Objective To investigate the clinical effect of root canal filled epoxy resin paste in the treatment of periapical periedontitis.Methods From January 2017 to January 2018,60 cases of periapical periodontitis in the Fourth People's Hospital of Tongxiang were selected and divided into two groups according to the random table method,with 30 cases in each group.The observation group was treated with root canal filling with epoxy resin paste,while the control group was treated with traditional root canal paste.The two groups were first examined by X ray examination before treatment,to determine the periodontal root tip condition,conventional pulp opening,root canal preparation and irrigation,and pullout.The pain effects of the two groups after 1 week of treatment were compared,and the efficacy of 6 months after treatment was compared.Results The pain level 0 in the observation group at 1 week after treatment (66.67％) was significantly higher than that in the control group (36.67％) (μ =5.41,P =0.019).The effective rate at 6 months after treatment in the observation group (90.00％) was higher than that in the control group (63.33％) (μ =5.96,P =0.013).Conclusion The root canal filling epoxy resin paste has significant clinical effect in the treatment of periapical periodontitis,and it is worthy of clinical application.

Objective To explore the effect and utilization of comprehensive treatment on intrahepatic recurrence after hepatic resection for hepatocellular carcinoma.Methods One and two year recurrent rate of 60 patients with hepatocellular carcinoma who underwent hepatic resection in a two-year follow up were analyzed retrospectively,control group 30 cases,comprehensive treatment group 30 cases.Results One and two year intrahepatic recurrent rate of comprehensive treatment is 13％(4/30)and 40％(12/30)respectively.The difference was statistically singnificant(x2=4.176,4.310,all P＜0.05).Conclusion The effect of comprehensive treatment on postponing intrahepatic recurrence after hepatic resection for hepatocellular carcinoma is obvious.

Objective To systemically evaluate the therapeutic effect of pramipexole in treating Parkinson's disease. Methods Pubmed, Embase, Cochrane Database were used to search for randomized control trials (RCTs) on Parkinson's disease treated with pramipexole. Meticulous data wre extracted and meta-analysis was performed according to a preset protocol. Results Ten RCTs involving 1738 patients were included. The results of meta-analysis showed that pramipexole decreased the total scores of unified Parkinson's disease rating scale [UPDRS, WMD=-10.01,95%CI (-12.76,-7.26)],UPDRS part [WMD=-2.44,95%CI(-2.93,-1.95)],and UPDRS partⅢ[WMD=-6.61,95%CI(-8.38,-4.84)]. Pramipexole also reduced the score of UPDRS part Ⅳ[WMD=-0.73,95%CI(-1.16,-0.30)] in advanced patients(P＜0.05＝.Three studies referred to the effect of pramipexole in treating parkinsonian tremor. However there was a clinical heterogeneity among the studies, and two of them revealed a significant difference. Conclusions Pramipexole might improve motor symptoms and the quality of life in advanced patients, as well as improve tremor, which needs more RCTs to be confirmed.

Objective To assess the prevalance and distribution of pain in Parkinson' s disease (PD) patients, and to describe the relationship between pain and development of disease and its impact on the quality of life. Methods 113 PD patients were assessed with Visual Analog Scale (VAS), Brief Pain Inventory (BPI), Unified Parkinson' s Disease Rating Scale (UPDRS), Hoehn-Yahr Scale (H-Y), Hamilton Anxiety and Depression Scale (HRSD, HAMA) and Pittsburgh Sleep Quality Index (PSQI). Patients were divided into no pain group, PD-pain group and non-PD-pain group. PD-pain group was divided into PD-pain direct group and PD-pain indirect group. And statistical analysis was performed for each group. Results The incidence of PD-pain was 42. 5% (48/113). And compared with no pain group, PD-pain group had earlier age at onset of disease, longer duration, higher HAMA, HRSD, UPDRS and H-Y score, higher daily L-dopa dose, with statistical significance. Compared with non-PD pain group, the differences in the onset of age (57.4±9.6 vs 65.9±8.7, t= -2.596, P =0.012), HRSD(12. 9±7.9 vs 8.7±3.7, t =2.605, P=0.014) and VAS (61.6±25.9 vs 38.0 ± 30. 1, U = -2.290, P =0.022) were also statistically significant. BPI was different between PD-pain direct group and PD-pain indirect group except normal work and relations with other people. Conclusion Pain is frequent in Parkinsonian population. Most pain was chronic and related to PD (PD-pain). These patients always have earlier onset age and poorer quality of life.

Objective To study the efficacy of entacapone for motor fluctuations in Parkinson's disease. Methods Pubmed, Embase, Cochrane Database were searched for randomized controlled trial studies (RCTs) on entacapone compared to placebo in the treatment of Parkinson' s disease with motor fluctuations. Data were extracted and evaluated by two reviewers independently with designed extractian form. Revman 4. 2. 10 software was used for data analysis. Results Ten RCTs involving 2212 patients were included. The Results showed that entaeapone tends to increase "on" time, decrease "off" time and daily levodopa dosage (WMD=-1.41,95% CI -2. 09- -0.72) and improve "on" time motor symptoms and the quality of life. But it might increase the rate of dyskinesia (OR=2.00, 95% CI 1.55-2.58).Conclusion The systematic review indicates that entaeapone might be an effective agent for parkinsonian patients with motor fluctuations and more high quality RCTs with the same effect measures are required.

