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Primary hypertrophic osteoarthropathy(PHO) is a rare disease also known as pachydermoperiostosis. We reported a painless case whose diagnosis was confirmed by genetic test. A 24-year-old male presented a series of symptoms that first began at 14. He suffered from progressive clubbed-fingers accompanied by swelling of the wrist and ankle joints. Facial skin concentric thickening and alar nose broadening appeared simultaneously and increased progressively. He was also prone to acne and hyperhidrosis. X-rays showed thickening of the metacarpal and phalangeal bones, as well as symmetrical periosteal ossification of both the tibia and fibula. Clinical diagnosis of PHO is difficult because of the variable features. With acromegaly excluded, the diagnosis was confirmed by a genetic test. Whole exome sequencing revealed a heterozygous SLCO2A1 c.611C > T(p.Ser204Lue) and SLCO2A1 c.1602C > A(p.Asn534Lys) mutation from each parent. It suggests that primary hypertrophic osteoarthropathy should be considered for young limb hypertrophic patients especially when periosteal thickening signs were showed in X-ray. A confirmatory diagnosis can be made through the genetic test.

PIK3CA-related overgrowth spectrum (PROS) is a rare condition characterized by disproportionate overgrowth of head, neck, trunk, or extremity, caused by PIK3CA gene mutation. This condition has negative impact on the physical appearance, functions, and psychosocial well-being of the patients. The condition causes social and economic burden, too. The gold standard for the diagnosis of PROS is the genetic testing using somatic tissue, but detecting low-level mosaic mutations of PIK3CA gene remains a challenge. There is no specific treatment now. Supportive management including surgery and other interventions have limited effects in improving cosmetic outcome and functions. Multidisciplinary collaboration is the key to the success of managing PROS. Targeted gene therapy is promising in improving the outcome for patients with severe PROS. Patients diagnosed with negative genetics test by the clinical measures are often ineligible for novel gene therapy. This article reviews the clinical manifestations, diagnosis, and treatments of PROS, aiming to improve the current understanding of this rare condition.

Nail-patella syndrome (NPS) is a hereditary rare disease that can involve fingernail, patella, elbow, and iliac bones. In this article, we report a case of a girl-9 and 1 quarter years old who had asthmatic contractures in both elbows, thumbnail hypoplasia in both hands, patellar dislocation of both knees, iliac angle protrusion of both sides, and scoliosis. Whole exome sequencing suggests the presence of a LMX1B NM_002316.4:c.706G > C(p.Ala236Pro) mutation. NPS is an autosomal dominant disease associated with gene mutation of LMX1B, which can be diagnosed by combining the patient′s clinical manifestations and genetic results. The treatment now only targets on symptoms, relieving the localized severe lesion but not cure right now.

Proteus syndrome is a rare congenital hamartomatous syndrome characterized by the asymmetric and disproportionate overgrowth of limbs, emergence of connective tissue nevi, epidermal nevi, ysregulated adipose tissue, and vascular malformations. The Proteus syndrome is caused by mosaicism of somatic activating mutation in the AKT1 gene which locates at chromosome 14q32.3. This syndrome is extremely rare, making it difficult to diagnose. The most commonly used diagnostic criteria are too complicated to be used in clinical practice. Surgery can partially alleviate the clinical symptoms of overgrowth, but it can't inhibit the progression of the disease. This article summarizes the diagnostic criteria, treatment principles, and perioperative managements for Proteus syndrome in the world. The article proposes the highly suspected morphological manifestations of Proteus syndrome was based on clinical experiences of the author.The article emphasizes using genetic detection of pathological tissue as the gold standard for diagnosis, and suggests targeted therapy as the optimal treatment for Proteus syndrome.

