There are many superiorities of multimedia in dermatovenerology as a modern teaching tool.This article summarizes the multimedia experience during dermatology teaching,then discusses and analyzes the advantages and disadvantages of multimedia courseware.And some corresponding measures are also put forward.

Crown Lengthening ; methods ; Crowns ; Dental Caries ; therapy ; Dental Restoration, Permanent ; Humans ; Root Canal Therapy ; Tooth Fractures ; therapy

Objective To further explore the blood supply and interventional therapy of adult cavernous hemangiomas of the liver (CHL).Methods Recently some authors reported that a satisfactory effect resulted from transcatheter portal venous embolization was obtained in few cases of CHL with blood supply of portal vein,and raised an objection to the standpoint that CHL was commonly supplied by hepatic artery completely.In order to get a scientific and reasonable explanation for it,this paper reviewed the vascular embryology and histology of the liver,the pathologic features of CHL as well as the relative literature,and combined with the investigation results of blood dynamic changes of CHL that had been performed in 2000～2002 by us.Results CHL was caused by the arrested development of hepatic sinusoids at the embryonic stage.Pathologically,CHL was consisted of a lot of enlarged abnormal sinusoids,which were variant in size and closely related with the hemodynamic changes of CHL (in inverse proportion).The CHL consisted of even and tiny abnormal sinusoids (diameter less than 50 ?m) pathologically usually presented a high flow.During the hepatic artery angiography or CTHA,it was rapidly filled by the arterial blood containing contrast media and frequently showed dense opacification or enhancement.Simultaneously this could result in increased pressure of abnormal sinusoids.When the sinusoidal pressure exceeded that of the connecting portal venules,the arterial blood containing contrast media filled in the abnormal sinusoids could lead to retrograde flow in the portal venules.That was arterial-portal venous shunts (APVS).These appearances described as above could also occur in some CHL with intermediate flow,in which many tiny abnormal sinusoids located in the peripheral area were identified pathologically.On the contrary,the CHL consisted of larger abnormal sinusoids (diameter more than 500 ?m) pathologically usually presented a low flow.During the hepatic artery angiography or CTHA,it was filled very slowly by the arterial blood containing contrast media and was difficult to opacify or enhance.Simultaneously this could result in a low pressure of abnormal sinusoids.When the sinusoidal pressure was lower than that of the connecting portal venules,the portal venous blood containing contrast media could easily flow into the abnormal sinusoids and make it enhanced during the direct or indirect portography (or CTAP).Conclusion CHL is really a congenital venous malformation.All the CHL with high flow and some CHL with intermediate flow are surely supplied by the hepatic artery and drained primarily by the peripheral branches of portal vein.However,in few CHL with marked lower flow,the portal vein should become a primary supply vessel,so a direct or indirect portography (or CTAP) must often be taken to identify the diagnosis.Thereby,the technique of transcatheter embolization of CHL including the aim,indication,approach,and the used sclerotic or embolic drugs,etc,should also be reconsidered in order to improve its therapeutic efficacy.

Alveolar Bone Loss ; surgery ; Humans ; Molar ; injuries ; surgery ; Periodontitis ; surgery ; Tooth Root ; injuries ; surgery

Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Hyperbilirubinemia, Hereditary ; diagnosis

