Perinatal prevalence of birth defects in the Mainland of China, 2000-2021: a systematic review and meta-analysis.

BACKGROUND: Although birth defects are of great concern globally, the latest national prevalence has not yet been quantified in China. We conducted a systematic review and meta-analysis to estimate the perinatal prevalence of birth defects in the Mainland of China between 2000 and 2021. METHODS: We performed a systematic literature search of six databases for relevant articles published between January 1, 2000, and March 1, 2023. We included published studies that reported data on the perinatal prevalence of birth defects in the Mainland of China. The DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and its 95% confidence interval (CI). We also conducted subgroup analyses and univariable meta-regressions to explore differences in prevalence by time period, geographic region, and other characteristics. RESULTS: We included 254 studies reporting the perinatal prevalence of birth defects and 86 studies reporting only the prevalence of specific types of birth defects. Based on 254 studies covering 74,307,037 perinatal births and 985,115 cases with birth defects, the pooled perinatal prevalence of birth defects was 122.54 (95% CI 116.20-128.89) per 10,000 perinatal births in the Mainland of China during 2000-2021. Overall, the perinatal prevalence of birth defects increased from 95.60 (86.51-104.69) per 10,000 in 2000-2004 to 208.94 (175.67-242.22) per 10,000 in 2020-2021. There were also significant disparities among different geographical regions. Congenital heart defects (33.35 per 10,000), clefts of the lip and/or palate (13.52 per 10,000), polydactyly (12.82 per 10,000), neural tube defects (12.82 per 10,000), and inborn errors of metabolism (11.41 per 10,000) were the five most common types of birth defects. The perinatal prevalence among males was significantly higher than that among females (ß = 2.44 × 10-3, P = 0.003); a higher perinatal prevalence of birth defects was observed among perinatal births whose mothers were ≥ 35 years (ß = 4.34 × 10-3, P < 0.001). CONCLUSION: Comprehensive and sustained efforts are needed to strengthen surveillance and detection of birth defects, improve prenatal and postnatal healthcare, and promote rehabilitation, especially in underdeveloped areas.

Association between air particulate matter pollution and blood cell counts of women preparing for pregnancy: Baseline analysis of a national birth cohort in China.

BACKGROUND: Limited evidence is known about whether long-term exposures to air borne particulate matters of 2.5 µm or less (PM2.5) impact human hematologic index for women preparing for pregnancy. No study assessed the effect of PM1, which is small enough to reach the blood circulation. OBJECTIVE: To evaluate whether exposure to PM1 and PM2.5 is associated with blood cell count of woman preparing for pregnancy. METHOD: Based on the baseline data of a national birth cohort in China, we analysed the white blood cell (WBC), red blood cells (RBC) and thrombocyte counts of 1,203,565 women who are aged 18-45 years, being Han ethnicity, had no chronic disease and preparing for pregnancy. We matched their home addresses and examination date with daily concentrations of PM1 and PM2.5 which were estimated by a machine learning method with remote sensing, meteorological and land use information. Generalized additive mixed model to examine the associations between exposure to one-year average exposure to PMs prior to the health examination and the blood cells counts, after adjustment for potential individual variables. RESULTS: A 10 µg/m3 PM1 increment was associated with -1.49% (95%CI: 1.56%, -1.42%) difference in WBC count; with 0.33% (95%CI: 0.30%, 0.36%) difference of RBC count; and with 1.08% (95%CI: 1.01%, 1.15%) difference of thrombocyte count. For PM2.5, the corresponding difference was -0.47% (95%CI: 0.54%, -0.39%) for WBC; was 0.06% (95%CI: 0.03%, 0.09%) for RBC; and was 1.10% (95%CI: 1.02%, 1.18%) for thrombocyte. Women working as workers, being overweight and with tobacco smoking exposure had higher associations between PMs and hematologic index than their counterparts (p < 0.05 for interaction test). CONCLUSION: Long-term exposure to PMs were associated with decrement in WBC, as well as increment in RBC and thrombocytes among Han Chinese women preparing for pregnancy. Measures such as using air purifiers and wearing a mask in polluted areas should be improved to prevent women from the impact of PMs.

