Objective To determine the mechanism underlying the mandibular angle enlargement and to provide a morphological basis for correcting the enlarged mandibular angle. Methods By axial computed tomography, it is possible to measure the width and length of the masseter and the medial pterygoid, the gonial angle, and the vertical height of the posterior mandible. The date were initially analysed by using a simple correctionials and indpendent sample T test. Results The distance between two Go points and gonial angle were significantly related with the thickness of masseter muscle, but the thickness of the medial pterygoid was on the contrary. There was significant differences between the group of prominence and the normal control in the gonial angle, the distance between two Go points and thickness of masseter . But there was no difference between the the two groups in the thickness of medial pterygoid. Conclusion The thickness of the masseter muscle is an important factor that affects the lower facial morphology. The hypertrophy of masserter muscle may cause the mandibular angle enlargement.

Objective To study effects of hepatic microcirculation and hepatic function using low dose HSS40 preoperation on the partial hepatectomy patients.Methods Sixty-five partial hepatectomy patients were randomly divided into study group (32 cases with HSS40,4 mL/kg,in 30 min) and control group (33 cases with RL,4 mL/kg,in 30 min).Patients of two groups were monitored in liver microcirculation,hepatic function parameters at different times before and after the infusion.Results Compared with the study group,the control group were more infusion (2400 ± 1650) mL and blood transfusion (550 ± 190) mL,the differences were statistically significant (P ＜0.05).Control group of nitric oxide (NO) T3 time(17.84 ± 6.26) μmol/L in the preexpansion compared with preoperative T0 time(38.06 ± 9.34) μmol/L and the study groupT3 time (36.37 ± 9.15) μmol/L was significantly decreased (P ＜ 0.05),and endothelin (ET) (T3 time 185.16 ± 41.34 pg/mL) was significantly higher (P ＜ 0.05),and the study group(T3 time 99.75 ± 30.31 pg/mL) than the control group variation amplitude,time later,the difference was statistically significant (P ＜ 0.05) ; Control group ALT,AST,DBLI,TBLI rise after preexpansion (P ＜ 0.05),and significantly higher than the study group (P ＜ 0.01),and the study group than the control group variation amplitude,time later,differences were statistically significant (P ＜ 0.05) ; while no significant changes in the concentration ALB two groups,the difference was not statistically significant difference (P ＞ 0.05).Conclusion Using low dose HSS40 preoperation on the partial hepatectomy patients can improve cardiovascular stability,protective effect on ischemia-reperfusion injury of liver,can increase the tissue perfusion,and improve the hepatic microcirculation,better able to maintain the stability of the liver function.

Objective] To prove the modified Maxingshigan Decoction(modified MXSGD) intervening radiation induced lung injury(RILI) through the TGF-β/Smad signaling pathway by selectively silencing the TGF-β1 gene. [Methods] (1)Total of 18 clean SD rats were randomly divided into two groups:Chinese medicine group treated with modified MXSGD and normal control group treated with saline. The serum was made after 3 days of taking drugs to prepare medicated serum. (2) The alveolar typeⅡcells were cultured. The total dose of radiation to cell was 8Gy, frequency 3.64Gy/min. The medicated serum was given to each group respectively. (3) After silencing TGF-β1 gene with RNA interference technology, the level of TGF-β1, PAI-1, CTGFmRNA was analyzed by PCR and the protein expression of Smads was measured by Western-blot. [Results] (1) Compared with rat serum group, the expressions of TGF-β1 mRNA, P-Smad2 in 10%medicated serum group were down-regulation or deceased(P<0.05).(2) Compared with rat serum group, the transcription levels of TGF-β1, and PAI-1 and CTGF were obviously suppressed after silencing TGF-β gene(P<0.05). (3) There was no significance effect on the expression of P-Smad2, P-Smad3, PAI-1mRNA and CTGF mRNA in both 10%medicated serum+siRNA group and rat serum+siRNA group(P>0.05). (4) Compared with rat serum+siRNA, the expression of Smad6 and Smad7 was increased in 10%medicated serum+siRNA group. The differences between the two groups were significant(P<0.05, P<0.01). [Conclusion] Modified MXSGD may intervene the RILI by regulating TGF-β/Smad signaling pathway.

