The procedure of occlusal treatment involves improving the morphology and the stomatognathic function.Several practical methods and morphological endpoints have been described in occlusal rehabilitation.We made a selection of these (mandibular position,oc-clusal plane,occlusal guidance,occlusal contact,face-bow transfer,use of an adjustable articulator and occlusal support)and performed a literature review to verify the existence of compelling scientific evidence for each of these.A literature search was conducted using Medline /PubMed in March 2011.Over 400 abstracts were reviewed,and more than 50 manuscripts selected.An additional hand search was also con-ducted.Of the many studies investigating stomatognathic function in relation to specific occlusal schemes,most studies were poorly designed and of low quality,thus yielding ambiguous results.Overall,there is no scientific evidence that supports any specific occlusal scheme being superior to others in terms of improving stomatognathic function,nor that sophisticated methods are superior to simpler ones in terms of clini-cal outcomes.However,it is obvious that the art of occlusal rehabilitation requires accurate,reproducible,easy and quick procedures to re-duce unnecessary technical failures and /or the requirement for compensatory adjustments.Therefore,despite the lack of scientific evidence for specific treatments,the acquisition of these general skills by dentists and attaining profound knowledge and skills in postgraduate training will be necessary for specialists in charge of complicated cases.

Objective To investigate the effect of combination of cervical manipulation with cervical conditioning exercise for the treatment of cervical spondylosis of neck type or nerve root type. Methods Seventy-two patients were randomly divided into a treatment group (37 patients) or a control group (35 patients) by using a random number table. Patients in the treatment group and in the control group were treated with combination of cervical manipulation or cervical manipulation only, respectively. At the end of treatment and 3 months, treatment effects were assessed by Neck Disability Index (NDI) and Visual Analog Scale (VAS). Results NDI scores in both of the treatment group and the control group after treatment were significantly lower han those before treatment (t=4.471 in the treatment group, t=3.599 in the control group, all P<0.05), and NDI score in the treatment group were significantly lower than that in the control group after treatment (t=-2.085,P<0.05). Follow-up at 3 months, NDI score in the treatment group was significantly lower than that in the control group (t=-4.549, P<0.05). Proportions of improved patients, as assessed by NDI items, including pain intensity, personal care, lifting, reading, headaches, concentration, work, sleeping, driving and recreation in the treatment group were significantly higher than those in the control groups (Z=-3.521,-3.331,-3.003,-3.001,-3.265,-3.198,-3.016,-3.000,-2.102,-2.971, respectively, all P<0.05). VAS scores in both of the treatment group and the control group after treatment were significantly lower than those before treatment (t=7.986 in the treatment group, t=6.507 in the control group, all P<0.05), and VAS score in the treatment group were significantly lower than that in the control group after treatment (t=-2.426,P<0.05). Follow-up at 3 months, the VAS score in the treatment group was significantly lower than that in the control group (t=-7.065, P<0.05). Proportions of improved patients in the treatment group was significantly higher than that in the control group (91.89% vs 74.29%; χ2=4.014, P=0.045). Conclusion Combination of cervical manipulation with cervical conditioning exercise may be superior to cervical manipulation only for the treatment of cervical spondylosis of neck type or nerve root type.

Objective To investigate the clinical efficacy of electroacupuncture incorporate with acupuncture point injection in treating cervical spondylotic radiculopathy.Methods 103 cases from Chen Jia Qiao Community Health Service Centre and other community centers during February 2011 to November 2012 were collected and randomly allocated into three group:a electroacupuncture group of 34 cases; an acupuncture point injection of another 34 cases and an observation group of 35 cases treated with electroacupuncture which incorporated with traction therapy.After the treatment,the therapeutic effects among three groups were compared.Results ① clinical efficacy comparing:total efficacy rate of observation group was 91.4％ (32/35),the electroacupuncture group was 73.5％ (24/34),the group treated with acupuncture point injection was 70.6％ (25/34).There were statistically significant differences between the observation group and the other two groups (Z=1.721,P＜0.05),while there's no statistically significant of comparison between the group treated with electroacupuncture and the group treated with acupuncture point injection (Z=2.473,P＞0.05).② NDI score comparing:NDI score of these three groups before and after treatment.Before treatment,the score of observation group was (12.32 ± 5.03) ; the electroacupuncture group was (12.96± 6.10) ; the acupuncture point injection group was (12.79±5.07),after treatment,the separate sore was (7.40±4.12),(6.08±3.60) and (6.08 ± 3.60) sequentially.There were statistically significant differences of NDI score of the three groups before and after treatment (P＜0.05).After treatment,the efficacy of observation group was better than the group treated with electroacupuncture and the group treated with acupuncture point injection(P＜0.05).③ signs or symptoms comparing:After treatment,there were statistically significant differences between the observation group and the other two groups on the aspect of relieving pain of neck and arm,numbness of arm and hand,and alleviating soreness when doing spurling test on cervical intervertebral foramen (Z-score is 2.603,2.862,2.307,P＜0.05).There's no statistically significant of comparison among three groups on the aspects of neck functional activities and segmental tenderness of cervical spondylosis (Z-score is 1.414,1.572,P＞0.05).Conclusion In treating cervical spondylotic radiculopathy,the total efficacy rate of electroacupuncture incorporate with acupuncture point injection was higher than only treat with electroacupuncture or acupuncture point injection.

