A maxillary first molar with 2 distinct palatal roots and an accessory canal was diagnosed by CBCT and microscope.An enamel protuberance at the cervical area was found.A properly usage of CBCT and microscope is helpful for the diagnosis and treatment of tooth with complex root canal system.

The bleeding in liver resection is an important factor influencing the operation risk and postoperative out comes.Hepatic vascular exclusion technique is an effective method to control the bleeding,which has been improved after being widely used in clinical practice.In this paper,the research progress on the clinical application of various kinds of hepatic vascular exclusion techniques was reviewed.

Objective To explore the relationship between the expression levels of excision repair cross complementation group 1(ERCC1), breast cancer susceptibility gene 1(BRCA1), thymidylate synthase (TS) mRNA and clinicopathological features, prognosis in advanced colorectal cancer, and the correlation between the expression levels of ERCC1 and BRCA1. Methods The expression levels of ERCC1, BRCA1 and TS mRNA of postoperative paraffin embedded tissue were tested by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) in 49 advanced colorectal cancer cases. The results were analyzed by χ2 test of the correlation between the expression levels and clinicopathological characteristics. Patients were followed up by clinic or telephone. The prognosis was analyzed by small sample Kaplan-Meier survival analysis and Log-rank time series analysis, and P<0.05 was statistically significant. Results The expression level of ERCC1 mRNA in patients with colorectal carcinoma had no obvious correlation with the clinical and pathological characteristics such as gender, age, tumor location, lymph node metastasis, distant metastasis, CEA and differentiation degree (P>0.05). The expression level of BRCA1 mRNA had no significant correlation with the above clinical and pathological features (P>0.05) except distant metastasis (P=0.030) and differentiation degree (P=0.002). The expression level of TS mRNA had no significant correlation with the above clinical and pathological features (P>0.05) except distant metastasis (P=0.003). The expression level of ERCC1 and BRCA1 mRNA obviously correlated (P=0.002). The 1 year overall survival rate was 95.92%(47/49);the 2 year overall survival rate was 83.67%(41/49);and the 3 year overall survival rate was 73.47%(36/49). Overall survival and progression-free survival time in ERCC1 mRNA low expression group (47.8, 41.0 months) was higher than that in ERCC1 mRNA low expression group (27.3, 20.0 months) respectively (P=0.001, P=0.001). Overall survival and progression-free survival time in BRCA1 mRNA low expression group (43.7, 42.7 months) was higher than that in BRCA1 mRNA high expression group (29.3, 25.1 months) respectively (P=0.009, 0.006). Overall survival time in TS mRNA low expression group (39.8 months) was higher than that in BRCA1 mRNA high expression group (25.2 months). Conclusions The expression level of ERCC1 mRNA is not correlated with its clinical and pathological characteristics, but with its biological characteristics. BRCA1 and TS levels are correlated with invasion and metastasis. Low levels of ERCC1 and BRCA1 expression have a better prognostic effect on platinum based first-line chemotherapy for advanced colorectal cancer, and they are correlated. Low level of TS also has longer disease-free survival. Three joint detection could be used as a prognostic factor for colorectal cancer chemotherapy.

OBJECTIVETo investigate the effect of Zige lyophilized powder for injection in improving the acute cerebral microcirculation disturbance in rats.

METHODWindow craniotomy was performed for rats after the drug administration for 14 days. The experimental microcirculation disturbance model was duplicated with high molecule dextran. After the drug administration, the micro-vein diameters of cerebral pla mater of various groups were observed and recorded under the biological microscope. The blood flow volume was monitored by laser Doppler flow-meter. HCT was measured by the electric resistance method. The hemorheological indexes were detected by the auto-hemorheological instrument.

RESULTZige lyophilized powder for injection (16.40, 32.70, 65.40 mg x kg(-1)) could significantly expand the micro-vein diameter of cerebral pla mater, improve the downward trend of the blood flow volume, and reduce the various hemorheological indexes.

