Objective:To evaluate evaluation of the changes of alveolar bone height in the periodontal patients with anterior teeth displacement before and after combined orthodontic periodontal treatment with circumferential fibrotomy. Methods: Totally 16 periodontal patients with anterior displaced teeth were analyzed after random clinical trialed as groups with and without circumferential fibrotomy of involving teeth followed by orthodontic intrusion. Evaluations of the changes of alveolar bone were given before and after treatment by means of periapical X ray film and CT scan of the involving teeth. Results: Orthodontic treatment with circumferential fibrotomy can increase the height of crest bone. Alveolar bone height was increased in the patients with circumferential fibrotomy followed by orthodontic intrusion of displaced anterior teeth. Alveolar bone height was increase by 1.2 mm on average in circumferential fibrotomy patient. In the patients with symmetric alveolar bone loss, 0.8 mm increase of alveolar bone height was observed following treatment. For the patients with asymmetric alveolar bone loss, 0.9 mm increase of alveolar bone height was detected in mild bone loss patients, but 1.4 mm and 2.2 mm increase of alveolar bone height were found in moderate and severe bone loss patients, respectively. For patients having the orthodontic treatment without circumferential fibrotomy, the alveolar bone height was increased by 0.1 mm only. Statistic significance was found between the circumferential fibrotomy group and non fibrotomy group. Conclusion: Combined orthodontic periodontal treatment with circumferential fibrotomy could correct the malpositioned teeth, and improve the periodontium conditions and gain the crest bone.

To provide theoretical and practical basis for the successful formulation design of physically-mixed inhalation dry powder of proteins and peptides, related references were collected, analyzed and summarized. In this review drug micronization technology and commonly used carriers for inhalation dry powder preparation were introduced. For proteins and peptides, supercritical fluid technology and spray-drying are more suitable because of their capabilities of keeping drug activity. Being approved by U. S. Food and Drug Administration, lactose has been extensively used as carriers in many inhalation products. Formulation and process factors influencing drug deposition in the lung, including carrier properties, drug-carrier ratio, blending order, mixing methods, mixing time and the interaction between drug and carrier, were elucidated. The size, shape and surface properties of carries all influence the interaction between drug and carrier. Besides, influence of micromeritic properties of the dry powder, such as particle size, shape, density, flowability, charge, dispersibility and hygroscopicity, on drug deposition in the lung was elaborated. Among these particle size plays the most crucial role in particle deposition in the lung. Moreover, based on the mechanisms of powder dispersity, some strategies to improve drug lung deposition were put forward, such as adding carrier fines, adding adhesive-controlling materials and reprocessing micronized drug. In order to design physically-mixed inhalation dry powder for proteins and peptides with high lung deposition, it is essential to study drug-carriers interactions systematically and illustrate the potential influence of formulation, process parameters and micromeritic properties of the powder.
Administration, Inhalation ; Drug Carriers ; chemistry ; Dry Powder Inhalers ; Lactose ; chemistry ; Particle Size ; Peptides ; administration & dosage ; Powders ; administration & dosage ; Surface Properties ; Technology, Pharmaceutical

Objective To systematically evaluate the application of problem-based learning (PBL)in the teaching process of health management major in China.Methods Databases including CNKI (1979 to December the 2015),VIP (1989 to December the 2015),Wanfang (1982 to December the 2015) and PubMed were systematically retrieved.Any literature about PBL of health management major was included.Seffdeveloped data extraction form was used for collecting the information.Data were input and analyzed using Excel 2007.Results 15 papers were included in the analysis.The first author mainly came from the northeast region of China (7).Most (10) papers did not get the funding support.No paper was published in the journals contained in the Guide to the Core Journals of China.6 papers of experimental studies compared the performance difference of students of the PBL and lecture-based learning (LBL),which was statistically significant.Conclusion PBL is superior to the LBL.However,due to the large difference in the quality of literature,more studies were needed to determine the effect of PBL.Moreover,we should pay attention to the combination of PBL and LBL.

Objective To investigate the efficacy of statin on carotid plaque stability in elderly patients assessed by K trans (the combination of E and F) of dynamic contrast material enhanced (DCE) magnetic resonance (DCE MR) imaging.Methods 37 elderly patients with carotid artery of low echo or mixed echo plaque in carotid artery patches were screened by B type ultrasound.According to the standard of 2011 ESC/EAS guidelines,all patients were divided into two groups:normal level of LDL-C group achieving LDL-C target and high level of LDL C group not achieving target of LDLC.Plaque area and size of lipid-rich necrotic core were measured by 3.0T enhancement magnetic resonance,and K trans was measured by DCE-MR dynamic contrast material enhanced (DCE) magnetic resonance (MR) imaging.and serum hs-C-reactive protein level was detected within 1 week.Results Plaque area,size of lipid-rich necrotic core,ratio of lipoid core over plaque area,K trans and serum level of hs-CRP were less in normal LDL-C level group than in high LDL-C level group [(2.06±0.45) mm2 vs.(3.63±0.62) mm2,(0.52±0.05) mm2 vs.(1.49±0.01) mm2,2 cases (11.8％) vs.14 cases (70.0％),(0.041±0.009) min1 vs.(0.079±0.011) min-1,(1.60±0.27) mmol/L vs.(2.80 ± 0.34),all P＜0.05].Linear regression analysis revealed that there was no significant correlations of K trans with the size of lipid necrotic core (r=0.19,P＞0.05) and hs-CRP (r=0.23,P＞0.05).Conclusions Dynamic contrast material enhanced (DCE) magnetic resonance (MR) imaging is a quantitative method assaying atheromatous plaque components; K trans may be a new indicator to measure the stability of plaques; Statin can stabilize plaques through inhibiting the proliferation of Vasa vasorum in plaque angiogenesis,anti-inflammatory and reducing the size of lipidrich necrotic core.

