Objective To study the effects of resin micro-leakage of different angles of cavity margins with composite resin filling.Methods Thirty extracted human molar with occlusal surfaces preparing hole into 3mm × 3mm × 3mm.Specimens were randomly divided into 3 groups,1 mm slopes of cavity margins were designed respectively,and three kinds of angles of cavity margins(45°,70°,90°)were filled on the ocelusive surfaces,then using Prime&Bond NT and Composite resin(ChrismaA2)to repair the holes directly.After 500 thermal cycling,all specimens were immersed in Indian ink for one week and the penetration depth was examined under stereo microscope.Results Cavity margin angles of 70°was better than those of 90° and 45°,the results was statistically significant(t=3.530,4.179,all P＜0.05).Conclusion To reduce the occurrence of the resin micro-leakage,cavity margin angles should be designed as short slant with an angle of 70°or so.

Objective To survey and analyze medical postgraduates' ideological and political awareness to provide evidence for improvement of ideological and political education.Methods By using the self-made questionnaire a survey was conducted among 1 199 medical postgraduates from April 1,2013 to April 10.The questionnaire included general condition,politics status,religion,collective consciousness,learning goals,the view about the construction of ideological and political education counselor team,etc.Advice and suggestions were given according to the analysis of the results.Results A total of 1 169 valid questionnaires were collected.Among all the members,the communist party members and league members account for 33.7％ and 47.6％,respectively; 92.5％ of the students had no religious beliefs; 15.1％ served as departments cadres,6.4％ served as universitylevel cadres; 41.3％ of the students thought their tutors care for them very much,and 66.9％ of the students could communicate with tutors weekly; 38.9％ of the students complained the main pressure came from family,while 24.2％ thought the main pressure came from the employment pressure; 47.5％ thought it was very necessary to establish a professional counselor team.Conclusions The survey is scientific and reasonable,providing a reliable basis to improve our postgraduate education.Most medical postgraduates have a firm and correct political position,and their world oudook and outlook on life are basically stable.However,there are many problems needed to be solved immediately.Considering the particularity of graduate education,it is necessary to reinforce the professional counselor and tutor team and further explore the medical postgraduates' ideological and political awareness education to promote the development of postgraduate education.

Objective To explore the effect of applying problem-based learning (PBL) combined with ' pre-resident physician' teaching model in clinical practice in the nephrology department.Methods Sixty students in clinical practice were divided into two groups:experimental group and control group.The students in experimental group were received PBL in combination with 'pre-resident physician' teaching model while those in control group were received traditional teaching model.The effect was evaluated according to the results of theoretic examination and investigation.The results were analyzed by x2 test and P ＜ 0.05 signified statistically significant.Results The average score of theoretic examination in experimental group was 80.22 while that in control group was 76.53.The students in experimental group had significant higher score than those in control group (P ＜ 0.05 ).The overall satisfaction degree was 93.00％ in experimental group concerning the 8 indicators in PBL combined 'pre-resident physician' teaching model,while that was 73.75 ％ in control group concerning the 8 indicators in traditional teaching mode.Concerning the aspects of teaching flexibility,arousing learning interest,training literature capacity and improving ability of independent problem solving,the satisfaction degree was higher in experimental group than in control group (P ＜ 0.05 ).Conclusion PBL in combination with ' pre-resident physician' teaching model has evident advantages in clinical practice in nephrology department.

Objective To study the clinical application value of plasma M2 pyruvate kinase (M2-PK),serum tumor marker carcinoembryonic antigen (CEA) and serum level of integrin-like protein-8 (ADAM8) in the diagnosis of Non-small cell lung cancer (NSCLC).Methods Seventy-five patients with NSCLC admitted to our hospital from April 2014 to August 2016 were randomly selected as study group.Seventy-five healthy subjects were randomly selected as control group.Serum ADAM8 and M2-PK levels were measured by enzyme-linked immunosorbent assay (ELISA) in all subjects,and serum CEA levels were determined by electrochemiluminescence (ECLIA).The clinical value of M2-PK,CEA and ADAM8 in diagnosis of NSCLC were analyzed by ROC curve.Results The levels of M2-PK,CEA and ADAM8 in the study group were significantly higher than those in the control group (P ＜ 0.05).The levels of M2-PK and CEA in patients with adenocarcinoma were significantly higher than those in squamous cell carcinoma patients (P ＜0.05),and the levels of M2-PK,CEA and ADAM8 in stage Ⅲ-Ⅳ patients were significantly higher than those in stage Ⅰ-Ⅱ patients (P ＜ 0.05).The AUC of M2-PK,CEA and ADAM8 combined detection (0.924) was significantly higher than that of M2-PK,CEA and ADAM8 separate detection (0.731,0.858 and 0.790),and the difference was statistically significant (P ＜ 0.05).The sensitivity and specificity of M2-PK,CEA and ADAM8 combined detection were significantly higher than those of M2-PK,CEA and ADAM8 separate detection (P ＜ 0.05).Conclusion The value of M2-PK,CEA and ADAM8 in diagnosing NSCLC has a certain clinical value,and the diagnostic value of M2-PK,CEA and ADAM8combined detection is superior to that of separate detection,and M2-PK,CEA and ADAM8 combined detection worthy of clinical application.

