Objective To evaluate the clinical effect of acupotomy therapy combined with acupuncture based on distal points selection for lumbar intervertebral disc protrusion ( LIDP) . Methods Sixty-eight LIDP patients were randomly divided into treatment group (N=33) and control group(N=35). The treatment group were given acupotomy therapy on the proximal positive response points in the lumbosacral region for relaxing the tendons,and acupuncture therapy based on distal points selection of Shugu, the Shu-stream point of the foot Taiyang bladder meridian, Zulinqi and Weizhong, the shu-stream point and the blood xi-cleft point of the foot Shaoyang gallbladder meridian respectively, twice a week, 2 weeks constituting one course of treatment. The control group was given conventional electroacupuncture therapy on Huatuo clip points, Dachangshu point, bilateral Shenshu points, Yinmen point, bilateral Zibian points and bilateral Yanglingquan points, and together with TDP radiation therapy, 5 times a week, 2 weeks constituting one course of treatment. The two groups received follow-up for one month. The low back pain scores of Japanese orthopaedic society ( JOA) and visual analog scores ( VAS) of pain were used for the evaluation of therapeutic effect after the treatment. Results ( 1) After treatment, the JOA scores were increased and VAS scores were decreased in both groups compared with those before treatment ( P< 0.05) , and the increase of JOA scores and the decrease of VAS in the treatment group were superior to those in the control group ( P< 0.05) . There was statistically significant difference of VAS scores between the two groups ( P < 0.05) during the follow-up period. ( 2) The total effective rate was 87.9%in the treatment group, and was 77.1%in the control group, the difference being significant (P<0.05) . Conclusion The acupotomy therapy combined with acupuncture based on distal points selection is effective and safe for lumbar intervertebral disc protrusion, which has the advantages of reliable long-term effect and low recurrence rate, showing good prospects for extensive clinical application.

OBJECTIVETo evaluate the bond strength and durability of a self-adhesive resin cement with a zirconia ceramic pretreated by a zirconia primer.

METHODSZirconia ceramic (Vita Inceram YZ) plates with a thickness of 2.5 mm were fired, polished, and then cleaned. Half of the polished ceramic plates were sandblasted with 50 μm alumina particles at 0.3 MPa for 20 s. The surface compound weight ratios were measured via X-ray fluorescence microscopy. The polished and sandblasted ceramic plates were directly bonded with self-adhesive resin cement (Biscem) or were pretreated by a zirconia primer (Z Primer Plus) before bonding with Biscem. The specimens of each test group were divided into two subgroups (n=10) and subjected to the shear test after 0 and 10,000 thermal cycles. The data were analyzed via three-way ANOVA.

RESULTSAfter air abrasion, 8.27% weight ratio of alumina attached to the zirconia surface. Compared with air abrasion, primer treatment more significantly improved the primary resin bond strength of the zirconia ceramic. The primary resin bond strength of the zirconia ceramic with no primer treatment was not affected by thermocycling (P>0.05). However, the primary resin bond strength of the zirconia ceramic with primer treatment was significantly decreased by thermocycling (P<0.05).

CONCLUSIONPrimer treatment can improve the primary resin bond strengths of zirconia ceramics. However, the bond interface of the primer is not stable and rapidly degraded during thermocycling.

Adhesives ; Aluminum Oxide ; Ceramics ; Dental Bonding ; Dental Porcelain ; Dental Stress Analysis ; Materials Testing ; Resin Cements ; Surface Properties ; Zirconium

Nowadays,with the introduction of the concept of minimally invasive surgery,laparoscopic surgery which occupied the mainstream operation method,vaginal surgery,and abdominal surgery were three main ways of gynecological surgery.Hysterectomy operation method as the routine operation of gynecology was changed as well.Laparoscopic hysterectomy has replaced transvaginal hysterectomy and transabdominal hysterectomy gradually.Historical development,operation indication,and advantages and disadvantages of hysterectomy are summarized in this article.

