Objective To analyze the anesthetic effect of Compound Articaine on Children's dental pulp without pain, and provide reference for clinical treatment.Methods124 patients with children with dental pulp disease in hospital from February 2015 to May 2016 were selected, patients were randomly divided into observation group and control group, every group with 62 cases.Control group patients were given Lidocaine anesthesia, observation group patients were taken trentment of compound articaine anesthesia, anesthetic effect of patients were compared.Changes in heart rate, blood pressure, adverse effects, and patient pain were recorded before and after anesthesia.ResultsThe total effective rate (96.8%) in the observation group was significantly higher than that in the control group (80.9%) (P<0.05).Observation group (79%) was significantly higher than the control group (1.6%,P<0.05), the observation group of severe pain rate (58.1%) was significantly lower than the control group (11.3%) (P<0.05),The heart rate and blood pressure in the observation group were no significant change, In the control group, the diastolic blood pressure (71.7±10.8) mmHg was significantly lower in the observation group (74.5±12.8) mmHg and the heart rate (80.2±8.8)/min was significantly higher than that in the observation group (76.2±8.3).Two groups of patients in the treatment of adverse reactions, including tachycardia, dizziness, headache, observation group of adverse reaction rate and the control group was not significantly different.ConclusionCompound articaine anesthesia was the implementation of children's dental painless treatment, can reduce the pain of patients, maintain the blood pressure and heart rate stable, has the use value.

Objective To investigate the safety and feasibility of Minocycline Hydrochloride Ointment and metronidazole membrane in the treatment of periodontal abscess.Methods80 cases of patients with periodontal abscess in our hospital from May 2014 to May 2016 were selected, these patients were randomly divided into Minocycline Hydrochloride Ointment group (n=40) and metronidazole membrane group (n=40) two groups, the periodontal probing depth, gingival bleeding index, plaque index, attachment loss, clinical efficacy, the incidences of adverse reactions and recurrence of the two groups were statistically analyzed.ResultsThe periodontal probing depth, gingival bleeding index, plaque index, attachment loss of the Minocycline Hydrochloride Ointment group were significantly lower (P<0.05), the total treatment efficiency 95% (38/40) was significantly higher than the metronidazole membrane group 77.5% (31/40) (P<0.05), the recurrence rate 2.5% (1/40) was significantly lower than the metronidazole membrane group 15% (6/40) (P<0.05), but the difference of the incidences of adverse reactions 10% (4/40), 7.5% (3/40) between the two groups was not significant.ConclusionMinocycline Hydrochloride Ointment metronidazole membrane in the treatment of periodontal abscess has higher safety and feasibility than metronidazole membrane, so is worthy of promotion in the clinical.

Objective To analyze the clinical manifestations,diagnosis,treatment and prognosis of patients with splenic abscess.Method The clinical data,including baseline clinical data,clinical features,past history,pathogen culture result,treatment and the prognosis were retrospectively analyzed in the patients with the discharge diagnosis splenic abscess from January 1991 to March 2012 in Peking Union Medical College Hospital.Results The media time from onset to Peking Union Medical College Hospital of the 19 patients were 29 days.Among them,9 patients were cured,8 were improved and 2 died.Risk factors,such as tumor burden,diabetes,and using immunosuppressive agents etc,can be found in most patients with splenic abscess.All the 19 patients had splenic image changes and non-specific clinical features.The most common three clinical symptoms were fever(18 cases),chills (12 cases) and shivering (11 cases).The most common three signs were abdominal tenderness (9 cases),left upper quadrant sensitive to percussion (7 cases) and splenomegaly (4 cases).The most common etiological culture results were gram negative bacilli (9 cases),gram positive coccus (8 cases),and fungi (4 cases).Conclusions Clinical features are non-specific in splenic abscess patients.Related exam such as ultrasound should be performed on patients with splenic abscess risk factors to avoid misdiagnosis.Empiric antibiotic administration should begin right after the diagnosis based on the image.Pathogen culture should be timely conducted after pus collection.Individual therapeutical protocol should be chosen according to patient's condition.

