Objective To evaluate the clinical efficacy of Yinhe gargle on infected root canals. Methods Forty-seven cases of root canal infection ( involving 48 affected teeth) were randomly divided into two groups. The experimental group (22 cases involving 22 affected teeth) was given intracanal medicament with Yinhe gargle, and the control group ( 25 cases involving 26 affected teeth) was given root canal disinfection with camphor phenol. After intracanal medicament for one week, therapeutic effect and safety were evaluated in the two groups. Results ( 1) During root canal disinfection, none of the subjects had adverse reaction such as hypersensitiveness or cauterization of soft tissue. Canal obturation was available after the first intracanal medicament for the infected root canals. (2) After intracanal medicament for one week, the effective rate in the experimental group was 95.45%, and was 100.00%in the control group, the difference being in significant (P>0.05). Conclusion Yinhe gargle has similar disinfection effect to camphor phenol on infected root canals, and it can be used as disinfection medicament for root canals.

OBJECTIVEThis study aims to observe the effect of orbital implant lengths on stress distribution in peri-implant surfaces.

METHODSThe three-dimensional finite element analysis models of craniofacial and orbital implants with a diameter of 3.75 mm and lengths of 3, 4, 6, and 10 mm were established. A force of 20 N was applied to the models. The stress and displacement distribution under every condition were recorded and analyzed.

RESULTSThe loading direction along the implant axis and the stress concentration on the implant root were observed. The loading direction was at a 45 degree angle relative to the implant axis, and the stress concentration was located at the implant neck and the first screw thread. The maximum stress of the 3 mm implant was significantly higher than that under the other two loading directions. The maximum displacement of the four lengths exhibited no significant change. Given the same implant length, stress, and displacement, the peak of the implant axial direction was lower than that of the 45 degree direction. The loading type was an important factor influencing the stress and displacement of peri-implant bones.

CONCLUSIONThe implants of more than 4 mm length can be considered for clinical use. The implant of 3 mm length should be implanted in a region with thicker cortical bone.

Background:For patients with liver cirrhosis and acute decompensation(AD),it is of great clinical importance to predict short-term mortality at admission. It has been reported that CLIF-C OF,MELD and MELD-Na score can accurately predict the short-term mortality,but all these scoring systems are complicated and have limits in their application. Aims:To define a simple and objective scoring system -- simplified MELD score for short-term mortality prediction in HBV-related cirrhotic patients with AD. Methods:A total of 890 consecutive HBV-related cirrhotic patients with AD hospitalized during Jan. 2005 to Dec. 2010 at Shanghai Ren Ji Hospital were enrolled retrospectively. Clinical data and patients’outcome were collected,and simplified MELD score was calculated by using total bilirubin,international normalized ratio and creatinine values at admission. Patients were classified into different prognostic groups according to their 28-day mortalities and simplified MELD score. Kaplan-Meier survival curve was used to analyze the 1-year accumulate survival rate,and ROC curve was used to evaluate the performance of different scoring systems in predicting 28-day mortality. Results:Simplified MELD score at admission could classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups and different long-term prognostic groups;the score of low,moderate and high 28-day mortality group was 0-2,3 and 4-6,respectively,and the corresponding mortality was 5. 5% ,19. 8% and 48. 6% ,respectively. Simplified MELD score had the same good performance as compared with the CLIF-C OF,MELD and MELD-Na scores in predicting 28-day mortality,the area under ROC curve was 0. 828,0. 831,0. 828 and 0. 830,respectively. Conclusions:Simplified MELD score can accurately classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups at admission. It is convenient for using in clinical practice.

