OBJECTIVE To investigate the serum toll-like receptor 4(TLR4),matrix metalloproteinase-3(MMP-3),in-terleukin-1β(IL-1β)and peripheral blood helper T-cell 17/regulatory T-cell(Th17/Treg)levels in patients with chronic periodontitis infected with porphyromonas gingivalis(Pg),as well as their diagnostic value of Pg infection in patients with chronic periodontitis.METHODS Totally 390 cases of patients with chronic periodontitis who at-tended Tianjin Stomatological Hospital from Jan.2022 to Jan.2024 were selected as the study subjects,and were divided into the infected group(113 cases)and the uninfected group(277 cases)according to Pg infection,and those patients in the infected group were further classified into the mild group(31 cases),the moderate group(45 cases),and the severe group(37 cases)according to the condition of the disease.Serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg levels were compared between the infected and uninfected groups and patients with different conditions of chronic periodontitis Pg infection,and the infected group was included in the positive and the uninfected group was included in the negative,and the receiver's operating characteristics(ROC)curves were plotted to obtain the area under the curve(AUC)to analyze the diagnostic value of single and combined de-tection of serum TLR4,MMP-3,and IL-1β,Peripheral blood Th17/Treg for Pg infection in patients with chronic periodontitis.RESULTS Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the infected group were(20.41±5.12)ng/ml,(6.12±2.03)μg/L,(10.24±2.19)μg/L and(0.32±0.10),higher than those in the uninfected group(P＜0.05).Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the se-vere group were(22.58±6.10)ng/ml,(8.12±2.67)μg/L,(12.49±3.10)μg/L and(0.52±0.15),higher than those in the moderate group[(14.78±3.44)ng/ml,(6.15±2.07)μg/L,(7.23±1.99)μg/L and(0.22±0.07)]and mild group(P＜0.05),which in the moderate group was higher than those in the mild group(P＜0.05).The results of ROC analysis showed that the AUC of serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg combined test for diagnosing Pg infection in patients with chronic periodontitis was 0.937,which was higher than that of the four single tests(P＜0.05).CONCLUSION Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg were highly expressed in chronic periodontitis patients infected with Pg,and all four indicators can participate in the progression of the disease,and the combined detection of these four indicators has a higher diagnostic value for Pg infection in patients with chronic periodontitis.

OBJECTIVE To investigate the serum toll-like receptor 4(TLR4),matrix metalloproteinase-3(MMP-3),in-terleukin-1β(IL-1β)and peripheral blood helper T-cell 17/regulatory T-cell(Th17/Treg)levels in patients with chronic periodontitis infected with porphyromonas gingivalis(Pg),as well as their diagnostic value of Pg infection in patients with chronic periodontitis.METHODS Totally 390 cases of patients with chronic periodontitis who at-tended Tianjin Stomatological Hospital from Jan.2022 to Jan.2024 were selected as the study subjects,and were divided into the infected group(113 cases)and the uninfected group(277 cases)according to Pg infection,and those patients in the infected group were further classified into the mild group(31 cases),the moderate group(45 cases),and the severe group(37 cases)according to the condition of the disease.Serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg levels were compared between the infected and uninfected groups and patients with different conditions of chronic periodontitis Pg infection,and the infected group was included in the positive and the uninfected group was included in the negative,and the receiver's operating characteristics(ROC)curves were plotted to obtain the area under the curve(AUC)to analyze the diagnostic value of single and combined de-tection of serum TLR4,MMP-3,and IL-1β,Peripheral blood Th17/Treg for Pg infection in patients with chronic periodontitis.RESULTS Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the infected group were(20.41±5.12)ng/ml,(6.12±2.03)μg/L,(10.24±2.19)μg/L and(0.32±0.10),higher than those in the uninfected group(P＜0.05).Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg levels in the se-vere group were(22.58±6.10)ng/ml,(8.12±2.67)μg/L,(12.49±3.10)μg/L and(0.52±0.15),higher than those in the moderate group[(14.78±3.44)ng/ml,(6.15±2.07)μg/L,(7.23±1.99)μg/L and(0.22±0.07)]and mild group(P＜0.05),which in the moderate group was higher than those in the mild group(P＜0.05).The results of ROC analysis showed that the AUC of serum TLR4,MMP-3,IL-1β,and peripheral blood Th17/Treg combined test for diagnosing Pg infection in patients with chronic periodontitis was 0.937,which was higher than that of the four single tests(P＜0.05).CONCLUSION Serum TLR4,MMP-3,IL-1β and peripheral blood Th17/Treg were highly expressed in chronic periodontitis patients infected with Pg,and all four indicators can participate in the progression of the disease,and the combined detection of these four indicators has a higher diagnostic value for Pg infection in patients with chronic periodontitis.

