BACKGROUND: Teeth are often cut by high-speed turbine engine which drill and friction also will irritate the dental nucleus and periapex directly and cause pain. Eutectic mixture of local anesthetics (EMLA) was reported in dental caries treatment for pain released.OBJECTIVE: To observe the analgesia effect and influence on electra vital force of EMLA when used for dental caries preparation. DESIGN: Self matched-pairs control randomly observation.SETTING: Department of Dentistry, the Stomatological College, the Fourth Military Medical University of Chinese PLA. PARTICIPANTS: Fifty patients including 28 males and 22 females were selected from the Department of Dentistry, the Stomatological College, the Fourth Military Medical University of Chinese PLA from January 2000 to January 2001. Their ages ranged from 18 to 55 years, and the mean age was 36 years. Inclusion criteria: ① Patients whose suffered from teeth only had a superficial hole and needed to be filled. The patients should have 2 teeth that need therapy at the same time and the 2 teeth should in different quadrant regions of the mouth; ② Patients without allergy history of local anesthetics; ③ Patients had signed in the informed consent; patients without cardiovascular diseases or dental ulcer. The experiment was in accordance with the ethics standards, and all patients provided the informed consent.METHODS: ① Grouping and intervention: Assigned to groups with self matched-pairs control method randomly by the side of coin to decide the experiment and teeth; the teeth for experiment were smeared with 2 g of EMLA (Astra AB, Sweden) on the surface of tooth and the bilateral periodontal mucous membrane with cotton bud, after 5 minutes smearing to treat the teeth. The control teeth were not smeared the EMLA to treat. ② Visual analogue scales (VAS) scores and electra vital force: The electra vital force (SYBLONENDO USA) of teeth was measured after 5 minutes, and the VAS score was recorded to evaluate the pain of teeth when incised and ground and compare it with that of control group.MAIN OUTCOME MEASURES: VAS scores and electra vital force.RESULTS: Fifty patients were included in the final analysis. ① VAS scores: The average VAS scores of teeth during treatment after smeared with ELMA were 2.54±0.84. While that of teeth not smeared with EMLA was 7.42±0.51 (P < 0.01). ② Electra vital force: The average value of electra vital force before smeared with EMLA was 45.76±1.56 while that after smeared with EMLA was 64.34±2.28 (P < 0.01).CONCLUSION:EMLA can improve the electra vital force of teeth and has analgesia effect during the dental caries treatment.

Through the questionnaire survey we try to know about the students evaluation of the effectiveness of PBL teaching model.PBL can make students explore and use theoretical knowledge,and improve their ability to analyze and solve problems,but the disadvantages should still be improved.

Objective To evaluate application of antihypertensive drugs.Methods We counted up and analyzed the sum of money,using frequency,quantity and dayly therapeutic fees of the antihypertensive drugs by methods of money ranker and DDDs analysis.Results The most often used antihypertensive drugs were the three as follows:calcium channel blocker,?-receptor blocker and angiotensinⅡ receptor antagonist.We earned more money for the three antihypertensive drugs:calcium channel blocker,angiotensinⅡ receptor antagonist and angiotensin converting enzyme inhibitor.Conclusions The using of antihypertensive drugs is rational.And also we should avoid adverse reaction caused by these drugs compatibility use and ensure medicative safety.

Proton pump inhibitors as a kind of acid drug are widely used in clinical.However,it is overused all over the world although generally safe and effective.Studies have shown the uncertainty of potential long-term adverse effects,especially the contact with the mechanism of gastric cancer.Clinicians should pay more attention to the potential carcinogenic risk of long-term proton pump inhibitors in treatment.The mechanism of pathophysiology and the clinical researches of proton pump inhibitor-induced gastric neuroendocrine tumors,gastric carcinoma,and gastric cardia cancers are summarized as follows.

