Objective To investigate the natural head position and cervical posture in the patients with different vertical facial patterns with skeletal class Ⅰ relationship,and to clarify the relationships between vertical facial patterns and natural head position, cervical posture in the patients with skeletal class Ⅰ relationship. Methods 94 patients aged 8- 15 years old with skeletal class Ⅰ relationship were selected as the subjects.The subjects were classified into high angle group,average angle group,and low angle group according to their mandibular plane angles.The cephalometric radiographs in natural head position were taken,and the variables representing craniofacial morphology,head position,and craniocervical posture were measured.The intergroup differences in variables were compared.Results The inclinations of mandible to the true vertical and cervical column (ML/VER,ML/OPT,ML/CVT)were smallest in high angle group,and they were largest in low angle group (P <0.01);other variables representing head posture and craniocervical posture (NSL/VER,FH/VER,NSL/OPT,NL/OPT,NSL/CVT,FH/CVT)were largest in high angle group,and they were smallest in low angle group (P <0.05).The inclinations of ramus to cervical column (RL/OPT,RL/CVT)were largest in high angle group and they were smallest in low angle group (P <0.01).There were no significant differences in the inclinations of cervical column and cervical lordosis (OPT/HOR,CVT/HOR,OPT/CVT)among three groups (P >0.05). Conclusion The significant differences exist in natural head position and cervical posture among the patients with skeletal class Ⅰ relationship with different vertical facial patterns (high angle,average angle,low angle);the subjects with high angle show extended head position and cervical posture,while the subjects with low angle exhibit the opposite tendency.

Objective To evaluate the efficacy,indications and clinical outcomes of the treatment of thoracolumbar fractures by short segmental pedicle screws fixation at the level of the fracture.Methods Thirtytwo patients with thoracolumbar fracture,who underwent surgical procedure of short segmental pedicle screws fixation at the level of the fracture from 2007 to 2010,were followed up.X rays were performed preoperatively and postoperatively to locate the injured vertebral segment height and fractured kyphosis vertebral (Cobb angle).Frankel standard was used to assess the spinal cord function.Results All patients were followed up for 12 to 20 months and were in satisfying condition in the reduction of fracture.After surgery,the height of fractured vertebral body leading edge recovered from preoperative (32.4％ ～69.3％,averaged (51.6 ± 17.8)％ ) to (85.6％ ～99.2％,averaged (92.8 ±6.2)％ ) after two weeks and (90.6％ ～97.8％,averaged (93.8 ±3.6)％ ) at the last follow-up.Fractured vertebral Cobb angle was recovered from the preoperative ( 12.8 ° ～ 30.5 °,averaged [20.8±9.1] °) to (0° ～7.8 °,averaged [4.9 ±3.2] °) two weeks later and (2.0° ～ 12.0°,averaged [ 6.2 ± 4.6 ] o at the last follow-up.Cobb angle of the injured vertebral segment and the extend of vertebral compression were significantly improved after the angle was corrected ( P ＜0.01 ).Conclusion Using reduction and short segment pedicle screw fixation at the fracture level would be helpful to correct kyphotic vertebral compression and restore the height of injured vertebrate,which was also of benefit to increase the stability of short-segment posterior fixation system and reduce the loss of correction in a long run.

Objective To examine the synaptic structure and glutamatergic transmitter of the pathway linking the anterior thalamic nucleus(ATN) and the subicular complex. Methods The HRP tracing and post embedding immunogold technique were used. Results In the anterior thalamic nucleus,anterograde HRP labelled terminals contained clear round synaptic vesicles and several mitochondria,and formed asymmetric synaptic contacts with HRP-labelled or non-HRP labelled dendrites.The highest densities of immunogold particles following glutamate immunostaining were found in HRP-labelled terminals and similar axon terminals devoid of HRP reaction product,They formed asymmetric synaptic contacts(Gray type Ⅰ) with dendrites.The average density of those immunogold particles was more than 3 times higher than that of the gold particles in the dendrites of their contacts and over 6 times higher than that of the particles in the terminals that formed symmetric synapses(Gray type Ⅱ).In two serial GABA immunogold reactive sections,Gray tpye Ⅱ terminals were heavily labeled whereas Gray type Ⅰterminals displayed a very slight labelling.In glutamate immunogold reactive sections,Gray type Ⅱ terminals were slightly labeled.A GABA positive terminal which formed symmetric synapses with HRP-labeled dendrites and the terminal which formed asymmetric synapses converged on the same dendrite.Conclusion The terminals of projection neurons in the pathway linking the anterior thalamic nucleus and the subicular complex are glutamatergic.In anterior thalamic nucleus corticothalamic projection neuron terminals form asymmetric synaptic contacts with HRP-labelled thalamocortical projection neurons by axo-dendritic synapses.

