The etiology of rotated maxillary central incisor is unclear, but it has a clear familial tendency. Except for the environmental factors, gene expression directly influences craniofacial growth and the types of malocclusion deformity. In this article, a case of 180° rotated left maxillary central incisor of a male with family history of the deformity was reported. Relevant literature was also reviewed.
Humans ; Incisor ; Male ; Malocclusion ; diagnosis ; Maxilla

BACKGROUND:There is lack of an objective and standardized animal model for assessing the therapeutic effect of physical and medication treatment on bone defoct, the effectiveness of operation, as well as the role of bone substitute in the repairing of bone defects.DESIGN:Verified study on the experimental model of bone nonunion in rabbitsSETTING: Department of Orthopaedics in Shenzhen people' s Hospital MATERIALS:Twenty common grade pure New Zealand rabbits of either gender were selected with body mass of (2.5±0.5)kg,aged 6 to 8 months.METHODS :This experiment was carried out at the experimental animal center of Shenzhen people's Hospital between May and August 1999. 1.5cm bone segment (including periosteum)was cut off in the middle of forearm radius in 20 common grade pure NewZealand rabbits,the broken ends were covered with bone wax, 10 weeks later, the bone nonunion status was assessed by macropathological observation, pathohistological and X-ray examination.MAIN OUTCOME MEASURES:Observations on rabbit forearm radius defects by macropathological observation, pathohistological and X-ray examination.RESULTS :Twenty rabbits(40 side radius)were enrolled in this study and weeks later, bone defect region was found filled with fibrous cicatricial tissue without osseous connection ,bone wax was not absorbed, capitulum was ossified with medullary cavity blocked,a small amount of callus formed at both broken ends of fractural bone ,length of bone defect ranged from 0.8 to blocked under optical microscope,chondrocyte and osteocyte could be observed arranging disorderly and covered with fibrous membrane,defect reosseous connection could be detected at defect region at week 10,broken end was ossified and medullary cavity was blocked ,there was small amount of callus appeared at both broken ends displaying irregular shape.CONCLUSION:Bone nonunion experimental animal was successfully established on rabbits in this study, with pathological changes meeting the need of bone nonunion and displaying typical properties,which can be used as reliable and feasible experimental animal model.

ObjectiveTo assess myocardial perfusion by the end-systolic and end-diastolic replenishment parameters of real-time myocardial contrast echocardiography (MCE).MethodsTwenty-one patients with myocardial infarction(MI) and normal control group of 6 cases underwent intravenous realtime myocardial contrast echocardiography via slow and homogeneous venous injections of SonoVue.MCE images were obtained from the apical 4-chamber,2-chamber,and long-axis views.According to the exponential function:y(t) =A [1 - e-kt] + B,the time intensity curves were obtained.By an off-line ECG triggering and curve fitting,the replenishment parameters A value,k value,A × k value were obtained separately from end-systolic and end-diastolic images.ResultsIn normal control group,the end-systolic replenishment parameters A value,k value,A × k value were all lower than that of the end-diastolic replenishment parameters[(6.21 ± 2.69)dB vs (7.93 ± 3.66)dB,P ＜0.05；0.36 ± 0.15 vs 0.42 ± 0.19,P ＜ 0.01 ;2.88 ± 1.29 vs 3.39 ± 1.61,P ＜0.05,respectively].The end-diastolic replenishment parameters were found significantly greater variability than the end-systolic values (variation coefficient CV:A value 46.2％ vs 43.3％,k value 45.2％ vs 41.4％,A× k value 47.5％ vs 44.8％,all P ＜0.05).In 21 patients,the end-systolic replenishment parameters in myocardial segments supplied by infarct-related coronary artery were significantly lower than that in myocardial segments supplied by non - infarct - related coronary artery.ConclusionsThe end-systolic and end-diastolic replenishment parameters of real time myocardial contrast echocardiography can assess myocardial perfusion.The variability of the end-systolic replenishment parameters is smaller than that of the end diastolic parameters.Significant variability in k-value suggests that this parameter is best suited for before-after study in the same patient.