0bjective: To establish a three-dimensional finite element model of mandible and study the transverse displacement of proximal segment after Bilateral Sagittal Split Ramus Osteotomy (BSSRO) with different retrogression amounts during mastication. Methods: DICOM data of a skull model were processed with MIMICS and ANSYS software, reconstructing the 3D model including the teeth and temporomandibular joint in order to simulate BSSRO and evaluate the transverse displacement of proximal segment with different retrogression amounts during mastication. Results: The mean of proximal segment width change were 2.955 mm and 3.490 mm, when retrogression amounts of distal segmentwere 3 mm and 8 mm, respectively.No significant difference between the two groups were found (P=0.131). Meanwhile the displacement color scale of the 3D finite element models showed that the apparent transverse displacement distribution of the proximal segment was measured around the gonial area, decreased from the exterior to the interior. Conclusions The mandibular angle width was significantly expanded right after BSSRO. The masticatory muscle system and single cortical fixation system played an important role in expanding the width of proximal segment. However there was no correlation between the widening effect and retrogression amounts of distal segment of mandible.

Objective: To evaluate the surgical prediction accuracy of Proplan CMF software for zygomatic reduction surgery using L-shaped osteotomy. Methods: Pre-and-postoperative 1-year CBCT data of 26 patients with zygomatic arch hypertrophy were imported in Proplan CMF software during 2014 Jan. to 2016 Jun., the 3D models were reconstructed for simulation of L-shaped osteotomy, characteristic landmarks were selected and 3D point measurement system was established. The measurement result were analyzed by one-way ANOVA. Meanwhile, the overlap color grading charts of preoperative and simulated images were also observed. Results: The facial width, bilateral zygomatic process angle and facial width index were [(128.56±2.72) mm, (106.87±2.53)°, (108.56±3.02)°and 1.41±0.03] in postoperative result, [(129.49±2.26) mm, (108.68±2.40)°, (108.85±3.02)°and 1.42±0.03]in simulated result and [(135.45±2.45) mm, (102.50±2.60)°, (103.41±2.56)°and 1.48±0.05] in preoperative result, with significant difference between preoperative and postoperative result, or between preoperative and simulated result (P<0.05), while no significance between postoperative and simulated result (P>0.05). The soft tissue zygomatic process distance was(153.25±2.58) mm in preoperative result, (150.23±2.76)mm in postoperative result , (149.36±3.27)mm in simulated result, with no significance between any of two groups result (P>0.05). The zygomatic process distance and bilateral zygomatic process tragal distance were (126.35±2.56) mm, (68.75±2.15) mm and(68.86±3.21) mm in postoperative result, showing significant differences compared with preoperative result [(120.16±3.18) mm, (74.58±3.19) mm and(76.14±3.15) mm] and simulated result [(118.86±3.45) mm, (73.85±3.57) mm and(76.87±2.58) mm] respectively(P<0.05), while zygomatic arch distance was not statistically different among the three groups(P>0.05). It indicated that predictive accuracy of facial width, facial width index, zygomatic process angle, soft tissue zygomatic arch distance was high but the soft tissue zygomatic process distance and zygomatic process tragal distance was relatively low. Meanwhile, the color overlay image showed that predictive accuracy was not good in the zygomatic region while the zygomatic arch area was high. Conclusions The predictive accuracy of Proplan CMF software for zygomatic arch hypertrophy is relatively high except for the zygomatic region. Further improvement of the CMF software is needed.

