Objective To explore the effects of continuous positive airway pressure (CPAP) on N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) in the non‐obese patients with obstructive sleep apnea (OSA) .Methods A total of 41 cases of severe OSA complicating coronary artery disease(CAD) were divided into two groups based on their body mass index (BMI):obese group (BMI>28 kg/m2 ) and non‐obese group (BMI≤28 kg/m2 ) .All the patients were treated by CPAP for 24 weeks .Serum NT‐proBNP lev‐el was detected by adopting the electrochemiluminescence method ,the changes of the serum levels of NT‐proBNP were compared between before and after treatment .Results The NT‐proBNP level after treatment in the non‐obese group was significantly de‐creased ,which was decreased from (141 .8 ± 156 .5)pg/mL before treatment to (106 .7 ± 167 .2)pg/mL ,the difference was statisti‐cally significant (P<0 .05);the NT‐proBNP level after treatment in the obese group showed the increasing trend ,which was in‐creased from (32 .2 ± 24 .5)pg/mL before treatment to (86 .3 ± 174 .4)pg/mL ,the difference was not statistically significant (P>0 .05) .Conclusion CPAP can effectively decrease the NT‐proBNP level in non‐obese patients OSA complicating CAD .

Objective To analyze the clinical observation and incidences of complications of therapeutic post-endoscopic retrograde cholangiopancreatography (ERCP).Methods The clinical information of 1 482 cases of therapeutic ERCP was analyzed retrospectively.Results Among them,468 cases had nasal biliary drainage,532 cases had pancreatic or bile duct stent after endoscopic procedure and the other 482 case hadn't.For the drainage group, there were 396 cases of biliary stone,36 cases of simple dilatation of common bile duct,8 cases of biliary cyst,6 cases of strictured papilla,18 cases of inflammatory stricture of common bile duct,2 cases of sclerosing cholangitis and 2 cases of autoimmune pancreatitis.For the pancreatic or bile duct stent group,there were 483 cases of malignant bili-ary obstruction,13 cases of biliary stone,28 cases of pancreatic duct stone,3 cases of sclerosing cholangitis and 5 cases of inflammatory stricture of common bile duct.And there were 385 cases of biliary stone,36 cases of simple dilatation of common bile duct,38 cases of inflammatory stricture of common bile duct,11 cases of strictured papilla, 9 cases of pancreatic duct stone and 3 cases of biliary cyst for un -drainage group.The incidences of acute pancreati-tis and acute cholangitis (4.4%,2.6%)were higher in un -drainage group than the nasal biliary drainage group (1.5%,0.6%,P <0.05)or the stent group(1.7%,0.8%,P <0.05).The incidences of duodenum or biliary tract perforation and upper gastrointestinal hemorrhage(0.2%,1.2%)were not significantly different compared with the nasal biliary drainage group(0.2%,0.6%,P >0.05)and the stent group(0.4%,0.8%,P >0.05).The incidences of 4 kinds of complications were not significantly different between the nasal biliary drainage group and the stent group.Conclusion Endoscopic nasal biliary drainage or stent can prevent and treat some of therapeutic ERCP com-plications effectively.

ObjectiveTo evaluate the effect of aminoguanidine on expression of inducible nitric oxide synthase (iNOS) in neurons in the small intestinal nerve plexus of starved rats.MethodsNinety male SD rats weighing 230-270 g were randomly divided into 3 groups:group normal control (group C,n =10) ; group starvation (group S,n=40) and group starvation + aminoguanidine (group A,n =40).The animals were allowed free access to water but no food during starvation in S and A groups.In group A the animals were given aminoguanidine 150 mg·kg-1 ·d-1 intraperitoneally during starvation.Ten animals were sacrificed at 3,5,7 and 9 d of starvation respectively and intestine specimens were taken for determination of ratio of intestinal transit using dextran blue-2000 as indicator.Then the specimens of intestinal myenteric nerve plexus of ileum were collected and stained by histochemistry with nicotinamide-adenine dinucleotide phosphate-d for determination of iNOS expression.ResultsStarvation significantly reduced the small intestinal transit and increased iNOS expression in neurons in the myenteric nerve plexus of small intestine in proportion to days of starvation in group S compared with group C.Intraperitoneal aminoguanidine significantly attenuated the starvation-induced changes in intestinal transit and iNOS expression.ConclusionAminoguanidine can attenuate the up-regulation of the expression of iNOS in neurons in the myenteric nerve plexus of small intestine induced by starvation and is helpful in promoting the intestinal transit in starved rats.