Aim To investigate the difference in pharmacokinetics between gatifloxacin mesylate(GATM) and gatifloxacin(GAT) in SD rats in vivo.Method The plasma concentration-time courses of GAT in rats were measured by HPLC method after a single oral dose of GATM and GAT,and the pharmacokinetic parameters were estimated by program 3p97 software.Results The results shown that both of GATM and GAT plasma concentration-time courses were best fitted to two-compartment models after a single oral dose(GATM 23.43 mg?kg~(-1)and GAT 20 mg?kg~(-1),respectively).The major average pharmacokinetic parameters of GATM were as follwing: T_(2)?: 9.13 h,AUC: 15.05 mg?L~(-1)?h,C_(max): 4.41 mg?L~(-1),and T_(max): 0.5 h,respectively.On the other hand,the pharmacokinetic parameters of GAT were as follwing: T_(2)?:10.70 h,AUC:13.84 mg?L~(-1)?h,C_(max):4.25 mg?L~(-1),T_(max):0.5 h,respectively.Conclusion Under the equi-mole dose condition treated as above,both of pharmacokinetic characters between GATM and GAT were not significantly differences in rats

Objective To investigate the effect of endoscopic sphincterotomy(EST) combined with endoscopic papillary large balloon dilation(EPLBD) in the treatment of common bile duct stones. Methods A total of 128 patients treated with EST combined with EPLBD for common bile duct stones were divided into 0 min group, 1 min group, 3 min group and 5 min group, according to the different balloon expansion times. The balloon was extended to the required diameter and was maintained to the corresponding time, and then decreased the pressure to remove the balloon. Patients were given routine monitoring and treatment after operation. All patients were observed more than 48 h to determine whether there were early complications such as pancreatitis and bleeding. The effectiveness of EPLBD was evaluated by the stone diameter, expansion balloon diameter, ERCP operation time and use of stone breaker. The safety was evaluated by the occurrence of complications including postoperative pancreatitis, bleeding and perforation. Results All patients were successfully removed stones. There were no significant differences in the maximum diameter of stone, the diameter of bile duct dilatation and the diameter of balloon dilatation between groups. No bleeding, perforation, biliary tract infection and acute pancreatitis were found in patients. There were no significant differences in the utilization rates of stone breaker between groups. ERCP operation times showed a trend of decreased first and then increased in 0, 1 and 3 min groups (P<0.05). There was no significant difference in ERCP operation time between 3 min group and 0 min group. There were no significant differences in incidence rates of high amylase between groups. Conclusion EST combined with EPLBD is a safe and effective treatment for early stage of larger common bile duct stones, of which 1 minute group shows better effect.

Thyroid nodules are very common.Its etiological factors include hyperplasia,adenomas,cancer,cysts,and thyroiditis.Most of thyroid nodules are benign.The management of thyroid nodules whether thyroidectomy or observation is according to their nature.So,the key of the therapy is to identify that they are benign or malignant.We should comprehensive evaluate patients' history,physical examination,laboratory examination,and auxiliary examination for judging the nature of thyroid nodules and making decision in the choose of thyroidectomy or observation.

OBJECTIVE:To investigate the postoperative analgesic effect of Dexmedetomidine combined with Remifentanil on patients in lung cancer resection and its effect on immune function. METHODS:60 lung cancer patients in lung cancer resection were randomly divided into control group(30 cases)and observation group(30 cases). All patients with endotracheal intubation re-ceived lung cancer resection under general anesthesia. After surgery,control group received Remifentanil hydrochloride 10μg/(kg·d)+Ondansetron hydrochloride injection 16 mg,adding into 0.9% Sodium chloride injection co-formulated into 100 ml;observation group received Dexmedetomidine hydrochloride injection 0.75 μg/(kg·d)+Remifentanil hydrochloride 10 μg/(kg·d)+Ondansetron hydrochloride injection 16 mg,adding into 0.9% Sodium chloride injection co-formulated into 100 ml. Background doses in 2 groups were 2 ml/h,self-controlled amount was 2 ml,lockout time was 15 min. Visual analog pain score (VAS),IFN-γ,IL-10 level,T cell subsets(CD3+,CD4+,CD8+,CD4+/CD8+)after 6,12,24,48 h and the incidence of adverse reactions in 2 groups were observed. RESULTS:VAS scores after 6,12,24,48 h in observation group were significantly lower than control group,and VAS scores after 24,48 h in 2 groups were significantly lower than that after 6 h,with statistical significance(P<0.05). IFN-γ levels after 6,12,24,48 h in observation group were significantly lower than control group,and IFN-γ levels after 12,24,48 h in 2 groups were significantly lower than that after 6 h,IL-10 level after 12,24,48 h in observation group were significantly higher than that 6 h and control group,with statistical significance(P<0.05). CD3+after 6,24,48 h,CD4+after 6,12,48 h,CD4+/CD8+af-ter 12,24,48 h in observation group were significantly higher than control group,CD8+ after 12,24 h were significantly lower than control group,CD3+,CD4+ after 12,24,48 h in 2 groups,CD4+/CD8+ in control group,and CD8+ after 12,24 h in observa-tion group and after 24 h in control group were significantly lower than that after 6 h,with statistical significance(P<0.05). There was no significant difference in the incidence of adverse reactions in 2 groups(P>0.05). CONCLUSIONS:The postoperative anal-gesic effect of Dexmedetomidine combined with Remifentanil on patients in lung cancer resection is superior to Remifentanil alone, it can improve the immune function,with good safety.

