[Objective]To observe the bone repairing efficacy of large segmental femur defects in rabbits with calcium phosphate cement(CPC)combined with bone morphogenetic protein(BMP)and massive bone allograft,which may benefit the clinical application of large segmental bone allograft transplantation.[Method]Fifty-four New Zealand white rabbits were divided into three groups and a 2 cm femur defect was created on one side of each rabbit,followed by implantation with:CPC combined with BMP and massive bone allograft(Group A),bone allograft only(Group B)and autograft transplantation(Group C).Intramedullary nails with a 3 mm diameter fixed all the grafts transplanted.The bone defect repair efficacy was evaluated by radiology and histology exam at 4,8 and 12 weeks after operation.[Result]The bone reparation capacities of allograft with CPC/BMP complex was better than that of the allograft alone after 4 ~8 weeks of transplantation,which were similar to the result of autograft transplantation.Complete bone union was achieved for all the groups after 12 weeks of operation,with better bone remodeling for group A and group C transplantation.The healing process of CPC/BMP combined with allograft transplantation was featured with large amount of bone callus forming surrounding the graft-host bone union area and the surface of allograft,which composd the extra cortical bone bridge and ingrowth(EBBI).Bone invasion,resorption as well as new bone genesis were seen in the surface of bone allograft at early stage,companied by expansion of Haversians canal,with more lanner cells,osteoblasts,osteoclasts and blood cells inside the allograft.CPC was slowly biodegraded with the bone graft resorption and new bone regeneration.[Conclusion]CPC combined with BMP can improve the bone reparation and substitution process in massive bone allograft transplantation for the treatment of large segmental bone defects.

Objective: To evaluate the effects of functional appliance and multi-bracket appliance on Angle Class II malocclusions coupled with vertical and transversal problems. Methods:Headgear-activator, Herbst appliance and multi-bracket appliance were used to treat 20 patients with Class II malocclusions coupled with vertical and transversal problems aged from 10 to 15 years. The lateral cephalograms were measured with Winceph 8. 0 software and statistical analysis was carried by SPSS 13. 0 software. Results:The sagi-tal, vertical, transversal problems had mainly been resolved at the end of functional appliance treatment. The SNB were increased( P<0. 05), ANB were decreased(P<0. 05), upper posterior teeth were intruded and distally moved(P<0. 05), lower posterior teeth were extruded and mesialy moved(P<0. 05). After multi-bracket appliance treatment, the anterior teeth achieved normal overbite and over-jet. The molar relationship changed from class II to class I. Mandibular plane angle was not clockwise rotated(P>0. 05). The upper and lower dentition were harmony in sagital, vertical and transversal. Conclusion: Functional appliance combined with multi-bracket appliance can be used effectively and conveniently for the treatment of Class II malocclusions coupled with vertical and transversal prob-lems.

Objective_ To investigate the effect of resting heart rate on the progression to diabetes in impaired glucose regulation patients. Methods A total of 638 patients with impaired glucose regulation, from January 2011 to December 2012 in our endocrinology clinic, were selected for the study. According to the resting heart rate, patients were divided into four groups:<66 beat/min group, 66 to 69 beat/min group, 70 to 75 beat/min group, and>75 beat/min groups. All patients'baseline data were collected. The incidences of diabetes in different resting heart rate groups were compared, and the relationship between resting heart rate and the progression to diabetes was estimated using multiple regression analysis. Results In 704 patients with impaired glucose regulation, 636 patients have been completed 2 years follow-up, or reached the end of follow-up ( diagnosed as diabetes ) , the follow-up rate was 90. 34%. During two years follow-up, the incidence of diabetes of<66 beat/min group, 66 to 69 beat/min group, 70 to 75 beat/min group, and>75 beat/min group were 16. 2%, 19. 4%, 25. 0%, and 33. 0%, respectivlely. And the Cochran Armitage trend test showed that χ2 =11. 109, P=0. 001, the difference was statistically significant ( P<0. 05). According to blood glucose monitoring, the 636 patients with impaired glucose regulation were divided into impaired fasting glucose group, impaired glucose tolerance group and impaired fasting glucose combined with impaired glucose tolerance group:the Cochran Armitage trend test showed that, with the resting heart rate accelerating, the incidence of diabetes increased. The incidence of diabetes in impaired fasting glucose combined with impaired glucose tolerance group was higher than that of impaired fasting glucose group and impaired glucose tolerance group ( P=0. 062, 0. 113). The average resting heart rate in 68 impaired glucose regulation patients progressed to diabetes was (79.8±8.3)beat/min,andin568non-diabetescases,itwas(74.5±7.2)beat/min(t=-5.043,P<0.01). With the use of patients progressing to diabetes as the dependent variable, different resting heart rate group as independent variables, and resting heart rate<66 beat/min group as a reference, the logistic regression analysis showed that the risk of the progression to diabetes increased with the resting heart rate levels. Conclusion Higher resting heart rate is linked to higher risk of diabetes in patients with impaired glucose regulation.

