Objective:To investigate the effect of of simvastatin on bone formation and bone mineral density(BMD) during the retention after orthodontic tooth movement. Methods:Orthodontic tooth movement of upper first molar was performed in 40 rats with coil spring for 21 days. 40 rats were randomly allocated into 5 groups: basic control group,negative control group and 3 simvastatin groups(2.5 mg?kg-1, 5.0 mg?kg-1 and 10.0 mg?kg-1respectively).Rats in basic control group were killed when appliances were removed after 21 days.The experimental groups were administered simvastatin daily from 1 day before appliances removed for 4 weeks.The negative control group received the isotonic saline as control.4 weeks later all animals were anesthetized and killed. Level of serum Ca and P in blood, ALP, BGP and BMD were monitored.Results:①Between experimental groups and the negative control group, in amounts of ALP and BGP,the anterior were higher than the posterior (P0.05). ②The alveolar near the maxillary first molar,BMD of the basic control group was the highest(P

OBJECTIVEWe aims to evaluate the therapeutic effect of maxillary protraction on maxillary maldevelopment using Coben analysis to illustrate the advantages of Coben analysis in identifying pathogenic mechanisms and in designing treatment plans for Class III malocclusions.

METHODSA total of 120 patients were diagnosed to have skeletal Class I maloc- clusions with maxillary maldevelopment. These patients were selected as the subjects of the present research. Maxillary protraction was exerted to promote maxilla growth. Cephalometric analysis was conducted by using Coben analysis and angle analyses of Beijing Medical University to collect data before and after maxillary protraction.

RESULTSAccording to Coben analysis measurements, the height of facies cranii increased after maxillary protraction. The depth of lower face decreased, whereas that of mid-face increased and the Ptm-A value increased significantly in the mid-face (P < 0.001). In the angle ana- lysis of Beijing Medical University, SNA, ANB, U1/NA, U1/SN, MP/SN, and Y-axis angles increased significantly (P < 0.001), whereas SNB, U1/L1 (P < 0.001), and L1/MP (P < 0.05) decreased.

CONCLUSIONMaxillary protraction has a significant effect on growing skeletal Class III malocclusions withthe chief mechanism of Ptm-A value just diagnosed as minor by Coben analysis. Coben analysis is visual and clear in identifying pathogenic mechanisms of Class III malocclusions.

Totally 79 obese children and 64 children with normal body weight were included in the present study.Serum apolipoprotein A5 (ApoA5) and leptin levels were determined by ELISA and fasting insulin by RIA.The clinical data including height,body weight,waist circumference,blood pressure,blood lipid,blood glucose,etc,were collected.Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated.The results showed that compared with normal weight children,both serum leptin and insulin levels were significantly raised in obese children [19.15 (13.01 ～ 25.08) ng/ml vs 3.29 (1.45 ～ 6.02) ng/ml and 15.44 (12.05 ～ 20.26) μg/L vs 10.12 (8.60 ～ 12.60) μg/L,both P＜0.01],while ApoA5 level was significantly lowered [134.5 (105.9 ～ 172.7) ng/ml vs 2005.9(164.3 ～ 265.3) ng/ml,P＜0.01].Serum ApoA5 was negatively correlated with serum leptin and insulin (both P＜0.01).

