TBL (Team-based learning) model is a new teaching method.By evaluating the effect of TBL model in theory teaching on Chinese orthodontic postgraduate program in the department of Orthodontics,Guanghua School of Stomatology,Sun Yat-sen University,and comparing the traditional teaching model which centered on teachers,we have probed into the application experience of TBL teaching method in curriculum setting of preclinical theoretic learning in orthodontics postgraduate education.The result shows TBL has significantly enhanced students' enthusiasm for learning,sense of collaboration,and has improved the quality of education.TBL method is better,even though there is something that needs to be improved.

Objective A headspace-gas chromatography method was established for determination of methanol in Huox-iang Zhengqi Tincture. Methods Headspace-gas chromatography was performed on a HP-INNOWAX capillary col-umn, with nitrogen as carrier gas and FID as detector. The injector temperature was at 150℃ and the detector tempera-ture was at 200℃ , and temperature programming and split stream sampling were used. Results A good linearity was obtained within the designed range, the average recovery was 98.89 % with the RSD of 1.36 %, which met the correla-tive criterion of China Pharmacopoeia. Conclusion This method is proved to be accurate, and it has a good reproducibil-ity and can be used to determinate the residual methanol in Huoxiang Zhengqi Tincture.

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.

Objective To evaluate the clinical value of co-observation of the expression of MAGE-A3 gene and MDR1 gene on esti-mating the curative effect in non M3-subtype acute leukemia. Methods Expressions of MAGE-A3 and MDRI were measured in 77 patients with non M3-subtype acute leukemia by RT-PCR method. Clinical observation was done to estimate the relationship between the genes with curative effect in non M3-subtype acute leukemia. Results Expression of MAGE-A3 and MDRI gene were 50. 6% and 23. 3% in non M3-subtype acute leukemia patients. Positive expression of MDRI in MAGE-A3-positive and negative patients were 46. 2% and 13. 2% (P < 0.01). The complete remission rate in MAGE-A3 negative and positive patients were 86. 8% and 64. I% (P <0. 05). Complete remission (CR) rate in MDR1 negative and positive patients was 83.3% and 56. 5% (P <0. 05). Complete remission rate were 87.9% and 55.6% in beth negative and both positive expression of MAGE-A3 and MDR1 (P < 0. 05). Conclusion The patients of positive expression of MAGE-A3 in non M3-subtype AL had higher expression of MDR1. The patients with negative expression of beth MAGE-A3 and MDR1 had higher CR rate than that in both positive patients. These researches indicated that eo-observatian of the expression of MAGE-A3 and MDR1 can predict the curative effect in non M3-subtype AL.

Objective To understand the diagnostic value of blink reflex (BR) in central neuropathy by observing the variations of blink reflex in diabetic patients. Methods Electrical pulse was used to stimulate the supraorbital nerve at the supraorbital notch. The responses of bilateral orbicular muscles of the eye were recorded, the variations of the latency and amplitude of R 1 and R 2 recorded on the side of stimulation and of R′ 2 recorded on the contralateral side were measured. Results There was significant prolongation in the latency and lowering of the amplitude of R 1, R 2 and R′ 2 in the diabetic patients compared with the control group. The abnormality rate of BR increased gradually with the prolongation of diabetic duration. Conclusion BR examination might provide an objective index for nervous damage in diabetic patients and it is helpful in early diagnosis of diabetic neuropathy.

Objective To evaluate the stability and compressive mechanical functions of the lumbar spine following insertion of a new self-made allograft interbody fusion cage.Methods Anti-bending intensity with three points test,anti-rotation intensity and compressive stiffness were measured at L4-L5 lumbar spine on five adult human fresh cadaveric specimens following insertion of a new self-made allograft interbody fusion cage and compared with that of before and after nucleus pulposus removal.Results The anti-bending intensity of flexion and extension of lumbar spine after inserting a new allograft interbody fusion cage was increased significantly(P

BACKGROUND:Activating transcription factor 4 is found as an activating factor that can regulate osteogenic differentiation and function, and plays a critical role in the osteogenic differentiation.
OBJECTIVE:To investigate the expression and significance of activating transcription factor 4 in the osteogenic differentiation of bone marrow mesenchymal stem cells from Sprague-Dawley rats.
METHODS:Bone marrow mesenchymal stem cells from Sprague-Dawley rats were cultured using the whole bone marrow adherence method, and ossification revulsant was added to induce passage 3 cells. cells with no osteogenic induction served as controls. RT-PCR and western blot assay were employed to dynamical y monitor expression of activating transcription factor 4.
RESULTS AND CONCLUSION:RT-PCR results showed that activating transcription factor 4 mRNA expression increased with the increasing osteogenic differentiation, and peaked at day 16. Western blot analysis showed that the protein expression of activating transcription factor 4 tended to increase with the increasing osteogenic differentiation, peaked at day 16 and stil maintained at a higher level at day 19. Compared with the uninduced cells, activating transcription factor 4 in the induced cells exhibited a higher expression at mRNA and protein levels (P<0.05). These findings indicate that activating transcription factor 4 expression is elevated during osteogenic differentiation, showing a positive correlation with osteogenic ability of bone marrow mesenchymal stem cells.

