Musculoskeletal multibody dynamics investigation for the different medial-lateral installation position of the femoral component in unicompartmental knee arthroplasty / 生物医学工程学杂志

The surgical installation accuracy of the components in unicompartmental knee arthroplasty (UKA) is an important factor affecting the joint function and the implant life. Taking the ratio of the medial-lateral position of the femoral component relative to the tibial insert (a/A) as a parameter, and considering nine installation conditions of the femoral component, this study established the musculoskeletal multibody dynamics models of UKA to simulate the patients' walking gait, and investigated the influences of the medial-lateral installation positions of the femoral component in UKA on the contact force, joint motion and ligament force of the knee joint. The results showed that, with the increase of a/A ratio, the medial contact force of the UKA implant was decreased and the lateral contact force of the cartilage was increased; the varus rotation, external rotation and posterior translation of the knee joint were increased; and the anterior cruciate ligament force, posterior cruciate ligament force and medial collateral ligament force were decreased. The medial-lateral installation positions of the femoral component in UKA had little effect on knee flexion-extension movement and lateral collateral ligament force. When the a/A ratio was less than or equalled to 0.375, the femoral component collided with the tibia. In order to prevent the overload on the medial implant and lateral cartilage, the excessive ligament force, and the collision between the femoral component and the tibia, it is suggested that the a/A ratio should be controlled within the range of 0.427-0.688 when the femoral component is installed in UKA. This study provides a reference for the accurate installation of the femoral component in UKA.

Epididymis cell atlas in a patient with a sex development disorder and a novel NR5A1 gene mutation / 亚洲男科学杂志(英文版)

This study aims to characterize the cell atlas of the epididymis derived from a 46,XY disorders of sex development (DSD) patient with a novel heterozygous mutation of the nuclear receptor subfamily 5 group A member 1 (NR5A1) gene. Next-generation sequencing found a heterozygous c.124C>G mutation in NR5A1 that resulted in a p.Q42E missense mutation in the conserved DNA-binding domain of NR5A1. The patient demonstrated feminization of external genitalia and Tanner stage 1 breast development. The surgical procedure revealed a morphologically normal epididymis and vas deferens but a dysplastic testis. Microfluidic-based single-cell RNA sequencing (scRNA-seq) analysis found that the fibroblast cells were significantly increased (approximately 46.5%), whereas the number of main epididymal epithelial cells (approximately 9.2%), such as principal cells and basal cells, was dramatically decreased. Bioinformatics analysis of cell-cell communications and gene regulatory networks at the single-cell level inferred that epididymal epithelial cell loss and fibroblast occupation are associated with the epithelial-to-mesenchymal transition (EMT) process. The present study provides a cell atlas of the epididymis of a patient with 46,XY DSD and serves as an important resource for understanding the pathophysiology of DSD.

Finite element analysis on stress concentration improvement in patellofemoral joint by releasing lateral patellar retinaculum with stiletto needle based on the theory of Jinshugu() / 中国骨伤

OBJECTIVE@#To study mechanism of improvement of stress concentration on patellofemoral joint by stiletto needle releasing lateral patellar retinaculum guided by the theory of Jinshugu() and based on the finite element model of knee joint. and to elucidate the biomechanical mechanism of stiletto needle releasing changing patellar trajectory and reducing patellofemoral joint pressure.@*METHODS@#CT data of knee joint from a normal male (aged 29, heighted 171 cm, weighted 58 kg) was selected. Starting with construction of three-dimensional model of knee joint by using finite element software, the finite element model of knee joint with complete tendonand bone structures were established through several steps, such as geometric reconstruction, reverse engineering, meshing, material assignment and loading analysis. The loading condition was set as 500 N load on knee joint, and the average tensile stress of quadriceps femoris tendon was about 200 N. To simulate the release of lateral patellar retinaculum by stiletto needle at 30 and 90 position of knee flexion in finite element model separately, and to compare the improvement of stress concentration of patellofemoral joint by stiletto needle intervention under different knee flexion conditions.@*RESULTS@#The peak stress of patellofemoral joint and tibiofemoral joint decreased after stiletto needle releasing of patellofemoral lateral retinaculum compared with before intervention, which was(1) knee flexion at 30 degrees:patellar cartilage decreased by 0.498 MPa (decreased 9.06%), femoral trochlea decreased by 0.886 MPa(decreased 16.27%);(2) knee flexion at 90 degrees:patellar cartilage decreased by 0.558 MPa (decreased 8.6%), femoral trochlea decreasedby 0.607 MPa (decreased 9.94%).@*CONCLUSION@#Releasing lateral patellofemoral retinaculum with stiletto needle could effectively alleviate the stress concentration of patellofemoral joint and reduce local stress peak value, which it is helpful to improve patellar trajectory and make stress distribution more uniform.

