[Study of cross-sectional morphology of root canals in Tibetan mandibular incisors by micro-computed tomography].

Objective: To study the cross-sectional morphology of root canal system of Tibetan mandibular incisors by micro-CT. Methods: From October 2019 to October 2020, one hundred and thirty-six mandibular incisors were collected from Tibetan patients [(51.9±16.4) years old, range from 25 to 80 years] who underwent teeth extraction due to severe periodontitis at the Department of Stomatology, Tibetan Hospital of Traditional Tibetan Medicine, including 84 mandibular central incisors and 52 mandibular lateral incisors. These teeth were scanned at 23 µm voxel size resolution. Root lengths from cemento-enamel junction (CEJ) to apex of mandibular incisors were measured. According to the length, the root was divided as cervical 1/3, middle 1/3 and apical 1/3, and the numbers of root canals were recorded simultaneously. The major diameter, minor diameter, and dimension were measured per millimeter in cross section for mandibular incisor with single root canal, and the ratio of major diameter to minor diameter (Dmax/Dmin) as well as roundness were calculated for morphological analysis. The diversions and conversions from CEJ to apex in cross section were recorded for mandibular incisor with multiple root canals. Results: For mandibular central incisors with single root canal, the Dmax/Dmin was highest in middle 1/3 of the root [1.99 (1.31, 2.79)], which was significantly higher than cervical 1/3 and apical 1/3 (P=0.010, P=0.003). The roundness was least in middle 1/3 [0.47 (0.31, 0.66)], which was significantly lower than cervical 1/3 and apical 1/3 (P=0.010, P=0.001). For mandibular central incisor with multiple root canals, the highest incidence of multiple root canals was 40.5% (34/84), and mainly detected in middle 1/3 of the root [32.1% (27/84)]. For mandibular lateral incisor with single root canal, the roundness was greatest in apical 1/3 of the root [0.61 (0.49, 0.71)], which was significantly higher than cervical 1/3 (P=0.001) and middle 1/3 (P=0.001). The highest incidence of multiple root canals was 34.6% (18/52), all of which were detected in apical 1/3. Conclusions: In Tibetan mandibular central incisors, the cross-sectional morphology of root canals was long and narrow in middle 1/3, and multiple root canals were more likely to be found here. In Tibetan mandibular lateral incisors, the cross-sectional anatomy of root canal was relatively close to circle in apical 1/3, but the shape was still so irregular that one root canal may divide into two here.

[Study on the effect of integrated traditional Chinese and western medicine in the treatment of brucellosis].

Objective: To observe the clinical effect of integrated traditional Chinese and western medicine on brucellosis and its influence on humoral immune indexes. Methods: In October 2019, 169 cases of brucellosis hospitalized in Tianjin Second People's Hospital were selected as the research objects, and divided into two groups according to the random number method, 84 cases in the integrated treatment group and 85 cases in the western medicine treatment group. The western medicine treatment group was given antibiotics and other routine western medicine support treatment. The integrated treatment group was given traditional Chinese medicine for treatment based on syndrome differentiation, on the basis of western medicine treatment group, and 6 weeks was a course of treatment. The clinical efficacy and Traditional Chinese Medicine (TCM) syndrome scores were compared between the two groups of patients after treatment, and the changes in humoral immune indexes, biochemical, and liver and kidney functions of the patients before and after treatment were analyzed. Results: The total effective rate was 100.00% (84/84) in the integrated treatment group and 97.65% (83/85) in the western medicine treatment group. The difference was not statistically significant (P>0.05) . The difference was not statistically significant (P>0.05) . There was no statistically significant difference in TCM syndrome scores between the two groups before treatment (P>0.05) , and the TCM syndrome scores after treatment were lower than before treatment (P<0.05) . Among them, the TCM syndrome scores of the integrated treatment group were lower than those of the western medicine treatment group (P<0.05) . There was no significant difference in IgG, IgA, IgM, C3, C4, miRNA-155, C-reactive protein (CRP) , erythrocyte sedimention rate (ESR) , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) between the two groups before treatment (P>0.05) . After treatment, IgG, IgA, IgM, miRNA-155, CRP, ESR, ALT and AST were all lower than before treatment, and C3 and C4 complement levels were higher than before treatment (P<0.05) . Among them, IgG, IgA, IgM, miRNA-155, CRP, ESR, ALT and AST in the integrative treatment group were all lower than the western medicine treatment group, while the C3 and C4 complement levels were higher than the western medicine treatment group (P<0.05) . Conclusion: The treatment of brucellosis with integrated traditional Chinese and western medicine can significantly improve the TCM syndrome score and reduce the levels of CRP and ESR. The mechanism of action may be related to the regulation of the patient's humoral immunological indicators.

