Objective: To examine the hypodontia in orthodontic patients and to investigate the correlation between the hypodontia and skeletal class. Methods:The hypodontia were determined by panoramic radiographs,and skeletal class were evaluated by lateral cephalograms. The correlation between the hypodontia and skeletal class were analyzed by statistic methods. Results:The number of hypodontia in anterior upper arch was higher than those in lateral upper arch and the number of hypodontia in anterior lower arch was higher than those in lateral upper arch (P

ObjectiveTo evaluate the long-term outcomes of carotid endarterectomy versus carotid artery stenting for carotid stenosis.MethodsPubMed, EMBASE, and the Cochrane databases were retrieved.The randomized controlled trials of comparing CEA with CAS in patients with carotid artery stenosis were enrolled.The data such as the research basic characteristics and the long-term outcomes including stroke or death combined endpoints, any stroke or any death were extracted.The Stata software was used to conduct statistical analysis.ResultsA total of 7 randomized controlled trials and 8 210 patients were included.The median follow-up time was 2-7.4 years.The overall quality of the included studies was high and the risk of bias was low.The meta-analysis showed that the risks of the combined endpoint of stroke or death (hazard risk [HR] 1.21, 95% confidence interval [CI] 1.04-1.39), any stroke (HR 1.32, 95% CI 1.15-1.51) and ipsilateral stroke (HR 1.26, 95% CI 1.02-1.55) in the CAS group were significantly higher than those in the CEA group;the risks of death (HR 1.06, 95% CI 0.95-1.18), disabling stroke (HR 1.23, 95% CI 0.95-1.60), non-ipsilateral stroke (HR 1.12,95% CI 0.81-1.55) and restenosis (HR 1.18,95% CI 0.91-1.52) were not significantly different between between the CAS group and the CEA group.Conclusions CAS and CEA are associated with similar risks of long-term death, disabling stroke, non-ipsilateral stroke and restenosis.The risks of long-term combined endpoint of stroke or death, any stroke and ipsilateral stroke significantly higher with CAS.These results suggest that CEA remains the treatment of choice for carotid stenosis.

Objective To observe the protective effect of pretreatment with wortmannin against pancreas and liver injuries indued by severe acute pancreatitis(SAP) in rats and investigate its mechanism.Methods Fifty-four SD rats were randomly divided into 3 groups: control group(C group),SAP group(P group) and SAP+wortmannin group(PW group)(n=18 per group). SAP model was induced by retrograde infusion of 50g/L sodium taurocholate into the biliopancreatic duct of rats,except C group in which sodium taurocholate was replaced by normal saline. Serum level of tumor necrosis factor-alpha(TNF-?)、 alanine aminotransferase(ALT)、aspartate aminotransferase(AST)、and nuclear factor-kappa B(NF-?B)in liver were detected. Histopathology of liver and pancreas was studied.Results In P group, serum levels of TNF-?、ALT、AST and NF-?B in liver were significantly elevated(P

Objective:Living organ transplantation prolongs the life of many dying patients, but there are many disputes, especially the definition ofliving organ transplantation between non relatives. The definition of this ter-minology is closely related to medical students′cognitive ofliving organ transplantation between non relatives. The medical students are the main reserve army of medical staff and the executor of living donor organ transplantation in the future, who directly determine the organ transplantation and affect the doctor-patient relationship. This paper is to investigate and analyze the status of the medical students′recognition of cross transplantation between non rela-tives. Methods:A total of 450 medical students of Qingdao university were selected with cluster method and were investigated using self-designed questionnaire. Data were analyzed by SPSS 22. 0. Results:The overall recogni-tion rate toliving organ cross transplantation between non relatives was relatively low. The difference was statisti-cally significant (P<0. 05), namely that students in higher grade had lower recognition. The difference was statis-tically significant (P < 0. 05) between different specialties, and the recognition degree of students majoring in clinical medicine and ecsomatics was higher. Conclusion:The medical students of Qingdao University understand the concept of living organ cross transplantation between non relativesfuzzily, and the recognition degree is low.

Objective To discuss the feasibility of neuroendoscopic third ventriculostomy for chronic posttraumatic hydrocephalus (PTH).Methods Nineteen cases of chronic PTH treated with neuroendoscopic third ventriculostomy between October 2010 and October 2014 were analyzed retrospectively.There were 13 males and 6 females, aged 11-57 years (mean, 36.3 years).Trauma resulted from traffic accidents in 14 cases, falls in 4 cases and blunt object hitting in 1 case.Of the 19 cases analyzed, 5 had Glasgow Coma Scale (GCS) score of 13-15, 5 had score of 9-12 and 9 had score of 5-8 at admission.Results of operation were assessed with the Canada multicenter evaluation criteria.Prognosis was analyzed with the Glasgow Outcome Scale (GOS).Results All cases were followed up for mean 13.6 months (range, 6-26 months).Improvement of symptoms was achieved in 17 cases, but was not seen in 2 cases.Of the 2 cases, one required ventriculoperitoneal shunt two weeks after ineffective ventriculostomy, and one required second ventriculostomy one month after the presence of stoma blockage.No serious complications occurred.At follow-up, 9 cases had GOS score of 5, 8 cases had score of 4 and 2 cases had score of 3.Conclusions Neuroendoscopic third ventriculostomy is in line with the physical characteristics in cerebrospinal fluid circulation, which implies no shunt implantation, less operative trauma and less complications.The procedure is an effective approach for chronic PTH.