Construction and simulation mechanical analysis of dynamic knee joint finite element model based on CT image / 中国骨伤

OBJECTIVE@#To construct a dynamic knee joint finite element model based on CT image data and verify the validity of the model. To provide a simulation model and basic data for biomechanical research of the knee joint by further finite element analysis.@*METHODS@#The CT data of a healthy male knee joint was selected. With the help of Mimics 19.0 and Hypermesh 12.0 software, a high simulation finite element model of knee joint was established following steps, including geometric reconstruction, reverse engineering, meshing and material characterization. The dynamic knee flexion model was generated by determining the boundary conditions and torque loading, and the validity of themodel was confirmed. The biomechanical changes of the tibiofemoral and patellofemoral joints under different knee flexion angles were analyzed by applying the loads (500 N) to the finite element model during knee flexion.@*RESULTS@#A finite element model of knee joint was established based on CT images and anatomical characteristics. The model included three-dimensional elements such as bone, ligament, cartilage, meniscus and patellar retinaculum. The different finite element models of knee flexion states were produced by applying different torques after establishing boundary conditions. According to equivalent conditions (knee flexion 30 degrees, quadriceps tendon under 200 N stretch), the peak stress value of patella was 2.209 MPa and the average Mises stress was 1.132 MPa; the peak stress value of femoral trochlear was 1.405 MPa and the average Mises stress was 0.936 MPa. The validity of the model was proved by the difference between the model and previous studies of 1% to 13.5%. Dynamic model loading showed that the Mises stressof tibiofemoral joint decreased with the increase of knee flexion angle, while the Mises stress of patellofemoral joint was positively correlated with knee flexion angle. The Mises stress of cartilage stress planes at different knee flexion angles was significantly different(<0.05).@*CONCLUSION@#The finite element model established in this study is more comprehensive and can effectively simulate the biomechanical characteristics of dynamic knee joint, which provides support for further simulation mechanics researches of the knee joint.

Radiosensitization of sodium glycididazole in esophageal cancer evaluated by 18F-FMISO PET/CT / 中华核医学与分子影像杂志

Objective To investigate the feasibility of sodium glycididazole(CMNa)on the radio-sensitization of esophageal cancer(EC)by 18F-fluoromisonidazole(FMISO)PET/CT.Methods A total of 60 patients with EC from December 2016 to December 2017 were enrolled prospectively and were divided into control group(n = 30;21 males,9 females;age:(56.6±10.0)years)and experimental group(n=30;20 males,10 females;age:(59.3±9.0)years)using completely randomized grouping design.Patients in the control group received radiotherapy alone,and those in the experimental group were treated with conventional radiotherapy and CMNa.All patients underwent 18F-FMISO PET/CT imaging 1 week before and after radiotherapy.The imaging results were visually and semi-quantitatively analyzed.The maximum standardized uptake value(SUVmax),tumor/muscle ratio(T/M),and hypoxia volume(HV)were calculated.Paired t test,two-sample t test and/x2 test were used to analyze the data.Results T/M and HV in the control group before and after radiotherapy were 3.92±0.57 vs 1.66±0.35,(1.84±0.31)vs(1.04±0.15)mm3,respectively;T/M and HV in the experimental group before and after radiotherapy were 4.01±0.68 vs 1.27±0.11,(2.01±0.22)vs(0.90±0.09)mm3,respectively.The primary tumor T/M,HV after radiotherapy in 2 groups were significantly lower than those before radiotherapy(t values:12.15-24.43,all P<0.05)and the amplitudes of T/M and HV in the experimental group were significantly higher than those in the control group(?T/M:2.77±0.60vs 2.25±0.49,?HV:(1.12±0.18)vs(0.81±0.26)mm3;t values:3.00 and 1.80,both P<0.05).Meanwhile,the local control rate of EC after 3 months in the experimental group was higher than that in the control group(80.0%(24/30)vs 53.3%(16/30);x2=4.80,P<0.05).Conclusion CMNa has the radiosensitizing effect on EC and the 18F-FMISO PET/CT can evaluate the radiosensitization effect.

