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In order to explore the quality characteristics of ‘Akizuki’ pear fruit (Pyrus pyrifolia) from different regions, the quality indexes of pear fruit from six geographical origins were determined, and gas chromatography-ion mobility spectrometry (GC-IMS) was used to determine their volatile aromatic compounds. The results showed that the titratable acid content of pear fruit from Ningling, Henan province was significantly higher than that of pear fruit from the other regions. There were significant differences in the contents of soluble solids, total flavonoids, and total phenols among some regions (P < 0.05). Totally 76 volatile aroma components were identified in the pericarp and pulp of pear fruit from the six different regions, including 23 esters, 20 aldehydes, 11 alcohols, 4 ketones, 1 olefin, 3 acids, and 14 other compounds. There were 24 more volatile aroma components in the pericarp than in the pulp. The unique volatile aroma components including isobutyl acetate, methyl butyrate, and isovaleraldehyde were detected in pear fruit from Weixian, Hebei province when compared with the other regions. Similarity analysis from fingerprints showed clear distinction among pear fruit from different regions. This study has provided information about the quality and aroma characteristics of ‘Akizuki’ pear fruit from different regions, and demonstrated that GC-IMS has potential application prospects for geographical origin differentiation and traceability of ‘Akizuki’ pear fruit.

Objective To evaluate the effect of glandular involvement and persistent human papillomavirus（HPV） infection upon the recurrence of high-grade squamous intraepithelial lesion（HSIL） of the cervix， aiming to provide evidence for postoperative clinical management. Methods Clinical data of 596 HSIL patients who underwent cold-knife conization were collected， including 240 cases of glandular involvement（glandular involvement group） and 356 cases of non-glandular involvement（non-glandular involvement group）. The recurrence of HSIL at postoperative 2 years was considered as the end point. The differences between recurrent and non-recurrent patients were compared. According to glandular involvement and HPV-16 infection， patients were divided into the glandular involvement+HPV-16 infection， glandular involvement alone， HPV-16 infection alone and non-glandular involvement+non-HPV-16 infection groups， respectively. The differences in the recurrence rate of HSIL were compared among four groups. Results Among 596 HSIL patients， 75 cases recurred（12.6%）. HPV-16 infection rate in the glandular involvement group was 67.9%， significantly higher than 23.0% in the non-glandular involvement group， and the difference was statistically significant（P < 0.05）. In univariate analysis， the proportion of≥45 years old， glandular involvement and persistent HPV-16 infection were not significantly correlated with the recurrence of HSIL（all P > 0.05）. The recurrence rates of HSIL were 33.8%， 10.9%， 8.5% and 9.7% in the glandular involvement+HPV-16 infection， glandular involvement alone， HPV-16 infection alone and non-glandular involvement+non-HPV-16 infection groups， respectively. The recurrence rate of HSIL in patients with glandular involvement+HPV-16 infection was significantly higher than that in other three groups， and the difference was statistically significant（all P < 0.017）. Conclusions HSIL patients with glandular involvement and persistent HPV-16 infection are prone to relapse after cervical cold-knife conization. For these patients， active surgical regimen should be adopted and postoperative follow-up should be strengthened.

Objective To investigate the clinical features and treatment outcomes of chronic non-bacterial osteomyelitis (CNO) from five tertiary pediatric rheumatology services in China and provide possible treatment options for clinicians. Methods In this multicenter, retrospective study, pediatric patients diagnosed with CNO in Children's Hospital of Fudan University, Peking Union Medical College Hospital, Children's Hospital of Nanjing Medical University, Children's Hospital of Chongqing Medical University and the First Hospital of Jilin University from March 2014 to August 2022 were included. According to the treatment plan, the patients were divided into nonsteroidal anti-inflammatory drugs (NSAID) group, traditional disease modifying anti-rheumatic drugs (DMARD) group, tumor necrosis factor inhibitor (TNF-i) group, bisphosphonate group, and bisphosphonate+TNF-i group, and physician global assessment score was used to evaluate the efficacy. Results Retrospective data analysis showed that the disease was more common in boy sthan girls(31 vs. 27), and the average age at onset of symptoms was 8.5±3.4 years, the mean age of diagnosis was 9.8±3.2 years, and the Median follow-up was 10.9(5.0, 30.1) months. A total of 46 cases (79.3%) were diagnosed in the last 3 years. Bone pain and / or arthralgia was the predominant symptom in 54(93.1%) patients followed by fever in 31(53.4%) patients. Raised inflammatory markers (ESR and CRP) were present in 87.9% and 77.6% of the patients. The most frequently affected bones were lower limb bones, including 42 cases of femur and 41 cases of tibia; 3 patients had compression fractures of the vertebrae at the time of diagnosis. Bone biopsy was conducted in 33 cases, and subacute or chronic osteomyelitis manifested with inflammatory cells infiltration were detected. The remission rate was not statistically different between treatment groups (P=0.562), with the remission rate at 11 months in the bisphosphonate+TNF-i group being 60.0%, 55.6% and 33.3% in the NSAID and DMARD groups respectively; 66.7% and 52.4% in the NSAID and TNF-i groups respectively at 12 months. A total of 40 patients were followed up for ≥6 months, with the remission rate of 81.3%. Conclusions Our multicenter study describes the features and outcomes of CNO patients in China. The characteristics of CNO children from multiple centers in China were lack of specificity. Bone pain and/or arthralgia were the main clinical symptoms, accompanied by fever, normal white blood cells, and raised inflammatory markers (CRP and/or ESR). Although anti-inflammatory treatment regimens were different, the efficacy of the treatment groups was similar. Anti-inflammatory therapy is currently the first choice.

Objective To analyze the clinical phenotype and immunological characteristics of a patient with heterozygous mutation of PTEN and enrich the clinical phenotypes related to PTEN mutation. Methods A retrospective analysis of the clinical data of a patient with PTEN heterozygous mutation admitted to the Children's Hospital of Chongqing Medical University was conducted. Peripheral venous blood was extracted for medical whole-exome comprehensive detection, and the PTEN mutation was confirmed by Sanger sequencing. Flow cytometry was applied to detect the lymphocyte subsets and immunophenotype of the patient. The expression level of PTEN protein in peripheral blood mononuclear cells was detected by Western blot, and the healthy control was the patient's father. Results The patient was a boy of 1 year and 4 months, with macrocephaly (head circumference > P99), verrucous epidermal nevus, delayed psychomotor development and delayed language learning as the main manifestations. Gene sequencing revealed a de novo heterozygous mutation of PTEN c.388C > T(p.R130X). Reduced expression of PTEN protein was observed in peripheral blood mononuclear cells of the patient. For immunological characteristics, the IgA level mildly decreased(0.177 g/L), with increased counts of terminally differentiated memory CD4+ T cells, terminally differentiated memory CD8+ T cells, transitional B cells, but phosphorylation of PI3K/Akt/mTOR pathway in T cells was normal. The patient mainly manifested as PTEN hamartoma tumor syndrome related phenotype, without any classic activated phosphatidylinositol 3-kinase δ syndrome-like phenotype. Conclusions This patient has a de novo heterozygous mutation of PTEN c.388C > T(p.R130X), which has not been previously reported in China. This article could enrich clinicians' understanding of the disease and assist clinical diagnosis and treatment.

