As a new surface technology, microarc oxidation can be applied to the ceramic coating with bioactivity on Ti alloy. With good biocompatibility, high bond strength and short healing period, the film is worth applying to clinical operation. In this paper such information of microarc oxidation is reviewed as its developing history, research progress and basic principle. The structure, properties and bioactivity of the ceramic coating are also introduced.

Objective To study a histopathological classification system for hippocampal cell loss in patients suffering from mesial temporal lobe epilepsy.Methods Fifty-one surgically resected specimens were microscopically examined with respect to neuronal cell loss in hippocampal subfields CA1—CA4.Clinical data including age at first seizure,with or without initial precipitating injuries (IPIs),latecy,epilepsy duration,Engel score of half and one year after surgery were collected to analyse the clinical characteristics between different pathological types.Eight additional hippocampal specimens obtained from neurologically healthy autopsies served as controls.Results (1)Five distinct patterns were recognized within a consecutive cohort of anatomically well-preserved surgical specimens.Type 1 a (21/51,41.18 ％):severe cell loss in CA1 and moderate neuronal loss in all other subfields excluding CA2; Type 1b(18/51,35.2％):severe cell loss in all sectors; Type 2(9/51,17.65％):severe neuronal loss restricted to sector CA1 ;Type 3 (1/51,1.96％):severe neuronal loss restricted to the hilar region; no mesial temporal sclerosis (2/51,3.92％):a group comprised hippocampi with neuronal cell densities not significantly different from age matched autopsy controls.(2)The patients of type 1 a and 1 b had younger age of first onset,longer latency and duration,more frequency of IPIs,the proportion of ourrence of febrile seizures in type 1a was 10/19,type 1b was 7/16,type 2 was 4/7,type 3 was 0 (x2 =11.790,P =0.019).(3) The patients of type 1a and 1 b had better postsurgical outcome.Conclusion Type 1 is the most common type of mesial temporal sclerosis,which have better postsurgical outcome than the other 3 types.

Objective: To investigate the clinicpathologic features and probable mechanisms of massive subcortical heterotopia. Methods: Clinical data, histologic features and neuropathologic data were analyzed in five cases of massive subcortical heterotopia collected from Xuanwu Hospital, Capital Medical University from January 2014 to October 2017. Results: All five patients (three males and two females) had a history of refractory epilepsy with a mean period of 15.4 years (range 7 to 21 years). The median age at surgery was 28.6 years(range 20 to 39 years). Magnetic resonance imaging showed that the lesions were located in the temporal lobe (two cases), parietal lobe (one case), both temporal and occipital lobes (one case) and both temporal and parietal lobes (one case). Pathologic examination disclosed that massive gray matter in subcortical and deep white matter with various shape and size. Moreover, one case also showed subpial and periventricular heterotopias and polymicrogyria. Polymicrogyria or hippocampal sclerosis were seen in the remaining three cases. None of the five patients experienced seizure attacks during the follow-up period. Conclusions Heterotopia is malformations due to abnormal neuronal migration. Massive subcortical heterotopia due to widespread abnormal neuronal migration is relatively rare. The mechanism of heterotopia together with polymicrogyria needs further discussion.

Objective: To investigate the expression of LC3B, p-AMPKα and p27 in cortical tuberous sclerosis complex (TSC). Methods: Nineteen specimens of surgically resected TSC cortical tubers were collected at Xuanwu Hospital, Capital Medical University, from 2014 to 2017. The expression of the three proteins in the lesions and the adjacent relatively normal regions was detected by immunohistochemical staining (EnVision two-step method). Results: LC3B was mainly expressed in the dysmorphic neuron and giant cell in TSC cortical tubers and in the adjacent relatively normal neurons, and the expression was diffuse or perinuclear cytoplasmic. There was no significant difference in the average optical density between abnormal cells and neurons adjacent to the lesions (0.343±0.195 vs. 0.419±0.088, P>0.05). p-AMPKα was localized in the cytoplasm of dysmorphic neurons and giant cell in TSC cortical tubers. The average optical density of abnormal cells in the lesions was significantly higher than that of neurons adjacent to the lesions (0.306±0.123 vs. 0.233±0.654, P<0.05). P27 showed nuclear positivity, mainly expressed in the neurons and glial cells close to TSC cortical tubers, while the positive rate in the abnormal cells in TSC cortical tubers was low (15/19 vs. 7/19, P<0.05). Conclusion There is no significant decrease in the level of autophagy in dysmorphic neurons and giant cells in TSC cortical tubers, which may be related to the compensatory mechanism of AMPK signaling pathway, but without activation of downstream p27.

