Micro-CT analysis of tooth development of C57BL/6 mice strain / 中华口腔医学杂志

Objective: To investigate the normal process of tooth development of C57BL/6 mouse strain by using micro-CT for better understanding about the tooth development of the human being and other species. Methods: A total of 54 C57BL/6 mice were used at postnatal day 1 (P1), P3, P7, P10, P14, P21, P28, P42 and P56 (n=6 for each age group). After euthanasia, the skulls and alveolar bones (with molars) were isolated and scanned by micro-CT scanner. After three dimensional reconstruction, the developmental status of the crown and root(s) for each tooth type was examined in different views. Results: The tooth development of mice from birth to mature (P56) could be divided into three stages. The first stage was from P1 to P14, in which the crowns of all the first, second and third molars had formed, while the roots had not fully developed yet. The second stage was from ablactation (P21) to P28, in which all the roots of the molars had reached their normal length, and the apical foramens had closed. Due to the mastication and occlusal abrasion, the incisors exhibited sharp cutting edges at the buccal enamel layer, and the corresponding molars formed a pit-to-fossa articulated relationship. The third stage was from P42 to P56, in which the root canal differentiation occurred, and 1-2 canal configuration was formed in several flat roots. The development of molar roots had completed and the apexes were enlarged due to the deposition of cementum around. Conclusions: In the process of mouse tooth development, the mineralization of the cusps, followed by crown formation and roots elongation, was precisely regulated in a spatial-temporal pattern. The incisors and the molars exhibited different modes of development.

Immune checkpoint inhibitors induced pituitary immune-related adverse events: diagnosis and management / 中华肿瘤杂志

Immune checkpoint inhibitors (ICIs) have been used in treating a wide variety of cancers, but they challenge clinicians with a series of special immune related adverse events (irAEs) resulting from activated immune system. Since June 2018, when the first programmed cell death 1 (PD-1) inhibitor, nivolumab, was approved by the National Medical Products Administration (NMPA), abundant experience has been accumulated in coping with irAEs from PD-1 and PD-1 ligand 1 (PD-L1) blockade therapies. In October 2021, the first CTLA-4 inhibitor, ipilimumab, which has a different spectrum of irAEs was also approved by NMPA. The discrepancy in clinical features of pituitary irAEs is obvious between these two types of ICIs. Pituitary irAEs include hypophysitis and hypopituitarism. In this review of latest literature, we have summarized the incidence, possible mechanisms, time of onset, clinical presentations, hormone test, pituitary imaging, treatment strategies and recovery patterns of pituitary irAEs. By referring to domestic and foreign clinical guidelines, we have proposed practical suggestions for screening, diagnosing and treating pituitary irAEs.

Pituitary immune-related adverse events induced by programmed cell death protein 1 inhibitors in advanced lung cancer patients: A report of 3 cases / 北京大学学报(医学版)

