The patients with skeletal Class Ⅱ high-angle malocclusion are frequently complicated by idiopathic condylar resorption(ICR),which may lead to temporomandibular joint(TMJ)dysfunction and dentofacial deformities.This article reports the diagnosis and treatment process of a 24-year-old female patient with skeletal Class Ⅱ high-angle malocclusion accompanied by ICR.The patient's chief complaints were anterior open bite and TMJ pain,and was diagnosed with ICR through clinical examination and imaging.After stabilizing condylar resorption with occlusal splint therapy,combined orthodontic-orthognathic treatment was performed.The 42-month follow-up revealed:well-aligned dentition with complete closure of diastemas,significant improvement of protrusive facial profile(ANB angle reduced by 4.2°),complete resolution of TMJ pain and clicking,and establishment of stable Class Ⅰ occlusion.Three-dimensional CT demonstrated satisfactory condylar bone remodeling and normalized joint space.Through multidisciplinary treatment,both occlusal function and facial aesthetics were significantly improved.This case demonstrates that orthodontic-orthognathic treatment should be performed after condylar stabilization in ICR patients,and occlusal splint therapy serves as an effective preoperative intervention.

Objective To investigate the expression level of WT1 gene in the bone marrow of patients with AML-M2 and its impact on the therapeutic effect and prognosis.Methods qRT-PCR was used to detect WT1 gene and AML1-ETO gene expression in bone marrow of 126 patients with AML-M2 and 30 control samples.The mutations of NPM1,FLT3-ITD/TKD,C-Kit8/17,DNMT3A and CEBPa were detected by Sanger gene sequencing method.Results The expression level of WT1 gene was significantly higher in patients with AML-M2 than the control group(0.0024 vs 0.080,P＜0.001).The level of WT1 gene expression was positively correlated with age(r=0.314,P=0.011)and the proportion of bone marrow original cells(r=0.534,P=0.010),the differences were statistically significant.The expression level of WT1 gene in normal karyotype group and abnormal karyotype group was significantly different(P=0.040).A comparison of AML1-ETO positive group and AML1-ETO negative group showed that the WT1 gene expression levels of the two groups were significantly different(P=0.032).The WT1 gene in the bone marrow of patients,who were AML1-ETO positive,with AML-M2 was positively correlated with the AML1-ETO gene expression level(r=0.524,P=0.037),and the AML1-ETO gene and WT1 gene expression levels were effectively tracked in 20 patients who werel AML1-ETO positive,with all positively correlationship(P＜0.05).There was no significant difference in the complete remission(CR)rate between WT1 gene high expression group and WT1 gene low expression group(66.7％vs 60.4％,P＞0.05).Both univariate analysis and multivariate COX analysis indicated that WT1 high expression group had higher overall survival(OS)rate(P＜0.05).Conclusion The expression level of WT1 gene in bone marrow may be used as a molecular index to monitor minimal residual disease(MRD),which has important clinical significance for prognosis as-sessment of AML-M2 patients.

Objective To summarize the potential risk factors that may arise in the national drug sampling and testing inspection process in recent years,to focuse on the operation of the quality management system,and to put forward proposals on how to do a good job under the new drug regulatory model of sampling and testing work.Methods Focusing on the investigation of data integrity and authenticity,the analysis focuses on the analysis of risk points such as reagent management,standard substance management,instrument,and facility management,electronic data management and other issues,and carries out a comprehensive verification of the effectiveness of the operation of the quality management system and so on.Results National drug sampling and testing institutes should strengthen the overall quality management,according to the operation of the laboratory,combined with their respective risk characteristics,reagent management,standard substance management,instrument and facility management,electronic data management and other aspects of the risk of systematic sorting and the establishment of the risk alert function,the development of risk warning lists,and the implementation of the corresponding risk control strategy.Conclusion National drug sampling and testing institutes must strengthen the operation of the process of influencing factors in the effective control of the emphasis on the testing of the work of the key control points and continue to standardize and improve the inspection process of the quality system to ensure that the quality of the various activities in a controlled state.

