Aim: To improve the synthesis for 2, 5-anhydro-3,4, 6-tri-O-benzyl-D-glucitol. Methods: Dehydration of D-mannitol, followed by a reaction sequence of selective protection, benzylation, deprotection, tritylation, benzy-lation and removal of the trityl group, afforded the title compound. Results: Based on the improvement of the reported synthetic route, 2,5-anhydro-3,4,6-tri-O-benzyl-D-glucitol was synthesized in seven steps from D-mannitol with a total yield of 8. 3% . Conclusion: This new method features mild reaction conditions and facile work-up.

Objective To evaluate the application effect of teaching-picture archiving and communication system (T-PACS) in training image reading ability of eight-year-program students. Methods Sixty students were divided into two groups: control group (applying traditional teaching method) and experimental group (applying traditional teaching method and T-PACS) when doing clinical medical image reading ability training. Making multimedia teaching movie, clinical image reading teaching and establishing image database by T-PACS were used in experiment group. Mean-while, reading room was set up and classroom teaching and problem-oriented assignments were in-creased. Finally objective evaluation of image recognition ability and questionnaire were used to compare the teaching effect. Measurement data were expressed as x±s. Total scores of image reading were am-alyzed by t test. Full score rates were analyzed by X2 test. Results The results showed that the score of medical image reading ability was higher in experimental group (90.08±4.52) than in control group (86.92±4.68) (P=0.010). There were differences in respiratory and orthopedic full score rate (P=0.006;P=0.035). Most students thought that application of T-PACS could effectively improve the teaching and learning quality. Conclusions Application of T-PACS can improve the medical image reading ability of eight-year-program medical students and is worth further promoting.

BACKGROUND:Titanium al oy with good biocompatibility, corrosion resistance and mechanical properties have been widely used in clinic. How to give its excel ent antibacterial properties so as to cope with plant-associated infections has become a research focus in recent years. OBJECTIVE:To review the principle, techniques, classification and relative merits of antimicrobial coating. METHODS:A computer-based search of Scopus database and VIP database was performed by the first author to retrieve relevant articles published from January 1990 to January 2014 using the keywords of“titanium al oy, plant, antibacterial, coating”. RESULTS AND CONCLUSION:Coatings can be classified into antibiotic coating, non-antibiotic organic antimicrobial coating, inorganic antibacterial coating, anti-adhesion coating, antibacterial bioactive polymer coating, al of which have better biocompatibility, but also have their limitations. Current studies concerning antimicrobial coatings mainly focus on how to enhance the binding force between antimicrobial coating and the substrate as wel as how to get a good anti-bacterial ability, biocompatibility, high wear resistance and persistence;antibacterial phase structure and distribution effects on the bacterial colonization. The antibacterial phase structure and distribution is the key factor for the antimicrobial properties of titanium al oys with either entirely added anti-bacterial elements or surface coating.

Objective·To identify the relationship between the estimated fetal weight (EFW) discordance and birth weight (BW) discordance, and evaluate the accuracy of ultrasonography in predicting birth weight discordance (△BW) of twin pregnancy. Methods·The ultrasound was used to detect the growth of twins at different gestational weeks and the data were analyzed to compare the difference between EFW discordance (△EFW) and ?BW. Results·About 15.9 percent of twins (totally 277 cases) had severe △BW (△BW ≥20%) in our study, and the percentages of dichorionic-diamniotic twin (DCDA) and monochorionic-diamniotic twin (MCDA) were 68.2% and 31.8%, respectively (P>0.01). Compared with △EFW in other gestational weeks,△EFW last time before parturition was most consistent of △BW. Furthermore, the negative predictive value of MCDA was highest (94%) at 22-24 gestational weeks. Conclusion·Twin △BW was relatively better predicted by △EFW last time before parturition. Twin pregnancy without severe △EFW (△EFW<20%), especially MCDA with △EFW<20% at 22-24 weeks, had low probability of selective intrauterine growth restriction in the future.

