Objective To investigate the effect of different premolar extraction patterns on Bolton index and occlusal relationship of skeletal Class Ⅱmalocclusion.Methods The plaster models of 62 patients with skeletal ClassⅡmalocclusion were selected and con-verted into digital models by iTeroElement scanner.Each model was simulated by the four premolar extraction pattrens,and tooth ar-rangement test was performed after tooth extraction.The Bolton index before and after tooth extraction was calculated,and the occlusal relationship after tooth arrangement was evaluated to explore its law.Results All the four premolar extraction patterns resulted in a significant decrease in the Bolton index over-all ratio in skeletal ClassⅡpatients,and compared with the extraction patterns of 4/4 and 4/5,the patterns of 5/4 and 5/5 resulted in a greater decrease in the Bolton index over-all ratio(P＜0.001).For skeletal classⅡmal-occlusion,the tooth arrangement test was conducted on the basis of establishing the neutral relationship of first molar.The average value of anterior teeth over-jet obtained by patterns of 4/4 and 4/5 was within the normal range(＜3 mm).The average value obtained by pat-terns of 5/4 and 5/5 was greater than the normal range(＞3 mm),and the difference was statistically significant(P＜0.001).Conclu-sion The premolar extraction patterns of 4/4 and 4/5 are more conducive to normalizing the Bolton index over-all ratio and establis-hing the better occlusal relationship for skeletal Class Ⅱ malocclusion.

Objective:To explore the relationship between sleep quality and perceived stress and analyze the role of ego depletion and mindfulness in their relationship.Methods:Totally 326 police officers were selected and assessed with the Pittsburgh Sleep Quality Index(PSQI),Chinese Perceived Stress Scale(CPSS),Brief Ego Deple-tion Scale(BEDS),and Mindful Attention Awareness Scale(MAAS).Results:The average PSQI score was(9.1±3.0).There was a partial mediation effect between CPSS scores and PSQI scores,and the mediation effect ac-counted for 27.03％.The MAAS scores were regulated between CPSS scores and BEDS scores(β=-0.01,P＜0.01),CPSS scores and PSQI scores(β=-0.01,P＜0.001),and BEDS scores and PSQI scores(β=-0.02,P＜0.01).Conclusion:The sleep quality of the police officers is related to perceived stress,and ego depletion plays a mediating role between them,and mindfulness acts as a protective factor in the whole process.

Parkinson's disease (PD) is one of the hotspots in the research field of neurodegenerative diseases, and its pathogenesis is still controversial. Trace metal elements play an important role in normal growth and development of the human body. Metal ions can cross the blood-brain barrier and enter the brain, leading to α-synapnuclein aggregation, mitochondrial dysfunction, and degeneration of dopaminergic neurons, and then inducing the occurrence of PD. This article mainly reviewed the potential mechanisms of metal elements in PD, discussed the role of metabolic imbalance of common trace metals (copper, iron, manganese, and zinc) in PD, and put forward new insights into the treatment of PD.

Objective: To evaluate the impact of bleomycin/etoposide/cisplatin (BEP) and paclitaxel/carboplatin (PC) chemotherapy regimens on the fertility and prognostic outcomes in malignant ovarian germ cell tumor (MOGCT) patients who underwent fertility-sparing surgery (FSS). Methods: A propensity score matching algorithm was performed between the BEP and PC groups. The χ2 test and the Kaplan-Meier method were used to compare the fertility outcome, disease-free survival (DFS) and overall survival (OS). The Cox proportional hazards regression analysis was used to identify risk factor of DFS. Results: We included 213 patients, 185 (86.9%) underwent BEP chemotherapy, and 28 (13.1%) underwent PC chemotherapy. The median age was 22 years (range, 8–44 years), and the median follow-up period was 63 months (range, 2–191 months). Fifty-one (29.3%) patients had a pregnancy plan, and 35 (85.4%) delivered successfully. In the before and after propensity score matching cohorts, there were no significant differences in spontaneous abortion, selective termination of pregnancy, during-pregnancy status, and live birth between the BEP and PC groups (p>0.05). Fourteen (6.6%) patients experienced recurrence, including 11 (5.9%) in the BEP group and 3 (10.7%) in the PC group. Four (1.9%) patients in the BEP group died. Kaplan-Meier analysis revealed no significant differences in DFS (p=0.328) and OS (p=0.446) between the BEP and PC groups, and the same survival results were observed in the after matching cohort. Conclusion The PC regimen is as safe as the BEP regimen for MOGCT patients with fertility preservation treatment, and no differences were observed in fertility and clinical prognosis.

