Objective To evaluate the clinical effect of CEREC chairside on atypical porcelain inlay restoring class [[cavity.Methods 30 patients that required re-treatment because of resin restoration failure and early posterior proximal caries were selected randomly.The original fillings,secondary carious tissues and undercut parts were removed.The clear and round edge lines were prepared.With Sirona CEREC Blocs,35 atypical ceramic inlays were produced in accordance with CEREC AC CAD/CAM standard procedures.After clinical trial and modification,the inlays were bonded with 3M Veneer resin adhesive cement.Evaluation was done immediately and 3,6,12 and 24 months after restoration.Two senior prosthodontists did the evaluation according to the modified USPHS criteria.Results The evaluation results were all A when estimated immediately after restoration.None inlay falled off during the first two years.However,3 inlay were found to be damaged when reviewed at the 24th month.There exsited two patients having mild symptoms of dentine hypersensitivity which appeared at the beginning and died out gradually.Generally speaking,more than 90％ of inlay restorations had reached the USPHS criteria A.Color match and retention represented better effects.Conclusions CEREC atypical ceramic inlays can effectively restore Class Ⅱ cavity,short-term effect is good,but long-term effect still needs further observations.

Background Serum cystatin C levels can be used to predict morbidity and mortality in patients with cardiovascular disease. However, the clinical relevance of serum cystatin C levels in patients with hypertensive left ventricular hypertrophy (LVH) has rarely been investigated. We designed the present study to investigate whether serum cystatin C levels are associated with cardiac structural and functional alterations in hypertensive patients. Methods We enrolled 823 hypertensive patients and classified them into two groups:those with LVH (n=287) and those without LVH (n=536). All patients underwent echocardiography and serum cystatin C testing. We analyzed the relationship be-tween serum cystatin C levels and LVH. Results Serum cystatin C levels were higher in hypertensive patients with LVH than in those without LVH (P＜0.05). Using linear correlation analysis, we found a positive correlation between serum cystatin C levels and interven-tricular septal thickness (r=0.247, P＜0.01), posterior wall thickness (r=0.216, P＜0.01), and left ventricular weight index (r=0.347, P＜0.01). When analyzed by multiple linear regression, the positive correlations remained between serum cystatin C and interventricular septal thickness (β=0.167, P＜0.05), posterior wall thickness (β=0.187, P＜0.05), and left ventricular weight index (β=0.245, P＜0.01). Con-clusion Serum cystatin C concentration is an independent marker for hypertensive LVH.

Qi-Gui-Yin (QGY) compound, which composes of five herbal medicines of Astragalus membranaceus (Fisch.) Bge., Angelica sinensis (Oliv.) Diels, Lonicera japonica Thunb., Artemisia annua L., and Polygonum cuspidatum Sieb.et Zucc., which is able to treat antibiotic-resistant bacteria with antibiotics, and also to delay or even reverse the bacterial resistance producing. However, QGY compound is a complex mixture. And it is very difficult to elaborate its material foundation. Therefore, chemical constituents in five herbal medicines were summarized through searching of the related literatures. And then, 170 kinds of bioactive ingredients were classi-fied in order to provide evidences for the study on chemical constituent of QGY compound and identify its mate-rial foundation of delaying drug resistance .

BACKGROUND: H-type vessels are mainly distributed in the metaphysis, which can promote the proliferation of osteocytes, further accelerating osteogenesis.OBJECTIVE: To investigate the expression of H-type vessels in the subchondral bone during the occurrence and development of osteoarthritis.METHODS: 8-week-old C57 mice were randomly divided into experimental and sham groups, followed by the right medial menisectomy to establish the osteoarthritis models or only articular capsulotomy. The knee samples were removed at 4 weeks postoperatively, and were stained with safranin-O-fast green to evaluate the degree of injury. The expression levels of CD31, Emcn and matrix metalloproteinase 13 were detected by immunofluorescent staining. The changes of the subchondral bone were observed by hematoxylin-eosin staining and the changes of bone mass in the subchondral bone were analyzed by micro-CT.RESULTS AND CONCLUSION: Compared with the sham group, the Osteoarthritis Research Society International scores, expression levels of CD31, Emcn, H-type vessels and matrix metalloproteinase 13, as well as the bone mass in the subchondral bone were significantly increased in the experimental group (P < 0.05). To conclude, the increased H-type vessels in the subchondral bone promote the hyperplasia and remodeling of subchondral bone in the progression of osteoarthritis.

