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The aim of this study was to compare the efficiency of four final irrigation protocols in smear layer removal and bacterial inhibition in root canal systems. Thirty roots inoculated with Enterococcus faecalis were prepared with ProTaper Universal files. The teeth were disinfected by conventional needle irrigation, sonic agitation using the EndoActivator device, passive ultrasonic irrigation, or an M3 Max file. Teeth with no root canal preparation served as blank controls for the establishment of the infection baseline. Teeth with preparation but no final irrigation served as a post-instrumentation baseline. After the final irrigation, the teeth were sectioned in half. One half of each tooth was examined by scanning electron microscopy (SEM) to assess smear layer removal using a five-point scale. The other half was examined by confocal laser scanning microscopy (CLSM) using the LIVE/DEAD BackLight bacterial viability kit to evaluate the depth of bacterial survival in dentinal tubules. SEM analysis revealed no significant difference in smear layer removal throughout the whole canal among the EA, PUI, and M3 Max groups (P > 0.05). CLSM revealed that PUI achieved the greatest bacterial inhibition depth in the coronal ((174.27 ± 31.63) μm), middle ((160.94 ± 37.77) μm), and apical ((119.53 ± 28.49) μm) thirds of the canal (all P < 0.05 vs. other groups). According to this comprehensive SEM and CLSM evaluation, PUI appears to have the best infection control ability in root canal systems.
Subject(s)
Humans , Dental Pulp Cavity , Edetic Acid , Microscopy, Electron, Scanning , Root Canal Irrigants , Root Canal Preparation , Smear Layer , Sodium HypochloriteABSTRACT
Objective:To compare the effects of three root canal sealers with respect to time on biocom-patibility of human periodontal ligament cells (hPDLCs).The sealers included zinc oxide and eugenol based sealers (ZOE),epoxy resin sealers (ERS)and silicone based sealers (SBS).Methods:hPDLCs were primarily cultured,with the method combining of tissue explant and enzymatic digestion.The cells were then exposed to different extract fluids:(1)ZOE extracted for 24 h group ;(2)ZOE extracted for 1 week group;(3)ZOE extracted for 2 weeks group;(4)ERS extracted after 24 h group;(5)ERS extracted after 1 week group;(6)ERS extracted after 2 weeks group;(7)SBS extracted after 24 h group;(8)SBS extracted after 1 week group;(9)SBS extracted after 2 weeks group;(10)Dulbecco modified Eagle’s me-dium/F12(DMEM/F12)as negative control group.Cell morphology was observed under an inverted mi-croscope.Cell proliferation was measured by methyl-thiazol-diphenyltetrazolium (MTT)assay.ALP assay kit was used for measuring alkaline phosphatase (ALP)activity.Sealers of 2 weeks’setting time were then immersed in an osteogenic medium for examination of mineral nodules and calcium deposits.Re-sults:Considering the relative growth rate (RGR),ZOE was severely to moderately cytotoxic (RGR:13.6% -39.9%),while ERS was slightly or not cytotoxic (RGR:87.6% -95.3%).Only SBS did not show any cytotoxicity after setting (RGR:91.8% -106.7%).The setting time influenced the cytotoxic-ity of ERS which decreased after 1 week.Considering the ALP activity,there was no difference between SBS group and control group(F =3.397,P =0.053).According to the results of calcium deposits, ZOE:D562 nm =0.180 ±0.050,ERS:D562 nm =2.968 ±0.201,SBS:D562 nm =3.623 ±0.039,Control:D562 nm =3.477 ±0.102,the ranking of ALP activity and calcium deposits was as follows:ZOE
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Objective To evaluate the efficacy and safety of peroral direct cholangioscopy (PDCS) in the treatment of refractory common bile duct stones after retrograde cholangiopancreatography (ERCP).Methods Data of 13 patients who underwent peroral direct cholangioscopy for refractory common bile duct stones after retrograde cholangiopancreatography at our institution from April 2012 to August 2014 were retrospectively analyzed.Completion rate,side-effects and complications were summarized.Results Peroral direct cholangioscopy was successfully performed with electrohydraulic lithotripsy and stones were removed in 12 of the 13 patients.Lithotripsy and stone removal failed in one patient,though the ultraslim endoscope accessed distal common bile duct near the stone.Stones were removed directly with