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Non-healing diabetic wounds (DW) are a serious clinical problem that remained poorly understood. We recently found that topical application of growth differentiation factor 11 (GDF11) accelerated skin wound healing in both Type 1 DM (T1DM) and genetically engineered Type 2 diabetic db/db (T2DM) mice. In the present study, we elucidated the cellular and molecular mechanisms underlying the action of GDF11 on healing of small skin wound. Single round-shape full-thickness wound of 5-mm diameter with muscle and bone exposed was made on mouse dorsum using a sterile punch biopsy 7 days following the onset of DM. Recombinant human GDF11 (rGDF11, 50 ng/mL, 10 μL) was topically applied onto the wound area twice a day until epidermal closure (maximum 14 days). Digital images of wound were obtained once a day from D0 to D14 post-wounding. We showed that topical application of GDF11 accelerated the healing of full-thickness skin wounds in both type 1 and type 2 diabetic mice, even after GDF8 (a muscle growth factor) had been silenced. At the cellular level, GDF11 significantly facilitated neovascularization to enhance regeneration of skin tissues by stimulating mobilization, migration and homing of endothelial progenitor cells (EPCs) to the wounded area. At the molecular level, GDF11 greatly increased HIF-1ɑ expression to enhance the activities of VEGF and SDF-1ɑ, thereby neovascularization. We found that endogenous GDF11 level was robustly decreased in skin tissue of diabetic wounds. The specific antibody against GDF11 or silence of GDF11 by siRNA in healthy mice mimicked the non-healing property of diabetic wound. Thus, we demonstrate that GDF11 promotes diabetic wound healing via stimulating endothelial progenitor cells mobilization and neovascularization mediated by HIF-1ɑ-VEGF/SDF-1ɑ pathway. Our results support the potential of GDF11 as a therapeutic agent for non-healing DW.

This study aimed to evaluate and compare the demographic characteristics of mandibular condylar fractures between children and adolescents.The sample was composed of all children (less than 12 years) and adolescents (between 13 and 18 years old) who presented with mandibular condylar fractures within a 5-year period (January 2011 to April 2016). The age, gender, time of injury, mechanism of trauma, location and pattern of fracture, associated injuries and treatment methods were recorded and analysed. Data analysis included chi-square test and Fisher exact test. Differences at p less than 0.05 were considered significant.A total of 111 children and 39 adolescent patients with condylar fractures were registered and compared. More children than adolescents were involved in falls from a height (p = 0.007), but nearly no relationship was observed between the trauma aetiology and type of condylar fracture in the two patient groups. Condylar head fractures occurred most frequently in the children and adolescents, especially in the children (p 0.05). Condylar neck fractures were more frequently observed in the adolescent patients (p 0.001) than in the children. Green-stick fractures occurred only in the child patients (p = 0.005). The patients who fractured other sites of the mandible tended to show a decreased frequency of dislocation (condylar head was out of the glenoid fossa) (p = 0.024). Symphysis/para-symphysis fractures were highly common in the children who sustained unilateral condylar fractures, compared to adolescents (p 0.05). The patients with bilateral condylar fractures were more frequently associated with other mandibular fractures (children, p = 0.001; adolescents, p = 0.011), especially the fracture of the mandibular body or symphysis. The children who sustained extracapsular fractures were more prone to fractures of other mandibular sites (p = 0.009), especially fracture of the symphysis/para-symphysis (p = 0.014). Intracapsular fractures in children were treated non-surgically more frequently than surgically (p 0.001). The extracapsular fractures (mild and serious fractures) in children were also treated non-surgically more frequently (p 0.05).The trauma mechanisms, incidence, pattern and treatment of condylar fractures in children substantially differ from those in adolescents. This study was conducted to enable the understanding of the differences in condylar fractures between children and adolescents. Accordingly, preventive measures and treatment plans in children or adolescents should be applied differently.

The terrestrial cryosphere functions to provide critical freshwater and serve societies and ecosystems, driving nature's contributions to people (NCP). This becomes increasingly important for the oasis areas in Northwest China. The cryospheric meltwater is in demand to support the economy and reduce poverty, accompanied by growing requirements to protect the environment. We intend to investigate the contributions of cryospheric meltwater by analyzing the spatial functions and services pertinent to provisioning meltwater in China. Based on the currently available datasets during the 2000s of glaciers, snow cover, and permafrost, spatial clustering was utilized to analyze the contributions at the third-level basin scale. Further assessment is carried out for the exposure of primary, secondary, and tertiary industrial sectors to cryospheric meltwater, which reflects the spatiality of potential services that cryospheric meltwater may provide. In results, we spatially cluster the contribution of cryospheric meltwater into six function zones and twenty-seven sub-zones, in association with the degree of their reliance on glaciers, snow cover, and permafrost. Considering the sector's exposure, we further spatially cluster the contribution areas into eleven service zones concerning the potential service of cryospheric meltwater. Generally, the cryosphere contributes approximately 8.3% of the total water resource in China, with function zones mainly distributed in northeastern China, Qinghai−Tibet Plateau (QTP), and other arid regions of Northwest China with various significance. The overall contribution ratios of the glacier, snow cover, and permafrost to cryospheric meltwater are about 35.6%, 56.5%, and 7.9%, respectively. By looking into the service zones, the cryospheric meltwater mainly contributes to the primary industry in Northwest China and QTP, even though it has less significant effects on all other industrial sectors, while the services to the ecosystem are mainly located in QTP and high mountain regions. The results offer an overarching view on the contributions of cryospheric meltwater in China.