Objective:To assess the effects of Herbst two phase treatment on temporomandibular joint(TMJ) position analyzed by CBCT.Methods:15 patients of permanent dentition with class Ⅱ malocclusion combined with mandibular retrusion were treated by Herbst appliance as the 1st phase,then the 4 1st premolars of each patient were extracted,the fixed appliance of edgewise was applied as the 2nd phase of treatment.CBCT examination was carried out at the following stages:2 weeks before Herbst treatment(T1),at the start of the treatment when Herbst appliance was placed(T2),immediately after Herbst appliance was removed(T3) and immediately after the edgewise appliance was removed(T4).The InvivoDental software was used to calculate the joint space of TMJ from the three -dimensional CBCT images.The acquired data were then statistically analyzed.Results:During T1-T2-T3 stages,the anterior joint space was decreased and then increased,superior joint space and posterior joint space were increased and then decreased.During T3-T4 stages,the superior joint space and posterior joint space decreased further,but anterior joint space did not change.No significant difference was found in the anterior joint space,superior joint space and posterior joint space between T1 and T4 stage.Conclusion:At the start of treatment with Herbst appliance,the condyle is displaced in an anterior and inferior direction.At the end of functional treatment,especially the end of two phase treatment,the condyle is drawed back nearly to the original position.

The effectiveness and safety of renal denervation for treating resistant hypertension have been demonstrated by previous studies; meanwhile its potential therapeutic role for chronic kidney disease has also been indicated. Recent clinical and animal studies have confirmed that renal denervation did not cause further damage to renal function of patients with chronic kidney disease; conversely, it may have potential benefits for the patients. In this paper, we reviewed the application and effect of renal denervation in chronic kidney disease.

Objective To evaluate the value of ultrasound elastography score and strain ratio index in the differential diagnosis of thyroid solid nodules. Methods Eighty-six thyroid solid nodules of 69 patients were divided into 2 groups based on their pathologic results: benign nodules group and malignant nodules group.Compared with pathological results, each thyroid solid nodules' elastographic scores and strain ratio index were respectively analyzed. The sensitivity, specificity and accuracy of elasticity score and strain ratio index were calctlated.The receiver operator characteristic (ROC) curves were drawn according to the results, to choose the best cut-off value.Results There were 67 nodules in benign nodules group and 19 nodules in malignant nodules group. The diameter of benign nodules was (2.05 ± 0.21)cm, malignant nodules was (1.62 ± 0.12)cm. There were no significant differences in the elasticity score and strain ratio index between benign and malignant nodules(t= - 1.736, P ＞ 0.05). Malignant lesions had a higher score and strain ratio index(median 3, 3.97, respectively) than benign ones(median 2, 1.66,respectively, Z = - 5.290, - 5.450, all P ＜ 0.05). If the cut-off value of the elastographic scores was equal or more than 3, the sensitivity, specificity and accuracy were 84.2%(16/19) ,86.6%(58/67) and 86.0%(74/86), respectively,with an area under ROC curve of 0.854. If the cut-off value of the strain ratio index was equal or more than 2.50,the sensitivity, specificity and accuracy were 89.4%(17/19),86.6%(58/67) and 87.2%(75/86), respectively, with an area under ROC curve of 0.911. Conclusion Elasticity score and strain ratio index are helpful in differentiating benign and malignant lesions of thyroid with high clinical value.

The increasing number of TCM standards brings challenges to the practice of standards development,revision and comprehensive management.Therefore,empowering standards with digital technology has significant strategic significance.This article proposed a modeling method for inter standard relationships based on entity-relation model by deeply mining and interpreting the information of TCM standard titles,constructed a relationship model containing 7 relationship patterns,and demonstrated the application scenarios of the model using standard retrieval as an example,with the purpose to provide support for machine reading and using standards,improving the efficiency of TCM standard retrieval,mastering target standard related resources,and promoting the digital transformation of TCM standards.

