BACKGROUND: The filling compactness can not be guaranteed due to apparatus retention in traditional lateral condensation.The warm gutter filling can achieve good results because of the easy changeable of gutta-percha in softening states.OBJECTIVE: To compare the warm gutta-percha fillings (Obtura Ⅱ and BeeFill 2 in1 filling) and cold lateral compacted gutta-percha with the bypassing root canal preparation in the intracanal separated instrument of oval canal.METHODS: Firstlythe 60 oval root canals of fiat mandibular central incisors were randomly divided into three groups, with 20 teeth in each group. After that, the root canal was filled with BeeFill 2 in1, Obtura Ⅱ condensation, and lateral condensation.The percentage of void at 5-mm to root tip versus cress section area was observed under a scanning electron microscope.RESULTS AND CONCLUSION: Under in vitro condition, the difference of percentage of void area versus root canal area between the Obtura Ⅱ condensation group and the lateral condensation group had significance (P=0.013), and the similar difference could be found between the BeeFill 2 in1 condensation group and the lateral condensation group (P=0.014), but the difference had no significance between the BeeFill 2 in1 condensation group and the Obtura Ⅱ condensation group (P=0.088).The results revealed that the root canal can be sealed accurately when establish hypass root next to the separated instrument and filled with BeeFill 2 in1 warm gutter filling.

Abortion, Habitual ; therapy ; Female ; Humans ; Medicine, Chinese Traditional ; methods ; Pregnancy

Comrade LU Zhi-jun, a famous surgeon and acupuncture expert, was a leading cadre in health field with outstanding achievements, and a leader of western medicine doctors learning traditional Chinese medicine in the Chinese Communist Party, and also he was a main establisher of The China Academy of Chinese Medical Sciences and a founder of TCM scientific researches and integrated Chinese and western medicine in new China. The present paper reviews the course of LU Zhi-jun in learning and applying acupuncture and moxibustion therapy and a part of works carried out in faithfully implementing our party's policies for uniting Chinese and Western medicine, and in development of TCM including acupuncture and moxibustion in past tens years.
Acupuncture Therapy ; History, 20th Century ; Humans ; Moxibustion

BACKGROUND:Obturation with warm gutta-percha can achieve perfect three-dimensional root canal obturation effect. Due to specific structure of oval canal, particularly in the bypass preparation process, excessive cutting of local tooth tissue may lead to tooth tissue thinning and irregular shape. The separation equipment is the metal with good heat conduction, so the heat caused by the bypassing warm gutta-percha obturation would burn periodontal tissue remains controversial. OBJECTIVE:To investigate the changes of root surface temperature produced by two bypassing warm gutta-percha obturation for the separation instrument in oval canalin vitro by using infrared thermography. METHODS:Forty mandibular first premolars were harvested from oval canals, and were separated using stainless steel 15# K file at apical 3 mm, with the length of 3 mm. The root canal bypassing was prepared using TF nickel-titanium file under operating microscope. The teeth were randomly divided into two groups, with 20 teeth in each group, and were obturated with the Thermafil warm gutter-percha and E&Q plus warm gutta-percha vertical compaction, respectively. An infrared thermoviewer was used to measure the external root surface temperature before and after the obturation. RESULTS AND CONCLUSION:Two warm gutta-percha obturation methods used for separating instruments bypassing in the oval root canal, had both caused the rise of root surface temperature, which was less than 10℃. In the Thermafil group, the temperature changes were 3.2-8.1℃ and the average change was 4.97℃. In the vertical condensation group, the temperature changes were 5.5-9.8℃ and the average change was 7.35℃. There were significant differences in the change of root surface temperature between the two groups (P < 0.05). Thermafil warm gutter-percha obturation would increase the root surface temperature, but cannot damage periodontal tissues. It is more secure than warm gutta-percha vertical condensation.

OBJECTIVETo explore the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) combined with infusion of propofol in anodynia bronchoscopy.

