BACKGROUND:Sagittal split ramus osteotomy is one of the most popular surgical procedures for correcting various mandibular deformities. There have been numerous modifications to this technique on the basis of clinical experiences and observation, but relevant anatomical data are very limited. A lot of anatomic studies on the mandible have been performed during the recent 20 years. OBJECTIVE:To entirely understanding the morphology of the mandibular ramus in the sagittal split ramus osteotomy and to explore the research progress in the sagittal split ramus osteotomy. METHODS:An electronic search of CMB and Medline was performed for relevant reviews and papers published from 1991 to 2011. Progress in the sagittal split ramus osteotomy was also analyzed. RESULTS AND CONCLUSION:Total y 26 articles related to the sagittal split ramus osteotomy were enrol ed. The keys to avoiding complications due to the sagittal split ramus osteotomy are as fol ows:distribution of cancel ous bone in the mandibular uvula area, distribution of cancel ous bone between the mandibular canal and buccal cortical bone during splitting progress, as wel as location and trend of the mandibular canal. Pre-operative CT test contributes to a successful sagittal split ramus osteotomy and a reduction in complications, and the anatomical measurement can be applied clinical y to a greater extent.

The main pathogenesis of Sjogren's syndrome was Yin Deficiency, dryness caused by blood stasis,dryness caused by dry poisoning, dryness caused by dampness, Qi deficiency, and incoordination of spleen and stomach,which led to damage of body fluid or transport barrier. Usually such factors were mutually intercross and interact, existing in the whole process of the disease. This is the important factor for a long course and intractable disease.

Objective:To investigate the impact of butylphthalide on homocysteine, CRP and nerve function in the patients with a-cute progressive cerebral infarction. Methods:Totally 122 cases of patients with acute cerebral infarction were randomly divided into the observation group (n=60) and the control group (n=62). The control group was treated with the routine treatment, and the ob-servation group was treated with butylphthalide additionally. The treatment course was two weeks. The total effective rate, blood Hcy, the level of plasma CRP and the changes of neurological function deficits scale in both groups before and after the treatment were ob-served and compared. Results:The overall response rate in the observation group (81. 67%) was significantly higher than that in the control group (64. 52%). After the treatment, the blood Hcy and CRP in both groups were significantly lower than that before the treatment(P<0. 05), and that of the observation group was significantly lower than that of the control group(P<0. 05). The neuro-logical function deficits scale in both groups were significantly lower than that before the treatment(P<0. 05), and that of the observa-tion group was significantly lower than that of the control group at the same period. The two groups during the treatment showed no sig-nificant adverse reactions. Conclusion: The effect of butylphthalide in the patients with acute cerebral infarction is effective, which can reduce blood Hcy, the level of plasma CRP and the neurological function deficits scale, and improve the neurological function with-out obvious adverse reactions during the treatment course.

Objective To investigate the value of T cell subsets predicting stroke-associated infection (SAI) in patients with acute ischemic stroke.Methods The consecutive patients with acute ischemic stroke within 36 hours after symptom onset were included.The peripheral venous blood samples were collected the next morning after admission.A flow cytometry was used to detect T cell subsets.The patients were divided into either an infected group or a non-infected group according to whether they had infection or not in hospital within 2 weeks.The information of the risk factors for ischemic stroke was collected,and the relationship between SAI and related risk factors was analyzed.Results A total of 55 patients with acute ischemic stroke were included,28 of them were in the infected group and 27 were in the non-infected group.The percentages of CD3 +T cells (63.42 ± 8.84％ vs.69.55 ± 10.05％ ; P =0.022) and CD4+ T cells (35.34 ± 7.10％ vs,40.46 ±7.24％; P =0.014),and CD4+/CD8+ ratio (1.23 ±0.38 vs.1.55 ±0.56; P =0.023) in the infected group were significantly lower than those in the non-infected group.The multiple regression analysis showed that the higher NIHSS score (odds ratio [ OR] 1.295,95％ confidence interval [ CI] 1.084 - 1.574; P =0.004) and t he decreased percent age of CD4+ T cells (OR 0.874,95 ％ CI 0.784 - 0.974,P =0.015) were the independent predicting factors for SA1.The percentage of CD4+ T cells ＜ 70.35％ had the best predictive value for the occurrence of SAI (sensitivity 77.8％ and specificity 92.3％).Conclusions The decreased proportion of the auxiliary T cells after the onset of acute ischemic stroke may increase the susceptibility of SAI.The detection of T cell subsets may predict the SAI in a certain degree.