Association between airborne particulate matter and renal function: An analysis of 2.5 million young adults.

BACKGROUND: Limited studies have examined the impact of airborne particulate matter of 2.5 µm or less (PM2.5) on renal function. No study has examined the effect of PM1, which is small enough to reach the blood circulation. We examined whether exposure to PM1 or PM2.5 affected renal function of young Han Chinese. METHOD: We included 2,546,047 young adults who were aged 18 to 45 years, being Han ethnicity and had no chronic disease from a Chinese national birth cohort. Serum creatinine (Scr) of each participant was measured during the baseline examination. Estimated glomerular filtration rate (eGFR) were calculated for each participant using the latest Chronic Kidney Disease Epidemiology Collaboration equation. One-year average exposure to PM1 and PM2.5 prior to the health examination for each participant were estimated using machine learning models with satellite remote sensing information. Generalized additive mixed models were used to estimate associations between PM1 or PM2.5 and renal function after adjusting for detailed individual variables. RESULTS: A 10 µg/m3 increment in PM1 exposure was associated with -0.95% (95%CI: -1.04%, -0.87%) difference of eGFR in females and -0.37% (95%CI: -0.44%, -0.31%) in males. For PM2.5, the corresponding difference of eGFR was -0.99% (95%CI: -1.05%, -0.93%) in females and -0.48% (95%CI: -0.53%, -0.43%) in males, respectively. Associations between eGFR and PM were higher in females compared to males (p < 0.05 for interaction test). Association with PM1 were weaker than that with other fractions included in PM2.5. Participants who worked as farmers, were of normal weight, were not exposed to tobacco smoking, did not drink alcohol, had higher associations between eGFR and PM than their counterparts (p < 0.05 for interaction test). CONCLUSION: Exposure to PM1 and PM2.5 was associated with reduced renal function among Han Chinese at reproductive age.

Folic Acid Supplementation and the Association between Maternal Airborne Particulate Matter Exposure and Preterm Delivery: A National Birth Cohort Study in China.

BACKGROUND: Potential modification of the association between maternal particulate matter (PM) exposure and preterm delivery (PTD) by folic acid (FA) supplementation has not been studied. OBJECTIVE: We examined whether FA supplementation could reduce the risk of PTD associated with maternal exposure to PM in ambient air during pregnancy. METHOD: In a cohort study covering 30 of the 31 provinces of mainland China in 2014, 1,229,556 primiparas of Han ethnicity were followed until labor. We collected information on their FA supplementation and pregnancy outcomes and estimated each participant's exposure to PM with diameters of ≤10µm (PM10), 2.5µm (PM2.5), and 1µm (PM1) using satellite remote-sensing based models. Cox proportional hazard regression models were used to examine interactions between FA supplementation and PM exposures, after controlling for individual characteristics. RESULTS: Participants who initiated FA ≥3 months prior to pregnancy (38.1%) had a 23% [hazard ratio (HR)=0.77 (95% CI: 0.76, 0.78)] lower risk of PTD than women who did not use preconception FA. Participants with PM concentrations in the highest quartile had a higher risk of PTD [HR=1.29 (95% CI: 1.26, 1.32) for PM1, 1.52 (95% CI: 1.46, 1.58) for PM2.5, and 1.22 (95% CI: 1.17, 1.27) for PM10] than those with exposures in the lowest PM quartiles. Estimated associations with a 10-µg/m3 increase in PM1 and PM2.5 were significantly lower among women who initiated FA ≥3 months prior to pregnancy [HR=1.09 (95% CI: 1.08, 1.10) for both exposures] than among women who did not use preconception FA [HR=1.12 (95% CI: 1.11, 1.13) for both exposures; pinteraction<0.001]. The corresponding association was also significantly lower for a 10-µg/m3 increase in PM10 [HR=1.03 (95% CI: 1.02, 1.03) for FA ≥3 months before pregnancy vs. 1.04 (95% CI: 1.03, 1.04) for no preconception FA; pinteraction<0.001]. CONCLUSION: Our findings require confirmation in other populations, but they suggest that initiating FA supplementation ≥3 months prior to pregnancy may lessen the risk of PTD associated with PM exposure during pregnancy among primiparas of Han ethnicity. https://doi.org/10.1289/EHP6386.