Objective: To explore the effect of ultrasound on dentin smear layer's surface and bonding strength of the universal resin adhesive under self-etching mode. Methods: Forty mandibular third molars without caries were randomly divided into two groups; one was polished with silicon carbide sandpaper; the other was polished with silicon carbide sandpaper followed by ultrasonic treatment. Scanning electron microscope (SEM) was used to observe surface of the dentin. Treated teeth were bonded with two universal resin adhesives, Clearfil Universal Bond (pH=2.3) and All-Bond Universal (pH=3.1), and the penetration of the bonding interface was observed with a confocal laser scanning microscope (CLSM) after Rhodamine B staining. Finally, the micro tensile bond strength test was conducted to test the adhesion. Results: The SEM showed that after polishing with silicon carbide sandpaper, the smear layer of the dentin surface was scratched, and dentin tubules were almost completely blocked, with no obvious dentin tubules exposed. After ultrasonic treatment, the scratches were reduced, and a large number of dentin tubules were exposed. CLSM showed that both adhesives could penetrate the dentin along the dentin tubules more deeply after ultrasound treatment. Micro tensile bond strength tests showed that ultrasonic treatment could enhance the bonding strength of two universal resin adhesives. However, there was no statistical difference in bonding strength between these two universal resin adhesives under the same treatment. . Conclusion Ultrasound can partially remove the smear layer on dentin's surface, expose dentin tubules, and increase universal resin adhesives' penetration depth and bonding strength under self-etching mode

Objective To study the effects of alpinetin on apoptosis of Hep3B cells and explore the related mechanism.Methods Hep3B cells were cultured in vitro,treated with alpinetin; RT-PCR and Western blot was used to detect the mRNA and protein levels of Bcl-2; MTT assay was used to detect the cellular growth inhibitory rate; Annexin V-FITC/PI double staining was used to detect the apoptosis rate of cells; Mitochondrial membrane potential was analyzed by flow cytometry; Western blot was used to detect protein expression of Caspase-3,9 and Cytochrome C ; the experiment was carried out in four groups:control group,high dosage of alpinetin group,middle dosage of alpinetin group and low dosage of alpinetin group.Results The expression of Bcl-2 in Hep3B cells were decreased by alpinetin.After treated with different dosages of alpinetin (40,80,120 μmol/L),the apoptotic inhibitory rate detected by MTT were 6.38％ ± 1.32％,21.58％ ± 1.97％ and 43.18％ ± 3.89％,significantly higher than those in control group (tlowdose =13.01,tmiddle dose =15.12,thighdose =14.79,average P ＜ 0.01) ; the expression of mitochondrial membrane potential green fluorescence protein (GFP) were 18.93％ ± 2.3％,31.11％ ± 2.67％ and46.06％ ± 2.95％,significantly higher than those in control group (tlow dose =16.70,tmiddle dose =31.38,thigh dose =48.15,average P ＜ 0.01).Western blot analysis showed that the expression of Caspase-3,9 andCytochrome C in cytoplasm significantly was higher than those in control group(Caspase-3:llow dose =11.94,tmiddle dose =10.18,thigh dose =18.82,average P ＜0.01; Caspase-9:tlow dose =15.11,tmiddle dose =20.41,thish dose =21.25,average P ＜0.01; Cytochrome C:tlow dose =15.11,tmiddle dose =28.47,thigh dose =16.01,average P ＜ 0.01).while that Cytochrome C in mitochondria significantly lower than those in control group (tlow dose =16.70,tmiddle dose =12.00,thighdose =27.61,average P ＜ 0.01).Conclusions Alpinetin promotes apoptosis of human hepatic cancer cells Hep3B by down-regulating Bcl-2,probably through mitochondrial pathway.

In this study, we obtained the TiO2 films with different thickness by micro-are oxidation (MAO) on commercially available pure titanium. By altering the duration time, we got the films 5 microm, 10 microm, and 20 microm in thickness, respectively. XRD and SEM were employed to characterize the phase, composition and microstructure of the films. The MAO film, which was about 5 microm thick, was porous and even with the pore size about 1 microm. No other crystalline phase except anatase was detected by XRD. The film, which was 10 microm thick, was similar to the former. The pores were well separated and homogeneously distributed over the surface. The XRD pattern indicated that the film was composed of anatase and a minor amount of rutile, whereas the pore size of 20 microm film was about 4-6 microm and was bigger than the others. Furthermore, the small cracks were easy to observe. XRD pattern showed that the Ti peak was significantly reduced and new Ca, P, O containing compound was formed in addition to rutile and anatase with the film thickness increasing. There were significant differences in regard to surface roughness of the three groups. These findings suggest that the film thickness has an intense effect on the quality of the MAO coating. By changing the film thickness, we can extensively change the composition, structure and chemical properties of the surface layer on titanium.
Coated Materials, Biocompatible ; chemistry ; Oxidation-Reduction ; Porosity ; Surface Properties ; Titanium ; chemistry

