Objective:To evaluate shaping ability of stainless steel fi les. Methohs: A computer assistant measure system for the simula tion of root canal was set up and used for quantitative analysis of root shape o f eight simulated root canals during stainless steel files shaping process. Results:Although the stainless steel files were precurved, they stra ightened the simulated canals obviously. The cutting of the stainless steel file s on curved root canals was unbalanced. Conclusion:More flexible files and improvement of technique are essential for curved canals shaping.

Objective To assess prevalence and risk factors of illness within the past 2 weeks among rural residents in Menglian,under the background of essential public health service implemented generally. Methods In February 2012, the questionnaire method was employed to investigate the two-week morbidity in 2011 rural residents sampled by multistage stratified random sampling from Menglian population. Results The prevalence, that of illness within two-week among 2011 rural residents in Menglian, was 97.5‰ (95%CI 84.5‰-110.5‰) . It was lower than that of the rural region IV in China (149.6‰, <0.05) .Its age trend was the same as that of the rural region IV in China,the prevalence in 0-14 years old children,however,was higher than the counterpart in the rural region IV in China. The diseases, which two-week morbidity ranked the top five, were acute upper respiratory infection, acute gastroenteritis, hyperostosis, acute tracheobronchitis and rheumatoid arthritis. The results of multilevel logistic regression model fitted by group-level explanatory variable mountainous area, individual-level random slopes variable gender and other individual background variables indicated that there were across-level interactions between mountainous area and gender ( <0.05), the family income lower than RMB 15000 (odds ration 3.2378, 95%CI 1.9014-5.5130) and age (odds ration 1.0163, 95%CI 1.0002-1.0327) had a positive effect to two-week morbidity, and contrasting to unmarried, married had a negative effect to two-week morbidity (odds ratio 0.4727, 95%CI 0.2534-0.8819) . Conclusions Comparing with that of the rural region IV in China before implementing essential public health service, the two-week morbidity in Menglian was lower. For further elevating the health level of population, the strategies, such as intensifying material and child hygiene in the mountain area, improving sanitary conditions of low income family, and updating health consciousness in single population,would be implemented.

Objective To assess the protective effect of remifentanil on cultured human hepatocytes against anoxia-reoxygenation injury. Methods Cultured hepatocytes were divided into 5 groups: group C receiving normoxia as control; groups AR, R, CH, R+CH receiving 15-hour xypoxia followed by 5-hour reoxygenation (group R receiving 5 ng/ml remifentanil, group CH 10 ?mol/L chelerythrine, group R+CH 5 ng/ml remifentanil and 10 ?mol/L chelerythrine before reoxygenation). The content of MDA in the hepatocyte mitochondria were measured. The rate of apoptotic cells was measured by flow cytometry. The expression of protein kinase C mRNA was measured by RT-PCR. Results Anoxia-reoxygenation caused dramatic increase in the content of MDA, the rate of apoptotic cells and the expression of protein kinase C mRNA. The three indexes mentioned above of groups R and CH were between that of groups C and AR (P

Objective To assess the implementation of essential public health services (EPHS), and determine the main influencing factors for EPHS in Menglian. Methods In September 2012, the questionnaire survey method was employed to collect the data of EPHS implementation in 2011 in three community medical institutes and the EPHS evaluation of health staff sampled by stratified random sampling in Menglian. Results In 2011, the report rates of infectious diseases epidemics, public health emergencies and health inspection were all 100%, the inoculation rates of most vaccines were over 90%,and the health management rates of the children aged 0 to 6 years,pregnant and lying-in woman,aged population,hypertensives, type 2 diabetes patients and serious psychotics were high (about 85%) . The establishment rate of heath archives (60%to 70%),the controlling rates of blood pressure in the hypertensive population (about 50%), the rates of glycemic control in type 2 diabetes patients (55%to 70%) and the steady rates of serious psychotics (50% to 60%), however, were low. The implementation of EPHS was unbalance among towns, suburbs and outer suburbs. The main factors that influenced the EPHS implementation were inadequate human resources, insufficient or unused health devices, ambiguous responsibilities among the health institutes, non-cooperative behaviors, and unhealthy living habits in rural residents. Conclusions The implementation of many EPHS items is good. For promoting EPHS,it is necessary to train human resources,activiate unused health devices,get support of residents and carry out health education.

