60 cases(aged 18-40 years) underwent orthodontic treatment were divided into 2 groups.30 patients in group A were treated with invisible aligners,while 30 in group B with fixed orthodontic appliance.Periodontal indices (PI,GI,SBI,PD)were examined before treatment,6 weekes,6 months and 12 months after treatment.Before and 6 weeks after treatment the indices were not statistically different between groups,6 and 12 months after treatment the indices of group A were lower than those of group B (P ＜ 0.05).The invisalign appliance is more propitious to periodontal health than the fixed orthodontic appliance.

BACKGROUND: Research shows that the auditory brainstem response (ABR) wave amplitude of tinnitus patients often act as big Ⅲ small Ⅴ.Tinnitus masking is a therapy of tinnitus, then how dose the ABR change in the process of tinnitus masking?OBJECTIVE: To observe the changing characteristics of ABR in patients with tinnitus as well as the changing rules of ABR after tinnitus masking.DESIGN: Case-control and self-control.SETTING: Department of Otorhinolaryngology, First Hospital of Jilin University.PARTICIPANTS: Continuous tinnitus group: 63 cases (68 ears) were selected from the Clinic of First Hospital of Jilin University from March 1999to October 2001. Control group: 10 cases (20 ears) of normal hearing youth (20-23 years old). All subjects received the examination and treatment voluntarily.METHODS: The ABR was firstly detected in tinnitus patients (foreheadmastoid conducting method was adopted), and examination of tinnitus as well as tinnitus masking test (masking for 5 minutes) were respectively conducted, immediately after that, the ABR was detected to do control-observation with the control group.MAIN OUTCOME MEASURES: ①The characteristics of ABR in patients with tinnitus. ②Effects of tinnitus masking on the amplitude wave of ABR, which was divided into positive group in residual inhibition test and negative group in residual inhibition test for analyzing.RESULTS: A total of 83 subjects were involved in the analysis of results.①The amplitude wave of ABR in youth of normal hearing were small Ⅲ big Ⅴ, whereas that in 22 ears (32.4％) out of 63 subjects (68 ears) were big Ⅲ smallⅤ, in which 17 ears were of patients positive residual inhibition test, and 5 were of negative.②After tinnitus masking therapy, 10 ears out of 17 ears of patients positive in residual inhibition test turned from big Ⅲ small Ⅴ to small Ⅲ big Ⅴ, and the wave amplitude of Ⅲ wasre duced in 3 ears, while the ABR in 2 ears out of 5 ears of negative patients turned to small Ⅲ bigⅤ, and there were no changes in other 3 ears.CONCLUSION: Tinnitus masking therapy can convert the abnormal ABR wave amplitude in patients with tinnitus to normal, which will be taken as the objective index in judging whether it is positive in residual inhibition test.

OBJECTIVE: Assessed the feasibility of application of free fibular flap and clinical significance of pre-operational contrast enhanced CT angiography in functional reconstruction of oral and maxillofacial hard and soft tissue defects. METHOD: Eight cases with mandibular and soft tissue defects received a free fibula flap using arteriovenous anastomosis anastomosis method. The relationship between fibula flap design, size, repair parts and survival were analyzed. Preoperative enhanced CT angiography (CTA) examination was conducted to detect any abnormal blood vessels in fibula flap valve area. RESULT: Peroneal artery and posterior tibial artery variation was identified in one case of gums cancer, who used other muscle flap. Free fibula flap in the other 7 cases survived, which carried a skin island with an area ranging from 6 cm x 2 cm to 10.0 cm x 3.5 cm. Postoperative facial appearance, functionality, dental occlusion and voice function was normal. Lower limb function returned to normal from 2 weeks to 4 months after surgery. CONCLUSION CTA examination of the free vascularized fibula flap in the preoperative evaluation of the donor site is a valuable tool. Free fibula flap of bone, periosteum and bone marrow has a dual blood supply and are highly resistant to infection after transplantation. Personalized shaping osteotomy allowed for accurate recovery of mandibular alveolar patterns. Furthermore, the height and width of the fibula and the thickness of cortical bone is suitable for dental implants. Free fibula flap skin island can also be used to monitor the post-operative blood supply and is an ideal technique for mandible and soft tissue defects reconstruction as well as functional restoration.
Adult ; Aged ; Angiography ; methods ; Female ; Free Tissue Flaps ; blood supply ; Humans ; Male ; Maxillofacial Injuries ; surgery ; Middle Aged ; Mouth Neoplasms ; surgery ; Reconstructive Surgical Procedures ; methods

