Objective: To explore the operation method and clinical effect of treatment for bilateral cleft lip with improved straight line closure. Methods: On the basis of straight line closure, the vermilion and anterior lip pear were repaired with the muscle-vermilion labial flap of lateral lip. In order to close nasal floor, flap-C from lateral wall of anterior lip and flap-G from nasal wing base were designed, meanwhile, nasal mucosa flap-D and flap-H from two sides of nasal base fissure were designed. The function of the orbicularis oris was repaired by cutting off the anomaly adhesion of the orbicularis oris. Results: The post-operational upper lip was thickened together with good shape and vermilion color, there was no obvious dynamic abnormality, nasal floor was closed well. Conclusion: The improved straight line closure can obtain good shape of lip, reduce the whistling deformities, oronasal fistula and dynamic abnormality.

Objective To further explore the mechanism by which bone morphogenetic protein 4(BMP-4)might be involved in hematopoietic differentiation of the yolk sac.We observed the expression of BMP-4,CD34,CD133 and tyrosine kinase receptors(KDR) in the blood island of the yolk sac at embryonic 3 to 8 weeks.Methods Gene expression was analyzed by RT-PCR and the presence of BMP-4,CD34,CD133 and KDR proteins was confirmed by immunohistochemistry in 57 human embryos.Results In the human yolk sac,we found that BMP-4 was expressed at high levels from the 16th day to the 7th week,and decreased quickly after week 7.The results showed that KDR,CD133 and CD34 largely appeared on the 21st and 30th day,then increased at the 6th week,and decreased quickly after week 7.Furthermore,Ihh,SCl,GATA-1,GATA-2 and PU.1 mRNAs showed that PU.1 was not expressed on the 16th day;however,other factors were expressed all the time.Conclusion The distribution of BMP-4,KDR,CD34,CD133 and transcription factors expression highly suggested that BMP-4 was secreted from the yolk sac which might exert its effects on the specification of human hemangioblast and hematopoietic stem cells from the embryonic mesoderm in vivo through transcription factors.

BACKGROUND:Studies have shown that placement, needling point, angle and length of pedicle screws for thoracic vertebral fractures have been unified. Many studies concerned axial pul-out force and biomechanical behavior of a single screw, but few reports addressed the biomechanical behavior after the replacement with three kinds of screw connecting to rods. OBJECTIVE:To further observe and compare biomechanical behavior after three kinds of thoracic screw placement connecting rod using biomechanical testing, to understand the strength of thoracic pedicle screw replacement connecting rods, and the effects of its puling out on the stress of the bone surrounding the placement site. METHODS:The fresh frozen specimens of thoracic vertebra were divided into three groups at random: the pedicle fixation group, the transverse process-vertebral body fixation group, and modified rib transverse process fixation group. Thoracic pedicle screw system was inserted by the standard placement method in each group. The experiment was measured on the mechanical equipment. During puling out, the strength that bone bore was described with dynamic curve, folowed by statistical analysis. The difference in the gripping force on the thoracic vertebra among three kinds of screw placement method was compared. RESULTS AND CONCLUSION: Among three kinds of screw placement methods and among three kinds of screw placement methods on the injured vertebral body, the gripping force was significantly bigger in the pedicle fixation group than in the transverse process-vertebral body fixation group and modified rib transverse process fixation group (P < 0.01). No significant difference in the gripping force was detected between the transverse process-vertebral body fixation group and modified rib transverse process fixation group. Results verified that the stability of loading ability was apparently better in the pedicle fixation group compared with the transverse process-vertebral body fixation group and modified rib transverse process fixation group.

AIM:To identify and quantify the expression of IL-1βand IL-17 in mast cells ( MCs) in different types of human pericapical diseases using double immunofluorescence staining .METHODS: The specimens ( n=102 ) , including healthy control ( n=35 ) , periapical cyst ( n=35 ) and periapical granuloma ( n=32 ) , were involved in the present study .The tissue samples were fixed in 10% buffered formalin for at least 48 h and then embedded in paraffin . Serial 5-μm-thick sections were deposited onto SuperFrost/Plus microscope glasses .Routine staining of the sections using hematoxylin&eosin ( HE) was performed for morphological evaluation .The number of IL-1βand IL-17 positive MCs was identified by double immunofluorescence staining .RESULTS:Compared with the healthy controls , the inflammation score of periapical lesions was significantly increased in the periapical patients (P<0.01).The density of IL-1βand IL-17 posi-tive MCs in the periapical lesions were obviously higher than that in the healthy controls (P<0.01).However, no signifi-cant difference between periapical cyst and periapical granuloma was observed .The Pearson correlation analysis showed that there was a positive correlation between the density of IL-1βand IL-17 double positive MCs and inflammation score in dif-ferent groups of specimens (P<0.01).CONCLUSION:There is significantly increased number of MCs , along with in-creased density of IL-1βand IL-17 positive MCs in human periapical lesions .The increased density of IL-1βand IL-17 positive MCs has the similar tendency as the severity of tissue inflammation in human periapical lesions , suggesting that IL-1βand IL-17 positive MCs may play an important role in the pathogenesis of human periapical diseases .

