Objective To investigate the clinical effect and safety of the application of contitunous renal replacement therapy (CRRT) in non-kidney severe patients in MICU.Methods Twenty-nine cases who underwent the CRRT in MICU were included in the study.Vessel pathway were all through inserting double channel catheter in femoral vein or internal carotid vein.According to the patient's condition,patients were treated by slow continuous ultrafiltration( CVVH )or continuous veno-venous hemodialysis (CVVHDF).The duration was 4-12 hours or continuation if necessary.The volume of blood flow was 100-180 ml/h.The displacement liquid was 30-50 ml/time.The volume of dehydration was 0-4 kg according to the patient's condition.The clinical symptoms,hemodynamics,blood biochemistry,PaO2/FiO2,pH,tumor necrosis factor and acute physiology and chronic health evaluation (APACHE) Ⅱ were observed before and after therapy.The complications were monitored.Results The vital signs of the patients became stable shortly after CRRT therapy,before CRRT temperature ( 37.6 ± 0.88 ) ℃,respiratory rate ( 110.3 ± 19.54)time/min,the oxygention index (262.6 ± 10.6),WBC ( 11.33 ± 2.27) × 109/L,NE (85.62 ± 7.83 ) %,AST ( 74.58 ± 19.34 ) U/L,APPACHE Ⅱ score ( 24.37 ± 9.23 ),after CRRT temperature ＞( 36.84 ± 0.58 ) ℃.respiratory rate ( 102.0 ± 16.2 ) times/min,the oxygention index ( 373.2 ± 11.2),WBC (9.62 ±3.26) × 109/L,NE (71.58 ± 10.54) %,AST(38.34 ± 13.96) U/L,APACHE Ⅱ score ( 14.65 ± 6.54).There were significantly difference between the indices at before and after treatment ( P ＜ 0.05 ).Serious ions and acid base abnormality were rectified during CRRT therapy without any severe complications.Conclusions CRRT therapy could decline the level of infections reaction and improve organs' function,adjust the balance of internal environment,stable hemodynamics without any severe complication after treatment.CRRT is safe and effective.In conclusion,CRRT is a primary treatment and an important supportive therapy.

Objective To compare the application values of different blood transfusion modes in placenta previa cesarean section.Methods The clinical data in 82 pregnant women with placenta previa undergoing cesarean section in our hospital from February 2013 to January 2016 were collected.The patients were divided into the autologous group (autologous blood stored blood transfusion,n=42) and allogeneic group (allogeneic blood transfusion,n=40) according to different blood transfusion modes.The changes of blood routine indexes such as hemoglobin (Hb),platelet count (PLT),hematocrit (Hct),white blood cell count (WBC) and red blood cell count (RBC) in the two groups before and after operation were recorded.Postpartum blood lossb amounts,autologous and allogeneic blood transfusion volume were compared between the two groups.The pregnant outcomes were observed,and the incidence rates of blood transfusion complications were statistically analyzed.Results (1)The accumulative blood loss volume and allogeneic blood transfusion volume in the autologous group were significantly lower than those in the allogeneic group (P<0.05);(2) PLT and WBC after operation in the two groups were significantly increased,while RBC,Hb and Hct were decreased.The levels of postoperative Hb,PLT and Hct in the autologous group were higher than those in the allogeneic group (P<0.05);(3) the neonatal Apgar scores at 1,5 min after birth,and umbilical artery blood pH value showed no statistically significant difference between the two groups (P>0.05);(4)The total incidence rate of complications in the autologous group was significantly lower than that in the allograft group (P<0.05).Conclusion Adopting autologous blood stored blood transfusion scheme during cesarean section in women with placenta previa has no negative effect on maternal and neonatal outcomes,meanwhile which can reduce the incidence of transfusion complications,is safe and feasible.

Objective To detect beta-human papilloma virus (HPV) and determine its genotype in actinic keratosis (AK) lesions.Methods Tissue specimens were collected from the lesions of 39 patients with AK and normal skin of 40 healthy controls.A nested PCR was performed to detect alpha-HPV and beta-HPV DNA in these specimens.The genotype of beta-HPV was determined in beta-HPV DNA-positive specimens by a common PCR using specific primers targeting 12 HPV genotypes,including HPV 5,8,15,17,19,20,21,23,36,38,49 and 80.Results The detection rate of beta-HPV DNA was 84.6％ (30/39) in the patients with AK,and 30.0％ (12/40) in the healthy controls (x2 =6.76,P ＜ 0.05),while no significant difference was observed in the detection rate of alpha-HPV DNA between the two groups (12.8％ vs.7.5％,x2 =0.91,P ＞ 0.05).HPV 38 was the predominant genotype of beta-HPV in these patients with a detection rate of 36％ (12/33),followed by HPV36.The prevalence of all the 12 genotypes of HPV was consistently low in the healthy controls.Mixed HPV infections were observed in 10 AK lesions,but in none of the healthy controls.No statistical difference was noted in the positivity rate of beta-HPV among patients at different ages,of different genders,with different occupations or clinical courses (x2 =0.53,0.94,0.81,0.73,respectively,all P ＞ 0.05).Conclusions Compared with healthy controls,the patients with AK showed a higher beta-HPV infection rate,with HPV38 as the predominant genotype.

