Objective To observe the temporomandibular joint spaces changes after the plastic surgery of combined zygoma with mandibular angel.Methods We randomly selected 59 patients with prominent zygoma and mandibular angle,screening periodontal disease,TMJ pain and partial jaw.Bilateral zygomatic arch coarctation,jaw edge of the mandibular angle ostectomy and the mandibular body outer panel split were used.All patients accepted CT scan and three-dimensional reconstruction before operation,10 days after operation and 6 months after operation,and then image analysis softwares were used to measure the line distance of corresponding angle (0°,60°,120°,and 180°)at the TMJ sagittal plane.The 0° (EE 'pitch) and 60° (AA'pitch) represented for pre-space,the 60° and 120° (PP'pitch) was upper-space,the 120° and 180° (SS'pitch) was posterior-space.Results 0° and 60° had the same change trend,which slightly increased at 10 days after operation.The difference before operation and 10 days,6 months after operation were not statistically significant (P ＞ 0.05);120° and 180° had the same change trend,which increased at 10 days after operation.The difference between before operation and 10 days after operation was statistically significant (P ＜ 0.05),but the difference between before operation and 6 months after operation was not statistically significant (P＞ 0.05).Conclusions In the short term after plastic surgery of zygoma combined with mandibular angel,the TMJ upper and posterior spaces are changed,and the interspace reduced.This may indicate that the TMJ has compensatory ability,and short-term changes can return to normal.

Objective To investigate the epidemiological and clinical characteristics of an outbreak of tsutsugamushi disease in Chuzhou region, Anhui Province, and to clarify the new changes of epidemic focus of tsutsugamushi disease in China. Methods Field epidemiological investigation and analysis of clinical features were done. The detections of specific antibodies against Rickettsia tsutsugamushi were conducted to diagnose tsutsugamushi disease using colloidal gold immunochromatography assay combined with Well-Felix reaction. The geomorphic and climatic characteristics of the new epidemic focus were investigated. Results The outbreak occurred from October to November, 2007. The epidemic focus located on mountainous brushland regions, and the air temperature fluctuated from 20-4 ℃. Nineteen cases of tsutsugamushi disease in the new-found epidemic focus were finally diagnosed, 9 cases out of them were hospitalized, another 9 had recovered when diagnosed by serological tests; the remaining one had classical manifestations of tsutsugamushi disease but did not receive the serological test for certain cause. The main clinical symptoms were chilly in 14 cases, fever in 19 cases, headache in 15 cases; among the 9 hospitalized patients, the symptoms were lymphadenectasis in 8 inpatients, skin rash in 7 inpatients, splenomegaly in 4 inpatients and skin eschar and ulcer in 7 inpatients and Weil-Felix reaction by OXκantigen positive in 4 cases; the specific antibodies against Rickettsia tsutsugarnushi of 18 tested cases were all positive. No severe complications occurred in all patients. Before the first case was identified, all other cases were not diagnosed in time and did not receive correct antibiotic treatment. Nine hospitalized patients recovered rapidly with the treatment of doxycycline. Conclusions The outbreak of tsutsugamushi disease in Anhui Province in 2007 is type of emerged in autumn and transitional epidemic focus. There is epidemic focus of tsutsugamushi disease in northern region of Anhui Province. Doxycycline is rapid and effective for the treatment of tsutsugamushi disease.

Objective　To study the probability of using hepatitis D virus (HDV) ribozyme as a kind of anti-hepatitis-C-virus (HCV) gene thera-py drugs. Methods　The natural HDV genomic ribozyme′s stem Ⅳ was optimized and its substrate-binding region reconstructed, thus three recombinant HCV-specific HDV genomic ribozymes RzC1, RzC2 and RzC3 were obtained. HCV RNA 5'-noncoding region and 5'-fragment of C region (HCV RNA5'-NCR-C) were transcribed from plasmid pHCV-neo by T7 phage RNA polymerase in vitro, and radiolabelled at its 5'-end. The trans-cleaving reaction was performed by mixing the ribozymes and substrate at mol ratio 100∶1 under conditions as follows: 37℃, pH7.5, Mg2+ 20 mmol/L and deionized formamide 2.5 mol/L. Percentage of trans-cleaved products were calculated at different time points and used as the activity indicator of the three ribozymes. Results　RzC1, RzC2 trans-cleaved more substrate when the time extended, and got to 24.9%,20.3% after reac-ting for 90 minutes respectively; RzC3 was not able to trans-cleave its substrate. Conclusion　Recombinant HDV genomic ribozymes have the ability to trans-cleave HCV RNA, but the appropriate target sequence should be selected.

