Endodontic microsurgery is a vital treatment modality for teeth with persistent periradicular pathoses that have not responded to nonsurgical retreatment. The principle is to determine the reason for failure, completely eliminate the infection and promote periapical healing. Within recent years, endodontic microsurgery has evolved to become standardized and presents with a high success rate. However, its outcome is still influenced by many factors, including anatomy, periodontal condition, crown-to-root ratio, occlusion, the type of periradicular lesion, and prosthesis. Moreover, endodontists always concentrate on “the apex”, paying little attention to the general preoperative evaluation, accurate diagnosis, and comprehensive treatment plan. This article reviews the latest literature on these issues and the clinical experience of our research group and discusses the correlation between endodontic microsurgery and other oral disciplines, including periodontology, prosthodontics, oral implantology, oral and maxillofacial surgery and orthodontics. The oral interdisciplinary assessment should be made with comprehensive consideration of the root canal system, periradicular lesion, adjacent anatomical relationships, periodontal condition, occlusion, and esthetic rehabilitation. Based on these findings, the continuity of treatment will be optimized, and the best treatment plan will be proposed to provide clinical strategies for the diagnosis and treatment of complex periradicular diseases.

Teaching rounds is an important part of clinical teaching practice, therefore, we established a demonstration team for teaching ward rounds. By formulating standard operation procedure for teaching rounds and encouraging innovation on teaching models, the team played a demonstration role in the clinical teaching rounds, which not only made up the shortcomings in teaching, but also improved the teaching level of clinical teachers and the quality of clinical training.

Objective To establish a method for concentration determination of garlic saponins PIEB in the rat plasma and study the pharmacokinetics of PIEB.Methods The separation was performed on a reverse phase Athena C18-WP (50mm×2.1mm, 3μm), with the mobile phase consisted of elution of acetonitrile-water (contain 0.05％formic acid) at a flow rate of 0.3ml/min.After intravenous and gavage administration, the blood samples of rats were collected in different time, and measured by LC-MS/MS.The pharmacokinetics parameters were calculated by Inna Phase Kinetica2000TMpharmacokinetics software.Results There was a good linearity of the calibration curves over the concentration range of 10-2 430ng/ml (r=0.999 1), and the investigation of methodology all accorded with the demands.After intravenous administration of 50mg/kg PIEB in rats, the maximum concentration of PIEB was achieved immediately.The t1/2of PIEB was about 322minutes and the MRT was 270minutes.After oral administration of low, medium and high concentrations of garlic saponin, the AUC and cmaxincreased with the increasing of dosage, which were consistent with the features of linear pharmacokinetics.Conclusion The established method was simple, accurate and sensitive, which could be suitable for the contents determination of garlic saponins PIEB in the rat plasma.

Objective To compare the characteristics of sleep disorder and its effect on health-related quality of life in patients with Parkinson's disease (PD) between early-stage and middleand late-stages.Methods One hundred and fifty-one patients collected in our hospital from September 2014 to May 2016 were divided into PD patients at early stage (grading 1-2,n=82) and PD patients at middle-and late-stages (grading 3-5,n=69) according to Hoehn-Yahr (H-Y) grading.Mini-Mental Status Examination (MMSE),Hamilton Anxiety Rating (HAM-A) scale and Hamilton Depression Rating (HAM-D) scale,Unified Parkinson's Disease Rating Scale Ⅲ (UPDRSⅢ),H-Y grading,Non-motor Symptoms Questionnaire (NMS) and Parkinson's Disease Sleep Scale (PDSS) were used to evaluate cognition states,emotion states,movement functions,disease severity,nonmotor symptoms and sleep disturbances of patients from the two groups.The 39-item Parkinson's Disease Questionnaire (PDQ-39)was used to evaluate the quality of life of PD patients.Results The incidence of sleep disorder in PD patients at middle-and late-stages was significantly higher than that in PD patients at early stage (P＜0.05),and the total scores of PDSS in PD patients at middle-and late-stages were significantly lower than those in PD patients at early stage (P＜0.05).Fragmented sleep (31.7％ and 47.8％) and excessive sleepiness at daytime (38.7％ and 43.5％) were the most common problems in patients from the two groups.Sleep disorder was negatively correlated with duration,and scores of HAM-A,HAM-D,UPDRSⅢ and H-Y grading,while it was positively correlated with MMSE scores in patients from the two groups (P＜0.05).Sleep disorder was negatively correlated with NMS scores and daily levodopa equivalent dose in PD patients at middle-and late-stages (P＜0.05).Multivariate regression analysis indicated that PDSS total scores were negatively correlated with HAMD scores and positively correlated with MMSE scores in all patients (P＜0.05).PDSS total scores were negatively correlated with duration in PD patients at middle-and late-stages (P＜0.05).Sleep disorder was negatively correlated with total scores of PDQ39,mobility,activity of daily living,communication ability and body discomfort in PD patients at middle-and late-stages (P＜0.05).Conclusions The quality of sleep disorder in PD patients at middleand late-stages is worse than that in PD patients at early stage,and the quality of life is further reduced than that in PD patients at early stage.The course of disease has a great influence in sleep disorder of PD patients.