Objective To analyze the reasons of the emergency patients forgoing the invasive rescue therapy and to put forward the corresponding strategy.Methods According to whether the patients accepted the invasive rescue therapy or not,2 673 patients in resuscitation room of Peking Union Medical College Hospital were divided into rescue group (group R) and do not rescue group (group DNR).There were 2 147 cases in group R and 526 case in group DNR.The rescue consent form or do not rescue consent form was required to sign by patient self,patient' s family member or relatives.The patient' s basic information,underlying disease,payment of medical expenses,personnel who signed the consent form,treatment and prognosis in both groups were investigated.Results There was no significant gender deference in both groups (x2 =1.86,P =0.173).The mean age of patients in group DNR was much higher than that in group R (69.5 ±-12.5 vs.58.6 ± 19.2 years,F =28.92,P =0.000).The proportion of patients outside Beijing in group DNR was higher than that of group R (51.90％ vs.44.01％,x2 =10.59,P =0.001).The ratios of chronic heart failure,chronic respiratory failure,chronic hepatic encephalopathy,chronic renal failure,malignant tumor in group DNR were significantly higher than that of group R (8.17％ vs.3.03％,8.17％ vs.2.61％,3.80％ vs.1.16％,5.32％ vs.1.44％,11.98％ vs.2.28％,all P=0.000).The proportion of patients without insurance in group DNR was higher than that of group R (52.09％ vs.41.08％,x2 =20.87,P =0.000).Except the ratio of patients self signing the consent form in group DNR was higher than that of group R (3.04％ vs.0.42％,x2 =64.40,P =0.000),there were no significant deference in other people who signed the consent form such as patient's offspring,spouse,parents,siblings and others.Univariate and multivariate logistic regression analyses showed older age,non Beijing patients,chronic underlying diseases,without insurance and patients self signing the consent form were the major risk factors on refusing the invasive rescue therapy.The mortality rate of group DNR was much higher than that of group R (19.39％ vs.7.68％,x2=64.40,P=0.000).Conclusions Most of patients who refused to accept invasive rescue therapy were elderly people or in condition of end stage of chronic disease.The doctors and nurses in emergency department should continue to take care of these patients and make use of noninvasive methods to treat them or relieve their pain.

Cardiopulmonary resuscitation is the most comonly used method facing cardiac arrest.The 2010 CPR guidelines emphasized high quality chest compressions and recommended continuous compression for 2 minutes after defibrillation to minimize interruptions in compressions.However,starting chest compressions immediately after a defibrillation shock may be harmful,if the heart is providing spontaneous beats and being subjected to external compressions at the same time.So it is very important to recognize ROSC during CPR,the methods of which include touching the pulse,amplitude spectral area,partial pressure end-tidal carbon dioxide,coronary perfusion pressure,central venous oxygen saturation,chest compression fraction,regional cerebral oxygen saturation,photoplethysmography,conjunctival oxygen tension,transthoracic-impedance plethysmography and echocardiography.This paper gives a review of the ROSC prognosis and recognition methods during CPR.

Objective_To investigate the effect of estrogen(E2) on different age rat groups of Parkinson’s disease (PD) models induced by Rotenone and its mechanism.Methods_24-month-old SD rats(high age group)and 12-week-age SD rats( low age group ) were divided into control group ( saline ) , Rotenone treatment group ( Rotenone 2 mg/kg), Estrogen treatment group(Rotenone 2 mg/kg and E2 1 mg/kg)and Tamoxifen treatment group(Rote-none 2 mg/kg, E2 1 mg/kg and Tamoxifen 1 mg/kg).Behavior tests were carried out to observe the change of movement function, Immunohistochemistry and Western blot were used to assess the changes of TH and LC-3. HPLC-ECD was used to detect possible changes of monoamine neurotransmitters in striatum.Results_1) Rotenone reduced significantly old age rat’s rotarod latencies and prolonged the climbing pole time(P<0.05).E2 ameliorated this effect, Tamoxifen reduced the effect of E2.2) Rotenone significantly reduced the number of TH positive cells in
high age rats(P<0.05), E2 partly restored TH positive cell loss, Tamoxifen reduced this effect of E2, so did the ex-pression of TH protein.3)Rotenone increased the expression of LC-3(P<0.05), E2 did not affect the expression of LC-3, so did Tamoxifen.4)Rotenone significantly decreased the level of DA and its metabolite DOPAC(P<0.05), elevated the level of 5-HT especially in old rats(P<0.05).E2 downregulated the influence, and Tamoxifen reduced the effect of E2.5)Rotenone increased the number of autophagosomes, but E2 increased the proportion of autolyso-somes/autophagosomes.Conclusions_Old age rat PD model was more reliable.Estrogen promoted autophagy ma-ture, and had obvious therapeutic effect on rat PD model induced by rotenone.

