The maxillary first premolar is a transitional tooth between incisors and molars. Most maxillary first premolars have 2 root canals. However, the bilateral maxillary first premolar with 3 roots and 3 canals has not been described. This article reports a rare case:The bilateral maxillary first premolar with 3 roots and 3 canals.

Objective To examine the hemodynamic changes and oxygen metabolism during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty patients (18 male, 2 female) aged (60?8)yr, weighing (71?9)kg undergoing OPCABG were studied. The patients were premedicated with diazepam 10 mg PO 2h before operation and morphine 10 mg and scopolamine 0.3 mg im 30 min before operation. Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1, fentanyl 5-10 ug?kg-1 and vecuronium 0.12-0.15 mg?kg-1 and maintained with 0.5%-2% isoflurane inhalation, fentanyl 10-20 ug?kg-1 and intermittent iv boluses of vecuronium and in some patients propofol infusion. Radial artery was cannulated. Swan-Ganz catheter was placed via internal jugular vein into pulmonary artery. Hemodynamic parameters including MAP, HR, cardiac index (CI), stroke volume (SV), MPAP, PCWP, SVR, left ventricle stroke work index (LVSWI) and RVSWI; oxygen metabolism including oxygen delivery (DO2) , oxygen consumption (VO2) and oxygen extraction ratio (ERO2); regional cerebral oxygen saturation (rSCO2) and arterial blood lactate level (ABL) were measured and recorded before skin incision (A), when pericardium was incised before operation on the heart (B), during operation on the heart (C), 10 min after operation on the heart (D) and at the end of surgery (E) . Results During surgical manipulation on the heart (C) MAP, SV and CI decreased while CVP and HR increased, but the decrease in CI and SV was not significant. During manipulation on the heart(C) DO2 decreased whereas ERO2 increased, but there was no significant change in VO2. After manipulation on the heart (D) DO2 and ERO2 returned to the pre-manipulation level. Arterial blood lactate concentration increased at E. Conclusion OPCABG can be performed uneventfully under our general anesthetic regimen. During operation while the beating heart is being manipulated MAP tends to decrease while CVP and HR increase. The changes are of short duration and do not result in any serious consequeaces.

Animals ; Cattle ; China ; epidemiology ; Echinococcosis ; epidemiology ; parasitology ; transmission ; Echinococcus granulosus ; pathogenicity ; Humans ; Seasons

Objective To explore the influence of score sheet of colostomy on reduction of complication in non-hospitalized patients with colostomy stoma.Methods 186 patients with colostomy stoma were randomly divided into group A and group B.Group A used the score sheet of colostomy with nurses during hospitalization and after discharge.Group B were in routine treatment without using the score sheet of colostomy.The two groups were followed-up by phone or by visiting in the following 1,3,6 months after discharge.Results The complications between the two groups were evaluated.The risk of the complications was only 14.0％ in group A,and the risk in group B was 36.6％.The results of self-satisfaction degree was significantly different between two groups.Conclusions The use of the score sheet of colostomy can significantly reduce the incidence of stoma complications and obviously improve the quality of life of the patients with colostomy.

Objective To evaluate the effects of hydrocolloid dressings with conventional care in the prevention of pressure ulcers.Methods Randomised controlled trials and quasi-randomised trials,which assessed the effects of hydrocolloid dressings in preventing pressure ulcers compared to conventional care were sought.Data were pooled using RevMan 5.0.Results 17 eligible trials were identified with a total of 1 371 study participants.Meta-analysis showed that:Compared to conventional care,conventional care and hydrocolloid dressings were effective for preventing pressure ulcers for patients at risk of pressure ulcers [RR =0.29,95％CI (0.18,0.46)] and using noninvasive positive pressure ventilator [RR=0.30,95％CI (0.18,0.52).Conclusions Hydrocolloid drcssings and conventional care can reduce the pressure ulcer incidence of patients at risk of pressure ulcer or using noninvasive positive pressure ventilator.

Background and purpose:Studies have shown that ribosomal protein L8 (RPL8) is shared by melanomas, gliomas and ovarian carcinomas. A peptide of RPL8 signiifcantly stimulated proliferation and cytokine expression of the hepler T cell clone and lymphocytes in melanoma patients. RPL8 may stimulate anti-tumor immunity, making RPL8 an attractive candidate for therapeutic intervention. In this study, we prepared DC pulsed by RPL8 (RPL8-DC) and investigate the anti-tumor effect of RPL8-DC on melanoma in mice.Methods: The recombinant protein was achieved through IPTG induction in E. coli and identiifed with Western blot. Bone marrow-derived DC was loaded with RPL8 protein. RPL8 and CD11c, CD80, MHC-Ⅰ, MHC-Ⅱmolecules on dentritic cells were monitored by lfuorescence microscope and FACS analysis, respectively. The anti-tumor effect of T cells in vitro was detected by MTT assay. Subcutaneous tumors were induced in C57BL/6 mice using B16 cells. The tumor volumes were measured after injection with RPL8-DC. Results:The puriifed protein was combined with speciifc antibodies. DCs pulsed by RPL8 were visualized under lfuorescent microscopy. CD11c, CD80, MHC-Ⅰ, MHC-Ⅱmolecules on DCs were up-regulated after stimulation with RPL8 and LPS. B16 cells were inhibited by T cells stimulated with RPL8-DC. The inhibition rate of tumor cells was 70%in RPL8-DC group when effector-to-target ratio was 30∶1, which was higher than PBS and DC groups. Inhibition of growth could be observed more signiifcantly in mice after the treatment with RPL8-DC. The mice receiving the therapy of RPL8-DC were able to survive much longer than the mice receiving control therapy. Conclusion:The DC pulsed by RPL8 protein can inhibit the growth of melanoma.

