Fused teeth is defined as the union of enamel and dentin of two or more teeth germs,yielding a single tooth during tooth develop-ment.Their treatment is complex and usually need multidisciplinary approaches.This report presents a case of fused teeth treated by he-misection and discusses the clinical features and treatment options.

Objective To explore the clinical curative effect of hyperbaric oxygen therapy for severe cranio-cerebral injury,and its influence on the level of serum interleukin -1 beta(IL -1 )and interleukin -6(IL -6). Methods 150 patients with severe craniocerebral injury were selected and divided into two groups by random and single blind method.75 patients of the control group were treated with conventional therapy,75 patients of the observation group were given hyperbaric oxygen on the basis of the conventional treatment,and the clinical efficacy was compared between the two groups.Results The total effective rate of the observation group was 94.67%,which was significantly higher than 77.33% of the control group,the difference was statistically significant(χ2 =7.83,P <0.05).There were no significant differences in GCS and ADL scores between the two groups(t =1.22,2.39,all P >0.05).After treat-ment,the GCS and ADL scores of the observation group were (12.18 ±2.13)points,(67.46 ±12.55)points,which were significantly higher than those before treatment(t =8.01,7.76,all P <0.05),and there were significant differ-ences between the two groups(t =7.23,6.82,all P <0.05).Before treatment,there were no significant differences in the serum levels of IL -6 and IL -1 between the two groups(t =2.10,1.01,all P >0.05).After treatment,the serum levels of IL -1 and IL -6 in the observation group were (127.48 ±16.35)pg/mL,(89.66 ±13.47)pg/mL, which were significantly lower than before treatment(t =8.34,7.89,all P <0.05),there were significant differences between the two groups(t =7.65,7.22,all P <0.05).Conclusion Implementation of hyperbaric oxygen in patients with severe traumatic brain injury on the basis of conventional symptomatic treatment can effectively improve the clinical symptoms and signs,reduce the serum IL -1 and IL -6 levels,promote the recovery of brain function and ability of daily life,and which is worth to be promoted in clinical.

Objective To explore the clinical effect of early mechanical ventilation coupled with mild hypothermia in the treatment of severe traumatic brain injury(STBI)and its effect on serum C -reactive protein (CRP)and hemorheology.Methods According to the order of admission,110 patients with STBI were divided into two groups.55 cases in the control group were given conventional symptomatic treatment and early mechanical ventilation, while 55 patients in the observation group were given early mechanical ventilation coupled with mild hypothermia.The clinical efficacy was compared between the two groups.Results The good prognosis rate was 74.55% in the observation group,which was significantly higher than 56.36% of the control group (χ2 =7.65,P <0.05).The serum CRP in the observation group admitted to hospital 2,3,5,7d were significantly decreased compared with the control group(t =7.48,8.04,7.34,7.82,all P <0.05).After treatment,the hear whole blood viscosity was (6.03 ±0.89)mPa·s, low shear whole blood viscosity was (3.18 ±0.19)mPa·s,plasma viscosity was (1.21 ±0.18)mPa·s,hematocrit was (37.56 ±3.23)%,and those were decreased compared with before treatment(t =8.45,7.54,7.04,8.02,all P <0.05).And there were significant differences compared with the control group(t =7.77,6.69,6.44,7.49,all P <0.05).Conclusion The effect of early mechanical ventilation coupled with mild hypothermia in the treatment of STBI has good effect,and it can reduce serum CRP levels,improve blood rheology,which is conducive to patients'prognosis.

