早期釉质脱矿是龋病防治的有效阶段,传统的治疗方法主要包括药物治疗和修复治疗.树脂渗透技术是一种采用特殊低黏度树脂渗透到早期龋齿多孔病变体层中的微创技术,为早期釉质脱矿的治疗提供了新的选择.相较于传统的治疗方法,树脂渗透治疗无痛、微创、对患者依从性要求低,远期疗效好.文章就树脂渗透技术的原理、优势、适应证以及与其他牙科材料的联合应用做一综述..

目的 对慢性鼻-鼻窦炎患者采取鼻内镜手术治疗的临床疗效以相关影响因素展开分析.方法 101例慢性鼻-鼻窦炎患者,均给予鼻内镜手术治疗,术后随访12个月,比较患者术后3、6、12个月症状评分,观察治疗效果,分析治疗效果的影响因素.结果 术后3个月,患者鼻滴漏评分为(6.41±2.55)分,嗅觉减退评分为(6.87±3.11)分,鼻塞评分为(7.41±2.25)分,头晕头痛评分为(5.21±1.21)分;术后6个月:鼻滴漏评分为(4.22±2.11)分,嗅觉减退评分为(5.04±2.21)分,鼻塞评分为(5.63±1.98)分,头晕头痛评分为(2.87±1.03)分;术后12个月:鼻滴漏评分为(2.04±0.54)分,嗅觉减退评分为(2.63±1.24)分,鼻塞评分为(1.74±0.36)分,头晕头痛评分为(0.21±0.11)分.术后12个月,患者鼻滴漏、嗅觉减退、鼻塞、头晕头痛评分均低于术后3、6个月,术后6个月均低于术后3个月,差异具有统计学意义(P<0.05).101例患者治疗显效30例,有效47例,无效24例,总有效77例,总有效率为76.2％.治疗无效患者年龄≥65岁、饮酒、鼻息肉、变应性鼻炎、长期使用鼻减充血剂以及长期使用鼻用激素类药物占比均高于治疗有效患者,差异具有统计学意义(P<0.05);治疗无效患者男性、鼻中隔偏曲、嗅觉障碍占比与治疗有效患者比较,差异无统计学意义(P>0.05).结论 慢性鼻-鼻窦炎患者采取鼻内镜手术的治疗效果受年龄、饮酒、鼻息肉、变应性鼻炎、长期使用鼻减充血剂以及长期使用鼻用激素类药物等多种因素的影响,为了提高预后效果,医护人员应根据患者情况采用合适的治疗方法 .

Background Renal transplant lithiasis is a rather unusual disease, and the recurrence of lithiasis presents a challenging situation. Methods We retrospectively analyzed the medical history of one patient who suffered renal transplant lithiasis twice, reviewed the relevant literature, and summarized the characteristics of this disease. Results We retrieved 29 relevant studies with an incidence of 0.34 to 3.26% for renal transplant lithiasis. The summarized incidence was 0.52%, and the recurrence rate was 0.082%. The mean interval after transplantation was 33.43 ± 56.70 mo. Most of the patients (28.90%) were asymptomatic. The management included percutaneous nephrolithotripsy (PCNL, 22.10%), ureteroscope (URS, 22.65%), extracorporeal shockwave lithotripsy (ESWL, 18.60%) and conservative treatment (17.13%). In our case, the patient suffered from renal transplant lithiasis at 6 years posttransplantation, and the lithiasis recurred 16 months later. He presented oliguria, infection or acute renal failure (ARF) during the two attacks but without pain. PCNL along with URS and holmium laser lithotripsy were performed. The patient recovered well after surgery, except for a 3 mm residual stone in the calyx after the second surgery. He had normal renal function without any symptoms and was discharged with oral anticalculus drugs and strict follow-up at the clinic. Fortunately, the calculus passed spontaneously about 1 month later. Conclusions Due to the lack of specific symptoms in the early stage, patients with renal transplant lithiasis may have delayed diagnosis and present ARF. Minimally invasive treatment is optimal, and the combined usage of two or more procedures is beneficial for patients. After surgery, taking anticalculus drugs, correcting metabolic disorders and avoiding UIT are key measures to prevent the recurrence of lithiasis.

