BACKGROUND: There are various methods for management of allogeneic bone, xenogeneic bone and various tissue engineered materials, but there is no ideal method for treatment of insufficient bone mass following jaw defects. OBJECTIVE: To observe the repair efficiency of bone composite and biomembrane following large mandibular defect and mandibular defect combined with tooth luxation in animal studies. DESIGN, TIME AND SETTING: The controlled observational animal study was performed at the Animal Laboratory of Zhejiang University from March to July 2006. MATERIALS: The mixed proportion of Bio-oss material and autologous bone powder was 1:1. The proportion of recombinant human bone morphogenetic protein-2 freeze-dry powder dissolved in autologous fresh blood was 0.25 mg:1 mL. Bone powder mixture was moistened by blood containing human bone morphogenetic protein to stick on the medicine spoon for moulding easily. METHODS: Ten New Zealand rabbits were selected. Consecutive bone defects (15 mm×6 mm×5 mm) were made in the inferior border of bilateral mandible body. Bone composite and Bio-gide membrane were randomly implanted into one side (bone composite + Bio-gide membrane group). Another side was directly sutured as blank control group. The remaining 30 rabbits were considered bone composite + Bio-gide membrane + implantation tooth group. A bone defect (15 mm×6 mm×8 mm) was made at the upper site of inferior border of mandible, with the combination of tooth luxation. Bone composite and Bio-gide membrane were implanted, and the luxation teeth were implanted into the original site. MAIN OUTCOME MEASURES: Implantation site, composite conjugation, loose of bone formation and implanted teeth were generally observed. New bone formation at the bone defect site was observed using radiograph and histological method. RESULTS: At 12 weeks following surgery, a bone defect, which was smaller than the original bone, was found at the mandibular defect site in the blank control group. New bones were visible in the mandibular defect site in the bone composite + Bio-gide membrane group. Radiograph demonstrated that the density of defect bone site was similar to normal bone tissue. Histological method revealed that bone implant formed board-shaped bone. No significant loose was detected in implanted teeth of 17 rabbits in the bone composite + Bio-gide membrane + implantation tooth group. Radiograph demonstrated that no transparent area was found in the root tip of 13 rabbits. Histological method showed replacement resorption in 13 rabbits. CONCLUSION: Bone composite combined with Bio-gide membrane for repairing large mandibular defect obtained good efficiency. The outcome of autologous tooth implantation is acceptable in the near future.

Objective To know the epidemiological characteristics of hand-foot-mouth disease in Yangpu District and provide evidence for specific strategies and measures of hand-foot-mouth disease activity prevention and control. Methods Descriptive analysis of the data from hand-foot-mouth disease epidemic situation in Yangpu District from 2005 to 2008 was made. Results 1 348 cases were reported in the whole Yangpu District from 2005 to 2008, and no severe cases, no death. The average morbidity in Yangpu District was 27.48/100 000. The male to female ratio was 1.46∶1. The infection occurred to infants aged from 1 year to 5 years (85.39%). The incidence of the native population children aged 2 to 3 exceeded 10/100 000. The season peak appeared from May to July (70.18%), and outbreaks used to occur at nurseries and kindergartens. The typical clinical presentations mainly included fever and rash. The rash mainly occurred to hands, feet, mouth, buttocks and so on. Conclusions Incidence varied significantly between different sexes, seasons and ages. It can cause large-scale epidemic in a short period of time, the epidemic was very difficult to control, but the leaders attach importance to take the early warning and monitoring, accuratey deal with emergencies, health education promotion and training of comprehensive measures, the epidemic can be effectively controlled.