【Objective】The study was carried out to study the effects of nitrogen application rate and transplanting density on dry matter production and nitrogen use efficiency of double cropping hybrid rice.【Method】Zhuliangyou 819 was used as early rice material and Taiyou 398 was used as late rice material. Three nitrogen application levels (N1, N2, N3 at 0, 120, 150 kg/hm2 for early rice and N1, N2, N3 at 0, 150 and 225 kg/hm2 for late rice, respectively) and three transplanting densities(M1, M2, M3 at 13.3 cm×16.7 cm, 13.3 cm×20.0 cm, 16.7 cm×20.0 cm for early rice and M1, M2, M3 at 16.7 cm×20 cm, 16.7 cm×23.3 cm, 16.7cm×26.7cm for late rice, respectively).【Result】Increasing nitrogen fertilizer can significantly improve the accumulation of dry matter quality of rice, and the effect of transplanting density on dry matter quality is small. The dry matter quality of early and late rice is the highest in N3M1 treatment at maturity, in which the dry matter quality of early rice is 8.81%- 110.24% higher than that of other treatments, and that of late rice is 9.12%-117.12% higher than that of other treatments. The nitrogen uptake and utilization efficiency of early rice N2M2 treatment was up to 60.73%, and that of late rice N2M3 treatment was up to 63.20%. Increasing nitrogen fertilizer could not significantly improve the contribution rate to yield, and had little effect on the harvest index of late rice; Increasing nitrogen fertilizer application in early and late rice could significantly increase the total nitrogen accumulation of rice, with an increase of 67.50%-77.03% in early rice and 73.18%-115.12% in late rice; Each fertilization treatment of early rice had little effect on the agronomic and physiological utilization efficiency of nitrogen fertilizer. The increase of agronomic and physiological utilization efficiency of nitrogen reduction treatment of late rice was 52.66% and 59.00%; Nitrogen reduction in early and late rice can improve the partial fertilizer productivity of rice, and the growth rates of early and late rice are 15.54% and 48.58% respectively. The contribution rates of transplanting density to the yield of early and late rice were 18.52%-47.22% and 23.42%-35.42% higher in M3 treatment than in M1 and M2 treatment, respectively; It had little effect on total nitrogen accumulation, harvest index, agronomic utilization rate and partial fertilizer productivity; Low planting density can improve the physiological utilization rate of early rice, with an increase of 52.19%-144.14%, but it has little effect on the physiological utilization rate of late rice.【Conclusion】Therefore, N2M2 and N3M3 treatment can maintain high nitrogen use efficiency and dry matter accumulation of double cropping hybrid rice, and N2M2 treatment can save fertilizer and maintain high nitrogen use ability.

The hot deformation behavior of TB8 titanium alloy with a lamellar α structure in the α+β dulex phase region was investigated. The results show that at the strain rate of 1 s-1, a continuous flow softening phenomenon is observed in the curve of the samples deformed at 650 ℃, while a discontinuous yield phenomenon is visual in the curve of the samples when the deformation temperature is higher than 650 ℃. The discontinuous yield phenomenon is gradually disappeared with increasing deformation temperature and strain rate. When the strain rate is 0.001 s-1 and the deformation temperature is 750 ℃ as well as 800 ℃, typical characteristics of dynamic recrystallization is presented in the curve of the samples. The relationship among peak stress σp temperature T and strain rate ε · and is characterized by Arrhenius-type constitutive equation. The equation between the material constants (α, Q, n and lnA) and strain is constructed. The effect of strain on the material constants (α, Q, n and lnA) of the Arrhenius-type constitutive equation is analyzed. The value of α is increased with true strain, while the values of Q, n and lnA are gradually decreased. The correlation coefficient (R2) and the AARE value between the experimental and the predicted stress are 0.945 and 9.08%, respectively. This indicates that the strain-compensates Arrhenius type constitutive equation can better predict the flow stress value under different deformation conditions for the TB8 titanium alloy with a lamellar α structure deformed in the α+β dulex phase region.

Soil salinization has become an important factor limiting crop yield and quality, affecting crop yields worldwide. As an important fruit crop, the harm of salt stress and the lack of salt tolerant rootstocks have become important issues threatening the healthy and sustainable development of the modern apple industry. Therefore, studying the response and adaptation of apple trees to salt stress is of great practical significance and urgency. In this study, total RNA was extracted from the leaves and roots of Malus zumi (Mats.) Rehd. seedlings were treated with 0, 0.2% and 0.6% NaCl after 0, 4, 8 and 12 days, and RNA-seq libraries were constructed. A total of 575 miRNAs were identified, including 315 known mdm-miRNAs and 260 new miRNAs. In addition, differentially expressed (DE) miRNAs exhibited tissue-specific expression patterns in response to salt stress. At the same time, a data set for deep sequencing of miRNA in Malus zumi (Mats.) Rehd was provided, and bioinformatics methods were used to control the quality of the original data. High quality sequences were obtained, and BLAST software was used to compare the predicted target gene sequences with NR, Swiss Prot, Pfam and other databases to obtain annotation information of salt tolerance related genes. GO analysis shows that miRNAs and target genes related to salt stress are mainly involved in the response to stimuli in biological processes. This will provide theoretical data basis for the utilization of Malus zumi (Mats.) Rehd and favorable support for the breeding of salt tolerant rootstocks. [ABSTRACT FROM AUTHOR]

