OBJECTIVETo evaluate the incidence of two-rooted mandibular premolar morphology using full-mouth periapical film series in a Chinese population, with particular emphasis on bilateral incidence, so as to provide a clinical anatomical basis for root canal treatment in mandibular premolars.

METHODSA total of 2015 patients who underwent dental treatment and had full mouth periapical radiographs at the Peking University School of Stomatology from April 2011 to April 2012 were enrolled in this study. Three experienced dentists reviewed the patients' periapical films and classified the root morphology of mandibular premolars bilaterally. The incidence of unilateral and bilateral double roots were recorded and calculated, including confirmed and suspected bucco-lingual root types.

RESULTSIn terms of the morphology of two-rooted mandibular first premolars, of the 2015 cases with complete root formation, two-rooted first premolars were detected in 120 cases, with a total number of 159 teeth. According to the number of teeth, the overall incidence of double roots was 4.03% (159/3972). In terms of the morphology of two-rooted mandibular second premolars, of the 2015 cases with complete root formation, two-rooted second premolars were detected in 24 cases, with a total number of 33 teeth. According to the number of teeth, the overall incidence of double roots was 0.85% (33/3880).

CONCLUSIONSThe roots of mandibular premolars display specific morphological patterns. Based on a large sample, we observed and calculated not only the occurrence rate of bucco-lingual and mesio-distal double roots in first and second mandibular premolars, but also the incidence of unilateral or bilateral double roots within the same mandible. These findings could provide useful information on the anatomical structure of mandibular premolars for endodontic, prosthodontic and surgical procedures, and could improve the quality of treatment and reduce complications.

Adolescent ; Adult ; Aged ; Bicuspid ; abnormalities ; Child ; Humans ; Mandible ; Middle Aged ; Periapical Tissue ; diagnostic imaging ; Radiography ; Tooth Root ; abnormalities

Objective To investigate the current situations in stroke-prevention knowledge and influential factors in hypertensive patients from the communities of Guangzhou.Methods 94 hypertensive patients visiting the community health service centers in Guangzhou participated in the survey using stroke-preventing knowledge questionnaire.Results The total score on the stroke-preventing knowledge was(62.70±18.39).By stepwise regression analysis,those female and well-educated scored higher. The score on monitoring the blood pressure was the lowest(43.09±25.77).There were mistakes in medication,physical exercises and living habits.Conclusions The hypertensive patients in the communities in Guangzhou lack of stroke-preventing knowledge.In the stroke-preventing education,those male patients as well as those with less education deserves more attention.

Objective To investigate the interference and associated mechanism of hnman tissue kallikrein (HK) gene on renal interstitial fibrosis in rats with 5/6 nephrectomy. Methods Human kallikrein cDNA was packed in a recombinant adeno-associated virus(rAAV)-based plasmid vector. The rAAV-HK was produced by transfection in 293 cells. Twenty-four male Wistsr rats were divided into sham operation and operation groups. The rats with 5/6 nephrectomy were randomly divided into simple operation, control and experiment groups. The rats in experiment group received single dose rAAV-HK via the tail vein with 1×1011 pfu. Before nephrectomy and every month after surgery until the rats were sacrificed, the caudal arterial pressure was measured using tail cuff blood pressure determinator. Three months after HK gene delivery, the rats were sacrificed. The expression of HK in rats was assessed by RT-PCR, Western blot and enzyme-linked immunosorbent assay (ELISA). The pathological changes of renal interstitium were evaluated by Masson stainning, and the distribution of bradykinin B2 receptor (BKB2R) and angiotensin Ⅱ typel receptor (ATIR) was examined by immunohistochemistry. The expressions of BKB2R, AT1R, p-MAPK protein in renal tissue were detected by Western blot. Results Three months after HK gene delivery, the systolic blood pressure of experiment group was significantly decreased compared with the control group [(163±13) nun Hg vs (217±16) mm Hg, P<0.01](1 mm Hg=0.133 kPa). Compared with sham rats, the rats in simple operation group and control group had much more renal interstitial collagen deposition and more serious fibrosis performance, but renal interstitial collagen deposition and fibrosis were significantly ameliorated in the rats of experiment group. In addition, the tubulointerstitial injury index of HK transgenic rats was significantly lower than that of the rats in control group (1.33±0.73 vs 3.01±0.62, P<0.01). Up-regnlating expression of bradykinn B2 receptor protein and down-regulating expression of AT1 receptor and p-MAPK protein were found in renal tissues of experimental group after three months (P<0.05). Conclusion HK gene delivery significantly alleviates renal interstitial fibrosis in rats with 5/6 nephrectomy through regulating the expression of bradykinin B2 receptor, AT1 receptor and p-MAPK in renal tissue.

