Objective:To evaluate the effectiveness and treatment feature of maxillary incisor extraction in orthodontics.Methods:9 patients underwent orthodontic treatment with maxillary incisor extraction,5 female and 4 male,with an average age of 1 7.2 years at the start,were included.5 patients were treated by extraction of both upper incisors and lower first premolars,4 by extraction of the abnor-mal incisor and the first premolars in the other three quadrants.Cephalometric and Bolton index analysis were carried out.Results:Sat-isfactory treatment results were observed in all patients.Before treatment the predicted Bolton index of the patients of the anterior ratio and the overall ratio were 80.1 4% and 91 .3%,after orthodontic treatment 78.68% and 90.28%,respectively.Cephalometric analysis showed that U1 -NA(mm),U1 -NA,L1 -NB(mm),L1 -NB,U1 -SN,L1 -MP,UL-E and LL-E were decreased(P <0.05).Conclu-sion:Individual treatment plan based on Bolton index analysis and the corresponding techniques and methods,the patients with abnor-mal upper incisors can be effectively treated with the extraction of maxillary incisors.

Objective To evaluate the indications and effectiveness of lower incisor extraction in orthodontics.Methods Twenty-three adult patients with lower incisor extraction were included in the study.The cases consisted of 14 female and 9 male patients with an average age of 23.2 years at the start.One single lower incisor was extracted in 17 patients and the other tow upper premolars were extracted in 6 patients.Cephalometric and casts analyses were carried out.Results Total treatment time was 13-23 months.All extraction space was closed after the treatment.All patients achieved satisfactory treatment results,with normal overbite and overjet and stable occlusal relationship.There were no significant changes before and after treatment on cephalometric analysis.The intercanine width was reduced by from pretreatment to posttreatment [(26.89--2.89) mm vs (23.92-t-1.54) mm (P＜0.05)].Conclusions The intercanine width is reduced after lower incisor extraction.In order to achieve satisfactory clinical effect,we should carefully select cases and pay attention to the corresponding techniques and methods.

0.05). From clinical point of view,it is suggested that the weight can be advantageous to forecasting Cr of children.

Objective To investigate the effects of different modes of mechanical ventilation on lung function during open heart surgery in children with pulmonary hypertension (PH). Methods Twenty-four patients with moderate PH aged 3 mon-12 yr 2mon (group M) and twenty-four patients with severe PH aged 3 mon-7yr 9mon (group S) were further divided randomly into 3 subgroups based on the modes of mechanical ventilation used: pressure-controlled ventilation(PCV) only and alveolar pressure (Palveo) was maintained at 0 cm H2O during CPB (group M1/S1 n = 8); PCV + PEEP (2 cm H2O) and Palveo was maintained at 2 cm H2O during CPB (group M2/S2 n = 8); and PCV+ PEEP (4 cm H2O) and Palveo was maintained at 4 cm H2O during CPB (group M3/S3 n=8). The patients were premedicated with atropine 0.01 mg ?kg -1 and midazolam 0. 1 mg?kg-1 . Anesthesia was induced with fentanyl 20?g?kg-1 and vecuronium 0. 1 mg?kg-1 and maintained with vecuronium infusion(70?g?kg-1?h-1 ) and inhalation of N2O-O2 and isoflurane. The children were mechanically ventilated after intubation and the ventilatory parameters were VT = 10-12 ml ?kg-1, F = 20 bpm and I : E = 1: 2. Lungs were lavaged and 2-3 ml of aspirate were taken for determination of surfactant. Total protein (TP), total phospholipid -(TPL), saturated phosphatidylcholine (Sat PC) and respiratory system compliance(Crs) was measured before skin incision( T0 ), before CPB (T,), at the end of CPB ( T2) and at the end of surgery(T3 ) . Results (1) Crs decreased significantly at T2 and T3 as compared with that at T0 and T1 in group M1/S1 and M2/S2 but in group M3/S3 there was no significant difference in Crs between T0, T1 and T2-3. (2) Sat PC/TPL and Sat PC/TP decreased significantly after CPB (T2, T3 ) in group M,/S, and M2/S2 but in group M3/S3 there was no significant difference in Sat PC/TP and Sat PC/TPL between T0-1 and T2-3. Conclusion PEEP 4 cm H2O can effectively prevent postoperative lung function from worsening in children with pulmonary hypertension undergoing open heart surgery with CPB.