[ ABSTRACT] AIM:To establish the insulin resistance rat model for evaluating the correlation of omentin-1 level and insulin resistance.METHODS: SPF male Wistar rats ( n =30 ) were randomly divided into normal control group (NC, n=15) and high-fat diet group (HF, n=15).The rats in NC group were fed with basic diet.The insulin resistant model was established by feeding the rats with high-fat diet in HF group.After 10 weeks, 5 rats in each group were as-sessed by the technique of hyperinsulinaemic-euglycaemic clamp.After the insulin resistant model was successfully estab-lished, the body weight and fasting blood glucose were detected.The concentration of fasting serum omentin-1 was analyzed by ELISA.Fasting serum insulin was measured by radioimmunoassay.RESULTS: No difference of fasting blood glucose between the 2 groups was observed.The level of fasting serum insulin in HF group was significantly higher than that in NC group ( P <0.05 ) .The level of serum omentin-1 in HF group were significantly decreased compared with NC group (P<0.01).Pearson’s correlation analysis showed that negative correlations between serum omentin-1 and fasting serum insulin (r=-0.654,P<0.01), serum omentin-1 and free fatty acid (r=-0.446, P<0.05) was found.CONCLU-SION:In rats, serum omentin-1 level began to decrease at insulin resistance stage.As serum omentin-1 level decreased, the basal insulin level increased, indicating that decreased serum omentin-1 level may be an early factor of IR, diabetes and cardiovascular diseases.

Objective To compare the characteristics of intrahepatic cholangiocarcinoma (ICC) and different differentiated hepatocellular carcinoma (HCC) by CEUS and evaluate the diagnostic value of CEUS.Methods The cases who underwent CEUS and were pathologically demonstrated as ICC (n=34) and HCC (n=136) were observed.The characteristics of ICC and different differentiated HCC in conventional ultrasound and CEUS were analyzed,and the diagnostic efficiency of wash out time were calculated.Results ICC had higher percentage (24/34,70.59％) of washout emerging in early portal phase than those of HCC.And ICC had lower percentage (0;4/34,11.76％) of washout emerging in middle and late portal phase than poorly and moderate differentiated HCC.Poorly differentiated HCCs had higher percentage (16/41,39.02％) of washout emerging in middle portal phase than well differentiated HCC.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,positive likelihood ratio and negative likelihood ratio of washout time in diagnosis of ICC were 82.35 ％ (28/34),91.18％ (124/136),70.00％ (28/40),95.38％ (124/130),89.41％ (152/170),9.4,0.2,respectively.The rise time of ICC and well,moderate and poorly differentiated HCC were (13.03 ± 3.49) s,(13.80 ± 3.04)s,(14.89±4.12)s,(16.00±3.38)s,respectively,and the difference was significant (F=4.369,P＜0.05).The rise time of ICC was significantly higher than that of well differentiated HCC (P＜0.05).Conclusion The CEUS performances are different significantly among ICCs and different differentiated HCCs,which has value for the differential diagnosis.

Objective To evaluate the feasibility and accuracy of full volume three-dimensional echocardiography(FV3DE) for quantifying the left ventricular volume in healthy fetuses. Methods Two hundred and twenty-two normal fetuses with gestational ages between 20 and 40 weeks were investigated. Full volume three-dimensional, two-dimensional (2D) and M-mode images were acquired by Philips iE33 system and data was processed offline using QLAB analysis software. Left ventricular end-systolic volume(ESV) and end-diastolic volume ( EDV) were measured using semiautomated border detection echocardiographic techniques, and compared with 2D biplane Simpson's method and M-mode Teichholz formula. Results Thirty-six fetuses with poor three-dimensional images and 5 twin pregnancies were excluded,the study subjects consisted of 181 singleton fetuses. The highest concordance correlation ( r =0.987 for EDV, r =0.988 for ESV) P <0. 001) was noted between 2D biplane Simpson's and FV3DE-derived values with a small bias (0. 332 ml for EDV,0. 135 ml for ESV). The Bland-Altman analysis showed that FV3DE had the best reproducibility than M-mode Teichholz formula and 2D biplane Simpson's method. Intra- and interobserver error of EDV were 2.85% and 4.22% for FV3DE,8.37% and 8.98% for 2D biplane Simpson's rule,30. 63% and 54. 70% for M-mode Teichholz formula. Intra- and interobserver error of ESV were 2.34% and 6. 14% for FV3DE,6. 26% and 11.7% for 2D biplane Simpson's rule,43.06% and 66.03% for M-mode Teichholz formula. Conclusions FV3DE is a novel technique that can be more accurate than conventional methods in quantification of fetal left ventricular volumes, it may provide new insight into evolving fetal cardiac structure and function.