Objective To investigate the expression level of WT1 gene in the bone marrow of patients with AML-M2 and its impact on the therapeutic effect and prognosis.Methods qRT-PCR was used to detect WT1 gene and AML1-ETO gene expression in bone marrow of 126 patients with AML-M2 and 30 control samples.The mutations of NPM1,FLT3-ITD/TKD,C-Kit8/17,DNMT3A and CEBPa were detected by Sanger gene sequencing method.Results The expression level of WT1 gene was significantly higher in patients with AML-M2 than the control group(0.0024 vs 0.080,P＜0.001).The level of WT1 gene expression was positively correlated with age(r=0.314,P=0.011)and the proportion of bone marrow original cells(r=0.534,P=0.010),the differences were statistically significant.The expression level of WT1 gene in normal karyotype group and abnormal karyotype group was significantly different(P=0.040).A comparison of AML1-ETO positive group and AML1-ETO negative group showed that the WT1 gene expression levels of the two groups were significantly different(P=0.032).The WT1 gene in the bone marrow of patients,who were AML1-ETO positive,with AML-M2 was positively correlated with the AML1-ETO gene expression level(r=0.524,P=0.037),and the AML1-ETO gene and WT1 gene expression levels were effectively tracked in 20 patients who werel AML1-ETO positive,with all positively correlationship(P＜0.05).There was no significant difference in the complete remission(CR)rate between WT1 gene high expression group and WT1 gene low expression group(66.7％vs 60.4％,P＞0.05).Both univariate analysis and multivariate COX analysis indicated that WT1 high expression group had higher overall survival(OS)rate(P＜0.05).Conclusion The expression level of WT1 gene in bone marrow may be used as a molecular index to monitor minimal residual disease(MRD),which has important clinical significance for prognosis as-sessment of AML-M2 patients.

Objective To summarize the potential risk factors that may arise in the national drug sampling and testing inspection process in recent years,to focuse on the operation of the quality management system,and to put forward proposals on how to do a good job under the new drug regulatory model of sampling and testing work.Methods Focusing on the investigation of data integrity and authenticity,the analysis focuses on the analysis of risk points such as reagent management,standard substance management,instrument,and facility management,electronic data management and other issues,and carries out a comprehensive verification of the effectiveness of the operation of the quality management system and so on.Results National drug sampling and testing institutes should strengthen the overall quality management,according to the operation of the laboratory,combined with their respective risk characteristics,reagent management,standard substance management,instrument and facility management,electronic data management and other aspects of the risk of systematic sorting and the establishment of the risk alert function,the development of risk warning lists,and the implementation of the corresponding risk control strategy.Conclusion National drug sampling and testing institutes must strengthen the operation of the process of influencing factors in the effective control of the emphasis on the testing of the work of the key control points and continue to standardize and improve the inspection process of the quality system to ensure that the quality of the various activities in a controlled state.

Objective To explore the effect of different miniscrew placement heights on the distribution of biologi-cal forces produced by clear aligner combined with intramaxillary traction for mandibular molar distalization,to identify the miniscrew location that is conducive to the protection of lower anterior tooth anchorage and to provide a reference that can be used when designing clinical treatments.Methods Mimics,GeomagicStudio 2017,SolidWorks 2016,and Ansys workbench were used to establish finite element analysis models and perform mechanical analysis under the fol-lowing six working conditions:working condition 1 was the control group without miniscrews;working conditions 2 to 5 had miniscrew in the buccal bone cortex between the first and second molars of the lower jaw 10 mm,7 mm,4 mm,and 1 mm from the top of the alveolar crest,respectively;working condition 6 had the miniscrew in the center of the buccal tongue at the anterior edge of the ascending branch of the lower jaw 5 mm above the occlusal plane.Results On the sagittal axis,miniscrew anchorage caused distal displacement of all teeth.Compared to the control group,in the miniscrew group,the displacement of the anterior molars exceeded that of the second molars.On the vertical axis,the result in the control group was similar to backward bending;the results in the miniscrew groups resembled the effect of a lever,lowering the lateral incisors and canines and raising the central incisors and first premolars.On the coronal ax-is,the second premolars and the first molars showed lingual displacement in the control group,and only the premolars and first molars showed lingual displacementin the miniscrew groups.The canines were the teeth that were most strong-ly affected by the change in miniscrew placement height.Conclusion The higher the miniscrew position is,the stron-ger the protective effect on the anterior anchorage.According to the miniscrew placement height,the mandibular arch should be properly narrowed,the central incisors and first premolars should be lowered,and the lateral incisors and ca-nines should be raised when designing clinical treatments.

