Objective: To investigate the effect of a metal occlusal surface and stress interruption design on minimally invasive prosthodontics for patients with distal extension absence and insufficient occlusal gingival distance. Methods : We retrospectively studied the case of minimally invasive prosthodontic (Vitallium 2000) combined with a metal occlusal surface for distal extension absence in a patient with insufficient occlusal gingival distance; the stress breaking design and pressure impression technology are examined, and relevant articles are reviewd. Results: The design effectively solves the problems of insufficient occlusal gingival distance, large occlusal force and easy denture fracture. Reviewing the relevant literature, stress interruption design can effectively protect abutment teeth, but the behavior of stress interruption design and stress conduction phenomena in the mouths of patients has not been reported. The T-scan test results of this study showed that before and after wearing the denture, the occlusal force distribution ratio of the patient changed from 77.5% on the left and 22.5% on the right to 61.3% on the left and 38.7% on the right. The occlusal force distribution ratio of the right dentition to the total occlusal force increased by 16.2%, and the occlusal force became better distributed. Further analysis showed that the occlusal forces on the left and right sides were nearly the same in the initial occlusion stage. As the occlusal force was further increased, the proportion of the occlusal force on the right side decreased in the middle of the occlusion stage and further decreased in the final occlusion stage until it reached a dynamic balance. The above T-scan test and literature review results suggest that this dynamic balance phenomenon of bite force is related to the stress interruption design and the stress conduction effect of the split framework. Conclusion The composite of stress interruption design and metal occlusal surface allows for minimally invasive prosthodontics for the treatment of distal extension absence in patients with insufficient occlusal gingival distance.

Objective:To investigate the effect of pioglitazone on white matter injury after cerebral ischemia-reperfusion in mice and its mechanism.Methods:Forty-two young male C57BL/6J mice were randomly divided into sham operation group, model group, and pioglitazone group ( n=14 in each group). The model of cerebral ischemia-reperfusion was induced by transient middle cerebral artery occlusion with suture-occluded method. On the 3 rd and 7 th day after the establishment of the model, the neural function was assessed by the adhesive removal test. The mice were killed on the 7 th day after the establishment of the model. HE staining was used to detect the extent of cerebral infarction. Immunofluorescence staining and Western blot analysis were used to detect the degree of white matter damage and the changes of microglia phenotype. Results:On the 7 th day after cerebral ischemia-reperfusion, the adhesive removal time in the PGZ group was significantly shortened compared with the model group ( P<0.05), the percentage of cerebral infarction volume was significantly reduced ( P<0.05), the ratio of MBP/NF200 fluorescence intensity in the cortical and striatal areas was significantly increased (all P<0.05), and the number of CD16 +/Iba1 + microglia was significantly decreased ( P<0.01), while the number of CD206 +/Iba1 + microglia tended to increase, but there was no statistical difference. Conclusion:Pioglitazone may reduce the degree of white matter injury and nerve function damage in mice with cerebral ischemia-reperfusion, and its mechanism may be associated with regulating the transformation of microglia from M1 type to M2 type.

Ischemic stroke is a type of cerebrovascular disease with high morbidity, high mortality and high disability, which brings a huge medical burden to the society. Long non-coding RNA (lncRNA) H19 is closely associated with the pathophysiological mechanisms such as oxidative stress, inflammation, apoptosis, autophagy, and neurogenesis after ischemic stroke. It has received widespread attention in recent years. This article reviews the pathophysiological mechanism of lncRNA H19 in ischemic stroke, in order to provide new ideas for the diagnosis and treatment of ischemic stroke.

Traditional Chinese medicine (TCM) syndromes have a certain genetic background. It is of great significance to study the essence of syndromes, and through genetic polymorphism research, the objectification of TCM syndromes can be realized. There are multiple relationships between genetic polymorphisms and TCM syndromes:including the relationship between internal factors and external manifestations, the relationship between macrocosmic view and microcosmic view, and the relationship between objectivity and subjectivity. This article reviews the current research progress on the correlation between genetic polymorphism and TCM syndromes in order to provide some ideas for the objectification of syndromes.

Objective: To investigate the effects of extreme high and low temperatures on admission risk of acute ischemic stroke (AIS) and its etiology subtypes. Methods: From January 1, 2016 to December 31, 2017, the data of inpatients with AIS from Zhongnan Hospital of Wuhan University and the meteorological data and air pollution data from China Meteorological Data Network in the same period were collected continuously. According to TOAST etiology criteria, the patients were divided into large artery atherosclerosis (LAA), small vessel occlusion (SVO), cardioembolism (CE), and stroke of other etiology (SOE). A time series analysis of the distributed lag model was used to investigate the effects of extreme high and low temperatures on the admission of patients with AIS and its etiology subtype, and air pollution, air pressure, humidity, and wind speed were used as confounding factors to exclude interference. Results: A total of 1 413 patients with AIS were enrolled, including 906 men (64.4%), age 67.7±12.8 years. The thresholds of extreme low temperature (1%, 5% and 10% of the average temperature) were 0.7 ℃, 3.3 ℃, and 4.9 ℃. The thresholds of extreme high temperature (90%, 95% and 99% of the average temperature) were 29.2 ℃, 31.6 ℃, and 32.9 ℃. Extreme high temperature increased the risk of hospitalization in patients with AIS (lag 0 day; relative risk [RR] 1.54, 95% confidence interval [CI] 1.01-2.34). It was mainly related to the increased risk of hospitalization in patients with CE subtype (lag 0 day; RR 7.64, 95% CI 1.19-49.09). There was no significant correlation between the extreme low temperature and the risk of hospitalization of AIS (lag 2 days; RR 0.99, 95% CI 0.71-1.37), but it significantly increased the risk of hospitalization in patients with LAA subtypes (lag 2 days; RR 3.04, 95% CI 1.33-6.95), and it was still statistically significant at lag 3 days (RR 2.87, 95% CI 1.57-5.25) and lag 4 days (RR 2.19, 95% CI 1.15-4.15). Conclusion Extreme high temperature may increase the risk of hospitalization in patients with AIS and CE subtypes, while extreme low temperature may increase the risk of hospitalization in patients with LAA subtypes.