Objective To analyze the genotypes of adenovirus(Ad)strains isolated from young children with acute respiratory infection syndrome during 2004-2006.Methods Seven human adenovirus strains isolated during 2004 and 2006 were detected with tissue culture,PCR with adenovims specific-primers and sequencing for hexon and fiber genes.Results The results showed that all 7 adenovirus strain belonged to adenovirus genera B.3 of the 7 isolates were Ad3,BJ060605-1,BJ060316-and BJ040228 had high homology of nucleic acid.98.9%-100%.Three of 7 were Ad7,the homology of nucleic acid of BJ050520.BJ060421-4 and BJ040226 were 97.6%-100%.Strain SX060418-1 was 100% homologic with Ad11 strain L08232(GenBank).Conclusion Little variation of fiber gene was found for 2004 to 2006 isolares and the typing with fiber sequencing is similar with that of hexon gene of adenovirus isolates.

Objective To investigate the influence of Herba Epimedium, a kidney-strengthening Chinese herb, on the regenerate ossification of nano-hydroxyapatite/collagen/ polylactic acid (nHAC/PLA) in the repair of rabbit mandibular defect. Methods Sixteen rabbit models with 10 mm × 8 mm subperiosteal mandibular defect were established. The rabbits were randomly divided into 2 groups, namely Herba Epimedium group and control group. In both groups, the left mandibular defect region (short for left side) was not filled with any material, while the right mandibular defect region ( short for right side) was filled with nHAC/PLA. On week 2, 4, 8, 12 after modeling, rabbits in each group were killed, and then the macro-view, imageology and histology of the bilateral mandibles were observed. The data of the regenerate bone areas were calculated and analyzed with analysis of variance (ANOVA) . Results The imageological results showed bone mineral density in the right side of Herba Epimedium group and the control group, and in the left side of Herba Epimedium group were higher than those in the left side of the control group on week 2, 4, 8, 12 after modeling. The histological results showed that the regenerate ossification in the right side of Herba Epimedium group and the control group was superior to that in the left side of the corresponding groups, with more regenerative bone and vessels. In the right side of Herba Epimedium group and the control group, amount of bone-like tissues were grown into nHAC/PLA, and the maturity degree of bone tissue was increased with the prolongation of time. And the changes were more obvious in the right side of Herba Epimedium group, showing as the remaining of nHAC/PLA having been surrounded and replaced by regenerative bone tissue. Regenerative bone area was increased in both sides of Herba Epimedium group, which differed from the same side of the control group (P<0.05) . The differences of the regenerative bone area were also significant between the left side and right side of the same group (P<0.05) . Conclusion Herba Epimedium can effectively accelerate the repair of mandibular defect, and nHAC/PLA is of good biocompatibility, osteoinduction and bone conduction, and can be expected for bone defect repairing in clinic.

Objective:To observe the effect of orbital implant load angle on the stress distribution of peri-implant surface.Methods:The 3D finite element analysis model of orbital implant with diameter of 3.75 mm and length of 6 mm was established.A force of 20 N was applied on the model at various angles.The stress distribution and displacement of the implant were recorded and analyzed.Results:Under 0°,1 0°,20°,30°,45°and 90°the maximum stress(MPa)on the peri-implant surface was 3.1 73,6.535,1 0.506,1 4.1 68, 1 8.949 and 24.755,the maximum displacement(μm)of the implant was 1 .761 ,3.654,7.665,1 1 .567,1 6.774 and 25.072,respec-tively.Conclusion:The loading angle is an important factor influencing stress and displacement of peri-implant bone.

