Objective To investigate the effect of cobalt chromium alloy onlay on the direct repair of cracked vital pulp teeth with the resin compostie filling and porcelain-fused-to-metal (PFM ) crown repair as the control .Methods 201 cracked vital pulp teeth from 201 cases were randomly divided into 3 groups according to the clinical symptoms :mild discomfort at occlusion (group A) ,pain at occlusion accompanied with transient pain to cold or hot stimulation (group B) and pain at occlusion accompanied with continuous pain to cold or hot stimulation(group C) .The cracked teeth directly were restored by the resin composite filling ,cobalt chromium alloy onlay and PFM crown repair and the effective rate in each group was observed after 2-year follow up .Results The effective rate of the group A ,B and C were statistically significant different from each other (P<0 .05) .The effective rate of the co-balt chromium alloy onlay and the PFM crown was statistically significant higher than that of resin composite (P<0 .05) .Conclusion The direct repair with cobalt chromium alloy onlay is an effective repair method for the cracked vital pulp teeth with mild discomfort at occlusion and mild pain accompanied with transient pain to cold or hot stimulation .

Objective To investigate the feasibility and superiority of video-assisted thoracic surgery (VATS) in the diagnosis and treatment of chest trauma feasibility and superiority.Methods 60 cases were randomly selected and divided into the observation group (n =30) and control group (n =30) by random number table.The observation group was treated with VATS and the control group was treated with traditional methods.Incision length,after the first three days of pain,blood transfusion,closed drainage time,drainage,postoperative hospital stay,postoperative day 7 1S forced expiratory volume (FEV1) and other related indicators were compared between the two groups.Results Incision length of the observation group was (7.41 ± 5.52) cm,which was significantly shorter than (18.62 ± 4.11) cm of the control group (t =7.54,P ＜ 0.05).Amount of blood transfusion and drainage of the observation group were (199.88 ± 23.00) mL and (199.52 ± 18.48) mL,which were significantly less than (465.67 ± 41.88) mL and (560.02 ± 44.98) mL of the control group (t =6.38,6.98,all P ＜ 0.05).In the observation group patients after the first three days VAS score was (3.61 ±0.20) points,lower than (6.01 ±0.25) points of the control group (t =6.64,P ＜ 0.05).Postoperative hospital stay was (6.50 ± 0.45) d,shorter than (11.33 ± 0.50) d of the control group(t =7.95,P ＜0.05).Conclusion VATS has the advantages of intuitive and strong,trauma,pain,faster recovery,shorter hospital stay,less closed thoracic drainage,fewer complications and so on in chest injury diagnosis and treatment.

Aim To investigate whether Rhizoma curcumaecould induce pregnane X receptor(PXR)-mediated transcriptional expression of CYP3A4 and study the modulatory effects on the enzyme activity and mRNA expression of CYP3A in the rat liver.Methods Transient cotransfection reporter gene assays were performed in HepG2 cells;the rat liver microsomal cytochrome P450 and CYP3A isoenzyme-erythromycin N-demethylase(ERD)activities were determined by UV chromatography;the mRNA expression level of CYP3A was detected by reverse transcriptase-polymerase chain reaction(RT-PCR).Results In vitroinvestigation showed Rhizoma curcumaeand its four selected constituents could induce the CYP3A4 transcriptional expression by activating PXR.In vivoinvestigation showed the CYP450 content of liver microsomes and enzyme activity of CYP3A were markedly increased and induced by Rhizoma curcumaeextract;at the mRNA level, the expression of CYP3A1 and CYP3A2 gene were markedly induced by Rhizoma curcumaeextract.Conclusions Rhizoma curcumaeand its four selected constituents could induce the expression of the CYP3A4 gene transcriptional expression through activating PXR;Rhizoma curcumaeextract could increase and induce the enzyme activity and mRNA expression of CYP3A.