Objective To explore the relationship between KAI1 gene expression in papillary thyroid carcinoma and clinicopathological features and prognosis. Methods KAI1 mRNA expression was detected by Real Time Polymerase Chain Reaction in 21 cases papillary thyroid carcinoma tissues and 21 cases adjacent normal tissues, as well as 7 cases benign thyroid disease tissues. KAI1 protein expression was detected by immunohistochemisty in 60 cases papillary thyroid carcinoma tissues and 20 cases thyroid adenoma tissues. Results KAI1 mRNA expression in papillary thyroid carcinoma was significantly higher than that in adjacent normal tissues (P ＜ 0. 05) and benign thyroid lesion tissues (P ＜ 0. 05). Positive expression rate of KAI1 protein was 68. 3% in papillary thyroid carcinoma and 25% in thyroid adenoma tissues. The difference was statistically significant (P ＜0. 01). In papillary thyroid carcinoma, positive expression rate of KAI1 protein in the group without lymph node metastasis was higher than that in group with lymph node metastasis (P＜0.05). There was no difference in positive expression rate of KAI1 protein for male or female patients (P ＞0. 05). KAI1 protein expression in papillary thyroid carcinoma was not related to patients' ages, tumor size, TNM staging or capsule invasion (P ＞ 0. 05). Conclusions The abnormal expression of KAI1 mRNA and protein is correlated to the genesis and progress of papillary thyroid carcinoma,which provides a clue for treatment and prognosis assessment of papillary thyroid carcinoma

Objective:To observe the clinical efficacy of long-time needle retaining at Baihui(GV20)on post-stroke cognitive impairment(PSCI)and its effects on the cognitive ability and living ability of the patients.Methods:A total of 62 PSCI patients were divided into a control group and an observation group by the random number table method,with 31 cases in each group.The control group was treated with routine treatment for stroke in the recovery period plus cognitive training.The observation group received additional acupuncture at Baihui(GV20)with long-time needle retaining based on the same intervention in the control group.The Montreal cognitive assessment(MoCA)was used to evaluate the cognitive ability of patients.The activities of daily living(ADL)scale was used to evaluate the living ability of patients.And the mini-mental state examination(MMSE)scale was used to evaluate the mental state,concentration,language,and abstraction cognition of patients.After 4 weeks,the curative efficacy was observed,and the scores of cognitive level,living ability,mental state and concentration,language,and abstraction understanding ability were compared between the two groups.Results:During the trial,1 patient in each group dropped out due to personal reasons and was unable to continue the treatment.After 4 weeks of treatment,the total effective rate was 83.3%in the observation group and 66.7%in the control group,and the difference between the two groups was statistically significant(P<0.05);the scores of MoCA,ADL,and MMSE,and scores of concentration,language ability,and abstraction understanding ability were all increased,and were statistically different from those before treatment in each group(P<0.05);the scores in the observation group were all higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).Conclusion:On the basis of routine treatment and cognitive training,the clinical efficacy of additional acupuncture at Baihui(GV20)with long-time needle retaining in the treatment of PSCI is better than that of routine treatment plus cognitive training;the treatment can better improve the cognitive function and mental state of patients,and improve their living ability.

Objective To investigate the anatomic characteristics of the nasolabial fold and to give an accurate description and definition of it in order to to provide theoretical basis for plastic, cosmetic and maxillofacial surgery. Methods Ten (20 sides) adult fresh bodies with vascular perfusion of formalin fixed after morphological observation under a 10 × magnifying len. Results Nasolabial fold was a border between fat-rich zone and non-fat zone in the midfacial region. The nasolabial fold derived from nasal alar skin point in the transverse portion of nasalis, and ended at the outer skin point of zygomaticus major muscle in the mouth. From the anatomy point of view, the nasolabial fold was divided into three segments: the upper, the middle and the under. The upper segment ( Ⅰ ) was the transverse portion of nasalis, (20. 38± 0. 74) mm in length; the middle section ( Ⅱ ): levator labii superioris,(17.13 ± 0.57) mm in length; the under segment (Ⅲ ): modiolus, (20. 81 ±0. 70) mm in length. The nasolabial fold was a connecting region where seven mimetic muscles inserted into the skin point. Superficial musculoapneurotic system (SMAS) and the nasolabial fold were composed of seven mimetic muscles belonging to the same layer. Conclusions The nasolabial fold is a region where the seven mimetic muscles insert into the skin point for connection, and regardless of age, it is an eternal existence. The nasolabial fold is different from the nasolabial wrinkle formed with facial aging and the nasolabial ridges formed by facial mimetic muscles changes.

