Objective:To study the technique of treatment of ma lo cclusion with congenital individual missing lower incisor . Method s: Ten cases of malocclusion(male 3, femal 7) with congenital missi ng lower incisor were selected. The casts and cephalograms of pretreatment and posttreatment were measured and analysed respectively. The malocclusions were corrected by changing the position of jaws and teeth. Stripping, extraction and so on were applied in the treatment for the achievement of normal overjet and ov erbite according to the Bolton index. Results: Intercusp al bite, normal overjet and overbite were achieved in the ten cases. The majorit y of lower anterior teeth were anteversion. The width between lower canines decr eased. Conclusion: Satisfactory occlusion can be achieve d by orthodontic treatment in the patients of malocclusion with congenital indiv idual lower incisor missing.

33 cases of pain due to neural - root type cervical spondylosis were treated by Bitongxiao. with another 31 cases treated by Jingfukang granule as control. The pain scores in both groups before and after the treatment were markedly decreased (all P

Objective To investigate the value of percutaneous transhepatic cholangiobiopsy (PTCB) in the diagnosis of obstructive jaundice.Methods The clinical data of 826 patients with obstructive jaundice who received PTCB at the First Affiliated Hospital of Zhengzhou University from April 2001 to December 2011 were retrospectively analyzed.The pathological results,positive rates of PTCB and complications were analyzed.The safety and efficacy of PTCB and the pathological features of malignancy causing obstructive jaundice were summarized.The difference in the positive rates of PTCB for biliary and non-biliary malignancies was analyzed by chi-square test.Results A total of 826 patients received PTCB,and the success rate was 100％.Eighty-six patients had complications postoperatively,including transit bilhaemia in 47 patients,bile leakage in 11 patients,temporary biliary hemorrhage in 28 patients,no severe complications occurred.There were 740 patients were with malignant biliary stricture and 86 with benign biliary stricture.Seven Hundred and twenty-seven patients were with positive results of PTCB (641 were with cancerous stricture and 86 with inflammation of biliary tract or fibrogenesis),and 99 patients were with false negative results.The overall positive rate of PTCB was 88.01％ (727/826).Malignant neoplasm accounted for 89.59％ (740/826) of the factors causing obstructive jaundice,and well-,moderate-and poor-differentiated neoplasms were accounted for 57.88％ (371/641),19.97％ (128/641) and 22.15％ (142/641).Biliary adenocarcinoma was the main pathologic type,which was accounted for 96.41％ (618/641).The positive rates of PTCB for biliary and non-biliary neoplasms were 89.50％ (469/524)and 79.63％ (172/216),with significant difference (x2 =12.87,P ＜ 0.05).Conclusions PTCB is a safe,feasible and easy way to diagnose obstructive jaundice.Biliary neoplasms are the best indications for PTCB.Well differentiated neoplasm is the main pathological type causing the obstructive jaundice.

Objective To evaluate laparoscopic splenectomy through amputation of secondary splenic pedicles.Methods From February 2010 to March 2016 33 patients underwent laparoscopic splenectomy.Patients were followed up by outpatient examination and telephone interview.Follow-up period ended in April 2016.Results All the 33 patients successfully underwent laparoscopic amputation of secondary splenic pedicle splenectomy.The operation time and volume of intraoperative blood loss were (155 ± 42) min and (210 ± 50) ml.Three patients had postoperative complications including two with ascites sand one with small amount splenic fossa bleeding.All the patients were followed up for a median time of 21 months (range,1-65 months).During the follow-up,1 patient died of hepatic encephalopathy and 32 patients were doing well.Conclusion Laparoscopic amputation of secondary splenic pedicle splenectomy is safe and feasible.

