Objective: To observe the effects of Thermafil obturat ion technique.Methods: 60 premolars with pulp pathema or periapical dese ase were divided into two groups with 30 in each at random,The teeth were treate d and the root canals were obturated by Thermafil obturation technique and later al condensation technique respectively. Preoperative and postoperative radiograp hs of each tooth were taken. Obturation time, incidence of pain during obturatio n and quality of obturation were compared.Results: Overfi lling was found in 11 cases in Thermafil group,while 3 in lateral condensation group( P 0.05).The average obturation tim e per canal of Thermafil and lateral condensation technique was 36.6 s and 247 .4 s respectuively ( P

Objective To investigate the spectrum of spiral CT imaging findings of blunt liver trauma.Methods Clinical data of 17 patients with blunt liver trauma were retrospectively collected. All patients underwent standardized spiral CT examination of the upper abdomen, which include plain scan, arterial phase and portal venous phase acquisition. The morphology, density and integrity of liver parenchyma and intrahepatic venous structures were carefully observed, as well as regions of porta hepatis, peritoneal cavity and retroperitoneal space.Results Twelve cases (70.6%) developed hepatic parenchymal laceration. There were 9 cases (52.9%) of traumatic hematoma, among which 5 were intraparenchymal and 4 were subcapsular. One case (5.9%) showed active bleeding within an intrahepatic hematoma, while two cases (11.8%) had injury (laceration) of hepatic veins. There were 7 patients (41.2%) who demonstrated the so-called “halo sign” around the intrahepatic portal branches. Thirteen patients were associated with peritoneal fluid (blood) collection, 3 with hematoma or hemorrhage of the right adrenal gland, 8 with plural effusion and 3 cases with rib fractures of right lower chest. Conclusion CT imaging findings of blunt liver trauma include parenchymal laceration, intraparenchymal and /or subcapsular hematomas, active hemorrhage, and tear of hepatic veins. Plain CT scan and contrast-enhanced dual-phase acquisition is very important for the comprehensive evaluation of patients with blunt liver trauma.

Objective To investigate the diagnostic value of a fast gradient-echo(GRE) three-dimensional contrast-enhanced volumetric interpolated breath-hold examination(3D-VIBE) MR sequence in evaluating focal liver lesions.Methods Conventional spin-echo T2W,2D GRE T1W plain scan and Gd-enhanced 3D-VIBE multi-phasic(early arterial,late arterial and portal venous phases) acquisitions were prospectively performed for 51 consecutive patients suspected of having focal liver lesions on CT or ultrasound imaging.Native T2W and 2D GRE T1W were acquired first,then 3D-VIBE fast scanning at early arterial,late arterial and portal venous phases respectively.The SNR and CNR of the liver lesions on plain scan and the enhancement patterns on contrast-enhanced 3D-VIBE images were carefully observed with correlation of the clinical and surgical pathological findings.Results There exited certain differences in SNR,CNR,and the enhancement patterns of different kinds of focal hepatic lesions in plain scan and Gd-enhanced multi-phasic 3D-VIBE acquisitions.Conclusion 3D-VIBE MR sequence is helpful in the detection and characterization of focal liver lesions.

Clinical laboratory information system is the key to the realization of total laboratory automation,standardization,intelligent and digitization.In recent years,with the establishment,application,popularization and upgrading of clinical laboratory information system,it is very important to establish the construction criterion of clinical laboratory as soon as possible.Now according to the requirements of construction and management of modern clinical laboratory and combining with the practical application of clinical laboratory information system in our hospital at domestic settings,the standardization construction of clinical laboratory information system was discussed in this article.

