Actinomyces ; isolation & purification ; Actinomycosis ; microbiology ; Apicoectomy ; methods ; Candida albicans ; isolation & purification ; Candidiasis ; microbiology ; Enterococcus faecalis ; isolation & purification ; Foreign Bodies ; complications ; Gram-Positive Bacterial Infections ; microbiology ; Humans ; Microsurgery ; methods ; Periapical Periodontitis ; etiology ; microbiology ; surgery ; therapy ; Radicular Cyst ; complications ; Root Canal Filling Materials ; therapeutic use ; Root Canal Therapy ; methods

Objective To detect the change of cerebral perfusion in pediatric patients with Leigh's syndrome (LS)by using MR perfusion technique.Methods Twelve patients with Leigh's syndrome and thirteen normal children were scanned with the sequence of flow-sensitive alternating inversion recovery exempting separate T_1 measurement (FAIREST).Their relative cerebral blood flow(rCBF)values were obtained in regions of bilateral basilar nuclei and bilateral thalami.Student t-test was used to compare them between the two groups and receiver operating characteristic(ROC)curve analysis was carried out.Results Statistical analysis revealed significant difference between two groups in the regions of bilateral basilar nuclei and right thalamus(t =3.26,P =0.002;t =2.25 ,P =0.018 ;t =2.88 ,P =0.004,respectively).The rCBF values for LS group and control group were 0.432?0.158 and 0.619?0.125 for right basilar nuclear, 0.478?0.186 and 0.621?0.123 for left basilar nuclear,0.630?0.189 and 0.833?0.160 for right thalamus,respectively.The areas under the ROC curves were 0.833 and 0.756 for the rCBF of right and left basilar nuclear,respectively.Conclusion Relative CBF maps may reveal changes of cerebral blood flow in some specific brain regions in patients with Leigh's syndrome.It can provide additional information to the clinicians in the evaluation of the disease.

AIM: To assess the relative agreement of GAT and NCT in IOP measurement by comparing the differences between Goldmann applanation tonometer (GAT) and non-contact tonometer (NCT) in intraocular pressure (IOP) detection.METHODS: IOP of 529 eyes of 265 volunteers were measured with both NCT and GAT, respectively.RESULTS: The measurement results of NCT were lower than that of GAT, there was significant difference between the IOP measured with NCT and GAT (19.13 vs23.43, t=22.644, P＜0.05). With the increasing of IOP values, the difference magnitude was greater, especially in IOP group that was more than 30mmHg, but the correlation coefficient became lower.CONCLUSION: The measurement results with NCT are lower than that of GAT. When the IOP with the NCT is in borderline value, it need be corrected with GAT, in order to discover the pathologically elevated IOP and avoid the misdiagnosis and mistreatment of glaucoma.

Objective To compare the multilineage differentiation potential of human dental pulp cells (DPC) and periodontal ligament cells (PDLC) in vitro, and to identify the stem cell characteristics. Methods Human DPC and PDLC were isolated by enzymatic digestion. STRO-1 expression was investigated by flow cytometry. Cells were induced to odontogenic/osteogenic differentiation, adipogenic differentiation and chondrogenic differentiation. The multilineage differentiation capacities of DPC and PDLC were evaluated by yon Kossa stain, anti-osteocalcin (OCN) and anti-dentin sialoprotein (DSP) immunocytochemistry, oil red O stain, Alcian blue stain, anti-collagen type Ⅱ immunocytochemistry, and real time RT-PCR. Results Colony formation was observed in DPC and PDLC, with STRO-1 positive rate of ( 16. 5% ± 4. 2% ) and ( 11.6% ± 1.1% ) respectively. Multilineage differentiation was demonstrated in 100% of DPC samples in contrast to 83.3% of PDLC samples. OCN, dentinsialophosphoprotein ( DSPP),peroxisome-proliferator-activated receptor gamma 2 (PPARγ2), lipoprotein lipase (LPL) and collagen type Ⅱ mRNA levels in DPC and PDLC were significantly upregulated after induction (P <0. 001 ). There were significant differences in the ratio of upregulation of OCN and PPARγ2 mRNAs between DPC and PDLC (P <0. 001 ). Conclusions DPC and PDLC contain similar proportion of mesenchymal stem cells and possess comparable multilineage differentiation capacities.

