Objective:To analyze the impact of NBP on the expression of HSP 70 and TLR4 in the rat with ischemia-reperfusion.Methods:The 144 rats were divided into 3 groups,Sham group,IR group and NBP group.The 3 groups were divided into 4 groups again according to the time of reperfusion (6h,12h,24h and 48h).The intraluminal ischemia-reperfusion model was made by improved Longa.When the model was made successfully ,the rat in NBP group was gave oral NBP immediately while the IR and Sham group was gave oral NS.The neurological deficit scores , number of apoptotic cells , expression of HSP70 and TLR4 were compared during the 3 groups.Results:The neurological function ,apoptosis,the expression of HSP70 and TLR4 in NBP group at any reperfusion time were statistical lower than in IR group.In all the infusion periods,apoptotic cells in IR and NBP group were significantly higher than that in the Sham group.In all the infusion periods ,the positive cells in IR and NBP group were significantly lower than that in the Sham group.Conclusion:NBP can protect the function of neuron by improving the inhibition of HSP 70 and TLR4.

Objective To investigate the olanzapine and quetiapine quetiapine in the treatment of Alzheimer's disease patients of different clinical effects and influence on the swallowing function of patient.Methods According to the order of visits to the author departments were 73 cases of Alzheimer's patients were divided into group A(37 cases) and group B(36 cases).Patients in group A were treated with olanzapine in the treatment of, and group B with quetiapine in the treatment, the time of the two groups of patients are 12 weeks, to observe the differences of the two groups during the treatment of swallowing function indexes and clinical efficacy.Results After treatment, the MMSE scores of two groups of patients compared with pre-treatment, there was no statistical significance and BEHAVE-AD score before treatment significantly decreased ( P <0.05 ).Post-treatment, the patients in two groups of MMSE, BEHAVE-AD score difference does not have statistical significance.The difference of clinical efficacy between two groups post-treatment was not statistically significant.Watian drinking water test score of two groups Post-treatment, SaO2 decreased value compared with those pre-treatment significantly increased (P<0.05).After treatment of two groups of patients Watian drinking water test score difference does not have statistical significance, and post-treatment, patients in group B of SaO2 decreased value lower than that in group A ( P <0.05 ).Mild dysphagia, two cases of moderate swallowing dysfunction occurred in twenty-six patients in group A, group B with mild swallowing dysfunction occurred in twenty-one patients, A group of swallowing dysfunction more serious than group B serious ( P <0.05 ) .Conclusion Olanzapine and quetiapine quetiapine in the treatment of patients with Alzheimer's disease clinical effect quite, patient's swallowing function cause some adverse effects, effects of olanzapine is more serious.

Objective To investigate the effect of butylphthalide on Nrf2 signaling pathway after cerebral ischemia-reperfusion in rats and neuroprotective effect.Methods A model of middle cerebral artery ischemia-reperfusion injury in rats was induced by suture method.The rats were randomly divided into 4 groups:a sham operation,an ischemia-reperfusion,a low-dose (100 mg/kg) butylphthalide,and a high-dose (400 mg/kg) butylphthalide.Neurological deficit score was performed at 24 h after referfusion.Western blotting was used to detect the Nrf2 expression,the superoxide dismutase activity and malondialdehydecontent in the ischemic brain tissue.TUNEL assay was used to detect the nerve cell apoptosis.Immunohistochemical staining was used to detect the expression of cleaved caspase-3.Results Butylphthalide significantly upregulated the Nrf2 protein expression with a dose-dependent manner (P ＜ 0.05),increased superoxide dismutase activity (P ＜ 0.05),decreased malondialdehyde content (P ＜ 0.05),decreased numbers of cleaved caspase-3 positive cells and apoptotic cells (P ＜ 0.05).Conclusions Butylphthalide may play a significant neuroprotective effect after cerebral ischemia-reperfusion injury in rats.Its role may be associated with the upreglation of Nrf2 signaling pathway and enhancing antioxidant activity

A 43-year-old female presented with multiple, painful, erythematous papules and nodules on the dorsal of the body over the past 17 years. The tumor was painful after cold stimulus and the significant symptoms improved for recent 3 years. Histopathological examinations confirmed the clinical diagnosis of cutaneous leiomyomas. A surgical procedure was one of the therapeutic options in the case of multiple and painful leiomyomas.