Objective To evaluate the therapeutic efficacy of atomoxetine hydrochloride for attention deficit hyperactivity disorder (ADHID) combined with Tourette syndrome (TS).Methods Twenty-six cases of children with ADHD combined with TS were firstly diagnosed American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-Ⅳ) of ADHD and TS were treated with atomoxetine.The symptoms were improved and conditions were assessed based on the fourth version of ADHD parent rating scale and the severity of Yale comprehensive pumping quantity during pre-treatment,the 2nd,4th,6th and the 8 week of therapeutic courses,respectively.The adverse reaction was observed.Results 1.Compared with pre-treatment,attention deficit scores after treatment were statistically different (t =8.41,9.97,all P ＜ 0.05) in the 6th,8th week of therapeutic courses;hyperactivity /imnpulsivity scores were statistically different (Z =-4.39,-4.47,-4.46,all P ＜0.05) in the 4th,6th,8th week; Motor tics scores were statistically different (t =18.30,18.67,20.32,all P ＜ 0.05) in the 4th,6th,8th week; The vocal tic score:the second weeks already had statistically different(t =5.45,P ＜ 0.05); And the impaired function score were statistical significance (Z =-3.95,-3.94,all P ＜ 0.05) at the 6th and 8th week.2.The effective rate of ADHD and TS was 7.69％ and 15.38％,respectively in the 2td week.The curative effect had no statistical significance (x2 =0.188,P ＞0.05).But at the tourth week of assessment,and the rates of curative effect were respectively 19.23％ and 46.15 ％.It had statistical significance (x2 =3.923,P ＜ 0.05).In the 6th,8th weeks,there was no significant difference between the 2 efficiency (x2 =0.083,0.103,all P ＞0.05).3.During the treatment,no severe adverse reaction had appeared.Conclusions Atomoxetine in ADHD comorbid TS had exact curative effect and no obvious adverse reactions.In the treatment of ADHD,hyperactivity / impulsivity effect is better than the attention deficit.In the treatment of TS,vocal tics onset is better than the motor tics.In comparison of ADHD with TS,TS symptoms improve faster than ADHD in the onset,but the final effect is quite.

Objective To investigate cytotoxicity and its mechanism of bilirubin on different types of neurons of rat in primary culture. Methods Toxic effect of bilirubin on primary cultured neurons (at cerebellar oranule hippocampal and cortical neurons) was observed. Ncuron survival was detected by fluorescei diacetate (FDA) staining. Measurement of fluorescent intensity of intracellular dilirudin were performed by microspectroflurimetry imaging system. Results Biliruin induced cytotoxicity to different type neurons in a dose-dependent manner. Exposed at 8d to different concentrations of bilirubin (4.3 ?mol/L、8.6 ?mol/L and 17.1 ?mol/L); cerebellar gtanule neuron survival werc (50.1?3.1)%,(18.5?2.3)%, (2.0?2.4)%, cortical neuron survival were (90.7?7.8)%, (85.3?5.3)%,(74.5?2.4)%, and hippocampal neuron survival were (75?6)%, (62?5)%, (49?5)% respectively. The toxic effect of bilirubin on ccrebellar granule neuron was significantly higher than that on hippocampal and cortical neurons. The fluorescent intensity of bilirubin in gra- nule, hippocampal and cortical neurons were 33.4?2.3、10.7?3.0、21.9?4.3 respectively three hours after addition of bilirubin to the medium. Significantly higher bilirubin concentration was found in granule neurons than that in hippocampal and cortical neurons (P

A simple and efficient method, based on ultrasound-assisted polymer surfactant-enhanced emulsification microextraction followed by gas chromatography-mass spectrometry( GC-MS) , was developed for the determination of eight aromatic amines ( AAs ) in aqueous sample. The main parameters affecting the performance of the purposed method were optimized, and the optimized conditions were obtained as follows:150 μL of extractive solvent ( dichloroethane ) , polymer surfactant ( sodium alginate ) concentraction of 0. 20 g/L, pH 7. 0, salt addition of 3%, and ultrasound time of 1 min. Under the optimal conditions, the linear ranges of the method were 0. 1-200 μg/L for 3,3’-dichlorobenzidine, 0. 3-200 μg/L for 2,4,5-trimethylaniline, 4-chloro-o-toluidine, 3,3’-dimethyl-4,4’-diaminodiphenylmethane, 3,3’-dimethylbenzidine and 4 , 4’-methylene-bis-( 2-chloroaniline ) , 0 . 5-200 μg/L for 4-aminoazobenzene and 3 , 3’-dimethoxy-benzidine. The correlation coefficients (R2) and the detection limits were 0. 9961-0. 9997 μg/L and 0. 08-0. 3 μg/L, respectively. The intra- and inter-day RSDs were less than 10. 6% and 11. 0%. The purposed method could be applied to the analysis of AAs in water sample collected from tap water and river water. In comparison with the common SA-USAEME, conventional surfactant was replaced with water-soluble polymer surfactant to solve the problems of potential pollution, and the polymer surfactant was natural and insoluble in extractive solvent. Compared with other solid-phase extractions, the proposed method had the advantages such as simple operation and low cost.