Objective To explore the prognosis and its related factors of three-dimensional conformal radiotherapy (3D-CRT) for elderly patients with esophageal carcinoma. Methods From January 2001 to August 2007, 89 elderly patients aged 65 years or more with esophageal carcinoma were treated with 3D-CRT. And the local control rates, survival rates and its related prognostic factors were evaluated retrospectively, using SSPS11.5 software. Results The 1-, 2-, 3-and 4-year local recurrence-free survival rates were 65.2%, 43.0%, 27.3% and 22.3%, respectively. The 1-,2-, 3-and 4-year overall survival rates were 68.5%, 48.8%, 36.8% and 25.2%, respectively. And the median survival time was 21.5 months. With univariate analysis, the significant prognostic factors included the different diet before radiotherapy (χ~2=6.26, P=0. 012), T stage (χ~2=8. 80, P=0. 003), N stage (χ~2=4.33, P=0. 038), clinical stage (χ~2=7.88, P=0. 005), the largest diameter of tumor in CT scanning image (χ~2=10.88, P=0.004), recent efficacy (χ~2=5.28, P=0. 022) and chemotherapy (χ~2=5.49, P=0.019). And the factors which were not related with prognosis included gender (χ~2=0.74, P=0. 390), age (χ~2=1.89, P=0. 170), lesion length showed by esophageal angiography (χ~2=2. 38, P=0.123), lesion length showed by CT (χ~2=2.69, P=0.101),primary tumor site (χ~2=2.12, P=0. 146), coexistent disease (χ~2=0. 03, P=0. 874), exposure mode (χ~2=0.04, P=0.847) and radiation dose (χ~2=0. 24, P=0. 627). Multivariate analysis revealed that the different diet before treatment (P=0. 002), the clinical stage (P=0. 007) and chemotherapy (P=0. 011) were independent prognostic factors. Radiation induced esophagitis was observed in 20 cases in grade 0, 30 cases in grade 1, 32 cases in grade 2, 7 cases in grade 3. And acute radiation pneumonitis was observed in 89 patients, with 57 in grade 0, 20 in grade 1, 8 in grade 2, 2 in grade 3 and 2 in grade 5. Until the end date of follow-up, 60 patients had died: 29 cases died of local recurrence or uncontrolled disease, 11 cases died of metastasis, 5 cases died of local recurrence with metastasis, and 15 cases died of other reasons. Conclusions 3D-CRT can be considered as an effective and feasible approach for elderly patients with esophageal cancer. The 3D-CRT provides them with less obstruction of diet, early clinical stage and longer survival time. 3D-CRT combined with chemotherapy may improve survival rate.

Objective · To investigate the difference in myocardial strain of left ventricle between obstructive hypertrophy cardiomyopathy (HCM) and nonobstructive HCM. Methods · Cardiac magnetic resonance imaging (MRI) exam was performed on 48 sequential enrolled patients with HCM (18 with obstructive HCM, and 30 with nonobstructive HCM), whose left ventricular ejection fractions (LVEF) were over 50%. Twenty-five healthy volunteers were examined as normal controls. Global longitudinal strain (GLS), global radial strain (GRS), global circumferentialstrain (GCS), LVEF, left ventricular end diastolic volume (LVEDV), left ventricularmass (LVM), left ventricular end diastolic volume index (LVEDVI), and left ventricular mass index (LVMI) were collected and compared. Radial strain, circumferential strain and peak radial displacement were also measured in medial segment of left ventricle according to American Heart Association (AHA) 17-segment model. Results · ① LVEF of the patients with obstructive HCM was bigger than those of nonobstructive HCM patients and control group (P<0.05). LVM and LVMI of the HCM groups were bigger than those of control group (P<0.01). ② Left ventricle GLS, GRS, and GCS significantly decreased in the patients with nonobstructive HCM compared to those with obstructive HCM (P<0.05). The three parameters of two HCM groups were significantly lower than those of healthy volunteers (P<0.05). ③ Compared with obstructive HCM patients,the segmental parameters of left ventricule, the medial segment circumferential strain and radial strain of nonobstructive HCM patients significantly decreased (P<0.05), and the two parameters of both HCM groups were lower than those in healthy volunteers. Compared with obstructive HCM patients and healthy volunteers, peak radial displacement of left ventricule medial segment in nonobstructive HCM witnessed a significant decrease, while no significant difference was observed between obstructive HCM patients and healthy volunteers. Conclusion · In the LVEF preserved HCM patients, the myocardial strain of left ventricle in nonobstructive HCM patients decrease significantly than that in obstructive HCM patients, which may result in the different clinical outcomes intwo types of HCM patients. It is suggested that the myocardial strain is more sensitive than ejection fraction in the evaluation of myocardial performance of HCM patients.