Study of Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine in patients with type 2 diabetes / 国际中医中药杂志

Objective@#To evaluate the effects of the classical prescriptions Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine on the lipid metabolism disorder and changes of intestinal microflora in patients with type 2 diabetes mellitus (T2DM).@*Methods@#A total of 120 patients who met the inclusion criteria were divided into the two group according to the treatment order, with 60 patients in each group. Both groups were given conventional hypoglycemic therapy, the control group was given bifidobacteria lactobacillus triple viable tablets, and the treatment group was given Dahuang-Huanglian-Xiexin decoction on the basis of the control group. Both groups were treated with 14 days for one course and 4 courses in total. The number of gram-positive coccus (G+c), gram-negative coccus (G-c), gram-positive bacillus (G+b) and gram-negative bacillus (G-b) in each 500 bacteria were observed under oil microscope, and the cocci/bacillus ratio were calculated. The TC and TG were detected by oxidase method, and HDL and LDL were detected by automatic biochemical analyzer. The FPG, 2 hPG and HbA1c were detected by automatic biochemical analyzer. TCM symptom scores were calculated.@*Results@#After treatment, the abdominal distension, congestion discomfort, and constipation score were significantly lower than the control group (t values were 3.685, 3.551 and 3.708, respectively, all Ps<0.05); Serum TG, TC and LDL-c levels were significantly lower than the control group (t values were 3.602, 3.581 and 3.421, respectively, all Ps<0.05); HDL-c level was significantly higher than that of the control group (t=3.358, P=0.046); Serum FPG, 2 hPG and HbA1c levels were significantly lower than the control group (t values were 3.502, 3.271 and 3.708, respectively, all Ps<0.05). After treatment, the G-c (271.47/500 ± 22.63/500 vs. 266.81/500 ± 22.36/500, t=3.792), G+b (81.26/500 ± 6.52/500 vs. 73.19/500 ± 6.94/500, t=3.511), G-b (183.76/500 ± 16.19/500 vs. 164.37/500 ± 15.83/500, t=3.306) levels in the treatment group significantly higher than those in the control group (P<0.05). After treatment, both c/b levels was (0.65 ± 0.13 vs. 0.87 ± 0.21, t=3.325) decreased significantly (P<0.05).@*Conclusions@#Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine can improve the clinical symptoms of T2DM patients, reduce blood glucose and lipid levels, and inhibit the body mass and improve insulin resistance by adjusting the structure of intestinal flora, increasing probiotics and reducing pathogenic bacteria.

Anatomical hepatectomy combined with intraoperative choledochoscopy in treatment of complicated hepatolithiasis / 中华肝胆外科杂志

Objective@#To study the clinical outcomes of anatomical hepatectomy combined with intraoperative choledochoscopy in treatment of complicated hepatolithiasis.@*Methods@#The clinical data of 176 patients with complicated hepatolithiasis who underwent operation at the Department of General Surgery of No.960 Hospital of PLA from May 2005 to July 2015 were analyzed retrospectively. The data included general data, clinical manifestations, types of stones, operative methods, postoperative complications and follow-up.@*Results@#There was no perioperative death. The postoperative complications which occurred in 31 patients (17.6%) included lung infection, intra-abdominal infection, bile leakage, and liver failure. Eighteen patients (10.2%) were found to have residual stones. After a follow-up which ranged from 1 to 3 years, 152 patients (94.4%) had good clinical outcomes. Recurrent stones were found in 12 patients (7.5%).@*Conclusion@#Anatomical hepatectomy combined with intraoperative choledochoscopy improved operative outcomes in patients with complicated hepatolithiasis and decreased residual stone and recurrence rates.