BACKGROUND: Xiaohuoluo pill can expel pathogenic wind, remove dampness and activate collaterals. It is used for treatment of Bi-syndrome due to wind-cold-dampness, pain and numbness in limbs.OBJECTIVE: To observe the pharmacological effect of Xiaohuoluo pills on secondary immune response, specific immunity (including cellular immunity and humoral immunity), non-specific immunity [including complement 3(C3), mononuclear phagocyte system (MPS) and red blood cell (RBC)adhesion function] and free radical injury as well as pain and many other inflammations in mice.DESIGN: A randomized controlled stratified trial.SETTING: Guangzhou Institute of Traditional Chinese Medicine and Chinese Materia Medica; Department of Pharmacy, Guangzhou Hospital of Traditional Chinese Medicine.MATERIALS: Totally 628 NIH and ICR mice of 6 to 8 weeks were involved in this trial. Xiaohuoluo pills (components: Dannanxing, Zhichuanwu, Zhicaowu, Dilong, Ruxiang and so on; Chenli Pharmaceutical Factory,Guangzhou; Brach No. 19980612) were used in this trial. Rabbit antimouse immunoglobulin G (IgG) and C3 antiserum reagent kit (Guangzhou Institute of Medicine and Health) and reagent kit for measuring the antioxidizing activity of superoxide dismutase (SOD) and the level of malondialdehyde (MDA) (Jiancheng Institute of Bioengineering, Nanjing) were used.METHODS: This trial was carried out in the Guangzhou Institute of Traditional Chinese Medicine and Chinese Materia Medica; Department of Pharmacy, Guangzhou Institute of Medicine and Health during September 1998 to December 1999. ① To observe the suppressive effect of Xiaohuoluo pills on cock red blood cell (CRBC)-induced secondary immune response: Eight-four ICR mice, male and female in half, were selected.Twenty of 84 mice served as blank controls; The other 64 mice were intraperitoneally injected with cyclophos-phamide (CY) of 0.2 g/kgonce. On the 4th and 12th days, CRBC was intraperitoneally injected into the mice twice to induce immunoenhancing pathological models to form secondary immune response. Mice served as blank controls were intraperitoneally injected with the same volume of normal saline; The immunoenhanced mice were assigned into 3 groups by a lot: CY group (n=20, CY, 40 mg/kg, intragastric administration, I.g.), Xiaohuoluo pills (n=21, Xiaohuoluo pills suspension, 5.54 g/kg, I.g.) and model group (n=20, distilled water, the same volume as other groups, I.g.); once a day within 7 successive days. 19 days later, the levels of serum IgG and C3 were measured with single immunodiffusion method, and the level of circulating immune compound (CIC) was measured with polyethylene glycol precipitation method. ② To observe the suppressive effect of Xiaohuoluo pills on delayed type hypersensitivity (DTH): Fifty-four ICR mice, male and female in half, were selected. On the 1st day, the mice were sensitized by subcutaneous injection of 10 g/L 2,4-dinitrofluorobenzen e (DNFB) of 50 μL for each. On the 4th day, the sensitized mice were assigned into 3 groups by a lot: Prednisone group (n=18, prednisone, 0.01 g/kg, I.g.), Xiaohuoluo pills (n=18, Xiaohuoluo pills suspension, 5.54 g/kg, I.g.), model group (n=18, distilled water, the same volume as other groups, I.g.), all once a day within 7 successive days. 11 days later, 10 g/L DNFB of 25μL was spread on the right ear of each mouse in each group. The swelling degree was calculated 24 hours later (The mass difference between right ear and left ear). ③ To observe the suppressive effect of Xiaohuoluo pills on immune adhesion function of RBC of mouse: Thirty-six NIH mice, male and female in half, were selected and assigned into 3 groups by a lot: CY group (n=12, CY, 20 mg/kg,I.g.), Xiaohuoluo pills (n=12, Xiaohuoluo pills suspension, 5.54 g/kg, I.g.)and blank control group (n=12, distilled water, the same volume as other groups, I.g.), once a day within 7 successive days. 7 days later, blood was taken from the orbit of mice for calculating the rosette rate of RBC-C3b receptor and the rosette rate of RBC immune compound. ④ To observe the suppressive effect o20 Mg/kg, I.g.),Xiaohuoluo pills group (Xiaohuoluo pills suspension, 5.54 g/kg, I.g.) , once a day within 7 successive days; IgM-type hemolytic concentration (HC50)was measured at 2 hours after the last administration on the 7th day [ (Sample absorption / Absorption at HC50 of CRBC) ×diluted time]. The levels of serum C3 and MDA and the activity of SOD were measured according to the method from corresponding reagent kit. ⑥ To observe the suppressive effect of Xiaohuoluo pills on agar granulation tissue hyperplasia in mice:Fifty-nine NIH mice were selected and given subcutaneous injection of 20 g/L agar of 0.5 mL for each. 24 hours later, the mice were assigned into 3 groups by a lot: diclofenac group (diclofenac, 10 mg/kg,I.g..), Xiaohuoluo pills group (Xiaohuoluo pills suspension, 5.54 g/kg, I.g.) and model group (distilled water, the same volume as other groups, I.g.), once a day within 7 successive days; On the 8th day, the mice were sacrificed. The hyperplasiainhibiting effect was presented in the form of the mass of agar granulation tissue in one kilogram body mass ⑦ To observe the suppressive effect of Xiaohuoluo pills on acetic distortion reaction: Sixty-three NIH mice were se lected and assigned into 3 groups by a lot: diclofenac group (diclofenac,50 mg/kg, I.g.), Xiaohuoluo pills group (Xiaohuoluo pills suspension, 5.54 g/kg,I.g.) and model group (distilled water, the same volume of other groups, I.g.),once a day within 2 successive days. At 2 hours after the last administration, the mice were given intraperitoneal injection of 0.1 mol/L acetic acid of 0.2 mL for each one. The times of distortion of mice within 20 minutes were counted. ⑧ To observe the effect of Xiaohuoluo pills on the acute exudative inflammation evoked by dimethylbenzene, croton oil and carrageenan, and the level of prostaglandin E in the inflammatory exudates:Totally 219 NIH mice were selected and assigned into 3 groups by a lot:diclofenac group (diclofenac, 50 mg/kg, I.g.), Xiaohuoluo pills group (Xiaohuoluo pills suspension, 5.54 g/kg, I.g.) and model group (distilled water, the same volume of other groups, I.g.) once a day within 2 successive days. At 2 hours after the last administration, dimethylbenzene of 25 μL was spread on the right ear for 20 minutes, or croton oil of 25 μL was also spread on the right ear, 4 hours later, the swelling of right ear was calculated (mass of right ear-mass of left ear). 10 g/L carrageenan of 20 μL was subcutaneously injected into the right foot, 3 hours later, the swelling degree was calculated (The difference of right foot and left foot); and the level of prostaglandin E in the inflammatory exudates was measured. ⑨ t test(t' test for heteroscedasticity) was used for comparing the difference in measurement data among groups.MAIN OUTCOME MEASURES: Pharmacological effect of Xiaohuoluo pills on secondary immune response, specific immunity, non-specific immunity and free radical injury as well as pain and many other inflammations in mice.RESULTS: Totally 628 NIH and ICR mice were involved in result analysis. ① The level of IgG and CIC of mice in the model group was significantly higher than that in the other 3 groups respectively (P ＜ 0.01),while the level of C3 was significantly lower than that in the other 3 groups (P ＜ 0.05 to 0.01). ② The swelling degree of mice in the diclofenac group and Xiaohuoluo pills group was significantly lower than that in the blank control group respectively ( both P ＜ 0.01). ③ The rosette rate of RBC-C3b receptor and RBC immune compound in the blank control group was significantly higher than that in the other 2 gro ups respectively (P ＜ 0.01). ④ The phagocytic index (K value )in the diclofenac group and Xiaohuoluo pills group was significantly lower than that in the blank control group, respectively (both P ＜ 0.01).⑤ IgM-type HC50 and the level of serum MDA of CY group and Xiaohuoluo pills group were obviously lower than those in the immune control group (P ＜ 0.01),while the level of C3 was higher than that of immune control group, there was no significant difference in the activity of serum SOD between CY group or Xiaohuoluo pills group and immune control group (P ＞ 0.05). ⑥The ratio of agar granulation tissue mass to body mass in the diclofenac group or Xiaohuoluo pills group was significantly lower than that in the model group(P ＜ 0.01).⑦ The times of distortion of mice within 20 minutes in the diclofenac group or Xiaohuoluo pills group were signifi cantly less than those of model group(P ＜ 0.01,0.05).⑧The ear swelling degree of dimethylbenzene-induced inflammatory models and croton oil-induced inflammatory models,and foot swelling degree of carrageenan-induced acute inflammatory models as well as the level of prostaglandin E in the inflammatory exudates in the diclofenac group were significantly milder or lower than those in the model group(P ＜ 0.05 to 0.01),and the level of prostaglandin E in the inflammatory exudates in the Xiaohuoluo pills group was significantly lower than that in the model group (P ＜ 0.01).CONCLUSION: Xiaohuoluo pills possess pharmacological effects of immunosuppression, anti-proliferative inflammation, analgesia and antioxidation.

