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Objective: To explore the possible anti-atherosclerotic mechanisms of glucose co-transporter-2 inhibitor canagliflozin. Methods: ApoE-/-mice fed on Western diet were randomly assigned into the model group (n=10) and the canagliflozin group (n=10). C57BL/6J mice fed on normal diet were chosen as the control group (n=10). Mice in the canagliflozin group were gavaged with canagliflozin for 14 weeks. The presence and severity of atherosclerosis were evaluated with HE and oil red O stainings in aortic root section slices. PCR assay was performed to determine the mRNA expression levels of nitric oxide synthase. Hepatic transcriptome analysis and hepatic amino acid detection were conducted using RNA-seq and targeted LC-MS, respectively. Results: HE staining and oil red O staining of the aortic root showed that AS models were successfully established in ApoE-/-mice fed on Western diet for 14 weeks. Canagliflozin alleviated the severity of atherosclerosis in pathology. Hepatic transcriptome analysis indicated that canagliflozin impacted on amino acid metabolism, especially arginine synthesis in ApoE-/-mice. Targeted metabolomics analysis of amino acids showed that canagliflozin reduced hepatic levels of L-serine, L-aspartic acid, tyrosine, L-hydroxyproline, and L-citrulline, but raised the hepatic level of L-arginine. Compared to the model group, the canagliflozin group exhibited higher serum arginine and nitric oxide levels as well as elevated nitric oxide mRNA expression in aortic tissues (P<0.05). Conclusion: Canagliflozin regulated the amino acid metabolism, reduced the levels of glucogenic amino acids,and promoted the synthesis of arginine in atherosclerotic mice.

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Objective: To explore the possible anti-atherosclerotic mechanisms of glucose co-transporter-2 inhibitor canagliflozin. Methods: ApoE-/-mice fed on Western diet were randomly assigned into the model group (n=10) and the canagliflozin group (n=10). C57BL/6J mice fed on normal diet were chosen as the control group (n=10). Mice in the canagliflozin group were gavaged with canagliflozin for 14 weeks. The presence and severity of atherosclerosis were evaluated with HE and oil red O stainings in aortic root section slices. PCR assay was performed to determine the mRNA expression levels of nitric oxide synthase. Hepatic transcriptome analysis and hepatic amino acid detection were conducted using RNA-seq and targeted LC-MS, respectively. Results: HE staining and oil red O staining of the aortic root showed that AS models were successfully established in ApoE-/-mice fed on Western diet for 14 weeks. Canagliflozin alleviated the severity of atherosclerosis in pathology. Hepatic transcriptome analysis indicated that canagliflozin impacted on amino acid metabolism, especially arginine synthesis in ApoE-/-mice. Targeted metabolomics analysis of amino acids showed that canagliflozin reduced hepatic levels of L-serine, L-aspartic acid, tyrosine, L-hydroxyproline, and L-citrulline, but raised the hepatic level of L-arginine. Compared to the model group, the canagliflozin group exhibited higher serum arginine and nitric oxide levels as well as elevated nitric oxide mRNA expression in aortic tissues (P<0.05). Conclusion: Canagliflozin regulated the amino acid metabolism, reduced the levels of glucogenic amino acids,and promoted the synthesis of arginine in atherosclerotic mice.