OBJECTIVETo evaluate the effect of taper and inserting angle on stability of micro-implants in type II bone and to provide theoretical evidence for clinical selection of taper and inserting angle.

METHODSThree-dimensional finite element models of type II bone sections and micro-implants were fabricated. They were designed using different tapers (diameter between 1.1 to 1.6 mm, taper between 0 to 0.0625) and different inserting angles ranging from 30 degrees to 90 degrees (30 degrees, 45 degrees, 60 degrees, 75 degrees, 90 degrees). Effects on the maximum von Mises stresses in mandible and micro-implants, as well as on the maximum displacements in micro-implants, were analyzed under an applied 2 N horizontal force.

RESULTSThe inserting angle had a significant effect on stresses and displacements, with lower distribution of stresses and displacements occurring at 60 degrees. The effect of the taper was also related to the inserting angle. The minimum stresses were 5.013 4 MPa (cortical bone) and 25.1310 MPa (micro-implant) in model D at 60 degrees. The displacements of micro-implants were proportional to the taper.

CONCLUSIONThe inserting angle has a significant effect on stability of micro-implants, and the recommended inserting angle is 60 degrees. The influence of taper on the stability of micro-implants is related to the inserting angle. The micro-implant with 0.0375 taper (maximum diameter is 1.6 mm, minimum diameter is 1.3 mm) is more suitable for type II bones.

Bone and Bones ; Dental Implants ; Dental Stress Analysis ; Finite Element Analysis ; Humans ; Mandible ; Stress, Mechanical

OBJECTIVEThis study aims to evaluate the effectiveness of arthrocentesis on Wilkes III stage patients. Clinical examinations and magnetic resonance imaging (MRI) findings before treatment and six months after treatment were compared and analyzed.

METHODSA total of 137 outpatients diagnosed with temporomandibular joint internal derangement (TMJID) associated with Wilkes III stage through clinical examination and MRI findings from January 2013 to December 2013 were randomly included. All the patients were successfully treated with arthrocentesis. Moreover, all the patients accepted clinical and MRI examination before arthrocentesis treatment and six months after. Clinical examination included visual analogue scale and opening degree, whereas MRI examination included articular disc morphology and effusion in the upper compartments. Statistical analysis was performed using SPSS 20.0.

RESULTSResults showed that the average score of visual analogue scale six months after treatment was significantly lower than that before treatment (P < 0.05). The success rate was 78.1% (107/137). The rate of disc deformity after arthrocentesis treatment was higher than that before the treatment. By contrast, the positive rate of effusion after arthrocentesis was significantly lower than that before the treatment (P < 0.05). Bilaminar zone adaptive changes (disk-like) were found in seven cases (5.1%, 7/137) after treatment.

CONCLUSIONArthrocentesis could effectively relieve pain of the TMJID patients. Furthermore, MRI results indicated that arthrocentesis could significantly decrease articular effusion. Arthrocentesis was effective for the treatment of Wilkes III stage in the short term. Adaptive changes in bilaminar zone occurred in a few patients. However, serious disc deformity with the passage of time is a trend that has been observed.

Arthrocentesis ; Humans ; Joint Dislocations ; Magnetic Resonance Imaging ; Outpatients ; Range of Motion, Articular ; Temporomandibular Joint Disc ; pathology ; surgery ; Temporomandibular Joint Disorders ; diagnosis ; surgery ; Treatment Outcome ; Visual Analog Scale