ObjectiveTo evaluate the efficacy of hypertonic saline (HS) treatment in cardiopulmonary resuscitation (CPR) in animal models of cardiac arrest (CA).Methods PubMed and EMBASE data were retrieved from January 1st, 1966 to September 30th, 2014, and Wanfang data and CNKI were searched from January 1st, 1990 to September 30th, 2014 for randomized controlled trials (RCTs) regarding CPR intervention of CA animal models with HS. HS was intravenously infused at the initiation of CPR in HS group, without limiting its dosage or concentration. The same volume of normal saline (NS) was given in NS group. Meta-analysis concerning the rate of restoration of spontaneous circulation (ROSC), the serum sodium concentration before CA and during CPR, and related hemodynamic parameters, including mean arterial pressure (MAP) and coronary perfusion pressure (CPP) at the immediate beginning of CPR and 90 minutes after ROSC was conducted by RevMan 5.3 software.Results A total of 8 RCTs were included. Meta-analysis showed that compared with NS group, the rate of ROSC [relative risk (RR) = 1.23, 95% confidence interval (95%CI) = 1.05-1.43,P = 0.010], serum sodium concentration during CPR [weight mean difference (WMD) =17.44, 95%CI = 12.57-22.31,P< 0.01], and the level of MAP at 90 minutes after ROSC (WMD = 4.81, 95%CI =1.58-8.03,P = 0.003) were significantly improved in HS group. There was no significant statistic difference in other hemodynamic parameters, including serum sodium concentration before CA (WMD = 0.78, 95%CI = -0.26-1.82,P =0.14), MAP (WMD = 5.43, 95%CI = -0.74-11.59,P = 0.08) and CPP at the immediate beginning of CPR (WMD =6.82, 95%CI = -5.54-19.19,P = 0.28), and CPP at 90 minutes after ROSC (WMD = -0.77, 95%CI = -10.33-8.80, P = 0.88) between two groups. It was showed by funnel chart that bias was not significant in the published articles. Conclusion This systematic review indicates that HS infusion is followed by an improved ROSC rate, serum sodium concentration during CPR, and MAP at 90 minutes after ROSC in animal models of CA.

Objective To evaluate role of intracoronary electrocardiogram (IcECG) in examining early myocardial damage during elective percutaneous coronary intervention (PCI). Methods Eighty-six patients of coronary heart disease with normal serum levels of creatine kinase-myoglobin (CK-MB) and cardiac troponin T (cTnT) before the procedure and undergone elective PCI were enrolled in the study.Their IcECG were recorded by a intracoronary guidewire and serum levels of CK-MB and cTnT were measured at baseline and eight and 24 hours after the procedure, respectively. The patients were divided into two group, abnormal and control, according to whether they had significant shift at ST-segment in IcECG.Cardiac events after intervention in the patients were followed-up and recorded. Myocardial damage was defined as serum level of cTnT increased to above the upper normal value after intervention. Results Significant shift at ST-segment in IcECG during PCI in 30 (35%, abnormal group) and no shift in other 56patients (65%, control group) of 86 patients with normal serum levels of cardiac markers before the procedure was observed, and all the procedure were successful Serum levels of cTuT and CK-MB significantly increased after intervention in 30 patients of abnormal group than those in control one ( P <0. 01 ). Sensitivity of intracoronary ST-segment shift was 77 percent for predicting myocardial damage, and specificity was 94 percent, with positive and negative predictive values of 90 percent and 86 percent,respectively. More cardiac events were observed at 4-week follow-up after intervention in abnormal group than those in control one (P<0. 05) and major coronary event-free survival was significantly lower in those with post-procedural ST-segment elevation in IeECG (P < 0. 05). Conclusions ST-segment shift in IcECG may be helpful for predicting myocardial damage during PCI procedure on time.