Objective:To analyse the long-term efficacy in childhood T-cell acute lymphoblastic leukemia (T-ALL) cases enrolled in the national protocol of childhood leukemia in China-acute lymphoblastic leukemia (NPCLC-ALL) 2008.Methods:Clinical data of 96 patients diagnosed as T-ALL and treated with NPCLC-ALL2008 protocol between January 2009 and December 2017 in the Department of Hematology-Oncology, the Children′s Hospital, Zhejiang University School of Medicine were analyzed retrospectively. Predictive value of minimal residual disease (MRD) monitored by flow cytometry was analyzed. Kaplan-Meier method was used for long-term survival analysis.Results:A total of 96 evaluable patients with newly diagnosed T-ALL were analysed, including 72 males and 24 females. The age was 9.5 (ranged from 1.0 to 16.0) years. The follow-up time was 5.7 (ranged from 1.0 to 9.7) years. Among 96 patients, 92 (96%) achieved complete remission. The 5-year event free survival (EFS) and overall survival (OS) rates were (61±6) % and (70±5) %, respectively. Relapse occurred in 18 cases and the 5-year cumulative incidence of relapse was (27±6) %. Twenty-four patients died. The 5-year OS rates of patients with MRD>5% on day 15 of induction therapy was significantly worse than those with MRD≤5% ((60±12) % vs. (72±6) %, χ 2=3.904, P=0.048) . The 5-year EFS and OS rates were obviously lower in patients with MRD>10% before the consolidation therapy ((50±35) %). The 5-year OS rates of patients with relapsed disease was significantly worse than those without ((26±13) % vs. (81±5) %, χ 2=18.411, P<0.01). The earlier the relapse, the worse the prognosis. The 5-year OS rates for patients relapsed within 6 months, within 3 years and more than 3 years, were (25±22) %, (30±14) % and (50±35) % respectively (χ 2=13.207, P<0.01). Conclusions:NPCLC-ALL2008 protocol is effective for childhood T-ALL. The MRD guided accurate risk stratification and individualized treatment can reduce the relapse and improve the survival rate of pediatric T-ALL.

Objective To study the value of magnetic resonance vessel wall imaging in assessing the atherosclerotic plaque burden of rabbit model.Methods We built up abdominal atherosclerotic animal model in 30 New Zealand rabbits by high lipid diet combined with abdominal artery denudation.The animals were divided into 3 groups randomly,which were the 1-week group,1-month group and 2-months group.The MRI and histology examination were carried out at relative time points.The correlations of area or thickness of vessel wall by MRI with histology examination were analyzed.Results Among the 30 rabbits,3 died due to anesthesia or surgery,one rabbit model failed because of the thin vessel,and another 3 died of diarrhea or inflammation during the high lipid diet feeding.Eventually,totally 23 rabbits fulfilled the examinations (7 in 1-week group,7 in 1-month group and 9 in 2-months group).The vessel wall area of histology examination grew larger along with the post-surgery duration,from 1.7663 mm2of 1-week group to 2.4371 mm2 of the 1-month group till 3.5978 mm2 of 2-months group,with statistic significant difference among 3 groups (F=5.052,P=0.017).There were strong correlations of area or thickness vessel wall resulted from MRI with histology examination(r=0.688,0.642;P=0.001,0.002).Conclusions High resolution MR vessel wall imaging technique may evaluate and follow up the plaque burden in the early stage of atherosclerosis.

Objective To understand the family burden of Alzheimer' s disease (AD) and associated factors.Methods The subjects were 168 caregivers of patients with AD selected from two class 3A hospitals and three communities in Taiyuan through cluster sampling.The data were collected by using the Caregiver Burden Inventory (CBI) and the Family Burden Scale (FBS) of diseases.Path analysis was applied to identify the factors associated with the total score of CBI.T-test and One-way analysis of variance were applied to identify the factors associated with the total score of FBS.Multiple linear regression analysis was applied to identify the factors associated with family burden of AD.Results The total score of the caregivers' burden was 52.41 ± 17.07.AD patients' cognitive function had direct (standardized β =-0.280,P＜0.001) and indirect effect on CBI;while daily performance of AD patients had indirect effect on CBI.The total score of family burden was 16.23 ± 9.00.Univariate analysis showed that the sex,age,education level,cognitive function,daily performance,mental status,depression and dementia rating of AD patients might affect the total score of FBS (P ＜ 0.05).Multivariate analysis showed that the factors which affected the total score of FBS included the sex (standardizedβ =0.280,P ＜ 0.01),cognitive function (standardizedβ =-0.158,P =0.033) and daily performance of AD patients (standardizedβ=-0.155,P=0.039).Conclusion The caregiver and family burden of AD was mainly associated with the cognitive function and daily performance of AD patients.It is necessary to take targeted measures to reduce the caregiver and family burden of AD.

