Objective: To evaluate the treatment efficacy of reverse flaring technique applied by two rotary instruments, Hero 642 and ProTaper, on complicated molar root canal preparation. Methods: 100 molars with curved root canals (maximum curved angle ≥25 degrees) suffered from pulpitis or periapicities were randomly divided into two groups. In experimental group reverse flaring technique was applied by rotary instruments while in control group reverse flaring technique was not adopted. 50 experimental teeth with curved canals were operated with K files, Hero 642 and ProTaper in sequence. Lateral condensation obturation method was utilized in both groups. Root canal preparation and obturation efficiency were evaluated by X-ray, root canal preparation time and complication incidence (1 year follow-up rate was 95%). Results: Reverse flaring technique applied by Hero 642 and ProTaper Ni-Ti rotary instruments on complicated (curved) root canal preparation in group A demonstrated better root canal coning and smoothness, without instrument fractures, while instrument fractures occurred in control group. Significant difference was found in exact root canal obturation rate and not enough full rate, root canal smoothness and postoperative pain between two groups(P<0.05). Conclusion: Reverse flaring technique applied by Hero 642 and ProTaper NI-Ti rotary instruments indicates complementary potencies, demonstrating satisfactory root canal shape and obturation effectiveness, and lower complication incidence. Reverse flaring technique applied by Ni-Ti rotary instruments is apt for medium/severe curved root canal preparation and worthy of clinical application.

Objective To investigate the clinical characteristics of a clustering infection caused by human adenovirus-B type 7 (HAdV-B7) which occurred in one military camp located at the southeastern coastal region in January 2014.Methods All clinical characteristics of the 70 patients were collected for analysis,including clinical symptoms and signs,chest computer tomography (CT) scans and laboratory results.Throat swabs were collected and real time polymerase chain reaction (RT-PCR) was performed to detect viral nucleotide.Results The prominent symptoms of these patients with HAdV-B7 infection included fever (100.0％,70/70),cough (82.9％,58/70),productive cough (72.9％,51/70) and sore throat (61.4％,43/70).All patients showed posterior pharyngeal wall linear congestion with ovoid follicle.Fifty-four (77.1 ％) patients had enlarged tonsils and 46 (65.7 ％) patients had tonsils covered by white secretions.Fifty-eight (82.9 ％) patients had pharyngeal follicular hyperplasia.Fifty-one (72.9 ％) patients had abnormalities on chest radiograph,including lung-marking fuzzy,pulmonary interstitial inflammation and parenchymal serous exudation.Of the 54 throat swabs from patients,34(63.0％) were identified as HAdV-B7.All patients were cured.Conclusions The clinical features of patients with HAdV-B7 infection are different from other viral infection.HAdV-B7 is easy to cause clustering infection in particular populations.Early detection and early intervention are needed to avoid exacerbation and transmission.

Objective To evaluate measurement of the submucosal thickness with endoscopic ultrasonography (EUS) for activity of Crohn disease (CD).Methods Ten patients with active stage of CD and 10 healthy controls (HC) underwent EUS.Simple endoscopic score for Crohn disease(SES-CD)and submucosal thickness at the most severe lesions were measured and recorded.Submucosal thickness of the same region in CD patients were measured at remissive stage.In order to analyze the relationship between submucosal thickness and the stage of CD, submucosal thickness were compared among patients at active stage of CD, remissive stage of CD and HC.And the cut-off value of submucosal thickness was calculated to diagnose the stage of CD.Results The mean submucosal thicknesses of active stage and remissive stage of CD were 6.48±1.95 mm and 2.47±1.08 mm,respectively (P<0.01).The correlation analysis showed that submucosal thickness had a positive correlation with Crohn disease activity index(CDAI)(r=0.708,P<0.01) and SES-CD(r=0.807,P<0.01).Receiver operating characteristic curve analysis was used for 10 cases of CD patients and the area under the curve was 0.985(P<0.01).The cut-off value of submucosal thickness to diagnose active stage of CD was 3.85 mm, and the sensitivity and specificity reached 100% and 90% respectively.The Youden index was 0.9.Conclusion Measurement of gastrointestinal submucosal thickness by EUS could contribute to evaluate the stage of CD and to guide clinical treatment.