OBJECTIVETo evaluate the influence of eugenol-containing and resin-containing endodontic sealers on the bond strength of fiber posts using different strategies of root canal irrigation.

METHODSForty-eight mandibular premolars were endodontically treated. The specimens were randomly assigned into two groups according to different endodontic sealers. Group A used Endofil (eugenol-containing endodontic sealer), and group B used AH-plus (resin-containing endodontic sealer). After post space preparation, each group was randomly assigned into three subgroups according to the strategies of root canal irrigation (eight premolars in each subgroup). Group Al and B1: 0.9%NaCl irrigation; Group A2 and B2: 17% ethylene diamine tetraacetic acid (EDTA)+5.25%NaClO+0.9%NaCl irrigation; Group A3 and B3: ultrasonic agitation associated with 1 7%EDTA+5.25%NaClO+0.9%NaCl. One week after the cementation of fiber posts using RelyX™ Unicem, a push-out test was performed to measure the bond strength of the posts. The microstructure of the root canal surface was examined under scanning electron microscope (SEM).

RESULTSThe bond strengths of the six groups were as follows: Al (7.96±2.23) MPa, A2 (9.95±2.89) MPa, A3 (18.88±3.69) MPa, B1 (11.41±3.71) MPa, B2 (14.00±4.04) MPa, and B3 (19.14±3.27) MPa. Statistical analysis revealed a significant interaction between the different endodontic sealers and the strategies of root canal irrigation (P<0.05). Lower bond strength was found in group Al but not in group BI (P<0.05), and the same result was revealed when comparing group A2 and B2. No significant difference was observed between group A3 and B3 (P>0.05). SEM showed that the root canal in group A3 and B3 achieved the cleanest surface with nearly all dentine tubules opened.

CONCLUSIONThe eugenol-containing endodontic sealer can impair the bond strength of fiber posts compared with the resin-containing sealer when the root canal is irrigated by 0.9% NaCl or 17%EDTA+5.25%NaClO+0.9%NaC. No difference was observed between the two sealers when using 17%EDTA+5.25% NaCIO+0.9%NaCl combined with ultrasonic irrigation.

Bicuspid ; Cementation ; Dental Bonding ; Dental Pulp Cavity ; Dental Stress Analysis ; Dentin ; Humans ; Post and Core Technique ; Root Canal Filling Materials ; Root Canal Irrigants ; Root Canal Therapy

OBJECTIVEThis study aimed to investigate the influence of coping material and porcelain firing on the marginal and internal fit of computer-aided design/computer-aided manufacturing (CAD/CAM) of zirconia ceramic implant- and titanium ceramic implant-supported crowns.

METHODSZirconia ceramic implant (group A, n = 8) and titanium metal ceramic implant-supported crowns (group B, n = 8) were produced from copings using the CAD/CAM system. The marginal and internal gaps of the copings and crowns were measured by using a light-body silicone replica technique combined with micro-computed tomography scanning to obtain a three-dimensional image. Marginal gap (MG), horizontal marginal discrepancy (HMD), and axial wall (AW) were measured. Statistical analyses were performed using SPSS 17.0.

RESULTSPrior to porcelain firing, the measurements for MG, HMD, and AW of copings in group A were significantly larger than those in group B (P < 0.05). After porcelain firing, the measurements for MG of crowns in group A were smaller than those in group B (P < 0.05), whereas HMD and AW showed no significant difference between the two groups (P > 0.05). Porcelain firing significantly reduced MG (P < 0.05) in group A but significantly increased MG, HMD, and AW in group B (P < 0.05) HMD and AW were not influenced by porcelain firing in group A (P > 0.05).

CONCLUSIONThe marginal fits of CAD/CAM zirconia ceramic implant-supported crowns were superior to those of CAD/CAM titanium ceramic-supported crowns. The fits of both the CAD/CAM zirconia ceramic implant- and titanium ceramic implant-supported crowns were obviously influenced by porcelain firing.

