objective: To evaluate the effects of multiloop edgewise archwire(MEAW) therapy in the treatment of open bite. Methods: 20 cases of open bite (male 7 ,female 13 ,aged 13～25 yrs old) were treated by MEAW technique.The effects were evaluated by cephalometry. Results: After treatment ANB *, U1 SN *, L1 MP ** , U 6 SN *, U6 PP(mm) *, L6 MP * and L6 MP(mm) * decreased, L1 MP(mm) ** , U1 L1 ** and OB(mm) ** increased( * P

Objective:To compare the effects of distal movement of canines between elastic traction and canine lace back in the aligning stage of preadjusted appliance. Methods:50 cases with Angle I malocclusion were divided into two groups after first premolar extraction. Patients in both groups were treated by the same kind of preadjusted appliance in the aligning stage. Canine lace back was used in one group and elastic traction in another.Treatment was countinued for 12 weeks.Measurements of the dental models and the cephalograms were conducted before and after treatment.Results:Compared to the canine lace back, the decrease of the width between the cuspids of upper premolars and that between that of lower molars, the increase of the angle of the distally tipped canines and the mesially tipped lower molars and the lingually tipped incisors, the higher speed and larger distance of distal moving canines were achieved more easy with elastic traction. On the contrary, the larger distance of mesial moving molars were attained with canine lace back. The differences of all the measurements above between the two methods were significant(P

Objective To study the diagnostic value of proton magnetic resonance spectroscopy(MRS) in patients with minimal hepatic encephalopathy(MHE).Methods MRS of cingulated cortex and frontal lobe were acquired using point resolved echo spin spectroscopy(PRESS) sequences in 26 patients with MHE.Peak area of each metabolite,including NAA,Cr,Cho,mI,Glx and their ratios to Cr were computed,respectively.Then the results were compared with normal control group.Results Compared with the normal control group,MHE group showed significant decreased Cho/Cr,mI/Cr(P0.05).Conclusions The patients with MHE show that Cho and mI significantly decrease and Glx significantly elevate in cingulate cortex and frontal lobe on MRS.Diagnostic value of MRS is significant to MHE.

Diabetes mellitus is an independent predictor of high platelet reactivity after antiplatelet therapy in patients with ischemic stroke,and the latter is closely related to the increased risk of recurrence of stroke.The mechanisms of high platelet reactivity in patients with diabetes or insulin resistance are associated with a variety of factors.Some circulating molecules can be used as markers for predicting the reactivity of platelets.Monitoring of platelet reactivity after treatment with new antiplatelet agents may provide basis for individualized antithrombotic therapy in ischemic stroke patients with diabetes or insulin resistance.

Minocycline is the second generation semisynthetic tetracycline antibiotics.A variety of animal models and clinical trials have shown that it has neuroprotective effect.Its mechanism is associated with inhibiting apoptosis, alleviating inflammatory reaction, reducing infarct volume, and alleviating vascular injury.This article reviews the neuroprotective effect of minocycline in preclinical phase and early clinical trials of acute ischemic stroke.

Clopidogrel can inhibit platelet aggregation and reduce the risk of recurrent stroke.However,it is a great difference in antiplatelet inhibition in different populations.This article reviews the mechanism of clopidogel resistance and its countermeasures in the prevention of ischemic stroke.

Objective T lymphocyte subsets in children with characteristics observed with infec-tious mononucleosis (infectious mononucleosis,IM),to explore its reference value.Methods January 2011 to December 2014 during a pediatric door altogether 115 cases of hospitalized children were divided in-to three groups,51 cases of IMgroup,33 atypical group,31 patients flyers syndrome,selecting outpatient healthy children as 101 cases the control group.For each group T lymphocyte subsets:CD3 + CD4 +,CD3 +CD8 +,CD4 +/CD8 + ratio,analyze the differences between the groups was significant.Results Compared four groups of T lymphocyte subsets (CD3 +,CD3 +CD4 +,CD3 +CD8 +,CD4 +/CD8 + ratio)change char-acteristics,IMgroup,atypical group,flyers syndrome group and the control group,the difference was sta-tistically significance (P <0.05),presence prompts patients significant immune dysfunction;children IM group than in the atypical group,flyers syndrome group CD3 +,indicators of changes in CD3 +CD4 +,CD3 +CD8 +,CD4 +/CD8 + ratio and other more obvious The difference was statistically significant (P <0.05), described IMgroup of children was more severe immune dysfunction;atypical combination Flyer syndrome group,the difference was not statistically significant (P >0.05),two groups of children described in T there was no significant difference in lymphocyte immune.Conclusions T lymphocyte subsets have some reference value in the differential diagnosis of IM,and prompt clinical attention to EB virus infection in chil-dren whose immune function,can help prevent and treat.

