Objective To evaluate the molecular mechanism of 11 beta-hydroxysteroid dehydrogenase type 1 (11 β-HSD1)in tumor necrosis factor-α (TNF-α) induced insulin resistance.Methods The optimal concentration and incubation time of TNF-α for treating HepG2 cells were selected.Real-time polymerase chain reaction(PCR)and Western blot analysis were used to explore the effect of TNFα on the mRNA and protein expression levels of 11β-HSD1,glucocorticoid receptor (GR),phosphoenolpyruvate carboxylase(PEPCK)and glucose 6-phosphatase(G6Pase).Glucose(GO) Assay Kit was used to determine the level of gluconeogenesis.Liver/Muscle glycogen assay kit,PAS/Glycogen Stain kit were used to detect glycogen synthesis.The expression of AKT/GSK pathway was analyzed by Western blot analysis.In addition,HepG2 cells were pre-treated with BVT2733,a specific inhibitor of 11β-HSD1,before exposure to TNFα The expression of AKT/GSK pathway,the level of gluconeogenesis and glycogen synthesis were analyzed.Results The expression of 11β-HSD1 was increased along with the increasing concentration of TNF-α,showing a dose-dependent effect.When HepG2 cells treated with the optimal dose of TNF-α 10 μg/L for 24 hours,the levels of GR,gluconeogenesis and gluconeogenesis-related genes PEPCK and G6Pase were increased,while conversely,the levels of phosphorylation of AKT and GSK,and glycogen synthesis were decreased.However,all the above effects induced by TNF-α in HepG2 cells were greatly reversed by BVT2733 pre treatment.Conclusions 11 β-HSD1 participates in TNF-α-induced insulin resistance in HepG2 cells,and BVT2733 could significantly improve insulin sensitivity.

Objective: To explore the relationship between dietary patterns and non-alcoholic fatty liver disease(NAFLD) among college freshmen of Hangzhou area, and provide scientific evidence for the prevention of NAFLD in universities. Methods: The 1 752 freshmen students from six universities were selected to perform a questionnaire survey, including general information, and dietary survey in the last year, by using a random sampling method. Factor analysis was used to achieve the major dietary patterns. Results: Three dietary patterns were obtained from the analysis, including the animal food, Western fast food, and traditional Chinese patterns. After adjusting for confounding factors, participants in the highest tertile of the animal food and Western fast food pattern had significantly higher BMI (P<0.01). Besides, participants in the highest tertile of the Western fast-food pattern had higher ALT and AST than those in the lowest tertile(P<0.05). Conversely, participants in the highest tertile of the traditional Chinese pattern had lower BMI, ALT and AST than those in the lowest tertile(P<0.05). Logistic regression analysis showed that Western pattern might increase the risk of NAFLD (OR=1.26, 95%CI=1.09-1.72, P<0.05), whereas the traditional Chinese pattern might decrease the risk of NAFLD (OR=0.51, 95%CI=0.38-0.74, P<0.05). Conclusion Different dietary patterns are closely related to NAFLD in college freshmen. Chinese traditional food should be kept their diet, red meat and fried food should be reduced to decrease. the risk of NAFLD.

Objective To explore the clinical effect of surgery-first approach (SFA) for correcting adult skeletal class Ⅲ malocclusion deformity patients.Methods A total of 28 adult patients diagnosed with skeletal class Ⅲ malocclusion were treated.Bilateral sagittal split ramus osteotomy (BSSRO) and geniplasty were performed without presurgical orthodontics treatment;postoperative orthodontics treatment was carried out after a healing period of 2-4 weeks.Lateral cephalometric radiographs were taken preoperatively (T1),within a week posoperatively (T2) and six months posoperatively (T3);cephalometric measurements were carried out by the software.Results All the patients were satisfied with the effect,no complications occured.The mean postoperative orthodontics treatment duration was 13.2 months.The mean setback of mandible at Po and B point was (7.74 ± 3.93) mm (P＜0.01) and (8.13±3.84) mm (P＜0.01),and superior movement lengths were (2.73±1.83) mm and (2.76±1.67) mm,respectively.Compared to T2,Po and B point moved forwardly with (2.36±1.23) mm and (2.66±1.65) mm,and inferior movment were (2.16±1.37) mm and (1.21±0.87) mm,respectively.The mean decrease of SNB and GA was (3.74± 1.61)° (P＜ 0.01),(3.41± 1.87)° (P＜0.01),respectively.During postoperative period,both of them increased,although these were no statistical differences.Conclusions SFA combined postoperative orthodontics therapy is feasible for the correction of adult skeletal class Ⅲ malocclusion,which has shorter treatment duration than traditional joint orthognathic-orthodontic.With the advantages of earlier improvements in patient's facial aesthetics and dental function,the reduction in difficulty and treatment duration of orthodontic management,and increasing patient acceptance.