Objective To explore the effect of QizhiJiangtang Capsule on the insulin resistance (IR)in the diabetic rats,and to clarify the action mechanism.Methods The diabetes rat models were induced by high fat diet combined with STZ injection.The successful models of the rats were randomly divided into diabetes group (DM), ShenqiJiangtang Granule group (SQ)and high (QJH),middle-(QJM),low (QJL)doses of QizhiJiangtang Capsule groups;at the same time control group (NC)was established. The drug concentrations in high, middle and low-doses of QizhiJiangtang Capsules groups were 1.35, 0.68, and 0.34 g · kg-1 respectively;and the concentration of ShenqiJiangtang Granule was 0.27 g·kg-1.After the diabetic model was established successfully, the rats were treated for 8 weeks on the basis of drug dose.Then the levels of fasting blood glucose (FBG),fasting insulin (FINS),insulin resistance index (IRI)and biochemical indexes related to lipid metabolism of the rats were measured using blood glucose detector and automatic biochemistry analyser.The gene expression of insulin receptor substrate-1 (IRS-1),phosphatidyl inositol 3-kinase (PI3K),and glucose transporter 4 (GLUT4)in liver tissue were examined by Real Time PCR.The levels of tumor necrosis factorα(TNF-α)and adiponectin (ADPN)in serum were detected using ELISA.Results Compared with control group,the levels of FBG,FINS and IRI of the rats in diabetes group were significantly increased (P<0.05 or P<0.01 );the serum total cholesterol (TC), triglyceride (TG)and low density lipoprotein (LDL)levels were significantly increased (P<0.05 ), while the serum high-density lipoprotein (HDL)level was significantly decreased (P<0.05);the mRNA expression levels of IRS-1,PI3K and GLUT4 in liver tissue were decreased (P<0.05);the level of serum TNF-αwas increased (P<0.05),but the ADPN level was decreased (P<0.05).Compared with diabetes group,the FBG level and IRI of the rats in QizhiJiangtang Capsule and ShenqiJiangtang Granule groups were significantly decreased (P<0.01);the levels of FINS of the rats middle and high doses of in QizhiJiangtang Capsule groups and ShenqiJiangtang Granule group were significantly decreased (P<0.05);the levels of serum TC,TG and LDL of the rats in middle dose of QizhiJiangtang Capsule group and ShenqiJiangtang Granule group were significantly decreased (P<0.05 or P<0.01),but the HDL level was increased (P<0.05);the mRBA expression lvels of IRS-1,PI3K and GLUT4 inliver tissue were increased (P<0.05);the levels of serum TNF-αof the rats in middle dose of QizhiJiangtang Capsule group and Shenqijiangtang Granule group were significantly decreased (P<0.05),but the serum ADPN levels were increased (P<0.05 ). Conclusion QizhiJiangtang Capsule can significantly improve the IR in the diabetic rats,and the pharmacological mechanisms are related to adapting the blood lipid component and insulin signal transduction pathways.

Objective To investigate the effect of different injection rate of contrast medium on the quality of multislice spiral CT portography(SCTP). Methods Thirty patients with no prominent difference in the age and weight randomly divided into 3 groups (10 cases each group) underwent contrast-enhanced CT scan of abdomen. Non-ionic contrast medium (300 mgⅠ/ml, 1.5 ml/kg) was injected through antebrachium veins with power injector at the rates of 2.0 ml/s,3.0 ml/s and 4.0ml/s. Arterial phase acquisi-tion was made using the software of automated bolus triggering with a ROI placed on abdominal aorta when 100 HU was reached, and 7 seconds and 20 seconds later, portal phases were done respectively. The attenuations of portal vein(PV) and hepatic parenchy-ma of 3 groups were measured on source images. Then the oblique axial and coronal maximum intensity projection(MIP) maps were reconstructed at workstation and PVs were observed. Statistics analysis was made with software of SPSS 11.5. Results The attenu-ations of PV in 2.0ml/s, 3.0 ml/s and 4.0 ml/s groups were (150.80±21.16)HU, (170.90±17.26)HU and [181.90±22.88) HU respectively. There was obvious difference between 2.0ml/s and 4.0ml/s groups for atteuation of PV(P=0.017). The differences of CT attenuation of PV-hepatic parenchyma in three groups were (50.20±17.40) HU, (67.10±23.08) HU and (76.20±22.75) HU respectively. Prominent difference was also found between 2.0 ml/s and 4.0 ml/s groups(P=0.039). The grades of segment of PV displayed on SCTP maps were 4.20±1.14,4.90±0.99 and 5.50±0.53 in 2.0 ml/s,3.0 ml/s and 4.0 ml/s groups respectively, which were of obvious differences between them (P=0.013). Conclusion Injection rate of contrast medium dose influence the quality of SCTP of PV,SCTP quality is best with velocity of flow at 4.0 ml/s.