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Objective: Osteoarthritis (OA) is a degenerative joint disease. Excessive nitric oxide (NO) mediates the chondrocyte inflammatory response, apoptosis, and extracellular matrix (ECM) degradation during the occurrence and development of OA. NO in chondrocytes is mainly produced by inducible nitric oxide synthase (iNOS). The aim of this study was to design and synthesize an iNOS dimerization inhibitor and evaluate its effects on chondrocyte inflammation and articular cartilage injury in OA via in vitro and in vivo experiments. Design: The title compound 22o was designed, synthesized, and screened based on a previous study. The effects of different concentrations (5, 10, and 20 µM) of compound 22o on chondrocyte inflammatory response and ECM anabolism or catabolism were evaluated by Western blot and real-time quantitative reverse transcription-polymerase chain reaction using the rat chondrocyte model of IL-1ß-induced OA. Furthermore, different doses (40 and 80 mg/kg) of compound 22o were administered by gavage to a rat OA model induced by anterior cruciate ligament transection (ACLT), and their protective effects on the articular cartilage were evaluated by histopathology and immunohistochemistry. Results: Compound 22o showed effective iNOS inhibitory activity by inhibiting the dimerization of iNOS. It inhibited the IL-1ß-induced expression of cyclooxygenase-2 (COX-2) and matrix metalloproteinase 3 (MMP3) in the chondrocytes, decreased NO production, and significantly increased the expression levels of the ECM anabolic markers, aggrecan (ACAN), and collagen type II (COL2A1). Gavage with compound 22o was found to be effective in the rat OA model induced by ACLT, wherein it regulated the anabolism and catabolism and exerted a protective effect on the articular cartilage. Conclusions: Compound 22o inhibited the inflammatory response and catabolism of the chondrocytes and reduced articular cartilage injury in the rat OA model, indicating its potential as a disease-modifying OA drug.

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Severe coronavirus disease 2019 (COVID-19) is characterized by systemic inflammation and can result in protracted symptoms. Robust systemic inflammation may trigger persistent changes in hematopoietic cells and innate immune memory through epigenetic mechanisms. We reveal that rare circulating hematopoietic stem and progenitor cells (HSPC), enriched from human blood, match the diversity of HSPC in bone marrow, enabling investigation of hematopoiesis and HSPC epigenomics. Following COVID-19, HSPC retain epigenomic alterations that are conveyed, through differentiation, to progeny innate immune cells. Epigenomic changes vary with disease severity, persist for months to a year, and are associated with increased myeloid cell differentiation and inflammatory or antiviral programs. Epigenetic reprogramming of HSPC may underly altered immune function following infection and be broadly relevant, especially for millions of COVID-19 survivors. One Sentence SummaryTranscriptomic and epigenomic analysis of blood reveal sustained changes in hematopoiesis and innate immunity after COVID-19. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=197 HEIGHT=200 SRC="FIGDIR/small/479588v1_ufig1.gif" ALT="Figure 1"> View larger version (54K): org.highwire.dtl.DTLVardef@1ffe42dorg.highwire.dtl.DTLVardef@dd4868org.highwire.dtl.DTLVardef@1bcae8borg.highwire.dtl.DTLVardef@674e85_HPS_FORMAT_FIGEXP M_FIG C_FIG