To investigate the effect of tumor necrosis factor death receptor (DR) 4 demethylation to the proliferation and apoptosis of myeloid leukemia K562 cells.The logarithmic phase of K562 cells were treated by desitabine (DCA) at 0, 0.8, 1.6 and 3.2 μmol/L, and the cells were divided into control group, DCA low dose group, DCA medium dose group and DCA high dose group respectively. The cells in control group were treated by tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) 0.5 μg/ml for 24 h, and the cells were divided into TRAIL group. The cells in DCA high dose group were treated by TRAIL 0.5 μg/ml for 24 h, and were divided into DCA high dose + TRAIL group. Methylation-specific polymerase chain reaction (MS-PCR) was used to measure the methylation status of the DR4 gene promoter in the control group and DCA low, medium and high dose groups. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to determine the relative expression of DR4 mRNA and protein in the control group and DCA low, medium and high dose groups. Dime- thylthiazole (MTT) method was used to determine the inhibition rate of cell proliferation of the cells in control group, DCA high dose group, TRAIL group, DCA high dose + TRAIL group. Flow cytometry was used to determine the apoptotic rate of the cells in control group, DCA high dose group, TRAIL group, DCA high dose + TRAIL group.The cells in the control group were methylation-positive, the brightness of the methylation bands of the cells in the DCA low, medium, and high dose groups was gradually decreased to disappear, and the DCA high dose group showed negative for methylation. The relative expression of DR4 mRNA and protein in the control group, DCA low, medium and high dose groups was increased sequentially (r=0.624, 0.704). The inhibition rate of cell proliferation of the cells in the control group, DCA high dose group, TRAIL group, DCA high dose + TRAIL group was increased sequentially (r=0.653, 0.754, 0.709, 0.725) at 24, 48 and 72 h.DCA can reverse the methylation level of DR4 gene promoter in ML K562 cells and up-regulate the expression of DR4, which may enhance the proliferation inhibition and apoptosis promotion effects of TRAIL on K562 cells.DR4去甲基化对髓性白血病K562细胞增殖凋亡作用的研究.研究肿瘤坏死因子死亡受体（DR）4去甲基化对髓性白血病K562细胞增殖、凋亡的影响.取对数期K562细胞，采用地西他滨（DCA）0、0.8、1.6、3.2 μmol/L干预，分别设为对照、DCA低剂量、DCA中剂量和DCA高剂量4组。取对照组细胞，采用肿瘤坏死因子相关凋亡诱导配体（TRAIL）0.5 μg/ml干预24 h，设置为TRAIL组；取DCA高剂量组细胞，采用TRAIL 0.5 μg/ml干预24 h，设置为DCA高剂量＋TRAIL组。甲基化特异性聚合酶链反应（MS-PCR）检测对照组和DCA低、中、高剂量组DR4基因启动子甲基化状态；实时荧光定量聚合酶链反应（qRT-PCR）、Western blot检测对照组和DCA低、中、高剂量组DR4 mRNA及蛋白相对表达量；二甲基噻唑（MTT）法检测对照组、DCA高剂量组、TRAIL组、DCA高剂量＋TRAIL组细胞增殖抑制率；流式细胞术检测对照组、DCA高剂量组、TRAIL组、DCA高剂量＋TRAIL组细胞的凋亡率.对照组细胞呈甲基化阳性状态，DCA低、中、高剂量组甲基化条带亮度逐渐降低至消失，DCA高剂量组呈甲基化阴性状态；对照组和DCA低、中、高剂量组DR4 mRNA及蛋白相对表达量依次升高（r=0.624、0.704）；对照、DCA高剂量、TRAIL、DCA高剂量＋TRAIL组24、48和72 h增殖抑制率、凋亡率依次升高（r=0.653、0.754、0.709，0.725）.DCA可逆转ML K562细胞中DR4基因启动子甲基化水平，上调DR4表达，可能会增强TRAIL对K562细胞的增殖抑制及凋亡促进作用.

Juan Wang, Jun Yang, Xue Wen Yang, Xiao Hua Li, Jian Jun Yang, Gang Ji Department of Digestive Surgery, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, People’s Republic of ChinaCorrespondence: Gang JiDepartment of Digestive Surgery, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, People’s Republic of ChinaEmail jigangfmmu@163.comJian Jun YangDepartment of Digestive Surgery, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, People’s Republic of ChinaEmail yangjj@fmmu.edu.cnBackground: Totally laparoscopic total gastrectomy (TLTG) using the overlap reconstruction method is associated with fewer postoperative complications and fast recovery than laparoscopic-assisted radical total gastrectomy (LATG). However, evidence on the safety and feasibility of TLTG (overlap reconstruction) in patients with advanced Siewert III esophagogastric junction cancer and gastric cancer of the upper and middle third of the stomach is scarce.Methods: This study is a prospective, single-center, single-blind, two-arm randomized controlled trial designed to include 292 patients with advanced Siewert III esophagogastric junction cancer and gastric cancer of the upper and middle third of the stomach who will be randomly assigned to two groups: a TLTG overlap group (n=146) and an LATG group (n=146). The patients’ demographics, pathological characteristics, intraoperative variables, postoperative complications, postoperative recovery variables, 3-year disease-free survival and 3-year overall survival will be collected and analyzed. The primary outcome is the postoperative complications within 30 days after surgery including intra-abdominal hemorrhage, anastomotic leakage, duodenal stump fistula, pancreatic fistula, chyle leakage, abdominal infection, intestinal obstruction, wound complications, pulmonary infection, pleural effusion, pulmonary embolism, cardiovascular and cerebrovascular complications, and deep vein thrombosis. The secondary outcomes are the 3-year disease-free survival and 3-year overall survival.Discussion: This trial will provide high-level evidence for the safety and feasibility of TLTG (overlap reconstruction) compared with LATG in advanced Siewert III esophagogastric junction cancer and the upper and middle third of gastric cancer.Trial Registration: This trial has been registered at the Chinese Clinical Trial Registry: ChiCTR1900025667 (registration date: September 4, 2019).Keywords: totally laparoscopic total gastrectomy, laparoscopic-assisted total gastrectomy, overlap reconstruction, Siewert III esophagogastric junction cancer, gastric cancer, randomized controlled trial