Objective To study inflammatory cytokines changes in brain tissue of neonatal rats with periventricular leukomalacia (PVL).Method A total of 80 neonatal SD rats (P3) were randomly assigned into 2 equal groups,sham-operated group and PVL group.Rats in each group were further assigned into four subgroups (12,24,48,72 h),with 10 rats in each subgroup.The hypoxic-ischemic PVL modal were established following the procedure:first,isolation and ligation of left common carotid artery,and then exposed to 8％ O2 and 92％ N2 for 2.5 h.The sham-operated rats were processed with isolation of left common carotid artery only.Rats of the four subgroups were sacrificed at 12,24,48 h and 72 h respectively,then the brains were rapidly removed in corresponding time.Pathological changes of brain tissues were observed using HE stain.The mRNA expression levels of tumor necrosis factor α(TNF-α)and inter leukin-1β (IL-1β) were assessed using real-time quantitative PCR assays,the protein levels of TNF-α and IL-1β were detected using enzyme linked immunosorbent assay method.Result The brains tissues of rats in PVL group showed remarkably hyperemia and edema,with left ventricle enlargement.Periventricular white matter structure was disintegrated comparing with sham-operated group.The expression of TNF-α and IL-1 β mRNA in PVL group increased significantly,reaching peak by 24 h and then gradually decreased 72 h after the procedure.The mRNA levels of TNF-c and IL-1 β were significantly different between each two time points of 12,24 h and 48 h in PVL group (P ＜0.05).However,there was no differences between 72 h and 48 h within PVL and sham-operated group group(P ＞0.05).In PVL group,the protein expression trends of TNF-α and IL-1 β were similar to mRNA expression trends.Moreover,the protein levels were significantly different between each two time points of TNF-α and IL-1 β,respectively (P ＜ 0.01).The protein expression levels of TNF-α were different at each time point between PVL group and sham-operated group[(189.2 ± 20.4) pg/ml vs.(131.4 ±5.2) pg/ml at 12 h,(213.8 ± 16.7) pg/ml vs.(127.7 ±7.4) pg/ml at 24 h,(181.7 ± 15.0) pg/ml vs.(126.3 ± 6.0) pg/ml at 48 h,(159.6 ± 25.3) pg/ml vs.(131.4 ± 6.0) pg/ml at 72 h;P ＜0.01].The protein levels of IL-1β were different between the two groups only at 24 h and 48 h.[(121.8 ±30.0) pg/ml vs.(67.4 ± 13.7) pg/ml,(83.3 ± 15.7) pg/ml vs.(65.3 ± 14.9) pg/ml;P ＜0.05].In sham-operated group,no differences of TNF-α and IL-1 β protein levels were found between any different time points (P ＞ 0.05).Conclusion Inflammatory cytokines such as TNF-α and IL-1β are involved in ischemic-hypoxia induced PVL.Dynamic detection of inflammatory factors is expected to be an important method of early diagnosis,assessment of treatment efficacy and prognosis of PVL.

Objective To investigate the application of ultrasound visualization in instantly evaluation and supplement therapeu-tics in the treatment of uterine fibroids and adenomyosis with high intensity focused ultrasound (HIFU ) .Methods 57 patients with 67 uterine fibroids and 31 patients with 41 adenomyosis were treated with JC-200 HIFU treatment system and monitored the blood flow change in the lesion with B-ultrasound .Evaluated the curative effect with ablation ratio and ablation ratio after supplement therapeutics .Results The average ablation ratio of 57 uterine fibroids was(84 .6 ± 16 .1)% and the increased to(87 .0 ± 10 .7)% af-ter supplement therapeutics to 9 lesions with blood flow in the border of all .The changes were no significance(P>0 .05) .The aver-age ablation ratio of 31 adenomyosis was(62 ± 22 .7)% and increased to(74 ± 14 .7)% after supplement therapeutics to 11 lesions with blood flow in the border of all .The changes were statically significance(P<0 .05) .Conclusion Ultrasound visualization could be used to evaluate the area and extent of ablation with HIFU therapy ,it can clear lesions remaining parts and guiding the supple-ment therapeutics to improve the ablation ratio .Ultrasound visualization provided an evidence of therapeutics in the early period .