Objects To evaluate the immune protective effect of dexmedetomidine on breast cancer dur-ing perioperative radical mastectomy via sevoflurane inhalation general anesthesia. To explore reasonable anesthet-ic strategyfor breast cancer radical mastectomy. Methods Patients were divided into two groups. Patients in ex-perimental group receivedgeneral anesthesia with dexmedetomidine and sevoflurane. Control group means general anesthesia with sevoflurane only. In both groups, the level of cortisol, IL-6, IL-8 and of TNF-αin serum were measured at 5 time points , 30 minutes before anesthesia , after cutting skin , after surgery , 24 h after surgery and 72 h after surgery. Results The amount of anesthetic used to induce general anesthesia in the experimen-talgroup were lower than that of the control group.There is no obvious difference of cortisol , IL-6, IL-8 and of TNF-αin serumat the time of 30 min before anesthesia between two groups.Concentrations ofseveral markersin-creasedafter anesthesia, of which experimentalgroup were lower than that of the control group. Conclusions Dexmedetomidine could be immunoprotective for patient with breast cancer during perioperative radical mastecto-my via sevoflurane inhalationgeneralanesthesia. This study recommends usingmultiple anestheticdrugs to anes-thetize patients of breast cancer when performing radical mastectomy.

Purpose To investigate the expression and significance of epiderma1 growth factor receptor( EGFR)mutation-specific anti-bodies in 1ung adenocarcinoma. Methods Immunohistochemica1( IHC)technique was used to detect the expression of EGFR muta-tion-specific antibodies(EGFR-19,EGFR-21)and EGFR tota1 protein antibody(EGFR-P)in 171 cases of 1ung adenocarcinoma with resected specimens,and EGFR gene mutation was a1so performed by amp1ification refractory mutation aystem-PCR( ARMS-PCR). The expression of EGFR-19,EGFR-21 and EGFR-P mutant proteins was compared with EGFR gene mutation and their re1ationship with histo1ogica1 c1assification and c1inica1 characteristics were ana1yzed. Results The expression of EGFR mutant protein was corre1ated with the poor differentiation group inc1uding micropapi11ary and so1id predominant types( P=0. 021 ). EGFR-21 high expression was re1ated to p1eura1 invasion(P=0. 005). The coherence of IHC(with EGFR-19/21 antibodies)and ARMS-PCR was existed(Kappa>0. 4 ). Taking ARMS-PCR as a standard,the sensitivity and specificity of EGFR-19 and EGFR-21 were 65. 0% and 89. 4%, 70. 0% and 97. 6%,respective1y. Conclusions Expression of EGFR mutation-specific antibodies is associated with poor differentia-tion and p1eura1 invasion. It suggests a worse prognosis indicator in 1ung adenocarcinoma. Because of the coherence with ARMS-PCR, using IHC with mutation-specific antibodies to detect the mutant proteins of EGFR-19/21 may act as a pre1iminary screening method of EGFR gene mutation.

Objective To determine whether store-operated Ca2+ entry (SOCE) is involved in chronic hypoxia-induced alteration of intracellular Ca2 + concentration ([Ca2+] i) and proliferation in pulmonary arterial smooth muscle cells (PASMC).Methods Rat PASMCs were cultured and treated in normoxia (21％O2) or hypoxia (4％ O2) condition.The proliferation of PASMC was detected by cell counting kit-8 (CCK-8) assay.[Ca2 +] i,SOCE and the effects of store-operated Ca2 + channel (SOCC) inhibitors,SKF96365 and NiCl2,on SOCE in hypoxic PASMCs were tested by InCyte [Ca2 +] i measurement system.Results Hypoxia for 24-60 h augmented PASMC proliferation (1.12 ± 0.09 vs 0.71 ± 0.05,P ＜ 0.05) and [Ca2 +] i [(214.8 ± 20.4) nmol/L vs (115.2 ± 13.2) nmol/L,P ＜ 0.05] in a time-dependent manner with the maximum effect at 60 h.Perfusion of Ca2+-free Krebs solution containing nifedipine (5 μ mol/L),cyclopiazonic acid (CPA,10 μmol/L) in PASMCs caused a small transient increase of [Ca2+]i with peak [Ca2+]i (113.3 ± 49.3) nmol/L.Chronic hypoxia (4％ O2,60 h) enhanced [Ca2+]i level with peak value of (193.2 ± 22.7) nmol/L (P ＜ 0.05) in PASMC.After restoration of extracellular Ca2+,CPA caused marked increase of [Ca2+]i with peak value of (328.0 ± 56.7) nmol/L.Chronic hypoxia strengthened CPA-induced increase of [Ca2 +] i with peak value of (526.0 ± 33.7) nmol/L (P ＜ 0.05) in PASMCs.Either SKF96365 50 μmol/L or NiCl2 500 μmol/L distinctly attenuated CPA-induced enhancement of [Ca2 +] i,the peak value of which dropped from (526.0 ± 33.7) nmol/L to (170.4 ± 26.4) nmol/L (P＜0.05) or (177.4±45.9) nmol/L (P＜0.05) respectively.Conclusion Chronic hypoxia boosts the release of Ca2+ from sarcoplasmic reticulum and promotes the activity of SOCC and SOCE,leading to [Ca2 +] i elevation and proliferation of rat PASMCs.

