Skeletal class Ⅱ malocclusion is characterized by maxillary protrusion,mandibular retrognathia,or a combination of both,and often accompanied by vertical dimensional discrepancies;treatment is complex,and combined orthodontic-orthognathic surgery is needed for the adult patients.Clear aligner therapy has gradually been applied in complex orthodontic cases.However,limited cases have been reported domestically and internationally regarding the application of clear aligner therapy combined with orthognathic surgery.This article presented a case of a patient with skeletal class Ⅱ high-angle malocclusion treated with the combined therapy and analyzed the clinical efficacy of the treatment appraoch to provide reference for the clinical practice.Extraction of impacted wisdom teeth 18,28,38,and 48,as well as orthodontic teeth 15,25,34,and 44,was performed in stages before orthodontic treatment.Clear aligner therapy was used for preoperative orthodontics.In sagittal plane,a super-complete class Ⅱ canine and molar relationship and a 13-14 mm overjet of the anterior teeth were established.The maxillary and mandibular arch morphology was matched horizontally.The orthognathic surgery included maxillary LeFort Ⅰ osteotomy,bilateral sagittal split ramus osteotomy(BSSRO)and chinplasty.Fine occlusal adjustment was conducted after operation.After treatment,the skeletal relationship between upper and lower jaw was corrected to normal;subspinale-nasion-supramental angle(ANB)was improved from 12.3° to 4.7°;the patient established the class Ⅰ canine and molar relationship,with normal overjet and overbite;root parallelism was good and there was no obvious root resorption;the facial soft tissue profile was significantly improved,and nasion-subnasale-pogonion angle(N-Sn-Pg)was improved from 143.9° to 162.8°.The curative effect was stable 1 year after operation.Clear aligner therapy can efficiently complete combined orthodontic and orthodontic surgery in the complex cases.Compared with the fixed appliance,it is more beneficial to the patients'need for beauty and the maintenance of periodontal health.

Objective:To measure the magnetic field correction factor of reference ionization chamber in a 1.5 T magnetic field and to explore the response of the ionization chamber among different angles between magnetic field and ionization chamber axis.Methods:A home-made magnetic compatible one-dimensional water tank was used to measure the response of PTW30013 and IBA FC65-G in 7 MV photon beam of Elekta Unity with and without magnetic field. The ionizing current was collected by PTW UNIDOS Tango electrometer. The effective measurement point of ionization chamber was positioned to the isocenter of MR-linac using electronic portal image device. The influence on water absorbed dose of reference point was obtained by Monte Carlo calculations.Results:The response of ionization chambers in strong magnetic field was related to the angle between chamber axis and magnetic field. The response of ionization chamber was significantly affected in perpendicular magnetic field with a deviation up to 4.54% compared to parallel magnetic field. The deviation between the magnetic field correction factors measured for parallel or reverse-parallel was 0.03%-0.24%. The magnetic field correction factors for PTW30013 and FC65-G measured in parallel magnetic field were 0.9934±0.0077 and 0.9990±0.0076, respectively.Conclusions:This study experimentally verifies that positioning the ionization chamber axis parallel to the magnetic field direction in MR-linac reference dosimetry can minimize the magnetic field impact. The determined magnetic field correction factor and uncertainty in 1.5 T magnetic field can provide necessary data for establishing an MR-linac reference dosimetry protocol.

ObjectiveTo explore the effect of Zishenwan on glucose and lipid metabolism in spontaneous type 2 diabetes （db/db） mice and investigate the underlying mechanism for improving diabetes based on intestinal barrier function and skeletal muscle transcriptome sequencing results. MethodLiquid chromatography-tandem mass spectrometry （LC-MS/MS） was used to analyze the components of Zishenwan. Sixteen 6-week-old db/db mice were divided into a model group and a Zishenwan group， while eight wild-type mice were assigned to the normal group. The Zishenwan group received oral administration of drugs for six weeks， during which fasting blood glucose， body weight， and food intake were measured. Serum total cholesterol （TC） and triglyceride （TG） levels were determined， and fasting insulin levels were measured to calculate the homeostatic model assessment of insulin resistance （HOMA-IR）. After the treatment， skeletal muscle and ileum tissues were collected， followed by hematoxylin-eosin （HE） staining. Immunohistochemistry was used to detect the expression of tight junction proteins occludin and zonula occludens-1 （ZO-1） in the ileum. Transcriptome sequencing was performed to detect the skeletal muscle transcriptome， and enrichment analysis was conducted for differentially expressed genes. ResultMultiple active components were identified in Zishenwan. Compared with the normal group， the model group showed increased fasting blood glucose， body weight， TC， TG， and HOMA-IR （P<0.01）. Compared with the model group， Zishenwan significantly reduced fasting blood glucose， body weight， TC， TG， and HOMA-IR in db/db mice （P<0.01）， while there was no statistically significant difference in food intake. Compared with the normal group， the model group exhibited lipid deposition in skeletal muscle， as well as structural changes in the ileum， with significant decreases in the protein expression levels of intestinal occludin and ZO-1 （P<0.01）. Compared with the model group， Zishenwan improved the pathological changes in skeletal muscle and ileum， and increased the protein expression of occludin and ZO-1 in the ileum （P<0.01）. Transcriptome analysis suggested that Zishenwan might improve skeletal muscle metabolism and increase insulin sensitivity in mice. ConclusionZishenwan can improve glucose and lipid metabolism in db/db mice， and this effect may be related to its protection of intestinal barrier function and transcriptional regulation of skeletal muscle metabolism-related genes.

