Lymph node dissection was the key procedure of pancreatic surgery.The majority of guidelines indicated that extended lymph node dissection was helpless for improving survival rate.However,there were still quite a few researches which demonstrated that the extended dissection was a valuable procedure.It was still a controversial topic considering lymph node dissection.To review the shortcomings of previous randomized controlled trials (RCT),this article combined the experience of new techniques in pancreatic surgery,which are developing rapidly in recent years,and our theory and practice of radical resection of retroperitoneal lipo-lymphatic layer (RRRLLL).Therefore,the controversy and update of extended lymph node dissection for pancreatic head carcinoma were discussed,which could provide references for standardizing the treatment of extended lymph node dissection in clinical practice.

Objective To observe the clinical disinfection effect of root canal with non-filling medication.Methods 50 patients who required root canal therapy for apical period(acute or chronic) or pulp necrosis were involved in the study.Non-filling medication on the root canals were taken bacteria from the root canals were collected and cultured before and after the treatment.Results Bacteria were detected in every specimen,which were mixture of aerobes and anaerobes.One week later,only two strain were detected in two specimen.Conclusion Non-filling medication can be used as an effective disinfection to sterilize root canal.

Objective To study the curative effect of arthroscopic debridement in the treatment of knee osteoarthritis with moderate-to-severe degenerative cartilage. Methods Arthroscopic knee debridement combined with postoperative rehabilitation exercise was carried out in 17 cases (21 knee joints) of knee osteoarthritis with moderate-to-severe degenerative cartilage. Results The operation time was 55~100 min (mean, 75 min). No surgical complications occurred. The postoperative hospital stay was 15~ 20 days (mean, 13 days). The passive range of motion of the knee joint during the surgery was 0?~120? and the range of motion after the surgery, 0?~110?. Follow-up was conducted for 5~36 months (mean, 21 months). The curative effect was classified as “good” in 6 cases (8 joints), “fair” in 9 cases (11 joints) and “poor” in 2 cases (2 joints). The range of motion of the knee was 0?~ 120?. Conclusions Arthroscopic debridement is an effective option for the treatment of knee osteoarthritis with moderate-to-severe degenerative cartilage.

Objective To analyze the space-time characteristics of hand-foot-mouth disease (HFMD) in Shijiazhuang by using geographic information system (GIS).Methods The data of HFMD during 2009 to 2011 in Shijiazhuang were collected and GIS database was created.Special map was drawn by PHGIS software to analyze the space-time characteristics of HFMD in Shijiazhuang.Results The epidemic situation of HFMD in Shijiazhuang appeared sporadic with local centralization.The attack ranked alternately rise year after year and high epidemic areas were geographically complimentary.Overall epidemic levels tend dropping from 2009 to 2011 and there were differences among areas.The high-attack areas of HFMD changed over time.Conclusions GIS can provide direct-viewing of the space-time characteristics of HFMD and further understand the prevalence of HFMD,which could help to provide the scientific basis of HFMD control in Shijiazhuang.

Objective To evaluate the orthodontic effect of surgery on mixed dentition period class Ⅲ malocclusion and to investigate the effective therapeutic method of the skeletal class Ⅲ malocclusion.Methods A total of 20 patients aged 8.5 to 9.1 years with early mixed dentition class Ⅲ skeletal malocclusion.The treatment was divided into two phases.During the first phase,the entire stuffy group was treated with a bonded maxillary expansion and protraction.During the second phase,the entire study group received multiple loop edgewise arch wire (MEAW) treatment until an ideal occlusion relationship achieved.Comparison of the pre-and post-orthodontic treatment cephalometric radiographs had been done after maxillary protraction and MEAW were applied for patients.Results In the 20 patients after orthodontic treatment,Class Ⅲ skeletal facial profile was improved,the retraction of anterior teeth was obvious,and there were significant changes in dentition; the profile of soft tissue and satisfactory occlusion relationship were significantly improved,as compared with the changes between pre-treatment and post-treatment.Conclusions Skeletal Ⅲ malocclusion in early mixed dentition can be successfully treated.The results can be satisfied with improved class Ⅲ skeletal and molar relationship,high-angle and profile of soft tissue.

Objective To study the expression of KISS-1 in normal endometrium and in ectopic endometri-um patients with endometriosis. Methods The expression of KISS-1 in 55 cases of normal endometrium as well in 46 cases of ectopie endometriurn with endometriosis were detected by immunohistochemicai EliVision plus method. Results The positive expression rates of KISS-1 in ectopic endometriotic tissues and in normal endometri-urn were 30.43 % and 63.64 % respectively ,and the positive expression rates in ectopic endometriotic tissues signifi-cantly lower than those in the normal endometrium( P< 0.01, P < 0.05). Conclusion The decreased expression of KISS-1 may be related to the mechanism of endometriosis.

OBJECTIVETo investigate the synergistic effect of transforming growth factor-beta1 (TGF-beta1) and platelet-derived growth factor-BB (PDGF-BB) on the expression of integrin beta3, in periodontal membrane of rat orthodontic tooth.

METHODSAn orthodontic tooth movement model was established. Up to 32 experimental rats were randomly divided into four groups according to a random number table. The four groups were injected with 1% PBS, TGF-beta1 (5 ng), PDGF-BB (10 ng), and combined TGF-beta1 (5 ng) and PDGF-BB (10 ng) in the buccal submucosal, respectively. The volume injected in each group was 0.1 mL. The animals were then sacrificed on the 10th day. The left maxillary first molar and periodontal tissue were taken. Different expressions of integrin beta3 were detected in periodontal tissues through immunohistochemistry. Mean optical density (OD) values of the positive fields were examined. The data obtained were analyzed through ANOVA. The data followed normal distribution, and were compared via t-test.

