The relationship between the dental occlusion and temporomandibular disorders (TMDs)has been one of the most controversial topics in the dental community.In a large epidemiological cross-sectional survey-the Study of Health in Pomerania (Germany)-associations between 1 5 occlusion-related variables and TMD signs or symptoms were found.In other investigations,additional occlusal variables were i-dentified.However,statistical associations do not prove causality.By using Hill's nine criteria of causation,it becomes apparent that the evi-dence of a causal relationship is weak.Only bruxism,loss of posterior support and unilateral posterior crossbite show some consistency across studies.On the other hand,several reported occlusal features appear to be the consequence of TMDs,not their cause.Above all,however, biological plausibility for an occlusal aetiology is often difficult to establish,because TMDs are much more common among women than men. Symptom improvement after insertion of an oral splint or after occlusal adjustment does not prove an occlusal aetiology either,because the a-melioration may be due to the change of the appliance-induced intermaxillary relationship.In addition,symptoms often abate even in the ab-sence of therapy.Although patients with a TMD history might have a specific risk for developing TMD signs,it appears more rewarding to fo-cus on non-occlusal features that are known to have a potential for the predisposition,initiation or perpetuation of TMDs.

Objective To assess the influence of full-thickness continuous suture method and layer interrupted suture method in emergency abdominal operation closure.Methods Two hundred and thirtyseven patients of emergency abdominal operation were divided into full-thickness continuous suture method group (145 cases) and layer interrupted suture method group (92 cases) according to the suture method.The rate of incision liquefaction and infection,time of incision suture were compared between the 2 groups,the patients with incision liquefaction and infection were given bacterial culture.Results The time of incision suture in full-thickness continuous suture method group was significantly shorter than that in layer interrupted suture method group [(18.37 ± 7.42) min vs.(25.92 ± 5.79) min],there was statistical difference (P ＜0.01).There were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing between the 2 groups (P ＞ 0.05).In full-thickness continuous suture method group,the rate of incision liquefaction and infection in median incision was significantly lower than that in rectus abdominis incision [18.58％ (21/113) vs.31.25％ (10/32)],the rate of incision primary healing was significantly higher than that in rectus abdominis incision [81.42％ (92/113) vs.68.75％ (22/32)],there were statistical differences (P ＜ 0.05).In layer interrupted suture method group,there were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing between median incision and rectus abdominis incision [33.33％ (23/69) vs.26.09％(6/23),66.67％ (46/69) vs.73.91％ (17/23),P ＞ 0.05].The rate of incision liquefaction and infection in median incision of full-thickness continuous suture method group was significantly lower than that in median incision of layer interrupted suture method group,and the rate of incision primary healing was significantly higher than that in median incision of layer interrupted suture method group,there were statistical differences (P ＜ 0.05).There were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing in rectus abdominis incision between the 2 groups (P ＞ 0.05).The bacterial culture result in patients with incision liquefaction and infection showed positive was in 26 cases,in full-thickness continuous suture method group was in 10 cases (6.90％,10/145),in layer interrupted suture method group was in 16 cases (17.39％,16/92),there was statistical difference (P ＜0.05).The mostly bacterial of infection was Escherichia coli.Conclusions The full-thickness continuous suture in median incision can shorten operative time and reduce the rate of incision liquefaction and infection in emergency abdominal operation.Suture technique has important impact on incision healing.

Objective To compare the clinical results of the unilateral hemilaminectomy approach and the total laminectomy ap-proach in the treatment of subdural extramedullary tumors.Methods One hundred cases with subdural extramedullary tumors from Sep-tember 2010 to September 2013 in the General Hospital of Ningxia Med.Univ.underwent surgery intervention were prospective analyzed. Among them,50 cases( the observation group) received tumor resection by the unilateral hemilaminectomy approach,and another 50 cases ( the control group) received the treatment by the total laminectomy approach.All received electrophysiological monitoring in the opera-tion.Operation time,intraoperative bleeding,postoperative hospitalization duration and postoperative recurrence rate in 6 months to 1 year etc.were recorded and compared.Results Operation time,intraoperative bleeding,postoperative hospitalization duration and postoperative fields time in the the observation group were less than the control group(P<0.05).There was no significant difference in curative effect aspects.In the postoperative follow-up(6 months to 1 year) ,the spinal instability cases in the observation group(0 case) was significantly less than the control group (6 cases).Conclusion Compared with the total laminectomy approach,the unilateral hemilaminectomy ap-proach in the treatment of subdural extramedullary tumors has more advantages as follows:better curative effect, smaller trauma, quicker recovery, fewer complications, great maintenance in spinal mobility and stability etc.

