This case report presents an extracted maxillary third molar,which have 3 separate roots with 5 canals,the canal configuration in mesiobuccal root are 3 separate orifices and canals,1 apical foramen.The clinician should be aware of this anatomical variation,avoid the missed canals.

OBJECTIVE: To introduce and analyze the present status of research on decomposed recipes of traditional Chinese medicine (TCM). METHODS: The relevant literature on the study of the decomposed recipes of TCM in the past five years was collected and analyzed. RESULTS AND CONCLUSION: Studies on the decomposed recipes of TCM have been made from the whole body level to the organ, cell and molecular research level. The pharmacological research in vitro is the main way and quantitative changes of the chemical ingredients have been measured before and after composition. It is very important to combine the modern science and technology in exploring the composing mechanisms of TCM remedies.

Hypertension is a global problem,affecting both developed and developing nations. The mor-bidity of hypertension in children and adolescents has increased year by year in recent years. Hypertension in children can cause target organ damages(mainly renal,cardiovascular,central neurological,or optic fundal). In clinical practice,we need to find simple and easy methods for early recognition of target organ damages,thus se-rious consequences in adult hypertension may be prevented.

To study the influences of the demographic evolution to government expenditure on health by using the method of generalized method of moment(GMM)by dynamic panel data of 31 provinces or cities from 1998 to 2011. The result showed that the elderly dependency ratio had a significant positive impact on government health expenditure, while the reduction of child dependency ratio would increase it. There were clear differences among regions. The elderly and child dependency ratio were both significantly positive for the eastern region, no significant effect for the central, and positive and negative respectively for the western. Therefore, it is needed to further improve the proportion of government health spending in total health expenditure, increase transfer payment, reduce regional differences and achieve the equalization of basic public health services.

Urinary tract infection (UTI)is a commonly encountered disease during routine clinical care. In the mean time, it is also a commonly encountered hospital acquired infection. UTI possesses various clinical symptoms, and usually the symptoms are atypical. The detection of leukocyturia and bacteriuria is an essential index for screening and confirmatory diagnosis of UTI. This article summarized the pathogenesis of UTI, diagnostic criteria, clinical significance and application evaluation of detection of the WBC and bacteria in urine.

Objective To investigate the diagnostic value of serum amyloid A(SAA)in diagnosing acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Methods A total of 86 patients with AECOPD and 46 patients with stable COPD were recruited.SAA determined with ELISA was compared between AECOPD patients and stable COPD patients.The changes of SAA,WBC,the percentage of neutrophils and C-reactive protein (CRP) of AECOPD patients Was compared before and immediately after the last treatment procedure.Results The SAA levels in AECOPD patients were higher than those in stable COPD patients [(182.33±50.12)mg/L vs (6.24±3.05)mg/L,P<0.05].The change of SAA was more evident than that of serum WBC and the percentage of neutrophils before and after the treatment procedure. SAA was more sensitive than CRP in diagnosing lung function severity of AECOPD patients.Conclusion SAA has great diagnostic value in AECOPD diagnosis and evaluation of lung function severity.

Autoimmune polyendocrinopathy syndrome type Ⅰ( APS-Ⅰ) is a rare autosomal recessive disorder caused by mutations in autoimmune regulator gene( AIRE) . A number of mutations have been described in the AIRE gene of patients with APS-Ⅰ, including nonsense mutation, missense mutation, silent mutation, splice site mutation, insertions and deletions mutation, et al. The mutation characteristics of the APS-Ⅰ pathogenic gene have been reviewed in the article.

Objective To observe the bleeding risk of short-term intensive statin therapy after coronary artery bypass grafting. Methods A total of 240 patients treated with coronary artery bypass grafting were randomly divided into group A(experimental group)and group B(control group). All pa-tients were normalized to conventional treatment and they were given low molecular weight heparin for an-ticoagulant therapy during the perioperative period. Patients in group A were given 40 mg of atorvastatin before surgery,and 40 mg of atorvastatin every night for one month after the surgery. Patients in group B were given 10 mg of atorvastatin every night during the treatment. One month after the operation,platelet aggregation rate and bleeding events of patients were compared. Results There were significant differ-ences in maximum platelet aggregation rate[(14. 5 ± 3. 7)% vs(38. 1 ± 7. 4)% ,P < 0. 05],inhibition rate of platelet aggregation[(79. 5 ± 4. 3)% vs(50. 8 ± 10. 2)% ,P < 0. 05],and incidence of postopera-tive bleeding[27. 5% vs 12. 5% ,P < 0. 05]between group A and B,respectively. Conclusion Short-term intensive statin therapy can increase the bleeding risk after coronary artery bypass grafting.

Objective To compare cardiovascular responses of intubations by Discopo and Macintosh laryngoscope in elderly patients with hypertension. Methods Sixty elderly hypertensive patients with ASAⅡ~Ⅲundergoing elective surgery were equally randomized into two groups. After induction of general anesthesia , orotracheal intubation was performed with Discopo or Macintosh. The Mean arterial pressure (MBP) and heart rate (HR), as while as Electrocardiogram (ECG) and Blood oxygen saturation (SpO2), were recorded before (baseline values) and at 1,3,5 minutes after intubation(post-induction values). The rate of one-time successive intubation,intubation time and complication were also recorded. Results Compared with the macintosh group, the rate of one-time successive intubation was higher and the intubation time was shorter in the Discopo group (P< 0.05, respectively),with no complications. Compared with T0,MBP and HR at T2 in the two groups and T3 in the Macintosh group increased significantly (P < 0.05). Compared with the Macintosh group,MBP and HR at T2,T3 of the Discopo group decreased significantly (P < 0.05). Conclusion Little effect of tracheal intubation with Discopo on cardiovascular response was observed in elderly hypertensive patients.

Functional gastrointestinal disorders is a common functional disease without organic pathologic changes, mainly including functional dyspepsia, irritable bowel syndrome and functional constipation.As the dissatisfaction, side effects and recurrence with drug treatment, transcutaneous electrical stimulation has taken an important role in the treatment of functional gastrointestinal disorders in recent years.This article reviewed the progress of transcutaneous electrical stimulation in treatment of functional dyspepsia, irritable bowel syndrome and functional constipation.