Pituitary immune-related adverse events induced by programmed cell death protein 1 inhibitors in advanced lung cancer patients: A report of 3 cases SUMMARY Programmed cell death protein 1 (PD-1) and its ligand 1 (PD-L1) have been widely used in lung cancer treatment, but their immune-related adverse events (irAEs) require intensive attention. Pituitary irAEs, including hypophysitis and hypopituitarism, are commonly induced by cytotoxic T lymphocyte antigen 4 inhibitors, but rarely by PD-1/PD-L1 inhibitors. Isolated adrenocorticotropic hormone(ACTH) deficiency (IAD) is a special subtype of pituitary irAEs, without any other pituitary hormone dysfunction, and with no enlargement of pituitary gland, either. Here, we described three patients with advanced lung cancer who developed IAD and other irAEs, after PD-1 inhibitor treatment. Case 1 was a 68-year-old male diagnosed with metastatic lung adenocarcinoma with high expression of PD-L1. He was treated with pembrolizumab monotherapy, and developed immune-related hepatitis, which was cured by high-dose methylprednisolone [0.5-1.0 mg/(kg·d)]. Eleven months later, the patient was diagnosed with primary gastric adenocarcinoma, and was treated with apatinib, in addition to pembrolizumab. After 17 doses of pembrolizumab, he developed severe nausea and asthenia, when methylprednisolone had been stopped for 10 months. His blood tests showed severe hyponatremia (121 mmol/L, reference 137-147 mmol/L, the same below), low levels of 8:00 a.m. cortisol (< 1 μg/dL, reference 5-25 μg/dL, the same below) and ACTH (2.2 ng/L, reference 7.2-63.3 ng/L, the same below), and normal thyroid function, sex hormone and prolactin. Meanwhile, both his lung cancer and gastric cancer remained under good control. Case 2 was a 66-year-old male with metastatic lung adenocarcinoma, who was treated with a new PD-1 inhibitor, HX008, combined with chemotherapy (clinical trial number: CTR20202387). After 5 months of treatment (7 doses in total), his cancer exhibited partial response, but his nausea and vomiting suddenly exacerbated, with mild dyspnea and weakness in his lower limbs. His blood tests showed mild hyponatremia (135 mmol/L), low levels of 8:00 a.m. cortisol (4.3 μg/dL) and ACTH (1.5 ng/L), and normal thyroid function. His thoracic computed tomography revealed moderate immune-related pneumonitis simultaneously. Case 3 was a 63-year-old male with locally advanced squamous cell carcinoma. He was treated with first-line sintilimab combined with chemotherapy, which resulted in partial response, with mild immune-related rash. His cancer progressed after 5 cycles of treatment, and sintilimab was discontinued. Six months later, he developed asymptomatic hypoadrenocorticism, with low level of cortisol (1.5 μg/dL) at 8:00 a.m. and unresponsive ACTH (8.0 ng/L). After being rechallenged with another PD-1 inhibitor, teslelizumab, combined with chemotherapy, he had pulmonary infection, persistent low-grade fever, moderate asthenia, and severe hyponatremia (116 mmol/L). Meanwhile, his blood levels of 8:00 a.m. cortisol and ACTH were 3.1 μg/dL and 7.2 ng/L, respectively, with normal thyroid function, sex hormone and prolactin. All of the three patients had no headache or visual disturbance. Their pituitary magnetic resonance image showed no pituitary enlargement or stalk thickening, and no dynamic changes. They were all on hormone replacement therapy (HRT) with prednisone (2.5-5.0 mg/d), and resumed the PD-1 inhibitor treatment when symptoms relieved. In particular, Case 2 started with high-dose prednisone [1 mg/(kg·d)] because of simultaneous immune-related pneumonitis, and then tapered it to the HRT dose. His cortisol and ACTH levels returned to and stayed normal. However, the other two patients' hypopituitarism did not recover. In summary, these cases demonstrated that the pituitary irAEs induced by PD-1 inhibitors could present as IAD, with a large time span of onset, non-specific clinical presentation, and different recovery patterns. Clinicians should monitor patients' pituitary hormone regularly, during and at least 6 months after PD-1 inhibitor treatment, especially in patients with good oncological response to the treatment.

Pingchan granule for depressive symptoms in parkinson's disease: A randomized, double-blind, placebo-controlled trial / 中西医结合学报

BACKGROUND@#Depression in Parkinson's disease (dPD) is closely related to quality of life. Current studies have suggested that Pingchan Granule (PCG) might be effective for treating dPD.@*OBJECTIVE@#This study determines the efficacy of PCG for depressive symptoms in Parkinson's disease (PD).@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS@#This was a randomized, double-blind, placebo-controlled trial, conducted in Longhua Hospital, Shanghai, China. Patients diagnosed with idiopathic PD and clinically significant depressive symptoms (defined by a 24-item Hamilton Rating Scale for Depression [HAM-D] score ≥ 8) were included in this study, randomly assigned to PCG or placebo group in a 1:1 ratio and followed for 24 weeks.@*MAIN OUTCOME MEASURES@#The primary outcome was the change from baseline to week 24 in HAM-D score among the set of patients who completed the study following the treatment protocol (per-protocol set). Secondary outcomes included changes in scores on the Unified Parkinson's Disease Rating Scale (UPDRS) part 2 (UPDRS-II), UPDRS part 3 (UPDRS-III), Parkinson's Disease Sleep Scale (PDSS) and Hamilton Rating Scale for Anxiety (HAM-A), between baseline and week 24.@*RESULTS@#Eighty-six patients were enrolled, and 85 patients were included in the per-protocol set. HAM-D scores decreased by an adjusted mean of 11.77 (standard error [SE] 0.25) in the PCG group and 3.86 (SE 0.25) in the placebo group (between-group difference = 7.91, 95% confidence interval [7.22, 8.80], P < 0.001), in the multivariable linear regression. Improvements in scores on the UPDRS-II, UPDRS-III, PDSS, and HAM-A scales were also observed.@*CONCLUSION@#Treatment with PCG was well tolerated and improved depressive symptoms and motor and other non-motor symptoms in PD.@*TRIAL REGISTRATION@#Chinese Clinical Trial Register: ChiCTR-INR-17011949.

