Objective The clinical effect of Allitride as disinfectant in infective root canal of deciduous teeth was studied. Methods 40 teeth were put into the cotton thist with Allitride juice in root canals,sealed by zno for a week. FC CP were used in the contrast groups with consist of 38 teeth. Results The effect of 24 teeth in the Allitride group were excellent, 13 teeth were benign, The efficiency was 92 percent. In CP group, 8 teeth were excellent, 5 teeth were benign, The efficiency was 72 percent. 11 excellent effect and 7 benign effect were in FC group. The efficiency was 90 percent. There are significant difference between Allitrade group and GP group(P0.05). The Allitride effect have not significant relation with age, tooth position.Conclusions Allitride is a good disinfectant adapt to infective root canal of deciduous teeth.

Objective To evaluate reoperations for benign bile duct strictures after a prewousRoux-en-Y hepaticojejunostomy.Methods Clinical date of 28 patients with previous reconstruction of Roux-en-Y hepaticojejunostomy for benign bile duct strictures were retrospectively analyzed.For data staftstical analysis t-test and stepwise logistic regression analysis were used.Results Reoperative surgery was performed for residual biliary stones with bile duct stricture in 10 cases(35.7%),simple anastomotic stricture of hepaticojejunostomy in 11 cases(39.3%),remained biliary stricture after initial rear in 6 cases (21.4%).anastomotic leakage with duodenal leakage in one case(3.6%).Mode of reoperation:18 cases (64.3%)underwent hepatic lobectomy with Roux-en-Y hepaticojejunostomy,liver splitting approach to Roux-en-Y hepaticojejunostomy in 5 cases(17.9%),right hemihepatectomy in one case(3.6%),resection of anastomotic stenosis involved segment and Roux-en-Y hepaticojejunostomy in one case(3.6%),abdominal drainage and duodenum fistulization and jejunum ostomy in one case(3.6%),choledocholithotomy with T-tube drainage in 2 cases(7.1%);Thirteen patients(46.4%)developed postoperative complications.Conclusion Biliary tract stenosis remains the main cause for reoperation in patients undergoing a faeled reconstruction.Wide and patent biliary tract drainage and reconstruction somenmes necessitate a hepatic lobectomy.

OBJECTIVETo observe the long-term efficacy and safety of telbivudine (LdT) for pregnant women with chronic hepatitis B (CHB) and their children born from the treatment period.

METHODSA total of 118 pregnant women with CHB were enrolled in the study and provided informed consent for participation. The women opted for participation in the treatment group (7 =73; LdT 600 mg once daily, starting in early pregnancy and continued until after delivery) or in the control group (n =45; no LdT treatment). All newborns were given active and passive immunization upon birth and tested for serum hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), anti-hepatitis B core antibody (anti-HBc), anti-hepatitis B surface antibody (anti-HBs) and HBV DNA at 0, 1, 7 and 12 months of age. The Paediatrics Neuropsychological Development Scale for Children aged 0 - 6 (5 items) established by the Capital Institute was used to test the children; in addition, the children were evaluated by observation for action ability (fine and gross motor skills), adaptability, language ability and social behaviour. Total IQ was estimated as a developmental quotient (DQ) by using the equation: points from the 5 scale items actual age in months * 100.

RESULTSThe LdT group included 69 women with successful pregnancies, 1 case of miscarriage and 3 cases that were lost to follow-up. The control group included 34 women with successful pregnancies, 4 cases of miscarriage, 1 case with fatal outcome, and 6 cases of no pregnancy. Compared to the control group, the LdT group had a significantly higher successful pregnancy rate (x² =4.86 in the LdT group, P < 0.05). In addition, the LdT group had a significantly higher rate of term delivery (53 cases vs. 34 cases, x² = 6.38, P < 0.05). The neonates born to the women in the LdT group included 53 cases of weakly-negative HBsAg at birth and 1 case at 1 month old, as well as negativity for HBV DNA, and HBsAg remaining weakly positive at 6 months old; the intrauterine infection rate was 1.8% and no case of deformity occurred.Among the 34 neonates in the control group, 6 showed HBsAg positivity at 1 month old, and the HBsAg positivity remained for all 6 at 6 months old; the intrauterine infection rate was 16.6%, which was significantly higher than that of the LdT group (x² = 5.10, P < 0.05). The neonates in the LdT group had a significantly higher anti-HBs production rate at 1 year old than those in the control group (98.1% (52/53 vs. 82.4% (28/34). X² = 4.87, P < 0.05). The neonates in the LdT group showed normal growth and development for all 53 cases of young children, and IQ levels of excellent for 3 cases, smart for 8 cases, normal for 40 cases, and low for 2 cases. The neonates in the control group showed normal growth and development for all 34 cases of young children, and IQ levels of excellent for 2 cases, smart for 4 cases, normal for 27 cases, and low for 1 case.

