BACKGROUND:To maintain the long-term effect of ful crown largely depends on the health of periodontal tissues. OBJECTIVE:To explore the effect of CAD/CAM zirconia al-ceramic crown restoration on the state of periodontal health. METHODS:Sixty-four abutments of 55 patients were randomly divided into two groups:the experimental group included 32 abutments of 29 patients which would be restored by CAD/CAM zirconia al-ceramic crowns;the control ed group included 32 abutments of 26 patients which would be restored by Ni-Cr al oy porcelain-fused-to-metal restorations. The volume of gingival crevicular fluid and the levels of interleukin-6 and tumor necrosis factor-αin the two groups were examined at the pre-restoration and post-restoration stages. Meanwhile, periodontal clinical indicators, including sulcus bleeding index, probing depth, plaque index and attachment loss were recorded. RESULTS AND CONCLUSION:No difference in various indexes was found in the experimental group before and after restoration (P>0.05). At 12 months after restoration, in the control group, the volume of gingival crevicular fluid, the levels of interleukin-6 and tumor necrosis factor-α, sulcus bleeding index, probing depth, and plaque index were al increased (P>0.05);meanwhile, these indexes in the experimental group were significantly lower than those in the control group (P<0.05). Experimental findings suggest that the CAD/CAM zirconia al-ceramic crown restoration is more favorable to the health of periodontal tissues.

BACKGROUND:Patellar tendinopathy is tiny damage at tendon insertion.Changes in the strength balance between medial vastus muscle(VM)and musculus vastus lateralis(VL)in the quadriceps may lead to patellar abnormal motion,even have an impact on the tendon insertion.OBJECTIVE:To compare and analyze knee mechanical charactedstics and surface electromyography of the quaddceps in athletes with patellar tendinopathy.in order to provide scientific basis for the prevention and treatment of patellar tendinopathy.DESIGN,TIME AND SETTING:Self-control experiment was performed in Central Laboratory of Physical Education College of Soochow University from June to July 2009.METHODS:A total of 10 athletes with patellar tendinopathy aged(21.44±1.51)yeam were selected as patellar tendinopathy group and 10 normal athletes aged(21.37±1.36)years were selected as normal control.MAIN OUTCOME MEASURES:①Knee flexor and extensor muscles peak torque in concentric and eccentric isokinetic exercise between two groups.②Comparison of quadnceps integrated electromyogram(IEMG)between two groups.③Comparison of VM/VL in different kinds of exercises between groups.RESULTS:The ratio of flexor and extensor peak torques of the patellar tendinopathy group was significantly greater than the normal group in concentric and eccentric isokinetic exercises(P＜0.05 or 0.01).VM IEMG of the patellar tendinopathy was significantly less than normal group(P＜0.05 or 0.01),but no difference was found in VL and rectus femoris IEMG between two groups.During the period of isometric exercise and isokinetic exercise,the ratios of VM/VL of the patellar tendinopathy group were remarkably lower than the normal group (P＜0.05 or 0.01).CONCLUSION:There are significant differences between flexor and extensor torques in patellar tendinopathy athletes.VM is under-activity and there is an imbalance between VM and VL.

Objective To study the clinical study of the effect of removing blood stasis and eliminating powder on the recovery of wrist function after distal radius fracture.MethodsA total of 82 patients with distal radius fractures were selected from September 2012 to October 2016.The random number table method was divided into study group and control group.The two groups were given intervention, and the study group (VAS score), the correlation index(swelling time, pain time, fracture healing time), clinical curative effect and the recovery of wrist function were observed and compared with the two groups.ResultsAfter treatment, the VAS scores of the two groups were significantly lower than those before treatment, and the VAS scores of the study group were significantly lower than those of the control group (P<0.05).After the treatment group, the swelling time, pain time (P<0.05).After treatment, the total effective rate was 87.80% higher than that of the control group (68.29%) (P<0.05).After treatment, the two groups were significantly higher than those in the control group (P<0.05), and the wrist function scores of the study group were significantly lower than those of the control group (P<0.05).ConclusionThe combined effect of removing blood stasis and eliminating powder is effective in the treatment of distal radius fractures, which can effectively reduce the pain and reduce the healing time of the fracture and promote the recovery of the wrist function.