Anatomical hepatectomy combined with intraoperative choledochoscopy in treatment of complicated hepatolithiasis / 中华肝胆外科杂志

Objective To study the clinical outcomes of anatomical hepatectomy combined withintraoperative choledochoscopy in treatment of complicated hepatolithiasis.Methods The clinical data of176 patients with complicated hepatolithiasis who underwent operation at the Department of General Surgeryof No.960 Hospital of PLA from May 2005 to July 2015 were analyzed retrospectively.The data includedgeneral data,clinical manifestations,types of stones,operative methods,postoperative complications andfollow-up.Results There was no perioperative death.The postoperative complications which occurred in 31patients (17.6％) included lung infection,intra-abdominal infection,bile leakage,and liver failure.Eighteen patients (10.2％) were found to have residual stones.After a follow-up which ranged from 1 to 3years,152 patients (94.4％) had good clinical outcomes.Recurrent stones were found in 12 patients(7.5％).Conclusion Anatomical hepatectomy combined with intraoperative choledochoscopy improvedoperative outcomes in patients with complicated hepatolithiasis and decreased residual stone and recurrencerates.

Study of Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine in patients with type 2 diabetes / 国际中医中药杂志

Objective To evaluate the effects of the classical prescriptions Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine on the lipid metabolism disorder and changes of intestinal microflora in patients with type 2 diabetes mellitus (T2DM). Methods A total of 120 patients who met the inclusion criteria were divided into the two group according to the treatment order, with 60 patients in each group. Both groups were given conventional hypoglycemic therapy, the control group was given bifidobacteria lactobacillus triple viable tablets, and the treatment group was given Dahuang-Huanglian-Xiexin decoction on the basis of the control group. Both groups were treated with 14 days for one course and 4 courses in total. The number of gram-positive coccus (G+c), gram-negative coccus (G-c), gram-positive bacillus (G+b) and gram-negative bacillus (G-b) in each 500 bacteria were observed under oil microscope, and the cocci/bacillus ratio were calculated. The TC and TG were detected by oxidase method, and HDL and LDL were detected by automatic biochemical analyzer. The FPG, 2 hPG and HbA1c were detected by automatic biochemical analyzer. TCM symptom scores were calculated. Results After treatment, the abdominal distension, congestion discomfort, and constipation score were significantly lower than the control group (t values were 3.685, 3.551 and 3.708, respectively, all Ps<0.05); Serum TG, TC and LDL-c levels were significantly lower than the control group (t values were 3.602, 3.581 and 3.421, respectively, all Ps<0.05); HDL-c level was significantly higher than that of the control group (t=3.358, P=0.046); Serum FPG, 2 hPG and HbA1c levels were significantly lower than the control group (t values were 3.502, 3.271 and 3.708, respectively, all Ps<0.05). After treatment, the G-c (271.47/500 ± 22.63/500 vs. 266.81/500 ± 22.36/500, t=3.792), G+b (81.26/500 ± 6.52/500 vs. 73.19/500 ± 6.94/500, t=3.511), G-b (183.76/500 ± 16.19/500 vs. 164.37/500 ± 15.83/500, t=3.306) levels in the treatment group significantly higher than those in the control group (P<0.05). After treatment, both c/b levels was (0.65 ± 0.13 vs. 0.87 ± 0.21, t=3.325) decreased significantly (P<0.05). Conclusions Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine can improve the clinical symptoms of T2DM patients, reduce blood glucose and lipid levels, and inhibit the body mass and improve insulin resistance by adjusting the structure of intestinal flora, increasing probiotics and reducing pathogenic bacteria.

