Dental Bonding ; Dental Implant-Abutment Design ; Humans ; Matrix Metalloproteinases

Objective To investigate the effect of intensive insulin therapy in parenteral nutrition for patients with abdominal operation.Methods 50 patients with 1 week or more complete intestinal nutrition after abdominal surgery and parenteral nutrition stress hyperglycemia were selected and randomly divided into control group (25 cases) and treatment group (25 cases).The control group adopted conventional insulin treatment(10.0 ~11.1 mmol/L blood glucose target value),the treatment group adopted intensive insulin treatment (7.8 ~10.0 mmol/L blood glucose target).The blood glucose time,hospitalization time and cost were compared between the two groups,and the occurrence of complications was recorded.Results In the treatment group,the blood sugar control standard time was (5.16 ±1.25)d,hospitalization time was (7.69 ±2.14)d,which were shorter than those in the control group,the hospitalization expense in the treatment group was (1 045.16 ±114.17)yuan,which was lower than (2 217.18 ± 242.18)yuan of the control group,the differences were statistically significant(t =6.460,6.270,14.499,all P <0.05).The incidence rate of complications of the treatment group was 8.00%,which was significantly lower than 28.00% of the control group,the difference was statistically significant (χ2 =13.550,P <0.05).The mortality rate of the treatment group was 4.00%,which of the control group was 8.00%,the difference was not statistically signifi-cant between the two groups(χ2 =1.418,P =0.233).Conclusion Intensive insulin therapy can effectively control the blood glucose level in patients with non diabetes after abdominal operation,and can reduce the incidence of complications,it is worthy of recommending.

Migraine is a common neurovascular disease in clinical practice,its pathogenesis is both involved in the nervous system and vascular system.Many researchers believe that there are complex relationships between migraine and ischemic stroke.This article reviews the advances in this field in recent years.

OBJECTIVETo summarize laws of acupoint selection of prescriptions for treatment of cervicogenic headache by acupuncture in modern literature.

METHODSRandomized controlled trials (RCTs) involving acupuncture and moxibustion for treatment of cervicogenic headache were recruited from CBM (1978-2012), VIP (1989-2012), Wanfang Database (1998-2012), CNKI (1979-2012), PubMed (1966-2012), EMbase (1980-2012), and Cochrane Library (Volume 4, 2012). Hand recruitment was also auxiliarily used. The frequency and percentage of common acupoints, the distribution of acupoints along 14 meridians and across each part of the body, the application of specific acupoints, and features of using prescriptions for specific acupoints were statistically described.

RESULTSTotally 37 recruited papers included 42 acupoints and 159 times. Common acupoints covered Fengchi (GB20, 28 times), Jingjiaji (EX-B2, 21 times), Baihui (DU 20, 12 times), Tianzhu (BL9, 1 times), and Ashi point (11 times). Meridians along which acupoints were used mainly covered Foot-shaoyang Gallbladder Meridian, Foot-taiyang Bladder Meridian,and DU meridian. Acupoints were mainly needled from head, neck, and upper limbs. Eight confluence points and luo-connecting point were commonest used as specific acupoints. Acupuncture prescriptions were mostly composed of multiple acupoints. Filliform needle was mainly used in acupuncture methods, followed by electro-acupuncture needle.

CONCLUSIONSModern acupuncture treatment of cervicogenic headache focuses on local specific points and acupoints along meridians. Acupoints were mostly selected from head, neck, and upper limbs by syndrome typing of Chinese medicine.

Objective: To study the protective effect of anti-tumor necrosis factor-?antibody (TNF-? Ab) on lung injury after cardiopulmonary bypass(CPB). Methods: 20 patients with valve diseases underwent valve replacement under CPB. The patients were randomly divided into two groups: control group and TNF-? Ab group. In the TNF-? Ab group, human TNF-? Ab was dropped into the intracheal tube before operation and just after releasing the aortic clamp, respectively. Lung dynamic compliance, blood neutrophils count and TNF-? from the right and left atrium were determined perioperatively. Results: The dynamic compliance of the lung in TNF-? Ab group was higher than that in control group. TNF-? Ab can reduce releasing of TNF-? and restrain leukocyte accumulation in the lung. Conclusion: TNF-? Ab has markedly protective effect on lung injury after CPB.