Objective:To detect the value of utilizing bpMRI in prostate biopsy in the detection of prostate cancer with PSA≤20ng/ml.Methods:The clinical data of 394 patients who underwent prostate biopsy in the First Affiliated Hospital of Nanjing Medical University from November 2017 to October 2019 were retrospectively analyzed. Of all the patients, 177 underwent modified systematic biopsy, named TRUS group, 217 patients accepted pre-biopsy bpMRI examination, undergoing modified systematic biopsy if Prostate Imaging Reporting and Data System (PI-RADS) score < 3 or MRI-TRUS cognitive fusion targeted prostate + systematic biopsy if PI-RADS score ≥ 3, named MRI group. The median age of TRUS group was 66 (61, 74) years old, prostate specific antigen (PSA) was 9.52 (7.26, 12.30) ng / ml, and prostate volume (PV) was 36.84 (28.95, 57.72)ml. The median age of MRI group was 66 (59, 72) years old, PSA was 8.84 (6.65, 12.16) ng/ml, and PV was 39.45 (29.25, 58.69)ml. There was no difference in above parameters between the two groups. The χ 2 test was used to compare the detection rate of prostate cancer and clinically significant prostate cancer (CsPCa) between the two groups. Results:There was no significant difference in the detection rates of prostate cancer between TRUS group and MRI group [51.41% (91/177) vs. 48.39% (105/ 217), P = 0.550], but the detection rates of CsPCa were significantly different [26.55% (47/177) vs. 36.41% (79/217), P = 0.037]. In patients with PSA ≤ 10 ng / ml, there was no significant difference in the detection rates of prostate cancer between the two groups [43.62% (41/94) vs. 43.08% (56/130), P = 0.936], but there was a significant difference in the detection rates of CsPCa [17.02% (16/94) vs. 28.46% (37/130), P = 0.047]. There was no significant difference in the detection rates of prostate cancer [60.24% (50/83) and 56.17% (48/87), P= 0.504] and the detection rates of CsPCa [37.35% (31/83) vs. 48.28% (42/87), P = 0.150] between the two groups. The total detection rates of the last two needles in TRUS group and MRI group were 23.16% (41/177) and 36.63% (86/217), respectively, with significant difference ( P=0.001); the detection rates of CsPCa in the last two needles were 11.86% (26/177) and 29.03% (63/ 217), respectively, with significant difference ( P < 0.001). In MRI group, the detection rates of prostate cancer in patients with PI-RADS score <3, 3, 4, 5 were 21.21% (7/33), 25.84% (23/89), 73.24% (52/71), 95.83% (23/24), respectively; the detection rates of CsPCa were 12.12% (4/33), 17.98% (16/89), 54.93% (39/71), 83.33% (23/24), respectively. Conclusions:In patients with PSA ≤ 20 ng / ml, prostate biopsy based on bpMRI may improve the detection of CsPCa, especially in patients with PSA ≤ 10 ng/ml.