Objective To build a diagnostic model of gastric cancer based on deep learning and evaluate the performance of the model. Methods The pathological sections of patients diagnosed with normal gastric mucosa, chronic gastritis, high-grade intraepithelial neoplasia or gastric adenocarcinoma by endoscopic examination in Zhejiang Provincial People's Hospital from January 2015 to January 2020 were retrospectively selected. The pathology slides were scanned at ×20 magnification to generate whole slide images (WSIs). These WSIs were randomly divided into patch classification data set, slide classification training set and slide classification test set at a ratio of 2:2:1. After the lesion regions of the patch classification data set were annotated and the patches were selected, they were randomly divided into training set, test set and validation set at a ratio of 20:1:1. The deep learning model Efficientnet and ResNet were used to train and the convolutional neural network (CNN) model for cancer and non-cancer classification was constructed. Based on the patch classification test set and validation set, the performance of the model was evaluated. The results were evaluated by the patch classification accuracy and the area under the curve (AUC). This model was used for image stitching to generate the cancerous heat map of WSIs and extract the slide-level cancer and non-cancer classification features of the heat map. LightGBM slide-level classification algorithm were trained and evaluated, and the gastric cancer of WSIs were diagnosed and recognized. The results were evaluated by AUC, accuracy, sensitivity and specificity. Results A total of 500 pathological sections of benign gastric diseases (normal gastric mucosa, chronic gastritis) and 500 pathological sections of gastric cancer (high-grade intraepithelial neoplasia and gastric adenocarcinoma) that met the inclusion and exclusion criteria were selected. The patch classification data set, slide classification training set and slide classification test set were 400, 400 and 200, respectively. The patch classification training set, test set, validation set were 402 000, 20 000, 20 000, respectively. CNN model based on Efficientnet-b1 network structure for patch classification in test set and validation set achieved the highest accuracy[test set: 91.3% (95% CI: 88.2%-95.4%); validation set: 92.5%(95% CI: 89.0%-95.3%)]and the highest AUC[test set: 0.95(95% CI: 0.93-0.98); validation set: 0.96(95% CI: 0.92-0.98)]. The AUC of the model based on LightGBM algorithm was 0.98(95% CI: 0.89-0.98), with accuracy of 88.0%(95% CI: 81.6%-94.3%), sensitivity 100%(95% CI: 88.0%-100%), and specificity 67.0%(95% CI: 57.0%-85.0%). Conclusion The CNN diagnostic model based on the pathology slides of gastric biopsy can locate the cancerous tissues, classify patch-level and slide-level lesion natures accurately, identify gastric cancer accurately, which has the potential to improve the diagnosis efficiency.

【Objective】 Lodging refers to the process that the crop shoots are displaced from their vertical stance. It is impacted by many factors including whether, crop varieties, soil type. The objective of this work is to experimentally study the variation of lodging between different winter wheat lines in a sandy fluvo-aquic soil in Henan province. 【Method】 The experiment was conducted in a field in which we compared 13 winter wheat lines. For each line, we measured the material properties and lodging resistance of its stems during the middle grain-filling stages under different agronomic managements. The relationship between the lodging resistance index (CLRI) of the second internode and nine culm properties was calculated using correlation, cluster and principal component analysis. 【Result】 Plant height and location of the gravitational center of the aerial parts had little impact on the lodging of the wheat in the middle grain-filling stage. The mechanical strength of the second internode of all lines was negatively correlated to the CLRI though not at a significant level. Plant height and the ratio of length of the second internode to plant height were both negatively correlated with the mechanical strength and the CLRI, both at significant level. The culm diameter, stem thickness and the ratio of stem thickness to culm diameter were all positively correlated with the mechanical strength and CLRI at significant level. Cluster analysis of Group I showed that reducing plant height and optimizing the second internode improved lodging resistance of the wheat, while the Group II analysis revealed that optimizing the traits of the second internode were equally effective. The result of Group III was that reducing plant height and increasing mechanical strength of the stems can also improve the lodging resistance. There were three principal component factors cumulatively contributing 83.72% of the principal component analysis, and the principal component factors (PCF) reflected 48.11% of the variation in the stem. Stem thickness, ratio of stem thickness to culm diameter and the mechanical strength were the major factors controlling PCF1, while plant height, dry density and location of the gravitational center were key determinants of PCF2. Stem thickness and location of the gravitational center were the main factors of PCF3. 【Conclusion】 Lodging resistance index (CLRI) is a parameter determined by a multitude of factors, but it can be estimated using the ratio of length of the second internode to the plant height, as well as stem thickness, culm diameter, the ratio of stem thickness to culm diameter. Breeding new genotypes to improve above crop traits are needed to enhance their lodging resistance when the crops are grown in the sandy fluvo-aquic soil in Henan province.

Taking a low-speed two-stroke marine diesel engine bedplate as the research object.The main bearing seat（material ZG200-400） crack growth rate was tested,and the fatigue crack growth rate and the Paris formula of the stable expansion section were obtained.The three-dimensional crack propagation life analysis model of the main bearing seat was established by the sub-model method.The real boundary conditions of the main bearing seat was obtained by combining with the analysis results of the alternating stress of the bedplate under the actual operating conditions of the engine（360 degree crank angles）.The crack growth life of the main bearing seat with initial crack was calculated.The analysis results show that the crack growth life is less than that of the low-speed two-stroke marine diesel engine overhaul inspection interval.The research results of the thesis provide an reference for the damage tolerance in design engineering application.

Objective To analyze the morphology and incidence of middle mesial canal (MM) and isthmus in the mandibular first permanent molar by cone⁃beam computed tomography (CBCT). Methods Statistical analysis was per⁃ formed on images from patients who underwent CBCT examination in the Department of Radiology at Stomatological Hospital, Southern Medical University. Samples exhibiting root canal treatment, root resorption and calcification were ex⁃ cluded. Data regarding sex, age, the presence or absence of isthmus and MM, and the number of roots and root canals were recorded. Results Of the 217 mandibular first molar samples, 8 (3.7%) had an MM, and 2 (0.9%) had an inde⁃ pendent apical foramen. The overall incidence rate of isthmus was 57.1%; this rate was 50.7% in the cervical third of the root canal, 17.5% in the middle third, and 13.4% in the apical third. The incidence rate of isthmus was 61.8% on the left side, 52.3% on the right side, 58.7% in males, and 55.8% in females. No significant difference was found be⁃ tween the left and right sides or between females and males (P > 0.05). The incidence rate of isthmus in people under 60 was greater than 50% but was significantly lower in people older than 60. Conclusion Only a very small propor⁃ tion of MMs have an independent apical foramen in the mandibular first molar. The incidence of isthmus in the mesial root of the mandibular first permanent molar is high, and isthmus usually occurs in the cervical third of the root canal. During root canal treatment or apical surgery, attention should be given to the physical and chemical preparation of the isthmus.

The calculation of the meshing stiffness of the worm gear is the basis of the foundation of dynamics analysis. In view of the Uzbekistan Maidanak observatory 1 m telescope worm gear and worm drive renovation project,based on the theory of finite element analysis for ZC3 worm gear with loaded contact,a method for calculating the time-varying meshing stiffness of ZC3 worm gear is proposed. The finite element model is built by using Workbench and the meshing stiffness curve is obtained. The results show that the meshing curve of ZC3 worm has obvious periodicity. The minimum value of the meshing stiffness is 104. 4 MN·m,which appears at the position where the front pair of teeth exits meshing in the double tooth contact area of the teeth.And the maximum value of the meshing stiffness is 219. 7 MN·m,which appears in the middle of the single tooth contact zone. The basic conditions for the dynamics analysis of reconstruction project is provided by the research result.