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Objective:To screen the differentially expressed exosomal miRNAs derived from liver cancer stem cells (LCSCs) and its effect on the malignant biological characteristics of liver cancer cells.Methods:miRNA expression profile chip was used to analyze the differentially expressed exosomal miRNA derived from LCSCs. The effects of miRNA on malignant phenotypes of LCSCs were identified. The cells were further treated with doxorubicin at different concentrations (0, 150, 300 μmol/L), and the expression level of miR-196a was detected by quantitative real-time PCR (qRT-PCR). The apoptosis of liver cancer cells cultured by exosomes derived from LCSCs (Exo-NC group) and exosomes derived from miR-196a inhibited LCSCs (Exo-Inhibitor group) and the activity of caspase3/7 under the action of exosomes from LCSCs were detected. Nude mice were randomly divided into Do-PBS group, Do-Exo-Inhibitor group and Do-Exo-NC group using random number table method, with 5 mice in each group, and the effect of miR-196a on nude mice xenograft tumor model with liver cancer cells was analyzed.Results:In this study, exosomes were isolated and purified from CD133 + Huh7 stem cell culture supernatant. miR-7162-3p, miR-1910-5, miR-3613-3p, miR-196a and miR-155-5p were up-regulated, while miR-1246 and miR-3613-5p were down-regulated. miR-7162-3p, miR-196a and miR-155-5p in exosomes had important effects on the self-renewal ability of LCSCs. miR-1910-5p, miR-196a and miR-155-5p had important effects on the invasion ability of liver cancer stem cells, among which miR-196a had the most significant inhibitory effect. Treatment for 24 h, the miR-196a expression level of the 0, 150 and 300 μmol/L doxorubicin was 0.96±0.05, 1.23±0.05 and 2.33±0.03 respectively, with a statistically significant difference ( F=996.90, P<0.001). Treatment for 48 h, the miR-196a expression level of the 0, 150 and 300 μmol/L doxorubicin were 1.02±0.07, 2.35±0.05 and 2.89±0.55 respectively, with a statistically significant difference ( F=303.00, P<0.001). When the concentration of doxorubicin was 0 and 300 μmol/L, the apoptosis rates of the Exo-NC group were 9.37%±0.19% and 11.64%±0.27%, and those of the Exo-Inhibitor group were were 18.80%±1.91% and 22.79%±1.57%, with statistically significant differences ( t=4.41, P=0.048; t=4.96, P=0.038). When doxorubicin was not used, the ratios of caspase3/7 in the Exo-NC group at 24 h and 48 h were 0.94±0.08 and 0.97±0.09, and those in the Exo-Inhibitor group were 1.56±0.01 and 1.58±0.01, with statistically significant differences ( t=11.41, P=0.008; t=6.07, P=0.026). Under 300 μmol/L doxorubicin, the ratios of caspase3/7 in the Exo-NC group at 24 h and 48 h were 0.95±0.07 and 1.36±0.08, and those in the Exo-Inhibitor group were 2.84±0.08 and 3.20±0.14, with statistically significant differences ( t=24.20, P=0.002; t=15.78, P=0.004). The results of xenograft tumor in nude mice showed that the tumor volumes of Do-PBS, Do-Exo-Inhibitor and Do-Exo-NC groups increased successively, which were (1 051.86±89.90) mm 3, (1 310.91±86.66) mm 3 and (2 185.14± 352.34) mm 3 respectively, with a statistically significant difference ( F=30.28, P<0.001). The weights of the transplanted tumors in the 3 groups increased successively, which were (0.36±0.10) g, (0.39±0.12) g and (0.76±0.16) g respectively, with a statistically significant difference ( F=11.81, P=0.002). The expression of miR-196a in tumors was significantly decreased after miR-196a inhibitor transfection. The expression levels of the 3 groups were 1.05±0.16, 0.38±0.08 and 2.17±0.26, with a statistically significant difference ( F=48.93, P<0.001). Conclusion:The exosomal secreted by LCSCs can enhance the resistance of liver cancer cells to doxorubicin by miR-196a.

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OBJECTIVE@#In this study, we investigated the changes in peripheral blood inflammatory factors and intestinal flora in acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV)-positive individuals (AIDS/HIV patients), and explored the relationships among intestinal flora, peripheral blood inflammatory factors, and CD4+ T lymphocytes.@*METHODS@#Thirty blood and stool samples from an AIDS group and a control group were collected. The levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA), and the number of CD4+ T lymphocytes by a FACSCount automated instrument. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the messenger RNA (mRNA) levels of Bifidobacterium, Lactobacillus, Escherichia coli, Enterococcus faecalis, and Enterococcus faecium. Correlations among intestinal flora, inflammatory factor levels, and CD4+ T lymphocyte values were evaluated using the Spearman correlation coefficient.@*RESULTS@#The levels of TNF-α and IL-6 in the AIDS group were higher than those in the control group, while the number of CD4+ T lymphocytes was lower. The amounts of Bifidobacterium and Lactobacillus in the AIDS group were significantly lower than those in control group, while the amounts of E. coli, E. faecalis, and E. faecium were much higher. The amounts of Bifidobacterium and Lactobacillus were negatively correlated with the content of TNF-α and IL-6 and the CD4+ T lymphocyte count, while those correlations were reversed for E. coli, E. faecalis, and E. faecium.@*CONCLUSIONS@#The intestinal microbiota of AIDS/HIV patients were disordered, and there was a correlation between the amount of intestinal flora and the number of CD4+ T lymphocytes and the levels of TNF-α and IL-6.

