Objective:To investigate biomechanical changes of mandible in the impact injure simulated by finite element method (FEM).Methods:Mimics and Comsol software were used to build a FEM of human craniofacial bone based on CT scan data of a normal adult.LS-DYNA and Hypermesh software were used to simulate the impact with different quality,velocity and angulation pro-duced injures of human mandible,the biomechanical parameters of the mandible in the impact injury process were analysed.Results:A FEMof human maxillofacial bone was established,and the dynamic process of different impact force produced damage was simula-ted.Mandibular chin,angle and condylar neck was the stress concentrated area in the process of mandible injury.There was higher stress peak at the site which was closer to the impact position,the stress peak arrival time was also earlier.When the impactor with the same quality,the bigger the velocity,the greater the stress peak.When the impactor with the same velocity,the bigger the quali-ty,the greater the stress peak.When the impactor with the same velocity and quality,there was greater stress peak under the impact to mandible from angulation of 0 degree.Stress transfered to the surrounding bone from the impact position radially and gradually re-duced.The bone area with small cross-section was prone to high stress and more serious damage.Conclusion:The quality,the ve-locity,the impact angle and the impact site are the factors affecting the severity of impact injury.

AIM: To prepare a nanodrug MMC-ATS-@PLGA using polylactic acid hydroxyacetic acid copolymer(PLGA)as a carrier and mitomycin C(MMC)loaded on PLGA, and to analyse the biological safety and treatment effect of this nanodrug on inhibiting the proliferation of filtering bleb scarring after glaucoma surgery in vivo.METHODS: The thin-film dispersion hydration ultrasonic method was used to prepare the MMC-ATS-@PLGA, and its physical and chemical properties were detected. The effect of MMC-ATS@PLGA on rabbit corneas was analysed through corneal fluorescence staining and HE staining, and tear film rupture time(BUT), Schirmer test and intraocular pressure data were collected to analyse ocular surface biosafety. A slit lamp was used to observe and calculate the filtration bubble size, and the tissue morphological changes were analysed by conjunctival HE staining. In addition, immunohistochemistry and Elisa were used to compare the anti-inflammatory effects of Flumiolone Eye Drops(FML), MMC, and MMC-ATS-@PLGA nanoparticles on inhibiting the formation of filtering bleb scarring after glaucoma surgery from multiple perspectives via comparative proteomic analysis.RESULTS: The average particle size and zeta potential of MMC-ATS-@PLGA were 128.78±2.54 nm and 36.49±4.25 mV, respectively, with an encapsulation efficiency and a drug loading rate of(78.49±2.75)% and(30.86±1.84)%, respectively. At 33°C(the ocular surface temperature), the cumulative release rate of the MMC-ATS-@PLGA nanoparticles reached(76.58±2.68)% after 600 min. Moreover, corneal fluorescence staining, HE, BUT, Schirmer, and intraocular pressure results showed that MMC-ATS-@PLGA had good biocompatibility with the ocular surface of rabbits. At 3 wk after surgery, the area of filtering blebs in the MMC-ATS-@PLGA group was significantly larger than that in the FML group and MMC group, and the filtering blebs in the control group had basically disappeared. Pathological tissue analysis of the conjunctiva in the filtering blebs area of the eyes of the rabbits revealed that compared with that in the normal group, the morphology of the collagen fibres in the MMC-ATS-@PLGA group was relatively regular, the fibres were arranged neatly, and the tissue morphology was similar to that of the normal group. Immunohistochemistry and Elisa confirmed that compared with those in the normal group, the expression levels of α-SMA, CTGF, and type Ⅲ collagen fibre antibodies were significantly increased in the control group. After FML, MMC, or MMC-ATS-@PLGA treatment for 3 wk, the expression of inflammatory factors gradually decreased. Among the groups, the MMC-ATS-@PLGA group showed the most significant decrease(P<0.05).CONCLUSION: This study successfully synthesized a nanomedicine(MMC-ATS-@PLGA)that inhibits scar proliferation after glaucoma filtration surgery. The drug had stable physicochemical properties, good biocompatibility, and better anti-inflammatory effects by inhibiting the expression of α-SMA, CTGF, and type Ⅲ collagen fibres, which can prevent the formation of scarring in the filtering blebs area, thereby improving the success rate of glaucoma filtering surgery.

