AIM:To investigate the effect and the mechanism of Zhibai Dihuang Pill(Radix Rehmanniae praeparata,Fructus Corni,Rhizoma Dioscoreae,Rhizoma Anemarrhenae,Cortex phellodendri Chinensis,etc.) on patients with hyperthyroidism. METHODS: Eighty-five hyperthyroid patients were randomly divided into two groups.The control group(40 cases) were treated with propylthiouracil,while the treatment group(45 cases) were treated with propylthiouracil and Zhibai Dihuang Pill;in the 12-week long treatment period,the heart rate,body weight,thyroid free FT_3、FT_4 and TSH and the serum level of FAA,resistin,adiponectin,leptin of patients in both groups were measured. RESULTS: After treatment,the heart rate,the serum of FT_3,FT_4 decreased and the body weight,TSH increased in both groups(P0.05).(CONCLUSION): Zhibai Dihuang Pill can improve the abnormal metabolism of sugar and fat in patients with hyperthyroidism by its actions on the serum level of FFA,resistin,adiponectin,leptin.

Objective Acute Stanford type A aortic dissection(aTAAD) is often misdiagnosed as acute coronary syndrome(ACS), anti-platelet therapy for ACS will influence the timing and outcome of aTAAD.We reviewed the surgical outcome of these misdiagnosed aTAAD patients.Methods From January 2011 to October 2015, 309 aTAAD patients have received surgical therapy in our department, among them 15 patients had misdiagnosed as ACS and taken oral anti-platelet therapy, 9 male and 6 female, the average age was(60.6±8.7) years.Retrospectively reviewed the data of perioperative and follow-up period.Results 5 patients took orally aspirin, 10 took aspirin and clopidogrel.2 patients had received operation 7 days after stopping the agents, 3 days for 3 patients, 1 day for 1 patient, and the other 5 patients received emergency operation without stopping the agents.The cardiopulmonary bypass time was(259.7±64.8) minutes, aortic cross-clamp time was(181.0±51.7) minutes, and selective cerebral perfusion and lower body arrest time was(34.9±8.1) minutes.There were 2 in-hospital deaths due to circulation failure(mortality 13.3%).The average drainage volume in the first 24 hours after operation was(800.7±598.8)ml.During a mean follow-up period of(20.6±17.4) months, one patient had suddenly death.Conclusion aTAAD misdiagnosed as ACS was not rare, anti-platelet therapy will increase the risk of bleeding.The decision of operation time rely on considering balance between the rupture risk of aortic dissection and the hemorrhage risk of anti-platelet therapy.Emergency operation for these patients will increase the bleeding and transfusion.

Molecular target-based cancer therapy is playing a more and more important role in cancer therapy because of its high specificity, good tolerance and so on. There are different kinds of molecular targeted drugs such as monoclonal antibodies and small molecular kinase inhibitors, and more than 50 drugs have been approved since 1997. When the first monoclonal antibody, rituximab, was on the market. The development of molecular target-based cancer therapeutics has become the main approach. Based on this, we summarized the drugs approved by FDA and introduced their mechanism of actions and clinical applications. In order to incorporate most molecular targeted drugs and describe clearly various characteristics, we divided them into four categories: drugs related to EGFR, drugs related to antiangiogenesis, drugs related to specific antigen and other targeted drugs. The purpose of this review is to provide a current status of this field and discover the main problems in the molecular targeted therapy.
Angiogenesis Inhibitors ; Antibodies, Monoclonal ; Drug Delivery Systems ; Humans ; Molecular Targeted Therapy ; Neoplasms ; drug therapy ; Protein Kinase Inhibitors ; Receptor, Epidermal Growth Factor ; antagonists & inhibitors

