Objective·To explore the effect of all-trans retinoic acid(ATRA)of different concentrations on osteogenic differentiation of jaw bone mesenchymal stem cells(jBMSCs)in rats.Methods·jBMSCs from 4-week-old Sprague-Dawley(SD)rats were isolated and cultured with whole bone marrow adherence method.The surface antigens were identified by using flow cytometry.Alkaline phosphatase(ALP)staining/alizarin red staining,oil red O staining and alcian blue staining were used to prove the multilineage differentiation potential of jBMSCs after osteogenic,adipogenic and chondrogenic induction respectively.jBMSCs were induced in osteogenic medium with ATRA of concentration of 0.01,0.1,1,5,10,20 μmol/L in vitro,and dimethyl sulfoxide(DMSO)was used as control group.Cell viability of jBMSCs in different groups were determined by CCK8.ALP staining and alizarin red staining were used to investigate the osteogenic ability of jBMSCs in each group and screened the concentrations for subsequent experiments.Quantitative real-time polymerase chain reaction(qPCR)and immunofluorescence staining were used to analyze the expressions of osteogenesis-related genes and proteins in jBMSCs of different concentrations.Results·The flow cytometry analysis showed that more than 98%of P1 jBMSCs were positive for CD29+CD90+CD31-CD45-,which was congruent with the characteristics of bone mesenchymal stem cells.The results of ALP staining/alizarin red staining,oil red O staining and alcian blue staining indicated that the P1 jBMSCs had the multilineage differentiation potential of osteogenesis,adipogenesis and chondrogenesis.The results of ALP staining/alizarin red staining showed that the osteogenic activity and mineralization ability of jBMSCs in 0.01,0.1 and 1 μmol/L ATRA groups were increased compared with those in the control group,while the osteogenic activity and mineralization ability were decreased when the concentration of ATRA increased,especially higher than 5 μmol/L(all P<0.05).qPCR analysis showed that the mRNA expression levels of osteogenesis-related genes such as Alp,bone sialoprotein(Bsp),collagen type Ⅰ α1(Col1a1)and osteocalcin(Ocn)were higher in the 0.1 and 1 μmol/L ATRA groups compared to the control group.However,further increasing the concentration of ATRA led to a decrease in gene expression levels,and when the concentration exceeded 5 μmol/L,it began to be lower than the control group level(all P<0.05).The immunofluorescence staining showed that the expression of osteogenic related proteins SP7,ALP and OCN in the 0.1 and 1 μmol/L ATRA groups were increased compared to the control group,while further increasing the concentration of ATRA led to a decrease in protein expression.When the concentration was higher than 5 μmol/L,it began to be lower than the control group level(all P<0.05).Conclusion·Lower concentrations(0.1,1 μmol/L)of ATRA can promote the osteogenic differentiation of rat jBMSCs,and the promoting effect reaches its peak at 0.1 μmol/L,while the effect can be weakened by further increasing the concentration.Higher concentrations(5,10,20 μmol/L)of ATRA could inhibit the osteogenic differentiation of rat jBMSCs,showing an inhibitory effect.In this study,the dual-directional effect of retinoic acid on osteogenic differentiation of jBMSCs was demonstrated in vitro,and 0.1 μmol/L ATRA was identified as the optimal concentration for osteogenic differentiation of jBMSCs in rats,which provided a reference basis for the development of in vivo studies and clinical application of ATRA.

Objective To evaluate the effectiveness of computer aided design (CAD) and three bit printing in the management of orthognathic surgery.Methods A total of 5 cases of patients with jaw deformity were involved in this study;jaw teeth and CT scanning laser scanning hefore surgery,virtual surgery design of 3D reconstruction and fusion data were analyzed,according to the design scheme of double jaw surgery combined with genioplasty;design and 3D printing of maxillary Le Fort Ⅰ osteotomy,genioplasty titanium alloy resin osteotomy and positioning guide,sagittal split ramus osteotomy by 3D printing and plate technology were used in this approach.The postoperative results were compared with the surgical planning by three-dimensional measurement and statistical analysis.Results When the operation guide plate was applied smoothly,the maximum error for maxilla was 1.2 mm (0.3-1.2 mm),and the maximum error for genioplasty was 1.7 mm,(0.5-1.7 mm),and the mean error was less than 1 mm.Follow-up for 12 months showed no adverse reaction.Conclusions Three dimensional printing surgical guide plate can accurately provide the osteotomy information,effectively control the jaw movement,and improve the orthognathic surgery accuracy of patients with partial jaw deformity.