Objective To identify the metabolites of loganin in rat urine through using ultra high performance liquid chromatography combined with triple TOF mass spectrometry (UPLC-Q-TOF/MS/MS) after oral administration of loganin;To summarize the metabolic pathway of loganin. Methods Rats were given a gavage with loganin. The urine samples were prepared by use of solid phase extraction (SPE). The chromatographic separation was performed on an UPLC C18 column with gradient elution program of acetonitrile and 0.1% formic acid aqueous as mobile phase. Dynamic background subtraction (DBS) technology was employed to trigger information dependent acquisition (IDA) to obtain the characteristic fragment ions of metabolites. Results MetabolitePilot software including several data processing methods were employed to speculate the structures of liganin metabolites and three metabolites were identified. Then, the metabolic pathway of loganin in rats was summarized. Conclusion The analytical method was simple, credible and highly-sensible, which is useful for screening and identifying trace constituents in vivo.

Objective To explore antibiotics resistance profiles and DNA fingerprints of Pseudomonas aeruginosa isolates resistant to imipenem (IRPA). Methods DNA fingerprints of 56 strains isolated from ICU (intensive care unit) were constructed by ERIC-PCR (enterobacter repetitive intergenic consensus-PCR). MICs (minimal inhibitory concentrations) were determined by agar dilution method.Results 33 genotypes were got from 56 strains by ERIC-PCR. Of 8 frequently used antibiotics, 5 of them showed resistance rate higher than 50%. Conclusion It is high time to pay attention to multi-drug resistance of IRPA. The exist of prevalence of IRPA clone in ICU advise us to control of IRPA in hospital effectively.

Objective: To identify the most appropriate meteorological variable for forecasting the health risk of high temperatures. Methods: The surveillance on causes of death, meteorological data and surveillance on air quality among registered residents in Ningbo City, Zhejiang Province during the period between May and October from 2013 to 2019 were collected. The association models of daily minimum temperature, average daily temperature, daily maximum temperature, daily minimum heat index, average daily heat index, daily maximum heat index, average daily apparent temperature and torridity index with deaths and years of life lost (YLL) were created using time series analysis and distributed lag non-linear models, and the model fitting effect was evaluated using the minimum Akaike information criterion (AIC) procedure. The most appropriate meteorological variable for forecasting gender-, age- and mortality-specific health risks of high temperatures was identified. Results: A total of 120 628 deaths were reported during the study period, with daily deaths of 94 cases, and daily YLL rate of 19.74 person-years/105. Except for daily minimum heat index and torridity index, the exposure-response relationships between other six meteorological variables and deaths and overall YLL rate all appeared a “J” shape. The lowest AIC values and the optimal model fitting effects were measured for the association models between average daily temperature and whole populations, females, subjects at ages of 65 years and older, and deaths and YLL rates due to circulatory diseases and respiratory diseases. Conclusion High model fitting effects are observed between average daily temperature and deaths and YLL rates, which are more suitable for forecasting the health risk of high temperature.

