Root canal biofilm is frequently detected in the canal wall of infected root canal and the root canal with failed root canal therapy. Due to its special structure and diverse composition, root canal biofilm has the ability of the drug tolerance and antiimmunity, which lead to apical periodontitis. This review summarizes the features of the root canal biofilm and latest clinical methods to remove it.

Objective To investigate the effects of Bushen Yangxue decoction combined with hormone replacement effects on sex hormone level and symptom score in patients with premature ovarian failure .Methods 112 patients with premature ovarian failure from March 2014 to November 2015 in Zhejiang Tongde Hospital were divided into two groups with 56 cases in each group.The control group was treated with hormone replacement therapy , the combined group was treated with Bushen Yangxue decoction on the basis of the control group.The curative effect was compared between the two groups, the sex hormone, traditional Chinese medicine symptoms score, QOL score and endometrial thickness were compared between the two groups before treatment, at the end of treatment and 3 months after discontinuation.Results At the end of the treatment, there was no significant difference in total effective rate between the combined group (91.07%) and the control group (85.71%).At the end of the treatment, the scores of TCM symptoms and QOL scores were significantly lower in the two groups, and the endometrial thickness was significantly higher (P<0.05), compared with the control group at the end of treatment,the combined group TCM symptom score was lower(P<0.05), QOL score and endometrial thickness had no significant difference, after stopping drug for three months, there was no significant difference in the levels of TCM score, QOL score, endometrial thickness between the two groups.In the control group TCM score, QOL score were significantly higher, and significantly higher than the levels of the same period of the combined group, endometrial thickness was significantly lower, and the level of the same period was significantly lower than that of the combined group(P<0.05), at the end of treatment, the two groups of FSH, LH significantly decreased, E2 significantly increased(P <0.05), there was no significant difference between the two groups, after stopping drug for three months, there was no significant difference in the levels of E2, LH, FSH.The control group, LH and FSH levels were lower and E2 levels were higher in the control group at three months after discontinuation compared with those at the end of treatment (P<0.05).Compared with the control group, LH and FSH levels were lower and E2 levels were higher in the combined group after 3 months of drug withdrawal (P<0.05).Conclusion Bushen Yangxue decoction combined with hormone substitution method can significantly increase in patients with premature ovarian failure of sex hormone level, improve the recovery of patients with ovarian function.

BACKGROUND:Nanosilver has significant antibacterial properties, and nanohydroxyapatite has good biological activity and mechanical strength, while their mixture cannot only promote bone formation but also have antibacterial properties. OBJECTIVE:To observe the effect of nanosilver and nanohydroxyapatite mixed filing on the osseointegration of immediate implants. METHODS: Nine New Zealand white rabbits were randomly divided into experimental group (n=6) and control group (n=3) after four incisors from the upper and lower jaw were extracted. The mixture of nanosilver and nanohydroxyapatite was filed into the tooth socket in the experimental group, while nanohydroxyapatite was filed into the tooth socket in the control group. Titanium screw was immediately implanted into both groups. The intact maxila and mandibular specimens were harvested at the 4th, 8th, and 12th weeks after operation. Gross observation, X-ray bone density analysis, torque test and histological observation were conducted. RESULTS AND CONCLUSION:The gray value and maximum torque value of regenerated osseous tissue at different time points in experimental group were significantly higher than those in the control group (P < 0.05). Within 12 weeks of implantation, the bone formation rate and maturity of new bone tissue were higher in the experimental group compared with the control group, and no inflammatory cel infiltration occurred. At the 4th week after implantation, there was a large amount of inflammatory cel infiltration, and few inflammatory existed at the 8th week after implantation. These results demonstrate that compared with nanohydroxyapatite alone, the mixture of nanosilver and nanohydroxyapatite shows better antibacterial effect, biocompatibility and osteoinductive ability, which may accelerate osseointegration and promote osteogenesis.

Objective To investigate experience in nursing the patients with emergency traumatic injury combined with postoperative atelectasis. Method The clinical data of 11 patients with emergency traumatic injury combined with postoperative atelectasis were reviewed for summarizing the nursing experience. Result The clinical symptoms of all the 11 patients disappeared and the lungs reexpanded. Conclusion Careful observation of the disease conditions in order to prevent and treat atelectasis by airway humidification, sputum drainage and early exercises are effective for the cure of postoperative atelectasis.

BACKGROUND: Based on a mouse model of tibial implantation, some scholars have found that the CaP-coated implant with recombinant human parathyroid hormone (1-34) (PTH(1-34)) shows strong osteogenesis effect at early stage, but this coating has not been applied in the oral environment.OBJECTIVE: To explore the role of local application of PTH(1-34) on immediate implant osseointegration . METHODS: Nine New Zealand white rabbits were randomly divided into two groups (six in experimental group and three in control group). All of the tooth sockets were filled with heterogeneous freeze-dried bone firstly after four incisors of each rabbit were extracted. In the experimental group, a titanium screw with PTH(1-34) loaded CaP coating was implanted into each tooth socket, while in the control group, a titanium screw with only CaP coating was implanted. The animals were executed respectively at 4, 8, 12 weeks after operation, and the intact maxillary and mandibular specimens were harvested and tested by gross observation, bone density analysis, torque test, histologic al observation, X-ray observation.RESULTS AND CONCLUSION: The gray value and maximum torque value of regenerated osseous tissue at different time points in the experimental group were significantly higher than those in the control group (P < 0.05). Within 4-12 weeks after implantation, regenerated and mature bone tissue appeared earlier in the experimental group than the control group. A large amount of new blood vessels were seen in the experimental group at 8 weeks after implantation, while in the control group, there were only few new blood vessels. To conclude, the local application of PTH(1-34) can promote bone formation, improve the implant-bone bonding strength, and enhance the stability of the implant.

