BACKGROUND:Scholars have carried out a lot of research on the main cariogenic microorganisms, but there is stil no comprehensive and systematic evaluation. OBJECTIVE:To perform an evidence-based medicine analysis on the six main cariogenic microorganisms. METHODS:Literature about microbial factors and age factors of caries disease etiology were retrieved, which were published from 2011 to 2014 in the Cochrane Library, EMBASE, PubMed, Wanfang, China Biology Medicine disc (CBMdisc), Chinese Journal Ful-text Database (CJFD) and VIP. Eligible studies were divided into two groups according to absorbance values: observation group (higher absorbance value) and control group (lower absorbance value). The probability of dental caries under the impact ofStreptococcus mutans, Lactobacilus microbe,Prevotela,Selenomonas,Capnocytophaga,Veilonelawere statisticaly analyzed using Meta-analysis. RESULTS AND CONCLUSION:Eight articles were included in result analysis. Odds ratio (OR) values refer to the statistical difference in the probability of dental caries under same pathogenic factors between two groups:OR > 1 indicates the incidence of dental caries is higher in the observation group than the control group, andOR < 1 suggests the incidence of dental caries is lower in the observation group than the control group. Meta-analysis results showStreptococcus mutans (OR=2.41),Lactobacilus microbe (OR=1.68),Prevotela (OR=2.75),Capnocytophaga (OR=1.98),Selenomonas(OR=2.38), indicating that the probability of dental caries is higher in the observation group than the control group, and these microorganisms are greatly correlated with the occurrence and development of dental caries;Veilonela (OR=0.45), indicating the probability of dental caries is lower in the observation group than the control group, andVeilonela has smal correlation with dental caries and only plays an important role in a certain development stage of dental caries.

Objective To evaluate salvage liver transplantation(LT)for postoperative tumor recurrence or liver dysfunction in patients of hepatocellular carcinoma(HCC).Methods From April 2001 to March 2006,97 HCC patients with the tumor within Milan Criteria underwent LT as the primary treatment(71 cases)and salvage LT because of after resection tumor recurrence(n=20)or postoperative liver dysfunction(n=6).Perioperative and postoperative parameters and long-term survival were compared between the groups of primary LT and salvage LT.Results The mean age(50.0 years vs.49.7 years),gender,and etiology of liver disease(hepatitis B/C/nonviral)were comparable between the two groups.In the salvage LT group.the mean time between liver resection and LT was 2.50 years.Clinical characteristics such as tumor number(1.37 vs.1.50),operative time(7.92 hours vs.8.56 hours),blood loss (1981.69 ml vs.2626.92 ml)and transfusion(1981.69 ml vs.2626.92 ml)were not statistically different (P＞0.05)between the two groups.The size of largest tumor was significantly different between salvage LT group and the primary LT group(2.81 cm vs.2.05 cm)(t=2.298,P=0.028).By a median follow up of 14.63 months,overall survival after liver transplantation was not different between the 2 groups(X2=0.003.P=0.959).Conclusion In selected patients,liver resection prior to transplantation does not increase the morbidity or impair long.term survival following LT.Therefore.1iver resection prior to transplantation can be integrated with the treatment strategy for HCC.

Objective:To study the mental health of old people who live in endowment institutions in Shandong Province and its influencing factors. Methods: A sample of 2200 old people over 60 years old was selected with the stratified random sampling method. They were investigated using the self-designed questionnaires, symptom checklist (SCL-90), and Social Support Rating Scale. A total of 2013 questionnaires were recovered effectively (91. 5%), and 271 questionnaires were analyzed in this study. Results:41. 7% of old people in endowment insti-tutions in Shandong Province is positive in SCL -90 . Multivariate analysis showed that self -care ability ( P =0 . 045 ) and type of chronic disease ( P=0 . 025 ) associated with mental health problems of old people in Shandong Province. Conclusion:The mental health status of old people in endowment institutions in Shandong Province was not optimistic and its influencing factors included self-care ability and the type of chronic disease. It should take measures to promote successful aging in Shandong Province.