Objective To investigate CT features of pediatric mediastinal neuroblastoma.Methods The CT performance of pediatric mediastinal neuroblastoma confirmed by clinical and pathology in 17 cases were retrospectively analyzed.The tumor growth pattern,size,density,degree of enhancement,invasion to the surrounding tissues and metastatic characteristics were observed,and the results were compared with pathological analysis.Results Among the 17 cases,2 were at the right posterior upper mediastinum,3 at posterior right middle and upper mediastinum,3 at the posterior right middle and lower mediastinum,1 at the posterior right lower mediastinum,3 at the posterior left middle mediastinum,3 at the posterior left middle and lower mediastinum,1 at the posterior left lower mediastinum,and 1 at bilateral posterior middle and lower mediastinum.The average tumor size was 6.3 ×4.3 cm,ranging from 2.3 ×2.0 cm ～ 12.6 ×4.0 cm.CT plain scan showed 8 cases with clear boundary and 9 case without clear boundary.13 cases were with inhomogeneous density and 4 cases with homogeneous density.8 calcification of grainy or strip was found in the tumor.10 cases were with pleural thickening and 5 cases with pleural effusion.6 cases were with tracheal or main bronchial compression,4 with cardiac compression,7 with pulmonary artery compression,and 1 with descending aorta compression were found.6 cases were with tumors crossing the midline,5 with intervertebral foramen growth,3 wrapped around the aorta,3 with rib attack damage,2 with rib compression deformation,2 with thoracic invasion,and 1 into the upper abdomen.10 cases were with mediastinal lymph nodes enlargement,10 with bone metastasis,4 with cervical lymph nodes enlargement,1 with liver metastasis,and 1 with cerebral metastasis.Enhanced CT scan was performed in 14 cases:11with inhomogeneous enhancement,and 3 with homogeneous enhancement.The average CT value of the 3 mild enhancement was 36 HU,ranging from 20 to 56 HU.The average CT value of the 8 moderate enhancement was 53 HU,ranging from 36 to74 HU.The average CT value of the 3 marked enhancement 72 HU,ranging from 56 to 88 HU.7 punctate vessels and 6 polycystic changes were found in the tumors.Conclusions Mediastinal neuroblastoma in children are with certain characteristics.CT findings with clinical manifestations can make a definite diagnosis.

OBJECTIVETo investigate the clinical characteristics of Segond fracture combined with injuries, and to explore the operative method and opportunity.

METHODSFrom June 2010 to December 2014, 10 patients with Segond fracture were treated. There were 10 males, ranging in age from 26 to 69 years old, with a mean of 42 years old. Under arthroscopy examination within 7 to 10 days after injury, 6 patients had compete rupture of anterior cruciate ligament and meniscus injury; 2 patients had tibial avulsion fractures of the ACL combined with meniscus injury. At 4 to 8 weeks after injury, 2 patients were performed with arthroscopy examination; 1 patient had complete rupture of anterior and posterior cruciate ligament combined with meniscus injury; and the other patient had complete rupture of anterior cruciate ligament alone. All the patients with cruciate ligament rupture were treated with reconstruction of cruciate ligament; 9 patients had meniscus injuries were treated with menisus plasty or suture; and 2 patients had tibial avulsion fractures of the ACL were treated with non-absorbable Ethicon suture fixation under arthroscopy. After operation, the Lysholm scoring system was used to evaluate clinical effects.

RESULTSEight patients were operated within 10 days after injury, the knee joints swelling was obvious at the 3rd day after operation, and blood oozing was found by joint puncture. These 8 patients did out-of-bed activity with assistance at 1 week postoperatively. Other 2 patients performed operation in 4 to 8 weeks after injury without knee joint obvious swelling at the 3rd day after operation, and no blood oozing was found by joint puncture. These 2 patients did out-of-bed activity with assistance after 3 days postoperatively. All the patients were followed up, and the duration ranged from 12 to 24 months, with an average of 18 months. Postoperative Lysholm score of all patients was higher than preoperative scor, and the results were satisfactory.