The mechanical behavior and fracture modes of DP980 high strength steels were studied by comparing the results of dynamic tensile tests at strain rates from 10-3s-1 to 103s-1. The results show that the strength of DP980 steel remains almost unchanged and the plasticity decreases by 7.5% as the strain rate increasing from quasi-static(10-3s-1) to 100s-1. When the strain rate increases from 100s-1 to 103s-1, the strength keeps increasing, while the plasticity increases by 14% at the strain rate ranging from 100s-1 to 102s-1, but then follows by a decrease of 24.7% in the range of 102s-1 to 103s-1. The strain rate sensitivity coefficient m increases with the increasing of the strain rate. During the plastic deformation, the multiplication reinforcement of dislocation and the motion resistance due to the acceleration of dislocation in ferrite matrix are the main reasons for the strength enhancement. The plastic deformation concentrates in the ferrite, and the microvoids and cracks propagate along the martensite-ferrite interface. In the thickness direction of specimen, the macrographs of fracture are "V" shape cups when strain rate is lower than 101s-1, but the pure sheer shape with 45° to the tensile direction when strain rate is over 101s-1.

In order to reveal sequence boundary formation mechanism of large scale craton epicontinental basin and coal accumulation characteristics under paleogeographic setting of isochronous sequence stratigraphic framework, sequence stratigraphic framework and coal accumulation were analyzed for the Permo-Carboniferous of Benxi-Shanxi Formation in the eastern Ordos Basin. A total of four types of sequence boundary are identified, which are regional unconformity surface, transgressive direction turnaround surface (BTR) resulted from settlement difference of basin basement, and normal regressive erosion surface (NSS) , exposed surface (NES) , corresponding conformity surface (NCC) , and river erosion surface(FEU) resulted from compulsory regression, exposed surface (FES), corresponding conformity surface (FCC). Coal-bearing strata is divided into three third-order sequences and six fourth-order sequences. Authores find that cyclical changes of base level controls the occurrence of coal accumulation, coal-base depositional environment and basin basement subsidence rate during coal accumulation period controls seam thickness and continuity. Paleogeographic comprehensive coal accumulation model within isochronous stratigraphic framework is proposed. The results show that widely distributed thick coal seams form around II-type sequence interface and the largest regression surface (initial flooding surface) of I-type sequence; under the lagoon-tidal flat context, coal-center is located in the tidal flat depositional environment, whose remaining accommodation space is small; under the lagoon-delta-tidal flat context, coal-center is located in the tidal flat depositional environment, whose remaining accommodation space is moderate and basement subsidence rate is large; under the shallow river delta context, coal-center is located in the restricted sea and lakes and bays of the delta plain depositional environment, whose remaining accommodation space is large and basement subsidence rate is large. [ABSTRACT FROM AUTHOR]