Objective: To investigate the clinical features of Hashimoto′s thyroiditis(HT) with elevated serum IgG4 levels and to guide the clinical practice. Methods: Serum IgG4 concentrations were detected in patients with HT by nephelometric immunoassay. These patients were classified into two groups according to the IgG4 levels: positive group(IgG4≥1.35 g/L), and negative group(IgG4<1.35 g/L). The clinical characteristics of these two groups, including age, gender, medical history, serological features, and ultrasound were compared. Results: Nine out of 111 patients with HT were positive with IgG4(8.11%), all of them were women. There was no significant difference in gender, age, BMI, dose of levothyroxine administration, FT₃, FT₄, and TSH levels between the two groups. The volume of thyroid in positive group was larger than that in negative group [57.81(38.36, 74.93) ml vs 25.07(18.48, 42.14) ml, P=0.015], and the level of thyroglobulin antibodies(TgAb; P=0.011) and thyroid peroxidase antibodies(TPOAb; P=0.025) in positive group were also significantly higher than those in negative group. Moreover, the positive group had a slightly higher risk of PTC than that of negative group(11.1% vs 2.94%, P=0.290), though the difference was not significant. Correlation analysis showed that IgG4 was positively associated with TgAb, TPOAb, and thyroid volume. Conclusions The levels of TgAb and TPOAb are higher, the volume of thyroid gland is greater, and the risk of PTC with lymph node metastasis is more frequent in HT patients with elevated serum IgG4. For HT patient with elevated serum IgG4, their thyroid function and morphology should be more closely monitored.

Objective: To compare the surgical accuracy of the 3D printing surgical guide and traditional occlusal splint in the treatment of skeletal facial asymmetry cases. Methods: 12 facial asymmetric patients underwent joint orthognathic and orthodontics treatments were included in this research. In the 3D printing group (n=6) the pre-surgical CT scan for the skeleton and laser scan for the dentures were performed and 3D orthognathic procedures including Le FortⅠ and BSSRO combined with genioplasty were planned. The 3D printing surgical guides were manufactured and applied during surgeries. Another 6 cases were received same procedures by traditional occlusal splint techniques as the control group. Post-surgical CT reconstruction and 3D superimposition with pre-surgical planning was carried out for outcome comparison. Results: The maximal error of maxillar was 0.65 mm and average error was less than 1 mm in 3D printing group, while the maxillary maximal error was 2.11 mm and average error was greater than 1 mm in traditional group which showed the statistical significance (P<0.05). Conclusions The usage of 3D printing surgical guide could improve the orthognathic surgical precision by controlling the jaw bone in a three-dimensional way.

Objective:To explore combined detection of mad2 with anti-nuclear mitotic spindle apparatus antibody(MSA)and anti-centromere antibody(ACA)and their clinical value for the diagnosis of small cell lung cancer(SCLC).Methods:One hundred and twen-ty SCLC patients,110 non-small cell lung cancer(NSCLC)patients,and 115 pulmonary nodule(PN)patients were enrolled in this study. The expression of mad2 was analyzed by qt-PCR.MSA and ACA were detected by indirect immunofluorescence(IIF)staining.Results:mad2 was overexpressed in SCLC and NSCLC samples(P<0.05).There were significant differences between the results obtained for SCLC and NSCLC samples by qt-PCR(P<0.05).AUC in ROC curve for mad2 expression was 0.799 with an intermediate diagnostic value. In the correlative analysis,the odds ratio of MSA and ACA was 6.94 and 5.60,respectively.In the correlation analysis,Kappa value of mad2 with MSA was 0.49,and Kappa value of mad2 with ACA was 0.42.In the parallel analysis,the sensitivity and specificity was 83.31% and 79.34%,respectively,while the Youden Index was 0.62.Moreover,in the serial analysis,the sensitivity and specificity was 65.32% and 93.35%,respectively,and the Youden Index was 0.59.Conclusions:In comparison with the NSCLC and PN samples,mad2 was overexpressed in SCLC samples.Therefore,mad2 ought to play a critical role in the pathology of SCLC.The combined expression of mad2 with MSA and ACA may contribute to enhancing the sensitivity and specificity of detection;this expression may allow early diag-nosis and clinical diagnosis of SLCC and may be a promising treatment for SCLC.