Tissue factor pathway inhibitor (TFPI) is the main inhibitor of tissue factor-mediated coagulation.TFPI is expressed by endothelial and smooth muscle celis in the vasculature.Endothelium-derived TFPI has been reported to play a regulatory role in arterial thrombosis.However,the role of endogenous TFPI in vascular smooth muscle cells (VSMCs) in thrombosis and vascular disease development has yet to be elucidated.In this TFPIFlox mice crossbred with Sma-Cre mice were utilized to establish TFPI conditional knockout mice and to examine the effects of VSMC-directed TFPI deletion on development,hemostasis,and thrombosis.The mice with deleted TFPI in VSMCs (TFPIsma) reproduced viable offspring.Plasma TFPI concentration was reduced 7.2％ in the TFPIsma mice compared with TFPFlox littermate controls.Plasma TFPI concentration was also detected in the TFPITie2 (mice deleted TFPI in endothelial cells and cells of hematopoietic origin) mice.Plasma TFPI concentration of the TFPITie2 mice was 80.4％ lower (P ＜ 0.001) than that of the TFPIFlox mice.No difference in hemostatic measures (PT,APTT,and tail bleeding) was observed between TFPIsma and TFPIFlox mice.However,TFPIsma mice had increased ferric chloride-induced arterial thrombosis compared with TFPIFlox littermate controls.Taken together,these data indicated that endogenous TFPI from VSMCs inhibited ferric chloride-induced arterial thrombosis without causing hemostatic effects.

A 51-year-old man presented with a 4-month history of upper abdominal distending pain and 1-month history of cutaneous nodules and plaques on the neck, trunk and bilateral thighs. The patient underwent many gastrointestinal tract examinations in several local hospitals, and symptomatic treatment did not work. The biopsy of nodules on the abdomen revealed medium- to large-sized atypical lymphoid cells within numerous small vessels in lower dermis and subcutaneous fat tissue. Additionally, the atypical cells were present exclusively within vascular lumina. Immunohistochemical labeling showed the reactivity of neoplastic cells to CD2, CD99, CD3ε, CD43, CD56, Epstein-Barr virus-encoded small nuclear RNAs (EBER), and cytotoxic proteins such as T-cell intracellular antigen-1 (TIA-1) and perforin, but not to CD4, CD8, CD20, CD79a,CD30, cytokeratin (CK), S100, or CD68. The endothelial cells lining the involved vessels exhibited the reactivity to CD31 and CD34. Based on the above findings, the patient was diagnosed with intravascular NK/T-cell lymphoma firstly manifesting as gastrointestinal tract symptom and complicated by skin lesions. Following combined chemotherapy with cyclophosphamide, daunorubicin, vincristine, prednisone and etoposide, the patient experienced a quick and satisfactory recovery and the follow-up still continued.

Objective To assess the influence of laparoscopic sleeve gastrectomy (LSG) on the nutritional status in patients with obesity.Methods From August 2014 to July 2015, 24 obese patients underwent LSG in Dongfang Hospital Affiliated to Tongji University.Weight and nutritional status of these patients were measured pre-operatively and 3, 6, and 12 months after surgery.Results The mean body weight of the 24 obesity patients was (81.94±21.39) kg, (78.83±24.49) kg, (62.67±10.79) kg 3, 6, and 12 months after surgery, respectively, which were significantly lower than the preoperative body weight [(99.02±23.92)kg] (P=0.004).The serum levels of albumin, hemoglobin, and trace elements (including calcium, iron, zinc, magnesium, and copper) showed no significant change after surgery (all P>0.05).Plasma vitamin D[25(OH)D] increased significantly from (13.1±4.1)μg/L preoperatively to (19.8±5.3)μg/L 12 months after surgery (P=0.031).Folic acid was (6.2±3.9)μg/L before LSG and significantly increased to (14.2±9.2) μg/L 3 months later surgery (P=0.009);the folic acid level gradually decreased 6 and 12 months after LSG but was still higher than the preoperative level.Conclusion Vitamin D deficiency is present in obese patients before LSG.After surgery, while the serum albumin and trace elements have no obvious change, the vitamin D and folic acid levels remarkably increase.

