BACKGROUND:There are many methods for dental impression disinfection, including ultraviolet disinfection method, spraying, immerses disinfection method, argon plasma jet and radio frequency glow discharge on the argon gas ionization disinfection method. At present, there is stil lack of studies addressing the disinfection effect after gargling with mouthwash.
OBJECTIVE:To detect the kil ing effect on bacteria and fungi from the dental impressions, which are taken after gargling with cetylpyridinium chloride gargle and stable chlorine dioxide gargle, respectively.
METHODS:One hundred patients were randomly divided into cetylpyridinium chloride gargle group and stable chlorine dioxide gargle group. They were told to gargle with clean water for 1 minute, and then impressions were taken to remove the models with sterile cotton swab sampling in neutralizing agent which were sent to laboratory for bacteria and fungi culture. After 1 hour, the patients were asked to gargle with the different mouthwashes for 1 minute again, and then sterile cotton swab sampling was done at the same position for bacteria and fungi culture. The number of colonies was recorded, and the kil ing effects on kil ing bacteria and fungi on the surface of the impressions before and after gargling with different mouthwashes were observed.
RESULTS AND CONCLUSION:The number of bacteria and fungi before gargal had no significance difference before gargling. After gargling, the number of bacteria and fungi on the model was significantly lower than before (P<0.001). Two groups did not appear with any adverse reactions, and patients felt refreshed and comfortable after gargling with mouthwash. To gargle with mouthwash before taking impressions can control the number of bacteria and fungi on the samples effectively, thereby achieving the aim of control ing the mutual infections between the doctor and the patients effectively.

BACKGROUND:VITA 3D Master shade guide is a newly launched colorimetric system in recent years, with a wide clinical prospect.
OBJECTIVE:To evaluate the significance of dentin colorimetric evaluation for accurate color section of cast ceramic prostheses.
METHODS:Using conventional colorimetric assay and conventional colorimetric assay combined with dentin colorimetric assay (combined colorimetric assay), 30 patients were subject to colorimetric evaluation 1/3 to the neck, central part, and cut end of the tooth. In CIE1976L*a*b*color system, a digital SLR camera (Canon D50) was used for colorimetric measurement and analysis of cast ceramic prostheses prepared with two colorimetric methods and teeth with the same name. And a variety of new colorimetric methods were analyzed based on examples.
RESULTS AND CONCLUSION:In the conventional colorimetric group,△L*was 1.22±0.16,△C*was 1.19±0.20,△H*was 0.31±0.05,△E*was 1.32±0.13. in the combined colorimetric group,△L*was 1.03±0.11,△C*was 1.12±0.19,△H*was 0.29±0.03,△E*was 1.23±0.11. Cast ceramic prostheses prepared by conventional colorimetric method were satisfactory in 22 cases, while cast ceramic prostheses prepared by the combined colorimetric method were satisfactory in 23 cases. There was no difference in patient satisfaction for color rendition (P>0.05), but chromatic difference analysis was significantly different between the two groups (P<0.05).

BACKGROUND:At present, the confrontation of CAD/CAM systems and the lost wax casting method for marginal adaptation has been widely concerned, but the results are controversial. OBJECTIVE:To compare the marginal adaptation of single cobalt-chromium PFM crowns produced by 3 Shape CAD/CAM systems and the lost wax casting method. METHODS: A maxilary first premolar was prepared according to the standards. 50 resin-generation models were created by bi-color silicone rubber method and randomly divided into two groups: CAD/CAM group (A1-A25) and cast group (B1-B25). Al the models were cast in plaster. In CAD/CAM group, the digital impressions were obtained by optical scanning, then designed through computer and cut directly by NC miling machine. In cast group, metal ceramic crowns were made by the lost wax casting method. When crowns were al seated on the working dies, the marginal gaps were copied with light silicone rubber and then embedded with occlusal silicone rubber. The thickness of crown marginal gap was measured with a stereo microscope. RESULTS AND CONCLUSION:The average vertical clearance was (34.67±7.48)μm of CAD/CAM group, while (53.70±9.64)μm of the cast group; the difference was statisticaly significant between two groups (P < 0.05). The average level clearance was (37.61±7.63)μm of CAD/CAM group, while (53.02±10.65)μm of the cast group, and the difference was statisticaly significant between two groups (P < 0.05). Experimental findings suggest that, the marginal adaptation of single cobalt-chromium PFM crowns cast produced by 3 Shape CAD/CAM systems is clinical acceptable (< 120μm), and CAD/CAM systems of metal casting is obviously better than the lost wax casting in building metal based crowns with adaptable margin.

Anterior shoulder instability is a very difficult issue to treat,especially with glenoid bone defect.When the defect is small,there is little influence on shoulder instability.The larger the defect is,the more influence there will be.Most authors agree that glenoid bone reconstruction should be considered when glenoid bone defect is more than 20％-25％.In this condition soft tissue procedures alone are not enough to provide stability to the shoulder.To date,there is still not an ideal typing of glenoid bone defect.There are many methods of assessing the size of bone defect.Pico system is one of the most common methods,as it is easier and more precise.Numerous surgical procedures have been described to address the bone defect.The Bristow procedure,the Latarjet procedure and the Eden-hybinette procedure are effective and most popular around the world.The Latarjet procedure can provide more bone blocking than the Bristow procedure,and is more popular.The Eden-hybinette procedure dose not need coracoid transfer and then has no damage of normal anatomical structure.But it also lack the hanging effect of the conjoint tendon.After all,each procedure has its advantage and disadvantage in treating anterior shoulder instability associated with glenoid bone defect and should be chosen depending on the characteristics of each patient and the preference of each surgeon.Furthermore,more new and effective treatments are still needed.