3D printed external fixator for treatment of tibial fractures / 中华骨科杂志

Objective To investigate the feasibility and primary clinical outcomes of a kind of independent research and development customized 3D printed external fixator in the treatment of tibial fracture.Methods Data of 7 tibial fracture patients who were treated using computer-assisted reduction and 3D printing technique including a new kind of customized external fixator with automatical reduction function from December 2013 to November 2015 were retrospectively analyzed.There were 5 males and 2 females in this cohort.The age of the patients ranged from 25 to 49 years old,with an average age of 38.1 years old.The procedure was as follows.At first,two or three pins were placed separately into the distal and proximal tibia away from fracture site.Then,the CT scanning was performed on the fractured tibia.According to the CT scanning data,the external fixator was designed by computer software and manufactured by the 3D printing technique.The reduction of tibial fracture was achieved automatically after the 3D printed external fixator was connected to the inserted pins.Finally,the accuracy of reduction was assessed by postoperative X-ray image.During the different fracture healing course,the stress environment could be dynamically adjusted by screwing or unscrewing the nuts to fulfill rigid fixation,compression fixation or elastic fixation for the bone healing.Results All the 7 cases had obtained successful reduction by only one time operation with the 3D printed external fixators.The average lateral angulation was 1.42°± 1.13°,and the average anteroposterior angulation was 1.65°± 1.36°,while the average lateral displacement was 1.38± 1.44 mm,and the average anteroposterior displacement was 1.83± 1.30 mm,which were measured from postoperative X-ray image.The individual durations of the operation were 9 min,8 min,9 min,1.5 min,1.4 min,1.4 min and 2.4 min,respectively.All fractures had achieved bony union in 19-25 weeks after operation,with an average time of 21.4±1.6 weeks.All patients were followed up for 6 months when removal of the external fixator,and no refracture occurred.Conclusion The customized 3D printed external fixator has the function of automatical reduction.In addition,it can provide three kinds of fixation modes,which are rigid fixation,compression fixation and elastic fixation.It has the advantages of simple operation,accurate reduction,reasonable fixation,etc.

Radiosensitization of irisquinone on the Warburg effect of MDA-MB231 cells / 中华放射医学与防护杂志

Objective To study the radiosensitization of irisquinone on the Warburg effect of MDA-MB231 cells.Methods MDA-MB231 cells in the exponential growth phase were divided into 6 groups:control group,irisquinone group,radiation group,irisquinone plus radiation group(Irisquinone + RA),negative control group,and experimental group (siRNA).Colony formation assay was used to measure cell survival fraction of MDA-MB231 cells.Single-hit multi-target model was used to fit the survival curve and calculate the sensitive enhancement ratio (SER).Flow cytometry was used to measure cell apoptosis.The relative expression levels of HK Ⅱ mRNA and protein in each group were detected by qRT-PCR and Western blot respectively.Results The values of D0,Dq and SF2 in the irisquinone plus radiation group were obviously lower than those in the radiation group.The SER of irisquinone was 1.52.Compared with the other groups,the cell apoptosis rate was increased (t =13.29,12.09,5.90,3.83,P ＜ 0.05),while the relative expression levels of HK Ⅱ mRNA (t =9.14,10.48,3.40,P＜0.05) and protein (t=13.39,16.08,5.81,P ＜ 0.05) were decreased in the irisquinone plus radiation group significantly.Conclusions Radiosensitization function of irisquinone inhibits the Warburg effect of MDA-MB231 cells by down-regulating the expression of HK Ⅱ.

