Objective To seek the least damage to tooth structure and method of treatment to obtain the minimal microleakage.Methods 600 posterior teeth in vitro constant,according to the random number table method,were divided into 6 groups:A,B,C,D,E,F,l00 cases in each group.The pigmentation of deep pit and fissure or pit and fissure caries of the suspicious isolated human premolar were selected as observation objects,respectively.a Er:YAG laser,a high-speed diamond bur and clean cup brush were used to prepare for isolated anterior molar occlusal pit and fissure.And the performance of each sample was filled with light curing composite resin and fluid,Six different filling conditions of filling body and fissure between microleakage and bonding interface were observed by dye penetration method and scanning electron microscopy.Results The efficiency of F group was 99％,which was significantly higher than 87％ of C group (χ2 =5.84,P ＜0.05),55％ of D group(χ2 =7.21,P ＜0.05) and 87％ of E group (χ2 =11.65,P ＜ 0.05).The efficiency of C group was 87％,which was significandy higher than 43％ of A group (χ2 =3.97,P ＜ 0.05) and 61％ of B group (χ2 =8.35,P ＜ 0.05).The efficiency of B group was 61％,which was significantly higher than 43％ of A group (χ2 =6.25,P ＜ 0.05).Conclusion Er:YAG laser with fluid resin filling is the most effective way for the clinical treatment of pit and fissure deep narrow,already susPicious pit and fissure caries pit and fissure sealant failed teeth.

Objective To investigate the effect of Er:YAG laser irradiation on the structure of dental hard tissue.Methods 2 teeth (8 samples) were randomly selected from 26 teeth enamel group(104 samples) for blank control(group C).The remaining 24 teeth (96 samples) were randomly divided into A group (irradiation 10 s) and B group (20 s irradiation),each group according to power were randomly divided into 1,2,3,4,5,6 W six subgroups,each subgroup had 8 samples.Using a Er:YAG laser at 20 Hz frequency,according to the corresponding packet (with different power and different irradiation time) were irradiated for each sample.Dentin grouped with enamel group.To observe the changes of different energy and the pit diameter and depth.Results The enamel surface pit diameter was compared by different irradiation time and power,different power within the same irradiation time (t =1.89,2.02,2.76,1.98,1.37,1.42,all P ＜ 0 05) ; compared between B group and the A group under the same power (t =1.23,3.23,2.04,1.45,1.42,1.87,all P ＜ 0.05).The enamel surface pit depth was compared by different irradiation time and power,different power within the same irradiation time (t =1.15,3.09,2.32,1.76,1.51,1.59,all P ＜ 0.05) ;compared between B group and the A group under the same power (t =1.15,3.09,2.32,1.76,1.51,1.59,all P ＜0.05).The dentin surface pit diameter was compared by different irradiation time and power,different power within the same irradiation time (t =1.15,3.09,2.32,1.76,1.51,1.59,all P ＜ 0.05) ; compared between B group and the A group under the same power(t =1.15,3.09,2.32,1.76,1.51,1.59,all P ＜ 0.05).The dentin surface pit depth was compared by different irradiation time and power,diffe rent power within the same irradiation time (t =2.12,2.04,1.82,1.43,1.31,1.76,all P ＜ 0.05) ; compared between B group and the A group under the same power(t =2.34,3.13,2.76,1.45,1.34,1.62,all P＜0.05).Conclusion With the increase in the laser energy and the irradiation time,the diameter and depth of enamel pits produced also continuously increase;With the increase in the laser energy and the irradiation time,dentin diameter and depth of the pits produced constantly increased.The different parameters of Er:YAG laser irradiation of dental hard tissues have different effects on the structure.

Objective:To observe the therapeutic effect of scalp acupuncture combined with body acupuncture in treating cancer patients with intractable hiccups after radiochemotherapy. Methods:Thirty-two cancer patients with intractable hiccups after radiochemotherapy who met the inclusion criteria were selected. The Line 2 Lateral to Forehead (MS 3) of scalp stimulation areas as well as body acupoints including Danzhong (CV 17), Zhongwan (CV 12), bilateral Cuanzhu (BL 2), Neiguan (PC 6), Zusanli (ST 36) and Taichong (LR 3) were punctured. The treatment was given once a day, 5 treatments constituted a course, and the efficacy was evaluated after 2 treatment courses. Results:After 10 treatments, 26 cases were cured, 4 cases were improved, and 2 cases were invalid, and the total effective rate was 93.8%. Conclusion:Scalp acupuncture combined with body acupuncture in treating intractable hiccups in cancer patients after radiochemotherapy has reliable therapeutic effect, and it is easy-to-operate and can effectively alleviate the suffering of patients with less adverse reaction.

