Objective To compare the influence of resin core on overall bending strength of fiber post-core restoration.Methods 60 mandibular first premolar extracted because of orthodontic treatment was selected.3M light -cured composite resin P60,medental dual-cured resin,pulpdent dual-cured resin combined with viva carbon fiber reinforced glass fiber post were applied.The changes of teeth in vitro were observed when strength was given on.Results The flexural strength of 3M light-cured composite resin was (80.182 ±9.512)N,Medental dual-cured resin was (87.805 ± 11.649) N,Pulpdent dual-cured resin was (85.458 ± 10.845) N.The flexural strength of 3 M light-cured composite resin was lower than that of medental dual-cured resin and pulpdent dual-cured resin (t =5.758,3.084,both P ＜ 0.05).There was no statistical differences of flexural strength between medental dual-cured resin and pulpdent dual-cured resin(t =0.718,P ＞ 0.05).There was large area of resin broken off after 3M light-cured composite resin core fracture.There was only fracture of medental dual-cured resin core and pulpdent dual-cured resin core.Conclusion The bending strength of dual-cured resin is better than that of highly filled light curing composite resin in large tooth hard tissue defect restoration with fiber post-core,and core broken off is rare.Dual-cured resin is better post-core materials.

Objective To describe the echocardiographic and clinical findings of patients with accessory mitral valve(AMV).Methods Four adult patients were diagnosed to have AMV by Doppler echocardiography.Results All the four patients had cardiac murmur but 2 were asymptomatic.Echocardiogram showed that two cases had isolated AMV with significant left ventricular outflow tract (LVOT)obstruction.Another patient was complicated by idiopathic hypertrophic subaortic stenosis and his systolic pressure gradient across the LVOT reduced to normal after taking negative inotropic drugs.The fourth patient was associated with complex congenital cardiac anomalies but without LVOT obstruction.Conclusions AMV may not be very rare as previously reported.An echocardiographic examination Can detect AMV and difierentiate it from other causes of LVOT obstruction.

Objective To explore the relationship between syndrome differentiation of diabetic retinopathy (DR) and pattern of visual evoked potential (P-VEP).Methods One hundred and eighty-six eyes from 104 cases of DR were allocated to three groups according to TCM syndrome:qi-yin deficiency (Group A),qi stagnation and blood stasis (Group B) and yin-yang deficiency (Group C).P-VEP induced by various space frequency (0.388?Hz,1.55?Hz) and pictures of various colors (black/white,red/magenta,blue/green) was observed in the three groups and compared with that in the normal control group (Group D).Results One hundred and three eyes in Group A mainly manifested as simple DR,47 eyes in Group B and 36 eyes in Group C mainly manifested as proliferative DR.The latency of P 100 was prolonged and the amplitude was decreassed in all groups of DR,but the latency of P 100 was much prolonged in Group B,the amplitude was much decreased in Group C and the changes were less in Group A.Conclusion P-VEP varies in different TCM syndrome types of DR,and determination of P-VEP under various stimulating conditions may serve as an index of syndrome differentiation of DR.

Objective To assess the radial systolic function of left ventricle(LV) in patients with dilated cardiomyopathy(DCM) by velocity vector imaging(VVI).Methods Sixteen patients with DCM and twenty control subjects were detected by VVI.VVI data were collected from the six basal segments and six mid segments in parastenal LV short axis views.The radial systolic velocity(V) ,strain(ε) ,strain rate(SR),the time to peak systolic velocity(PTV) and the time to maximum strain(PTε) were measured with special software.The differene of the earliest and the latest time to peak velocity(T-max) and the standard deviation of time to peak velocity(T-SD) of 12 segments were calculated.Results Compared to the controlled group,patients with DCM had significantly lower radial V,ε and SR (P ＜0.01) in all the 12 segments,significantly longer PTV and PTε (P ＜ 0.05) in most segments, and significantly larger T-max and T-SD (P ＜0.05).Conclusions VVI is useful to assess the abnormalities in LV radial movement in patients with DCM and could provide more information about regional cardiac function.