Evaluation of radiosensitivity enhancement by irisquinone with 18F-FETNIM microPET/CT imaging in breast cancer bearing nude mice / 中华核医学与分子影像杂志

Objective To investigate the effect of irisquinone (IR) on the radiosensitization of MDA-MB-231 breast cancer in nude mice using 18F-fluoroerythronitroimidazole (18F-FETNIM) microPET/ CT.Methods Thirty-two nude mice bearing MDA-MB-231 breast cancer were divided into 4 groups by random number table method (n =8 for each group):group A was treated with radiotherapy alone,group B was treated with radiotherapy and IR,group C was treated with IR alone,and group D was fed with distilled water.18F-FETNIM microPET/CT images were obtained to monitor the maximum standardized uptake value (SUVmax) of tumor before radiotherapy and 24 h after radiotherapy.The mice were sacrificed and tumor tissues were removed for HE staining.The expression of hypoxia inducible factor-1α (HIF-1α) was detected by immunohistochemical (IHC) method.Data were analyzed by paired t test,one-way analysis of variance,the least significant different t test and Pearson correlation analysis.Results There was no significant difference in SUVmax among the 4 groups before radiotherapy (1.429±0.090,1.430±0.076,1.445±0.071,1.432± 0.074;F=0.072,P＞0.05).At 24 h after radiotherapy,the SUVmax of group A and B decreased significantly (1.075±0.098,0.890±0.076;t values:12.888,33.217,both P＜0.05),and there was significant difference between group B and group A (t =4.197,P＜0.05).However,the SUVmax of group C and D increased significantly (1.617±0.090,1.644±0.063;t values:-11.009,-16.061,both P＜0.05).Pathological results showed that tumor cells in group A and B were reduced.IHC results showed that the expression of HIF-1α was lower in group B than others ((26.75±7.19)％;F=46.745,t values:2.898-9.743,all P＜ 0.05).The expression of HIF-1α was positively correlated with SUVmax(r =0.89,P＜0.05).Conclusion 18F-FETNIM microPET/CT could evaluate the radiosensitization effect of IR on MDA-MB-231 breast cancer in nude mice.

Study on PSA oxygen generating technology with variable frequencies,constant pressure and self-adaptivity to altitude changes / 医疗卫生装备

Objective To provide technical support for developing portable and carrying PSA medical oxygen generators under variable altitudes. Methods Based on the operation principle of PSA technology, the effects of altitude on the performance capacity of series of PSA medical oxygen generators were analyzed. PSA oxygen generating technology was explored with an inlet system with variable frequencies and constant pressure. The problems due to the introduction of the converter were discussed during studying key technologies, and some countermeasures were put forward accordingly. Trials were executed with 1.2 Nm3/h generator taken as an example. Results The PSA medical oxygen generator developed met the requirements of corresponding standards of medical molecular sieve oxygen generator at the altitudes from 0 to 4451 m. Conclusion The PSA oxygen generator has its adaption altitude enhanced significantly.

The effects of different irrigation methods on postoperative life quality after impacted mandibular wisdom tooth removal / 实用口腔医学杂志

Patients underwent impacted mandibular wisdom tooth removal were randomly divided into 3 groups before operation.Patients in group A (n =41) were given pericoronal rinsing with 3 ％ H2O2 and saline before operation and irrigation once with povidone-iodine after tooth removal.Those in group B (n =43) were given irrigation with saline before and after tooth removal.47 patients in group C were given no irrigation as the controls.There was no significant difference in postoperative pain 3 days after operation among the 3 groups.Significant difference was found in postoperative pain 7 days after operation and mouth-opening 3 and 7 days after operation.There was significant difference in PoSSe scores among 3 groups but no difference between group A and B.It could be concluded that irrigation in pre-and post-operation can reduce the influence of teeth removal on life quality of the patients.