Objective To evaluate the effects of hyperbaric oxygen (HBO) and cisplatin (DDP) on inhibition of A549/DDP cells in vitro and to explore the impacts of HBO on cell cycle and apoptosis.Methods The cytotoxicity of HBO and DDP was determined by Methyl thiazolyl tetrazolium (MTF) assay; flow cytometry (FCM) was used to investigate the impacts on cell cycle and apoptosis of cell line A549/DDP.Results Hyperbaric oxygen alone significantly suppressed A549/DDP cells proliferation (P ＜ 0.05),compared with control group of normal oxygen,and the inhibition ratio was 2.90％.DDP at concentrations ranging from 3 μg/ml to 24 μg/ml significantly inhibited the proliferation of A549/DDP cells in a dose dependent manner,that was concentrations of 3,6,12 and 24 μg/ml brought inhibition ratio of 1.87％,4.62％,11.15％ and 30.45％ ; Hyperbaric oxygen can enhance the inhibition effect of DDP to A549/DDP cells,when hyperbaric oxygen affiliated with DDP of concentrations above,the inhibition ratios were 4.37％,8.92％,21.88％ and 48.71％,respectively,which has significant difference with the single DDP groups.FCM analyses showed that HBO arrested A549/DDP cells at the S phase,that was cell number of G0/G1 phase reduced significantly and of S phase raised significantly,compared with normal oxygen group(P ＜0.01),that was the percentages of cells in S phase of control group were 9.5％ and HBO group were 20.9％,while the percentages of cells in G0/G1phasc were 82.2％ and 66.3％,respectively.In addition,there were more apoptotic cells in the HBO group with the percentage of 7.9％,while the percentage was 2.8％ in the normal oxygen group.Conclusion Hyperbaric oxygen could play together with DDP to inhibit A549/DDP cells proliferation.HBO could block the cell cycle at S period and induce apoptosis.

Objective To explore the clinical characteristics and risk factors of catheterrelated infection in continuous renal replacement therapy (CRRT) patients.Methods The demographic and clinical data of CRRT patients who inserted with double-lumen non-cuffed dialysis catheter at the First Affiliated Hospital of Sun Yat-sen University from January 1,2016 to December 31,2016 were collected.According to the presence or absence of catheter-related infections,they were divided into infected group and uninfected group.Statistics and analysis of the incidence and pathogenic characteristics of catheter-related infections;Comparison of clinical features of infected and uninfected groups;A multivariate Cox proportional hazard model was used to analyze risk factors for catheter-related infections.Results A total of 364 patients with CRRT (437 cases of central venous catheterization) were enrolled in the study.Catheter-related bloodstream infection (CRBSI) and catheterrelated colonization (CRCOL) rates were 3.565 and 2.228 events per 1000 catheter-days.These catheters were associated with higher proportion of inserted in ICU (P=0.007),immunosuppression (P=0.002),receive catecholamine inotropes therapy (P=0.001) and shock (P=0.030).The infection catheters also had shorter indwelling time (P=0.032) and lower level of blood hemoglobin (P=0.017),serum creatinine (P=0.004),blood brain natriuretic peptide (P=0.005) pericatheter use.The most common pathogens were Gram-negative bacteria,especially Acinetobacter baumannii,which caused 37.5％ CRBSI and 20.0％ CRCOL.Multivariate Cox regression model showed female (P=0.029,HR=2.151),diabetes (P=0.016,HR=2.807),receive catecholamine inotropes therapy (P=0.012,HR=2.655),immunosuppression (P=0.037,HR=2.203) were independent risk factors associated with catheterrelated infection.Conclusions The incidence of CRBSI and CRCOL is 3.565 and 2.228 events per 1000 catheter-days CRRT patients in our hospital.The most common pathogen of catherter-related infection is Gram-negative bacteria.Female,diabetes,received catecholamine inotropic drugs,and immunosuppression were independent risk factors associated with catheter-related infection.

Objective To study the diagnostic value of narrow-band imaging ( NBI) combined with endoscopic ultrasonography ( EUS) for ampullary tumors. Methods A total of 21 patients suspected with ampullary lesions by imaging or endoscopic examination from December 2015 to March 2017 were enrolled in this prospective study. All patients underwent NBI and EUS, and 20 patients underwent biopsy. The type of ampullary tumor was predicted by preoperative examination, and appropriate treatment methods were chosen. The final diagnosis was confirmed by biopsy, surgical pathology, and clinical follow-up for more than 6 months. The accuracy of NBI combined with EUS and biopsy in diagnosis of ampullary malignant tumors was calculated according to the gold standard. The Chi-square test was used to compare diagnostic accuracies. Results The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of NBI combined with EUS in diagnosis of ampullary malignancies were 94. 1％ (16/17), 100. 0％ (4/4), 95. 2％ (20/21), 100. 0％ (16/16), and 80. 0％ (4/5), respectively. The corresponding indicators of preoperative biopsy were 41. 2％ ( 7/17) , 100. 0％ ( 3/3) , 50. 0％ ( 10/20) , 100. 0％ ( 7/7) , and 23. 1％( 3/13) , respectively. The accuracy of NBI combined with EUS in diagnosing ampullary malignant tumor was significantly higher compared with preoperative biopsy ( P=0. 004) . Conclusion NBI combined with EUS can more accurately predict benign or malignant ampullary tumor, and better guide the choice of surgical methods compared with preoperative biopsy.