Objective To study the distribution of Candida infection and drug tolerance in intensive care unit(ICU). Methods A retrospective study was conducted. The critical patients admitted from January 2011 to December 2013 in ICU of the First Hospital of Jiaxing in Zhejiang Province were enrolled,and their clinical data with positive Candida culture and drug susceptibility results in specimens of sputum,urine,blood,ascites,bile, etc were collected. In the study of these 3 years in ICU,the situation of Candida infection,the distribution of positive specimen,the condition of distribution of different strains of Candida,and the Candida tolerance to antifungal drugs were analyzed. Results From 2011 to 2013,2 412 times of patients(including one patient had admitted into ICU for more than one time)were admitted into ICU in which 407 cases were of Candida infection(16.9%),and the rate of Candida infection was rising gradually in the 3 years〔2011 to 2013 Candida positive rates were 13.4%(77/573), 16.1%(146/907),19.7%(184/932)〕,the difference being statistically significant(P<0.01). In the 407 strains of Candida,166 strains(40.8%)were isolated from sputum,157(38.6%)from urine,53 strains(13.0%)ascites, 13 strains(3.1%)blood,11 strains(2.7%)bile,7 strains(1.7%)from other specimens. The strain distribution of Candida was mainly as follows:Candida albicans(174 strains),Candida glabrata(131 strains),Candida tropicalis (83 strains),Candida parapailosis(5 strains),Candida krusei(12 strains),and 2 strains of rare Candida portugal and Lipolztica. From 2011 to 2013,the highest tolerance of Candida albicans,Candida glabrata,Candida tropicalis to fluconazole,itraconazole,Fushita Yasu and other antifungal drugs was in 2013,and the lowest was in 2012,the rates of tolerance of the above 3 strains of Candida to amphotericin B being 0,to itraconazole being the highest(10.9%, 27.8%,9.6%,respectively),to Fushita Yasu the secondary(6.6%,11.0%,0,respectively)and to fluconazole the last(4.7%,7.4%,1.9%,respectively),and the rates of tolerance of Candida parapsilosis,Candida krusei,Candida Portugal,Candida lipolztica to amphotericin B,fluconazole,itraconazole,Fushita Yasu were all 0. Conclusion In ICU,the Candida infection is mainly in the respiratory tract and urinary tract,its rate of infection has a tendency of rising,and the rate of Candida tolerance to itraconazole is the highest.

Objective To investigate the incidence and risk factors of surgical site infection ( SSI ) in patients with colorectal cancer .Methods Clinical data of patients with colorectal cancer undergoing surgical treatment in Jiaxing First Municipal People’ s Hospital from October 2011 to December 2014 were retrospectively reviewed.The gender, age, underlying diseases, smoking history, preventive medication, abdominal surgery history , type of surgery , preoperative levels of hemoglobin and albumin , use of laparoscopy, use of stapler, combined organ resection, TNM staging, American Society of Anesthesiologists ( ASA) score was documented .Multivariate logistic regression analysis was performed to identify the risk factors of SSI .Results A total of 773 patients were enrolled in the study , and SSI was observed in 144 cases (18.63%).Multivariate logistic regression analysis showed that use of laparoscopy ( OR =0.35, 95%CI:0.15-0.79,P <0.05), use of stapler (OR =0.59, 95% CI: 0.39-0.88,P <0.05) were protective factors for SSI, while diabetes (OR=2.11, 95% CI: 1.25-3.58,P<0.01), liver cirrhosis (OR=2.12,95%CI:1.18-3.79,P<0.05), ASA score (3-4 points) (OR=2.01,95%CI:1.20-3.58, P<0.01), combined organ resection (OR=2.17,95% CI:1.20-3.92,P<0.05), and anastomotic leak (OR=6.85, 95%CI:3.01-15.63,P<0.01) were risk factors for SSI.Conclusions The incidence of SSI is high in patients with colorectal cancer undergoing surgery .Use of laparoscopy and stapler may reduce the incidence of SSI .

Objective To investigate the clinical features, therapeutic strategy and prognosis of pediatric benign cerebellar astrocytomas (BCAs). Methods 101 children with BCAs diagnosed histopathologically were analyzed retrospectively and followed up. Results There were 50 boys and 51 girls with a median age of 9.8 years old. The sizes of tumors were 3～7.5 cm. 46 cases were with solid-tumor, 24 with the tumor in the cyst, 31 with the cysty in the tumor. 39 cases were located in cerebellum vermis, 58 cases were in the cerebellar hemisphere and 9 cases were adhesive with brain stem located in the forth ventricle. 92 cases were total removed and 9 cases were subtotal removed. 87 patients were followed up for 1～5 years, and all of them has survived, without radiotherapy or chemotherapy. Conclusion Pediatric benign cerebellar astrocytomas mostly grows in cerebellar hemisphere， also in vermis frequently. Neuroimaging and pathology may conduce to the diagnosis. Microsurgical resection may result in optimal outcome.