Objective To observe the effect of leflunomide and cyclophosphamide combined with prednisone in the treatment of idiopathic membranous nephropathy .Methods 30 patients with idiopathic membranous nephropa-thy were randomly divided into two groups ,15 cases in each group .A group was treated by leflunomide combined with prednisone , B group was treated by cyclophosphamide combined with prednisone , 6 months a course .The clinical effect,24h urine protein quantity,serum albumin levels,blood fat,renal functions and adverse reactions were com-pared.Results 3,6 months after treatment ,the remission rates in A group were 60.00%,73.33%,those in B group were 53.33%,66.67%(χ2 =0.965,0.896,all P>0.05).After treatment,24h urine protein quantity,serum albu-min levels in the two groups [A group:(1.33 ±1.25)g/24h,(38.24 ±4.84)g/L;B group:(1.42 ±1.37)g/24h, (37.12 ±5.43)g/L] were significantly lower than those before treatment [A group:(7.34 ±2.75)g/24h,(20.31 ± 7.33)g/L;B group:(7.22 ±2.84)g/24h,(20.46 ±7.73)g/L] (A group:t=6.232,5.734,all P<0.05;B group:t=5.934,5.267,all P<0.05).After treatment,total cholesterol,triglyceride in the two groups [A group:(6.74 ± 1.45)mmol/L,(2.43 ±0.75)mmol/L;B group:(6.63 ±1.45)mmol/L,(2.14 ±0.63)mmol/L] were significantly lower than those before treatment [A group:(11.94 ±2.98) mmol/L,(3.56 ±1.35) mmol/L;B group:(11.53 ± 2.84)mmol/L,(3.24 ±1.46)mmol/L] (A group:t=6.246,5.234,all P<0.05;B group:t=5.256,5.672,all P<0.05).There were no significant differences in urea nitrogen ,serum creatinine between before and after treatment in the two groups(all P>0.05).There were no significant differences in above indicators between A group and B group after treatment (all P>0.05).The incidence rate of adverse reactions in A group (13.33%) was significantly lower than that in B group(40.00%)(χ2 =4.246,P<0.05).Conclusion The clinical efficacy of leflunomide is similar to cyclophosphamide in treating idiopathic membranous nephropathy with fewer adverse reactions .

Objective:To evaluate the relation between the single nucleotide polymorphism of CYP2D6 gene G4268C and the genetic susceptibility to lung cancer. Methods: A case-control study was conducted among 118 lung cancer patients and 118 control subjects (matched for sex, age) to investigate the role of CYP2D6 gene G4268C polymorphism in lung cancer; PCR-RFLP was used to identify the genotypes of polymorphism. Logistic regression was used to analyze the relationship between polymorphism and genetic susceptibility to lung cancer. Results: The frequency of G4268→C mutation in case and control group were 69.49% and 75.00%, respectively. Non-C4268/C genotype (including G4268/G and G4268/C genotype) was correlated to the high risk of lung cancer, with OR adjusted by gender, age and smoking being 1.80 (95% CI=1.06-3.06), especially to lung adenocarcinoma (OR being 2.95 95% CI=1.39-6.23). After stratified analysis of smoking history and adjusting by gender and age, it was revealed that non-C4268/C genotype was associated with significantly increased risk of lung cancer in non-smokers and light-smokers group, with OR=2.12 (95% CI=1.03-4.36) and OR=3.75 (95% CI=1.15-12.22), respectively. Conclusion: C4268/C genotype may be a protective factor in lung adenocarcinoma patients and may decrease the risk of lung cancer in non-smokers and light-smorkers.