CONCLUSIONChildbearing chronic HBV patients treated with LdT had higher rates of successful pregnancy, blocking of intrauterine infection and anti-HBs reduction compared to their untreated counterparts. The children bom to LdT-treated women showed no difference in long-term growth and development and total IQ from the children born to the untreated women with chronic HBV.

Adolescent ; Adult ; Antiviral Agents ; adverse effects ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Infant ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; prevention & control ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; Thymidine ; adverse effects ; analogs & derivatives ; therapeutic use ; Young Adult

ObjectiveTo demonstrate the efficacy and safety of Hangzhou tacrolimus capsule (Saishi Tac capsule,Hangzhou Zbongmei Huadong Pharmaceutical Co.Ltd,China) in Chinese liver transplant recipients.MethodsMulticenter,randomized open-labeled,prospective controlled clinical trial was performed in de novo Chinese liver transplant recipients.According to inclusive and exclusive criterion,83 liver recipients from 11transplant centers were enrolled.The recipients accepted Saishi Tac capsule,mycopheolate and steroid 48 h post-operation.The initial dose of Tac was 0.1-0.15 mg kg-1day-1and C0 was 8-12 ng/ml in the first 60 days,followed by 5-10 ng/ml until the terminal observation time poiut (12 weeks after transplantation).The efficacy and safety were estimated during the period.The primary efficacy endpoint of the study was the incidence of biopsy-confirmed acute rejection.Graft survival was the secondary endpoint.Safety was assessed by monitoring laboratory parameters and adverse events reported over the course of the study,such as infection,renal damage,hypertension,hyperlipema and diabetes mellitus and other adverse affairs.ResultsThe dose of Tac at 1st,2nd,4th and 8th week post-operation was (4.1±1.9),(4.5±2.1),(4.5±2.1),(4.4±1.8) and (4.1±2.1) mg,and correspondjng values to the C0 were (8.1±4.5),(8.9±4.5),(8.8±4.3),(8.8±4.1) and (8.0±2.8) ng/ml.During 12 weeks of follow-up,the incidence of biopsy-confirmed acute rejection was 4.8％ (4/83),and all of cases were reversed by implosive therapy.The survival rate of graft hver was 100％.The incidence of lung infection and diabetes mellitus was both 6.02％.ConclusionSaishi Tac capsule was safe and effective to Chinese liver transplant recipients.

Objective To explore the clinical significance and operational methods during extended radical excision for pancreatic cancer combined with portal vein ( PV )/superior mesentery vein ( SMV ) resection,and to investigate the management of iatrogenic arterial injury. Methods Clinical date of 242 patients with pancreatic cancer undergoing extended radical excision were retrospectively analyzed. All cases were divided into three groups, patients with PV/SMV resection were in group A (n = 51 ), patients with iatrogenic arterial injury during operation were in group B(n =5) ,patients without resection of vessels werein group C (n = 186 ). Operating time、volume of intraoperative blood transfusion, time of vascular interruption、the mean hospitalization,postoperative complications and postoperative survival analysis among three groups were compared with each other. Results Operating time in group A、B and C were (442. 85 ± 102. 32 ) min, ( 348. 62 ± 92. 31 ) min and ( 315.00 ± 83.43 ) min respectively, volume of intraoperative blood transfusion were ( 1430. 83 ± 1092. 43 ) ml、( 1420. 22 ± 794. 41 ) ml and ( 928. 19 ±571.57) ml respectively,operating time and volume of intraoperative blood transfusion were of significantly difference(P <0. 05) among the 3 groups,there was no significant difference in the mean hospitalization and postoperative complications. The postoperative median survival period was 18.4 months for patients of pancreatic adenocarcinoma with PV/SMV resection, the postoperative median survival period was 16. 1 months without PV/SMV resection, there was no significant difference between these by postoperative survival analysis. In the 51 cases with vessel resection,7 cases underwent partial resection of the vascular wall,44 cases underwent segmental resection, reconstruction of the portal vein was performed by end-to-end anastomosis in 38 patients, stent graft in 6 cases, the mean length of the PV/SMV resection was (2. 92 ±1.35 ) cm; latrngenic arterial injury occurred during operation in 5 patients ( 1 in hepatic artery, 1 in superior mesenteric artery, 3 in celiac think), the artery was reconstructed by end-to-end anastomosis in 4 cases,repair in 1 case. Conclusions Active and reasonable operation for pancreatic cancer with PV/SMV resection is important for improving the rate of surgical resection and the quality of life. Because of complex topography,iatrogenic vascular injury may happened frequently.

