Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Angelicae Sinensis Radix (AS) is reproted to exert anti-depression effect (ADE) and nourishing blood effect (NBE) in a rat model of depression. The correlation between the two therapeutic effects and its underlying mechanisms deserves further study. The current study is designed to explore the underlying mechanisms of correlation between the ADE and NBE of AS based on hepatic metabonomics, network pharmacology and molecular docking. According to metabolomics analysis, 30 metabolites involved in 11 metabolic pathways were identified as the potential metabolites for depression. Furthermore, principal component analysis and correlation analysis showed that glutathione, sphinganine, and ornithine were related to pharmacodynamics indicators including behavioral indicators and hematological indicators, indicating that metabolic pathways such as sphingolipid metabolism were involved in the ADE and NBE of AS. Then, a target-pathway network of depression and blood deficiency syndrome was constructed by network pharmacology analysis, where a total of 107 pathways were collected. Moreover, 37 active components obtained from Ultra Performance Liquid Chromatography-Triple-Time of Flight Mass Spectrometer (UPLC-Triple-TOF/MS) in AS extract that passed the filtering criteria were used for network pharmacology, where 46 targets were associated with the ADE and NBE of AS. Pathway enrichment analysis further indicated the involvement of sphingolipid metabolism in the ADE and NBE of AS. Molecular docking analysis indciated that E-ligustilide in AS extract exhibited strong binding activity with target proteins (PIK3CA and PIK3CD) in sphingolipid metabolism. Further analysis by Western blot verified that AS regulated the expression of PIK3CA and PIK3CD on sphingolipid metabolism. Our results demonstrated that sphingolipid metabolic pathway was the core mechanism of the correlation between the ADE and NBE of AS.
Rats ; Animals ; Rats, Sprague-Dawley ; Molecular Docking Simulation ; Network Pharmacology ; Drugs, Chinese Herbal/chemistry* ; Metabolomics/methods* ; Mass Spectrometry

An increasing number of studies have recently indicated the important effects of gut microbes on various functions of the central nervous system.However, the underlying mechanisms by which gut microbiota regulate brain functions and behavioral phenotypes remain largely unknown. We therefore used isobaric tags for relative and absolute quantitation (iTRAQ)-based quantitative proteomic analysis to obtain proteomic profiles of the hippocampus in germ-free (GF), colonized GF, and specific pathogen-free (SPF) mice. We then integrated the resulting proteomic data with previously reported mRNA microarray data, to further explore the effects of gut microbes on host brain functions. We identified that 61 proteins were upregulated and 242 proteins were downregulated in GF mice compared with SPF mice. Of these, 124 proteins were significantly restored following gut microbiota colonization. Bioinformatic analysis of these significant proteins indicated that the glucocorticoid receptor signaling pathway and inflammation-related pathways were the most enriched disrupted pathways. This study provides new insights into the pathological mechanisms of gut microbiota-regulated diseases.

Objective To explore the effects of trimetazidine (TMZ) on newly onset of type 2 diabetes mellitus(T2DM) in coronary artery disease patients. Methods Using nested-case-control study and a total of 639 coronary artery patients but without T2DM were enrolled. All the patients were followed-up until March, 2015. T2DM was diagnosed with OGTT. The effects of TMZ on T2DM onset, serum levels of fatty acid, HbA1c and insulin were analyzed. Results At the end of the followed-up, a total of 103 T2DM patients were identified. TMZ is still an independent risk factor of newly onset of T2DM after confounding factors were adjusted. TMZ therapy reduced serum HbA1c, FFA and insulin levels. Besides, TMZ treatment was related to proper time to reach the peak of insulin secretion. Conclusion TMZ therapy can reduce newly onset of T2DM in coronary artery disease patients. The affects of lowering serum FFA, which caused insulin resistance, may be its underlying mechanism.

Objective To investigate the problems during using, standard and quality management of the POCT glucose meters in hospital, to analyze the solutions, and to provide reference data for improving the test level of POCT in hospital.Methods The amount, brand and application of portable glucose meters in the hospital were obtained by 3 rounds of surveillance from May to July in 2013.All of those glucose meters were taken part in external quality assessment of Clinical Laboratory Center of National Health and Family Planning Commission.The test results of those glucose meters were compared with that of automatic biochemical analyzer, the comparison results were then analyzed.Results The POCT glucose meters possessed 5 brands in our hospital, and the amount and type of glucose meters in some clinical departments were often changed.When 4 brands which were detected as quality control samples by ministry of health, the accuracy of detection results of 3 concentration of brand Ⅲ were substandard, the CV% of two levels were 11.9%and 10.1%respectively, the remaining 3 brands were in line with the requirements.The qualified percentages of 3 times of comparison were 85.0%, 92.0%and 97.4%.Conclusions The hospital should select the brand of portable glucose meters reasonably, correct use of glucose meters, and it is very necessary to build indoor and interstitial quality evaluation system, at the same time, suggesting the hospital to establish the POCT quality management team, to carry out the instrument comparison periodically, so to guarantee the accurate, reliable results of POCT in hospital.

Aim To investigate the effects of diterpene ginkgolides meglumine injection (DGMI ) on amino acids and monoamine neurotransmitters in rats with cerebral ischemia/reperfusion injury.Methods In-traluminal suture was applied to establish middle cere-bral artery occlusion (MCAO/R)model with ischemia for 1.5 h and reperfusion for 24 h.After the adminis-tration of DGMI (i.v.),the levels of amino acid and monoamine neurotransmitters in brain tissue were de-tected through HPLC-ECD.Results DGMI down-reg-ulated the concentrations of aspartic acid, glutamic acid,glycine and γ-aminobutyric acid which were in-creased in MCAO/R group.DGMI also reduced the levels of norepinephrine epinephrine,glyoxylic acid, serotonin and 5-HIAA in cortex and hippocampus,and increased adrenaline content compared to the model group.Conclusion DGMI exhibits a protective role in rats with cerebral ischemia /reperfusion injury through regulating amino acids and monoamine neuro-transmitters.