Objective:To evaluate the effects of maxillary protraction with or without rapid maxillary expansion in the treatment of Class Ⅲ malocclusion by Meta-Analysis.Methods:The randomized controlled trail,quasi-randomized controlled trail and the clinical controlled trail about the treatment of Class Ⅲ malocclusion by protraction with or without expansion were searched in the database of Cochrane Library,Embase,PubMed,Medline,CBM,Wan Fang,CNKI,VIP.2 authors qualified and extracted the data independently.Then the Meta-analysis was performed by using the RevMan 5.3 software.Results:7 studies with 228 cases were included,114 cases were treated by maxillary protraction with expansion and the other 114 cases by maxillary protraction without expansion.The Meta-analysis showed that:there was no significant difference in SNA,SNB,ANB and SN-PP except ANS-Me,U1-NA,SN-MP.A favorable improvement of the sagittal relationship between maxillary and mandibular was observed by using protraction whether with expansion or not.The expansion did not shorten the course of treatment,but it lowered the inclination of upper incisors,resulting in more clockwise rotation of mandibular plane and increase of the facial vertical dimension.Conclusion:Maxillary protraction with rapid maxillary expansion can be used in the treatment of class Ⅲ malocclusion with incisor labioclination.

Objective The aim of this study was to determine whether multi?parameters MRI of tongue carcinoma have the potential to predict cervical lymph node metastases. Methods A total of 46 patients with tongue carcinoma, who underwent MRI scan preoperatively, were investigated retrospectively and were divided into cervical lymph node (LN) metastases group (unilateral LN+, n=16;bilateral LN+, n=14) and no cervical lymph node metastases group (LN-, n=16) according to their pathological grading. Of the 40 patients with tongue carcinoma underwent plain and contrast MRI scan, 6 patients have plain MRI scan, and 32 have DWI examination.The ADC value, tumor length, tumor thickness, sublingual distance between tumor and sublingual space, and para?lingual distance between tumor and tongue midlinedetermined from MRI, were preoperatively estimated and compared with the pathological findings of cervical lymph nodes. A unpaired t test was used to analyze normal distributed continuous data, and a Mann?Whitney U test was used to analyze abnormally distributeddata. The ROC was used to evaluate the efficacy of MRI in predicting the metastasis of cervical lymph nodes. Results The indexes of ADC value, tumor length, tumor thickness, and para?lingual distance between tumor and tongue midline, which all showed significant difference between LN+group and LN-group (all P<0.05), and the index of sublingual distance between tumor and sublingual space showed no significantly association with LN+ (P>0.05). The index of ADC value showed significant difference between unilateral LN+group and bilateral LN+group (P<0.05), and the other indexes, which all showed no significantly association with bilateral LN+ (all P>0.05). The ROC curve analysis of the ADC value, tumor length, tumor thickness, and para?lingual distance between tumor and tongue midline of the neck lymph node metastasis were carried out, with the cutoff set as 1.13×10?3 mm2/s, 31.08 mm, 17.33 mm and-2.26 mm. The corresponding area under curve(AUC), sensitivity, and specificity were 0.878, 90.9%and 90.0%; 0.822, 83.3% and 81.3%; 0.834, 86.7% and 81.3%; 0.794, 86.7% and 75.0%, respectively. The ROC curve analysis of the ADC of the bilateral neck lymph node metastasis was also carried out, with the cutoff of ADC value set as 1.07×10?3 mm2/s, the corresponding AUC, sensitivity, and specificity were 0.806, 80.0%and 75.0%. Conclusion The ADC value, tumor length ,tumor thickness and para?lingual distance between tumor and tongue midline,determined from MR imaging, all can be used as independent factors in predicting cervical lymph node metastasis, where ADC value may be helpful to predict bilateral neck lymph node metastasis.