Objective To evaluate the effect of 15-deoxy-△12,14-prostaglandin J2 (15d-PGJ2) on endotoxin-induced acute lung injury (ALI) in rats.Methods Forty healthy male Sprague-Dawley rats, aged 3-5 months, weighing 220-250 g, were randomly divided into 4 groups (n =10 each) using a random number table: control group (group C), 15d-PGJ2 group, lipopolysaccharide (LPS) group, and LPS +15d-PGJ2 group.In group 15d-PGJ2, 15d-PGJ20.3 mg/kg was injected via the tail vein, while the equal volume of normal saline was given in group C.In LPS and LPS+15d-PGJ2 groups, ALI was produced with LPS 6 mg/kg injected through the tail vein, and then the equal volume of normal saline and 15d-PGJ2 0.3 mg/kg were injected, respectively.At 4 h after LPS injection, blood samples were drawn from the abdominal aorta for blood gas analysis, and arterial oxygen partial pressure (PaO2) was recorded.The rats were then sacrificed, lungs were removed for microscopic examination, and for determination of wet/dry lung weight ratio (W/D ratio), TNF-α, IL-8 and cytokine-induced neutrophil chemoattractant-1 (CINC-1) contents (by enzyme-linked immunosorbent assay) , and nuclear factor kappa B (NF-κB) p65 and IκB-α expression (by Western blot).Results Compared with group C, no significant change was found in PaO2, W/D ratio, contents of TNF-α, IL-8 and CINC-1, and expression of NF-κB p65 and IκB-α in group 15d-PGJ2 (P＞0.05), and PaO2 was significantly decreased, W/D ratio and contents of TNF-α,IL-8 and CINC-1 were increased, the expression of NF-κB p65 was up-regulated, and the expression of IκB-α was down-regulated in LPS and LPS+ 15d-PGJ2 groups (P＜0.05).Compared with group LPS,PaO2 was significantly increased, W/D ratio and contents of TNF-α, IL-8 and CINC-1 were decreased, the expression of NF-κB p65 was down-regulated, and the expression of IκB-α was up-regulated (P＜0.05),and the pathological changes were attenuated in group LPS+ 15d-PGJ2.Conclusion 15d-PGJ2 can mitigate endotoxin-induced ALI in rats.

ObjectiveThe aim of this study is to analyze the etiology and status of bone age of children with short stat-ure.MethodsAnthropological and physical examination data were retrospectively collected and studied in 2132 children with short stature in the department of endocrinology between 2009 and 2014. Growth hormone (GH) levels were determined by ar-ginine-clonidine test. Bone age was determined by CHN scoring.ResultsAmong the 2132 patients, 1333 were males and 799 were females. Mean age is 9.03 ± 3.04 years old, mean bone age is 6.81 ± 3.05 years. Of them, 324 cases (15.2%) were diagnosed complete GH deifciency, 780 cases (36.59%) were partial GH deifciency, 27cases (1.27%) were multiple pituitary hormone de-ifciency, 13 cases (1.64%) were hypothyroidism, 893 cases (41.89%) were idiopathic short stature, 19 cases (0.89%) were small for gestational age (SGA), 40 cases (1.88%) were chromosomal disorders, etc. Signiifcant difference in age and bone age was found using t test (P<0.05). Signiifcant differences in Δage were found between etiological categories using ANOVA (P=0.000). Δage was signiifcantly and negatively associated with peak GH using Pearson's correlation.ConclusionsGH deifciency is the most common cause of short stature. Bone age of children with short stature is commonly delayed. Δage was signiifcantly and negatively associated with peak GH. Multiple pituitary hormone deifciency has a signiifcant effect on bone age. The etiology of patients with short stature cannot be determined just by bone age.

