Tissue engineering of oral and maxillofacial surgery is a newly subject and animportant branch of tissue engineering. The study is to evaluate fundamental medical ethics principle in the tissue engineering of oral and maxillofacial surgery on the view medical ethcs. Strengthening the ethical education on oral and maxillofacial surgeon and right education on patients are in favor of development of tissue engineering in the oral and maxillofacial surgery.

Objective To analyze MRI findings of the mitochondrial encephalopathy, in order to improve the understanding of this disease. Methods MR findings of 5 patients of clinically proved mitochondrial encephalopathy were retrospectively analyzed. Results Brain parenchymal lesions in all patients were low intensity on T1WI and high signal intensity on T2WI. One patient had bilateral globus pallidus involvement, while involvement of gray matter and white matter were observed in 4 patients. Three patients had enlargement of supratentorial ventricles, 2 patients had cerebellar atrophy and 1 patient had bilateral basal galia calcification. Conclusion MRI can show the intracranial lesions in patients with mitochondrial encephalomyopathy clearly, but accurate diagnosis should depend on clinical data.

Objective To design a method for detecting multileaf collimator (MLC) leaf position accuracy in implementing a static intensity-modulated plan and to analyze the impacts of leaf errors on dose of targets and normal organs.Methods Static intensity-modulated planning for twenty lung cancer cases through dose verification was sorted in an ascending order according to the number of segment,and then the first and the last 10 plans were sorted as the simple plan group and the complex plan group,respectively.These plans were transmitted to a Varian 600CD accelerator and implemented by it.Photos were taken with PV aS500 electronic portal imaging device (EPID) and actual position of leafs was determined by gradient algorithm to calculate the pass rate for leaf verification.MLC files were modified according to examination results and the plans were re-calculated while keeping other parameters unchanged.Thus,difference of targets and normal organs dose distribution before and after the appearance of leaf errors were obtained.Results The dose distribution of most organs after leaf errors were increased or decreased,and the maximum dose of spinal cord in the sixth and thirteen cases exceeded the limit of 45 Gy.In the group of simple plan only the changes of maximum dose to the spinal cord were statistically significant(t =-3.08,P ＜ 0.05),while in the group of the complex plan all changes of D95％ of PGTV and PTV,maximum dose of the spinal cord,V20 of lung and V40 of heart were statistically significant(t =-1.89,-1.99,-2.36,-2.55,-1.85,P ＜ 0.05).Conclusions To ensure the safety and effects,it was necessary to detect leaf position,particularly the complex intensity-modulated planning.Electronic portal imaging devices and treatment planning system could detect leaf positions during the implementation of a plan and obtain the actual dose of targets and normal organs.

Objective To evaluate the diagnostic value of MR in carotid artery involvement using surgery and pathology as gold standard.Methods 37 patients with suspected neck masses underwent MR scan.One radiologist unaware of the pathological results measured the nine indexes as following:axial surrounding angle(AXA),long axis angle(LAA),the adjacent length of tumor long axis(LLA),the tumor long axis length(TLAL),the ratio of the adjacent length of tumor long axis and the tumor long axis length (LLA/TLAL),the perivascular fatty gap,vascular displacement,vascular deformation and magnetic resonance angiography(MRA) evaluation of artery involvement.The comparison of diagnostic value used ROC curve,sensitivity,specificity and accuracy.The cat-egorical data used Fisher orχ2 test,and measurement data used t test.Results Four indexes (AXA,LAA,LLA/TLAL and MRA) had significantly statistical value for evaluating the arterial invasion.The AUC of AXA,LAA,LLA/TLAL were 0.910,0.775 and 0.766 (P <0.05),respectively.Using 145°,61°,0.553 and MRA to indicate invasion for diagnostic value,the sensitivity and spe-cificity of those four indexes were 100.0% and 89.2%,66.7% and 89.2%,100.0% and 59.5%,33.3% and 100.0%,respective-ly.Conclusion The four indexes including AXA,LAA,LLA/TLAL and MRA evaluation of artery involvement have statistic value but with poor stability.MRA had limited diagnostic value although it’s beneficial to observe the carotid artery.

