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 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 explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.