Objective To explore the application of olfactory assessment and substantia nigra ultrasonography in early diagnosis of Parkinson's disease (PD).Methods Thirty PD patients,admitted to our hospital from March 2015 to March 2017,were served as PD group and 30 healthy subjects were served as control group.Olfactory assessment tool Sniffm Sticks-1 6 and substantia nigra ultrasonography were performed;the sensitivity,specificity and positive predictive value of olfactory assessment,transcranial ultrasonography,and combined measurement for diagnosis of PD were calculated,respectively.Correlations of results of olfactory assessment,transcranial ultrasonography with age,gender,course of disease,and Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) scores were analyzed.Results There were 25 PD patients with olfactory test (SS-16) scores≤ 10 and 22 control subjects;the olfactory test (SS-16) scores in PD patients were 7.83±2.23,which were significantly lower as compared with those in control subjects (12.03±1.96,P＜0.05);the incidence of olfactory dysfunction in PD group was 83.33％ and that in control group was 26.67％,with statistical significance (P＜0.05).There were 23 PD patients with area of substantia nigra hyperecho≥ 0.20 cm2 and 26 control subjects;area of substantia nigra hyperecho was (0.22±0.06) cm2 in PD group,which was signfciantly increased as compared with control group ([0.11 ±0.07] cm2,P＜0.05);the incidence of pathological substantia nigra hyperecho in PD group was 76.67％ and that in control group was 13.33％,with significant difference (P＜0.05).The sensitivity of olfactory assessment,transcranial ultrasonography,and combined measurement for diagnosis of PD was 83.33％,76.67％,86.67％,indicating that combined measurement had significantly higher sensitivity that the other two method (P＜0.05).SS-16 scores and area of substantia nigra hyperecho were unrelated with gender,age,duration and UPDRS Ⅲ scores (P＞0.05).Conclusion Combination of olfactory test and substantia nigra hyperecho can improve the diagnosis sensitivity of PD.

Objective To research the epithelial-mesenchymal transition (EMT) effects of cuprous oxide nanoparticles (CONPs) on melanoma.Methods Cuprous oxide nanoparticles were prepared hydrothermally.The B16 cells were cultured with cuprous oxide nanoparticlesat different concentrations (5,25,50 μg/ml).The changes of the morphology of the B16 cell were observed under the inverted microscope.The effects of CONPs on B16 cell migration ability were detected through the Wound healing assay and the Transwell assay.Then cell immunofluorescence and western blotting were used to test the EMT related molecular markers, including E-cadherin, N-cadherin, Cytokeratin, and Vimentin.Results The synthesized cuprous oxide nanoparticles distribute uniformly with a diameter of 40 nm.Our study indicated that CONPs inhibited the EMT of B16 cell.A conversion process was discovered in this study.In B16 cells, CONPs inhibited B16 cell migration, promoted the expression of E-cadherin, Cytokeratin and Desmoplakin, while the expression of N-cadherin and Vimentin was repressed in protein level.Conclusion Cuprous oxide nanoparticles can significantly restrain the invasion and metastasis of melanoma cells and inhabit the EMT of B16 cells.

Objective:To optimize the formula of regorafenib solid dispersion .Methods: On the basis of preliminary studies on the carrier and drug/carrier ratio, an orthogonal test was used to study the formula of regorafenib solid dispersion .The orthogonal table of L9 (34 ) was designed to study the drug/carrier ratio, ultrasound time and bath temperature .Results: Regorafenib solid dispersion was prepared by a solvent method with polyvinylpyrrolidone K 30 as the carrier.The drug/carrier ratio was 1 ∶7, the ultrasound time was 4min, and the bath temperature was 30℃.Regorafenib solid dispersion showed good stability confirmed by differential scanning calorimetry and X-ray diffraction .The dissolution in 30 min reached above 90 %.Conclusion: The preparation process is stable and reproducible , which can be used to prepare regorafenib solid dispersion .