Preliminary establishment of reference interval for non-fasting serum triglycerides among healthy middle-aged and elderly people in some communities Beijing / 中华检验医学杂志

Objective:To establish the reference interval of serum triglyceride (TG) for 4 hours after meal in healthy middle and old people of Beijing community, and to provide the diagnostic basis for the judgment of dyslipidemia after meal.Methods:Selected 369 elderly people from January to October 2018 in the health examination of Guang′anmen Hospital of the Chinese Academy of Traditional Chinese Medicine. The subjects collected fasting venous blood samples in the morning the next day after fasting for 12 hours, then ate a standard breakfast that conformed to the local dietary habits, and collected venous blood samples again 4 hours after eating. Serum TG levels were measured 4 h after meal using AU5822 fully automatic biochemical analyzer and matching reagents. The comparison of postprandial TG between different age and sex groups was statistically significant using the nonparametric test of two independent samples, and the comparison between postprandial and fasting TG using the nonparametric test of two paired samples with P<0.05 as the difference. The 95% confidence interval was calculated using a nonparametric method according to the relevant requirements of the CLSI EP28-A3c file, and the reference interval was expressed as P2.5, P97.5. Results:The median 4-hour post-prandial TG of the middle-aged and elderly aged 45-59 years and those aged ≥ 60 years at health checkups were 1.65 (1.25, 2.13) mmol/L and 1.58 (1.25, 2.00) mmol/L, there was no significant difference between the two groups ( Z=-1.040, P>0.05). There was no statistical difference between males 1.69 (1.22, 2.31) mmol/L and females 1.63 (1.26, 2.12) mmol/L at 4 hours postprandial TG levels in the 45-59 year-old group ( Z=-0.179, P>0.05),there was also no statistical difference between 1.64 (1.22, 2.06) mmol/L for men and 1.53 (1.28, 1.99) mmol/L for women aged 60 years or older ( Z=-0.256, P>0.05).Compared with the median fasting TG of 1.05 (0.87, 1.29) mmol/L, the median serum TG of 1.61 (1.25, 2.09) mmol/L at 4 hours after meal was significantly increased ( Z=-16.449, P<0.01). The difference between postprandial and fasting was 0.52 (0.30, 0.85) mmol/L.The reference range of serum TG at 4 hours after meal was 0.82 to 3.02 mmol/L. Conclusion:In this study, the reference range of serum triglycerides for 4 hours after meal was established in some healthy elderly population groups in Beijing.

Evaluation of therapeutic effects of transplantation of human stem cells from apical papilla ameliorates on collagen-induced arthritis / 中国免疫学杂志

Objective:To study the effect of transplantation of stem cells from the apical papilla (SCAP) to collagen-induced arthritis (CIA).Methods:Twenty DBA/1J mice with collagen Ⅱ-induced arthritis were equally divided into 2 groups and treated with human SCAP and PBS,respectively,with other 6 normal mice as negative control.Inflammation was evaluated by measuring clinical score,TNF-α and anti-CⅡ antibody levels (ELISA),histological analyses and micro-CT analyses.The levels of CD4+Th cells subsets in spleens were assessed by flow cytometric analysis.Results:System infusion of SCAP could significantly reduce the severity of CIA, and resume the balance of Th cells subsets.Conclusion:SCAP transplantation can induce immune tolerance and ameliorate the CIA in-flammation.

