Objective To assess the effect and safety of mono and combination of intravenous flurbiprofen axetil (FP) and epidural tramadol on postoperative pain after cesarean section. Methods Eighty parturients undergoing selected cesarean section with combined epidural spinal anesthesia were randomly allocated into 4 groups (n=20 in each): Group FT treated with intravenous FP 50 mg immediately after the umbilical cord was clamped (T1) and epidural tramadol at the time of suturing peritonaeum (T2);Group FF treated with intravenous FP 50 mg at T1 and T2;Group T treated with epidural tramadol 100 mg at T2, and Group F treated with FP 50 mg at T2. Postoperative pain was assessed by parturients using visual analog scales (VAS) at 2, 4, 8, 12, 24 h after surgery. The cases that patients required rescued analgesia were recorded as well as the times of analgesics administration. The events of nausea and vomiting within 24 hours as well as the time of first breast-feeding were observed. Results All groups were similar in VAS at 2 hours after surgery, but were statistically significant different at 4, 8, 12 and 24 hours. Group FF showed significant lower VAS than the other 3 groups. However, no significant difference of VAS was observed among the other 3 groups. Rescued analgesia was administered once after surgery to 7 cases in Group F, 4 in Group T, and 2 in Group FT. No patient in Group FF required rescued analgesia. There was significant difference in the rate of rescued analgesia post surgery among the 4 groups (P=0.0149). No significance in the incidence of nausea and vomiting was observed in 4 groups. There was no significant difference in the time of first breast-feeding after surgery in the 4 groups (F=0.54,P=0.657). Conclusions Intravenous flurbiprofen axetil administration immediately after the umbilical cord is clamped and at the time of closing peritonaeum in cesarean section could relieve postoperative pain and reduce postoperative rescue analgesic requirement without increasing the incidence of nausea and vomiting.

Objective To assess the safety and effect of intraoperative cell salvage (ICS) during cesarean section.Methods This was a case-control study in which 60 gravidas who received ICS (ICS group) and 60 gravidas who received allogenic transfusion (control group) during caesarean section in Obstetrics and Gynecology Hospital of Fudan University during January 2014 to December 2016 were enrolled.Subjects in the two groups were matched in age,gestational age,gestational complications (placenta increta,placenta previa,scarred uterine,leiomyomas and anemia) and hemorrhagic volume during cesarean section.Several indicators including complications of transfusion,postoperative recovery,expense of transfusion,as well as the complete blood count and body temperature before and after operation were compared between the two groups.T,rank-sum or Chi-square test was used for statistical analysis.Results (1) No significant difference in age,gestational age,twin gestation,complications,preoperative body temperature,or the volume of hemorrhage or transfusion was observed between the two groups (all P＞0.05).(2) The autotransfusion volume was 385 (161-583) ml in the ICS group.Fifteen cases (20.0％) in the ICS group also received additional transfusions of leukocyte-reduced red blood cell (RBC) suspension,fresh frozen plasma and cryoprecipitate and two cases (3.3％) received additional transfusions of leukocyte reduced RBC suspension and fresh frozen plasma.The two groups showed no significant difference in the cost of transfusion or per-capita transfusion volume of fresh frozen plasma or cryoprecipitate.However,the transfusion volume of leukocyte-reduced RBC suspension was lower in the ICS group as compared with that in the control group [M(P25-P75),1.9 (1.5-4.5) vs 4.1 (2.8-6.2) U,Z=-2.800,P=0.005].(3) There was no significant difference in complete blood count or coagulation function between the two groups before the operation.White blood cell (WBC) counts in the two groups were elevated following operation.Postoperative WBC count in the control group was higher than that in the ICS group,while the levels of RBC and hemoglobin were lower than those in the ICS group following operation (all P＜0.05).(4) No amniotic fluid embolism was reported in the two groups.Only one case of rash was reported in the ICS group,which was fewer than the transfusion reactions occurred in the control group [1.7％ (1/60) vs 13.3％ (8/60),x2=5.886,P=0.016].(5) The two groups showed no significant difference in preoperative temperature,the highest temperature within three days after operation or incision healing.Compared with the patients in the control group,those in the ICS group had shorter hospital stay [(4.7± 1.1) vs (6.3 ±1.8) d,t=3.341,P＜0.05].Conclusion ICS is a safe and effective measure for gravidas at higher risk of hemorrhage during cesarean section.