Objective To sum up the experiences of the application of gastric cancer postoperative gastroin-testinal decompression tube.Methods Retrospectively analyzed the implementation of postoperative gastrointestinal decompression tube undergoing elective surgery.The clinical data of 15 cases of gastric cancer,preoperative education communication,preoperative preparation,intraoperative and postoperative treatment were analyzed.Results 14 cases recovered,1 case was not completely correct anastomotic fistula by malnutrition.The average for the first time the anus exhaust time was (48.7 ±16.4)h,for the first time defecation time was (65.1 ±5.7)h,postoperative length of hospi-tal stay was (12.4 ±3.1)d,postoperative nausea and vomiting occurred in 2 cases,diarrhea in 2 cases,sore throat discomfort in 3 cases.Conclusion Postoperative gastric cancer patients with gastrointestinal decompression tube can reduce stress damage,improve postoperative experience,accelerate the postoperative rehabilitation,does not increase the incidence of postoperative complications,it is safe and feasible.

Objective To investigate the effect of CD40/CD40 ligand on the genesis and development of coronary artery disease (CAD),and the inhibitory effect of cyclosporine A (CsA) on CD40/CD40 ligand. Methods A total of 71 patients were divided into four groups:acute myocardial infarction group (AMI, n=19), unstable angina pectoris group (UAP, n=18), stable angina pectoris group (SAP, n=17) and normal control group (N, n=17). Flow cytometry was used to detect the expres?sion of CD40 and CD40L in peripheral blood mononuclear cells (PBMCs) of four groups. The group in which CD40 and CD40L were produced at the highest level was chosen, and a series concentrations of CsA(H1:0 mg/L, H2:0.01 mg/L, H3:0.1 mg/L, H4:1 mg/L)were used to treat the cells. Then the expressions of CD40 and CD40L were measured by flow cytome?try. Results Compared with N group,the expression of CD40 was significant higher in other groups (P<0.05). The expres?sion of CD40 was significant higher in UAP group and AMI group than that of SAP group. There was no significant difference in the expression of CD40 between UAP group and AMI group (P>0.05). The expression of CD40L was elevated and fol?lowed by different severity of CAD. There was significant difference in the expression of CD40L between groups (P<0.05) . AMI group showed the highest expression of CD40 and CD40L. After being treated with CsA, the expression of CD40 was higher in H1 group than that of H3 group and H4 group (P<0.05). The expression of CD40L was significantly higher in H1 group than that of other three groups (P < 0.05). Conclusion CD40 and CD40L may be involved in the development of CAD. Moreover, it might be restrained by CsA via regulation of CD40/CD40L.

Objective To study the effect of cardiac troponin T(cTnT)on the prognosis of chronic heart failure in the elderly patients.Methods Serum level of cTnT,and serum activities of creatine kinase (CK)and creatine kinase-MB(CK-MB)were measured in 60 elderly patients of chronic heart failure with varied classes of cardiac function.Cardiac events,including malignant cardiac arrhythemia,repeated or aggravated heart failure or cardiac death,in patients with increased cTnT during hospitalization were compared to those without it.Results Serum level averaged(89.1?13.6)mmol/L for CK and(7.9? 1.4)mmol/L for CK-MB in 20 patients with Class Ⅱ cardiac function by New York Heart Association (NYHA)classification and without increased cTnT,(88.2?13.4)mmol/L for CK and(7.5?1.8) mmol/L for CK-MB in 19 patients with Class Ⅲ cardiac function and four of them with increased cTnT,and (93.3?14.2)mmol/L for CK and(8.1?1.6)mmol/L for CK-MB in 21 patients with Class Ⅳ cardiac function and 14 of them with increased cTnT.Malignant cardiac arrhythemia occurred in six,repeated heart failure in eight,and death in three of 18 patients with increased cTnT,and one,two and one in 22 patients without increased cTnT,respectively.Incidence of cardiac events was higher in patients with increased cTnT than those without it(P

We describe the prenatal diagnosis and postnatal follow-up of a fetus with a pericallosal lipoma diagnosed by MRI. The pregnant woman was admitted to Zhongnan Hospital of Wuhan University in February 2019. MRI examinations with multiple sequences and imaging methods were performed prenatally at 31 +6 and 38 +3 weeks of gestation, and at two days and three months postnatally. The MRI images showed that the corpus callosum was normal and the lesion was located around the corpus callosum, with high signal intensity on T1 weighted imaging, medium-to-high signal intensity on T2 weighted imaging, and low signal intensity on fat suppression sequence. No abnormal blood vessels were found on susceptibility-weighted imaging and time-of-flight magnetic resonance angiography sequences. Based on the prenatal and postnatal MRI findings, the tumor was clinically diagnosed as a pericallosal lipoma.