Objective To observe the effect of prevention and treatment of gastrointestinal failure and coagu-lation function in severe acute pancreatitis(SAP)with single Rhubarb.Methods 68 caese with SAP were randomly divided into control group(n =34)and treatment group(n =34)by random number table.Both two groups were given routine western medicine,but in the treatment group the patients were additionally administered with single Rhubarb orally or nasal feeding.The time of first defecation,abdominal pain disappeared,bloating disappeared,upper abdomi-nal tenderness disappeared,serum amylase recovery,correction degree of coagulation function and average hospitaliza-tion days of the two groups were compared.Results The time of first defecation in the treatment group was (46.0 ± 18.0)h,which was (73.0 ±23.0)h in the control group,there was significant difference between the two groups(t =2.43,P <0.05).The time of abdominal pain disappeared[(4.3 ±1.2)d],bloating disappeared[(5.2 ±1.6)d], upper abdominal tenderness disappeared[(5.0 ±1.7)d],serum amylase recovery[(6.2 ±1.3)d]of the treatment group were significantly shorter than those of the control group[(5.6 ±1.7)d,(6.7 ±2.3)d,(6.4 ±2.1)d,(8.9 ± 1.6)d](t =2.36,2.17,2.60,2.48,all P <0.05).The average hospitalization days of the treatment group[(24.5 ± 12.3)d]was significantly shorter than the control group[(30.6 ±12.9)d](t =2.65,P <0.05).5 days after treat-ment,in the treatment group,the partially activated thromboplastin time(APTT)[(30.39 ±4.98)s]and prothrombin time(PT)[(12.65 ±1.32)s]were significantly shorter than the control group[(37.25 ±6.27)s,(14.87 ±1.68)s] (t =2.54,2.43,all P <0.05).The platelet count(PLT)and the fibrinogen(FIB)in treatment group were (186.30 ± 59.82)×109 /L and (3.89 ±1.17)g/L repectively,those in control group were (131.80 ±48.57)×109 /L and (5.29 ±1.33)g/L repectively,the differences were statistically significant between the two groups(t =2.16,2.83,all P <0.05).Conclusion The routine western medicine and additionally administered with single Rhubarb can effec-tively prevent and treat gastrointestinal failure,significantly improve coagulation function in SAP.