Objectives By measuring left ventricular diastolic function and arterial stiffness,this study aims to probe into the effect of diabetes mellitus(DM) on left ventricular diastolic function and arterial stiffness,and evaluate the correlation between left ventricular diastolic funotion and arterial stiffness.Methods Seventy-six inpatients were enrolled.According to their coronary angiography,OGTF test results and past history of DM,patients were divided into controlled,CHD(coronary heart disease with no DM),and CHD+DM groups.Through invasive hemodynamic monitoring during left ventricular angiography,left ventricular end-diastolic pressure(LVEDP)and tan index were collected.Carotid-femoral pulse wave velocity(c-f PWV),reflected wave augmentation index (AIx@75) and other data reflecting the degree of arterial stiffness were collected bedside with non-invasive means.SPSS 18.0 was used for statistical analysis.Results No significant difference was found between groups for LVEDP,tau index,and AIx@75.In terms of c-f PMV,The CHD+DM group(8.79±1.59)cm/s differed significantly from the CHD group (7.43±1.42)cm/s and the controlled group(6.83±1.14)cm/s.No correlations were found between c-f PMV and LVEDP or tau index.A positive correlation was found between AIx@75 and tau index.Conclusions Compared with the controlled group and CHD patients with no DM,CHD+DM patients show worse arterial stiffness with no difference in ventricular diastolic function.There is a positive correlation between arterial stiffness and diastolic dysfunction.

Objective To observe the characteristic of the functional magnetic resonance imaging (fMRI) brain map in health adult undergoing clenching and relaxing the fist, for exploring the essence of the fMRI brain map in patients suffering from motor dysfunction by cerebrovascular accidents. Methods Twelve healthy volunteers had been chosen to partake the experience. Everyone had accomplished the following three actions separately: (1) Only clenching and relaxing the fist of left hand. (2) Only clenching and relaxing the fist of right hand. (3) Clenching and relaxing the fist of both hands at one time. The data had been analyzed statistically using analysis of functional neuroimages (AFNI) software. Results Under condition of F (6,1121), P = 0.005. Only clenching and relaxing the fist of left hand had gained the following brain functional area: right precentral gyms, left parietal,right superior temporal gyrus,right parietal, right parahippocampal gyrus, right superior frontal gyrus, right medial frontal gyrus, left precuneus, right superior parietal lobule, right middle frontal gyrus, left superior frontal gyrus. Only clenching and relaxing the fist of right hand had gained the following brain functional area: left precentral gyms, left postcentral gyrus right parietal, right medial frontal gyrus. Clenching and relaxing the fist of beth hands simultaneously had gained the following brain functional area: left precentral gyms,left postcentral gyrus, right precentral gyrus, right postcentral gyrus. Conclusions Hand movement (clenching and relaxing the fist) has its own specific brain activated areas. The brain areas activated by clenching and relaxing the fist of both hands simultaneously concentrate in the motor area of both cerebral hemisphere. The brain areas activated by clenching and relaxing the fist of single hand contain not only the motor area, but also the supplementary motor area. As compared with the right handedness, the brain areas activated by clenching and relaxing the fist of left hand is more widespread.

A simple and green method for the determination of trace bisphenol A( BPA) was established by coupling supported ionic liquid solid phase extraction to β-cyclodextrin modified ionic liquid carbon paste electrode-based electrochemical detection ( SILs-SPE-ED) . The synthesized imidazolium ionic liquid modified styrene type macroporous resin was used as adsorbent for SPE of BPA. The critical parameters that affect the extraction efficiency were optimized, including 0. 4 g of packing material quantity, 200 mL of sample solution at pH 7. 0, 5 mL of methanol as an eluent solvent, and 4. 5 mL/min of the SPE flow rate. Dynamic adsorption test showed that the maximum adsorption capacity of BPA on the SILs-SPE cartridge was 10. 1 mg/g, and the enrichment factor was 40 . The calibration curve showed a good linearity between the anodic current and the BPA concentration in the range of 1. 0×10-8-1. 0×10-6 mol/L (i. e. 2. 3-228μg/L). The detection limit was 4. 16×10-9 mol/L (equal to 0. 95 μg/L). The SILs-SPE-ED method was applied to the analysis of water and plastic samples and the results agreed well with HPLC method.