Various composite materials are now used as artificial tissue substitutes, and are defining new frontiers in tissue engineering. In the present study, composite membranes based on silk fibroin (SF) were fabricated to form a synthetic periosteum. The fabricated membranes were physicochemically characterized by their morphology, porosity, biocompatibility, biodegradability, chemical structure, and mechanical properties. Following the addition of polycaprolactone (PCL) to the silk fibers, there was a 3–5-fold increase in the elongation at break compared with the pure silk membranes, and surface wettability was retained. The degradation time of the SF within the membranes was also prolonged by adding PCL. Compared with pure PCL membranes or plastic culture plates, the SF-based membranes significantly enhanced the cellular viability and osteogenic differentiation capability of MC3T3-E1 cells. Higher expression levels of osteogenic differentiation markers (runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), and osteopontin (OP)) further supported the use of the SF component in bone-related applications. A non-rigid internal fixation (non-RIF) fracture model that healed via endochondral bone formation was created, and fracture callus samples were collected to perform micro-computed tomography, histology, and immunohistochemistry analyses at 8 weeks after surgery. A smaller bone volume accompanied by a mineralized bony callus was observed in SF/PCL membrane-treated rats. Immunohistochemistry also indicated that the SF/PCL membrane-treated rats exhibited increased osteocalcin expression but reduced collagen type X expression. These findings could lead to an alternative strategy for treating comminuted fractures with enhanced intramembranous ossification and reduced endochondral ossification.

Objective. The masticatory muscles are the most important contributor to bite force, and the temporomandibular joint (TMJ) receives direct occlusal loading. The present study aimed to investigate condylar remodeling after masseter muscle atrophy in rats.Methods. Sixty 5-week-old female Sprague-Dawley rats were divided into the following 3 groups: the control group, soft diet (SD) group, and botulinum toxin (BTX) group. The cross-sectional area (CSA) of the masseter muscles was investigated as well as atrogin-1/MuRF-1 expression. Changes in the condylar head were evaluated by H-E, toluidine blue staining, and contour measurements. The biomechanical sensitive factors PTHrP Ihh, Col2a1, and ColX of condylar cartilage were detected by immunohistochemical staining and western blotting. Furthermore, micro-CT and tartrate-resistant acid phosphatase (TRAP) staining were performed to determine the osteopenia in subchondral bone.Results. The histological and protein analysis demonstrated muscle hypofunction in the SD and BTX groups. Condylar cartilage contour was diminished due to different treatments; the immunohistochemistry and protein examination showed that the expressions of PTHrP, Ihh, Col2a1, and ColX were suppressed in condylar cartilage. A steady osteoporosis in subchondral bone was found only in the BTX group.Conclusion. The current results suggested that a steady relationship between muscular dysfunction and condylar remodeling exists.

This study aims to identify and distinguish various factors that may influence the clinical symptoms (limited mouth opening and malocclusion) in patients with maxillofacial fractures. From January 2000 to December 2009, 963 patients with maxillofacial fractures were enrolled in this statistical study to aid in evaluating the association between various risk factors and clinical symptoms. Patients with fractured posterior mandibles tended to experience serious limitation in mouth opening. Patients who sustained coronoid fractures have the highest risk of serious limitation in mouth opening (OR = 9.849), followed by arch fractures, maxilla fractures, condylar fractures, zygomatic complex fractures and symphysis fractures. Meanwhile, the combined fracture of zygomatic arch and condylar process results in normal or mild mouth opening. High risks of sustaining malocclusion are preceded by the fracture of nasal bone (OR = 3.067), mandible, condylar neck/base, combined fracture of zygomatic arch and condylar process, mandibular body, bilateral condylar, dental trauma, mandibular ramus, symphysis, mandibular angle and mid-facial. Patients who experienced serious limitation in mouth opening are treated with surgery more frequently (OR = 2.118). No relationship exists between the treatment options and the patients with malocclusion.

Antimicrobial resistance is an urgent global health challenge in human and veterinary medicine. Wild animals are not directly exposed to clinically relevant antibiotics; however, antibacterial resistance in wild animals has been increasingly reported worldwide in parallel to the situation in human and veterinary medicine. This underlies the complexity of bacterial resistance in wild animals and the possible interspecies transmission between humans, domestic animals, the environment, and wildlife. This review summarizes the current data on expanded-spectrum β-lactamase (ESBL), AmpC β-lactamase, carbapenemase, and colistin resistance genes in Enterobacteriaceae isolates of wildlife origin. The aim of this review is to better understand the important role of wild animals as reservoirs and vectors in the global dissemination of crucial clinical antibacterial resistance. In this regard, continued surveillance is urgently needed worldwide.

