Root canal therapy is the most efficient way to treat pulptitis and periapical inflammation, which can clear infections of root canal systems, fill the root canal firmly, and avoid reinfection. However, the variations in root canal morphology and complexity of infection confer difficulty in thoroughly eliminating microorganisms and their by-products in the root canal system, especially in the root apex area (including the top one-third of the root canal and periapical tissue), which is described as the hardest area to clean during endodontic treatment. Infection is difficult to remove entirely because the apex area is hard to approach using dental instruments and because of the existence of special morphological structures, such as apical ramification, intercanal anastomoses, and lateral branch of root canal. This review gives a brief introduction of the characteristics and difficulties of apical infection and knowledge on how to control such infections, including root apex preparation, irrigation and disinfection, and root canal filling.
Dental Pulp Cavity ; Humans ; Infection Control ; Periapical Periodontitis ; Root Canal Filling Materials ; Root Canal Irrigants ; Root Canal Obturation ; Root Canal Preparation ; Root Canal Therapy

Objective To investigate the impact of alterations within the space of Disse micro- environment on the migration of hepatic stellate cells(HSC) during the process of liver fibrosis,and to ex plore the novel mechanism of liver fibrosis from the view of cell migration.Methods A modified in vitro Boyden chamber system to partially mimic in vivo microenvironment of Disse space of normal and liver fibrosis was employed.The effects of fibrogenetic growth factors on the migration of HSC in liver fibrosis were observed via cell migration and cell proliferation experiments.Results Enhanced platelet-derived growth factor(PDGF)-BB,transforming growth factor(TGF)-?1 and/or epithelial growth factor(EGF) in liver fibrosis resulted in an increase in migratory capacity of activated HSC.The enhanced migration of HSCs induced by PDGF-BB was partially associated with their increased proliferation,while,TGF-?1 or EGF-induced migration was proliferation independent.The elevation of basic fibroblast growth factor (bFGF) or vascular endothelial growth factor(VEGF)during liver fibrosis had no effect on the migration of HSCs.Conclusions The study provides valuable insights into the role of space of Disse microenvironment in regulating HSC migratory behavior.TGF-?1,PDGF-BB and EGF,which increased in liver fibrosis, could induce the migration of activated HSC.However,bFGF or VEGF has no such kind of effect,al- though they also increased during liver fibrosis.

Objective: To analyze the prescription dosage for discharged patients in our hospital and investigate the potential risks.Methods: A retrospective research method was adopted to statistically analyze 55 872 discharge instructions from July to September in 2015,and more attention was paid to the prescriptions with dosage over 4 weeks,expecially the ones with 26-week dosage, and the related influencing factors were studied as well.

Objective To investigate the clinical features ,diagnosis and treatment of cesarean scar pregnancy (CSP) .Methods We retrospectively analyzed the medical history ,clinical manifestation ,diagnoses ,treatments and outcomes of 42 patients with ec‐topic pregnancy in the cesarean scar .Results All cases got diagnosed by transvaginal ultrasound .The error rate of first diagnosis was 40 .4% (17/42) .There were 25 cases of conservative therapy ,in which 12 cases were resolved with laparoscopic surgery and 1 case resolved with open surgery ;in the first process 15 cases were carried out laparoscopic surger in which 1 case were converted to laparotomy ;abdominal surgery were underwented in 1 case and were cured .Only one case underwent abdominal total hysterectomy as of failure after uterine artery embolization .After initial conservative treatment 3 cases were hospitalized again and 2 cases under‐went reoperation .41 patients were successfully retained the uterus and normal menstrual cycle returned at two months after opera‐tion .Conclusion The early diagnosis for CSP mainly depended on ultrasound and the thickness of incision muscle layer is an impor‐tant basis for choice of treatment .Checking the thickness of incision muscle layer for CSP mainly depended on ultrasound ,and lapa‐roscopic surgery is an ideal method for diagnosis and treatment of CSP .

The microstructure of cationic cyclopeptide (TD-34) treated Caco-2 cell membrane was observed, and we discussed the relationship between membrane structure and insulin transmembrane permeability. Atomic force microscope (AFM) was used to observe living cell membrane in air condition and tapping mode. Results showed that the surface of Caco-2 cell membrane treated with TD-34 lost its smoothness and nearly doubled its roughness. Apparent permeability coefficients (P(app)) of insulin in Caco-2 cell monolayers increased 2.5 times. In conclusion, AFM can be used to observe microstructure of cationic cyclopeptide treated cell membrane and cationic cyclopeptide enhanced insulin delivery across Caco-2 cell membrane by increasing membrane fluidity.

