Objective To explore the application value of calcium hydroxide agent in root canal disinfection of patients with chronic periapical periodontitis in stomatology department.Methods 108 cases patients with chronic periapical periodontitis from June 2013 to June 2014 in Cixi Guanhaiwei Zhen Health Centers were randomly divided into study group (n =54) and control group (n=54).The control group received camphor phenol cotton for root canal disinfection, and study group received calcium hydroxide agent.The clinical curative effect between two groups was compared.Results After 7 days’ treatment, the total effective rate was 98.15%in study group, which was significantly higher than 79.63%in control group (χ2 =9.375,P<0.05).After follow up 6 months, the total effective rate was 94.44%in study group, which was significantly higher than 77.78%in control group (χ2 =6.271,P<0.05).The incidence of endodontic interappointment pain (EIP) in study group was 11.11%, which was significantly lower than 25.93%of control group (χ2 =3.93,P<0.05).Conclusion Calcium hydroxide agent has a significant efficacy on in root canal disinfection of patients with chronic periapical periodontitis in stomatology department, could reduce the incidence of EIP and promote healing of chronic periapical periodontitis, which is the first disinfectant in the stomatology department of primary hospital.

In recent years, many countries in the world has established the projects of medical education objectives. The goals for the projects are to develop a consensus within the medical education community on the attributes that medical students should possess at the time of graduation, and to set several learning objectives that can guide each medical school as it establishes its own program.Chinese medical schools should feel a sense of urgency in responding to the intent of these actives.

Aim To observe the effects of amlodipine on cell cycle,cell cycle-related genes and cyclin expression of human breast carcinoma MCF-7 cells.And to probe effects of amlodipine on cell cycle and its mechanism of human breast carcinoma MCF-7 cells.Methods In vitro growth inhibitory effects of amlodip-ine on human breast carcinoma MCF-7 cells were determined by MTT assay,cell cycle distribution was detected by flow cytometry,the Mrna expression levels of cell cycle-related genes cyclinD1 and p21 were treated by RT-PCR,and the protein expression of cell cycle protein cyclinD1 and p21 were assessed by Western blot.Results With dose and time dependently,amlodipine could inhibit the proliferation of human breast carcinoma MCF-7 cells in vitro.The IC_(50) was 14.439 μmol·L~(-1).When breast cancer cells MCF-7 were treated with 7.22 μmol·L~(-1)(1/2 IC_(50)),14.439 μmol·L~(-1)(IC_(50))and 28.88 μmol·L~(-1)(2IC_(50))amlodipine for 48 h,the ratios in the G_0/G_1 phase were significantly increased as compared with control group(P<0.05).Amlodipine inhibited the expression of Mrna and protein of cyclinD1,while increased the expression of Mrna and protein of p21.Conclusions Amlodipine exhibits obvious anti-tumor activities on human breast carcinoma MCF-7 cells and arrest cell cycle in G_1 phase.The mechanism of G_1 phase arresting may be related to modulating the Mrna and protein expression of cell cycle-related gene cyclinD1 and p21.

Objective:To study the ultrastructural changes of the junctional epithelial after dental preparation. Methods: Junctional epithelium (JE) of left premaxillary teeth was detached by diamond bur in 8 rabbits (group 1) and by surgical knife in another 8 rabbits (group 2). JE of the right teeth without treatment was used as the controls. 4 animals in each group were sacrificed 1 and 2 weeks after operation respectively.Samples were prepared for transmission electron microscope observation.Results: In the two tested groups reattachment was observed 2 weeks after operation,degeneration of mitochondria in JE cells and destruction of basement membrane were observed. No significant difference was observed between group 1 and group 2.Conclusion: Dental preparation may result in ultrastructural changes of JE cells.

[Objective]To summarize the experiences of total hip replacement with cementless joint components in the treatment of osteoarthritis secondary to acetabular dysplasia in adults and to evaluate its early effect. [Method]From March 2000 to March 2007, thirty hips in 25 adult patients with osteoarthritis secondary to acetabular dysplasia undergoing total hip replacement with cementless joint components were included in this study. Of the patients, 5 were male and 20 were female.Their ages ranged from 35 to 55 years with an average age of 55 years. The patients mainly complained of pain and claudication. According to the Hartofilakidis classification , Semi-dislocation occurred in 21 hips and high-dislocation in 9 hips.Five patients underwent bilateral total hip replacements and twenty patients had unilateral total hip replacement.[Result]The duration of follow-up ranged from 8 months to 7 years ( average 3 years and 9 months ) . The average Harris score was increased from 36.09 to 88.21 points, They could take care of themselves and returned to their previous job. All the patients were pain-free and there was no sign of aseptic looseing or subsidence.[Conclusion]Total hip replacement with cementless joint components is an effective method for the treatment of osteoarthritis secondray to acetabular dysplasia in adults.The key point to the success for operation are appropriate cementless joint components, deepened medial wall of the acetabulum and improved the techniques of bone graft in the true acetabulum.