Objective: To investigate the role of NF-?B in signal transduction of hepatocyte apoptosis in liver injury. Methods: A total of 42 Chang-Bai piglets were divided into 7 groups: control group, 1, 2, 4, 8, 12, and 24 hours wound group. The model of intestinal perforations due to abdominal firearm wound was established in wound groups. Hepatic NF-?B activity was measured with immunohistochemical staining and image analysis in all groups. Hepatocyte apoptosis indexes and serum ALT levels were also determined. Results: Levels of hepatic NF-?B activity in wounded groups were significantly elevated compared with control group, and there were two peaks (1 and 8 hours group P

In order to increase the production of insecticidal crystal proteins Cry1 and Cry2, firstly, Plack-ett-Burman design was applied to evaluate the effectiveness of the related nutrition factors; it was found that the soybean powder and MnSO4?H2O were significant factors for Cry1 production, but the yield of Cry2 wasn’t effected remarkably in such medium. Then the steepest ascent experiment was adopted to approach the optimal region of the medium composition. Lastly, the optimal concentration of the soybean powder and MnSO4?H2O was 11.5 and 0.02 g/L, obtained by response surface methodology (RSM). The final yields of Cry1 and Cry2 was 0.32 mg/mL and 0.11 mg/mL, increasing twice more than that in the medium optimized before. The median lethal concentration (LC50) of optimal medium was 1.09 ?L/mL. The toxicity to Heli-coverpa armigera was significantly enhanced than the old one.

OBJECTIVETo investigate the value of MRI follow-up in pediatric patients with spinal tuberculosis.

METHODSFrom February 2004 to April 2013, MRI imaging data in 21 children with spinal tuberculosis by pathologically and clinically proven were retrospectively analysed. There were 11 males and 10 males, with an average age of 9.4 years old ranging from 2 to 14 years old. Eighteen patients were received conservative treatment, 3 patients were treated by surgical operation. The course of disease ranged from 2 months to 3 years. All cases underwent two or more MRI examinations for follow-up. MRI findings of the first and second examination were comparatively analyzed,including signal changes of vertebral body and intervertebral, paraspinal abscess and the change of kyphosis angle.

RESULTSIn the 21 cases with tuberculosis, 85 vertebral bodies were affected in total, including 10.6%(9/85), 49.4%(42/85) and 40%(34/85) vertebral bodies separately in the cervical,thoracic, lumbosacral spine. Follow-up MRI showed vertebral body shape and signal had no obvious change during or after treatment, 15 cases with vertebral bodies changed flat or cuneate, 10 cases with disc involvement,and intervertebral space became narrowing at different level. Among 13 patients with kyphosis angle greater than 0°, 7 were located on thoracic, 2, 3, 1 were on thoracolumbar, lumbar and cervical spine, respectively. Among 18 cases with conservative treatment,kyphosis angle were 0° on the first and the follow up MRI of 8 patients. One case of mild (<10°) kyphosis,follow-up MRI during therapy showed the angle slightly increased; 5 cases with moderate (10° to 30°), follow-up MRI during therapy showed no obvious change; 4 cases with severe (>30°), follow-up MRI during and after therapy showed kyphosis increased in varying degrees.

CONCLUSIONFollow-up MRI can make a big difference in the spinal tuberculosis of children; it can clearly show the change of the vertebral body and intervertebral space, paraspinal abscess and the kyphosis angle after the treatment,which can provide reference for clinical treatment and estimating prognosis.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Drug Monitoring ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Retrospective Studies ; Spine ; diagnostic imaging ; Tuberculosis, Spinal ; diagnostic imaging ; drug therapy ; surgery