Supplementation of Merino ewes with vitamin E plus selenium increases α-tocopherol and selenium concentrations in plasma of the lamb but does not improve their immune function.

Vitamin E and selenium have been reported to improve immune function across a range of species. Ewes lambing on poor-quality dry pasture in autumn in Western Australia are at risk of being deficient in vitamin E and selenium at lambing thus predisposing their lambs to deficiencies and increasing the risk of infection and disease. This study tested the hypotheses that (i) supplementation of autumn-lambing ewes with vitamin E plus selenium in late gestation will increase the concentrations of vitamin E and selenium in plasma in the ewe and lamb and (ii) that the increased concentrations of vitamin E and selenium in plasma in the lambs will improve their innate and adaptive immune responses and thus survival. Pregnant Merino ewes were divided into a control group (n=58) which received no supplementation or a group supplemented with vitamin E plus selenium (n=55). On days 111, 125 and 140 of pregnancy ewes in the vitamin E plus selenium group were given 4 g all-rac-α-tocopherol acetate orally. On day 111 the ewes were also given 60 mg of selenium as barium selenate by subcutaneous injection. The concentrations of α-tocopherol and selenium were measured in ewes and/or lambs from day 111 of pregnancy to 14 weeks of age±10 days (weaning). Immune function of the lamb was assessed by analysing the numbers and phagocytic capacities of monocytes and polymorphonuclear leucocytes and plasma IgG and anti-tetanus toxoid antibody concentrations between birth and 14 weeks of age±10 days. Maternal supplementation with vitamin E plus selenium increased the concentration of α-tocopherol in plasma (1.13 v. 0.67 mg/l; P<0.001) and selenium in whole blood (0.12 v. 0.07 mg/l; P<0.01) of the ewes at lambing compared with controls. Supplementation also increased the concentration of α-tocopherol (0.14 v. 0.08 mg/l; P<0.001) and selenium (0.08 v. 0.05 mg/l; P<0.01) in lambs at birth compared with controls. There was no significant effect of supplementation on immune function or survival in the lambs.

Cross-resistance between voriconazole and fluconazole for non-albicans Candida infection: a case-case-control study.

Cross-resistance (CR) between voriconazole and fluconazole for non-albicans Candida (NAC) species is not uncommon, but little is known about the risk factors and clinical consequences associated with this resistance phenotype. A case-case-control study was performed at a university-affiliated hospital in China between November 2012 and April 2016. The two case groups respectively comprised patients with a mono-resistance (MR) NAC infection (fluconazole or voriconazole resistance) and patients with a CR NAC infection (fluconazole and voriconazole resistance). Patients with a no-resistance (NR) NAC infection were included as the control group. Models were adjusted for demographic and clinical risk factors, and the risk of resistance associated with exposure to specific antibiotics or non-antibiotics were assessed. Of 259 episodes, 33 (12.7%) and 27 (10.4%) were identified as MR and CR NAC infections, respectively. The broad use of azoles was strongly associated with the emergence of MR and CR NAC infections (adjusted odds ratio [95% confidence interval] = 2.69 [1.10-6.58] and 2.53 [1.02-6.28], respectively). The time at risk (1.02 [1.00-1.03]) with 12 days as a breakpoint was also an independent risk factor for CR NAC infection. The number of species associated with a high minimum inhibitory concentration (≥128 µg/mL) of fluconazole was higher for CR NAC infections than for MR NAC infections. Different resistance phenotypes (CR vs. MR vs. NR) were associated with all-cause mortality rates. These findings indicate a worrisome propensity of CR NAC infections and emphasize the need for strict antifungal stewardship.

