Objective To study the effectiveness of alkaline electrolyzed water (AEW)in the cleaning of medical instruments and its corrosive effect on metal. Methods Medical instruments of solid smooth,solid with gear or tube were cleaned with AEW adding ultrasonic washing,cleaning efficacy were compared with conventional method, AEW without pulsing ultrasonic washing and control group,corrosive effect of AEW on metal immersed in AEW was tested. Results Cleaning efficacy of solid smooth,solid with gear or tube instruments were significantly differ-ent among four groups(F= 10.868,14.268,6.146,respectively,all P<0.05). For solid smooth instruments, cleaning with AEW adding ultrasonic and cleaning without ultrasonic had a better effect than conventional cleaning (both P<0.005);For solid with gear instruments,AEW adding ultrasonic cleaning obviously had a better effect than conventional cleaning and AEW without ultrasonic cleaning(both P<0.001 );For tube instruments,cleaning efficacy of three cleaning methods were not significantly different (all P>0.05). AEW had no corrosive effect on stainless steel and copper. Conclusion The cleaning efficacy of AEW on solid smooth,solid with gear instruments is su-perior to conventional cleaning method,and can achieve better effectiveness if ultrasonic cleaning is added.

The effects of rapamycin on the expression of Bcl-2 and Bax protein in in vitro cultured human lens epithelial cells (LECs) and cell cycle were investigated in order to provide the theoretical basis for the development of new inhibitory drugs for clinical prevention and treatment of after-cataract. The cultured LECs of second and third passages were collected and treated with rapamycin. The LECs were transferred into 96-well culture plates and divided into 6 groups, and each group was set to have 8 duplicate wells. In the negative control group, the LECs were given culture medium only, and in the blank control group, only culture medium was given. In the four rapamycin-treated groups, different concentrations (20, 40, 60 and 80 ng/mL) of rapamycin were given. After treatment for 24, 48 and 72 h, the absorbance (A) values in each well were determined by MTT assay. The cell cycles of all groups were detected by using flow cytometry. Real-time fluorescent quantitative polymerase chain reaction (RFQ-PCR) and Western blot were used to detect the mRNA and protein expression of Bcl-2 and Bax respectively. MTT assay showed that rapamycin could inhibit proliferation of LECs in a time- and dose-dependent manner. Flow cytometry revealed that rapamycin could block the conversion of LECs from G1 phase to S phase, resulting in the increase of cells in G(1) phase and the decrease of the cells in S phase. RFQ-PCR indicated that rapamycin could down-regulate the expression of Bcl-2 mRNA, but up-regulate the expression of Bax mRNA, suggesting it could induce apoptosis of LECs. Western blot demonstrated that rapamycin could suppress the expression of Bcl-2 protein, but promote the expression of Bax protein. It is concluded that rapamycin could inhibit proliferation of LECs probably not only by blocking the progression of cell cycle, but also by promoting the induction of apoptosis.

ObjectiveTo explore the relationship between β2-adrenergic receptor (β2-AR) gene Arg16Gly polymorphism and essential hypertension (EH) in elder (≥60 years old).Methods150 old healthy controls and 115 old patients with EH (all of them without kin relation) were selected to test genotype of β2-AR by the technique of polymerase chain reaction-restriction fragment length polymorphism (PCR-PFLP).ResultsThe frequencies of three genotypes (Arg/Arg, Arg/Gly and Gly/Gly) were 22.81%, 53.51% and 23.68% in the EH group and 27.33%, 67.33% and 5.33% in the controls respectively. The frequencies of Arg and Gly allele were 49.56 % and 50.44% in the EH group, and 61.00% and 39.00% in the controls. There was a significant difference in distribution of alleles/genotypes between EH group and controls ( P<0.05).Conclusionβ2-AR Arg16Gly gene polymorphism is possibly associated with hypertension in this study population.