Objective To investigate the effect of ovarian cycle on the sedative effect of propofol in patients. Methods Forty ASA Ⅰ or Ⅱ patients, aged 20-40 yr, with body mass index 20-25 kg/m2 , scheduled for elective gynecologic laparoscopic surgery, were divided into 2 groups according to the progesterone level ( n = 20 each): follicular phase group (group F, serum progesterone concentration 0.31-1.52 ng/ml) and luteal phase group (group L, serum progesterone concentration 5.16-18.56 ng/ml). Anesthesia was induced with target-controlled infusion (TCI) of propofol and iv injection of fentanyl and cisatracurium. The initial target plasma concentration (Cp) of propofol was set at 2 μg/ml, after the Cp reached the predetermined level, the Cp increased by 0.5 μg/ml every 30 s until the patients lost consciousness and BIS value was decreased to 50. The BIS value and Cp of propofol was recorded when the patients lost consciousness. The Cp of propofol was also recorded when BIS value was decreased to 50. The patients were tracheal intubated and mechanically ventilated. Anesthesia was maintained with TCI of propofol combined with remifentanil. BIS value was maintained at 45-55 by adjusting the Cp of propofol. Results The Cps of propofol were significantly higher when the patients lost consciousness and when BIS value was decreased to 50 in group F than in group L ( P ＜ 0.05 or 0.01) . There was no significant difference in BIS value when the patients lost consciousness between the two groups (P ＞ 0.05). Conclusion Ovarian cycle can affect the sedative effect of propofol in patients, which shows that the sedative effect during the follicular phase is lower than that during the luteal phase.

Objective To evaluate the value of MR imaging with a contrast enhanced multi phasic isotropic volumetric interpolated breath hold examination (VIBE) in diagnosis of primary liver carcinoma. Methods Thirty two consecutive patients with surgical pathologically confirmed 42 foci of primary carcinoma of liver underwent comprehensive MR examination of the upper abdomen, routine two dimensional (2D) T1WI and T2WI images were acquired before administration of Gd DTPA for contrast enhancement. Then, contrast enhanced multi phasic VIBE was acquired followed by 2D T1WI images. The lesion appearances on hepatic arterial, portal venous and equilibrium phases of VIBE sequence were carefully observed along with delineation of hepatic arterial and portal venous structures. The lesion detection rates and lesion characterization ability were compared among various MR sequences. Results 33(78.6%), 30(71.4%), 38(90.5%) and 42(100%) foci were displayed respectively on T2WI, non enhanced T1WI, enhanced T1WI and enhanced 3D VIBE images ( P

Objective To investigate the effect of glucose-based peritoneal dialysis fluids and icodextrin-based peritoneal dial-ysis fluids on the expression of TLR2 and TLR4 on huamn peritoneal mesothelial cells .Methods Human peritoneal mesothelial cell line 5 - 10 generations(HMrSV5) was cultured in DMEM /F12 medium supplemented with 10% (v/v) fetal calf serum (FCS) .Cell viability and cell proliferation were assessed using M TT method .The experiment were divided into 5 different groups :group A (control group) ,1 .5% dextrose group ,2 .5% dextrose group ,4 .25% dextrose group and 7 .5% Lcodextrin group .Icodextrin group (aikau dextrin) ,TLR2 and TLR4 expression were detected by Western blot .Results Treatment with different concentrations of glucose-based peritoneal dialysis fluids for 24 h did not affect the expression of TLR2 and TLR4 protein .In addition ,after stimula-tion for 48 h ,1 .5% dextrose ,2 .5% dextrose ,4 .25% dextrose decreased TLR2 expression by (5 .5 ± 2 .8)% ,(31 .4 ± 7 .5)% , (54 .9 ± 1 .9)% respectively ,TLR4 expression by (32 .9 ± 17 .6)% ,(47 .7 ± 13 .5)% ,(66 .4 ± 13 .5)% respectively .Stimulation for 72 h ,decreased TLR2 expression by (29 .4 ± 14 .7)% ,(38 .9 ± 9 .9)% ,(63 .5 ± 16 .5)% respectively ,TLR4 expression by(59 .5 ± 16 .8)% ,(63 .1 ± 9 .5)% ,(79 .2 ± 14 .0)% respectively .There was no significant change in TLR2 and TLR4 protein expression on 7 .5% icodextrin group .Conclusion Glucose-based peritoneal dialysis fluids ,but not icodextrin-based peritoneal dialysis fluids downregulates expression of TLR2 and TLR4 by HM rSV5 .