Objective To systematically review the efficacy and safety of drug-eluting stent(DES) versus coronary artery bypass grafting(CABG) in the treatment of left anterior descending coronary artery(CAD) stenosis.Methods Literature about the efficacy and safety of DES versus CABG for LAD stenosis was retrieved from digital databases of MEDLINE, EMbase, PubMed, and the Cochrane Library by November 2016.Data extraction and quality assessment of included studies were conducted by two independent reviewers.RevMan 5.3 software was used to perform meta-analysis.Results Ten studies involving 9771 patients were finally included.The results of meta-analysis showed that there was no significant difference in mortality [RR=0.88,95%CI(0.70,1.11),P=0.28],major adverse cardiovascular events[MACE,RR=1.04,95%CI(0.88,1.24),P=0.63] or myocardial infarction [MI,RR=0.92,95%CI(0.56,1.53),P=0.75], but PCI-DES significantly increased the risk of TVR [OR=2.43,95%CI(1.61,3.69),P<0.0001].Conclusion For LAD stenosis, PCI-DES strategy causes as high a rate of mortality, MACE and MI as CABG or DES, but PCI-DES can significantly increase the risk of TVR, so we should be cautious clinically.

Objective To analyze the perioperative conditions and long-term survival of patients with non-small cell lung cancer (NSCLC) after thoracoscopic lobectomy. Methods 119 patients with NSCLC underwent thoracoscopic lobectomy from January 2006 to December 2012 were enrolled in the study, then collecting and analyzing their perioperative indicators, pathological results and follow-up data. Results 9 patients converted to thoracotomy with a conversion rate of 7.0 %. The median operation time, the median intraoperative blood loss and off-bed activity time were 170 min (65~440 min), 90 ml (15~3 000 ml) and (32.9 ± 16.3) h after operation respectively. The time and amount of postoperative drainage, the length of hospital stay were (6.7 ± 3.2) d, (1 690.0 ± 410.5) ml, (9.2 ± 4.0) d respectively. The incidence of perioperative mortality and postoperative complications were 0.8 %, 13.4 % respectively. For postoperative pathological type, 96 cases of adenocarcinoma, 19 cases of squamous carcinoma, 2 cases of adenosquamous carcinoma and 2 cases of large cell carcinoma. For discharge patients, the median follow-up time was 34.5 months (0 ~ 102 months). The incidence of local recurrence and distant metastasis in observation group were 5.0 % and 17.6 % respectively. 1-year overall survival (OS) and disease free survival (DFS) were 85.3 % and 79.5 %, 3-year OS and DFS were 69.8 % and 64.8 %, 5-year OS and DFS were 60.8 %and 58.6 % respectively. There was no significant difference in 1-year, 3-year and 5-year OS and DFS between adenocarcinoma and squamous carcinoma (P > 0.05) while there were significant difference in local recurrence and distant metastasis among different stages (P < 0.05). In addition to slightly low OS, DFS of Ⅲ a , Ⅲ b and Ⅳ DFS and OS, the overall living conditions among all stage were similar. Conclusions The long-term survival condition of thoracoscopic lobectomy for NSCLC is ideal, and it’s a safe and effective operation, worthy of clinical promoting.

BACKGROUND:Bilateral-sagitta-split-ramus-osteotomy (BSSRO) has become a conventional method to correct facial deformities, and the finite element method is a significant way to study biomechanics of the mandible and temporomandibular joint (TMJ) after BSSRO. OBJECTIVE: To establish a precise and high simulation model of mandible containing TMJ after BSSRO with internal fixation, which is the base to study the biomechanics of the mandible and TMJ after BSSRO. METHODS: Spiral CT scan was used to get the data of DICOM that were input into MIMICS to establish the three-dimensional model of the mandible. The three-dimensional model was wrapped into a single closed shel for mesh generation and conversion in ANSYS. Then, the model was input into the ANSYS software for temporomandibular joint reconstruction and simulation of BSSRO and internal fixation. RESULTS AND CONCLUSION: The three-dimensional finite element model of mandible containing TMJ after BSSRO was established using MIMICS and ANSYS. This model had biological similarity and geometric similarity in comparison with the human tissues. The model could undergo various internal fixations through antedisplacement, retroposition and rotational movement of the distal end. Based on different experimental purposes, the established model can apply a load to al parts to study changes in stress and displacement of different tissues after BSSRO and internal fixation, and it also can be used to study the effect of different fixation materials on the rear stability after internal fixation.