This paper presents a new medical data visualiz ation method called multi-resolution blending rendering which has been deve lope d for visualizing the large medical volume data sets. Different from those multi -resolution rendering methods which simplify the structures by polygon mesh opt imization technique, the new method uses different resolution levels to represen t different parts of a structure at the same time. So, it can preserve the integ rality of the structure and emphasize the important part of the structure when simplifying the structure. The new method also takes advantage of the good qualit ies of the wavelet transform and constructs the multi-resolution blending model of the structureby orthogonal wavelet transform and transition operator. The experiment proves that our method can effectively simplify the model of the structure, enormously reduce the number of the triangle of the structure and speedup the structure rendering. It is especially suitable for interactive observations on a complex medical structure.

Objective:To investigate the expression of HIF-1?and its relationship with angiogenesis in osteosarcoma.Methods: Osteosarcoma MG-63 cells were cultured in vitro under hypoxia and mimic hypoxia conditions.Thirty paraffin-embedded osteosarcoma tissues and 20 fresh frozen osteosarcoma specimens were collected.The mRNA and protein expression of HIF-1?and VEGF were detected by RT-PCR,Western blotting,ELISA,and immunohistochemistry methods.The mean vessel density(MVD)were also calculated.Results:The mRNA level of HIF-1?had no change under hypoxia and minic hypoxia conditions,whereas the protein expression was increased dramaticaly.The mRNA and protein expression of VEGF was significantly increased under hypoxia and minic hypoxia conditions.The positive rate of HIF-1?mRNA(90%)and VEGF(100%)in 20 fresh frozen tissues were higher than those of the para-tumor tissues(P

Cholesteatoma, Middle Ear ; Humans ; Male ; Young Adult

OBJECTIVETo study the clinical effects of Fuzheng Huayu Gantang comprehensive therapeutic program (FHGP) on post-hepatitis B liver cirrhosis associated with glyco-metabolic abnormality (LCGA).

METHODSThe patients with LCGA enrolled in the randomized controlled clinical trial were assigned to 2 groups, the treated group (68 cases) and the control group (74 cases), they were treated respectively by FHGP and conventional TCM and Western medicine therapeutic program for 3 months. Indexes including fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2 h PG), fasting insulin (FINS) were detected, homeostasis model assessment insulin resistance (HOMA-IR) was calculated, and the score of syndrome was recorded before and after treatment. Then the effects on syndrome and glyco-metabolic abnormality were evaluated through statistical analysis.

RESULTSLevel of 2 h PG after treatment was lowered in both groups (P < 0.01), but significant difference was found in the pre-treatment to post-treatment decrement of FPG and HOMA-IR between the two groups (P < 0.05). The syndrome improving rate and the total effective rate on glyco-metabolic abnormality in the treated group were significantly better than those in the control group respectively (85.3% vs 64.9% , P < 0.01; 80.9% vs 62.2%, P < 0.05).

CONCLUSIONFHGP has the capability to improve the syndrome and glyco-metabolic abnormality of patients with LCGA.

Adolescent ; Adult ; Aged ; Blood Glucose ; metabolism ; Combined Modality Therapy ; Drug Therapy ; methods ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Insulin Resistance ; Liver Cirrhosis ; etiology ; metabolism ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Phytotherapy ; methods ; Treatment Outcome

Objective To investigate the expression and effect of secondary lymphoid tissue chemokine(SLC)in experimental ulcerative colitis(UC)in rats.Methods Thirty Spague-Dawley rats were divided into control group and UC group.SLC expression in colon tissues was detected by RT-PCR and immunohistochemistry,respectively.Results The transcriptional level of SLC in UC tissues was significantly higher than that in the control group(0.846?0.07 vs 0.312?0.12,P＜0.01).The positive expression of SLC was concentrated mainly on submucosa,and the positive rate of SLC protein expression in UC group significantly higher than that in control group(P＜0.01).Conclusion SLC overexpression could contribute to the pathological processes in UC rats,thus SLC may be an ideal ther- apeutic target for UC.