Clinicopathological analysis of 5 cases of placental mesenchymal dysplasia / 临床与实验病理学杂志

Purpose To explore the clinicopathological features, diagnosis, differential diagnosis and prognosis of placental mesenchymal dysplasia. Method The clinicopathological data of 5 cases with placental mesenchymal dysplasia were retrospectively analysed and related literatures were also re-viewed. Results All of 5 patients were consciously fetal movement disappeared or found abnormal ultrasound results at routine examination of the pregnancy. The placentas were enlarged, partly with oedematous "grape-like" cysts. On histologic exami-nation, enlarged villi with varying degrees of edema contained abnormal thick walled fetal blood vessels. The chorionic vessels were expanded and congested, and some chorionic villi showed mesenchymal cell hyperplasia. In immunohistochemical staining, p57 was positive, and Ki-67 showed low expression. There was no the trophoblastic proliferation. It's mainly differential diagnosis was hydatidiform mole.2 cases were accompanied with stillbirth. Conclusion The diagnosis of placental mesenchymal dysplasia can be confirmed by pathology examination. When a cystic placenta is detected by ultrasound examination, placental mesenchymal dysplasia should be considered in the differential diagnosis.

Biosynthesis of [S]-naproxen starch ester by Carica papaya lipase in intermittent opening reaction mode

In order to brought S-naproxen into small intestine, an optically pure [S]-naproxen starch ester was produced by lipase through enantio-selective trans-esterification of racemic naproxen methyl ester with pretreatment starch in solvent system. With carefully selection of the reaction medium [isooctane], lipase [Carica Papaya Lipase, CPL] and the reaction mode [intermittent opening], a high conversion rate [48.6%] and enantiomeric excess of product [99.6%] was obtained. The slow release macromolecular [S]-Naproxen had been synthesized to improve the efficacy of racemic naproxen and overcome its side effects. The enanitomeric ratio of CPL [E=52.5] was higher than CRL [E=22] and greatly influenced by the byproduct methyl alcohol. The intermittent opening reaction mode was the effective way to remove the inhibition of methyl alcohol and to improve the enantio-selectivity of CPL. S-naproxen starch was confirmed by HPLC and [1]H NMR. This method may also apply to preparation the other optically pure 2-phenylpropionic acid derivatives. S-naproxen starch was a new optically pure derivatives possessing emulsifying and slow release properties would be widely applied to the food, pharmaceutical and biomedical industries

Impact of the CFTR chloride channel on the cytoskeleton of mouse Sertoli cells / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the impact of the chloride channel dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) on the cytoskeleton of Sertoli cells in the mouse.</p><p><b>METHODS</b>TM4 Sertoli cells were cultured and treated with CFTR(inh)-172 at the concentrations of 1, 5, 10 and 20 μmol/L for 48 hours. Then the cytotoxicity of CFT(inh)-172 was assessed by CCK-8 assay, the expressions of F-actin and Ac-tub in the TM4 Sertoli cells detected by immunofluorescence assay, and those of N-cadherin, vimentin and vinculin determined by qPCR.</p><p><b>RESULTS</b>CFTR(inh)-172 produced cytotoxicity to the TM4 Sertoli cells at the concentration of 20 μmol/L. The expressions of F-actin and Ac-tub were decreased gradually in the TM4 Sertoli cells with the prolonging of treatment time and increasing concentration of CFTR(inh)-172 (P < 0.05). The results of qPCR showed that different concentrations of CFTR(inh)-172 worked no significant influence on the mRNA expressions of N-cadherin, vimentin and vinculin in the Sertoli cells.</p><p><b>CONCLUSION</b>The CFTR chloride channel plays an important role in maintaining the normal cytoskeleton of Sertoli cells. The reduced function and expression of the CFTR chloride channel may affect the function of Sertoli cells and consequently spermatogenesis of the testis.</p>

Evaluation and comparison of practice guidelines and consensus on type 2 diabetes: a systematic appraisal / 中国药学杂志

OBJECTIVE: To evaluate the quality of now available clinical guidelines and consensus statements on type 2 diabetes. Based on this assessment, the comparison of guidelines and consensuses is made to give some suggestions on the methods of making these documents. METHODS: PubMed, Embase, CNKI, Wanfang, SinoMed and guideline websites were systematically searched. Literatures were screened according to defined criteria for including. AGREE II was used to instrument assess the quality of the guidelines and consensuses. RESULTS: The result showed that the quality of included guidelines is various, but the overall quality of guidelines is still higher than consensuses. Guidelines got high scores in scope and purpose domain and clarity of presentation domain, but low scores in rigor of development domain and applicability domain. Consensus statements got low scores in all 6 domains. CONCLUSION: The main reason for the difference is consensuses have poor methodology. Rapid advice guidelines were suggested as an alternative for consensus statements.

