The book Acupuncture-moxibustion Clinical Skills Training is one of "Twelfth Five-Year Plan" in novative teaching materials, which is published by People's Medical Publishing House. Through learning the first half of the book commonly used needling and moxibustion techniques, it is realized that the selection of book content is reasonable and much attention is paid to needling and moxibustion techniques; the chapter arrangement is well-organized, and the form is novel, which is concise and intuitive; for every technique, great attention is paid to standardize the manipulation procedure and clarify the technique key, simultaneously the safety of acupuncture and moxibustion is also emphasized. The characteristics of the book, including innovativeness, practicability, are highlighted, and it greatly helps to improve students' clinical skills and examination ability.
Acupuncture ; education ; standards ; Acupuncture Therapy ; instrumentation ; methods ; standards ; Books ; Clinical Competence ; standards ; Humans ; Moxibustion ; instrumentation ; methods ; standards ; Reference Standards ; Teaching ; standards ; Teaching Materials ; standards

Objective To investigate the mechanisms of erythropoietin-producing hepatocellular A3 (EphA3) in the invasion of hepatocellular carcinoma (HCC) cells.Methods Hepatic cell HL-7702 and HCC cell and HCC cell lines HepG2 and MHCC97H were cultured.The expression of EphA3 in the HepG2 and MHCC97H cells was suppressed by siRNA interference,and then were divided into the untreated group,the control group and the siRNA intervention group.The expression of EphA3 was detected by RT-PCR and Western blot.The invasion ability of HepG2 and MHCC97H was detected by Transwell chamber.The protein expression of VEGF and activity of vascular endothelial growth factor (VEGF) were detected by western blot and ELISA.All data were analyzed using the analysis of variance or LSD-t test.Results The relative mRNA expressions of EphA3 in HL-7702,HepG2,and MHCC97H cells were 0.94 ±0.13,1.76 ±0.16 and 3.62 ±0.14,respectively,and the protein expressions of EphA3 in the 3 cells were 0.96 ±0.12,1.59 ±0.11 and 3.82 ±0.11.There was significant difference in the EphA3 expression between HL-7702 cells and HepG2,MHCC97H cells (t =2.511,6.437 ; 2.321,6.895,P ＜ 0.05).The relative mRNA expressions of EphA3 in the HepG2 cells in the untreated group,the control group and the siRNA intervention group were 0.95 ±0.11,0.96 ±0.12 and 0.31 ±0.15,respectively.There was significant difference in the mRNA expression of EphA3 in the HepG2 cells between the siRNA intervention group and the control group (t =4.051,P ＜ 0.05).The relative mRNA expressions of EphA3 in the MHCC97H cells in the untreated group,the control group and the siRNA intervention group were 0.97 ± 0.16,0.95 ± 0.14 and 0.40 ± 0.11,respectively.There was significant difference in the mRNA expression of EphA3 in the MHCC97H cells between the siRNA interference group and the control group (t =5.237,P ＜0.05).The relative protein expressions of EphA3 in the HepG2 cells in the untreated group,the control group and the siRNA intervention group were 0.97 ± 0.16,0.95 ± 0.15 and 0.32 ± 0.17,respectively.There was significant difference in the protein expression of EphA3 in the HepG2 cells between the siRNA interference group and the control group (t =4.145,P ＜ 0.05).The relative protein expressions of EphA3 in the MHCC97H cells in the untreated group,the control group and the siRNA intervention group were 0.95 ± 0.11,0.96 ± 0.12 and 0.38 ±0.17,respectively.There was significant difference in the protein expressions of EphA3 in the MHCC97H cells between the siRNA interference group and the control group (t =4.327,P ＜ 0.05).The numbers of HepG2 cells penetrated the Watrigel in the untreated group,the control group and the siRNA intervention group were (111 ±4)/10HPF,(109 ±5)/10HPF and (51 ±3)/10HPF,respectively.There was significant difference in the number of HepG2 cells between the siRNA interference group and the control group (t =7.582,P ＜ 0.05).The numbers of MHCC97H cells penetrated the Watrigel in the untreated group,the control group and the siRNA intervention group were (402 ± 6)/10HPF,(397 ± 7)/10HPF and (152 ± 7)/10HPF,respectively.There was significant difference in the number of MHCC97H cells between the siRNA interference group and the control group (t =9.479,P ＜ 0.05).The relative protein expressions of VEGF in the HepG2 cells in the untreated group,the control group and the siRNA intervention group were 0.98 ± 0.11,0.96 ± 0.13 and 0.57 ± 0.11,respectively.There was significant difference in the protein expression of VEGF of the HepG2 cells between the siRNA interference group and the control group (t =3.167,P ＜ 0.05).The relative protein expression of VEGF in the MHCC97H cells in the untreated group,the control group and the siRNA intervention group were 0.97 ±0.14,0.98 ±0.12 and 0.34 ± 0.15,respectively.There was significant difference in the protein expression of VEGF of the MHCC97H cells between the siRNA interference group and the control group (t =4.278,P ＜ 0.05).The relative activities of VEGF proteins of HepG2 cells in the untreated group,the control group and the siRNA intervention group were 0.96 ±0.15,0.94 ±0.11 and 0.47 ±0.13,respectively.There was significant difference in the activity of VEGF protein in the HepG2 cells between the siRNA interference group and the control group (t =3.981,P ＜ 0.05).The relative activities of VEGF proteins in MHCC97H cells in the untreated group,the control group and the siRNA intervention group were 0.98 ±0.12,0.97 ±0.12 and 0.38 ±0.14,respectively.There was significant difference in the activity of VEGF protein in the MHCC97H cells between the siRNA interference group and the control group (t =4.059,P ＜ 0.05).Conclusions EphA3 plays an important role in the invasion of HCC cells via regulating the protein expression and activity of VEGF.EphA3 might be a new target for the treatment of HCC.