METHODSNinety patients who received selective bronchoscopy were randomized into a group of compound TEAS with infusion of propofol (group A), a group of compound fentanyl with propofol (group B) and a group of simple propofol (group C). In group A, the plaster electrode stimulation was applied at bilateral Hegu (LI 4), Laogong (PC 8), Neiguan (PC 6) and Waiguan (TE 5). The anesthesia was induced after 20 min of stimulation till the end of examination. In group B and group C, the electric stimulation was not adopted. In group B, before anesthesia, fentanyl 1 microg/kg was injected intravenously. Afterwards, the intravenous infusion of propofol was used in the the three groups for anesthesia. The mean arterial pressure (MAP), heart rate (HR), saturation of pulse oximetry (SpO2) and respiratory rate (RR) were recorded at different time points. The induced dosage and total dosage of propofol, examination time, the awakening time and adverse reactions were observed in the patients of each group.

RESULTSThe difference in examination time was not significant among the three groups (P > 0.05). The postoperative awakening time in group A was earlier than that in group B and group C [(220.3 +/- 110.5) s vs (285.6 +/- 109.4) s, (290.1 +/- 105.1) s, both P < 0.05]. The total dosage of propofol in group C was larger than those in group A and group B [(288.5 +/- 26.7) mg vs (225.1 +/- 30.2) mg, (230.4 +/- 29.3) mg, both P < 0.05]. The induced dosage in group C was larger than those in group A and group B [(193.7 +/- 42.3) mg vs (152.3 +/- 36.1) mg, (155.4 +/- 40.5) mg, both P < 0.05]. Every life physical sign in group A during examination was more stable as compared with that in group B and group C. The incidence of hypotension and bradycardia in group A were lower than those in group C [3.3% (1/30) vs 26.7% (8/30), 0% (0/30) vs 20.0% (6/30), both P < 0.05]. The adverse incidence of oxygen supply in group A was lower than that in group B [6.7% (2/30) vs 33.3% (10/30), P < 0.05]. Intraoperative awareness and improper memory did not happen in postoperative investigation.

CONCLUSIONIn the transcutaneous electrical acupoint stimulation combined with infusion of propofol in anodynia bronchoscopy, the physical sign of patient is stable with less adverse reactions. This method reduces anesthetic dosage and shortens the postoperative awakening time, which can be effectively applied in bronchoscopy.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Analgesia ; Anesthetics, Intravenous ; administration & dosage ; Bronchoscopy ; Female ; Humans ; Male ; Middle Aged ; Pain Management ; Propofol ; administration & dosage ; Transcutaneous Electric Nerve Stimulation

Objective To investigate the effect of L-carnitine on pathological changes of myocardium and the underlying mechanism in chronic renal failure rats (CRF). Methods A total of 55 male SD rats were randomly divided into sham group (n=10),model group (n=15),low dose (300 mg/kg),medium dose (600 mg/kg) and high dose (900 mg/kg) L-carnitine group(n=10,each).5/6 subtotal nephrectomy was performed in these rats without sham group.One week after the operation,normal saline or corresponding dose L-carnitine were intragastrically administrated to sham and model group or L-carnitine groups for 17 weeks.Transthoracic echocardiography,mean arterial pressure (MAP),heart rate (HR) and heart weight/body weight were assessed.Moreover,24h urine protein,renal function,SOD,MDA,IL-6,ATP,ADP were measured at the end of the study.Additionally,pathological changes in myocardium were detected by light microscope and transmission electron microscope. Results (1) ATP (μmol/g·wt)in L-carnitine groups (2.35±0.24,3.59±0.28,3.78±0.25) was significantly higher than that in model group (1.61±0.12) (all P＜0.01).(2) Thickness of posterior wall of left ventricle (mm) in high dose L-carnitine group was thinner than that in model group (3.74±0.23 vs 4.18±0.48,P＜0.05). (3) The ratios of heart weight to body weight in both medium dose and high dose L-carnitine groups (3.92±0.27,3.65±0.2) were significantly lower compared to model group (3.99±0.27) (all P＜0.01). (4) Under light microscopy,disarrangement and hypertrophy of cardiac myocytes,increased myocardial fibrosis were observed in model group, while these changes and the pathological scores were significantly improved in both medium dose and high dose L-carnitine groups (7.14±1.07,6.13±0.99),as compared with model group (9.88±1.13) (all P＜0.01).Under electron microscopy,typical changes in cardiac hypertrophy were observed,including dissolution of myocardial fibers,increasing and swelling of mitochondria,membrane rupture as well as matrix increase in model group,while these changes were ameliorated by L-carnitine in a dose-dependent manner. (5) Seventeen weeks after the treatment,both IL-6 and MDA were decreased in all L-carnitine-treated groups than those in model group [IL-6 (ng/L):261.86±13.18,240.12±18.7,233.34±36.88 vs 596.64±81.41; MDA (nmol/L):15.23±2.01,12.41±0.6.10.97±1.9 vs 21.84±2.71).Whereas,SOD (U/ml) were increased in L-carnitine-treated groups (51.2±6.11,58.51±5.52,60.63±6.94) than that in model group(32.01 ±5.69 )(all P＜0.05).(6) No significant differences of systolic,diastolic blood pressure or MAP were found among groups. Conclusion L-carnitine can improve energy metabolism,micro-inflammation and oxidative stress in myocardium of CRF rats,which may be associated with the amelioration of cardiac hypertrophy and fibrosis.