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Objective To evaluate the efficiency and functional improvement of masseter-to-facial nerve transfer for patients who acquired a proximal iniury to the facial nerve and preliminary determine the influence factors for recovery.Methods From January,2015 to May,2016,the clinical data of 6 patients with facial paralysis underwent nerve anastomosis were analyzed retrospectively.These patients were required to come back to the hospital for a check every 3 months,in order to evaluate their facial nerve function.House-Brackmnann(H-B)grading was used to evaluate the pre-oerative,post-operative and follow-up status.The masseter-to-facial nerve anastomosis was performed in all the 6 patients.Results All patients were followed-up.The mean time of follow-up was 16 months (ranged from 6 to 23 months).Among 6 cases,the facial nerve function was improved in 5 cases,unchanged in 1 case.The postoperative H-B grades were Ⅱ in 3 cases,Ⅲ in 2 cases.The improvement of facial paralysis was most significant for orbicularis muscles,followed by the orbicularis oculi muscles,and the worst was the improvement of frontal muscles.Conclusion Masseter-to-facial nerve transfer anatomosis is a useful treatment for facial paralysis and can improve the facial function.

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BACKGROUND:Tissue-engineered bone can be obtained by the combination of chondrocytes and polyglycolic acid scaffold. OBJECTIVE:To investigate the effect of alogeneic chondrocytes/polyglycolic acid scaffold compound in the repair of thyroid cartilage defects in rabbits. METHODS: Twenty New Zealand adult rabbits were randomly divided into experimental group with implantation of alogeneic chondrocytes/polyglycolic acid scaffold compound and control group with implantation of polyglycolic acid scaffold. Gross and histological observations were done at 4 and 8 weeks after implantation. RESULTS AND CONCLUSION: (1) Gross observation results: 4 weeks after surgery, cartilage defects in the experimental group were repaired certainly, and no necrosis appeared in the repair area; in the control group, the defects were filed with muscle and connective tissues. At 8 weeks after implantation, cartilage defects in the experimental group were further repaired, with unclear repair boundaries, and in the control group, cartilage defects were no repaired and showed a notable boundary with the surrounding normal cartilage tissues. (2) Immunohistochemical staining results: the expression of type II colagen in the experimental group was higher than that in the control group (P < 0.05) at 4 and 8 weeks after implantation. These findings indicate that the alogeneic chondrocytes/polyglycolic acid scaffold compound can promote the repair of thyroid cartilage defects in rabbits.

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From January 2013 to January 2015, 19 patients of traumatic hemothorax with hemorrhagic shock were treated in our department by thoracoscopic surgery combined with autologous blood transfusion. This study retrospectively analyzed the therapeutic effect and shared our experience. The average amount of blood transfused back was 662.41 ml ± 269.15 ml. None of the patients developed transfusion reaction and were all discharged uneventfully. Thoracoscopic surgery combined with autologous blood trans- fusion is effective in the rescue of patients with progressive hemothorax and hemorrhagic shock. When corresponding indications are well managed, treatment for these patients is quicker, safer, and more effective.

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Objective To investigate the relationship of RhoA and Snail expressions, and the invasion and metastasis in salivary adenoid cystic carcinoma (SACC). Methods The expressions of RhoA protein and Snail protein in 55 samples of SACC (SACC group ) and 20 samples of para-carcinoma normal tissues(control group) were detected using immunohisto?chemical method. The relationship between RhoA protein and Snail protein expressions and clinical and pathological charac?teristics were analyzed. Results The positive expressions of RhoA protein (69.1% vs 5.0%) and Snail protein (72.7% vs 10.0%) were significantly higher in SACC group than those in control group (P < 0.05). The positive expression rates of RhoA protein and Snail protein were significantly higher in patients with lymph node metastasis than those in patients with?out lymph node metastasis. The positive expression rates of RhoA protein and Snail protein were significantly higher in pa?tients atⅢ+Ⅳstage than those in patients atⅠ+Ⅱstage. The positive expression rates of RhoA protein and Snail protein were significantly higher in substantive carcinal tissues than those in screen roller type and tubular carcinal tissues. The posi?tive expression of Snail protein was significantly higher in substantive and tubular carcinal tissues than that in screen roller type carcinal tissues (P<0.05). There were no significant differences in positive expression rates of RhoA and Snail between different gender, age and different carcinal tissues. There was a positive correlation beween expression rates of RhoA and Snail protein in SACC (r=0.414, P<0.001). Conclusion RhoA and Snail may both facilitate the infiltration and metastasis of SACC through RhoA/ROCK/PKD1/NF-kappa B/Snail signaling pathways.