OBJECTIVETo investigate the crystallographic properties of the mineral phases of normal enamel and dentin (dental apatite) in deciduous and permanent teeth.

METHODSThree kinds of physical methods including X-ray diffraction (XRD), infrared absorption spectroscope (IR) and electron probe micro-analysis (EPMA) were utilized in this study.

RESULTSDental apatite was not uniphase, but multiphase, which could be described as carbonate-substituted hydroxyapatite. Compared to dentin apatite, the higher crystallinity and expanded a-axis lattice parameters were found in enamel. Chemical analyses demonstrated that higher concentrations of Mg and CO(3)(2-) were found in dentin than those of enamel. But enamel had higher Cl content.

CONCLUSIONSThe differences among enamel and dentin, in terms of lattice parameter and crystallinity may be partially attributed to the incorporation of Mg, CO(3)(2-) and Cl minor elements.

Dental Enamel ; chemistry ; Dentin ; chemistry ; Electron Probe Microanalysis ; methods ; Humans ; Spectrophotometry, Infrared ; methods ; Tooth ; chemistry ; X-Ray Diffraction ; methods

Objective To study protective and therapeutic measures to improve perioperative safety in extremely elderly patients with biliary diseases.Methods A retrospective case-control study was conducted.The clinical data of elderly patients with biliary diseases treated at the Department of General Surgery,Beijing Electric Power Hospital,from July 2013 to December 2018,were collected.According to age,the patients were divided into the high age (HA) group (≥80.0 years) and the middle-low age (MLA) group (60.0～79.0 years).The related indexes of perioperative safety such as preoperative coexisting diseases,functions of liver,kidney,heart and lung,surgical procedures,intraoperative blood loss,operation time,postoperative hospital stay and postoperative hospital stay were analyzed and compared between the two groups.Results Of the 372 included patients,there were 168 males and 204 females,aged 60.0 to 96.0 (72.0 ± 8.6) years.There were 69 elderly patients (37 males and 32 females) aged 80.0 to 96.0 (84.4 ±3.8) years in the HA group.There were 303 patients in the middle and lower age group (131 men and 172 women),aged 60.0 to 79.0(68.4 ±5.8) years (MLA group).(1) Preoperative coexisting diseases were significantly increased in the HA compared with the MLA group (all P ＜ 0.05),including the proportion of coexisting coronary heart disease [34.8％ (24/69) vs.18.5％ (56/303)],hypertension [68.1％ (47/69)vs.46.9％ (142/303)],chronic bronchitis with emphysema [17.4％ (12/69) vs.3.6％ (11/303)],hypoproteinemia [39.1％ (27/69) vs.26.7％ (81/303)],and anemia [42.0％ (29/69) vs.11.9％ (36/303)].(2) Laboratory examinations:the functions of liver,kidney,heart,lung and blood coagulation were significantly worse in the HA compared with the MLA group (P ＜ 0.05).(3) Surgical procedures:the proportion of open cholecystectomy with transcystic common bile duct exploration (OC + OTCBDE) was higher [17.4％ (12/69) vs.6.9％ (21/303)],while laparoscopic cholecystectomy (LC) was lower [43.5％ (30/69) vs.62.7％ (190/303)],in the HA compared with the MLA group (P ＜0.05,totally).(4) Operative effects:the intraoperative blood loss [30.0 (20.0,75.0) ml vs.20.0 (10.0,30.0) ml],operation time [90.0(72.5,137.5) min vs.77.0(55.0,115.0) min],postoperative hospital stay [10.0(6.0,18.0) d vs.7.0(4.0,11.0) d],and length of hospitalization [17.0(11.5,23.0) d vs.13.0(9.0,19.0) d] were significantly increased or prolonged in the HA compared with the MLA group (all P ＜0.05).