and HS21 group compared with the sham group (P<0.05), and no difference was found between the later 2 groups (P>0.05). Conclusion The impairment of spatial learning and memory is the most seriously 7 days after heat stroke in rats, and it may remain for long time.

Objective To explore the clinical efficacy of secondary unreamed intramedullary nailing following primary external fixation for open tibial shaft fractures.Methods From March 2011 to June 2014,we treated 28 open tibial shaft fractures.They were 17 men and 11 women,aged from 21 to 62 years (average,38.2 years).After thorough debridement,the tibia was stabilized temporarily with external fixation.The wounds were handled with primary closure or secondary repair with skin grafts or tissue flaps.After the wounds healed,the external fixation was replaced by unreamed intramedullary nailing.Fracture union and complications were documented.The clinical efficacy was evaluated at the final follow-ups according to the Johner-Wruhs scoring system.Results All the 28 patients were followed up for 12 to 18 months (average,13.5 months).Bony union was achieved in all after 4 to 15 months (average,4.9 months).Delayed union was observed in 4 cases which were healed after dynamic fixation.There was no deep infection,nail breakage,malunion or limb shortening in any one.Mild knee pain was reported by 5 cases after surgery.According to the Johner-Wruhs criteria,18 cases were excellent,7 good,and 3 moderate,giving an excellent to good rate of 89.3％.Conclusion Primary external fixation and secondary unreamed intramedullary nailing can result in good fracture union with satisfactory biomechanical stability and favorable early rehabilitation in the treatmeut of open tibial shaft fractures.

Objective: To study the antioxidation and effects of water soluble extract from Natto on hyperlipidemia. Methods: The model of experimental hyperlipidemia was induced by high cholesterol diet. 18 rabbits were divided into 3 groups : model group, natto extract group and control group. Results: The natto extract could reduce the blood total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), malon-dialdehyde (MDA), atherogenic index (AI) of experimental rabbits 39.88% , 44.54% , 48.84%, 48.25% and 70.20%, respectively, and increase high density lipoprotein cholesterol (HDL-C), superoxide dismutase(SOD) 75.81% and 38.32%, respectively. Natto extract could prevent effectively the fatty degeneration of liver cells observed by pathological sections. Conclution: Natto extract can efficiently prevent the formation of experimental hyperlipidemia.

Objective To summarize the clinical experience in 58 cases of split liver transplantation (SLT).Methods A retrospective analysis was conducted on 58 cases of SLT during June 2006 to January 2011.There were 13 cases performed at the first phase (2006.6-2008.12),and 45 cases at the second phase (2009.1 2011.1). The survival rate of patients,recovery of liver function,re-transplantation rate,incidence of vascular complications and biliary complications were observed,and the causes of death were analyzed.Results The median follow-up time of all the patients was 11.4 months (0-48 months).The 1- and 2-year cumulative survival rate was 77.4％ and 68.3％ respectively,re-transplantation rate was 6.9％,the incidence of vessel complications was 13.8％,and biliary complication rate was 32.1％.Fifteen cases died,including 8 deaths which were related to surgical complications.Conclusion With the donor split technology improvements and refinements in partial liver transplantation, the survival rate of SLT recipients is significantly increased,but selection of recipients is still the key factor that impacts survival rate of recipients receiving SLT.SLT can expand the resource of liver donors,and adequate selection of recipients can obtain better results.

Objective : To investigate the efficiency of combined application of dental endoscope and ultrasonic technique in treating concealed root canals. Methods : 87 complicated and difficult cases which were not found root canals during endodontic treatment by naked eyes were selected. The canal orifices were probed and negotiated with the aid of dental endoscope and ultrasonic instruments. And the success rate was recorded. Results: 121 concealed root canals which from 87 complicated and difficult cases were classified into 64 calcified canals, 39 narrow curved canals and 18 canals with anatomic variation. Among them, 94 canals were found and then negotiated, and the total success rate was 77.68%. There was no significant difference between the success rates in treating calcified root canals, narrow curved canals and canals with anatomic variation (χ2=5.477, P > 0.05). Conclusion The combined application of dental endoscope and ultrasonic instruments can effectively improve the success rate of finding and negotiating concealed canals.

