Objective Both right and left ventricular function should be taken into account in the assessment of anthracycline (ATC)-induced cardiotoxicity.The aim of this study was to assess the subclinical dysfunction of right cardiac system in patients with newly diagnosed lymphoma who received ATC treatment by echocardiography.Methods A total of 74 patients with lymphoma who received ATC treatment were enrolled.Each patient underwent transthoracic echocardiographic examination before chemotherapy as well as after two,four and six cycles of ATC remedy.Right atrial (RA) and right ventricular (RV) end-diastolic area (EDA) and end-systolic area (ESA) were calculated.RV end-diastolic volume (EDV) and end-systolic volume (ESV),as well as RV ejection fraction (EF) were measured simultaneously.Tissue Doppler imaging (TDI) measurements of systolic and early or late diastolic myocardial velocities of RV free wall at tricuspid annuals were also analyzed.Two-dimensional speckle tracking echocardiography (2DSTE) was conducted to evaluate RV free wall strain along with strain rate.Results None of the echocardiographic parameters showed significant alteration after two and four cycles of chemotherapy compared with those at baseline (P＞0.05).At the end of the therapy (i.e.after six cycles of ATC treatment),there was still no statistical difference on TDI data aswell as 2DSTE measurements (P＞0.05).An unexpected finding was that the RAEDA((6.6±1.9) cm2 vs (7.7±2.4) cm2) and RAESA ((8.8±2.5) cm2 vs (10.8±2.8) cm2) revealed obvious dilatation after six cures of the regimen compared with those at baseline (P＜0.01).Similar morphologic characteristics displayed on the RVEDA ((14.1 ±3.4) cm2 vs (16.2±3.7) cm2) and RVESA ((7.9±1.9) cm2 vs (9.0±2.2) cm2) (P＜0.01)simultaneously.Furthermore,RVEDV ((29.8±10.5) ml vs (37.0±12.7) ml) and RVESV ((12.7±4.4) ml vs (15.0±5.2) ml),as well as RVEF ((59.4±5.8)％ vs (56.4±5.8)％),in patients with lymphoma presented statistically significant difference between basic state and the level after six cycles of chemotherapy (P＜0.01).Meanwhile,no marked change was detected on left ventricular ejection fraction(LVEF) throughout the follow-up period (P＞0.05).Conclusions Echocardiography can be used easily and noninvasively to assess right cardiac system subclinical dysfunction.ATC-induced cardiotoxicity of right cardiac system is firstly manifested as morphological changes than the measurements with novel echocardiographic techniques.In addition,RVEF expresses as a valuable parameter for assessing subtle RV impaired performance in patients with lymphoma received ATC therapy.

Objective To investigate the value of echocardiographic Tei index combined with serum high-sensitivity cardiac troponin T(hs-cTnT) on monitoring cardiac toxicity associated with anthracycline chemotherapy drug in patients with diffuse large B-cell lymphoma(DLBCL).Methods PW-Tei index,TDI-Tei index of left/right ventricles and radionuclide cardiac measurement were acquired from 56 patients with DLBCL before,after the completion of 2-4 cycle(100-200 mg/m2) and 6-8 cycle(300-400 mg/m2) of the regimen,part of them received serum hs-cTnT detection at the same time.Cardiac toxicity event was defined as a relative reduction of radionuclide left ventricular ejection fraction(LVEF) of ≥10％ during the regime or an absolute radionuclide LVEF≤50％ after the complete chemotherapy.Results Compared with baseline,left ventricular PW-Tei index significantly increased after whole cures [(0.36-± 0.12) vs (0.44 ±0.13) vs (0.40 ± 0.13),P =0.002].After complete regimen,serum hs-cTnT level elevated significantly [(0.006 ± 0.006)tg/L vs (0.012 ± 0.007) μg/L vs (0.020±0.013)tμg/L,P =0.001].The sensitivity,specificity and area under ROC curve of early diagnosis of anthracycline-induced cardiotoxicity with elevated serum hs-cTnT in 2-4 cycle and increased left ventricular PW-Tei index in 6-8cycle detected together were 75％,85％,0.736 and 92％,50％,0.675,respectively(all P ＜0.05).Conclusions Echocardiographic PW-Tei index combined with serum hs-cTnT is a simple method and can be easily obtained in outpatient settings to monitor early cardiac toxicity induced by anthracycline therapy.