Objective To discuss the effects of multimodal combination dialysis on Klotho protein, fibroblast growth factor-23 (FGF-23) and brain natriuretic peptide (BNP) in patients with maintenance hemodialysis (MHD). Methods A randomized controlled trial (RCT) was conducted. 120 patients who was diagnosed with chronic renal failure (CRF) uremia receiving MHD over 3 months admitted to Blood Purification Centre of Department of Nephrology of the Second People's Hospital of Guiyang from December 2015 to December 2016 were enrolled, who were randomly divided into hemodialysis (HD) group (HD for 8 times a month), HD + hemofiltration (HF) group (HD for 8 times a month + HF once a month), and HD + HF + hemoperfusion (HP) group (HD for 8 times a month + HF for 4 times a month + HP once a month), with 40 patients in each group. Before and after treatment for 6 months and 12 months, blood was taken from venous circuit tube, the serum Klotho protein and FGF-23 levels were determined by enzyme linked immunosorbent assay (ELISA), and the serum BNP level was determined by electrochemiluminescence. Results 120 patients with MHD were enrolled in the final analysis without withdrawal. There were no significant differences in the levels of Klotho protein, FGF-23, or BNP before enrollment among the three groups (all P > 0.05). Compared with those before enrollment, the levels of serum Klotho protein after enrollment in three groups showed a sustained upward tendency, which were higher in HD + HF + HP group than in HD + HF group and HD group (μg/L: 2.59±0.61, 1.63±0.35, 1.13±0.26 at 6 months, F = 119.374, P = 0.000; 6.98±1.21, 3.57±1.03, 2.12±0.43 at 12 months, F = 275.675, P = 0.000); the levels of FGF-23 showed a sustained downward tendency, which were lower in HD + HF + HP group than in HD + HF group and HD group (ng/L: 69.22±38.26, 132.28±61.18, 178.50±74.64 at 6 months, F = 33.509, P = 0.000; 32.81±17.32, 87.93±43.27, 146.33±69.28 at 12 months, F = 55.466, P = 0.000);the BNP showed a similar tendency as FGF-23 (ng/L: 4083.39±2864.53, 7245.69±4643.81, 7969.12±5360.85 at 6 months, F = 8.758, P = 0.000; 1521.86±894.63, 4554.32±1969.84, 5013.89±2033.64 at 12 months, F = 49.003, P = 0.000). Conclusion Multimodal combination dialysis can increase the Klotho protein level, and decrease the levels of FGF-23 and BNP in MHD patients with CRF uremia.

Objective To compare the clinical therapeutic effect of percutaneous nephrolithotomy (PCNL) and flexible ureteroscope lithotripsy (FUL) for unilateral lower-calyceal calculi with the diameter of 10-20 mm. Methods The clinical data of 65 patients with unilateral lower-calyceal calculi with the diameter of 10-20 mm were retrospectively analyzed. Thirty cases were treated with PCNL (PCNL group), and 35 cases were treated with FUL (FUL group). The operative time, success rate of lithotomy, haemoglobin decrease after operation, postoperative hospital stay, hospitalization expenses and complication were compared between 2 groups. Results Treatment was completed successfully in the patients of 2 groups, without ureteral perforation, avulsion and other serious complications intraoperatively and postoperatively. There were no statistical differences in success rate of lithotripsy, incidence of high fever after operation and postoperative analgesia rate between 2 groups (P>0.05). The operative time and hospitalization expenses in FUL group were significantly higher than those in PCNL group:(95.27 ± 22.69) min vs. (62.25 ± 20.73) min and (17 242 ± 2 679) yuan vs. (14 205 ± 1 654) yuan, and the haemoglobin decrease after operation and postoperative hospital stay time were significantly lower than those in PCNL group:(0.67 ± 0.33) g/L vs. (7.98 ± 4.33) g/L and (3.75 ± 0.78) d vs. (6.54 ± 1.68) d, and there were statistical differences (P<0.05). Conclusions For the treatment of lower-calyceal calculi with the diameter of 10-20 mm, the success rates of lithotripsy of PCNL and FUL are similar. FUL has less trauma, with shorter postoperative hospital stay time, but the cost is relatively high.