To prepare recombinant human retinol binding protein 4 (RBP4) by using the baculovirus expression system and to detect its immunogenicity, the fusion DNA fragment of secretory signal peptide SS64 and human RBP4 gene was subcloned into a baculovirus transfer vector pFastBac-dual(pFBd), and the corresponding recombinant transfer plasmid was transformed into E. coli strain DH10bac, after transposition recombinant shuttle bacmid was screened out. The logarithmic phase Sf9 cells were transfected with the recombinant bacmid and then the recombinant baculovirus containing hRBP4 expression box were generated. After amplification of recombinant baculovirus, the recombinant baculovirus seeds were obtained. To express human RBP4, logarithmic phase Sf9 cells were infected with the virus seeds and SDS-PAGE and Western blotting were used to detect and identify the expression. Finally, to prepare a batch of RBP4 protein, logarithmic phase Sf9 cells in suspension culture were infected with recombinant baculovirus seeds and the supernatant was harvested after 120 hours post-infection for purification. Finally for preparation of polyclonal antibody and evaluation of immunogenicity, the recombinant hRBP4 from insect cells and from E. coli were immunized rabbits. Restriction enzyme digestion and sequencing confirmed that the recombinant baculovirus transfer plasmid was constructed correctly, and subsequently recombinant RBP4-bacmid was generated successfully. SDS-PAGE and Western blotting analysis suggested that human RBP4 protein was highly expressed in Sf9 cells with the molecular weight of approximately 23 kDa. The recombinant RBP4 protein could be secreted into the medium efficiently, and the expression level was calculated amount of 100 mg/L. Finally the rabbit antiserum was harvested after recombinant RBP4 immunization, therein the titer of antiserum against baculovirus recombinant RBP4 is 1:100 000 whereas the titer of antiserum against E. coli recombinant RBP4 is only 1:10 000. Overall, human RBP4 was high efficiently expressed successfully with good antigenicity in baculovirus system, and high affinity antiserum was obtained. A solid foundation was laid for the next step of the preparation of human serum RBP4 detection kit.
Animals ; Baculoviridae ; genetics ; Blotting, Western ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; Genetic Vectors ; Humans ; Immune Sera ; Insecta ; Rabbits ; Recombinant Proteins ; biosynthesis ; immunology ; Retinol-Binding Proteins, Plasma ; biosynthesis ; immunology ; Sf9 Cells ; metabolism ; Transfection

Objective:To translate the English version and cross-cultural adaptation of Readiness for Return-To-Work Scale (RRTW) into Chinese and tested the reliability and validity of the Chinese version of RRTW in young and middle-aged stroke patients.Methods:RRTW was translated into Chinese with standard translation-retroversion. From August to December 2020, 235 stroke patients in the First Affiliated Hospital, College of Medicine, Zhejiang University were recruited by convenient sampling. The scale was tested by the reliability and validity.Results:The Chinese version of RRTW for stroke was composed of two parts: The first part was divided into four dimensions, with a total of 13 entries; For the unworked stroke population, the second part was divided into two dimensions, with a total of nine entries for the reworked stroke population. The content validity index (CVI) for each item was from 0.875 to 1.000. The total CVI for all items was 0.994. The Pearson correlation coefficient between dimension and scale was from 0.523 to 0.876. Four common factors were obtained from the first part and the cumulative contribution rate was 62.563%. Two common factors were obtained from the second part and the cumulative contribution rate was 49.908%. The Cronbach α coefficient in the first part was 0.760 and in the second part was 0.693.Conclusions:The Chinese version of RRTW for stroke patients has good reliability and validity, which can be used to assess the readiness level of stroke patients to return to work in Chinese society.

Cognitive impairment after infectious meningitis seriously affects the activities of daily living for survivors. There has been lack of systematic researches on the cognitive impact of infectious meningitis so far, it is not clear how to early identify and evaluate the cognitive impairment after meningitis, how to properly carry out early rehabilitative intervention to improve the activities of daily living and to reduce the social and economic burden of patients. This article reviews the characteristics, evaluation methods and rehabilitative interventions of cognitive impairment in patients after infectious meningitis, to provide reference for clinical application.

Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.

Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.

The Notch signaling pathway plays a pivotal role in the process of neurogenesis in central nervous system. It not only maintains the appropriate number and proportion of neurons and glial cells in the growth and development of embryo, but also regulates the injured neural stem/progenitor cells to differentiate into neurons/glial cells of the adult nervous system, promoting the repair of the nervous system.