Objective To explore the expression of HR and Her?2 in breast cancer primary tumor and axillary lymph node metastasis. Methods Four hundred and twenty?eight female patients with unilateral breast cancer combined with axillary lymph node metastasis treated in the Affiliated Suqian Hospital of Xuzhou Medical University from January 2011 to January 2016 were selected in this study. Immunohistochemistry was used to detect the expression of ER,PR,Her?2 and Ki67 in primary tumor and axillary lymph node metastasis. Results The positive rates of ER expression were 75. 9% ( 325/428 ) and 70. 3% ( 301/428 ) respectively in primary tumor and axillary lymph node metastasis. The positive rates of PR expression were 61. 4% ( 263/428) and 56. 1% ( 240/428 ) respectively in primary tumor and axillary lymph node metastasis. The rates of Her?2 overexpression were 20. 1% ( 86/428) in primary tumor and the positive rate of Her?2 in axillary lymph node metastasis was 22. 7%( 97/428 ) . The positive rates of Ki67 expression were 45. 6%( 195/428 ) and 39. 7%(170/428) respectively in primary tumor and axillary lymph node metastasis. The expression of ER,PR,Her?2 and Ki67 in primary and axillary lymph node metastasis showed no statistical significance ( P>0. 05 ) . The molecular typing of primary tumor and axillary lymph node metastasis were not consistent in 31 patients ( 31/428,7. 24%) ,including 14 cases of primary tumor Luminal A,9 cases of Her?2 overexpression in axillary lymph node metastasis and 5 cases of triple negative breast cancer. Primary tumor Luminal B was detected in 10 cases, while 6 cases of Her?2 overexpression in axillary lymph node metastasis and 4 cases of triple negative breast cancer. Primary tumor Her?2 was overexpressed in 4 cases,while 1 case of Luminal A,3 cases of Luminal B in axillary lymph node metastasis. There were 3 cases of primary tumor triple negative breast cancer,while 2 cases of Luminal B in axillary lymph node metastasis and 1 case of Her?2 overexpression. Conclusion The expressions of ER, PR, Her?2 and Ki67 in primary tumor and axillary lymph node metastasis of some breast cancer were different. Immunohistochemistry for primary tumor and axillary lymph node metastasis of stage II?III breast cancer patients should be routinely carried out. Based on molecular typing of primary tumor and axillary lymph node metastasis,individualized treatment plan can be developed,so that patients will benefit from it.

In order to explore the treatment of Her-2 positive breast cancer patients who failed in multi-line treatments, we retrospectively analyzed the clinical data of a patient with refractory Her-2 positive breast cancer.The patient was initially diagnosed as Her-2 positive advanced breast cancer.After six line treatment in the outer hospital, the patient′s condition was basically in a progressive state.The breast tumor was broken and purulent, the lung metastasis increased, and the patient′s quality of life was poor.The patient was admitted to Department of Breast Surgery of Affiliated Suqian Hospital of Xuzhou Medical University, after MDT discussion, we gave pyrrolotinib combined with capecitabine treatment, the chest wound healed gradually, the lung metastasis gradually reduced, and the quality of life was better.A retrospective analysis of this case showed that pyrrolidine combined with capecitabine may bring hope to Her-2 positive breast cancer patients who failed to receive multi-line therapies, especially those who failed to target therapy.

Objective To explore the application of paclitaxel or docetaxel combined with cisplatin (TP) with cyclophosphamide,pirirubicin and fluorouracil (FAC) in the primary tumor molecular typing Luminal A,axillary lymph node metastasis three negative breast cancer. Methods From January 2012 to January 2014, the clinical data of forty-nine patients with were selected. All patients were divided into two groups by balance randomization method, TP group and FAC group. Twenty-five patients were treated with TP regimen and 24 patients were treated with FAC regimen. The clinical efficacy was evaluated after six cycles of chemotherapy. Chemotherapy effects,adverse reactions and survival rates of two groups were compared. Results All patients were given intravenous chemotherapy according to the plan and were evaluated for clinical efficacy. The response rate (RR) was 64. 0％ in TP group,including 4 cases of complete remission (CR),12 cases of partial remission (PR),7 cases of stable disease(SD) and 2 cases of progressive disease(PD). The adverse reactions were gastrointestinal reactions and granulocytopenia. The median progression-free survival ( PFS) and overall survival ( OS) were respectively 12. 4 months and 34. 1 months. In FAC group,the response rate ( RR) was 33. 3％,including 2 cases of CR,6 cases of PR,11 cases of SD and 5 cases of PD. The adverse reactions were gastrointestinal reactions,granulocytopenia and premature atrial contraction. The median PFS and OS were 7. 2 months and 20. 7 months respectively. The effective rate of TP group was higher than that of FAC group (χ2=4. 608,P=0. 032),and the progression-free survival time and total survival time were longer than those of FAC group (χ2 =8. 317, 8. 563, P=0. 004, 0. 003 ) . Conclusion Compared to FAC regimen, TP regimen could improve the survival rate of patients better with breast cancer of Primary tumor Luminal A and Axillary Lymph Node Metastasis Triple negative type, and adverse reactions were tolerated, it may be an optimized chemotherapy.