Objective To investigate the effect of microinvasive thread embedding on vertebral artery blood flow in cervical spondylotic vertebral arteriopathy and further ascerta in that microinvasive thread embedding is a new long-acting acupuncture method for treating cervical spondylotic vertebral arteriopathy.Method Sixty patients meeting the inclusion criteria were randomly allocated to acupuncture and thread embedding groups.The acupuncture group received conventional acupuncture and the thread embedding group, microinvasive thread embedding.The symptoms and function were scored using theEvaluation Scale for Cervical Vertigoand bilateral vertebral artery blood flow was measured using transcranial Doppler after one day and three weeks of treatment.Result The symptoms of vertigo improved somewhatin the thread embedding group at one day after treatment compared with before treatment (P<0.05).At three weeks after treatment,vertigo,neck-shoulder pain, abilities in daily living and working and the total score improved in both groups of patients (P<0.05), and vertigo and abilities in daily living and working improved significantly in the thread embedding group compared with the acupuncture group (P<0.05). Bilateralvertebral artery Vm increased significantly in both groups of patients after treatment(P<0.05) and increased more significantly in the thread embedding group than in the acupuncture group after one day and three weeks of treatment (P<0.05). PIof the rightvertebral arterydecreased somewhat in both groups after three weeks of treatment (P<0.05) but there was no statistically significant difference between the twogroups(P>0.05). The total efficacy rate was 83.3% in the thread embedding group, which was higher than 60.0% in the acupuncture group (P<0.05).Conclusion Microinvasive thread embedding can improve the symptoms, vertebral artery blood flow and the quality of life in patients with cervical spondylotic vertebral arteriopathy.

Objective To investigate the therapeutic effect of microinvasive PGLA thread embedding on neck pain due to cervical spondylosis. Method One hundred and five cervical spondylosis patients with complaints of neck pain were randomly allocated to three groups, 35 cases each. The thread embedding group received PGLA thread embedding therapy;the control group, acupuncture with thread-embedding needles (without thread embedding);the acupuncture group, conventional acupuncture. Result There was a significant difference in the relief of symptoms and signs between the thread embedding or acupuncture group and the control group (P<0.05). There were statistically significant pre-/post-treatment differences in the VAS score and the PPI score in the thread embedding and acupuncture groups (P<0.05). There were statistically significant post-treatment differences in the above scores between the thread embedding or acupuncture group and the control group (P<0.05). The total efficacy rate was 17.1% in the control group, 77.1%in the acupuncture group and 94.3%in the thread embedding group. The total efficacy rate was significantly higher in the thread embedding group than in acupuncture and control groups. Conclusion The therapeutic effect on neck pain due to cervical spondylosis is produced by PGLA thread stimulation of the acupoints and not by simple injurious stimulation with thread-embedding needles. PGLA thread embedding has a marked therapeutic effect on neck pain due to cervical spondylosis.

Objective To develop and validate a new genioplasty templates system for monoblock osseous genioplasty.Methods Thirty-six patients with chin deformities were enrolled in this study.The chin template system included a cutting guide and a repositioning guide for a genioplasty.Chin templates were designed in a computer and fabricated using a three-dimensional printing technique.The accuracy of the genioplasty templates were assessed by comparing the actual postoperative outcomes with the virtual plan.Results All genioplasty was successfully completed by the template system.The largest linear rootmean-square deviation(RMSD) between the planned and the postoperative chin segments was 1.16 mm and the largest angular RMSD was 3.06°.Conclusions The results showed that the chin template system provides a reliable method for transfer of genioplasty planning.The operation precision of the genioplasty can be improved by using the surgical templates system.