Background The surgical approach of the zygomaticomaxillary complex fracture is usually performed with preauricular coronal incision assisted with intraoral maxillary sulcus incision. There will be preauricular scars postoperatively. Methods The authors introduce a postauricular hemicoronal incision to avoid the formation of scars in front of the ear. Results and discussion The postauricular hemicoronal incision can avoid vascular damage caused by careless operation in the preauricular approach. It eliminates the possibility of dissection or ligation of the superficial arteries and veins when preauricular approach was used. It results in no scar in front of ear, while reducing suture time and complexity.

Objective This study aimed to explore and make an understanding of absorption existed in children with intracapsular fractures. Methods The sample was composed of all children (less than 12 years) who presented with intracapsular fractures within a 5-year period (January 2011 to April 2016). Data about age, gender, date of injury, dates of admission and discharge, transfer and/or referral by other clinics or local facilities, mechanism of trauma, location and pattern of fracture, associated injuries, centimeter of mouth opening, treatment methods, image date of pre- and post-treatment (including time of review), position of condylar head in pre-treatment or post-treatment, and absorption of condylar head in pre-treatment or post-treatment were recorded and analyzed. Data analysis included the Chi-Square test, the Fisher exact test, and the t-test. Logistic regression analysis was utilized to control the confounding variables. Probabilities of p less than 0.05 were considered statistically significantly different. Results In the 5 years records retrieved during this study, 93 children patients sustained a total of 140 condylar head fractures. Statistical analysis revealed that abduction of condylar process in post-treatment was highly related to the condylar absorption. Patients associated with other mandibular fractures were highly related to abduction of condylar process. Patients with condylar head fractures, the closer to the medial of the condylar process, the higher the risk of abduction of the condyle. No matter what kind of treatment method is used, it is very difficult to reverse the abduction of condylar process in children patients with intracapsular fractures efficaciously. Conclusion Abduction of condylar process in post-treatment was highly related to the condylar absorption. Patients associated with other mandibular fractures were highly related to abduction of condylar process. Children patients who presented with condylar head fractures, the closer to the medial of the condylar process the higher the risk of abduction of the condyle. Neither surgery nor conservative treatment can recover the abduction of condylar process efficaciously.

We aimed to investigate the association between dihydropyrimidine dehydrogenase (DPYD) gene polymorphisms and the risk of pediatric acute lymphoblastic leukemia (ALL) and its prognosis after chemotherapy. A total of 147 pediatric ALL patients diagnosed by our hospital between January 2011 and December 2014 were included in the case group, and 102 healthy people who received a physical examination during the same time frame in our hospital were included in the control group. DNA sequencing was applied for site determination and genotyping of the DPYD 85T C, 2194G A, 1156G T, and IVS14 + 1G A polymorphisms. The genotype and allele frequencies of the two groups were compared. A significant difference was found in the comparison of the mutant gene and allele frequencies of the 85T C polymorphism between the case and control groups (P 0.05). The CT and CC genotypes in the 85T C polymorphism were associated with the risk of the disease (OR = 1.592, 95 % CI = 1.010-2.509), suggesting that the recessive gene (85C) was more likely to lead to the occurrence of ALL compared with the dominant gene (85T) (P 0.05). Patients carrying the C allele of the 85T C polymorphism presented higher damage of their liver functions and higher infection rates compared with patients carrying the non-C allele (P 0.05). A higher proportion of liver function damage and a higher infection rate were found in patients with the GA genotype in the IVS14 + 1G A polymorphism compared with the GG genotype (P 0.05). The complete remission (CR) rate in patients with the GG genotype in the IVS14 + 1G A polymorphism was higher than in patients with the GA genotype (P = 0.020). After 5-fluorouracil/calcium folinate (5-FU/CF)-based chemotherapy, the event-free survival (EFS) rate of patients with the TT genotype was higher than patients with the CT and CC genotypes (P 0.05). Our results revealed that the C allele of the 85T C polymorphism might be associated with susceptibility to pediatric ALL. Patients carrying the C allele may have an increased risk of ALL. Thus, the 85T C polymorphism may be a predictor of CR for pediatric ALL patients.

Plenty of studies have investigated the effect of methionine synthase (MTR) A2756G polymorphism on risk of developing pediatric acute lymphoblastic leukemia (ALL), but the available results were inconsistent. Therefore, a meta-analysis was conducted to derive a more precise estimation of the association between MTR A2756G polymorphism and genetic susceptibility to pediatric ALL. The PubMed, Embase, Google Scholar, Web of Science, ScienceDirect, Wanfang Databases and China National Knowledge Infrastructure were systematically searched to identify all the previous published studies exploring the relationship between MTR A2756G polymorphism and pediatric ALL risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were applied to evaluate the strength of association. Sensitivity analysis and publication bias were also systematically assessed. This meta-analysis finally included ten available studies with 3224 ALL cases and 4077 matched controls. The results showed that there was significant association between MTR A2756G polymorphism and risk of pediatric ALL in overall population (AG vs. AA: OR = 1.13, 95%CI = 1.02–1.26, P = 0.02; AG+GG vs. AA: OR = 1.13, 95%CI = 1.02–1.25, P = 0.01; G allele vs. A allele: OR = 1.10, 95%CI = 1.01–1.20, P = 0.03). In the stratification analyses by ethnicity, quality score and control source, significant association was found in Caucasians, population-based designed studies and studies assigned as high quality. In conclusion, this meta-analysis suggests that MTR A2756G polymorphism may influence the development risk of pediatric ALL in Caucasians. Future large scale and well-designed studies are required to validate our findings.

