Objective To compare the clinical effects of four kinds of gingival retraction technique in treat-ment of anterior teeth restoration.Methods 169 patients for 352 teeth with tooth body and tooth dentition defect by anterior crown bridge repair were chosen and divided into 4 group by patients'order,including A group(88cases)with single track method,B group(91cases)with single line for two times method,C group(89cases)with double line method and D group(94cases)with double line for two times method.And the fixed restoration satisfaction rate of anterior teeth of both groups was compared.Results The satisfaction rates of gums,shoulder,impression,model and restoration of A group were 73.9%,70.1%,69.3%,65.9%,61.4% respectively,which of B group were 83.5%, 80.2%,80.2%,80.2%,76.9%;which of C group were 84.3%,80.9%,78.7%,77.5%,76.4%;which of D group were 94.6%,93.6%,92.6%,92.6%,90.4%.There were no significant differences in the fixed restoration satisfaction rate of anterior teeth between B group and C group(χ2 =2.43,1.17,2.85,3.04,2.30,all P >0.05). The fixed restoration satisfaction rate of anterior teeth of D group were significantly better than A,B and C groups (χ2 =14.90,16.39,15.83,19.87,21.38,all P <0.05 ).Conclusion Double line for two times method in the treatment of anterior teeth restoration can efficiently avoid ree gingival damage in the situation with abutment shoulder preparation,improve the quality of preparation,impression and model,and are helpful to higher the fitness of the neck of anterior teeth fixed restorations.

University of Manchester who first introduced Problem based learning(PBL)to the UK medical education,and adopted this new curriculum in 1994.Notably,Cambridge and Oxford have always had a high proportion of student-centred and self-directed learning,and have therefore not introduced PBL.Other medical schools have followed the example of Manchester,now PBL has become the mainstream curriculum in British medical edacation.First,this article is going to introduce how PBL curriculum is structured at Manchester medical school,and then reflect and give some thoughts on its current practice.

Objective To investigate the prevalence of hyperglycemia in patients with primary aldosteronism.Methods Thirty two patients diagnosed as primary aldosteronism(PA) in our hospital from 2010 to 2013 (PA group),and 40 patients as essential hypertension (EH group).Two groups were measured and compared,including blood pressure,plasma aldosterone,urine aldosterone,and plasma potassium.Oral glucose tolerance test (OGTT) was performed and homeostasis model assessment-insulin resistance index(HO-MA-IR) were calculated.Results The prevalence of hyperglycemia was 43.75％ in PA group,including 25％ patients of glucose intolerance and 18.75％ patients of diabetes mellitus,which was significantly higher than those of EH group (25％,12.5％,and 12.5％,respectively).PA group's fasting and 2-hour postprandial insulin levels and insulin resistance index were higher than that of EH group.Conclusions The present study indicated that patients with PA had a significantly high prevalence of glucose metabolism disturbance and insulin resistance.Screening test should be performed and avoid missed diagnosis.

Objective To determine the incidence, clinical manifestation and risk factors of immune reconstitution inflammatory syndromes (IRIS) in highly active antirctroviral therapy (HAART) for HIV/AIDS patients. Methods Two hundred and twelve HIV/AIDS patients received HAART, and were followed up for 6 months. The incidence time and disease spectrum of IRIS were observed. Multiple logistic regression analysis was performed to identify the risk factors for IRIS. Results Among 212 patients, there were 59 (27.8%) experienced an IRIS event during the first 6 months of HAART, 2 of which died (2/59,3.39% ). Median time of IRIS onset was 21 days form HAART initiation. The disease spectrum included tuberculosis, herpes virus infections, pneumocystis jirovecii pneumonia, cryptococcal meningitis and penicillium marneffei infection. Risk factors of IRIS included baseline infections ( OR = 1. 655, P =0.010),fever during HAART ( OR = 2. 344, P= 0.006), and baseline CD4 + count ( OR = 1. 556, P = 0. 034).Conclusions IRIS usually occurred within the first month from HAART initiation, and tuberculosis and herpes virus infection are most common. The occurrence of IRIS is associated with the antigens burden and the decreased baseline CD4 + count.