CONCLUSIONFor Segond fractures, firstly, it is important to gain early diagnosis for treatment. Secondly, it is often associated with the rupture of anterior cruciate ligament and meniscus injuries, and the best time of cruciate ligament rebuilding and meniscus repairing maybe between 4 to 8 weeks after injury. Thirdly, personalized treatment should be chosen according to different complications.

Adult ; Aged ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Humans ; Male ; Middle Aged ; Tibial Fractures ; complications ; diagnosis ; surgery ; Tibial Meniscus Injuries

Objective To comprehensively study the oxidative stress of bone tissue in rats with chronic fluorosis treated with anti-oxidant,the oxidative damage of lipid,protein and DNA.Methods Forty Wistar rats weaned 2 weeks were randomized by weight and divided into 4 groups according to body weight,control group (treated with tap water) and 3 NaF (sodium fluoride) exposure groups (treated with NaF at 50,150 and 250 mg/L),5 female rats and 5 male rats in each group.NaF was given through drinking water.After 6 months of treatment,a 12-hour urine samples were collected,then rats were killed,serum was collected,right rear tibiofibula was separated.Bone and urinary fluoride content and incidence rate of dental fluorine were studied and the levels of bone tissue suppression function of hydroxy free radical,superoxide dismutase (SOD),catalase (CAT),glutathione peroxidase (GSH-Px),8-hydroxydeoxyguanosine (8-OHdG),protein carbonyls (PCO),and malonaldehyde (MDA) were assayed.Results ① Results of suppression function of hydroxy free radical:The difference of bone tissue suppression function of hydroxy free radical among control [(22.99 ± 4.31)U/mg prot],low-excess dose [(22.76 ± 8.11)U/mg prot],medium-excess dose [(13.47 ± 4.56)U/mg prot] and high-excess dose [(19.40 ± 5.92)U/mg prot] groups was statistically significant (F =5.01,P ＜0.05).②Results of SOD:The difference of bone tissue SOD among control [(5.06 ± 1.16)U/mg prot],low-excess dose [(5.32 ± 1.18)U/mg prot],medium-excess dose [(3.71 ± 0.72)U/mg prot] and high-excess dose [(4.80 ± 1.10)U/mg prot] groups was statistically significant (F =4.44,P ＜0.05).③ Results of CAT:The difference of bone tissue CAT among control [(25.20 ± 5.91)U/mg prot],low-excess dose [(22.53 ± 7.10) U/mg prot],medium-excess dose [(17.96 ± 4.71)U/mg prot] and high-excess dose [(19.52 ± 5.52)U/ mg prot] groups was statistically significant (F =2.85,P ＜0.05).④Results of GSH-Px:The differences of bone tissue GSH-Px among control [(52.86 ± 12.88)U/mg prot],low-excess dose [(70.05 ± 15.72)U/mg prot],medium-excess dose [(51.55 ± 6.97)U/mg prot] and high-excess dose [(57.47 ± 10.99) U/mg prot] groups was statistically significant (F =4.89,P ＜0.05).⑤Results of PCO:The differences of bone tissue PCO among control [(58.73 ± 20.86)ng/L],low-excess dose [(89.41 ± 26.20)ng/L],medium-excess dose [(97.07 ± 22.24)ng/L] and highexcess dose [(83.96 ± 29.55)ng/L] groups was statistically significant (F =4.43,P ＜0.05).⑥Results of 8-OHdG:The differences of bone tissue 8-OHdG among control [(87.66 ± 6.32)ng/L],low-excess dose [(86.31± 6.30)ng/L],medium-excess dose [(92.17 ± 4.28)ng/L] and high-excess dose [(88.02 ± 6.14)ng/L] groups was not statistically significant (F =1.88,P ＞ 0.05).⑦Results of MDA:The differences of bone tissue MDA among control [(3.70 ± 1.73) nmol/mg prot],low-excess dose [(2.10 ± 0.95)nmol/mg prot],medium-excess dose [(3.32± 2.20)nmol/mg prot] and high-excess dose [(2.71 ± 2.18)nmol/mg prot] groups was not statistically significant (F =1.37,P ＞ 0.05).Conclusions The activity of SOD and CAT of bone tissue are inhibited and suppression function of hydroxy free radical is decreasing under fluorosis influence,which results in protein damage.Oxidative stress is considered to be one of the mechanisms of skeletal fluorosis.