Objective To explore the effect of different miniscrew placement heights on the distribution of biologi-cal forces produced by clear aligner combined with intramaxillary traction for mandibular molar distalization,to identify the miniscrew location that is conducive to the protection of lower anterior tooth anchorage and to provide a reference that can be used when designing clinical treatments.Methods Mimics,GeomagicStudio 2017,SolidWorks 2016,and Ansys workbench were used to establish finite element analysis models and perform mechanical analysis under the fol-lowing six working conditions:working condition 1 was the control group without miniscrews;working conditions 2 to 5 had miniscrew in the buccal bone cortex between the first and second molars of the lower jaw 10 mm,7 mm,4 mm,and 1 mm from the top of the alveolar crest,respectively;working condition 6 had the miniscrew in the center of the buccal tongue at the anterior edge of the ascending branch of the lower jaw 5 mm above the occlusal plane.Results On the sagittal axis,miniscrew anchorage caused distal displacement of all teeth.Compared to the control group,in the miniscrew group,the displacement of the anterior molars exceeded that of the second molars.On the vertical axis,the result in the control group was similar to backward bending;the results in the miniscrew groups resembled the effect of a lever,lowering the lateral incisors and canines and raising the central incisors and first premolars.On the coronal ax-is,the second premolars and the first molars showed lingual displacement in the control group,and only the premolars and first molars showed lingual displacementin the miniscrew groups.The canines were the teeth that were most strong-ly affected by the change in miniscrew placement height.Conclusion The higher the miniscrew position is,the stron-ger the protective effect on the anterior anchorage.According to the miniscrew placement height,the mandibular arch should be properly narrowed,the central incisors and first premolars should be lowered,and the lateral incisors and ca-nines should be raised when designing clinical treatments.

Objective To explore the effect of different miniscrew placement heights on the distribution of biologi-cal forces produced by clear aligner combined with intramaxillary traction for mandibular molar distalization,to identify the miniscrew location that is conducive to the protection of lower anterior tooth anchorage and to provide a reference that can be used when designing clinical treatments.Methods Mimics,GeomagicStudio 2017,SolidWorks 2016,and Ansys workbench were used to establish finite element analysis models and perform mechanical analysis under the fol-lowing six working conditions:working condition 1 was the control group without miniscrews;working conditions 2 to 5 had miniscrew in the buccal bone cortex between the first and second molars of the lower jaw 10 mm,7 mm,4 mm,and 1 mm from the top of the alveolar crest,respectively;working condition 6 had the miniscrew in the center of the buccal tongue at the anterior edge of the ascending branch of the lower jaw 5 mm above the occlusal plane.Results On the sagittal axis,miniscrew anchorage caused distal displacement of all teeth.Compared to the control group,in the miniscrew group,the displacement of the anterior molars exceeded that of the second molars.On the vertical axis,the result in the control group was similar to backward bending;the results in the miniscrew groups resembled the effect of a lever,lowering the lateral incisors and canines and raising the central incisors and first premolars.On the coronal ax-is,the second premolars and the first molars showed lingual displacement in the control group,and only the premolars and first molars showed lingual displacementin the miniscrew groups.The canines were the teeth that were most strong-ly affected by the change in miniscrew placement height.Conclusion The higher the miniscrew position is,the stron-ger the protective effect on the anterior anchorage.According to the miniscrew placement height,the mandibular arch should be properly narrowed,the central incisors and first premolars should be lowered,and the lateral incisors and ca-nines should be raised when designing clinical treatments.

