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.

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 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.

Objective To observe the lung protective effect of Tongfu Xiefei method (TFXF) in rats with sepsis, and to discuss its possible mechanism.Methods Forty-two Sprague-Dawley (SD) rats were randomly divided into blank control group (n = 6), model group (n = 18) and TFXF group (n = 18). Sepsis model was reproduced by cecal ligation and puncture (CLP) in rats of model group and TFXF group. After the reproduction of sepsis model, rats in TFXF group received Tongfu Xiefei granules 0.01 mL/g by gavge, while those in model group were given equal dose of normal saline by the same way. The rats in blank control group received no treatment. At 3, 6, 12 hours after CLP, abdominal aorta blood was collected for blood gas analysis and inferior vena cava blood was collected for determination of the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Bronchoalveolar lavage fluid (BALF) was collected for measurement of concentrations of total protein (TP), total phospholipid (TPL), and desaturated phosphatidyl choline (DSPC). The ratio of wet/dry lung weight ratio (W/D) was measured, and malondialdehyde (MDA) and myeloperoxidase (MPO) in lung tissues were determined. The pathologic changes in their lungs were observed with light microscopy.Results Compared with those in blank control group, the levels of pH value, arterial oxygen partial pressure (PaO2), HCO3-, base excess (BE) were lowered, and partial pressure of carbon dioxide of arterial blood (PaCO2) was increased in model group. The serum concentrations of TNF-α and IL-6 were gradually increased after the reproduction of sepsis model. Compared with those in blank control group, the levels of TP, TPL, and DSPC/TPL in model group were decreased, while the levels of W/D, MDA and MPO were increased. Compared with those in model group, pH value was elevated in TFXF group at 3 hours (7.27±0.04 vs. 7.18±0.07,P < 0.05). PaO2 (mmHg, 1 mmHg = 0.133 kPa) was improved at 3, 6, 12 hours (3 hours: 128.00±16.05 vs. 106.78±10.73, 6 hours: 98.46±15.97 vs. 72.80±16.33, 12 hours: 90.70±9.31 vs. 74.28±12.19, allP < 0.05). The serum concentrations of TNF-α (ng/L) in TFXF group were significantly lower than those in model group at 12 hours (508.20±94.08 vs. 756.60±138.77,P < 0.05), and the serum concentrations of IL-6 (ng/L) in TFXF group were significantly lower than those in model group at 6 hours and 12 hours (6 hours: 687.80±35.00 vs. 849.40±148.28, 12 hours: 728.80±214.41 vs. 917.00±245.96, bothP < 0.05). Compared with those of model group, the levels of TP (g/L) in BALF in TFXF group were significantly decreased at 12 hours (1.01±0.23 vs. 1.60±0.47,P < 0.05), and the levels of TPL (mg/L) in TFXF group were significantly increased at 12 hours (86.40±11.33 vs. 62.40±16.33,P < 0.05). The levels of DSPC/TPL in TFXF group were significantly higher than those in model group at 6 hours and 12 hours (6 hours: 0.58±0.13 vs. 0.38±0.10, 12 hours: 0.45±0.13 vs. 0.24±0.07, bothP < 0.05). The levels of W/D in TFXF group were significantly higher than those in model group at 3 hours (3.84±0.25 vs. 2.99±0.50,P < 0.01), but lower than those in model group at 12 hours (3.21±0.53 vs. 4.89±1.14,P < 0.05). The levels of MDA (nmol/mg) in TFXF group were significantly lower than those in model group at 6 hours and 12 hours (6 hours: 4.04±2.58 vs. 8.89±2.61, 12 hours: 11.31±3.60 vs. 20.60±8.10, bothP < 0.05), while the levels of MPO (U/g) in TFXF group were lower than those in model group at 12 hours (4.79±0.66 vs. 7.22±1.76,P < 0.05). Compared with model group, the lungs in TFXF group showed less morphological changes under light microscopy, such as pulmonary edema, congestion, effusion and fibrosis.Conclusions The method of Tongfu Xiefei may improve hypoxemia and metabolic acidosis, alleviate lung edema and ameliorate pulmonary pathological changes in rat sepsis model. Tongfu Xiefei method shows a protective effect in sepsis by the way of reducing peroxidative damage, inhibiting the release of proinflammatory factors and abating degradation of lung surfactant.