Application of laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma / 中华消化外科杂志

Objective To investigate laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma (HCC).Methods Twenty-three patients with HCC who were not suitable for one-stage hepatectomy were admitted to the Sichuan Provincial People's Hospital from March 2009 to February 2012.Their clinical data were retrospectively analyzed.Laparoscopic-guided selective portal vein ligation was firstly performed,dynamic changes of hepatic volume and predicted volume of liver to be resected were detected by computed tomography.Two-stage open hepatectomy was performed after assessment of resectability of HCC.All data were analyzed using the analysis of variance or q test.Results Laparoscopic-guided selective portal vein ligation was successfully performed on 22 patients (2 patients received concomitant cholecystectomy because the right branch of portal vein was difficult to expose),1 patient was converted to open surgery because of hemorrhage during portal vein separation.Three patients with multiple lesions received transcatheter arterial chemoembolization at 1 week after selective portal vein ligation.Dull pain in the hepatic region,low fever,nausea and vomiting were observed in the 23 patients,while no severe complications including peritoneal hemorrhage,bile leakage,hepatapostema was observed.The levels of aspartate aminotransferase,alanine aminotransferase and total bilirubin were back to normal at 1 week after the surgery.The right liver volume at postoperative week 3 was (590 ± 154)cm3,which was significantly smaller than (698 ± 135)cm3 before surgery.Compared with right liver volume at postoperative week 1,2,3,the right liver volume before operation was significantly smaller (F=15.62,P ＜0.05).The left hepatic volume at postoperative week 3 was (408 ± 149)cm3,which was significantly bigger than (331 ± 68)cm3 before operation.The left liver volume before operation was significantly different from those at postoperative week 1,2,3 (F =17.48,P ＜ 0.05).The predicted ratio of liver to be resected was 60％ ± 18％ at postoperative week 3,which was significantly smaller than 67％ ± 15％ before operation (F =12.35,P ＜ 0.05).Two patients with insufficient hyperplasia of offside liver,2 patients with intrahepatic metastasis at postoperative week 3,2 patients were lost to follow up and 3 patients gave up hepatectomy,14 patients received hepatectomy at 2-4 weeks after laparoscopic-guided selective portal vein ligation.The resection rate was 60.9％ (14/23).There were 2 patients received extended right hepatectomy,8 received right hepatectomy,4 received non-anatomical hepatectomy.All the 14 patients recovered well,and no hepatic failure,severe peritoneal effusion and infection was observed.Conclusion Laparoscopic-guided selective portal vein ligation is easy to perform,and it extends the indication of hepatectomy,increases the safety of two-stage hepatectomy.

Application of damage control surgery idea in the treatment of severe pancreatic duodenal injury / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the significance of damage control surgery (DCS) in the treatments of severe pancreaticoduodenal injuries.</p><p><b>METHODS</b>Clinical data of 19 patients with severe pancreaticoduodenal injuries managed with DCS approach in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine and the First Affiliated Hospital of Wenzhou Medical College from March 2005 to January 2013 were analyzed retrospectively.</p><p><b>RESULTS</b>Three cases were cured after damage control operation and postoperative ICU resuscitation treatment. Twelve cases underwent definite operations (distal pancreaticojejunal Roux-en-Y anastomosis, proximal duodenojejunal Roux-en-Y anastomosis or pancreaticoduodenectomy) after damage control operation and postoperative ICU resuscitation treatment and cured. Four cases died after damage control operation due to multiple organ failure and the mortality was 21.1%.</p><p><b>CONCLUSION</b>Application of DCS approach can improve the prognosis of patients with severe pancreaticoduodenal injuries.</p>