Objective To explore the impact of season and latitude on multiple sclerosis by study the onset/relapse season and latitude distribution in multiple sclerosis (MS) patients.Methods A total of 264 MS patients , with 88 males and 176 females, who were hospitalized in Beijing Tiantan Hospital from January 2002 to December 2012, were enrolled in the study and all the clinical data were retrospectively analyzed.The mean age was (33.9 ± 12.3) years old, with the disease duration of (6.3 ±4.5) years and 453 cases of relapse.The recurrence of MS was collected by four seasons, with March to May defined as spring, June to August as summer, September to November as autumn and December to February as winter.MS patients lived in Beijing (39.39° N-41.07° N) were chosen to test the correlation between the incidence/recurrence and monthly mean temperature, sunlight exposure intensity and duration.All the patients were divided into the high latitude group and the low latitude group, taken the latitude median (40.22° N) of Beijing area as the boundary.Gender composition, age of onset, disease duration and recurrence rate were compared between the two groups.Results Most of the onset/ relapse of MS were observed in winter (134 cases), while summer (97 cases) took the least.In the same latitude region (Beijing area), the onset/ relapse of MS was negatively correlated to the mean temperature and sunlight exposure intensity (r =-0.699, P =0.006;r =-0.623, P =0.015).Recurrence was higher in the high latitude group than in the low latitude group [68.7％ (123/179) vs 63.0％ (51/81), P =0.000], while no significant difference was found in gender composition, age of onset and disease duration between the two groups.Conclusion The onset/recurrence of MS has obvious seasonal characteristics.The onset/recurrence of MS is correlated with latitude, temperature and sunlight exposure intensity of the habitation of MS patients.Environmental factors are important cause of the onset/recurrence of MS, with sunshine exposure as the most key factor.

OBJECTIVE:To discuss the role of hospital pharmacists in the clinical drug trial.METHODS:The role of hospital pharmacists in publicizing and training of Good Clinical Practice(GCP),in the formulation of each standard operating instruction and in each stage of clinical drug trial was analyzed.RESULTS&CONCLUSION:Hospital pharmacists played a key role in clinical drug trial.They can get to know the basic research methodology from participating in the clinical drug trial,meanwhile their consciousness on scientific research can be strengthened.

Objective: To study the effect of interleukin 1(IL 1?) on the metabolism of osteoarthritic and normal mature condylar chondrocytes in temporomandibular joints, and investigate the role of IL 1? in the pathogenesis of temporomandibular joint osteoarthritis. Methods: The primary generation of osteoarthritic and normal condylar chondrocytes cultured in the monolayer condition was treated with 20 ?g?L -1 recombined human interleukin 1? (rhIL 1?), and then collected to be detected with RT PCR method for the cellular metabolism including mRNA expression of type Ⅱ collagen, aggrecan, collagenase, insulin like growth factor 1 (IGF 1), and transforming growth factor?1(TGF?1). Results: The normal mature condylar chondrocytes showed the obviously decreased mRNA expression of type Ⅱ collagen and aggrecan after the intervention of exogenous IL 1?, but less influence could be found for the collagenase expression. The osteoarthritic condylar chondrocytes exhibited the decreased mRNA expression of type Ⅱ collagen and collagenase under the effect of IL 1?, while the cellular mRNA expression of aggrecan didn’t change obviously. The intervention of exogenous IL 1? didn't show an obvious influence on the cellular expression of endogenous growth factors such as IGF 1 or TGF ?1 for both the normal and osteoarthritic condylar chondrocytes cultured in vitro. Conclusion: IL 1? could not only disturb the expression of cartilage matrix molecules by the normal condylar chondrocytes, which lead to the lesion of condylar cartilage, but also worsen the abnormal cartilage matrix environment within the osteoarthritic condylar cartilage.