Objective To discuss the clinical effect of hepatic artery reconstruction using donor′s iliac artery through abdominal aorta bypass graft in orthotopic liver transplantation. Methods The clinical data of liver transplantation recipients who got hepatic artery reconstruction using donor′s iliac artery through abdominal aorta bypass graft from January 2006 to April 2018 in the First Hospital, China Medical University, were retrospectively analyzed. The observation indexes included recovery of liver function and occurrence of complication like hepatic artery thrombosis. Trying to find what types of liver transplantation recipients should receive hepatic artery reconstruction. Results Eight recipients were incorporated into study, including 1 recipient with common hepatic artery hypoperfusion because of splenic artery steal syndrome, 3 recipients with slim common hepatic artery, and 4 recipients with weak or stratified common hepatic artery wall. The mean blood flow of the reconstructed hepatic artery was (315±178) mL/min. Except for 2 recipients with jaundice due to stenosis of the hepatic outflow tract and bile duct anastomosis, the liver function of other recipients recovered well. One recipient was diagnosed as hepatic artery thrombosis 2 months after transplantation, and then developed liver abscess and died of multiple organ failure half a year later. The rest of the recipients still alive and no hemadostenosis and thrombosis were found up to November 2018. Conclusions When conventional anastomosis of donor and recipient hepatic artery can not be performed, using donor′s iliac artery to reconstruct the hepatic artery of recipient through abdominal aorta bypass graft can be considered. Key words: Liver transplantation; Hepatic artery reconstruction; Bypass graft; Iliac artery

Objective To determine the risk factors associated with early allograft dysfunction (EAD) after liver transplantation. Methods We retrospectively analyzed the records of 138 patients who underwent liver transplantation from January 2006 to October 2016 in our department. Transplant recipients were divided into two groups:those who met the diagnostic criteria of EAD (EAD group) and those who did not (non-EAD group). We compared blood flow into the transplanted livers and other clinical features between the two groups using univariate and multivariate analysis. Results Intraoperative portal vein flow (PVF) maximum was significantly different between the two groups. Multivariate analysis revealed that intraoperative PVF maximum ＜1 600 mL/min was the only independent risk factor for the occurrence of EAD after liver transplantation in this cohort. Conclusion Intraoperative PVF maximum ＜1 600 mL/min is an independent risk factor for the occurrence of EAD after liver transplantation. Measuring intraoperative blood flow into the transplanted liver in liver transplant recipients may help identify patients at risk for developing EAD.

目的:探讨影像导航系统在鼻内镜额窦手术中的应用效果.方法:接收在本院进行鼻内镜额窦手术的患者共84例,随机分为观察组与对照组,对照组给予常规鼻内镜手术治疗,观察组给予影像导航系统进行鼻内镜手术治疗,对比两组患者的临床效果.结果:观察组患者的平均手术时间为(55.32士23.46)min,平均出血量为(123.17士52.42)mL,对照组患者的平均手术时间为(67.41±25.95)min,平均出血量为(127.78士64.58)mL,观察组患者的平均手术时间明显低于对照组(P＜0.05),观察组患者的平均手术时间明显低于对照组(P＜0.05);两组患者的平均术中出血量之间的差异不具有统计学意义(P＞0.05).结论:影像导航系统在鼻内镜额窦手术当中可以取得显著的效果,能够使手术时间明显缩短,使术中出血量明显减少,同时可以准确定位.

目的 探讨受体肝动脉变异对肝移植术后肝动脉、胆道及门静脉并发症的影响及防治.方法 收集我院2004年1月至2016年9月实施的197例肝移植手术病例临床资料,进行回顾性总结与分析,统计肝动脉的变异情况及其对并发症的影响.结果 受体肝动脉变异(变异组)22例(1 1.6％),未变异(非变异组)175例(88.4％),变异组与非变异组肝动脉血流无统计学差异[(240.4±151.8) mL/min vs(175.7±100.2) mL/min,P=0.098],门静脉血流无统计学差异[(1 752.5±471.9) mL/min vs(1 688.9±787.1) mL/min,P=0.801].出现肝动脉并发症23例(11.7％),2组无统计学差异(3/22 vs 20/175,x2=0.002,P＞0.05);胆道并发症41例(21％),2组无统计学差异(5/22 vs 36/175,x2=0.002,P＞0.05);门静脉并发症17例(8.6％),2组无统计学差异(3/22 vs 14/175,x2=0.235,P＞0.05).结论 受体肝动脉变异不会增加肝移植术后肝动脉、胆道及门静脉并发症的发生率.

