BACKGROUND:Class II malocclusion is commonly observed in clinics, with the main manifestation of skeletal malocclusion, and mandibular retrusion is the main reason. Class II malocclusion should be treated early to correct skeletal malformation and improve facial appearance. OBJECTIVE:To compare the biomechanics change in early treatment of Class II division 1 malocclusion with Twin-Block appliance and straight wire appliance combined with face-bow and Class II drawing. METHODS: Thirty patients with malocclusion who were at peak velocity on the growth curve were randomly divided into two groups, with 15 cases in each group. Patients in each group were treated with Twin-Block appliance and straight wire appliance combined face-bow and Class II drawing, respectively. The cephalometric records of al patients were examined before and after the treatments. The acquired data were processed by statistical analysis. RESULTS AND CONCLUSION:After treatment, al molars and cuspid teeth achieved or reached Class I, and ANB angle decreased to normal range. The bone effect of Twin-Block appliance was more significant than straight wire appliance. Using Twin-Block appliance, the length of mandible body and lower face height increased significantly. Experimental findings indicate that, Twin-Block appliance has significant therapeutic effects in treatment of early skeletal Class II division 1 malocclusion patients, who are at peak velocity on the growth curve. With the biomechanical effects, this treatment corrects asymmetrical jaw relation, reconstructs the tissue, and obtains satisfactory lateral facial profile of soft tissues. The therapeutic effect is more obvious for patients with obvious mandibular retrusion, flared upper incisors and upright lower incisors.

Objective To observe the influence of short-term continuous subcutaneous insulin infusion(CSII)on ?-cell function in newly diagnosed type 2 diabetes(T2DM).Methods A total of 32 inpatients with newly diagnosed T2DM who had a 14-day course of CSII were randomly assigned to two groups of OGTT and arginine stimulating test(AST).Before and after 3 days and 14 days CSII treatments,OGTT and AST were performed respectively.The changes of the values of plasma glucose,HOMA-IR,HOMA-? and △C30/△G30,△C120/△G120 or arginine-induced acute C-peptide reaction(ACRARG)in two groups were compared.Results In OGTT,the values of plasma glucose and HOMA-IR were decreased,HOMA-? and △C120/△G120 were increased significantly after CSII therapy,both in day 3 and day 14;and △C30/△G30 were unchanged after 3 days but increased markedly after 14 days.However,in ACRARG,the above mentioned parameters almost remained unchanged after CSII treatment in 3 days or 14 days.Conclusions In newly diagnosed T2DM with elevated fasting glucose levels,intensive insulin therapy can partly improve ?-cell function showed by OGTT,not by AST.

AIM：To investigate the role of NF-κB in the activation of inducible nitric oxide synthase (iNOS) gene by tumor necrosis factor alpha (TNF α) and lipopolysaccharide (LPS) in endothelial cells and effect of antioxidant on the induction of iNOS. METHODS：Rat pulmonary microvascular endothelial cell (RPMEC) was cultured and the cells were identified with antiendothelial cell antibody CD31 using immunohistochemistry(ABC). The concentration of nitrite in the culture media was determined based on Griess reaction. iNOS mRNA was analyzed using RT-PCR and Northern blot. NF-κB in cell nuclei was detected with electrophoresis mobility shift assay (EMSA). RESULTS：A marked production of nitrite in RPMECs was found after 24 hours treatment with TNF α(105 U/L) and LPS (1 mg/L) (P＜0.01). The level of iNOS mRNA increased significantly after adding TNF α(105 U/L) and LPS (1 mg/L) to the cell media for 2 hours (P＜0.05). Pretreatment with cycloheximide (CHX, 10 mg/L) or antioxidant, PDTC (0.1 mmol/L) or NAC (20 mmol/L) significantly decreased nitrite production and iNOS mRNA expression induced by TNF α(105 U/L) and LPS (1 mg/L) (P＜0.05). Furthermore, there was a dose-effect relationship between PDTC/NAC and inhibitory effect. TNF α (105 U/L) and LPS (1 mg/L) triggered the activation and translocation of NF-κB. This effect was blocked by adding PDTC (0.1 mmol/L) or NAC (20 mmol/L) to the cell media for 1.5 hours.CONCLUSION：1.TNFα and LPS may induce iNOS gene expression at transcriptional or posttranscriptional level. The upregulation of iNOS depends on new protein synthesis. 2. The induction of iNOS gene expression by TNFα and LPS is dependent on the activation of NF-κB. 3. Antioxidants may inhibit the induction of iNOS gene through the inhibition of NF-κB activation.