Clinical study on Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis in pancreaticoduodenectomy / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To study the influence of Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis (SPDJCS) on the incidence of pancreatic fistula after pancreaticoduodenectomy, and to analyze its applicability, safety, and efficacies.</p><p><b>METHODS</b>A prospective controlled trial was conducted with 165 cases receiving pancreaticoduodenectomy in the Department of Hepatopancreatobiliary Surgery from January 2010 to May 2012. The patients were divided into Group A (end-to-end/end-to-side invaginated anastomosis, n=52), Group B (end-to-side mucosal anastomosis, n=48), and Group C (SPDJCS, n=65). The preoperative data, intraoperative data, and operative outcomes (incidence of pancreatic fistula, operation time, intraoperative blood loss, peritoneal drainage, peritoneal hemorrhage, peritoneal abscess, delayed gastric emptying, pulmonary infection, postoperative infection, blood transfusion, and perioperative mortality) were compared among the 3 groups.</p><p><b>RESULTS</b>The total incidence of pancreatic fistula was 13.9% (23/165) in all the 165 patients. The incidence in Group A and Group B was 23.1% (12/52) and 18.8% (9/48), both higher than that in Group C [3.1% (2/65), both P<0.05]. Group C showed significantly better outcomes than group A and B in terms of the operation time (5.5±1.2 hours vs. 6.1±1.1 hours, 5.5±1.2 hours vs. 6.3±1.5 hours), volume of blood loss (412.0±205.0 mL vs. 525.0±217.0 mL, 412.0±205.0 mL vs. 514.0±217.0 mL), and postoperative drainage amount of plasma tubes (175.0±65.0 mL vs. 275.0±80.0 mL, 175.0±65.0 mL vs. 255.0±75.0 mL) (all P<0.05), while Group A and Group B displayed no difference in these aspects (P>0.05). As complications other than pancreatic fistula were concerned, the three groups were not different from each other (P>0.05).</p><p><b>CONCLUSIONS</b>SPDJCS may have the effect of reducing the incidence of pancreatic fistula after pancreaticoduodenectomy. It could be safe, practical and convenient technique of anastomosis for pancreaticojejunostomy.</p>

Pancreatic-duct hanging and continuous suturing maneuver in end-to-side anastomosis after pancreticoduedenectomy / 中华肝胆外科杂志

Objective To evaluate the impact of pancreatic duct hanging and continuous suturing maneuver in end-to-side pancreaticojejunostomy on the incidence of pancreatic fistula after pancreaticoduodenectomy (PD),and to study the feasibility,safety and efficacy.Method 165 patients who underwent pancreaticoduodenectomy were randomly selected and the incidences of pancreatic fistula for the different types of pancreaticojejunostomy were analyzed.Results The overall rate of pancreatic fistula was 13.9％ (23/165).The incidences of pancreatic fistula after pancreatic duct hanging and continuous suturing maneuver in end-to-side anastomosis (3.1％,2/65,group C) was significantly lower than the traditional intussusception anastomosis (23.1％,12/52,group A,P＜0.05) and the mucosa mucosa anastomosis (18.8％,9/48,group B).There was no significant difference between the traditional intussusception anastomosis and the mucosa mucosa anastomosis (P＞0.05).In group C,the average operative time,intraoperative blood loss,and postoperative drainage was obviously superior to the A and B group (P＜0.05).There was no significant difference between the A and B group (P＞0.05).The other complications showed no significant differences among the three groups (P＞0.05).Conclusion Pancreatic-duct hanging and continuous suturing maneuver in end-to-side anastomosis significantly reduced the rate of pancreatic fistula after pancreaticoduedenectomy.It was feasible,safe,convenient to use and should be popularized.

A micro-computed tomographic analysis of the apical anatomy of permanent three-rooted mandibular first molars / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the anatomic features of the root apexes of permanent three-rooted mandibular first molars.</p><p><b>METHODS</b>A total of 122 permanent mandibular first molars of Han Chinese patients were collected. Twenty three-rooted and 25 two-rooted molars were scanned by micro-CT and then reconstructed three-dimensionally. The apical anatomy of the tooth models were analyzed in software Mimics 10.01. The long and short diameters of the apical constriction (AC), the distances between AC, apical foramen (AF) and apex were measured. One-way ANOVA and LSD-t tests were used to compare the groups in relation to AC diameter and the distances between the AC, AF and apex.</p><p><b>RESULTS</b>The AF of the mesiobuccal (MB) canals most frequently presented at the distal side of the apex (10 cases in three-rooted and 6 cases in two-rooted group), and of the mesiolingual (ML) canals, most often at the lingual side (8 cases in each group). The AF of the distobuccal (DB) roots were frequently located at the distolingual (DL) side (10 cases), and those of the DL roots and distal canals of two-rooted molars were most often at the buccal (7 cases) and distal (11 cases) sides, respectively. The percentage of the "classical" singular AC was 53% (80/151). The average long(D) and short(d) diameters of the AC of the DB canals were (0.32 ± 0.09) mm and (0.25 ± 0.05) mm, respectively, significantly larger than the DL canals [D = (0.27 ± 0.08) mm, d = (0.22 ± 0.06) mm, P < 0.05] and the ML canals [D = (0.24 ± 0.06) mm, d = (0.19 ± 0.06) mm, P < 0.01). In three-rooted group, the mean distances between AC and AF, AF and apex, and AC and apex were (0.67 ± 0.32), (0.49 ± 0.28) and (1.01 ± 0.34) mm, respectively.</p><p><b>CONCLUSIONS</b>The AF of three-rooted mandibular molars frequently deviate from the root apex, and the AC of the DB canal is wider than those of the other canals. The mean distances between AC, AF and the apex suggest that root canal therapy should terminate at 1 to 1.5 mm short of the radiographic apex.</p>