Background:A recent perspective European study has shown that Chronic Liver Failure-Consortium Organ Failure score(CLIF-C OFs)is an effective diagnostic criteria for acute-on-chronic liver failure(ACLF)in alcoholic or hepatitis C virus patients with acute decompensation(AD). Aims:To assess the efficacy of CLIF-C OFs for distinguishing ACLF in non-hepatitis B virus(HBV)-related chronic liver disease patients with AD. Methods:A total of 274 consecutive non-HBV-related chronic liver disease patients with AD from Jan. 2005 to Dec. 2010 at Shanghai Ren Ji Hospital were enrolled. Patients were divided into three groups:ACLF at admission,ACLF developed within 28-day and non-ACLF according to CLIF-C OFs criteria. Clinical and biochemistry characteristics,severity of the disease and 28-day and 90-day mortality data between ACLF and non-ACLF groups were analyzed. Results:Of the patients assessed,40 had ACLF at admission,27 had ACLF developed within 28-day,207 remained not having ACLF. Patients in ACLF group had higher TB,Cr,INR,ALT,AST,ALB,WBC,score of Child-Pugh,CTP,MELD,MELD-Na than non-ACLF patients(P <0. 05),and were younger in age(P < 0. 01). Incidences of hepatic,renal,cerebral,coagulation,circulation and lung failure,28-day mortality,90-day mortality were significantly higher in ACLF group than in non-ACLF patients( P <0. 01). However,no significant differences were seen in the characteristics mentioned above between ACLF at admission group and ACLF developed at 28-day group(P > 0. 05). TB level at admission and infection occurred within 28-day were the risk factors for developing ACLF(P < 0. 05). Conclusions:ACLF constitutes a more severe subgroup in non-HBV-related chronic liver disease patients with AD,and CLIF-C OFs could help to distinguish ACLF patients out from non-HBV-related chronic liver disease patients with AD.