Hepatocellular Carcinoma Patients May Benefit From Postoperative Huaier Aqueous Extract After Liver Transplantation.

BACKGROUND: Liver transplantation has been the first choice for most early- or intermediate-stage hepatocellular carcinoma (HCC) cases. However, postoperative anti-HCC therapies remain controversial. In this study, we aimed to evaluate the safety and efficacy of Huaier aqueous extract (Jinke), when used as an adjuvant postoperative anti-HCC therapy. METHODS: We retrospectively collected the clinical and follow-up data of HCC patients who underwent liver transplantation at our center. We divided them into 2 groups: a control liver transplantation group and a Huaier treatment group. The baseline characteristics, tumor characteristics, intraoperative data, postoperative recovery, long-term overall survival rate, and tumor-free survival rate were compared between the 2 groups. RESULTS: Fifty-three patients were included in our study, including 28 patients who underwent postoperative Huaier therapy and 25 patients who underwent liver transplantation without postoperative Huaier therapy. The baseline and tumor characteristics were similar between the 2 groups. None of the patients in the Huaier group experienced any severe adverse events. The long-term predictive overall survival was similar between the 2 groups (P = .202). However, the Huaier group had a higher predictive tumor-free survival rate than the control group (P = .029). And the 10- and 30-month predictive tumor recurrence rates were 17.9% and 35.7% in the Huaier group, which were significantly lower than those in the control group (60% and 64%; P < .05). CONCLUSIONS: HCC patients may benefit from Huaier therapy after liver transplantation, but a longer follow-up time and larger cohort study may be necessary to be sure.

Circadian rhythms in the hypothalamo-pituitary-adrenal (HPA) axis.

The pronounced daily variation in the release of adrenal hormones has been at the heart of the deciphering and understanding of the circadian timing system. Indeed, the first demonstration of an endocrine day/night rhythm was provided by Pincus (1943), by showing a daily pattern of 17-keto-steroid excretion in the urine of 7 healthy males. Twenty years later the adrenal gland was one of the very first organs to show, in vitro, that circadian rhythmicity was maintained. In the seventies, experimental manipulation of the daily corticosterone rhythm served as evidence for the identification of respectively the light- and food-entrainable oscillator. Another 20 years later the hypothalamo-pituitary-adrenal (HPA)-axis was key in furthering our understanding of the way in which rhythmic signals generated by the central pacemaker in the hypothalamic suprachiasmatic nuclei (SCN) are forwarded to the rest of the brain and to the organism as a whole. To date, the adrenal gland is still of prime importance for understanding how the oscillations of clock genes in peripheral tissues result in functional rhythms of these tissues, whereas it has become even more evident that adrenal glucocorticoids are key in the resetting of the circadian system after a phase-shift. The HPA-axis thus still is an excellent model for studying the transmission of circadian information in the body.

Impact of Ca2+ flux inhibitors on acrosome reaction of hamster spermatozoa.