Objective To investigate the differentiation of dendritic cells from monocytes of the peripheral blood in patients with psoriasis. Methods Flow cytometry was used to analyze the phenotype of monocyte derived dendritic cells (MoDC). The capacity of MoDC to stimulate the proliferation of T lymphocytes was evaluated by allogeneic mixed lymphocyte reaction. Results Monocytes in the peripheral blood of patients with psoriasis could differentiate into dendritic cells. Expression of CD40, CD80, CD86 and HLA-DR by MoDC was significantly increased in patients with psoriasis compared with that in normal controls (P

Objective To explore the differences of the life styles and their influencing factors among students who came from city,countryside or migrant families.Methods The stratified cluster random sampling method was conducted to recruit 1980 college students from 4 colleges of Huainan,Anhui.Results The study showed that under the ternary social structure college students from city preferred to the higher degree of T1,T2 or T3 dietary patterns,of which the OR (95％ CI) were 0.432 (0.255-0.730),0.140 (0.073-0.267) and 0.402 (0.236-0.683),respectively.They chose to exercise in middle-intensity physical activity for 30 minutes,of which OR (95％CI) was 0.524(0.352-0.779).Also there were much more drinkers in this group,of which the OR (95％ CI) was 0.564(0.325-0.981).Secondly,college students from migrant families in city preferred to T2 and T4 dietary pattern in low degree,of which OR (95％ CI) were 1.714(1.165-2.519) and 1.592(1.100-2.305),respectively.And they exercise 5 times or less per week in middle-intensity physical activity and the OR (95％ CI) was 0.699(0.535-0.912).Thirdly,college students from countryside preferred to T1,T2 and T3 dietary pattern in low degree and the OR (95％ CI) were 1.548 (1.083-2.213),1.498 (1.048-2.141) and 1.740(1.216-2.491),respectively.However,they preferred T4 dietary pattern in high degree rather than in low degree,in which the OR (95％ CI) was 0.624(0.436-0.893).They exercise more than 5 times and more than 30 minutes per time in middle-intensity physical activity,of which OR (95 ％ CI) were 1.314 (1.022-1.688) and 1.472 (1.071-2.022).Conclusion College students from three groups lived in different life styles and much more attention should be paid to them.

Objective To explore the impact of different specific body positions on blood pressure and heart rate.Methods The blood pressure and heart rate of 178 healthy teachers and students was tested with BIOLIGHT M69 in different body positions.Results ①Blood pressure and heart rate were significantly higher in squatting position than in other three specific positions(sitting position, supine position, and standing position) (P<0.01). ②The blood pressure and heart rate were going up from standing position, and standing position with right arm lifting, to standing position with arm weight lifting positions (P<0.01). Conclusion The change of special body positions resulted in change of blood pressure and heart rate.

The plastic splint PCL,which is introduced in this article,is a new type of medical exter- nal immobilization material.During the course of its development,the burden has been optimality seeked with regressive orthogonality after screening of the material.Its function has attained the international levels during the eighties.This splint may be used not only in the treatment of burns and various orthopedic conditions,but also in the immobilization of fracture and rehabilation treatment of orthopedic patients etc.