Objective To investigate the causes of and prevention for cerebral complications in perioperative period in patients with carotid stenosis. Methods The causes and treatment of cerebral complications among 133 cases of carotid stenosis during perioperative period from May 2004 to Jun 2009 were analysed retrospectively. Results Among 133 cases, 94 cases underwent carotid endarterectomy (CEA) and 39 cases had carotid artery stenting(CAS). Cerebral complications developed in 16 cases including 3 cases of more than two attacks. 5 cases suffered from tansient ischemia attacks (TIA)or cerebral ischemia before operation. 5 developed TIA or cerebral hyperperfusion syndrome (CHPS) among those undergoing CEA and 4 developed TIA or CHPS among CAS cases. During postoperative period, 8 cases developed TIA, CHPS,cerebral infarction or cerebral hemorrhage. Conclusions Prevention and treatment of cerebral complications is extremely important durning surgical therapy of carotid stenosis.

Objective:To investigate the expression of serum human phosphatidylethanolamine-binding protein 4 (hPEBP4) in patients with multiple myeloma (MM) and its clinical significance.Methods:A total of 59 symptomatic MM patients admitted to West Branch of Beijing Chaoyang Hospital from September 2016 to September 2018 were selected as the research objects. According to the CRAB symptoms [elevated serum calcium (C), kidney injury (R), anemia (A), bone lesions (B)], all patients were divided into 2 groups, including the active group of 44 patients with CRAB symptoms, and the response group of 15 patients who achieved at least partial remission after chemotherapy and symptom relief of CRAB. According to the degree of bone lesions (BL), 30 patients with severe bone-related events were grouped as the severe bone lesions (SBL) group, and 14 patients were grouped as the non-severe bone lesions (NSBL) group. According to the revised international prognostic staging system (R-ISS), patients in the active group were divided into three subgroups: stage Ⅰ, stage Ⅱ, and stage Ⅲ, including 26, 11 and 7 patients, respectively. A total of 15 healthy examination people whose gender and age matched those of the patients were treated as the healthy control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of hPEBP4, tumor necrosis factor ligand superfamily member 14 (LIGHT/TNFSF14) and activin A of patients in different groups. Pearson was used to analyze the relationship of the expressions of multiple factors in the active group. The optimal cut-off value of multiple factors diagnosing MM was determined by using receiver operating characteristic (ROC) curve, and according to the cut-off value, the differences in overall survival (OS) of patients with different stratification were compared.Results:In the active group, the respond group, the healthy control group, the level of hPEBP4 was (1.48±0.64) μg/L, (1.49±0.75) μg/L, (0.31±0.10) μg/L, respectively; the level of LIGHT/TNFSF14 was (169±112) ng/L, (256±132) ng/L, (44±27) ng/L,respectively; the level of activin A was (383±266) ng/L, (223±79) ng/L, (234±85) ng/L, respectively; and the differences were statistically significant (all P<0.05). In the active group, the level of hPEBP4 was (1.06±0.60) μg/L, (1.15±0.50) μg/L, (1.73±0.68) μg/L, respectively in patients with stage R-ISSⅠ, R-ISSⅡ and R-ISS Ⅲ, and the difference was statistically significant ( F=3.287, P=0.032). The level of activin A was (219±55) ng/L, (247±117) ng/L, (450±215) ng/L, respectively among patients in stage R-ISSⅠ, R-ISSⅡ, R-ISS Ⅲ, and the level of activin A in stage R-ISS Ⅲ was higher than that in stage R-ISSⅠand R-ISSⅡ (all P < 0.05). The levels of LIGHT/TNFSF14 and activin A of SBL patients were higher than those of NSBL patients [(174±101) ng/L vs. (98±53) ng/L; (467±238) ng/L vs. (189±71) ng/L, all P < 0.05]. The level of hPEBP4 was positively correlated with the levels of M protein ( r=0.694, P < 0.01) and activin A ( r=0.252, P < 0.01) of IgG patients in the active group. ROC curve analysis showed that the optimal cut-off value of hPEBP4, LIGHT/TNFSF14, activin A diagnosing MM was 1.04 μg/L, 97.0 μg/L, 156.2 ng/L. The median overall survival (OS) time of patients with hPEBP4 >1.04 μg/L and hPEBP4 ≤ 1.04 μg/L was 57 months (95% CI 22-92 months) and not reached, respectively, and the difference was statistically significant ( P < 0.05); while the median OS time of patients with activin A ≥ 156.2 ng/L and activin A < 156.2 ng/L was 61 months (95% CI 24-98 months) and not reached, respectively, and the difference was statistically significant ( P < 0.05). Conclusions:High expression level of hPEBP4 is related with the progression of MM. It is positively related with the level of M protein and negatively with the OS of MM patients. It is suggested that hPEBP4 may be used as an important marker to judge disease progression and tumor burden in MM. LIGHT/TNFSF14 and activin A cooperate with hPEBP4 to participate in the pathological processes of tumor microenvironment of MM.