Objective:To compare the effects of a single dose of dexrazoxane or cAMP and their combined use on anthracycline cardiotoxicity in the multiple treatment course of patients with hematological malignancies to explore better alternatives for reducing an-thracycline cardiotoxicity. Methods: In the study, 80 patients were randomly divided into 4 groups with 20 cases each. Group A ( cAMP group) received cAMP 20 ml·d-1 for a week before every treatment course. Group B was treated with dexrazoxane and adria-mycin at a dosage ratio of 10∶1 via a fast intravenous drip 30 min before the application of anthracycline chemotherapy, and the 20 ml cAMP was given once a week before the chemotherapy session. Group C only received dexrazoxane. Anthracyclines was administered 30 min before each chemotherapy session. Groups A, B, and C were the experimental groups, and group D was designed as the blank control group. All groups received four complete cycles of chemotherapy. The ECG changes, echocardiography ( left ventricular ejection fraction, LVEF) and B-type brain natriuretic peptide ( BNP) values of all the groups were observed before and after the chemotherapy. Results:As for the ECG changes, group B and C had lower incidence rate of abnormal ECG than group A and D(P<0. 008 3). Sig-nificantly decreased LVEF and increased BNP values were observed in group A, B and C compared with those in the control group ( P<0. 05), and group B showed the most significant effect. Conclusion:All of the studied treatments can effectively reduce anthracy-cline chemotherapy-induced cardiotoxicity in cancer patients, and the combination of cAMP and dexrazoxane exhibits the best effect. Dexrazoxane has better protective effect on myocardial cells than cAMP.

Thermoablation is a local treatment effectively used to prevent metastasis of colon cancer in the liver and can retain peripheral normal liver tissues. Ablation therapy is less invasive, easier to use, and more repeatable than surgery. This form of therapy also allows the local control of unresectable diseases. Furthermore, thermoablation can be applied as an alternative therapy for small re-sectable lesions in patients who manifest insufficient hepatic function after surgery or those with severe complications. Ablation therapy can artificially increase the surgical margin, thereby increasing the resection rate in patients. Multiple lesions in the liver and surgically inaccessible or unresectable diseases can also be removed. However, several limitations, including the local recurrence of the disease and treatment-related complications in patients, are also observed. The treatment outcome of thermoablation therapy can be further im-proved because this technique is used as a part of multimodality treatment.

Objective To observe the degree of choriocapillary ectasia (CCE) and sub-foveal choroidal thickness (SFCT) in central serous chorioretinopathy (CSC) with different activity and discuss their relations.Methods Forty eyes of 40 CSC patients were recruited.The activity of CSC was determinate by fundus fluorescein angiography (FFA).There were 23 eyes with active CSC (active-CSC group),and 17 eyes with inactive CSC (inactive-CSC group).All eyes in both groups were examined with optical coherence tomography angiography(OCTA),and the CCE area of the choriocapillary layer was measured within a 3 mm× 3 mm zone centered on the central fovea of macula.Ectasia was classified based on CCE area,more than 66％ of examination area was high ectasia,and 33％-66％ as medium ectasia,below 33％ as low ectasia.SFCT was measured with frequency domain optical coherence tomography.The relationship between CCE degree,SFCT and CSC group was analyzed.Results Among the 23 eyes of active-CSC group,there were 5 eyes of low ectasia,12 eyes of medium ectasia,6 eyes of high ectasia.Among 17 eyes of inactive-CSC group,there were 11,4,2 eyes of low,medium and high ectasia respectively.Active-CSC group had more advanced degree of ectasia than that in inactive-CSC group(Z=-2.472,P=0.013).SFCT of active-CSC group and inactive-CSC group were (418.13±-126.15),(429.76±105.80) μm respectively,the difference was not significant (t=-0.308,P=0.760).SFCT in eyes with low ectasia,medium ectasia,high ectasia were (419.13±105.60),(381.00±125.12),(515.13±67.68) μm respectively.The difference among the three group was statistical significant (F=4.106,P=0.025).SFCT in eyes of high ectasia was obviously thicker than low ectasia and medium ectasia,the difference was statistical significant (P=0.007,0.048);the SFCT difference between low ectasia and medium ectasia did not appear statistical significance (P=0.326).There was no linear relation between SFCT and CCE degree (r=0.247,P =0.124).Conclusions Active-CSC eyes has more advanced CCE degree than inactive-CSC eyes,but SFCT is the same between the two groups.High ectasia eyes have thicker SFCT.