AIM:To observe the improvement in the endothelial function of patients with long-term use of Shexiang Baoxin Pill(Moschus,Ginseng extract,Calculus bovis,Cortex cinnamomi,Styrax,Venenum bufonis,and Borneolum Syntheticum)(SXBXP).METHODS:Eighty patients with CHD were randomly assigned into the SXBXP group and the control group.Two groups were controlled with the usual treatment.SXBXP 2 pills,po.tid.were taken in the SXBXP group and continued for at least 6 months.The ultrasound assessment of endothelial-dependent flow-mediated vasodilation(FMD)of the brachial artery was applied in the 3rd,6th and 18th and simultaneous determination of nirtogen oxides(NO),nitricoxide synthase(NOS),superoxide dismutase(SOD),endothelin(ET)was made.RESULTS:Follow-up checkups revealed that the level of FMD and SOD in the 3rd month,the level of NO,NOS and ET in the 6th month in SXBXP group were better than those in the control group at the significant level(P＜0.05).Patient keeping on taking SXBXP up to the 18th month,the obvious improvement in the level of FMD,NO,NOS and SOD was showed(P＜0.05).CONCLUSION:Administration of SXBXP could improve endothelial function in the CHD patients significantly.

Objective To evaluate the impact of autoantibodies to angiotensin Ⅱ type 1 receptor AT1-AA on clinic outcomes of delayed graft function (DGF) grafts.Method We reviewed the records of all 139 consecutive adult recipients who received single kidney transplantation and clinical management between Jan.2010 and Dec.2012 in our centre.The serum levels of AT1-AA were measured by a streptavidin-enzyme-linked immunosorbent assay.All patients with DGF were enrolled in this study and divided into two groups:(1) AT+ DGF group (serum AT1-AA positive,11 cases) ;(2) AT-DGF group (serum AT1-AA negative,23 cases).All clinical and laboratory data were recorded in our transplant database system at each visit.Result 139 recipients were enrolled.The overall presence of DGF was 24.5％ (34/139).The incidence of DGF in patients with high binding AT1-AA was significantly higher than that in those with low binding of AT1-AA (11/24 vs.23/115,45.8％ vs.20.0％,P＜0.05).In addition,longer duration of renal replacement therapy (59 ± 32 vs.47 ± 26 months,P＜0.05),higher resistance index (0.80 ± 0.10 vs.0.72 ± 0.10,P＜0.05) of allografts and more severe acute tubular injury (2.7 ± 0.5 vs.1.8 ± 1.1,P＜0.05)/acute tubular necrosis (0.9 ± 0.5 vs.0.5 ± 0.3,P＜0.05) were observed in AT + DGF group than in AT-DGF group.One-year graft survival and death censored graft survival were similar between two groups (90.9％ vs.95.7％,P＞0.05).Conclusion Presence of high binding anti-AT1 receptor had detrimental impacts on initiation and development of DGF.

Objective To analyze safety,efficacy and resection methods of video-assisted thoracic surgery(VATS) for the treatment of intralobar pulmonary sequestration(IPS).Methods Data of 17 patients who were diagnosed as IPS and received VATS from December 2006 to September 2011 were retrospectively analyzed.The patients were 7 males and 10 females with the mean age of 40.3 (14-61) years.Diagnosis was confirmed in 9 patients by enhanced CT and unconfirmed in 8 patients.Three ports were used for surgery.After the aberrant artery was confirmed,liner stapler was used in 16 patients to cut it and Hem-o-lok was used in 1 patient because the aberrant artery was about 3 mm in diameter and long enough.If the diameter of the aberrant artery was longer than 10 mm,a stapling device without knife was used to occlude it centrally and a second stapling device was used to cut it peripherally.Wedge resection or lobectomy was performed due to the different conditions.When the lesion was small with linited range in CT image and the lesion was easily distinguished from normal lung tissue during operation,wedge resection was preferred.Results Seventeen patients underwent VATS successfully without any conversion to thoracotomy or any serious complications.Five patients were planned to receive wedge resection and one was converted to lobectomy.Another 12 patients were planned to receive lobectomy and all succeeded.The mean operating time was 128 (80-170)min.The mean blood loss was 80 (5-200) ml.The mean days of chest tube maintained were 4.0 (2-6) days.The mean postoperative hospitalization days were 7.6 (4-11) days.All patients were diagnosed as IPS according to operating in-sight and postoperative pathology.There was no patient suffering from chronic cough,bloody sputum or recurrent pneumonia during the follow-up.Conclusion VATS for the treatment of IPS is safe and feasible.If conditions permit,wedge resection or segmentectomy may be preferred.