By mechanical analysis to analyze the mechanism of wheel hub stud rotating and transtensional when taking strenuous test to forklift transmission,if pre-tightening force between rim and wheel hub is not enough because of the unqualified nut,Ground braking force is more than friction force when truck brakes,rim rotates to the brake drum and nut,wheel hub stud bears extra twisting force between rim and nut,causing wheel hub stud rotating and transtesional. Learning the mechanism of wheel hub stud rotating and transtensional is helpful to know further the wheel hub stud working force condition,and it can give theoretical basis to the failure analysis of wheel hub stud and nut

Interference of Al3+ on the determination of free acid by potentiometric titrator and its elimination Al3+ in solution is easy to hydrolyze, which seriously interferes with the determination of free acid. In this paper, NaF solution is used to mask Al3+, and the content of free acid in the solution containing Al3+ is determined by automatic potentiometric titrator. The feasibility of masking Al3+ by NaF solution is demonstrated through solution chemical analysis. The precision of NaF masking automatic potentiometric titration for the determination of free acid content in the solution containing Al3+ is less than 2.0%, the recovery of standard addition is 98.9%-102%, and compared with manual titration, the reliability test result is t=0.25. The results above show that the method has the advantages of high accuracy and good repeatability. [ABSTRACT FROM AUTHOR]

The polycarboxylate superplasticizer with low molecular weight was synthesized via catalytic chain transfer copolymerization of polyethylene glycol monomethyl methacrylate (MAPEG) and methacrylic acid (MA) in this paper. Gel permeation chro matograph (GPC) tests confirmed the molecular weight of the synthesized polycarboxylate superplasticizer was as low as 7710 and the conversion rate of MAPEG 92.8%. Then adsorption experiment found that the low molecular weight polycarboxylate superplasticizer could keep continuous adsorption onto the cement particles for a long time. Finally the mortar and concrete tests indicated the low molecular weight polycarboxylate superplasticizer had a viscosity-reducing capacity in cement based materials. Meanwhile it had a long fludity retention capactiy, could keep the low-middle slumps concrete stable for at least 2h. [ABSTRACT FROM AUTHOR]

In order to optimize the parameter settings of the time-gated digital optical frequency domain reflectometer ( TGD-OFDR) system, an experimental system was built based on the optical pulse compression reflectometry. Theoretical analysis and experimental verification were carried out, and simulation and experimental data were obtained. Both of the results show that the system signal-to-noise ratio (SNR) is only related to the chirp rate. When the pulse power of the probe light and the signal power of the local oscillator light have been set, the chirp rate increases with the SNR decreasing. And the phase noise decreases firstly and then increases with the increase of the pulse width with the minimum value of about 2. 5μs when the sweep range keeps 80MHz. Hence, the optimal phase noise (minimum value) can be obtained by adjusting the pulse width with the maximum sweep frequency range of the system remains unchanged. The results have certain reference significance to the parameter optimization of the TGD-OFDR system design. [ABSTRACT FROM AUTHOR]

Objective To compare and analyze the performances of radio visio graphy (RVG), cone-beam computed tomography (CBCT), and transparent teeth in diagnosing the first molar root canal system in vitro; to provide an anatomical image of the first molar root canal therapy and analyze the relationship between the first molar root canal image and root canal anatomy. Methods A total of 269 extracted first molars were examined by RVG and CBCT in the mesiodistal and buccolin-gual sections. Transparent teeth were then constructed using dying root canals. The root canal system and the communicating branches between the pipes of the coronal 2/3 and apical 1/3 areas of each root canal were displayed using RVG, CBCT, and transparent teeth. The performance of CBCT in the diagnosis was evaluated. Results The display rate of the first molar root (coronal 2/3) was 96.55% in CBCT. A significant difference was found between CBCT and the transparent teeth in the apical 1/3 area of the first molars (P<0.05). The shapes of the mesial roots of the mandibular and maxillary first molars exhibited significant variance. The incidence rates of double and multiroot canals and pipe transport were high. Conclusion CBCT and transparent teeth exhibit nearly equal performance in displaying the coronal 2/3 area of the root canal system. However, the performance of transparent teeth in displaying the apical 1/3 area is higher than that of CBCT. Meanwhile, the RVG-provided display of the multiroot canal and bifurcate root canals is limited. The incidence rates of double or multiroot canals and pipe transport in the mesial roots of the mandibular and maxillary first molars are high. CBCT has numerous advantages in displaying the root canal; it is also the most reliable method for diagnosing root diseases without trauma. [ABSTRACT FROM AUTHOR]

Dazomet is a kind of crystal solid that is stable at room temperature and acts as a fumigant. It is commonly used to control soil fungi, as an insecticide, and in sterilization and weeding. It can effectively kill root-knot nematodes, soil pests, weeds, and many soil-borne disease-causing organisms, to provide clean and healthy soil. Dazomet slowly decomposes and releases methyl isothiocyanate, methylamine, carbon disulfide, and hydrogen sulfide in acidic soil, and diffuses upward through the spaces in the soil to kill contact organisms. When agricultural crops are planted in soil treated with cotton wool, the residues in the grown crop can cause harm to human body when consumed. To ensure the quality and safety of food crops, it is important to develop a detection method for dazomet and its metabolites in plant-derived foods. Hence, in this study, a rapid and simultaneous determination method was developed for dazomet and its metabolite methyl isothiocyanate residues in plant-derived foods by gas chromatography-triple quadrupole mass spectrometry (GC-MS/MS). The sample pretreatment and chromatographic conditions were optimized in the experiment. Subsequently, dazomet and its metabolite methyl isothiocyanate residues in vegetables, fruits, grains, nuts, tea, and spices were extracted with ethyl acetate, and purified using graphitized carbon, a primary-secondary amine, stearyl-bonded silica gel, and anhydrous magnesium sulfate as dispersive solid-phase extraction sorbents. After centrifugation and filtration, the target compounds were analyzed in the multiple reaction monitoring (MRM) mode by GC-MS/MS, and quantified by matrix matching external standard method. The matrix effects of the samples were also evaluated. The matrix effect was found to be in the range of 2.5% to 13.6% for methyl isothiocyanate in 16 matrices. As this matrix effect was weak, there was no need for compensatory measures. In contrast, the matrix effect of dazomet in 16 matrices was in the range of 240.3% to 331.2%. This matrix effect was strong and required compensation. Finally, a matrix matching calibration method was used to compensate the matrix effects. The relative matrix effects of other tested substrates were analyzed using lettuce as the representative substrate; it was found that all showed weak matrix effects. Therefore, the use of lettuce as a representative matrix to prepare a matrix standard curve can effectively correct the matrix effects of dazomet and methyl isothiocyanate in other substrates. Under the optimal conditions, the calibration curves were linear in the range of 0.005-1 mg/L with correlation coefficients higher than 0.99. Recovery tests were conducted by adding mixed standards to blank samples at four levels. The recoveries were in the range of 74.2%-117.2% with relative standard deviations (RSDs, n =6) of 2.8%-9.0%. The limits of quantification (LOQs) of dazomet and methyl isothiocyanate were 0.01 mg/kg. The accuracy and precision of this method met the requirements of pesticide residue determination. The established method was used to detect dazomet and its metabolite methyl isothiocyanate residues in six samples of Chinese cabbage, Chinese chives, cowpea, lettuce, eggplant, ginger, celery, potato, orange, kiwifruit, tomato, chili, rice, tea, almond, and Cuminum cyminum L. in the laboratory, and nothing was detected. The method is simple, rapid, and sensitive; overcomes the shortcomings of existing methods that require two pretreatment steps and two sets of equipment; and meets the requirements for the detection of dazomet and its metabolite methyl isothiocyanate residues in plant-derived foods.