Objective　To explore the association of Cyclophilin A，cerebral related blood indexes and carotid plaque’s formation and stability as well as cerebral infarction. Methods　From December 2017 to December 2018，56 patients with acute cerebral infarction were admitted to cerebral infarction group；72 patients with carotid atherosclerotic plaques but no acute cerebral infraction were regarded as plaque group；40 healthy human who neither suffered from cerebral infarction nor carotid atherosclerotic plaques were divided into non-plague group；The degree of plaque stability in each group was expressed by plaque score. The higher the plaque score，the more unstable the plaque was；The content of CypA were determined by enzyme-linked immunosorbent assay，and the common blood indexes data were collected from the text results of medical records；Carotid artery plaque was detected by carotid artery ultrasound，and the plaque score was determined according to the morphology of carotid artery plaque in ultrasound. Results　There were statistically significant differences in CyPA levels between the non-plague group and the non-cerebral infraction group.（P<0.05）. CyPA level was regarded as a risk factor for the development of carotid atherosclerosis plagues（OR=1.002，95%CI 0.824～1.219）. There was no statistical significance between CyPA levels and carotid artery plaque score（the stability of carotid atherosclerotic plaque）in cerebral infarction and non-cerebral infraction group. （P>0.05）. There was an significant difference in carotid atherosclerotic plaque score between the cerebral infarction group and plaque group. （P<0.05）. In cerebral infraction group，the content of fibrinogen and glycosylated hemoglobin were positively correlated with carotid atherosclerotic plaque score and the hemoglobin was negatively correlated with the carotid atherosclerotic plaque score，and these differences were statistically significant. （P<0.05）. Ordinal logistic regression showed that fibrinogen level was regarded as a risk factor for the development of carotid atherosclerosis plagues（OR=8.988，95%CI 3.017～3.422），hemoglobin level was regarded as a protective factor for the development of carotid atherosclerosis plagues（OR=0.936，95%CI 134.031～144.583）. In plaque group，the content of high-density lipoprotein have positive correlation with the carotid atherosclerotic score，and the difference is statistically significant. （P<0.05）. Ordinal logistic regression showed that high-density lipoprotein level was regarded as a protective factor for the development of carotid atherosclerosis plagues（OR=0.052，95%CI 1.237～1.364）. Conclusion　The serum content of CyPA was a risk factor for the formation of carotid atherosclerosis plaque，but it was not related to the stability of the plaques. The degree of plaque instability in patients with acute cerebral infarction was significantly increased compared with the patients without cerebral infarction. For patients with acute cerebral infarction，the contents of fibrinogen and glycosylated hemoglobin were negatively correlated with the stability of carotid atherosclerotic plaques，hemoglobin content was positively correlated with the stability of carotid atherosclerotic plaques. Fibrinogen level was regarded as a risk factor for the development of carotid atherosclerosis plagues. Hemoglobin level was regarded as a protective factor for the development of carotid atherosclerosis plagues. For patients without acute cerebral infraction，the content of high-density lipoprotein was positively correlated with the stability of carotid atherosclerotic plaques and was regarded as a protective factor for the development of carotid atherosclerosis plagues.

Objective: To investigate the prognostic impact of alterations of epidermal growth factor receptor(EGFR) and MGMT in glioblastoma. Methods: The retrospective study included 161 supratentorial glioblastomas diagnosed in the Department of Pathology, Xuanwu Hospital, Capital Medical University from 2009 to 2015. EGFR and EGFRvⅢ protein expression was detected by immunohistochemistry; EGFR amplification was detected by fluorescence in situ hybridization; MGMT promoter methylation was detected by pyrosequencing. The change of molecular genetics EGFR and MGMT and outcome were assessed statistically. Results: There were 161 patients, including 85 (52.8%) males and 76 (47.2%) females. The mean age was 53 years, and the median overall survival was 13 months. The integrated classification of glioblastoma included 16 IDH-mutant, 134 wild type, and 11 NOS. The rate of overexpression of EGFR protein was 32.9%(53/161), and that of EGFR amplification was 37.5%(18/48). There was high concordance between immunohistochemistry and FISH(85.4%, Kappa=0.475, P<0.01) and between the level of EGFR protein and EGFR amplification (P<0.01). Twelve cases showed EGFRvⅢ expression, and all also showed EGFR protein overexpression; 149 cases were EGFRv Ⅲ wild type, and EGFR protein overexpression was seen in 27.5%(41/149) of cases. There was no correlation between EGFR and EGFRv Ⅲ expression. Of all cases, 70.2%(106/151) showed MGMT promoter methylation by pyrosequencing. The changes of molecular genetics of EGFR and MGMT were not related. EGFR amplification and protein overexpression had no significant relationship with prognosis. Patients with EGFRv Ⅲ-mutant had shorter survival time than the EGFRv Ⅲ-wild type(P=0.014); patients with MGMT promoter methylation had better prognosis than without (PFS:P=0.002,OS:P=0.006),and MGMT promoter methylation was an independent predictor for overall survival (HR=0.269, 95%CI 0.124-0.583, P=0.001). Conclusions EGFR protein expression by immunohistochemistry correlates with the status of EGFR amplification. Patients with EGFRv Ⅲ-mutant tumors have poorer prognosis than that with EGFRv Ⅲ-wild type tumors. MGMT promoter methylation is closely associated with prognosis and an independent predictor for overall survival.

OBJECTIVES: At present, the research on clear aligner of molar distalization mainly focuses on the upper jaw, while the research on mandibular molars is few.This study aims to evaluate the therapeutic effect of mandibular molars distalization with clear aligner via cone beam CT (CBCT) and Dolphin software. METHODS: Twenty cases of mandibular molars with clear aligner were included according to the inclusion and exclusion criteria. CBCT was taken before treatment (T0) and when the first molar was moved in place (T1). Dolphin software was used to measure the effectiveness of molar distalization. Three-dimensional changes in direction and the impact on the incisors and facial soft and hard tissues were evaluated. RESULTS: The effective rates of crown and root distalization of the second and first mandibular molars were 74%, 49%, and 71%, 47%, respectively. The second and first molars were both the distal buccal cusp with the largest distalization [(2.15 ± 0.91) mm and (1.85±1.09) mm], respectively, with significant difference between the T0 and T1 ( CONCLUSIONS Clear aligner can effectively move mandibular molars farther, the crown is more effective than the root, and it is tilted. The second mandibular molar is more effective than the first mandibular molar in its distant displacement and three-dimensional changes. Molar distalization causes minor changes in mandibular incisors and facial soft and hard tissues.
Cephalometry ; Maxilla ; Molar ; Orthodontic Appliances, Removable ; Tooth Movement Techniques

Prostate cancer (PCa) patients who progress to metastatic castration-resistant PCa (mCRPC) mostly have poor outcomes due to the lack of effective therapies. Our recent study established the orphan nuclear receptor ROR