Ship ballast water can control the roll, trim, and draft of the ship, and thus ensuring the balance and stability of the ship in the course of sailing, and playing a vital role in the safe navigation of ships. The annual discharge of ship ballast water is very large in China. About three to five billion cubic meters of ship ballast water is discharged into offshore or inland waters every year. This water contains plankton, pathogens, and their larvae or spores. If not be handled appropriately, this will have a serious impact on the ecological environment of the discharge waters. Ballast water is usually treated by electrolysis before being discharged. Sodium hypochlorite can be generated, which can kill microorganisms; however, the by-products trihalomethanes (THMs) are cytotoxic and biotoxic. Studies have shown that THMs may cause fetal growth retardation, spontaneous abortion, or death. The concentration of THMs in drinking water is closely related to the risk of bladder cancer death. Hence, it is important to establish a method for the determination of THMs in ship ballast water. The four kinds of THMs are chloroform, dichlorobromomethane, chlorodibromomethane, and tribromomethane. At present, ship ballast water is mostly analyzed by gas chromatography (GC) using an electron capture detector (ECD) or by gas chromatography-mass spectrometry (GC-MS). Given the low boiling point of THMs, headspace injection and purge-and-trap can be used. Gas chromatography-negative chemical ionization-mass spectrometry (GC-NCI-MS), was adopted. NCI is a soft ionization technique that shows special response to compounds bearing electronegative elements or groups. THMs contain electronegative chlorine atoms and bromine atoms. Therefore, NCI is a good choice for their analysis. The samples were processed by the headspace injection technique. The NaCl content in 10 mL sample was optimized in headspace injection. The results showed that 3.0 g NaCl was the most suitable dosage. The analytes were separated on a DB-5MS UI capillary-column (30 m×0.25 mm×1.0 μm). The target compounds were quantified by using the external standard method in selected ion monitoring (SIM) mode. The four THMs were not only well separated but also showed a high response at 0.2 μg/L. The four THMs showed good linear relationships in the range of 0.2-50 μg/L, with correlation coefficients≥0.995. The limits of quantification (LOQs, S/N =10) were 0.1-0.2 μg/L, and the average recoveries of the four THMs were 90.3%-106.8% at the three spike levels of 0.2, 0.5, and 2.0 μg/L. The relative standard deviations were 1.4%-6.2%. The LOQs of the THMs in the GB/T 5750.8-2006 Standard Test Method of Drinking Water Organic Matter Index are 0.3-6.0 μg/L. It can be seen that the LOQs of the THMs are greatly reduced in this study. The proposed method is accurate, stable, and reliable, and it can be used for monitoring the four THMs in ship ballast water. The method was applied for the detection of 36 ship ballast water samples. In all cases, the detection rates of tribromomethane, chlorodibromomethane, dichlorobromomethane, and chloroform were 83.3%, 69.4%, 22.2%, and 19.4%, respectively. The detection values of tribromomethane, chlorodibromomethane, dichlorobromomethane, and chloroform were 34.25-221.5 μg/L, 3.52-41.87 μg/L, 1.52-8.56 μg/L, and 0.02-5.46 μg/L, respectively. Based on the analysis of several ship ballast water samples (electrolytic water), it was concluded that the greater the number of bromine atoms in the THMs, the higher are the detection rate and detection value in ship ballast water. Compared to chloroform, tribromomethane is more harmful to living beings. China has acceded to the International Convention on Ship Ballast Water and Sediment Control and Management. There is an urgent need to establish analysis methods with high sensitivity, good stability, and high accuracy in addition to determining standards and regulations for ship ballast water.

Objective: To validate the prevalence, severity, characteristics and coronary calcified score(CACS) of coronary artery plaques in women are different from men., Methods: A total of 3 752 patients with suspected coronary artery disease in the First Affiliated Hospital of China Medical University were enrolled between September 2011 and December 2013. Patients with suspect CAD underwent 256-detecter coronary computed tomography (CCTA) and CACS measurement were enrolled. The differences of sex-associated coronary artery plaques were assessed. The univariable and multivariable Logistic regression were employ to assess the association female and male with coronary artery plaques., Results: A total of 3 752 patients including 1 832 females and 1 920 males, the average age of the patients was (56 ± 11) years. Women were older and less smoker than men. The prevalences of any plaque, 2-,3-/LM disease and significant/severe stenosis significantly decreased in female than male (all P<0.01). The proportion of non-calcified plaques significantly higher and mixed plaque significantly lower in female than male (all P<0.01). the proportion of women were significantly lower than men in CACS>0 (all P<0.01). The similar tendency also happened in four age-matched female and male subgroups. After adjustment, female was the significant protective factor for significant and severe stenosis, 2- and 3-/LM vessel disease, calcified and mixed plaques, and CACS>100 (all P<0.01); female was the significant protective factor for non-calcified plaques in the univariate analysis (P<0.01). When the age ≥ 65, female became the significant risk factor for coronary artery plaques (all P<0.01)., Conclusions: Women have less prevalence and extensive coronary artery plaques and lower CACS, the plaque characteristics in women is more frequently composed by non-calcified plaques than men, even after matched by age. With age, female change from a protective factor to a risk factor for coronary artery plaques.