BACKGROUND:The design of post and core of the molar is affected by various factors,including the effect of the number of posts on the retention force and the effect of the number of posts on the dentin stress and distribution.OBJECTIVE:To make a mechanical analysis on the three-dimensional finite element models of the mandibular first molar defect restored with different numbers and locations of gold alloy posts,cores and all-ceramic crown.METHODS:Cone-beam CT based three-dimensional finite element models of post and core restored first mandibular molars were established,with seven different post designs.According to the numbers and location of gold alloy post inserted into root canal,a single post was placed at the mesial buccal root in group A,a single post at the mesial tongue root in group B,a single post at the distal root in group C,two posts at the mesial buccal root and the distal root in group D,two posts at the mesial buccal root and mesial tongue root in group E,two posts at the mesial tongue root and the distal root in group F,one post respectively at the mesial buccal root,mesial tongue root and distal root in group G.The von Mises criterion was applied for comparing the maximum yon Mises stress value of dentin and stress concentration areas in the seven models which restored with golden alloy posts and cores with all-ceramic crown under the maximum (600 N),vertical (225 N),inclined (225 N) and horizontal (225 N) loads.RESULTS AND CONCLUSION:Under vertical,inclined and horizontal direct loads,the maximum stresses on the remaining dentin in group C were significantly lowest,compared with the groups A and B.The maximum stresses on the remaining dentin changed irregularly with the variation of the numbers and location of posts,when the mandibular first molar defect was restored with all-ceramic crown with gold alloy posts and cores.Under the horizontal load,the maximum Von Mises stress value of the dentin increased remarkably.Under the horizontal load,the maximum stresses on the remaining dentin in group E were the highest.To conclude,the numbers and location of posts and cores have influence on magnitude and distribution of stress,when the mandibular first molar defect is restored with all-ceramic crown with gold alloy post and core.

Objective To investigate the location of CYLD in the neurons and explore the expression of CYLD in OGD/reperfusion-induced neuronal necroptosis.Methods Primary cortical neurons were cultured for 6days and neuronal purity was observed by double staining immunofluorescence of β3-tubulin and DAPI.The location of CYLD was identified by double staining immunofluorescence of NeuN,DAPI and CYLD using primary cortical neurons cultured for 14 days.Then,primary cortical neurons were divided into 8 groups:Control,EBSS,DMSO,OGD/reperfusion(0 h,2 h,6 h,8 h,12 h).Neurons were pretreated with zVAD-fmk for 30 min,OGD for 2 h and the levels of CYLD were evaluated after reoxygenation at different time points.The peak value(8 h) was chosen as reoxygenation time point.Neurons were divided into two groups as Control and OGD.The levels of CYLD were determined in both cytoplasm and nucleus after OGD 2 h and reoxygenation 8 h.Results The double staining immunofluorescence showed that neuronal cultured purity was about 70％ and the CYLD strongly expressed in nucleus but weakly in cytoplasm.The levels of CYLD increased gradually with different reoxygenation time and arrived at peak value after reoxygenation for 8 h (P ＜ 0.05),which was in accordance with the change of LDH (P ＜0.05) (Control (1.00±0.00),EBSS (1.07 ±0.03),DMSO (1.09 ±0.03),0h (1.40±0.12),2 h (1.74±0.08),6 h (2.25 ± 0.12),8 h (2.97 ± 0.15),12 h (3.01 ± 0.08)).The level of cytoplasm CYLD increased significantly in the OGD group (reoxygenation for 8 h)than that in control group (P＜0.05).But the level of nucleus CYLD had no difference between OGD and control group (P ＞ 0.05),which was in accordance with the results of immunofluorescence.Conclusion The CYLD in neurons cytoplasm is involved in necroptosis induced by OGD/deprivation and downregulating of CYLD has a protective effect on the brain injury resulted from ischemia/ reperfusion.