AIM:To compare the accuracy of conventional contact A-scan and IOL Master in measuring axial length and anterior chamber depth, and to evaluate the characteristics of these two different methods.METHODS:Totally 145 cases (189 eyes) who underwent phacoemulsification and intraocular lens implantation in our hospital from January 2015 to December 2016 were observed prospectively.They were divided into five groups according to ocular axial length measured by IOL Master(Group A:AL≤22mm, Group B:22mm28mm).The axial length and anterior chamber depth were measured by A-scan and IOL Master respectively before operation, corneal curvature was measured by IOL Master.AL≤22mm using Hoffer Q formula to calculate the crystal degree, AL>22mm using Haigis formula to calculate the crystal degree.Analysis of axial length, anterior chamber depth and mean absolute refractive error at 3mo after surgery.RESULTS:The axial length measured by A-scan and IOL-master:Group A were 21.48±0.41mm and 21.46±0.40mm (P>0.05);Group B were 23.13±0.62mm and 23.14±0.63mm(P>0.05);Group C were 25.24±0.56mm and 25.27±0.59mm(P>0.05);Group D were 26.97±0.59mm and 27.03±0.64mm(P>0.05);Group E were 30.76±1.40mm and 31.01±1.53mm(P<0.05).Mean absolute refractive error (MAE) at 3mo after surgery by A-scan and IOL Master:Group A were 0.50±0.30D and 0.43±0.27D(P>0.05);Group B were 0.48±0.34D and 0.45±0.32D(P>0.05);Group C were 0.56±0.32D and 0.49±0.40D(P>0.05);Group D were 0.64±0.16D and 0.50±0.22D(P>0.05);Group E were 0.91±0.47D and 0.62±0.29D(P<0.05), MAE≤±0.50D were 38.7% and 65%(P<0.05), MAE≤±1.00D were 69.2% and 83.3%(P>0.05).Anterior chamber depth measured by A-scan and IOL Master:Group A were 2.81±0.35mm and 2.82±0.41mm (P>0.05);Group B were 3.04±0.50mm and3.10±0.47mm (P>0.05);Group C were 3.55±0.62mm and 3.60±0.52mm (P>0.05);Group D were 3.42±0.24mm and 3.51±0.30mm(P>0.05);Group E were 3.50±0.28mm and 3.61±0.34mm(P>0.05).CONCLUSION:IOL Master and contact A-scan have a high degree of consistency in the biological measurement, IOL Master has higher accuracy for patients with high myopia and long axis.It is a simple, accurate, good-repeatable and non-contact measurement tool.

Objective To study the changes and clinical significance of serum kalium,natrium,chlorine,calcium and glucose in children with febrile convulsion(FC).Methods Serum kalium,natrium,chlorine,calcium and glucose concentrations were measured in 41 children with FC(FC group),30 children with fever and without convulsion(fever group) and 30 normal children(normal group) by automatic biochemical detector.Results Serum kalium and calcium concentrations had no significant difference between FC group and fever group,but they were significantly lower than those of normal group(F=5.965,3.048 P0.05).Conclusions There are hyponatremia,hyperglycemia and lowered blood kalium and calcium in patients with FC.Hence,while treating the patient with FC,the disturbance of blood electrolytes and glucose need be corrected to avoid the recurrence of FC and the progressive injury of important organs such as brain.

Objective To analyze the effect of the false lumenstatus of different methods in a single center.Methods From January 2010 to December 2015,391 cases of acute Stanford A aortic dissection were treated in our center.139 cases(of which 108 malesand 31 females) were finally selected after excluding the cases who died during hospitalization,whose perioperative clinical data were incomplete,follow-up information were incomplete,and DeBakey type Ⅱ aortic dissection and the cases with descending aorta dilatation.The average age was(50.3 ± 11.6) years(22-76 years).According to the methods for aortic arch and descending aorta,139 cases were divided into 5 groups:24 cases in AR(including ascending aorta replacement,ascending aorta + hemi-arch replacement and ascending aorta + island-arch replacement),9 cases in AR + SET (including ascending aorta + hemi-arch replacement + stent elephant trunk and ascending aorta + island-arch replacement + stent elephant trunk),42 cases in Arch + SET(ascending aorta + arch replacement + stent elephant trunk),22 cases in AR + TBS (ascending aorta + triple branched stent) and 42 cases in AR + FS(ascending aorta + arch fenestrated stent).Statistical analysis the size of true lemen and the status of false lumen among these five groups in the level of aortic arch,the distal end of stent,diaphragm,celiac artery,renal artery and iliacartery postoperatively.Results Different levels of descending aorta in each group have showed arying degrees of true lumen open and thrombosisof false lumen during follow-up period.Among them,cases with aortic arch treatment and stent implantation have showed higher ratio of thrombosis of false lumen.Effects of different stents were similar,which all promoted the process of thrombosis of false lumen.Conclusion Three methods for aortrc arch and desc ending aorta repair including Cronus (R),triple branched stent and arch fenstrafed stent had similar clinical aortic false lumen closure rate.Three methods had similar long term effect.