Objective To evaluate the clinical significance and cardiac function of fetuses with intracardiac hyperechogenic focus(ICEF) by fetal echocardiography. Methods Fetal echocardiograms were performed on 1291 fetuses for evaluation of fetal heart structures and rhythms. Echocardiographic characteristics of ICEF were investigated. Fetal systolic and diastolic functions of 399 fetuses with an isolated ICEF were compared with 128 normal fetuses using conventional two-dimensional, M-mode, pulsed Doppler echocardiography and myocardial Doppler tissue imaging(DTI). Results The prevalence of ICEF was 34. 7% (448/1291). Twenty-four(5.4%) cases were found with cardiovascular malformations. There was 1 (0.22%) case of ICEF fetus associated with chromosomal abnormality (trisomy 21 ). Comprehensive fetal echocardiographic data analysis showed no significant differences in heart dimensions, global cardiac functions,and myocardial performances in the two groups( P ＞0.05). Conclusions An isolated ICEF in the fetal heart is not associated with increased risk for chromosome abnormalities. Fetuses with ICEF do not indicate impaired left ventricular systolic or diastolic function, therefore having no hemodynamic significance.

BACKGROUND: The bone marrow stromal cells in red bone marrow (RBM) are the non-specific bone growth factors,and the target cells of bone morphogenetic protein (BMP), and they have the activities of osteoinduction and osteogenesis.Injectable calcium alginate gel (CaAG) is a degradable biomaterial with good histocompatibility,it provides scaffold for the proliferation and adhesion of osteoblasts and chondroblasts,and it is good for the proliferation of new capillaries.OBJECTIVE:To prepare CaAG-BMP-RBM gel compound,and observe its osteoinductivity.DESIGN:A randomized controlled animal trial.SETTINGS:Department of Orthopaedics,Shenzhen People's Hospital;Department of Orthopaedics,Union Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology.MATERIALS:The experiments were carried out in Shenzhen People's Hospital from February 2002 to February 2003.Twenty-seven pure SD rats, either male or female,weighing (200±20) g,were purchased from the Animal Experimental Center of Southern Medical University (No.SCXK2002-99).BMP was bought from Xijing Hospital affiliated to the Fourth Military Medical University of Chinese PLA.METHODS:The rats were randomly divided into three groups:CaAG-BMP-RBM group(n=9),CaAG.BMP group (n=9) and CaAG group (n=9).In the CaAG-BMP-RBM group,the rats were anesthetized,then 0.1 mL RBM collected from trochanteric section of fetour was added into the prepared CaAG-BMP compound (0.4 mL),sufficiently mixed,and then injected into posterior femoral muscle.The rats in the CaAG-BMP group and CaAG group were implanted with CaAG-BMP and CaAG into bilateraI posterior femoral muscles respectively.①The conditions of becoming conscious after anesthesia, incision healing, diet and activities were observed, the size and consistency of the implants and distribution of vessels were also observed.②The indexes were detected at 1,2 and 4 weeks after model establishment respectively,and 3 rats were used for each time point.The sections were observed under light microscope.and the activity of alkaline phosphatase (ALP) was determined.MAIN OUTCOME MEASURES: ①General conditions of animals and gross observation of the implants;②Histopathological observation;③ALP activities.RESULTS: All the 27 SD rats were involved in the analvsis of results.The rats became conscious at 4.6 hours after anesthesia,and they could eat normally;Hematom at incision disappeared.and the rats could move normally at 24 hours;No sign of infection at incision was observed at 72 hours;The incisions healed completely and suture shed after 2 weeks.The incisions were stage Ⅰ healing in all the 27 rats.①Results of gross observation of the implants:At 1 week after implantation.the size of implant did not decrease and vessels in-grew in both the CaAG-BMP-RBM group and CaAG-BMP group;At 2 weeks,lhe quality was hard, and the section appeared as gray and white with deposition of bone-like tissues;At 4 weeks,a great amount of vessels in-grew,and there were many depositions of hard bone-like tissues.②Results of the histopathological observation under light microscope:In the CaAG-BMP.RBM group.many mesenchymal cells aggregated, osteoblasts and chondroblasts proliferated actively al 1 week;The chondrocytes tended to mature with cartilage-like and bone-like matrixes at 2 weeks; Many osteocytes were observed and fibrous bone formed at 4 weeks.which were more then those in the other two groups.③Results of ALP activity:At 1.2 and 4 weeks after implantation.the ALP activities in the CaAG group [(0.179±0.018),(0.058±0.017).(0.027±0.018)IU/g] were lower than those in the CaAG-BMP-RBM group[(0.922±0.226),(1.169±0.249),(0.431±0.081)IU/g,P＜0.01);At 1 and 4 weeks,the ALP activities in the CaAG-BMP group[(0.447±0.015),(0.276±0.081)IU/g]were lower than those in the CaAG-BMP-RBM group (P＜0.05).CONCLUSION:The compound of CaAG-BMP-RBM possesses stable and lasting osleoinductivity.