OBJECTIVETo explore the best intervention time of acupuncture and moxibustion for peripheral facial palsy (Bell's palsy) and the clinical advantage program of selective treatment with acupuncture and moxibustion.

METHODSMulti-central large-sample randomized controlled trial was carried out. Nine hundreds cases of Bell's palsy were randomized into 5 treatment groups, named selective filiform needle group (group A), selective acupuncture + moxibustion group (group B), selective acupuncture + electroacupuncture (group C), selective acupuncture + line-up needling on muscle region of meridian group (group D) and non-selective filiform needle group (group E). Four sessions of treatment were required in each group. Separately, during the enrollment, after 4 sessions of treatment, in 1 month and 3 months of follow-up after treatment, House-Brackmann Scale, Facial Disability Index Scale and Degree of Facial Nerve Paralysis (NFNP) were adopted for efficacy assessment. And the efficacy systematic analysis was provided in view of the intervention time and nerve localization of disease separately.

RESULTSThe curative rates of intervention in acute stage and resting stage were 50.1% (223/445) and 52.1% (162/311), which were superior to recovery stage (25.9%, 35/135) separately. There were no statistical significant differences in efficacy in comparison among 5 treatment programs at the same stage (all P > 0.05). The efficacy of intervention of group A and group E in acute stage was superior to that in recovery stage (both P < 0.01). The difference was significant statistically between the efficacy on the localization above chorda tympani nerve and that on the localization below the nerve in group D (P < 0.01). The efficacy on the localization below chorda tympani nerve was superior to the localization above the nerve.

CONCLUSIONThe best intervention time for the treatment of Bell's palsy is in acute stage and resting stage, meaning 1 to 3 weeks after occurrence. All of the 5 treatment programs are advantageous to Bell's palsy. In the condition of the limited medical sources, the simple filiform needle therapy is recommended in acute stage. For the patients with the disorder above chorda tympani nerve, the line-up needling on muscle region of meridian is not recommended.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Disease Progression ; Facial Paralysis ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

Leigh syndrome is a genetically heterogeneous disease caused by defects in enzymes involved in aerobic energy metabolism and the Krebs' cycle. Deficiency of pyruvate dehydrogenase complex E1 alpha subunit (PDHA1) is the common cause of Leigh syndrome. In this study, one Chinese case of PDHA1 deficiency was reported. The patient was a boy with normal mental development, retarded motor development, general weakness, hypotonia and areflexia. Muscle histopathological findings suggested axonal peripheral neuropathy. Brain magnetic resonance imaging at 5 years of age revealed bilateral putamina lesions and periventricular white matter demyelination, supporting the diagnosis of Leigh syndrome. A C214T mutation in exon 3 of the PDHA1 gene was detected. After the treatment of thiamin, coenzyme Q10, Lcarnitine and carbohydrates-restricted diet, his movement ability improved significantly. At present, the patient is 8 years old and has normal school life. PDHA1 deficiency is an X-linked inherited metabolic disease, which shares various clinical manifestations and leads to difficult diagnosis. This patient predominately presented with progressive weakness and was diagnosed by gene analysis.
Child, Preschool ; Diagnosis, Differential ; Humans ; Leigh Disease ; diagnosis ; genetics ; therapy ; Male ; Mutation ; Pyruvate Dehydrogenase (Lipoamide) ; genetics

Leigh syndrome is a genetically heterogeneous disease caused by defects in enzymes involved in aerobic energy metabolism and the Krebs', cycle. Mitonchondrial complex I deficiency is a main cause of Leigh syndrome. In this study, a Chinese child with Leigh syndrome caused by 13513G>A mutation was reported. The proband was the first child of his parents. The previously healthy boy presented with generalized epilepsy at 12 years of age. When he visited Peking University First Hospital at 13 years of age, he had subacute loss of vision in two eyes and temporal defect of visual field in the left eye. He walked with a spastic gait. His blood lactate and pyruvate levels were elevated. Muscle biopsy showed mild lipid accumulation in muscle fiber. An electrocardiogram showed incomplete right bundle branch block. Brain magnetic resonance imaging showed bilateral, symmetrical lesions in the basal ganglia, supporting the diagnosis of Leigh syndrome. 13513G>A mutation was identified by gene analysis in the patient, which led to mitochondrial respiratory chain complex I deficiency. Multivitamins and L-carnitine were administered. At present, the patient is 16 years old and has progressive deterioration with significant muscle weakness and body weight loss. He is absent from school. He has no obvious retardation in intelligence. 13513G>A mutation was first identified by gene analysis in Chinese population with Leigh syndrome. This may be helpful in genetic counseling.
Adolescent ; DNA, Mitochondrial ; genetics ; Electron Transport Complex I ; deficiency ; Humans ; Leigh Disease ; genetics ; Male ; Mutation

OBJECTIVETo evaluate the feasibility and efficacy of surgical treatment for patients with primary hyperparathyroidism (pHPT).