Through the excellent experiment of cardiovascular system in pathology, the prac-tice of the teaching reform was carried out such as combining flow model with real specimens, digital sections with light microscope slides, inserting the use of special staining experiments in combination with digital medical image analysis and the simulation of cardiovascular clinical pathological case dis-cussions. Linking theory with experiment teaching and experiment teaching with clinical practice was focused on, which not only stimulated students' interest in learning and their exploring thinking and hands-on ability, but also promoted them to obtain good learning effect, thus improving the teaching quality.

Objective To investigate the association between single nucleotide polymorphisms in the intron 1 of thyroid stimnulating hormone receptor gene (TSHR) and Graves' disease (GD) in the Chinese Han population from Linyi city,Shandong Province.Methods A total of 1759 GD patients and 1740 control subjects were recruited for genotyping in TSHR intron 1 with genome-wide association study (GWAS) and Taqman probe technique.At the same time,serum thyroid hormone and TSH receptor antibody (TRAb) levels of patients were determined.Results Five SNPs were selected for further replication.The rs12101261 _T was significantly associated with GD risk ( OR=1.257,95％CI 1.137-1.390,P =8.23 × 10-6 ). Logistic regression identified that rs12101261 was an independent susceptibility locus of GD ( P=1.61 × 10-3 ).Furthermore,rs12101261 _T was strongly associated with GD ( OR =1.317,95％ CI 1.171-1.481,P=4.14× 10-4 ) in TRAb positive patients,but no association in TRAb negative patients ( OR=1.056,95％ CI 0.892-1.251,P=0.524 ).Serum TRAb concentration showed remarkable difference among three genotype groups of rs12101261.Conclusions Five SNPs in TSHR intron 1 are associated with GD.rs12101261 contributes to increased GD risk independently and is associated with serum TRAb level.

Objective To compare the effects of pulse high-volume hemofiltration (PHVHF) and continuous veno-venous hemofiltration (CVVH) on severe acute panceatitis (SAP). Method From January 2005 to December 2009, a total of 38 patients with SAP were randomly(random number) divided into PHVHF group ( n = 18)and CVVH group ( n = 20). After hemofiltration for 72 hours, clinical symptoms, APACHE Ⅱ score, biochemical changes and mortality were observed. The levels of TNF-α, IL-6, and IL-10 in plasma were assayed by using ELISA before and after treatment. The doses of dopamine used in shock patients were also observed. Measurement data were expressed in(-x) ± s, and t-test was used for comparison between two groups. Results In both groups ,symptoms were markedly improved after treatment. The APACHE Ⅱ score, serum amylase, creatinine, and white blood cell count were decreased ( P ＜ 0.05). Besides, hypoxemia and acidosis were corrected, and the PHVHF group was superior to the CVVH group especially in heart rate, breathing and APACHE Ⅱ score ( P ＜ 0. 05).The levels of TNF-α, IL-6 and IL-10 decreased in both groups ( P ＜ 0.05), and the PHVHF group was superior to the CVVH group ( P ＜ 0. 01 ). The doses of dopamine used in shock patients also decreased in both groups ( P ＜0. 01 ), and they decreased more in PHVHF group than in CVVH group ( P ＜ 0.05). The mortality was 11.1%in PHVHF group and 25 % in CVVH group. Conclusions PHVHF is obviously superior to CVVH in the treatment of SAP, and can serve as an important adjuvant therapy for SAP, stabilizing the hemodynamics and reducing the levels of pro-inflammatory factors and mortality.

Objective To study the expression and clinical significance of Survivin and PTEN in cervical carcinoma. Methods The expression of Survivin and PTEN in 60 cases of cervical carcinoma, 15 cases of CIN Ⅰ , 15 cases of CIN Ⅱ, 15 cases of CIN Ⅲ and 15 cases of normal cervical tissues were detected by immunohistochemical staining. Results The expression positive rates of Survivin were 86.67 %, 80.00 %,33.33 %, 20.00 % and 0, respectively, and those of PTEN were 21.67 %, 40.00 %, 80.00 %, 86.67 % and 100.00 % in cervical carcinoma, CIN Ⅲ, CIN Ⅱ, CIN Ⅰ and normal cervical tissues, respectively. The expression positive rates of Survivin were increased along with normal cervical epithelium, CIN Ⅰ, CIN Ⅱ,CIN Ⅲ and invasive carcinoma of cervix;while those of PTEN were inverse order.Compared with the expression positive rates of Survivin and PTEN protein in the CIN Ⅱ group, those in the CIN Ⅲ group had significant differences (P <0.01 and P <0.05, respectively). Expressions of Survivin and PTEN were correlated to the size of focus(P <0.05), the depth of tumor and pelvic lymphnode metastasis (P <0.05), but not to clinical staging, pathological types, pathological grading and age(P >0.05). There was a negative correlation between the expression of PTEN and Survivin in cervical carcinoma. Conclusion The expressions of Survivin and PTEN are correlated with invasion and metastasis of cervical carcinoma, and be related to clinical pathotology.Survivin and PTEN may play a important role in the formation, proliferation, differentuation and metastasis of cervical carcinoma. They may be used as markers of early diagnose, efficacy and prognosis evaluation.