BACKGROUND:Caspase plays a crucial role in the cellapoptosis, but the influence of different facial nerve injury on caspase 1, caspase 8, cyto-c protein expression and their correlation stil remain unclear.
OBJECTIVE:To construct facial nerve crush or distal transection injury models, observe the morphological changes of facial motoneurons, investigate death gene caspase 3, caspase 8, cyto-c expression, and analyze their correlation.
METHODS:Facial nerve crush or distal transection injury model was established in the right facial nerve of rats, while the left facial nerve served as normal controls. We observed the morphology and the death of facial motoneurons with toluidine blue staining and transmission electron microscope. Expressions of caspase 3, caspase 8 and cyto-c proteins were studied by immunohistochemistry analysis fol owing facial nerve injury.
RESULTS AND CONCLUSION:Both facial nerve distal transection and crush injury resulted in the death of facial motoneurons, and the death pattern was mainly apoptosis. Caspase 3, caspase 8 and cyto-c protein expressions were observed in the subnucleus of normal rat facial nucleus. cells of the distal transection group were stained more intensely than that of crush group. Expressions of these proteins began to increase at 3 days after the injuries. Caspase 3 and caspase 8 protein expression peaked at 14 days, whereas cyto-c protein expression peaked at 7 days after the injuries. Expressions of caspase 3, caspase 8 and cyto-c proteins were correlated with facial nerve injury type and injury time. Expressions of caspase 8 and cyto-c protein were correlated with expression of caspase 3 protein. The findings indicate that, caspase 8 and cyto-c contribute to activate caspase 3, and caspase cascade reaction plays an important role in the apoptosis of facial motoneurons.

Objective To explore the application of high-frequency color Doppler in the diagnosis of infant intussusception and the selection of reduction mode according tO the hemodynamic situations of intussusception intestine tube and blood vessel in mesentery.Methods A total of 377 cases of doubtful intussusception infants wete checked by high-frequency color Doppler.After they had been diagnosed,the hemodynamic situations of intussuscepiton intestine tube and blood vessel in mesentery were carefully observed and the ultra-sound had 3 types and then the hydrostatic enema reduction was chosen as treatment method.Results A total of 263 cases was diagnosed by highfrequency colot Doppler with rate of coincidence of 100%.Among them are 253 successful cases reduced by hydrostatic enema.The successful rate of reduction was 96.2%and the 10 failed cases were changed to be treated bv operation.The intestinal wall of intussusception tube in failure group had serious dropsy without blood flow shown.Conclusions It is accurate that the infant intussusception is diagnosed by high-frequency color Doppler.According to the hemodynamic situations of intussusceptin intestine tube and blood vessel in mesentery,the infant intussusception can be divided into 3 types as follows:type Ⅰ:the blood signal of intestinal tube and wall is up or normal,which shall be reduced by hydrostatic enema;type Ⅱ:the blood signal of intestinal tube and wall is small with high obstruction index,which shall be reduced by hydrostatic enema as possible as it can;type Ⅲ:the intestinal wall has serious dropsy with rather high obstruction index and without blood flow shown,in which the hydrostatic enema redHetion shall bebanned and the operation shall be carried out as soon as possible.

