BACKGROUND:Obturation with warm gutta-percha can achieve perfect three-dimensional root canal obturation effect. Due to specific structure of oval canal, particularly in the bypass preparation process, excessive cutting of local tooth tissue may lead to tooth tissue thinning and irregular shape. The separation equipment is the metal with good heat conduction, so the heat caused by the bypassing warm gutta-percha obturation would burn periodontal tissue remains controversial. OBJECTIVE:To investigate the changes of root surface temperature produced by two bypassing warm gutta-percha obturation for the separation instrument in oval canalin vitro by using infrared thermography. METHODS:Forty mandibular first premolars were harvested from oval canals, and were separated using stainless steel 15# K file at apical 3 mm, with the length of 3 mm. The root canal bypassing was prepared using TF nickel-titanium file under operating microscope. The teeth were randomly divided into two groups, with 20 teeth in each group, and were obturated with the Thermafil warm gutter-percha and E&Q plus warm gutta-percha vertical compaction, respectively. An infrared thermoviewer was used to measure the external root surface temperature before and after the obturation. RESULTS AND CONCLUSION:Two warm gutta-percha obturation methods used for separating instruments bypassing in the oval root canal, had both caused the rise of root surface temperature, which was less than 10℃. In the Thermafil group, the temperature changes were 3.2-8.1℃ and the average change was 4.97℃. In the vertical condensation group, the temperature changes were 5.5-9.8℃ and the average change was 7.35℃. There were significant differences in the change of root surface temperature between the two groups (P < 0.05). Thermafil warm gutter-percha obturation would increase the root surface temperature, but cannot damage periodontal tissues. It is more secure than warm gutta-percha vertical condensation.

Objective To observe the effect of Sini decoction on inflammatory response and immune function in septic rats and to discuss its possible mechanism.Methods 66 Sprague-Dawley (SD) rats were randomly divided into normal control group (n=6),model group (n=30),and Sini decoction group (n=30).Septic model was reproduced by intraperitoneal injection of lipopolysaccharide (LPS,5 mg/kg).After the reproduction of sepsis,rats in Sini decoction group received Sini decoction (5 g/kg) by gavage,while those in model group were given equal dose of normal saline in the same way.Rats in normal control group did not receive any treatment.Blood was collected via eye sockets at 2,12,24,48,72 hours after LPS administration,then the rats were sacrificed.The concentrations of inflammatory mediators,such as interleukin (IL-1,IL-6,IL-10),tumor necrosis factor-α (TNF-α),and the expression level of monocyte human leukocyte antigen-DR (HLA-DR) were determined with enzyme linked immunosorbent assay (ELISA),and the pathological changes in intestinal mucosa were observed under electron microscope.Results The concentration of IL-1 (ng/L) at 2 hours in model group was gradually increased and peaked at 48 hours (4.07 ± 0.10),and then gradually decreased,while the IL-1 level in Sini decoction group peaked at 12 hours (2.98 ± 0.12) followed by a gradual decrease.IL-6 (ng/L) in model and Sini decoction groups peaked twice at 12 hours (91.39 ± 1.55,73.00 ± 2.38) and 48 hours (82.51 ± 1.49,64.68 ± 1.68) respectively.IL-10 (ng/L) in model group gradually decreased after peaking at 2 hours (86.66 ± 6.12),and that in Sini decoction decreased at 12 hours (71.61 ± 2.35) followed by an increasing tendency,and approached normal level at 48 hours (109.09 ±4.77 vs.124.01 ± 7.89,P＞0.05).TNF-α (ng/L) in model group was gradually increased and peaked at 48 hours (83.37 ±3.79),and that in Sini decoction peaked at 12 hours (48.52 ± 1.21),and decreased to normal level at 72 hours (18.59 ± 1.97 vs.15.50 ± 2.68,P＞0.05).During the course of the experiment,as compared with those of the model group,level of IL-1,IL-6,and TNF-α were significantly lower at all time points in Sini decoction group,and IL-10was significantly higher.The expression level of HLA-DR (μg/L) in model and Sini decoction groups peaked at 2 hours (4.86 ± 0.15,4.85 ± 0.17),and then gradually lowered.HLA-DR expression μg/L) at 48 hours and 72 hours in Sini decoction group was significantly lower than that in model group (48 hours:4.21 ± 0.12 vs.2.74 ± 0.16,72 hours:3.80 ± 0.09 vs.2.27 ± 0.12,both P＜0.01).Pathological study of intestinal mucosa showed that the intestinal mucosa were infiltrated significandy by inflammatory cells,and villi were damaged severely in both model group and Sini decoction group at 2 hours after LPS challenge.Infiltration of inflammatory cells in Sini decoction group was less intense after 12 hours,and the intestine villi repair was more obvious compared with model group.Conclusion Sini decoction could regulate systemic inflammatory response,and promote the repair of intestinal mucosa,the intestinal function and the immune status of septic rats.