Objective To study clinical effect of vaginoplusty with sigmoid colon by laparoscopic surgery. Method Clinical data of 45 cases with laparuscopic vaginoplasty using a vuscularized pedicled sigmoid colon flap were reviewed, including 41 cases with congenital absence of vagina and 4 cases with male pseudohermaphroditism. Operation time, blood loss, the anatomical and functional newly forming vagina were evaluated. Results The sigmoid colon colpopoiosis was preformed successfully in all 45 cases. The range of operation time was 135-245 minutes and the mean time was 157 minutes. The mean blood loss was 82 ml during operation. The artificial vaginas had excellent cosmetic outcome, including adequate vaginal length, good lubrication, and appearance and physical functions similar to natural vagina. A vaginal mould was employed for more than 3 months in 34 cases, achieving a good dilatation of the artificial vagina. Twenty-five patients with satisfied sexual intercourse were reported. Conclusion Laparoscopic vaginoplasty using a vuscularized pedicled sigmoid colon flap is a feasible and ideal management.

Objective To investigate the clinical value of combined thoracoscopic and laparoscopic esophagectomy for the treatment of esophageal carcinoma.Methods The clinical data of 50 patients who underwent combined thoracoscopic and laparoscopic for the treatment of esophageal carcinoma at the Jiangdu People's Hospital of Yangzhou from May 2013 to August 2014 were retrospectively analyzed.The patients underwent the thoracoscopic mobilization of the intrathoracic esophagus and lymph node dissection in the left lateral decubitus position, and then the patients underwent laparoscopic mobilization of the stomach and lymph node dissection in the horizontal position, finally the gastric tube was pulled out to have stapled anastomosis through left neck.The operation time, volume of intraoperative blood loss, number of lymph node dissected, amount of postoperative thoracic drainage, time to resume diet after surgery, postoperative hospital stay and results of pathological examination were collected.Patients were followed up via telephone interview and out-patient examination till September 2014.The recovery condition and survival of patients were collected.The measurement data with normal distribution were presented as (x) ± s or mean value (range).Results There was no patient transferred to open thoracic surgery or abdominal surgery.The operation time of thoracoscopic and laparoscopic procedures were (85 ±30)minutes and (55 ± 22) minutes, respectively.The total operation time was (210 ± 40) minutes.The mean volume of intraoperative blood loss was 115 mL (range, 50-210 mL) in the thoracic cavity and 65 mL (range, 30-100 mL) in the abdomen.The mean number of lymph nodes dissected was 11.3 (range, 8.0-15.0) in the thoracic cavity and 8.5 (range, 6.0-12.0) in the abdomen.The mean volume of postoperative thoracic drainage, mean time to resume diet and postoperative hospital stay were 340 mL (range, 200-650 mL) , 7 days (range, 6-8 days) and 12 days (range, 11-14 days).The 50 cases were diagnosed as esophageal squamous cell cancer and staged as T1-3N0-1M0 by postoperative pathological examination, with negative upper and lower margin.There was 1 case of anastomotic leak, 3 cases of lung infection who were cured by symptomatic treatment and 3 cases of recurrent laryngeal nerve injury after operation who recovered after 6-month follow-up.All patients were successfully followed up without recurrence and death.During the follow-up of 1-16 months, 2 patients were found anastomotic stricture at postoperative 3 months, and were cured by endoscopic dilation for 3 times.Conclusion Combined thoracoscopic and laparoscopic esophagectomy is safe and effective for the treatment of esophageal carcinoma.

Aim To investigate the effects of silencing MALAT1 gene on cell proliferation inhibition and apop-tosis induced by Melittin in human hepatocellular car-cinoma HepG2 cells. Methods The inhibitory rate of cell proliferation treated with Melittin in HepG2 cells was examined by MTT assay. Apoptotic rate was detec-ted by flow cytometry. The MALAT1 expression level in HepG2 cells was measured by qPCR. Specific siR-NAs were utilized to silence MALAT1 expression. The rates of cell proliferation inhibition and apoptosis in HepG2 cells treated with siRNA and Melittin were compared with those of Melittin alone. Results Melit-tin significantly suppressed the growth of HepG2 and induced cell apoptosis in a dose-dependent manner. Compared with normal liver cell lines, MALAT1 was highly expressed in HepG2 cells ( P<0. 05 ) . The ex-pression of MALAT1 in HepG2 cells was inhibited by Melittin, and the inhibitory rate increased with the in-crease of concentration. The rates of cell proliferation inhibition and apoptosis in HepG2 cells treated with siRNA and Melittin were significantly higher than those treated merely with Melittin. Conclusion Melittin can reduce the expression of MALAT1 and silencing MALAT1 can effectively promote proliferation inhibi-tion and apoptosis in HepG2 cells induced by Melittin.