Objective To evaluate the subclinical dysfunction of left ventricle (LV) induced by anthracycline(ATC) in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) by two-dimensional speckle tracking echocardiography (2DSTE) as well as real-time three-dimensional echocardiography (RT3DE).Methods Traditional echocardiography images and RT3DE images were acquired from 59 patients with DLBCL before,after the completion of two cures(100 mg∕m 2)and four cures of the regimen(200 mg∕m 2).LV global longitudinal strain(GLS),global circumferential strain(GCS),LV apical rotation and basal rotation,LV end-diastolic volume (EDV),end-systolic volume (ESV),stroke volume(SV) and ejection fraction(EF)were calculated simultaneously.Results Compared with baseline, LV apical rotation and basal rotation reduced significantly after two cures and four cures of therapy [LV apical rotation:(5.34±1 .80)°vs (3.80±1 .45)°vs (2.96±1 .1 8)°;LV basal rotation:(-3.32±1 .14)°vs (-2.65±1 .12)°vs (-2.56±1 .19)°;both P <0.01].LV GLS and GCS decreased significantly till four cures of treatment compared with those at baseline[GLS:(-21 .62±2.5 1)% vs(-20.1 7±2.74)%;GCS:(-26.34±4.76)% vs (-23.27 ±4.73)%;both P <0.01].The alternation on EDV,ESV,SV and EF manifested no visible degradation during the whole procedure (P > 0.05 for all). Conclusions Cardiotoxicity during the early phase of anthracycline treatment can be detected via 2DSTE prior to the traditional echocardiographic expression of ventricular systolic function.The left ventricular rotation index seems to be more sensitive than strain parameters for the estimation of early cardiac injury in patients with ATC chemotherapy.There is no safe dose for anthracycline in all patients with DLBCL treated with anthracycline even at lower doses.

As an important component of worldwide injury prevention, China has made great contribution to the development. China is serving as a model for other countries in the world, especially for developing countries, and China's experiences have great implications for them. Besides the description of the present situation and trends of China's injury prevention work and review for its development history, this paper has also introduced the existing issues and the current challenges, and informed the efforts of the staff in related field to find solutions from different aspects. All of them jointly boosted the development of global injury prevention.

Objective: To understand the status and trend of the mortality rate of falls in different gender, age groups and provinces in China from 1990 to 2015, to explore the number of subgroups of different trends in all provinces, and to determine the different trajectory of subgroups. Methods: Using the mortality rate of falls in China from 1990 to 2015 from the Global Disease Burden 2015 (data covers 31 provinces, autonomous regions, municipalities, as well as Hong Kong and Macau Special Administrative Regions, excluding Taiwan Province) to describe the status of the mortality rate of falls in different gender, age group and provinces in China 2015 and to calculate the corresponding relative change. Using log linear model to calculate the annual percent changes from 1990 to 2015. The number of subgroups and corresponding characteristics of different trajectories were analyzed by trajectory model to analyze with four indicators, P value of the coefficient of independent variables with different orders in all subgroups, Bayesian information criterion, log Bayes factor and average posterior probability. Results: In 2015, the age standardized mortality rate of falls in China was 8.38/100 000 (95%UI: 5.54/100 000-9.30/100 000), which was higher in men (10.81/100 000, 95%UI: 6.58/100 000-12.14/100 000) than that in women (5.84/100 000,95%UI: 3.41/100 000-6.62/100 000), and in the elderly aged 70-year-old and above (60.50/100 000, 95%UI: 38.36/100 000-67.75/100 000) than that in other age groups. From 1990 to 2015, there was no obvious change in the age standardized mortality rate of falls in total population, men and women with average percent change about 0.37 (95%UI: -0.08-0.83), 0.45 (95%UI: 0.05-0.84) and 0.31 (95%UI: -0.26-0.87) respectively, but a significant decrease and increase could be seen in children under 15-year-old, especially under 5-year-old with average percent change about -4.07 (95%UI: -5.62--2.51), and the elderly aged 70-year-old and above with average percent change about 1.89 (95%UI: 1.42-2.37) respectively. Four types of trajectories could be categorized for different trends of age standardized mortality rate of falls in all provinces. The first group had the lowest fall mortality with a downward trend. The fall mortality was close in the second and third group but with different change tendency, a decreasing propensity in the former and an increasing one in the latter. The fourth group had the highest fall morality with obvious fluctuation. Conclusion There was no significant change in the age standardized mortality rate of falls in China from 1990 to 2015. However, the trend of age standardized mortality rate of falls varied in different age and provinces during the same period of time.