Herpes simplex virus type 1 (HSV-1) is a commonly occurring human pathogen worldwide. There is an urgent need to discover and develop new alternative agents for the management of HSV-1 infection. Tripterygium hypoglaucum (level) Hutch (Celastraceae) is a traditional Chinese medicine plant with many pharmacological activities such as anti-inflammation, anti-tumor and antifertility. The usual medicinal part is the roots which contain about a 1% yield of alkaloids. A crude total alkaloids extract was prepared from the roots of T. hypoglaucum amd its antiviral activity against HSV-1 in Vero cells was evaluated by cytopathic effect (CPE) assay, plaque reduction assay and by RT-PCR analysis. The alkaloids extract presented low cytotoxicity (CC_(50) = 46.6 μg/mL) and potent CPE inhibition activity, the 50% inhibitory concentration (IC_(50)) was 6.5 μg/mL, noticeably lower than that of Acyclovir (15.4 μg /mL). Plaque formation was significantly reduced by the alkaloids extract at concentrations of 6.25 μg/mL to 12.5 μg/mL, the plaque reduction ratio reached 55% to 75% which was 35% higher than that of Acyclovir at the same concentration. RT-PCR analysis showed that, the transcription of two important delayed early genes UL30 and UL39, and a late gene US6 of HSV-1 genome all were suppressed by the alkaloids extract, the expression inhibiting efficacy compared to the control was 74.6% (UL30), 70.9% (UL39) and 62.6% (US6) respectively at the working concentration of 12.5μg/mL. The above results suggest a potent anti-HSV-1 activity of the alkaloids extract in vitro.

RNA interference(RNAi)is a process by which introduced small interfering RNA(siRNA)can cause the specific degradation of mRNA with identical sequences. The human herpes simplex virus type 1(HSV-1)RR is composed of two distinct homodimeric subunits encoded by UL39 and UL40, respectively. In this study, we applied siRNAs targeting the UL39 and UL40 genes of HSV-1. We showed that synthetic siRNA silenced effectively and specifically UL39 and UL40 mRNA expression and inhibited HSV-1 replication. Our work offers new possibilities for RNAi as a genetic tool for inhibition of HSV-1 replication.

Objective To investigate the protective effect of dexamethasone on stress response induced by intraute-rine balloon aortic valvuloplasty (IUBAV) in a fetal lamb model. Methods Twenty-four near term twin pregnant goats were randomly assigned to control group (n=12) and dexamethasone group (intracardiac injection of dexamethasone) (n=12). Ultrasound guided IUBAV model was established. According to the combination of treatment and operation, 48 fetal lambs were divided into four groups. The following parameters were dynamically monitored by ultrasound, which were fetal and neonatal heart rate (HR), cardiac rhythm, aortic resistance index (RI) and pulsatility index (PI). On established IUBAV model, blood samples and liver tissue specimens were taken from fetal/neonatal goats for detection of blood glucose (Glu), lactate acid (LA), plasma epinephrine (E), norepinephrine (NE), cortisol (Cort), hepatic glycogen staining. Results IUBAV resulted in increased values of Glu, LA, E, NE and Cort levels, and decreased pH value, there were significant differences between pre-and 3h-post procedure (P<0.05), and significant differences were also existed in these values between pre-and 3d-post procedure (P<0.05). After administrating dexamethasone, the changes of Glu, LA, E, NE, Cort and pH levels were suppressed effectively. Fetal hepatic glycogen was consumed in large amounts due to IUBAV while recovered 3 days after IUBAV by glycogen staining. After administrating dexamethasone, hepatic glycogen consumption related to IUBAV was obviously inhibited. After IUBAV, fetal aortic RI was increased, and there was significant differences compared with pre-procedure (P<0.05). Up to 3d-post procedure, the values of RI recovered to some extent, but statistical difference was exist-ed compared with pre-procedure (P<0.05). After administrating of dexamethasone, increased aortic RI was effectively sup-pressed. Conclusions IUBAV could lead to reversible stress response and increased aortic RI in a fetal lamb model which could be alleviated by dexamethasone.

