Objective:To evaluate the effects of different ultrasonic retroprep tips on the root-end preparation in cadavers.Methods:34 anterior teeth in situ in maxillary and mandibular jaws in cadavers were chosen and the root-end of 3 mm of all teeth was exposed. Root canal was prepared and filled with gutta-purcha in all teeth,3 mm of the root end was cut off.The teeth were divided into 2 treat-ment groups(n=1 5),and 1 control group(n=4).The root-end preparation was made using ultrasonic diamond tip and stainless steel tip respectively to 3 mm depth.The teeth in control group were not treated.Microcracks,marginal integrity and gutta-percha clearance were observated under SEM.Results:Diamond ultrasonic tips provoked a smaller number of cracks(P=0.059)and destroy of margin-al integrity(P=0.269)than stainless steel tips.Less gutta-percha clearance was produced by stainless steel tip than that by diamond ultrasonic tip(P=0.006).Conclusion:Diamond ultrasonic tip is more suitable for root-end preparation.

Objective To assess the adequacy of decompression immediately in anterior cervical surgical procedures with epidurography, and to prevent from leaving compressive materials. Methods After completing primary decompression of anterior cervical intervertebral space by discectomy or corpectomy, posterior longitudinal ligaments were incised or resected, 5-10 ml Omnipaque 300 contrast medium was injected into upper and lower segments of decompressed area through a soft 18# injection needle. Distribution of the contrast medium in front of dura mater was observed by fluoroscopy so as to identify whether the spinal cords were decompressed completely. 64 patients suffered from cervical spondylotic myelopathy, and spinal cords were compressed respectively by giant intervertebral disc prolapse, osteophyte or short segmental OPLL. Intraoperative epidurography was performed after primary anterior decompression. If contrast medium in front of dura mater was discontinued by fluoroscopy, incomplete decompression was judged. 39 of 64 patients were followed up after operation, and in 18 patients of them MRI were taken within 1-12 weeks after operation. Neurological function was compared between preoperation, immediate postoperation and final follow-up by means of JOA scores. Results After completing primary decompression, epidurographs showed that the contrast medium were continuous in front of dura mater in 49 cases(77%), 11 patients of them were examined by MRI during follow-up and the images indicated that cervical cords were free of compression. In 15 cases (23%), the contrast medium was not continuous in front of dura mater, then decompression was performed further until the contrast medium no any interruption. 7 patients of them were confirmed by MRI that cervical cords were no more compressed. 39 patients were followed up postoperatively with a mean follow-up of 13 months. Neurological function was recovered immediately after operation by 52% and 61% at final follow-up. No neurological deficit progressed in all of them. Conclusion Intraoperative epidurography is effective and safe for assessment of decompression during anterior cervical surgical procedures.

Objective: To study the effect of antidepressant in treatment of patients with PSD (post-stroke depression) Method: 121 patients with PSD in their rehabilitation period were stratified by results of HAMD and then randomly divided into two groups, the study group (n=64) received Paroxetine 20 mg daily, the control group (n=57) received placebo After 4 months, the result was assessed with HAMD, CSS and ADL (activity of daily living) Result: In the period of rehabilitation of stroke, the degree of neurological impairment (CSS score) was positively correlated to depression (r=0 99, P

To establish a rat model of frostbite and to evaluate the effects of different administration methods of Huangqi Guizhi Wuwu Decoction (HGWD), a compound traditional Chinese herbal medicine for warming meridians to disperse cold, on rats with frostbite.

Objective To explore the measures to prevent recurrent laryngeal nerve (RLN)injury during thyroid surgery.Methods The clinical data of 223 patients undergone thyroid surgery were retrospectively analyzed.Among the 223 surgeries,69 sides were undergone regional protection act of RLN and 191 sides were performed RLN exposure.Results There were 2 cases of RLN injury from the regional protection operation of RLN,including 1 case of temporary nerve injury which could be resulted from surgery clamp and 1 case of permanent nerve injury which might be caused by mistaking ligation during surgery.There was only 1 case of temporary nerve injury in RLN exposure procedure which was probably caused by the postoperative nerve edema and was recovered 2 months after the operation.The total RLN injury rate was 1.35％.Conclusion For benign thyroid lesions and non-dorsal lesions or during partial excision of the gland,the regional protection of RLN is helpful to prevent RLN injury.In cases with dorsal lesions of thyroid or contralateral RLN injury,or during lobe subtotal resection,lobe resection and reoperation,exposing RLN to prevent injury is necessary.Taking different approaches based on the profiles of lesions and surgical procedures to prevent RLN injury can significantly reduce the risk of RLN injury.

Objective To explore the effects of angelica naphtha on the withdrawal signs and norepinephrine neurotransmitter in uorphine-dependent rats.Methods 72 SD rats were randomly divided into control group,model group,clonidine group and three angelica naphtha groups (80,40 and 20 mg/kg).Rats were received gradualy increasing doses of morphine to produce physical dependence.Withdrawal symptoms were evaluated by Ryuta Tomoji score.The level of norepinephrine and normetanephrine(NMN) were tested by enzyme-linked immunosorbent assay(ELISA).Results The scores of withdrawal signs were (4.00± 3.29),(30.13±4.41),(18.96± 4.43),26.04±4.13),(22.33±4.60) and (19.00±3.47),respectively.The morphine withdrawal signs were reduced by angelica naphtha in a dose-dependent manner(P＜0.01),also significantly reduced the level of NE and NMN and the ratio of NMN/NE in the nucleus ceruleus and prefrontal cortex(all P＜0.01).Conclusion Angelica naphtha alleviates the withdrawal synlptons in morphine-dependent rats,which may be related to the inhibition of excessive turnover of norepinephrine neurotransmitters in the nucleus ceruleus and prefrontal cortex.