Purpose:To explore the relationship between the expression of nm23mRNA,p16 and the oncogenesis,development and metastasis of lung cancer.Methods:Expressional level of nm23mRNA,p16 was detected in 72 human lung cancer samples and 23 normal tissues adjacent to cancer respectively,and their correlation with lymph node metastasis and the degree of cell differentiation was studied by immunohistochemistry (IHC) and in situ hybridization (ISH) methods on tissue microarray.Results:The positive expression for nm23mRNA in cancer samples,in human tissues adjacent to cancer and in primary cancer with lymph node metastasis was 55.6%(40/72),82.6%(19/23),25.0%(6/24) respectively.The positive expression for p16 was 45.8%(33/72),73.9%(17/23),25.0%(6/24) respectively.The expression level of nm23mRNA and p16 were closely related to the degree of cell differentiation( P 0.05).Conclusions:These results suggest that nm23 gene and p16 gene are closely related to the degree of cell differentiation and lymph node metastasis of lung cancer.The lower expression level of nm23mRNA and p16 predicts the metastasis of lung cancer, and the two genes may be an index in monitoring the status and evaluating the prognosis of the lung cancer.

Objective To observe and explore clinical efficacy ofTianma-Gouteng decoction combined valsartan in the treatment of patients with renal hypertension and its effects on renal function. Methods A total of 130 patients with renal hypertension were enrolled and randomly divided into a study group (68 patients) and a control group (62 patients). Both groups were given prescription of lower sodium diet, exercising and enalaprilscheme. On this basis, the control group plus valsartan, and the study group was further added withTianma-Gouteng decoction. After 2 courses treatment, renal function, and blood pressure of both groups were compared, and clinical efficacy on blood pressure were evaluated.Results After treatment, the SBP (126.8 ± 9.1 mmHg vs. 134.1 ± 8.8 mmHg,t=4.648), DBP (82.4± 5.0 mmHgvs. 85.3 ± 5.4 mmHg, t=3.167), Scr (148.5 ± 46.3μmol/Lvs. 172.1 ± 52.0μmol/L, t=2.723), BUN (8.3 ± 2.7 mmol/Lvs. 9.7 ± 3.1 mmol/L,t=2.734) and 24hAlb (1.7 ± 0.6 gvs. 1.9 ± 0.7 g,t=2.209) in the study group were significantly lower than control group (P<0.05 orP<0.01). The total effective rate in the study group was significantly increased than that in the control group (91.2%vs. 79.0%;χ2=0.383,P=0.050).Conclusion Valsartan combined with Tianma-Gouteng decocntion can reduce blood pressure, and alleviate the kidney damage effectively.

Objective To investigate the value of clinical parameters in predicting the initiation of renal replacement therapy(RRT) in acute kidney injury (AKI) patients with cardiorenal syndrome (CRS).Methods A total of 75 AKI patients hospitalized with CRS were enrolled.All patients received pharmacologic therapy on the beginning 3 days.The patients whose heart function improved were divided into control group (n=39),and the patients whose heart function worsened were divided into RRT group (n=36).Clinical and laboratory data on the first day and the fourth day were collected and analyzed.The factors on the first day were labeled asⅠ ,and those on the fourth day were labeled asⅡ. The ratio of some parameters calculated were labeled asⅡ/Ⅰ .Area under curve (AUC) of receiver operating characteristic curve (ROC) of these factors was used to evaluate the sensitivity and specificity in predicting the initiation of RRT.Results The patients in RRT group had significantly higher levels of BNP-Ⅱ,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ (P ＜ 0.01),and lower levels of 24 hours urine volume-Ⅰ and 24 hours urine volume-Ⅱ (P ＜ 0.01).From ROC curve analysis,the AUC of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,creatinine Ⅱ / Ⅰ,BNP-Ⅱ levels and BNP Ⅱ/Ⅰ to predict RRT were 0.736,0.875,0.747,0.779 and 0.894 respectively.When the cutoff values of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,BNP-Ⅱ levels,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ were 905 ml (sensitivity 75％,specificity 94.9％),1450 ml (sensitivity 75％,specificity 100％),3360 ng/L (sensitivity 72.2％,specificity 100％),1.37 (sensitivity 75％,specificity 100％) and 1.25 (sensitivity 72.2％,specificity 94.4％) respectively,the value of the parameters to predict RRT was high.Conclusions The 24 hours urine volume,BNP levels after treatment and the dynamic changes of BNP levels and creatinine levels can be used as predictors of the initiation of RRT in the AKI patients with CRS.