OBJECTIVE:To systematically review the efficacy and safety of gemcitabine combined with docetaxel in the treat-ment of non-small cell lung cancer(NSCLC),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,Elsevier,CJFD,Wangfang Database and VIP,randomized controlled trials(RCT)about the ef-ficacy and safety of gemcitabine combined with docetaxel(test group)versus the 3rd generation chemotherapeutic agents combined with cisplatin(control group)in the treatment of NSCLC were collected. Meta-analysis was performed by using Rev Man 5.3 soft-ware after quality evaluation by modified Jadad scale. RESULTS:Totally 9 RCTs were included,involving 1 986 patients. Results of Meta-analysis showed,there were no significant differences in the total effective rate [RR=0.93,95%CI(0.83,1.05),P=0.27], 1-year survival rate [RR=0.97,95%CI(0.87,1.09),P=0.64],the incidences of liver dysfunction [RR=0.35,95%CI(0.06,2.18), P=0.26] and leukopenia [RR=0.80,95%CI(0.57,1.10),P=0.17] and decreased rate of hemoglobin [RR=0.65,95%CI(0.25, 1.69),P=0.38] in 2 groups;the incidences of liver dysfunction [RR=0.09,95%CI(0.02,0.38),P=0.001] and neurotoxicity in test group were significantly lower than control group,while the incidence of lung injury [RR=8.71,95%CI(2.04,37.12),P=0.003] was significantly higher than control group,the differences were statistically significant. CONCLUSIONS:Gemcitabine com-bined with docetaxel shows similar efficacy to the 3rd generation chemotherapeutic agents combined with cisplatin in the treatment of NSCLC,less effect on renal function and nerve while high on pulmonary toxicity.

Objective: To evaluate the clinical result of atlantoaxial reduction and fixation guided by the intraoperative CT.Methods: Sixteen cases were retrospectively studied, including seven males and nine females, with the mean age of 49.9 years.Twelve cases were diagnosed as chronic atlantoaxial instability or dislocation, while four cases as acute odontoid fracture and dislocation.Among the sixteen cases, fourteen underwent atlantoaxial fusion, while two underwent temporary atlantoaxial fixation without fusion.The intraoperative CT was used in the setting of: 1.Evaluating the atlantoaxial reduction before the screw insertion;2.Guiding the C1 and C2 pedicle drilling (two cases using additional three-dimensional printing drilling template);3.Evaluating the position of the screws and reduction after the atlantoaxial fixation.In addition, three-dimensional drilling template combined with intraoperative CT was used in two cases.CT scanning frequency was calculated.To evaluate the accuracy rate of screw fixation under the intraoperative CT, 19 cases without the intraoperative CT were studied as the control group.Results: Averaged CT scanning frequency was 1.4 times (Once in eleven cases, twice in four and three times in one).Among the sixteen cases, mal-positioned C1 screws were found and revised in two cases.No spinal cord injury or vertebral artery injury occurred.The follow-up ranged from three to ten months, with the mean of 6.7 months.Fourteen cases achieved solid osseous fusion, and two with temporary fixation had odontoid fracture union.Anatomic reduction was achieved in all the cases.Eleven cases with preoperative myelopathy had postoperative improvement and their mean JOA scores improved from 12.1 to 14.4.To the last follow-up, no hardware complications were found including screw broken, rod broken or fixation loosening.All the screws of intraoperative CT group had good positions.For 19 cases of the control group, there were two cases of mal-positioned screws (10.5%).Conclusion: Advantages of atlantoaxial reduction and fixation guided by the intraoperative CT included: improving the accuracy of the atlantoaxial screws, exactly evaluating the reduction of the atlantoaxial joint, immediately discovering the mal-positioned screws and avoiding the revision surgery.A good clinical result was found in the preliminary study.

This article discussed the applications of body language in rehabilitation teaching from 3 aspects including the concept, thetype and the application methods of body language.