Objective:To investigate the value of growth differentiation factor-15 (GDF-15) and extravascular lung water index (EVLWI) in severity grading and prognosis prediction of patients with acute respiratory distress syndrome (ARDS).Methods:Patients with ARDS aged 18-75 years admitted to the department of respiratory intensive care unit (RICU) of Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2019 to February 2020 were enrolled. All patients were treated with conventional therapies such as mechanical ventilation, anti-infection, stabilization of water, electrolytes and acid-base environment, blood purification and nutritional support according to their conditions. Besides, the pulse-indicated continuous cardiac output (PiCCO) was performed after admission to the department, and EVLWI before treatment and at 24, 48 and 72 hours of treatment were recorded. Serum GDF-15 level was measured by enzyme linked immunosorbent assay (ELISA) during the same period. Patients were classified as mild, moderate, and severe degree according to the 2012 Berlin Definition of ARDS, and EVLWI and GDF-15 levels in patients with different disease levels before and after treatment were compared. In addition, the length of intensive care unit (ICU) stay, ICU mortality, and 28-day mortality of patients with different GDF-15 or EVLWI levels were analyzed comparatively, with the GDF-15 3 458 ng/L and EVLWI 15 mL/kg as the cut point.Results:A total of 82 patients with ARDS were enrolled, including 22 patients with mild ARDS, 28 patients with moderate ARDS, and 32 patients with severe ARDS. The GDF-15 and EVLWI levels in patients with moderate and severe ARDS at each time point before and after treatment were higher than those in patients with mild ARDS. Both GDF-15 and EVLWI levels in patients with severe ARDS were higher than those in the patients with moderate ARDS. The differences were statistically significant at all the time points except for the difference of GDF-15 levels at 24 hours after treatment (ng/L: 3 900.41±546.43 vs. 3 695.66±604.73, P > 0.05). [GDF-15 (ng/L): 3 786.11±441.45 vs. 3 106.83±605.09 before treatment, 3 895.48±558.96 vs. 3 333.29±559.66 at 48 hours, 3 397.33±539.56 vs. 3 047.53±499.57 at 72 hours; EVLWI (mL/kg): 19.06±1.91 vs. 14.31±1.50 before treatment, 18.56±2.23 vs. 13.26±1.69 at 24 hours, 17.23±1.76 vs. 12.45±1.36 at 48 hours, 15.47±1.81 vs. 11.13±2.19 at 72 hours, all P < 0.05]. According to the cut-off value, there were 23 patients with GDF-15 ≥ 3 458 ng/L and GDF-15 < 3 458 ng/L respectively and there were 23 patients with EVLWI ≥ 15 mL/kg and EVLWI < 15 mL/kg respectively. The length of ICU stay and 28-day mortality in patients with high GDF-15 were significantly higher than those in patients with low GDF-15 [length of ICU stay (days): 21.22±2.69 vs. 15.37±3.14, 28-day mortality: 56.5% vs. 21.7%, both P < 0.05]. The length of ICU stay and 28-day mortality in patients with high EVLWI were also significantly higher than those in patients with low EVLWI [length of ICU stay (days): 18.45±2.61 vs. 14.98±2.75, 28-day mortality: 47.8% vs. 17.4%, both P < 0.05]. Conclusion:To some extent, GDF-15 and EVLWI levels reflect the severity of patients with ARDS, and high GDF-15 and EVLWI levels are significantly associated with poor prognosis in patients with ARDS.

Objective:To evaluate the prognostic value of extravascular lung water index (EVLWI) , soluble intercellular adhesion molecule-1(sICAM-1) and Krebs yon den lungen-6 (KL-6) in severe pneumonia patients with Severe Acute Respiratory Syndrome (ARDS).Methods:A prospective study was conducted in Respiratory Intensive Care Unit of the Affiliated Zhengzhou Central Hospital of Zhengzhou University from October 2017 to February 2020. The study included 65 severe pneumonia patients with ARDS, who was performed by measurement of pulse index continuous cardiac output and survived more than 3days after admission. The Extravascular Lung Water Index (EVLWI) , sICAM-1, KL-6 and Oxygenation Index(OI) on 1st, 3rd and 5th day were detected. APACHEⅡ score, patient survival events (days) and survival outcome were recorded. Correlation analysis between EVLWI, sICAM-1, KL-6 and OI was performed on the 1st, 3rd and 5th day after admission. Independent risk factors of mortality in severe pneumonia patients with ARDS were analyzed by multiple logistic regression. Receiver operating characteristic curve was drawn, and the prognostic value of each parameter was assessed finally.Results:The PCT, EVLWI, sICAM-1, KL-6 and APACHEⅡ score in the death group were significantly higher than those in the survival group ( P<0.05) at RICU admission, and the length of RICU stay was significantly shorter than that in the survival group ( P<0.05), while differences in other clinical characteristics between two groups were not statistically significant ( P>0.05) . These parameters including levels of EVLWI, sICAM-1, KL-6, Procalcitonin and APACHE Ⅱscore in the death group were significantly higher than those in the survival group on the 1st, 3rd and 5th day ( P<0.05), whereas the OI was significantly lower than that of the survival group on the 3rd and 5th day ( P<0.05). Logistic regression analysis showed that EVLWI, sICAM-1, KL-6 level were significantly related with the mortality of these patients. The levels of sICAM-1, kl-6 and EVLWI on 1st, 3rd and 5th day after RICU admission showed a significant negative correlation with OI ( P<0.001). Whereas, The levels of sICAM-1, kL-6 on 1st, 3rd and 5th day showed a significant positive correlation with EVLWI ( P<0.001). The sensitivity and specificity of sICAM-1, KL-6 combined with EVLWI in prognosis evaluation on 1st, 3rd and 5th day were 75.0%, 84.4%, 85.0%, 66.7%, 80.0%, 86.7%, respectively. The AUC was 0.864, 0.881, 0.892 on 1st, 3rd and 5th day, respectively ( P<0.001), which had a better prognostic value than each of them. Conclusions:EVLWI, sICAM-1 and KL-6 were independent risk factors for the prognosis of severe pneumonia patients with ARDS. The combination of EVLWI, sICAM-1 and KL-6 might be important in early predicting the prognosis of the 28d mortality.