Objective To study the diagnosis and therapy of Hashimoto's disease (HD) with thyroid nodule. Methods The clinical data of 187 patients with nodulous Hashimoto's disease who had operation in our hospital from 1995 to 2008 were analysed retrospectively. Results The nodules coexisting with Hashimoto's disease were thyroid carcinoma, nodular goiter, thyroid follicular adenoma and lymphoma accounting for 11.2% (21/187), 26.7% (50/187), 15% (28/187) and 1.6% (3/187) respectively. Conclusions HD patients with thyroid nodules especially the single nodule that can not be distinguished from cancer should have operation in time. Ultrasound guided needle aspiration will be helpful for the preoperative diagnosis and the frozen section may guide the surgical modality.

From pregnant women's psychological point of view, the variant characters and the underlying causes are analyzed when they are in the period of childbirth and puerperium. The role of medical staff and the treatments in clinical psychological heath for pregnant women are discussed, which could help the pregnant women give birth smoothly and healthy in puerperium.

Objective To study the molecular identification method of Candida species and lay the foundation of molecular diagnosis for deep candidiasis. Methods PCR was used to amplify the internal transcribed spacer region of ribosomal DNA from 11 type strains of 9 pathogenic Candida spp. and 39 clinical Candida isolates, and the products were digested with three types of restriction endonucleases (MspⅠ,DdeⅠand HaeⅢ). Results Five patterns of products with different molecular weights were obtained after amplification from 9 Candida spp., and the products were digested with MspⅠ, DdeⅠand HaeⅢ, producing 8, 5 and 4 unique band patterns, respectively. Conclusion PCR-RFLP is reliable, specific and useful for the identification of common pathogenic Candida species.

Photodynamic therapy (PDT) has been wildly used in the treatment of tumors and dermatologic diseases,especially,when the traditional therapies are ineffective or bring side effects.Moreover,with the deepening of the studies,its effects in anti-microbial has been found.PDT in the treatment of infectious diseases has attracted more and more attention of scholars.In this review,we discussed the mechanism of the PDT,studies in the sterilization of a variety of oral pathogenic bacteria by the PDT and its potential applications in clinic.

Microvascular endothelial cell (MVEC) is one of the target cells of TNFα (TNF effect). The dysfunction of MVEC induced by TNF plays an important role in some cardio-cerebral vascular diseases. ① Cell proliferation kinetic: Using flow cytometry, we found cell count ［(4.30±0.34)×107／L)］ in TNF group (4×105 U/L) was obviously less than that in control ［(5.23±0.50)×107／L, P＜0.01］. The cells of G1 phase were more than those of the control, while the cells of G2, S and M phase became less (P＜0.05). ② Coagulant and anticoagulant: 72 h after MVEC cultued in the media, the content of 6-keto-PGF1α (RIA) and activity of PAI decreased significantly in TNF (4×105 U/L) group (P＜0.01, vs control). The difference between TXB2 content and t-PA activity in groups was not significant (P＞0.05). ③ Adhesive molecule: The effect of low concentration TNF (＜4×105 U/L) on adhesion between cultured MVEC and leukocytes was not signficant, but when the concentration of TNF reached 8×105 U/L or more, 12 h after culture the adhesion rate between MVEC and neutrophil increased 30.8%±4.5%. If adding monoclonal antibody of ICAM-1/CD11 into media, the adhesion rate of leukocytes decreased significantly (from 31.2% to 63.4%). ④ NO: The level of nitrite in culture media (Griess reaction) was higher than that of control (P＜0.05) after pretreatment of TNF (2×106 U/L) for 6 h. Adding L-NMMA, Dexamethasone or Cycloheximide in media could block the increase of nitrite induced by TNF, while L-Arg could enhance it. The expression of iNOS mRNA of PMVEC increased significantly after treated with TNF (2×106 U/L) for 24 h (quantitative RT/PCR). Pretreatment with Dexamethasone or Cycloheximide could block the increase (P＜0.05). Meanwhile, the expression of eNOS mRNA decreased significantly compared with control, the decrease can be blocked by Cycloheximide but not by Dexamethasone. So that TNF can induce the expression of iNOS mRNA in PMVEC, but inhibited the expression of eNOS mRNA. NO production in PMVEC can be time-dependently induced by TNF. ⑤ Apoptosis: Adding high concentration TNF(＞1.2×106 U/L) in culture media for 12 h can induce apoptosis of PMVEC with electron microscopy, flow cytometry (PI/AnnexinV stain), TUNEL and DNA ladder eletrophoresis. Meanwhile, expression of apoptosis-associated gene Bcl-2 mRNA decreased and that of Fas mRNA increased (Northern blot). The expression of FADD, caspase 3 and caspase 8 enhanced too. So that signal of apoptosis induced by TNF may be transmitted following the cascade of Fas→FADD→caspase8→caspase3. In conclusion, it should be paid attention to metabolism inability and dysfunction induced by TNF which can not found easyily using light microscope. High concentration TNF can induce apoptosis of endothelial cells regulated by apoptosis-associated genes. The changes mentioned above are common pathway in pathogenesis of some diseases related to TNF.