Background and purpose:The prognosis of advanced esophageal carcinoma is poor,there are no standard regimens for these patients. This study was to observe and evaluate the clinical feasibility and effi cacy of combined esophageal stent insertion with radiotherapy and concurrent chemotherapy in the treatment of locally advanced esophageal carcinoma. Methods:66 patients with esophageal carcinoma who were not suitable for operation were analyzed retrospectively. In the therapy group,stent was placed in order to relieve esophageal stenosis,and then followed by 3D-CRT and concurrent chemotherapy,while patients in the control group were treated with the placement of stent alone. According to the evaluating standards of WHO and Stooler classifi cation,we evaluated the effi cacy. Results:In the study group,72.2% of 36 cases was observed as partial response(PR),and 13.9% with complete response(CR),overall response rate was 86.1%. 6 and 12 months survival rates were 88.9% and 72.2% in the study group,compared to 53.3% and 26.7% in the control group,respectively(P

Objective To improve the diagnosis and treatment of acute exacerbation in idiopathic pulmonary fibrosis(IPF)Methods A case with clinical proven acute exacerbation in IPF and treated with corticosteroid was described and the foreign literature was reviewed.Results Most patients with idiopathic pulmonary fibrosis(IPF)show slowly progressive deterioration.However,accelerated deterioration also occurs without any definite factors on infection,heart failure,et al in a few of patients with IPF who have previously shown slowly progressive deterioration,and for part of patients corticosteroid treatment is effective.Conclusion Some acute exacerbation in idiopatic pulmonary fibrosis can be idiopathic.

Objective To compare the clinical efficacy of two surgical methods for the treatment of anal fissures in elderly patients.Methods A total of 138 elderly patients with anal fissures treated at our hospital from January to December 2016 were randomly divided into the conventional method group(69 cases) and the modified method group (69 cases).Patients in the conventional method group were treated with lateral sphincterotomy,while patients in the modified method group were treated with modified longitudinal sphincterotomy with transverse suture.Outcomes of treatment,VAS scores,incision wound infection rates,postoperative voiding dysfunction rates and recurrence rates were compared.Results There was no significant difference in overall effectiveness between the modified method group (98.6％)and the conventional method group(94.2％) (x2=1.8677,P=0.1717).The rates of incision wound infection,moderate postoperative urinary retention and recurrence in the conventional method group(8.7％,42.0％ and 10.1 ％,respectively)were significantly higher than those in the modified methods group(0.0 ％,15.9 ％ and 0.0％,respectively) (x2 =4.3561,11.4061 and 5.4177,respectively,P =0.0369,0.0007 and 0.0199,respectively).At 12 hours after operation,favorable VAS scores and incision healing times were observed in the modified method group,compared with the conventional method group,and the differences were statistically significant(each P＜0.05).Conclusions Modified longitudinal sphincterotomy with transverse suture produces about the same overall effectiveness as does lateral sphincterotomy in the treatment of elderly patients with anal fissures,but it is superior in reducing incision wound infection,moderate postoperative voiding dysfunction,recurrence and pain intensity,and in promoting incision healing.

Purpose To explore the role of cell blocks combined with immunohistochemical examination in the diagnosis and differential diagnosis of malignant pleural effusion,and to explore the role of pleural effusion cell blocks in lung adenocarcinoma molecular pathology examination.Methods 142 cases of malignant pleural effusion based cytology,cell blocks of HE staining and immunohistochemical staining by EnVision twostep were retrospectively analysed,the tumor classification was made through analyzing the characteristics of the cells combined with antibody expression.The detection of epidermal growth factor receptor (EGFR) gene mutation of 40 cases of lung adenocarcinoma diagnosed after immunohistochemical staining were used by ARMS-PCR method.Results Among 142 cases of malignant pleural effusion,there were 99 cases caused by lung adenocarcinoma,4 cases of lung small cell carcinoma,3 cases of lung squamous cell carcinoma,13 cases of breast carcinoma,9 cases of ovarian carcinoma,2 cases of gastric carcinoma,1 case of thyroid carcinoma,1 case of endometrial carcinoma,5 cases of mesothelioma,3 cases of lymphoma,1 case of malignant melanoma,1 case of synovial sarcoma.In 40 cases of lung adenocarcinoma pleural effusion cell block,there were 20 cases with EGFR mutations,9 cases of 19del mutations and 11 cases L858R mutations.Conclusion The pleural effusion cell blocks combined immunohistochemistry are useful to improve the accuracy of diagnosis of patients with pleural effusion,and helpful for the determination of classification and the primary site of tumor,assessment of prognosis.Pleural dffusion cell block may used to detect EGFR mutations of lung adenocarcinoma,which provide new source of specimen for the gene detection of lung adenocarcinoma.

Blood-brain barrier is a natural protection for human body. It protects central nervous system from the interruption and damage of xenobiotics. However, it prevents potential drugs aimed at central nervous system, thus becomes an obstruction for the development of central nervous system drugs. The recent development of blood-brain barrier permeability research and several lead optimization strategies to improve blood-brain barrier permeability are reviewed. These structure optimization methods include increasing lipophilicity, reducing hydrogen bond doners, simplifying molecule, increasing rigidity, lowering polar surface area, avoiding acid group, prodrug strategy, modifying into active transporter's substrates, as well as avoiding P-glycoprotein recognized structures.
ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Biological Transport ; Blood-Brain Barrier ; Central Nervous System ; drug effects ; Central Nervous System Agents ; pharmacokinetics ; Drug Design ; Humans ; Permeability ; Xenobiotics ; adverse effects