Objective To examine the distribution of bacterial species and antimicrobial susceptibility profile of pathogens in febrile neutropenic patients.Methods A total of 355 bacterial strains were isolated from febrile neutropenic patients in Shanghai General Hospital from January 2005 to December 2012. Antimicrobial susceptibility testing was done by Kirby-Bauer method. The susceptibility testing results were analyzed according to CLSI 2014 breakpoints.Results Gram-negative bacteria accounted for 70.4% of the 355 isolates, while gram-positive organisms accounted for 29.6%. The most common bacterial species werePseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Stenotrophomonas maltophiliaand Staphylococcus haemolyticus. Non-fermentative bacteria accounted for 53.2% of all the gram-negative bacterial isolates. All theEnterococcus and
Staphylococcus isolates were susceptible to linezolid, vancomycin and teicoplanin. All theStaphylococcus strains were resistant to methicillin.P. aeruginosa isolates were relatively more susceptible to cefoperazone-sulbactam, piperacillin-tazobactam and cefepime (>70%) than imipenem (40.8%) and meropenem (59.2%). All theK. pneumoniae isolates were susceptible to imipenem and meropenem and more than 70% of the isolates were susceptible to cefoperazone-sulbactam, amikacin. More than 80% of theA. baumannii isolates were susceptible to carbapenems, cefoperazone-sulbactam, amikacin, ciprolfoxacin and aminoglycosides. All the E. coli isolates were susceptible to carbapenems and more than 70% were susceptible to cefoperazone-sulbactam and ceftazidime. More than 90% of theS. maltophilia strains were sensitive to levolfoxacin, minocycline, cefoperazone-sulbactam and trimethoprim-sulfamethoxazole.Conclusions Our data suggest that gram-negative bacteria, especiallyEnterobacteriaceae and non-fermentative bacteria, are still the primary pathogens in febrile neutropenic patients. Antimicrobial resistant strains are prevalent. Such data of bacterial species and antimicrobial susceptibility proifle of pathogens in febrile neutropenic patients are useful for empirical antimicrobial therapy of such infections.

Inherited metabolic disorders, also known as congenital metabolic diseases, refer to a group of diseases that cause a series of clinical symptoms due to gene mutations, such as enzyme deficiency, dysfunction of cell membrane or receptor deficiency, resulting in biochemical metabolic disorders, accumulation of intermediate or bypass metabolites, or lack of final metabolites. Inherited metabolic disordersoften occur in childhood, progressively aggravating, irreversible nervous system damage, and even death. Tandem mass spectrometry (MS/MS) has been widely used in newborn screening abroad and in China. This technology not only expands the screening spectrum of newborn screening, but also improves the screening efficiency, specificity and sensitivity, which opens up a new field for disease screening. With deepening the understanding of the mechanism of inherited metabolic disorders and mass spectrometry technology, its clinical application becomes more significant in diseases screening and diagnosing.

Objective:To evaluate the role of P2X 7 receptor in microglia in the medial prefrontal cortex (mPFC) in neuropathic pain (NP) and the relationship with autophagy in rats. Methods:Sixty-four healthy SPF male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-250 g, were divided into 4 groups ( n=16 each) using a random number table method: sham operation group (S group), NP group, sham operation+ P2X 7 receptor blocking group (SP group), and NP+ P2X 7 receptor blocking group (NP+ P group). The NP model was established by ligation of the sciatic nerve.Fourteen days later a cannula was placed in the mPFC with a brain stereotactic instrument, P2X 7 receptor blocker A-740003 0.5 μg/0.5 μl was injected into bilateral mPFC for 3 consecutive days starting from the 14th day in SP and NP+ P groups, and DMSO 0.5 μl was injected instead of A-740003 in S and NP groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 3, 7 and 10 days after establishing the model and 14, 15 and 16 days after administration.Then the rats were sacrificed, and the mPFC was removed for determination of the expression of P2X 7 receptor and mRNA and autophagy-related proteins Beclin1 and LC3Ⅱ/Ⅰ (by quantitative real-time polymerase chain reaction or by Western blot) and co-expression of P2X 7R and microglia (by immunofluorescence) and the number of autophagosomes in mPFC (with a transmission electron microscope). Results:Compared with group S, MWT was significantly decreased, and TWL was shortened at 3, 7 and 10 days after establishing the model, the expression of P2X 7 receptor and mRNA, Beclin1 and LC3Ⅱ/Ⅰ was up-regulated at 30 min after administration on 16 days after establishing the model, and the number of cells co-expressing P2X 7 receptor and IBA-1 and the number of autophagosomes were increased in NP and NP+ P groups ( P<0.05), and no significant change was found in the indexes mentioned above in group SP ( P>0.05). Compared with group NP, MWT was significantly increased, and TWL was prolonged at 30 min after administration on 14, 15 and 16 days after establishing the model, the expression of P2X 7 receptor and mRNA, Beclin1 and LC3Ⅱ/Ⅰ was down-regulated, and the number of cells co-expressing P2X 7 receptor and Iba-1 and the number of autophagosome were decreased in group NP+ P ( P<0.05). Conclusion:Up-regulation of P2X 7 receptor expression in microglia in mPFC is involved in the process of NP in rats, which is associated with the promotion of autophagy.