Objective To investigate the effect of erythropoietin(EPO)on the proliferation of neural stem cells(NSCs)derived from central canal of adult rat spinal cord in vitro ,so as to provide a theoretical basis for clinical treatment of spinal cord injury by autotransplanting or allograft transplanting of adult spinal cord NSCs. Method NSCs were isolated from the central canal of the adult rats spinal cord by microsurgical method,and Nestin(nestin)and Sox2 immunofluorescence stain were used to identify the cells. After cells were treated with different dose of EPO,5,10,20 and 40 U/mL,respectively,the optical treatment concentration and time were determined by CCK8 assay. The effect of EPO on the cell count and the expression of Cyclin D1 in NSCs were detected at the treatment time 96 h. Result The NSCs derived from the central canal of adult SD rats spinal cord could stably express protein Nestin and transcription factor Sox2. As the results of CCK8 test,cell counts and real-time quantitative PCR showed the optimal treatment of concentration and time maybe 20 U/mL and 96 h. Conclusions This study shows that EPO can promote the proliferation of NSCs derived from central canal of adult rat spinal cord,and the optimal treatment of concentration and time for proliferation might be 20 U/mL and 96 h.

Objective To study the effect of ganglioside combined with hyperbaric oxygen on mild to moderate craniocerebral trauma , and its effect on serum neuron specific enolase ( NSE ) and myelin basic protein ( MBP) levels.Methods Following the random number table method ,110 patients with mild and moderate cranioce-rebral trauma were randomly divided into the observation group and the control group ,55 cases in each group.The observation group was treated with ganglioside combined with hyperbaric oxygen therapy ,while the control group was treated with hyperbaric oxygen alone .The clinical efficacy ,the Glasgow Coma Scale ( GCS) ,the levels of serum NSE and MBP before and after treatment were compared between the two groups .Results The effective rate of the observation group was 94.55％,which was significantly higher than 81.82％ of the control group,the difference was statistically significant(χ2 =4.274,P<0.05).The D-value of GCS before and after treatment in the observation group was (2.97 ±0.59)points,which was significantly higher than that of control group (t=17.601,P<0.05). The levels of serum NSE and MBP of the observation group were significantly lower than those of the control group ( t=14.674,10.450,all P<0.05).Conclusion Ganglioside combined with hyperbaric oxygen can promote the recovery of neurological function ,has significant effect and high safety in the treatment of mild to moderate craniocerebral trauma .

Objective To investigate the manifestation of facioscapulohumeral muscular dystrophy (FSHD) in oral and maxillofacial region.Methods A total of 12 patients diagnosed as FSHD and 20 healthy volunteers were included in the study.Their medical history was collected from these patients.The decayed missing filled teeth (DMFT),calculus index-simplified (CI-S),occlusal relationship,maximal opening of mouth and maximum bite force were recorded.The impressions were taken to measure the maximal hight of palate and the width of palate.The lateral cephalometric radiographs were also taken to measure the mandibular plane-frankfurt horizontal plane angle (MP-FH).They finally received oral and maxillofacial region MRI examination to observe the masseter muscle,medial pterygoid muscle and lateral pterygoid muscle.The data were analyzed by t-test or Wilcoxon signed ranks test.Results There was no significant gender difference in FSHD group.The average age of treatment was (27.5±8.1) years and the average age of onset was (15.7±7.5) years.Nine patients liked to eat soft foods,4 patients had difficulties of closing eyes,8 patients had difficulties of cheek-bulging,10 patients showed pouty lips and 9 patients had mesio-malocclusion.DMFT (4.0±2.3),CI-S (5.8±2.1),male maximal hight of palate (20.5±2.1) mm,female maximal hight of palate (17.9±1.6) mm,MP-FH (31.8°±2.2°) of FSHD group were greater than those of the control group.Male width of palate (34.8±1.4) mm,female width of palate (33.7±1.5) mm,male maximum bite force (451.7±39.0) N,female maximum bite force (326.7± 21.6) N,maximal opening of mouth (3.5±0.4) cm of FSHD group were less than those of the control group (P ＜ 0.05).Maxillofacial MRI showed muscle asymmetr in 11 cases of masseter and 6 cases of medial pterygoid muscle,5 cases of lateral pterygoid,and these muscle showed mild fatty infiltration mainly concentrating in the grade 0,grade 1 and grade 2.Conclusions The FSHD patients have poor oral hygiene,low masticatory function,limited mouth opening,high palate and narrow arch and different degree of malocclusion.The patients' masseter muscle,medial pterygoid muscles and lateral pterygoid muscles exhibit asymmetrical atrophy and fatty infiltration.