Objective To detect the expression level of human zinc finger 23 (ZNF23) in hepatocellular carcinoma tissue samples and HepG2 cell lines and investigate the relationship between hZNF23 expression and clinicopathological characteristics of HCC and cell apoptosis. Methods The expression levels of hZNF23 and GAPDH mRNA in 37 cases of HCC were measured by real-time RT-PCR. The association between the expression of hZNF23 and the clinicopathological characteristics of HCC was analyzed. Cultured HepG2 cells were divided into 4 groups ( control group, 1.25 μg/ml , 2.5 μg/ml and 5 μg/ml cisplatin)or 6 groups( control group, 1.25 μg/ml, 2.5 μg/ml, 5 μg/ml, 10 μg/ml and 20 μg/ml cisplatin). MTT method was employed to evaluate cell proliferation. Annexin V-FITC assay was used to assess percentage of apoptotic HepG2 cells. The expression levels of hZNF23 and GAPDH mRNA of HepG2 cells after apoptosis induced by cisplatin with a series of concentrations were measured by real-time RT-PCR.Results The median ( quartile1, quartile 3) expression levels of hZNF23 mRNA in 37 HCC tissue samples and adjacent tissue samples were 8.84 (3.59-15.05), 22.20 ( 13.85-42.90 ), respectively. There was significant difference ( U = 259.5, P ＜ 0.01 ). The median ( quartile1, quartile 3 ) expression levels of hZNF23 mRNA in cancer tissue samples with Edmondson stage Ⅰ + Ⅱ [12.80(4.80-19.50)] was much higher than those in stage Ⅲ + Ⅳ [5.01 ( 2.88-11.68 ), U = 99.00, P ＜ 0.05] The median ( quartile1,quartile 3 ) expression levels of hZNF23 mRNA in patients with and without hepatic cirrhosis were 9.92(3.80-15.25) , 3.21 (2.78-3.60), respectively. The median ( quartile1, quartile 3 ) expression levels of hZNF23 mRNA in HBV infection and non-infection patients was 9.09(3.72-15.25 ), 2.48 (1.79-12.10),respectively. There was no significant difference between groups with and without hepatic cirrhosis and between HBV infection and non-infection groups( U = 16. 00 and 24.00, P ＞0.05 ). MTT assay indicated that cisplatin significantly inhibited HepG2 cells proliferation in a dose-dependent manner. Annexin V-FITC/PI assay showed that HepG2 cells apoptosis rates were (0.9 ± 0.2 ) %, ( 4. 2 ± 0.3 ) %, ( 9.8 ± 4. 3 ) %,(23.0 ± 6.0)%, respectively. Cisplatin significantly induced HepG2 cells apoptosis in a dose-dependent manner( F = 27.89, P ＜ 0.01 ). The expression levels of hZNF23 mRNA in cisplatin groups [( 10.39 ±3.08) × 10-5, (24.10 ± 2.09) × 10-5, (6.90 ± 2.24) × 10-4] were significantly lower than that of the controlgroup[(94.80±1.80) ×10-5, F=6.027, P＜0.01]. Conclusions The expression level hZNF23 mRNA is related to Edmondson stage of HCC. The apoptosis effect of cisplatin on HepG2 cells may be associated with the upregulation of hZNF23.

Objective To Know the present situation of diabetes′ self-management ,explore its influencing factors and provide theoretical evidences for conducting diabetic health education and improving patients′ level of self-management .Methods Using random sampling method ,we took 483 cases of diabetic patients concluded inpatient and outpatient from a first class hospital and two community hospitals who meet the inclusion criteria from March 2011 to April 2013 in Chongqing city .All patient were investi-gated with diabetes self-management questionnaire scale .Results 500 questionnaires ,received 483 valid questionnaires ,and the ef-fective rate of recovery is 96 .6% .Among 483 cases of diabetic patients in the investigation ,78 .7% of patients understood diabetes knowledge from medical staffs .In the aspect of following the treatment plan :drug plan had the best executive power with 59% ;the average score of diabetes knowledge was (41 .747 ± 10 .23) ,score index was 51 .5% ;82 .2% of patients did ,not understand their value of glycated hemoglobin ,44 .5% of patients did not understand the two-hour postprandial blood glucose ;The average score of diabetes′self-care behaviors was(3 .59 ± 1 .249) ,score index was 51 .29% ,different score index accompany with different self-man-agement levels .Educational level ,retirees ,diet control ,blood glucose monitoring ,the understanding of diabetes knowledge were pro-tective factors for receiving health education .Conclusion Patients grasp diabetic knowledge are poorly in average ,the present situa-tion of patients′self-management is not optimistic ,it is better to increase the health education of diabetes′ self-management ,and make great efforts to improve diabetes′self-management skills .

Objective To discuss the clinical features of bilateral multiple renal angiomyolipomas (RAML) with tuberous sclerosis complex (TSC).Methods Clinical data of 10 cases of bilateral multiple RAML associated with TSC treated from Jan.2003 to Dec.2010 were retrospectively reviewed.There were 4 males and 6 females in the study group,aged from 18 to 45 years,with an average age of 34 years.Three cases were treated urgently due to RAML hemorrhage.Five cases were treated due to back pain.One case was treated for hematuria.One case was diagnosed during physical examination.Facial angiofibroma occurred in 7 cases and facial flat speckle in 1 case.Epilepsy was indentified in 6 cases.Four cases had hypophrenia and 2 cases presented with symptoms of the classic triad:epilepsy,facial angiofibroma and hypophrenia.One case underwent urgent selective transcatheter arterial embolization (SEA).Eight cases (9 sides) underwent renal sparing operation.Conservative therapy was adopted in 2 cases.ResultsThe SEA was done successfully and bleeding ceased.AⅡ surgeries were completed successfully.The diameter of the biggest tumor resected was 8.0 cm.The number of tumors resected was 2 - 6,with an average of 3.5.The mean operative time was 70 min (range 50 to 120 min).The mean time of controlling the renal artery was 26 min.The mean intraoperative hemorrhage was 150 ml.One case required a blood transfusion.None of the cases re-hemorrhaged after operation.Pathology revealed RAML.There was no recurrence in 8 cases and follow-up ranged from 3 to 60 months,with an average of 25 months.A hemorrhage did occur on the oppositer side in 1 case 4 months after surgery.In 2 cases,a conservative therapy of regular monitoring and follow-up at 24 and 36 months was chosen.The serum creatinine of all the patients was in a normal range.Conclusions The bilateral multiple RAML associated with TSC must be diagnosed as soon as possible and treated depending on the size,location and developing circumstance of the tumor in a timely fashion.Renal sparing surgery and SEA are effective therapies.

