Implantation window is the transient period when the embryos develop into blastocysts and the uterus differentiates into the receptive state synchronically. Estrogen and progesterone are the comprehensive regulating molecules during this process. They influence the proliferation and differentiation of multiple cell types in the uterus through the modulation of various local-signaling molecules.Uterus and blastocyst interact by the paracrine effects of prostaglandin, histamine, calcitonin, cytokines and growth factors at implantation window. This molecular cross-talk modulates the interaction between trophectoderm and uterine luminal epithelium. Once the implantation window is open, it then switches into unreceptive state spontaneously.

Objective To observe the Clinical study on the acupuncture ot zhibi 3 in the treatment of non-allergic rhinitis.Methods 20 individuals over 15 years old with non-allgergic rhinitis were prospectively recruited from rhinology clinic and ward of Beijing TongRen Hospital from December 2008 to August 2009.Acupuncture points of treat nasal 3 and the compatibility of Fengchi,Hegu were performed by once a week for 7 weeks.The changes of the total nasal symptom score (TNSS) and the Mini-Rhinoconjunctivitis Quality-of-Life Questionnaire (Mini-RQLQ) were observed at baseline and recertification every week.Results After 7 weeks treatment,we found the fourth week of score in fatigue (0.5±0.2; 2.6±1.2,respectively),embarrassed (1.0±0.3; 3.7-0.3,respectively),sleep (0.8±0.1; 4.1±0.9,respectively)、the quality of life (1.0±0.4; 3.8±0.7,respectively),congestion (0.6±0.4; 2.6± 1.0,respectively),rhinorrhea (1.2±0.5; 4.4±0.7,respectively),sneezing (1.6±0.5; 5.0±0.6,respectively),nasal itching (1.7±0.6; 4.4±0.9,respectively) were significantly improved over 75％ (15/20) compared with the baseline (P＜0.05).However,at the sixth week,congestion,rhinorrhea,sneezing were recurring,especially rhinorrhea,but the benefit effects of acupuncture were more than 55％ comparing with baseline.Contusion Acupuncture of zhibi 3,and Fengchi,Hegu may have the effective effects on non-allergic rhinitis.

BACKGROUND: At present, there is no consensus on the timing of post space preparation in the clinical medical treatment. But it can be inferred from some studies that post space preparation may affect coronal microleakage using different fil ing materials. OBJECTIVE: To compare the effects of immediate post space preparation and delayed post space preparation restoration on coronal microleakage using different fil ing materials. METHODS: Forty-eight extracted and single-rooted premolars were randomly divided into six groups (n=8 per group): premolars were fil ed with AH-plus paste and gutta-percha with the immediate post space preparation as group A1; premolars fil ed with mineral trioxide aggregate paste and gutta-percha with the immediate post space preparation as group A2; premolars fil ed with AH-plus paste and gutta-percha with the delayed post space preparation 1 week later as group B1; premolars fil ed with mineral trioxide aggregate paste and gutta-percha with the delayed post space preparation after 1 week later as group B2;premolars fil ed with AH-plus paste and gutta-percha as negative control group; premolars fil ed with gutta-percha as positive control group. Afterwards, al specimens were soaked for 4 weeks under simulated oral environment to measure the length of coronal microleakage by pressurized dye penetration method. RESULTS AND CONCLUSION: No coronal microleakage was found in the negative control group, but serious coronal microleakage occurred in the positive control group involving the entire root canal. And there was no significant difference in the length of coronal microleakage between group A2 and B2, as wel as between group A1 and A2 (P > 0.05); but the length of coronal microleakage in the group A1 and B2 was significantly less than that in the group B1 (P < 0.05). These results show that the delayed post space preparation has overt effect on the coronal microleakage of root canal fil ed with AH-plus paste.

Objective To explore the effects of combination of traditional Chinese medicine (TCM)and western medicine on a variety of allergen induced severe perennial seasonal allergic rhinitis patients who were treated invalidly with antihistamines and intranasal flixonase for more than two years.Methods 16 patients with moderate to severe allergic rhinitis who were uncontrolled with antihistamines and intranasal flixonase for one week were treated by combination with TCM of Xin-Yi-Qing-fei San or Gyokubeifu-san mixed formula for two weeks.Nasal symptoms,its effects on the quality of daily life,and telephone follow-up half a year later were evaluated.Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life.Results After 2 weeks combination-treatment,the nasal symptoms of congestion,rhinorrhea,sneezing,nasal itching,and nasal obstruction were significantly improved compared with combination-before [(52.0± 11.1)％,(69.1±5.3)％,(68.3±12.3)％,(55.5±10.0)％to (10.9±2.4)％,(8.9±3.2)％,(12.5±4.3)％,(13.2±5.3)％,respectively].The before and after treatment of nasal function of nasal minimum cross-sectional area (MCA),nasal cavity volume (V5) and nasal airway resistance (R75 and R150) respectively were (0.58±0.12)cm2,(0.38 ± 0.23) Pa/cm3 · s-1,(0.44 ± 0.32) Pa/cm3 · s-1,(3.50 ± 2.33) cm2 to (0.48 ± 0.23) cm2,(0.31 ±0.33) Pa/cm3 · s-1,(0.31 ±0.37)Pa/cm3 · s-1,(2.24± 1.03) cm2 (P＜0.01).In addition,findings of patients with nasal symptoms by half year follow-up were significantly better than those of before.Conclusion The interventionof TCM can effectively control the perennial and seasonal severe symptoms of patients with AR,and improve the quality of life of patients.