The authors made a profound review on the development and the recent status of craniomaxillofacial surgery in China during past three decades. The emphases were placed on the following aspects: the modifications of the reconstructive procedure and minimal invasive mode, the researches on molecular genetic characteristics of the congenital craniofacial malformations, the clinical applications of three-dimensional digital computer-aided techniques (including three-dimensional printing and prefabricated template for precious osteotomies), the craniomaxillofacial defects reconstructing by using the distraction osteogenesis and osseous integrated titanium implant and prothesis, etc . Finally, the authors outlooked prospectively the future trends of the craniomaxillofacial surgery.

Objective: To explore the efficacy and safety of laparoscopic tunnel-like peri-anterior superior iliac spine suspension(L-TASISS) or combined with stapled transanal rectal resection (STARR) in the treatment of pelvic organ prolapse (POP) with outlet obstructive constipation (OOC)., Methods: A total of 119 POP patients complicated with OOC( II( to IIII( stage evaluated by POP-Q) received L-TASISS or combined with STARR in the First Affiliated Hospital of Zhengzhou University from August 2010 to January 2015. Clinical and follow-up data of these patients were analyzed retrospectively and compared before and after operation., Results: Among 119 cases, 51 cases(42.9%) underwent L-TASISS alone, and 68 cases (57.1%) received L-TASISS combined with STARR. All the 119 patients were successfully operated without conversion to open surgery. The operation time was (67.8±10.9) minutes, the intra-operative blood loss was (10.3±3.8) ml, the indwelling catheter time was (3.6±1.1) days, and hospital stay was (5.1±1.8) days. One month after operation, abdominal wall pain or stress occurred in 15 cases, of whom 3 cases were improved by local block injection, 1 case by incision stitches release, the rest ameliorated spontaneously within 3 months after surgery. No potential ureterostenosis, hydroureterosis, internal iliac vascular thrombosis resulting from compression of the mesh and other complications related to the mesh were found. One year after operation, all the patients were followed up. The OOC remission rate was 78.2%(93/119), of whom 76 cases were satisfied and 17 patients were completely satisfied. One case(0.8%) with stress urinary incontinence did not improve. Fifteen cases(12.6%) with algopareunia or dyspareunia did not achieve remission, but there was no new algopareunia or dyspareunia case. Eleven patients (9.2%) presented recurrence of symptoms, of whom 9 cases(7.6%) complained of sensation of incomplete evacuation. Two cases(1.7%) were graded as POP-Q II(, and 1 case (0.8%) as POP-Q III( after surgery. Constipation Score of all the patients was 1.4±0.9 (compared to 7.8±3.6 preoperatively) according to Rome III( criteria. Enterocele occurred in 53 cases (44.5%) preoperatively corresponded with only 1 case (0.8%) after operation (χ(2)=64.77, P=0.000). One hundred and six cases (86.6%) with defecation difficulties and 87 cases (73.1%) with sensation of incomplete evacuation before operation were significantly improved after surgery, corresponding with 7(5.9%) and 9 (7.6%) symptomatic cases respectively (χ(2)=155.78, P=0.000). Three cases (2.5%) with preoperative fecal incontinence symptoms were improved after operation as well., Conclusion: The procedure of L-TASISS or combined with STARR for POP patients with OCC has good short-term efficacy, and is safe and feasible.

Objective: To compare the changes of enamel surface and cross-sectional microhardness of artificial caries immediately and after the twice demineralization through coating resin infiltration, fluoride varnish and fissure sealant., Methods: A total of forty bovine lower incisors enamel samples with artificial caries lesions by the demineralization liquid were used in the experiment. The specimens were then randomly divided into four groups as group A(resin infiltration), B(fluoride varnish), C (fissure sealant), D(control), 10 specimens in each group. The samples were sectioned vertically into two halves through the centre. One half of each sample the surface and cross-sectional microhardness was measured. The other half was put into demineralization liquid for 14 days, then the surface and cross-sectional microhardness was measured again. The cross section morphology of the samples was observed by scanning electron microscope., Results: The surface of enamel had the highest microhardness value, and with the increase of cross- sectional depth, the microhardness value declined gradually. Variance analysis showed that the difference was statistically significant in the cross-section of different depth among the four groups(P<0.05). The microhardness values of the surface and the cross- section at 40 µm of each group in immediate measure showed the values were significantly higher in group A, B and C than in group D. There was no significant difference in the microhardness value of cross-section at 80 µm between group A[(324 ± 17) kg/mm(2)] and group C[(316 ± 20) kg/mm(2)], but they were significantly higher than group D. There was no significant difference between group B[(303 ± 13) kg/mm(2)] and group D[(294 ± 23) kg/mm(2)]. At 120 µm level, the microhardness value of group A was significantly higher than those of the other three groups. After the twice demineralization, the enamel surface microhardness value of the specimens was the same as the first measurement. In the cross-section at 40 µm level, the microhardness value was equal to the value of cross-section at 80 µm level of the first measurement. In the cross- section at 80 µm and 120 µm level, the microhardness value of group A was significantly higher than those of the other three groups., Conclusions: Resin infiltration can effectively strengthen microhardness of enamel surface and cross-section of different depth of artificial caries.

Objective: To observe the feasibility and safety of carotid angioplasty stenting (CAS) for high-grade extracranial carotid artery stenosis combined with severe tortuosity., Methods: Twenty patients diagnosed with high-grade extracranial carotid artery stenosis combined with severe tortuosity by cerebral angiography, who were in hospital in neurology department of China-Janpan friendship from June 2011 to June 2014. Twelve of these patients were symptomatic. All cases weren't suit for or disagreed with carotid endarterectomy (CEA) to accept CAS. We retrospectively discussed the rates of technical success, the perioperative complications and clinical improvement. During the follow-up for 4 to 40 months we observed the events of cured carotid artery territory stroke and death, and record the plaque hyperplasia in stent, in-stent restenosis, stent deformation or fracture by color doppler ultrasonography or craniocervical CT angiography., Results: (1) The results of operation: the rate of technical success was 19/20 and the rate of the distal protection device placement was 18/20. One stent and 2 distal protection device were difficult to pass the tortuous access vessels. The kinking was the most common in circuity classification of internal carotid artery. The stenosis was significantly improved after stenting, and the mean degree of stenosis was reduced from (82% ± 9%) before stenting to (7% ± 6%) after stenting. Although 5 patients were with perioperative complications, all symptoms disappeared within 1 weeks, and there was no stent related death and disability. There were 4 cases with vascular spasm, one of them was combined with carotid sinus reaction, and anther with transient ischemic attack (TIA) during operation. There was one with ipsilateral carotid territory minor stroke. (2) The results of prognosis and follow up: The clinical symptoms from 12 symptomatic patients were improved significantly on discharge, and the average NIHSS scores on admission were reduced from (4 ± 4) to (2 ± 2) on discharge. One patient experienced ipsilateral carotid territory minor stroke and another patient experienced ipsilateral carotid territory TIA during the follow-up for an average of 19 months, and there were 5 cases with mild plaque hyperplasia in stent and no in-stent restenosis, stent deformation or fracture., Conclusion: The severe tortuosity of extracranial carotid artery may affect the using of intervention materials and increase the complexity of CAS, but for the patients who disagree with CEA or were with the contraindications to CEA, CAS may be still a relatively safe, effective and alternative treatment.

