Objective:To study the effects of file tip size on the accuracy of Root ZX apex locator during electronic measurements in enlarged root canals.Methods: Forty premolars mounted in 20 g/L agar were used.First,the canals were instrumented using size 15-40 K-files with a size 40 as the master apical file(MAF).Second,the canals were enlarged using 45-60 K-files with the step-back way and 60 K-file as the MAF.In each step,the length was measured with a Root ZX using small and large tip size files.Results: File tip size and the degree of root canals enlarged both had a significant influence on the measurement,the difference was 0.22 mm.Conclusion: The measured working length with smaller size files become shorter when the root canals are enlarged.A file size comparable to the root canals should be used with root length measurement before root canal fillings.

Objective:To evaluate the safety and feasibility of root canal therapy in leukemia patients before bone marrow transplantation.Methods:15 root canal therapy of teeth with chronic periapical diseases were performed in 15 patients with leukemia before bone marrow transplantation.Diameters of the shaded area of periapex were all less than 0.5 cm.The root canal therapy was done at appropriate time,restricted hemateikon(neutrophil counts range from 3.0?109/L ~10?109/L,platelet counts more than 50?109/L),all the teeth were done with root canal therapy according to the principle of root canal therapy.All the patients were monitored by return visit after transplantation.Results:It did not happen any odontogenous complication with 15 patients during the bone marrow transplantation period.The periapical diseases of 15 teeth have been well controlled after root canal therapy.Conclusion:Teeth with chronic periapical diseases of patients with leukemia before bone marrow transplantation can be preserved after adequate root canal therapy and the root canal therapy is safe.

Objective To detect the serum level of interleukin (IL)-1 1, lymphocyte subsets and NK cells in patients with idiopathic thrombocytopenic purpura (ITP), and explore the related factors in the pathogenesis of ITP. Methods The serum level of IL-11, lymphocyte subsets and NK cells were detected by double antibody sandwich enzyme linked immunosorbent assay (ELISA) and flow cytometry in 50 ITP patients (ITP group) and 30 controls (control group). Results The platelet in ITP group [ (30.21 ± 19.40) ×109/L] was lower than that in control group [ (207.21 ± 31.55 ) × 109/L] obviously (P ＜ 0.05 ); the serum level of IL-11 in ITP group [(255.72 ± 163.43) ng/L] was significantly higher than that in control group [ (40.60 ± 5.57 ) ng/L ] (P ＜ 0.05 ). The correlation analysis indicated that the blood serum levels of IL- 11 had negative relationship with the platelet (r = -0.557 ,P ＜ 0.05). The percentage of CD3+ and CD4+ T lymphocyte percentage, CD4+/CD8+ in ITP group were lower and the percentage of CD8+ T lymphocyte was higher than those in control group obviously (P ＜ 0.05 ). The percentage of CD3- CD(16+56) +NK cell in ITP group was lower than that in control group (P ＜ 0.05). Conclusion IL-11, lymphocyte subgroup and NK cell change correlate with ITP morbidity closely, and the IL-11 level and the platelet possibly have the negative feedback control action.

Objective To investigate the effect of sanbai granules on the patients with leucoderma.Methods 180 cases with leucoderma were selected and divided into two groups.90 cases in the control group were treated by Methoxsalen Tablets 10mg,1 times a day,2h sunlight after the medication,appropriate amount external of Compound Kaliziran tincture and Halometasone.90 cases in the experiment group were treated on the base of the control group with Sanbai granules.The activity of tyrosinase,amount of melanin in the serum,clinical effect and amount of skin regeneration between two groups were compared.Results Compared with the control group, the activity of tyrosinase and melanin in serum of the experiment group were higher (P<0.05),the clinical effect rate were higher(P<0.05),number of skin regeneration piece was higher(P<0.05).Conclusion Sanbai granules can effectively improve the activity of tyrosinase and melanin in patients with leucoderma, and it has important significance for the treatment of leucoderma.

Following great progress on the pathogenesis of lupus nephritis (LN) and publication of many high quality (prospective,randomized,multicenter) clinical trials of glucocorticoids-plus-immunosuppressive interventions,the American College of Rheumatology (ACR),European League Against Rheumatism (EULAR)/European Renal Association-European Dialysis and Transplant Association (ERA-EDTA),and Kidney Disease:Improving Global Outcomes (KDIGO) published or renewed in succession in 2012 special guidelines or recommendations for screening,casedefinition,treatment and management of LN.The paper introduces the key contents to provide reference for the clinical practice.