Objective To investigate the effect of hyperbaric-oxygen therapy on osteoprotegerin (OPG) and integrin β1 (Itgβ1 ) expression during mandibular distraction osteogenesis .Methods Forty New-Zealand rabbits were used .The animals were randomly divided into two groups (experimental group and control group) with 20 animals each ;after accomplished osteotomy and implant distraction devices on mandible bilaterally for 3 days of latency period ,the device was activated at the rate of 0 .8 mm per day for 10 days .All animals in the experimental group were subjected to hyperbaric oxy -gen for 90 minutes once a day since the beginning of distraction ,and lasted for four weeks .In control group ,all the distractors were activated following the same distraction protocol as the experimental group ,but without hyperbaric oxygen therapy .Five animals of each group were sacrificed at 10th day after distraction ,7th ,14th and 28th day of consolidation , respectively .The lengthened mandibles were harvested and processed for immunohistochemical examinations to detect OPG and Itg β1 expres-sion in the distraction gap .Semi-quantitative analysis was carried out by image analysis software . Results OPG staining was mainly located in the membrane and cytoplasm of osteoprogenitor cells and osteoblasts in the distraction zones .The expression of OPG increased after distraction accomplished and reached to the peak at 7th day of consolidation ,and then decreased gradually .At every time point , the level of expression of OPG in the experimental group was remarkably higher than those in control group .There were significant differences between the experimental group and control group ( P <0 .01) .Itgβ1 mainly located in actively proliferating osteoblasts ,fibroblasts and mesenchymal cells . The expression of Itgβ1 decreased significantly after reached to the peak at the 10th day distraction .At 10th day distraction ,7th and 14th day of consolidation ,Itgβ1 expressed more strongly than that in the experimental group ,which was remarkably higher than those in control group .There were significant differences between experimental group and control group (P < 0 .05) .At 28th day of consolidation , Itgβ1 expressed weakly ; there was no significant difference between the two groups ( P > 0 .05 ) . Conclusions Hyperbaric oxygen therapy can up-regulate the expression of OPG and Itgβ1 in the dis-traction gap ,which may promote osteoblast differentiation ,proliferation ,enhance osteoblast func-tion ,and new bone formation in distraction gap .

Objective:To seek a minimally invasive method for costal cartilage harvest by using two different costal cartilage harvest techniques in rhinoplasty and to compare their influence on donor site pain.Methods:Fourty-three female patients who underwent costal cartilage harvest for rhinoplasty from Dec. 2016 to Dec. 2017 were randomly divided into two groups. We harvested the right side seventh costal cartilage in both groups. In control group, we harvested a full thickness segment of costal cartilage in each patient, whereas we harvested a split thickness segment of costal cartilage by preserving the superior strip in experimental group. Donor site pain was evaluated via visual analogue scale (VAS) 6 h, 24 h, 48 h and 72 h after surgery.Results:The VAS scores (mean±standard deviation) at different time points in the control group were (5.515±1.085), (5.250±1.302), (5.315±1.117) and (4.895±1.042). And in the experimental group, they were (2.665±0.713), (2.261±0.642), (1.609±0.398) and (1.383±0.514), respectively. The VAS scores at different time points were significantly higher in the control group than that in the experimental group ( P<0.05). Conclusions:The superior strip preserved costal cartilage harvest technique significantly reduces postoperative donor site pain.