Objective To discuss the preventive strategy of complications in reoperation of differentiated thyroid carcinoma (DTC).Method Clinical data of 114 patients with DTC who needed reoperation because of recurrence or inadequate operation were reviewed retrospectively.The reoperations included total thyroidectomy for 101 cases,lobectomy for 13 cases,central compartment neck dissection for 94 cases,and lateral neck dissec tion for 65 cases.Results 8 cases (8.77％) suffered from temporary RLN injury,one patient (0.88％) has permanent nerve palsy.Nerve dysfunction recovered after reoperation in 4 cases who had suffered from recurrent laryngeal nerve palsy in previous operations.Transient hypoparathyroidism occured in 10 patients (8.77％),and per manent hypoparathyroidism happened to 2 patients (1.75％).Conclusion For patients undergoing reoperation,detailed preoperative examination,proper operative approach,meticulous dissection on the thyroid capsule,visual identification of RLN followed anatomic landmark and intraoperative nerve monitoring (IONM) are key factors to reduce complications in reoperation of DTC.

Objective To discuss the surgical treatment of differentiated thyroid carcinoma ( DTC) viola-ting larynx and trachea .Methods 29 patients with DTC violating larynx and trachea received primary tumor re-section.Among them, 6 patients were with larynx violation , 3 patients with larynx and trachea violation , 16 pa-tients with trachea violation , and 4 patients with anterior strap muscles and skin violation .In addition, 5 patients were type I , 4 patients type II , 9 patients type III , and 11 patients type IV .All patients accepted the total thy-roidectomy.For patients with larynx and trachea violations , 9 received the slashing tracheal surgery ( type I and II) , 15 patients received the window resection and sternocleidomastoid muscle periosteal flap reconstruction , sleeve resection and anastomosis reconstruction , and window resection and gastrostomy .3 patients received total laryngectomy , 2 patients received partial laryngectomy and 4 patients with skin invasion received the reconstruc-tion with pectoralis major muscle flap .Results For these patients , 25 patients were with papillary adenocarcino-ma, and 4 patients with follicular carcinoma .All patients were followed up for 1 to 8 years.3 cases suffered from recurrence, 2 cases with tracheal recurrence received reoperation .3 cases with lung metastasis received the I 131 therapy, among whom 2 cases achieved the local control of lung tumor and the other one survived with tumor .1 patient died of the neck lymph nodes recurrence .25 patients survived over 3 years.13 patients survived over 5 years.Conclusions For patients with DTC with larynx and trachea violation , we should try our best to eliminate the tumor tissues.For the organs invaded by tumors , if possibly, elimination is also needed .This will eliminate or release the suffocation resulted from bleeding or obstruction .In addition , the function of larynx and trachea can be reconstructed and the life quality of these patients can be improved through the flap reconstruction and trachea anastomosis.Standard endocrine therapy and nuclear medicine therapy contribute to the prognosis improvement .