Objective: To investigate the efficacy and safety of Ji-Tai tablet and Ji-Tai tablet combined with buprenorphine in the treatment of patients with acute withdrawal syndrome of mild heroin dependence., Methods: A total of 150 patients with mild heroin dependence were recruited, and were randomly assigned to a Ji-Tai tablet group (n=50), a Ji-Tai tablet combined with buprenorphine group (n=50) and a control group (n=50) during a 10-day clinical trial. Opiate withdrawal scale (OWS) was used to measure the severity of withdrawal symptoms. Anxiety symptoms assessments were made at 0 day (baseline), the day 5 (middle), and the day 10 (end) by the Hamilton anxiety scale (HAMA). Symptoms were assessed before and 1 h or 2 h after medication each day. The total withdrawal symptoms scores and the daily reduction rate were used to measure the effect of Ji-Tai tablet vs Ji- Tai tablet plus buprenorphine. Safety evaluation was carried out by the following measures: baseline of treatment, drug side effects after the treatment, vital signs (blood pressure, heart rate, and respiration rate), laboratory examination (routine blood and urine tests and the liver and kidney function tests), and electrocardiograms., Results: A total of 142 mild heroin dependence patients performed the experiments (including 48 in the Ji-Tai tablet group, 48 in the Ji-Tai tablet with buprenorphine group and 46 in the control group). The scores of baseline withdrawal symptoms were 43.520±19.786, 42.640±17.648 and 47.100±24.450, respectively, with no significant differences among the 3 groups (all P>0.05 ). During the 10-day treatment, the reduction rate of acute withdrawal symptoms scores increased daily, the acute withdrawal syndrome scores and the anxiety symptoms scores declined from day 0 to day 10, there was also no significant difference among the 3 groups (all P>0.05). Ji-Tai tablet did not affect vital signs such as blood pressure, heart rate, and respiration rate., Conclusion: Ji-Tai tablet or Ji-Tai tablet combined with buprenorphine had no effect on acute withdrawal symptoms of mild heroin dependence.

Objective: To explore the relationship between basal artery hypoplasia (BAH) and posterior circulation ischemic stroke and its clinical characteristics to improve the understanding of BAH., Methods: A total of 328 hospitalized patients from April 2012 to April 2014 were enrolled retrospectively. With normal course and regular shape of basilar artery on brain magnetic resonance angiography (MRA), other causes of posterior circulation ischemic stroke were excluded. They were divided into BAH (n = 48) and non-BAH (n = 280) groups according to the morphology and diameter of basilar artery on head MRA. We compared the general information and intracranial vascular variations between two groups, especially the incidence rate of posterior circulation infarction and mean blood flow velocity (Vm) of basal artery by analyzing clinical information and MRI findings. Meantime, their clinical outcomes were observed through follow-ups. And detailed clinical features were discussed for the patients with posterior circulation infarction in the BAH group., Results: (1) The concurrent lesions included vertebral artery intracranial segment hypoplasia (n = 24, VAH), fetal type posterior artery (n = 18, FTPA), persistent trigeminal artery (n = 1) and giant fenestration variation on vertebral artery (n = 1) in the BAH group. In comparison, it was more liable to cranial vascular variations in the BAH group (P < 0.05). (2) The incidence rates of posterior circulation infarction for two groups were 35.4% (17/48) and 8.6% (24/280) respectively. In comparison, these cases in the BAH group were more likely to suffer from posterior circulation ischemic stroke (P < 0.05) and the Vm of basal artery in the BAH group was obviously lower than that in the non-BAH group (P < 0.05). (3) these cases with stroke in two groups had no mortality during a follow-up period of 4-28 months. There were 3 cases with recurrent posterior circulation stroke in the non-BAH group. The number of cases with mRS scoring 2 points or less in the BAH group was more than that in the non-BAH group at discharge, 30 or 90 days after discharge (P < 0.05). (4) these cases with posterior circulation stroke in the BAH group often presented as lacunar syndrome (9/17), paramedian infarction in pons (9/17) and bilateral VAH plus unilateral FTPA (8/17)., Conclusion: As a relatively rare disease, BAH often has other intracranial vascular variants. Posterior circulation stroke occurs due to reduced blood supply of vertebrobasilar system, especially pons infarction. Though with relatively good clinical outcomes, we still need to make an early diagnosis and strengthen stroke prevention.

Objective: To investigate the feasibility and efficacy of laparoscopic subtotal colectomy and modified Duhamel procedure combined with transanal endoscopic microsurgery (TEM) in the treatment of severe functional constipation(SFC)., Methods: The clinical data of 10 patients with SFC treated by laparoscopic surgery combined with TEM between May 2010 and October 2012 in Ruijin Hospital of Shanghai Jiaotong University School of Medicine were retrospectively analyzed. The gastrointestinal quality of life index(GIQLI), Wexner constipation scale and daily frequency of defecation postoperatively during follow-up were collected., Results: All the 10 operations were successfully accomplished laparoscopic subtotal colectomy combined with TEM without abdominal incision. There was no conversion to open procedure. One case had preventive terminal ileum stoma. The mean operative time was (256 ± 58) min. The mean blood loss was (178 ± 67) ml. The mean time to first flatus was (40 ± 11) h. There were no ureteric injury, anastomotic leak, pelvic sepsis and other complications postoperatively. There was one case of insufficient small bowel obstruction which was released by conservative treatments. The patients were discharged from the hospital in (9.0 ± 1.5) d postoperatively. The GIQLI in one year postoperatively was (112 ± 10) points, which indicated good results compared to (75 ± 12) points preoperatively (P=0.000). The Wexner constipation scale was 20.8 ± 2.2 preoperatively and decreased to 5.2 ± 1.8 at one year follow-up(P=0.000)., Conclusion: Laparoscopic subtotal colectomy and modified Duhamel procedure combined with TEM provides SFC patients a safe and feasible minimally invasive surgery.

Objective: To explore the etiologies and imaging features of longitudinally extensive spinal cord lesion (LESCL)., Methods: The etiologies and magnetic resonance (MR) imaging features of 51 hospitalized LESCL patients from January 2011 to August 2013 were reviewed and retrospectively analyzed., Results: Among them, the causes were neuromyelitis optica spectrum disorder (NMOSD, n = 25), isolated longitudinally extensive transverse myelitis (n = 6), subacute combined degeneration (n = 4), multiple sclerosis (MS, n = 3), paraneoplastic myelopathy (n = 3), anterior spinal artery syndrome (n = 3), acute disseminated encephalomyelitis (n = 2), spinal dural arteriovenous fistula (n = 2), intramedullary spinal cord metastasis (n = 1), myelopathic leukemia (n = 1) and syringomyelus (n = 1). For MR imaging, at least one lesion of each patient presented continuously longitudinal profile and whole-length spinal cord was involved in 11 patients., Conclusion: LESCL may be caused by various diseases. And the imaging features may aid its diagnosis despite a lack of specificity.

Objective: To analyze the effect of mandibular distraction on the maxilla growth in children with hemifacial microsomia through measurement with the posterior-anterior cephalometric X-ray films and Three-dimensional CT reconstruction images., Methods: The deviation angular of maxilla occlusion plane and nasal base plane from the infra-orbital plane were measured on the posterior-anterior cephalometric X-ray films in 22 patients before and half a year after operation. The vertical distance from the midpoint of 5th teeth alveolar and the lowest point of maxillary sinus to reference plane were measured on 3D reconstruction images in 15 patients. The data were statistically analyzed., Results: On posterior-anterior cephalometric X-ray films, the cant of occlusion plane were significantly reduced (P < 0.05), While the angular of nasal base plane and the infra-orbital plane had no significant change. On 3D reconstruction images, all the detection points had significantly declined except the lowest point of maxillary sinus on normal side., Conclusions: Distraction osteogenesis of mandible can promote the growth of the maxilla in children with HFM, the accelerated growth parts include alveolar bone and maxillary sinus.