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Objective To investigate the information access, its influencing factors and related problems in under-graduates of medical colleges and universities.Methods Information access in undergraduates of medical colleges and universities was investigated with questionnaires.Results It was the tendency to search information on Internet using mobile phone, the interest in information access on Internet was affected by the coverage of WiFi, audio and visual frequencies were the important resources, problems existed in the matching of web page and intelligent mobile phone.Conclusion Information access in undergraduates of medical colleges and universities is affected by the software and hardware of mobile phone and network communication cost, and the healthy use of mobile phone is influenced by social environment in undergraduates of medical colleges and universities.Mobile phones greatly influence the reading forms in undergraduates of medical colleges and universities and the spreading ways of medical information.

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Objective To analyze the clinical treatment effect of non-gland-derived mass on the neck,and discuss the distribution types and the best treatment options.Methods A total of 76 cases with non-gland-derived mass on the neck were analyzed retrospectively,and the treatment effect was analyzed.Results In the 76 cases,25 cases were benign tumors,19 cases were malignant tumors,32 cases were non-rumors.Surgical treatment was preferred to tumors.According to the nature of the lesions,non-tumors mass shoud choose surgical treatment or medication.Conclusion Non-gland-derived mass on the neck with multiple presentations,it is necessary to choose personal therapies according to the characteristics of masses.

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<p><b>BACKGROUND</b>Lumbar pedicle screw fixation and fusion are major procedures for treating discogenic low back pain (DLBP). However, due to its advantages of preserving the segmental motion and biomechanical simulation, artificial total lumbar disc replacement (TDR) is increasingly popular.</p><p><b>METHODS</b>From 2007 to 2010, 68 DLBP patients were enrolled. TDR were performed on 34 patients and the other 34 controls underwent the traditional fixation procedure. Qualitative and quantitative evaluations were followed including the changes in range of motion (ROM) and interpedicle height (IPH) at the posterior intervertebral body of operated level, in 6 and 12 months, and 3 years, postoperatively.</p><p><b>RESULTS</b>Qualitative results showed satisfying improvement in the two groups after 6 and 12 months, respectively, and the inter-group differences were significant (P > 0.05). The results of ROM and IPH have shown significant differences between the TDR and spinal fusion groups (P < 0.05).</p><p><b>CONCLUSION</b>With similar clinical improvements as the traditional spinal fusion method, TDR offered significantly better ROM and intervertebral foramen height.</p>

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Pedestrian safety in China is an important but largely neglected issue, in part due to the substantial under-reporting within police data. In this study we aimed to examine changes in pedestrian fatality between 2006 and 2010 in China using non-police reported data. A multi-year study was conducted based on the mortality data during 2006-2010 from the Disease Surveillance Points (DSP) data in China. Between 2006 and 2010, the crude pedestrian mortality increased from 7.0 to 10.5 per 100 000 populations. Annual pedestrian mortality from DSP data was 13 times in 2006 and 55 times in 2010 mortality for pedestrians and passengers from police-reported data in the corresponding years. After controlling for sex, age, and urban/rural, the mortality increased by 44% from 2006 to 2010 (adjusted mortality rate ratio (MRR)=1.11, 95% CI 1.10-1.12). The problem of pedestrian deaths is much more serious in China than that officially reported by the police. Significant and urgent efforts are needed to save lives of pedestrian in China.