OBJECTIVETo appraise the significance of extravascular lung water index (EVLWI), pulmonary vascular permeability index (PVPI), and intrathoracic blood volume index (ITBVI) in the differential diagnosis of the type of burn-induced pulmonary edema.

METHODSThe clinical data of 38 patients, with severe burn hospitalized in our burn ICU from December 2011 to September 2014 suffering from the complication of pulmonary edema within one week post burn and treated with mechanical ventilation accompanied by pulse contour cardiac output monitoring, were retrospectively analyzed. The patients were divided into lung injury group ( L, n = 17) and hydrostatic group (H, n = 21) according to the diagnosis of pulmonary edema. EVLWI, PVPI, ITBVI, oxygenation index, and lung injury score ( LIS) were compared between two groups, and the correlations among the former four indexes and the correlations between each of the former three indexes and types of pulmonary edema were analyzed. Data were processed with t test, chi-square test, Mann-Whitney U test, Pearson correlation test, and accuracy test [receiver operating characteristic (ROC) curve].

RESULTSThere was no statistically significant difference in EVLWI between group L and group H, respectively (12.9 ± 3.1) and (12.1 ± 2.1) mL/kg, U = 159.5, P > 0.05. The PVPI and LIS of patients in group L were respectively 2.6 ± 0.5 and (2.1 ± 0.6) points, and they were significantly higher than those in group H [1.4 ± 0.3 and (1.0 ± 0.6) points, with U values respectively 4.5 and 36.5, P values below 0.01]. The ITBVI and oxygenation index of patients in group L were respectively (911 197) mL/m2 and (136 ± 69) mmHg (1 mmHg = 0.133 kPa), which were significantly lower than those in group H [(1,305 ± 168) mL/m2 and (212 ± 60) mmHg, with U values respectively 21.5 and 70.5, P values below 0.01]. In group L, there was obviously positive correlation between EVLWI and PVPI, or EVLWI and ITBVI (with r values respectively 0.553 and 0.807, P < 0.05 or P < 0.01), and there was obviously negative correlation between oxygenation index and EVLWI, or oxygenation index and PVPI (with r values respectively -0.674 and -0.817, P values below 0.01). In group H, there was obviously positive correlation between EVLWI and ITBVI (r = 0.751, P < 0.01) but no obvious correlation between EVLWI and PVPI, oxygenation index and EVLWI, or oxygenation index and PVPI (with r values respectively -0.275, 0.197, and 0:062, P values above 0.05). The total area under ROC curve of PVPI value for differentiating the type of pulmonary edema was 0.987 [with 95% confidence interval (CI) 0.962-1.013, P < 0.01], and 1.9 was the cutoff value with sensitivity of 94.1% and specificity of 95.2% . The total area under ROC curve of ITBVI value for differentiating the type of pulmonary edema was 0.940 (with 95% CI 0.860-1.020, P < 0.01), and 1,077. 5 mL/m2 was the cutoff value with sensitivity of 95.2% and specificity of 88.2%.

CONCLUSIONSEVLWI, PVPI, and ITBVI have an important significance in the differential diagnosis of the type of burn-induced pulmonary edema, and they may be helpful in the early diagnosis and management of burn-induced pulmonary edema.

Blood Gas Analysis ; Blood Volume ; Burns ; complications ; Capillary Permeability ; Diagnosis, Differential ; Extravascular Lung Water ; Humans ; Lung ; blood supply ; Lung Injury ; physiopathology ; therapy ; Monitoring, Physiologic ; Pulmonary Edema ; diagnosis ; etiology ; ROC Curve ; Respiration, Artificial ; Retrospective Studies