In February, 2019, a patient with a defect of open dorsal cartilage and bone in the first metatarsal head, including the defects of soft tissue, tendon and joint capsule, was treated in our department. After multiple debridement, the vascularised medial femoral condyle osteochondral chimeric tissue flap was transferred to repair the composite tissue defect in the metatarsal head at the second stage. After 18 months of follow-up, the patient felt no pain in the foot and walking, and there was no sign of lameness and discomfort at donor sites. The postoperative functional recovery was satisfactory.

Objective This study aims to observe the effect of orbital implant lengths on stress distribution in peri-implant surfaces. Methods The three-dimensional finite element analysis models of craniofacial and orbital implants with a diameter of 3.75 mm and lengths of 3, 4, 6, and 10 mm were established. A force of 20 N was applied to the models. The stress and displacement distribution under every condition were recorded and analyzed. Results The loading direction along the implant axis and the stress concentration on the implant root were observed. The loading direction was at a 45 degree angle relative to the implant axis, and the stress concentration was located at the implant neck and the first screw thread. The maximum stress of the 3 mm implant was significantly higher than that under the other two loading directions. The maximum displace-ment of the four lengths exhibited no significant change. Given the same implant length, stress, and displacement, the peak of the implant axial direction was lower than that of the 45 degree direction. The loading type was an important factor influencing the stress and displacement of peri-implant bones. Conclusion The implants of more than 4 mm length can be considered for clinical use. The implant of 3 mm length should be implanted in a region with thicker cortical bone.