extraction basket under PDCS in 7 patients,and duodenoscopy was performed in 5 patients due to too many stone fragments.Stone removal was successfully completed at one time in 9 cases.Stones removal failed in 3 cases at one time because of too many stone fragments,but was successful with duodenoscopy a week later after a temporary biliary tract stenting.Andoxygen saturation decreased in one patient due to vomit during the operation.Sputum in oropharyngeal area was immediately sucked out and the gastric juice at the bottom of the stomach was also sucked by endoscopy.Oxygen saturation returned to normal levels and the subsequent operation was not affected.No aspiration pneumonia occurred after the operation.Hyperamylasemia occurred in two patients,and postoperative biliary tract infection occurred in one,but the situation was controlled after appropriate treatment.Conclusion PDOS using an ultraslim endoscopy is an effective and feasible endoscopic procedure for the refractory common bile duct stones.This study provides a new method for the treatment of refractory common bile duct stones.
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<p><b>OBJECTIVE</b>To investigate the expression of stromal cell-derived factor-1 (SDF-1) in human stem cells from apical papilla (SCAP), and to evaluate the effect of lipopolysaccharide (LPS) on SDF-1 expression by SCAP.</p><p><b>METHODS</b>SCAP were isolated from dental papilla of human immature third molars. The expression of SDF-1 was evaluated by reverse transcription-PCR (RT-PCR). After SCAP being exposed to different concentrations (0.1, 1.0, 10 mg/L) of LPS for 24 and 48 h, the effect of LPS on cell proliferation and gene expression of SDF-1 was investigated by cell counting kit-8 and real-time PCR respectively, while cells without LPS stimulation were considered as negative control.</p><p><b>RESULTS</b>LPS had no significant effect on SCAP proliferation until day 7. RT-PCR assays demonstrated that SCAP expressed SDF-1 mRNA. Different concentrations of LPS significantly promoted the SDF-1 expression in SCAP after 24 h (F = 12.102, P = 0.002) and 48 h (F = 39.054, P < 0.001) exposure, with relative gene expression ratio (experimental/control) increased to 1.4 ± 0.1, 2.2 ± 0.4, 2.3 ± 0.5 in 24 h group and 2.1 ± 0.4, 3.4 ± 0.3, 3.8 ± 0.5 in 48 h group.</p><p><b>CONCLUSIONS</b>Isolated SCAP in cultures have the expression of SDF-1 mRNA. LPS can significantly promote the expression of SDF-1 in SCAP.</p>
Subject(s)
Humans , Cell Differentiation , Cell Proliferation , Chemokine CXCL12 , Genetics , Metabolism , Dental Papilla , Cell Biology , Gene Expression , Lipopolysaccharides , Pharmacology , Stem Cells , MetabolismABSTRACT
Objective To investigate the diagnostic and therapeutic value of peroral cholangioscopy for residual stones after retrograde chalangiopancreatography (ERCP).Methods The soft-tipped guidewire (0.021in) was linked to 3-0 silk thread on the front of extraction balloon catheter outside as a guide device.After retrograde chalangiopancreato-graphy (ERCP) for common bile duct stones,extraction balloon with the guide device was sent to intrahepatic bile duct by duodenoscopy,and residual stones were observed and removed with a stone basket directly under ultrathin upper endoscope if the residual stones were small ; if the stones were large,they were crushed with electrohydraulic lithotripsy before being removed.Results The ultrathin upper endoscope were successfully inserted into hilar bile duct in 42 cases of 46 patients,and failed in 4 cases,and the success rate of insertion was 91.3％.The mean time was 11.3 min from the mouth into hilar bile duct.Stones were found larger than 4 mm in diameter in 6 of 42 patients,and stone residual rate was 14.3％.The biggest stone was 10 mm× 12 mm in diameter.Stones were found in in 2 of 27 patients after ERCP,and the stone residual rate was 7.4％.Stones were found in 4 of 15 patients after ERCP basket lithotripsy,and the stone residual rate was 26.7％.Stones were removed directly in 5 in 6 cases with extraction basket,they were crushed in 1 case by electrohydraulic lithotripsy and then removed with basket.No serious complications were observed.Conclusion The application of peroral cholangioscopy using an ultrathin upper endoscope is feasible.The method is a useful endoscopic procedure for extraction of residual stones,which helps to avoid repeated treatment.
