Enamel pearl is an ectopic enamel, which usually occurs in the root bifurcate or approaching enamel-cementum site of the first maxillary molar. A case of multiple enamel pearls on the left maxillary third molar is reported in this paper, and relevant literature was reviewed.
Dental Cementum ; Dental Enamel ; abnormalities ; Humans ; Molar ; Molar, Third ; Tooth Root

Objective To investigate the effect of age on activity of cholineacetyltransferase(ChAT) and acetylcholinesterase(AChE) in cerebral cholinergic nerve system of rat.Method According to age,male Sprague-Dawley rats were divided into the following 3 groups at random: 4～5 weeks old group,4～5 months old group,14～15 months old group(n=10,respectively).Chromatometry was used to assay the activity of ChAT and AChE in cerebral cortex,hippocampus and corpus striatum.Results In 14～15 months old rats,activity of ChAT and AChE in cerebral cortex,hippocampus and corpus striatum was prominantly reduced,as compared with that in 4～5 months old rats and in 4～5 weeks old rats(ChAT: P0.05).Conclusion There is a negative correlation between age and activity of ChAT and AChE in cerebral cholinergic nerve system.

Objective:To investigate the efficacy differences between domestic gefitinib and original gefitinib in the first-line treatment of patients with epidermal growth factor receptor (EGFR) sensitive mutation advanced non-small cell lung cancer (NSCLC) (stage Ⅲ B and Ⅳ). Methods:A total of 91 cases with EGFR sensitive mutation advanced NSCLC in Dezhou People's Hospital of Shandong Province from January 2017 to July 2019 were selected and were randomly divided into the observation group (47 cases) and the control group (44 cases) according to random number table method. The observation group was given the treatment of domestic gefitinib, and the control group was given the treatment of original gefitinib, and then the treatment outcome, adverse reactions, survival status and the cost of two groups were compared.Results:The objective response rate in the observation group and the control group was 91.5% (43/47) and 84.1% (37/44), respectively; the disease control rate in the observation group and the control group was 100.0% (47/47) and 97.7% (43/44), respectively; and the differences were not statistically significant ( χ2 = 2.708, P = 0.224; χ2 = 1.080, P = 0.484). The median progression-free survival (PFS) time of domestic gefitinib group and original gefitinib group was 13.26 months (95% CI 11.34-14.66 months) and 13.19 months (95% CI 12.52-15.48 months), respectively, and the difference was not statistically significant ( P = 0.735). The subgroup analysis showed that the median PFS time of patients with an exon 19 deletion mutation in the observation group and the control group was 12.98 months (95% CI 11.25-14.75 months) and 13.89 months (95% CI 12.04-15.96 months), respectively, and the difference was not statistically significant ( P = 0.604). The median PFS time of patients with an exon 21 L858R missense mutation in the observation group and the control group was 15.08 months (95% CI 11.79-18.21 months) and 11.94 months (95% CI 9.20-14.79 months), and the difference was not statistically significant ( P = 0.114). There was no statistically difference in the incidence of adverse reactions including skin rash, diarrhea, interstitial pneumonia, oral mucositis, nausea and vomiting, myelosuppression, abnormal aminotransferase of the two groups of patients (all P > 0.05). The treatment cost in the observation group and the control group during the treatment period was (2 118.43±137.93) yuan per month and (5 945.48±247.48) yuan per month, respectively, and the difference was statistically significant ( t = 12.854, P = 0.001). Conclusions:Domestic gefitinib and original gefitinib have the same therapeutic efficacy in the treatment of EGFR sensitive mutation advanced NSCLC. The adverse reactions are similar between domestic gefitinib and original gefitinib. Compared with the original gefitinib, the drug economy of domestic gefitinib is better and it can significantly reduce the financial burden of patients, and it can be used as an important option in the first-line treatment of patients with EGFR sensitive mutation advanced NSCLC.