OBJECTIVE To observe and compare the cytotoxicity induced by andrographolide (AD)and its water soluble derivatives:andrographolide sodium bisulfite(ASB),active pharmaceutical ingredients of Chuanhuning and Yanhuning on human renal tubular epithelial cells (HK-2),and to explore the ASB-induced endoplasmic reticulum stress(ERS)mechanism. METHODS HK-2 cells were treated with the above four drugs respectively. The survival rate was examined by methyl thiazolyltetrazolium (MTT) assay and 50% inhibitory concentration (IC50) was calculated. In ASB treated group, Hoechst33342 staining and flow cytometry analysis were used to determine cell apoptosis, intracellular superoxide dismutase(SOD)activity and malondialdehyde(MDA)content were examined, and the protein expressions of binding immunoglobulin protein (Bip),C/EBP-homologous protein (CHOP)and cysteine-containing aspartate-specific protease 4(caspase 4)were detected by Western blotting. RESULTS The four drugs inhibited HK-2 cell growth in a time-dependent and concentration-dependent manner. At 24 h,the IC50 of AD (30.6 μmol · L- 1) was lower than that of others. Active pharmaceutical ingredients of Chuanhuning and Yanhuning (16.2 and 15.6 mmol · L- 1) were very close,ASB was 29.4 mmol · L-1. ASB(0,15,30 and 60 mmol · L-1)increased the apoptotic rate and caused the decrease in SOD activity and the increase in MDA content in a dose-dependent manner. Compared with control group,the protein expression of CHOP increased (P<0.01) at 8 h with ASB (30 and 60 mmol · L-1)treatment,Bip and caspase 4 had no significant change. In addition,at 24 h, ASB(60 mmol·L-1) decreased the expression of Bip(P<0.05),ASB(30 and 60 mmol·L-1)promoted the expression of CHOP(P<0.01),and the protein expression of activated caspase 4 increased in a concentration-dependent manner(P<0.01). CONCLUSION AD and its water soluble derivatives have a toxic effect on HK-2 cells. CHOP and caspase 4 pathway related to ERS is involved in ASB-induced apoptosis.

BACKGROUND:Due to the complexity and irregularity of bypass obturation of oval root canal and the particular stress of the post and core to the tooth, we have not yet found a reasonable post crown for dental restoration after bypass obturation of the oval root canal.
OBJECTIVE:To compare the flexural capacity of the three kinds of post-and-core repair systems (cobalt-chromium cast post and core, zirconium oxide post and core, and CAD/CAM-fabricated glass fiber post and core) after bypass obturation of the oval root canal warm gutta.
METHODS: Ninety mandibular first premolars were selected for bypass obturation of the root canal with Obtura II & System B, and then randomized into three groups that were respectively restored with cobalt-chromium cast post and core, zirconium oxide post and core and CAD/CAM-fabricated glass fiber post and core. After that, cobalt-chromium metal crown was used for ful-crown restoration. Fracture strength and fracture type were recorded in different groups.
RESULTS AND CONCLUSION: The fracture resistance was higher in the cobalt-chromium cast post and core group and zirconium oxide post and core group than the glass fiber post and core group (P < 0.05), and the former two groups had no significant difference. Cobalt-chromium cast post and core was fractured at the root of tooth, and could not be repaired; the zirconium oxide post and core was fractured at the root neck and root of tooth, which was confirmed as reparative fracture; the glass fiber post and core was fractured at the tooth neck, which could be restored. These findings indicate that the cobalt-chromium cast post and core can bear greater occlusal force, but has a higher probability of root fracture; the CAD/CAM-fabricated glass fiber post and core exhibits a lower probability of root fracture

BACKGROUND:Currently, there are many studies on colapsed repair, but a systematic and horizontal comparison is not reported yet. OBJECTIVE: To compare the effect of conventional resin adhesive, resin adhesive+silane coupling agent and adjacent surface open part of the crown on colapsed repair through clinical trial and in vitro experiment. METHODS: (1) Clinical trial: 90 patients with porcelain colapse were randomized into three groups, and respectively treated with conventional resin adhesive, resin adhesive+silane coupling agent and adjacent surface open part of the crown. Success rate was measured and compared among three groups at 1 year after repair. (2) In vitro test: Twenty test specimens were equaly divided into two groups, and treated with conventional resin adhesive and resin adhesive+silane coupling agent, respectively. Then, shear strength was detected in the two groups. Twenty double-crown specimens were equaly divided into four groups. The first three groups were treated with sand blasting, silane coupling agent and their combination treatment, respectively; the rest group had no treatment (control group). After repair, the tensile strength of each specimen was detected.RESULTS AND CONCLUSION:The success rate of colapsed repair was 37% for conventional resin adhesive, 90% for resin adhesive+silane coupling agent and 100% for adjacent surface open part of the crown. The shear strength was (13.978±0.343) MPa for the conventional resin adhesive and (10.058±0.64) MPa for resin adhesive+silane coupling agent, and there was a significant difference between two methods (P < 0.01). The tensile strength was (0.68±0.04) kN in the control group, (1.00±0.02) kN in the sand blasting group, (1.31±0.08) kN in silane coupling agent group, and (1.09±0.04) kN in the combination group, and there was a significant differences between groups (P < 0.01). Experimental results show that the silane coupling agent+resin adhesive treatment and adjacent surface open part of the crown are superior to conventional resin adhesive.