BACKGROUND: Human keratinocyte growth factor-2 (hKGF-2) has extensive physiological functions, which plays an important role in embryonic development, tissue-repairing, nervous regeneration, vascularization and development of tumor.OBJECTIVE: To clone hKGF-2 gene, obtain the expression of hKGF-2 in Escherichia coli(E.coli) and determine its bioactivity, so as to provide experimental basis for further investigation.DESIGN: Open experiment.SETTING: Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention.MATERIALS: The experiment was conducted in State Key Laboratory of Viral Genetic Engineering, Institute for Viral Disease Control and Prevention of Chinese Center for Disease Control and Prevention. The temperature control expression vector pBV220 was constructed by State Key Laboratory of Viral Genetic Engineering; EcoR Ⅰ , BamH Ⅰ , T4 DNA ligase (Promega Co., Ltd.); The specific polymerase chain reaction (PCR) of hKGF-2 (Manufactured by Shanghai Boya Biotechnology Co., Ltd.); Heparin-Sepharose CL-6B (Pharmacia Company); PCR rapid purification kit,Trizol kits for total RNA extract, Kits for RT-PCR (GIBCO Co., Ltd.); Kits for rapid extraction of plasmid DNA (Boda Company); BL-21-codon plus compent cells (Stratagene Co., Ltd.).METHODS: High-expression strain BL-21 codon plus competent cells was used to express and purify initially recombinant hKGF-2 protein, and its activity was detected. RT-PCR was adopted to obtain hKGF-2 cDNA from lung tissues of naturally aborted fetus and clone it into pBV220 carri er plasmid. The hKGF-2 protein expressed in BL-21 codon plus competent cells of E.coli. Affinity chromatography and ion exchange chromatography were applied in isolation and purification, and the bioactivity of expression protein was determined in cell proliferation test.MAIN OUTCOME MEASURES: The length and sequence of cDNA segment in hKGF-2, the expression of hKGF-2 gene inE.coli and the purification of hKGF-2 activity.RESULTS: The segment of hKGF-2 cNDA was about 500 bp, and hKGF-2 protein highly expressed in BL-21, which had soluble expression in the supernatant. SDS-PAGE showed that the relative molecular mass was about 20000, and hKGF-2 protein could significantly promote the mitotic activity of NIH3T3 cells. The A value (490 nm) of hKGF-2 in the 1 μg/L, 5 μg/L and 10 μg/L groupswere higher than that in the blank control group, and the differences were significant (which were 0.174±0.022,0.220±0.029,0.306±0.050,0.066±0.004 respectively,P ＜ 0.001).CONCLUSION: hKGF-2 gene is successfully cloned, which highly expresses in BL-21 of the E.coli. Purified hKGF-2 protein can stimulate the proliferation of NIH3T3 cells and significantly promote its mitotic activity.

Objective To observe prospectively the role of endoscopic diagnosis and treatment of biliary leakages in patients with liver transplantation, and the incidence of bile duct stricture after healing of the leakage. Methods Six eases of T-tube leakage and seven cases of anastomosis leakage complicating liver transplantation were enrolled in this prospective study. Six patients treated by endoscopic plastic stent placement , 2 by naso-biliary catheter drainage, 2 by papillosphincterotomy and 3 by naso-biliary catheter drainage combined with plastic stent placement. Some patients received growth hormone treatment. Results The bile leak resolution time was between 10-35 days in 10 patients with complete document. The median time of leak resolution was 15. 3 days. Four cases of anastomosis stricture, three cases of common hepatic duct and one ease of multiple bile duct stenosis were observed by followed-up nasobiliary catheter cholangiography or ER-CP. Conclusion Endoscopic nasobiliary catheter or plastic stent placement is a safe and effective treatment for bile duct stricture occurred after bile leak resolution in most of liver transplantation patients. Naso-biliary catheter combined with plastic stent placement maybe the best choice for treating bile leak, because, theoretically, it may prevent serious condition happened at accidental nasobiliary catheter dislocation, and it may have prophylactic effect on upcoming bile duct stricture and should be further confirmed.