Objective To investigate the efficiency of transjugular intrahepatic portosystemic shunt (TIPS) with Fluency stent in improving the hepatic and renal function and survival rate in patients with decompensated cirrhosis.Methods The decompensated cirrhosis patients who were treated in our hospital from May 2008 to September 2011 were retrospectively analyzed.One group of patients (n =48) undergoing TIPS was randomly selected as treatment group,while another group of patients (n =48) treated by medicine and therapeutic endoscope was randomly chosen as control group.Clinical data and fellow-up data were retrospectively reviewed.There was no significant deviation in baseline characteristics (age,gender composition,etiology,renal function,hepatic function et al) among all the patients before the operations; The laboratory results of hepatic and renal function in 2 groups before and after operation (1 week,20 days,3 months,6 months,1 year,2 years,3 years) were recorded and compared with independent samples t-test or Wilcoxon rank sum test.The survival rates of two groups in 3 years were analyzed using Kaplan-Meier survival curve and compared with Chi-square test.Results Three years after the operation,there were significant differences between the treatment group and the control group in AST(70.8 vs.108.7 U/L,Z =-2.958,P ＜ 0.05) and TBIL (51.2 vs.76.2 μmol/L,Z =-2.004,P ＜ 0.05).The Cr value of the 3rd year after the treatment were (9928.2 ± 2363.8) in the the control group and (7742.1 ± 2845.6) μmol/L in the treatment group(t =-2.074,P ＜ 0.05).BUN of the 1st,2nd and 3rd years after the treatment were (2.0 ± 1.1),(2.3 ± 1.5),(2.5 ± 1.3) mmol/L in the treatment group,while it was (2.6 ± 1.1),(3.8 ±1.2),(5.4 ± 1.1)mmol/L in the control group.There was significant difference between the 2 groups (t =-2.222,-3.940 and-6.110,P ＜ 0.05).Comparing the survival rate in the 2 groups with Kaplan-Meier survival curve,the 3 year survival rate in the treatment group was 46.2％,while in the control group it was only 30.0％ (x2 =6.341,P ＜ 0.05).Conclusions Compared with medicine therapy and therapeutic endoscopy,TIPS with Fluency stent may improve the hepatic function,renal function and survival rate in liver cirrhosis patients.It is a safe and effective therapy choice for patients with decompensated cirrhosis.

Objective To evaluate the effect ofcytochrome P450 isoenzyme subfamily 2C19 (CYP2C19)gene polymorphism on the clopidogrel antiplatelet therapy in cirrhosis patients after receiving transjugular intrahepatic portosystemic shunt (TIPS).Methods The clinical data of 171 cirrhosis patients,who were treated with TIPS during the period from January 2013 to December 2014,were retrospectively analyzed.During operation both the portal vein and the elbow vein blood samples were collected and sent for CYP2C19 gene testing.After TIPS,clinical follow-up checkup was made once every 3 months.The gene detection results and clinical follow-up findings were comparatively analyzed.Results A total of 110 patients,who had not received blood transfusion before TIPS and who had regularly taken clopidogrel antiplatelet therapy after TIPS were enrolled in the study.The mean time to take clopidogrel was 192.4 days (31-517 days),and the gene detection results of portal vein and elbow vein were quite consistent.CYP2C19 genotype of *1/*1 was found in 49 patients (44.5％),CYP2C19 genotype of *1/*2 in 27 patients (24.6％),CYP2C19 genotype of *1/*3 in 18patients (16.4％),CYP2C19 genotype of *2/*2 in 11 patients (10.0％),CYP2C19 genotype of *2/*3 in 3patients (2.7％),and CYP2C 19 genotype of *3/*3 in 2 patients (1.8％).Following-up examinations showed that the incidence of shunt dysfunction in patients carrying slow metabolic gene was 87.5％ (14/16),which was significantly higher than that in patients carrying moderate metabolic gene (20.0％,9/45;x2=22.9,P=0.006)as well as in patients carrying fast metabolic gene (8.2％,4/49;x2=37.91,P=O.O00 1).Multivariate analysis of Cox regression model indicated that CYP2C19 slow metabolic gene variation was an important predictive factor for shunt dysfunction (95％CI:1.80-9.03,P=O.O00 7).Conclusion CYP2C19 slow metabolic gene variation,including genotype of *2/*2,*2/*3 and *3/*3,is an important factor that can influence the efficacy of clopidogrel treatment after TIPS.Preoperative CYP2C19 gene detection results can provide useful information,which is very helpful in making an effective and reliable anti-platelet treatment plan for patients after TIPS.

