The electromyogram(EMG) of lateral pterygoid muscle (LP) in 43 patients with LP dysfunction was measured before, when and after the use of occlusal splint. The postural and clenching activity of superior LP decreased dramatically when patients were wearing the occlusal splint. Normal EMG was observed in patients with normal arthrograra when the symptoms and signs were eliminated or reduced by occlusal splint. The EMG of dysfunctional LP in some patients with anteriorly displaced disk recovered to that with normal function as the incoordinated condyle -disk rektion was corrected. However, LP dysfunction was still present in most patients with irreversible anterior disk displacement and disk perforation after splint therapy.

medial distal wall. The root canal length of central and lateral incisors were (12.96?6.46) mm and (11.47?6.32) mm respectively. The double root canal was found in 35.9 % of central incisors and in 27.5% of lateral incisors. Most mandibular incisors with long concavity had single root canal. Conclusion: The root canal wall of mandibular incisors was thinner in medial and distal wall than in lingual and labial wall. Mandibular incisors have higher rate in double root canal and the long concavity is not significantly related with number of root canal.

Objective: To determine if the hemagglutinin A (HagA) of Porphyromonas gingivalis could be involved in the adhesion and invasion in human gingival epithelial cells (HGEC). Methods:P. gingivalis 381 hagA mutant was constructed by conjugation method. The whole length of hagA gene was cloned into pYA292 in Salmonella typhimurium x4072 (S. typhimurium-hagA). The strains were used to test their ability of adhesion and invasion into HGEC using a standard antibiotic protection assay. S. typhimurium x4072 strains containing empty vectors were used as negative control. HagA expression in S. typhimurium-hagA was confirmed by Western blot. Results:Although there were no significant differences between P. gingivalis 381 hagA mutant and wild type in adhesion and invasion into HGEC, the adhesion values of S. typhimurium-hagA to HGEC were increased by 3 times compared to their respective controls, while the invasion ability of S. typhimurium-hagA was 4 times greater than that of the negative controls. Conclusion: These results suggest that HagA may participate in P. gingivalis adhesion and invasion into HGEC.

Objective To observe the substance P(SP) and calcitonin gene-related peptide(CGRP) expressions in the temporomandibular joints(TM J) of the rats undergone emotional stress and explore the relationship between emotional stress and temporomandibular joint disorder(TMD). Methods Ninety SD rats were averagely randomly divided into emotional stress ( ES ) group( n = 30 ), electric foot-shocked (FS) group ( n = 30 ) and control (CON) group( n = 30). The emotional stress was induced by communication box. The TMJ tissues in ES and CON groups were removed after 1, 3 and 5 weeks of emotional stress for scanning electron microscope ( SEM ) test and immunohistochemistry test. The SP and CGRP expressions were examined with SABC immunohistochemistry and then analyzed by image analysis system. Results The expressions of SP and CGRP had significant difference after 1 ,3 and 5 weeks emotional stress ( SP: 124.5 ± 16.9,185.6 ± 1.8 and 193.5 ± 3.5, respectively; CGRP: 185.9 ±5.3, 112.5 ±5.2 and 174.3 ±5.3 ,respectively) (P＜0. 05 ). The SEM results showed that there was a series of structural change on the condylar surface after emotional stress. Conclusion The SP and CGRP energy nerve fibers take part in the TMJ pathological process undergone emotional stress.

Objective:To observe the influence of emotional stress on the temporomandibular joint(TMJ) of SD rats. Methods:Standard animal model of emotional stress was created by emotion communication emergency box technique in 30 SD rats and foot-shocked in another 30. Control rats were 30 without treatment. The microstructure and ultrastructure of the disc surface, condylar surface and external pterygoid muscle were observed 1, 3 and 5 weeks after emotional stress treatment. Results:Obviously pathological changes were observed in the experimental animals, especially at 3 weeks, involving the fissures on the disc and condylar surface, the collagen fibers were disordered. Electron microscopy observation showed that condylar collagen was exposed. The mitochondria edema and vacuolar degeneration in the external pterygoid muscle were found.At 5 weeks, the condylar cartilage started to recover. Conclusion:Long term emotional stress may lead to pathological changes of the temporomandibular system. The changes can be partly recovered after a certain time of adaption of TMJ.

Objective To study the effect of sevoflurane and propofol anesthetic techniques on interleukin (IL)-6 and IL-10 in patients with laparoscopic hysterectomy.Methods Fifty elective laparoscopic hysterectomy patients were randomly divided into sevoflurane group (25 patients) and propofol group (25 patients) who received either sevoflurane or propofol for their anesthesia.After induction,adjusted the sevoflurane inhalation concentration in sevoflurane group and propofol pumping speed in propofol group.Maintained the Bispectral index (BIS) value at 50 +5.Recorded heart rate (HR),mean arterial blood pressure (MAP),BIS,IL-6,IL-10 on 5 min before anesthesia (T1),10 min after pneumoperitoneum (T2),40 min after pneumoperitoneum (T3) and 5 ain before the end of the operation (T4),and compared.Results The level of BIS,HR,MAP in two groups and between two groups had no significant difference (P ＞ 0.05).The level of IL-6,IL-10 on T2-T4 were significantly higher than those on T1 [sevoflurane group:(31.0 ± 9.0),(33.0 ± 11.0),(34.0 ± 16.0) ng/L vs.(29.0 ± 8.0) ng/L and (19.3 ± 1.7),(24.0 ± 2.8),(27.0 ± 8.0) ng/L vs.(2.0 + 0.4) ng/L; propofol group:(38.0 ± 9.0),(40.0 + 12.0),(45.0 ± 18.0) ng/L vs.(29.0 + 11.0) ng/L and (8.2 ± 2.3),(11.0 ± 4.2),(18.0 ± 7.0) ng/L vs.(2.0 ± 0.3) ng/L] (P ＜ 0.05).The level of IL-6,IL-10 on T1 between two groups had no significant difference (P ＞ 0.05).The level of IL-6 on T2-T4 in sevoflurane group was significantly lower than that in propofol group and the level of IL-10 on T2-T4 in sevoflurane group was significantly higher than that in propofol group (P＜ 0.05).Conclusions At maintaining the balance of cytokines in laparoscopic hysterectomy,the effect of sevoflurane is better than propofol.Sevoflurane is more suitable for maintenance of anesthesia for laparoscopic gynecologic operation.