Objective · To explore the change of metabolomic profiling after erlotinib (anepithelial growth factor receptor tyrosine kinase inhibitor)resistance of lung adenocarcinoma cells (PC9-ER), and find the differential metabolome associated witherlotinib resistance. Methods · Metabolic profiling of PC9-ER cells and homologous parent PC9 cells was acquired by the ultraperformance liquid chromatography tandem quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS). The data were analyzed by multi-dimensional statistical methods, such as partial least squares projection to latent structures-discriminant analysis (PLS-DA), to select and identify differential metabolites associated with erlotinib resistance. Results · A total of 14 differential metabolites were identified in PC9-ER cells. Seven up-regulated metabolites included N-acetylspermidine, phosphatidylethanolamine, AMP, pantothenic acid,proline, glutamate, and histidine, while seven down-regulated metabolites included citrulline, phosphorylcholine, glutathione, cysteinylglycine, glutathione oxidized, NAD, and S-adenosylmethionine, mainly participating in glutathione metabolism, glutamate metabolism, ammonia recycling, and protein biosynthesis. Conclusion · Metabolic profiling of erlotinib-resistant lung adenocarcinoma cells was changed. The information of differential metabolites associated with erlotinib resistance could provide clues for new resistance mechanisms and potential metabolism-related drug targets.

Objective To study the relationship between the polymorphism of interleukin-12B (IL-12B)gene and coronary heart disease.Methods We recruited 256 patients with coronary heart disease admitted to our department as the study group and 256 normal subjects as the control group.The polymorphism of IL-12B gene was detected by polymerase chain reaction and single nucleotide polymorphism.Coronary artery stenosis,visfatin,high sensitive C reactive protein and cardiac function were determined.Results The difference in rs15677380 and rs14050311 allele frequencies between the study group and the control group was significant (χ2 =6.19,7.24,P=0.045,0.021).The G allele of rs15677380 and C allele of rs14050311 were risk factors for coronary heart disease (OR=1.32,1.49).Conclusion IL-12B gene is associated with the occurrence and development of carotid atherosclerosis and participates in the development of coronary heart disease.

Objective To compare the dosimetric differences between two plans of RapidArc and 5F-IMRT for breast cancer radiotherapy after breast-conserving surgery.Methods Eight female patients with left-sided breast cancer after breast-conserving surgery were selected.A dose of 50 Gy in 25 fractions was prescribed for plans of RapidArc and 5F-IMRT.Target conformity index (CI),homogeneity index (HI),target coverage,exposure dose volume delivered to organ at risk were compared between two plans.At the same time,treatment delivery time and monitor units (MU) were also compared.Results The target conformity index (CI) in RapidArc plan (·0.88 ±0.03) was higher than that in 5F-IMRT plan (0.79 ±0.02,t =8.28,P ＜ 0.05).The homogeneity index (HI) in RapidArc plan 9.01 ± 0.73 was significantly lower than that in 5F-IMRT plan10.44 ± 1.08 (t =-2.73,P ＜0.05).For the dose volume delivered to the ipsilateral lung in two plans,the values of V10,V20,V30,and Dmean in RapidArc plan were lower than those in 5F-IMRT plan(t =-7.53,-7.20,-8.39,-7.80,P ＜ 0.05).However,the value of V5 in RapidArc plan was higher than that in 5F-IMRT plan (t =5.67,P ＜0.05).For the heart,the values of V5,V10 and Dmean in RapidArc plan were higher than those in IMRT plan(t =10.46,28.76,5.40,P ＜ 0.05),while the value of V30 in RapidArc plan was lower than that in 5F-IMRT plan(t =-6.12,P ＜0.05).The values of V5 in contralateral lung and breast were higher in RapidArc plan than those in 5F-IMRT plan(lung:t =21.50,P ＜0.05;breast:t =5.44,P ＜0.05).The MU in RapidArc plan was decreased by 25％,and the average treatment delivery time was saved by 60％,compared with that of 5F-IMRT plan.Conclusions During breast cancer radiotherapy after breast-conserving surgery,compared with 5F-IMRT plan,the RapidArc plan could improve the target HI,and reduce both the irradiated dose in high-dose volume and MU,and shorten the treatment time,but increased the exposed volume in low-dose volume of normal tissues.