Objective:To investigate the effects of metformin on the survival of patients with advanced non-small cell lung cancer (NSCLC).Methods:PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and other databases were searched from the beginning of database construction to February 2020, relevant literatures were screened and included, and the characteristics of the literatures were extracted. RevMan 5.3 software was used to analyze progression-free survival (PFS), overall survival (OS), hazard ratio(HR) and 95% CI; the heterogeneity and publication bias were also evaluated. Results:A total of 11 studies were enrolled, and metformin did not improve PFS in patients with advanced NSCLC ( HR = 0.80, 95% CI 0.58-1.09, P = 0.15). The subgroup analysis results of different treatment strategies showed that metformin combined with tyrosine kinase inhibitor (TKI) ( HR = 0.71, 95% CI 0.32-1.57, P = 0.39), chemoradiotherapy ( HR = 0.97, 95% CI 0.59-1.61, P = 0.92), and immune checkpoint inhibitor (ICI) ( HR = 0.64, 95% CI 0.35-1.16, P = 0.14) did not improve the PFS. Metformin improved OS in patients with advanced NSCLC ( HR = 0.84, 95% CI 0.75-0.93, P = 0.001). Metformin combined with TKI ( HR = 0.68, 95% CI 0.38- 1.22, P = 0.19) and ICI ( HR =0.80, 95% CI 0.39-1.63, P = 0.54) did not improve OS of patients, while metformin combined with chemoradiotherapy could improve OS ( HR = 0.85, 95% CI 0.78-0.93, P < 0.01). No evidence of publication bias was shown in the funnel plot analysis. Conclusions:Metformin can prolong OS time in patients with advanced NSCLC, especially in patients undergoing metformin combined with radiotherapy and chemotherapy, or concurrent chemoradiotherapy.

Objective To discuss the influence of exogenous Gibberellin (GA3) and abscisic acid (ABA) on genetic expressions of key enzymes in ethylene synthesis in Taizishen (Pseudostillaria Root, Radix Pseudostellariae) , and provide reference for intelligent use of growth regulators during cultivation of Taizishen.Methods The genes of key enzymes in ethylene synthesis of Taizishen were screened and identified from transcriptome database by using local Blast method.Hai'ershen in full-bloom stage was treated with exogenous GA3 and ABA, and samples were collected at different time points (20 d, 40 d, 50 d and 60 d.The genetic expressions of key enzymes in ethylene synthesis of Taizishen were detected by using real-time fluorescence polymerase chain reaction (RT-PCR).Results There were totally 6 genes of key enzymes in ethylene synthesis in roots of Taizishen obtained, and they were named PhACO1, PhACO2, PhACO3, PhACS1, PhACS2 and PhSAMS.GA3 and ABA could regulated the expressions of above 6 genes, and expressions of PhACO1, PhACO2, PhACS1 and PhSAMS were up-regulated after treated with GA3, and expressions of PhACO3 and PhACS2 were up-regulated after 20 d to 40 d and down-regulated after 50 d to 60 d.The expressions of genes of key enzymes in ethylene synthesis in Taizishen showed down-regulation at first and then up-regulation after treated with ABA, but different genes had different demonstrations.The expression of PhACO1 was up-regulated after 20 d to 60 d, and down-regulated after 40 d to 50 d.The expressions of PhACO2 and PhACO3 were down-regulated after 20 d to 50 d, and up-regulated after 60 d.The expression of PhACS1 was down-regulated after 20, up-regulated after 40 d to 60 d.The expressions of PhACS2 and PhSAMS were down-regulated.Conclusion GA3 and ABA may control the ethylene signaling pathway to regulate plant growth through affecting the ethylene biosynthesis of Taizishen.It is speculated that Taizishen is treated with suitable concentration of GA3 in adventitious root growth period and treated with ABA treatment in root thickening period, the yield of Taizishen will be increased.