Objective To investigate the influence of Guhong injection (GHI) on ATPase activity and inflammatory response after cerebral ischemia/reperfusion (I/R) injury in rats, and evaluate its protective effects on cerebral I/R injury. Methods Seventy-two male Sprague-Dawley (SD) rats were divided into sham group, I/R group, nimodipine group, and the low-dose (2.5 mL/kg, GHI-L), medium-dose (5.0 mL/kg, GHI-M), and high-dose (10.0 mL/kg, GHI-H) of GHI groups according to the random number table method, with 12 rats in each group. The middle cerebral artery occlusion (MCAO) model was established by the intraluminal suture method to prepare the model of focal cerebral ischemia, and reperfusion was performed after 1.5 hours of occluding the middle cerebral artery; the sham group had the same operation process except inserting the nylon thread. The injection of drug in various drug-treated groups was carried out via a tail vein at 0, 12, 24 hours after the onset of reperfusion, while the sham group and I/R group received the same amount of normal saline. At 12 hours after last drug administration, the scores of neurological deficit symptoms were evaluated; the cerebral infarction was observed by triphenyl tetrazolium chloride (TTC) staining; the Na+-K+-ATPase and Ca2+-ATPase activities in the brain tissue were measured by phosphorus determination; the contents of interleukin-6 (IL-6), monocyte chemotactic factor-1 (MCP-1), nitric oxide (NO) in serum were detected by enzyme linked immunosorbent assay (ELISA). Results Compared with the sham group, the neurological function score was significantly decreased, the cerebral infarction was serious, the activities of ATPase was obviously decreased, and the levels of serum inflammatory factors were significantly increased in I/R group. Compared with the I/R group, the neurological function scores were significantly increased in GHI-L group, GHI-M group, GHI-H group and nimodipine group (9.03±0.63, 10.54±2.55, 12.33±1.87, 12.06±1.89 vs. 8.17±1.05, all P < 0.05), the volumes of cerebral infarction were obviously reduced [(18.51±1.80)%, (15.98±1.34)%, (8.61±1.16)%, (8.09±0.96)% vs. (26.52±2.07)%, all P < 0.01], the activities of ATPase were significantly increased [Na+-K+-ATPase (μmol·mg-1·h-1):5.10±0.30, 5.34±0.26, 6.19±0.17, 5.86±0.31 vs. 3.98±0.35, Ca2+-ATPase (μmol·mg-1·h-1): 3.68±0.44, 4.43±0.29, 5.03±0.27, 4.17±0.30 vs. 1.87±0.46, all P < 0.01], and the levels of serum inflammatory factors were decreased obviously [IL-6 (ng/L): 51.61±5.55, 43.88±4.05, 39.71±2.22, 41.28±2.66 vs. 60.11±6.61, MCP-1 (ng/L): 227.82±7.07, 201.58±13.10, 177.23±10.46, 126.80±8.49 vs. 296.01±12.85, NO (μmol/L): 54.48±3.23, 46.84±2.69, 41.15±2.80, 48.62±2.34 vs. 65.25±3.88, all P < 0.05]. Conclusions GHI not only can improve the energy metabolism of brain tissue in a dose-dependent manner, but also inhibit the inflammatory cascade of damage after cerebral I/R in rats, which might be its protective mechanism on cerebral ischemia injury.

Purpose To evaluate the application value of using a-cyanoacrylate rapid medical glue in preoperative localization of ground-glass nodules under CT guidance.Materials and Methods 48 cases were retrospectively analyzed,in which the pulmonary ground-glass nodules took preoperative localization under CT guidance.The rapid medical glue was injected in pulmonary ground-glass nodules,which was used for preoperative localization.Results After preoperative localization of rapid medical glue in 48 cases,pulmonary ground-glass nodules of all patients were resected successfully by video-assisted thoracoscope surgery (VATS).The complications of pneumothorax did not occur in all cases,with little pulmonary hemorrhagein in 10 cases.Conclusion When the fast medical glue has been used in the CT-guided preoperative localization of ground-glass nodules,there are advantages of high accuracy of localization and surgery.Moreover,this method is simple,safe and effective.

Objective To analyze the clinical effect of laparoscopic ovarian endometriosis (EMs) cyst resection and the influence of different operative methods on follicle loss.Methods Selected 86 EMs patients with laparoscopic ovarian cyst resection in our hospital from January 2013 to January 2016 and randomly divided them into two groups.The control group adopted traditional blunt tearing method,while the observation group adopted sharp isolating method.The specimen thickness along with the number,thickness and grading of specimen with ovarian cortex at hilus orarii,middle part of ovarian fossa and ovarian fossa were observed.Meanwhile,the influence on ovarian function and follicle loss of the two operation methods were compared.Results The specimen thickness close to the hilus orarii was more than that of the ovarian fossa and the middle part of ovarian fossa (t =4.474,t =3.520,P ＜ 0.001).The thickness of specimen with ovarian cortex at ovarian fossa was significantly less than that of the middle part of ovarian fossa and the hilus orarii (t =1.705,t =4.428,P =0.046,P =0.000).The number of specimen ovarian cortex grading of 3 to 4 at hilus orarii was 20,which was significantly more than 2 at the ovarian fossa and 2 at the middle part(x2 =19.790,x2 =19.790,P ＜ 0.001).The specimen thickness and ovarian cortical thickness of the middle part of the observation group were less than those of the control group (t =3.897,t =2.166,P =0.000,P =0.017).The specimen number of ovarian cortex at the hilus orarii was significantly less than the control group(x2 =5.512,P =0.019),and the specimen thickness and the ovarian cortex thickness were obviously less than those of the control group (t =4.992,t =2.349,P =0.000,P =0.011).After operation,the differences between FSH,LH,and E2 levels in the two groups were not statistically significant(P ＞ 0.05),but the ovarian sinus follicle number and ovarian volume of the observation group were significantly more than those of the control group (t =7.181,t =10.921,P ＜ 0.00 001).The pregnancy rate of the observation group was 60.0％,which was significantly higher than 43.75 ％ of the control group (x2 =5.289,P =0.021).Conclusion The laparoscopic ovarian EMs cyst resection can cause the great loss of follicle in the progress of resecting cyst at hilus orarii,and advanced sharp separation can obviously reduce the loss of normal ovarian follicles and cause smaller influence on ovarian function.