Objective To develop a 3D finite element model for the human craniomaxillofacial region in an attempt to offer basis to the research of simulation of craniomaxillofacial injury.Methods A healthy adult male was submitted to head CT scan, and the data was imported into the Mimics 15.0 software for threshold segmentation and 3D reconstruction according to the classifications of bone tissue, skin tissue and subcutaneous tissue.The reconstruction data was imported into 3D reverse software Geomagic Studio 2012, and the images were optimized and the 3D model was generated.The three parts of the model were fitted according to the actual proportion using the 3D control software Solidworks 14.0, and then the boundary conditions were derived.Hypermesh 12.0 finite element processing software was used to build the volume mesh, and the model was established.Each layer of the model was given to the material parameters, and the simulation conditions were provided to test the model.Results This model was completely composed of volume meshes, including 214,250 hexahedral meshes and 411,920 nodes.This model can clearly show the stress distribution, the trend of fracture line, the displacement of fracture block of soft and hard tissue during the simulation, and the results are consistent with clinical practice.Conclusion A three-dimentional finite element model with good performance is established, which can be used for biomechamics simulation analysis of multiple sites on the head or the whole structure, and has a certain significance in clinical and scientific research.

Objective To investigate the status of blood donation in Shanghai streets,understanding the motivation of the donors for blood donation and how many times they had donate their blood.Here,we intend to improve work efficiency in order to better serve the blood donators and to provide a theoretical basis.Methods To gain insight into the understanding and attitude of citizens for blood donation,we analyzed the volunteer blood donors in 387 vehicles and 436 outdoor pre mobilization object by six months,questionnaire in blood collection vehicle or at scene etc.Results The survey specifically reflected the understanding,attitude and motivation of citizens and foreign workers for blood donation in Shanghai.Conclusion There existed many problems such as wrong recognition,diversified motivation among many citizens for blood donation.More publicity and education for the knowledge of blood donation are needed and it plays significant and longlasting role for blood donation.

The carotid initima-media thickness(CIMT)in 78 cases of type 2 diabetic patients was measured.The level of plasma endogenous secretion receptor for advanced glycation end-products(esRAGE)in patients with normal CIMT was higher than those with chickened CIMT[(0.257 3±0.165 6 vs 0.155 4±0.0701)μg/L,P<0.01].esRAGE was negatively associated with CIMT(r=-0.247,P<0.05).Logistic regression analysis showed that CIMT was negatively associated with esRAGE and hish density lipoprotein cholesterol,but was positively associated with age.

Objective: To compare droplet digital PCR (ddPCR) and Super-amplification refractory mutation system (ARMS) in the detection of T790M mutation of epidermal growth factor receptor (EGFR) in the plasma of non-small cell lung cancer patients who had developed resistance to EGFR tyrosine kinase inhibitor (TKI) , and to investigate the clinical application of ddPCR. Methods: Plasma samples were collected from non-small cell lung cancer patients who had acquired EGFR-TKI resistance at Shanghai Pulmonary Hospital, Tongji University, from May 2017 to November 2017. Extracted ctDNA was analyzed by ddPCR and Super-ARMS to evaluate the T790M mutation status of EGFR gene. Results: A total of 37 patients with activating EGFR mutation that acquired resistance to EGFR-TKI were selected in the study, including 17 male and 20 female with a median age of 64 years (range 40-83 years). Before TKI treatment, all the patients harbored EGFR inhibitor sensitive mutations but without T790M mutation. After acquiring resistance to EGFR-TKI treatment, the T790M mutation rate detectable by ddPCR was 45.9% (17/37). In contrast, the mutation rate of T790M detectable by Super-ARMS was 35.1% (13/37, P<0.05). For the 13 positive cases detected by Super-ARMS (ΔCt<8), they were all positive by ddPCR assay; Among the 10 negative cases detected by Super-ARMS (ΔCt≥8), there were 3 cases positive by ddPCR assay. For patients without ΔCt by Super-ARMS assay, there was one weak positive case detectable by ddPCR assay. Among 17 EGFR T790M positive patients, 9 received EGFR inhibitor Osimertinib treatment, and 7 of them had good therapeutic response after the treatment. Conclusions While a significant correlation between the two methods is shown. ddPCR is more sensitive than Super-ARMS in the detection of EGFR T790M mutation, indicating that it is a better method in guiding target drug therapy of non-small cell lung cancer patients after acquiring the resistance to EGFR-TKI.