BACKGROUND: Inflammatory and proliferating effect after mechanical injury of vascular wall is the major cause of restenosis. Nuclear factor-kappa B (NF-κB) in the NF-κB/Rel family is expressed in a variety of cell types and activates a series of target genes, which are related to the pathophysioiogy of vascular wall.OBJECTIVE: To investigate the effect of antisense and decoy NF-κB oligonucleotides on vascular smooth muscle cell (VSMS) proliferation in vitro and neointimal proliferation and monocyte chemotactic protein-1 (MCP-1) in the balloon-injured carotid artery of rats.DESTGN: Randomized controlled animal trial.SETTTNG: Department of Cardiology, Ruijin Hospital, Medical College, Shanghai Jiaotong University.MATERTALS: Totally 126 male Sprague-Dawley (SD) rats, aged 3 months, weighing 350 to 380 g, were involved in this study. Synthesis of primer and oligonucleotide: they were synthesized and designed by Shanghai Bioengineering Co. Ltd according to literatures and international internet cDNA library.METHODS: This study was carried out in the Laboratory of Cell Biology, Medical College, Shanghai Jiao Tong University and Cardiovascular Laboratory, Ruijin Hospital Affiliated to Shanghai Jiaotong University from May 2001 to March 2003.Rat aortic smooth muscle cells were isolated from May 2001 to March 2003. Rat thoracic aorta vascular smooth muscle cells were cultured by primary-explant method. And the third to fifth generations of VSMCs were involved in the experiment. Proliferating cell nuclear antigen (PCNA) NF-κB p65 protein synthesis in proliferating smooth muscle cells were detected. SD rat carotid artery underwent balloon injury. The involved 126 rats were randomly divided into 7 groups with 18in each group: normal group: normal group (the procedure was the same as other group except for balloon injury), sense group, antisense group, decoy group, scramble group, antisense plus decoy group, model group. Each group includes 6time points (6 hours, and 1,3,5,7,14 days, n =3). Then, the effect of antisense and decoy NF-κB oligonucleotides on intimai proliferation and MCP-1 and NF-κB p65 and extracellular signal regulated kinase(ERK2) expression in the balloon-injured carotid artery of rats were detected.MAIN OUTCOME MEASURES: ①Effect of oligonucleotide of NF-κB p65 on VSMCs proliferation; ② NF-κB p65 gene expression and protein synthesis; ③ Patho-morphological change after carotid balloon-injury. ④ Vascular MCP-1 mRNA Expression in balloon-injured rat carotid artery; ⑤ MCP-1 immunoreactivity in the injured arterial wall detected by immunohistochemistry; ⑥ NF-κBp65 and ERK2 protein synthesis after balloon-injury detected by Western blot in injured rat carotid arteries.RESULTS: ①PCNA protein synthesis increased in proliferating smooth muscle cells. ②NF-κB p65 gene expression was found in the cytoplasm and nucleus of proliferating smooth musclecells by in situ hybridization and NF-κB p 65 protein level increased in proliferating smooth muscle cells by flow cytometry. NF-κB p65 gene expression in antisense group decreased 53.66% compared with in sense group; it decreased 57.35% in decoy group compared with in scramble group. There were all statistical differences(P＜0.05).③ PCNA expression were inhibited in proliferating smooth musclecells by antisense and decoy oligonucleotides. Compared with positive control group, PCNA protein expression in antisense group and decoy group decreased 45.12% and 45.05%,respectively. ④ In model group, sense group and scramble group, vessel intimal area, medial area and intimal area/medial area increased at the 5th day after balloon-injury and reached the maximum at the 7th day after injury. The intimal area/medial area was significantly decreased in the antisense group and decoy group. The effect of antisense plus decoy oligonucleotides was more obvious than that of antisense group and decoy group alone but there were not significant differences among three groups. ⑤ Reverse transcription-polymerase chain reaction showed that MCP-1 mRNA expression was significantly increased 6 hours after balloon-injury, but not evident after 1 day. It was increased at the 3th, 5th and 7th days continuously, but decreased at the 14th day. MCP-1 mRNA expression was decreased at each time point in antisense group, decoy group, antisense plus decoy group (P＜0.05). ⑥Western blot analysis showed that NF-κB p65 was weakly expressed at 6 hours after vascular balloon-injury, increased significantly at 1 day, reached the peak at 7 days and weakened at 14 days, while ERK2 protein was weakly expressed, a little increased at 1 day, reached the peak at 7 days and weakened at 14 days. Treatment of antisense group, decoy group and antisense plus decoy group inhibited protein synthesis more significantly than those of model group, sense group and scramble group (P＜0.05).CONCLUSTON: NF-κB expression increases in proliferating smooth muscle cells. NF-κB modulates genes expression and protein synthesis of MCP-1 and ERK2. Cellular proliferation in vessel wall dynamically changes after balloon angioplasty injury. Antisense and decoy oligonucleotide of NF-κB by local lipofectamine transfer inhibit the expression of regulated target gene.