BACKGROUND:It is convenient to fabricate porcelain veeners using chairside computer aided design/computer aided manufacture (CAD/CAM) system. However, the color of the restorations is not ideal when the veener is cemented immediately, so different surface treatments are needed. OBJECTIVE:To investigate the influence of different surface treatments on the color of chairside porcelain veneers made of CEREC Blocs and the color match between the porcelain veneers and teeth. METHODS:Five fresh extracted maxillary central incisors were selected and prepared. Twenty-five 0.6 mm porcelain veneer specimens were fabricated with Sirona CEREC Blocs by chairside CAD/CAM system, and then randomized into five groups. Untreated specimens served as control group. The other four groups were treated respectively by polishing, glazing, glazing after polishing or staining. The color parameters of specimens and the teeth were measured with ShadeEye NCC on the middle 1/3 region of labial surfaces, and color differences (ΔE) between the specimens and teeth were calculated. Data were analyzed by SPSS 19.0 software. RESULTS AND CONCLUSION:Compared with the control group, the L* value of the glazing, glazing after polishing and staining groups were significantly decreased (P<0.05). The L* value of the staining group was the lowest. The a* and b* values had no significant differences between groups (P>0.05). Compared with the control group, the ΔE values of glazing, glazing after polishing and staining groups were significantly decreased (P<0.05), and the ΔE value of the staining group was the lowest. The ΔL* values of glazing, glazing after polishing and staining groups were significantly lower than those of the control group (P<0.05), and the ΔL* value of the staining group was the lowest. Compared with the control group, only the Δb* value of staining group was decreased significantly (P<0.05). The Δa* values did not differ significantly between groups (P>0.05). These results suggest that the chairside porcelain veneers made of CEREC Blocs can obtain satisfactory aesthetic appearance by glazing and staining.

Objective: The aim of this study was to evaluate the efficacy and safety of bevacizumab combined with chemotherapy for patients with advanced gastric cancer. Methods: Two researchers searched PubMed, Embase, Cochrane Library, Chinese Journal Full-text Database, VIP Chinese Science & Technology Journal Database and Wanfang database, and collected domestic and abroad published research literature about bevacizumab combined with chemotherapy in treatment of advanced gastric cancer. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and assessed quality of the included studies. Then Meta-analysis was conducted using RevMan 5.3 software. Results: Five randomized control trials involving 1 202 patients were included. The Meta-analysis showed that there were statistical significances between bevacizumab combined with chemotherapy group and chemotherapy alone group in complete remission [odds ratio (OR) = 2.17, 95% confidence interval (CI)+1.07-4.38, P = 0.03], partial remission (OR = 1.53, 95% CI: 1.19-1.97, P = 0.001) and response rate (OR = 2.03, 95% CI: 1.25-3.28, P = 0.004). While there was no statistical difference in one-year survival rate (OR = 1.25, 95% CI: 0.99-1.58, P = 0.06). In terms of adverse reactions, there were statistical significances between bevacizumab combined with chemotherapy group and chemotherapy alone group in the incidence of hypertension (OR = 7.29, 95% CI: 2.71-19.64, P < 0.000 1), and toxicities were not significantly different between two groups for myelosuppression, gastrointestinal reactions, impaired liver function and arterio-venous thromboembolism. Conclusion: Bevacizumab combined with chemotherapy in the treatment of patients with advanced gastric cancer can improve the response rate, but the scheme may increase the incidence of hypertension.

Objective To evaluate the efficacy of combination therapy with M and α receptors antagonist for the treatment of double-J stent related lower urinary tract symptoms.Methods From May 2013 to May 2014,131 cases,including 71 male and 60 female cases,were accepted the doubte-J stent indwelling after the ureteral lithotripsy,laparoscopic ureterlithotomy and pyeloureteroplasty.Their data was retrospectively reviewed.The age ranged from 29 to 64 years old,mean (47.4 ± 15.2) years old.They were divided into 4 groups randomly,including group A (control group,n =30),no drugs were taken;group B (tamsulosin group,n =34),0.2 mg tamsulosin was taken qd;group C (solifenacin group,n =32),5 mg solifenacin was taken qd;group D (tamsulosin combined with solifenacin group,n =35),0.2 mg tamsulosin and 5mg solifenacin were taken qd.The IPSS scores,QOL scores and visual analogue pain scale (VAPS) scores were assessed pre-operation,1 week after operation,and 4 weeks after operation,respectively.Results All patients were followed-up until the end of this study.In each time point,the IPSS scores in group A was 9.01 ± 2.79,13.18 ± 3.79 and 13.79 ± 3.76,respectively.In group B,the IPSS scores were 7.89 ± 4.29,12.39 ±3.90 and 12.21 ±3.87,respectively.In group C,the IPSS scores were 7.94 ±4.27,12.70 ±4.01 and 11.98 ±4.69,respectively.In group D,the IPSS scores were 8.21 ±3.18,11.97 ±5.03 and 8.17 ± 3.25,respectively.Significant difference in total IPSS scores and obstruction symptom scores were shown between pre-and post-operation (P ＜ 0.05).Comparing to other groups,group D exhibited the significant improvement in IPSS scores 1 and 4 weeks after the operation (P ＜0.05).4 weeks after operation,the QOL scores in group D was significantly lower than that in other groups (P ＜ 0.05).While the VAPS scores didn t show significant differences among those groups (P ＞ 0.05).Conclusion M and α receptors antagonist combination therapy can significantly improve lower urinary tract symptom due to indwelling double J stents.