Objective To investigatc the role of phosphatidylinositol 3-kinase (PI3K)/protein-serine-threonine kinases (Akt) signal pathway in ginsenoside Rb1 pretreatment-induced attenuation of myocardial ischemiareperfusion (I/R) injury in diabetic rats.Methods Male SD rats weighing 250-300 g were used in this study.Diabetes mellitus was induced by intraperitoneal streptozotocin and confirmed by fasting blood glucose ≥ 16.7mmol/L.Eight weeks after diabetes mellitus was induced,48 rats were randomly divided into 4 groups ( n =12each):group myocardial I/R (group I/R); group ginsenoside Rb1 (group R); group ginsenoside Rb1 + wortmannin (PI3K inhibitor) (group RW) and group wortmannin (group W).Myocardial I/R was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 120 min reperfusion.Ginsenoside Rb1 40 mg/kg was injected iv at 10 min before ischemia in groups R and RW,while in groups RW and W wortmannin 15 μg/kg was injected iv at 20 min before ischemia.Arterial blood samples were collected at the end of 120 min reperfusion for determination of creatine kinase (CK) and lactate dehydrogenase (LDH) activities.The rats were then sacrificed.The infarct size was measured by tetrazolium method.Myocardial apoptosis was detected by TUNEL and apoptotic index (the number of apoptotic myocardial cells/the total number of myocardial cells) was calculated.The expression of Akt and phosphorylated Akt (p-Akt) was determined by Western blotting.Results Ginsenoside Rb1 pretreatment significantly reduced the infarct size,myocardial cell apoptotic index and serum CK and LDH activities and up-regulated p-Akt expression in group R as compared with group I/R.The protective effects of ginsenoside Rbl against myocardial I/R injury were significantly attenuated by wortmannin pretreatment in group RW compared with group R.Conclusion PI3K/Akt signal pathway is involved in the protective effects of ginsenoside Rb1 against myocardial I/R injury in diabetic rats.

Objective To evaluate the effectiveness and safety of a sodium hyaluronate-containing dressing for skin wound healing after Q-switched laser therapy.Methods Sixty-six patients with facial pigmentary disorders were enrolled in this study.After treatment with Q-switched laser,the patients were randomly and equally divided into three groups to apply a sodium hyaluronate-containing dressing,a thermal spring water-containing facial mask and a distilled water-containing facial mask respectively.The dressing or facial masks were externally applied to the face for 15 minutes once immediately after the laser therapy,then,once every night for 14 consecutive days.Inflammatory responses,such as erythema,edema and burning sensation,were measured semi-quantitatively on day 1,3,7 and 14 separately after the laser therapy.The time for skin wound healing and degree of patients' satisfaction were compared among these groups by chi-square test and rank sum test,respectively.Results The sodium hyaluronate-containing dressing and thermal spring watercontaing facial mask were superior to the distilled water-containing facial mask in the improvement of erythema,edema and burning sensation after the laser therapy (all P ＜ 0.05).Compared with the patients applying the thermal spring water-containg facial mask and those applying the distilled water-containing facial mask,those applying the sodium hyaluronate-containing dressing felt better,with significantly increased skin cleanliness,humidity,smoothness,confort degree and overall satisfaction (all P ＜ 0.05).Conclusion The sodium hyaluronate-containing dressing is effective for improving acute inflammatory responses and increasing skin cleanliness,humidity and smoothness after laser therapy.

