Objective To evaluate short-term fowllow-up results of castable ceramic-IPS Empress Ⅱ onlays in restoring severe tooth defects with low occlusogingival dimension from clinical aspects.Methods 41 units of the onlay were fabricated and applied in 37 patients,who were divided into experimental group and control group.The experimental group were restored with IPS EmpressⅡcastable ceramic onlay which was bonded by a dual-cure adhesive system.The control group were restored with mental onlay which was bonded by glass-ionomer cements.All these cases were followed at 6 and 12 months after cementation of the restorations.Metewands were established to evaluate its clinical effects.Results Onlay made from IPS Empress Ⅱ castable ceramic demonstrated natural and esthetical appearance.In addition,proximal contact,retention and marginal fit of the restorations were good.No gingivitis was found.Conclusion The reliability of onlay made from IPS Empress Ⅱ castable ceramic is greatly improved due to the strengthening effects of the lithium disilicate structures.In addition,the better esthetics compared to resin filling technique makes it a comparatively ideal all-ceramic system for onlays.

Objective:To investigate the differential diagnosis of MRI between male malignant and benign breast lesions.Methods:Totally 34 patients with male breast lesions who underwent breast MRI examination from January 2011 to March 2019 were collected from Shanghai Cancer Center.All images were evaluated by two radiologists who were blinded to pathological results. When there was a disagreement, another independent senior radiologist assessed the imaging features. The imaging features including lesion location, T 1WI signal, T 2WI signal, lesion type and accompanying signs were evaluated. All lesions were confirmed by biopsy or surgical pathology. Twelve patients were in benign group, 22 patients in malignant group. The imaging findings of MRI were recorded and statistically analyzed by univariate analysis (continuous variables were tested by Mann-Whitney U test and categorical variables were tested by Fisher′s exact test). Results:Among the 34 patients, 31 cases clinically touched the mass and 3 cases showed simple nipple bleeding. In MRI signs, breast cancer showed mass-like enhancement (22/22), benign lesions showed non-mass enhancement (7/12), the difference was statistically significant ( P<0.05). And ipsilateral axillary enlarged lymph nodes only appeared in breast cancer, which was significantly different from that in benign lesions ( P<0.05). There was no significant difference in age, lesion location, T 1WI signal, T 2WI signal, skin thickening and nipple invagination between benign and malignant lesions. There was no significant difference in the size, shape and edge of the mass between benign and malignant lesions on MRI ( P>0.05). Conclusions:MRI can distinguish male malignant and benign breast lesions. Most of non-mass enhancement are benign lesion and enlarged lymph nodes are helpful to detect breast cancer, nipple retraction and skin thickening in the diagnosis of male breast cancer are limited.

Objective To explore the effects of willed movement on neurological performance and the extracellular signal-regulated kinase (ERK) and cAMP response element binding protein (CREB) pathway in rats following focal cerebral ischemia.Methods Reversible middle cerebral artery occlusion was induced in 144 male SpragueDawley rats using intraluminal sutures,and they were randomly divided into a control group,a swimming exercise group,an environment modification group,and a willed movement group.The observation time points were at 7,15 and 30 days after reperfusion.A behavioral test was performed to evaluate any neurological deficiency.Reverse transcription PCR (RT-PCR) and immunofluorescence were used to detect the ERK and CREB responses in terms of mRNA and phosphorylated ERK (pERK) and phosphorylated CREB (pCREB) protein in the peri-ischemic brain tissue.Results The climbing frequency of the willed movement group was significantly higher than that of the environment modification group.Three days after reperfusion the neurological deficit scores of all groups began to decrease,and that of the willed movement group had decreased significantly more than in the other three groups at all time points.ERK/CREB mRNA and pERK and pCREB protein expression were dramatically up-regulated in the willed movement group at 7,15 and 30 days after reperfusion,significantly more than in the other three groups.Conclusions Willed movement may promote motor recovery by up-regulating and activating the ERK/CREB pathway following focal cerebral ischemia.

Objective:To investigate the effects and the possible mechanisms of Neiguan(PC6)and Gongsun(SP4)on the hypothalamic-pituitary-adrenal(HPA)axis in rats with functional dyspepsia(FD),thus to provide a theoretical basis for the clinical application of the Eight Confluent Points.Methods:Forty specific-pathogen-free Sprague-Dawley rats were divided into a blank group,a model group,an electroacupuncture(EA)group,and a Western medicine group by the random number table method,with 10 rats in each group.Rats in the blank group did not receive modeling or intervention.Rats in the other three groups were subjected to the FD with mood disorder model using the compound etiology modeling method.After the successful modeling,rats in the model group did not receive any interventions,rats in the Western medicine group received deanxit and mosaprid intervention,and those in the EA group received EA intervention on the ipsilateral Neiguan(PC6)and Gongsun(SP4)for 21 d.The sugar-water consumption rate was measured before the experiment and before and after interventions to assess the emotional status.The gastric emptying rate was measured after interventions to assess the gastrointestinal dynamics.The expression levels of hypothalamic corticotropin-releasing hormone(CRH),pituitary adrenocorticotropic hormone(ACTH),and adrenal corticosterone(CORT)were measured by enzyme-linked immunosorbent assay.Results:Compared with the blank group,the sugar-water consumption rate and the gastric emptying rate were decreased(P<0.01),and the hypothalamic CRH,pituitary ACTH,and adrenal CORT expression levels were increased(P<0.01)in the model group.Compared with the model group,the sugar-water consumption rate and the gastric emptying rate were significantly increased(P<0.01),while the expression levels of hypothalamic CRH,pituitary ACTH,and adrenal CORT were significantly decreased(P<0.01)in the EA group and the Western medicine group.The differences between the EA group and the Western medicine group were not statistically significant(P>0.05).Conclusion:The Eight Confluent Points Neiguan(PC6)and Gongsun(SP4)can improve the mood and gastrointestinal dynamics in FD rats,which may be achieved by down-regulating the hypothalamic CRH,pituitary ACTH,and adrenal CORT,as well as by correcting the HPA axis hyperfunction.