Objective:To investigate the effects of iron sucrose combined with recombinant human erythropoietin(EPO)on perioperative anemia and early functional recovery in elderly patients with intertrochanteric fractures.Methods:A retrospective comparative analysis was performed on 78 elderly patients who received PFNA treatment for intertrochanteric fractures in our hospital from July 2016 to December 2018.In the observation group, 40 cases were treated with iron sucrose combined with erythropoietin during the perioperative period.No perioperative intervention measures were taken for the control group.Hemoglobin(Hb)levels at 1, 3, 5, 7 days and before discharge and Harris scores of hip joints before surgery, 2 weeks and 3 months after surgery were compared between the two groups.Results:Hb levels were higher in the observation group than in the control group at 5 d[(98.8±8.6 g/L vs.92.2±8.5 g/L, t=3.389, P=0.001)]and 7 d[(105.4±8.9)g/L vs.(94.8±8.5)g/L, t=5.370, P=0.000]after surgery and before discharge[(115.4±8.6)g/L vs.(100.6±8.2)g/L, t=7.771, P=0.000]. Harris scores were higher in the observation group than in the control group 3 months after surgery(82.4±3.8 vs.75.8±2.5, t=8.933, P=0.000). Pearson' s correlation analysis showed that Hb levels at 5d and 7d after surgery were positively correlated with Harris scores at 3 months after surgery.Hb levels before discharge had an effect on Harris scores at 3 months after surgery. Conclusions:The combined administration of iron sucrose and EPO perioperatively can promote postoperative Hb recovery, reduce the incidence of anemia, accelerate early functional recovery and improve the quality of life in elderly patients with intertrochanteric fractures.

Objective To analyze risk factors for the perioperative heart failure following hip fracture surgery in the aged patients.Methods The present study included 186 elderly patients(≥ 65 years)who had received hip fracture surgery from August 2009 to Janurary 2014 in our department.Their clinical data were analyzed to define risk factors for perioperative heart failure.Results Factors significantly affecting the perioperative heart failure included age,gender,hypertension,time from injury to operation,general health before injury,pain score,perioperative blood transfusion,perioperative human serum albumin transfusion,fluid infusion during operation,perioperative balance between daily fluid intake and output,perioperative temperature changing and heart diseases.A multivariate Logistic regression analysis revealed that the independent risk factors for perioperative heart failure included general health before injury (OR =21.967,P=0.000),perioperative balance between daily fluid intake and output (OR =19.349,P =0.005),heart diseases (OR =6.009,P =0.006).Conclusions In aged patients undergoing hip fracture repair operations the independent risk factors for perioperative heart failure include general health before injury,perioperative balance between daily fluid intake and output,heart diseases.Perioperative risk assessment and prevention are the keys of better prognosis.

Objective To study the tooth germ development of mouse molar in fluorosis.Methods We established an acute fluorosis model and used HE-staining after preparing specimens of different stage of mouse first molar developing tooth germ.Results The developing molars of the control fetuses were at the bell stage of odontogenesis,whereas those of the experimental population were at cap stage.The ameloblasts became shorter and lost polarity.The arrangement of ameloblasts fell into disorder at the bell of differeiational stage and secretory stage.Conclusion The developing molars of the experimental fetuses were retarded.High-dose fluoride has a strong effect in the ameloblasts at the bell of differetiational stage and secretory stage.

Objective To study the antagonistic effects of magnesium-selenium-fluorine preparation on dental fluorosis of mice and its mechanism,and to provide a foundational basis for prevention and control of dental fluorosis.Methods Eighty male SPF ICR mice,were divided into 8 groups according to body weight by random number table method:control group,magnesium group,selenium group,magnesium-selenium group,fluoride group,magnesium-fluorine group,selenium-fluorine group and magnesium-selenium-fluorine group.The control group,magnesium group,selenium group and magnesium-selenium group drank double steamed water,and the other four groups drank 50 mg/L F-double steamed water.The control group and fluoride group fed conventionally.Magnesium group and magnesium-fluorine group fed conventionally by adding MgSO4·7H2O 162.5 mg/kg.Selenium group andselenium-fluorine group fed conventionally by adding Na2SeO3 ·5H2O 2.0 mg/kg.Magnesium-selenium group and magnesium-selenium-fluorine group fed conventionally by adding MgSO4·7H2O 162.5 mg/kg and Na2SeO3·5H2O 2.0mg/kg.Then incisor specimens were obtained after the mice were put into death after treatment for 42 days.The expression of amelogenin was observed with immunohistochemical staining.And gray value is expressed as a result,the greater the gray value,the less protein expression.Results The results of light microscope showed that ameloblasts in the fluoride group showed disarrangement and even had vacuolar.The change of ameloblasts in the magnesium-selenium-fluorine group had no significant difference with control group.The expressions of amelogenin in enamel matrix of fluoride group (131.03 ± 11.14) was significantly higher than those of others (control group:143.44 ± 2.52,magnesium group:143.73 ± 12.43,selenium group:148.89 ± 2.85,magnesium-selenium group:148.38 ± 7.58,magnesium-fluorine group:145.90 ± 7.00,selenium-fluorine group:148.70 ± 4.90,and magnesiumselenium-fluorine group:151.89 4± 4.59,all P ＜ 0.05).The expression of amelogenin in ameloblast of fluoride group (165.49 ± 5.66) was significantly lower than those of control group,magnesium group,magnesium-fluorine group and selenium group (151.35 ± 2.52,149.27 ± 11.13,146.21 ± 4.84 and 150.39 ± 6.65,all P ＜ 0.05).The expression of amelogenin in ameloblast of selenium-fluorine group (165.46 ± 5.81) was significantly lower than those of magnesium group,magnesium-fluorine group and selenium group (all P ＜ 0.05).The results of factorial analysis showed that magnesium and selenium affected the expression of amelogenin in enamel matrix (F =4.195,15.009,all P ＜ 0.05),the interaction between fluoride and magnesium had an effect on the expression of amelogenin in enamel matrix (F =4.402,P ＜ 0.05).Interaction of fluoride,magnesium and selenium had no effect on the expression of amelogenin in enamel matrix (F =1.561,P ＞ 0.05).The fluoride,magnesium and selenium affected the expression of amelogenin in ameloblast (F =18.463,9.372,4.741,all P ＜ 0.05),the interactions between fluoride and magnesium,magnesium and selenium had effects on the expression of amelogenin in ameloblast (F =10.351,5.919,all P ＜ 0.05).Interaction of fluoride,magnesium and selenium had no effect on the expression of amelogenin in ameloblast (F =1.460,P ＞ 0.05).Conclusions There is an antagonistic effect of magnesium on the expression of enamel protein in fluorosis mice.However,it can not be considered that there is an effect of selenium on the expression of enamel protein in fluorosis mice.

