Humans ; Mandible ; Maxilla ; Molar ; Open Bite ; complications ; Tooth, Deciduous ; Tooth, Impacted ; complications

Clinical thinking of Clinicians in Dongyang People's Hospital is gradually shifting from ‘empirical medicine’ to ‘evidence-based medicine’ after popularizing of evidence-based medicine, training core members and implementing multi-layered, multi-channeled, comprehensive and sustainable resident doctor training mode with clear steps and purposes within three years. This paper discussed on reasonable clinical practice of evidence-based medicine in primary hospital and provided realistic basis for the further development and improvement of training of evidence-based medicine in primary hospital.

Education of evidence-based medicine in clinical research is important in enhancing primary hospital clinical research capacity and quality.Dongyang People's Hospital of Zhejiang Province has carried out evidence-based medicine education and training,and greatly improved the performance of clinical research and development of scientific researchers.

Objective:To evaluate skeletal,dentoalveolar and soft tissue profile changes by activator therapy in patients with different skeletal patterns of Class Ⅱ1 malocclusions.Methods:22 subjects(10 girls,12 boys,mean age 11.5 ±0.67 years) in the mixed or early permanent dentition,were included and divided into low angle(n =15) and average angle(n =7) groups on the basis of skeletal pattern.All patients were treated with a traditional activator.The skeletal,dentoalveolar and soft tissue profile changes were compared on lateral cephalograms before and after treatment.Statistical analysis was performed with t-test of SPSS 13.0 at a level of significance of P ＜ 0.05.Results:Activator treatment in these growing patients resulted in a correction of the skeletal Class Ⅱ relationship (decrease of ANB,Wits and NA-Pg),an advancement of the mandibular structures(increase of Co-Pg and L1-APg),and changes of the teeth(increase of L6-MP).The changes of Wits,NA-Pg and L1-APg value of low and average angle groups were 1.34° ± 1.82 ° and 3.50 ° ± 1.77°,(3.06 ± 2.00) mm and (5.80 ± 3.17) mm,(-1.16-± 1.74) mm and (-2.83 ± 1.48) mm respectively(P ＜0.05).No statistical significance was found in the soft tissue profile changes whether intra-class or inter-group comparison.Conclusion:The activator appliance is effective in treating growing patients with mandibular deficiency,and mandibular reconstruction,in patients with average angle it is more effective than in those with low angle.

Objective To assess the efficacy and safety of intrapleural instillation of Yadanzi (Brucea Javan-ica)oil emulsion injection and cisplatin for malignant pleural effusion by literature searching and meta -analysis. Methods Databases were searched for random controlled trails (RCTs)including Pubmed,the Cochrane Library, CNKI,VIP,Wanfang Database and CBM.The quality of included RCTs was evaluated and the data were collected by 2 evaluators independently.Meta -analysis was performed using RevMan 5.2.Results 18 RCTs involving 1 322 par-ticipants was included.The results of meta -analysis indicated that intrapleural instillation of Yadanzi oil emulsion injection and cisplatin could improve the treatment efficiency of malignant pleural effusion (OR =3.82,95%CI 2.94 ~4.96,P <0.01)and improve the quality of life of patients(OR =4.07,95%CI 2.87 ~5.79,P <0.01),and reduce the gastrointestinal tract reaction (OR =0.55,95%CI 0.38 ~0.78,P <0.01)and white blood cell reduction occurs (OR =0.34,95%CI 0.25 ~0.46,P <0.01).Conclusion Intrapleural instillation of Yadanzi oil emulsion injection and cisplatin was effective and safe in the treatment of malignant pleural effusion,while the further studies should make efforts in improving research quality.

OBJECTIVETo establish animal models for research of orthodontic tooth under rapid movement through distraction osteogenesis of the periodontal ligament, and to approach the rules of bone formation and the relationship between new bone formation and angiogenesis.

METHODS48 rats of which the right maxillary first molars were removed were randomly divided into experimental and orthodontic control group. The orthodontic model was established according to traditional method, and the stretch device was installed in the experimental group after reducing the second molar's mesial bone resistance. Four animals in each group were randomly selected to be killed at 6 time points (at day 0, 3, 5, 10, 20, and 30). After specimens were obtained, immunohistochemical staining was done. The expression of vascular endothelial growth factor (VEGF) and osteocalcin (OC) were investigated.

RESULTSIn the experimental group, VEGF was mainly expressed in vascular endothelial cells, fibroblasts, osteoblasts, osteoclasts, and bone cells. The positive expression of VEGF gradually increased, the peak appeared at day 10 on the tension side, and the other side was at day 5. OC-positive signals were seen in the extracellular matrix of periodontal ligament and osteoblastic cells, and its peak appeared at day 10 on both tension and pressure side. The expression of VEGF and OC were similar in orthodontic control group, but the level was lower.

CONCLUSIONVEGF and OC involve in the remodeling of periodontal tissues and play an important role during periodontal ligament distraction osteogenesis. Angiogenesis is earlier than bone formation, or both appear simultaneously.