Objective To investigate the influence of pullulan molecular weight and spacer length on the properties of modified pullulan carriers including morphologies,sizes and in vitro release behaviours of drug-loading carriers.Methods Using cholesterol as hydrophobic ligand,succinic anhydride and 1,6-hexyldiisocyanate as spacers,hydrophobic modified pullulans with different molecular weights were prepared.Self-assembled nanoparticles were then formed in the aqueous solution,and drug-loaded nanoparticles were prepared by dialysis method.The influence of pullulan molecular weight and spacer length on the loading-content,morphologies and in vitro release behaviours of drug-loading nanoparticles were then investigated in detail.Results Self-assembled nanoparticles could be formed by the cholesterol-modified pullulan,and doxorubicin and mitoxantrone could be loaded into cholesterol-modified pullulan to form nanoparticles.Pullulan molecular weight and spacer length show influences on sizes,morphologies and stabilities of pullulan nanoparticles and drug-loaded nanocarriers.Conclusions Before drug loading,nanoparticles with larger moleculare weight and shorter spacer length are more stable in solution,while after drug loading,the influences of these two factors on the nanoparticles are drug-type depended.

Objective To investigate the effectiveness and safety of minimal invasive surgery combined with ventriculoscope for the treatment of basal ganglia hemorrhage.Methods From June 2014 to June 2015 there were 57 patients with basal ganglia hemorrhage were selected into this study.These patients were signed into the minimal invasive surgery combined with ventriculoscope group and the craniotomy group according to the methods of surgery they received.And the clinical outcomes of the two groups were compared.Results Compared with the craniotomy group,patients in the minimal invasive surgery combined with ventriculoscope group got a significantly lower Glasgow coma scale at 7 days,14 days and 28 days after the operation (P =0.02,0.04,0.04);the hospital stays were significantly reduced in the minimal invasive surgery combined with ventriculoscope group [(21.45 ±5.67)d vs.(25.67 ±7.45)d,P =0.02];and the operation time were significantly reduced as well [(134.45 ±21.11)min vs.(178.65 ±45.32)min,P =0.000)].There was no significant difference in intra-cranial pressure,rate of hematoma clearance,rate of organ functional failure,rate of re-bleeding and mortality 28 days after operation (P >0.05).Conclusion The minimal invasive surgery combined with ventriculoscope is effective and safe for the treatment of basal ganglia hemorrhage,which is worthy of popularization.

OBJECTIVETo evaluate the efficacy of allograft fibula in anterior cervical fusion for cervical spondylosis patients treated by Smith-Robinson operation supplemented with anterior instrumentation.

METHODSThe clinical outcome of 38 patients with cervical spondylosis treated by Smith-Robinson operation using allograft fibula supplemented with anterior titanium plate were retrospectively studied. The patients were followed up on average was (9.5 +/- 3.4) months. The average preoperative and postoperative JOA scores were assessed and myelopathy severity was graded using the Nurick myelopathy grading system. Lateral views in neutral position, in flexion, and in extension of preoperative cervical roentgenograms were analyzed in comparison with last follow-up films to identify the changes in the height of intervertebral space and the quality of fusion.

RESULTSStatistical analysis of all patients revealed mean JOA scores of 12.54 +/- 1.62 and 16.07 +/- 1.13 before surgery and at final examination (P < 0.05), respectively. And the mean Nurick grades were 2.46 +/- 0.43 and 0.72 +/- 0.37 before and after surgery (P < 0.05), respectively. Radiographic follow-up revealed that the height intervertebral space and the lordosis of the cervical spine had been restored and no allograft was found displaced or collapsed and also revealed that all grafts obtained union by 5 months after surgery.

CONCLUSIONSFibular allograft can replace autologous iliac crest graft in the treatment of cervical spondylosis patients. This method is safe and efficacious and can avoid bone graft-site morbidity.

Adult ; Aged ; Cervical Vertebrae ; pathology ; Female ; Fibula ; surgery ; Humans ; Male ; Middle Aged ; Spinal Osteophytosis ; surgery ; Transplantation, Homologous

Objective:To investigate the effect of S100 calcium-binding protein A9(S100A9)activation of nuclear factor kappa-B(NF-κB)on the upregulation of toll-like receptor 7(TLR7)expression and the release of inflammatory factors in microglia,as well as its underlying mechanism.Methods:The viability of BV2 microglia was assessed using CCK-8 kit.Transcriptome sequencing was employed to compare differential genes(DEGs)and identify target genes from the pool of differentially expressed genes.This analysis was complemented by GO analysis,KEGG enrichment analysis and the STRING database.The expression of TLR7 mRNA was verified by real time RT-PCR.The expressions of CD68 and CD206 were detected using immunofluorescence.The expressions of CD68,CD206,TLR7,p65,and p-p65 were detected using Western Blot.The level of interleukin 6(IL-6)and tumor necrosis factor alpha(TNF-α)were verified by ELISA.Results:Moderate concentrations of S100A9 had no inhibitory effect on microglial viability.Compared to the control group,the experimental group showed a significant increase in the expression level of CD68 pro-tein,while the CD206 protein was decreased.This suggests that S100A9 promotes the activation of BV2 microglia into pro-inflammatory types.TAK-242,an inhibitor of toll-like receptor 4(TLR4),significantly inhibited the expression levels of TNF-α and IL-6 after S100A9 stimulated BV2 cells.Activation of the TLR4/NF-κB pathway promoted the ex-pression of TLR7 protein.Conclusion:The moderate concentration of S100A9 can promote the polarization of microglia towards a proinflammatory direction.It also promotes the expression of TLR7 and the release of various inflammatory factors,including TNF-α and IL-6,through the activation of the TLR4/NF-κB pathway.This activation has an obvious proinflammatory effect.