Ca(2+) plays a prominent role in the regulation of critical functions of spermatozoa, such as capacitation, acrosome reaction (AR), and fertilization. While there is consensus that Ca(2+) is essential, researchers have reported conflicting results as to what happens to Ca(2+) flux across the sperm membrane during capacitation and AR. The purpose of the present study was to further delineate the function of Ca(2+) channels and their role in sperm capacitation and AR. Epididymides were obtained from healthy adult male hamsters. Spermatozoa were washed with modified Tyrode medium supplemented with 0.3% bovine serum albumin, adjusted to 4.5 x 10(7) motile sperm/mL and incubated in 200-microL droplets for 4 hours at 37 degrees C in the presence of trifluoperazine (TFP), a calmodulin inhibitor, at 25, 50, 100, or 150 nM; verapamil (VP), a Ca(2+) channel inhibitor, at 25, 50, 100, or 150 nM; or nifedipine (NF), a voltage-dependent Ca(2+) channel inhibitor, at 50, 100, 200, or 400 nM. Spermatozoa were assessed for AR by using Coomassie brilliant blue staining techniques. Results indicated that incubation of sperm with Ca(2+) channel inhibitors for 4 hours significantly reduced AR in the study groups (TFP: 88% +/- 2.3%, 65% +/- 2.0%, 60% +/- 2.2%, 54 % +/- 2.2%, respectively; VP: 45% +/- 1.3%, 23 % +/- 1.2%, 12% +/- 1.0%, 8% +/- 0.6%, respectively; and NF: 11% +/- 0.8%, 9% +/- 0.3%, 7.0% +/- 0.1%, 6.0% +/- 0.1%, respectively) compared with control group (95% +/- 3.0%, P < .05). However, increasing the concentrations of TFP and NF did not result in further suppression of AR. In summary, the antagonists of calmodulin and Ca(2+) channel inhibitors suppress sperm AR.

Advances in TCM treatment of hyperprolactinemia.

In recent years, rapid progress has been seen in the treatment of hyperprolactinemia with TCM and materia medica. The old pattern of simply using bromocryptine to treat the disease has been changed. Most of the cases reported in this paper were primary hyperprolactinemia, with other primary diseases excluded. As TCM treatment produces definite therapeutic effects with few side-effects, the methods above reported are worth recommending.

Ultrastructural observation on macrophage-lymphocyte interactions in semen from Tripterygium wilfordii Hook.f. takers.

Sixty-nine specimens from Tripterygium Wilfordii Hook.f. (TWH) users were investigated by electron microscopy. No macrophages were demonstrated in the 21 specimens collected prior to the administration of TWH. However, it was found in 23 out of the 48 semen specimens obtained following the TWH administration. The macrophages were functionally active as shown by the presence of a large number of cytoplasmic processes and pseudopodia on the surface, and primary and secondary lysosomes in the cytoplasm. The macrophages phagocytized sperm debris and degenerated or dead spermatids with formation of specific phagosomes. Around those macrophages, lymphocytes were commonly noted. The cytoplasmic processes of the two cell types could come into contact or even fuse with each other, leading to tight junction-like structure; in some of the contacts, the plasma membranes were found dissolved so as to form direct cytoplasmic linkage.

The introduction of computer-based patient records in The Netherlands.

Computer-based patient records, although an area of active research, are not in widespread use. In June 1992, 38% of Dutch general practitioners had introduced computer-based patient records. Of these, 70% had replaced the paper patient record with a computer-based record to retrieve and record clinical data during consultations. Possible reasons for the use of computer-based patient records include the nature of Dutch general practice and the early and active role of professional organizations in recognizing the potential of computer-stored patient records. Professional organizations issued guidelines for information systems in general practice, evaluated available systems, and provided postgraduate training that prepares physicians to use the systems. In addition, professional organizations successfully urged the government to reimburse general practitioners part of the expenses related to the introduction of computer-based patient records. Our experience indicates that physicians are willing and able to integrate information technology in their practices and that professional organizations can play an active role in the introduction of information technology.

[Pharmacological study on Cordyceps sinensis (Berk.) Sacc. and ze-e Cordyceps].

The Ze-e Cordyceps is similar to the Cordyceps sinensis in such pharmacological actions as calming, enduring hypoxia, dilating trachea, male sex hormone action, antiphlogistic and toxicity, etc. It is thus suggested that the Ze-e Cordyceps may be used place of the Cordyceps sinensis in clinical practice.