Objective To evaluate the effect and safety of glucocorticosteroids in prevention of post-ERCP pancreatifis(post-endo- scopic retrograde cholangiopancreatography pancreatitis,PEP).Methods The database of Cochrane Library(issue 4,2006),Medline (1966-2007.1),EMBASE(1986-2007.1)and CBM(1978-2007.1)were searched.The cited literature of obtained articles and some core English and Chinese medical journals(July,2006-Jan,2007)relevant to gastro-enterolngy were also searched by hand.All random- ized controlled trials(RCT)comparing glucocorticosteroids to placeboes in prevention of PEP were included.Data collection and literature evaluation were performed by two reviewers independently.RevMan 4.2.8 was used for statistical analysis.Result Six RCTs were includ- ed in meta-analysis which showed no statistical difference for the incidence of overall PEP between the glucocorticosteroids group and place- bo group(RR=1.11,95%CI 0.89-1.39).Stratified by severity of PEP,four trials were included.Meta-analysis showed no statistical difference for the incidence of mild to moderate PEP and severe PEP between the two groups(RR=1.17,95%CI 0.91-1.51 for mild- moderate PEP;RR=1.79,95%CI 0.69-4.65 for severe PEP).Stratified by therapeutic ERCP,three RCTs were included.Meta-analy- sis showed no statistical difference for the incidence of PEP between the two groups(RR=1.24,95%CI 0.91-1.67).3 trials as to inter- im-analysis were excluded by sensitive analysis.Meta-analysis also showed no statistical difference for the incidence of PEP between the two groups(RR=0.73,95%CI 0.44-1.20).Conclusion Based on current evidence,glucocorticosteroids is not beneficial in preventing the occurrence of PEP.Further high quality study is needed to disclose the efficacy of glucocorticosteroids in prevention of PEP.

Objective To explore the feasibility of laparoscopic common bile duct exploration without T-tube drainage.Methods A to-tal of 37 patients who were addmitted into our hospital from May 2014 to August 2015 with common bile duct stones were analyzed.Among these patients,22 cases were given T-tube drainage while the other 15 cases were not.The operation time,hospitalization expenses,anal ex-haust time,postoperative hospitalization time,bile leakage rate and the satisfaction of patients after surgery in the two groups were observed. Results In the non-T-tube group,the anal exhaust time was (1.41 ±0.82)d and the hospitalization time was(4.82 ±1.61)d,which were lower than(3.81 ±1.09 )d and (11.17 ±1.19 )d respectively in the T-tube group,and the differences were statistically significant (P <0.05).The number of bile leakage (0%)in the non-T-tube group was also significantly lower than 31.82% in the T-tube group (P <0.05).The satisfaction rate of patients in the non-T-tube group(100%)was significantly higher than that in T-tube group (50%),and the difference was statistically significant(P <0.05).Conclusion The laparoscopic common bile duct exploration without T-tube drainage is feasible and it can be popularized in clinic.

Objective To evaluate the prevention of glucocorticoid -induced avascular necrosis of the femoral head(ANFH)with Tongluo Shenggu Capsule(TSC).Methods One hundred and twenty adult SD rats were randomized into six groups:normal control group,model group,clofibratum group and three -dose TSC groups(high -,moderate -and low -dose respectively).ANFH rat models were established by injection of glucocorticoid once per week and the med-ication groups were given drugs by ga stric infusion one time a day.The rats were killed in the fourth,eighth and twelfth week respectively.Then the macrosc opic and microscopic feature of the f emoral head were observed,and ink -p erfused specimens of the femoral head were detected and analyzed by auto -photograph software of Metamoph to evaluate the pre-ventive effect of TSC.Results In TSC groups,bone trabecula grew we ll,similar to the normal group;lacu nar bone per-centage was lower than that in the mod el group;fatty degeneration in marrow cavity of the femoral head was redu ced,andthe number of subcartilaginous bloo d vessels and their diameter were increased as compared with those in the model group(P

Background and purpose: E-cadherin (EC) is a type of glycoprotein, which could maintain epithelial polarity and cell-cell junction. It is thought to be associated with the development and progression of hepatocellular carcinoma (HCC). The study aimed to detect expression of uniting detection sEC and AFP before and after operation in patients, and to monitor recurrence of postoperative. Methods:The levels of sEC and AFP in 105 HCC patients were tested by enzyme linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) before and after operation as well as in 70 healthy controls. Theirs correlation with clinical and pathological factors was analyzed. We analyzed the level of plasma sEC and AFP of 47 patients who had been suffered from the hepatocellular carcinoma operation and relapse. Results: The levels of sEC and AFP in HCC patients before operation were significantly higher than in controls, which declined significantly one week after operation. The sEC level before operation showed significant correlation with TNM staging (P<0.01), edmondson grade, the carcerous thrombi within the portal vein and the capsule of carcinoma (P<0.05), but not with age of patients or the tumor size (P>0.05). While AFP only correlation with TNM staging (P<0.05), not with others factors (P>0.05). When the recurrence was confirmed, the level of sEC was much higher significantly than the level postoperation (P<0.01). Conclusion:The levels of sEC in HCC patients before operation are closely related with prognosis and recurrence of HCC. The unites detection of sEC+AFP may be a predictive factor for recurrence of postoperation.