METHODSThe studies were analyzed for 55 patients with pHPT who underwent parathyroidectomy in our hospital from 1985 to 2002.

RESULTSEight patients were asymptomatic. The skeletal manifestations were found in 24 cases, urinary stones in 10 cases, and both skeletal manifestations and urinary stones in 13 cases. Pathological bone fractures occurred in 16 cases. Hypercalcemia was discovered in all patients with the average value of (3.1 +/- 0.4) mmol/L, ranging from 2.7 to 3.9 mmol/L and. Fifty patients showed elevated parathyroid hormone (PTH) with the average value of (489.2 +/- 69.2) pg/ml, ranging from 102 to 2,000 pg/ml. Preoperatively all patients underwent sonography, CT and/or scintigraphy. The overall preoperative image-directed localization rate was 90.9%. Follow-up was done from 6 months to 2 years after surgery. The symptoms and signs of all patients relieved postoperatively with the improving of osteoporosis and healing of bone fracture. Of all cases, 39 presented with temporary hypocalcemia, 37 showed circumoral paresthesia in whom 10 showed tetany, 15 showed eucalcemia and one had mild hypercalcemia after operation. The serum calcium was normal in all cases with hypocalcemia by Rocaltrol and calcium supplementation for 1 - 3 weeks. PTH level decreased to normal fro 2 weeks to 2 months in 47 cases and was still mildly higher than normal in 3 cases.

CONCLUSIONSParathyroidectomy is an effective approach to patients with pHPT. With preoperative image-directed localization techniques, minimally invasive parathyroidectomy is a valid surgical strategy.

Adolescent ; Adult ; Aged ; Female ; Humans ; Hyperparathyroidism ; diagnosis ; surgery ; Male ; Middle Aged ; Parathyroidectomy ; methods ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the use of dental operating microscope (DOM) and ultrasonic instruments in treating blocked canals.

METHODS135 blocked canals in 92 teeth were treated with ultrasonic tips and files under DOM. The etiology of canal blockage included calcification, broken instruments, post, resinifying therapy or ledge. These canals were negotiated and root canal therapy or pretreatment was performed. The success rates were calculated.

RESULTS77 teeth were successfully managed with a success rate of 83.7%. 84.4% of the blocked canals were negotiated. The success rates of each category of the blocked canals were: 88.1% for calcified canals; 76.9% for canals blocked by instrument fragments; 100% for canals blocked by post; 81.1% for canals subjected to resinifying therapy; and 78.6% for ledged canals. Complications such as root canal perforation or vertical fracture did not occur.

CONCLUSIONThe use of DOM and ultrasonic instruments is proved to be an effective way in the management of blocked canals.

Adult ; Aged ; Calcinosis ; complications ; Female ; Humans ; Male ; Microscopy ; Middle Aged ; Root Canal Therapy ; methods ; Treatment Outcome ; Ultrasonic Therapy

Objective To develop a method of quantitative analysis of multi-components by single marker (QAMS) for simultaneously determining five compounds in Curcumae Aromaticae Radix.Methods An HPLC method was developed as QAMS to determine curcuma diol,ocathydro-1,4-dihydroxy-1,4-dimethyl-7-(propan-2-ylidene)azulen-5(1H)-one,original curcumol and curcumin in Curcumae Aromaticae Radix,using curdione as intermal reference substance,and the relative correction factor (RCF) of the four components was determined by HPLC with good reproducibility.Their contents in 10 batches of samples,collected from different areas,were determined by both external standard method and QAMS.Result No significant differences were found in the quantitative results of four compounds in 10 batches of Curcumae Aromaticae Radix determined by external standard method and QAMS.Conclusion It is feasible and suitable to evaluate the quality of Curcumae Aromaticae Radix by QAMS.