Objective To summarize the characteristics and treatment methods of de novo malignancies in recipients after renal transplantation. Methods Clinical data of 43 patients with de novo malignancies after renal transplantation among 759 recipients were analyzed retrospectively. Characteristics, treatment methods and prognosis of the de novo malignancies after renal transplantation were summarized. Results The incidence of de novo malignancies in recipients after renal transplantation was 5.7％. The age of onset was (52±11) years old, and the de novo malignancies was diagnosed in 13-193 months with the median of 60 months after renal transplantation. The 43 patients with de novo malignancies included 9 cases of primary renal carcinoma, 7 cases of bladder carcinoma, 6 cases of lung carcinoma, 5 cases of lymphoma, 4 cases of colorectal carcinoma, 4 cases of mammary carcinoma, 2 cases of skin carcinoma, 1 case of adrenal carcinoma, 1 case of gastric carcinoma, 1 case of primary carcinoma of liver, 1 case of pancreatic carcinoma, 1 case of scalp angiosarcoma and 1 case of meningioma, and they were treated by surgical procedure, adjusting immunosuppressive therapy, radiotherapy or chemotherapy after diagnosed. The postoperative 1- and 5-year survival rates were 81％ and 63％, respectively. Conclusions The incidence of de novo malignancies in recipients after renal transplantation is higher than that in healthy subjects, and urological neoplasm is most common. Radical resection should be considered first, and antineoplastic combined therapy can be performed for the patients who cannot undergo surgery. Meanwhile, dosage of immunosuppressive agents can be reduced and medication regimens can be adjusted, thus effectively prolonging the survival time of patients.

Objective:To construct the expression plasmid of human sorbin and SH3 domain containing 1(hPlk4) gene and identify expression and localization of hPlk4 in U2OS osteosarcoma cells.Methods:Using pGEX-4T-2-hPlk4 plasmid as a template,human Plk4 coding sequence was amplified by polymerase chain reaction(PCR) and cloned into 3*Flag empty vector.After the target region was identified by double enzymes digestion and sequencing,the plasmid was transiently transfected into U2OS osteosarcoma cells.The 3*Flag-hPlk4 plasmid expression in U2OS cells was detected by Western blot assay.The localization of 3*Flag-hPlk4 fusion protein in U2OS cells was observed with laser scanning confocal microscopy.The hPlk4 protein was purified by immunoprecipitation assay.Results:Human Plk4 gene was successfully constructed into the 3*Flag expression vector.The expression of 3*Flag-hPlk4 fusion protein was detected by Western blot assay and pulled down by anti-flag antibody.Its localization is at the cytoplasm and perinuclear of U2OS cells.Conclusion:The 3*Flag-hPlk4 recombinant plasmid was successfully cloned into eukaryotic expression vector.The expression of 3*Flag-hPlk4 fusion protein was pulled down by anti-flag antibody and localized at the cytoplasm and perinucleus.

目的 构建hPlk3真核表达载体并证实融合蛋白在细胞内的表达及定位.方法 提取工具细胞Hela的mRNA,反转录为cDNA.PCR扩增hPlk3基因cDNA全长,并将其亚克隆至pEGFP-C1表达载体中.然后将构建的重组质粒进行酶切和测序鉴定,并转染到工具细胞COS-7中,提取细胞蛋白进行Western blot检测其表达.最后利用激光共聚焦扫描显微镜观察pEGFP-hPlk3在COS-7细胞内的定位.结果 hPlk3基因cDNA全长克隆到了真核表达载体pEGFP-C1中,酶切鉴定片段为1941bp,并测序成功.Western blot检测到了GFP-hPlk3融合蛋白表达,分子量约为98kDa.pEGFP-hPlk3在COS-7细胞中主要定位于细胞质和核周.结论 成功构建了hPlk3基因cDNA全长的真核表达载体,pEGFP-hPtk3蛋白在COS-7细胞中主要定位于细胞质和核周.

Objective To construct an eukaryotic expression vector GFP-hPlk1 and identify the expression and localization of hPlkl in osteosarcoma U2OS cells.Methods Using pcDNA3.1-hPlk1 as a template,we obtained human Plk1 coding sequence by polymerase chain reaction(PCR) amplification and cloned it into the eukaryotic expression vector.The plasmid was identified by restriction enzyme digestion and DNA sequencing,GFP-hPlk1 was transiently transfected into osteosarcoma U2OS cells and examined by Western blot.The localization of GFP-hPlk1 in U2OS cells was observed with laser scanning confocal microscopy.hPlk1 protein was purified by immunoprecipitation assay.Results hPlk1 cDNA was successfully constructed into the expressing vector pEGFP-C 1.The length of the fragment identified by restriction enzyme digestion was 1812 bp.The expression of GFP-hPlk1 fusion protein with a molecular weight of 93 000Da was detected by Western blot and pulled down by GFP antibody,localized in the cytoplasm and perinucleus in U2OS cells.Conclusion The recombinant plasmid of hPlk1 gene was successfully constructed,GFP-hPlk 1 fusion protein was expressed in U2OS cells.