Antigens, Bacterial ; immunology ; Drug Resistance, Bacterial ; immunology ; Signal Transduction ; immunology ; Vaccines, Subunit ; immunology

Soladulcidine is a steroidal alkaloid abundant in Solanum dulcamara L. with antitumor and other biological activities. In this study, ten soladulcidine derivatives were synthesized through esterification at C-3-hydroxy group, modification at NH group of F ring of esterification of E ring-opening products. The in vitro antiproliferative activity of these synthesized derivatives against prostate cancer (PC-3) cell line was assessed. Within this series of compounds, compound 19 exhibited the most potent inhibitory effect against the proliferation of PC-3 cell line (IC50=4.80±.9μmol/L).

Objective This study aimed to explore clinical characteristics of four types of obesity based on metabolic classification. Methods Forty-eight obese patients were divided according to their clinical characteristics into 4 groups including metabolic healthy obesity (MHO), hypometabolic obesity (LMO), hypermetabolic obesity (HMO), and metabolic obesity with inflammation (IMO). 20 normal weight individuals were also recruited as a control group. Body fat, body weight, visceral index, and basal metabolism were measured by Omron body fat meter. Fat content and its distribution were measured by dual energy X-ray absorptiometry. All participating patients underwent various tests for 75 g oral glucose tolerance, blood glucose, insulin, C peptide. Lipid profile, thyroid function and sex hormones levels, and inflammation factors were also measured. Results (1)Patients in MHO group had higher body fat content, but had no metabolic disorder and inflammation. Their hormones levels were normal. (2) Lower metabolic rate and lower hormones levels were found in the patients in LMO group with increasing visceral fat. Trunk/subcutaneous fat mass was significantly higher than that in MHO group(1. 19 ± 0. 25 vs 0. 97 ± 0. 32, P<0. 05). There were abnormal lipid and glucose metabolism in LMO group. The insulin action index was significantly lower than that in MHO group(0. 006 6 ± 0. 002 7 vs 0. 012 1 ± 0. 009 5, P<0. 05). The area under the curve of glucoseconcentrationwassignificantlyhigherinLMOgroupthanthatinMHOgroup[(18.71±8.68vs12.70±4.63) mmol/L, P<0. 05]. (3)Heart rate and blood pressure were higher in HMO group. The heart rate was significantly increased compared with that in MHO group [(90. 50 ± 8. 24 vs 73. 20 ± 14. 11) beat/min, P<0. 05]. The waist circumference was significantly larger than that in MHO group [(111. 88 ± 10. 54 vs 98. 05 ± 15. 56) cm, P<0. 05]. (4) In IMO group, insulin action index was significantly lower than MHO group (0. 007 0 ± 0. 003 3 vs 0.0121±0.0095,P<0.05). ThetrunkfatmassanduricacidlevelsweresignificantlyhigherthanMHOgroup [(17236.38±4610.60vs15816.10±5453.42)gand(468.28±121.32vs376.84±97.14) μmol/L,bothP<0. 05]. Patients in IMO group had acanthosis nigricans, but their glucose level was relatively normal. Conclusion The metabolic-based obese diagnosis is essential for understanding the obesity etiology and providing individualized treatment.