Objective: To investigate the differentially expressed genes (DEGs) associated with the occurrence and development of breast cancer and to screen the molecular markers for breast cancer by bioinformatic analysis. Methods: Three breast cancer microarray datasets were downloaded from Gene Expression Omnibus (GEO) database. GEO2R was used to identify DEGs. The differentially co-expressed genes in the three datasets were screened by Venn diagram. GO function enrichment analysis and KEGG signal pathway analysis were performed using DAVID. The protein-protein interaction (PPI) network of DEGs was constructed using STRING. The most important modules in the PPI network were analyzed using Molecular Complex Detection (MCODE), and the genes with degree≥10 were identified as Hub genes. Hierarchical clustering analysis of hub genes was conducted using UCSC Cancer Genomics Brower. The survival curve and the co-expression network of hub genes were constructed using cBioPortal. Results: A total of 65 DEGs were screened from the three data sets. Eight hub genes, CTNNB1, CDKN1A, CXCR4, RUNX3, CASP8, TNFRSF10B, CFLAR and NRG1, were finally obtained, which exerted important roles in cell adhesion, proliferation and apoptosis regulation etc. Clustering analysis showed that the differential expression levels of CTNNB1, CFLAR, NRG1 and CXCR4 were associated with the occurrence of breast cancer. The overall survival analysis indicated that the patients with elevated CDKN1Aexpression had significantly shorter overall survival time (P<0.01). Conclusion: The hub genes identified in the present study can be used as molecular markers for breast cancer, providing candidate targets for diagnosis, treatment and prognostic prediction of breast cancer.

This article reviews the clinical studies about the treatment of allergic rhinitis （AR） with traditional Chinese medicine （TCM） in recent years. AR is a common and frequently occurring disease in the department of otolaryngology. The common manifestations of AR include nasal congestion， sneezing， runny nose， and nasal itching. AR， belonging to the category of rhinitis， is a dominant disease in the TCM treatment of otorhinolaryngologic diseases and head and neck diseases. The ancient literature has laid a solid theoretical basis on the etiology and pathogenesis of AR. According to the ancient literature， the theoretical basis， and their own experience， modern doctors classified the causes of AR into the disorders in Zang-fu organs and six meridians. Most of the explanations focus on the disorders in Zang-fu organs， especially the lung， spleen， and kidney. The clinical studies in this field mainly involve TCM treatment alone， integrated TCM and Western medicine treatment， and TCM external treatment. These therapies have good efficacy in the clinical treatment of AR. Among them， TCM treatment alone has significant advantages in alleviating the symptoms and nasal signs， declining the scores of related scales， and reducing the eosinophil count （EOS） of nasal secretions， with definite long-term efficacy. Integrated TCM and Western medicine treatment can complement with each other. The TCM external treatment methods include acupuncture， moxibustion， acupoint catgut embedding， acupoint application， and nasal irrigation with TCM， which are safe， simple， acceptable by patients and have good therapeutic effect. Finally， the clinical research status of TCM treatment of AR was summarized， and suggestions were put forward from three aspects： standardizing the clinical research protocol of TCM， encouraging pure TCM research， and exploring the mechanism of TCM treatment on the basis of frontier research achievements. This review aims to provide higher-level evidence for subsequent clinical research and promote the research on dominant AR diseases.