Objective: To compare and analyze the performances of radio visio graphy (RVG), cone-beam computed tomography (CBCT), and transparent teeth in diagnosing the first molar root canal system in vitro; to provide an anatomical image of the first molar root canal therapy and analyze the relationship between the first molar root canal image and root canal anatomy., Methods: A total of 269 extracted first molars were examined by RVG and CBCT in the mesiodistal and buccolingual sections. Transparent teeth were then constructed using dying root canals. The root canal system and the communicating branches between the pipes of the coronal 2/3 and apical 1/3 areas of each root canal were displayed using RVG, CBCT, and transparent teeth. The performance of CBCT in the diagnosis was evaluated., Results: The display rate of the first molar root (coronal 2/3) was 96.55% in CBCT. A significant difference was found between CBCT and the transparent teeth in the apical 1/3 area of the first molars (P < 0.05). The shapes of the mesial roots of the mandibular and maxillary first molars exhibited significant variance. The incidence rates of double and multiroot canals and pipe transport were high., Conclusion: CBCT and transparent teeth exhibit nearly equal performance in displaying the coronal 2/3 area of the root canal system. However, the performance of transparent teeth in displaying the apical 1/3 area is higher than that of CBCT. Meanwhile, the RVG-provided display of the multiroot canal and bifurcate root canals is limited. The incidence rates of double or multiroot canals and pipe transport in the mesial roots of the mandibular and maxillary first molars are high. CBCT has numerous advantages in displaying the root canal; it is also the most reliable method for diagnosing root diseases without trauma.

A method was developed for the determination of the residues of meptyldinocap (2,4-dinitro-6-(1-methylheptyl) phenyl crotonate, 2,4-DNOPC) as 2, 4-dinitrooctylphenol (2,4-dinitro-6-(1-methylheptyl) phenol, 2,4-DNOP), which is a hydrolysate of 2,4-DNOPC, in six vegetable and fruit by using liquid chromatography coupled with electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS). The residues of 2,4-DNOPC in vegetable and fruit samples were extracted by the mixture of acetone, methanol and hydrochloric acid, then extracted by liquid-liquid partitioning, hydrolyzed under alkaline condition with ultrasonication, and extracted again by liquid-liquid partitioning, then analyzed by using LC-MS/MS in multiple reaction monitoring (MRM) mode via negative electrospray ionization with an Agilent ZORBAX SB-C, column. The method was validated at four fortification levels in vegetable and fruit. The validation results were as follows: the recoveries of 2,4-DNOPC in cabbages were from 89.7% to 93.3% (the relative standard deviations (RSD) of 6. 3% - 8.5%), in cucumbers from 87.7% to 95.1% (RSD of 5.8% -10.4%), in tomatoes from 89.3% to 96.0% (RSD of 6.8% -9.2%), in apples from 92.0% to 98.3% (RSD of 5.1% - 10.3%), in pears from 89.0% to 95.0% (RSD of 5.3% -10.2%), in grapes from 81.2% to 95.8% (RSD of 5.8% - 10.4%). The limits of quantification of 2,4-DNOPC in all the test samples were 0. 01 mg/kg. The results showed that the method is simple, rapid, and is characterized with acceptable sensitivity and accuracy to meet the requirements of the pesticide residue analysis. This method is applicable to confirm the residues of meptyldinocap in vegetable and fruit samples.

A method was developed for the determination of thiophanate-methyl and carbendazim residues in cucumber and soil by using QuEChERS-high performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS). The residues in the samples were extracted by acetonitrile, cleaned up by developed QuEChERS method, and then analyzed by using LC-MS/MS in multiple reaction monitoring (MRM) mode via positive electrospray ionization with an Agilent ZORBAX SB-C, column (30 mm x 2.1 mm, 5 microm) as the analytical column. The recoveries of thiophanate-methyl spiked at four levels of 0.01, 0.05, 0.1 and 1.0 mg/kg were from 87.3% to 96.0% with the relative standard deviations (RSDs) of 8.0%-9.3% in cucumber, from 88.8% to 93.4% with the RSDs of 5.3%-9.9% in soil; the recoveries of carbendazim spiked at the same levels as those of thiophanate-methyl were from 87.1% to 92.3% with the RSDs of 5.2%-7.5% in cucumber, from 85.8% to 90.9% with the RSDs of 5.3%-13.2% in soil. The method is simple, rapid and characterized with acceptable sensitivity and accuracy to meet the requirements of the pesticide residue analysis. This method is applicable to confirm the residues of thiophanate-methyl and carbendazim

Gestational choriocarcinoma is the most common gestational trophoblastic neoplasia. It is prone to hematogenous metastasis, most commonly to the lungs. With the advent and development of chemotherapy, choriocarcinoma has become a curable tumor. However, patients with drug-resistant and recurrent choriocarcinoma are difficult to treat, even with the management of pulmonary metastasis. Resorting to surgery is also a tough decision given the challenges of identifying the appropriate surgical indication and timing. This review discusses the basic principles of management as well as recent advances in the diagnosis and treatment of patients with pulmonary metastasis of gestational choriocarcinoma.

Objective: To investigate the surgical technique of the pericanal electrode insertion technique for ies cochlear implantation., Method: Forty cases of sensorineural deafness were subjected to the ies cochlear implants. Cochleostomy was performed through the external auditory canal with a microdrill anterior to the round window. The electrode impedance and electrically auditory brainstem responses(EABR) were tested during the operation. The X-ray photographs were taken after the operation. The cochlear implant was activated in all 40 cases 4 weeks following surgery., Result: All of the electrodes were inserted and all of the implants worked well. No electrode extrusions or serious surgical complications happened during postoperative observation for 6 months., Conclusion: The pericanal electrode insertion technique is a safe approach for ies cochlear implantation.

Background and Objective: The aim of this study is to explore the reproducibility of volume-based quantitative measurement of non-small cell lung cancer (NSCLC) perfusion at 64-slice CT., Methods: Fourteen patients with proved advanced NSCLC were enrolled in this dynamic first pass volume-based CT perfusion (CTP) study (8x5 mm collimation), and they underwent the second scan within 24 h. According to the longest diameters, those patients were classified to <3 cm and >3 cm groups, and each group had 7 patients. Intradclass correlation coefficient (ICC) and Bland-Altman statistics were used to evaluate the reproducibility of CTP imaging., Results: In both groups of advanced NSCLC, the reproducibility with BF, BV, and PS values were good (ICC > 0.75 for all), but mean transit time (MTT) values. For advanced NSCLC (<3 cm), repeatability coefficient (RC) values with blood flow (BF), blood volume (BV), MT and permeability surface area product (PS) values were 56%, 45%, 114%, and 78%, respectively, and the 95% change intervals of RC were -39%-53%, -29%-62%, -83%-145%, and -57%-98%, respectively. For advanced NSCLC (>3 cm), those values were 46%, 30%, 59%, and 33%, respectively, and the 95% change intervals of RC were -48%-45%, -33%-26%, -54%-64%, and -18%-48%., Conclusion: There is greater reproducibility of tumor size >3 cm than that of < or =3 cm. BF and BV could be addressed for reliable clinical application in antiangiogenesis therapeutic monitoring with advanced NSCLC patients.