CONCLUSIONZige lyophilized powder for injection shows the effect in improving the cerebral microcirculation.

Animals ; Brain ; blood supply ; drug effects ; Brain Ischemia ; drug therapy ; physiopathology ; Cerebrovascular Circulation ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Powders ; administration & dosage ; Rats ; Rats, Sprague-Dawley

Objective To design and express a novel peptide based on ricin toxin antibody in E. coli, and to evaluate its biological activity. Methods Based on the crystal structure of ricin toxin A chain (RTA) and the RTA-rRNA interact in the complex model, the steric conformation of RTA was theoretical modeled and its functional domain was preliminarily determined. The humanized single-domain RTA antibody was designed rationally by computer-guidod molecular design method. Its coding sequence was ob- tained by overlapping extension PCR, and cloned into the pET-32a vector. The fusion protein was then ex-pressed in E. coli BL21 (DE3), identified by Western blot, and purified with Ni-NTA agarose. The binding and neutralizing activity of this novel peptide for riein was evaluated by competitive ELlSA assay and MTT assay. Results A recombinant human single-domain antibody expressing a polypeptide against RTA in the CDR3 loop was designed. The fusion protein was successfully expressed in E. coll. The purified protein can bind to ricin, and neutralize its activity in SP2/0 viability assay. Conclusion The success of the novel pep-tide based on riein toxin antibody provides a novel method to develop new generation of ricin antagonists.

Objective:This study aims to evaluate the clinical effect and adverse reactions of oxaliplatin or irinotecan plus capecitabine treatment for colorectal liver metastases. Methods:Data from 125 cases of colorectal liver metastasis patients were continuously enrolled and randomized into two groups, i.e., 63 in group one (treatment group) and the other 62 in group two (the control group). Capecitabine was administered at 1 000 mg/m2 doses, twice a day from d1 to d14, to all patients. Irinotecan was administered at 150 mg/m2 in d1 to group one, and oxaliplatin was administered at 130 mg/m2 in d1 to group two. The drug administration cycle lasted for 21 days in both regimens, with at least 6 administration cycles. The total course was for 6 months at most. The therapeutic efficacy, median progression-free survival time, median survival time, short-term clinical effect, and adverse drug reaction were monthly determined. Results:The overall response rates and disease control rates were 33.3%and 66.7%in group one, respectively, and 35.5%and 70.9%in group two, respectively, with no significant differences between the groups (P>0.05). The median survival time and median progression-free survival time were 14 months and 5 months in group one, respectively, and 12 months and 5 months in group two, with no significant differences between the two groups (P>0.05). The level-Ⅲand-Ⅳadverse drug reactions mainly include hematological toxicity, gastrointestinal reactions, and hand-foot syndrome. The diarrhea frequency is obviously higher in group one than in group two, and the difference between the two groups is sta-tistically significant (P<0.05). No significant differences were observed in the other adverse reactions between the groups (P>0.05). Conclusion:The Oxaliplatin or Irinotecan plus Capecitabine treatment is effective for colorectal liver metastases, which enhances survival rate and reduces patient suffering because of it has less side effects and good tolerance. The treatment must be further generalized and clinically applied.

Objective To investigate the clinical features and treatments of pituitary abscess.Method The clinical data of 6 patients with pituitary abscess were examed along with a review of the literature.Results Of 6 patients,headache was presented in 5 patients,hypopituitarism in 4 patients,visual disturbance and/or bitemporal hemianopsia in 4 patients and fever in 1 patient.MRI and CT images showed a cystic sellar lesion with ring enhancement in 5 patients.Preoperative diagnosis of pituitary abscess was made in 2 patients,pituitary adenomas in 3 patients and craniopharyngiomas in 1 patient.All cases were treated surgically by transsphenoidal approach in 5 patients and transscranial in 1 patient.Followed with postoperative antibiotics therapy for 3 weeks,the symptoms were improved postoperatively in all cases.Followed up 8 months to 10 years,1 patient who underwent craniotomy recurred and wag cured by via transsphenoidal surgery.Conclusions The pituitary abscess is easily misdiagnosed.The cystic pituitary lesion should be considered the possibility of pituitary abscess.Transsphenoidal surgery and proper perioperative antibiotics therapy are the keys to the treatment of pituitary abscess.