Objective To report a pedigree with X?linked dominant protoporphyria(XLDPP), and to detect 5?aminolevulinic acid synthetase 2(ALAS2)gene mutations in this pedigree. Methods A clinical investigation was performed in a pedigree with XLDPP, and relevant data were collected from family members. A next?generation sequencing method was applied to screen possible mutation sites, and Sanger sequencing was performed to determine pathogenic gene mutations. Dermoscopy was conducted to observe skin lesions in the patients with XLDPP, and the Fotofinder system and very high frequency (VHF) ultrasound system were utilized to assess the severity of photodamage. Liver and gallbladder ultrasonography as well as blood examination were performed for all the family members. Results A deletion mutation, c.1706?1709ΔAGTG, was detected in the ALAS2 gene on the X chromosomes of all the patients in this family, which led to replacement or loss of 19-20 C?terminal residues through transcriptional frameshifting, and eventually caused an increase in ALAS2 activity. In the patients with XLDPP, skin photodamage was relatively severe;protoporphyrin?induced hepatobiliary damage was observed and aggravated with age;anemia and iron deficiency occurred sometimes. Conclusion The deletion mutation c.1706?1709ΔAGTG of the ALAS2 gene may be the underlying cause of XLDPP in this pedigree.

Objective To discuss the clinical effect of Penumbra aspiration system combined with Trevo thrombectomy device in treating acute intracranial main artery infarction.Methods The clinical data of a total of 5 patients with acute intracranial main artery infarction,who were treated with ACETM thrombectomy device combined with Trevo visible thrombectomy stent,were retrospectively analyzed.The lesions included anterior circulation infarction (n=2) and posterior circulation infarction (n=3).The mean age of patients was (60.4±11.6) years old.The operation time spent for thrombectomy,the recanalization time of occluded vessels,and the recovery of neural function were assessed.Results The puncture-recanalization intervals in the 5 patients were 29 min,32 min,35 min,33 min and 30 min respectively,with a mean time of (31.8±2.4) min.After intraoperative cerebral infarction thrombolysis treatment,the cerebral blood flow grading reached level 3.NIHSS score was remarkably improved from preoperative (11.0±7.4) points to 24 hpostoperative(4.2±1.1) points,to 7 days-postoperative(1.8±1.3) points,and to 30 days-postoperative (0.9±0.6) points (P＜0.05).Modified Rankin scale (mRS) score was 0-2 points in all patients.No intracranial hemorrhage transformation occurred.Conclusion In treating acute intracranial main artery infarction,ACETM thrombectomy device combined with Trevo visible thrombectomy stent can achieve the best recanalization effect with less times of thrombectomy procedure and short operation time.The clinical prognosis is satisfactory.

As the state vigorously promotes the high-quality development of hospitals and improves people's medical ex-perience,the patient-centered hospital should make full use of technological resources such as the Internet,5 G and artificial in-telligence,vigorously develop mobile medical services and artificial intelligence services,transform and optimize the diagnosis and treatment process,and streamline all links before,during and after diagnosis so as to provide better data services to the pa-tient to ensure that they can get things done with greater ease.The patients'medical experience and hospital management effi-ciency can be greatly improved.In this study,specific measures to create a new diagnosis and treatment model through the con-struction of smart hospital platform were expounded in order to provide references for related research and policy formulation of other Chinese medical institutions.

OBJECTIVE:To observe the clinical efficacy and safety of intravitreal injection of ranibizumab combined with argon laser therapy in the treatment of ischemic neovascular glaucoma. METHODS:A total of 166 patients with neovascular glaucoma selected from our hospital during Mar. 2014-Mar. 2016 were divided into control group and observation group according to random number table,with 88 cases in each group(there were 117 and 125 eyes respectively). Both groups received argon laser photocoagulation therapy twice a week for 1 month. Observation group was additionally given intravitreal injection of Ranibizumab injection(0.5 mg)once a week,for 1 month. Clinical efficacies of 2 groups were observed,and the intraocular pressure and visual acuity of 2 groups were observed before treatment,1 week and 1 month after treatment. The occurrence of ADR was recorded. RESULTS:After 1 month of treatment,total response rate was 95.20％ in observation group,which was significantly higher than 76.92％ in control group,with statistical significance (P<0.05). After 1 week of treatment,intraocular pressures of observation group were lower than before treatment and control group at the same time,while visual acuity was better than before treatment and control group at the same time,with statistical significance (P<0.05). After 1 month of treatment,intraocular pressures of 2 groups were decreased significantly and visual acuity was significantly improved;intraocular pressure was decreased and visual acuity was improved more significantly in observation group than control group,with statistical significance(P<0.05 or P<0.01). The incidences of ADR of 2 groups were 3.41％ and 2.27％,without statistical significance (P>0.05). CONCLUSIONS:The ischemic intravitreal injection of ranibizumab combined with argon laser therapy is better than argon laser therapy alone in the treatment of ischemic neovascular glaucoma,and can significantly reduce intraocular pressure and improve visual acuity with good safety.