In the course of follow-up analyses of visual field test,it should take more than two visual field tests that had similar results as baseline test,and some factors should be taken into account,such as accordant testing conditions,reliable indeces,test errors and fluctuation effects,and so on.The indeces of Mean Deviation(MD)and Pattern Standard Deviation(PSD)could reflect the whole change trend of follow-up visual field test,while sensitivity value of every point and their pattern deviations could help to analyse tiny changes of visual field tests.Those statistic softwares provided by automatic perimetry should be used adequately.Through the follow-up analyses of visual field test,glaucoma doctors could adjust therapy schemes in time in order to obtain objective intraocular pressure and stabilize visual field and glaucoma.

Objective To compare the differences of cognitive dysfunction and hippocampal atrophy among patients with temporal lobe epilepsy (TLE) and healthy controls and probe into the relativity of cognitive dysfunction with hippocampal atrophy after temporal lobe epilepsy. Methods Forty-nine TLE cases and 20 healthy individuals were randomly selected. The WAMS-R and WAIS-R scales were adopted to assess the memory and intelligence of all the subjects. Hippocampal volumes were measured by semiautomatic measurement on the head magnetic resonance imaging (MRI). The degree of hippocampal atrophy (DHA) and asymmetry index (AsI) were caculated by adjusting hippocampal volumes and ratio of difference of two lateral hippocampal volumes. Results Compared with the healthy controls, not only did the TLE patients exhibit more memory deficits (83.2±21.0,t=-3.365 ,P=0.001 ), but also more fullscale intelligence (91.0±12.3, t=- 4.291, P=0.000). The bilateral hippocampi of all TLE patients significantly decreased in volume ( P=0.000 ) and increased in AsI ( t=3.975, P=0.000 ). The MQ of TLE patients was significantly negatively related to the duration of the illness ( r=-0.339, P=0.017 ). The bilateral DHA and the hippocampal AsI were negatively related to Z scores (left: r=-0.297, P= 0.038, right: r=-0.305, P=0.033, AsI: r=-0.441, P=0.002), repectively. Conclusions The more the DHA and asymmetry of bilateral hippocampi, the worse the cognitive dysfunction. The quantitative measurements of hippocampal volume could be used as a clinically effective factor for evaluating the decrease of the intelligence of TLE patients.

Objective To construct an RNA interference vector to down-regulate X-linked inhibitor of apoptosis(XIAP)gene and study the RNA interference effect on the cell cycle and growth of ovarian cancer.Methods Oligonucleotides of 64 base pairs for hairpin RNA targeting XIAP were designed, chemically synthesized,annealed,and cloned into the pSUPER vector.After identification by restriction digestion,the correct vectors were transiently transfected into SKOV3 cells,a human ovarian cancer cell line.The XIAP mRNA was detected by RT-PCR.The proteins were detected by western blot and indirect immunofluorescence staining.Flow cytometry(FCM)analysis and methyl thiazolyl tetrazolium(MTT)assay method were applied to measure cell cycle,cell growth and sensitiveness to cisplatin.Results SKOV3 cells had a high level expression of XIAP.The vector of RNA interference,which can interfere with XIAP gene was successfully constructed.After transient transfection,the expression of XIAP protein was significantly decreased in SKOV3 cells and the value of relative density was 3584?124,2138?65,1973?80 and 110 ?12,respectively(P=0.0334).At the same time,the expression of XIAP mRNA was decreased accordingly and the value of relative density was 6674?274,4532?107,2322?57 and 1864?78, respectively(P=0.0127).The FCM results showed that,the vector could increase the number of cells in G_1 phase compared with parent cells and compared with the cells transfected with pSUPER(P