Objective To evaluate the Laparoscopic combined fiber choledochoscope common bile duct cho-lelithotomy for my own clinical experience in rencent five years.Methods Clinic data of 25 cases with choledocholi-thiasis undergoing laparoscopic common bile duct cholelithotomy from June 2010 to March 2014 were retrospectively analyzed.Results The operation was performed successfully in 24 cases,a case conversions to laparotomy,21 cases with T-tube drainage,3 cases with primary ductal submucosa closure.The operative time was 105 to 305min,mean (184.0 ±12.2 ) min, postoperative hospitalization time was 6 to 10 day, mean ( 7.7 ±0.2 ) day, a case residual stones,no bile leakage.Conclusion The beginning of Laparoscopic combined fiber choledochoscope common bile duct cholelithotomy,one-stage suture of common bile duct should be selected carefully, timely transfer laparotomy, should not aim for laparoscopic surgery success rate.

Objective to probe the potential application and advantages of heuristic method in the film-reading session of Imaging Radiology.Methods 66 eight-year program clinical medical juniors in the grade of 2008 to 2010 in Beijing University were selected as the subject and were evenly divided into two groups.Experimental group(n=33) was taught with heuristic method,in which the teacher ask questions and lead the students to find the way to solve problems in the way of clinical thinking mode.Control group(n=33) was taught with didactic method.The analysis of final examination of radiology course and an anonymous questionnaire survey were carried out at the end of semester,and the questionnaire survey to the students in grade 2008 and 2009 was conducted again after 1 years of their clinical practice.Results The score of students in experimental group were higher than those of control group (P=0.015,0.001,0.026 for the students in the grade of 2008,2009 and 2010 seperately).The two survey shows that the experimental group is better than the control group in the aspects of learning interest,clinical thinking ability,clinical application ability,solving difficult problem ability and language expression ability.Conclusion In the medical imaging practice teaching for clinical medical specialty undergraduate,the reasonable application of heuristic teaching,helps to improve students' learning enthusiasm and initiative,helps to cultivate medical students' ability of clinical application,and at the same time,can also improve teachers' teaching level.

Objective To evaluate the efficiency of interventional treatment for primary liver cancer with spontaneous rupture. Methods Three cases of spontaneous rupture of primary liver cancer were undertaken hepatic arterial chemoembolization with prior chemo-infusion and followed by gelfoam partical and stripes for embolization Results 3 cases of massive type of primary liver carcinoma with spontaneous rupture were all successfully once embolized, including one with additional super liquefied lipiodal as embolic agent who has been survived for more than 20 months. Conclusions Hepatic arterial chemo-embolization shows prominent hemostasis during emergency for spontaneous rupture of primary hepatic carcinoma providing double effectiveness of hemostasis and treatment.

Objective To clarify the diagnostic value of salivary gland ultrasonography in Sj(o)gren's syndrome (SS),and its correlation with the disease activity index and important organs involvement were analyzed.Methods A total of 116 patients with SS were involved,including 71 cases of primary SS and 45cases of secondary SS.Ultrasonography examination of major salivary glands was conducted for these patients,at the same time the clinical data including inflammatory parameters,the immunological parameter and the involved systems were collected.Ultrasonography examination was conducted in 49 cases as the control group.Use t test,x2test and analysis of variance for statistical analysis.Results The positive rate of salivary gland uhrasonography in SS (56/116,48.3％) was significantly higher than that of the normal control groups (1/49,2.0％),(The chi-square value was 32.57,P＜0.05),the sensitivity of salivary gland ultrasonography in primary SS (62.0％) was obviously higher than secondary SS (27％),(The Chi-square value was 13.75,P＜0.01).The specificity of salivary gland ultrasonography was 98％.The scores of salivary gland ultrasonography had shown positive correlation with the erythrocyte sedimentation rate,the levels of Immunoglobulin (Ig)G,and RF(r=0.234,0.353,0.176;P=0.002,0.000,0.013),and negative correlation with the white blood cell count (r=-0.292,P=0.000).Conclusion Salivary gland ultra-sonography provides additional evidence for the diagnosis of SS,particularly in primary SS groups.The scores of ultrasonography are correlated with inflammatory biomarkers,indicating that salivary gland ultrasonography is related to disease activity.

Aim Toinvestigatetheroleofbrain-de-rived neurotrophic factor(BDNF)-tyrosine receptor ki-nase B (trkB ) signaling pathway in the therapeutic effects of ketamine on diabetic neuropathic pain.Meth-ods Forty-eightWistarrats,aged3months,weighing 200~250 g,were equally randomized into 4 groups(n=12 ):control group (C group ), saline group (S group),ketamine group (K group)and ketamine +ANA-12 group (KA group ).Rats in S,K and KA groups were intraperitoneally injected with a single of streptozotocin(STZ)65 mg·kg-1 to construct diabetic neuropathic pain model.After twenty-eight days,rats in S,K and KA groups were intraperitoneally injected with saline, ketamine 10 mg·kg-1 and ketamine 10 mg·kg-1 +ANA-12 0. 5 mg·kg-1 for consecutive 7 days, respectively. On the 8th day, mechanical withdrawal threshold(MWT)of rats was measured.Af-ter that,the rats were immediately sacrificed,and dor-sal ganglion of lumbar spine and prefrontal cortex (PFC)were harvested for measuring BDNF,p-trkB/trkB,synaptophysin and spine density by Western blot andglogistaining.Results ComparedwithCgroup, rats in S group significantly decreased MWT,BDNF, p-trkB/trkB,synaptophysin and spine density in dorsal ganglion and PFC (P <0. 05 ).Compared with S group,rats in K group showed a significant increase of MWT,BDNF,p-trkB/trkB,synaptophysin and spine density in the all observed regions(P<0. 05 ).On the contrary,rats in KA group showed a significant de-crease of MWT and BDNF,p-trkB/trkB,synaptophys-in and spine density as compared with K group in all regions(P<0. 05 ).Furthermore,BDNF was positive-ly correlated with spine density in all regions (P <0.05).Conclusion BDNF-trkBsignalingpathway mediates ketamine-induced therapeutic effects in dia-betic neuropathic pain.