Objective Based on the multi-camera digital image correlation (DIC) method, the dynamic deformation characteristics of human hand during grasping were studied. Methods A continuous four-camera DIC system was established to measure surface strain of the skin on the back of the hand during grasping process, and then through the connection between skin, joints, bones and muscles, the regular pattern of muscle deformation could be known indirectly. Results Four grasping postures (medium cylinder, lateral pinch, index finger extension, power sphere) were measured. It was found that the increases of strain magnitude were different at different positions on back surface of the hand under different grasping postures, and the maximum principal strains were between 0.1 and 0.3. The movement characteristics for each muscle group of the hand under different grasping postures were obtained through analysis. Conclusions This method has the characteristics of non-contact, full field, intuitive results, which provides a new way for in vivo measurement of dynamic deformation during grasping.

Objective:To study the effect of compound Lactobacillus acidophilus on the apoptosis of intestinal epithelial cells and expression of proliferating cell nuclear antigen (PCNA) in rats with necrotizing enterocolitis, so as to provide some theoretical reference for the application of compound Lactobacillus acidophilus in the prevention and treatment of necrotizing enterocolitis(NEC) for newborn infants. Methods:Thirty-six 48-hour old newborn SD rats were randomly divided into normal group, model group and intervention group, with 12 rats in each group.The NEC model was established by hypoxia and cold stimulation for 3 days, and the intervention group was given the compound Lactobacillus acidophilus at the same time; after the model was established, all the rats were sacrificed after 12 hours of fasting and their intestinal tissues were excised by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method to determine the condition of apoptosis and to detect expression of the PCNA gene in the intestinal tissues by fluorescent quantitative PCR. Results:(1) The apoptosis rates of the intestinal tissues: in the model group, the normal group and the intervention group were (88.33±2.77)%, (4.75±0.75)% and (44.41±4.81)%, respectively, and the differences had statistical significance(all P<0.05). (2) The PCNA expression in the intestinal tissue by real-time PCR in the model group, normal group and intervention group were (9.28±3.26)×10 -4, (15.35±1.91)×10 -4 and (12.09±3.06)×10 -4, respectively, and the differences had statistical significance(all P<0.05). Conclusions:The apoptosis rate of intestinal epithelial cells increases and PCNA expression decreases when NEC occurs.Compound Lactobacillus acidophilus can reduce apoptosis, promote intestinal epithelial cell proliferation, and thus help to reduce the risk and severity of NEC in neonatal rats.

In order to obtain the serotype distribution of E.coli from duck and to screen the vaccine bacterial strains,the serotype identifications and biological characteristics of E.coli were analyzed in recent years from Shandong,Hebei and other areas of commercial duck field;selections of vaccine strains were detected by the virulence and immunogenicity.Totally 44 isolated bacterial strains of E.coli from duck were identified to a total of six serotypes:O78,O93,O76,O2,O92 and O32.The O78 serotype was the dominant serotype,accounting for 56.8％ (25/44);O93 serotype for 15.9％ (7/44) according to bacterial Oantigen typing.The strain SD (O78 serotype) was confirmed to have strong virulence and good immunogenicity.The O78,O93 and O76 are the dominant serotypes of duck E.coli in the study areas.The SD strain could be used as the candidate for the next development of inactivated vaccine.