Hand gesture of rotation, scaling and translation is the key problem of gesture recognition. This paper proposes a gesture recognition algorithm based on Hausdorff-like distance template matching of gesture main direction. Firstly, we segment hand gesture from video stream. Secondly, we calculate the main direction of gesture in the image, and build a 2D rectangular coordinate system. Then, we clockwise divide the gesture into eight sub-image area along the main direction of gesture and calculate the coordinates of target pixel points in each sub-image area in the 2D rectangular coordinate system. Finally, the algorithm of Hausdorff-like distance template matching is used to recognize the final gesture. Experimental results show that this algorithm can achieve real-time correct recognition of gestures in relatively stable light conditions. The overall recognition rate can reach 95%.

Aiming at making the simulation of human visual attention behavior more truly in computer, starting from analyzing operator’s cognitive model, a gesture tracking algorithm is put forward based on the distribution model of visual attention. To begin with, analyzing the change of the operator human eye sight, a visual attention model was built. Secondly, the basic characteristics of visual attention model were studied. Finally, the three Gauss formula is used to describe the model. Experimental results show that the algorithm can effectively improve the speed and tracking accuracy of gesture interaction.

Gesture has different speed in the process of movement. To reflect the different speed of the user, this paper presents a gesture speed estimation method. Firstly, we use data glove and camera to establish the relation between the variation of gesture contour and that of gesture speed. Secondly, we build the gesture speed estimation model by stages. Finally, we get the real-time speed of hand motion through this model and complete interactive task. The main innovation of this paper is that we reveal the relation between the gesture contour and speed to lay the foundation for further capture the interaction of user intention. Experimental results indicate that the time cost of our method decreased by 31% compared with freehand tracking based on behavioral models and the 3D interactive system based on our model is of high the user experience.

The aim of the present study was to evaluate the safety of gastrectomy without nasogastric and nutritional intubations. Between January 2010 and August 2015, 74 patients with gastric cancer received total gastric resection and esophagogastric anastomosis without nasogastric and nutritional intubations at the First Department of Digestive Surgery of the XiJing Hospital of Digestive Diseases (Xi'an, China), of whom 42 were also received earlier oral feeding within 48 h. The data were retrospectively analyzed. An additional 301 cases who underwent traditional postoperative intubation were used for comparison. In patients without intubation compared with those managed traditionally with intubation, the mean operative time was decreased (190.97±38.18 vs. 216.12±59.52 min, respectively; P=0.026). In addition, the postoperative activity was resumed earlier (1.16±0.47 vs. 1.36±0.84 days, respectively; P=0.009), oral food intake was started earlier (4.28±1.79 vs. 5.71±2.66 days, respectively; P=0.009), the incidence of fever was lower (12.16 vs. 29.23%, respectively; P=0.003), and the incidence of total complications was not statistically significantly different between the two groups (9.41 vs. 6.31%, respectively; P=0.317). There were no significant differences regarding complications of the anastomotic port (1.37 vs. 1.69%, respectively; P=0.849). Compared with traditional postoperative management, earlier oral feeding did not increase the incidence of complications (7.21 vs. 4.76%, respectively; P=0.557). Our results suggest that total gastric resection without nasogastric and nutritional intubation is a safe and feasible option for patients undergoing total gastrectomy.

Previous studies have investigated the association between cytotoxic T-lymphocyte antigen-4 (CTLA-4) polymorphisms and breast cancer susceptibility, but the results remained inconsistent. Therefore, we evaluated the relationship between four common CTLA-4 polymorphisms and breast cancer risk by a meta-analysis, aiming to derive a comprehensive and precise conclusion. We searched EMBASE, Pubmed, Web of Science, CNKI, and Wanfang databases until July 18th, 2016. Finally, ten eligible studies involving 4,544 breast cancer patients and 4,515 cancer-free controls were included; all these studies were from Asia. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the breast cancer risk in five genetic models. The results indicated that the CTLA-4 +49A>G (rs231775) polymorphism had a significant association with decreased breast cancer risk in allelic, homozygous, dominant and recessive models. Also, the +6230G>A (rs3087243) polymorphism reduced breast cancer risk especially in the Chinese population under homozygous and recessive models. In contrast, the −1661A>G (rs4553808) polymorphism increased breast cancer risk in allelic, heterozygous and dominant models, whereas −1722 T>C (rs733618) did not relate to breast cancer risk. In conclusion, CTLA-4 polymorphisms significantly associate with breast cancer susceptibility in Asian populations, and different gene loci may have different effects on breast cancer development. Further large-scale studies including multi-racial populations are required to confirm our findings.