Objective To explore the effect of different miniscrew placement heights on the distribution of biologi-cal forces produced by clear aligner combined with intramaxillary traction for mandibular molar distalization,to identify the miniscrew location that is conducive to the protection of lower anterior tooth anchorage and to provide a reference that can be used when designing clinical treatments.Methods Mimics,GeomagicStudio 2017,SolidWorks 2016,and Ansys workbench were used to establish finite element analysis models and perform mechanical analysis under the fol-lowing six working conditions:working condition 1 was the control group without miniscrews;working conditions 2 to 5 had miniscrew in the buccal bone cortex between the first and second molars of the lower jaw 10 mm,7 mm,4 mm,and 1 mm from the top of the alveolar crest,respectively;working condition 6 had the miniscrew in the center of the buccal tongue at the anterior edge of the ascending branch of the lower jaw 5 mm above the occlusal plane.Results On the sagittal axis,miniscrew anchorage caused distal displacement of all teeth.Compared to the control group,in the miniscrew group,the displacement of the anterior molars exceeded that of the second molars.On the vertical axis,the result in the control group was similar to backward bending;the results in the miniscrew groups resembled the effect of a lever,lowering the lateral incisors and canines and raising the central incisors and first premolars.On the coronal ax-is,the second premolars and the first molars showed lingual displacement in the control group,and only the premolars and first molars showed lingual displacementin the miniscrew groups.The canines were the teeth that were most strong-ly affected by the change in miniscrew placement height.Conclusion The higher the miniscrew position is,the stron-ger the protective effect on the anterior anchorage.According to the miniscrew placement height,the mandibular arch should be properly narrowed,the central incisors and first premolars should be lowered,and the lateral incisors and ca-nines should be raised when designing clinical treatments.

Objective To explore the effect of different miniscrew placement heights on the distribution of biologi-cal forces produced by clear aligner combined with intramaxillary traction for mandibular molar distalization,to identify the miniscrew location that is conducive to the protection of lower anterior tooth anchorage and to provide a reference that can be used when designing clinical treatments.Methods Mimics,GeomagicStudio 2017,SolidWorks 2016,and Ansys workbench were used to establish finite element analysis models and perform mechanical analysis under the fol-lowing six working conditions:working condition 1 was the control group without miniscrews;working conditions 2 to 5 had miniscrew in the buccal bone cortex between the first and second molars of the lower jaw 10 mm,7 mm,4 mm,and 1 mm from the top of the alveolar crest,respectively;working condition 6 had the miniscrew in the center of the buccal tongue at the anterior edge of the ascending branch of the lower jaw 5 mm above the occlusal plane.Results On the sagittal axis,miniscrew anchorage caused distal displacement of all teeth.Compared to the control group,in the miniscrew group,the displacement of the anterior molars exceeded that of the second molars.On the vertical axis,the result in the control group was similar to backward bending;the results in the miniscrew groups resembled the effect of a lever,lowering the lateral incisors and canines and raising the central incisors and first premolars.On the coronal ax-is,the second premolars and the first molars showed lingual displacement in the control group,and only the premolars and first molars showed lingual displacementin the miniscrew groups.The canines were the teeth that were most strong-ly affected by the change in miniscrew placement height.Conclusion The higher the miniscrew position is,the stron-ger the protective effect on the anterior anchorage.According to the miniscrew placement height,the mandibular arch should be properly narrowed,the central incisors and first premolars should be lowered,and the lateral incisors and ca-nines should be raised when designing clinical treatments.