Objective:To confirm the potential of growth-related gene productβ(GROβ) as a biomarker for colorectal cancer. Methods:Serum GROβlevels in 123 subjects with colorectal cancer, 88 healthy controls, and 125 subjects with other diseases were measured using enzyme-linked immunosorbent assay. Serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in all subjects were measured using immunoluminometric assay. Statistical analyses were conducted to determine the associa-tions between serum GROβlevels and clinical parameters for colorectal cancer. The receiver operating characteristic (ROC) curves of GROβ, CEA, and CA19-9 were analyzed. Results:The serum GROβlevels were higher in patients with colorectal cancer (median=96.15 pg/mL) than in the healthy controls (median=43.28 pg/mL, P<0.01) and in patients with other diseases (median=57.30 pg/mL, P<0.01). The serum GROβlevels in patients with colorectal cancer were positively correlated with the tumor-node-metastasis staging (P<0.01) and depth of infiltration (P<0.05), but not with the histological grade, tumor embolus, lymph node metastasis, gross pathologic tu-mor type, or gender of the patients. The sensitivity and specificity of the assay for serum GROβwere 56.1%(69/123) and 95.31%(203/213), respectively. The diagnostic sensitivity was 22.2%(4/18) for stage I and 66.7%(26/39) for stage II when the data of GROβwere combined with the data of CEA and CA19-9. The ROC curve constructed with the data of GROβ(0.834) was larger than that construct-ed with the data of CEA (0.739) or CA19-9 (0.676) for discriminating colorectal cancer from the matched controls. Conclusion:These preliminary results indicated that the serum GROβlevel could be a useful biomarker for colorectal cancer diagnoses.

Objective To explore the association of serum soluble Klotho (sKlotho) with nonfatal cardiovascular disease (CVD) and all-cause/CVD mortality in maintenance hemodialysis (MHD) patients.Methods A total of 132 MHD patients admitted during October 2011 were enrolled.Serum sKlotho was measured by ELISA.Demographic data,including age,gender and comorbid conditions,were obtained from their medical histories,and parameters including calcium,phosphorus and albumin were assessed.The occurrence time of nonfatal CVD and all-cause mortality were recorded during the 60 months follow-up.MHD patients were categorized into four groups according to the quartiles of sKlotho:group Ⅰ (sKlotho ＜ 361.34 ng/L),group Ⅱ (361.34 ng/L≤sKlotho＜ 398.81 ng/L),group Ⅲ (398.81 ng/L≤sKlotho＜445.99 ng/L) and group Ⅳ (sKlotho≥445.99 ng/L).Spearman correlation analysis and binary Logistic regression analysis were used to test the association between sKlotho and nonfatal CVD events.The impacts of sKlotho on all-cause mortality and CVD mortality were assessed by Kaplan-Meier method with log-rank test.Cox regression model was applied to evaluate the effect of sKlotho on MHD patients outcomes.Results All 132 MHD patients had sKlotho ranging from 304.02 ng/L to 550.62 ng/L.And 87 patients suffered from nonfatal CVD,with 192 episodes of nonfatal CVD during the follow-up period.The sKlotho had negative correlations with coronary artery disease (r=-0.286,P=0.001),congestive heart failure (r=--0.190,P=0.029),cerebrovascular accident (r=-0.240,P=0.006) and peripheral arterial occlusion (r=-0.243,P=0.005).The sKlotho were risk factors of coronary artery disease (OR=0.989,P=0.023) and peripheral artery occlusion (OR=0.988,P=0.046).35 patients died in the follow-up period,including 27 death from CVD.The all-cause mortality and CYD mortality rates were significantly different among four groups (P=0.036,P=0.047).Survival rates of all-cause death and CVD death varied among four groups (x2=8.076,P=0.044;X2=7.866,P=0.049).Patients in group Ⅳ had higher survival rates of allcause death and CVD death than those in group Ⅰ and group Ⅱ (all P ＜ 0.05).Multivariate Cox regression analyses revealed diabetes and age were independent risk factors for all-cause mortality and CVD mortality (all P ＜ 0.05),but sKlotho was not associated with the poor prognosis (HR=0.996,P=0.256;HR=0.996,P=0.287).Conclusions Patients with lower sKlotho have worse nonfatal CVD ratio,especially coronary artery disease and peripheral arterial occlusion.Reduced serum sKlotho is associated with all-cause and CVD mortality,but sKlotho is still not a predictive indicator of prognosis of MHD patients.