Objective To investigate the clinical efficacy of precise liver resection of liver tumors adjacent to the main pipeline.Methods The retrospective and descriptive study was conducted.The clinical data of 22 patients who underwent precise resection of liver tumors adjacent to the main pipeline in the Affiliated Tumor Hospital of Zhengzhou University between December 2014 and June 2016 were collected.According to preoperative precise evaluation and fully intraoperative exposed tumors,different methods of blood flow occlusion were choosed timely,and then precise resection of the liver was evaluated based on tumor location and size,relationship between tumor and blood vessels and the degree of liver cirrhosis.The operation procedures,operation time,time of liver resection,volume of intraoperative blood loss,number of patients with perioperative blood transfusion,postoperative complications,duration of postoperative hospital stay and follow-up were observed.The follow-up was performed by outpatient examination and telephone interview up to September 2016.Tumor recurrence of patients with hepatocellular carcinoma (HCC) was monthly detected by alpha-fetoprotein retest and color Doppler ultrasound of the liver or computed tomography (CT) within 3 months postoperatively.Tumor recurrence of patients with cholangiocarcinoma was monthly detected by tumor marker retests,color Doppler ultrasound of the liver or CT,and then patients without tumor recurrence received reexamination once every 2 months after 3 months.Patients with liver hemangioma were followed up once every 2-3 months and once every 6 months after half a year,and follow-up included the liver function,ultrasound and other imaging examinations to detect the tumor recurrence.Measurement data with normal distribution were represented as-x±s.Results All the 22 patients underwent successful precise resection of liver tumors.Twenty patients received intraoperative ultrasound localization.Blood flow occlusion of 22 patients:Pringle was conducted in 6 patients,treatment of the corresponding hepatic pedicle in 3 patients,selective hepatic blood flow occlusion in 8 patients,total hepatic blood flow occlusion in 2 patients and non-hepatic portal occlusion in 3 patients.Precise resection of the liver of 22 patients:1 patient underwent right trisegrnentectomy,2 underwent left hepatectomy,2 underwent segment Ⅳ a resection of the liver,2 underwent segment Ⅳ resection of the liver,3 underwent segment Ⅴ resection of the liver,3 underwent segment Ⅷ resection of the liver,1 underwent middle lobe resection of the liver and 8 underwent partial resection of the liver.Operation time,time of liver resection,volume of intraoperative blood loss and number of patients with perioperative blood transfusion were (213±39) minutes,(57± 19) minutes,(518± 98) mL and 3,respectively.Of 22 patients,5 with postoperative complications were improved after symptomatic treatment,including 2 with effusion at surgical site,2 with right pleural effusion and 1 with bile leakage.The duration of postoperative hospital stay of 22 patients was (8.9± 1.6)days.Twenty-one patients were followed up for 3-20 months,with a median time of 12 months.Two of 22 patients had recurrence during the follow-up,and no recurrence at surgical site was detected.Conclusion Precise resection of liver tumors adjacent to the first and second hepatic hilum is safe and feasible,with the advantages of less intraoperative bleeding and low incidence of postoperative complications.

Aim To determine the function of nuclear factor-κB ( NF-κB ) in immunological liver injury of rat model and its effect on CYP2E1 expression, content and metabolic activity. Methods The immunological liver injury rat model was prepared by injection of Ba-cillus Calmette Guérin ( BCG,125 mg · kg-1 ) for 14 days. The hepatic tissue injury was revealed by hema-toxylin and eosin ( HE ) method and serum concentra-tion of alanine aminotransferase( ALT) , aspartate ami-notransferase ( AST ) respectively. CYP450 total con-tent in hepatic homogenate was determined by spectro-photography. The expression of CYP2E1 protein was detected by Western blot analysis. The enzyme kinetics of CYP2 E1 probe drug chlorzoxazone was evaluated by high-performance liquid chromatography ( HPLC ) as-say. Results The results showed that BCG-pretreat-ment ( 125 mg · kg-1 ) significantly increased the weight of liver and spleen, serum levels of ALT and AST(P<0. 01) , and decreased CYP2E1 expression, content and metabolic activity ( P <0. 05 ) . Adminis-tration of ammonium pyrrolidine dithiocarbamate (PDTC) (50, 100, 200 mg·kg-1) reversed the a-bove hepatic injury stimulated by BCG in vivo. Moreo-ver, PDTC dose-dependently inhibited the down regu-lation of CYP2 E1 ( P<0. 05 ) . Conclusion Passiva-tion of NF-κB can inhibit the down regulation of CYP2 E1 in liver tissue of immunological liver injury rats;NF-κB may be involved in CYP2 E1 down-regula-tion.

Objective To investigate the regulatory effects of miR-145 on the proliferation,cell cycle and apoptosis of a human keratinocyte cell line HaCaT.Methods miR-145 mimics and negative control (NC) mimics were chemically synthesized and then transiently transfected into HaCaT cells respectively.After additional culture for different durations,real-time PCR was performed to determine the expression level of miR-145,MTS assay to estimate cell proliferation,and flow cytometry to detect cell apoptosis and cycle.Luciferase assay,real-time PCR and Western blot were conducted to determine whether NRAS was the target gene of miR-145.Results The miR-145 expression level in miR-145 mimic-transfected cells increased by 85.00 ± 1.21 folds compared with NC mimic-transfected cells (t =115.90,P ＜ 0.0001).The transfection with miR-145 mimics significantly inhibited the proliferation of HaCaT cells (F =8.76,P =0.008),and the inhibitory effect significantly varied with the duration (24-96 hours) of culture after transfection,with no interaction effect between the transfection with miR-145 mimics and culture duation (F =1.21,P =0.18).Compared with NC mimic-transfected cells,those transfected with miR-145 mimics showed a significant increase in the proportion of early apoptotic cells (18.9％ ± 4.1％ vs.4.3％ ± 1.2％,t =7.126,P ＜ 0.01),late apoptotic cells (9.3％ ± 2.3％ vs.3.6％ ± 1.6％,t =12.38,P ＜ 0.01),G1-phase cells (85.83％ ± 5.2％ vs.62.08％ ± 6.23％,t =11.78,P =0.007),but a significant decrease in the percentage of G2-phase cells (6.26％ ± 1.2％ vs.19.36％ ± 3.45％,t =7.610,P =0.017) and S-phase cells (7.91％ ± 1.3％ vs.18.56％ ± 5.23％,t =7.230,P=0.019).As luciferase assay showed,luciferase activity was significantly lower in HaCaT cells cotransfected with miR-145 mimics and a recombinant luciferase reporter vector psi-CHECK2-NRAS-wild carrying the wild-type 3'UTR of NRAS than in those cotransfected with NC mimics and the vector psi-CHECK2-NRAS-wild (t =11.09,P =0.008),but similar between cells cotransfected with miR-145 mimics and a recombinant luciferase reporter vector psi-CHECK2-NRAS-mut carrying the mutant-type 3'UTR of NRAS and those cotransfected with NC mimics and the vector psi-CHECK2-NRAS-mut (P ＞ 0.05).Real-time PCR and Western blot revealed that the overexpression of miR-145 mimics had no significant effect on NRAS mRNA expression (P ＞ 0.05),but significantly inhibited NRAS protein expression (1.52 ± 0.07 vs.0.20 ± 0.02,t =28.43,P＜ 0.01).Conclusion miR-145 might inhibit proliferation and promote apoptosis of HaCaT cells by influencing cell cycle via NRAS.