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Objective To investigate the risk factors and treatment efficiency for lung cancer patients with venous thromboembolism (VTE). Methods Total 282 cases of lung cancer patients with VTE were enrolled into two groups , including the VTE group and the non-VTE group , for comparation analysis based on a series of clinical data. Results The occupation rate of adenocarcinoma and Ⅳ period were 65.28% and 87.50% in VTE group, respectively, higher than those of 51.43% and 75.71% in the non-VTE group. The increased rate of blood viscosity and d-dimer respectively were 65.28% and 70.83%, higher than those of 51.43% and 56.67% in the non-VTE group, with significant differences (P < 0.05, respectively). Result of logistic regression analysis showed that tumor stage , d-dimer levels , smoking , age , and blood viscosity levels were highly correlated with venous thrombosis in patients with lung cancer, and the OR value among them was 3.802, 2.339, 5.814, 3.875 and 6.404, respectively, with significant differencees (P < 0.05, respectively). Conclusions Lung adenocarcinoma with stage Ⅳ, smoking , age and increase of blood viscosity and d-dimer were the important risk factors for VTE in patients with lung cancer chemotherapy. Timely assessment of risk factors and early anticoagulation therapy in lung cancer patients with venous thromboembolism associated with VTE can improve the treatment efficacy and reduce the complications.
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Objective To evaluate the effect of clinical pathway in pulmonary thrombus embolism (PTE) .Methods 60 cases of PTE were admitted department of respiratory from 2011 to 2012 and divided into the experimental group and the control group ,30 cases for each group .The control group was implemented with normal process of hospital management while experimental group de-veloped clinical pathways .The efficacy ,department of respiratory drug costs ,complications and patient satisfaction were recorded and computed .Results The average department of respiratory and drug costs in experimental group respectively was (17 .13 ± 2 .22)days ,(16 545 .04 ± 1 557 .44) RMB and (7 050 .83 ± 372 .74) RMB ;less than (19 .77 ± 3 .41)day ,(17 709 .45 ± 1 902 .05) RMB and (7 345 .75 ± 450 .82) RMB in control group ,there were significant difference between the two groups (P0 .05) .Conclusion The effect of clinical pathway in PTE have a positive role in reducing hospitalization time ,total costs ,drug costs and increasing satisfaction ,it is worth to develop in primary hos-pital .