Objective To investigate the prevalence and characteristics of adverse reactions to cosmetics in China,and to provide a basis for further supervision.Methods The diagnosis of adverse reactions to cosmetics was according to 7 national standards (GB17149.1-7-1997) including the A general rule for the diagnosis and management of skin diseases induced by cosmetics.Data regarding gender,age,occupation,educational background,disease types,cosmetic types,and so on,were collected from patients with adverse reactions to cosmetics at 13 surveillance sites in China during 2005-2014.A descriptive statistical analysis was carried out.Results During 2005-2014,a total of 13 534 cases of adverse reactions to cosmetics were reported to the monitoring system.Of these cases,95.40％ (12 912/13 534) were female,and 80.85％ were young or middle-aged (20-44 years).Finally,5 446 cases were confirmed to be adverse reactions to cosmetics,among which,94.66％ (5 155/5 466) were contact dermatitis to cosmetics,and 132 were other types that were not included in the A general rule for the diagnosis and management of skin diseases induced by cosmetics.Among these confirmed cases,14 209 cosmetic products were involved,and ordinary skin care products predominated in these products.The proportion of imported cosmetic products (48.79％,6 932/14 209) was slightly higher than that of domestic products (43.21％,6 139/14 209).The number of reported eases increased by 13.16％ per year from 2005 to 2009,but decreased by 17.96％ per year from 2010 to 2014.Conclusion Adverse reactions to cosmetics are a complicated and important public health issue,and effective measures should be taken based on their characteristics.

Described in this paper are the new development trends of LibQual+in foreign libraries, such as its modified analysis techniques, its perfected analysis methods, integrated LibQual+and other evaluation tools, further application of LibQual+evaluation analysis results.The successful application of LibQual+data analysis in University of California and University of York is a good inspiration to the domestic libraries.

Objective To investigate the Adamkiewicz artery visualization using gemstone spectral CT angiography (CTA) with optimal monochromatic technique.Methods The prospective study was approved by the local institutional review board,and written informed consents were obtained for all the examinations.The successive 58 patients with suspected aortic aneurysm or dissection underwent aortic gemstone spectral CTA.They were divided into two groups based on the different reconstruction protocols:A,optimal monochromatic reconstruction;B,polychromatic reconstruction.Visualization rate of Adamkiewicz artery in two groups were recorded.Objective(measure CT value of the descending aorta and calculate signal-to-noise ratio [CNR]) and subjective (score of Adamkiewicz artery visualization) were evaluated.Paired samples t,Chi-square and Mann-Whitney U test were used for statistical analysis.Results CT value of descending aorta and CNR of group A [(568.4 ± 57.5)HU and (52.3 ± 8.1)] were significantly higher than group B[(346.2 ± 48.6)HU and (26.7 ± 3.7)] (t=12.70 and 15.20,P＜0.01).The visualization rate of Adamkiewicz artery in group A (94.8％,55/58) was higher than B (82.8％,48/58;x2=4.20,P=0.04).The score of group A (55 cases,3.9±0.8) was significantly higher than the group B (48 cases,3.4±1.0)(Z=-2.40,P=0.02).Conelusion Gemstone spectral CTA with optimal monochromatic reconstruction can improve the visualization efficiency and quality of the Adamkiewicz artery compared with routine polychromatic reconstruction protocol.

OBJECTIVETo investigate the characteristics and the short- or long-term treatment outcomes of the adult patients with acute myeloid leukemia (AML) in China.

METHODSFrom 1999 to 2010, 822 adult cases with AML were enrolled, diagnosed and classified by the FAB and WHO criteria, respectively. The treatment outcomes and prognostic factors were analyzed retrospectively.

RESULTSIn all patients with a median age of 38.5(15-83) years, acute monoblastic and monocytic leukemia (M5), AML with t(15;17)/PML-RARα (APL) and AML with t(8;21)/AML1-ETO(M2b) were the most common subtypes, accounting for 29.7%, 20.9% and 14.6% respectively. In APL patients, CR was achieved in 95.2%, with an early death (ED) rate of 4.8%. And the estimated overall survival (OS) and disease-free survival (DFS) at 5 year was 87.5% and 88.8%, respectively. Patients with other AML subtype (Non-APL) revealed a CR rate of 82.0%, ED of 4.3%, and estimated 5-year OS and DFS both of 48.8%. The OS rate of Non-APL patients at 3-year varied significantly (P<0.01) among three prognostic groups by cytogenetic risk stratification:favorable, 69.5%; intermediate, 52.8%; unfavorable, 29.8%. The prognostic factors for OS among Non-APL included age, cytogenetic abnormalities, courses of the median/high-dose cytarabine and allogeneic hematopoietic stem cell transplantation.

CONCLUSIONWhen compared with the previous reports, the AML patients in our study were younger and showed a different subtype distribution. Treatment outcomes of APL and Non-APL were just the same as those in international leukemia centers. Chemotherapy by risk stratification, after diagnosis and classification according to the WHO criteria, is a key point to improve the outcomes in AML.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; Cytarabine ; Disease-Free Survival ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute ; Middle Aged ; Oncogene Proteins, Fusion ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Young Adult