Objective To investigate and compare the clinical thinking ability of medical graduate students of different majors and different grades to explore the influencing factors of clinical thinking ability. Methods 180 graduate students in Medical College of Qingdao University were sur-veyed,including 54 nursing and 126 clinical medicine graduates of different grades. We used a self-designed scale of clinical thinking ability which included three main dimensions (critical thinking abil-ity, systematic thinking ability, evidence-based thinking ability) and twenty-four level 2 items. Ap-plying t test, ANOVA, multiple linear regression analysis for data statistical analysis. Results There's no significant difference comparing the scores of nursing graduates to the scores of clinical medical graduates(t=-0.80, P>0.05). However, there is significant difference in the different grade graduates (F=53.43, P<0.05). The multiple linear regression analysis shows that the practice time, reading professional literature quantity, and starting research earlier or later,are signif-icantly related to the clinical thinking ability(P<0.05). Conclusion The clinical thinking level of medical graduate students is generally high, and the higher grade, the higher level of clinical think-ing ability. We must strength-en the training of clinical thinking ability of medical graduates.

Objective To investigate the effect ofdiammonium glycyrrhizinate on neurovascular units in rats after cerebral ischemia reperfusion (IR) injury.Methods Two hundred and forty health SD rats were randomly assigned into normal control group (n=30),sham-operated group (n=30),IR group (n=90) and diammonium glycyrrhizinate group (DG,n=90).The rats in the IR group and DG group were divided into 2,6 and 12 h subgroups after modeling,respectively (n=30).The rats in the IR group and DG group were induced middle cerebral artery occlusion (MCAO) models,and after the models were successfully established,9.11 mL DG sodium chloride injection was given to DG group,while equal saline to normal group,sham-operated group and IR group via the tail vein.The brain tissues of each group were harvested 2,6 and 12 h,resperctively,after modeling.The infraction rate was measured by TTC staining;immunohistochemistry was employed to detect the expresions of Claudin-5 and vessel endothelium (VE)-Cadherin;Western blotting was used to detect the protein expression levels of Rac-1 and Claudin-5.Results The DG group had signficantly lower infarction rate than IR group 2,6 and 12 h after modeling (P＜0.05).The Claudin-5 expression rates in the 6 h and 12 h DG subgroups were signficantly higher than those in the 6 h and 12 h IR subgroups (P＜0.05).The VE-Cadherin expression rates in the DG group were significantly higher than that in IR group at 2,6 and 12 h after modeling (P＜0.05).Samely,the Claudin-5 relative quantity in DG group was significantly higher than that in IR group at 2,6 and 12 h after modeling (P＜0.05).The Rac-1 quantity in DG group was only statistically higher than IR group at 2 h after modeling (P＜0.05).Conclusion The DG can upregulate the Rac-1,VE-Cadherin and Claduin-5 expressions in neurovascutar units,and partly protect neurovascular units after cere bral acute IR injury.

OBJECTIVETo investigate the influence of mTOR expression on prognosis of early stage NSCLC.

METHODSOne-hundred and thirty-eight patients who underwent radical surgery for early stage NSCLC in our hospital from Janurary 2002 to December 2006 were included in this study. There were 83 males and 55 females, in an average age of 65.8 years, for both genders). The influence of age, gender, tumor typing, pathological grading, pathological staging and mTOR expression on patients' survival were analyzed by univariate and multivariate analyses.

RESULTSThe 5-year survival rate of the 138 cases was 44.8%. Immunohistochemical examination showed that mTOR-positive cases accounted for 101 while mTOR-negative cases accounted for 37. The 5-year survival rate of mTOR-positive patients was 32.7% and that of mTOR-negative patients was 56.4% (P = 0.019). Univariate analysis showed that mTOR expression, pathological staging and N1 lymph node metastasis were identified as significant prognostic factors, and were correlated to prognosis (P < 0.05 for all). Multivaraite analysis showed that pathological staging, mTOR expression, N1 lymph node involvement were identified as independent prognostic factors for patients with early NSCLC (P < 0.05 for all).

CONCLUSIONSOur findings suggest that overexpression of mTOR indicates a poor prognosis for NSCLC. mTOR, pathological stage and N1 lymph node metastasis are independent prognostic factors in early stage NSCLC.