Objective To investigate the value of adenosine deaminase( ADA) for the diagnosis of tubercu-lous pleural effusion.Methods A retrospective analysis was made of 324 cases of tuberculous pleural effusion patients which were effective treated and 68 cases were diagnosed of malignant pleural effusion.By drawing receiver operating characteristic curve, the best threshold of diagnosing of tuberculous pleural effusion was determined,and the distribution characteristics of ADA in tuberculous pleural effusion were analyzed.Results When the ADA was set at 19.5U/L it was good for identifying tuberculous empyema and tuberculous pleurisy.The activity of ADA in group of different gender did not have significant difference(Z=-0.572,P=0.283).The activity of ADA had significant difference between tuberculous empyema with tuberculous pleurisy patients(Z=-2.317,P=0.01),and the same as in group of different ages between less than or equal to 45 years old with the others(Z=-2.387,P=0.008).The activity of ADA had significant difference between tuberculous empyema and tuberculous pleurisy patients of younger than 45 years old(Z=-2.740,P=0.003),but not in the group of less than or equal to 45 years old (Z=-0.267, P=0.390).Conclusion The activity of ADA is good for identifying diagnosis of tuberculous pleural effusion and malignant pleural effusion, especially in tuberculous empyema and less than or equal to 45 years old patients.The standard of diagnosis and the nature of the tuberculous pleural effusion may affect the cut-off value of ADA.

0 05) CONCL_USION:The adsorption of infusion set will not result in obvious changes of drug concentration

Objective To explore the difference involved in the activation of inflammation pathway and the plasma level of inflammatory factors in the subjects with different sorts of insulin sensitivity. Methods The study was carried out in 38 women, consisting of obesity (n = 22 ) and control (n = 16 ) groups according to body mass index. The insulin sensitivity was assessed by homeostasis model assessment of insulin resistance (HOMAIR). Plasma concentrations of interleukin-6 (II-6) and IL-1β were determined by enzyme immunoassay. Western blot analysis was used to examine total protein expression and phosphorylation levels of IκB kinase (IKK) ,inhibitor of nuclear factor-κB ( IκB ) in peripheral blood leukcocytes. Electrophoretic mobility shift assay (EMSA)was used to detect the binding activity of NFκB. Results The levels of fasting plasma insulin[62.2 ( 20.0-127. 0) pmol/L vs 19. 15 ( 14. 2-47. 8 ) pmol/L, P<0. 01], HOMA-IR[2. 32 ( 0. 76-5.49 ) vs 0.70(0.53-1.7),P<0.0l], HbA1 C[(5.42±0. 45 ) % vs ( 5.08 ±0. 38) %, P<0. 05], triglyceride[( 1.75 ±0. 68 vs 1.22 ±0. 58 )mmol/L, P<0. 05], plasma IL-6[3. 15 (0. 03-22. 2) pg/ml vs 1.26 (0. 74-6.06 ) pg/ml, P<0. 01], and IL-1 β[6. 53 ( 0. 84-36 ) pg/ml vs 3. 16( 1.48-8. 86 ) pg/ml, P<0. 01]in obesity group were significantly higher than those in control group. Compared with control group, the levels of IKKo, IKKβ expression and IκBα serine phosphorylation in obesity group were markedly increased, while the expression of IκBα was significantly reduced. Accompanied with the degradation of IκBα protein, the binding activity of NFκB in obesity group was significantly increased. Conclusions The plasma levels of IL-6 and IL-1β were significantly raised in obesity group. The activation of IKK-IκB-NFκB pathway is closely associated with the genesis and development of insulin resistance in obese subjects.

Three-orientation medical talent training mainly include humanistic quality cultivation, professional quality and physical and mental quality. With professional ability as the guidance of profes-sional quality education requires students not only to grasp skilled medical technology, but also have the ability to enhance the medical technology. Based on the orientation of training target, this research mainly from habit set, authority set, set the multitude and empirical mind-set four aspects in this paper, the critical thinking, and put forward problems from finding problems, and expounds the innovative thinking of concise problem.