Objective To find new way to reduce non-recurrent laryngeal nerve (NRLN) injuries by applying intraoperative neuromonitoring(IONM) to identify NRLN in thyroidectomy. Methods Records of 279 patients who underwent complex thyroidectomy by applying IONM to identify and monitor RLN from Mar. 2009 to Jan. 2010 were veviewed. We proposed the skills to identify and monitor NRLN and predict RLN varition through exploring vagus nerve and RLN before RLN dissection. Results 6 cases NRLN located on the right side were all accurately identified by IONM, thus no injury of NRLN occurred during thyroid operations. Conclusions NRLN is difficult to be predicted preoperatively and identified by naked eyes. The application of IONM to predict, identify and monitor NRLN could remarkably reduce the possibility of NRLN injury.

Objective To investigate the diagnostic and treatment results of arteriovenous fistula of cauda equina.Methods From January 2000 to December 2015,9 Patients with arteriovenous fistula of cauda diagnosed and treated at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively,including 6 males and 3 females.Their ages were 17-58 (mean 39±14) years.The diagnoses were confirmed by digital subtraction angiography (DSA) or surgery (the lesions were located on the cauda equine,which were fed by the arterial supply of the nerve root,and the drainage vein flowed upward into the perimedullary vein).The clinical data,imaging data,and treatment follow-up results of the patients were analyzed.Results The patients presented with weakness of both lower extremities and disturbances of bowel movement and urination.Aminoff Logue score for spinal function was 7.2±3.2 before procedure.The median course of disease was 6.0 (4.5-18.0) months.Angiography showed that the vascular architecture types of the lesions were divided into simple fistula type and micro-nidus type.The feeding arteries were all the nerve root branches of the internal iliac artery.Three patients complicated with conical part of the intramedullary arteriovenous malformations.Eight patients were treated with endovascular embolization,one was treated by operation.No patients were treated with combined interventional surgery,and no surgery-related complications were observed.The mean follow-up duration was 20.1±6.7 months.Imaging follow-up showed that they all reached anatomic cure.Aminoff Logue score dropped to 4.6±2.8 after treatment.There were significant differences before and after treatment in Aminoff Logue score of the patients (t=4.276,P<0.05).Conclusions The nerve root arteriovenous fistula of the cauda equina can be diagnosed by DSA findings.Symptomatic patients are eligible for the indication of endovascular or surgical treatment.Anatomy and functional prognosis are satisfactory after treatment.

Objective: To investigate the clinical efficacy of needling Danzhong(CV 17) in the treatment of postpartum hypogalactia and provide clinical evidence for indications of the point. Methods: A multi-centre single-blind randomized controlled trial was carried out. Two hundred and seventy-six puerperal women with postpartum hypogalactia were randomly allocated into acupuncture group and herb group, and respectively treated for three consecutive days. The degree of mammary fullness, the amount of milk secreted, prolactin, baby weight, the frequency and volume of artificial feeding, the number of infant urination events, and the duration of baby crying were observed. The clinical curative effects on postpartum hypogalactia were compared. Results: Hypogalactia was effectively treated in both acupuncture and herb groups. There were statistically significant differences in degree of mammary fullness, amount of milk secreted, baby weight, the frequency and amount of artificial feeding, and the number of infant urination events between pretreatment and post-treatment, but no difference between the two groups. There was no significant difference in prolactin in the acupuncture group and there was a difference in prolactin in the herb group between pretreatment and posttreatment. Conclusion: Needling Danzhong(CV 17) can effectively promote lactation.