BACKGROUND:Interproximal contact loss is a complication of posterior crown/bridge restorations with a higher incidence, and it is induced by a variety of factors, such as age, tooth position, occlusal contact, tooth loss time, whether there is a repair on the free end.OBJECTIVE:To study and analyze the loss of interproximal contact between posterior crown/bridge restorations and adjacent teeth.METHODS: This was a single-center, prospective, observational clinical trial which has been completed at the Stomatology Hospital Affiliated to Southwest Medical University, China. Totaly 82 patients who had underwent posterior crown/bridge restorations from June 2015 to June 2016 in the Stomatology Hospital Affiliated to Southwest Medical University were selected. The time of denture wearing was 1-40 months, and the interproximal contact loss was defined by a 30 μm adjacent contact check or a flossing that can pass through the detection area with no resistance. Single-factor analysis and multiple correlation analysis were performed to analyze the interproximal contact loss at 1, 3, 6 months after posterior crown/bridge restorations. The study protocol was approved by the Ethics Committee of the Stomatology Hospital Affiliated to Southwest Medical University of China with an approval number of 2016024. All protocols were in accordance with Declaration of Helsinki, formulated by the World Medical Association. All patients and their relatives were informed of study protocols and provided a written informed consent prior to the beginning of the trial.RESULTS AND CONCLUSION:Of the 82 patients enroled, there were 41 adjacent contact zones with the emergency of interproximal contact loss, including 20 maxillary and 21 mandibular. It indicated that the interproximal contact loss had no association with the upper and lower jaw. Single-factor analysis showed that the time of denture wearing, tooth loss time and repair of the free end were confirmed as independent influencing factors for the complications (P < 0.05). Multiple correlation analysis found that free end repair and short-term tooth loss were independent factors of the interproximal contact loss. To conclude, free end repair and tooth loss time should be considered in the posterior crown/bridge restorations in order to minimize the occurrence of interproximal contact loss.

Purpose To investigate the diagnostic value of p16/Ki-67 dual stain cytology for detection of cervical precancerous lesions as a novel option for cervical lesions screening.Methods A total of 295 cases diagnosed as atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) from thinprep cytologic test (TCT) were selected.Double staining of p16/Ki-67 cytology,vaginal biopsy,biopsy and pathological examination were applicated,p16/Ki-67 dual stain cytology was compared with that of biopsy and pathological examination.At the same time,The sensitivity and specificity of p16/Ki-67 dual stain cytology between ASC-US and LSIL was analyzed.Results The positive rate of p16/Ki-67 dual stain cytology were 37.42％ and 36.36％ in ASC-US and LSIL,respectively.The positive rate of cervical intraepithelial neoplasia 2/3 (CIN2/3) were 25.77％ and 25.76％.The sensitivity and specificity of the p16/Ki-67 test for detecting CIN2/3 was 83.33％ and 78.51％.The sensitivity and the specificity of the p16/Ki-67 test for detecting CIN2/3 was 85.30％ and 80.61％ in LSIL group.Conclusion p16/Ki-67 double stain cytology detection can improve the sensitivity of CIN2/3 and the specificity of human papilloma virus (HPV).p16/Ki-67 double stain detection can effectively triage the high grade cervical lesions in TCT and improve the accuracy of cervical cancer screening.

Objective To investigate the infection status quo and genotype distribution of human papillomavirus(HPV) infection situation among females in west Guangxi area.Methods Cervical exfoliative cells samples from 3 315 women were collected to detect HPV genotyping with Cape flow-through hybridization.Then the results were statistically analyzed.Results The overall HPV infection rate was 21.30%(706/3 315),in the females of HPV positive infection,the high-risk type infection was predominant,accounting for 89.52%(632/706).The HPV infection type was dominated by single type infection,accounting for 72.66% the double infection accounted for 22.10%(156/706). The 21 HPV subtypes were detected.The high-risk HPV subtypes with high detection rate were HPV52(26.77%),HPV16(15.30%) and HPV58(15.01%).The low-risk HPV subtypes with high detection rate were HPV CP8304(11.90%) and HPV6(3.68%).The HPV subtypes were distributed differently at different ages.In 7 age groups of≤20,>20-30,>30-40,>40-50,>50-60,>60-70,>70 years old,the infection rates of high risk HPV were 21.62%(8/37), 19.26%(120/623),17.66%(220/1 246), 14.88%(153/1 028), 16.83%(51/303),15.52%(9/58) and 30.00%(6/20) respectively,showing no statistically significant differences among them(χ2=10.019,P=0.124).Conclusion Cervical HPV infection are mainly high-risk HPV subtypes and single type infection in females of western Guangxi area.The HPV subtypes with high infection rate are 52,16,58 and CP8304.

In order to promote the integration between disciplines, the convergence between basic course and clinical teaching, increasing students ability including the active learning and life-long learning ability, finding problem and solving problem ability, teamwork spirit and so on. After nearly 3 years preparation, Hebei Medical University successfully carried out the PBL teaching in Seven-year Clinical Medicine Science. Combining with the teaching activities, formative assessment was carried out, and PBL teaching website was established. The reform has already achieved initial results, got good responds from teachers and students. Through the study, it has been confirmed that the PBL teaching method in Hebei Medical University is effective and worthy to reference.

