Impacted teeth are usually involved in permanent dentition but not in primary dentition. This paper reports a clinical case of unerupted mandibular second deciduous molar inferior to the second premolar.
Bicuspid ; Dentition, Permanent ; Humans ; Mandible ; Molar ; Tooth, Deciduous ; Tooth, Impacted ; Tooth, Unerupted

Objective To further explore the pathogenesis of disturbed adaptive immune response in infants with sepsis. Methods Forty-eight infants with sepsis and 26 age-matched healthy infants were enrolled in this study. The HLA-DR expression of CD14~+ monocyte, the proportion of CD4~+ CD25~+ Foxp3~(high) Tr cells and the proportion of Thl7 cells were measured by flow cytometry. Cytokines (IL-1β, IL-6, TNF-α, IL-10, TGF-β and IL-17A) were measured by ELISA. Real-time PCR were used to evaluate the mRNA levels of Foxp3, ROR-γt in CD4-positive cells and IL-17A. Forty-eight infants with sepsis were divided into two groups according to HLA-DR expression of CD14~+ monocyte: DR-H group ( ＞ 30% ) and DR-L group ( ＜ 30% ). Results The ratio of IL-10/TNF-α in DR-L group was higher than that in healthy control or DR-H group(P ＜0.05). The proportion of CD4~+ CD25~+ Foxp3~(high) Tr cells and mRNA expression of transcription factor Foxp3 in DR-L group was found to be significantly higher than that in healthy control or DR-H group(P＜0.05). The proportion of Thl7 cells, Serum concentration of IL-17A, the mRNA expression of IL-17A and transcription factor ROR-γt were significantly increased in DR-H group and DR-L group (P ＜ 0.05) , while there is no significant difference between DR-H and DR-L group( P ＞0.05). Serum levels of Th17-inducing cytokine such as IL-1β, IL-6 were significantly elevated in DR-H group and DR-L group (P＜0.05), while there is no significant difference between DR-H and DR-L group( P＞0.05). Serum level of CD4~+ CD25~+ Foxp3~(high) Tr-inducing cytokine TGF-p in DR-L group was higher than that in DR-H or healthy control group(P＜0. 05). Conclusion Over-activation of Th17 cells may be one of the factors causing aberrant increase of pro-inflammatory cytokine/chemotatic factor in infant with sepsis. The imbalance of CD4~+ CD25~+ Foxp3~(high) Tr cells/Th17 cells may be contributed to the pathogenic mechanism of mixed antagonist response syndrome ( MARS) in infant with sepsis. The changes of cytokine environment in infants with sepsis may be one of the factors causing the imbalance of CD4~+ CD25~+ Foxp3~(high) Tr cells/Th17 cells.

Objective To evaluate the results of acromioclavicukr crook plate in treatment of acromioclavicular joint dislocation and distal clavicular fracture and discuss causes for complications and preventive measures.Methods From September 2003 to April 2007,open reduction and acromiocla vicular crook plate fixation was done on 38 patients with acromioclavicular joint dislocation and distal clavicular fracture including 17 with acromioclavicular dislocation and 12 with distal clavicle fractures.Postoperative rehabilitation began early.Results Of all,27 patients were followed up for mean 21 months (3-37 months) and obtained bone healing.The internal fixation was removed at 6-8 months postoperatively and the outcome was evaluated with Karlsson rating system,which showed 22 patients at grade A,four at grade B and one at grade C.There was no dislocation or fracture after the internal fixation was removed ranging.Three patients with limited abduct motion <90° during certain movements got better after plate removal.One patient had acromio clavicular erosion.Conclusions The application of acromioclavicular crook plate provides accurate anatomical reduction and early rehabilitation and enables fast functional recovery.Technically,the implant needs to be used precisely.It is better to get appropriate early exercise and remove plate as early as possible.

