Extraction of teeth is the most basic and widely used operation of oral and maxillofacial surgery. According to characteristics of extraction of teeth, the author views medical ethics principles which in the diagnoses and treatments process from the aspect of medical ethics, they are,①Doctors must intensify their own quality and self - cultivations and establish the idea of " People First ". ②Doctors must carry on the overall and systematic inspection, make the plan of diagnoses and treatments synthetically toimplement the idea of " People First ". ③Doctors should pay attention to interact with patient, meet different patients' demands and create the harmonious medical environment.

AIM: To study the effectiveness of hyaluronidase periocular injection combined with α - lipoic acid and Chinese medicine in the treatment of diabetic vitreous hemorrhage.
METHODS: Retrospective analysis of 67 patientswith proliferative diabetic retinophathy ( PDR ) and vitreous hemorrhage, were divided into two groups: treatment group and control group. There were 32 cases in every group, the treatment group were giving hyaluronidase periocular injection combined with α - lipoic acid intravenously and with traditional Chinese medicine in promoting blood circulation to remove blood stasis, control group were only given Chinese medicine treatment in promoting blood circulation to remove blood stasis.
RESULTS: Followed up 2-3mo, the total efficiency of treatment group ( 78%) was better than control group (57%), there was statistically significant difference ( P<0-05 ) . The efficiency of the two groups' patients with vitreous hemorrhage more than 2wk time was 22% and 25% respectively, there was no statistically significant difference in the two groups (P>0. 05).
CONCLUSION: Hyaluronidase periocular injection combined with α-lipoic acid and Chinese medicine in the treatment of PDR combined with vitreous hemorrhageis more effective than only use Chinese medicine. But it only has effect for the early, over 2wk, it has no significant effect.

OBJECTIVE:To study the feasibility of 10 kinds of culture media used in pharmaceutical microbial limit test stated in Chinese Pharmacopoeia(2010 edition)autoclaving at 121 ℃ for 15 min. METHODS:The performance(color,pH,sterility,the growth-promoting activity,antibacterial ability,indication)of 10 kinds of culture media including Modified Martin Broth medium were tested after autoclaving at 121 ℃ for 15 min or in the parameters from the product instructions according to GB4789.28-2013 and the requirements for quality control of culture media in Chinese Pharmacopoeia(2010 edition). The quality of the media were compared after autoclaved by different parameters. RESULTS:The quality of the media which were autoclaved at 121 ℃ for 15 min were equivalent with the media which were autoclaved by the parameters from the product instructions,and their quality met the requirements for quality control of media in Chinese Pharmacopoeia(2010 edition). CONCLUSIONS:The sterilization parame-ters of 10 kinds of media in Chinese Pharmacopoeia (2010 edition) can be adjusted to be autoclaved at 121 ℃ for 15 min,the quality of the media remain stable after autoclaving.

Objective To explore the molecular mechanisms of primary amenorrhea by using arrayCGH technology. Methods Ten patients with primary amenorrhea and 10 female volunteers with regular menstrual cycles as healthy controls were selected. All patients and control samples were analyzed by conventional chromosome analysis (G-banding technology) and array-CGH technology, respectively. ArrayCGH was performed using Affymetrix Cytogenetic 2. 7M arrays following the manufacturer's standard protocol. Results Both the patient group and control group analyzed by conventional G-banding karyotype technology showed a negative result with a normal female karyotype: 46, XX. The result of array-CGH analysis demonstrated a microdeletion of approximately 110 000 bp located at the end of the short arm of X chromosome [46, X, del (X) (p22. 33 )] were identified in 5 patients, which was not detected in the control group. All healthy control samples by array-CGH analysis showed no pathological DNA copy number variation. Conclusions Array-CGH technology can improve the diagnosis rate of chromosomal disease at the DNA level. It is necessary to provide array-CGH for higher resolution genetic analysis of idiopathic primary amenorrhea patient who can not be identified by conventional technology.

OBJECTIVESTo investigate the apoptosis induced by antisense oligodeoxynucleotide (ASODN) against survivin and the mechanisms after the hepatocellular carcinoma SMMC-7721 cells transfected with the ASODN.

METHODSThe ASODN was transfected into SMMC-7721 cells mediated by liposomal reagent. The changes of cell cycle and apoptotic rate were detected by flow cytometry. The changes of cell skeleton was observed through confocal microscope. The activity of p38MAPK and caspase-3 were detected by immuno-precipitation and kinase activity assess methods, respectively.