RESULTSCompared with the control groups, the expression of integrin beta3 was higher in the experimental groupin tension sides (P < 0.01). Significant differences in tension sides between the single-injection groups and the combined group were observed (P < 0.01). Compared with the control groups, the expression of integrin beta3 was higher in the experimental group in compression sides (P < 0.05). In addition, there was no significant differences in compression sides between the single-injection groups and the combined group (P > 0.05).

CONCLUSIONIn terms of local regulatory factors, TGF-beta1 combined with PDGF-BB enhance the expression of integrin beta3 in the periodontal membrane and accelerate periodontal remodeling. The synergistic effect of the two growth factors is better than the single growth factor.

Objective Through constructing prokaryotic expression vector pET-30a-GPI-B7-1, to gain purified GPI-B7-1 fusion protein so as to confirm the tumor immune effect. Methods The DNA fragment encoding the signal for GPI-anchor attachment of hPLAP-1 and the cDNA encoding the human costimulatory molecule CD80 ( BT-1 ) were cloned from fresh placenta and human peripheral blood monocytes (PBMC) respectively. The two fragment were annealed to form a fusion gene (GPI-BT-1) by PCR. Then the fusion gene was inserted into the prokaryotic expression vector pET-30a, resulting in pET-30a-GPI-BT-1. Transfer to E. coli BL21, purified fusion protein were analysed by SDS-PAGE and Western blot. Results Agarose gel electrophoresis map of GPI and BT-1 PCR products show that GPI goal gene strap was seen at 133bp region and BT-1 goal gene strap at 792 region. Identification of recombinant pET-30a-GPI-B7-1 by restriction enzyme and PCR illustrate two goal fragment for 5000 bp and 900 bp, to realize the expression of fusion gene ( GPI-B7-1 ) at the E. coli BL21. The fusion protein was successfully produced in the pET expression system induced by IPTG and purified by Ni2 + -NTA agarose column. By SDS-PAGE and Western blot analysis, the observed molecular weight of the fusion protein was 38 kDa. Conclusion The purified GPI-B7-1 fusion protein can be obtained from E. coli BL21 transfered by prokaryotic expression vector pET-30a-GPI-B7-1, which will prove useful tool for the study of tumor immune therapy.

Objective To investigate the level of five auto-antibodies including MCV and GPI in the serum of RA patients and assess the application value of five auto-antibodies in RA diagnosis.Methods The five auto-antibodies were detected by ELISA in serum samples of 150 patients with RA and 40 healthy controls,32 patients of SLE,30 patients of OA,20 patients of AS,20 patients of SS,20 patients of CTD.Results The positive rates of these five auto-antibodies in RA patients were significantly higher than in other group(X2=88.5,76.0,279.2,88.2,94.8,P＜0.05).Except anti-AKA,there was no the differences in the level of other antibodies among groups(X2=21.9,9.4,20.2,43.2,41.6,P＞0.05).Anti-MCV and anti-GPI has the highest sensitivity(78.0% and 83.3%),while anti-CCP has the highest specificity(97.1%)and anti-AKA has good specificity(96.1%)and lowest sensitivity(49.4%).When two antibodies were detected together,the sensitivity and specificity of MCV/CCP were highest(92.7% and 96.9%).When RF/GPI/CCP were detected together,the sensitivity and specificity were 90.7% and 96.9%,respectively.When RF/MCv/CCP were detected together,the sensitivity and specificity were 94.0% and 96.9%.Conclusions Anti-MCV and anti-GPI has the hishest sensitivity in laboratory diagnosis of RA,while anti-CCP has the highest specificity and anti-AKA have good specificity and lowest sensitivity.The combination detection can decrease the amount of missed diagnosis caused by single test. The combination detection of RF/GPI/CCP and RF/MCV/CCP will improve sensitivity and specificity for diagnosis to the RA patients.

Objective To investigate the dynamic changes of interleukin-1 receptor-associated kinases (IRAK-4) in hypoxic neurons and explore their role in regulation of inflammatory reaction. Methods The B35 cells exposed to hypoxia of 3% O2,5% CO2 and 92% N2 were cultured for 1,3,6, 12,24,48,72 and 96 hours respectively. Then, mRNA and protein expressions of IRAK-4 were detected by RT-PCR and Western blot, the expression of IRAK-4 in the cells were observed by laser scanning con-focal microscope (LSCM), and the concentration of IL-6 was measured by ELISA method. Results After hypoxia, the mRNA and protein expressions of IRAK-4 were increased at one hour, reached the peak at six hours (P<0.05), kept at a high level at 12 hours (P<0.05) , but decreased gradually to the normal oxygen level at 24 hours (P < 0.05) and to below the normal oxygen level at 48 hours (P < 0.05). Immunofluorescence results showed that the fluorescence intensity of IRAK-4 was gradually increased with time. The changes of IL-6 in the supernatant were positively correlated with protein expression of IRAK-4 (r =0.84, P < 0.05 ). Conclusions Hypoxia can increase the expression of IRAK-4 at transcription and translation levels in a certain period of time, which may participate in down-stream inflammatory reaction and lead to increase of IL-6 expression.