Objective: To evaluate the change of tooth root volume and length after rapid maxillary expansion by CBCT three dimensional reconstruction method. Methods: 33 patients underwent rapid maxillary expansion were examined by CBCT before and after treatment. The CBCT images of the first,second premolars and the first molars were segmented and reconstructed by Mimics image processing software for the analysis of the changes of root volume and length. All data were analyzed by SPSS software statistically. Results: After maxillary expansion,all root volumes were reduced(P ＜ 0. 05),more reduction was observed in anchorage teeth than in non-anchorage teeth(P ＜ 0. 05). The length of most teeth roots was not decreased(P＞ 0. 05) except the buccal and distal roots of the first molars(P ＜ 0. 05). Conclusion: Rapid maxillary expansion may result in root resorption and this resorption is mainly based on the volume decrease.

Objective To compare dental and skeletal changes after rapid maxillary expansion in patients with different bone ages.Methods Thirty-seven patients in different growth period were divided into three groups according to cervical vertebral maturation (CVM).There were 13 patients in the growth acceleration group,13 patients in growth peak group,and 11 patients in growth deceleration group.Conebeam computed tomography(CBCT) images were segmented and reconstructed using Mimics image processing software to assess the change of palatal morphology before and after treatment.Statistical analysis was carried out using SPSS 17.0 software.Results After the expansion the posterior teeth and alveolar bone were tilted and the mid-palatal suture was opened in all three groups.The first molar angle in the three groups decreased by 2.66°±1.04°,3.53°±0.81° and 12.32°± 1.64°,respectively and no significant difference was found between the acceleration group and the peak group (P ＞ 0.05),but the changes in the acceleration group and the peak groups were significantly less than that in the deceleration group (P＜0.05).The palatal angle in the three groups increased by 6.01°±2.06°,4.79°± 1.31° and 6.73°± 1.71°,respectively and no significant difference was found between the acceleration group and the deceleration group (P ＞ 0.05),but the changes in the acceleration group and the deceleration group were significantly greater than that in the peak group (P ＜ 0.05).The palatal cemento-enamel junction (CEJ) width,the middle palate width and the mid-palatal suture width in the three groups increased by (7.37± 1.31),(6.68± 0.72) and (5.13± 1.42) mm;(5.72±1.68),(4.82± 1.66) and (3.42± 1.15) mm;(3.14±0.45),(2.98±0.51) and (0.96±0.83) mm,respectively and no significant difference was found between the acceleration group and the peak group (P ＞ 0.05),but the changes in the acceleration group and the peak group were significantly greater than that in the deceleration group (P ＜ 0.05).Conclusions The mid-palatal suture could be opened in patients in different CVM period.More skeletal and less dental effects were found in patients in the growth acceleration and peek group than in those in the growth deceleration group and the inclination of the alveolar bone could be avoided to a greater degree in patients in the growth peek group.

Child ; China ; Coronavirus ; Epidemiology ; Humans

Objective:To analyze the molecular epidemiological characteristics of the Corona virus disease 2019 (COVID-19) cases in Shijiazhuang, which can reveal the origin of the outbreak and provide a scientific basis for COVID-19 prevention and control.Methods:From January 2 to January 8, 2021, a total of 404 samples from 170 COVID-19 cases were collected from the Shijiazhuang Fifth Hospital. The consensus sequence of 2019 novel Coronavirus(2019-nCoV) was obtained through multiplex polymerase chain reaction-based sequencing. The sequences of 170 COVID-19 cases were analyzed by the PANGOLIN, and the data were statistically analyzed by T-test.Results:Among the 404 COVID-19 samples, a total of 356 samples obtained high quality genome sequences (>95%,100×sequencing depth). The whole genome sequences of 170 COVID-19 cases were obtained by eliminating repeated samples. All 170 sequences were recognized as lineage B1.1 using PANGOLIN. The number of single nucleotide polymorphism arrange from 18-22 and most of the single nucleotide polymorphism were synonymous variants. All of 170 genomes could be classified into 48 sub-groups and most of the genomes were classified into 2 sub-groups (66 and 31, respectively).Conclusions:All cases in this study are likely originated from one imported case. The viruses have spread in the community for a long time and have mutated during the community transmission.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.