临床资料患者,男,29岁.主因右前臂伸侧暗红色结节1年,于2013年9月17日就诊.1年前,患者右前臂无明显诱因出现一个红丘疹,皮损逐渐变硬,偶感刺痛.体格检查:系统检查未见异常.皮肤科检查:右前臂伸侧可见单发黄豆大暗红色硬结节(图1),直径0.8cm,质地坚实,与表面皮肤黏连,可推动.实验室及辅助检查:血、尿常规,肝肾功能正常,胸部X线片,肝、胆、脾、胰腺B超正常.门诊诊断:皮肤纤维瘤?手术完全切除后行组织病理检查示:真皮内见一肿物,由组织细胞、成纤维细胞组成,见大量多核巨细胞,肿物内可见裂隙,周边大量红细胞及含铁血黄素沉积及囊性出血(图2~4).免疫组化:CD68(+),Vimentin(+),sma(+),Desmin(+),CD31(-),CD34(-)(图5~7).诊断:动脉瘤样纤维组织细胞瘤.扩大切除后至今随访无复发.

Objective:To construct the expression plasmid of human Sestrin2 (hSesn2)gene and identify the ex-pression and localization of hSesn2 in osteosarcoma MG - 63 cells. Methods:Human hSesn2 coding sequence was ob-tained by polymerase chain reaction (PCR)amplification and cloned into 3*Flag tag expression plasmid. After the target cDNA was identified by double enzymes digestion and sequencing,the plasmid was transiently transfected into osteosarcoma MG - 63 cell line. The expression of the recombinant plasmid in MG - 63 cells was detected by Western blot. The localization of 3*Flag - hSesn2 in MG - 63 cells was observed with laser scanning confocal microscopy. The hSesn2 protein was purified by immunoprecipitation assay. Results:Human Sesn2 plasmid containing 3*Flag tag was successfully constructed. The fragment length was identified as 1443bp by restriction enzyme digestion. The protein level of 3*Flag - hSesn2 fusion protein was detected by Western blot as a molecular weight of 55kDa and pulled down by Flag antibody. The localization of recombinant protein is in the cytoplasm and perinucleus of MG - 63 cells. Conclusion:The hSesn2 recombinant plasmid was successfully constructed. The expression of 3*Flag - hSesn2 fu-sion protein was identified and pulled down by Flag antibody,and it was localized in cytoplasm and perinucleus of MG- 63 cells.

Objective To discuss the correlation between peak intensity (PI) of contrast enhanced ultrasound and injury severity after liver ischemia reperfusion.Methods Pringle's maneuver was used to establish the liver 15-min ischemia model.Contrast enhanced ultrasound was used to observe the hepatic perfusion after reperfusion of 1 h,6 h and 24 h,and the PI was recorded.The correlation analysis on PI with alanine aminotransferase (ALT),aspartate aminotransferase (AST) and pathologic changes (Suzuki standard) was done.Results PI decreased after 1 h,6 h,and 24 h of liver reperfusion,most significantly at 6 h.ALT reached the peak after 1 h of reperfusion and then decreased after 6 h and 24 h.AST increased after 6 h of reperfusion and decreased after 24 h.After 1 h of reperfusion,mild injury appeared in pathology and the injury became severe after 6 h,then it got moderate-to-severe after 24 h of reperfusion.PI was negatively correlated to ALT,AST and pathologic injury degree.Conclusion The PI relates to the degree of hepatic injury after liver ischemia/reperfusion.The more severe the injury is,the lower the PI.

报道辽宁省首例公民逝世后器官捐献(DCD)婴幼儿供肾的多器官获取,探讨供肾修整和成人移植及其围手术期治疗相关问题.

Objective:To construct the expression plasmid of human sorbin and SH3 domain containing 1(hSesn1)gene and identify the expression and localization of hSesn1 in MG-63 osteosarcoma cells.Methods:GST-hSesn1 was used as a template,human SESN1 coding sequence was amplified by polymerase chain reaction(PCR)amplification and cloned into 3*Flag empty vector.After the cloning target was identified by double enzyme digestion and sequenced,the plasmid was transiently transfected into MG-63 osteosarcoma cells.The expression of the recombinant protein in MG-63 cells was detected by Western blot assay.The localization of 3*Flag-hSesn1 in MG-63 cells was observed by laser confocal scanning microscopy.The hSesn1 protein was purified by immunoprecipitation assay.Results:hSesn1 gene was successfully constructed into the 3*Flag expressing plasmid.The expression of 3*Flag-hSesn1 fusion protein was detected by Western blot and pulled down by anti-flag antibody.The localization of fusion protein is at the cytoplasm and near nuclear membrane of MG-63 cells.Conclusion:The recombinant hSesn1 plasmid was successfully cloned into eukaryotic expressing vector,and the expression of 3*Flag-hSesn1 fusion protein was pulled down by anti-flag antibody and majorly expressed at the cytoplasm and partly nuclear.