Objective To investigate the effect of short-term environmental ozone (O3) exposure on hospitalization risk of acute ischemic stroke (AIS) and its subtypes.Methods From January 1,2016 to December 31,2017,the hospitalization data of patients with AIS from Zhongnan Hospital of Wuhan University,air pollutant data published by China Air Quality Online Monitoring and Analysis Plafform,and the meteorological data published by China Meteorological Data Network were collectcd.According to TOAST etiological classification criteria,the patients with AIS were divided into large-artery atherosclerosis (LAA),small-artery occlusion (SVO),cardioembolism (CE),and stroke of other etiology (SOE).The effect of short-term O3 exposure on the hospitalization risk of AIS and its subtypes was analyzed retrospectively using a distributed lag non-linear model of time series analysis.Results A total of 1 413 patients with AIS were enrolled,including 910 males (64.4％),aged 67.7± 12.8 years (range,18-99 years).Short-term O3 exposure increased the overall hospitalization risk of AIS [relative risk (RR) 1.06,95％ confidence interval (CI) 0.99-1.13],mainly caused by increased hospitalization risks of LAA (RR 1.17,95％ CI 1.02-1.34;lag 5 d) and SVO (RR 1.24,95％ CI 1.06-1.45;lag 3 d).After introducing double pollutant (O3 + other pollutants) model its RR did not have significant changes.A stratified analysis based on demographic characteristics and vascular risk factors showed that the different populations had different sensitivities to the acute hazard effects of O3.Conclusion Short-term exposure to O3 could significantly increase the hospitalization risks of LAA and SVO.

Ischemic stroke is a common neurological disease. MicroRNAs not only play an important role in acute phase of ischemic stroke, but also regulate neurogenesis and angiogenesis after stroke. This article reviews the research progress and prospects of microRNAs as a therapeutic target for ischemic stroke.

Objective To evaluate the effect of isosceles right angle triangulation on deep vein puncture under ultrasound localization. Methods In this prospective randomized case-controlled clinical study, the enrolled patients who required deep veins puncture to establish transient hemodialysis pathway were randomly divided into treatment group treated with ultrasound localization puncture based on isosceles right triangle theory, and control group treated with traditional localization puncture following exploration of blood vessels using color doppler ultrasound, with 46 cases in each group. The differences in gender, age, causes for hemodialysis, puncture sites, successful rate of initial puncture, rates of complications and cathetering-consuming time were compared between two groups. Results The differences in gender, age, causes for hemodialysis and puncture sites between two groups were not statistically significant. In control group, 30 patients received puncture through internal jugular veins, among whom 16 received successful initial puncture, with the successful rate of initial puncture of 53.33%, and the cathetering-consuming time of (545.5 ± 120.3) s; and 16 patients received puncture through femoral veins, among whom 8 received successful initial puncture, with the successful rate of initial puncture of 50.00%, and the cathetering-consuming time of (500.6 ± 120.6) s. Meanwhile, in control group, 3 patients had hematoma in puncture sites, and another 3 had arterial mis-puncture, with the total rate of complications of 13.04%(6/46). In treatment group, 32 patients received puncture through internal jugular veins, among whom 31 received successful initial puncture, with the successful rate of initial puncture of 96.88%, and the cathetering-consuming time of( 99.5 ± 34.8) s;and 14 patients received puncture through femoral veins, among whom 14 succeed in initial puncture, with the successful rate of initial puncture of 14/14, and the cathetering-consuming time of (99.8 ± 44.8) s. None in treatment group had hematoma in puncture sites or arterial mis-puncture. Both groups finished deep veins puncture intubation successfully. Treatment group was markedly higher in the successful rate of initial puncture (P<0.05), notably shorter in cathetering-consuming time (P<0.05), and prominently lower in the total rate of complications than control group (P<0.05), and all differences were statistically significant. Conclusions Ultrasound localization based on isosceles right triangle theory has superiority to traditional B-ultrasound localization in deep veins puncture in that it can promote the successful rate of initial puncture and shorten cathetering-consuming time without increasing the occurrence rates of complications, and can be completely operated by single clinical physician independently, thus deserving to be popularized in clinical practice.

MicroRNA-494 (miR-494) is one of the microRNAs from 14q32.31 miR-gene cluster.Recently, miR-494 was found to closely relate with tumors and other diseases .This article reviews the expression changes , roles and possible regulatory mechanisms of miR-494 in multiple tumors and other hypoxia/ischemia diseases .Recent studies demon-strate that the expression of miR-494 is affected by many factors , and miR-494 could be a biomarker of diagnosis , staging and prognosis in tumors and other diseases , and a target of therapy in future .