Objective To explore the effect of dexmedetomidine on the stress and immunologic function in the patients undergoing uterectomy,and to provide an evidence for the medication in clinical anesthesia.Methods A total of 60 hysteromyoma patients who needed uterectomy were selected.All the patients were in ASAⅠ-Ⅱlevel. The patients were divided into observation group (n=30)and control group (n=30)according to administration of different types of drugs. Before anesthesia, the patients in observation group were given dexmedetomidine (l μg·kg-1 )with a concentration of 4 g· L-1 for 10 min,while the patients in control group were given equal normal saline.The induction was performed 10 min after infusion pump.Sevoflurane and fentanyl were used for maintaining during the anesthesia.The blood samples of the patients in two groups before entering the operation room (T0),2 h after operation (T1),and extubation after operation (T2)were collected.The serum cortisol (COR)and interleukin-2 (IL-2)concentrations,plasma T lymphocyte subpopulations and NK levels were detected. Results The differences of COR and IL-2 concentrations at T0 between two groups were not statistically significant (P >0.05).The COR concentrations at T2 in two groups were significantly higher than those at T0 (P <0.05). The COR concentration at T2 in observation group was significantly lower than that in control group (P <0.05). The serum IL-2 concentration was gradually decreased with the prolongation of time observation in two groups.The serum IL-2 concentration in observation group was significantly higher than that in control group (P <0.05).The differences of CD3+ ,CD4+ ,CD8+ ,CD4+/ CD8+ ,and NK levels at T0 between two groups were not statistically significant (P >0.05).The differences of CD8+ level in each time point between two groups were not statistically significant (P > 0.05).The CD3+ ,CD4+ ,CD4+/ CD8+ , and NK levels at T1 and T2 in control group were significantly lower than those at T0 (P < 0.05 ). The CD3+ , CD4+ , CD4+/ CD8+ , and NK levels at T2 in observation group were significantly higher than those in control group (P <0.05).Conclusion Dexmedetomidine assisting anesthesia can alleviate the postoperative stress reaction,and reduce the effect of anesthesia and operation wound on the cellular immune function.It is beneficial for the postoperative rehabilitation.

Objective:To explore the influencing factors of recovering to normal atrioventricular nodal conduction (AVNC) in patients with acute myocardial infarction (AMI) complicated III atrioventricular block (AVB) .Meth‐ods:According to III AVB recovered to normal or not ,a total of 82 AMI complicated III AVB patients were divid‐ed into recovery group (n=51) and non- recovery group (n=31 ,including three cases undergoing permanent pace‐maker implantation and 28 dead cases) .The relationship among diabetes mellitus (DM) history ,ischemic precondi‐tioning (IP) ,levels of creatinine (Cr) and hemoglobin (Hb) at hospitalization ,systolic blood pressure (SBP) ,Killip class , cardiogenic shock and recovering to normal AVNC etc .were observed in two groups .Results:There were no significant difference in age ,sex proportion ,smoking history ,hypertension history ,DM history ,IP ,duration from onset to arriving at emergency room ,heart rate and SBP at hospitalization ,Hb level and early reperfusion treatment between two groups , P>0.05 all .Compared with recovery group ,there were significant rise in percentages of Kil‐lip ≥class II (39.2% vs .80.6% ) ,cardiogenic shock (21.6% vs .45.2% ) ,anterior wall infarction (7.8% vs . 32.3% ) ,Cr level [ (107.25 ± 6.69) μmol/L vs .(132.43 ± 11.52) μmol/L] and mortality (0% vs .90.3% ) ,and significant reduction in percentage of inferior wall infarction (92.2% vs .67.7% ) in non - recovery group , P<0.05 or < 0.01. Multifactor Logistic regression analysis indicated that Killip class was the independent predictor (OR=0.190 , P= 0.002 ) influencing recovering to normal AVNC in AMI + III°AVB patients .Conclusion:Killip class is an independent predictor influencing recovering to normal AVNC in AMI +III°AVB patients .

Objective To explore the effect of palliative care led by oncology professional nurses in the elderly patients with late tumor. Methods Ninety patients who were diagnosed with late tumor were randomly divided into control group and intervention group. Routine nursing care was conducted in the control group and in the intervention group, palliative care lead by professional nurses was conducted besides the routine nursing care for 8 weeks. The two groups were compared in view of life, symptom distress, and self-efficacy intervention effect. Result The quality of life and self-efficacy were significantly higher than those of the control group (P<0.05) and the symptom distress was significantly lower than that of the control group eight weeks after the intervention (P<0.05). Conclusion The multi-disciplinary intervention led by the oncology professional nurses can improve the quality of life and self-efficacy of the patient and improve the symptoms of the patient.

Objective To explore the characteristics of TCM syndrome of vertigo. Method Patients of vertigo need to fill a form about the symptoms of TCM, and then analyze the frequence and percentage of the symptoms and the syndromes with SPSS software. Result Except vertigo or dizziness, the common accompanied symptoms were distractedness, feeling thirsty, tinnitus, poor memory, afraid of cold and vomiting, etc. There were 26 syndromes, and the top 5 of which are yin-deficiency of liver and kidney, wind stirring, phlegm blocking, qi-deficiency of spleen and blocking qi of liver. Conclusion The characteristics of syndrome of these patients of vertigo were same as the theory of TCM. The better way to find the characteristics of syndrome of vertigo still need to be explored.