Ambient temperature and the risk of preterm birth: A national birth cohort study in the mainland China.

BACKGROUND: Little is known about the effect of ambient temperature on preterm birth, especially for the trimester-specific effects. OBJECTIVE: To evaluate whether exposure to relatively low or high temperature during pregnancy is associated with increasing risk of preterm birth or not. METHOD: We analysed the data of a birth cohort with 1,281,859 singleton pregnancies during 2013-2014 and matched the home address of each pregnant women to the model based daily meteorological and air pollution data. Then we used the Cox proportional hazard regression models with random effect to estimate the non-linear associations between exposure to relatively low or high temperature at each trimester of pregnancy and the risk of preterm birth, after controlling for air pollution and individual-level covariates. FINDING: The overall preterm birth rate was 8.1% (104,493 preterm births). Exposure to relatively low or high temperatures during the entire pregnancy significantly increase the risk of preterm birth, with hazard ratios (HRs) [95% confidence intervals (CIs)] of 1.03 (95%CI: 1.02, 1.04) for relatively low (9.1 ℃, the 5th percentile) temperature and 1.55 (95%CI: 1.48, 1.61) for relatively high (23.0 ℃, the 95th percentile) temperature in comparison with the thresholds (12.0 ℃). Pregnant women at the early pregnancy (the 1st and 2nd trimester) are more susceptible to high temperatures while pregnant women at the late pregnancy (the 3rd trimester) are more susceptible to low temperatures. CONCLUSION: These findings provide new evidence that exposure to relatively low or high temperatures during pregnancy increases the risk of preterm birth, which can serve as scientific evidence for prevention of preterm birth.

Long-term exposure to airborne particulate matter of 1 µm or less and blood pressure in healthy young adults: A national study with 1.2 million pregnancy planners.

No evidence exists concerning the effect of airborne particulate matter of 1 µm or less (PM1) on blood pressure of young adults planning for pregnancy. We collected health examination information of about 1.2 million couples (aged 18-45 years) from a national birth cohort in China from Jan 1, 2013 to Oct 1, 2014 and matched their home address to daily PM1 and PM2.5 concentrations, which were predicted by remote sensing information. Generalized additive mixed models were used to analyze associations between long-term exposure to PM and blood pressure, after controlling for individual factors. A 10 µg/m3 increase in PM1 was associated with increased systolic blood pressure (SBP) for 0.26 (95%CI: 0.24, 0.29) mmHg in females and 0.29 (95%CI: 0.26, 0.31) mmHg in males, respectively. PM1 was also associated with increased DBP for 0.22 (95%CI: 0.20, 0.23) mmHg in females and 0.17 (95%CI: 0.15, 0.19) mmHg in males, respectively. Similar effects on blood pressure were found for PM2.5, meanwhile, the effect of PM2.5 on SBP increased with the scale of PM1 included in PM2.5 (p for interaction term <0.01). In summary, long-term exposure to PM1 as well as PM2.5 was associated with increased SBP and DBP of Chinese young adults planning for pregnancy.

Seroepidemiology of Syphilis Infection among 2 Million Reproductive-age Women in Rural China: A Population-based, Cross-sectional Study.