Inner ear diseases are common in the field of otolaryngology,including hearing loss,tinnitus and peripheral vestibular dysfunction.Their pathogenesis is relatively complex,which is one of the hot spots in current research.A large number of studies have demonstrated that sleep disorder is an important inducement of inner ear diseases.This paper reviews the impact of sleep deprivation on inner ear diseases in order to pro-vide a theoretical basis for the mechanisms of sleep deprivation on inner ear diseases.

Objective To investigate the role of TLR4/NF-κB signaling pathway in mediating sleep depriva-tion induced endolymphatic hydrops.Methods A total of 30 healthy sprague-dawley(SD)rats were randomly di-vided into the control group、big platform control group,and 2 w,3 w,4 w sleep deprivation group,with 6 rats in each group.Modified multiple platform method was adopted to establish the rat sleep deprivation model.Before and after the experiment,the open field and acoustic brain-stem response(ABR)was conducted to evaluate the behavior and hearing level.After ABR test,blood samples were collected from abdominal aorta,and serum levels of TNF-αand MCP-1 were detected by ELISA.The cochlea was dissected,the severity of endolymphatic hydrops was as-sessed by calculating the ratio of the cross sectional area of the membranous cochlear duct(SM)to that of the mem-branous cochlear duct+scale vestibuli(SM+SV).Positive expression of IL-1β,TNF-α,MCP-1,TLR4,NF-κB P65 in rat cochlear tissues was detected via immunohistochemical staining.After the experiment,the changes of hearing level,the severity of endolymphatic hydrops and TLR4/NF-κB signaling pathway related proteins and down-stream inflammatory factors expression level were observed.The correlation between TLR4/NF-κB signaling path-way and hearing level and endolymphatic hydropsin rats was analyzed.Results ABR results showed an increased threshold of wave Ⅱ in the sleep deprivation group compared to those of the control group and big platform control group(P＜0.05).The rate of hydrops was 0％in control and big platform control groups,16.67％in 2w sleep deprivation group and 25％in 3 w and 4 w sleep deprivation group.The concentrations of TNF-αand MCP-1 in ser-um of rats in sleep deprivation groups were higher than those in control and big platform control groups,and the 4w sleep deprivation group were statistically significant compared with control and big platform control groups.The ex-pressions of IL-1β,TNF-α,MCP-1,TLR4 and NF-κB P65 in the cochlear spiral ganglion,spiral canal,stria vascu-laris and spiral ligament of rats in sleep deprivation groups were higher than those in control and big platform control groups.Conclusion Sleep deprivation may induce endolymphatic hydrops by the TLR4/NF-κB signaling pathway.

Objective To study the effects and mechanisms of molecular targeted drug combination on multi-driven proliferation hepatocellular carcinoma SK-Hep-1 cells. Methods Four molecular targeted drugs (HG6-64-1, Dasatinib, Crizotinib, and Sunitinib) were used to treat SK-Hep-1 cells, and the monophasic kinetic analysis curve and two-phase analysis curve were drawn. Western blot analysis was used to detect the effects of the above drugs on key signaling pathways in SK-Hep-1 cells. MTT assay was used to detect the effects of the above drugs and their combination on the proliferation of SK-Hep-1 cells. Results Compared with the monophasic kinetic analysis curve, the biphase analysis curve could better fit the effects of molecular targeted drugs on SK-Hep-1 cells, which predicted that the combination of HG6-64-1, Dasatinib, and MK-2206 could effectively inhibit the proliferation of SK-Hep-1 cells. Conclusion Two-phase kinetic analysis can quantitatively describe the response of multi-driven proliferation hepatocellular carcinoma SK-Hep-1 cells to molecular targeted therapy. The combination of HG6-64-1, Dasatinib, and MK-2206 is a potential drug combination for the treatment of hepatocellular carcinoma.

Objective To explore the application value of dazzle speed dual-source dual-energy CT imaging in head and neck arteries. Methods Total 96 patients were enrolled into two groups randomly in this study. Fourty-eight pa tients were scanned the dual-energy scanning mode (140 kV/Sn80 kV,210/105 mAs) in group A. The other 48 patients were scanned in a tranditional Neuro-DSA mode (120 kV/245 mAs) in group B. The CT volume dose index (CTDI vol) and the subjective image quality score were compared between two groups. Results The difference of the subjective im age quality score was significant between the two groups(P<0.05), the effective dose of group A was decreased by 25%compared with the dose of group B [(7.54±0.05) mGy vs (10.67±0.08) mGy). Conclusion Radiation dose is lower, image quality is better in the dazzle speed dual-source double energy imaging of the head and neck vascular when compared to the conventional Neuro-DSA imaging. But excessive?subtraction angiography exists in the bone of the skull base, the technology needs to be improved.