Objective To investigate the feasibility and potential advantages of RapidArc applied to the radiotherapy of the postoperative rectal cancer.Methods 8 postoperative patients with rectal cancer were selected to be treated with a dose of 50Gy in fraction of 2Gy every time and 5 times a week.IMRT and RapidArc were used respectively to compare different target conformities,homogeneity index,dose-volume histogram data,treatment times and monitor units.Results The conformal index by RapidArc was 0.89±0.02 which was better than those by 5F-IMRT,0.87±0.02 (t =3.286,P ＜ 0.05),while the homogeneity index of target volume (1.060±0.005) and average dose [(52.55±0.76) Gy] by RapidArc were a little less than the homogeneity index of target volume (1.064±0.007) and average dose [(52.90±0.82) Gy] by 5F-IMRT (t =-1.459,-1.000,P ＞ 0.05).The exposure dose and mean dose of bladder and small bowel in high dose region by RapidArc were lower than those by 5F-IMRT,as well as bone marrow.The differences were statistical significant (P ＜ 0.05).The monitor units by RapidArc and by 5F-IMRT were (631±68) MU and (1046±146) MU,respectively (t =-5.830,P ＜ 0.05),while the mean treatment times were (78±5) s and (348±29) s,respectively (t =-26.358,P ＜ 0.05).Conclusion Compared with 5F-IMRT,RapidArc improves the target conformities and lowers the exposure dose for the organs at risk in high dose region while using fewer monitor units and less treatment time,which helps comforting patients and improving the efficiency.

Objective To summarize our experience in hepatic artery reconstruction in adult-to-adult right lobe living donor liver transplantation(LDLT).Methods A retrospective analysis was made for 17 cases undergoing LDLT in our center from May 2007 to Oct 2008.Results All the 17 right lobe graft of the liver was supplied by single right hepatic artery and the mean diameter of right hepatic artery was 3.1 mm.The hepatic artery for segment 4 was mainly originated from left hepatic artery(12/17,70.1%).The recipient right or left hepatic artery was used in 14 cases of reconstruction,proper hepatic artery was used in 2 cases,and gastroduodenal artery was used in one case.Anastomosis was performed with interrupted 8-0 prolene and 12-16 stitches were made on the posterior wall first and then the anterior wall to avoid turning over the vessel.The mean anastomosis time was(51±26) minutes and all hepatic arteries were patent immediately after anastomosis.Hepatic arterial complications including hepatic artery thrombosis (HAT)did not occur after LDLT.Conclusions Detailed evaluation and careful protection of the hepatic artery of segment 4 are the key to successful reconstruction of hepatic artery in LDLT.Anastomosis was performed without flipping the artery wall helped to reduce the difficulty of operation remarkably and with a good result.

Objective To investigate the impact of percutaneous coronary interventional (PCI) on the inflammatory indices and postoperative vascular restenosis.Methods This study involved 90 patients undergoing PCI procedures for Coronary artery disease (CAD) compromising a single coronary artery.Fourty healthy individuals with normal findings by coronary angiography were selected as the control group.Before and after PCI or coronary angiography,plasma hs-CRP and IL-6 were measured in all the subjects by immunonephelometry and enzyme-linked immunosorbant assay (ELISA),respectively.Results (1) In the CAD patients,the plasma hs-CRP level was significantly elevated after PCI as compared with the preoperative level((18.69 ±5.14) mg/L vs (14.45 ± 4.32) mg/L,t =1.42,P ＜ 0.01),whereas in the control group,the hs-CRP level underwent no significant changes after coronary angiography((13.59 ±5.99) mg/L vs(12.46 ±5.35) mg/L,t =1.25,P ＞ 0.05).(2) PCI procedures also resulted in significant elevation of plasma IL-6 level in the CAD patients((1.87±0.45) pg/L vs (1.35 ±0.39) pg/L,t =1.33,P＜0.01),but in the control group,IL-6 showed no significant variation after coronary angiography ((1.32 ± 0.41) pg/L vs (1.21 ± 0.38)pg/L,t =1.16,P ＞ 0.05).We observed significant difference of hs-CRP and IL-6 levels between the CAD patient group and the control group (t =4.96,6.61 respectively,P ＜ 0.01).Conclusion Plasma hs-CRP and IL-6 are elevated in CAD patients following PCI procedures.But the roles of elevated hs-CRP and IL-6 in the vascular restenosis following the procedures need further investigation.