Objective To compare the effect of mirror therapy (MT) supplemented by early rehabilitative intervention and acupunture therapy on recovery of hemiplegic limb function versus routine occupational training in post-stroke elderly patients.Methods Totally 120 acute-stroke elderly patients with limb paralysis were randomly divided into two groups:MT group and control group (n=60,each).All 120 patients received routine rehabilitative intervention and acupunture therapy except for 30 minutes mirror therapy daily as add-on therapy to the MT group,all patients were assessed with Chinese Stroke Scale(CSS) and the Barthel index(BI) before and after treatment 1 and 3 months.Results At the end of 1 and 3 months of treatment,CSS in the MT groups was (15.6±8.5)scores,(11.6±7.2)scores,ADL was (75.3±13.9)scores,(80.1±13.0)scores;CSS in the control group was (16.2±5.8)scores,(14.8±6.1)scores,ADL was (68.2±13.5)scores,(70.5±12.9)scores.Before treatment,CSSandADLwas (21.3±7.1)scores,(63.7±12.6)scoresin the MT group; (20.8 ± 7.6) scores,(61.7 ± 11.4) scores in the control group.There were significant differences in CSS and ADL between groups,except CSS after 1 month (t=1.40,2.38,-3.27,-3.47; P=0.166,0.019,0.001,0.001,respectively).After 3 months of treatment,CSS and ADL in the MT group had considerably outperformed those of the control group(t=2.40,-3.47,P＜0.05 or 0.01).Conclusions Mirror therapy is better than routine occupational training in improving the motor function of limbs and activities of daily living(ADL) ability 3 months after stroke,on the basis of early rehabilitative intervention and acupunture therapy.

Objective To evaluate the value of echo‐contrast RT‐3DE for assessment of left ventricular volume and function in patients with left ventricular non‐compaction(LVNC) .Methods Twenty‐one patients of LVNC were involved and underwent non‐enhanced and contrast‐enhanced RT‐3DE to evaluate left ventricular end‐diastolic volume (LVEDV) ,left ventricular end‐systolic volume (LVESV) ,left ventricular ejection fraction (LVEF) .The endocardial border definition of LV was graded for each of the 16 LV segments as follows :0 = border invisible ,1 = border visualized only partially ,and 2 = complete visualization of the border .Three image‐quality groups (good ,fair ,and uninterpretable) were identified . Results ①Duringcontrast‐enhancedRT‐3DE,ascomparedwithnon‐enhancedRT‐3DE,thenumberof segments with complete visualization of the endocardial border increased significantly (55% vs 82% ,P <0.01) ,and the number of patients with a good‐quality echocardiogram increased significantly (33% vs 81% , P <0.01) .②Contrast‐enhanced RT‐3DE provided significantly larger values of LVEDV ( P < 0 0.1) and LVESV ( P < 0 0.1) as compared with non‐enhanced RT‐3DE ,the values of LVEF were not statistically different between the two techniques ( P =0.07) .③Intra‐and inter‐observer agreement for assessment of LV volumes and systolic function improved during contrast‐enhanced RT‐3DE ,as compared with non‐enhanced RT‐3DE .Conclusions Contrast‐enhanced RT‐3DE can increase the prevalence of good‐quality echocardiograms and significantly improve the reproducibility of LV volumes and function measurements .

Objective To analyze the characterization of cognitive function in Parkinson's disease with dementia and Alzheimer's disease. Methods Cognitive function was examined in Parkinson's disease with dementia (PDD) patients ( n = 30) , Alzheimer's disease (AD) patients ( n = 30) and healthy elderly control subjects ( n = 60) . Neuropsychological evaluation contained semantic fluency test, phonemic fluency test, action fluency test, objective and action naming tests. Results In PDD group , the score of semantic fluency test is 9. 33 ±2. 78, 6. 17 ± 1.67 of phonemic fluency test and 7.03 ±2. 34 of action fluency test,it is 6.90 ±2.47, 7.87±2.01,8.30±3. 17 of AD group. The score of objective and action naming tests is 36.33 ±3.39, 17.63 ±2. 17 in PDD group,while AD patients is 33.23 ±3.56 and 22.33 ±2.37. The verbal fluency tests and naming tests were impaired in PDD and AD patients compared with the healthy elderly control group (P ＜ 0. 01 ), phonemic fluency, action fluency and action naming were more impaired in PDD patients compared with the AD group , while semantic fluency and objective naming were more impaired in AD patients (P ＜ 0. 01 ). Conclusions Executive function deficit and naming impairment are found in PDD and AD patients, it shows that PDD is characterized by the addition of cortical dysfunction upon a predominant and progressive fronto-subcortical impairment. There is subcortical dysfunction in AD patients.