Along with the transformation of the pattern of the medicine and the development of dental medicine,more and more patients accept orthodontic treatment.The patients have higher expectations of the treatment.As a result,the abilities to make clinical communication for orthodontic postgraduates should be improved.The article discusses how to improve the orthodontic postgraduates' abilities in the hope that it will be of some help to them.

10.3969/j.issn.1007-3969.2013.05.003

Objective To investigate the common chromosome abnormalities in the patients with multiple myeloma and the relationships of cytogenetic abnormalities and clinical features. Methods The interphase fluorescence in situ hybridization (I-FISH) analysis method was designed to detect RB1-/13q14-and 14q32 rearrangements in 49 MM patients. The statistic value of its effect on clinical features were determined. Results FISH disclosed 14q32 translocations in 26 of the 40 (53.1%) patients. 25 out of the 49 (51.02 %) cases were found with deletion of chromosome 13q14 included del(RB1) in 9 (18.4 %) and del(13q14.3) in 18 (36.7 %). 13q14 deletion and 14q32 translocation were simultaneously observed in 18 (36.7 %) cases. Spearman correlation analysis were found associated of 14q32 rearrangement with the percentage of plasma cells in bone marrow (r=0.316, P=0.27). Conclusion The frequency of 13q14 deletion and 14q32 gene translocation in multiple myeloma are high. There is a significant correlation between the presence of 14q32 translocations and chromosome 13 abnormalities in MM patients. The percentage of 14q32 translocation in plasma cells was increased significantly. The 14q32 translocation is an independent prognostic factor.

OBJECTIVE:To establish a method for the separation and detection of related substances in baicalein,identify its structure and preliminarily explore the degradation mechanism. METHODS:HPLC was adopted to detect the baicalein,related impurities and forced destruction of degradation products in synthesis process:the column was ES Industries? FluoroSep-RP Phenyl with mobile phase of 0.3%formic acid-methanol-acetonitrile(gradient elution)at a flow rate of 1.0 mL/min,the detection wavelength was 275 nm,the column temperature was 10℃,and the injection volume was 10μL. LC-MS/MS was conducted to identify the related substances and conjecture degradation mechanism:the column was ES Industries? FluoroSep-RP Phenyl with mobile phase of 0.3%formic acid- methanol (gradient elution)at a flow rate of 1.0 mL/min,the detection wavelength was 275 nm,column temperature was 10℃,and the injection volume was 10μL;ion source was electrospray ion source,positive and negative ions,nebulizer pressure was 55 psi and the drying gas flow was 11 L/min,drying gas temperature was 350℃,capillary voltage was 4.0 kV,detection modes were full-scan first-order MS and selective ion full-scan second-order MS,scan ranges were m/z 100-1000 (first-order MS) and 50-500(second-order MS),ionization voltage was 80-135 eV,and the collision energy was 10-30 eV. RESULTS:The linear range of baicalein was 2.4-480μg/mL(r=0.9999);RSDs of precision,stability and reproducibility tests were lower than 2.0%;the limit of quantitation was 7.2 ng,the limit of detection was 2.4 ng. Baicalein was well separated with related substance and 3 major degradation products,the related substance was chemical synthesis precursor wood butterfly;the degradation products were 6,7-quinone derivatives and 7,8-quinone derivatives,which were isomers;oxidative degradation products were benzoic acid phenyl ester derivatives. CONCLUSIONS:The main mechanisms of alkali degradation and oxidative degradation of baicalein include pyran, reciprocal rearrangement and oxidation reaction;the established method is specific and sensitive,and can be used for the detection of related substances in baicalein.

Objective To observe the fundus lesions in the unilateral rhegmatogenous retinal detachment (RRD) eyes and contralateral eyes in non-traumatic emmetropia patients,and explore the risks of lateral eyes.Methods This is a retrospective case analysis.A total of 426 patients of unilateral RRD diagnosed by clinical examination were enrolled in this study.There were 273 males and 74 females.The average age of onset was 54.7 years.81.46％ of them (347 patients) were 51-70 years old.The average detachment time was 2.12 months.They were divided into two groups,equal or lesser than 50 years old group and more than 50 years old group.A total of 100 patients (200 eyes) with ocular surface disorders were randomly selected as control.The lattice-like degeneration,cystic degeneration and dry retinal holes were treated with prophylactic laser photocoagulation.Follow-up period was 6 to 24 months.The age,gender,proliferative vitreous retinopathy (PVR) grading,best corrected visual acuity (BCVA),distribution and quantity of retinal holes,and posterior vitreous detachment (PVD) were retrospectively analyzed.The incidence of PVD among different age groups was compared with Chi square.Results Among 426 RRD eyes,there were 239 eyes (56.10％) with PVD.Among them,there were 30 eyes with age equal or lesser than 50 years old (12.55％) and 209 eyes with age more than 50 years old (84.75％).There were 187 eyes (43.90％) without PVD,which including 38 eyes with age equal or lesser than 50 years old (20.32％) and 149 eyes with age more than 50 years old (79.68％).The incidence of PVD among different age groups was statistically significant (x2=4.72,P＜ 0.05).There were 10,254,40 and 5 eyes in class A,B,C and D of PVR,respectively;117 eyes without PVR.The retinal hole was located in superior temporal,inferior temporal,superior nasal,inferior nasal and macular in 305,91,22,4 and 4 eyes,respectively.The number of holes was 1,2,and more than 3 in 297,89 and 40 eyes,respectively.The retinal detachment range of 1,2,3 quadrants and total dissociation were 92,230,71,33 eyes,respectively.The fundus lesion was found in 47 eyes (11.03％) in the lateral eyes.There were 20 RRD eyes in class B of PVR,and 27 RRD eyes in class C of PVR.Retinal degenerated area was found.Among them,the degeneration of 41 eyes was located in the temporal retina,45 eyes involved in a quadrant.There were 16 eyes with peripheral retinal dry holes;the holes diameter was less than 1,1-2,greater than 2 optic-discs in 6,11 and 5 retinal holes.At the end of the follow-up,there were 47 eyes with almost normal visual field,16 eyes with decreased visual acuity,noeyes with retinal detachment.In the control group,4 patients (5 eyes,2.50％) had fundus lesions.Conclusion The unilateral RRD in non-traumatic emmetropia mostly occurs in elderly patients;11.03％ of patients had fundus lesions in the contralateral eyes,higher than the general population.