BACKGROUND:Now, domestic total knee arthroplasty surgeries mainly use medial parapatel ar approach, with the disadvantages of large trauma and slower recovery. The quadriceps sparing approach is more accorded with normal anatomy, which can keep the knee extension system intact. The clinical comparison between quadriceps sparing approach and medial parapatel ar approach is rare.
OBJECTIVE:To compare the early effect of total knee arthroplasty through quadriceps sparing approach and medial parapatel ar approach.
METHODS:From January 2009 to January 2010, 55 patients (70 knees) were randomly divided into quadriceps sparing approach group (n=26, 35 knees) and medial parapatel ar approach group (n=29, 35 knees). Patients in two groups received total knee arthroplasty through quadriceps sparing approach and medial parapatel ar
approach respectively. The incision length, operative time, postoperative drainage volume, additional amount of etoricoxib tablets, pain degree, straight leg raising time, start walking time, hospitalization time, range of motion of knee joint, Hospital for Special Surgery Knee Score, radiographic alignment of al components and complications were compared between two groups. Al the prostheses used in this study were the Sigma type prostheses
provided by the rotation platform of Johnson&Johnson Company.
RESULTS AND CONCLUSION:Al the patients were fol owed-up for 12-24 months without infections, deep vein thrombosis, neurovascular injury, prosthesis instability, prosthesis loosening or displacement. Position of al the
prostheses was normal in patients. The operative time in the quadriceps sparing approach group was longer than that in the medial parapatel ar approach group (P=0.00), while the incision length, postoperative drainage volume, additional
amount of etoricoxib tablets, visual analog scale, straight leg raising time, start walking time, hospitalization time, range of motion of knee joint at 3 days after replacement and Hospital for Special Surgery Knee Score in the quadriceps
sparing approach group were better than those in the medial parapatel ar approach group (P<0.05). There were no
significant differences in range of motion of knee joint at 3 days after replacement and Hospital for Special Surgery Knee Score between two groups. The early effect of total knee arthroplasty through quadriceps sparing approach is better than the medial parapatel ar approach, and there is no significant difference in prosthesis alignment between two methods.

Objectives To analyze the expression of fibroblast growth factor-19(FGF-19) in hepatocellular carcinoma ( HCC) and adjacent tissues , and to investigate its clinical significance .Methods A total of 209 HCC patients who had undergone radical resection operations at Hospital 401 between January 2003 and December 2009 were chosen as samples . Immunohistochemistry method was employed to examine the expression level of FGF-19 in HCC and adjacent tissues .The relationship between FGF-19 protein expressions and clinicopathological features was analyzed by the chi -square test or Fisher exact probability .A survival curve was drawn using the Kaplan-Meier method and the Cox model was used to analyze factors that influenced survival .Results The rate of high expression of FGF-19 was 66.1% (138/209) in HCC, which was significantly higher than 46.9%(98/209) in adjacent tissues (P<0.05).The high expression of FGF-19 was related to the tumor capsule and tumor boundary (P<0.05).The overall survival in high expression of FGF-19 group was signifi-cantly lower than that in low expression group (P<0.05).Conclusion FGF-19 plays an important role in the carcinogen-esis and development of HCC , and a high expression of FGF-19 might be closely related to survival time of postoperative patients.FGF-19 might be a potential prognosis prediction factor for HCC .

Objective To evaluate the role of 5-HT5A receptors (5-HT5A R) in activation of astroglia in the spinal dorsal horn in a rat model of neuropathic pain induced by vincristine. Methods Forty adult male SD rats weighing 180-200 g were randomly divided into 4 groups ( n = 10 each): control group (group C);neuropathic pain group (group P);Ad-X-HK group (group B) and Ad-5-HT5A-siRNA group (group S). Neuropathic pain was induced by repeated intraperitoneal (IP) injection of vincristine 0.1 mg/kg according to the method described by Weng et al in group P, B and S. On the 2nd day after the last IP injection, the animals received artificial cerebrospinal fluid, Ad-X-HK and Ad-5-HT5A-siRNA 25 μl administered intrathecally (IT) in group P, B and S respectively. Paw withdrawal threshold to mechanical stimulus was measured before and on the 7th day after IT administration. The animals were then sacrificed. The lumbar segment ( L4.5 ) of the spinal cord was removed for determination of 5-HT5A R and GFAP expression. Results Body weight and paw withdrawal threshold were significantly decreased after repeated IP vincristine administration in group P compared with group C. IT Ad-5-HT5A-siRNA reduced pain threshold further in group S compared with group P. Repeated IP vincristine significantly increased the expression of 5-HT5A R and GFAP in spinal dorsal horn, and IT Ad-5-HT5A-siRNA significantly decreased the expression of 5-HT5A R while increased the expression of GFAP in spinal dorsal horn in group S compared with group P. Conclusion 5-HT5AR is involved in the inhibition of astrocyte activation, resulting in reduction of vincristineinduced neuropathic pain.