Objective:To study the effects of tetramethylpyrazine on the expressions of ferroptosis related molecules after spinal cord injury; To explore the mechanism of tetramethylpyrazine promoting the repair of spinal cord injury (SCI).Methods:Totally 36 SD rats were divided into sham-operation group, model group and tetramethylpyrazine group according to random number table method, with 12 rats in each group. The rats in the sham-operation group underwent laminectomy without injury to the spinal cord. The SCI model was prepared in the other two groups. The rats in the tetramethylpyrazine group were intraperitoneally injected with tetramethylpyrazine of 80 mg/kg, and the rats in the sham-operation group and model group were intraperitoneally injected with the same volume of normal saline, once a day, continuous intervention for 28 days. One day before operation and 1, 3, 5, 7, 14, 21, 28 days after operation, BBB limb motor function score was used to evaluate the limb motor function of rats. Nissl staining was used to observe the morphology of neurons. Prussian staining was used to observe iron deposition. Assay kit was used to detect the contents of MDA and ROS in spinal cord tissue. Western blot was used to detect the protein expressions of xCT, GPX4 and ACSL4, and qPCR was used to detect the mRNA expressions of mRNA of xCT, GPX4 and ACSL4.Results:On the 14th, 21st and 28th days after operation, compared with the model group, the BBB score of tetramethylpyrazine group increased ( P<0.01); tetramethylpyrazine could significantly improve the morphology and structure of neurons and reduce the iron content in spinal cord tissue; compared with the model group, the contents of MDA and ROS in the spinal cord tissue of tetramethylpyrazine group decreased ( P<0.01); the levels of xCT and GPX4 mRNA and protein increased ( P<0.01), while the expression of ACSL4 mRNA and protein decreased ( P<0.01). Conclusion:Tetramethylpyrazine can regulate lipid peroxidation by regulating the expressions of ferroptosis related molecules, which is conducive to the recovery of limb motor function in rats with spinal cord injury.

BACKGROUND:Studies have shown that there is a close association between spinal cord injury and ferroptosis,and that tetramethylpyrazine has the function of regulating redox reactions. OBJECTIVE:To investigate the regulatory effect of tetramethylpyrazine on ferroptosis in rats with spinal cord injury and its mechanism. METHODS:Thirty-six female specific pathogen-free Sprague-Dawley rats were randomly divided into sham-operated group,model group and tetramethylpyrazine group,with 12 rats in each group.Animal models of spinal cord injury were established using the modified Allen's method in the latter two groups.No treatment was given in the sham-operated group,while rats in the model and tetramethylpyrazine groups were given intraperitoneal injection of normal saline and tetramethylpyrazine solution,once a day,for 28 days. RESULTS AND CONCLUSION:The Basso,Beattie&Bresnahan Locomotor Rating Scale score in the tetramethylpyrazine group was lower than that in the sham-operated group but higher than that in the model group after 14,21,and 28 days of treatment(P＜0.05).After 28 days of treatment,hematoxylin-eosin staining showed that in the model group,the spinal cord tissue of rats showed cavity formation,necrotic tissue and inflammatory infiltration with fibrous tissue formation;in the tetramethylpyrazine group,the area of spinal cord tissue defects was smaller,and inflammatory infiltration and fibrous tissue formation were less than those in the model group.After 28 days of treatment,Prussian blue staining showed that a large amount of iron deposition was seen in the spinal cord tissue of rats in the model group,and less iron deposition was seen in the spinal cord tissue of rats in the tetramethylpyrazine group than in the model group.After 28 days of treatment,the levels of glutathione and superoxide dismutase in the rat spinal cord tissue were decreased(P＜0.05)and the level of malondialdehyde was increased in the model group compared with the sham-operated group(P＜0.05);the levels of glutathione and superoxide dismutase in the rat spinal cord tissue were increased(P＜0.05)and the level of malondialdehyde was decreased in the tetramethylpyrazine group compared with the model group(P＜0.05).After 28 days of treatment,qRT-PCR and western blot assay showed that the mRNA and protein levels of glutathione peroxidase 4,ferritin heavy chain,and ferroportin in the rat spinal cord tissue in the model group were decreased compared with those in the sham-operated group(P＜0.05),while the mRNA and protein levels of glutathione peroxidase 4,ferritin heavy chain,and ferroportin in the rat spinal cord tissue in the tetramethylpyrazine group were increased compared with those in the model group(P＜0.05).Immunofluorescence staining showed that after 28 days of treatment,the neuronal nuclei positive staining in the spinal cord of rats was the most in the sham-operated group and the least in the model group.To conclude,tetramethylpyrazine can improve motor function and play a neuroprotective role in rats with spinal cord injury by regulating ferroptosis.