Summary: The changes in the expression of cardiac bradykinin B2 receptors (BKB2Rs) and endogenous nitrix oxide synthase (eNOs) mRNA were studied in rats with remnant kidneys. Thirty-two rats were divided into sham-operated and experimental groups randomly (n=16 in each group). The remnant kidney model was established by 2-stage 5/6 nephrectomy. Blood pressure and serum Cr were measured before operation and 15, 30, 60, 120 days after 5/6 nephrectomy. Eight animals in each group were killed at the first month and 4th month after the operation. The expression of BKB2Rs and eNOs mRNAs was detected by using RT-real time PCR from isolated left ventricle, and their correlation was also analyzed. The results showed that blood pressure and serum Cr were increased significantly 15 days after 5/6 nephrectomy (both P<0.01), and the hypertension and azomia existed constantly till 120 days but had no significant fluctuation. Cardiac BKB2Rs and eNOs mRNA was declined time-dependently (both P<0.05). And there was a close positive correlation between cardiac BKB2Rs and eNOs mRNA (r=0.82, P<0.01). It was suggested that a significant chronic renal failure can be produced at least 15 days after 5/6 nephrotomy and can sustain more than 4 months. The expression of BKB2Rs and eNOs was down-regulated time-dependently in this model, and there was a significant correlation between them.

Objective To study the effects of different hemodialysis modes on growth factor-15 (GDF-15) and left ventricular function in uremic patients undergoing maintenance hemodialysis (MHD). Methods One hundred and twenty uremic patients with chronic renal failure whose MHD > 3 months admitted to Guiyang Second People's Hospital from June 2017 to June 2018 were enrolled, and they were divided into a hemodialysis (HD)+ hemofiltration (HDF)+hemoperfusion (HP) group (HD 8 times per month, HDF 4 times per month, HP 1 time per month), a HD+HDF group (HD 8 times per month, HDF 1 time per month) and a HD group (HD 8 times a month) according to different dialysis modes, each group 40 cases. The patients' venous blood was collected before treatment and 6 months and 1 year after treatment, serum was separated, and the GDF-15 levels in the three groups were detected; the left ventricular end-diastolic dimension (LVDD), left ventricular end-systolic dimension (LVDS), left ventricular end-diastolic volume (LVVD), left ventricular end-systolic volume (LVVS), left ventricular posterior wall thickness (LVPWT), ventricular septal thickness (LVST), maximum blood flow ratio (E/A) of early to late diastole and left ventricular ejection fraction (LVEF) in three groups were detected by echocardiography. Results After treatment, the GDF-15 levels and LVDD, LVDS, LVVD, LVVS, LVPWT, LVST and E/A in the three groups were significantly lower than those before treatment, while LVEF was significantly higher than that before treatment (all P < 0.05); the changes after treatment in the HD+HDF+HP group were more significant than those in the HD+HDF group and HD group [GDF-15 (ng): 853.78±78.80 vs. 921.73±72.54, 971.07±72.05, LVDD (mm): 48.25±1.25 vs. 50.67±1.26, 51.69±1.33, LVDS (mm): 35.21±1.01 vs. 37.84±0.90, 38.91±0.83, LVVD (mL): 101.44±4.40 vs. 109.27±6.47, 115.11±5.46, LVVS (mL): 35.75±1.52 vs. 37.75±1.70, 39.48±1.48, LVPWT (mm): 8.26±0.77 vs. 10.24±0.98, 11.22±0.91, LVST (mm): 9.07±0.48 vs. 10.47±0.61, 11.60±0.58, E/A: 1.03±0.05 vs. 1.07±0.06, 1.15±0.08, LVEF: 0.64±0.03 vs. 0.59±0.03, 0.51±0.04, all P <0.05]. Conclusion The combined hemo- dialysis with different hemodialysis modes can effectively reduce the level of GDF-15 in uremic patients with chronic renal failure and MHD and improve their left ventricular function, thus the incidence of cardiovascular events and mortality in such patients can be decreased.