Making dental impressions and models is a part of daily routine work for dental nurses in the orthodontic department in China. This paper analyzes the common problems encountered in the process of making dental impressions and models, and emphasizes the importance of quality control and supervision during this process. A method of combining real-time monitoring and periodic inspection based on nurse-doctor cooperation was put forward to ensure the quality of dental impressions and models. Firstly, the nurses should be well trained with the instruction of doctors before on duty; Secondly, the head nurse should be responsible for implementing real-time monitoring and periodic inspections to find the problems and take measures in time. Also, the doctors should check the dental impressions and models in time, especially for those models with special demands, and help the nurses to improve their skills constantly.

Mutated K-RAS is found in 15%～30% NSCLC patients, the mutations of K-RAS and EGFR are mutually exclusive,K-RAS mutations have poor sensitivity to EGFR-TKIs. The response of C-225 is not restricted to mutated K-RAS, NSCLC patients with K-RAS mutations are associated with unfavorable prognosis. A number of different approaches such as Ftase inhibitors, RAF inhibitors, MEK inhibitors aimed at abrogating K-RAS activity to improve clinical response have been explored in clinical trials.

Objective To evaluate the efficacy of radiofrequency ablation combined with absolute ethanol injection in the treatment of hepatocellular carcinoma (HCC), and to study the value of contrast-enhanced ultrasound in the evaluation of therapeutic effect.Methods From May 2015 to May 2017, 60 patients with liver cancer (72 lesions) were treated in our hospital.The patients were divided into 3 groups, the RFA treatment group (n=20), 24 lesions, the PEI treatment group (n=20), 22 lesions, and the RFA+PEI treatment group (n=20) with26 lesions.3 groups of patients were treated with contrast-enhanced ultrasound (CEUS), routine color Doppler ultrasound (CDUS), enhanced CT to evaluate the specific situation of the tumor, and evaluate the therapeutic effect again after operation.The rates of necrosis, lesion inactivation and residue were evaluated in each group.Results The necrosis rate of RFA group, PEI group and RFA+PEI group were66.67%,81.82% and 96.15%, respectively.The necrosis rate of CT group was the highest, and the difference was statistically significant (P<0.05) in RFA+PEI group.Comparison of different imaging to assess the sensitivity and specificity of CDUS, to evaluate the sensitivity and specificity were 81.36% and 53.85%;CEUS to evaluate the sensitivity and specificity were 98.31% and 84.62%, significant difference was statistically significant (P<0.05).Conclusion RFA+PEI treatment program is better than RFA and PEI alone treatment, the treatment effect is better, CEUS in the evaluation of RFA+PEI treatment effect, has higher clinical value.

Objective To explore the imaging features of bone tumor of fibrous tissue origin.Methods 31 patients with bone tumor of fibrous tissue or igin confirmed by pathology were analyzed. All patients were examined by X-ray, of them, 6 by CT in the meantime.Results Non-ossifying fibroma(NOF n=14)occured commonly i n long bone,the imaging findings presented sacculated and expanded bone destruct ion which was encircled by sclerotic borders,bony septum could be observed iusid e the lesion.Ossifying fibroma(OF n=10)occured more in maxillofacial bone,there were circle or elliptical and expansive bone change,and most of them associated with local bone malformation.Depending on the ossified degree,the density of les ion,could be hyperdense,ground-glass opacity,cyst or mixed density,defined borde r,partly associated with sclerotic borders.Desmoplastic fibroma of bone(DF n=1) presented multiple patchy bony erosion at lateral of lower part of femur,and ext ending to articalar facies,ill-defined border,and soft tissue slightly swelling. Fibrosarcoma of bone(FS n=6) occured commonly in long bone,presened bitted-like or greater patchy osseous absorption with soft fissue mass,rarely periosteal rea ction and calcification.58.08% patients(18/31) were accurately diagnosed.The nat ure of 6 patients was undefined.Misdiagnosis was made in 7.Conclusion Most of NOF and OF are of specific imaging fin dings and can be accurately diagnosed before cperation.DF is of slight symptoms with invaded growth and is easily misdiagnosed.In the imaging features of FS are apparently different with various type and histological differentiation,it must be differentiated from other diseases.