Aged ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Rate ; TOR Serine-Threonine Kinases ; metabolism

Objective To summarize the characteristics of clinical manifestation of bone flare after the treatment with new endocrine therapy in patients with metastatic castration-resistant prostate cancer (mCRPC) in order to evaluate the curative effect of patients properly and determine the reasonable treatment strategy.Methods We retrospectively analyzed the clinical data of two patients with mCRPC performed "bone flare" defined as PSA decline and bone metastases progression in the initial treatment with new endocrine therapy in Urology Department of Peking University First Hospital,and analyzed the clinical characteristics and treatment methods with the relative literature.Case 1,a 79-year-old man,presented with frequent urination and prostate-specific antigen (PSA) was 115.900 ng/ml,was diagnosed as prostate cancer (cT3N0M1) with bone metastasis.After androgen deprivation therapy of 24 months,PSA elevated and multiple bone metastases progressed.The patient was diagnosed with mCRPC and then began the treatment of enzalutamide.Case 2,a 62-year-old man,complained about emaciation and frequent urination,was diagnosed with prostate cancer(cT4N1M1)with bone and lymph metastases.After androgen deprivation therapy of 22 months,PSA elevated and multiple bone metastases progressed.The patient was diagnosed with mCRPC and then began the treatment of abiraterone.Results Case 1 was treated with enzalutamide and 2 months later PSA decreased from 133.400 ng/ml to 5.530 ng/ml,while bone scan showed multiple bone metastases,part of which was newly metastatic lesions.6 months later,the number of metastatic lesions kept stable,and part of lesions presented metabolism decrease.8 months later,the number of metastatic lesions began to decrease.1 year later,the patient started to receive chemical therapy because of the progression of the disease.After 5 cycles of chemotherapy,PSA progression occurred and chemotherapy was stopped.Liver failure and disseminated intravascular coagulation caused death in June 2016.Case 2 was treated with abiraterone and 2 months later PSA decreased from 54.820 ng/ml to 3.580 ng/ml,while bone scan showed multiple bone metastases,part of which was newly metastatic lesions.6 months later,the number of metastatic lesions began to decline.10 months later,the number of metastatic lesions kept stable.The treatment of abiraterone was continued so far and the patient was in a stable condition.Conclusions Enzalutamide and abiraterone,two new endocrine therapy,are determined as preferred methods for the treatment of mCRPC.The bone scanning is required to evaluate the possibility of "bone flare" which is defined as PSA decline and bone metastases progression in the initial treatment.These patients should be evaluated to make appropriate clinical decision.

Objective:The purpose of this study was to examine the clinical features and initial treatment outcomes of elderly individuals with idiopathic membranous nephropathy.Methods:This study retrospectively analyzed the clinical characteristics and therapeutic effect of hospitalized patients aged 60 years or older with renal-biopsy-proven idiopathic membranous nephropathy for at least one year.Results:This study enrolled a total of 91 elderly patients with IMN, consisting of 51 males(56.0%)and 40 females(44.0%). The median age of the patients was 67 years.The urinary protein creatinine ratio(uPCR)and urinary albumin creatinine ratio(uACR)of the patients were 4 454.3 mg/g and 2 258.5 mg/g, respectively.The median 24-hour urinary protein and urinary albumin levels were 5 098.2 mg/24 h and 2 800.6 mg/24 h, respectively.The average estimated glomerular filtration rate(eGFR)was(60.5±20.4)ml·min -1·1.73 m -2.Out of the total of 61 patients, 67.0% achieved remission, including complete and partial remission, within a year of renal biopsy.The levels of uPCR and uACR were significantly higher in the non-remission group compared to the remission group(5 462.5 vs.2 271.1 mg/g, P<0.001; 2 774.4 vs.1 320.0 mg/g, P=0.001). Additionally, the levels of 24h urinary protein and urinary albumin were significantly higher in the non-remission group compared to the remission group(6 526.4 vs.3 210.4 mg/g, P=0.002; 3 067.7 vs.2 102.4 mg/g, P=0.007). The remission group had a higher proportion of patients receiving immunosuppressive therapy(85.2% vs.33.3%, P<0.001). The remission rates were higher in patients treated with glucocorticoid combined with cyclophosphamide, glucocorticoid combined with calcineurin inhibitors, or glucocorticoid combined with mycophenolate mofetil compared to those receiving conservative treatment(88.2% vs.31.0%, P=0.001; 80.0% vs.31.0%, P<0.001; 100.0% vs.31.0%, P=0.007). There was no significant difference in remission rate between the three immunosuppressive therapy groups( P>0.05). However, upon further analysis, it was found that the levels of uPCR, uACR, and serum cystatin C(CysC)were higher in the immunosuppressive therapy groups compared to conservative treatment.Additionally, serum total protein and albumin were lower in the immunosuppressive therapy groups, and these differences were statistically significant( P<0.05). Conclusions:The majority of elderly patients diagnosed with IMN have multiple comorbidities.For those at high risk with elevated urinary protein levels, early initiation of immunosuppressive therapy may lead to a higher initial urinary protein remission rate.Therefore, it is advisable to develop individualized treatment plans for elderly patients with IMN based on their clinical characteristics, as well as the risks and benefits associated with immunosuppressive therapy.