Objective To evaluate the efficacy of different doses of dexmedetomidine for prevention of shivering after combined spinal-epidural anesthesia in the patients undergoing caesarean section.Methods A total of 120 patients,of ASA physical status Ⅱ or Ⅱ,aged 20-40 yr,with body mass index≤ 35 kg/m2,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were randomly divided into 4 groups (n =30 each) using a random number table:control group (group C) and dexmedetomidine 0.1,0.3 and 0.5 μg/kg groups (D1,D2 and D3 groups).Combined spinal-epidural anesthesia was performed at L3,4 interspace with isobaric 0.5％ bupivacaine 2 ml.In D1,D2 and D3 groups,dexmedetomidine 0.1,0.3 and 0.5 μg/kg (in 50 ml of normal saline) were infused intravenously,respectively.In group C,normal saline 50 ml was infused at a rate of 5 ml/min.The development of shivering,bradycardia,hypotension,nausea and vomiting was recorded during the period from the end of dexmedetomidine infusion to PACU discharge time.Results Compared with group C,the incidence and degree of shivering and incidence of nausea and vomiting were significantly decreased in D2 and D3 groups,and no significant change was found in the parameters mentioned above in group D1.Compared with group D2,the incidence and degree of shivering and incidence of nausea and vomiting were significantly decreased in D3 group.Conclusion Dexmedetomidine 0.3 and 0.5 μg/kg can prevent shivering after combined spinal-epidural anesthesia in the patients undergoing caesarean section,and 0.5 μg/kg provides better efficacy.

BACKGROUND: At present, there is no consensus on the timing of post space preparation in the clinical medical treatment. But it can be inferred from some studies that post space preparation may affect coronal microleakage using different fil ing materials. OBJECTIVE: To compare the effects of immediate post space preparation and delayed post space preparation restoration on coronal microleakage using different fil ing materials. METHODS: Forty-eight extracted and single-rooted premolars were randomly divided into six groups (n=8 per group): premolars were fil ed with AH-plus paste and gutta-percha with the immediate post space preparation as group A1; premolars fil ed with mineral trioxide aggregate paste and gutta-percha with the immediate post space preparation as group A2; premolars fil ed with AH-plus paste and gutta-percha with the delayed post space preparation 1 week later as group B1; premolars fil ed with mineral trioxide aggregate paste and gutta-percha with the delayed post space preparation after 1 week later as group B2;premolars fil ed with AH-plus paste and gutta-percha as negative control group; premolars fil ed with gutta-percha as positive control group. Afterwards, al specimens were soaked for 4 weeks under simulated oral environment to measure the length of coronal microleakage by pressurized dye penetration method. RESULTS AND CONCLUSION: No coronal microleakage was found in the negative control group, but serious coronal microleakage occurred in the positive control group involving the entire root canal. And there was no significant difference in the length of coronal microleakage between group A2 and B2, as wel as between group A1 and A2 (P > 0.05); but the length of coronal microleakage in the group A1 and B2 was significantly less than that in the group B1 (P < 0.05). These results show that the delayed post space preparation has overt effect on the coronal microleakage of root canal fil ed with AH-plus paste.

BACKGROUND: Apical sealing ability is the key to ensure the long-term curative effect of root canal therapy. The post space preparation exposes some inevitable influence on root canal sealing ability, so how to minimize this effect becomes a hot spot.OBJECTIVE: To explore the effects of immediate or delayed post space preparation on the apical sealing ability of different root canal sealers.METHODS: Forty-eight extracted human premolar teeth were obtained, and the tooth crown was cut off. The samples were randomly divided into three groups (n=16 teeth per group). Group A underwent the immediate post space preparation; group B underwent the delayed post space preparation; group C without the post space preparation. Then all groups were subdivided into two groups, and then were filled with the gutta-percha/AH-Plus (groups A1, B1 and C 1)or the gutta-percha/mineral trioxide aggregate (groups A2, B2 and C2). The depth of apical dye penetration was measured using pressure-driven system. RESULTS AND CONCLUSION: There were no significant differences in the apical microleakage between groups A1 and B1, A2 and B2, C1 and C2 (P > 0.05). The apical microleakage in the group A1 was significantly higher than that in the group A2, and the group B1 also showed higher apical microleakage than the group B2 (P < 0.05). Our findings suggest that either immediate or delayed post space preparation exposes little influence on the apical microleakage after root canal filling with gutta-percha/mineral trioxide aggregate, which exhibits better apical sealing ability than the AH-plus.

Objective To explore the short‐term effect of chronic periodontitis patients after implant treatment .Methods Selected 60 cases of tooth loss in chronic periodontitis patients as research group ,a total of 75 implants were placed ,and 50 cases of periodontal healthy teeth missing patients as control group ,a total of 67 implants were placed .Compared two groups of modification sulcus bleeding index(mBII) ,papilla index score(PIS) ,modification plaque index(mPLI) and probing depth(PD) 6 months after op‐eration ,and detected implant sulcular fluid IL‐2 ,IL‐8 content in two groups before and after operation .Results Research group 75 implants had 2 off on their own ,implant loosening degrees 0 ,implant survival rate was 97 .3% ;the control group had no implant failure ,implant loosening of implant survival rate was 100% ,two groups of implant survival rate was no significant difference(χ2 =2 .737 ,P= 0 .098) .The mSBI ,PIS ,mPLI ,PD in research group and control group had no statistically significant(P > 0 .05) .Re‐search group sulcular fluid IL‐2 ,IL‐8 content was significantly higher than those in control group before and after the operation (P< 0 .05) .Conclusion The short‐term effect of implant treatment in chronic periodontitis patients is satisfactory ,without increas‐ing the risk of peri‐implantitis ,and worth of clinical promotion .