Objective To investigate the antibiotic resistance of extended-spectrum-β-1actamases (ESBLs)-producing Escherichia coli (E.coli) and Klebsiella pneumoniae (K.pneumoniae) isolates and the risk factors of bloodstream infections caused by these strains.Methods Clinical data of 131 patients with E.coli or K.pneumoniae-induced bloodstream infections admitted in the Second Affiliated Hospital of Zhejiang Chinese Medical University during September 2009 and June 2014 were retrospectively analyzed.Species identification and antimicrobial susceptibility test were performed by Vitek 2 system,and ESBLs production was tested by standard disk diffusion method.Logistic regression analysis was performed to identify the risk factors of bloodstream infections induced by ESBLs-producing strains.Results Among 131 patients,65 were infected with ESBLs-producing strains,and 66 were infected with non-ESBLs-producing strains.The resistance rates of ESBLs-producing strains were above 50％ for penicillin,aztreonam and third/fourth generation cephalosporins,which were significantly higher than those of non-ESBLs producing strains.The resistance rates of ESBLs-producing E.coli and K.pneumoniae to carbapenems and piperacillin/tazobactam were 0-2.0％,2.3％ and 0-14.3％,26.7％,respectively.The univariate analysis revealed that patients with exposure to cephalosporins in recent 3 months (x2 =18.322,P ＜ 0.01),prior infection with ESBLs-producing strains (x2=14.610,P＜0.01),indwelling catheter in recent 3 months (x2 =13.016,P ＜ 0.01),history of hospitalization in recent 3 months (x2 =11.269,P ＜ 0.01),exposure to quinolones in recent 3 months (x2 =10.638,P ＜ 0.01),nosocomial infection (x2 =8.205,P ＜ 0.01),history of indwelling deep venous catheter or percutaneous central catheter in recent 3 months (x2 =4.817,P ＜ 0.05) and exposure to glucocorticoid hormone in recent 3 months (x2 =4.265,P ＜ 0.05) were associated with infection of ESBLs-producing strains.Multivariate Logistic regression analysis revealed that exposure to quinolones in recent 3 months (OR =6.851,P ＜ 0.01),prior infection with ESBLs-producing strains (OR =6.344,P ＜ 0.01),exposure to cephalosporins in recent 3 months (OR =3.719,P ＜ 0.01),and indwelling catheter in recent 3 months (OR =3.180,P ＜ 0.05) were independent risk factors for ESBLs-producing E.coli or K.pneumoniae infection.Conclusions ESBLs-producing E.coli or K.pneumoniae isolates are highly resistant to most antibiotics,and multidrug-resistance is common.Carbapenems were still the most effective antibiotics against ESBLs-producing E.coli or K.pneumoniae infection.Rational use of cephalosporins and quinolones,strictly following aseptic technique in operation,strict use of indications for indwelling catheterization,and completely eradicating ESBLs-producing strains in previous infections may be helpful in reducing bloodstream infections by ESBLs-producing E.coli or K.pneumoniae.

Objective To develop a method of quantitative analysis of multi-components with single marker (QAMS) for simultaneous determination of Salidroside, Loganin and Polydatin;To validate its accuracy and feasibility in Buxin Ruanmai Granules.Methods Salidroside was used as the internal reference substance, and the content of Salidroside in Buxin Ruanmai granules was determined by external standard method, with a purpose to establish its relative correction factor with Loganin and Polydatin. The contents of Loganin and Polydatin were calculated by the relative correction factor, and then multi-components assay with single marker was realized. The three contents in Buxin Ruanmai Granules were determined by both QAMS and external standard method, and their results were also compared.Results The results of 10 batches of samples by two methods did not show significant difference, which showed that relative correction factors had good reproducibility and credits.Conclusion The QAMS method can be used to quality evaluation with multiple indicators of Buxin Ruanmai Granules.

[Objectives]This study was designed to evaluate the treatment effects of a new movable molardistalization appliance for distal movement of maxillary first molars on Angle's Class Ⅲ malocclusion adolescence patients with the second premolar crowded.[Methods]Sixteen patients were treated by a new movable molardistalization appliance.Cephalometric analysis and model measurement was carried out before and after the treatment.Data were analyzed by paired t-test.[Results]The molars were distalized 5 mm during an average time of 3.8 months.There were significant increases in the Angle SNA and A-NPg(P ＜0.05).[Conclusion]it was a effective way to get space and improve patient's profiles on Angle's Class Ⅲ malocclusion adolescence patients with the second premolar crowded by the new movable molardistalization appliance.It was also conducive to patient's oral hygiene.

Objective To investigate the modulating effects and explore their mechanism of 9-nitrocamptothecin and its liposomes to induce apoptosis and inhibit cell cycle in HepG2 and L02 cell lines. Methods Cells were incubated with 9-nitrocamptothecin(9NC) or with 9-nitrocamptothecin liposomes for 24 h, 48 h and 72 h, then, the cell viability was measured via MTT assay; cell cycle and apoptosis was evaluated by flow cytometry after stained by PI and Annexin V-PE/7AAD. Additional, Western Blot was used to evaluate the expression of cell cycle and apoptosis related protein. Results Both cells viability were apparently inhibited by the 9-nitrocamptothecin and 9-nitrocamptothecin liposomes, the inhibitory effect showed a time-dependent and dose-dependent manner. Both S and G2/M phases arrest were observed after incubated with drugs. HepG2 cell was completely arrested in S phase when 9NC concentration over than 0. 1 μmol/L after incubation for 24 h, while more than 95% cells arrested in G2/M phase when 9NC concentration is 0. 1 μmol/L after incubation for 72 h. Apoptosis induction effect also showed a time-dependent and dose-dependent manner. Western Blot results showed the expression of Bax and Caspase-3 were upregulated while Cyclin A, Cdk2, Cyclin E and Bcl-2 were downregulated. More importantly, the compounds were more cytotoxic to the cancer cell lines than to the normal liver cell. Conclusions 9-nitrocamptothecin and 9-nitrocamptothecin liposomes can potently inhibit cell growth via regulation of cell cycle and induction of apoptosis, and this effect was preferentially in cancer cell. Inhibitory of 9-nitrocamptothecin liposomes was slightly better than the 9-nitrocamptothecin.