Objective: To explore the relationship between different tissue levels of polyunsaturated fatty acid (PUFA) and the clinicopathologic parameters in colorectal carcinoma (CRC) and evaluate their prognostic significance., Methods: Fresh frozen malignant tissue was obtained from 82 colorectal cancer patients at PLA general Hospital from December 2010 to March 2011. The immunohistochemical results were obtained for vascular endothelial growth factor (VEGF), P53 and Ki-67. The relationship between the PUFA level and such clinicopathological profiles as age, gender, location, differentiation degree, TNM (tumor, node and metastasis) stage, VEGF, Ki-67 and P53 was analyzed., Results: Tissue level of arachidonic acid (AA) in patients aged over 60 years (n = 44) was significantly lower than those under 60 years (n = 38) (0.12% ± 0.06% vs 0.17% ± 0.09%, P = 0.045). In patients with tumor size < 5 cm (n = 42), tissue level of EPA was significantly higher (0.29% ± 0.13% vs 0.20% ± 0.14%, P = 0.030) while ω-6/ω-3 PUFA lower (10.8 ± 2.6 vs 13.2 ± 6.4, P = 0.031). Significant statistical difference existed in tissue level of LA, AA/ω-3 PUFA in different differentiation degrees(P = 0.013, 0.027). Tissue level of linoleic acid(LA) in poorly differentiated tumor was the highest (19.9% ± 6.3%) while AA/ω-3 PUFA the lowest (4.1 ± 2.0, P < 0.05). Tissue level of LA was higher in VEGF-positive tumors than those in VEGF-negative counterparts(16.2% ± 3.7% vs 13.9% ± 2.7%, P = 0.009) while the ratios AA/ω-3 PUFA, AA/ω-6 PUFA, AA/LA in VEGF-positive tumors were lower than those in VEGF-negative counterparts (5.0 ± 1.8 vs 6.7 ± 3.3, 0.30 ± 0.09 vs 0.34 ± 0.09, 0.50 ± 0.21 vs 0.61 ± 0.21, P = 0.004, 0.038, 0.030) . In Ki-67 negative LA was highest (22.5% ± 10.1%, P = 0.048). No significant differences existed in the level of PUFA among the gender, the clinicopathological stage, lymph node metastasis and groups with differential expressions of P53 (all P > 0.05)., Conclusions: The tissue levels of PUFA are somewhat correlated with the clinicopathologic parameters of CRC. And the prognosis of CRC may be evaluated through the test of PUFA.

Objective: To study the changes in the intensity and temporal pattern of target gene expression in the tumor tissue of nude mice bearing human nasopharyngeal carcinoma (NPC) following injection of recombinant adeno-associated virus (rAAV) and recombinant adenovirus (AdV) in vivo., Methods: EBV-positive human NPC cell line C666-1 was inoculated subcutaneouly in nude mice. After the tumor mass reached 3 mm in diameter, 1.5 × 10(11) v.g (virus genome) rAAV-EGFP, 2.5 × 10(8) pfu rAdV-EGFP or their balanced mixture was injected intratumorally. At 5 and 10 days after the injection, the tumor tissues were harvested for immunohistochemical staining of GFP, and the ratio of the GFP-positive cells and the intensity of GFP expression was determined., Results: Immunohistochemistry for GFP showed that 5 days after the injection, GFP expression was detected (1.70 ∓ 0.48) in the tumor tissue in rAAV group, and the peak expression levels was seen in rAdV group (6.00∓1.94); the expression level was comparable between the combination group (6.90 ∓ 1.92) and rAdV group. At 10 days, GFP expression was considerably lowered to 2.00 ∓ 0.67 in rAdV group but increased to 8.00∓1.15 in rAAV group. The expression in the combination group maintained a high level at 10 days (10.10∓1.63), which was significantly higher than that in rAAV group (P%0.001)., Conclusion: Transfection with rAAV combined with rAdV allows instant, sustained and significantly enhanced expression of the target gene in the tumor tissue. This approach takes advantages of the two viruses and can be ideal for exogenous gene delivery into the tumor tissues.

Objective: To detect the serum proteomic fingerprints in patients with hypopharyngeal squamous cell carcinoma (HPSCC) by surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) protein chip array technique., Methods: The serum samples were obtained from 58 HPSCC patients for protein expression analysis using SELDI-TOF Protein Chip technique and cation-exchange (CM10) protein array. All the spectra were compared and the qualified mass peaks with mass-to-charge ratios (m/z) between 1 and 70 kD were autotimatically detected. The tree analysis pattern was generated using Biomarker Patterns Software., Results: The protein profiles of HPSCC serum were analyzed according to the clinical and pathological features of the patients and their treatment response. No significant difference was noted in the serum proteins between HPSCC patients with different statuses of cervical lympha node metastasis (P>0.05), and the difference between well differentiated and poorly differentiated HPSCC was only minor. No significant difference was found in the serum proteins between chemotherapy-sensitive patients and the insensitive patients (P>0.05), but 5 proteins were identified to be overexpressed in the sensitive patients (P < / = 0.05). Radiotherapy-sensitive HPSCC patients were segregated from the insensitive group with a sensitivity of 86.67% and specificity of 100%., Conclusion: The serum protein at the m/z value of 6115.74 is overexpressed in radiotherapy-sensitive HPSCC patients. Serum protein profiling allows the prediction of radiotherapy response in HPSCC patients, and the identified proteins may serve as candidate biomarkers for predicting the radiotherapy sensitivity of HPSCC.