Objective: To evaluate dimensions of the nasopalatine canal and the relationship between the canal and the central incisors, and the canal and the crest, by using cone-beam computed tomography ( CBCT) . Methods:This study included 129 CBCTs, and the sagittal slices were used to measure the lower diameter ( Sda) , median diameter ( Sdb) , and higher diameter ( Sdc) , for calculating the average sagittal diameter ( Sd ); the coronal slices through canals were used to measure the lower diameter ( Hda) , median diameter ( Hdb ) , and higher diameter ( Hdc ) for calculating the average horizontal diameter ( Hd) , length ( H);the sagittal slices were used to measure the buccal bone thickness off the canal ( Bt) , and the distance to the crest off the lowest point ( At) , the horizontal slices were used to measure the distance between the canal and the central incisors ( Id) . These subjects were divided into two groups by gender;and divided into three groups by ages: (1) ≤30 years old, (2) 31 -50 years old, and (3) ≥51 years old. SPSS 17. 0 statistical software was used for statistical analysis. Results:The overall Sd was (3. 41 ± 0. 87) mm, the Hd was (5. 16 ± 0. 93) mm, and the difference was statisti-cally significant. The H was (14. 29 ± 3. 27) mm, the Bt was (7. 49 ± 1. 05) mm, the At was (8. 25 ± 1. 71) mm, and the Id was (2. 71 ± 0. 89) mm. Of the male and female, the Sd were (3. 64 ± 0. 90) mm and (3. 28 ± 0. 82) mm, P=0. 017; the Hd were (4. 98 ± 0. 89) mm and (5. 27 ± 0. 94) mm, P=0. 081;the H were (15. 47 ± 2. 75) mm and (13. 59 ± 3. 32) mm, P=0. 001;the Bt were (7. 90 ± 0. 96) mm and (7. 25 ± 1. 03) mm, P=0. 001; the At were (7. 41 ± 1. 86) mm and (8. 44 ± 1. 90) mm, P=0. 001; the Id were (2. 71 ± 0. 87) mm and (2. 72 ± 0. 91) mm, P =0. 983. Among the groups, no statistically significant differences were detected of the Sd (P =0. 325), of the Hd (P =0 . 636 ) , of the H ( P=0 . 292 ) , and of the Bt ( P=0 . 116 );statistically significant differences were de-tected of the At ( P=0 . 010 ) , and of the Id ( P<0 . 001 ) . Conclusion:The nasopalatine canal anatomy is highly variable. Gender is related to the nasopalatine canal length, Bt width, and At distance. While age was related to At, and Id, but no effect on nasopalatine dimensions. The CBCT is a useful device for studying the nasopalatine canal in three dimensions, prior to dental implant placement.