Objective To investigate the clinical application value of fluorescence PCR in vitro diagnosis(IVD)reagent kits in the HLA-B27 detection by comparing 2 kinds of HLA-B27 IVD reagent kit approved by CFDA.Methods A total of 573 clinical blood samples were collected and detected for HLA-B27 by the approved reagent kits based on the fluorescence PCR technique and the flow cytometry.The samples with inconsistent testing results by the two kits were further confirmed by the PCR sequencing.At the same time,about 5% samples of the positive results detected by the fluorescence PCR method were extracted for conducting the re-testing.Results Among 573 samples,191 samples were HLA-B27 positive and 382 cases were HLA-B27 negative by flow cytome-try;the same samples had 194 cases of HLA-B27 positive and 379 cases of HLA-B27 negative by real-time PCR.With flow cytome-try as reference of the final results,the positive coincidence rate of the two kinds of kit was 96.33%(184/191),the negative coinci-dence rate was 94.76%(362/382),27 samples had inconsistent results from the two kinds of assay(accounting for 4.71% of the to-tal number of samples),the total coincidence rate was 95.29% [(184+362)/573],the Kappa value was 0.896(P =0.02);the chi-square test P =0.021,the two kinds of testing method had the high consistency,but the differences existed in the testing results. The re-testing results by PCR sequencing(including 27 samples with inconsistent results by two kinds of kit)were entirely consist-ent with the fluorescence PCR testing results.Conclusion Compared with the authority method flow cytometry for HLA-B27 tes-ting in clinic,the fluorescence PCR kit may present more accurate judging ability for the HLA-B27 testing on the basis of ensuring the higher consistency of the testing results,is easier compared with the sample preparation and operating procedures,and has the stronger clinical application value and prospects s.

OBJECTIVE:To explore the effects of pioglitazone on secreation and mRNA expressions of TNF-? in adipocytes of high-cholesterol model rats.METHODS:30 rats fed with high-cholesterol diet for 8 weeks were randomly assigned to receive high cholesterol diet alone(high-cholesterol group,n=15) or high-cholesterol diet plus pioglitazone(3 mg?kg-1?d-1) (pioglitazone group,n=15) for 4 weeks.Another 15 rats were assigned to control group and fed with common diet for 12 weeks.Then the rats were sacrificed,with indexes such as blood lipid,serum concentration and mRNA expression of TNF-? in adipocytes of high-cholesterol rats determined.Besides,normal adipocytes were taken and treated with lipopolysaccharide and different concentrations of pioglitazone (0.1,1.0,10.0 ?mol?L-1) followed by a determination of TNF-? level and mRNA expression level.RESULTS:Compared with high-cholesterol group,serum concentration and mRNA expression of TNF-? in pioglitazone group were significantly lowered,but pioglitazone treatment showed little impact on blood sugar level and blood lipid level.Pioglitazone(0.1,1.0,10.0 ?mol?L-1) dose-dependently inhibited lipopolysaccharide-induced TNF-? secretion and mRNA expression in cultured adipocytes.CONCLUSION:Pioglitazone can reduce TNF-? level of fatty tissue and serum in high-cholesterol model rats.

Objective To evaluate the method of flow cytometric analysis of T lymphocyte subsets in bodyfluid of the pa-tients. Methods In ovder to get T lymphocytes by 3-colour staining method utilizing SSC/CD3Percp antibody,47 bronchoalveolar lavage fluid and 50 were tested by flow cytometery. Results 1)The percentage of Th is (67.98±7.41) % ,Ts(27.36±6.41) % and Th/Ts(2.60±0.64)in BALF with lung cancer,and the percentage of Th is (37.61±4.8)% ,Ts(67.97±4.20)% ,and Th/Ts(0. 47±0.10)in BALF with lung cancer respectively, and the Th cells in BALF with lung cancer were lower than those in the benign pulmonary disorder(P<0.05), and the Th/Ts ratio was significantly lower while the Ts cells were significantly higher in BALF of lung cancer(P<0.01), comparied with the benign pulmonary disorder; 2)The percentage of Th is (35.76±7.71) % and Ts(64.31 ±7.37) % and Th/Ts(0. 57 ± 0. 18) in BALF with lung cancer, and the percentage of Th is(49.27 ± 12.88) %, Ts(44.54 ± 9. 56) %,and Th/Ts is (1.13 ± 0.29) in BALF with benign pulmonary disorder. The Th cells in BALF with lung cancer was lower than those in the benign pulmonary disorder(P<0.05) ,the Th/Ts ratio were significantly lower and the Ts cells were significantly higher in BALF of lung cancer(P<0.01) comparied with the benign pulmonary disorder;3)The percentage of This(35.76±7. 71) %,Tsis(64.31 ± 7.37) % and Th/Ts are(0.57 ± 0. 18) in BALF with lung cancer, and the percentage of Th is (49.27 ± 12. 88) %, Ts is (44.54 ± 9.56) %, and Th/Ts is(1.13 ± 0.29) in BALF with benign pulmonary disorder. Respectively, the Th cells in BALF with lung cancer were lower than those in the benign pulmonary disorder(P<0.05), the Th/Ts ratio were significantly low-er and the Ts cells were significantly higher in BALF of lung cancer(P<0.01)comparied with the benign pulmonary disorder. Con-clusion The immunity function in the patients with lung cancer was significantly decreased. Flow cytometric approach is valuable in analyzing T lymphocyte subsets in BALF.