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<p><b>OBJECTIVE</b>Use sagittal reconstruction CT to verify the surgical strategy for cervical ossification of the posterior longitudinal ligament (OPLL).</p><p><b>METHODS</b>A retrospective study of 161 patients (106 males and 55 females) who had undergone surgery for OPLL from July 2007 to November 2010 was performed. The mean age at surgery was 54.5 years (range from 26 to 77 years). The mean follow-up period was 28 months (12 - 54 months). There were 40 patients accept anterior approach surgeries (anterior group) which include 14 cases of anterior cervical corpectomy and fusion and 26 cases of anterior cervical discectomy and fusion. There were 120 patients accept posterior approach surgeries (posterior group) which was spinous process-splitting laminoplasty for cervical myelopathy using coralline hydroxyapatite. One patient accepted combined anterior and posterior approach. According to the sagittal reconstruction CT, the main reason for spinal cord compression was cervical disc herniation in anterior group, and OPLL in posterior group. The level of spinal cord compression was 1 to 2 levels in anterior group, and 1 to 5 levels in posterior group with a major of 2 to 4 levels. As the classification of OPLL, segmental type and circumscribed type were major of segmental type in anterior group and all of the four types were in posterior group, the distribution of each type was average. The patients of posterior group were classified into two groups according to the modified K-line classification, and clinical results were compared between the two groups. The modified K-line was defined as a line that connects the midpoints of the spinal canal at C(2) and C(7) on sagittal CT myelography. Compression to the spinal cord did not exceed the K-line in the modified K-line(+) group and did exceed it in the modified K-line(-) group. Clinical data were compared using t-test or χ(2) test. Correlation analysis was used to determine the relationships of C(2)-C(7) angulation between sagittal reconstruction CT and neutral position X-ray.</p><p><b>RESULTS</b>The patient of anterior group had better recovery rate of the JOA score (72% ± 27%) than the posterior group (59% ± 35%) at the latest follow-up (t = 2.238, P = 0.027). In posterior group, the patients of modified K-line(+) group had better recovery rate of the JOA score (63% ± 37%) than the K-line(-) group (49% ± 30%) at the latest follow up (t = 2.150, P = 0.034). The C(2)-C(7) angulation on sagittal reconstruction CT was 11° ± 9° which has significantly correlated with the C(2)-C(7) angulation on neutral position X-ray which was 10° ± 10° (r = 0.947, P < 0.01).</p><p><b>CONCLUSIONS</b>Considering the selection of surgical approach, it should be combined with the main clinical diagnosis for spinal cord compression, the level of compression, the classification of OPLL and the kyphotic alignment of the cervical spine. The modified K-line is a simple and practical tool for making decisions regarding the surgical strategy for cervical OPLL patients.</p>

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Antibacterial monomers incorporated in dentin bonding systems may have toxic effects on the pulp. Thus, the cytotoxicity of antibacterial monomers and its underlying mechanisms must be elucidated to improve the safety of antibacterial monomer application. The influence of an antibacterial monomer, methacryloxylethyl cetyl ammonium chloride (DMAE-CB), on the vitality of L929 mouse fibroblasts was tested using MTT assay. Cell cycle progression was studied using flow cytometry. Production of intracellular reactive oxygen species (ROS) after DMAE-CB treatment was measured using 2,7-dichlorodihydrofluorescein diacetate staining and flow cytometry analysis. Loss of mitochondrial membrane potential, disturbance of Bcl-2 and Bax expression, as well as release of cytochrome C were also measured using flow cytometry analysis or Western blot to explore the possible involvement of the mitochondrial-related apoptotic pathway. DMAE-CB elicited cell death in a dose-dependent manner and more than 50 percent of cells were killed after treatment with 30 µM of the monomer. Both necrosis and apoptosis were observed. DMAE-CB also induced G1- and G2-phase arrest. Increased levels of intracellular ROS were observed after 1 h and this overproduction was further enhanced by 6-h treatment with the monomer. DMAE-CB may cause apoptosis by disturbing the expression of Bcl-2 and Bax, reducing the mitochondrial potential and inducing release of cytochrome C. Taken together, these findings suggest that the toxicity of the antibacterial monomer DMAE-CB is associated with ROS production, mitochondrial dysfunction, cell cycle disturbance, and cell apoptosis/necrosis.