BACKGROUND:Different methods and biomaterials have been applied in animal experiments and clinical practice to prevent the formation of epidural scars,Biodegradable and sticky semi-fluid gels are the most often used material.Salvia miltforrhiza radix (SMR) and carbomer have been clinically confirmed to be the safe and effective drugs and gel agents. OBJECTIVE:To observe the effect of SMR-gel on preventing epidural adhesion after laminectomy.DESIGN:A complete randomized grouping design, a controlled experiment. SETTING:Department of Orthopaedics,Shenzhen People's Hospital (Second Clinical College of Jinan University). MATERIALS:Thirty-six healthy pure New Zealand rabbits were used,either male of female,clean degree,2-3 years of age. They were randomly divided into four groups with 9 rabbits in each group:blank control group,gel contro group, HA group and SMR-gel group. Carbomer934 powder (Shanghai People's Pharmaceutical Factory, batch number: 20000510) , hyaluronic acid (HA) [Shandong Bausch & Lomb Freda Pharaceutical, Co., Ltd.,No.H10960136,2 mL (20 mg)].METHODS:The experiments were carried out in the animal laboratory of Shenzhen People's Hospital from April 2002 to August 2003.①Preparing SMR-gel:SMR was prepared into extract powder.Carbomer934 powder was added by water for dissolving and swelling and stayed overnight,then SMR-gel was prepared by dipping with triethanolamine,adding with SMR extract powder (2 g),then adding with purified water till 100.0 g and stirring uniformly.②The rabbits were anesthetized. and the lamina of vertebra was totally resected at L3 and L6 (reserving superior and Inferior articular processes).then defects of 10 mm×5 mm were made to expose the dura mater.The vertebral defects were added with 1 mL carbomer gel, 1 mL HA (20 g/L) and 1 mL SMR-gel in the gel control group,HA group and SMR-gel group respectively.whereas nothing was added in the blank control group.③Gross samples:Three rabbits were killed 4,6 and 8 weeks postoperatively in each group.vertebraI ventral fascia were stripped to remove the spinal segments (L3,L6) for operation completely,and totally 24 samples for each time.One sample was selected in each group 4 weeks postoperatively. and the samples were observed under H-600 transmission electron microscope (Hitachi). ④The adhesion compactness of scar tissue with dura mater was evaluated in the 24 samples of the 4 groups at 8 weeks postoperatively:There were 4 grades:No obvious adhesion between dural sac and scar tissue for grade O:Extensive and compact adhesion between dural sac and scar tissue. impossible blunt dissection between dural sac and scar tissue.incomplete dural sac after sharp dissection for grade Ⅲ.Each spinal segment was cut into 4 parts equally,and all were prepared into sections and stained,then the thickness of epidural scar was determined with Tiger2000 image analyzer. ⑤The rank sum test was used in the scar adhesion compactness grading evaluated with naked eyes,whereas analysis of variance.and two-two comparison were used in analyzing the thickness of epidural scar.P＜0.05 was considered as significant difference.MAIN OUTCOME MEASURES:①Results of gross scar adhesion compactness grading at 8 weeks and comparison of the thickness of epidural scar at 4.6 and 8 weeks;②Results of gross observation,histological examination and ultrastructure.RESULTS: All the 36 rabbits were involved in the analysis of results. ①Results of gross observation and pathohistological examination:There was compact adhesion at each time point in the blank control group,part adhesion in the gel control group and HA group, and no obvious adhesion in the SMR-gel group.②Results of quantitative analysis:The rabbits with lower scores of scar adhesion compactness grading In the blank control group,gel control group and HA group were obviously fewer than those in the SMR-gel group (W=45-52,P＜0.05-0.01).The scar thickness at 4 and 8 weeks in the SMR-gel group was obviously less than that in the other 3 groups(F=128.657,152.246,80.891,P＜0.01).③Results of observation under transmission electron microscope:The proliferation of fibroblasts at 4 week was active in the blank control group,gel control group and HA group,but inactive in the SMR-gel group.CONCLUSION:①SMR can inhibit the fibroblasts to proliferate,differentiate and synthetize into secretory collagens,and then inhibit the formation of epidural scar adhesion.②HA can be absorbed by organs very early,which reduces its role in preventing adhesion.Whereas carbomer gel can stay longer, and it plays a role in inhibiting and blocking adhesion in the whole process of wound repairing.