The aim of this study is to explore the expression and significance of urokinase-type plasminogen activator (u-PA) and vascular endothelial growth factor (VEGF) in gastric cancer, providing a novel insight for the diagnosis and treatment of gastric cancer. The gastric cancer specimens, which were excised from 87 patients and confirmed during July, 2012-July, 2014, were selected as observation group, and the normal tissue next to the tumor (more than 5 cm from the edge of the tumor) from 45 patients were randomly selected as control. u-PA and VEGF were detected by immunohistochemistry for the analysis of the correlation of u-PA and VEGF in two groups. The positive rates of u-PA and VEGF in gastric cancer tissue were 81.61 and 79.31 %, respectively, which were 6.67 and 8.89 % in the control group, respectively. The positive rates in the observation group were obviously higher than those in the control group, and the difference was statistically significant (P

To investigate the clinical efficacy of regimen consisting of lenalidomide combined with chemotherapy for acute leukemia and its impact on vascular endothilial growth factor (vEGF) and basic fibroblast growth factor (bFGF), and to analyze the relationship lenalidomide with therapeutic efficacy of leukemia.The patients with newly diagnosed acute myeloid leukemia (except M3) from October 2013 to October 2014 in our hospital were randomly divided into 2 groups: chemotherapy+placebo (CP) group and lenalidomide+chemotherapy (LC) group. In addition, healthy persons were used as healthy controls (HC). The expression of VEGF and bFGF was detected by ELISA, and the therapeutic efficacy for AML patients was analyzed.The therapeutic efficacy in LC group and CP group was 87.9% and 77.2% respectively. Before treatment, the VEGF level in LC and CP groups was obviously higher than that in HC group; after treatment, the VEGF level significanthy decreased, and the decreased degree in LC group was larger than that in CP group. Before treatment, the bFGF level in LC and CP groups was higher than that in HC group; after treatment, the bFGF level decreased, and decreased degree in LC group was larger than that in CP group.The lenalidomide combined with chemotherapy can significantly decrease the expression level of VEGF and bFGF, and enhance the remission rate of patients with AML.

Anterior segmental osteotomy has become an established surgical technique to achieve functional occlusion and improve the facial profile in the treatment of maxillary protrusion. Postoperative nasal changes, however, are somewhat unpredictable. The here presented subapical anterior maxillary segmental osteotomy has been developed to avoid such unintended nasal changes.Thirty-two patients (29 women and 3 men; age range, 18-40 y; mean age, 22 y) with maxillary protrusion underwent subapical anterior maxillary segmental osteotomy. A horizontal osteotomy was carried out between the apices of the anterior teeth and the piriform aperture, maintaining a distance of approximately 2 to 3 mm to the apices. Lateral to both canines, this horizontal osteotomy was connected with vertical osteotomies carried out along the alveolar socket of the first premolar on the right and left sides. Lateral cephalograms and lateral and en face photographs were taken preoperatively and postoperatively for analysis. All patients were followed up for at least 6 months.Significant changes were observed in hard tissue parameters except the anterior nasal spine. The nasal tip, the alar base, and the lip width remain to have no significant change. The ratio of the upper lip to the maxillary incisor retraction was 0.64:1. Whereas both the nasolabial angle and the philtrum length were significantly increased, the protrusion of the upper incisors and the vermilion length presented decreased. The intraoperative and postoperative courses were uneventful during the entire follow-up period.Subapical anterior maxillary segmental osteotomy provides a suitable option in the treatment of maxillary protrusion. It provides improvement of the aesthetic profile without nasal changes.

Age-related macular degeneration (AMD) is a major cause of blindness worldwide. Oxidative stress plays a crucial role in the pathogenesis of dry AMD. Quercetin has potent anti-oxidative activities, but poor bioavailability limits its therapeutic application. Herein, we prepared the phospholipid complex of quercetin (quercetin-PC), characterized its structure by differential scanning calorimetry, infrared spectrum and x-ray diffraction. Quercetin-PC had equilibrium solubility of 38.36 and 1351.27μg/ml in water and chloroform, respectively, which was remarkably higher than those of quercetin alone. Then we established hydrogen peroxide (H2O2)-induced oxidative injury model in human ARPE-19 cells to examine the effects of quercetin-PC. Quercetin-PC, stronger than quercetin, promoted cell proliferation, and the proliferation rate was increased to be 78.89% when treated with Quercetin-PC at 400μM. Moreover, quercetin-PC effectively prevented ARPE-19 cells from apoptosis, and the apoptotic rate was reduced to be 3.1% when treated with Quercetin-PC at 200μM. In addition, quercetin-PC at 200μM significantly increased the activities of SOD, CAT and GSH-PX, and reduced the levels of reactive oxygen species and MDA in H2O2-treated ARPE-19 cells, but quercetin at 200μM failed to do so. Molecular examinations revealed that quercetin-PC at 200μM significantly activated Nrf2 nuclear translocation and significantly enhanced the expression of target genes HO-1, NQO-1 and GCL by different folds at both mRNA and protein levels. Our current data collectively indicated that quercetin-PC had stronger protective effects against oxidative-induced damages in ARPE-19 cells, which was associated with activation of Nrf2 pathway and its target genes implicated in antioxidant defense.

The equilibrium solubility of the two pesticides – xanthone and xanthene – in supercritical carbon dioxide was determined with a flow-type method. Measurements were performed at pressures ranging from 80 to 300 bar and temperatures from 308.15 to 328.15 K. The results show that xanthene was much more soluble in supercritical carbon dioxide than xanthone with its solubility being over 10-fold higher than that of xanthone due to their different volatility related to their chemical structures. The determined solubility data were well correlated by the Peng–Robinson equation of state and the empirical density-based Chrastil model with the average absolute relative deviation (AARD) less than 11.5% for two solutes investigated.