[Objective]To explore the techniques and effect of atlantoaxial instability with posterior transarticular screw fixation.[Method]A prospective clinical analysis was performed for the results of the modified posterior C1、2 transarticular screw fixation,in which the middle site of lower margin in the axial inferior articular process was used as the screw entry point in the procedure.Twenty cases of atlantoaxial instability underwent the modified C1、2 stabilization with morselized autograft from September 2001 to September 2006.There were 15 males and 5 females,averaged 32.2 years(range 17 to 49 years).Of them,4 cases suffered from fresh injuries,14 from old trauma,1 from congenital deformity,and 1 from intraspinal tumor.Postoperative indexes including the reduction extent of vertebral body,internal fixation,bone fusion,clinical symptoms and their complication were observed periodically.[Result]Bilateral screw fixation was used alone in 17 cases,with Gallie interspinous wiring for added stability in 3.Anatomical reduction of the atlantoaxial joints was achieved in19 cases,while rotational dislocation was restored to a great extent in 1.Fixation of all the internal devices was very well in the group.All cases were followed up from 16 to 64 months(21 months on average).C1、2 bony fusion was obtained in postoperative 2 to 3 months,clinical symptoms relieved and no complications occurred.[Conclusion]The modified posterior transarticular screw fixation using new screw entry site is recommended as an effective treatment for C1、2 instability due to its simple procedure and satisfying curative effect.

As locking plate is widely used in periarticular and comminuted fractures as well as in fixation of osteoporotic bone,the events involving difficulty in removal of a locking plate increase gradually.Little research addresses the difficulty in implant removal.Stripping of the recess of the screw head,cross-threading between threads in the screw head and screw hole and cold welding are the main causes for difficulty in removing screws from a locking plate.Skills for implant removal include simple ones that require no use of special devices and complex ones that require use of special devices.Difficult implant removal will result in lengthened operation time,increased risk of secondary invasive surgery,residues of metallic shavings and so on.Prevention is the most effective countermeasure.This review summarizes the cause for difficult removal of locking plate and screws as well as the removing skills to help orthopedic surgeons prevent and respond to the difficulties intraoperatively.

Objective To study the CT features of the sero-hepatic type of hepatic tuberculosis.Methods This is a retrospective,multi-center and cross-sectional study.17 patients with the sero-hepatic type of hepatic tuberculosis from the Yueqing People' s Hospital (n =5),Second Affiliated Hospital of Wenzhou Medical College (n =5),and Wenzhou People's Hospital (n =7) were studied.All these patients were fasted for 8 h prior to CT scanning.They underwent enhanced after conventional CT breathless scanning with no abdominal pressure.Results The CT scans displayed 41 lesions in these 17 patients with the sero-hepatic type of hepatic tuberculosis,including a solitary lesion in 13 patients and multiple lesions in 4 patients.The diameter of the lesions varied from 0.8 to 4.7 cm,with a mean ± S.D.of 2.38 ± 4.82 cm.The CT features showed a localized spindle-shaped focal lesion just underneath the liver capsule with resultant concave compression of the adjacent liver tissue (n =22),spotted calcifications in the center of the focal nodules (n =1);and aggregation of multiple low density nodular foci (n =19).Additional CT features included focal nodules surrounded by a small amount of liquid (n =15),compression of adjacent liver tissue (n =22),a small amount of ascites (n =8),and retroperitoneal lymph nodes enlargement (n =2).These nodules showed moderate (n =5) and slight enhancement in the arterial phase (n =36);moderate (n =32) and mild enhancement in the portal venous phase (n =9);and moderate (n =32) and mild enhancement in the parenchymal phase (n =9),respectively.The nodules showed ring-shaped (n =26),honeycomb or multiple ring-shaped enhancement (n =15).The enhanced ring-shaped wall thickness varied from 0.2 to 0.9 cm,with a thin wall (n =30) and a thick wall (n =11).The center of the focal nodule was a low density sac-shaped area,with no obvious contrast enhancement.The CT value was 21 to 39 hu.The infiltrative liver tissues which surrounded the focal nodules were shown as lamellar areas of obvious arterial enhancement,with equidensity in the portal vein phase and equilibrium phase.Conclusions CT showed characteristic features of the sero-hepatic type of hepatic tuberculosis.Clinical and laboratory findings could provide important supplementary information to make the diagnosis.