Objective To study the appropriate neck irradiation volume for neck lymph nodenegative nasopharyngeal carcinoma patients by Meta-analysis.Methods The related references published from Jan 1990 to Jun 2013 were searched in Pubmed,Embase,Cochrane and Wangfang Databases.The qualified references for enrollment criteria were screened and the relative data were collected.The OR (Odds ratio) value by fixed effect model was used to evaluate the data for patients who received radiotherapy between the upper neck and whole neck irradiation.The endpoints including 5-year neck local control rate (LCR),neck-in-irradiation LCR,and neck-outsides-irradiation LCR.Results Five qualified references were screened and belonged to respective research.There enrolled 1 333 patients,including 970 patients who received the upper neck irradiation and 363 patients who received the whole neck irradiation,respectively.The forest plots revealed that there were no significant differences for 5-year neck LCR,neckin-irradiation LCR,and neck-outsides-irradiation LCR for patients received radiotherapy between the upper neck and whole neck irradiation.These OR values were 0.89 (95％ CI:0.41-1.94),1.29 (95％ CI:0.58-2.88) and 0.42 (95％ CI:0.07-2.36),respectively.Conclusions The Meta-analysis results suggest that irradiation to the upper neck for neck lymph node-negative nasopharyngeal carcinoma can be appropriate.

BACKGROUND:Many experiments have demonstrated that tissue engineering scaffolds prepared by polymer materials alone or biomaterials cannot meet the requirement of tissue engineering research.
OBJECTIVE:To evaluate biological characteristics and cel affinity of poly(hydroxybutyrate-co-hydroxyoctanoate)/col agen composite scaffold.
METHODS:Tissue engineering scaffolds were prepared by combination of poly(hydroxybutyrate-co-hydroxyoctanoate) and col agen at different proportions (2%, 4%, 6%, 8%and 10%) using solvent casting/particulate leaching method. Inner structure and apertures were observed by scanning electron microscope, and the porosity was determined by liquid displacement method. Rabbit chondrocytes were co-cultured with poly(hydroxybutyrate-co-hydroxyoctanoate)/col agen composite scaffold and poly(hydroxybutyrate-co-hydroxyoctanoate) scaffold. Growth curve of cel s was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and cel adhesion on the scaffolds was observed by scanning electron microscope.
RESULTS AND CONCLUSION:The pore size and porosity of the composite scaffold were about 200μm and (85±2)%, respectively. The cel affinity dynamical y increased with the increasing of proportion of col agen. Compared with the poly(hydroxybutyrate-co-hydroxyoctanoate) scaffold, the poly(hydroxybutyrate-co-hydroxyoctanoate)/col agen composite scaffolds are better to improve cel adhesion and proliferation, with favorable cel ular affinity.

A 56-year-old man with 1-year history of palpitation, heat intolerance and sweating, was diagnosed as thyrotropin (TSH) -secreting pituitary adenoma based on the symptoms of hypermetabolism, enlarged thyroid gland, inappropriately increased serum TSH concomitantly elevated plasma thyroid hormones and a pituitary tumor demonstrated on magnetic resonance imaging. Long-acting octreotide formulation was administered at a dose of 20 mg intramuscularly. Tumor volume shrinkage and improvement of thyroid function was achieved after a single drug injection; and the thyroid function returned to normal in 28 days. It is suggested that long-acting octreotide formulation might be used as a routine therapeutic approach prior to pituitary surgery, which may enhance the effectiveness of surgery and postoperative recovery.

Objective To evaluate clinical and pathologic factors associated with pelvic lymph node metastasis in patients with early-stage squamous cell carcinoma of the uterine cervir.Methods From February 2004 to January 2007,135 patients with stage Ⅰ b-Ⅱ a cervical squamous cell carcinoma in Women's Hospital,School of Medicine,Zhejiang University,were retrospectively studied.The relationship between pelvic lymph node metastasis and age,clinical stage,tumor size,grade of differentiation,depth of muscular invasion,lymphatic vascular space invasion,pretreatment level of serum squamous cell carcinoma antigen,pretreatment plasma level of fibrinogen,pretreatment leveh of hemoglobin and platelet were evaluated by univariate and multivariate analyses.Results Totally 3996 lymph nodes were dissected in 135 patients,with an average of 29.6 lymph nodes in each patient.12.6%of the patients(17/135)had metastasized pelvic lymph nodes.Univariate analysis indicated that tumor size(P=0.003),depth of muscular invasion(P=0.004),vasular space invasion(P<0.01),pretreatment levels of platelet(P=0.006)and fibrinogen(P<0.01)were significantly related to pelvic lymph node metastasis.Multivariate logistic regression analysis showed that lymphatic vascular space invasion(OR:3.674,95%CI:1.825-7.393,P<0.01)and pretreatment plasma level of fibrinogen(OR:4.568,95%CI:1.779-11.725,P=0.002)were significantly related to pelvic lymph node metastasis in patients with early-stage squamous cell carcinoma of the uterine cervix.Conclusion In early-stage cervical squamous cell carcinoma,lymphatic vascular space invasion and higher pretreatment plasma levels of fibrinogen are risk factors of pelvic lymph node metastasis.