RESULTSThere were control, sense control, 400, 600, 800, and 1 000 ng/ml ASODN groups (I - VI). The apoptotic rats were 0.70%, 0.76%, 2.43%, 7.82%, 23.11%, and 31.35% in groups I - VI, respectively, which in the ASODN-transfected groups were higher than that in the control group (tor=20.9, P<0.01). The activity of p38MAPK increased significantly, when the ASODN was transfected at the concentration of 600 ng/ml or more, so did the caspase-3 activity (the p38MAPK and caspase-3 activity in groups I - VI were 7.03, 7.07, 13.47, 16.37, 43.97, 47.87 and 0.015+/-0.010, 0.014+/-0.002, 0.026+/-0.003, 0.042+/-0.001, 0.093+/-0.001, 0.100+/-0.001, respectively).

CONCLUSIONSASODN targeting at survivin mRNA can induce G2/M stop, activate p38MAPK and caspase-3. The activated caspase-3 destroys the cell skeleton microfilament system, resulting in apoptosis.

Apoptosis ; Carcinoma, Hepatocellular ; drug therapy ; enzymology ; pathology ; Caspase 3 ; Caspases ; metabolism ; Cell Line, Tumor ; Humans ; Inhibitor of Apoptosis Proteins ; Liver Neoplasms ; drug therapy ; enzymology ; pathology ; Microtubule-Associated Proteins ; antagonists & inhibitors ; genetics ; Neoplasm Proteins ; Oligonucleotides, Antisense ; therapeutic use

OBJECTIVETo investigate the relationship between differential expression of VEGF and its receptors and clinical characteristics of childhood acute lymphoblastic leukemia (ALL).

METHODSExpressions of VEGF and its receptors (Flt-1, KDR) were assayed by ELISA and RT-PCR in healthy donors(20 cases), ALL patients in remission (20 cases), with low risk (29 cases) and with high risk (10 cases). The clinical data of all the patients and volunteers enrolled in this study were collected and analyzed according to the expression of VEGF and its receptors.

RESULTSThe expressions of VEGF were (574.37 +/- 208.45) ng/L, (387.93 +/- 175.86) ng/L, (135.80 +/- 111.28) ng/L and (91.16 +/- 41.34) ng/L in patients with high risk, standard risk, in remission and healthy donors, respectively. Expression levels of VEGF receptors were downwards with risk grades. The clinical manifestations were also in accord with the expression levels of VEGF and its receptors.

CONCLUSIONALL patients with highly expressed VEGF and its receptors are usually with higher tumor burden, and refractory treatment. Detection of VEGF and its receptors might be one of prognostic marker for ALL treatment.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; RNA, Messenger ; genetics ; Receptors, Vascular Endothelial Growth Factor ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

OBJECTIVEIn order to explore the roles of Huoxueruanjian compound on liver fibrogenesis and its molecular mechanism, this paper has investigated the Influence of blood serum with such traditional Chinese medicine compound on the expression of Smad3, Smad7 and procollagen alpha2(I) gene in hepatic stellate cell (HSC).

METHODSHSC-T6 was deal with different Concentration of blood serum medicine with Heluoshugan which was made by routine way. Then expression change of Smad3, Smad7 and procollagen alpha2(I) mRNA among each groups were observed by RT-PCR. Furthermore, the expression change of Smad3 protein were examined by Western blot.

RESULTSExpression of Smad3 and procollagen alpha2(I) mRNA as well as Smad3 protein had been downregulated after treating with blood serum medicine of Heluoshugan (P<0.01, P<0.05, respectively). The expression of procollagen alpha2(I) mRNA changed at the same tendency as those of Smad3. The role of blood serum medicine was significant difference between different concentration, P<0.05. And the expression of procollagen alpha2(I) mRNA changed in concentration-dependent manner. Blood serum medicine has no effects on the Smad7 mRNA.

CONCLUSIONThe anti-fibrosis roles of HuoXueruanjian Compound maybe influence the function of TGF-beta and Smad by nonspecific action, thereby inhibit the transcription of procollegan alpha2(I) mRNA and decrease the production of ECM. As regards Smad3, it may be facilitating the development of liver fibrosis when its expression increases. Otherwise, it manifest with anti-fibrosis role.

Animals ; Collagen Type I ; genetics ; DNA-Binding Proteins ; genetics ; Liver Cirrhosis ; drug therapy ; etiology ; pathology ; Medicine, Chinese Traditional ; RNA, Messenger ; analysis ; Rats ; Smad3 Protein ; Smad7 Protein ; Trans-Activators ; genetics