To improve the clinical teaching work, the objective structured clinical examination (OSCE) was first introduced into the periodontal clinical assessment held by Departments of Periodon-titis and Mucosal Disease. With the OSCE exam station and item pool established, standardized pa-tients tralned, the examination form reformed, the knowledge, skill, and attitude of the examinee were assessed comprehensively. Compared with traditional exam,the OSCE evaluated the examinee's skills on clinical admissions, history collection, treatment plan development better. Most examinee have got satisfactory result (pass rate: 86.4 %, 19/22; good rate: 36.4%, 8/22; excellent rate: 9.1%, 2/22). The feedback of the following questionnalre also showed that most of the candidates thought the OSCE helpful to promoting the learning of theoretical knowledge (87.5%, 14/16) and good for converting the learned knowledge and skills into occupation ability (87.5%, 14/16).

BACKGROUND:Nucleus pulposus cell apoptosis is the main pathological basis for intervertebral disc degeneration,and inflammation and peroxidation are important factors leading to apoptosis in the nucleus pulposus.Studies have shown that matrine has antioxidant,senescent,inflammatory and apoptotic effects,and may be a potential drug for the treatment of disc degeneration. OBJECTIVE:To investigate the effect of matrine on apoptosis of nucleus pulposus cells in rats with intervertebral disc degeneration by regulating the cyclic GMP-AMP synthase(cGAS)-stimulator of interferon genes(STING)signaling pathway. METHODS:(1)Nucleus pulposus cells of rats at a logarithmic phase were randomly separated into a control group,a model group,a low-dose matrine group,a high-dose matrine group,an empty group,and a high-dose matrine+cGAS overexpression group.Except for the control group,cell models of intervertebral disc degeneration were established in the other groups through oxygen-glucose deprivation.At the same time of modeling,the low-dose and high-dose groups were treated with 0.4 and 0.8 mmol/L matrine,respectively,and the empty group was transfected with the empty plasmid,while the high-dose+cGAS overexpression group was treated with 0.8 mmol/L matrine with the transfection of the cGAS overexpression plasmid.After 24 hours of treatment,cell activity and apoptosis,intracellular levels of reactive oxygen species,superoxide dismutase,tumor necrosis factor α and interleukin 1β,and intracellular expression of apoptotic proteins and cGAS-STING pathway proteins were detected.(2)Sixty Sprague-Dawley rats were randomized into six groups(n=10 per group):control group,model group,low-dose matrine group,high-dose matrine group,empty group,and high-dose+cGAS overexpression group.After 12 weeks of modeling,60 and 120 mg/kg matrine were given by gavage in the low-dose and high-dose matrine groups,respectively(once a day),and the empty plasmid was injected into the tail vein in the empty group(2 times/week),while the high-dose+cGAS overexpression group was given 120 mg/kg matrine by gavage and injected with cGAS overexpression plasmid to the tail vein.Treatment in each group was given consecutively for 3 weeks.Samples were taken after drug administration and assayed for apoptosis,levels of reactive oxygen species,superoxide dismutase,tumor necrosis factor α and interleukin 1β,as well as apoptotic protein and cGAS-STING pathway protein expression. RESULTS AND CONCLUSION:Compared with the control group,in the model group,cell activity and superoxide dismutase levels were decreased(P<0.05),and apoptosis rate,levels of reactive oxygen species,tumor necrosis factor α and interleukin 1β,and the expression of cGAS,STING,cleaved caspase-3 and Bax proteins were elevated(P<0.05).Matrine dose-dependently ameliorated the above changes in each index due to cellular modeling(P<0.05),whereas cGAS overexpression partially antagonized the ameliorative effect of high-dose matrine.Similar results to the in vitro cellular experiments were obtained in animal experiments.These results indicate that matrine could inhibit inflammation and oxidative stress by blocking the cGAS-STING signaling,which in turn attenuates apoptosis and elevates the activity of nucleus pulposus cells in rats with intervertebral disc degeneration.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care