Background miRNAs are a group of non-coding small RNA molecules,and they play an important role in regulating the apoptosis of LECs.The biological effects and mechanisams of miRNAs on LECs in agerelated cataract still need to be further elucidated.Objective This study was to investigate the anti-oxidative effects of miR-204 on age-related cataract in vitro.Methods The specimens of anterior lens capsules from agerelated cataract patients and normal donors were collected in Shandong Eye Institution and 20 subjects for each.The expression level of miR-204 was detected and compared between cataractous eyes and normol eyes by real-time fluorescence quantitative PCR (RT-qPCR).HLE-B3 cells,a human LEC line,were cultured,and the oxydative stress models of LECs were established by adding 200 μmol/L H2 O2 in the medium.The models were divided into model control group,miR-204 agomir group,agomir negative control group,miR-204 antgomir group and antagomir negative control group according to the difference of tranfected agents,and normal cells served as the control group.Twenty-four hours after transfection,the expression levels of miR-204 mRNA in the cells of various groups were detected by RT-qPCR to varify the transfection rate.Apoptosis rate of the cells was assayed by flow cytometry.The relative expression levels of TP53INP1 mRNA and p53 mRNA as well as their proteins were detected by RT-qPCR and Western blot,respectively.Results The mean expression level of miR-204 was significantly lower in the anterior lens capsules of cataractous eyes than that in the normal eyes (t=14.21,P＜0.05).The mean apoptosis rate of cells was 1.31±0.12,4.90±0.28,2.60±0.15,4.39±0.20,5.74±0.13 and 4.34±0.63 in the normal control group,model control group,miR-204 agomir group,agomir negative control group,miR-204 antgomir group and antagomir negative control group,respectively.The apoptosis rate was significantly increased in the model control group compared with the normal control group (t =-20.69,P＜0.01) and the apoptosis rate was also increased in the miR-204 antagomir group compared with antagomir negative control group (t =3.79,P＜0.05);while the apoptosis rate in the miR-204 agomir group was significantly declined in comparison with agomir negative control group (t=-12.20,P＜0.01).The relative expression levels of TP53INP1 and p53 mRNA and proteins in the cells were significantly higher in the model control group than those in normal control group (mRNA:t =6.44,11.71,both at P＜0.0I;protein:t =10.72,19.40,both at P＜0.01),and so were between the miR-204 antagomir group and antagomir negative control group (mRNA:t =4.07,3.74,both at P＜ 0.05;protein:t =7.18,10.58,both at P＜0.05).However,the expression levels of TP53INP1 and p53 mRNA and protein were significantly reduced in the miR-204 agomir group in comparison with the agomir negative control group (mRNA:t =-19.28,-10.58,both at P＜0.05;protein:t=-6.50,-6.36,both at P＜0.05).Conclusions miR-204 induces oxidative damage of age-related cataract via targeting TP53INP1,which suggests that the activation of TP53INP1-p53 signaling may be involved in the development of age-related cataract.

Aim To explore the therapeutic effects of 3′-daidzein sulfonate sodium(DSS) on isolated myocardial ischemia/reperfusion injury and the relation of its mechanism to anti-oxidation.Methods An isolated rat myocardial ischemia/reperfusion injury was made,and the injury was treated with DSS.Following the treatment,the coronary blood flow levels,left ventricular systolic pressure,and activities of enzymes(LDH,SOD,GSH-Px) were measured.Results After treatment,the isolated myocardial tissue showed an increase in the volume of perfusion and an increase in the enzymatic activities of LDH,SOD,GSH-Px in the myocardial tissue.Conclusion DSS has a therapeutic effect on isolated myocardial ischemia/reperfusion injury because it enhances anti-oxidative activity in myocardial tissue.

Aim To investigate the inhibitory effects of xanthotoxol(XT) on neutrophil infiltration and brain edema induced by focal cerebral ischemia-reperfusion injury in rats.Methods Focal cerebral ischemia-reperfusion model in rat was induced by transient occlusion of the middle cerebral artery for 2 hours and followed by 24 hours of reperfusion.XT(2.5,5 and 10 mg?kg-1,ip)was administered at 1 hour and 12 hours after the onset of ischemia,respectively.After 24 hours of reperfusion,the influence of XT on neurological deficit score,brain edema and infarct size were evaluated;the activity of Na+,K+-ATPase,Ca2+-ATPase and myeloperoxidasse(MPO) in the ischemic hemisphere cortex of the middle cerebral artery area was assayed by spectrophotometry;the expression of intercellular adhesion molecule-1(ICAM-1) and E-selectin was measured with immunohistochemistry.Results XT significantly reduced the neurological deficit score,brain edema and infarct size,enhanced activity of Na+,K+-ATPase and Ca2+-ATPas,suppressed the injury-induced upregulation of MPO activity and cell adhesion molecules(ICAM-1 and E-selectin) expression in the brain tissue.Conclusion XT attenuates brain damage following focal cerebral ischemia-reperfusion in rats and its mechanism may partly be due to the inhibition of inflammation and brain edema induced by ischemia-reperfusion.