Objective To observe the inhibitory effect and mechanism of 9-nitrocamptothecin liposomes on HepG2 liver carcinoma cells. Methods HepG2 cells were incubated with 9-nitrocampto-thecin(9NC) or with 9-nitrocamptothecin liposomes(9NC-LP) for 24 h, 48 h and 72 h. Cell viability was then measured by the MTT assay. Cell cycle and apoptosis were evaluated by flow cytometry.Western Blot was used to determine the expression of cell cycle and apoptosis related proteins. HepG2tumor-bearing mouse models were then established. The HepG2 tumor-bearing mice were randomly divided into control group, free liposomes group, DMSO group, 9NC low dose group, 9NC high dose group, 9NC-LP low dose group and 9NC-LP high dose group. There were 10 mice in each group.Drugs were administered by tail vein and tumor volume and body weight were observed 28 days after administration. Then animals were sacrificed and the expression of proteins from tumor homogenates was analyzed by Western blotting. Results In vitro, HepG2 cell viability was apparently inhibited by 9NC and 9NC-LP, and the inhibitory effect increased in a time-dependent and dose-dependent manner.Both S and G2/M phase arrests were observed after incubation with drugs. HepG2 cells were completely arrested in S phase with 9NC concentration over than 0.1 μmol/L after incubation for 24 h,while more than 95% of cells arrested in G2/M phase when 9NC concentration was 0.1 μmol/L after incubation for 72 h. In vivo, compared with the control group, the average tumor volume was reduced in both the 9NC and 9NC-LP group (P<0.05) , and the average animal body weight also decreased in both the 9NC and 9NC-LP group (P<0.05). There was no significant difference among the control group, free liposomes group, and DMSO group. The lights inhibition rates of tumor growth in the 9NC-LP(2.5 mg/kg),9NC-LP(1.5 mg/kg),and 9NC(1.5 mg/kg)groups were 87.02%, 51.57%and 35.47%, respectively. In the 9NC-LP(2.5 mg/kg)group, >50% of animals died 14 days after drug administration. Conclusion 9NC and 9NC-LP can inhibit HepG2 cell growth via cell cycle arrest and apoptosis induction. 9NC-LP has a more potent anti-tumor effect and fewer side effects in vivo,which means 9NC-LP is a promising compound for cancer therapy via intravenous administration.

BACKGROUND: It is very important to explore an optimal loading force that can both allow effective intrusion and cause no damage to the teeth.OBJECTIVE: To investigate the optimal loading conditions, including loading force values and directions, in the intruding mechanics of maxillary anterior teeth.METHODS: A three-dimensional finite element model (3D FEM) of the maxillary anterior teeth was constructed to include the periodontal ligament (PDL), alveolar bone, and appliance (brackets and wire). The initial stress distribution and force of the maxillary anterior teeth were analyzed when the 3D FEM was loaded with different intruding force values and directions. RESULTS AND CONCLUSION: The optimal value of the intruding force for 6 anterior teeth fell within the range from 0.5 N to 1.0 N. The maximum stress was detected at the distal cervical level of the lateral incisor, and a relatively even distribution of initial stress was observed at 20° palatal deviation to the Y axis. The results suggest that using mini-screw implants at the labial region between the canine and lateral incisor and a combined 0.5-1.0 N intruding force with a distal force could be an optimal intrusion force system by which patients with normal occlusion could obtain a pure intrusion of anterior teeth.