Objective To investigate the expression of Wnt/β-catenin signal antagonist DKK1 protein in callus of distraction gap during mandibular distraction osteogenesis (MDO).Methods Twenty four healthy New Zealand rabbits were randomly divided into distraction group,fracture control group,with twelve rabbits each,respectively.In distraction group,bilateral mandibular distraction models were established.In control group,after bilateral mandibular osteotomy,the two bone fragments were fixed by titanium plate and screws with a 5 mm gap.The expression of DKK1 in the distracted calluses was analyzed by cell digital imaging software.Results Expression of DKK1 was colocalized in the nucleus and cytoplasm of osteoblasts,fibroblasts,cartilageand newly embedded osteocytes.The expression of DKK1 increased following distraction activated after surgery,peaked at 10 days after surgery,the population of cells that stained for DKK1 decreased gradually.At 31 to 38 days postoperatively,DKK1 expression reduced gradually,mainly located in the osteocyte,and both nucleus and cytoplasm were positive staining.At each time point,the expression of DKK1 in distraction group was higher than that in the control group and the difference was statistically significant (P＜0.05).Conclusions During MDO,the Wnt/β-catenin pathway is activated due to the distraction and mechanical strain on the bone.With the increased expression of Wnt-related factors,the endogenous negative feedback is enhanced to induce DKK1 expression and to regulate the activated Wnt/β-catenin pathway.This would be beneficial to the new bone formation and remodeling in the distraction gap.

OBJECTIVE To establish the method for simultaneous determination of 11 components as narirutin in Biantong capsules，to conduct chemical pattern recognition analysis and to screen differential markers affecting their quality . METHODS HPLC method was adopted . The separation was carried out on Venusil XBP C 18 column with mobile phase consisted of acetonitrile - 0.1％ phosphoric acid solution with gradient elution at flow rate of 1.0 mL/min. The sample size was 10 µL，and column temperature was set at 30 ℃. The detection wavelengths were set at 283，330，520，220 nm，respectively. Using verbascoside as an internal standard ，the contents were determined by quantitative analysis of mult -components by single marker （QAMS），and the results were compared with those of external standard method . Cluster analysis ，principle component analysis and orthogonal partial least squares -discriminant analysis were performed with SPSS 26.0 and SIMCA 14.1 software. The differential markers affecting the quality of Biantong capsules were screened using the variable importance in projection （VIP）value greater than 1 as the standard . RESULTS The contents of narirutin ，naringin，neohesperidin，echinacoside，tubuloside A ，isoacteoside，cyanidin-3-O-glucoside， cyanidin-3-O-rutoside，atractylolide Ⅲand atractylolide Ⅰ were 0.739-1.265，1.134-2.158，1.407-2.359，1.368-2.502，0.304-0.522， 0.257-0.521，0.423-0.727，0.375-0.733，0.130-0.283 and 0.062-0.166 mg/g，respectively. The relative average deviation of them from the external standard method was less than 2％. The results of cluster analysis showed that 15 batches of samples could be grouped into three categories ，S1-S7 as a category ，S8-S10 as a category ，and S 11-S15 as a category ，which was consistent with the classification results of principal component analysis . The results of orthogonal partial least squares -discriminant analysis showed that the VIP values of cyanidin -3-O-rutoside，atractylolide Ⅲ， naringin，neohesperidin，echinacoside and verbascoside were all greater than 1. CONCLUSIONS The method for simultaneous determination of 11 components in Biantongcapsules， including narirutin ， is successfully established . Combined with chemical pattern recognition analysis ，it can be used for the quality control of Biantong capsules . Six components such as cyanidin -3-O-rutoside may be the differential markers that affect the quality of Biantong capsules .