Cholestatic liver diseases (CLD) are a series of hepatobiliary diseases characterized by dysfunction of bile formation, secretion and excretion and are induced by immune, genetic and environmental factors. The development and pathogenesis of CLD is still unclear, and it has a risk of progression to liver fibrosis and cirrhosis. Traditional medicines such as ursodeoxycholic acid (UDCA), glucocorticoids and immunosuppressants have certain limitations. More and more studies provide new insights into the mechanism of cholestasis to explore the therapeutic targets, and various drugs such as all-trans retinoic acid, microecologics and norursodeoxycholic acid emerge as new therapeutic drugs. This article reviewed the advances in treatment of CLD.

Non-alcoholic fatty liver disease (NAFLD) is a liver manifestation of the metabolic syndrome. The "second strike" theory implies that cytokines play vital roles in the pathogenesis of NAFLD. Tumor necrosis factor-α (TNF-α), an important member of the tumor necrosis factor family, is widely available and has various biological effects. The expression of TNF-α in vivo is tissue-specific and participates in various cellular activities. Low concentration of TNF-α is involved in anti-inflammation, while excessive TNF-α impairs systematic immune balance and contributes to pathological changes along with other inflammatory cytokines. This article reviewed the role of TNF-α in progression of NAFLD.

With the changes in people’s lifestyle and dietary structure, the incidence rate of nonalcoholic fatty liver disease (NAFLD) has been increasing year by year, and NAFLD has become a serious threat to human health. The treatment of NAFLD has always been a hot topic of basic and clinical research on liver diseases. In recent years, many studies have revealed that omega-3 polyunsaturated fatty acids (ω3-PUFA) can promote fatty acid oxidation, improve intestinal homeostasis, and thus improve lipid metabolism and liver inflammation, and therefore, more and more clinical studies have applied ω3-PUFA in the treatment of NAFLD. However, the mechanism of ω3-PUFA in the treatment of NAFLD is still unclear, and there are certain limitations in related clinical studies. This article mainly introduces the role of ω3-PUFA in NAFLD and the results of related clinical studies and further discusses the problems that need to be solved in ω3-PUFA for the treatment of NAFLD.

Liver fibrosis is a common reversible pathological change in chronic liver injury and may progress to liver cirrhosis, liver failure, and portal hypertension. In recent years, several studies have shown a significant change in chemokine profiles in patients with liver fibrosis, which is closely associated with the progression of liver fibrosis. Monocyte chemoattractant protein 1 (MCP-1) belongs to the family of CC chemokines and can induce the activation, recruitment, and migration of inflammatory cells during liver fibrosis. MCP-1 may be involved in the activation of hepatic stellate cells, the development of insulin resistance, and the progression to hepatocellular carcinoma. This article mainly reviews the potential role of MCP-1 and CC chemokine receptor in the progression of liver fibrosis and related therapies.

OBJECTIVETo conduct health economic evaluation of the prevention of mother-to-child HIV among pregnant women in Dehong prefecture, Yunnan province, China from 2004 to 2013.

METHODSData on cost were collected mainly from the annual prevention of mother-to-child transmission (PMTCT) reporting system of Dehong prefecture, and supplemented by HIV PMTCT-related resource allocation data from local health bureau. Effectiveness indexes were from local continuous HIV surveillance system and annual reported data. Cost-effectiveness and cost-utility analysis were used to conduct the health economic evaluation.

RESULTSFrom 2004 to 2013, 283980 pregnant women were screened for HIV, 2 059 were detected as positive, and the HIV positive rate was 0.73%. The total cost of the PMTCT program was 14 227 000 RMB after discounting, and the unit cost of positive case finding was 4 200 RMB. A total of 26 cases of adults and 325 infants were avoided HIV infection, and the cost-effectiveness ratio (CER) was 40 500 RMB/case. The total obtained quality adjusted life years (QALY) from the program was 8 911.5, each one of which cost 1 600 RMB/QALY. If the feeding pattern were breast feeding, CER would be 42 800 RMB/case and each one of QALY would cost 2 200 RMB.

CONCLUSIONBased on the cost-effectiveness and cost-utility analysis, the HIV PMTCT of Dehong prefecture had economic value, which indicates that continued investment is needed to strengthen local HIV PMTCT work.

Acquired Immunodeficiency Syndrome ; Adult ; Child ; China ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Female ; HIV Infections ; Health ; Humans ; Infant ; Infectious Disease Transmission, Vertical ; Mothers ; Pregnancy ; Quality-Adjusted Life Years