Objective To evaluate left ventricular wall motion changes after successful pereutaneous coronary artery intervention (PCI) in patients with acute myocardial infarction (MI) by velocity vector imaging (VVI). Methods Twenty patients with acute MI, 16 anterior MI and 4 inferior MI,were studied by VVI within 3 days before PCI, 1 week and 3 months after PCI. The VVI parameters included peak systolic myocardial velocity (Vsys), peak systolic strain (εsys), maximal strain (εmax), peak systolic strain rate ( SRsys), isovolumic relaxation strain rate(SRivr),segmental ejection fraction (sEF), time to peak of velocity (TPKvel),and time to peak of strain (TPKε). Results Compared with that before PCI,εsys, SRsys, sEF, PSI, SRivr/SRsys, and TPKε were improved one week after PCI,and were further significantly improved at 3 months follow-up. Conclusions The VVI parameters can be used to evaluate the effectiveness of PCI shortly after the procedure and during long-term follow-up.

Objective To investigate the curative effect of noninvasive mechanical ventilation (NMV) and its influence on plasma brain natriuretic peptide (BNP) and endothelin-1 (ET-1) in senile patients with cot pulmonale complicated with respiratory failure. Methods Eighty senile patients with cot pulmonale complicated with respiratory failure were randomly divided into treatment group (40 cases) and control group (40 cases). The treatment group was treated by NMV combined with routine therapy, and the control group was treated by only routine therapy including respiratory stimulant,lowering pulmonary artery pressure, cardiotonic agents, diuretics and nasal catheter oxygen inhalation. Blood pressure, heart rate (HR), respiratory rate (RR), blood gas analysis (pH, PaO2, PaCO2 ,SaO2) and clinical symptoms and signs were observed before and 72 hours after treatment. The plasma levels of BNP and ET-1 were also measured before and after treatment. Results Compared with the control group, the clinical symptoms and signs were significantly improved, SaO2 and PaO2 were significantly elevated, and PaCO2, HR and RR were significantly reduced in NMV group (t=2.23 ～ 3.92, P< 0.05 or P< 0.01). The plasma levels of BNP and ET-1 were significantly decreased after treatment in both groups,especially in the treatment group (t=2. 93,3. 56, P<0.01). The plasma levels of BNP and ET-1 had significantly negative correlation with PaO2 (r=-0.69,-0.61 ,P<0. 01) ,and positive correlation with PaCO2 (r= 0.51,0.42, P<0. 05). Conclusions NMV can improve hypoxemia and CO2 retention in senile patients with cot pulmonale complicated with respiratory failure,and may have some influences on neuroendocrine functions.

OBJECTIVE: To investigate the modulation of nitric oxide synthase (NOS) isoenzymes in skeletal muscle during 3 h ischemia/reperfusion (I/R, 3 h ischemia followed by 3 h reperfusion). METHODS: The extensor digitorum longuses (EDLs) from 20 adult rats were divided into 4 groups: the normal, the sham operation, the ischemia (3 h), and the ischemia/reperfusion group. One normal EDL from each rat was used as the non-operated control, and the opposite ones are distributed into the 3 remaining groups. All the samples were studied with Western blotting technique and immunohistochemistry staining. RESULTS: Three sizes of protein bands verified with the proteins of relative molecule to be of 155000, 140000 and 135000, were detected in the EDL homogenate by Western blotting, which were comparable with the positive controls for nNOS, eNOS and iNOS, respectively. Immunostaining demonstrated that nNOS was present in the muscle fiber, with a similar location of the muscle stria, eNOS was found apparently in microvascular endothelia, but not found in muscle fibers, and iNOS was found in the leukocytes around the muscle fiber and some endothelia cells. Immunostaining paralleled the Western blotting results. CONCLUSIONS: It suggests that the constitutive nNOS and eNOS protein can be regulated by I/R, and I/R results in a down regulation of nNOS and up-regulation of eNOS and iNOS in reperfused skeletal muscle. The fact that nNOS is present around stria suggests that nNOS may have a close relationship with muscle function. The localization of eNOS in endothelial cell indicates its role in regulating blood supply of the muscle. Based on these findings, it is possible that NO produced by distinct NOS may play a different role in I/R injury.