A method for the preparation of the standard gas mixture of 6 chlorinated hydrocarbons, containing dichloromethane, 1,1-dichloroethane, 1,2-dichloroethane, chloroform, 1,1, 1-trichloroethane, and 1,1,2-trichloroethane, at the concentration of 5 micromol/mol in nitrogen was developed. The reproducibility of this method and the homogeneity and long-term stability of the standard mixture were evaluated. The results showed that all 6 chlorinated hydrocarbons have shown stability as long as 12 months and the expanded relative uncertainty of 5%. The certified value of developed standard gas agreed with the similar standard gas from Scott Specialty Gases. This research established a foundation for the analysis of volatile chlorinated hydrocarbon gases.

The preparation method of new soil candidate certified reference materials (CRM) for the analysis of organochlorine pesticides in soils has been developed. The soil sample was dried, ground, homogenized and packed. After Soxhlet extraction and Florisil purification, the organochlorine pesticides in soil candidate were further determined using gas chromatography-mass spectrometry. The results showed that the soil collected from Shenyang was an ideal soil candidate material for organochlorine pesticide analysis. This method established a foundation for the development of soil reference materials for the analysis of organochlorine pesticides.

Objective: To evaluate the clinical effects of different catheter ablation strategies in the treatment of typical atrial flutter complicated with paroxysmal atrial fibrillation (PAF). [CTIA, pulmonary vein segmental isolation (PVSI), CTIA + PVI] to the patients coexisted with typical atrial flutter and PAF., Methods: 66 patients with typical atrial flutter complicated with PAF were divided into 3 groups: Group A (n = 30), undergoing cavotricuspid isthmus ablation, (CTIA), Group B (n = 17), undergoing pulmonary vein segmental isolation, (PVSI), and Group C (n = 19), undergoing CTIA + PVSI. Follow-up was conducted for 30.5 weeks +/- 10.4 weeks. The clinical curative effects, operation safety, and complication were evaluated., Results: The recurrence rate of typical atrial flutter within 12 weeks after operation of Groups A and C were 13.3% and 10.5% respectively, both significantly lower than that of Group B (52.9%, both P < 0.05) without no significant difference between Group A and Group C (P > 0.05). The recurrence rate of typical atrial flutter within 36 weeks after operation of the Groups A, B, and C were 10%, 11.8%, and 10.5% respectively, without significant differences among these 3 groups (all P > 0.05). The recurrence rates of PAF within 12 weeks and 30 weeks after operation of Groups B and C were 29.4% and 31.6%, and 23.5% and 26.3% respectively, all significantly lower than those of Group A (46.7% and 73.3% respectively, all P < 0.05) without significant o differences between Groups B and C., Conclusion: In patients with both typical atrial flutter and PAF, pure CTIA has a good effect on typical atrial flutter, whereas the PAF recurrence rate is higher; Pure PVSI has a good control of typical atrial flutter while curing PAF; PVSI + CTIA only reduces the early recurrence of typical atrial flutter, however, has no advantage in long-term follow up.

Objective: To study the feasibility of magnetron sputtering Cr-Ti-Al-N complex coating as an interlayer on titanium to enhance the titanium-ceramic binding strength., Methods: With a three-point bending test according to ISO 9693, the binding strength of Duceratin (Degussa) to titanium substrate prepared with 4 different surface treatments (polishing, polishing and megnetron sputtering Cr, Ti, Al, and N complex coating, sandblasting, sandblasting and coating) was evaluated. Ti/porcelain interface and fractured Ti surface were examined using scanning electron microscopy with energy-dispersive spectrometry (EDS)., Results: The binding strength of polished and coated titanium/Duceratin was significantly higher than polished titanium group (P<0.05). The binding strength of sandblasted and coated titanium/Duceratin did not differ significantly from that of sandblasted titanium group (P>0.05), and the strength in the two sandblasted titanium groups was significantly higher than that in polished and coated titanium group (P<0.05)., Conclusion: Megnetron sputtering Cr-Ti-Al-N complex on polished titanium can increase the titanium/porcelain binding strength. Megnetron sputtering coating is a promising Ti/porcelain interlayer.