BACKGROUND:: Quantifying syphilis prevalence is important for planning interventions and advocating for resources on syphilis. However, data on large sample studies regarding the prevalence of syphilis among reproductive-age women in rural China were not available for analysis. The aim of the study was to determine the prevalence, epidemiological characteristics, and related factors of syphilis infection among reproductive-age women in rural China. METHODS:: Data were obtained from a nationwide, population-based, cross-sectional study under the National Free Preconception Health Examination Project which covered all the 31 provinces in Mainland China. Women intending to get pregnant within the next 6 months were enrolled between January 1, 2010, and December 31, 2012. Sociodemographic, gynecological and obstetric characteristics, and other relevant information were obtained through face-to-face interviews. Treponema pallidum particle agglutination assay test was used to detect positive samples of syphilis. Univariate and multivariate logistic regressions were performed to assess the associations between syphilis seropositivity and related factors. RESULTS:: The overall seroprevalence of syphilis (SPS) among the 2,044,126 women who received syphilis screening test during 2010-2012 was 0.37% (95% confidence interval [CI]: 0.36-0.37%). The SPS appeared 0.24% (95% CI: 0.23-0.26%) and 0.66% (95% CI: 0.59-0.72%) in women at 21-24 and 40-44 years of age, respectively, showing an increase of SPS, parallel with age, and the difference was significant. SPS was significantly higher in ethnic minorities than that in Han nationality (0.58% vs. 0.35%, respectively, odds ratio [OR] = 1.41, 95% CI: 1.30-1.53) and higher in workers than that in farmers (0.45% vs. 0.36%, respectively, OR = 1.27, 95% CI: 1.14-1.41). Women with primary school or below level had a higher SPS as compared to those with college or above educational level (0.61% vs. 0.32%, respectively, OR = 2.49, 95% CI: 2.14-2.89), and the increase reversely correlated with the levels of education. Women whose spouses were syphilis seropositive had significant greater risk (OR = 48.26, 95% CI: 44.38-52.48) as compared those whose spouses were seronegative. Women who reported having had a history of sexually transmitted infections were more likely to be tested positive for serological syphilis (OR = 27.17, 95% CI: 20.44-36.11) as compared to those without. CONCLUSIONS:: High SPS is seen among reproductive-age women in rural China that calls for targeted interventions on syphilis prevention and control in this target population, with emphasis on those who are 35 years of age and above, less educated, being minor ethnicity, workers, and living in the western regions of China.

Status of HBsAg seroprevalence in 15 million rural couples in China: a cross-sectional study.

A cross-sectional analysis of prevalence of hepatitis B virus infection (HBV) among rural couples was conducted between 2010 and 2014. Serologic HBV markers, including hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), were tested. Primary outcome of interest comprised HBsAg positivity in couples (both positive: F+M+, only wife positive: F+M-, only husband positive: F-M+), and secondary outcome consisted of prevalence and risk factors of HBsAg positivity among husbands or wives. Of 14,816,300 couples included, 0.7% were F+M+; 6.3% were F-M+; 4.4% were F+M-, resulting in the overall seroprevalence of 11.4%. Individually, 6.1% were HBsAg positive with a higher rate seen in husbands (7.0%) than in wives (5.2%). Wife's HBeAg(+)/HBsAg (+) (AOR = 2.61), HBeAg(-)/HBsAg (+) (AOR = 2.23), positivity of syphilis (AOR = 1.50), living in a high-risk region (AOR = 1.46) were significantly predictors of HBsAg positivity in husbands. Prevalence and predictors of HBsAg positivity in wives had similar results. Our data show a high burden and discordant pattern of HBV infection in rural couples, and partner's double positivity of HBeAg and HBsAg was the most significant factor of HBV infection in couples. A comprehensive strategy that emphasizes vaccination and education is needed.

[Clinical application of extracted site preservation in dental implantation].

