Objective:To detect the effects of porcelain-fused-to-metal(PFM)crown on the periodontal tissue of the restored teeth,and the relationship between the levels of intedeukin(IL)-1β,aspartate transaminase(AST)and alkaline phosphatase(ALP)in gingival crevicular fluid(GCF)and the health condition of periodontal tissue.Methods:Among 28 patients,34 maxillary incisors with PFM crowns were selected for the study.There were 19 Ni-Cr PFM crowns and 15 Au-Pt PFM crowns.The contralateral homonymy natural teeth were healthy and treated as control teeth.The patients were followed up 6 to 8 months after restoring crowns.The values of IL-1β,AST and ALP in GCF were analysed.Results:The concentrations of IL1β and ALP were significantly higher in GCF of Ni-Cr PFM compared with those of control,whereas no significant difference in Au-Pt PFM group compared with that of control.The level of GCF-AST was higher in Ni-Cr PFM and Au-Pt PFM group than that of healthy control.Conclusion:Ni-Cr PFM crowns have negative influence on periodontal tissue,but Au-Pt PFM have little influence on periodontal tissue of the restored teeth.The activity of IL-1β,AST and ALP of GCF are sensitive to reflect the effect of PFM crowns of different materials on periodontal tissue.

Nrf2/Keap1/ARE is an important signaling pathway in maintaining the balance between peroxide and antioxidants. Once oxidative stress happened, Nrf2/Keap1/ARE would be ac-tivated to regulate the expression of downstream antioxidant pro-teins that could reduce the injury from oxidative stress and the level of oxidative stress. Recent researches show that Nrf2/Keap1/ARE signaling pathway is closely related to refractory re-spiratory diseases such as pulmonary fibrosis (PF), lung canc-er, chronic obstructive pulmonary disease (COPD), suggesting that Nrf2/Keap1/ARE signaling pathway may be a potential ther-apeutic target. This review focuses on the role of Nrf2/Keap1/ARE signaling pathway in refractory respiratory diseases in order to further understand the related mechanism and provide evidence for the diagnosis and treatment of refractory respiratory diseases.

Objective To evaluate the effect of percutaneous device closure guided by transesophageal echo-cardiography (TEE)on atrial septal defect(ASD)via right internal jugular vein(RIJV)in children.Methods A total of 8 cases with secundum ASD were recruited as candidates to receive percutaneous device closure via RIJV between July 22 and November 5,201 5 in Heart Center,Dalian Children′s Hospital.In this group,5 boys and 3 girls who were 5 months to 1 0 years old were included.The youngest patient was a 30 weeks premature infant of 5 months old,with 3 -month correction gestational age.All patients were clearly diagnosed as ASD by transthoracic echocardiography(TTE) before operation.Five patients had single central type ASD which were 5 -8 mm in diameter,and 3 patients had multi-ple(1 biforate and 2 cribriform)ASD which were 1 0 -1 2 mm in shunt range.New type Fustar curve adjustable sheath was delivered after RIJV accessed.By passing through the ASD by adjusting the depth and bending of the tips of sheath,then the device was delivered and released to close the ASD.The procedures were always guided and monitored by TEE.After the devices were released,the position of device,residual shunt,and the effect of valves were assessed by TEE or TTE.Results All patients were tested with TEE and TTE after procedure,devices were stable and well shaped,and the defects were closured well without any residual shunt.All the patients were followed up more than 6 months.No hydropericardium,thrombogenesis,tachyarrhythmia,complete atrioventricular block or other complications were found.Conclusions To close ASD with new type curve adjustable sheaths via RIJV may have wide indications, short operation path,well curative effect,minimal invasion and fast recovery in pediatrics,especially fit for the small age children with a big ASD who are difficult to treat via femoral vein.

Objective To explore the expression and clinical significance of IL-12 in acute cardiac allograft rejection in rats.Methods Two groups of SD rats received cervical heterotopic heart transplantation from allogeneic Wistar or syngeneic SD rats.The cardiac grafts were harvested at 1,3,5,and 7 days after transplantation and detected for the expression of IL-12 mRNA by reverse transcriptional polymerase chain reaction(RT-PCR).Results With the posttransplantation day delayed,the expression of IL-12 mRNA was significantly increased in allogeneic transplant group(P

Objective To investigate the changes of vertebral-basal artery and regional cerebral blood flow(rCBF) in patients with olivopontocerebellar atrophy(OPCA).Methods 10 patients with OPCA were examined by digital subtraction angiography(DSA) and single-photon-emission-computed tomography(SPECT),and compared with the control group(patients with vertigo or transient ischemic attack).Results In OPCA group,there were 5 cases with small vertebral artery(50%),4 cases with single vertebral artery(40%),9 cases with small and little vessels(90%),10 cases with poor stain in later arterial phase(100%) could be seen by DSA.The lower rCBF in cerebellum and brain stem were seen in 8 cases(80%)by SPECT.In control group,there were 3 cases(15%),4 cases(20%),4 cases(20%),3 cases(15%) and 7 cases(35%) respectively.There were significant differences between the two groups(all P

Chronic hepatitis B is a world-wide health problem and now at least 250 million people have been infected with hepatitis B virus. Current treatment of hepatitis B rarely achieves a cure because the viral replication template which called covalently closed circular DNA (cccDNA) are resistant to conventional therapies. The phenotype and function of natural killer cells from chronic hepatitis B patients are different to those from acute hepatitis B patients, suggesting that the function of NK cells may be related to clearance of HBV. Some studies have suggested that the differentiation, development and activation of natural killer cells are controlled by the mammalian target of rapamycin. The present review will mainly focus on the biology of hepatitis B virus, the differentiation and development of natural killer cells, and the progress of metabolism of natural killer cells.