Objective To investigate the clinical effect ofYishen-Lishi formula combined with conventional treatment for gouty nephropathy.MethodsA total of 118 patients with gout nephropathy were included and divided randomly into a conventional treatment group (n=60) and a combined treatment group (n=58) according to the random number table method. The patients in the conventional treatment group were treated with allopurinol and those in the combined treatment group were treated with allopurinol and Yishen-Lishi formula, both for 3 months. Serum uric acid, blood urea nitrogen (BUN), serum creatinine (SCr), 24 h endogenous creatinine clearance (CCr), 24 h urine protein, urineb2 microglobulin, serum triacylglycerol (TG), serum total cholesterol (TC), serum apolipoprotein A1, 24 h urine volume and urine pH were determined. The therapeutic effect was evaluated.ResultsThe urine pH (6.43 ± 0.6vs.6.21 ± 0.4;t=2.351,P=0.020), 24 h urine volume (3.3 ± 0.4vs.2.8 ± 0.6 L;t=5.308,P<0.001), 24 h CCr (1.61 ± 0.11 ml/svs. 1.33 ± 0.10 ml/s;t=14.477,P<0.001) and serum apolipoprotein A1 (1.90 ± 0.40 g/Lvs. 1.01 ± 0.33 g/L;t=13.203,P<0.01) in the combined treatment groupwere significantly higher than those in the standard treatment group. The serum uric acid (312.01 ± 33.56mmol/Lvs.350.12 ± 35.21 mol/L;t=6.015,P<0.001), BUN (6.22 ± 0.91 mmol/Lvs.11.50 ± 4.01 mmol/L;t=9.586,P<0.001), SCr (87.32 ± 13.90mmol/Lvs.122.54 ± 18.37mmol/L;t=11.743,P<0.001), 24 h urine protein (0.7 ± 0.2 gvs.1.2 ± 0.5 g;t=7.087,P<0.001), urineb2 microglobulin (220.3 ± 90.3mg/Lvs.330.1 ± 90.1mg/L;t=6.611,P<0.01), serum TG (5.11 ± 0.50 mmol/Lvs.6.30 ± 0.50 mmol/L;t=12.923,P<0.001), serum TC (1.50 ± 0.50 mmol/Lvs.2.30 ± 0.52 mmol/L;t=8.689,P<0.001) in the combined treatment group were significantly higher than those in the standard treatment group. The total effective rate inthe standard treatment group was significantly higher than those in the standard treatment group (89.7%vs.70.0%;χ2=5.871,P=0.015). ConclusionYishen-Lishi formula combined with conventional treatmentmay protect renal function, and reduce the blood lipids, its therapeutic effect is superior to conventional treatment alone in patients with gouty nephropathy.

Strokes due to atrial fibrillation (AF) are common and frequently devastating.While oral anticoagulant agents are the mainstay in the prevention of embolic events,they have several limitations and not all patients can tolerate them long term.The left atrial appendage (LAA) has been identified as the source of thrombus formation in nonvalvular AF.Several LAA closure devices have been developed,they have been successful in stroke prevention in patients with nonvalvular AF and fewer periprocedural complications.This article reviews the application of percutaneous left atrial appendage closure for stroke prevention in patients with nonvalvular AF.