Objective:To summarize the echocardiographic features and outcomes in fetuses with congenital ventricular outpouching (CVO).Methods:This retrospective study enrolled ten fetuses diagnosed with CVO by fetal echocardiography in the Affiliated Hospital of Qingdao University and Qingdao Women and Children's Hospital from January 2015 to April 2022. Clinical data were analyzed, including echocardiographic features, other intracardiac and extracardiac malformations, karyotypes, and pregnancy outcomes. Data were analyzed by descriptive statistics.Results:All ten cases were single, including eight ventricular diverticula and two ventricular aneurysms. Five cases had the anomaly in the left ventricular and the other five in the right. Five cases were isolated malformations, and the other five were complicated by other intra- or extracardiac malformations. A pathogenic copy number variation was detected in one case. Three pregnancies were terminated, and one was lost to follow-up. The other six fetuses were born alive and showed no obvious clinical symptoms or abnormalities in growth and development during 3-70 months of follow-up. The right ventricular diverticulum spontaneously disappeared in one case. One case with the right ventricular aneurysm was also diagnosed with noncompaction of the left ventricular myocardium by echocardiography at six months.Conclusions:Fetal CVO presents with typical echocardiographic features and can be diagnosed prenatally. Regular follow-up during pregnancy is recommended to observe the sizes of outpouchings and the occurrence of complications in fetuses with CVO after excluding other structural and chromosomal abnormalities to avoid unnecessary termination. Attention should also be paid to postnatal follow-up.

Objective:To explore the effect of "321" health education model in elderly patients with osteoporotic thoracolumbar fractures (OTF) .Methods:From January 2019 to June 2021, convenience sampling was used to select 112 elderly patients after OTF surgery in Hefei First People's Hospital as the research object. The patients were divided into the experimental group and the control group by random number table method, 56 cases in each group. The control group was given routine nursing and health education for patients after OTF surgery, while the experimental group was given "321" health education. The scores of Health Behavior Questionnaire, incidence of complications, and quality of life scores were compared between the two groups before intervention and after 6 months follow-up.Results:There were 54 and 51 patients in the experimental group and the control group, respectively, who completed the study. After 6 months of follow-up, the total score and the dimension scores of the Health Behavior Questionnaire in the two groups were higher than those before the intervention, except for the other behavior dimension, the total score of the Health Behavior Questionnaire and the scores of other dimensions in the experimental group were higher than those in the control group, all differences were statistically significant ( P<0.05) . The incidence of complications in the experimental group (3.70%, 2/54) was lower than that in the control group (15.69%, 8/51) , and the difference was statistically significant (χ 2=4.669, P=0.031) . The total score and the dimension scores of quality of life in the two groups were lower than those before education, and the total score and the dimension scores of quality of life in the experimental group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The "321" health education model in elderly patients after OTF surgery is beneficial to promote the osteoporosis prevention and health behavior of elderly patients after OTF surgery, reduce the occurrence of complications after OTF surgery, and improve the quality of life of patients.

Objective:To establish an HPLC method for the determination of N,N'-diacetyl-L-cystine in com-pound amino acid injection.Methods:The HPLC method parameters were as follows,The Atlantis dC18 column(4.6 mm × 150 mm,3 μm),The mobile phase was aammonium formate solution(315 mg ammonium formate was taken and dissolved with 960 mL water)-acetonitrile-methanoic acid(970∶30∶1)as a mobile phase,at a flow rate of 0.7 mL·min-1,and the detection wavelength of 210 nm.Results:The linear range of N,N'-diacetyl-L-cystine was 2.697-53.94 μg·mL-1(r=0.999 9),the limits of detection and quantification were 1.4 μg·mL-1 and 4.4 μg·mL-1 respectively.The average recovery was 100.2％with RSD of 0.5％.Conclusion:The method was proved to be suitable for the determination of N,N'()-diacetyl-L-cystine in compound amino acid injection.