Objective To evaluate various immediate managements of traumatic posterior urethral disruption in children. Methods 22 boys,2 to 14 years of age,with pelvic fracture and posterior urethral disruption were treated.There were 5 cases of partial urethral disruption,4 being managed by immediate suprapubic cystostomy and 1 by urethral catheterization.Of 17 cases of complete urethral disruption,6 underwent immediate suprapubic cystostomy with anastomosis of the disrupted ends later.The other 11 cases underwent primary urethral anastomosis via the perineum route. Results All the 5 partial disruption were cured without any complication.In 6 cases of complete urethral disruption with immediate suprapubic cystostomy,delayed repair was undertaken in 5. Of the 11 cases with primary urethral anastomosis,success and satisfactory result have been achieved in 10.Only 1 needed urethrostomy for further management. Conclusions For incomplete urethral disruption suprapubic cystostomy alone is indicated.For complete urethral disruption,primary urethral anastomosis via the perineal route would yield good result with much less chance of complications.

Objective To compare the cerebral protection effect of unilateral and bilateral antegrade selective cerebral perfusion during total aortic arch replacement. Methods From June 2003 to March 2004, 16 patients undergoing total aortic arch replacement were divided into two groups, randomized: unilateral antegrade selective cerebral perfusion (unilateral group, n=8) and bilateral antegrade cerebral perfusion (bilateral group, n=8). Preoperative and postoperative brain CT scan were performed. During the operation, the pressure in innominate artery and left common carotid artery were monitored. Blood gas samples were drawn from jugular venous bulb. Results There was no postoperative death and all patients were discharged from hospital. No new brain infarction occurred. Transient neurological dysfunction occurred in 1 patient of each group. In unilateral group, the pressure in innominate artery was higher than that in left common carotid artery during antegrade selective cerebral perfusion (P0.05). Conclusion Both methods of brain protection for patients undergoing total aortic arch replacement resulted in favorable levels of mortality and morbidity. The circle of Willis was patent and collateral flow was adequate. Unilateral antegrade selective cerebral perfusion has the advantage of simplicity. The bilateral perfusion pressure was more even in bilateral antegrade selective cerebral perfusion, and whether bilateral antegrade selective cerebral perfusion carry a higher risk of embolism need further investigation.

Objective To improve the diagnosis and treatment of inflammatory myofibroblastic tumor (IMT) of the urinary tract in pediatric.Methods The retrospective study of 12 IMT was based on information retrieved from Beijing Children's Hospital from January 2006 to July 2015.The literatures of urinary IMT were reviewed.There were 12 cases of urinary IMT, with 8 cases in bladder, 2 in kidney, 1 in ureter and 1 in prostate.Mean age at surgery was 6.4 years old (range 2months-13 years), 6 cases males and 6 females.Tumor resection were performed in 11 patients, biopsy was performed only in 1 patient.Results HE staining revealed diffuse appearing spindle myofibroblastic cells admixed with inflammatory cells.Immunohistochemistry showed positive ration for following markers as ALK (8/12), CK18 (6/12), Desmin (7/12), SMA (8/12), Actin (1/2), Vimentin (9/12).Negative staining were seen for Myoglobin, S-100 and Ki-67 ＜ 20％.Patients were followed up in 10 cases, lost to follow-up in 2;the mean follow-up time was 14.4 months (range 3-31 months).All patients recovered well without relapse or metastasis.Condusions Inflammatory myofibroblastic tumors of the urinary tract in pediatric were rare, without specific characteristic in clinical features and imaging.The main treatment of IMT is complete surgical excision.