BACKGROUND: During recent years, mononucleotide polymorphism of some genes is possibly related to affectability of osteoarthritis (OA). However, previous researches mainly compare the gene expression of synoviocytes between OA and rheumatoid arthritis (RhA); therefore, the correlation of gene expression between synovioblast and fibroblast in other tissues should be further studied as compared with OA.OBJ ECTIVE: To observe the differences of gene expression between OA synovioblast and skin fibroblast.DESIGN: Observational contrast analysis.SETTING: People's Hospital of Shenzhen City.PARTICIPANTS: Synovium tissue was derived from OA patients who received replacement of knee joint in the Department of Orthopaedics, People's Hospital of Shenzhen City. All OA patients met the diagnostic criteria of osteoarthritis established by American College of Rheumatology in 1995. Three patients including 1 male and 2 females aged more than 65 years old and they did not have cardiac and pulmonary disease and diabetes mellitus. Three male normal volunteers who aged 25 to 35 years did not have rheumatic disease, osteoarthritis and dermatosis. All subjects provided a confirmed consent. The main reagents were detailed as follows: RPMI1640 culture medium, fetal bovine serum and TRIZOL agent (Invitrogen Life Technologies Company, USA); pGEM-T pUC (Progema Company, USA);Display PROFILE-BASIC and Display PROFILE Probe kits (Qbiogen Company, USA).METHODS: The experiment was carried out in People's Hospital of Shenzhen City from January to June 2005. Synovium of OA patients were treated with primary culture to obtain synovioblast; meanwhile, skin fibroblast treated with primary culture from normal subjects was regarded as the control group. Restricted enzyme section differential display was used to separate the different-expressed genes of synovioblast and skin fibroblast in OA patients. In addition, blast technique was used to compare the resulted ranks with Genbank ranks.MAIN OUTCOME MEASURES: Differences of gene expression between synovioblast and skin fibroblast in OA patients.RESULTS: Gene expressions of superoxide dismutase (SOD), TFPI2, CXCL2, CXCL6 and transforming growth factor (TGF) were high in synovioblast of OA patients as compared with those in skin fibroblast of normal subjects.CONCLUSION: Gene expressions of SOD, TFPI2, CXCL2, CXCL6 and TGF are high in synovioblast of OA patients as compared with those in skin fibroblast of normal subjects. This suggests that gene may play a certain role in onset of OA.