Objective: To investigate the effect of human umbilical cord mesenchymal stem cells derived exosomes (hUC-MSC-exo) on the phenotype of peripheral blood macrophages from rabbit autoimmune dry eye and the expression of related cytokines. Methods: The hUC-MSCs were isolated and characterized.Exosomes derived from hUC-MSCs were extracted by ultracentrifugation and observed directly using electronic microscopy.Specific markers of exosomes were analyzed by Western blot.Six rabbits were randomly divided into the normal control group and the dry eye group by using the random number table method, 3 rabbits for each group.Rabbit model of autoimmune dry eye was established in the dry eye group, and the lacrimal glands were collected for quantitative real-time PCR (qRT-PCR) at the 8th week.In vitro, activated peripheral blood mononuclear cells (PBMCs) from rabbit autoimmune dry eye model were incubated with hUC-MSC-exo or phosphate buffered saline (PBS). After 48 hours, cells from the hUC-MSC-exo group and the PBS control group were collected.The mRNA expression levels of related cytokine genes and subpopulation-related marker genes in macrophages were quantified by qRT-PCR.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.This study protocol was approved by Ethic Committee of Tianjin Medical University Eye Hospital (No.TJYY20181217001). Written informed consent was obtained from each family before obtaining umbilical cord. Results: Exosomes derived from hUC-MSCs had typical morphology and specific markers.qRT-PCR results showed that, the relative expression quantity of M1 macrophages phenotypic molecular nitric oxide synthase 2 (NOS2) mRNA and inflammatory factor tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) mRNA in the lachrymal organization in the dry eye model group was significantly higher than those in the normal control group (3.06±1.00 vs. 1.00±0.03, 2.77±0.72 vs. 1.01±0.02 and 1.30±0.08 vs. 1.01±0.01, respectively), the relative expression quantity of M2 macrophages phenotypic molecular arginase 1 (Arg1), CD206 and IL-10 mRNA in the lachrymal organization in the dry eye model group was significantly lower than those in the normal control group (0.55±0.07 vs. 1.00±0.00, 0.60±0.13 vs.1.00±0.00, 0.65±0.14 vs. 1.01±0.01, respectively), with significant differences between them (all at P<0.05). In vitro, the relative expression quantity of M1 macrophages phenotypic molecular NOS2 mRNA and inflammatory factor TNF-α, IL-1β mRNA in PBMCs in the hUC-MSC-exo group was significantly lower than those in the PBS control group (0.59±0.08 vs.0.98±0.03, 0.56±0.07 vs. 1.03±0.11, 0.47±0.04 vs.1.00±0.08)(all at P<0.05); the relative expression quantity of M2 macrophages phenotypic molecular Arg1, CD206 mRNA and anti-inflammatory cytokine TGF-β, IL-10 and IL-4 mRNA in PBMCs in the hUC-MSC-exo group was significantly higher than those in the PBS control group (2.13±0.28 vs. 1.10±0.17, 1.32±0.03 vs. 1.01±0.06, 1.53±0.20 vs. 1.05±0.10, 1.47±0.08 vs.0.98±0.03, 1.51±0.16 vs. 1.01±0.03), with significant differences between them (all at P<0.05). Conclusions hUC-MSC-exo can polarize peripheral blood macrophages toward immune-suppressive M2-like phenotype, inhibit the production of pro-inflammatory cytokines TNF-α and IL-1β, and meanwhile increase the expression of anti-inflammatory factors IL-10 and TGF-β.