OBJECTIVE To investigate the effects of continuous positive airway pressure (CPAP) on patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) who underwent the revised uvulopalatopharyngoplasty (UPPP). METHODS 18 cases of severe OSAHS patients (therapy group) were selected for CPAP treatment in the 2nd week of postoperation. The average time of CPAP treatment was 34.3 days. The other 20 cases (control group) onlyunderwent operation. All patients were monitored with PSG before operation and in the 6 months postoperatively. RESULTS Compared with the result of pre-operative PSG, apnea hypopnea index (AHI) and Lowest SaO2 (LSaO_2) was improved (P＜0.001) in two groups. Compared with control group, LSaO_2 of the therapy group in the sixth month postoperatively was improved (P＜0.001), but the decreasing of AHI was not significant (P＞0.05). Contrast to the control group, the length of stage 1 and 2 decreased and that of REM increased. (P＜0.05). CONCLUSION For severe OSAHS patients who underwent uvulopalatopharyngo plasty, CPAP treatment for one month postoperatively could improve the hypoxia of patients, and prolong REM stage, shorten the stage 1 and 2 sleep. CPAP treatment in short time would be helpful for the severe OSAHS patients with revised UPPP.

Objective To prepare recombinant plasminogen activator(Pla) protein in E.coli BL21 cells that can be used in studying interactions between Yersinia pestis proteins and immunologic diagnosis of plague.Methods The pla gene was amplified by PCR and cloned into the pET28a expression vector.E.coli BL21 competent cells were transformed with the recombinant vectors, and isopropyl-β-D-thiogalactopyranoside ( IPTG) was added to induce expression of Pla protein. The expressed protein was detected by SDS-PAGE electrophoresis.The inclusion bodies of Pla protein were denatured in 8 mol/L urea, and then refolded using gradient urea solutions.The purified protein was identified by SDS-PAGE electrophoresis and Western blot.Results and Conclusion The constructed expression vector was demonstrated to be correct through agarose gel electrophoresis and sequencing.The recombinant Pla protein was accumulated as an inclusion body in E.coli, and the overexpression product was mainly a target protein, the yield of which was very high.SDS-PAGE purity of the bioactive Pla protein was obtained by denaturing and refolding the inclusion bodies.This study provides a simple and quick method for highly efficient preparation of biologically active Pla protein.

OBJECTIVE To evaluate the value of Epworth sleepiness scale(ESS) combined with home-based portable monitoring(PM) in the diagnosis of patients with obstructive sleep apnea syndrome(OSAS). METHODS Adult OSAS patients who visited Beijing Tongren Hospital and complained of snoring were included in this study. The overnight polysomnography(PSG) and the ESS were completed at the sleep center and the portable multi-channel monitoring was completed within one week. Subjects were divided into two groups according to their apnea hypopnea index(AHI) of PSG: simple snoring or mild OSAS group(AHI<15/h) and moderate-severe group(AHI≥15/h). The ESS score, respiratory disturbance index(RDI) of PM and other parameters were compared and the correlation of AHI with ESS scores, RDI were analyzed. The sensitivity and specificity of ESS score≥9 points, RDI≥15/h in the diagnosis of moderate-severe OSAS were calculated. RESULTS A total of 51 subjects were included in this study with 42 males(82.4％) and 9 females(17.6％). Mean age was(43.8±10.8) years, and the mean body mass index was(27.9±4.5)kg/m2; ESS scored 1-24 points and mean(8.6±5.0) points, 18 cases with ESS score ≥9 points; AHI ranged between 2.5 and 99.8/h with a mean of(37.4±29.8)/h. There were 19(37.3％) and 32(62.7％) patients in snoring-mild group and moderate-severe group, respectively. There was significant difference for ESS scores between the two groups(9.9±5.1 vs 6.6±4.2 points, P<0.05),RDI in moderate-severe OSAS group was significantly higher than that in snoring-mild group[(49.4±23.1)/h vs (6.8±4.5)/h, P<0.001)]. There was a positive correlation between the ESS score and PSG derived AHI(r =0.435, P =0.002); the PM derived RDI were significantly correlated with PSG derived AHI in snoring-mild group(r =0.706, P=0.001), moderate-severe group(r =0.873, P=0.000) and patients with ESS score ≥9 points(r =0.967, P=0.000). At a PSG threshold AHI=15/h, the sensitivity and specificity for ESS score ≥9 points were 45.2％ and 78.9％; the PM derived RDI≥15/h had a sensitivity and specificity of 84.4％ and 84.2％, respectively; the sensitivity and specificity for each individual screening tool along with the combination of ESS and PM were 100.0％ and 100.0％. CONCLUSION ESS combined with PM diagnostic method is a valuable measure for the diagnosis of moderate and severe OSAS patients.