Comparative study of 18F-FDG coincidence SPECT and 9gTcm-MDP bone scan for detecting malignancy / 中华核医学杂志

ObjectiveTo compare the diagnostic efficiency of 18F- FDG coincidence SPECT/CT and 99Tcm- MDP whole body bone scan (WBBS) in detecting malignancy.MethodsA total of 71 cases (male 45,female 26,mean age 59.2 ± 15.4 years) with clinically confirmed malignancy underwent both 99TcmMDP WBBS and 18F-FDG coincidence imaging within three weeks.The sensitivity,specificity,accuracy,positive and negative prediction value of these two imaging methods in detecting bone metastases were compared based on the results from pathology or clinical follow-up.x2test was used for data analysis.ResultsA total of 350 lesions (including primary,second malignancy and benign disease) in 71 patients were eval-uated.81.7％ (286/350) malignant lesions were identified by either 99Tcm-MDP WBBS (209/350,59.7％ ) or 18F-FDG coincidence imaging ( 141/350,40.3％ ) (x2 =25.65,P ＜ 0.01 ).The imaging findings of osteoblastic,osteolytic,mixed types of bone metastases by99Tcm-MDP WBBS and 18F-FDG coincidence imaging were significantly different (x2 =20.78,2.89 and 9.94,all P ＜ 0.05 ).The sensitivity,specificity,accuracy,false-positive,false-negative,positive and negative predictive values for detecting bone metastases by 18 F-FDG coincidence study and 99Tcm-MDP WBBS were as follows:11.72％ ( 15/128),91.67％(22/24),24.34％ (37/152),8.33％ (2/24),88.28％ (113/128),88.24％ (15/17),16.30％ (22/135) ; and 53.91％ (69/128),75.00％ ( 18/24),57.24％ (87/152),25.00％ (6/24),46.09％ (59/128),92.00％ (69/75),23.38％ ( 18/77 ).The sensitivity,accuracy,false-negative,positive-predicting value of the two methods had been significant different (x2 =32.70- 46.21,all P ＜ 0.01 ).When two methods were combined,the diagnostic efficiency could been improved.ConclusionThe 99Tcm-MDP WBBS and 18F-FDG coincidence imaging has a complementary role in detecting bone metastases.

Expression of heme oxygenase enzyme in the testis tissue and azoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the location of heme oxygenase (HO) enzyme in the human testis, and explore the correlation of the expression of HO enzyme with azoospermia by analyzing its different expression levels in the testes of nonobstructive azoospermia, obstructive azoospermia and normal men.</p><p><b>METHODS</b>We detected the location of the cells expressing HO enzyme in the human testis tissue using immunohistochemistry, determined the mRNA and protein expression levels of HO-1 and HO-2 in the testes of azoospermia patients and normal healthy men by RT-fluorescence quantitative PCR (RT-FQ-PCR) and Western blot, and explored the correlation of HO expressions with the pathogenesis of azoospermia.</p><p><b>RESULTS</b>HO-1 enzyme was expressed mainly in the Sertoli cells and HO-2 enzyme chiefly in the germ cells of the testis tissue. RT-FQ-PCR showed that the expression of HO-1 in the testis tissue was significantly lower in the nonobstructive azoospermia than in the normal and obstructive azoospermia groups (P < 0.05), with no significant difference between the latter two. Western blot revealed no obvious difference between the expression level of HO-1 protein and that of HO-1 mRNA. There were no differences in the expression level of HO-2 protein among the three groups.</p><p><b>CONCLUSION</b>The expression level of HO enzyme is significantly decreased in the testis tissue of nonobstructive azoospermia patients, and the expression of HO-1 protein is consistent with that of HO-1 mRNA. As HO-1 protects the testis tissue against various stress injuries through its antioxidant, anti-inflammatory and anti-apoptotic effects, its decreased expression level may be correlated with spermatogenic dysfunction, and therefore considered as a possible mechanism of nonobstructive azoospermia.</p>