Objective To evaluate the value of combining PCT, BNP, D-Dimer and PCIS score in predicting the prognosis of pediatric severe pneumonia in the early stage. Methods 80 cases of children with severe pneumonia were selected, 49 cases were boys , 31 cases were girls, with a median age of 7.5 months (1 month to 156 months). According to the final outcome, the cases are divided into treatment group and poor prognosis group. The score of PCIS, PCT, BNP and D-dimer within 24 hours after admission were recorded. According to the indicators, ROC curve was drawn independently and integrated with the four indicators,and the corresponding areas under ROC curve (AUC) were calculated to compare the accuracy of the assessment. Results The AUC of PCIS, PCT, BNP and D-dimer were between 0.7 and 0.9. The ROC curve integrated the four indicators showed the AUC were 0.932, which improved sensitivity and specificity. Conclusions The integration of PCIS, PCT, BNP and D-Dimer could improve the accuracy of prediction in the prognosis of severe pediatric pneumonia.

Objective To observe the preliminary clinical results and safety of 27-gauge microincision vitrectomy surgery for partial vitreoretinal diseases.Methods A total of 13 patients (13 eyes) who underwent 27-gauge microincision vitrectomy surgery were enrolled.The follow-up period was 6 to 12 months.Preoperative and postoperative visual acuity and intraocular,total operative time,cutting time for removing vitreous,wound healing status,intraoperative and postoperative complications were observed.Results Mean best corrected visual acuity improved from preoperative (1.26±0.66) logMAR (0.10±0.09) to postoperative (0.63±0.52) logMAR (0.35±0.24),and the difference was statistically significant (t=2.743,P=0.018).The difference of mean preoperative intraocular pressure (IOP),IOP of postoperative day 1,day 5,one month and final postoperative visit were not statistically significant (F=0.593,P＞0.05).The mean total operative and cutting times were (36.38±14.97) min and (10.12±3.54) min respectively.Postoperative scleral incision showed linear closure,no cases of postoperative sclerotomyrelated complications such as wound dehiscence,vitreous incarceration and subcoujunctival fluid were observed.No intraoperative and postoperative complications of iatrogenic retinal breaks,endophthalmitis,choroidal detachment,retinal detachment and vitrous hemorrhage were observed.Conclusions The 27-gauge microincision vitrectomy surgery can improve postoperative visual acuity for treatment of vitreoretinal diseases and induce fewer sclerotomyrelated complications,which maybe a safer surgical approach.

Objective To evaluate the effect of single CVVH and HDF on endothelial system. Methods Group CVVH:20 patients with multiple organ dysfunction syndrome ( MODS) underwent CVVH for 12h.Vascular access was through two-lumen catheter in femoral vein;Group HDF:Twenty patients with end stage renal disease (ESRD) on maintenance hemodialysis underwent HDF for 4h.Vascular access was through internal arteriovenous fistula.Group control:Healthy people were examined at our hospital.The se-rum levels of sVCAM-1, sICAM-1, vWF and MMP-9 were measured by enzyme-linked immunosorbent assay ( ELISA) after centrifugation in treatment group before and after treatment.Four cytokines were also meas-ured in fasting healthy subjects in the morning.Results The levels of serum sVCAM-1, sICAM-1, vWF, MMP-9 were significantly higher in Group CVVH and HDF than control group before and after treatment( P<0.05).Group CVVH:The serum levels of sICAM-1 and sVCAM-1 were significantly lower in post-treat-ment than pre-treatment, But the serum levels of vWF and MMP-9 showed no obvious changes after CVVH;Group HDF:the levels of four cytokines showed no obvious changes after single HDF.Conclusions Endo-thelium becomes impaired in MODS and ESRD patients, Endothelium may be protected by CVVH through the partial removal of cytokines harmful to endothelium in MODS patients.Single HDF therapy does not pro-tect endothelial function obviously in MHD patients.