Objective To investigate the effect of miR-10b on migration and invasion of human hepatocellular carcinoma (HCC) cell lines.Methods Transwell assay was used to evaluate the motility and invasiveness in different HCC cell lines,qRT-PCR was then used to detect the expression levels of miR-10b in different HCC cell lines.Artificial mimics of miR-10b were transiently transfected into HepG2 cells,which have low expression of miR-10b,and then the changes in migration and invasion were evaluated by Transwell assay.Antagomirs of miR-10b (miR-10b-AS) were transiently transfected into MHCC97H cells,which have high expression of miR-10b,and then the changes in migration and invasion were evaluated as well.Cell morphology changes were detected by immunofluorescence and electron microscopy,Results There was a significant correlation of miR-10b expression level with cell motility and invasiveness.Low-level expression of miR-10b was observed in HepG2 cells,which exhibited weak motility and invasiveness; whereas high-level expression of miR-10b was observed in MHCC97H cells,which exhibited strong motility and invasiveness.Up-regulation of miR-10b expression in HepG2 cells increased cell motility and invasiveness,whereas inhibition of miR-10b reduced cell motility and invasiveness in MHCC97H cells.Immunofluorescence and electron microscopy results showed that up-regulation of miR-10b in HepG2 cells significantly increased proliferation of filopodia and lamellipodia,whereas inhibition of miR-10b decreased filopodia and lamellipodia amount in MHCC97H cells.Conclusion miR-10b is involved in the invasion and metastasis of HCC cell through regulation of cytoskeleton in vitro and inhibition of miR-10b is likely to be a new molecular target to block metastasis.

Sorafenib is the only molecular targeted drug therapy for advanced liver cancer recommended by the European Association for the study of liver diseases (EASL), American Association for the study of liver diseases (AASLD) and the United States Food and Drug Administration (FDA). As a multi kinase inhibitors, sorafenib can inhibit multiple signal transduction pathways of tumor cell proliferation and angiogenesis and obviously prolong the late stage of disease progression time and overall survival in patients with hepatocellular carcinoma (HCC). Criteria for evaluation of the efficacy of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC) is increasingly perfect. The author gives a brief overview of the molecular mechanism, efficacy and safety and efficacy evaluation criteria of sorafenib in the treatment of advanced liver cancer.

Objective To study the expression of Notch3 in pancreatic ductal adenocarcinoma (PDAC) and to find out its relationship with clinical features and overall survival in patients with pancreatic ductal adenocarcinoma.Methods PDAC and adjacent non-cancerous tissues from 80 patients who under went surgery for primary PDAC in the Affiliated Tumor Hospital of Zhengzhou University were collected between 2008 and 2015.The specimens were divided into two subgroups by immunohistochemical staining of Notch3:the low expression group (0-4 points) and the high expression group (5-12 points).Correlations between expression of Notch3 with clinical features and prognosis of patients with PDAC were analyzed.Results A high expression of Notch3 gene was significantly associated with tumor grade,metastasis,venous invasion and TNM staging.Univariate Cox regression analysis showed that metastasis,venous invasion,TNM stage and protein expression of Notch3 were strongly correlated with overall survival of patients.Multivariate analysis showed that metastasis,TNM stage and Notch3 were independent risk factors of overall survival in patients with PDAC.Kaplan-Meier survival curves indicated that a high expression of Notch3 was an important risk factor of poor survival.Conclusions A high expression of Notch3 was significantly associated with progression and poor prognosis of PDCA.Notch3 may serve as a new indicator of PDAC progression and patient survival outcomes.