Asthma ; diagnosis ; Child ; Humans ; Perception

Objective:To identify the normal position of the root tips of lower premolars, first and second molars, the distances through 3-D reconstruction in 100 cases of general population were measured. Methods: The three distances were measured from 100 cases over 17 years old, divided by gender: 1. The distance of Mandible of the Centre (M) under the jaw to the lower edge of the next point (L);2. The distance of Mandible of the Centre (M) and M points to the horizon at the same point of the buccal (O);3. The distance of Mandible of the Centre (M) and M to the point in the same horizontal line at the side of the tongue(I). Results: The second premolar root tip of the jaw bone under the margin of the thick wall, the wall thickness of tongue in cheek bone lateral side of the wall in the first and second molars, the lower edge of the mandible bone wall, the tongue side of the wall, cheek bone side walls were thicker through 3-D reconstruction measurement than in normal way.Cheek bone was much thicker than the tongue side of the wall. Conclusion: The way of identifying the normal lower in the second premolar and the first and second molar root tip through the three distances by 3-D reconstruction will give us lots of help, such as: Orthognathic operation of the mandible sagittal split SSRO, scaling of cysts, planting of a certain theoretical basis for scientific research and teaching to provide a realistic and practical method.

OBJECTIVETo compare the differences between computer aided identification and ultra-thin layer slicing in measuring the lesions of femoral head necrosis,and to confirm the accuracy and practicability of computer aided method.

METHODSFrom June 2012 to December 2013, the X-ray and MRI of 24 patients (24 hips on unilateral) were reviewed, who had avascular necrosis of the femoral head (ANFA) at late stage (stage III and IV) according to the ARCO international staging system. There were 15 males and 9 females, with an average age of (65.1 ± 8.8) years old, ranged 33 to 74 years old. Based on the software system with seeds point identification, the ragional adaptive search method with computer aid was used to calculate the volume of necrotic lesion in femoral on MRI. Then the pathological slices of those intraoperative femoral heads were made to measure the gross volume of necrotic lesion in femoral head,and the values were compared with the data in the computer.

RESULTSFor 24 hips, by the calculation of computer, the necrotic volume was (20.00 ± 3.04) cm (ranged, 18.72 to 21.29 cm³). Under the pathological section, the necrotic volume of the femoral head was (19.89 ± 3.17) cm³ (ranged, 18.55 to 21.23 cm³). In computer and pathology two kinds of measurement, the two entire femoral head volume had no significant difference using these two measurements (t = -1.227, P = 0.232).

CONCLUSIONComputer aided identification for necrotic area of femoral head adaptive can demonstrate the morphology of femoral head necrosis accurately and reliably, which will help surgeon better understand the morphology and orientation in femoral head.

Adult ; Aged ; Diagnosis, Computer-Assisted ; Female ; Femur Head Necrosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged

Objective This study is to explore the safety,feasibility and efficacy of robotic laparoendoscopic single-site(LESS) zero-ischemia partial nephrectomy.Methods Two patients underwent robotic laparoendoscopic single-site zero-ischemia partial nephrectomy by our urologic surgical team at 22-May-2017 and 31-May-2017 in our institution.The salient patient demographics and tumor characteristics,including age,gender,body mass index (kg/m2),Charlson Co-morbidity Index (Age-weighted),tumor laterality,diameter (cm),R.E.N.A.L.nephrometry score and preoperative split renal function GFR [ml/(min · 1.73 m2)] were:73/56,female/male,25.2/19.8,2/0,lcft/right,1.8/1.4,5a/4a,left 43.8、right 49.2/left 38.8 、right 48.7 respectively.A 2-3 cm longitudinal skin incision was made at 4 cm below the inferior margin of rib arch at the level of midaxillary line (case NO.1) or peri-umbilicus (case NO.2).The da Vinci Si robotic Single-siteTM Port was inserted.The line of Toldt was incised with the colon medially mobilized.Gerota's fascia was opened,the main renal artery or its branches were dissected,then the renal mass fully dissected and exposed.The renal mass was entirely removed with approximately 0.5-1.0 cm surrounding normal renal parenchyma (unclamping in case NO.1,and selective branch clamping in case NO.2) and kidney reconstruction was conducted with 1-0 Quill Suture via hem-o-lock sliding technique.Results The two procedures were smoothly completed without any extra skin incision.Operative duration,estimated blood loss and skin incision length was respectively 230/190 min,100/60 ml,3.6/2.5 cm.Duration of two selective renal artery branches clamping in case NO.2 was 39 and 24 min.Postoperative pain measured by the visual analog pain scale (VASP) at day 1,day 2,day 3 was 5/4,3/3,2/1,Time off oral intake,duration of drainage and length of stay after surgery was 2/4 d、2/4 d、6/7d,respectively.The recovery of both patients were uncomplicated and discharged smoothly.Pathological examination revealed oncocytoma in case NO.1 and papillary renal cell carcinoma in case NO.2.Conclusions The initial experience shows the robotic laparoendoscopic single-site zero-ischemia partial nephrectomy is a safe,feasible and efficacious procedure.It may exhibit clinical benefits for patients in terms of pain control,convalescence and cosmesis,but in this early stage the clinical indications should be strictly controlled.