Objective:To analyze the causes of puncture wound infections induced by the high pressure resistant injectable PICC catheter in patients undergoing hematopoietic stem cell transplantation and management measures.Methods:linical data of 75 patients undergoing hematopoietic stem cell transplantation who were treated with the high pressure resistant injectable PICC catheter in our hospital from Nov.2017 to Nov.2019 were retrospectively analyzed.According to whether there were puncture wound infections, patients were divided into the infection group(n=26)and the non-infection group(n=49). Bacterial culture results of the infection group were recorded, and the related factors for puncture wound infections caused by the injectable PICC catheter were analyzed.Effective strategies to prevent high-risk factors, treatment frequency, treatment effect and healing time for patients with different degrees of puncture wound infections were discussed.Results:There were 26 patients in the infection group.The proportions of bacteria types associated with PICC catheter-related infections, in descending order, were as follows: Staphylococcus aureus(46.51%), Klebsiella pneumoniae(30.77%), Corynebacterium(15.38%)and others(7.69%). Significant differences were found in materials used, season of tube placement, timing of dressing changes, duration of catheterization, success rate of first tube placement and condition of dressing films between the non-infection and infection groups( t=5.5, 4.9, 5.0, 13.6, 9.4 and 6.2, all P<0.05). Logistic multi-factor analysis showed that non-U-shaped fixation, delay in dressing changes, long duration of tube placement, low success rate of first tube placement, and loose dressing films were the high-risk factors for PICC catheter-related infections( OR=2.78, 2.42, 3.16, 2.66 and 2.32, all P<0.05). Compared with patients with moderate and mild infections, patients with severe infections had a higher frequency of treatment, a lower total effectiveness rate and a longer healing time( F=10.353, 8.775 and 12.341, all P<0.05). Conclusions:Materials, timing of dressing changes, catheterization time, success rate of first tube placement and condition of dressing films are the high-risk factors for puncture wound infections caused by high pressure resistant injectable PICC catheters in patients undergoing hematopoietic stem cell transplantation.Developing effective intervention strategies can help control the incidence of wound infections.

Objective: To investigate the clinicopathological characteristics and diagnosis of ovarian Brenner tumors. Methods: Forty-seven cases of ovarian Brenner tumors were enrolled from January 2012 to May 2018 at Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Clinical data, imaging examination, histopathological characteristics and immunohistochemical phenotype were analyzed. Results: The age of the patients ranged from 30-73 years and the mean age was 55 years. Thirty-nine patients (83.0%) were postmenopausal. Forty cases (85.1%) of the Brenner tumors were benign, five (10.6%) borderline and two (4.3%) malignant. Usual tumor markers of ovarian carcinoma, including CA199 and CA125 were normal or mild elevated in the 47 cases. Imaging before surgery was not specific to Brenner tumors. Microscopically, benign Brenner tumors were composed of nests of bland, transitional-type cells within a fibromatous stroma. In our 5 cases of borderline Brenner tumors, mildly atypical transitional-type cells were projected into the cyst lumens and lack of stromal invasion. In 2 cases of malignant Brenner tumors, different degrees of nuclear atypial transitional-type cells exhibited stromal invasion. Immunohistochemical stains for CK7, GATA3, p63 and CK5/6 were positive in all cases. Ki-67 was less than 5% in Brenner tumors, and up to 20%-30% in malignant Brenner tumors. Conclusion Brenner tumors are mostly seen in postmenopausal patients and are usually benign. Imaging examination and usual ovarian tumor markers do not provide diagnostic value. Diagnosis and classification of Brenner tumors depend on histopathological evaluation.

Objective: To investigate the value of short tandem repeat (STR) genotyping in the diagnostic workup of molar and non-molar gestations with correlation of histological characteristics. Methods: Six hundred and fifty-six cases were selected based on clinically suspected hydropic abortion and/or molar pregnancy from July 2015 to September 2017 at Beijing Obstetrics and Gynecology Hospital. DNA was extracted from dissected chorionic villi and paired maternal endometrial FFPE tissue samples by Simplex OUP™ FFPE DNA Tissue Kit. STR genotyping was performed by PowerPlex 16 HS system. Results: DNA genotyping was informative in 649 of 656 cases, leading to identification of 215 hydatidiform mole gestations and 434 non-molar gestations. Most of non-molar gestations (375 cases, 86.4%) were diploid hydropic abortion. Various trisomy syndromes were found (53 cases, 12.2%), including trisomy 2, 3, 4, 7, 8, 13, 16 and 21. Only 2(0.5%) digynic triploid gestations were detected. Moreover, 4 cases (0.9%) of uniparental disomies (homologous or heterologous) were found. There were 196 cases with histologic diagnostic suspicious of hydatidiform moles were accurate sub-classified. Among them, 59 cases hydatidiform moles were under-diagnosed as diploid hydropic abortions, and 28 cases diploid hydropic abortions were over-diagnosed as hydatidiform moles.Compared with partial moles(PHM), there were no specific histomorphological features between the various types of non-molar gestations and partial moles for definitive diagnostic separation. There was no significant difference in the expression of p57^kip2 among PHM, trisomy and diploid hydropic abortions group (P=0.247). Conclusions STR genotyping can distinguish non-molar gestations from early hydatidiform moles, and efficiently avoid misdiagnosis based only on histological evaluation. Therefore, using STR genotyping, not only can the overdiagnosis of non-molar pregnancy be avoided, but also individualized management can be offered to patients including monitoring of serum hCG.