Ceramics ; Computer-Aided Design ; Crowns ; Dental Porcelain ; Dental Prosthesis Design ; Humans ; Titanium ; X-Ray Microtomography ; Zirconium

Objective To elucidate clinical pathological features of primary mediastinal B-cell lymphoma (PMBL) and its difference compared with diffuse large B-cell lymphoma,not otherwise specified (DLBCL,NOS).Methods The clinical histories and pathological datas of 24 PMBL cases and 31 cases of DLBCL,NOS as the control group were collected.Immunohistochemical staining and a follow-up study was conducted.Results The distribution of gender showed significant difference when the age of onset of PMBL patients was obviously younger with the medial age of 30 years old (P ＜ 0.001).All cases presented as a huge mass in mediastinal site with compression symptoms.PMBL was similar to DLBCL in the morphology of tumor cells but fibrosis of various degrees was common,more than 70.8 ％ (17/24) cases had the collagen bundles split.CD23 positive rate (40.0 ％,6/15) in PMBL was significantly higher than the control group (3.2 ％,1/31)(P =0.003).Conclusion PMBL frequently occurs in young female people,mostly happens in mediastinal site and adjacent area,but rarely has distant dissemination.PMBL has the characteristics of various degrees of collagen fiber hyperplasia,and CD23 positive could be used to differentiate PMBL from DLBCL,NOS.

OBJECTIVEThis study investigated the influence of different designs and porcelain/glaze firing on the marginal and internal fit of three kinds of computer aided design/computer aided manufacturing (CAD/CAM) zirconia ceramic implant-supported crowns.

METHODSThree groups of zirconia ceramic implant-supported crowns with different designs were produced from copings by using a Cercon CAD/CAM system (n = 8). The first two groups comprised double-layer crowns (zirconia coping + veneer) with regular (Group A) and full circumferential zirconia-collar marginal designs (Group B). The third group was composed of anatomic single-layer zirconia crowns without cores (Group C). Initially, the marginal and internal gaps of the copings and crowns were individually replicated by light-body silicon and then measured by micro-computed tomography scanning before and after porcelain/glaze firing. Five measurements were employed: vertical marginal gap (MG); horizontal marginal discrepancy (HMD); chamfer area (CA); axial wall (AW); and axial-occlusal transition area (AOT). Statistical analyses were performed by SPSS 17.0.

RESULTSHMD measurements in Group A were statistically higher than those in Groups B and C (P < 0.05), regardless of whether the values were obtained before or after porcelain/glaze firing. By contrast, the HIMD measurements in Groups B and C showed no significant difference (P > 0.05). Moreover, no differences were noted in MG, CA, AW, and AOT among the three groups (P > 0.05). All the measurements in the three groups showed no significant change after porcelain/glaze firing (P > 0.05), except for MG in Group A, which significantly decreased (P < 0.05).

CONCLUSIONThe marginal fits of the double-layer crowns with full circumferential zirconia-collar and the anatomic single-layer zirconia crowns were superior to that of the double-layer crowns with regular margins. The MG of the crowns with regular margins was obviously influenced by porcelain firing.

Computer-Aided Design ; Crowns ; Dental Porcelain ; Dental Prosthesis Design ; X-Ray Microtomography ; Zirconium

OBJECTIVETo evaluate the effect of different auxiliary resistance forms on the resistance and marginal fitness of complete crowns for short molar preparations.

METHODSA total of 70 Nissin resin teeth were prepared with 20° total occlusal convergence, 2.5 mm of occlusocervical height, and a shallow finish line on a milling machine. The milled preparations were then randomly assigned to 7 groups of 10. The first group was used as the control group. A total of 30 dies were modified by preparing interproximal grooves with angles of 0°, 6°, and 20° centered on the mesial and distal surfaces of the dies. The rest of the teeth were prepared with occlusal holes in the center of the occlusal surface milled with the same burs to form 0°, 6°, and 20° holes. Cobalt-chromium copings were fabricated for all specimens. The marginal gap of specific points on the axial surface was measured before and after cementation. The resistance of each specimen was evaluated by applying an external force at an angle of 45° to the long axis of the die by using a universal testing machine in a lingual to buccal direction. The maximum force applied before crown dislodgement was measured. Data were analyzed using the SAS 9.2 software.