Objective:To construct the expression plasmid of human Sestrin 3 (hSesn3) gene and identify expression and localization of the fusion protein in osteosarcoma MG-63 cells.Methods:Total mRNA was extracted from Hela cells,and the cDNA was reversely transcripted.The hSesn3 coding sequence was amplified by polymerase chain reaction (PCR) and sub-cloned into pEGFP-C1 empty vector.After the PCR fragment was identified by double restriction enzymes digestion and sequenced,the plasmid was transiently transfected into MG-63 osteosarcoma cells.The expression of the recombinant plasmid in MG-63 cells was detected by Western blot assay.The localization of pEGFP-hSesn3 in MG-63 cells was observed with laser scanning confocal microscopy.The hSesn3 protein was purified by immunoprecipitation assay.Results:hSesn3 was successfully constructed into the pEGFP-C1 expression plasmid.The length of the fragment identified by double restriction enzymes digestion was 1 410 bp.The molecular weight of pEGFP-hSesn3 fusion protein was 79 kDa.It is detected by Western blot assay.The pEGFP-hSesn3 fusion protein was mostly localized in the cytoplasm of MG-63 cells.Conclusion:The recombinant hSesn3 plasmid was successfully cloned into eukaryotic expression vector.The GFP-hSesn3 fusion protein was identified and pulled down by GFP antibody.The pEGFP-hSesn3 fusion protein was majorly localized in the cytoplasm of MG-63 cells.

Objective:To construct the expression plasmid of human Polo-like kinase 3 (hPlk3) gene and to identify the expression and localization of hPlk3 in U2OS osteosarcoma cells.Methods:GST-hPlk3 was used plasmid as a template,human Plk3 coding sequence was obtained by polymerase chain reaction (PCR) amplification and cloned into 3 * Flag expression plasmid.After the target region was identified by enzyme digestion and sequencing,the plasmid was transiently transfected into osteosarcoma U2OS cells.The expression of the recombinant plasmid in U2OS cells was detected by Western blot.The localization of 3 * Flag-hPlk3 in U2OS cells was observed with laser scanning confocal microscopy.The hPlk3 protein was purified by immunoprecipitation assay.Results:Human Plk3 coding sequence was constructed into the expressing vector 3 * Flag successfully.The length of the PCR fragment identified by restriction enzyme digestion was 1 941bp.The expression of 3 * Flag-hPlk3 fusion protein was detected by Western blot with a molecular weight of 74kDa and pulled down by Flag antibody.The localization of recombinant protein is in the cytoplasm and perinucleus of U2OS cells.Conclusion:The recombinant plasmid of hPlk3 gene was successfully constructed into eukaryotic expressing plasmid.The expression of 3 * Flag-hPlk3 fusion protein was identified and pulled down by Flag antibody.Furthermore,it was localized in cytoplasm and perinucleus.

Objective To construct the expression plasmid of human Sestrin 1 (hSesn1) gene and identify expression and localization of fusion protein.Methods Total mRNA was extracted from Hela cells,and cDNA was synthesized via reverse transcription.The hSesn1 coding sequence was sucessfully amplified by polymerase chain reaction (PCR) and cloned into pEGFP-C1 expression plasmid.After the hSesn1 gene was successfully identified by double enzymes digestion and sequencing,the plasmid was transiently transfected into COS-7 cells.The expression of the recombinant plasmid in COS-7 cells was detected by Western blot assay.The localization of pEGFP-hSesn1 in COS-7 cells was observed with laser confocat microscopy.Results hSesn1 cDNA was successfully constructed into the pEGFP-C1 expression vector.The fragment length identified by double restriction enzymes digestion was 1479bp.The expression of pEGFP-hSesn1 fusion protein was detected by Western blot assay.Its molecular weight is 80kDa.The pEGFP-hSesn1 fusion protein was mostly localized at cytoplasm and perinuclear of COS-7 cells.Conclusion The recombinant pEGFP-hSesn1 plasmid was successfully constructed,and the pEGFP-hSesn1 fusion protein was mostly localized at cytoplasm and perinuclear of COS-7 cells.