A 32P application device for the treatment of condyloma acuminatum in the rectum / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the use of a 32P application device (AD) in the treatment of condyloma acuminatum (CA) in the rectum, and to compare its clinical effect with that of the microwave therapy.</p><p><b>METHODS</b>This study included 107 cases of CA in the rectum, 99 males and 8 females, aged 21-58 (33.6 +/- 9.4) years. Forty-six of the patients (the AD group) were treated with a self-made 32P application device, which, as a tube-shaped carrier of radionuclide 32P colloid, was fixed in the rectum at the diseased part for medication at 4.9-8.2 Gy for 3-5 hours once and 1-2 times a week. The other 61 (the microwave group) were treated by microwave burning under local anesthesia. Both groups of patients were followed up for over 3 months for comparison of the therapeutic results and observation of the stability and reliability of the 32P application device.</p><p><b>RESULTS</b>The rates of cure, reoccurrence and adverse reaction were 84, 8%, 13.0% and 8.7% in the AD group, compared with 40.3%, 55.7% and 75.4% in the microwave group, with statistically significant differences between the two groups (P < 0.01).</p><p><b>CONCLUSION</b>The 32P application device, with its advantages of low cost, easy operation, good effect, high safety and reliability, low recurrence, fewer adverse events and good acceptability, is highly valuable for the treatment of CA in the rectum.</p>

Protective effects of oxymatrine on adriamycin-induced cardiotoxicity in rabbits and its mechanism / 上海第二医科大学学报

Objective To establish the in vivo models of adriamycin(ADR)-induced cardiotoxicity in rabbits, investigate the protective effect of oxymatrine (OMT) on ADR-induced cardiotoxicity, and explore the possible mechanism. Methods Twenty-six rabbits were randomly divided into ADR group (n=8, 2 mg/kg ADR), OMT group (n=5, 10 mg/kg OMT), ADR + OMT group (n=8, 10 mg/kg OMT was injected 30 min before ADR injection) and saline group (n=5, same quantity of normal saline), and rabbits in each group were infused with medicine or normal saline through ear marginal vein once a week for 8 weeks. The apoptosis of myocardial cells was detected by TUNEL methods, and the activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) was determined. Results After treatment, the body weight of ADR group was significantly lower than that of the other groups(P < 0.05), the activity of SOD and GSH-Px significantly decreased and the apoptosis index (AI) was significantly higher than that of the other groups(P <0.01). There were similar while minor changes in ADR + OMT group. There was no significant adverse effects in OMT group. Conclusion OMT protects heart from adriamycin-induced injury in rabbits, which may relate to the decrease in level of antioxidant and apoptosis of myocardial cells.

Preparation of adriamycin-loaded temperature/pH sensitive self-assembly block copolymer micelles / 药学学报

The dialysis method was employed to load adriamycin into the micelles formed by temperature and pH sensitive polyhistidine-co-DL-lactide-co-glycolide-polyethylene glycol poly DL-lactide-co-glycolide-co-histidine (OLH-b-PLGA-b-PEG-b-PLGA-b-OLH). The critical micelle concentration (CMC) of the copolymer was measured with pyrene fluorescent probe method under different temperatures. The entrapment rate and drug-loading rate were determined with dialysis method. The diameter, morphology and surface potential of the copolymer micelles were investigated by corresponding instruments, respectively. The release behavior of adriamycin from copolymer micelles and the pH sensitivity were studied. The CMC of the copolymers ranged from 0.022 4 to 0.001 7 microg x mL(-1). The entrapment rate and drug-loading rate were 92.8% and 15.7%, respectively. The micelles have a mean diameter of (61.7 +/- 13.4) nm, and zeta potential was -9.88 mV. The in vitro adriamycin release rate increased with the pH dropping from 7.4 to 5.0. The results indicated that the CMC of the copolymers decreased as the raising of temperature, drug release behavior from the micelles possessed clearly pH sensitivity, and the copolymers may have a potential in targeted delivery system for anticancer drugs.