Objective To investigate the role and possible mechanism of Chemokine receptor CXCR4 in the drug resistance of sorafenib in renal cell carcinoma.Methods 786-O cells were inoculated into the anterior sciatic region of nude mice subcutaneously,5 × 106 cells per point.The mice were given normal saline and sorafenib intragastric (80 mg/kg,1 time/day) when the transplanted tumor volume reached about 100 mm3.The tumor volume in the saline group was more than 1 500 mm3 at the 5th week,and the tumor was taken as the control tissue.Sorafenib group tumors started to grow accelerately at week 8,and the tumor volume was more than 1 500 mm3 at week 13.The 13th week tumors were used as resistant tissue.The expression of CXCR4 in control tissues and drug resistant tissues was detected by real-time quantitative PCR,western blotting and immunohistochemistry.The pcDNA3.1-CXCR4 plasmid was constructed and transfected into 786-O cells.The expression of CXCR4 was detected by real-time quantitative PCR and western blotting.The drug reactivity of the cells was measured by CCK-8 and monoclonal assay to compare the drug resistance of the control group,CXCR4 overexpression group and CXCR4 overexpression + CXCR4 inhibitor AMD3100 group.The phosphorylation of PKB,ERK and STAT3 in the control group,the sorafenib alone group,the overexpressing CXCR4 + sorafenib group and the overexpressing CXCR4 + sorafenib + AMD3100 group were deternined by Western blotting.Results Compared with the control tissues,the mRNA levels of CXCR4 in the drug-resistant tissues increased (3.22 ± 0.23) times,and the levels of protein expression increased (2.33 ± 0.47) according to western blotting,the differences were statistically significant (P ＜ 0.01).After overexpression of CXCR4,the nRNA expression of CXCR4 increased (78.3 ± 5.3) times,and the protein expression level increased (2.80 ± 0.95) times,and the differences were statistically significant (P ＜ 0.01),indicating that the expression model was established successfully.The drug response curves of the control group,CXCR4 overexpression group and CXCR4 overexpression + AMD3100 group on sorafenib were measured by cck8 method,and the ICS0 was (7.5 ±0.8) μmo]/L,(10.3 ±0.7) μmol/L,(5.7 ±0.6) μmol/L,the differences were statistically significant (P ＜ 0.05);The numbers of clones formed in the above three groups were 26 ± 5,56 ± 12 and 42 ± 9,respectively.The differences were statistically significant (P ＜ 0.05).Sorafenib could reduce the phosphorylation of PKB,ERK and STAT3,and overexpression of CXCR4 could reverse the inhibition of phosphatidylation of PKB,ERK and STAT3 by sorafenib.After inhibition of chemokine receptor CXCR4 activity by AMD3100,PKB,ERK,STAT3 phosphorylation was re-suppressed.Conclusions CXCR4 can promote renal cell carcinoma sorafenib resistance.The expression of CXCR4 increased in secondary resistant tumor tissue increased;CXCR4 may promote drug resistance by activating the cell viable pathway.The inhibition of CXCR4 signaling pathway is expected to improve the therapeutic effect of sorafenib in renal cell carcinoma.

Objective To study the relationship between the MDR1 gene expressions and CD56 antigen expression in patients with de novo acute myeloid leukemia(AML) and to explore the role of this two factors in clinical drug resistance and their correlation. Methods A real-time quantitative RT-PCR method was established for detecting MDR1 expression levels and three-color flow cytometry analysis using CD34/ SSC gating was used to examined CD56 antigen expression in 79 de novo AML patients. Results CD56 an-tigen was recorded in 19 out of 79 cases (24.1%) and particularly in those with M5 cytotypes. Moreover, CD56 expression was significantly associated with unfavorable cytogenetic abnormalities (P<0.05), Patients with t(8:21)had a significantly higher incidence (57.1%, 4/7) of CD56 expression than those with favora-ble karyotype(P<0.05). CD56~+ AML patients had a higher incidence of splenohepatomegalia and lactate dehydrogenase level than CD56~- patients(P<0.05). The median expression levels of MDR1 was statistical-ly higher in CD56~+ AML patients than that in CD56 patients(P<0.001). Patients with both high levels of MDR1 and CD56~+ had a significantly lower CR(complete remission) rate than those with both low MDR1 level and CD56 (58.8% vs 89.2%, P<0.01). Conclusion There is a linear correlation between MDR1 gene expression and CD56 expression in AML. Quantification of the MDR1 gene expression together with CD56 antigen expression is more effective to the judgement of prognosis in AML.