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<p><b>OBJECTIVE</b>To investigate the effect of Notch signaling pathway on human dental pulp cells.</p><p><b>METHODS</b>The γ-secretase inhibitor N-[N-(3, 5-difluorophenacetyl-L-alanyl)]-S-phenylglycine t-butyl ester(DAPT) was applied to inhibit the Notch signaling pathway of human dental pulp cells. The solvent dimethly sulfoxide (DMSO) served as the negative control.Senescence conditions were evaluated by cells morphology changes, the alkaline phosphatase (ALP) expression and its activity, senescence-associated β-galactosidase (SA-β-Gal) expression and the senescence related gene p53 expression.</p><p><b>RESULTS</b>After inhibition of the Notch signaling pathway, morphology changes, including flatter cells, larger plasma area, were seen in the 10th passage human dental pulp cells. ALP expression and activity showed a significant decrease at the 8th passage after inhibition (35.36 ± 2.55) U/g, compared with the negative control group[(49.76 ± 4.30) U/g] (t = 4.989, P = 0.008).SA-β-Gal-positive cells could be seen as early as the 8th passage and more positive cells were evident at the 10th passage. The relative expression level of p53 gene was elevated in the 10th passage cells (1.7 ± 0.4) compared with the negative control group(1.0) (t = 3.581, P = 0.012).</p><p><b>CONCLUSIONS</b>Human dental pulp cells became senescent at earlier passages after inhibition of Notch signaling pathway.Notch signaling pathway may affect life cycle of human dental pulp cells.</p>
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Humans , Cells, Cultured , Dental Pulp , Metabolism , Epithelial Cells , Receptors, Notch , Physiology , Signal TransductionABSTRACT
ObjectiveTo compare the neonatal outcomes between infants of assisted conception (AC) and natural conception (NC). Methods A prospective case-control study was conducted.Eligible mothers were invited to this study at 28 weeks of gestation and were followed up to delivery.All newborns were examined by pediatricians right after birth.Data including gestational age,birth weight,admission to neonatal intensive care unit (NICU),and presence of any major malformation were collected.Statistical analysis was performed with SPSS 13.0.Difference between two groups was compared by x2 test. ResultsSix hundred and seventy-three newborns were enrolled into this study,including 325 in AC group and 348 in NC group.There were no differences between the demographic characteristics of the two groups,including maternal age,parents' education,family income and proportion of primipara (P＞0.05).The incidences of twins (32.62％ vs 3.45％,x2 =98.88),preterm birth (30.46％ vs 7.76％,x2=56.92),low birth weight infant (32.31％ vs 8.91％,x2 =57.07)and admission to neonatal intensive care unit (27.38％ vs 8.91％,x2 =39.16) and proportion of cesarean birth (62.77％ vs 21.55％,x2=117.64) in AC group were significantly higher than in NC group (all P＜0.01),except for the incidence of birth defect (4.62％ vs 2.59％,x2=2.01,P＞ 0.05).However,no significant differences was found in the above items when only singletons were compared between the two groups (P＞0.05),except for the cesarean section rate (61.18％ vs 22.03％,x2 =100.93,P＜0.01).There were no difference in any of the above neonatal outcomes when different assisted reproductive technologies applied were compared(in vitro fertilization-embryo transfer,intracytoplasmic sperm injection and frozen embryo transfer) (P＞0.05).Conclusions Neonatal outcome after assisted conception is a bit worse than natural conception,which might mainly due to the large proportion of multiple pregnancy after assisted conception.In order to improve neonatal outcome after assisted conception,the number of embryos transferred should be limited.
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Objective:To evaluate the cytotoxicity of sodium hypochlorite(NaOCl) and chloramine-T at a same available chlorine concentration. Methods: L929 fibroblasts were used to test the cytotoxicity of NaOCl and chloramine-T at a same available chlorine concentration (0.500 0%, 0.250 0%,0.200 0%, 0.150 0%, 0.125 0%, 0.062 5%). Cell viability after 2 h, 30 min or 10 min exposure were measured by MTT assay. Results: Except the 0.500 0%-2 h group and 0.062 5%-30 min group, cell viability of NaOCl groups were higher than chloramine-T group(P<0.05). Conclusion: NaOCl solution has less cytotoxicity than chloramine-T at a same available chlorine concentration lower than 0.250 0%.
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Objective To explore the role and significance of standardized scheme for diagnosis and treatment of pulmonary thromboembolism(PTE).Methods The clinical data of 163 consecutive PTE patients who were treated in our hospital from Jan.1972 to Dec.2006 were retrospectively reviewed.The patients were divided into group A and group B based on the time of application of standardized treatment and diagnosis for PTE.The clinical data of the two groups were analyzed and compared.Results The main risk factors included deep vein thrombus,operation,injury,fracture and tumors,etc.Dyspnea was the most important clinical symptoms.The incidences of dyspnea in group A and B were 92.5% and 84.6%,respectively.The diagnostic case and the ratio of final diagnosis in group B was increased compared to those in group A on an annual basis.The median time for diagnosis was shortened(P