Objective To discuss the risk factors for coagulopathy in acute isolated traumatic brain injury (TBI).Methods A retrospective study was performed on 191 patients with acute isolated TBI hospitalized from July 2012 to June 2015.There were 70 patients with coagulopathy (coagulopathy group) and 121 patients without coagulopathy (control group).Age,gender,injury type,midline shift on CT and injury severity (Glasgow Coma Scale,GCS) were analyzed to identify the independent risk factors for coagulopathy using the logistic regression analysis.Correlation between the independent risk factors and coagulation indices was analyzed.Results Injury severity,acute subdural hematoma,intraventricular bleeding and midline shift on CT were identified as the independent risk factors for coagulopathy(P ＜ 0.05,OR ＞ 1).Furthermore,injury severity and acute subdural hematoma were respectively associated with abnormalities of international normalized ratio (INR) and fibrinogen (Fg) (P ＜0.05 or P ＜ 0.01),intraventricular bleeding with abnormalities of prothrombin time (PT) and platelet count (PC) (P ＜ 0.01),and midline shift on CT with abnormalities of Fg and PC (P ＜ 0.05).Conclusions Injury severity,acute subdural hematoma,intraventricular bleeding and midline shift on CT are independent risk factors for coagulopathy in patients with acute isolated TBI,and correlate with abnormalities of several coagulation indices.Changes in coagulation indices should be monitored accurately after TBI,and timely treatment of coagulopathy can improve the prognosis.

Objective The prognosis of traumatic brain injury is closely associated with the apoptosis of neural cells .This study investigated the anti-apoptosis effect of alpha lipoic acid (α-LA) and its possible mechanism in the mouse model of traumatic brain injury. Methods Seventy-two healthy male ICR mice were randomly divided into four groups of 18 each:sham operation +vehicle, sham operation +α-LA, trauma +vehicle, and trauma +α-LA.The model of traumatic brain injury was made by weight-dropping.The animals in the α-LA groups were treated with intragastric α-LA at 30 minutes after surgery, while those in the vehicle groups with oral dimethyl sulfoxide in corn oil .At 48 hours after treatment , brain samples were collected from the mice for determining brain edema , measuring the expressions of cytochrome c , Bcl-2-associated X protein ( Bax ) , and caspase-3 in the mitochondria and cytosol of the brain tissue by Western blot and immunohistochemistry respectively , and detecting the survival of the neurons and apoptosis of neural cells in the cortical area by Nissl staining and TUNEL , re-spectively. Results The brain water volume , caspase-3 expres-sion, and neural cell apoptosis were markedly higher while the neuron survival remarkably lower in the trauma +vehicle group than in the sham operation +vehicle and sham operation +α-LA groups ( P<0.01).Compared with the mice in the trauma +vehicle group, those in the trauma +α-LA group showed significantly reduced proportion of water in the brain tissue ([79.89 ±0.55] vs [81.71 ± 0.66]%, P<0.05), expression of caspase-3 ([58.40 ±7.31] vs [47.42 ±7.74]%, P<0.05), and apoptosis of neural cells ([59.63 ±8.61] vs [44.86 ±7.32]%, P <0.05), but increased survival rate of neurons ([44.45 ±10.56] vs [57.46 ± 11.01]%, P<0.05).The expression of cytochrome c in the mitochondria was remarkably decreased and that of Bax markedly in -creased in the trauma +vehicle than in the sham operation +vehicle and sham operation +α-LA groups (P<0.01). Conclusion Alpha lipoic acid has a protective effect against traumatic brain injury in mice , probably by inhibiting the apoptosis of neural cells through the mitochondrial pathway .