Practice abilityoriented professional quality training is an important part of thethree orientation talent training mode in Qiqihar Medical School, and it is the key link of the reform and inno-vation of talent training mode. This article mainly expounds the connotation of training mode in the three orientation under the guidance of medical personnel and medical research ability, and the training objec-tives cover innovative thinking ability and scientific research ability, including five aspects of training strat-egy such as reforming the teaching mode of the traditional theory course, setting up scientific research related courses, carrying out academic lecture, reforming the teaching mode of experiment course and con-structing the scientific research team of teachers and students by the scientific research project as well as seven aspects of the evaluation system, such as the literature review, the title of the report, academic report and research application writing, scientific research (comprehensive) experiment report, thesis writing and comprehensive performance, and deeply analyzes the close relationship between the practice ability and the medical research ability of medical students.

BACKGROUND:Studies have shown that bisphosphonates inhibit osteoclast resorption, but whether cathepsin K, a key cytokine of bone resorption, plays an effect has rarely been reported.
OBJECTIVE:To study the effect of bisphosphonate on capthesin K and bone resorption function during osteoclast differentiation.
METHODS:Osteoclasts were cultured by mouse monocyte-macrophage cellline-RAW264.7. The cells were divided into two groups:control group, treated with 100μg/L receptor activator of nuclear factorκB ligand factor;alendronate group, treated with 100μg/L receptor activator of nuclear factorκB ligand factor+10-7 mol/L alendronate. Osteoclastogenesis and resorption function of osteoclasts were examined at 7 days of culture and gene expression of capthesin K was detected by immunofluorescence method at 72 hours of culture. Western blot assay was used to detect capthesin K protein expression at 72 hours of culture.
RESULTS AND CONCLUSION:Tartrate-resistant acid phosphatase positive multinuclear cells were observed and resorption lacunae formed in two groups. Control group showed the higher number of tartrate-resistant acid phosphatase positive multinuclear cells and larger size of resorption lacunae than the alendronate group (P<0.01). Immunofluorescence showed expression of capthesin K was higher in the control group than the alendronate group (P<0.01);furthermore, the protein expression of capthesin K was also lower in the alendronate group than the control group (P<0.01). These findings indicate that bisphosphonates could strongly inhibit osteoclastogenesis and its resorption function by inhibiting gene expression of capthesin K.

BACKGROUND:Tartrate-resistant acid phosphatase is a specific marker for osteoclast differentiation and bone resorption, which is a sign of osteoclast maturity.
OBJECTIVE:To study the effect of alendronate on tartrate-resistant acid phosphatase related to osteoclast differentiation and bone resorption.
METHODOsteoclasts were cultured by mouse monocyte-macrophage cellline-RAW264.7. The cells were divided into two groupcontrol group, treated with 100μg/L receptor activator of nuclear factorκB ligand factor;alendronate group, treated with 100μg/L receptor activator of nuclear factorκB ligand factor+10-7 mol/L alendronate. Osteoclastogenesis and resorption function of osteoclasts were examined at 7 days of culture. Gene expression of tartrate-resistant acid phosphatase was detected by immunofluorescence method. Western blot assay was used to detect protein expression of tartrate-resistant acid phosphatase.
RESULTS AND CONCLUSION:Tartrate-resistant acid phosphatase positive multinuclear cells were observed and resorption lacunae formed in two groups. Control group showed the higher number of tartrate-resistant acid phosphatase positive multinuclear cells and larger size of resorption lacunae than the alendronate group (P<0.01). Immunofluorescence showed expression of tartrate-resistant acid phosphatase was higher in the control group than the alendronate group (P<0.01);furthermore, the protein expression of tartrate-resistant acid phosphatase was also lower in the alendronate group than the control group (P<0.01). These findings indicate that bisphosphonates could strongly inhibit osteoclastogenesis and its resorption function by inhibiting protein expression of tartrate-resistant acid phosphatase.