BACKGROUND:Exosomes are membrane vesicles secreted by mesenchymal stem cells. Increasing studies have shown that mesenchymal stem cells can secrete exosomes via paracrine function to play a role in tissue injury. However, reports on how to isolate and identify exosomes derived from human umbilical cord blood mesenchymal stem cells are few. OBJECTIVE:To extract, purify and identify exosomes derived from human umbilical cord blood mesenchymal stem cells. METHODS:The cellculture supernatant of human umbilical cord blood mesenchymal stem cells was col ected. Exosome was extracted and purified with ultrafiltration and gradient centrifugation methods. The morphology of exosome was observed by transmission electronic microscope, and the expressions of CD63, CD81, CD90, CD73, CD105, CD29, and CD166 in exosome of mesenchymal stem cells were analyzed by fluorescent activated cellsorting. RESULTS AND CONCLUSION:Mesenchymal stem cells from human umbilical cord blood secreted exosome which exhibited el iptic or saucer-like shape and its diameter ranged from 40 to 100 nm with membrane structure. Exosome could express the common surface adhesion molecules CD63, CD81 and the surface adhesion molecules CD90, CD73, CD105, CD29, CD166 of mesenchymal stem cells. These findings indicate that exosome may be secreted by mesenchymal stem cells of human umbilical cord blood, which contains plasma membrane proteins of umbilical cord blood mesenchymal stem cells.

Objective To explore the regulation of ROS level and ROS-triggered downstream events on SK-N-MC Ewing sarcoma cells upon apoptasis induction by 2-Methoxyestradiol (2-ME). Methods To detect the reversibility of apoptosis and the alternation of activity of respiratory chain, mitechondria transmembrane potential (△ψm), and cellular ROS level and to explore their association with flow cytometry, clark oxygen electronic node analysis, drug-removal design, and permeability transition (PT) pore stablizing agent. Results SK-N-MC cells were induced to ROS-dependent apoptosis. Apoptosis occured irreversibly after2-ME treatment for 3 h. Upon 2-ME treatment, the activity of respiratory chain was inhibited and the ROS generation was accelerated; the △ψm underwent the increasing within 3h but decreasing after 3h which could be reversed by PT pore stablizing; the ROS level underwent the continuous increasing and PT pore stablizing had no obvious effect on it. Conclusion 2-ME causes the acceleration of ROS generation via inhibiting the activity of respiratory chain and elevating the level of △ψm. ROS plays a signaling role and when total ROS accumulate to a threshold, the PT pore opening and the collapse of △ψm could be induced irreversibly and cell is eventually introduced to death.

Objective T o observe cardiac ultrastructure and the expression of heat shock protein 70 (H SP70) and hypoxia inducible factor-1α (H IF-1α) in electric shock death rats and to explore the application of these indexes as the basis of m edical identification in electric shock death. Methods Seventy-tw o SD rats w ere random ly divided into electric shock death group, postm ortem electric shock group and the control group. T he changes of m yocardial ultrastructure w ere observed by transm ission electron m icro-scope, and the expressions of m yocardial H SP70 and H IF-1α w ere observed by im m unohistochem ical technology. Results M yocardial m yofibril fracture, m itochondrial cristae and m em brane dissolution, and disordered arrangem ent of Z lines and M lines w ere observed in electric shock rats. H SP70 and H IF-1αw ere strong positive expressions in the electric shock death group, significantly com pared w ith the con-trol and postm ortem electric shock groups (P<0.05). Conclusion T he expressions of H SP70 and H IF-1αw ere obviously increased in electric shock death group, w hich m ay be used as the diagnostic indicator of electric shock death.