(5) Postoperative complications:the incidence of postoperative complications was significantly higher [30.4％ (21/69) vs.12.2％ (37/303)] in the HA compared with the MLA group (P ＜ 0.05).(6) Therapeutic outcomes:there was a cure rate of 95.7％ (66/69) in the HA group,and 97.7％ (296/303)in the MLA group.No significant difference in the therapeutic effects was found between the two groups (P ＞ 0.05).Conclusions Operation in extremely elderly patients with biliary diseases is safe and feasible.The key is to take measures such as actively treating preoperative coexisting diseases,strictly mastering operative indications,reasonably selecting surgical procedures,accurately carrying out precise operation,strictly monitoring and dealing with intraoperative emergency,timely preventing and treating postoperative complications,and especially focusing on maintaining cardiopulmonary function during the perioperative period.

Objective:The purpose of this study was to explore the critical values of monitored indexes of perioperative major adverse cardiac events(MACE), so as to take effective prevention and treatment measures in time to maintain the stability of perioperative cardiac function to further improve the perioperative safety of elderly patients with biliary diseases.Methods:The clinical data of 246 elderly patients with biliary diseases in our hospital from May 2016 to February 2022 were collected.According to whether MACE occurred during the perioperative period, they were divided into the MACE group and the non-MACE group.The differences of clinical data, the monitoring indexes of postoperative cardiac function, and the coagulation function between the two groups were compared and analyzed.Logistic regression was used to analyze the independent risk factors of perioperative MACE, the cut-off value of the receiver operating characteristic(ROC)curve was calculated, and the Logistic multivariate prediction model was established.Results:In the MACE compared with the non-MACE group, age, postoperative complications and mortality, postoperative hospital stay, and the levels of postoperative high sensitivity troponin-I(Hs-TnI), creatine kinase isoenzyme(CK-MB), myoglobin(MYO), B-type natriuretic peptide(BNP), and D-dimer(D-D)were significantly increased(all P<0.05). Multivariate Logistic regression showed that postoperative BNP and D-D were two independent risk factors for perioperative MACE, and their cut-off values in the ROC curve were 382.65 pg/mL and 0.975mg/L respectively.The Logistic multivariate prediction model established by the Logistic regression equation was P= ex/(1+ ex), X=-5.710+ 0.003X 1+ 0.811X 2, where X 1 was the postoperative BNP level and X 2 was the postoperative D-D level.The accuracy, specificity and sensitivity of this prediction model for predicting perioperative MACE were 96.3%(237/246), 100.0%(235/235), and 18.2%(2/11). Conclusions:The Logistic multivariate prediction model established in this study can effectively predict the occurrence of perioperative MACE in elderly patients.Postoperative BNP and D-D were two independent risk factors for perioperative MACE.The cut-off values of BNP and D-D in the ROC curve could be used as critical values for monitoring perioperative MACE.Therefore, it is of great clinical significance to take effective prevention and treatment measures in time to maintain the stability of perioperative cardiac function, and further improve the perioperative safety of elderly patients with biliary diseases.

Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
Consensus ; Dental Care ; Dental Caries/prevention & control* ; Humans ; Prevalence