PURPOSE: To introduce the method of extracted site preservation in dental implantation. METHODS: One hundred and fifty implants in 63 patients were placed by minimally invasive extraction, immediate implantation and guided bone regeneration for extracted site preservation. All the patients were followed-up for 1 year. RESULTS: (1) One hundred and fifty implants were placed successfully according to the criteria. (2) Alveolar ridge of extracted site preservation reduced 1 mm in height, buccal-lingual distance in alveolar ridge of extracted site reservation reduced 2 mm; (3) The shape of soft tissue was symmetrical. CONCLUSIONS: Minimally invasive extraction, immediate implantation and guided bone regeneration technique can be used to achieve extracted site preservation, which is the key to successful implantation.

[Clinical investigation of root retention or removal during impacted mandibular third molar extraction].

PURPOSE: To investigate the indication of root retention or removal during impacted mandibular third molar (IMTM) extraction and the relationship between the IMTM root and damage of mandibular alveolar nerve. METHODS: The data of roots from 135 cases performing IMTM extraction were retrospectively analyzed to compare the location relationship between the IMTM and the mandibular canal. RESULTS: (1)The relationship of 135 cases between the IMTM and the mandibular canal on panoramic radiographs was defined in three types, no contact type in 99 cases of IMTM(73%), point-contact type in 21 cases of IMTM(16%), and superimposition or line-contact type in 15 cases of IMTM(11%); (2)The roots of extracted IMTM were preserved in 18 cases(13%);(3)One month after the extraction of IMTM root, paresthesia in the lower lip disappeared in 17(94%) cases; 1 case had the symptom white resolved 8 months later. CONCLUSIONS: The indication of root retention in the IMTM extraction was as follows: (1)Less than 3mm of residual root; (2)Dental pulp is not infected;(3)The superimposition or line-contact type between the root of IMTM and the mandibular canal.

[Stray light and bandpass correction in the spectral measurement for light emitting diodes].

The present paper introduces the stray light and bandpass correction methods for spectrometers. The line spread function of spectrometer is characterized by a He-Ne laser. Assuming that the spectrometer is a wavelength invariable system, the stray light distribution matrix is constructed by the derived line spread functions. The stray light correction matrix is then derived by matrix conversion from the stray light distribution matrix. The measured signals of the spectrometer are finally multiplied by the stray light correction matrix to correct the stray light errors. The bandpass functions of the spectrometer are characterized in three different wavelength ranges, respectively. And then three groups of bandpass correction coefficients are calculated accordingly. The calculation is divided into several steps. Given the measurement results at the target wavelength position and the ones on the neighbor bandwidths, the bandpass correction results are obtained by weight averaging of them. The bandpass correction coefficients are used as the weights. The two correction methods are applied to a multi-channel fast spectrometer to measure LEDs of different color. The results show that the stray light and the bandpass errors can be corrected effectively. The chromaticity coordinates of the LEDs are corrected by (-0.003, 0.007) for the maximum. Furthermore, the method introduced in this paper can reduce the application cost, simplify the calculation under a reasonable precision, and make the application of the correction easier.

[Investigation of indication for emergency surgical treatment of condylar fracture].

PURPOSE: To investigate the indication for emergency surgical treatment of condylar fracture. METHODS: Eight patients with single condylar fracture and 3 patients with bilateral condylar fracture underwent emergency surgical treatment, the results were evaluated through radiographs and clinical examination. RESULTS: The mouth opening was normal with good occlusion,condylar anatomical contour was rehabilitated. CONCLUSIONS: Emergency surgical treatment of open condylar fracture is beneficial to healing of condylar fracture and reduction of occlusion.

Application of tissue microarrays to study the influence of dexamethasone on NF-kappaB expression of pancreas in rat with severe acute pancreatitis.