Objective: To summarize the individual design of the perforator flap based on the descending branch of the lateral circumflex femoral artery and ecological protection of the flap. Methods: From June 2013 to June 2017, 33 cases of extremities wound defects were repaired with the descending branch perforator flap of the lateral circumflex femoral artery. According to the chracteristics of extremity wound and the anatomy of the descending branch perforator of the lateral circum flex artery, a medial incision of the flap according to the demarcation line was performed. Through meticulous dissection, two perforator branches were found and traced on the surface of facia lata. The size of the kiss flap was adjusted according to the perforator caliber. The chimeric muscular flap was incised according to muscular penetration point of the perforator and the course of lateral fermoral nerve with cautious protection of muscular branch of femoral nerve. During the incision, fascia lata, nerves and muscles on donor site were protected to reduce the damage to donor site. Meanwhile, ecological structure on donor site was reconstructed. Our series include 22 males, 11 females. The average age ranged from 13 to 71 years (mean: 47years). There were 21 cases of wounds on dorsum manus and wrists and 12 cases of wounds on the dorsum pedis and lower limbs. The wound dimension ranged from 7 cm×8 cm to 13 cm×24 cm. The flap dimension ranged from 6 cm×7 cm to 8 cm×15 cm.There were 22 cases of KISS flaps and 11 cases of chimeric flaps. Wounds on all donor sites were primarily sutured. Course of the disease ranged from 1 week to 2 months. Results: All flaps were harvested uneventfully and survived well. No vascular crisis occurred. Wounds on all donor sites were primarily sutured. Three to 24 (mean 18) months of follow-up was made on 28 cases. The color and texture of flaps was good. Appearance of the flaps was good. Protective sensation recovered. Only linear scar can be seen on donor sites. No muscular hernia and cinesipathy was noticed on donor sites. Conclusions The size of KISS flaps depends on the caliber of perforator branch estimated intraoperatively. Muscular part of the chimeric flaps was harvested according to the muscular entry points of perforators and the demand of recipient sites. The wound defects were reconstructed individually according to the peculiarity of the defects. Fascialate, nervus cutaneus and muscle was cautiously protected in the course of flap harvest. Ecological structure was reestablished after flap harvest to reduce complications.

Objective: To evaluate the clinical effect of the modified nasolabial flap with facial subcutaneous pedicle advanced flap in repairing the defects after midcheek tumor resection. Methods: From June 2012 to June 2017, 27 patients with facial tumors were treated, and according to the nature of the tumor, the tumor tissue was enlarged, frozen pathological examination was performed during the surgery. Once the edge and the base were reported to be negative, the nasolabial flap with facial subcutaneous pedicle advanced flap with a maximum 1 cm wider than the defect width was designed according to the position and size of the wound. The proximal border of the flap was designed at the cured edge of the circular wound. The curved bottom edge of the circular wound was the proximal end of the flap. The defects ranged from 2.0 cm×3.0 cm to 2.5 cm×4.0 cm. The donor site was directly sutured after subcutaneously loosening. Results: The operation was smooth, and the flaps were about 3.0 cm×6.0 cm to 3.5 cm×7.0 cm. The flaps were well transported after surgery, and there was no bruising at the tip. The suture was removed 1 week after surgery. After 6-36 months of follow-up, postoperative scar was not obvious, which were most hidden in the nasolabial folds. There was no ectropion and mouth deformity. The flaps were not swollen, and the color and texture were close to that of normal skin. The appearance was satisfactory. Sensation of skin were well recovered. Conclusions The modified nasolabial flap with facial subcutaneous pedicle advanced flap is suitable for repairing the facial defects with satisfactory skin sensation and good appearance.