Objective To investigate the correlation between serum cystatin C (CysC) levels and cerebral microbleeds (CMBs) in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled.Susceptibility weighted imaging was used to identify the presence of CMBs.Particle-enhanced turbidimetric immunoassay was used to detect the levels of serum CysC.Results A total of 485 patients with acute ischemic stroke were enrolled,including 151 (31.1％) with CMBs.The level of serum CysC of the CMB group was significantly higher than that of the non-CMB group (1.24± 0.13 mg/L vs.1.02± 0.11 rmg/L; t=4.261,P＜ 0.001).Multivariate logistic regression analysis showed that the increased serum CysC level was an independent risk factor for the presence of CMBs in patients with acute ischemic stroke (each increase in one standard deviation,odds ratio 4.063,95％ confidence interval 2.142-8.127; P ＜0.001).Multiple linear regression analysis showed that the number of CMBs in patients with acute ischemic stroke increased with the increasing serum CysC level after adjusting for other confounders (r2 =0.361,P =0.017).Conclusions In patients with acute ischemic stroke,the serum CysC levels are independently associated with the CMBs,and the number of CMBs increases with the serum CysC level.

Objective:To investigate the correlation between heart rate variability (HRV) and cognitive impairment in patients with obstructive sleep apnea (OSA).Methods:Patients received polysomnography in Weihai Municipal Hospital from June 2019 to November 2020 were enrolled as the subjects of cross-sectional analysis. According to the Montreal Cognitive Assessment score, the patients with OSA were divided into a cognitive impairment group and a non-cognitive impairment group. Multivariate logistic regression analysis was used to determine whether HRV parameters were the independent influencing factors of cognitive impairment in patients with OSA. Multiple linear regression analysis was used to determine the independent correlation between HRV parameters and overall cognition as well as each cognitive domain in patients with OSA. Results:A total of 115 patients with OSA were included, including 80 males (69.6%), aged 58.25±9.88 years. Among them, there were 61 in the cognitive impairment group (53.0%) and 54 in the non-cognitive impairment group (47.0%). The standard deviation of the R-R interval in normal sinus beats (SDNN), the square root of the mean of the sum of the squares of the difference between adjacent NN intervals (RMSSD), the percentage of the number of pairs of adjacent R-R intervals differing by more than 50 ms (pNN50) and the power in high-frequency range (HF; 0.15-0.40 Hz) in the cognitive impairment group were significantly lower than those in non-cognitive impairment group (all P<0.05). Multivariate logistic regression analysis showed that SDNN (odds ratio [ OR] 0.551, 95% confidence interval [ CI] 0.380-0.798; P=0.002), RMSSD ( OR 0.516, 95% CI 0.342-0.779; P=0.002), pNN50 ( OR 0.900, 95% CI 0.834-0.971; P=0.006), LF ( OR 0.821, 95% CI 0.687-0.982; P=0.030) and HF ( OR 0.687, 95% CI 0.525-0.899; P=0.006) were the independent protective factors of cognitive impairment in patients with OSA. Multiple linear regression analysis showed that SDNN ( β=0.208, P=0.023), RMSSD ( β=0.228, P=0.011), pNN50 ( β=0.186, P=0.040), HF ( β=0.235, P=0.010) is independently correlated with overall cognitive function in patients with OSA. Conclusion:The decline of HRV parameters SDNN, RMSSD, pNN50 and HF is independently correlated with cognitive impairment in patients with OSA, suggesting that the decline of vagus nerve function may be involved in the mechanism of cognitive impairment in patients with OSA.

Objective To evaluate factors influencing long-term survival of biliary atresia patients receiving Kasai procedure and the prevention and treatment of surgical complications.Methods Among 97 biliary atresia patients undergoing Kasai or Suruga operation from Mar 1989 to Mar 1999, 35 cases have survived over five years.These 35 cases were classified intraoperatively into type Ⅱ (4 cases) and type Ⅲ (31 cases).Procedures included hepaticojejunostomy (12 cases), Suruga operation (hepaticojejunostomy with a jejunal fistula in 21 cases), hepaticocystomy (2 cases).Six patients underwent second hepaticojejunostomy because of porta hepatis obstruction.Results (1) Eighteen patients suffered from early cholangiolitis, and four cases developed late cholangiolitis, 5-8 years after closing the ascending stoma.(2) Five cases presented upper digestive tract hemorrhage caused by portal hypertension.(3) All patients were followed up from 5 to 15 years with 2 deaths.Conclusion Conventional surgical procedures still take important part in treating biliary atresia before liver transplantation is popularized.Factors influencing long term survival of patients receiving Kasai′s operation include age at operation, pathological classification of extrahepatic bile duct, with or without cholangitis after operation, and portal hypertension.