Objective To investigate the protective effect of icariin against varicocele-induced damage on rat epididymis. Methods Forty adolescent male SD rats were randomly divided into control group (n=10), experimental varicocele (EV) group (n=15), icariin (ICA) therapy group (n=15). Experimental varicocele model in the EV group and ICA group was established. The EV was induced by partial ligation of the left renal vein. The rats in the control group underwent a sham operation that separated the spermatic vessels without ligation. Each rat in the control group and EV group was lavaged with 2 mL physiological saline every day for 6 weeks. Each rat in the ICA group was lavaged with icariin [100 mg/(kg·d)] for 6 weeks. Rats in all groups were executed after 6 weeks. The contents of sialic acid were measured by spectrophotometry. Carnitine concentrations were measured by DTNB. HE stain was used to observe the microstructure changes in the epididymal tissue. Electron microscopy was used for observing the ultrastructural changes of the epididymis. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method was used to detect the apoptosis of the epididymal epithelium. Results Compared with the control group, the microstructure and ultrastructure of the epididymis in EV group showed pathological damage. Compared with the EV group, the damage of the epididymal microstructure and ultrastructure significantly alleviated. Apoptosis index (AI) of epididymal epithelium in the EV group was significantly higher than that in the control group (P<0.01). However, AI of epididymal epithelium in the ICA group was significantly lower than that in the EV group (P < 0.01). The sialic acid and carnitine concentrations of the epididymis in the EV group was significantly lower than that in the control group (P < 0.01), respectively. However, the sialic acid and carnitine concentrations of the epididymis in the ICA group was significantly higher than that in the EV group (P < 0.01), respectively. Conclusion This study indicates that varicocele could result in the apoptosis of epididymal epithelium and icariin decreased the varicocele-induced apoptosis , suggesting that varicocele could damage the structure and function of epididymis, which can be repaired by icariin.

Objective To explore the prevalence of sialorrhea and its clinical correlation with dysphagia in Chinese patients with Parkinson′s disease ( PD ).Methods One hundred and sixteen consecutive patients with a clinical diagnosis of PD were selected.Demographic data included sex , age, years of education, age at onset of PD, clinical genotype, disease duration, treatment, Hoehn and Yahr (H&Y) stage.Sialorrhea was assessed using the Unified Parkinson′s Disease Rating Scale (UPDRS) Ⅱitem number 6.All patients were studied with videofluoroscopic study of swallowing ( VFSS).Results The prevalence rate of sialorrhea in PD was 59.5% (69/116, 95% CI 50.6%-68.4%).Males were more likely to develop sialorrhea than females (47/70 vs 22/46,χ2 =4.298, P=0.038).PD patients′sialorrhea correlated with oral dysphagia:with food leaking from the mouth ( liquid r=0.229, P=0.014; juice r=0.197, P=0.034;pudding viscosities r=0.231, P=0.013;solid food r=0.255, P=0.006), with more than 1 ml of oral food residues (liquid r=0.319, P<0.01;solid food r=0.185, P=0.047), with delay in food transfer to the root of the tongue (liquid r=0.279, P=0.002; juice r=0.209, P=0.024), and delayed swallow transfer ( pudding viscosities r=0.257, P=0.005).Sialorrhea score was not related to H&Y stage, clinical course and levodopa equivalent doses (LED).The prevalence rate of dysphagia in PD was 87.1%(95% CI 81.0% -93.2%).Liquid was more likely to cause pharyngeal dysphagia ( P=0.03).With the increase in H&Y stage , so did the oral and pharyngeal stages of dysphagia.Late and mid-course was more likely to develop oral and pharyngeal dysphagia than those with early clinical course .Conclusions Sialorrhea and dysphagia are common non-motor symptoms in PD patients.Sialorrhea is more prevalent in males and correlates with oral phase of dysphagia.Liquid is more likely to cause pharyngeal dysphagia.With increase in H&Y stage , so did oral and pharyngeal dysphagia.Even though late clinical course is more likely to develop oral and pharyngeal dysphagia than early clinical course , the comparison between late and intermediate clinical courses does not reach statistical significance .