Objective:To discuss the value of congenital hypertrophy retinal pigment epithelium(CHRPE) in diagnosis of familial adenomatous polyposis(FAP).Methods: Twenty-two FAP patients who have received treatment in our department(January 2001 to June 2003) and 10 patients with sporadic colorectal polys(as control group) were subjected to optical fundus examination.The incidence,morphological feature and distribution of CHRPE were analyzed.Results: Seventeen(81.8%) of the 22 FAP patients were found to have CHRPE in optical fundus.The lesions showed a bilateral and multiple(≥2) distribution along the peripheral vessels with oval pigmentation.One patient was found to have CHRPE in the control group.Conclusion: Optical fundus examination is a highly sensitive and specific adjuvant diagnosis for FAP.It is a safe and effective way for screening FAP in FAP family members.

Objective To investigate the clinical efficacy of CRRT in the treatment of severe pancreatitis.Methods 120 patients with severe pancreatitis were divided into two groups according to the treatment.All the patients were given basic treatment in all groups.The Pa arterial oxygen pressure (PaO2),oxygenation index (PaO2/FiO2),and C-reactive protein (CRP) in the two groups after 72 hours of treatment were observed.The levels of blood lactate (Lac),APACHEII,tumor necrosis factor α(TNF-α),interleukin-6 (IL-6) and interleukin-1β (IL-1β) were measured before and after treatment 72 hours.A comparison of mortality and hospitalization time was observed in 28 days of treatment.Results After treatment,Lac [the control group (3.32±0.85)mmol/L,the observation group (2.55±0.65)mmol/L],APACHEII score [the control group (13.30±2.80)points,the observation group (12.01±2.60)points],CRP [the control group (24.30±2.80)mg/L,the observation group (12.33±1.60)mg/L] were significantly lower than before treatment [Lac:the control group (4.85±1.05)mmol/L,the observation group (4.90±1.02)mmol/L;APACHEII score:the control group (16.62±2.95)points,the observation group (16.90±3.01)points;CRP:the control group (40.32±3.10)mg/L,the observation group (40.40±3.51)mg/L;the control group:tLac=1.67,P=0.004,tAPACHEII=6.32,P=0.000,tCRP=29.71,P=0.000;the observation group:tLac=15.05,P=0.005,tAPACHEII=9.52,P=0.000,tCRP=56.36,P=0.000].PaO2 [the control group (75.30±4.80)mmHg,the observation group (84.31±4.60)mmHg], PaO2/FiO2 [the control group (225.30±14.83)mmHg,the observation group (256.31±14.65)mmHg] were significantly higher than before treatment [PaO2:the control group (60.32±4.15)mmHg,the observation group (60.40±4.01)mmHg;PaO2/FiO2:the control group (130.39±11.15)mmHg,the observation group (130.90±11.01)mmHg;the control group:tPaO2=18.29,P=0.000,tPaO2/FiO2=39.62,P=0.000;the observation group:tPaO2=30.35,P=0.000,tPaO2/FiO2=53.01,P=0.000].Those in the observation group were significantly improved than the control group (tLac=5.574,P=0.00,tAPACHEII score=2.615,P=0.005,tPaO2=3.646,P=0.0002,tPaO2/FiO2=11.523,P=0.00,tCRP=28.751,P=0.000).After treatment,the TNF-α,IL-6 and IL-1β levels in the two groups [the control group:IL-1β (70.32±6.85)ng/mL,IL-6 (103.30±8.80)ng/mL,TNF-α (89.30±8.80) ng/mL;the observation group:IL-1β(48.55±6.62)ng/mL,IL-6(92.01±8.60)ng/mL,TNF-α(57.31±7.60)ng/mL] were significantly improved than before treatment [the control group:IL-1β(82.85±7.05)ng/mL,IL-6(173.62±9.95)ng/mL,TNF-α (105.32±9.15)ng/mL;the observation group:IL-1β(83.90±7.32)ng/mL,IL-6 (175.90±10.01)ng/mL,TNF-α (106.40±9.01)ng/mL;the control group:tIL-1β=9.66,P=0.000,tIL-6=41.01,P=0.000,tTNF-α=9.77,P=0.000;the observation group:tIL-1β=27.74,P=0.000,tIL-6=49.23,P=0.000,tTNF-α=32.26,P=0.000].And those of the observation group improved more significantly than the control group (tIL-1β=17.702,P=0.00,tIL-6=7.107,P=0.00,tTNF-α=21.311,P=0.000).The mortality rate and hospitalization time of the observation group were 18.33% and (10.97±2.92)days,which were significantly lower than those of the control group [36.67%,(13.63±3.26)days;χ2=5.058,P=0.025;t=4.708,P=0.000).Conclusion The use of CRRT in the treatment of severe pancreatitis can improve the vital signs,reduce the inflammation index,improve the serum levels of inflammatory factors and lactic acid,reduce the mortality and hospital stay.