RESULTSThe results showed that the 0° groove, 0° hole, and 6° hole were effective in improving the resistance of the complete crowns (P<0.05). The 0° groove, 6° groove, 0° hole, 6° hole, and 20° hole had significant difference with the control group in terms of marginal discrepancies (P<0.05).

CONCLUSIONAuxiliary resistance forms with less degree indicate greater resistance force but worse marginal fitness. In clinical practice, if the resistance of a preparation is enough, the auxiliary resistance forms should be avoided from being used.

Cementation ; Crowns ; Dental Prosthesis Design ; Dental Prosthesis Retention ; Humans ; Molar ; Tooth Crown

Objective To study the role of PI3K-Akt-GSK-3β signaling in the apoptosis of renal tubular cells after ischemia-reperfusion injury and the protective mechanism of recombinant human erythropoietin(rHuEPO). Methods The human kidney tubular epithelial cells(HK-2)were cultured in vitro in different conditions as control group with serum, ischemia-reperfusion(IR)group, LY294002 group with LY294002(AKT inhibitor)10 μmol/L 30 minutes before IR treatment, LiCl group with LiCl(GSK-33 inhibitor)20 μtmol/L 30 minutes before IR treatment, rHuKPO group with EPO 20 U/ml 30 minutes before IR treatment, rHuEPO + LY294002 group with EPO 20 U/ml and in the presence of LY294002(10 μmol/L)30 minutes before IR treatment, rHuEPO +LiCl group with EPO 20 U/ml and in the presence of LiCl(20 μmol/L)30 minutes before IR treatment. Akt, GSK-33 and caspase-3 activation were measured by Western blotting. The apoptotic ratio of HK-2 cells was measured by flow cytometry. Cell viability was detected by MTT. Results In comparison with the control group, the apoptotic ratio raised up to 15.20%±1.43%, the expression of Akt activity decreased, GSK-33 activity and caspase-3 activity markedly elevated in IR group(P<0.05). LY294002 group up-regulated the apoptotic ratio(18.20%±2.06%), decreased the expression of Akt activity, increased GSK-33 activity and caspase-3 activity, however, LiCl group down-regulated the apoptotic ratio(12.30%±0.85%), increased the expression of Akt activity, decreased GSK-33 activity and caspase-3 activity compared with IR group(P<0.05). rHuEPO group remarkably decreased the apoptotic ratio(11.10%±1.62%), increased the expression of Akt activity, decreased GSK-33 activity and caspase-3 activity compared with IR group(P<0.05). rHuEPO+LY294002 group elevated the apoptotic ratio(13.40%±1.94%), decreased the expression of Akt activity, increased GSK-33 activity and caspase-3 activity, meanwhile, rHuEPO +LiCl group down-regulated the apoptotic ratio(7.50%±1.31%), increased the expression of Akt activity, decreased GSK-33 activity and caspase-3 activity compared with rHuEPO group(P<0.05). Conclusions PI3K-Akt-GSK-3β signaling pathway is involved in HK-2 cells apoptosis induced by ischemia-reperfusion injury and rHuEPO may be used as a new therapy.

Objectives:To explore the prevalence and correlates of attempted suicide among Beijing psycho-logical aids hotline callers,in order to provide knowledge of hotline-based suicide prevention.Methods:From De-cember 2002 to December 2008,all the effective callers who consulted themselves'psychological problem,by Bei-jing psychological aids hotline were interviewed by professional hotline operators during the consulting calling.Data of whether callers attempted suicidal behavior in 2 weeks prior to the calling,gender and other 5 demographic char-acteristics of callers were collected via hotline interview.A questionnaire including depression screening scale,com-mon psychiatric symptoms such as delusion,hallucination,etc.,a history of substance abuse or dependence,a histo-ry of suicidal behavior,having had acute or chronic life events,and severity of hopeless was used during hotline in-terview.Logistic regression model was used.Results:In 22 415 interviewed callers,362 (1.6%)callers (233 fe-males)reported that they attempted suicidal behavior in 2 weeks prior to the calling.After adjusted for demographic characteristics,prior suicidal behavior 2 weeks before calling (OR=4.43,95%CI:3.37-5.83),hopelessness (OR=2.01,95%CI:1.52-2.67),substance abuse (OR=1.97,95%CI:1.48 -2.62),acute negative life events (OR=1.94,95%CI:1.49-2.52),and severe depressive symptoms (OR=1.45,95%CI:1.08-1.95)were associatedwith attempted suicide among hotline callers.Conclusion:The rates of attempted suicide among hotline callers are probably high.Suicide prevention in hotline would shed light on improving coping skills for life events and sub-stance abuse problems for hotline callers.