OBJECTIVETo evaluate the effects of angle Class II division 2 malocclusion treated with Herbst appliance in young adults.

METHODSCast splint Herbst appliance and multi-bracket appliance were used to treat 12 patients with Class II division 2 malocclusion aged from 16 to 25 years old. The lateral cephalograms were measured with Winceph 8.0 software and statistical analysis was carried out by SPSS 13.0 software.

RESULTSThe changes in SNA, Co-Go, Go-Po after treatment had no statistical significance (P>0.05). The SNB increased and ANB decreased after treatment. Upper and lower incisors labially inclined and inter-incisor angle increased. Upper posterior teeth had distal movement, lower posterior teeth had mesial movement and extrusion. Mandibular plane angle and occlusal plane angle had clockwise rotation. The overbite decreased significantly, and the molar relationship changed from Class II to Class I in all patients.

CONCLUSIONHerbst appliance combined with multi-bracket appliance can be used effectively for correcting Class II division 2 malocclusion in young adults.

Adolescent ; Adult ; Cephalometry ; Female ; Humans ; Incisor ; Malocclusion, Angle Class II ; Mandible ; Orthodontic Appliances, Functional ; Young Adult

OBJECTIVETo observe the therapeutic effect of modified Longdan Xiegan Decoction (LXD) on hyperandrogenism in patients with polycystic ovary syndrome (POS) of stagnant fire in Gan channel type.

METHODSForty-eight patients were divided into two groups: the LXD group (25 cases) treated with LXI) for 3 months, and the Diane-35 group (23 cases) with Diane-35. Condition of menstruation, acne, hairiness were observed, basal body temperature (BBT) was measured, and the serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), free testosterone (FT), and androstenedione (A) were detected before and after 3 months' treatment. Meanwhile, adverse reaction was observed.

RESULTSAfter treatment, the condition of menstrual disorder, acne and single-phase BBT were improved significantly, and serum levels of LH, LH/FSH, FT and A decreased in both groups (P < 0.05), showed insignificant difference between them (P > 0.05). The PRL level dropped in the LXD group (P < 0.05), which significantly lower than that in the Diane-35 group (P < 0.05). There were 3 cases with adverse reaction of irregular colporrhagia and 5 cases with nausea and vomiting in the Diane-35 group, while no adverse reaction in the LXD group occurred.

CONCLUSIONModified LXD could significantly improve the condition in hyperandrogenism patients with POS of stagnant fire in Gan channel type.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperandrogenism ; drug therapy ; etiology ; Medicine, Chinese Traditional ; Phytotherapy ; Polycystic Ovary Syndrome ; complications ; drug therapy

Objective To investigate the genotype of metallo-?-lactamases (MBL) produced by carbapenem resistant Pseudomonas aeruginosa in pediatric patients.Methods 59 strains of resistance to imipenem or meropenem were collected from December 2003 to November 2005 in Beijing children's hospital.Isolates were further evaluated for MBL production by two screening methods.MBL Etest strips were used to screen the phenotype of MBL production.Molecular screening for blaVIM,blaIMP,blaSPM and blaGIM was carried out using primers targeting the conserved regions of the MBL genes.The PCR fragments obtained with integron primers were sequenced on both strands.The nucleotide sequences were compared with sequences available over the Internet.Results Of the 59 carbapenem resistant Pseudomonas aeruginosa included in this study,29 (49.2%)were MBL positive using Etest methods,and 39 (66.1%) of these tested positive for MBL genes by PCR.35 (89.7%) were positive for blaIMP genes and 4 (10.3%) were positive for blaVIM genes.All isolates were negative for SPM and GIM DNA sequencing revealed that the IMP-1 was detected in 35 IMP-producing isolates,and VIM-2 was detected in 4 VIM-producing isolates.Conclusions This study has demonstrated that MBL-producing strains in pediatric are more common than in adult.IMP-1-producing strains are the main in pediatric,and VIM-2-producing strains concurred.The production of MBL is one of the important reasons of carbapenem resistant Pseudomonas aeruginosa in pediatric.It is very important to monitor the production of MBL.