Objective: To detect differentially expressed proteins in hepatocellular carcinoma cell line SMMC-7721 treated separately by eight telomerase inhibitors including antisense oligodeoxynuclectide of human telomerase RNA (hTR-ASODN), sense oligodeoxynuclectide of hTR (hTR-SODN), ASODN of human telomerase reverse transcriptase (hTERT-ASODN), SODN of hTERT (hTERT-SODN), epigallocatechin gallate (EGCG), 3'-azido-3'-deoxythymidine (AZT), all trans-retinoic acid (ATRA) and adriamycin (ADM) using surface enhanced laser desorption/ionization time of flight-mass spectrom (SELDI-TOF-MS) technology., Methods: SELDI-TOF-MS technology and weak cation exchanger (WCX-2) protein chip were used to detect differentially expressed secretory and cytoplasmic proteins of SMMC-7721 cell treated separately by eight telomerase inhibitors. The control group was hepatocellular carcinoma SMMC-7721 cell without any disposal., Results: The results of WCX-2 protein chip showed that the secretory and cytoplasmic proteins were differentially expressed in SMMC-7721 cell treated separately by eight telomerase inhibitors. But some proteins were down-regulated or up-regulated together in all experimental groups. The molecular weight of these differential proteins were all less than 10,000 Da., Conclusion: Differentially expressed and common changes of proteins in SMMC-7721 cell treated separately by eight telomerase inhibitors would associate with telomerase activity.

Along with the deep-going researches on mechanism of apoptosis, the apoptosis inducers as anticancer drugs have been the hot points of researches for new drugs. In this paper are reviewed a number of related articles on the progress in cell apoptosis inducers including the derivative anthraquinone, saponin, flavonids and terpines. The mechanisms are analyzed and discussed. The researches into the molecular mechanisms of inducer can provide the theoretical basis for discovering new compound, and can find out the apoptosis inducers with high efficiency and low toxicity. There is hope of developing apoptosis inducers into safe and effectual anticancer drugs.

Objective: To study the influence of the pedicle length on the perforator flaps in hemodynamics., Methods: Four mature swine (2 males, 2 females; weight, 23.0 +/- 2.0 kg) were applied to the experiment. Two transverse abdominal skin flaps, based on the superior epigastric pedicle or its rectus abdominal muscle perforators, were designed; each swine was used as its own control. At 2 hours and 1, 2, 3 weeks postoperatively, the skin paddle perfusion and the blood stream velocity in the superior epigastric artery were measured by the Laser Doppler Flowmeter and the Color Doppler Ultrasound, respectively. Flap survival percentages were calculated by the grid method at 1 week postoperatively. The swine were euthanatized, and they underwent angiography at 3 weeks postoperatively., Results: At 2 hours and 1 week after operation, edema of the perforator flaps with the superior epigastric pedicle was more severe than that of the skin flaps with the rectus abdominal muscle perforator, and the skin perfusion had a statistical difference between the two kinds of flaps (P<0.05). The skin paddle viability and the skin perfusion had no statistical difference after the first week postoperatively (P>0.05). At 2 hours and 1 week after operation, the blood stream velocity in the superior epigastric artery in the perforator flap with the superior abdominal artery pedicle was reduced, and there was a statistical difference between the two kinds of flaps (P<0.05); however, the velocity was almost the same after the first week postoperatively., Conclusion: The excessively long pedicle of the perforator skin flap may have an unfavorable influence on the flap perfusion, especially during the first week after operation, because of the vascular compromise during the dissection of the long pedicle. The blood vessel anastomosis at this level of the blood vessels may have no relationship with the perforator flap in hemodynamics. This study can also indicate that the ligation of the branches in the recipient vessels cannot make the perforator flaps overperfused.

Objective: To study the operative effect and complication of the prosthesis replacement of the proximal humerus with malignant tumor., Methods: From October 1998 to August 2003, the prosthesis replacement was performed to treat the proximal femur with malignant tumor in 4 patients, including 2 patients with osteosarcoma (Enneking staging, I A) and 2 patients with giant cell tumor of the bone (II A, II B). By the International Society of Limb Salvage (ISOLS) criterion, the 2 cases of osteosarcoma were preoperatively scored as 4 and 5 points, and 2 cases of giant cell tumor of the bone were scored as 9 and 11 points. The patients' psychological conditions as well as their limb pain, shape, locality, activity, and function were also observed., Results: The follow-up for 24-58 months (mean, 44 months) showed that there was no local recurrence or infection in all the patients except one patient who had the loosening of the screws for the fixation 17 months after operation and had no treatment. After operation, all the patients had a better postoperative extention angle from 22 degrees to 41 degrees (mean, 25 degrees), bending angle from 29 degrees to 80 degrees (mean, 35 degrees), abduction angle from 5 degrees to 28 degrees, and circumgyrate angle from 15 degrees to 22 degrees in their shoulder joints. However, the shoulder joint function was still unstable to some extent and the joints had a decreased strength. By the criterion formulated by the ISOLS, the postoperative score for assessing the 2 patients with osteosarcoma was increased by 16 points when compared with the preoperative score; the score for the 2 patients with giant cell tumor of the bone was increased by 9.5 points., Conclusion: The prosthesis replacement to treat the malignant tumor of the proximal humerus is the good method of choice and has a good therapeutic result; however, there are more complications and so the method should be cautiously employed in the clinical practice.

Objective: To explore the indication, advantage and disadvantage of modified or classical technique of intraoral sagittal split ramus osteotomy (SSRO) for correction of mandibular prognathism., Methods: From January 1997 to January 2005, 95 patients suffering from mandibular prognathism or accompanied by other deformities were treated with modified or classical technique of intraoral SSRO. Of 95 cases, there were 34 males and 61 females, aging 15 to 44 years, including 53 cases of single mandibular prognathism, 28 cases accompanied with mandibular deviation, 11 cases accompanied with maxillary retrognathism, 2 cases accompanied with glossacele and 1 case accompanied with malar protrusion. X-ray cephalometry showed: sella-nasion-A point (SNA) 80-83 degrees, sella-nasion-B point (SNB) 80-84 degrees, A point-nasion-B point (ANB)--3-1 degrees. Forty-three cases were corrected by modified SSRO and 52 cases by classical SSRO., Results: The face appearance and dental articulation of all the patients were improved greatly. In patients by classical SSRO, disorder of local sensibility occurred in 9 cases, mandibular fracture during the cleavage of the ascending ramus in 1 case, significant bleeding in 1 case, postoperative infection in 1 case and postoperative relapse in 3 cases. In patients by modified SSRO, disorder of local sensibility occurred in 2 cases and postoperative relapse in 1 case; no mandibular fracture, significant bleeding, postoperative infection and other complications occurred. With a follow-up of 3 months to 7 years, X-ray cephalometry showed SNA 81-83 degrees, SNB 78-81 degrees and ANB 1-4 degrees., Conclusion: Modified SSRO is an ideal method of correcting mandibular prognathism, especially severer mandibular prognathism accompanied by mandible deviation deformity.

Objective: To investigate the methods of establishing 3-dimensional skull model using electron beam CT (EBCT) data rapid prototyping technique, and to discuss its application in repairing cranio-maxillo-facial trauma., Methods: The data were obtained by EBCT continuous volumetric scanning with 1.0 mm slice at thickness. The data were transferred to work-station for 3-dimensional surface reconstruction by computer-aided design software and the images were saved as STL file. The data can be used to control a laser rapid-prototyping device (AFS-320QZ) to construct geometric model. The material for the model construction is a kind of laser-sensitive resin power, which will become a mass when scanned by laser beam. The design and simulation of operation can be done on the model. The image data were transferred to the device slice by slice. Thus a geometric model is constructed according to the image data by repeating this process. Preoperative analysis, surgery simulation and implant of bone defect could be done on this computer-aided manufactured 3D model. One case of cranio-maxillo-facial bone defect resulting from trauma was reconstructed with this method. The EBCT scanning showed that the defect area was 4 cm x 6 cm. The nose was flat and deviated to left., Results: The 3-dimensional skull was reconstructed with EBCT data and rapid prototyping technique. The model can display the structure of 3-dimensional anatomy and their relationship. The prefabricated implant by 3-dimensional model was well-matched with defect. The deformities of flat and deviated nose were corrected. The clinical result was satisfactory after a follow-up of 17 months., Conclusion: The 3-dimensional model of skull can replicate the prototype of disease and play an important role in the diagnosis and simulation of operation for repairing cranio-maxillo-facial trauma.