BACKGROUND: The incidence of diabetic peripheral neuropathy (DPN) is affected by various related factors, which can manifeste in patients with simple diabetes mellitus. However, which of these factors are involved in the occurrence of DPN in diabetic patients?OBJECTIVE: To analyze the risk factors for DPN in patients with type 2 diabetes mellitus.DESIGN: A hospital-based one-to-one pair-matched case-controlled investigation.SETTING: School of Public Health, Tianjin Medical University.PARTICIPANTS: Totally 111 outpatients or inpatients with DPN (DPN group) were recruited from the Metabolic Disease Hospital of Tianjin Medical University from December 2002 to November 2003, including 53 males and 58 females. Inclusive criteria: Diagnosed according to the diagnostic standards for diabetes mellitus recommended by American Diabetes Association (ADA) in 1997; Typing for type 2 diabetes mellitus according to the program by ADA in 1997; Decline or disappearance of achilles tendon reflex, knee tendon reflex, etc.; Decline or disappearance of pain sensation and thalposis; Decline or disappearance of diapason vibration sense. Meanwhile, 111 outpatients or inpatients with simple diabetes mellitus were selected as the control group. Informed consents were obtained from all the subjects.METHODS: The patients were investigated at admission or in the outpatient department with self-designed questionnaires, including more than 80 items of general information, past history, family history, etc. The results of laboratory examinations were recorded. The data were catalogized and input into computer. Multivariate conditional logistic regression was used to establish main effect equation for analyzing the risk factors for DNP.MAIN OUTCOME MEASURES: Risk factors for DNP.RESULTS: All the 111 patients with DNP and 111 patients with simple diabetes mellitus were involved in the analysis of results. The protective factors for DNP included higher educational level, intensive treatment, coronary heart disease and tea drinking. The risk factors for DNP included longer duration of diabetes mellitus, poor situation of blood sugar control, treating with insulin, diabetic nephropathy, diabetic retinopathy, history of diabetic ketonemia, more meat intake before diabetes mellitus, vertigo, dryness of skin, hypertension, history of injury, history of smoking, higher waist-to-hip ratio, higher level of blood cholesterol. The results of multivariate Logistic regression analysis showed that the following factors were significantly associated with DPN: longer duration of diabetes mellitus, treating with insulin, vertigo, more meat intake before diabetes mellitus, alcohol drinking and history of injury (operation, frostbite, etc.).CONCLUSION: DPN is related to various risk factors, such as longer duration of diabetes mellitus, treating with insulin, vertigo, alcohol drinking, more meat intake before diabetes mellitus, history of injury, etc., which all can increase the risk of diabetic neuropathy in patients with type 2 diabetes mellitus. Patients and physicians should pay more attention to these risk factors during the course of prevention and treatment.

Objective To explore the causes of the misdiagnosis of spontaneous rupture of spleen.Methods 8 cases of spontaneous rupture of spleen during 1986～1998 were reviewed retrospectively.Results 5 cases were misdiagnosed, with the misdiagnosing rate of 62.5%.Conclusion For unknown upper bellyache accompanied with unexplainable loss of blood and with no history of trauma,the patients should be examined by B ultrasound or abdominal puncture should be peformed.If there is pathological process of liver and spleen such as schistosoma and hepatitis or the excessive functioning of spleen,the more attention should be paid to the occurrence of spontaneous rupture of spleen.Furthermore,the increase of the belly pressure caused by satiation or hard labour helps to diagnose such case.

The clinical data of 22 cases with gastrointestinal stromal tumors were retrospectively analized.The main clinical manifestations were gastrointestinal bleeding (14/22),abdominal discomfort (5/22) and abdominal lump (3/22),stomach was the most common site of the tumor (14/22).All 22 cases underwent surgical treatment and pathological examination confirmed that 12 cases were benign.Immunohistochemical results showed that 68% cases were negative in solubility acid protein-100 (S-100),and the positive rates of tyrosine-protein kinase acceptor 117 (CD117),hemopoietic stem cell antigen 34 (CD34) and negative rate of smooth muscle actin (SMA) were all 73%.Eighteen cases were followed up for 1-5 years after operation,among them 3 died.The survival was closely related to the size,the pathological characteristics and the recurrance of the tumor as demonstrated by multivariate Cox regression analysis.Since gastrointestinal stromal tumor has no specific clinical manifestations,preoperative diagnosis is difficulty,so surgical resection and subsequent pathological examination is used for confirmation of diagnosis,as well as treatment of the disease.