Objective To evaluate clinical features,insulin sensitivity and β-cell function of pregnant women with different glucose tolerance status,so as to identify the possible risk factors for adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM).Methods We retrospectively analyzed the clinical data of 360 pregnant women with positive results of 50 g glucose challenge test who received antenatal care and admitted for delivery in the period from January 2009 to June 2012 in Peking Union Medical College Hospital.According to the result of 100 g oral glucose tolerance test (OGTT),the 360 women were divided into GDM group (n =83),impaired glucose tolerance (IGT) group (n =75),and normal glucose tolerance (NGT) group (n =202).The blood glucose level in all those women was controlled in normal range for gestational period.We compared the general clinical data,biochemical indexes,insulin resistance index,insulin sensitivity index,function index of islet β-cell,first-and second-phase insulin secretion,insulin secretion-sensitivity index as well as the pregnancy outcomes of the 3 groups,analyzing the possible risk factors for adverse pregnancy outcomes in women with GDM.Results Compared with the NGT group,the pregnant women in GDM group were older [(33.1 ± 3.7) years vs.(31.7 ± 3.4) years,P =0.008],had higher systolic blood pressure [(115.8 ± 9.7) mmHg vs.(111.4 ± 13.5) mmHg (1 mmHg =0.133 kPa),P =0.031] and diastolic blood pressure in first trimester [(75.4 ±9.0) mmHg vs.(71.8 ±8.8) mmHg,P =0.010],higher positive rate of family history of diabetes in first-degree relatives (37.3％ vs.22.3％,P =0.012),positive rate of insulin therapy (10.8％ vs.0％,P =0.001),serum triglyceride level [(2.8 ±0.9) mmol/L vs.(2.3 ±0.9) mmol/L,P =0.001],free fatty acid level [(486.7 ± 137.6) μmol/L vs.(438.1 ± 140.7) μmol/L,P =0.033],and C-reactive protein level [(5.7 ± 4.3) mg/L vs.(3.6 ± 3.0) mg/L,P =0.001].The GDM group had a larger pre-pregnancy body mass index [(22.6 ± 2.9) kg/m2] than that in IGT group [(21.3 ± 2.7) kg/m2] (P =0.049) and NGT group [(21.2 ±2.8) kg/m2] (P =0.003).In the order from NGT to IGT to GDM group,the hemoglobin A1c [(5.2 ± 0.3) ％ vs.(5.3 ± 0.3) ％ vs.(5.4 ± 0.3) ％,P =0.001,P =0.007],the areas under curve of glucose [(20.4±2.0) mmol · h/L vs.(22.9 ± 1.5) mmol · h/L vs.(26.9 ±2.1) mmol · h/L,both P=0.001] and the areas under curve of insulin [(1.7 ±0.9) × 103 pmol · h/L vs.(2.1 ± 1.1) × 103 pmol · h/L vs.(2.7±1.3) ×103 pmol · h/L,P=0.001,P=0.007] increased gradually,while insulin sensitivity index (88.1 ± 52.1 vs.80.0 ± 30.6 vs.50.0 ± 24.1,P =0.001,P =0.014) and insulin secretion-sensitivity index (134 507.0 ± 43 291.0 vs.102 542.0 ± 15 291.0 vs.77 582.0 ± 20 764.0,both P =0.001) decreased gradually.The insulin resistance index in the GDM group (3.3 ± 2.2) was significantly higher than that in IGT (2.2 ± 1.0) and NGT groups (3.0 ± 1.1) (both P =0.001).The function of β-cell,first-and second-phase insulin secretion were not significantly different among the 3 groups.Compared with the NGT group,pregnant women with GDM had shorter gestational age [(38.8 ± 1.1) weeks vs.(39.4 ± 1.1) weeks,P=0.004] and higher incidence of adverse pregnancy outcomes (44.6％ vs.21.8％,P =0.001).Seven risk factors predicting adverse pregnancy outcomes in women with GDM were identified,including pre-pregnancy body mass index (P=0.017),0-,1-,and 2-hour blood glucose in 100 g OGTT (P=0.036,P=0.009,P=0.004),3-hour insulin (P =0.014),and hemoglobin A1 c (P =0.002) and C-reactive protein (P =0.005) in second trimester,among which 1-hour blood glucose displayed the highest coefficient (OR =2.767).Conclusions Pregnant women with GDM have elevated blood pressure,dyslipidemia and increased inflammatory cytokine C-reactive protein.Women with GDM and IGT both show insulin resistance and β-cell dysfunction,and these impairments are more severe in women with GDM.Higher pre-pregnancy body mass index and blood glucose levels during pregnancy are associated with adverse pregnancy outcomes in women with GDM.