Objective:To investigate the clinical effect of W-shaped genioplasty in the correction of broad and short chin deformity.Methods:Thirty-eight patients (5 males, 33 females, aged 20 to 41 years, mean 27.3 years) complained with broad and short chin were admitted to the Affiliated Friendship Plastic Surgery Hospitalof Nanjing Medical University from January 2019 to December 2021. CBCT scan and three-dimensional reconstruction were performed to design osteotomy line and determine the distance of chin lengthening, narrowing and advancing or retrocession preoperatively. Under general anesthesia, the W-shaped osteotomy was performed using an intraoral incision, and the angle between the bilateral free bone fragments, the distance of downward and forward movement were adjusted to change the curvature, width, length and prominence of the lower edge of the chin according to the preoperative designs. The results were evaluated by clinical appearances and image analyses at a follow-up of 3-24 months.Results:The amount of vertical lengthening of the chin in 38 cases were 2 mm to 5 mm, with an average of 3.02 mm. The horizontal narrowing width distances were 3-7 mm, with an average of 5.6 mm. The patients were followed up for 3-24 months, with an average of 10.6 months. There were no complications such as hematoma, wound dehiscence, accidental fracture, surgical area infection and permanent neurosensory disorder. 38 patients had transient sensory loss in the lower lip region of varying degrees, but all recovered spontaneously during routine follow-up period. All patients were satisfied with the improvement of facial contour.Conclusions:W-shaped geinoplasty preserves the central bone of the chin and the attachment of genioglossus muscle, which does not affect the normal anatomy and physiological function of the oral cavity. After osteotomy, the bone is removed and the bilateral bone fragments move flexibly. It can effectively change the radian, width, length and protrusion of the lower edge of the chin in three dimensions, so as to correct the wide and short deformity of the chin.

Objective:To investigate the effect of mandibular angle osteotomy on the morphological changes of mandible by using cone beam computed tomography (CBCT) scanning data and three-dimensional cephalometry.Methods:According to included and excluded criteria, the complete CBCT data of 20 female patients (aged 20-35 years with an average age of 25.5 years) from January 2016 to June 2018 who underwent curved mandibular angle osteotomy combined with splitting cortiectomy were selected. Seven items reflecting mandibular morphology before and after surgery were measured respectively. All the data were analyzed by the means of SPSS 12.0; linear correlation analysis and paired t test were used to evaluate the change of andibular morphology.Results:The measurement results of the mandible pre- and post-operative 10 days showed as follows: Go-Go decreased, both sides of Cd-Go, Go-Ri and MR-MA decreased, both sides of Go-Me became longer, both sides of Ar-Go-Me and MP-FH increased. The paired t-test results showed that there was significant difference before and after operation ( P<0.05), but there was no significant difference between the left and right measurement items ( P>0.05). Compared with that in 10 days after operation, the measurement items also changed 6 months after operation. There was no statistical difference between the above measurement items 6 months after surgery and 10 days after surgery ( P>0.05), and no statistical difference between the left and right sides ( P>0.05). Conclusions:The mandibular three-dimensional model which is reconstructed based on CBCT data, not only displays the three-dimensional anatomical structure that cannot be presented on X-ray film visually and comprehensively by means zoom, rotation and other operations, but also precisely and accurately shows the change of the shape of the mandible from the sagittal, coronal and horizontal plane with arbitrary cutting and rotation. The measurement of mandible is more accurate and reliable, and the surgical plan of mandibular angle osteotomy can be accurately planned preoperatively, and the operative effect can be quantitatively evaluated postoperatively.

Objective:To investigate the effect of eyebrow arch augmentation with personalized polyether ether ketone (PEEK) implant assisted by endoscope.Methods:From January 2019 to August 2021, 9 patients with low and flat eyebrow arch requiring eyebrow arch augmentation were treated in the plastic surgery department of the Friendship Plastic Surgery Hospital Affiliated to Nanjing Medical University. The cranial and maxillofacial CT scanning data were obtained before operation, the eyebrow arch elevation range and height were designed according to the patient's requirements, and personalized peek implants were manufactured. During the operation, a small temporal hairline incision was used to accurately separate the implantation cavity of individualized peek implants under the periosteum of the eyebrow arch implantation area with the aid of endoscope. Personalized PEEK implants were implanted under endoscope to make them fully fit with the eyebrow arch bone and fixed with titanium nails. Photos were taken and analyzed before and after operation.Results:All patients were followed up for 3 months to 2 years. Their facial expressions were normal, and there were no motor nerve injury, rejection and iatrogenic infection. The patients were satisfied with the postoperative effect. Compared with before operation, the low level of orbital bone in eyebrow area was improved, and the facial contour was three-dimensional and harmonious.Conclusions:The eyebrow arch augmentation with individualized peek implant assisted by endoscope is safe and effective. It can greatly reshape the upper contour of the face, deepen the upper eyelid fossa and improve the convex eye phenomenon, so as to achieve the cosmetic effect of enhancing the three-dimensional sense of the eyebrow orbital area, which is worthy of clinical application.