Objective:To explore the association between location of lower extremity deep venous thrombosis and incidence of pulmonary embolism in patients with lower extremity fracture during hospitalization.Methods:A retrospective study was conducted of the 1,620 patients who had been treated for lower extremity fracture and deep vein thrombosis from October 2014 to November 2019 at Department of Orthopaedic Trauma, Honghui Hospital. They were 726 males and 894 females, aged from 18 to 98 years (average, 64.0 years). By the anatomical location of thrombosis, they were divided into a proximal thrombosis group and a distal thrombosis group; by the laterality of thrombosis, they were divided into a bilateral thrombosis group and a unilateral thrombosis group which was further divided into a left thrombosis subgroup and a right thrombosis subgroup. The incidences of pulmonary embolism were compared between 2 corresponding groups and subgroups.Results:Pulmonary embolism occurred in 13 of the 1,400 patients with distal thrombosis and in 12 of the 220 patients with proximal thrombosis; the incidence of pulmonary embolism in the proximal thrombosis group (5.45%, 12/220) was significantly higher than that in the distal thrombosis group (0.93%, 13/1,400) ( P<0.001). Pulmonary embolism occurred in 10 of the 337 patients with bilateral thrombosis and in 15 of the 1,283 patients with unilateral thrombosis; the incidence of pulmonary embolism in the bilateral thrombosis subgroup (2.97%, 10/337) was significantly higher than that in the unilateral thrombosis group (1.17%, 15/1,283) ( P=0.017). Pulmonary embolism occurred in 5 of the 677 patients with left thrombosis and in 10 of the 606 patients with right thrombosis; the incidence of pulmonary embolism in the right thrombosis subgroup (1.65%, 10/606) was insignificantly higher than that in the left thrombosis subgroup (0.74%, 5/677) ( P=0.129). Conclusions:In patients with lower extremity fracture, those with proximal or bilateral thrombosis are more prone to pulmonary embolism than those with distal or unilateral thrombosis, but the possibility of pulmonary embolism cannot be ignored clinically in those with distal or unilateral thrombosis.

Objective :To explore correlation among serum levels of high sensitive C reactive protein (hsCRP) ,homocys-teine (Hcy) and severity of ischemic stroke in patients with ischemic stroke .Methods :A total of 131 patients with ischemic stroke were enrolled as stroke group .According to neurologic impairment score ,they were divided into mild group (n＝59) ,medium group (n＝41) and severe group (n＝31) ;according to infarct size ,they were divided into lacunar infarction group (n＝55) ,small infarction group (n＝46) and large infarction group (n＝30).Another 98 healthy subjects undergoing physical examination during the same period were selected as healthy control group .Serum levels of hsCRP and Hcy were measured in all groups ,and their correlation with clinic neurologic impairment degree and infarct size in patients with ische-mic stroke were analyzed .Results :Compared with healthy control group ,there were significant rise in serum levels of hsCRP and Hcy in stroke group ,P＝0.001 both .Compared with mild group ,there were significant rise in serum levels of hsCRP [ (4.43 ± 0.42) mg/L vs.(6.78 ± 1.48) mg/L vs.(9.52 ± 1.73) mg/L] and Hcy [ (17.49 ± 1.32) μmol/L vs. (22.18 ± 1.83) μmol/L vs.(26.01 ± 2.37) μmol/L] in medium group and severe group ,and those of severe group were significantly higher than those of medium group , P＝0.001 all ;compared with lacunar infarction group ,there were signif-icant rise in serum levels of hsCRP [ (4.13 ± 0.53) mg/L vs.(7.61 ± 1.47) mg/L vs.(9.49 ± 2.18 ) mg/L] and Hcy [ (18.49 ± 3.27) μmol/L vs.(22.53 ± 4.28) μmol/L vs.(27.38 ± 5.12) μmol/L] in small infarction group and large in-farction group ,and those of large infarction group were significantly higher than those of small infarction group (P＝0.001 all).Pearson correlation analysis indicated that serum serum levels of hsCRP and Hcy were significant positively correlated with clinic neurologic impairment score and infarct size in patients with ischemic stroke (r＝0.253～0.641 ,P＜0.01 all). Conclusion :Serum levels of hsCRP and Hcy are important indexes assessing severity of ischemic stroke .

Objective To investigate the efficiency and safety of endoscopic submucosal dissection (ESD)for rectal neuroendocrine neoplasm(NEN). Methods A retrospective analysis was performed on data collected from 58 consecutive patients with rectal NEN,who underwent endoscopic ultrasonography and followed by ESD from January 2006 to January 2016 at Peking University First Hospital. Patients′endoscopic and pathological features, clinical manifestations, R0 resection rate and follow-up results were studied. Results En bloc resection was achieved for all of the 58 lesions with a mean diameter of 7.6 mm(range 3.0-18.0 mm). The complete resection rate was 94.8%(55/58). One patient showed postoperative bleeding. The diameter of lesion more than 15 mm increased the risk of non-R0 resection(P<0.05). During the mean follow-up of 3.2 years(range 1.2-11.2 years), all patients remained free from local recurrence. However,distant metastasis was detected in 1 NEN G2 patient with lymphatic invasion(1.7%). Conclusion ESD is effective for treatment of rectal NEN with diameter less than 15 mm and causes less complications. Tumor features and stage determine the risk of distant metastasis,so long-term follow-up is essential.