Objective To compare sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation (SEM-rTMS) with routine repetitive transcranial magnetic stimulation (R-rTMS) in the treatment of primary insomnia. Methods One hundred and twenty six patients with insomnia were divided randomly into a SEM-rTMS group (44 cases) , a R-rTMS group (42 cases) and a sham rTMS group (40 cases). Each case was treated with rTMS for 30 min once a day for 10 d under double blinding of the patient and therapist. The clinical effect was observed along with Krakow sleep scores, electroencephalograms and blood pressure before and after a 10-day course of therapy and 30 days later. Results During rTMS treatment, some patients reported feeling sleepy, and this was confirmed by their EEGs at the time. After the entire course of therapy, 80% of the SEM-rTMS group and 45% of the R-rTMS group showed improvements, a significant difference. At the 30th day after therapy, the effect in the SEM-rTMS group was still significantly better than in the R-rTMS group. There were no obvious side effects in any group throughout the whole observation period. Conclusions SEM-rTMS is more effective and more reliable than R-rTMS. SEM-rTMS is safe to use with primary insomnia patients.

Objective To observe the effect of comprehensive rehabilitation on POEMS syndrome during sequel period. Methods Two cases of POEMS syndrome with multiple peripheral nerve injury as the main manifestation received physical therapy, occupational therapy, acupuncture, surface electromyography biofeedback and other comprehensive rehabilitation treatment. Results After treatment, the muscle strength, trunk balance, standing balance ability, activities of daily living (ADL) improved. The score of Berg Balance Scale increased from 18 to 28 in the first case, the modified Bathel Index increased from 55 to 70 in the second case. Conclusion Comprehensive rehabilitation can improve the function of patients with POEMS syndrome during sequel period, and surface electromyography biofeedback plays an im-portant role.

Objective:To evaluate the influence of delayed application of mixed self-etching bonding agent on the tensile bond strength.Methods:Two "two-bottle,one-step" self-etching adhesives,Adper Prompt and Xeno III,were evaluated.The occlusal enamel of human third molar was cut out and the exposed dentin surface was divided in two halves by a 1 mm deep groove in the labial-lingual orientation to allow for evaluation of immediate application and delayed application(0.5,1,2,3,4,5 and 6 h) of mixed self-etching bonding agent in the same specimen,followed by composite resin built-up on the adhesive.The bonded specimens were sectioned into beams of approximately 0.9 mm2 and subsequently subjected to micro-tensile bond strength testing at a crosshead speed of 1.0 mm/min.Results:The specimens bonded with the Adper Prompt within 5 h after mixing showed no different and that with the Xeno III within 3 h after mixing showed no different.Conclusion:The effective period for "two-bottle,one-step" self-etching adhesives after mixing is limited.Different bonding agents have different effective periods.

Objective To compare the theory of mind(TOM) abilities between autistic children's parents and the normal children' s,and to indirectly prove that TOM deficit in autism maybe related to heredity in cognitive neuropsychology.Methods This study examines TOM abilities in 32 autistic children' s parents and 32 normal children' s parents,using the computerized Yoni task and an extensive battery of neuropsychological tests.Results In contrast to findings in the control group,autistic children' s parents showed significantly lower scores in affective theory of mind( (23.06 ±5.12)vs(25.63 ±4.47),P＜0.01 ) and special emotion( ( 10.13 ±4.14)vs ( 14.87 ±2.21 ),P＜0.05),but not in cognitive theory of mind( (22.75 ±5.01 ) vs(22.56 ±5.63),P＞0.05).Conclusion The autistic children' s parents are impaired in affective theory of mind,and to indirectly prove that autistic TOM deficit maybe related to heredity in cognitive neuropsychology.

Objective To explore the activity and its possible neural mechanism of brain default mode network by using resting state functional magnetic resonance imaging (fMRI) in patients with mild cognitive impairment (MCI). Methods The 20 amnestic MCI patients and 25 healthy controls were included in this study, and all subjects underwent mini-mental state examination (MMSE), auditory verbal learning test (AVLT) and fMRI. The data were analyzed by amplitude of low frequency fluctuation (ALFF), and the enhanced and weakened regions of ALFF were observed and compared in both MCI patients and healthy controls. Results MMSE and AVLT tests showed that the memory function was seriously impaired in MCI patients compared with healthy controls, which is based on the short and long delayed episodic memory impairment (2.4±1.7 vs. 6.6±1.4, t=3.70, P＜0.01; 2.1±1.6 vs. 6.7±1.5, t=4.16, P＜0.01). The resting state fMRI showed that MCI patients had significant decreases of ALFF in hippocampal formation, parahippocampal cortex and lateral temporal cortex as compared with health controls (t=2.58, 2.43 and 1.75, all P＜0.01), which were closely relevant to the episodic memory. And they had significant increases in temporal-parietal joint and inferior parietal lobule (t=3.14 and 2.77, both P＜0.01). Conclusions MCI patients show significant decreased active intensity of some DMN nodes that is related to episodic memory in resting state. Increased active intensity in MCI patients would be some type of compensation.

Objective:To investigate the effects of bezafibrate (BF) on the activation,proliferation and differentiation of CD4+T cells from primary biliary cirrhosis ( PBC) patients and to elucidate the mechanisms for the immunosuppressive effects of BF and to further provide experience basis for BF target therapy PBC.Methods:PBMCs were isolated from PBC patients then CD 4+T cells were selected by MACS, and stimulated with anti-CD3, anti-CD28, in the presence of different concentration of BF.The cytokines were measured by ELISA,and the activation,proliferation and differentiation of CD4+T cells were analyzed by flow cytometry.Results:(1) BF could inhibit the activation of CD 4+T cells in PBC patients.(2) BF could inhibit the proliferation of CD 4+T cells in PBC patients in a dose-dependent manner (P<0.05).(3)BF could down-regulation IFN-γand IL-17 production of CD4+T cells in a dose-dependent manner ( P<0.05 ).Conclusion: BF could inhibit immune responses of PBC patients by suppressing CD 4+T cells activation;proliferation and cytokine production.