Aim Toconstructthreeplasmidsincluding Smad3 WT,Smad3 EPSM and Smad3 3S-A stable transfection in HepG2 cell lines to investigate phospho-domains of Snad3(pSmad3C or pSmad3L),their pro-tein expression and roles in HepG2 cell proliferation, apoptosisandcellcycle.Methods Threeplasmidsin-cluding Smad3 WT (Carry the wild Smad3 gene ), Smad3 EPSM(Carry the mutated phosphorylation site in linker region of Smad3 gene)and Smad3 3S-A(Car-ry the mutated phosphorylation site in C-terminal of Smad3 gene)were respectively transfected into HepG2 cells by using a liposome transfection reagent.Verifi-cation of positive cells was done by screening with G418 via co-culture.Transfection efficiency was deter-mined by Western blot.Cell proliferation was induced by exogenous TGF-β1 in the respective stably transfect-ed HepG2 cell lines.Cell proliferation was monitored by MTT.Cell cycle and apoptosis were determined by flowcytometry(FCM).Results Therewaselevated protein expression of the respective phospho-domain sites in the stably transfected HepG2 cells for Smad3 WT(C-terminus and Linker),Smad3 EPSM(C-termi-nus)and Smad3 3S-A(Linker),which indicated suc-cessful stable transfection of HepG2 cell lines.The re-sults from MTT experiment showed that TGF-β1 could induce proliferation of HepG2 cells with or without the transfection of Smad3 WT,Smad3 EPSM and Smad3 3S-A plasmids,meanwhile transfected Smad3 EPSM plasmids could significantly inhibit proliferation of HepG2 cells induced by TGF-β1 , and transfected Smad3 3S-A plasmids accelerate proliferation of HepG2 cells induced by TGF-β1 .Cell cycle analysis showed that the G0/G1 phase of HepG2 cells with stable trans-fection of Smad3 EPSM plasmid increased compared with HepG2 cells with or without stable transfection of Smad3 WT plasmid,meanwhile the G2/M phase of HepG2 cells with stable transfection of Smad3 3 S-A plasmid increased.Compared with Smad3 WT trans-fected cells, apoptosis in Smad3 EPSM transfected cells was markedly increased,while that of Smad3 3S-Atransfectedcellsdecreased.Conclusions Thethree plasmids of Smad3 WT,Smad3 EPSM and Smad3 3S-A stably transfected HepG2 cell lines have been suc-cessively constructed.The construction of three plas-mids transfected HepG2 cell lines provides the research foundation for studying medical as well as possible reg-ulatory mechanism of pSmad3 C/pSmad3 L.

Objective:To investigate the value of SFRP1 gene promoter methylation in PTC tissues, to eanalyze its correlation with clinical characteristics and biochemical indicators and its effect on mRNA expression, and to explore its value in clinical applications.Methods:97 patients with first-onset PTC were selected as the research subjects, and the patients’ PTC tissues (observation group) and adjacent tissues (control group) were taken. Methylation-specific PCR (MSR) was used to detect the methylation status of the SFRP1 gene promoter region, and mRNA expression was measured by fluorescent quantitative PCR. The methyltransferase inhibitor 5-Azacytidine was used to treat thyroid papillary cancer cell lines, detection of biochemical indicators and collection of clinical characteristics.Results:The positive rate of methylation of SFRP1 gene promoter region (70.1%) in PTC tissues was significantly higher than that of adjacent tissues (33.0%) ( χ2=26.747, P<0.001) ; the expression of SFRP1 gene mRNA in PTC tissues was significant MRNA expression in tissues adjacent to cancer ( t=2.886, P=0.007) , mRNA expression in methylated positive PTC tissues was also significantly lower than that in methylated negative PTC tissues ( t=2.065, P=0.038) ; with the concentration of 5-Azacytidine increased, the expression of SFRP1 gene mRNA in CGTHW-3 cells also gradually increased. In addition, the positive methylation rate in PTC tissues was related to the TNM stage ( χ2=5.487, P=0.019) and whether there was lymph node metastasis ( χ2=4.659, P=0.031) . The levels of TSH and TGAb in the methylation group were higher than those in the unmethylated group (TSH: t=2.234, P=0.023; TGAb: t=2.312, P=0.021) . Conclusion:High DNA methylation in the promoter region of SFRP1 gene can participate in the occurrence and development of PTC by down-regulating the mRNA expression of genes.