Objective:To investigate the effect of arthroscopically-assisted open reduction and internal fixation of intra-articular distal radius fracture.Methods:A retrospective cohort study was made on clinical data of 44 patients with distal radial intraarticular fracture admitted to Jing′an District Central Hospital, Fudan University between June 2017 and August 2020. There were 13 males and 31 females, at age of 35-85years [(62.5±12.9)years]. According to AO/OTA fracture classification system, there were 7 patients with type B and 37 with type C. Open reduction and internal fixation with volar plate was used in all patients, among which 22 were operated on using arthroscopy assistance (arthroscopy group) and 22 were operated on with traditional intraoperative fluoroscopy (fluoroscopy group). The operation time in both groups and triangular fibrocartilage complex (TFCC) injury and fracture displacement in arthroscopy group were recorded. Patient-rated wrist evaluation (PRWE) score, disabilities of the arm, shoulder and hand (DASH) questionnaire and range of wrist motion were compared between the two groups at 12 months after operation. The incidence of complications was observed.Results:All patients were followed up for 12-15 months [(13.3±1.1)months]. The operation time in arthroscopy group was (104.0±40.5)minutes, longer than (71.3±32.1)minutes in fluoroscopy group ( P<0.05). In arthroscopy group, 14 patients (64%) with TFCC injury were diagnosed intraoperatively, with the fracture displacement gap and step for 0.8 (0.3, 0.8)mm and 1.0 (0.3, 1.5)mm under arthroscopic vision, which were reduced to 0.3 (0.0, 0.5)mm and 0.5 (0.0, 0.5)mm after arthroscopically-assisted reduction (all P<0.05). The PRWE score in arthroscopy group was (9.8±4.9)points at 12 months after operation, lower than (13.4±5.8)points in fluoroscopy group ( P<0.05). The DASH questionnaire in arthroscopy group was (9.0±5.0)points at 12 months after operation, lower than (13.0±6.1)points in fluoroscopy group ( P<0.05). The dorsal extension and posterior rotation of the wrist in arthroscopy group were (73.8±8.9)° and (82.5±8.0)°, higher than (65.8±14.2)° and (76.3±10.4)° in fluoroscopy group (all P<0.05). There were no postoperative complications such as loosened or broken screws, vascular nerve damage, incision infection or traumatic arthritis in both groups. Conclusion:Arthroscopic-assisted open reduction and internal fixation of intra-articular distal radius fracture can increase the accuracy of joint surface reduction, improve postoperative wrist function and confirm the diagnosis of TFCC injury during operation.

Objective:To summary the mixed infection as well as clinical characteristics and analyze the risk factors for mixed infection of severe adenovirus pneumonia(SAP) in children.Methods:The clinical data of 114 children with SAP were retrospectively analyzed.Multivariate Logistic regression analysis was performed to assess the risk factors for mixed infection.Results:The incidence age was from 6 months to 2 years(62.5%). High fever(94.7%), cough(98.2%), dyspnea(86.8%) and lethargy(95.6%) were the main symptoms.Laboratory examination showed that children with SAP were prone to increased white blood cell count, C-reactive protein, procalcitonin, aspartate aminotransferase, alanine aminotransferase and CK-MB, as well as decreased proportion of CD3 + , CD4 + , CD8 + , CD4 + /CD8 + and NK cells.The main complications intrapulmonary organ were respiratory failure(80.7%). The main complications extrapulmonary organ were circulatory complications (55.3%). SAP was easily combined with other pathogenic infections.Streptococcus pneumoniae(22.9%)was the most common bacterial pathogen.Respiratory syncytial virus(10.0%)were the most common virus, in addition, mycoplasma pneumoniae(17.1%) was also common.Multivariable Logistic regression analysis showed that the decreasing ratio of CD4 + /CD8 + and NK cells, congenital heart disease and congenital airway dysplasia were the independent risk factors for mixed infection of SAP in children( P<0.05). Conclusion:The SAP patients could easily suffer from mixed infection and high fatality rate.Immune dysregulation is the important risk factors for mixed infection of SAP in children.So immunoregulatory treatment is very important.

Objective: To analyze the predictive value of the mortality risk score for severe hand, foot and mouth disease(MRSHFMD) system for the complications and mortality risk of severe hand, foot and mouth disease(HFMD) in children. Methods: This study included 354 children with severe HFMD who admitted in the pediatric intensive care unit(PICU) of Hunan Provincial Children′s Hospital from March 2012 to March 2014.The patients were grouped according to whether they had complicated nervous system damage, pulmonary edema, pulmonary hemorrhage and circulatory failure in the course of disease, and the prognosis was grouped according to their 28 d survival.The worst values of white blood cell count, blood glucose, blood lactic acid, N-terminal pro-brain natriuretic peptide, within 24 hours after admission were used to score MRSHFMD.The predictive value of MRSHFMD for nervous system damage, pulmonary edema, pulmonary hemorrhage, circulatory failure, and prognosis were evaluated using the receiver operating characteristic(ROC)curve. Results: The blood glucose, white blood cell count, blood lactic acid value, N-terminal pro-brain natriuretic peptide and MRSHFMD score of the children with HFMD complicated with nervous system damage, pulmonary edema, pulmonary hemorrhage and circulatory failure were significantly higher than those in the non-complicated groups(P<0.01). When the cut-off value of MRSHFMD score was 3, the area (95%CI) under the ROC curve were 0.723 (0.643-0.804), 0.870 (0.793-0.946), 0.921 (0.85-0.992), 0.944 (0.867-1.000) and 0.954 (0.000-1.000) of nervous system damage, pulmonary edema, pulmonary hemorrhage, circulation failure and death in children with HFMD, respectively.The specificity and sensitivity of predicting nervous system damage, pulmonary edema, pulmonary hemorrhage, circulatory failure and death were 44.6% and 95.8%; 67.5% and 95.5%; 83.3% and 95.1%; 89.3% and 95.1%; 90.9% and 93.7%, respectively. Conclusion MRSHFMD system is an effective tool to predict HFMD complications of pulmonary hemorrhage, circulatory failure, and death, which is worthy of clinical promotion.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care