Objective To explore the association between body mass index(BMI)/waist circumference (WC)and blood triglyceride(TG)level in adults. To evaluate the value of the BMI and WC in diagnosing the hypertriglyceridemia by the receiver operating characteristic(ROC)curve.Methods A total of 1 093 adults(707men and 356 women)were examined in our hospital from July to September in 2008.Height,weight,WC and blood triglyceride were measured and analyzed.The ROC curve was drawn to evaluate the sensitivity and specificity of the threshold values.Results The hypertriglyceridemia rate was 33.5%among men and 8.3%among women.The BMI and WC of hypertriglyceridemia group were significantly higher than those of normal TG group for both men and women(P<0.01).The area under ROC curve was 0.728±0.041 for men and 0.708±0.021 for women when using BMI to predict hypertriglyceridemia.The optimal threshold value was 24.5 for men and 22.5 for women.The area under ROC curve was 0.790±0.042 for men and 0.714±0.020 for women when using WC to predict hypertriglyceridemia.The optimal threshold value was 86 cm for men and 77 cm for women.Conclusions Both BMI and WC are associated blood triglyceride level. WC and BMI are useful parameters in predicting hypertriglyceridemia.

OBJECTIVETo investigate the changes in the quantity of colonizing Streptococcus mutans(S. mutans) and Actinomyces on the root surface plaque before and after post-core crown restoration of the mandibular first molars in the elderly patients.

METHODSA total of 30 elderly patients, each with one post-core crown restoration of the mandibular first molar, were randomly chosen to participate in the studies. Patients with mandibular first molars with post-core crown restoration and those with healthy contralateral mandibular first molars were divided into the test and control groups, respectively. Root surface plaques of the two groups were collected before tooth preparation, 72 h after preparation, one week after preparation, and one month after restoration. S. mutans, Actinomyces naeslundii (A. naeslundii) and Actinomyces viscosus (A. viscosus), were identified using colony morphology, biochemical techniques, and polymerase chain reaction (PCR). Plaque count was measured using microbial colony count.

RESULTSThe number of S. mutans and A. viscosus and A. naeslundii in the test group, which was statistically significant (P<0.05), increased 72 h after preparation. The quantities of S. mutans, A. viscosus, and A. naeslundii one week after preparation were significantly different (P<0.05). The plaque count of S. mutans, A. viscosus, and A. naeslundii in the test group decreased one month after restoration (P<0.05).

CONCLUSIONThe quantities of S. mutans, A. viscosus and A. naeslundii increase one week after preparation but decrease one month after restoration. The finding suggests that dentists should educate patients about plaque control during the early period after tooth preparation.

Actinomyces ; Actinomyces viscosus ; Aged ; Bacteria ; Crowns ; Dental Plaque ; Humans ; Post and Core Technique ; Streptococcus mutans ; Tooth Root

Objective To investigate the effects of interleukine-22 ( IL-22 ) on the expression of interleukin-6 (IL-6) by rheumatoid arthritis synovial fibroblasts (RASF), and to analyze their association with IL-17+CD4+T (Th17) cells differentiation.Methods RASF were isolated from six patients with rheu-matoid arthritis ( RA) and cultured in vitro.The expression of IL-6 at mRNA and protein levels by RASF were detected by qRT-PCR analysis and ELISA after treatment with different concentrations of IL -22 for dif-ferent periods of time.Anti-IL-22R1 blocking antibody and inhibitor assay were used to analyze the specific receptor and its downstream signaling pathways associated with IL-6 production.IL-22 pre-treated RASF and CD4+T cells were co-cultured for 3 days in the presence or absence of anti-IL-22R1 or anti-IL-6 to measure the percentage of Th 17 cells by flow cytometry .Results The expression of IL-6 by RASF was increased up-on IL-22 stimulation in a dose and time dependent manner (P<0.05), and that was closely related to IL-22R1 and its downstream signaling pathways of p38 and JAK2 (P<0.05).Co-culturing CD4+T cells with RASF and Transwell system indicated that the percentage of Th 17 cells was increased in IL-22 pre-treated group as compared with that in IL-22 untreated group , but it could be down-regulated by either blocking IL-22R1 or IL-6.Conclusion IL-22 promoted the expression of IL-6 by RASF and further enhanced Th 17 dif-ferentiation.Neutralizing IL-22 in synovium of patients with RA might be an effective therapeutic strategy for RA treatment.

Objective To study the effect of surfactants on the dissolution profiles of poorly water-soluble acidic drug nimesulide from sustained-release tablets.Methods The anionic surfactant sodium dodecyl sulfate (SDS), cationic sur-factant cetyltrimethyl ammonium bromide (CTAB) and nonionic surfactant polysorbate 80 (Tween 80) were used to prepare nimesulide micelles .The effect of the buffer , surfactant and ionic strength on the equilibrium solubility of the drug and the in vitro release of sustained-release tablets was studied .Results and Conclusion In pH 1.2 HCl solution, water and pH 6.8 phosphate buffer, the solubilization capacity of CTAB was the highest.However, in pH 9.0 Tris buffer, when CTAB concen-tration was at about 1%, the equilibrium solubility of nimesulide was at the trough value .The in vitro release results were similar to those of equilibrium solubility and the kinetic pattern conformed to the first order equation according to the coefficient R .