Immunohistochemical and Histochemical Analysis of Newly Formed Tissues in Root Canal Space Transplanted with Dental Pulp Stem Cells Plus Platelet-rich Plasma

Introduction

Tissue regeneration in root canals after pulpectomy can be achieved by transplantation of autologous dental pulp stem cells and/or platelet-rich plasma. However, the identity of the newly formed tissue in the pulp space has been only examined by histologic analysis. This study aimed to apply immunohistochemistry and histochemistry to detect specific markers in the newly generated tissues after root canal regenerative treatment.

Methods

In our previous study, 32 root canals in 4 mature dogs were treated with a pulp regeneration procedure after pulpectomy using either blood clot, transplantation of dental pulp stem cells, platelet-rich plasma, or a combination of cells and plasma. In the present study, the tissues were examined for the expression of periostin to detect periodontal ligament tissue, nestin and dentin sialoprotein for odontoblasts, and bone sialoprotein and osteocalcin for bone tissues. Samples were also stained for tartrate-resistant acid phosphatase (TRAP) as a marker for osteoclastic lineages.

Results

Continuous periostin-positive tissue was observed extending from the periodontal ligament into the inner canal surface in which the mineral islands were surrounded by weak periostin staining. There was also positive staining for TRAP, bone sialoprotein, and osteocalcin in the canal space, suggesting the presence of bone tissue. A layer of mineralized tissue along the inner surface of the root canal was negative for TRAP, suggesting the tissue likely to be cementum. In all samples, no nestin-positive reaction was observed, whereas dentin sialoprotein was detected in PDL, dentinal tubules, and intracanal fibrous tissues. There was no difference between any of the 4 groups.

Conclusions

The tissues formed in the dog mature root canals after regenerative endodontic procedures are not pulp tissues but mainly periodontal tissues.     

DNA定量分析辅助宫颈高度鳞状上皮内病变的即诊即治策略

目的探讨DNA定量分析在宫颈高度鳞状上皮内病变(HSIL)新即诊即治策略中的意义。方法细胞学HSIL病例129例,随机分成研究组与对照组,研究组在阴道镜诊断基础上,应用DNA定量分析,对阴道镜拟诊HSIL以上病变和DNA定量测定异常者,经患者知情同意,行宫颈环形电切术(LEEP),组织送病理检测,一次性完成诊断与治疗,即为"新即诊即治"方案;对照组采用传统"即诊即治"方案,比较两种方案在HSIL诊治符合率、过度治疗率、漏诊率的差异。结果研究组手术前后诊断符合率、过度治疗率及漏诊率分别为88.4%、5.8%、5.8%,对照组手术前后诊断符合率、过度治疗率及漏诊率分别为66.7%、10.0%、23.3%,差异有统计学意义(P0.01)。结论宫颈细胞学为HSIL,同时DNA倍体定量分析异常,经阴道镜检查怀疑高度病变的患者,采用即诊即治策略较为适宜。     

A nomogram based on age,prostate-specific antigen level,prostate volume and digital rectal examination for predicting risk of prostate cancer

Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population. A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen (PSA), prostate volume (PV), digital rectal examination (DRE) status, % free PSA and transrectal ultrasound (TRUS) findings were included in the analysis. A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy. A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy. The rate for positive initial prostate biopsy was 41.7% (223/535). The independent variables used to predict a positive initial prostate biopsy were age, PSA, PV and DRE status. The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%, respectively. Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram. The nomogram can be used to identify and counsel patients who should consider a prostate biopsy, ultimately enhancing accuracy in diagnosing prostate cancer.     

脱髓鞘脑病的临床特点分析

目的:探讨脱髓鞘脑病的临床特点。方法:回顾性分析50例脱髓鞘脑病患者的临床表现、病理检查结果、实验室和影像学资料及治疗。结果:50例患者的临床表现多样,主要为精神异常、运动障碍和视力损害,MRI检查有脑内广泛长T1、长T2异常信号改变,病理活检可见白质脱髓鞘改变。结论:脱髓鞘脑病临床表现复杂多样,诊断需结合患者的年龄、病程、前驱病史、临床症状、中枢神经系统病灶的数目和分布、实验室、影像学检查和病理活检,明确诊断后应尽早治疗。     

Novel use of an OSCE to assess medical students’ responses to a request for a low value diagnostic imaging test: A mixed methods analysis

ObjectiveEvaluate medical students’ communication skills with a standardized patient (SP) requesting a low value test and describe challenges students identify in addressing the request.MethodsIn this mixed-methods study, third-year students from two medical schools obtained a history, performed a physical examination, and counseled an SP presenting with uncomplicated low back pain who requests an MRI which is not indicated. SP raters evaluated student communication skills using a 14-item checklist. Post-encounter, students reported whether they ordered an MRI and challenges faced.ResultsStudents who discussed practice guidelines and risks of unnecessary testing with the SP were less likely to order an MRI. Students cited several challenges in responding to the SP request including patient characteristics and circumstances, lack of knowledge about MRI indications and alternatives, and lack of communication skills to address the patient request.ConclusionsMost students did not order an MRI for uncomplicated LBP, but only a small number of students educated the patient about the evidence to avoid unnecessary imaging or the harm of unnecessary testing.Practice implicationsKnowledge about unnecessary imaging in uncomplicated LBP may be insufficient to adhere to best practices and longitudinal training in challenging conversations is needed.     