To discuss the influence of dexamethasone on NF-kappaB expression of pancreas in rat with severe acute pancreatitis (SAP). Ninety rat SAP models were divided into the model group and dexamethasone treatment group with 45 rats in each group; another healthy 45 rats were selected to be the sham operation group. The groups were divided into the 3, 6 and 12 h group with 15 rats in each group. The survivals, pancreas pathological changes were observed 3, 6 and 12 h after operation. The changes in expression levels of NF-kappaB protein of pancreas tissue microarray were observed. The treatment group was significantly lower than the model group at 3 and 6 h (P < 0.05) and than the model group at 12 h in pancreas pathological scores (P < 0.01). The expression level of NF-kappaB protein of pancreas head of the treatment group was significantly less than that of the model group at 3 h (P < 0.01). The alleviation of pancreatic tissue injury by dexamethasone during SAP might be closely related to its role in inhibiting NF-kappaB expression and regulating cytokines. The advantages of tissue microarrays in pancreatitis pathological examination include time and energy savings, high efficiency and representative results.

Tissue microarrays in pathological examination of apoptotic acinar cells induced by dexamethasone in the pancreas of rats with severe acute pancreatitis.

BACKGROUND: The good therapeutic effects of large dose of dexamethasone on severe acute pancreatitis (SAP) patients have been proved. This study was designed to investigate the influence of dexamethasone on apoptosis of acinar cells in the pancreas of rats with SAP and the protein expression of the apoptosis-regulating genes Bax and Bcl-2. METHODS: Ninety Sprague-Dawley rats with SAP were randomly divided into a model group and a dexamethasone treated group (45 rats in each group), and another 45 rats formed the sham operation group. Survival rates were calculated and gross pathological changes in the pancreas of each group were observed under a light microscope 3, 6 and 12 hours after operation. Tissue microarray technology was applied to prepare pancreatic tissue sections. The changes in Bax and Bcl-2 protein expression levels of pancreatic tissues from each group were assessed by immunohistochemical staining, and TUNEL staining was used to evaluate changes in apoptosis index. RESULTS: The model and treated groups did not differ in mortality at each time point. The pathological score for the pancreas in the treated group was significantly lower than that in the model group at 3 and 6 hours. The positive rates of Bax protein expression in the head and tail of the pancreas in the treated group at all time points were all markedly higher than those of the model group. The positive rate of Bcl-2 protein expression in the head of the pancreas in the treated group was significantly higher than that of the model group at 3 hours. TUNEL staining showed that the pancreas head and tail apoptosis indices of the treated group were markedly higher than those of the model group after 6 hours. CONCLUSIONS: Apoptosis may be a protective response to pancreatic cell injury. The mechanism of action of dexamethasone in treating SAP may be related to the apoptosis of acinar cells in the pancreas induced by apoptosis-regulating genes such as Bax and Bcl-2. The advantages of tissue microarrays in pathological examination of the pancreas include saving of time and energy, efficiency and highly representative.

Study of the protective effects of dexamethasone on multiple organ injury in rats with severe acute pancreatitis.

CONTEXT: Pancreas, lung, kidney and liver injury has been proven to play an important role in severe acute pancreatitis. OBJECTIVE: To observe the protective effects of dexamethasone on multiple organs (pancreas, lung, kidney and liver) in rats with severe acute pancreatitis. ANIMALS: One hundred and thirty-five Sprague-Dawley rats. DESIGN: Ninety rats were prepared as severe acute pancreatitis models and were randomly divided into a control group and the dexamethasone treatment group (45 rats in each group). Another 45 rats were selected to be the sham operation group. Each group was randomly subdivided into 3 subgroups which were observed at 3, 6, and 12 h after surgery (15 rats in each subgroup). MAIN OUTCOME MEASURES: The survival, gross and pathological findings under the light microscope, and the pathological scores of multiple organs in each group were recorded. RESULTS: There was no significant difference in survival between the dexamethasone treatment group and the control group (P=0.494). The pancreas pathological score was significantly lower in the dexamethasone treatment group than in the control group at the various time intervals (overall: P<0.001; 3 h: P=0.019; 6 h: P=0.010, 12 h: P<0.001). The lung pathological score was significantly lower in the dexamethasone treatment group than in the control group at 6 and 12 h (P=0.023 and P<0.001, respectively). The kidney (P<0.001) and liver (P=0.009) pathological scores were also significantly lower in the overall dexamethasone treatment group than in the overall control group, but significant differences were found only in some time intervals (kidney: 6 and 12 h, P=0.006 and P=0.044, respectively; liver: 12 h, P=0.046). CONCLUSION: Intravenous injection of dexamethasone can alleviate pancreas, lung, kidney and liver injury of rats with severe acute pancreatitis and may have protective effects on multiple organ injury.