A new kind of method for intraperitoneal hyperthermic chemotherapy has been proved to be very effective for the therapy of gastrointestinal cancer. In this article is reported an intraperitoneal perfusion machine which is designed for instituting the treatment. The liquor of the chemotherapy drug is infused into the abdomen after being heated by heating system; the liquor flows out of the abdomen is abandoned. The temperature of heating and the velocity of flow are controlled by MCU, thus the temperature of the liquor of the chemotherapy drug in the abdomen can be adjusted to the most favarable temperature.

Background: Lung cancer is still the most common cause of cancer death. Although it is reported that the 5-year survival rate for lung cancer has been greatly increased, surgical results are controversial. The aim of this study is to investigate and evaluate the improvement of survival of lung cancer surgically intervened in PUMC hospital during the last 15 years., Methods: From January 1989 to December 2003, 1574 cases of lung cancer underwent surgical treatment and obtained follow-up. The results were retrospectively a- nalysed . All cases in this series were divided into two groups according to time, group A (1999-2003) and group B (1989-1998), and the differences of survival rate between group A and group B were compared., Results: The morbidity and mortality of group A decreased significantly when compared to group B (11.2% vs 19.2%, 1.06% vs 1.93%, respectively, P < 0.01). However, the 3- and 5-year survival rates had been obviously raised from 42.35% to 56.07%, and from 28.46% to 38.99%, respectively (P < 0.05 ). A significant improvement in survival was observed in patients with stageI, stage II and stage IIIA, but not in stage IIIB and stage IV. Also, the patients with lobectomy had better results but those with exploratory thoracotomy, limited resection, pneumonectomy and sleeve resection did not show better results., Conclusions: Lobectomy associated with systematic dissection of mediastinal lymph nodes has become the standard mode for the resectable lung cancer. Combination of complete resection and lymph nodes dissection, with postoperative adjuvant chemotherapy based on platinum/3rd generation medicine, have preliminarily been justified and proved an important approach for effective improvement of long-term survival of lung cancer.

Background: To study the effects of huTNF-α and hIL-2 gene transfection on the expression of MDR1 and LRP genes in lung cancer cell lines., Methods: huTNF-α and hIL-2 gene plasmids were constructed and transfected into A549, GLC-82, H446 and H460 cells with lipofectinmin. Positive clones were screened out by G418. The expressions of MDR1 and LRP genes were detected at mRNA level by reverse transcription polymerase chain reaction (RT-PCR) in the non transfected cells and the cloned cells., Results: MDR1 gene was positive in A549, GLC-82, H446 and H460 cell lines, LRP gene was positive in A549, GLC-82 and H460 cell lines; The transfected cell lines expressed both huTNF-α and hIL-2 gene, and the A549, H446 and H460 cell lines transfected with hIL-2 gene had no MDR1 expression at mRNA level compared with the non transfected ones., Conclusions: MDR1 and LRP genes are expressed in lung cancer cell lines, which indicates the presence of intrinsic drug resistance before any form of therapy. MDR1 gene is not expressed in hIL-2 transfected cell lines, which demonstrates that hIL-2 gene modulates the MDR1 gene expression at mRNA level, and may reverse the multidrug resistance of lung cancer.

Objective: To report the multi-channel cochlear implantation in patients with Common cavity malformation, including surgeries, pre and postoperative hearing assessments as well as outcomes of speech recognition., Method: Multi-channel cochlear implantation surgeries have been performed in 6 cases with common cavity malformation in our hospital from May 1995 to May 2002. The transmastoid lateral semicircular canal approach was used in these cases. The postoperative outcomes of these cases are compared with 6 cases of non-malformed cochlea as a control group., Result: Among the 6 cases, All 32 electrodes were inserted in 3 cases, 28 electrodes in 1 cases, 26 electrodes in 1 cases, 22 electrodes in 1 cases. The intra and postoperative complications of the surgeries have no significant difference compared with the surgeries of normal cochlea. The intraoperative "Ozze" occurred in 2 cases, the small CSF flowing occurred in 3 cases and no CSF flowing occurred in 1 case. Postoperative threshold in sound field were 30-40 dB recovery for all cases, and similar to the normal cochlea cases. Most of them received the similar hearing and speech recovery, compared with the result of non-malformed group. Only a few had a higher hearing threshold. The remote effect will be evaluated by long-term follow-up., Conclusion: Multi-channel cochlear implantation could be performed in the cases with common cavity malformation, but preoperative hearing assessments and proper images should be done.

Objective: To analyse the relationship of distortion product otoacoustic emissions(DPOAE), conventional pure tone audiometry and expanded high frequency audiometry, and discuss the originated mechanism of DPOAE and value in early diagnosis and detection noise-induced deafness., Method: DPOAE, conventional pure tone audiometry and expanded high frequency audiometry were performed in 42 young adults with normal hearing of control group and 20 noise exposure workers of test group. DPOAE amplitudes, conventional pure tone hearing thresholds and expanded high frequency hearing thresholds were compared., Result: In noise exposure workers against young adults with normal hearing, the pure tone hearing thresholds at 6.0 kHz and expanded high frequency area declined significantly(P < 0.05), DPOAE amplitudes at frequency from 4.0 to 6.0 kHz and 11.2 kHz declined significantly too(P < 0.05), but there existed no significantly difference at frequency from 12.5 to 16.0 kHz between the two groups(P > 0.05)., Conclusion: DPOAE is potential implement to early diagnose and detect noise-induced deafness. It seems likely that the origination of DPOAE not limited to the outer hair cell in corresponding cochlear area. The originated area and mechanism of DPOAE should be solved by further studies.

Objective: To study the surgical management of late complex posttraumatic enophthalmos., Method: According to the X-ray film and CT examination, the displaced orbital bone fragments was repositioned after osteotomy and rigid fixed by mini-plate and screws, then the orbital walls were repaired., Result: From July 1996 to June 2001, 42 cases were treated and the enophthalmos were obviously corrected or improved., Conclusion: The late complex posttraumatic enophthalmos can be corrected or obviously improved through reconstruction of the normal shape and volume by the reduction of displaced bone fragments and precise orbit wall repair.

Objective: To study the clinical manifestations, diagnostic methods, surgical management and prognosis of patients with neurogenic tumors of the mediastinum., Method: One hundred and ten patients with neurogenic tumors of the mediastinum were analyzed retrospectively., Results: After operation, 2 patients died in hospitalization and 8 experienced such complications as Horner's syndrome or laryngeal recurrent nerve paralysis. In 102 patients with benign tumors, 2 patients had recurrence, and 4 patients with neurofibrosarcoma or malignant neurilemmoma died within 3 years postoperatively., Conclusions: Most neurogenic tumors of the mediastinum are benign and could be diagnosed by chest X-ray or CT. The clinical manifestations, diagnosis methods, surgical management of the dumbbell tumors differ from others. Minimal invasive surgery and video assist thoracoscopy surgery are of special value in treatment of the selected neurogenic tumors of the mediastinum. Benign neurogenic tumors rarely recur after complete resection, and malignant neurogenic tumors have poor prognosis.