Objective: Signet-ring cell carcinoma is a relatively rare cancer which occurs principally in the stomach,colon-rectum,bladder and breast,but seldom in other parts.This article analyzes the clinical and pathologic features of 3 extremely rare cases of primary signet-ring cell carcinoma in the uterus.Methods: Three cases of primary signet-ring cell carcinoma in the uterus were observed by HE and immunohistochemical staining,their clinical features analyzed and the relevant literature reviewed.Results: Of the 3 cases,2 presented nodose tumors in the cervix while the other in the uterine cavity.Histologically,there was a diffuse infiltration of the tumor cells,with an appearance of signet-ring cells.Periodic acid-Sciff(PAS) staining revealed PAS-positive diastase resistant introcytoplasmic material.Immunohistochemically,the tumor cells were positive for CK and CEA.Conclusion: Primary signet-ring cell carcinoma of the uterus is extremely rare.It is always necessary to rule out a metastatic neoplasm by clinical examination and to differentiate it from other tumors/lesions with signet-ring cell features.

Interventional therapy is an important treatment for biliary stenosis.The treatment methods are different ac cording to the different causes.Conventional interventional therapy include biliary drainage,balloon dilatation and stent implantation.There are some new treatment methods such as radiofrequency catheter ablation and biliary stent loaded with 125I seeds.The applications of interventional therapy in biliary stenosis were reviewed in this article.

Objective To evaluate the clinical efficacy of local intra-arterial thrombolysis (LIT) with urokinase in patients with acute ischemic stroke.Methods One hundred and sixty two patients with acute ischemic stroke were treated with LIT by using urokinase and relationship of reconalization for different occluded arteries with the Glasgow outcome scale (GOS) scores three months later was analyzed. Results Angiography showed occlusion of the cerebral artery in 162 patients, among which 119(73.5%) patients showed the sites in the internal carotid artery system, with 27 occlusions in the internal carotid artery (ICA)trunk, 63(38.89%) in the middle cerebral artery (MCA)and 29(17.9%) in the anterior cerebral artery (ACA), and the remaining 43(26.5%)patients of vertebrobasilar artery (VBA); successful recanalization was achieved in 103 (63.58%)patients, including 11 (40.7%), 49(77.8%), 20(69.0%) and 23(53.3%), respectively, after intraarterial infusion of urokinase. Unsuccessful recanalization occurred in 59patients (36.42%). Followed up for 90 days, 90 (55.6%) patients obtained a good outcome; 72(44.44%) had poor prognosis including 20(12.35%) deaths. 8 patients associated with hemorrhage (4.9%) 73 with reperfusion injury (45.1%) and 5 arterial re-occlusion (3.1%). Based on statistic analysis, ICA trunk and VBA had low ratio of successful recanalization with poor clinic prognosis MCA and ACA possessed high ratio of successful recanalization and good clinic outcomes. There was a significant relationship between arterial recanalization rate and clinic prognosis (r=0.86).Conclusions Successful recanalization of cerebral occlusive artery by using intra-arterial thrombolysis could improve clinic prognosis in patients with acute ischemic stroke. Clinical prognosis has a significant relationship with both initial treatment time and arterial recanalization rate.

Objective To explore the causes and preventive measures of symptomatic intracranial hemorrhage in 217 patients with acute cerebral ischemic stroke treated with local intra-arterial urokinase. Methods From February1999 to June 2004, 217 patients were treated for acute ischemic stroke with local intra-arterial urokinase in our hospital. Factors associated with symptomatic intracranial hemorrhage of intra-arterial thrombolysis were analyzed by Stepwise logistic regression to identify some factors relating the prediction symptomatic intracranial hemorrhage. Results Symptomatic intracranial hemorrhage occurred in 8 cases (3.7%). Predictors of the symptomatic intracranial hemorrhage were the elevated systolic blood pressure before therapy (odds ratio, 1.096; 95% CI, 1.006 to 1.194) and urokinase (UK) treatment (odds ratio , 1.068; 95% CL, 1.053 to 1.247). Risk of secondary symptomatic intracranial hemorrhage was increased with elevated systolic blood pressure. Other factors like age, initial treating time, NIHSS, diabetes and collateral circulation did not predict the symptomatic intracranial hemorrhage respectively. Conclusions Predictors of symptomatic intracranial hemorrhage after local intra-arterial infusion of urokinase for acute ischemic stroke were the elevated systolic blood pressure before therapy and urokinase (UK) treatment.