Influence of dexamethasone on inflammatory mediators and NF-kappaB expression in multiple organs of rats with severe acute pancreatitis.

AIM: To observe the therapeutic effects of dexamethasone on rats with severe acute pancreatitis (SAP) and investigate the influences of dexamethasone on the inflammatory mediators and NF-kappaB expression in multiple organs of SAP rats as well as the mechanisms involved. METHODS: Ninety Sprague-Dawley (SD) rats with SAP were randomly divided into the model group (n = 45) and dexamethasone treatment group (n = 45), and another 45 rats were selected for the sham operation group. All groups were randomly subdivided into the 3 h, 6 h and 12 h groups, each group containing 15 rats. The survival of all groups and pathological changes of multiple organs (liver, kidney and lung) were observed at different time points after the operation. The pathological score of multiple organs was carried out, followed by the determination of amylase, endotoxin and TNF-alpha contents in blood. The tissue microarray was used to detect the expression levels of NF-kappaB p65 protein in multiple organs. RESULTS: There was no marked difference between the model group and treatment group in the survival rate. The amylase content of the treatment group was significantly lower compared to the model group at 12 h (P < 0.01, 7791.00 vs 9195.00). Moreover, the endotoxin and TNF-alpha levels of the treatment group were significantly lower than that of the model group at 6 h and 12 h (P < 0.01, 0.040 vs 0.055, 0.042 vs 0.059 and P < 0.05, 58.30 vs 77.54, 38.70 vs 67.30, respectively). Regarding the changes in liver NF-kappaB expression, the model group significantly exceeded the sham operation group at 3 h (P < 0.01, 1.00 vs 0.00), and the treatment group significantly exceeded the sham operation group at 12 h (P < 0.01, 1.00 vs 0.00), whereas no marked difference was observed between the model group and treatment group at all time points. The kidney NF-kappaB expression level in the treatment group significantly exceeded the model group (P < 0.05, 2.00 vs 0.00) and the sham operation group (P < 0.01, 2.00 vs 0.00) at 12 h. No NF-kappaB expression in the lung was found in any group. CONCLUSION: Dexamethasone can lower the amylase, endotoxin and TNF-alpha levels as well as mortality of SAP rats. NF-kappaB plays an important role in multiple organ injury. Further studies should be conducted to determine whether dexamethasone can ameliorate the pathological changes of multiple organs by reducing the NF-kappaB expression in the liver and kidney. The advantages of tissue microarrays in pancreatitis pathological examination include time- and energy- saving, and are highly efficient and representative. The restriction of tissue microarrays on the representation of tissues to various extents due to small diameter may lead to the deviation of analysis.

[Clinical study on the causes and treatment of endodontic interappointment emergencies].

OBJECTIVE: To investigate the causes and the treatment of endodontic interappointment emergencies. METHODS: An analysis were made for 55 teeth with endodontic interappointment emergencies. The root canals were sealed with dexamethasone and metronidazole,and filled with Vitapex add gutta-percha point after one week. An evaluation of curative effect was made after following up one year. RESULTS: The total incidence of endodontic interappointment emergencies was 12.59%(55/437). There was significant difference between pulpitis and pulp necrosis or apicitis(P<0.01). There was significant difference between anterior teeth and posterior teeth (P<0.01). The success rate was 92.7% after following up one year. CONCLUSION: The cause of endodontic interappointment emergencies was related to pulp status and tooth location,etc. The treatment that sealed the root canals with dexamethasone and metronidazole and filled with Vitapex add gutta-percha point is of availability.