Based on the Australian AR-DRGs, this research gathered the diagnosis related information on the first page of medical records and accomplished the computerization of data collection and analysis through the data-base of Shanghai Shenkang Hospital Development Center.According to the clinical practices, the DRGs model has been adjusted to complete the localization and a severity-based-DRGs model and grouping tool have been established for the municipal hospitals in Shanghai.

The performance evaluation is an effective method to guide the public hospitals behavior and pro-mote their sustainable development.The introduction of disease severity could make the performance evaluation sys-tem more scientific and reasonable, and encourage the hospitals to improve their technical skills and services ability. Based on the Shanghai diagnosis related groups system, a case-mix index ( CMI) was introduced and a severity score of disease was developed after the relative weight ( RW) adjustment to evaluate different types of disease severity in hospitals.The results have shown that CMI effectively reflects the patients'disease severity and the intensity of treat-ment in those hospitals taken into consideration.Therefore, the scientific indicators should be selected and the evalu-ation system should be improved thereby establishing an effective monitoring and dynamic adjustment mechanism and further developing the diagnosis related group application.

Performance appraisal is an important means for keeping hospitals on correct tracks for their medical services and their public interest nature,in addition to its importance in enhancing internal performance management within public hospitals.Since 2006,Shanghai Shenkang Hospital Development conducted performance appraisal for directors of 23 public hospitals in Shanghai.This paper highlights the importance of performance appraisal for these directors,and its significance in keeping the correct director of hospital operation.

Background and purpose:Differentiation of tumor tissue is an important factor on determining the prognosis of gastric cancer. This study aimed to investigate the expression levels and clinical signiifcance of gender determining region Y-box 2 (SOX2) gene and octamer binding factor 4 (OCT4) gene in gastric cancer tissues varying different differentiation degrees. Methods: Sixty cases with gastric cancer were recruited in this study. The gastric cancer tissues and corresponding normal mucosa of the 60 cases were obtained. The mRNA and protein level of SOX2, OCT4 gene are evaluated by the quantitative real-time PCR (qRT-PCR), Western blot and immunohistochemistry, respectively. The relationship between the expression levels of SOX2, OCT4 gene and clinical pathological parameters were also analyzed in this study. Results:The expression of SOX2 in both mRNA and protein levels had no signiifcant difference between the well-differentiated gastric cancer tissues and normal gastric mucosa (mRNA levels:t=0.1033, P>0.05;protein levels:t=0.116, P>0.05). However, both the mRNA and protein expression of SOX2 in patients with well-differentiated gastric cancer tissues were signiifcant higher than not only in patients with moderately differentiated gastric carcinoma (mRNA levels: t=12.48, P<0.05; protein levels: t=22.78, P<0.05) but also in patients with than poorly differentiated gastric carcinoma (mRNA levels:t=17.56, P<0.05;protein levels:t=30.00, P<0.05). In contrast to SOX2, both the mRNA and protein expression of OCT4 in patients with well-differentiated gastric cancer tissues were signiifcant lower than not only in patients with moderately differentiated gastric carcinoma (mRNA levels:t=13.23, P<0.05; protein levels: t=25.56, P<0.05) but also in patients with poorly differentiated gastric carcinoma (mRNA levels: t=12.10, P<0.05; protein levels: t=69.48, P<0.05). There was no significance of OCT4 mRNA and protein expression between the well-differentiated gastric cancer tissues and normal gastric mucosa (mRNA levels:t=2.436, P>0.05;protein levels:t=1.064, P>0.05). Immunohistochemical study demonstrated that the positive rate of SOX2 in patients with well-differentiated gastric cancer tissues (10/21) were higher than in patients with not only moderately differentiated gastric carcinoma (7/20) but also poorly differentiated gastric carcinoma (2/19, P<0.05), while the positive rate of OCT4 in cases with well-differentiated gastric cancer tissues (2/21) were lower than in cases with not only moderately differentiated gastric carcinoma (6/20) but also the poorly differentiated gastric carcinoma (12/19, P<0.05). There was no correlation between the expression of SOX2, OCT4 in gastric cancer and gender or age (P>0.05). Nevertheless, the expression of SOX2, OCT4 were positive or negative correlated with the pathological staging, the degree of inifltration and lymph node metastasis (P<0.05). Conclusion:Decreased SOX2 expression and increased expression level of OCT4 can promote the formation, development and invasion of gastric cancer and they may become biomarkers or the diagnosis, treatment and prognosis evaluation in gastric carcinoma.