Objective To explore the basic biological characteristics of lncRNA -uc.1 67,and its spatial dis-tribution,temporal expression pattern during the mouse embryonic development.Methods The UCSC genome browser of ENCODE was used to analyze preliminary bioinformatics of lncRNAs.Real -time (RT)-PCR was applied to detect the expression of uc.1 67 and neighboring genes in the embryonic mouse heart in different stages (P7.5,P1 1 .5,P1 4.5, P1 8.5).Dimethyl sulphoxide was used to induce P1 9 cell differentiation into the cardiomyocytes.RT -PCR was applied to detect the expression changes in uc.1 67 and neighboring genes on differential day 0,4,6,8 and 1 0.Results Full -length of human uc.167 was 201 bp,and human uc.167 was located in the genome 5q14.3 (chr5:88179623 -881 79824,GRCh37 /hg1 9).uc.1 67 mainly expressed in the ventricular muscle tissue.The expression of uc.1 67 was gradually decreased in the mouse embryonic heart development process(P7.5:1 .000 ±0.1 00,P1 1 .5:0.71 4 ±0.1 07, P1 4.5:0.393 ±0.043,P1 8.5:0.1 25 ±0.01 3),while the expression of its neighboring Mef2c gene was gradually in-creased(P7.5:1 .081 ±0.1 1 8,P1 1 .5:2.340 ±0.351 ,P1 4.5:3.958 ±0.542,P1 8.5:9.361 ±0.722),which showed an opposite trend.The expression of uc.1 67 during P1 9 cell differentiation into cardiomyocytes showed a an increase at first and then a decreasepattern,and the highest level expression of uc.1 67 was on differential day 4(d0:1 .071 ± 0.1 1 7,d4:4.71 4 ±0.501 ,d6:3.572 ±0.41 4,d8:2.550 ±0.31 4,d1 0:0.786 ±0.085).The expression of neigh-boring gene Mef2c was in an opposite trend(d0:1 .01 2 ±0.041 ,d4:0.353 ±0.037,d6:2.470 ±0.329,d8:6.706 ± 0.682,d1 0:7.765 ±0.705).Conclusions It is suggested that uc.1 67 may take part in the process of embryonic heart development and may play a role through negatively regulating its neighboring gene Mef2c.

OBJECTIVE:To investigate the compatibility stability of Fat-soluble vitamin (Ⅱ)/Water-soluble vitamin for in-jection with common electrolytes. METHODS:Referring to clinical common dose,Fat-soluble vitamin (Ⅱ) for injection/Wa-ter-soluble vitamin for injection collective packing [containing Fat-soluble vitamin(Ⅱ) for injection 2 ampoules and Water-soluble for injection 1 ampoule] were respectively mixed with Glucose injection,Potassium chloride injection,Concentrated sodium chlo-ride injection,Sodium bicarbonate injection,Potassium aspartate injection,Potassium aspartate and magnesium aspartate injection, Sodium glycerophosphate injection,Multi-trace elements injection (Ⅱ) to obtain mixture A-H. At room temperature (25 ℃),these mixtures were investigated in terms of appearance,pH value,osmotic pressure molar concentration and the number of insolu-ble particles at 0,1,2,3,4 h. The contents of bacterial endotoxin were tested at 0,4 h. RESULTS:Within 4 h after mixing, there was no significant change in appearance of those mixtures;pH value of mixture H changed greatly (RSD=5.13%,n=5), and that of mixture D and G increased significantly. The osmotic pressure molar concentration of those mixtures had no significantly change(RSD<2%,n=5)and lower than 600 mOsmol/kg. The bacterial endotoxin tests of those mixtures were negative. Two and four hours after mixing,the number of insoluble particles ≥10 μm in mixture B was increased significantly;2,3,4 h after mix-ing,the number of insoluble particles ≥10 μm in mixture E,F,H were increased significantly;0 ,1,2,3,4 h after mixing,the number of insoluble particles ≥10 μm in mixture G was increased significantly. There was statistical significance in the number of insoluble particle ≥10 μm in above mixtures compared to mixture A at the same time point(P<0.05),but it was in line with the standard of 2015 pharmacopeia. One,two,three and four hours after mixing,the number of insoluble particle ≥10 μm in mixture D was increased significantly,there was statistical significance compared to mixture A at the same time point(P<0.05);the num-ber of insoluble particle ≥10 μm in mixture D was beyond prescribed scope of pharmacopeia at 2,3,4 h after mixing. Within 4 h after mixing,both the number of insoluble particle ≥10 μm in mixture C and the number of insoluble particle ≥25 μm in edch mixture had no significant change,in accordance with pharmacopeia standard. CONCLUSIONS:Fat-soluble vitamin (Ⅱ)/Wa-ter-soluble vitamin for injection is not suitable for mixing with Multi-trace elements injection(Ⅱ),Sodium glycerophosphate injec-tion or Sodium bicarbonate injection due to great change of pH value and the number of insoluble particles.