Objective To evaluate the efficacy of the operation in the treatment of postoperative re-hemorrhage after splenec-tomy with periesophagogastric devascularization for advanced schistosomiasis. Methods Forty-three re-hemorrhage patients,who received varicose ligation combined with pericardial devascularization through left thoracic cavity with esophageal incision from Oc-tober 2002 to October 2011,after splenectomy with periesophagogastric devascularization due to portal vein hypertension,were in-vestigated retrospectively and followed up for 1 to 9 years. Results Forty-three re-hemorrhage patients operated included 27 cas-es of selective operation and 16 cases of emergency operation. The mean follow-up time was 6.8 years. The hemostasis rate was 100%. 0ne died after the operation because of engaging in heavy labor,two had melena and were completely relived with the con-servative treatment,and all the rest had a good recovery. Conclusion The operation of varicose ligation combined with pericardi-al devascularization through left thoracic cavity with esophageal incision in the treatment of postoperative re-hemorrhage after sple-nectomy with periesophagogastric devascularization for advanced schistosomiasis has a satisfied efficacy.

OBJECTIVE:To observe therapeutic efficacy and safety of Milrinone injection in the treatment of hypertensive heart disease complicated with heart failure. METHODS:A total of 120 patients with hypertensive heart disease complicated with chronic heart failure were randomized into control group and observation group according to random number table,with 60 cases in each group. Control group received routine therapy,including blood pressure controlling,anti-heart failure and other symptomatic treatment;observation group was additionally given Milrinone injection 0.3 mg/kg,continuous pump,qd. A treatment course lasted for 5 d. Both groups received one course of treatment each month for consecutive 6 months. Both groups were followed up for one year. 6 min walking distance(6MWD),BNP,LVEF,CI,LVEDD,heart rate,sitting systolic blood pressure(SiSBP)and sitting diastolic blood pressure(SiDBP),re-hospitalization rate and cardiovascular mortality were observed in 2 groups before treatment, after 3,6 months and 1 year of treatment;therapeutic efficacy of heart function and the incidence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in 6MWD,BNP,LVEF,CI,heart rate,SiSBP and SiDBP between 2 groups;after 3 months,6 months and 1 year of treatment,6MWD,LVEF and CI of 2 groups were increased significantly,while BNP,LVEDD,resting heart rate,SiSBP and SiDBP were decreased significantly;the observation group was significantly better than the control group,with statistical significance(P<0.05). Total response rate of heart function was 90.00%in observation group,which was significantly higher than 63.33% in control group,with statistical significance(P<0.05). After 1 year of follow-up,re-hospitalization rate of observation group was significantly lower than that of control group,with statistical sig-nificance (P<0.05);there was no statistical significance in cardiovascular mortality (P>0.05). There were no statistical signifi-cance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Milrinone injection shows good efficacy in the treatment of hypertensive heart disease complicated with heart failure,can significantly reduce BNP and re-hospitalization rate as well as improve prognosis with good safety.

BACKGROUND: Tissue engineering is a booming subject in recent years, involving skin, cornea, bone, cartilage, tendon and etc. Noticeably, tissue-engineered skin is an issue of concern, which provides an alluring prospect for the repair of skin defects. OBJECTIVE: To overview the latest research progress of tissue-engineered skin. METHODS: A computer-based research of Medline database from 1996 to 2017 was performed, with the English keywords of epidermis, dermis, tissue engineered skin. The latest research status of tissue-engineered skin was summarized in views of epidermal and dermal substitutes, followed by exploring the problems and prospects of tissue-engineered skin. RESULTS AND CONCLUSION: A total of 65 literatures were included. Complex skin substitutes include epidermis and dermis, in which hair follicles, sweat glands, sebaceous glands and other cutaneous appendages are absent. Therefore, how to solve above problems is a hotspot issue and major trend in tissue-engineered skin. Tissue-engineered skin aims to construct permanent skin substitutes containing melanocytes and Langerhans cells rapidly. Since the current tissue-engineered skin substitutes can completely replace skin tissues neither in morphology nor in function, in-depth studies are expected in the near future.