Hand Deformities ; pathology ; Humans ; Klippel-Feil Syndrome ; pathology ; Thumb

OBJECTIVETo evaluate the effectiveness of hypnotic and musical relaxation therapy and psychological consultation for parents of children with cleft lip and/or palate (CLP) and to provide a scientific basis of clinical-psychological treatment options.

METHODSSixty-six subjects with children with CLP participated in this study. The subjects were randomly assigned to a test group (n = 33) and a control group (n = 33). The test group was treated with hypnotic and musical relaxation therapy; the control group were subjected to psychological consultation. Anxiety and depression states were evaluated by using a self-rating anxiety scale (SAS) and a self-rating depression scale (SDS) before and after treatment was administered.

RESULTS1) The test group demonstrated a significant decrease in SAS and SDS scores (t = 2.855, P < 0.01; t = 2.777, P < 0.01). The control group showed a significant decrease in the SAS score (t = 1.831, P < 0.05) but failed to show a significant change in the depression score (t = 0.909, P > 0.05). 2) The test group yielded a higher percentage of remission indicated by the SDS scores than the control group (test group = 75.76%; control group = 60.61%; P < 0.05). The test group also displayed a higher percentage of remission indicated by the SAS scores than the control group (test group = 78.79%, test group = 69.70%; P < 0.05).

CONCLUSIONHypnotic and musical relaxation therapy can more effectively reduce the scores of the anxiety and depression states of the parents of patients with cleft lip and/or palate than psychological consultation.

Anxiety ; psychology ; therapy ; Child ; Cleft Lip ; psychology ; Cleft Palate ; psychology ; Depression ; psychology ; therapy ; Humans ; Hypnosis ; Music ; Parents ; psychology ; Relaxation Therapy ; methods ; Self-Assessment

In this paper, the process performance indexes (PPIs) P(p) and P(pk) were introduced and applied to evaluate the process capability and quality consistence of Chinese medicine products. The historical quality analysis data of Qingkailing injection were collected and taken as the research object. The confidence intervals of P(p) and P(pk) were estimated based on the Bootstrap sampling methods. Results showed that the value and width of the confidence interval P(p) of were smaller that of P(pk) suggesting that the P(pk) index was more sensitive than P(p) in process capability analysis. Within the production period concerned, the P(pk) values estimated from different quality indexes of Qingkailing injection, such as baicalin, cholic acid, geniposide and total nitrogen, were 1.122, 2.055, 1.564 and 0.891, respectively. It could be found that the cholic acid had the highest process capability, followed by the geniposide and baicalin. The total nitrogen had the lowest process capability, indicating that it is necessary to reinforce the quality management of total nitrogen related manufacturing processes. The case studies demonstrate the effectiveness and feasibility of PPIs, which are convenient to be used in production practice of Chinese medicine.
Chemistry, Pharmaceutical ; methods ; standards ; Drugs, Chinese Herbal ; chemistry ; standards ; Injections ; Quality Control

Abstract: The design space of the high shear wet granulation process was established and validated within the framework of quality by design (QbD). The system of microcrystalline cellulose-de-ioned water was used in this study. The median granule size and bulk density of granules were identified as critical quality attributes. Plackeet-Burmann experimental design was used to screen these factors as follows: dry mixing time, the impeller and chopper speed of dry mixing, water amount, water addition time, wet massing time, the impeller and chopper speed of wet massing and drying time. And the optimization was implemented with the central composite experimental design based on screened critical process parameters. The design space of the high shear wet granulation process was established based on the quadratic polynomial regression model. Since the P-values of both models were less than 0.05 and values of lack of fit were more than 0.1, the relationship between critical quality attributes and critical process parameters could be well described by the two models. The reliability of design space, illustrated by overlay plot, was improved with the addition of 95% confidence interval. For those granules whose process parameters were in the design space, the granule size could be controlled within 250 to 355 μm, and the bulk density could be controlled within a range of 0.4 to 0.6 g x cm(-3). The robustness and flexibility of the high shear wet granulation process have been enhanced via the establishment of the design space based on the QbD concept.