Objective To investigate the effect of microbubble (MB) contrast agents impacted by different parameters such as acoustic pressure, frequency, duration of exposure, and MB concentration under flowing condition. Methods A capillary flow mimic model was set up for observation and analysis of MB displacement and aggregation under stereomicroscope. Results The displacement and aggregation of ultrasonic occurred significantly at the frequency of 2.0 MHz than 1.0 MHz and 0.5 MHz. Under low acoustic pressure, MBs were not visually disrupted but the flow slowed down. The aggregation and deflection applying to MB was stronger in the tube happened at the MB concentration of 7×10~7/ml than 7×10~5/ml, but did not when the concentration rose to 7×10~9/ml because of the high viscosity. The ultrasound exposure time could not affect significantly in displacement and MB aggregation. Conclusion MB contrast agents can be manipulated under some ultrasound parameters. It is expected to be physically modulated in blood vessels, in order to increase targeted adhesions for many therapeutic purposes.

This paper analyzed the problems in eight-year program medical education including vertical curriculum design,traditional teaching model and written test-based evaluation system based on the theory of translational medicine and evidence-based medicine.With the social progress,these old systems are not helpful to produce innovative thinking,mobilize students'subjective initiative and cultivate self learning capacity.Finally,this paper proposed measures for curriculum reform from the aspects of curriculum design,teaching mode transformation and evaluation optimization aiming at reaching the educational goal of eight-year program.

Objective To discuss the application indications of emergency thoracotomy (ET) and the surgical strategy in the treatment of chest trauma .Methods The clinical data of 35 chest trauma patients treated by ET from January 2010 to March 2014 were analyzed retrospectively .Results In 35 cases ,the injury severity score (ISS) was 12-65 ,average 31 .63 .23 cases were pene‐trating injuries and 12 cases were blunt injuries .28 cases (80 .00% ) manifest as shock on admission .Blood loss in all cases was 1 000-5 000 mL ,average 2 400 mL and 20 cases were over 3 000 mL .ET was performed in the emergency room (6 cases) and the operative room (29 cases) .The time of admission to surgery in all cases was<30 min .12 cases (34 .29% ) died ,with average ISS score of 48 .26 .The main causes of death were cardiac tamponade and hemorrhagic shock .23 cases (65 .71% ) survived .The surviv‐al rates of penetrating and blunt injury were 78 .26% (18/23) and 41 .67% (5/12) respectively .The occurrence rate of complications in the survivals was 39 .13% (9/23) .Conclusion Massive bleeding ,ventilation dysfunction and cardiac tamponade caused by severe chest trauma are the important indications of ET ;the patient with chest penetrating injury on high‐risk positions should be actively performed the exploratory thoracotomy ;race against time rapid thoracotomy is the key for successful treatment .

Objective To assess the experience in the diagnosis and treatment of duodenal trauma.Methods The clinical data of 58 patients with duodenal trauma who were admitted to the Chongqing Emergency Medical Center from March 1994 to March 2013 were retrospectively analyzed.There were 47 patients with blunt injury and 11 with penetrating injury.The surgical procedure was selected by patient's condition and extent of injury combined with the clinical symptoms,imaging examination,abdominal puncture and the Organ Injury Scale grading system of the American Association for the Surgery of Trauma (AAST-OIS).All patients were followed up through outpatient examination and telephone interview till September 2013.Results Seventeen patients were diagnosed as with duodenal trauma before operation,and 41 patients were diagnosed during the operation.The injury of the first part of the duodenum was observed in 7 patients,second part in 28 patients,third part in 17 patients and fourth part in 6 patients.According to the AAST-OIS,7 patients were with grade Ⅰ injury,17 in grade Ⅱ,20 in grade m,9 in grade Ⅳ and 5 in grade Ⅴ.The 58 patients received operation,including 23 with simple suture,4 with serosa section,hematoma evacuation and repair,7 with pedicled ileal flap to repair duodenal defect,5 with resection of ruptured intestine and end-to-end anastomosis,12 with Roux-en-Y duodenojejunostomy,2 with gastrojejunostomy,4 with pancreaticoduodenectomy,1 with doudenal,choledochal and pancreatic duct extensive drainage.Forty-eight patients were cured successfully and 10 patients died,including 4 died of complications of the duodenal trauma.The duodenal stenosis,duodenal fistula and abdominal abscess were the main complications.Six patients were lost to follow-up and 42 patients were followed up from 6 to 36 months.There were 3 patients with gastrointestinal tract defect and obstructive symtoms,with a missing of complications at postoperative month 6 to 12.One patient with pancreaticoduodenal fistula were cured by conservative treatment at postoperative month 3 and the other patients were well survived.Conclusions Abdominal puncture and imaging examination such as CT are effective methods for the diagnosis of the duodenal injury.Surgical procedure selection should be based on the type and range of the injury.Effective duodenal decompression and complete peritoneal drainage are important for the success of surgery.