Objective To summarize the clinical experience of urethral realignment for treating early urethral injury under the guidance of ureteroscope,and evaluate its curative effect.Methods Twenty-nine male patients with urethral injury were selected,and 12 patients of posterior urethral injury,17 patients of former urethral injury.All the patients were treated with urethral realignment under the guidance of ureteroscope,postoperative indwelling catheter 3-8 weeks,every 7-16 days changed diameter increase 2 F the catheter 1 time.Results The 29 patients with urethral injury were a indwelling catheter success,all patients were no incontinence after operation 3 months.In the 29 patients,27 patients were urination unobstructed after catheter removal,2 patients were appeared urine line slim after 2 weeks,the 2 patients were normal urination after short urethral expansion.Conclusions The urethral realignment for treating early urethral injury under the guidance of ureteroscope has simple,lower complication,rapid recovery,better effect.The continuous flexible progressive urethral expansion and the strict nursing,which can effectively reduce the occurrence of urethral stricture.

Humans ; Hypereosinophilic Syndrome ; complications ; Male ; Middle Aged ; Thrombosis ; complications

BACKGROUND:The location of residual dentin may affect stress distribution of tooth root. ＜br> OBJECTIVE:To make a three-dimensional finite element analysis of gold al oy post-core and al-ceramic crown in the repair of structure defects of the mandibular first molar, and to provide a guideline for planning restoration for such kind of tooth structure defects. ＜br> METHODS:Three-dimensional finite element models of the restored first mandibular molars were constructed by CT image reconstruction technique. Then MIMICS software was used to separate the areas and finish the three-dimensional calculation. GEOMAGIC software was also applied to modify and generate a NURBS surface in each patch. Al components of the models were assembled under the ANSYS preprocessor. The Mohr strength theory was applied for comparing the maximum Mohr stress value of dentin and stress concentration areas in six models under different simulating loads. ＜br> RESULTS AND CONCLUSION:The restoration effects in six models were compared, the maximum Mohr stress value of dentin and stress concentration areas were not obviously different. The location of residual dentin has little influence on the stress value and distribution, when restored by gold al oy post-core and and al-ceramic crown.

Objective To compare the clinical value of nerve stimulator-versus ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery.Methods Forty patients,aged 18-60 yr,with body mass index of 18-30 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic surgery,were randomly assigned into 2 groups (n =20 each) using a random number table:nerve stimulator group (group S) and ultrasound group (group U).Epidural anesthesia was performed with 1.73 ％ carbonated lidocaine in both groups.0.2％ ropivacaine 5 ml/h was infused continuously after surgery to perform femoral nerve block for analgesia.VAS score at rest was assessed at 2,6,24 and 48 h after surgery.At 24 and 48 h after surgery,VAS scores during active and passive movement were assessed.The time for catheter placement near the femoral nerve and development of subcutaneous hematoma at the puncture site,local anesthetic intoxication and nausea and vomiting were recorded.The postoperative requirement for analgesics was also recorded.Results There was no significant difference in the VAS scores and puncture for femoral nerve block-and local anesthetics-related adverse events between the two groups.The time for catheter placement near the femoral nerve was 8.0 ± 1.4 and (6.7 ± 0.9) min in S and U groups,respectively,and the time was significantly longer in group S than in group U.No patients required rescue analgesic after surgery in both groups.Conclusion Nerve stimulator-guided continuous femoral nerve block provides higher clinical value than ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery and it is more suitable for clinical application.

Objective To evaluate the clinical effects of different doses of brachical plexus anesthesia in the emergency suture of hand trauma in preschool children .Methods Forty preschool children with hand trauma were choosen ,who were undergoing e‐mergency suture by general anesthesia combined with brachical plexus anesthesia .They were divided into group A(1 mg/kg ,n=20) and group B(2 mg/kg ,n=20) ,body movement during skin incision ,local injection with lidocaine ,propofol dose ,surgical time and wake up time were compared .Results There was no significant differences between the two groups in surgical time(P>0 .05) ,the cases of body movement during skin incision and local injection with lidocaine were 8 children ,which was higher than 2 children in group B(all P<0 .01) ,ropivacaine dose(14 .5 ± 5 .5)mg in group A were lower than group B (31 .6 ± 7 .2)mg(P<0 .01) ,propofol dose in group A(75 .6 ± 15 .2)mg were higher than group B(32 .7 ± 8 .6)mg(P<0 .01) ,wake up time in group A(11 .2 ± 3 .3)min were longer than group B(5 .9 ± 2 .3)min (P< 0 .01) .Conclusion The clinical effect of ropivacaine 2 mg/kg was superior than 1 mg/kg in brachical plexus anesthesia .