Baicalin alleviated rheumatoid arthritis synovitis of SD rats through TLR2-NF-κB pathway / 中国药理学通报

Aim To evaluate the effects of different doses of baicalin on rheumatoid arthritis (RA) in SD rats and explore the possible mechanism.Methods Firstly,the model of RA in SD rats was prepared and the hind foot swelling was measured;HE staining was used to observe the pathological changes of the knee joint synovial tissue;RT-qPCR was adopted to determine the mRNA expressions of TLR2 and MyD88 in synovial tissue;Western blot was used to determine the protein expressions of TLR2,MyD88 and NF-κB p65 aher intragastric administration of different doses of baicalin solution.Results Compared with the model,baicalin (60 and 30 mg · kg-1) could inhibit the proliferation of fibroblasts and inflammatory damages in synovial tissue,significantly cut down mRNA expressions of TLR2 and MyD88 (P ＜ 0.05) and markedly reduce protein expressions of TLR2,MyD88 and NF-κB p65 (P ＜ 0.01).Conclusion Baicalin has good effects on RA,which may be realized by inhibiting the activation of TLR2-NF-κB signaling pathway.

Effects of types of gingival flap suture on postoperative quality of life after removal of impacted mandibular wisdom teeth / 天津医药

Objective To evaluate effects of different types of gingival flap suture on the quality of life in patients after removal of mandibular third molar. Methods A randomized, controlled clinical trial design was adopted. Sixty-two patients in oral surgery department, Stomatology Hospital of Tianjin Medical University were selected. Patients were required removal of bilateral symmetry impacted mandibular third molars, and enclosed suture (primary suture) was used in one side, open drainage suture (secondary suture) was used in the other side. The postoperative symptom severity scale (PoSSe scale) was used to evaluate the quality of life in patients after removal of mandibular third molar. The evaluation was completed 7 days after surgery, and the scale was compared between two groups. Results A total of 57 cases of clinical data were enrolled in the final analysis. The operative time for primary suture group was (17.7±4.6) min, and the operative time for secondary su?ture group was (16.3 ± 5.1) min, the difference was not statistically significant (t=1.539, P>0.05). The PoSSe score was sig?nificantly higher in primary suture group (26.348 ± 12.414) than that of secondary suture group (21.633 ± 11.382, P<0.05). Conclusion Secondary suture reduces the influence of teeth removal on quality of life in patients through relieving pain and swelling, and which is suitable for clinical application.

PIK3CD gene silencing inhibiting the proliferation and migration of gastric cancer HGC-27 cells in vitro / 肿瘤

Objective: To investigate the effects of phosphoinositide-3 kinase, catalytic subunit delta (PIK 3CD ) gene silencing on the proliferation and migration of human gastric cancer HGC-27 cells in vitro and its possible mechanism. Methods: The expression level of PIK3CD mRNA in HGC-27 cells was detected by real-time fluorescent quantitative PCR. HGC-27 cells were transfected with recombinant plasmid MSCV-PIK3CD-shRNA, then the expression silencing of PIK 3CD gene was verified by real-time fluorescent quantitative PCR and Western blotting. The proliferation and migration abilities of HGC-27 cells after transfection with MSCV-PIK3CD-shRNA were detected by cell count kit-8 (CCK-8) assay and Transwell chamber assay, respectively. The expressions of Akt signal pathwayrelated proteins in HGC-27 cells after transfection with MSCV-PIK3CD-shRNA were detected by Western blotting. Results: The expression level of PIK3CD mRNA in gastric cancer HGC-27 cells was higher than that in normal gastric mucosal GES-1 cells. After transfection with MSCV-PIK3CD-shRNA, the expression levels of PIK3CD mRNA and protein in HGC-27 cells with high expression of PIK 3CD gene were significantly decreased (P < 0.05), and the cell proliferation and invasive abilities were significantly reduced (P < 0.05). PIK 3CD gene silencing had no effect on the expression of Akt, but significantly inhibited the expression of phospho-Akt (p-Akt) (P < 0.05). Conclusion: PIK3CD may promote the proliferation and migration of gastric cancer HGC-27 cells in vitro by activating Akt pathway.