Objective : To evaluate the excess mortality risk related to heat wave in Ningbo, Zhejiang from 2013 to 2018, so as to provide a basis for formulating coping strategies for heat wave. Methods : The data of daily mortality, meteorological and air quality from May to October in Ningbo from 2013 to 2018 were obtained from Ningbo Center for Disease Control and Prevention, Ningbo Meteorological Bureau and Environmental Monitoring Center of Ningbo, respectively. The generalized linear model ( GLM ) and distributed lag non-linear model ( DLNM ) were used to estimate the associations between heat wave and cause-specific mortality. Results : Among 1 104 days of the study period, 18 heat waves occured and lasted for 132 days, accounting for 11.96%. A total of 102 954 deaths were reported in the same period. The risks of mortality in circulatory system diseases ( RR=1.09, 95%CI: 1.03-1.16 ), respiratory system diseases ( RR=1.14, 95%CI: 1.04-1.25 ), digestive system diseases ( RR=1.38, 95%CI: 1.15-1.65 ), nervous system diseases ( RR=1.32, 95%CI: 1.08-1.61 ), mental disorders ( RR=1.51, 95%CI: 1.12-2.03 ) and accidental injury ( RR=1.18, 95%CI: 1.06-1.32 ) and all causes ( RR=1.10, 95%CI: 1.06-1.14 ) increased at lag 0-1 day of heat wave. The total excess death related to heat wave was 1 218 ( 95%CI: 731-1 705 ) . The excess deaths of circulatory system diseases, respiratory system diseases, accidental injury, digestive system diseases, nervous system diseases, mental disorders, urinary system diseases and endocrine system diseases were 313 ( 95%CI: 104-556 ), 206 ( 95%CI: 59-368 ), 164 ( 95%CI: 55-292 ), 122 ( 95%CI: 48-208 ), 69 ( 95%CI: 17-131 ), 56 ( 95%CI: 13-113 ), 18 ( 95%CI: -15-64 ) and 3 ( 95%CI: -51-72 ). The excess deaths of urinary system and endocrine system diseases was not statistically significant ( P>0.05 ). Conclusion Heat wave can increase the mortality risk on the day and after a day in Ningbo from 2013 to 2018. Circulatory system diseases, respiratory system diseases and accidental injury rank top three in excess deaths.

Objective: To investigate the prevalence of hepatitis B virus (HBV) carriage among pregnant and lying-in women in Cangnan County, Zhejiang Province from 2011 to 2022 and identify the influencing factors, so as to provide insights into the guidance of healthcare among HBV carriers during pregnancy. Methods: A total of 34 403 women delivered in The Third People's Hospital of Cangnan County from January 2011 to July 2022 were enrolled, and their demographics, HBV carriage and pregnant outcomes were collected. The prevalence of HBV carriage was analyzed among pregnant and lying-in women, and factors affecting HBV carriage were identified using a multivariable logistic regression model. Results: A total of 34 403 pregnant and lying-in women were enrolled, with a median age of 27.00 (interquartile range, 7.00) years, and including 8 118 floating populations (23.60%). The overall prevalence of HBV carriage was 3.44%, and the prevalence of HBV carriage was 1.59% from 2011 to 2014, 4.08% from 2015 to 2018 and 6.86% from 2019 to 2022, appearing a tendency towards a rise (P<0.05). Multivariable logistic regression analysis identified estimated age of delivery (20-24 years, OR=1.832, 95%CI: 1.037-3.235; 25-29 years, OR=2.404, 95%CI: 1.372-4.214; 30-34 years, OR=2.914, 95%CI: 1.656-5.129; 35-39 years, OR=3.116, 95%CI: 1.741-5.576; 40 years and older, OR=2.358, 95%CI: 1.145-4.858), floating population (OR=0.670, 95%CI: 0.574-0.782), scarred uterus after cesarean section (OR=1.228, 95%CI: 1.076-1.521) and year of delivery (from 2015 to 2018, OR=2.504, 95%CI: 2.143-2.926; from 2019 to 2022, OR=4.425, 95%CI: 3.779-5.182) as factors affecting HBV carriage among pregnant and lying-in women. Conclusions The prevalence of HBV carriage rate appeared a tendency towards a rise among pregnant and lying-in women in Cangnan County from 2011 to 2022. Estimated age of delivery, floating population, year of delivery and scarred uterus after cesarean section are factors affecting HBV carriage.

Objective To create an easy and specific rat model of isolated bilateral pulmonary contusion and determine the maximal sublethal injury energy.Methods Injury energy was produced by free falling weights and passed through a designed precordial shield to rats' bilateral posterolateral chest wall.The rats were divided into 2.1 J,2.4 J,2.7 J and 3.0 J groups,according to the volume of injury energy.Percentage of lung contusion volume in bilateral lung was measured by blood gas analysis and three dimensional CT (3DCT) at four hours post-injury to assess lung injury severity after contusion.Pathological examination of heart and lung tissue was performed to confirm pulmonary contusion and rule out myocardial contusion.Results Death rate in 3.0 J and 2.4 J groups was 33％ and 11％,respectively.PaO2 in 2.7 J group was significantly lower than that in 2.4 J group (P ＜ 0.01),but pulmonary contusion percentage in 2.7 J group was significantly higher than that in 2.4 J group (P ＜0.01).All groups showed negative correlation between PaO2 and pulmonary contusion percentage measured by 3DCT (R2 =0.762).Hemorrhage,atelectasis and neutrophil infiltration were documented in lung biopsy.No evidence of myofiber break was recorded in heart biopsy.Conclusion This method can duplicate satisfactory models of isolated bilateral pulmonary contusion and 2.7 J can be regarded as the maximal sublethral injury energy.