Objective:To seek any differential effect of combining repeated transcranial magnetic stimulation (rTMS) with a modified version of constraint-induced movement therapy (mCIMT) on the walking ability of stroke survivors.Methods:Seventy-five stroke survivors were randomly divided into a sham rTMS group, an rTMS group and a combined group, each of 25. In addition to 40 minutes of routine rehabilitation daily, including balance training, transfer training, muscle strength training, and proprioceptive training five times a week for 4 weeks, the sham rTMS group and rTMS group received sham or genuine rTMS. The combined group received 20 minutes of rTMS followed by mCIMT training 30 minutes later. The treatment was performed once a day, 5 days a week for 4 weeks. Before and after the treatment, all groups were evaluated using the Fugl-Meyer lower extremity assessment, the Berg balance scale, a 10-metre walk test and the modified Barthel index.Results:Significant improvement was observed in the average scores of all three groups in all of the assessments. The combined group′s averages were, however, significantly better than those of the other two groups.Conclusion:Supplementing mCIMT with rTMS can better improve the walking and other abilities in the activities of daily living of stroke survivors.

Objective:To evaluate the effect of combining contralateral high-frequency transcranial magnetic stimulation (rTMS) with biofeedback-controlled empty swallowing training on dysphagia among stroke survivors.Methods:Eighty dysphagic stroke survivors were divided at random into a control group, a biofeedback group, an rTMS group and a combined treatment group, each of 20. In addition to routine dysphagia rehabilitation, the biofeedback group and the rTMS group received empty swallowing training based on biofeedback or high-frequency rTMS applied to the healthy motor cortex as appropriate. The combined treatment group was given both. The treatment was administered once daily, 5 days a week for 3 consecutive weeks. Before and after the treatment, all of the subjects′ swallowing was evaluated using the penetration aspiration scale (PAS), functional oral intake scale (FOIS) and a standardized swallowing assessment (SSA). The latency and amplitude of the mylohyoid muscle′s motor evoked potentials (MEPs) were also recorded before and after the treatment.Results:After the treatment, significant improvement was observed in the average PAS, FOIS and SSA scores as well as in the latency and amplitude of the MEPs in the four groups. The average results in the combined treatment group were significantly better than in the other 3 groups. The latency of the mylohyoid muscle′s MEP was significantly shorter in the combined group than in the control and biofeedback groups on average, while the amplitude was significantly greater than in the control group.Conclusion:Combining contralateral high frequency rTMS with empty swallowing training based on biofeedback can better improve the swallowing of dysphagic stroke survivors.

Objective To investigate the role of lncRNA SNHG1 in homocysteine-induced pyroptosis of podocyte.Methods Cbs+/-mice were randomly divided into two groups:a normal diet group(ND)and a high me-thionine diet group(HMD).Western blotting was used to detect the protein expression levels of Caspase-1,Cleaved Caspase-1,and NLRP3.Mouse renal glomerular podocytes were cultured in vitro,and then assigned into a control group(Control,0 μmol/L Hcy)and a homocysteine intervention group(Hcy,80 μmol/L Hcy).Western blotting was used to detect the protein expression levels of Caspase-1,Cleaved Caspase-1,and NLRP3.Mouse renal glomerular podocyion group(OE-NC + Hcy)and the lncSNHG1 overexpression + homocysteine intervention group(OE-SNHG1 + Hcy)were also established.After 48 hours of intervention,Real-time fluorescence quantita-tive PCR was used to detect the expression of lncSNHG1 in podocytes after Hcy intervention.Western blot was used to detect the expressions of Caspase-1,Cleaved Caspase-3 and NLRP3.Immunofluorescence was used to de-tect the expression levels of GSDMD and GSDMD-N.ELISA was used to detect the contents of IL-1β and IL-18.Results(1)In the animal experiments,the expression levels of pyroptosis-related proteins Caspase-1,Cleaved Caspase-1,NLRP3,GSDMD,and GSDMD-N were all increased in the HMD group compared with the ND group.(2)In the cellular experiments,the expression levels of Caspase-1,Cleaved Caspase-1,NLRP3,GSDMD,and GSDMD-N were all increased in the Hcy group compared with the Control group,and the contents of pyroptosis-mediated inflammatory factors IL-1β and IL-18 were increased as well.(3)In the cellular experiments,the expres-sion of lncSNHG1 was increased in the Hcy group compared with the control group.After transduction with lnc-SNHG1 lentivirus,the expression of lncSNHG1 was increased in the OE-SNHG1 group,compared with the control group and the OE-NC group.(4)In the cellular experiments,the expressions of pyroptosis-related proteins Cas-pase-1,Cleaved Caspase-1,NLRP3,GSDMD,and GSDMD-N were increased compared with the OE-NC+Hcy group,and the contents of pyroptosis-mediated inflammatory factors IL-1β and IL-18 were increased in the OE-SNHG1+Hcy group.Conclusion These results indicate that lncSNHG1 may play a role in promoting Hcy induced podocytepyroptosis.