Massive open online courses (MOOCs) , which has caused a large scale of medical edu-cation in recent years, has led to an exploration boom in medical education. By the end of November 2014, on four large domestic and foreign MOOCs platform, a total of 178 medical related MOOCs were found, accounting for 12.2% of the total number of courses, among which public health MOOCs accounted for 44.9%. In terms of medical education, MOOCs are not only a powerful supplement of existing medical ed-ucation and can assist dissemination of medical knowledge, they can also promote pedagogy innovation and improve teaching quality to a certain extent. Moreover, the huge amounts of data collected by MOOCs can also be used to develop research of students' learning behavior. In addition, by recruiting study objects, the researchers have begun to use MOOCs supporting scientific research. As a novel educational development, MOOCs face many challenges while they bring opportuni-ties for medical education. However, active prac-tice and exploration will bring more powerful vitality for its development in the medical field.

Objective To investigate the significance of Dezocine combining Fentanyl used for postoperative PCIA in breast cancer patients.Methods One hundred and twenty six patients with ASA Ⅰ-Ⅲ entered the study.All patients were scheduled for breast cancer operation under intravenous analgesia with tube insertion and treated with PCIA after the operation.They were randomly divided into Fentanyl group (n =63) and Dezocine combining Fentanyl group(n =63).VAS,Ramsay,BCS in two groups were compared al 12 h,24 h,48 h after operation.Side effect was also detected.The changes of T cell subset and IL-2 were analyzed in the patients respectively at the first day before operation,at the first day after operation,at the seventh day after operation.Results At every time point,VAS in research group was significantly lower than that in control group(P ＜ 0.05).However,Ramsay in research group was obviously higher than that in control group(P ＜0,05).There were no significant differences in BCS between two groups (P ＞ 0.05).And no difference was found in the incidence of side effect between two groups (P ＞ 0.05).Compared with control group,the changes of T cell subset,IL-2 had no significant differences in research group at the first day after operation and at the first day before operation (P ＞ 0.05).At the seventh day after operation,the levels of CD4 +,CD4 +/CD8 +,IL-2 in research group were obviously higher than those in control group (P ＜ 0.05).However,the percentage of CD8 + T cells in research group was significantly lower than that in control group (P ＜ 0.05).Conclusions Dezocine combining Fentanyl in PCIA can increase analgesia effect with less side effect.It is positive to improve immunologic function for breast carcinoma patients after operation.

Objective To explore the role of parecoxib in protection of learning and memory ablility in rats with global cerebral ischemia/reperfusion injury. Methods Male Wistar rats were randomly divided into a sham group (S group), a ischemia/reperfusion group (I/R group), and a ischemia/reperfusion with parecoxib group (I/R+PA group). Global cerebral ischemia was induced by Pulsinelli 4-vessel occlusion. 72 h after reperfusion, Morris water maze was used to assess spatial learning and memory ability for consecutive five days. The histological changes in the hippocampus were detected by Nissl staining. Results As compared with the I/R group, rats in S guoup and I/R+PA group had a significantly shortened escape latency (P<0.05), and had significantly longer dwelling time in the former platform quadrant and more frequent cross-platform movement in the Morris water maze test. Conclusions Parecoxib plays a role in protection of learning and memory ability in rats with global cerebral ischemia/reperfusion injury.

OBJECTIVEThis study aims to evaluate the antimicrobial activity of decapeptide, a novel antimicrobial peptide, against several major cariogenic and periodontopathogenic bacteria in vitro. METHODS In this study, we investigated the antimicrobial activity of decapeptide against Streptococcus mutans (S. mutans), Streptococcus sobrinus, Lactobacillus acidophilus, Streptococcus sanguis, Streptococcus gordonii, Actinomyces viscosus, Actinomyces naeslundii, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, and Saccharomyces albicans in vitro using the agar diffusion method and broth dilution method. Furthermore, a time-kill kinetic study of decapeptide against S. mutans was performed.

RESULTSThe results showed that decapeptide exhibited antimicrobial activity against various oral bacteria and fungi. The minimum inhibitory concentration (MIC) of main cariogenic bacteria ranged from 62.5 μg · mL(-1) to 125 μg · mL(-1), and the MIC of periodontopathogenic bacteria tested ranged from 250 μg · mL(-1) to 1,000 μg · mL(-1). Among the bacteria tested, decapeptide had a strong inhibitory effect on cariogenic S. mutans. Results of the time-kill kinetic studies showed that decapeptide reduced the viable counts of S. mutans by more than one order of magnitude after 20 min of incubation, and thoroughly killed S. mutans after 30 min. No viable cells could be detected after 24 h of incubation.