Objective: To describe the trends and potential reasons responsible for injury mortality among children under 18 years old in different stages of the China Children’s Development Outlines (CCDO) for children from 1990 to 2017, in China. Methods: Data derived from the Global Burden of Disease 2017 (GBD2017) were used to analyze the change of injury mortality, among children under 18 years old, by sex and provinces. Results: Since 1990, the Chinese government had formulated and implemented three CCDOs on Children. Each CCDO proposed corresponding main targets and strategic measures based on the development of children under current situation, in each area, accordingly. The first two CCDOs failed to set clear targets for child injury prevention and control, but the third one did propose a quantifiable target. The injury mortality rate of children under 18 years old showed a declining trend in all periods of the three CCDOs, by 26.07%, 40.68% and 26.48%, respectively. Both boys and girls showed significant downward trend in these three stages. Mortality rate on child injury differed in these three stages in all the 31 provinces. Conclusion Thanks to the contribution of CCDO in different stages that providing important policies and impetus for the prevention and control of child injury, the number of deaths caused by child injury kept reducing, from 1990 to 2017, in China.

Objective: To describe the epidemiological characteristics of suicide death and self-harm/suicide in China from 2006 to 2016. Methods: Data in this study are from the datasets of National Death Cause Surveillance from 2006 to 2016 and the National Injury Surveillance Dataset 2016. The age-standardized death rate based on the population census in 2000 was used to describe the trend of suicide over years. This study also described the epidemiological characteristics of suicide death and the demographic characteristics, suicide methods and severity of patients who sought medical help after committing suicide or self-inflicted injury in 2016. Results: Age-standardized suicide mortality had been declining from 9.23/100 000 in 2006 to 5.33/100 000 in 2016 by 42.25%. Suicide mortality increased with age. In 2016, the suicide mortality in China was 7.05/100 000, and among people over 85 years old was 49.49/100 000. In 2016, the dominant two suicide methods were poisoning (39.12%) and sharp injury (25.62%). The first leading method of suicide in rural population, urban population and young people aged 10-to 17-year-old was poisoning (65.13%), sharp injury (29.90%) and fall (25.47%), respectively. As age increased, the severity of suicide/self-inflicted injury increased. The proportions of serious cases among young people aged 10-to 17-year-old and older people aged 60 years old and above who sought medical help after committing suicide or self-inflicted injury were 4.88% and 26.86%, respectively. Conclusion China′s suicide mortality has been declining and special attention should be given to the suicide of old people.

Objective: To analyze the current situation and the trend of the death due to foreign body in airway in children less than 5 years old in China from 1990 to 2017. Methods: Using the mortality data of foreign body in airway in China from 1990 to 2017 from the Global Disease Burden 2017 (data covered 31 provinces, autonomous regions, municipalities, as well as Hong Kong and Macau Special Administrative Regions, excluding Taiwan Province) to describe the death status of children under 5 years old due to foreign body in airway in China, and to calculate the relative change and 95% uncertainty interval (UI) of mortality rate and proportion of children under 5 years old due to foreign body in airway between 1990 and 2017. The robust linear regression was performed with the first-order lag of mortality, and the supremum Wald test was used to explore whether the mortality trend had obvious structural changes around a certain time point. Results: In 2017, the mortality rate of children under 5 years old due to foreign body in airway in China was 8.57/100 000 (95%UI: 7.41/100 000-9.57/100 000), and there was no significant difference between boys (9.05/100 000, 95%UI: 6.82/100 000-10.23/100 000) and girls (8.02/100 000, 95%UI: 7.02/100 000-9.12/100 000). The supremum Wald test showed that there was a structural change around the year of 2005 (P<0.001) in terms of the mortality rate of foreign body in the airway among children under 5 years old, which depicted a relatively stable trend before 2005 and a significant downward trend after 2005. Compared with 1990, the mortality rate of foreign body in airway among children, boys and girls under 5 years old in 2017 decreased by 49.32% (95%UI: 37.78%-65.41%), 41.22% (95%UI: 25.68%-68.26%) and 56.91% (95%UI: 44.78%-66.70%), respectively; the mortality proportion of foreign body in airway among increased by 153.33% (95%UI: 75.99%-204.56%), 171.05% (95%UI: 48.75%-239.63%) and 137.90% (95%UI: 86.62%-198.09%), respectively; the rank of foreign body in airway in all disease increased by 6 and became the first leading cause of injury from the second. Conclusion From 1990 to 2017, the mortality rate of foreign body in airway among children, boys and girls under 5 years old in China generally showed a downward trend. Compared with 1990, the mortality proportion of foreign body in airway among these population increased by a relatively large extent in 2017.