Objective To investigate the relationship between serum secreted frizzled-related protein 4 (SFRP4) and the first-phase of glucose-stimulated insulin secretion from pancreatic β cell under different glucose tolerance statuses. Methods Fifty-six patients with newly diagnosed type 2 diabetes mellitus ( T2DM group), 52 patients with impaired glucose tolerance (IGT group), and 42 subjects with normal glucose tolerance (NGT group) underwent intravenous glucose tolerance test. Fasting serum SFRP4 and interleukin ( IL)-1β were assayed by ELISA. Acute insulin response ( AIR), the area under the curve of the first-phase (0-10 min) insulin secretion (AUC), glucose disposition index(GDI), homeostasis model assessment for β cell function index(HOMA-β), and insulin resistance index(HOMA-IR) were calculated. Results (1) The levels of SFRP4 and IL-1β in T2DM group and IGT group were significantly higher than that in NGT group [(184. 38 ± 61. 34 or 141. 64 ± 40. 46 or 95. 46 ± 20. 13)ng/ ml, P<0. 01]. AIR, AUC, and GDI in T2DM group and IGT group were significantly lower than those in NGT group(P<0. 01), and these results were more significantly reduced in T2DM group compared with those in IGT group. (2) SFRP4 was negatively correlated with AIR, AUC, GDI, HOMA-β (P<0. 01), and positively correlated with fasting plasma glucose, 2 h plasma glucose after glucose loading, HbA1C , IL-1β, and high sensitive C-reactive protein(P<0. 01). (3) Multiple stepwise regression analysis showed that AUC, HOMA-IR, and serum IL-1β level were independently associated with SFRP4. Conclusion The concentration of serum SFRP4 is closely correlated with the glycolipid metabolic disorder, the first-phase of glucose-stimulated insulin secretion, and chronic low-grade inflammation. SFRP4 may be involved in the mechanism of β cell dysfunction in type 2 diabetes mellitus.

Objective To explore the feasibility of detecting the cytokeratin 20 (CK-20) mRNA in exfoliated urothelial cells for the diagnosis of bladder carcinoma. Methods Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the expression of CK-20 mRNA in cells collected from the urine of 45 cases of bladder cancer, 15 cases of cystitis accompanied by hematuria, 10 healthy volunteers, and 7 different cell lines, including bladder cancer cell line T24, kidney cancer 786-0 and GRC-1, breast cancer MCF-7 and MDA-MB-435, and ovary cancer SKOV 3 and 3AO. Results CK-20 mRNA expression was detected in 36 of 41 cases of bladder transitional cell carcinoma (87.80%), in 18 of the 21 GⅠ patients (85.71%), in 11 of the 13 GⅡ patients (84.62%), in 7 of the 7 GⅢ patients (100%), in 20 of the 22 T a-1 patients (90.91%), and in 16 of the 19T 2-4 patients (84.21%). Sensitivity of the method was found to be 87.80%, whereas specificity was 73.33%. In 15 patients with hematuria, there were 4 cases of false positive: 1 case of BPH, 1 case of atypical hyperplasia, 1 case of chronic inflammation, and 1 case undergoing TURP previously. CK-20 amplification band was also obtained in all of 19 cases of bladder transitional cell tumor tissues and bladder cancer cell line T24, but not in 4 patients with non-transitional cell carcinoma and 6 other tumor cell lines. No false positive cases were found in the healthy control group. Conclusion These results suggest that CK-20 might be a useful tumor marker for early noninvasive diagnosis and follow-up of bladder cancer by detecting CK-20 mRNA expression of uroepithelial cells from the voided urine specimen by RT-PCR.

OBJECTIVETo explore whether fractional anisotropy (FA) value could be taken as a quantitative indicator for tracing and reexamining amyotrophic lateral sclerosis (ALS), and to analyze the correlation between FA value and integrative medical treatment.

METHODSTotally 18 ALS patients were recruited in this study. All patients received diffusion tensor imaging (DTI) using 3. OT (Propeller HD) MRI twice. Six regions of interest (ROI) were selected to measure FA values. Survival analyses were performed in 11 cases of end point events.

RESULTS(1) Three ROI (cerebral peduncle, posterior limb of internal capsule, and corona radiata) all indicated that FA value was the highest in patients with mild health status scale of amyotrophic lateral sclerosis (ALS/HSS). (2) There was statistical difference in the means of FA values in cerebral peduncle, posterior limb of internal capsule, and corona radiata of 18 cases between initial examination and reexamination (P < 0.01). (3) Kaplan-Meier survival curve showed the survival rate of ALS patients decreased as time went by, with the median survival time of 48 months.

CONCLUSIONSFA value was inversely proportional to the severity of ALS, the more severe, the lower FA values. FA value was an objective indicator for assessing the severity of ALS. ALS is an incurable disease till now. Integrative medical treatment might become one direction for ALS patients.

Amyotrophic Lateral Sclerosis ; diagnosis ; therapy ; Anisotropy ; Diffusion Tensor Imaging ; Humans ; Integrative Medicine

OBJECTIVETo study effects of different interval year on Panax notoginseng plant soils middle and micro element content.

METHODThe dynamic change of Ca, Mg, Mn, Cu, Zn, B from Mabai, Matang, Gumu and Panlong were determined under different planting patterns (new soil, interval 5 years soil and continuous cropping soil).