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ObjectiveTo Compare the clinical results between microscope and loupes which used in microsurgical discectomy.MethodsA prospective randomized controlled trial of 93 patients who had undergone microsurgical discectomy from January 2007 to December 2010 was performed.Clinical results were assessed by comparing the following parameters between patients who had undergone the surgery by microscope and loupes:length of stay,hospitalization cost,operative time,estimated blood loss,Japanese Orthopaedic Association (JOA) score and JOA recovery rate,Odom's standard.ResultsForty-nine patients underwent surgery by microscope,and forty-four patients underwent surgery by loupes.Eighty patients received outpatient or telephone follow-up.The follow-up period was 6.17 to 52.90 months with an average of (29.64±13.05) months,and the follow-up rate was 86.02％.According preoperative data,the two groups didn't differ with respect to age,gender,level of radiculopathy,or preoperative JOA score and JOA recovery rate.No statistically significant differences were identified in postoperative JOA score and JOA recovery rate,length of stay,hospitalization cost,length of follow-up,or relapse rate.Statistically significant differences were identified in operative time,estimated blood loss,and follow-up JOA score and JOA recovery rate.Conclusion Microscope can provide relatively more clear and comfortable vision for the surgery.It can short the operative time,decrease blood loss,reduce the potential risk of nerve injury,and retain more normal tissue,which can ensure better clinical results.

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<p><b>OBJECTIVE</b>To incorporate an antibacterial monomer, methacryloxylethyl cetyl dimethyl ammonium chloride(DMAE-CB), into a dental adhesive, and to evaluate the antibacterial activity against Streptococcus mutans (Sm) of this DMAE-CB-incorporated adhesive after being cured.</p><p><b>METHODS</b>DMAE-CB was incorporated into a dimethacrylates-based dental adhesive as experimental group. The adhesive without DMAE-CB served as a negative control. Thirty-nine specimens were fabricated for each group. The effects of the cured adhesives on the growth and adherence of Sm were evaluated with growth inhibition assay and spectrophotometry respectively. The influence of aging treatment and saliva treatment on the antibacterial efficiency of the modified adhesive was evaluated. Moreover, the bacterial growth of Sm in the eluents of two different adhesives was examined.</p><p><b>RESULTS</b>Compared with negative control, the cured DMAE-CB-incorporated dental adhesive exhibited inhibitory effect on the growth and adherence of Sm. The inhibition rate was 99% and the absorbance value was (0.332 +/- 0.063) for experimental group, significantly lower than that of negative control (0.434 +/- 0.093, P = 0.021). Moreover, after aging treatment the DMAE-CB-incorporated adhesive could still inhibit the growth and adherence of Sm; the inhibition rate was 99%, and the absorbance value of experimental group was (0.372 +/- 0.062), significantly lower than that of negative control (0.455 +/- 0.066, P = 0.022). After saliva treatment the DMAE-CB-incorporated adhesive could still inhibit the growth and adherence of Sm; the inhibition rate was 90%, and the absorbance value of experimental group was (0.299 +/- 0.061), significantly lower than that of negative control (0.370 +/- 0.068, P = 0.045). However, the eluent of DMAE-CB-incorporated adhesive didn't show inhibitory effect on the growth of Sm when compared with negative control, and the antibacterial effect and the doubling time of experimental group [(130.5 +/- 8.4) min] had no statistical difference than negative control [(126.4 +/- 7.0) min, P = 0.298].</p><p><b>CONCLUSIONS</b>The incorporation of DMAE-CB can render the dental adhesive with antibacterial activity after polymerization via influencing the growth and adherence of Sm.</p>

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