OBJECTIVE: Treating Class II subdivision malocclusion with asymmetry has been a challenge for orthodontists because of the complicated characteristics of asymmetry. This study aimed to explore the characteristics of dental and skeletal asymmetry in Class II subdivision malocclusion, and to assess the relationship between the condyle-glenoid fossa and first molar. METHODS: Cone-beam computed tomographic images of 32 patients with Class II subdivision malocclusion were three-dimensionally reconstructed using the Mimics software. Forty-five anatomic landmarks on the reconstructed structures were selected and 27 linear and angular measurements were performed. Paired-samples t-tests were used to compare the average differences between the Class I and Class II sides; Pearson correlation coefficient (r) was used for analyzing the linear association. RESULTS: The faciolingual crown angulation of the mandibular first molar (p < 0.05), sagittal position of the maxillary and mandibular first molars (p < 0.01), condylar head height (p < 0.01), condylar process height (p < 0.05), and angle of the posterior wall of the articular tubercle and coronal position of the glenoid fossa (p < 0.01) were significantly different between the two sides. The morphology and position of the condyle-glenoid fossa significantly correlated with the three-dimensional changes in the first molar. CONCLUSIONS: Asymmetry in the sagittal position of the maxillary and mandibular first molars between the two sides and significant lingual inclination of the mandibular first molar on the Class II side were the dental characteristics of Class II subdivision malocclusion. Condylar morphology and glenoid fossa position asymmetries were the major components of skeletal asymmetry and were well correlated with the three-dimensional position of the first molar.
Anatomic Landmarks ; Cone-Beam Computed Tomography ; Crowns ; Head ; Humans ; Malocclusion* ; Molar ; Orthodontists ; Temporomandibular Joint*

Objective To study the effect of contusion and exhaustive exercise on satellite cells' activation and Pax7/CBF1/DAPT contents in skeletal muscles of rats,and reveal the repair mechanism of the skeletal muscle injury.Methods Twenty-four seven-week-old male Sprague-Dawley(SD)rats were randomly divided into a control(C)group,an immediately after exhaustive exercise(E0)group,a 24 hours after exhaustive exercise(E24)group and a 48 hours after exhaustive exercise(E48)group,each of 6.Other 18 SD rats were randomly divided into 3 groups,6 rats in each group:an immediately after contusion group(D0),a 24h post-contusion group(D24)and a 48h post-contusion group(D48).All groups were killed at different time points after exhaustive exercise and the contusion respectively while the control group was at resting state,and their serum was extracted.The right gastrocnemius muscles were resected and divided into 2 parts:one was used immediately for culturing satellite cells,while the other was stored in the bridge at-80℃.All the serum and gastrocnemius muscles were tested for Pax7,CBF1 and DAPT contents using the enzyme-linked immunosorbent assay(ELISA).Moreover,three-day-old newborn rats were also slaughtered for the above experiment.Results The results of culture in vitro showed that one day after the culture began a small amount of spindle satellite cells could be seen in the newborn rats,but the satellite cells of other groups were growing slowly.However,on the third day and the fifth day,the spindle satellite cells of each group began to proliferate in quantity and reached the peak.Then all the satellite cells had a good proliferation until the seventh day after serial passage,and some patial fusions to microtubules occurred.The biggest cell number and proliferation rate was in newborn rats,but no skeletal muscle satellite cell was found in the control group.At the same time,the number and the proliferation rate of skeletal muscle satellite cells in contusion groups were significantly higher than the exhaustive exercise groups.The results of Elisa showed that the contents of CBF1 and Pax7 in skeletal muscles in exhaustive groups and contusion groups,were significantly upregulated,compared to the control group(P＜0.05).Amomg them,the CBF1 content in group D0,together with the Pax7 content in group D24 and D48,was significantly higher than that of the other groups(P＜0.05).On the other hand,the content of DAPT in skeletal muscles of exhaustive groups and contusion groups,compared to the control group,was significantly downregulated (P＜0.05).To be more specific,the value of group D0 was significantly lower than that of the other groups (P＜0.05).However,there was no significant difference in it among group E0,E24 and E48.Conclusions Contusion and exhaustive exercise can activate the skeletal muscle satellite cells to proliferate and differentiate.The number of activated skeletal muscle satellite cells in the contusion groups is significantly larger than that of exhaustive groups maybe due to the stronger stimulating by contusion.Both contusion and exhaustive exercise increase the contents of Pax7 and CBF1 in skeletal muscles,but decrease that of DAPT.The Pax7 and CBF1 may play a positive regulating role in terms of activating skeletal satellite cells and repairing skeletal muscle injury,while DAPT may play a negative regulating role.