Objective To discuss the clinical and pathological features of malignant rhabdoid tumor of the ureter (MRTU).Methods One case of MRTU was reported, a six-year-old girl was admitted to our hospital on May 29, 2014, and presented left loin pain 2 weeks, ultrasound showed gradually progressing hydronephrosis and hydroureter.During a physical examination, she felt tenderness in the left kidney area and no mass was palpable in abdomen.The ultrasound showed left sided gross hydroureteronephrosis and a round hyperechogenic mass in the inferior pole of the left ureter (In front of the left iliac vessel), with no obvious borders.Contrast-enhanced CT suggested a gross dilatation of the left kidney and ureter with a solidappearing lesion in the lower ureter;neither additional abdominal abnormalities nor enlarged lymph nodes were seen in both examinations.The surgery began with incision of left lower abdomen.The partial ureter of neoplasm was excised along with invaded psoas and posterior peritoneum by gross inspection, then ureteroureterostomy was performed.The severed ureter was completely blocked with the ill-defined neoplasm and was 3.3 cm in length and 2.1 cm in width.Results The ureteral neoplasm was excised,along with the invaded psoas and posterior peritoneum,after that ureteroureterostomy was performed.HE showed the diffuse large round nuclei, vesicular chromatin, prominent nucleoli cells, and moderate amounts of eccentrically placed eosinophilic cytoplasm.Immunohistochemical studies were positive for cytokeratin, epithelial membrance antigen and vimentin, negative for INI1, METU hereby was confirmed.She underwent a chemotherapy regimen consisting of ICE, alternating with VDC.Four courses chemotherapy (3 months) later,CT scan suggested hematogenous metastasis of lung.The family refused further treatment and the patient died of systemic metastasis eight months after surgery.Conclusion MRTU was a rare and highly aggressive tumor with a poor prognosis.

Objective To retrospectively analyze the influence of perioperatively transfusing different ratios of fresh frozen plasma (FFP) to red blood cell (RBC) on prognosis of patients receiving massive transfusion.Methods From January 2010 to September 2012,139 surgical patients with transfusion of ≥ 10 RBC units within 24 hours were included in the study.Patients were categorised into three groups based on the FFP ∶ RBC scale:high scale group (FFP ∶ RBC ＞ 1 ∶ 1,n =19),middle scale group (FFP ∶ RBC =1 ∶ 2-1 ∶ 1,n =43) and low scale group (FFP ∶ RBC ＜ 1 ∶ 2,n =77).Comparison among the groups was made in aspects of transfusion of different blood products in hospital,blood routine index before and after massive transfusion,blood coagulation index,electrolyte index,hospital stay,ICU stay,cure rate and mortality.Results FFP transfusion was the most in high scale group (2 600 ± 1 582) ml,followed by (1 390 ± 1 043) ml in middle scale group and (318 ± 342) ml in low scale group (P ＜0.05).Platelet (PLT) transfusion was more in high scale group (0-1.4 units) and middle scale group (0-1.0 units) compared with that in low scale group (0-0.0 units,P ＜ 0.05).Volume of RBC and cryoprecipitate transfused revealed no significant differences among the groups (P ＞ 0.05).Before blood transfusion prothrombin time (PT) [(20.2 ± 10.7) s] and activated partial thromboplastin time (APTT) [(57.2±45.8) s] in middle scale group were significantly prolonged than those in high scale group [(14.3 ±4.4) s and (35.3 ± 10.0) s] and low scale group[(12.5 ± 1.7) s and (31.5 ± 5.9) s] (P ＜ 0.05),but the differences were insignificant in indices of hemoglobin (Hb),PLT,international normalized ratio (INR),K +,and Ca2 + (P ＞ 0.05).After blood transfusion Hb [(106.8 ± 31.7) g/L] and Ca2+[(1.99 ± 0.24)mmol/L] in low scale group were higher than these in middle scale group [(82.5 ± 32.2) g/L and (1.76 ± 0.38) mmol/L] and in high scale group [(91.3 ± 19.1) g/L and (1.96 ±0.25) mmol/L] (P ＜0.05),but there were no significant differences in PLT,PT,INR,APTT and K+(P ＞ 0.05).Moreover,hospital stay,ICU stay,cure rate and mortality were not differed significantly among the groups (P ＞ 0.05).Conclusion For massive transfusion patients,transfusion of FFP and RBC at a 1 ∶ 2 to 1 ∶ 1 ratio is beneficial to preventing coagulation dysfunction and reducing plasma total infusion volume,and exerts no effect on the prognosis.