Objective To analyze the diagnosis and treatment for complications of renal caliceal diverticulum with calculi or infection. Methods A retrospective investigation was performed on 29 cases with renal caliceal diverticulum. The 29 cases included 11 males and 18 females aged 18 to 61 years. Among the study group, 3 cases were simple renal caliceal diverticulum, 12 cases were diagnosed as diverticular calculi and 14 cases presented recurrent urinary tract infections including 3 cases with urinary fistula after unroofing and decompression as renal simple cyst from another hospital. Ten cases underwent an open operation that unroofed and decompressed the cyst, and sutured the diverticular neck. Eight cases underwent laparoscopic operation similar to the open operation, including lithotomy in caliceal diverticulum in 2 cases. Eleven cases diagnosed with caliceal diverticular calculi were taken one-stage percutaneous nephrolithotomy including dilating the diverticular neck, remaining the nephrostomy catheter and Double-J ureteral stents, and 1 case was transferred to open operation.Results The open and laparoscopic operations were performed successfully. One case was cured by Double-J ureteral stenting after postoperative urinary leakage. One case was transferred to open operation for the failure of percutaneous puncturation. X-ray examination revealed that there were no remaining stones after the operation. All the patients were followed up for 6 to 24 months without calculi and infection recurrence. Conclusions Stones and infection are common that complications of renal caliceal diverticulum. Percutaneous nephrolithotomy, laparoscopy and other operations were effective and feasible treatment options for cases with complications of renal caliceal diverticulum. Exact diagnosis was very important for treatment of renal caliceal diverticulum before operation.

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Objective To evaluate the effect of liberal transfusion versus restrictive transfusion strategies on the mortality rate of operative period and critically ill patients.Methods The domestic and abroad databases of WanFang Data,VIP,CBM,CNKI,Cochrane Library,PubMed,EMBASE,OVID and Web of Science were retrieved by computer.The randomized controlled trials(RCTs) on the effects of liberal blood transfusion versus restrictive blood transfusion strategies on the mortality were collected.The ¨Jadad scale¨ assessment tool provided by the Cochrane Collaboration was used to evaluate the quality of collected articles.Then the meta analysis was performed by using Review Manager(RevMan) version 5.3 software.Results Twenty-sevenRCTs involving 10 890 patients were included.The study indicated that there was no statistically significant difference between liberal transfusion group and restrictive transfusion group in the patients ' mortality[RR =0.97,95 ％ CI(0.83,1.13),P =0.69];the sub-group analysis showed that compared with the restrictive blood transfusion group,the liberal blood transfusion group could not effectively reduce the mortality of perioperative patients[RR=0.80,95 ％CI(0.62,1.03),P=0.08],and could not effectively reduce the mortality of critically ill patients[RR=1.09,95 ％CI(0.90,1.33),P =0.37].Conclusion The liberal blood transfusion can not significantly increase the survival rate of perioperative and critically ill patients compared with restrictive blood transfusion.

OBJECTIVE: To determine the clinical effect of standardized training and management of peripherally inserted central catheter (PICC) and catheter-related complications. METHODS: A total of 610 patients were divided into a control group and an observation group, the control group (n=300) were catheterized by trainees who received "short-term intensive training", the observation group (n=310) by "system standardized training and management". The clinical efficacy of catheterization and the rate of catheter-related complications were compared. RESULTS: There was significant difference in the one-time puncture success rate, one-time cannulation success rate, the time for operation and the pain score between the 2 groups (all P<0.01), and there was also significant difference in the occurrence of catheter extrusion, plug, arrhythmia, catheter-related thrombosis, phlebitis, puncture point effusion and catheter-related infection between the 2 groups (all P<0.05). CONCLUSION Standardized PICC training and management can improve the effect of catheterization and reduce the incidence of PICC-related complication.
Catheter-Related Infections ; prevention & control ; Catheterization, Peripheral ; methods ; Humans ; Incidence ; Inservice Training ; Thrombosis