Objective Pathogens from the nosocomial infection have been analyzed by MALDI‐TOF microbial identification system ,to evaluate mass spectrometry analysis advantage and explore the mass spectrometry method .Methods The pathogens have been analyzed by MALDI‐TOF microbial identification system ,by compared with the VITEK‐2 compact detection in the tes‐ting time ,detection rate and the amounts of identified strains .The homology differences have been analyzed by comparison calcula‐tion of common peaks from the fingerprint spectrums .Results Thirty‐one Escherichia coli strains ,28 Klebsiella pneumonia strains and 9 unusual pathogen strains have been identified by MALDI‐TOF MS for only 1 hours .It has more advantages than VITEK‐2 in the testing time and other aspects .Conclusion Nosocomial infection of pathogen shows a point source propagation mode centering on the department .MALDI‐TOF mass spectrometry is able to rapidly and correctly identify the pathogen .MALDI‐TOF microbial i‐dentification system is expected to be the major detecting technique in the field of the pathogen monitor and resistance monitoring a ‐nalysis .

Objective To establish a simple and quick loop-mediated isothermal amplification (LAMP)method for detection of Yersinia pestis.Methods LAMP Primers were designed based on the specific sequence 3a in Y.pestis chromosome.LAMP reaction results were detected using turbidity meter or visual method.The specificity of the constructed method was evaluated by detecting Y.pestis and its closely-related bacteria.The different dilution DNA template was detected with LAMP and PCR to evaluate the sensitivity of the method.Results Thirty strains of bacteria closely related to Y.pestis were detected by the constructed LAMP,and all the results were negative,indicating that the method had a very high specificity.The detection sensitivity of this LAMP assay was 20 pg of DNA per reaction,which was ten-fold that of the regular PCR.The detection reaction was completed in 25 min.Conclusion This LAMP method is quick,sensitive, specific and simple,which is expecked to become an effective method for rapid detection of Y.pestis on the scene.

Objective:To investigate the predictive value of serum C-type lectin-like receptor 2 (CLEC-2) combined with insulin resistance in the outcome of patients with acute ischemic stroke (AIS) after intravenous thrombolysis.Methods:Patients with AIS received alteplase intravenous thrombolytic therapy in the Department of Neurology, the Second Affiliated Hospital of Nantong University from October 2019 to March 2021 were enrolled retrospectively. According to the modified Rankin Scale score at 90 d after onset, they were divided into good outcome group (0-2) and poor outcome group (>2). Homeostasis model assessment of insulin resistance (HOMA-IR) was used to evaluate insulin resistance. Person correlation analysis was used to determine the correlation between CLEC-2 and HOMA-IR. Multivariate logistic regression analysis was used to determine the correlation between serum CELC-2, HOMA-IR and the outcome after intravenous thrombolysis. Receiver operating characteristic (ROC) curve was used to determine the predictive value of serum CLEC-2 combined with HOMA-IR for poor outcome after intravenous thrombolysis. Results:A total of 100 patients were enrolled (56 males, 56.0%; aged 70.6±10.86 years, range 49-83 years). The baseline National Institutes of Health Stroke Scale (NIHSS) score was 10.00±6.36. Senenty-four patients (74.0%) had a good outcome and 26 (26.0%) had a poor outcome. Person correlation analysis showed that there was a significant positive correlation between serum CLEC-2 and HOMA-IR ( r=0.523; P<0.001). Multivariate logistic regression analysis showed that after adjusting for confounding factors (C-reactive protein, baseline NIHSS score, onset-to-needle time), the highest quartile of serum CLEC-2 (compared with the lowest quartile: odds ratio [ OR] 4.836, 95% confidence interval [ CI] 1.105-21.169; P=0.036) and the highest quartile of HOMA-IR (compared with the quartile 1-3: OR 15, 95% CI 2.647-30.722; P=0.002) were the independent risk factors for the poor outcome in patients with AIS after intravenous thrombolysis. ROC curve analysis showed that the area under the curve for serum CLEC-2 combined with HOMA-IR to predict poor outcome was 0.785 (95% CI 0.688-0.883; P<0.001), the optimal cut-off value was 0.72, and the sensitivity and specificity were 76.0% and 95.0%, respectively. Conclusion:CLEC-2 combined with insulin resistance has a certain predictive value for the poor outcome of patients with AIS after intravenous thrombolysis.