Objective:To develop and validate an clinical prediction model for the risk of breast cancer-related lymphedema (BCRL).Methods:Breast cancer patients who were prepared to undergo axillary lymph node dissection were propsectively enrolled, indocyanine green combined with Photodynamic Eye (PDE) was applied to reveal the arm lymphatic flow . The arm lymphatic fluorescence images were collected to calculate the proportion of arm lymph flow above and below the axilla vein. Volumetric measurements of both arms and subjective questionnaire were performed to evaluate the occurrence of lymphedema. A difference in volume between the arms >10% was defined as lymphedema. Univariate logistic regression analysis was used to analyze the relationship between each factor and BCRL. The stepwise forward method was used to include multiple factors in the logistic regression analysis to establish the prediction model.Results:Three hundred and twelve patients were enrolled. Fourty-five (14.4%) patients developed BCRL. Using the coefficients obtained from multivariate analysis, BMI ( OR 95% CI: 1.34 (1.25-1.77), P<0.05), chemotherapy ( OR 95% CI: 2.26 (1.97-2.63), P<0.05), regional lymph node radiotherapy ( OR 95% CI: 1.59 (1.05-2.41), P<0.05) and the proportion of arm lymph flow above the level of the axillary vein ( OR 95% CI: 0.70 (0.68-0.81), P<0.05) were identified as independent predictive factors for BCRL, and the following prediction equation was derived: Y=0.369×(BMI at surgery)+0.713×(taxane-based chemotherapy)+0.862×(radiotherapy)-9.058×(proportion of the arm lymph above the axillary vein)-6.859 8. The ROC curve was screened to the optimal boundary value of 0.118 6 by the Youden's index. The sensitivity, specificity, positive predictive value and negative predictive value of prediction of this model were 93.3%, 79.4%, 73.3%, 98.6%, respectively. Conclusion:With the guidance of the predictive model, particular patients who need the preservation of axillary lymphatic system can be identified, and timely intervention can be carried out.

Objective:To investigate the expression of placental glucose transport protein (GLUT)1 and 4 in women with hyperglycemia in pregnancy.Methods:A total of 48 full-term singleton pregnant women who underwent elective cesarean section at Peking University First Hospital from January 2017 to December 2019 were included retrospectively, and were divided into pregestational diabetes mellitus (PGDM) group, gestational diabetes mellitus (GDM) group, and normal glucose tolerance (NGT) group (16 women in each). According to the blood glucose level after control during pregnancy, the PGDM and GDM groups were further divided into PGDM-, GDM-well controlled subgroups (both n=10), and PGDM-, GDM-uncontrolled subgroups (both n=6). The expression of GLUT1 and GLUT4 proteins, detected by Western blot, between different groups were compared and the correlation between GLUT1 and GLUT4 protein expression and the pre-pregnancy body mass index (BMI), pre-delivery weight,gestational weight gain (GWG), and neonatal birth weight were analyzed using two independent samples t-test, one-way analysis of variance, Kruskal-Wallis H-test, Chi-square test, and Pearson correlation analysis. Results:(1) The pre-pregnanct BMI and insulin treatment ratio in PGDM group were higher than those in GDM group and NGT group [27.0 kg/m 2 (22.1-29.9 kg/m 2) vs 22.9 kg/m 2 (20.5-25.7 kg/m 2) and 21.7 kg/m 2 (20.5-24.3 kg/m 2); 13/16 vs 1/16 and 0/16; all P<0.05]. In the PGDM group, fasting blood glucose at the second trimester and mean glycosylated hemoglobin during the second and the third trimester were higher than those in the GDM group [(6.1±1.2) vs (5.0±0.4) mmol/L; (5.9±0.5)% vs (5.2±0.3)%; both P<0.05]. (2) GLUT1 protein level was the highest in the PGDM group, followed by the GDM and NGT group (1.251±0.354 vs 1.004±0.368 vs 0.733±0.216, both P<0.05). And all the subgroups had higher protein level than NGT group [PGDM-good (1.270±0.417); PGDM-uncontrolled (1.218±0.245), GDM-well controlled (0.900±0.424); GDM-uncontrolled (1.177±0.158); LSD test,all P<0.05]. The variation of GLUT4 protein level was consistent with GLUT1. There was no significant difference in GLUT1 and GLUT4 expression between PGDM-uncontrolled and PGDM-well controlled subgroups, neither between GDM-uncontrolled and GDM-well controlled subgroups (all P>0.05). (3) GLUT1 and GLUT4 in the PGDM-well controlled subgroup, as well as GLUT1 in the GDM-uncontrolled subgroup, had a positive correlation with GWG ( r=0.635, 0.810, and 0.833, all P<0.05). Conclusions:The increased expression of placental GLUT1 and GLUT4 were associated with different types of gestational hyperglycemia and GWG. However, glucose control has little effect on placental GLUT expression.