Several studies have investigated the association between multidrug resistance gene (MDR1) C1236T polymorphism and leukemia risk, however, these published studies have yielded conflicting results. Thus, the present study carried out a meta-analysis to provide a more precise estimate of the effect of this polymorphism on the susceptibility to leukemia. The published case-control studies regarding the association between MDR1 C1236T polymorphism and leukemia risk were included following a computerized search of PubMed, Elsevier, The Cochrane Library, China National Knowledge Infrastructure and Wanfang Database. Either fixed- or random-effects models were applied to calculate the combined odds ratios (ORs) and 95% confidence intervals (CIs) by RevMan 5.2 software. Seven studies, including 846 cases and 1,523 controls, were included in the present meta-analysis. The results indicated that there was no significant association between the MDR1 C1236T polymorphism and leukemia risk in overall comparisons in all four genetic models (CT vs. CC: OR, 1.31, 95% CI, 0.89-1.91, P=0.17; TT vs. CC: OR, 2.16, 95% CI, 0.99-4.70, P=0.05; TT vs. CC+CT: OR, 1.72, 95% CI, 0.91-3.25, P=0.09; and CT+TT vs. CC: OR, 1.57, 95% CI, 0.96-2.56, P=0.07). In the subgroup analysis according to specific ethnicity, age and the type of leukemia, a significant association was found in adult leukemia (CT+TT vs. CC: OR, 2.77, 95% CI, 1.05-7.31, P=0.04) and chronic myeloid leukemia (CT vs. CC: OR, 1.71, 95% CI, 1.05-2.80, P=0.03). No significant publication bias was detected by funnel plot. Therefore, the meta-analysis indicated that the MDR1 C1236T polymorphism may contribute to the susceptibility to adult leukemia and chronic myeloid leukemia. Furthe well-designed studies based on larger sample sizes are required to validate these findings.

Choroidal neovascularization (CNV) is characterized by abnormal blood vessels growing from the choroid. Current remedies for CNV have not shown favorable therapeutic efficacy. It is urgent to identify and develop more safe and potent anti-CNV agents via multiple technologies. We previously showed that the natural product naringenin attenuated CNV. However, naringenin has poor water solubility and low bioavailability. Here, we prepared theβ-cyclodextrin (β-CD) complex of naringenin and characterized it using infrared spectra and X-ray diffraction analyses. Determination of content and solubility in the complex showed that naringenin accounted for 20.53% in the complex and its solubility was increased by more than 10-fold. Using a laser-induced CNV model in rats we demonstrated that naringenin/β-CD complex more significantly reduced CNV area than naringenin alone in rats. Furthermore, naringenin and itsβ-CD complex significantly inhibited the mRNA and protein expression of VEGF, COX-2, PI3K, p38MAPK, MMP-2, and MMP-9 in retina and choroid tissues. Naringenin/β-CD complex showed more significant inhibitory effect on VEGF and COX-2 expression than naringenin. These results collectively indicated that naringenin/β-CD complex could be a promising therapeutic option for CNV and that the beneficial effects could be linked to the anti-inflammatory properties of naringenin.

By evaluating the data of National Board Dental Examinations over recent 3 years, the disadvantages in the present dental education were analyzed and improvement schemes were proposed.The enrollment system, faculty, facility and equipment were evaluated for dental schools in Hubei province from 2008 to 2010, including 4 dental schools and 7, dental professional schools. The passing rate of National Board Dental Examinations and National Board Dental Assistant Examinations were summarized.Lack of faculty resources and over-enrollment were found in 7 dental professional schools. In dental professional schools, the number of dental simulation units compared to number of students enrolled was as low as 1:0.15. The passing rate of National Board Dental Examinations was 27.9%-30.1%, and the passing rate of National Board Dental Assistant Examinations was 32.5%-40.7%.The passing rate of National Board Dental Examinations and National Board Dental Assistant Examinations is limited mainly by the lack of faculty and equipment resources and over-enrollment. We propose that basic knowledge shall be enhanced in dental professional schools. In addition, the target of education should be shot as high as that in dental schools.

To establish the co-culture model of cancer cells and nerve, and to study the influence of esophageal cancer on nerve fibers.Mouse dorsal root ganglion (DRG) was cultured in sterile conditions by primary isolation. Co-culture model was established using matrigel matrix-embedded DRG and EC109 (esophageal cancer cell line) transfected with green fluorescent protein. Morphological changes of DRG, number and area of neurites were quantified with microscopy and image analysis. Furthermore, the mRNA expression of nerve growth factor(NGF) and brain derived neurotrophic factor(BDNF) was detected by real-time PCR.In mixture cultivation model of EC109 and DRG cells, directional outgrowth of neurite projecting to EC109 was observed, and the length of neurite was markedly longer in proximal field compared to distal field. The number and area of neurite were 87 and 346 μm(2) in proximal field respectively, and 23 and 141 μm(2) in distal field on the 7th day. The expressions of NGF and BDNF were up-regulated in esophageal cancer cells.The esophageal cancer may play an important role in nerve fiber growth and guidance, which may be associated with the up-regulation of NGF and BDNF expressions.