OBJECTIVE To investigate the potential protective effect of Achyranthes bidentata polysaccharides (ABP) on diabetes mice induced by streptozocin. METHODS Male ICR mice were divided into normal control, diabetes model and ABP 50 and 100 mg·kg~(-1) (ip, once daily for 15 d) treatment groups. On the day before ABP administration and after ABP administration for 8 and 15 d, the blood glucose content was detected with a glucometer and intraperitoneal glucose tolerance test was also conducted. After ABP administration for 15 d, the mice were sacrificed and body weight, heart, liver, spleen and kidneys weights were measured. The serum insulin concentration was determined by radioimmunoassay kit. The serum activities of glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT) and alkaline phosphatase (ALP), and serum concentrations of triglyceride (TG), total cholesterol (TC), calcium and phosphorus were measured by colorimetric method. Enzyme linked immunosorbent assay was employed to detect the concentrations of leptin, adiponectin, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in serum. RESULTS Compared with mice in normal control group, the body weight and serum insulin concentration decreased and blood glucose increased in diabetic model mice. ABP 50 and 100 mg·kg~(-1) treated mice were able to normalize glucose concentrations better following a glucose tolerance test, and the blood glucose level decreased by 27.4% and 16.3%, respectively, compared with that of diabetic model mice. The relative weights of spleen and kidneys, blood glucose level, serum TG and TC concentrations, and GOT, GPT and ALP activities in mice treated with ABP 50 mg·kg~(-1) were obviously lower than those of diabetes model mice. Serum leptin concentration was also markedly decreased near to normal level. However, serum concentrations of adiponectin, TNF-α and IL-6 were significantly increased comparing with diabetes model mice. ABP 100 mg·kg~(-1) had no obvious effect on serum TG and TC levels, and GPT and ALP activities. Its effects on the other parameters indicated above were similar to those in ABP 50 mg·kg~(-1) group. For the serum concentrations of insulin, calcium and phosphorus, no statistical difference could be observed among the different groups. CONCLUSION ABP possesses protective effect against streptozocin-induced diabetes in mice.

Clinical cases of TCM are used as important clinical data to record the whole process of the interaction between doctors and patients in the form of text.However,in the context of big data,there is a lack of research on the use of information covered in clinical cases.Therefore,we studied the method of extracting the symptom term from the history of present illness in TCM clinic in this paper,in order to lay the foundation for the further use of clinical cases.First,twelve thousand,three hundred and sixty-seven history data of present illness were obtained by random selection and expert review.According to the different disease types,they were divided into the two groups of the experiments:4,838 data in the diabetes group,7,529 data in the spleen and stomach disease group and 12,367 data in the mixed or combined group.A glossary of symptom terms covering 22,996 words were compiled.Then,five feature templates,such as sliding window feature,prefix and suffix character and lexical features,were selected.CRFs model was adopted to carry out named entity extraction experiment.As a result,in the open test,the performance of diabetes,spleen and stomach disease and mixed group were (0.83,0.8,0.82),(0.9,0.9,0.89) and (0.88,0.87,0.87),respectively,while the results were (0.83,0.82,0.83),(0.95,0.95,0.95) and (0.93,0.92,0.92) in the ten-fold cross validation.In conclusion,the results showed that the CRFs algorithm was an excellent sequence labeling algorithm and applied to the named entity extraction task of symptom history.