Objective To approach the mechanism and efficacy of regional intra-arterial infusion chemotherapy with the mixture of lipid emulsion-CDDP (LE-CDDP) for treatment of locally advanced pancreatic cancer. Methods Twenty-four health dogs were divided into four groups (group A, B, C, and D). The dosage of CDDP was used in 4 mg/kg/body weight for each animal The 20% LE, as a solvent, was used in the experimental animals with 2 ml/kg/ body weight (group A) and 1 ml/kg/bedy weight (group B), respectively. Normal sodium (NS) as a solvent was used as control with 2 ml/kg/bedy weight (group C) and 1 ml/kg/body weight (group D), respectively. The LE-CDDP mixture and the NS-CDDP mixture were infused into the proximal segment of splenic artery under the DSA, with transfemoral arterial approach. Blood samples were collected after infusion at 0,3,5,10,20,30,40,50,60 min and the tissues were obtained after the 60 min's blood sample was collected. Blood samples, absorbent gland in peripancreas, liver, spleen, kidney, heart, portal vein, the superior segment of jejunal and pancreas and parapancreatic tissues were obtained for CDDP concentration analysis and histopatholngic examination. Results The values of the area under curve (AUC), the incipient serum concentration ( C0 ) and the elimination half-life (t1/2 ) of the serum CDDP concentration-time curve in four groups were A (54. 5 ± 10.1)%,(2.6±0.5) mg/L, (16.7±3.6) min;B (18.3±6.0)%,(1.5±0.2) mg/L, (47.9 ± 11.1) min; C (116.7±20.6)%, (6.5±0.4) mg/L, (10.5±2.8) min and D (126.6±30.7)%, (5.5±0.4) mg/L, ( 10. 1±3. 1 ) min, respectively. There were significant difference among these four groups ( F(AUC) = 42. 42, F(C0) = 249. 61, F( t1/2 ) = 12. 48, P < 0. 01 ). The values of AUC and C0 in the group A were significantly lower than those in the group C (t(AUC) = 6. 64,t(C0) = 16. 34, P <0. 01 ), and the corresponding values in the group B being also significantly lower than those in the group D (t(AUC) = 8.49, t(C0) =22. 30, P<0. 01 ). The value t1/2 in the group A was significantly longer than that of in the group C ( t = 3.36, P < 0. 01 ), and that of group B was also significantly longer than that of group D ( t = 3.71, P <0. 01 ). The values of AUC and C0 in the group B were significantly lower than those in the group A (t(AUC) = 7. 57, t(C0) = 5.48, P < 0. 01 ), and the value t1/2 in the group B was significantly longer than that in the group A (t = 3.22, P < 0. 05 ). The concentrations of the left lobe and horn of pancreas were higher in the group B (0. 18, 0. 18 mg/L) than those in the group A (0. 05, 0. 05 mg/L) (t =2. 52, 2. 73, P < 0. 05). The tissue CDDP concentration of the right lobe of pancreas and spleen were no significant difference between group A ( 0. 11, 0. 29 mg/L ) and group B ( 0. 07, 0. 24 mg/L) ( P > 0. 05 ). Perivascular lymphocytic and neutrophilic infiltration, congestion and hemorrhage were found in the pancreas, parapancreatic absorbent gland, liver and spleen in the group A and group B. The micro-particles of intralipid were present in the capillary vessel of these tissues. No specific pathological changes were found in other groups and organs. Conclusions The regional intra-arterial infusion with LE-CDDP mixture could increase the pancreatic CDDP concentration, meanwhile, it also could decrease the serum CDDP concentration. The more of the CDDP concentration in the LE-CDDP mixture, the more CDDP concentration at the pancreatic tissue accordingly.