RESULTAll the micro elements (except Ca, Mg) of interval 5 years soil and continuous cropping soil were significantly higher than those of new soil. All the middle and micro elements (except B) of interval 5 years soil were significantly higher than those of the continuous cropping soil. Planting patterns had remarkable influence on the content of Mn, Cu, B, but not Zn Ca, Mg. Cu, Ca under the 3 planting patterns, and Zn under the continuous cropping pattern did not show significant quarter changes. B content increased with the elongation of implantation time. Zn in new soil and interval 5 years also increased with prolonging of planted time. Mg, Mn and Cu content reached to peak value on April next year, and reached to minimum on the end of this experiment. Compared with new soil, the proportion of Mn, Cu in total elements increased by 29%, 114%, Mg, B decreased by 18%, 38%, Zn and Ca changed slightly of interval 5 years soils; In continuous cropping soil, Mn, Cu and B increased by 50%, 120%, 22%, respectively, but Zn, Ca, Mg had no significant change.

CONCLUSIONContinuous cropping pattern could not induce the deficient of soil middle and micro elements, and thereafter might not result in continuous cropping obstacles. But the imbalance proportional of soil middle and micro elements in P. notoginseng plant soils may be one of the main reasons for continuous cropping obstacles.

China ; Kinetics ; Panax notoginseng ; growth & development ; Soil ; chemistry ; Time Factors ; Trace Elements ; chemistry

OBJECTIVETo study effects of different interval year on Panax notoginseng plant soils macro element content.

METHODThe dynamic change of total N, P, K and available N, P, K in soil from Mabai, Matang, Gumu and Panlong was determined under different planting patterns (new soil, interval 5 years soil and continuous cropping soil).

RESULTContents order of soil total N, P and available N, P were interval 5 years soil > continuous cropping soil > new soil. No significant quarter change on soil total N was found, but the other three showed inverted "v" curve, and the peak value appeared on April 2010. Content of soil total K did not change significantly, but the available K content order was new soil > continuous cropping soil > interval 5 years soil, the quarter change was similar as soil available N or P. The soil total N, P, K and available N, P, K were different of the 4 monitoring sites under the 3 interval planting modes. There was a significant correlation between soil total P and available P under all these 3 interval planting modes, but N and K. The propitiation of N-P-K of new soil, interval 5 years soil and continuous cropping soil were 1: 0.4: 2.4, 1: 0.4:1.4, 1:0. 4:2.0, respectively.

CONCLUSIONContinuous cropping pattern induce the accumulation of P, but deficient of K. The imbalance proportion of N, P and K was one of the incentives of continuous cropping induced obstacles. Strengthen the research of optimum proportion of soil N, P and K, and then eliminate continuous cropping obstacles by means of formulated fertilization is the future research direction.

Agriculture ; methods ; Breeding ; China ; Drugs, Chinese Herbal ; analysis ; Fertilizers ; analysis ; Nitrogen ; analysis ; metabolism ; Panax notoginseng ; chemistry ; growth & development ; metabolism ; Phosphorus ; analysis ; metabolism ; Potassium ; analysis ; metabolism ; Quality Control ; Soil ; chemistry

Objective To investigate the clinical risk factors of delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods From January 2015 to April 2016,106 consecutive patients with aSAH treated with endovascular embolization at the Department of Neurosurgery,Nanjing General Hospital of Nanjing Military Command were enrolled retrospectively.The patients were divided into either a DCI group (n =34) or a non-DCI group (n =72) according to whether the occurrence of DCI.The general information of patients were collected,including sex,age,Hunt-Hess grade,modified Fisher grade,world federation of neurosurgical societies (WFNS) grade,acute cerebral edema,early (bleeding 1-3 d) hypoalbuminemia,and hypohemoglobinemia.Univariate and multivariate Logistic regression analyses were used to analyze the risk factors for occurrence of DCI.Results The incidence of DCI was 32.1％ (34/106).The Hunt-Hess grade ≥ Ⅲ,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ,acute cerebral edema,the incidences of hypoalbuminemia and hypohemoglobinemia in the DCI group were higher than those in the non-DCI group.There were significant differences between the 2 groups (all P ＜ 0.05).There were no significant differences in the ratios of sex,age ≥ 55 years,hypertension,diabetes and hyponatremia between the 2 groups (all P ＞ 0.05).In univariate analysis,the Hunt-Hess grade ≥ Ⅲ grade,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ on admission,and hypoalbuminemia were used as the independent variables for multivariate analysis,the results showed that WFNS grade ≥ Ⅳ (OR,8.02;95 ％ CI 2.41-26.70),modified Fisher grades ≥ Ⅲ (OR,4.44;95％ CI 1.38-14.32),and hypoalbuminemia at day 1-3 (OR,5.42;95％ CI 1.40-20.76) were the independent risk factors for occurring DCI in patients with aSAH (all P ＜ 0.05),and the Hunt-Hess grade ≥ Ⅲ was not the risk factor for occurring DCI in patients with aSAH (OR,1.86;95％ CI 0.39-8.88,P ＞ 0.05).Conclusion The patients with hypoalbuminemia,WFNS grade≥Ⅳ on adrnission,and modified Fisher grade ≥ Ⅲ may were the independent risk factors DCI after aSAH,and the clinical diagnosis and treatment should attach great importance to.