DNA polymerases are responsible for ensuring stability of the genome and avoiding genotoxicity caused by a variety of factors during DNA replication. Consequently, these proteins have been associated with an increased cancer risk. DNA polymerase kappa (POLK) is a specialized DNA polymerase involved in translesion DNA synthesis (TLS) that allows DNA synthesis over the damaged DNA. Recently, some studies investigated relationships between POLK polymorphisms and cancer risk, but the role of POLK genetic variants in breast cancer (BC) remains to be defined. In this study, we aimed to evaluate the effects of POLK polymorphisms on BC risk. We used the Sequenom MassARRAY method to genotype 3 single nucleotide polymorphisms (SNPs) in POLK (rs3213801, rs10077427, and rs5744533), in order to determine the genotypes of 560 BC patients and 583 controls. The association of genotypes and BC was assessed by computing the odds ratio (OR) and 95% confidence intervals (95% CIs) from logistic regression analyses. We found a statistically significant difference between patient and control groups in the POLK rs10077427 genotypic groups, excluding the recessive model. A positive correlation was also found between positive progesterone receptor (PR) status, higher Ki67 index, and rs10077427 polymorphism. For rs5744533 polymorphism, the codominant, dominant, and allele models frequencies were significantly higher in BC patients compared to healthy controls. Furthermore, our results indicated that rs5744533 SNP has a protective role in the postmenopausal women. However, we failed to find any associations between rs3213801 polymorphism and susceptibility to BC. Our results indicate that POLK polymorphisms may influence the risk of developing BC, and, because of this, may serve as a prognostic biomarker among Chinese women.

To investigate the effect of muscular rehabilitation on recovery after sagittal split ramus osteotomy.Twenty-seven patients undergoing sagittal split ramus osteotomy received passive motion training and muscle endurance training after surgery using the new-developed mouth-opening trainer. The passive motion training began 2-3 days after the removal of inter-maxillary elastraction. The instrument was inserted into the inter-maxillary space for 5 min per time, 3-4 times per day. When the mouth opening reached a range of 20-25 mm, the muscle endurance training initiated. The results of the training were compared with another 20 cases who received the same surgery.The mouth opening of the patients who received muscular rehabilitation achieved the pre-surgical level 4 weeks after surgery [(34.72 ± 3.75) mm], the bite force reached the pre-surgical level 8 weeks after surgery [(231.08 ± 62.52) N], but in the 20 cases without training the mouth opening [(28.42 ± 4.11) mm] in 4 weeks and the bite force in 8 weeks [(210.90 ± 73.40) N] were lower after surgery than before surgery.The systematic and standard muscle function training, accompanied with the use of the new-developed mouth-opening trainer could improve the functional recovery of the patients who receive sagittal split ramus osteotomies.

To investigate the temporomandibular joint (TMJ) function of the condylar hyperplasia patients after condylectomy.Twelve patients with condylar hyperplasia were included in this study. Before and after condylectomy, they were examined and the Fricton' s Craniomandibular Index (CMI) was calculated to assess the functional disorder of TMJ.(1) The facial asymmetry was improved after condylectomy. The morphological symmetry of the bilateral condyle and ramus was displayed by X-ray examinations. There was new cortex formed on the surface of the operated condyle. (2) The TMJ function was improved in terms of Fricton's DI and CMI, which decreased from 0.131 and 0.066 to 0.042 and 0.021 respectively (P0.05).Condylectomy is an effective method to remedy facial asymmetry and, at the same time, improve the TMJ function of the condylar hyperplasia patients.

To investigate the electrosonography character of sounds emanating from anterior disc displacement with reduction of TMJ and the value of it in clinical diagnosis.The sounds from healthy TMJ, anterior disc displacement with or without reduction of TMJ, and osteoarthritis of TMJ were recorded and analyzed by K6-I system, then the data was used for diagnosis of anterior disc displacement with reduction in clinic.A special kind of waveform was found in the electrosonography of sounds from anterior disc displacement with reduction repeatedly, and seldom or not in sounds from healthy joints, anterior disc displacement without reduction or osteoarthritis of TMJ. The diagnostic sensitivity of anterior disc displacement with reduction by using electrosonography analysis was 77.2% and specificity was 93.3% when compared with the clinical diagnosis based on clinical appearance and radiography evidence.The special kind of waveform may be characteristic wave of sounds from anterior disc displacement with reduction of TMJ, which is useful for assistant diagnosis of anterior disc displacement with reduction in clinic.

Objective The objective of the present study was to evaluate the jaw function and anatomical changes subsequent to orthodontic treatment combined with mandibular advancement or set-back surgery. Study design The sample consisted of 67 combined skeletal and dental malocclusion patients, who had received orthodontic and surgical treatment previously. Three and 6 months following jaw surgery, the following jaw functions were evaluated: the level of occlusal force developed, the efficiency of masticatory function, the size in the temporomandibular joint (TMJ), the relationship between occlusal force and maxillo-mandibular skeletal change, and the range of mandibular movement. Results The results revealed that after surgery the occlusal force, masticatory function, TMJ positioning, and mandibular movement distance were all different from presurgery values. The surgical set-back group jaw function recovery proved to be more rapid than that for the mandibular-advancement group. Conclusion Surgical mandibular advancement and set-back by sagittal-split osteotomy influence subsequent mandibular function.

To investigate clinical features of disk displacement during the course of condylar fracture and to explore the techniques of disk reposition and suturation.32 patients (10 females and 22 males) who had disk displacements with condylar fractures were followed up. Reduction and reposition of the dislocated disks simultaneously with fixation of fractures were performed. 7 patients underwent intermaxillary fixation with elastic bands for 1 to 2 weeks.The occlusions were satisfactory in all cases but one for the reason of ramus height loss. No TMJ symptom was found when examined 3 months post operation.Anterior disk displacements were most occurred with high condylar process fractures. Surgical reposition and suturation of disk play an important role for the later TMJ-function.