To explore the clinical significance of serum cardiac troponin I (cTnI) for the detection of myocardial injury in children with Kawasaki disease (KD) in acute stage, the levels of serum cTn I, creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactic dehydrogenase (LDH) and glutamic oxalacetic transaminase (GOT) were determined in 40 children with KD and 23 controlled children without heart disease, respectively. The results showed that the levels of serum cTn I and CK-MB in the KD group were significantly higher than those in the controlled group (P＜0.001),while no obviously differences of CK, LDH and GOT were noticed between two groups (P＞0.05). cTn I was more sensitive comparing to CK-MB for the detection of myocardial injury (P＜0.05). It is concluded that the determination of cTn I and CK-MB will be available for the diagnosis of myocardial injury in children with KD in acute stage, and the determination of cTn I is more sensitivity and specificity comparing to CK-MB.

Objective To investigate the serum level of free fatty acid (FFA) and explore its relationship with cytokines and atherosclerosis (AS) in chronic kidney disease (CKD).Methods The serum level of FFA was determined with enzymatic colorimetry.IL-1 β, IL-6 and TNFα were determined with ELISA.High-sensitivity C-reactive protein (hsCRP) was measured with immunoturbidimetry.Prevalence of atherosclerosis was detected with carotid ultrasonography.We evaluated the relationship between serum levels of FFA and IL-1β,IL-6, TNFα, hsCRP as well as the renal function in 130 adult patients with CKD, stratified according to the GFR ( based on the National Kidney Foundation/Kidney Dialysis Outcomes Quality Initiatives) and in 58 hemodialytic (HD) patients.The relationship between FFA level and cardiac geometry incidence in CKD patients was analyzed with logistic regression model.Results The serum level of FFA was significantly higher in CKD patients as compared with that in the healthy controls [(492.63 ± 143.59)vs (302.65 ± 142.18) μ mol/L, P ＜ 0.01], even in the early stage of CKD.The level of FFA increased with the progression of renal dysfunction.In the non-dialytic CKD group, the level of FFA was negatively related to GFR and positively related to the proteinuria (P ＜ 0.05), while in the HD group, it was positively correlated with dialysis duration ( P ＜ 0.05 ).The serum levels of FFA were higher in CKD patients with carotid artery atherosclerosis than those in patients without ( P ＜ 0.05 or ＜ 0.01 ).However, in both groups with impairment of renal function, the levels of FFA were positively correlated with hsCRP, IL-1 β, IL-6,TNFα and TG( all P ＜ 0.05 ).A positive correlation between the level of FFA and the clinical manifestations such as carotid intimal medial thickness (IMT) and AS was also found.A negative correlation was found between the level of FFA and the serum level of albumin and GFR( P ＜ 0.05).Conclusion Serum levels of FFA are significantly higher either in non-dialytic CKD or in HD patients and it is related with hsCRP, IL-1 β, IL-6, TNFα as well as carotid artery atherosclerosis, indicating that FFA is an independent risk factor of AS in CKD.