Animals ; Molar ; Osteoblasts ; Osteocalcin ; Osteoclasts ; Osteogenesis ; Osteogenesis, Distraction ; Periodontal Ligament ; Rats ; Vascular Endothelial Growth Factor A

BACKGROUND: Because of complicated physiological environment and difficulty to control experimental conditions, it is difficult to get satisfactory results from in vivo studies of cell mechanics.OBJECTIVE: To study the action and mechanism of p38MAPK signaling pathways on myoblast apoptosis based on successful construction of in vitro mechanical stimulation models.METHODS: The C2C12 cells cultured in vitro were divided into control group and SB203580 treatment group. Cyclic tensile stress was applied on the C2C12 myoblast cells for 0, 6, 12 and 24 hours in each group. The Flexcell Strain Unit-5000T was used to expose C2C12 myoblast cell to an equiaxial cyclic of 15% magnitude and a frequency of 10 cycles/min, each cycle including the 3 s stretch and 3 s relaxation. Hoechst 33258 fluorescent staining and optical microscope were used to detect cell apoptosis. RT-PCR, flow cytometric analysis were used to observe the apoptosis of C2C12 myoblast cells and Western blotting were used to detect the activity of p38MAPK and p-p38MAPK. RESULTS AND CONCLUSION: The optical microscope tested the change in the morphology. Hoechst 33258 staining showed that after treatment with cyclic stress, the cell took the typical appearance of apoptosis with chromatin condensation and apoptotic bodies. RT-PCR and flow cytometry showed that with the extension of time the rate of the apoptosis of C2C12 myoblast cell increased. And cells imposed SB203580 before imposing cyclical tensile stress, the results showed that the apoptosis was markedly affected, and the p-p38MAPK expression declined apparently. These findings demonstrate that p38MAPK signaling pathways in stress mediated into C2C12 myoblast cell apoptosis plays an important role.

Objective To investigate the expressions of carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 15-3(CA15-3) and carbohydrate antigen 125(CA125) and their clinical significance in papillary thyroid carcinoma (PTC). Methods The expressions of CA19-9, CA15-3 and CA125 were detected by immunohistochemical MaxVision method in 80 cases of PTC and 80 cases of benign thyroid lesions (BTL), including 34 cases of nodular goiter, 26 cases of Hashimoto's thyroiditis and 20 cases of follicular adenoma. The relationship between expressions of CA19-9, CA15-3 and CA125 and the clinical pathological characteristics were analyzed. Results The expression rates of CA19-9, CA15-3 and CA125 in 80 cases of PTC were 85%, 100%and 43.8%respectively, compared with BTL, the difference was statistically significant (P < 0.01). There was no significant correlation between expressions of CA19-9, CA15-3 and CA125 and age, gender, number and diameter of tumor nodules, lymph node metastasis, and TNM staging (P > 0.05). The sensitivity of CA19-9, CA15-3 and CA125 in the differential diagnosis of PTC and BTL were 85%, 100% and 43.8% respectively, and the specificity were 91.3%, 36.3%and 91.3%, respectively. Conclusion The expressions of CA19-9, CA153 and CA125 are helpful for the differential diagnosis of PTC and BTL.

Objective To study the calcium metabolism in tacrolimus(FK506)induced rats nephrotoxicity and the preventive effect of calcium channel blocker.Methods Twenty-four Spragueinduced or FK506-induced nephropathy model.Blood creatinine,blood electrolytes,renal tissue histopathology(HE stain)and the change of ultrastructural organization in renal cells by transmission electron microscope were observed.Results The blood creatinine levels of both CsA and FK506 groups [(36.00±2.61)and(34.17±4.54)μmol/L] were significantly higher than those of the FK506+Dilgroup and control group(all P＜0.05).The blood calcium levels of both CsA and FK506 groups (2.00±0.04 and 2.05±0.04 mmol/L) were significantly lower than those of the FK506+Dil group and control group(all P＜0.05).The blood creatinine and calcium levels of FK506+Dil group were not significantly different with those of control group(P＞O.05).Histopathology examination showed cloudy swelling and vacuolization of the renal tubular epithelial cells and intra-cellular mitochondria swelling and vacuolization in the CsA and FK506 groups.However,the pathological changes of the FK506+Dil group were remarkably milder in comparison with the CsA and FK506 groups.Concluum channel blocker,Dil,could prevent the FK506-induced nephrotoxicity.

Objective To discuss the application of gelatin sponge-hemocoagulase plugging agent in patients with pulmonary puncture bleeding.Methods The clinical data of 43 patients with hemorrhage caused by DSA-guided lung puncture biopsy,who received gelatin sponge-hemocoagulase plugging agent treatment at the Jining Municipal First People's Hospital of China between September 2021 and May 2023,were collected,and the hemostatic effect of gelatin sponge-hemocoagulase plugging agent was analyzed.Results Successful lung puncture needle biopsy was achieved in all the 43 patients.The puncture needle channel occlusion was accomplished by using gelatin sponge-hemocoagulase plugging agent.Five minutes after occlusion treatment,in one patient,whose moderate hemoptysis with moderate bleeding shadow before puncture needle biopsy changed to bloody sputum,the intrapulmonary bleeding shadow displayed on image became slightly enlarged when compared the size five minutes ago,while in all the remaining patients successful hemostasis was achieved,the hemoptysis disappeared and the pulmonary hemorrhage shadow was similar to that five minutes ago.No occlusion-related complications occurred in all patients.Conclusion For the treatment of pulmonary hemorrhage caused by DSA-guided lung puncture biopsy,gelatin sponge-hemocoagulase plugging agent is clinically safe and effective.