Objective To explore the clinical value of N-terminal prosoma of B-type natriuretic peptide (NT-ProBNP) in assessing the heart function of the patients with chronic heart failure.Methods 94 inpatients diagnosed as chronic heart failure were divided into 4 groups (Ⅰ,Ⅱ,Ⅲ,Ⅳ) according to the cardiac function of NYHA Functional Class(NYHA-FC),and 5 inpatients with normal cardic function were also selected as control group.The plasma NT-ProBNP was detected.The results of heart color ultrasound was collected.Results In patients with heart failure,left ventricular end-diastolic dimension(LV) increased following the increase of plasma NT-ProBNP level.Among NYHA-FC groups,NT-ProBNP levels were different,which increased as the NYHA-FC upgrades.Spearman correlation analysis showed that NT-ProBNP had good correlation with both LV and NYHA-FC(r =0.453,P ＜0.01 ;r =0.538,P ＜ 0.01).There was also good correlation between LV and NYHA-FC(r =0.322,P ＜ 0.01) ;but the correlation was slightly lower than the previous.Conclusion NT-ProBNP can reflect the level of ventricular remodeling and the severity of the cardiac decompensation in chronic heart failure patients.

Objective To compare the efficacy of intralesional glucocorticoid injection with a needle-free injector versus an ordinary injector for the treatment of keloid. Methods A total of 60 patients with keloid were enrolled and randomly divided into two groups by using a random number table to receive intralesional injection of compound betamethasone with a needle-free injector(n=31)or an ordinary injector(n=29). The injection was given at a dose of 0.2 ml/cm3 once every 3 weeks for 3 sessions. Parameters for therapeutic efficacy were assessed, adverse reactions were recorded, and clinical pictures were taken before and after each treatment. Statistical analysis was carried out by the Mann-Whitney U test and chi-square test with the SPSS 19.0 software. Results Compared with the ordinary injector group, the needle-free injector group showed significantly different injection time during the first and second treatment (U=299.000, 773.500, respectively, both P=0.000), as well as duration of pain after the first injection(U=730.000, P=0.003). After three sessions of treatment, there was a significant difference in the volume, height, hardness of keloid, scores for pain, itching and appearance, and number of injection points between the needle-free injector group and ordinary injector group (U=295.000, 336.500, 264.000, 464.000, 451.500, 308.000, 233.500, P=0.001, 0.007, 0.000, 0.041, 0.043, 0.003, 0.001, respectively). No significant differences were observed in the incidence of adverse reactions between the two groups(all P>0.05). Moreover, the interval for lesion recurrence was significantly shorter in the needle-free injector group(11.8 days, 95%CI:10.96-12.6 days)than in the ordinary injector group(21.2 days, 95%CI:13.96-28.45 days). Conclusion Compared with the ordinary injector, the needle-free injector shows better efficiency for the treatment of keloid with decreased difficulty in injection and improved compliance in patients.