Objective To investigate the effect of quorum sensing autoinducer 3OC12-HSL of Pseudomonas aeruginosa on the apoptosis of Caco-2 cells and its mechanism. Methods Caco-2 cells were incubated with 3OC12-HSL for 4 h and then examined by MTT method for cytoactivities. Flow cytometry was used to analyze apoptosis rate of Caco-2 cells. Expression of apoptosis associated proteins p-p38/MAPK and NF-κB were detected by Western blot. Results After exposure to 3OC12-HSL for 4 h, cytoactivities of Caco-2 cells was reduced(P<0.05) with dose-dependent pattern, and higher dose of 3OC12-HSL leaded to increasing apoptosis rate of Caco-2 cells(P<0.05). 3OC12-HSL raised expression of apoptosis associated proteins p-p38/MAPK and NF-κB detected by Western blot. Conclusion Quorum sensing autoinducer 3OC12-HSL can effect cytoactivities of Caco-2 cells and may induce its apoptosis by enhancing the expression of p-p38/MAPK and NF-κB protein.

Objective To study the age, the degree of hearing loss and the characteristics of inner ear imaging in children with GJB2 and SLC26A4 gene mutation-related deafness.Methods A total of 218 children with GJB2 and SLC26A4 gene mutations were enrolled in this study.Among them, with the combined test of deafness gene chip and DNA sequencing, 123 patients were diagnosed with GJB2 homozygous or complex mutations, and 95 patients were diagnosed with SLC26A4 homozygous or complex mutations.The age of the onset, the degrees of hearing loss and CT features of the temporal bone in children with GJB2 and SLC26A4 mutations were studied.Results The incidence of GJB2 and SLC26A4 gene mutations was 43.09%, 37.40%, 14.63%, 4.88% and 24.2%, 44.21%, 18.95% and 12.63% in the periods of infancy,early childhood,preschool and shoolage,respectively.The age composition of onset in the two groups showed statistical significance(P=0.014).The constituent ratio of children with moderate, severe and extremely severe degrees of hearing loss in the two groups with GJB2 and SLC26A4 gene mutations were 8.94%, 17.89%, 73.17% and 9.47%, 34.74% and 55.79%, respectively.Most of the group with GJB2 gene mutation had profound hearing loss, and the composition ratio of hearing loss degree in SLC26A4 group was statistically significant(P=0.014).99.19% of the children with GJB2 gene mutation group had normal structures of the inner ears.Only one case of CT showed bilateral internal auditory canal stenosis.For 95.79% of the children with SLC26A4 gene mutation, the CT results of the temporal bone were associated with the vestibular aqueduct expansion.Conclusion The onset age of GJB2 gene mutation children is concentrated in the infancy.Most of them are with very severe sensorineural deafness, not associated with the inner ear malformation.The onset age of SLC26A4 gene deafness children is concentrated in the early childhood.Most of them are with severe and extremely sever sensorineural deafness, closely related to vestibular aqueduct expansion and inner ear malformations.

Objective To evaluate the therapeutic effect of bone marrow mesenchymal stem cells (BMSC) transplantation via renal artery in treating experimental rats with adriamycin-induced chronic nephro -pathy.Methods A total of 50 male Sprague-Dawley (SD) rats were used as experimental animals.Two rats were used for the isolation and culture of BMSC.Twelve rats were designed as blank control group (group N);in other 36 rats adriamycin was injected through caudal vein to establish rat models of chronic nephropathy,these 36 rats were randomly and equally divided into three groups with 12 rats in each group:control group (group C,n=12),BMSC transplantation via renal artery group (group A,n=12),and BMSC transplantation via caudal vein group (group V,n=12).For the rats of group N,the same amount of normal saline was injected through caudal vein.Results At each observation point,the levels of blood urea nitrogen,serum creatinine,24 h urinary protein and 24 h urinary microprotein in group A,V and C were remarkably higher than those in group N (P＜0.01).One and two weeks after BMSC transplantation,the 24 h urinary microprotein level in group A was significantly lower than that in group C (P＜0.01);the serum creatinine level in group A was significantly lower than that in group C and group V (P＜0.01).One week after BMSC transplantation,both the 24 h urinary protein level and 24 h urinary microprotein level in group A were strikingly lower than those in group V (P＜0.01),but two weeks after BMSC transplantation these differences between group A and group V became not statistically significant.Conclusion BMSC transplantation via renal artery can improve cell-homing efficiency and improve the repair of damaged tissue as well.