Objective: To investigate the status of passive smoking among pregnant women in Jinshan District, Shanghai Municipality, so as to provide insights into developing targeted smoking control measures and promoting maternal and infant health. Methods: Pregnant women who had early pregnancy registration at Jinshan District Community Health Service Center from April 2021 to December 2023 were selected as subjects. The basic information, passive smoking and awareness of passive smoking hazards among pregnant women were collected through questionnaire surveys, and passive smoking rate and awareness rate of passive smoking hazards were analyzed. Results: Totally 8 273 questionnaires were allocated, and 8 216 valid questionnaires were recovered, with an effective rate of 99.31%. The mean age of participants was (29.52±4.60) years. There were 4 991 participants with an education of college degree or above, accounting for 60.75%; 3 565 participants with the first pregnancy, accounting for 43.39%; 3 990 primiparas, accounting for 48.56%; 3 193 participants living with smokers, accounting for 38.86%. A total of 3 710 participants passively smoked, with a passive smoking rate of 45.16%. There were 2 817 participants passively smoked in public places, accounting for 75.93%; 2 253 participants passively smoked in workplaces, accounting for 60.73%; 1 563 participants that passively smoked at home, accounting for 42.13%. The awareness rates regarding the hazards of passive smoking to health, causing lung cancer in adults, causing lung diseases in children, causing preterm birth and low birth weight infants, and causing heart diseases in adults were 92.13%, 88.85%, 87.99%, 82.05% and 62.56%, respectively. Conclusion The rate of passive smoking among pregnant women in Jinshan District is comparatively high, while their awareness regarding non-respiratory diseases emanating from passive smoking is comparatively low.

Objective To assess the ability of ABCD3-Ⅰ score in evaluating the early risk of cerebral infarction after transient ischemic attack ( TIA ).Methods A total of 107 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrences of cerebral infarction within 2 days and 7 days were observed.Results The AUCRoc of ABCD2,ABCD3 and ABCD3-Ⅰ were 0.61,0.66 and 0.71 in predicting the risk of cerebral infarction within 2 days,and were 0.62,0.68 and 0.74 in predicting within 7 days,respectively.Among 107 patients with TIA,13 evolved into cerebral infarction within 2 days,accounting for 12.1％,and 24 within 7 days,accounting for 22.4％.According to ABCD3-Ⅰ criteria,17 patients were of low risk scored 0-3 ; 54 patients were of medium risk scored 4-7 ; and 36 patients were of high risk scored 8-13.The different incidence of cerebral infarction after TIA was related to ABCD3-Ⅰ score:the higher the score was,the higher incidence was.Except for age factor,every score item of ABCD3-Ⅰ display obvious influence to the occurrence of cerebral infarction within 2 days and 7 days after TIA (P ＜ 0.05 ).Conclusion ABCD3-Ⅰ criteria could more effectively predict the occurrence of early risk of cerebral infarction after TIA,which could be used in regular clinical practice for assistance in TIA risk stratification and treatment.