质子磁共振波谱分析对早期脑干损伤的临床价值

目的　探讨质子磁共振波谱 (1HMRS)分析对早期脑干损伤程度及预后评估的临床价值。方法　对 76例原发性脑干损伤患者和 10例健康青年志愿者进行脑干薄层磁共振波谱分析 ,观察两组脑干组织中N 乙酰门冬氨酸 (NAA)、总肌酸 (肌酸 磷酸肌酸 ) (Cr)、胆碱 (Cho)值及NAA/Cr、Cho/Cr值的变化 ,分析这些指标与格拉斯哥预后评分 (GOS)和伤后 90d改良Rankin残障程度的相关性。结果　原发性脑干损伤患者脑干组织早期NAA、Cho、Cr值和NAA/Cr、Cho/Cr值均较正常对照组下降 ;MRS积分与GOS、改良Rankin积分间存在显著相关性。结论　1HMRS分析对早期原发性脑干损伤的程度及预后评估有重要价值     

QWB在临床健康体检中的调查研究

目的评估临床健康体检者的生命质量及其影响因素研究。方法每一位同意进行调查的临床健康体检者由受过训练的医务工作人员面对面的完成QWB调查,并按要求记录健康体检者的一般情况,包括：性别、年龄、婚姻状况、职业和居住地。根据QWB各部分的权重分别计算各部分的权重分。选择性别、年龄、婚姻状况、文化程度、职业和居住地作为变量,作临床健康体检者生命质量的单因素的影响因子研究。结果临床健康体检者的QWB的总分、移动(MOD)、生理活动(PAC)、社会活动(SAC)和症状/复合健康问题(CPX)等5个纬度的得分为：总分0．8766000±0．1240000、移动(MOD)-0．0007920±-0．009720、生理活动(PAC) -0．0007012±-0．006586、社会活动(SAC)-0．0004268±-0．005493和症状/复合健康问题(CPX)- 0．1215000±-0．121500。临床健康体检者QWB量表得分的单因素的影响因子分析：结果显示：①性别：男性与女性的MOB、PAC、SAC、CPX、W得分比较,差异都无统计学意义(P＞0．05)；②年龄：PAC、SAC、CPX、W得分随着年龄段的上升而下降,其中CPX、W得分的差异有统计学意义(P＜0．05)；③)婚姻：MOB、PAC、SAC、W得分“在婚”高于“离异/丧偶/分居”,其中PAC得分差异有统计学意义(P＜0．05)；④文化程度：CPX、W得分随着文化程度的提高而增加,差异有统计学意义(P＜0．05)；⑤居住地：SAC、CPX、W得分“城市(镇)”显著高于“农村”(P＜0．05)。结论QWB量表总得分0．8766000,比国外的常模高,年龄、婚姻状况、文化程度、职业和居住地是QWB评分的影响变量。     

超声检查对小儿胃食管反流的诊断价值

目的　探讨超声检查对小儿胃食管反流 ( gastroesophagealreflux ,GER)诊断的临床应用价值。 方法对 48例临床确诊为GER的患儿 ,应用彩色多普勒超声检查。结果　超声诊断阳性 42例 ,诊断阳性率 87 5 %。结论超声诊断GER方便、安全、无创 ,可作为初步筛查小儿GER的首选方法     

结肠气钡双重造影和结肠CT应用价值的对比分析

目的 探讨结肠气钡双重造影和结肠CT在结直肠疾病诊断中的应用价值,并对比分析两种检查方法的优缺点.方法 回顾性分析2005年6月至2013年8月我院213例结肠气钡双重造影和结肠CT检查结果,对比观察两种检查方法所检出的病种、结直肠肿瘤和息肉的大小、部位及并发症发生情况.结果 结肠气钡双重造影对溃疡性结肠炎、慢性阑尾炎、憩室等疾病和近端结肠及小病灶的诊断能力优于结肠CT;结肠CT对结直肠肿瘤及远端结肠的诊断能力则优于结肠气钡双重造影.结论 结肠气钡双重造影和结肠CT各具优势,在临床工作中应视具体情况加以选择或联合应用.     

手术室空气微生物污染不同方法测定结果的比较

为比较平板沉降不同时间采样及其相应判定标准的结果,对相同的无人员洁净手术室空气交替先后分别进行检测与判定结果。结果表明,对35间手术室空气采样5 min与30 min及按其相应判定标准的细菌数超标率分别为57.1％与14.3％。两者差异有统计学意义(P<0.01)。