BACKGROUND: Apical sealing ability is the key to ensure the long-term curative effect of root canal therapy. The post space preparation exposes some inevitable influence on root canal sealing ability, so how to minimize this effect becomes a hot spot.OBJECTIVE: To explore the effects of immediate or delayed post space preparation on the apical sealing ability of different root canal sealers.METHODS: Forty-eight extracted human premolar teeth were obtained, and the tooth crown was cut off. The samples were randomly divided into three groups (n=16 teeth per group). Group A underwent the immediate post space preparation; group B underwent the delayed post space preparation; group C without the post space preparation. Then all groups were subdivided into two groups, and then were filled with the gutta-percha/AH-Plus (groups A1, B1 and C 1)or the gutta-percha/mineral trioxide aggregate (groups A2, B2 and C2). The depth of apical dye penetration was measured using pressure-driven system. RESULTS AND CONCLUSION: There were no significant differences in the apical microleakage between groups A1 and B1, A2 and B2, C1 and C2 (P > 0.05). The apical microleakage in the group A1 was significantly higher than that in the group A2, and the group B1 also showed higher apical microleakage than the group B2 (P < 0.05). Our findings suggest that either immediate or delayed post space preparation exposes little influence on the apical microleakage after root canal filling with gutta-percha/mineral trioxide aggregate, which exhibits better apical sealing ability than the AH-plus.

Comorbidities will inevitably lead to an increase in the number of medications used and adverse drug reaction events in elderly patients.Therefore, it is urgent to implement precision medicine in the elderly population.pharmacogenomic testing can increase the opportunity of individualized drug selection for elderly patients, reduce the risk of adverse drug reactions, reduce the cost-effectiveness ratio of medication, improve elderly patients' medication compliance, and thus reduce their readmission rate.Therefore, it is necessary to promote pharmacogenetic testing for elderly patients with comorbidities and polypharmacy, so as to provide measures for the implementation of personalized medicine in the elderly.

Objective To analyze the relationship between blood glucose,blood lipid and body mass index (BMI) in elderly patients with hypertension.Methods Form January 2016 to December 2017,376 hypertensive patients over 65 year old in Jinan city were enrolled in this study.The sex,age,BMI,fasting blood glucose and blood lipid were investigated and tested.The prevalence of coronary heart disease and diabetes mellitus in hypertensive patients were investigated,and the relationship between BMI and blood glucose,blood lipid and liver function index were explored.Results Of 376 hypertensive patients,the detection rate of diabetes mellitus was 21.01％ (79/376),221 cases were diagnosed with coronary heart disease,with the detection rate of 58.78％.With the rise of BMI,fasting blood glucose showed an upward trend.Person correlation analysis showed that there was a significant positive correlation between BMI and fasting blood glucose(r =0.167,P =0.003).The difference between TG and TC in different BMI groups was statistically significant(FTG =12.48,P ＜ 0.001;Frc =4.83,P ＜ 0.001).The content of alanine transaminase in the overweight group and obese group was significantly higher than that in the normal body weight group,the difference was statistically significant(F =5.24,P =0.005).Conclusion For elderly hypertensive patients,it is urgent to test blood glucose and coronary heart disease screening.For people over the age of 65,obesity is still an important risk factor for hyperlipidemia and hyperglycemia.Therefore,body weight control is needed in elderly patients with hypertensive.

Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

Objective To understand the implementation effects of control measures and the dynamic prevalence of drinking water-borne endemic fluorosis in Shandong Province.Methods From 2013 to 2017 in Shandong Province drinking water-borne endemic fluorosis areas,in accordance with the method of simple random sampling,10 monitored counties were selected,10 water fluorine decreasing projects were investigated of its running effect,and water fluoride was detected.In each monitored county,3 villages in the diseased areas were selected as fixed monitored villages.If the monitored village had changed its water,the operation of the project would be investigated.If the monitored village had not changed the water,one water sample would be collected according to 5 directions of east,west,south,north and middle to determine the water fluorine.All children aged from 8 to 12 in the village were also examined for dental fluorosis.X-ray fluorosis and urinary fluorosis in adults aged over 25 were detected in 2013 and 2017.Results From 2013 to 2017,in monitored counties,the normal operation rate of improved-water defluoridation projects was 99.19％ (368/371),the qualified rate of water fluoride content was 66.85％ (248/371).In 128 improved water projects,the normal operation rate was 100.00％ (128/128),the qualified rate of water fluoride content was 67.19％ (86/128).The average detection rate of dental fluorosis and community fluorosis index (CFI) in children aged 8-12 were 33.92％ (2 608/7 689) and 0.68 in all monitored counties from 2013 to 2017.The detection rate presented a declining trend year by year (x2 =152.47 P ＜ 0.01).The average detection rate and CFI in the villages with normal operation projects and qualified fluoride content were 26.10％ (1 311/5 023) and 0.47.The detection rate presented a declining trend year by year (x2 =207.67 P ＜ 0.01).The detection rate and CFI in the villages with water improvement projects under abnormal operation or excessive fluoride were 48.65％ (1 297/2 666) and 0.90.The detection rate of dental fluorosis in the villages with normal operation projects and qualified fluoride content was lower than the rate of the villages with water improvement projects under abnormal operation or excessive fluoride (x2 =193.98,P ＜ 0.01).In 2013 and 2017,X-ray detection rates of skeletal fluorosis in adults aged over 25 were 8.04％ (119/1 481) and 6.04％ (81/1 342),respectively.The adult urinary fluoride geometric mean values (1.24,1.49 mg/L) were lower than the normal limit of 1.6 mg/L both in qualified villages of water ffuoride content and exceeding-standard villages in 2017.Conclusions In Shandong Province,the effective water improvement has acquired some effects in control of drinking water-borne endemic fluorosis.But the water fluoride content of improved water defluoridation projects exceeds the national standard seriously and fluorosis has not been effectively controlled.