Objective To evaluate the results of the orthognathic surgery with computer aided simulation-three-dimensional(3D) printed surgical guide and dental model surgery in the treatmemt of patients with mandibular excess and facial asymmetries.Methods The coordinate system was built in ProPlan CMF 2.0 software,and the horizontal plane consisted of PoL,PoR,OrL,middle sagittal plane through nasion point and basion point and the plane perpendicular to the horizontal plane,coronoid plane through nasion point and the plane perpendicular to the horizontal plane and middle sagittal plane.The orientation of maxilla and mandibular distal segment was calculated by each triangle(U 1-U6L-U6R,L1-L6L-L6R,Me-M5L-M5R) before and after orthognathic surgery.A total of 60 mandibular excess patients with facial asymmetries were enrolled in this retrospective study.They were divided into two groups,group I with computer aided simulation,group Ⅱ with dental model surgery.The difference of maxillary occlusal plane roll and yaw angle,mandibular occlusal plane roll and yaw angle,and mandibular body plane roll and yaw angle were calculated.Statistical analysis was performed with SPSS 17.0 software.Results The yaw angle of mandibular occlusal plane of the dental model surgery and computer aided simulation was 0.36°± 0.48° and 0.84° ±0.36° (P=0.043),respectively.The roll angle of mandibular occlusal plane of the dental model surgery and computer aided simulation was 0.26°±0.79° and 0.54°±0.40°(P=0.032),respectively.The yaw angle of mandibular body plane of the dental model surgery and computer aided simulation was 0.60°± 1.04° and 0.23°±0.52°(P=0.008),respectively.The roll angle of mandibular body plane of the dental model surgery and computer aided simulation was 0.82°± 0.72° and 0.53°± 0.37° (P=0.028),respectively.The changes in computer aided simulation group were more obvious than that in the dental model surgery group,but the difference was not significant in the yaw angle of maxillary occlusal plane and the roll angle of maxillary occlusal plane between the two groups(P ＞ 0.05).Conclusions It was more effective to correct mnandibular asymmetry by computer aided simulation than dental model surgery.

OBJECTIVETo explore the relationship between the needling sensation of catgut embedding therapy and the depth of embedded catgut so as to improve the safety of the needle insertion and catgut implantation of the therapy.

METHODSTwenty healthy adults were selected. Under the ultrasound, the structure of the cervical Jiaji (EX-B 2) was observed. In the ultrasound guidance, the catgut was embedded. The two-dimensional imaging method was adopted to observe the anatomic structure and the procedure of needle insertion at the cervical Jiaji (EX-B 2). The high-frequency ultrasound was used to collect the images at Jiaji (EX-B 2) of C5 and determine the depths from the skin surface to the different layers of the point. Additionally, the visual analogue scale (VAS) was adopted to score the needling sensations when the needle inserted at different layers. The persistent sensation duration in the local area was followed continuously.

RESULTSUnder the ultrasound, the anatomic structure and tissue layers of cervical Jiaji (EX-B 2) were displayed clearly. The difference was significant in the average depth from the skin surface to the subcutaneous tissue, trapezius, splenius capitis, semispinalis capitis, semipinalis cervicis, multifidus and vertebral arch between the males and females (all P<0. 01). During the needle insertion, the sensations were apparently different when the implantation went to different layers. The qi arrival presented when the catgut was embedded to the trapezius, splenius capitis, semispinalis capitis, semipinalis cervicis and multifidus. But the distending pain was the most significant when in the myofascial. Commonly, the embedded catgut 2. 5 cm in length may be implanted deeply to the multifidus and the local needling sensation lasted averagely for (72. 0 ± 10. 2) h. Conclusion Under the ultrasound guidance, the depth of embedded catgut is clearly displayed at cervical Jiaji (EX-B 2). The needle insertion and the implanted material are visible, and the relationship between qi arrival and the layer of needle insertion is determined. The accuracy and safety of minimally invasive catgut embedding therapy is improved in the treatment of cervical spondylosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Catgut ; utilization ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles ; anatomy & histology ; diagnostic imaging ; Qi ; Sensation ; Spondylosis ; diagnostic imaging ; therapy ; Ultrasonography