CONCLUSIONThis study suggest that decapeptide might have potential clinical application in treating dental caries by killing S. mutans within dental plaque.

Aggregatibacter actinomycetemcomitans ; Anti-Bacterial Agents ; Anti-Infective Agents ; Bacteria ; Dental Caries ; Dental Plaque ; Kinetics ; Microbial Sensitivity Tests ; Mouth ; microbiology ; Porphyromonas gingivalis ; Streptococcus mutans

BACKGROUND:Using Twin-block appliance to treat mandibular retrusion,the mandible position changes greatly.The influence of this change on temporomadibular joint and the effect of Twin-block appliance on condylar growth remain unclear.OBJECTIVE:To observe the effect of Twin-block appliance on condylar process location during mandible forward positioning.PARTICIPANTS:A total of 20 patients with mandible retraction (Angel Ⅱ) malocclusion were selected from Department of Stomatology,First Sanatorium of Qingdao,Jinan Military Area Command of Chinese PLA,comprising 13 males and 7 females,aged 10.8 years (range 9-13 years).All patients were treated with Twin-block appliance.Four median joint pantomograms were taken before treatment,1 week after treatment,1 week and 1 year after treatment finish to measure the condylar process location.RESULTS AND CONCLUSION:In all cases,neutroclusion were obtained.No clicking,pain or other temporomadibular joint symptoms were observed.The condylar process position altered significantly.The anterior space distance was decreased,the superior space distance was increased,and posterior space was enlarged (P<0.05-0.01),i.e.condylar process moved downward and forward.The condylar process position was consistent with preoperative,and joint superior,anterior and posterior space distributed balancedly.Twin-block appliance could restore normal and harmonious process-fossa relationship through growth remodeling,but maintenance is necessary till the remodeling accomplish.

BACKGROUND: The initial stability of implantable distractor depends on the stress distribution of bone-distractor interface. The understanding of the biomechanical change in initial stage can improve the clinical success ratio of implantable distractor used in alveolar crest.OBJECTIVE: To evaluate the influence of bone quality on stress distribution and deformation in initial distraction stage.METHODS: Four three-dimensional models with 10 079-11 456 cells and 17 299-20 101 nodes were prepared by finite element methods (11 mm in length and 3.7-4.1 mm diameter). Implantable distractor was embedded in a segment of mandible. The elastic modulus of cancellous bone and the thickness of cortical bone, stress and deformation of bones and distractor were calculated.RESULTS AND CONCLUSION: The highest stress in the bone was concentrated in transportable section and the maximum deformation of transportable section was observed at the edge of the cortical bone, both of which were increased with bone quality decreased. The subsidence of distractor was observed with bone quality decreased. Bone quality influenced the initial stability and the result of the implantal distraction. The decrease of bone elastic modulus would increase the failure risk of distraction osteogenisis.

Objective:As the function of ??T cells and NK in the immunological therapy is showing more and more important,the characteristics of ?? T cells,NK and LAK were analyzed comparatively after that they were richened by isolating and incubating in vitro.Methods:The cells were collected using MACS after the cells were panned respectively with special monoclonal antibodies.Then the characteristics including proliferation,phenotype,cytotoxin and the down regulation blocked by specific antibodies were analyzed.Results:The ?? T cells can expand 600～800 times after culturing 2 weeks and the percent of CD3,CD8 and ?? expressed on the collected cells were 72.29%,58.02% and 65.98% respectively ?? T cells showed the high cytotoxin to K562(NK sensitive cell line),Raji and XG 7 cell lines(NK non sensitive cell lines).The percentage of cytotoxin reached 35.98%,52.27% and 69.08% respectively compared with ??T respectively.No obviously change of percent of ??T cytotxic ability to these target cells were observed using special MHC class I monoclonal antibody to block the ??T cell before coculturing the target cells with ?? T cells.Conclusion:All of ?? T cells,NK and LAK showed the non specific cytotoxin to tumor cells.The cytotoxic capability of ?? T cells did not be effected after blocking with MHC class I monoclonal antibody.These results demonstrated that ?? T cell could kill more kinds of tumor cells than NK and LAK.