Aim To discover specific telomerase inhibitors by high-throughput screening in the more than 2 000 strains of actinomycetes fermentation broth.Methods After verifying the three kinds of screening models for telomerase inhibitor by yeast PCR,the three yeast strains were inoculated overnight into yeast liquid culture which was lacking in histidine and contained 3-AT.Then concentration of yeast strains in culture liquid and dosage of screening sample were regulated for better adjustment to the high-throughput screening.At last the adjusted liquid culture containing yeast strain piped to 96-well plates,drug samples and control article were also added,then the yeast was incubated in the thermostat oscillator.At the same time OD_(595nm) of the yeast liquid was measured every 12 h by using Multifunctional Microplate Analyzer,and the samples whose inhibitory efficiency was over 0.45 were selected for secondary screening.Results The high-throughput screening method related to yeast three-hybrid system was effective in screening samples that had potential telomerase inhibitory ability.The initial concentration of yeast liquid OD_(595nm) was 0.04 and the best dosage of samples was 5 ml.14 active samples,whose inhibitory efficiency was over 0.45,were founded after primary and secondary screening.Conclusions High-throughput screening method related to yeast three-hybrid system is simple and stable in discovering telomerase inhibitors,and 14 new antitumor compounds are identified,which lays the foundation in the development of new anti-tumor agents.

OBJECTIVETo detect expression of p-glycoprotein (P-gp), multidrug resistance-associated protein (MRP), and glutathione S-transferase (GST-pi), and to evaluate its clinical significance in neuroblastoma (NB).

METHODSSP immunohistochemical technique was used to investigate expression of P-gp, MRP, and GST-pi in 70 cases of NB.

RESULTSThe frequency of expression of P-gp, MRP, and GST-pi was 61.4%, 38.6%, and 51.4%, respectively. The coexpression rate of P-gp and MRP, P-gp and GST-pi, MRP and GST-pi, P-gp, MRP and GST-pi was 32.9%, 35.7%, 27.1%, and 24.3%, respectively. Significant positive correlation was observed between P-gp and MRP expression (P = 0.001), and between MRP and GST-pi expression (P = 0.012), but no correlation was found between P-gp and GST-pi expression. The expression of P-gp and MRP was higher in tumors from patients over 1 year old compared with those less than 1 year old at diagnosis (P = 0.01, 0.018, respectively). MRP expression was higher in tumors from the metastatic than the non metastatic groups (P = 0.015). All tested proteins showed significant relationship to the differentiation of the tumor (P = 0.006, 0.000, 0.019, respectively), but no correlation was found to the stage of NB or sex of the patients. MRP expression was significantly related to the reduction of both median survival time and the two-year cumulative survival (P = 0.02). In contrast, P-gp and GST-pi expression had no correlation with survival.

CONCLUSIONSThe intrinsic multidrug resistance of NB involves the combined effects of P-gp, MRP, and GST-pi. MRP expression may be an important parameter in predicting the prognosis of patients with NB.

ATP-Binding Cassette, Sub-Family B, Member 1 ; biosynthesis ; Adolescent ; Child ; Child, Preschool ; Female ; Gene Expression ; Glutathione S-Transferase pi ; Glutathione Transferase ; biosynthesis ; Humans ; Immunohistochemistry ; Infant ; Isoenzymes ; biosynthesis ; Male ; Multidrug Resistance-Associated Proteins ; biosynthesis ; Neuroblastoma ; metabolism ; mortality ; Survival Rate