Objective:To evaluate the effects of the flowable resin used as pit and fissure sealant using different etching adhesive systems.Methods:60 caries-free extracted human premolars were randomly divided into 4 groups(n =1 5)and treated by Gluma, NT and 3M-Z350 flowable resin(group A);Clearifil SE Bond adhesive and 3M-Z350 flowable resin(group B),phosphoric acid etching,3M-Z350 flowable resin and phosphoric acid etching(group C)and 3Mconcise sealant(group D)respectively.After pro-cessing the tooth surface the pit and fissue of 1 0 sample in each group were sealed.The microleakage was measured by 1 % methyl-ene blue staining(n =8).The material-enamel interface was observed by SEM(n =2).The shear bond strength of the column-shaped samples with the diameter and the height of 3 mm(n =5)on the mesial or dental surface was examined by a test machine. The sealant cartridges and flowable resin cartridges with the diameter and height of 4 mm were used for the crushing strength exami-nation(n =1 0).Results:There was no significant difference in the microleakage among the 4 groups.SEMobservation showed that the resin tags of group A were long and dense and the resin tags of group B were short and sparse,bubbles and cracks were found on the local site in group A and B.The resin tags of group C were long and thin,but combined with tooth tightly;the resin tags of group D were short and dense;the penetration was poor at the bottom of the fissures in the 4 groups.The shear bond strength of Group A was the highest(P <0.01 ),that of group C was higher than that of group B and D(P <0.05).There was no significantly difference between group B and D(P >0.05).The compressive strength of flowable resin groups was higher than that of fissure seal-ant group(P <0.05).Conclusion:The shear bond strength and compressive strength of all-etching bonding system combined with flowable resin is superior to that of self-etching bonding system combined with flowable resin and the traditional sealant.Using Prime&Bond NT bond after acid etching may improve the shear bonding strength.

Objective To prove that valve sparing aortic root reconstruction may have an impact on the outcome and longevity of the repair for patients with acute type A aortic dissection.Methods Clinical data of 98 consecutive AAAD patients undergoing the valve sparing aortic root reconstruction were analyzed.The postoperative follow-up and the clinical effect of the procedure were retrospectively analyzed.Results Pre-operative grade of aortic insufficiency was(2.3 ± 0.5), CPB-time was (217.8 ± 43.1)min, aortic cross clamp time was(142.7 ± 37.4)min and stay on ICU (11.1 ± 5.7) days, while hospitalisation was(14.3 ± 3.2) days.8 patients(8.2％) died peri-operatively.None of the early deaths were valve-related.Rethoracotomy rate was 3.1％.All patients followed up(19.3 ± 7.6) (6-68) months.Survival at 1 year was 90.8％.Freedom from valvular reoperation was 97.9％ at 3 years.At last investigation, mean grade of aortic insufficiency for AADA was 0.5 ± 0.3 (0-3).Conclusion Regardless of the underlying indication, the aortic valve preserving reimplantation technique can be performed with favourable functional results.

Diagnosis, Differential ; Humans ; Hyponatremia ; diagnosis ; etiology ; therapy ; Inappropriate ADH Syndrome ; diagnosis ; etiology ; therapy

OBJECTIVEThis study aims to investigate the caries status of the first permanent molar and primary tooth among 7- to 9-year-old children in Tangshan city and the correlation between caries of primary tooth and the first permanent molar.

METHODSA stratified cluster sampling method was used on the basis of the Basic Approach of Oral Health Survey of WHO and the Guideline of the Third National Oral Health Survey. A total of 10 primary schools were randomly sampled in clusters that included 51 primary school sampling spots in Tangshan. The caries status of 1 794 children aged 7 years to 9 years was examined.

RESULTSThe prevalence rate of the first permanent molar caries was 47.49% (852/1 794), the mean number of DMFT was 1.30 ± 1.59, the mean number of DMFS was 1.96 ± 3.40, and the filling rate was only 2.35% (20/852). The preva- lence rate and mean DMFT of the first permanent molar caries showed significant difference between different ages and genders (P < 0.05). However, the mean DMFS of the first permanent molar caries only showed significant difference between the various ages (P < 0.05). The prevalence rate of the primary tooth caries was 83.11% (1 491/1 794), the mean number of dmft was 4.82 ± 3.55, the mean number of dmfs was 6.51 ± 5.61, and the filling rate was 12.41% (185/1 491). Caries of primary tooth was the first permanent molar caries risk factor [r = 0.277, OR = 5.736, P = 0.00, 95% CI (4.175, 7.881)]. Significant correlation was found between the caries of primary tooth and first permanent molar (r = 0.274, P < 0.001).

CONCLUSIONCaries status of the first permanent molar among 7- to 9-year-old children in Tangshan city is serious. Caries status of primary tooth may play an important role in predicting the first permanent molar caries in clinic and prevention.