Objective To investigate clinical significance and application of modified pelvic floor reconstruction developed by Peking Union Medical College Hospital ( MPFR ) in treatment of severe pelvic organ prolapse (POP) by comparing the effectiveness, quality of postoperative sexual life, life satisfaction and risk factors for POP recurrence with the following two surgical procedures: traditional total vaginal hysterectomy with anterior-posterior colporrhaphy (TVH-APC) and total vaginal hysterectomy with lateral colporrhaphy and sacrospinous ligament fixation and vaginal bridge repair and episiotomy (TVH-LC-SSLFVBR-EP). Methods Totally 173 patients with severe POP and at least two compartments defects of pelvic floor underwent surgeries in the study, 86 patients (group A) were treated by MPFR with polypropylene mesh application, 58 (group B) were treated by TVH-APC, and 29 patients (group C) were treated by TVH-LC-SSLF-VBR-EP. Peri-operative data and outcomes of postoperative courses at 6, 12, 18 months were collected and analyzed, in the meantime, the risk factors of recurrence were studied. Results (1) No statistical difference was observed among the above 3 groups in terms of length of operation, amount of blood loss, length of hospital stay, and morbidity after surgery ( P ＞ 0.05). ( 2 ) Cost hospitalization was ( 11 448 ±3049) Yuan in group A, which was significantly higher than (7262 ± 1607) Yuan in group B and (7140 ± 1817 ) Yuan in group C (P ＜ 0.05 ). (3) The length of vaginal cuff of (7.5 ± 1.4) cm in group A and ( 5.6 ± 1.1 ) cm in group C were significantly longer than (7.1±0.6) cm in group B ( P＜0.05). The width of vaginal cuff of (4.3±0.3) cm in group A was larger than (3.4±0.3) cm in group B and (3.3±0.4) cm in group C (P＜0.05). (4) The recurrence rate at 12 months after surgery was 12.8% (11/86)in group A, which was similar with 17.2%(5/29) in group C (P＞0.05) and significantly less than 36.2% (21/58) in group B (P＜0.05). The rate of active sexual life of 16.3% (14/86) in group A was significantly higher than 1.7% (1/58) in group B and 0 in group C ( P ＜ 0. 05 ). The index of life quality improvement at 12 months after surgery was 48±12 in group A, which was no less than 53±16 in group C ( P＞0.05) and higher than 27 ± 9 in group B ( P＜0.05). (5 ) Mesh rejection was observed in 6 patients in group A within 3 months after surgery, while the posterior vaginal wall was exclusively involved. No difference was found in urinary retention or urinary incontinence among three groups (P ＞0. 05 ). (6) The severe degree of POP, type of surgical procedure ( TVT-APC), anterior compartment defect of pelvic floor,and early days of performing pelvic floor reconstruction surgeries were high risk factors for POP recurrence (P＜ 0.05). Conclusions MPFR has a better curative effect and lower recurrence rate on patients with POP. It can help patients regain integrity of anatomical structure and functions of pelvic floor. TVH-LCSSLF-VBR-EP is also effective.

OBJECTIVETo investigate the possession of occupational health examination qualification among occupational health examination institutions in Zhejiang province, China and the application of GBZ188-2007 "Technical specifications for occupational health surveillance" among related government departments, and to provide a basis for revising and improving the specifications.

METHODSA questionnaire survey was carried out among occupational health inspection agencies, health supervision authorities, and enterprises of different sizes, which possessed provincial-level occupation health inspection qualifications and had engaged in occupational health examination for more than 2 years. The investigation included awareness, using frequency, and revision suggestion about GBZ 188-2007 "Technical specifications for occupational health surveillance".

RESULTSMedical institutions and centers for disease control and prevention (CDCs)showed a high rate of occupational health examination qualification possession in chemical substances, dust, noise, and high temperature and a low rate of qualification possession in physical factors, biological factors, special operations, and other aspects. These institutions showed high awareness of chemical substances, dust, and physical factors in GBZ 188-2007 "Technical specifications for occupational health surveillance" and low awareness of other factors. Medical institutions, CDCs, and provincial and municipal health supervision authorities used these specifications more frequently than county-level authorities and enterprises. More than 80% investigated units believed that the following issues required further optimization: occupational health care, emergency health examination regulations, classification of occupational health inspection reports, and special operation monitoring. It is consistently stressed that for exposure to chemical compounds that may bring harm to various organs of the body, explicit specifications should be made concerning health examination before, during, and after service. Conflicting opinions existed concerning the following issues: satisfaction with GBZ 188-2007 specifications, whether to add contents for care of personnel exposed to biological factors (such as forest encephalitis), the threshold of noise intensity to perform health care, and whether to add health care for exposure to compounds such as benzene and phenols.

CONCLUSIONThe occupational health inspection agencies in Zhejiang province have a high rate of qualification possession in health examination concerning chemicals, dust, noise, and high temperature. The medical institutions, CDCs, and health supervision departments above the county level often use the specifications at work. It is consistently recommended that more kinds of harmful substances should be included, and related specifications and issues should be further optimized, in order to better meet the requirement of occupational health care in the new era.

China ; Humans ; Occupational Exposure ; Occupational Health Services ; standards