The influence of the envelope flap and triangular flap designs on postoperative complications after mandibular third molar removal / 天津医药

Objective To evaluate effects of two different flap designs (envelope flap and triangular flap) on complica?tions after the mandibular third molar surgery. Methods A randomized, self controlled clinical trial design was selected for 52 patients treated in the outpatient surgery of Stomatological Hospital Affiliated to Tianjin Medical University. Patients were treated with envelope flap design for lower third molar removal in one side and triangular flap on the other side. VAS scores were used to evaluate postoperative pain. The postoperative swelling was evaluated by patient`subjective index. The degree of the upper and lower incisor distance was used to evaluate trismus. Data of postoperative swelling, pain and trismus were re?corded 1, 2 and 7 days after surgery. Data of postoperative wound dehiscence, bleeding situation and alveolitis were also re?corded and compared between two groups. Results There were no significant differences in postoperative pain after 1, 2 and 7 days between two flap designs (P>0.05). After 1 and 2 days there was more severe facial swelling in triangular flap group than that of envelope flap group (Z=2.005, Z=2.017, P0.05). There were no signifi?cant differences in postoperative pain, alveolitis, bleeding and wound dehiscence between two groups (P > 0.05). Conclu?sion The envelope flap is more conductive to the early recovery in patients after surgery, but in the long term there is no ob?vious difference between the two flap designs.

Time-dependent expression of PEDF and VEGF in blood serum and retina of rats with oxygen-induced retinopathy / 华中科技大学学报（医学）（英德文版）

The effects of the balance changes of pigment epithelium growth factor (PEDF) and vascular endothelial growth factor (VEGF) in whole-body and retinal tissue on rats with oxygen-induced retinopathy were investigated. Forty-eight neonatal SD rats at the age of 7 days were randomly divided into 4 groups. The neonatal rats in experimental groups were exposed to 75% to 80% oxygen for 5 days and then to normal air, and those in control groups were kept feeding in normal air. At the age of 17 and 22 days, all the neonatal rats received retina angiography with FITC-dextran and the pathological changes of retinal vessels and perfusion were observed. HE staining of the tissue section and the number counting of endothelial cells extending beyond the inner limiting membrane were performed to evaluate the endothelial proliferation. Immunohistochemistry was applied to detect the expression of PEDF and VEGF in retinal tissue, and ELISA to detect their expression in serum. A hypoxic-ischemic proliferation of retina and more endothelial cells extending beyond the inner limiting membrane were found in the neonatal rats in both experimental groups of 17-day old and 22-day old as compared with those in control group with the difference being statistically significant (P0.05). The serum PEDF concentration in the rats of 17 days old in experimental group was decreased significantly as compared with that in the rats of 17 days old in control group (P<0.01), and in experimental groups, the serum PEDF concentration of the rats of 22 days old was increased as compared with that of the rats of 17 days old (P<0.01). In conclusion, the obviously decreased serum PEDF concentration and the abnormal enhanced expression of VEGF density in local retinal tissue broke down the balance of PEDF/VEGF in whole-body or local tissues, which might play an important role in retinal vascular proliferation.

Time-dependent expression of PEDF and VEGF in blood serum and retina of rats with oxygen-induced retinopathy / 华中科技大学学报（医学）（英德文版）

The effects of the balance changes of pigment epithelium growth factor (PEDF) and vascular endothelial growth factor (VEGF) in whole-body and retinal tissue on rats with oxygen-induced retinopathy were investigated. Forty-eight neonatal SD rats at the age of 7 days were randomly divided into 4 groups. The neonatal rats in experimental groups were exposed to 75% to 80% oxygen for 5 days and then to normal air, and those in control groups were kept feeding in normal air. At the age of 17 and 22 days, all the neonatal rats received retina angiography with FITC-dextran and the pathological changes of retinal vessels and perfusion were observed. HE staining of the tissue section and the number counting of endothelial cells extending beyond the inner limiting membrane were performed to evaluate the endothelial proliferation. Immunohistochemistry was applied to detect the expression of PEDF and VEGF in retinal tissue, and ELISA to detect their expression in serum. A hypoxic-ischemic proliferation of retina and more endothelial cells extending beyond the inner limiting membrane were found in the neonatal rats in both experimental groups of 17-day old and 22-day old as compared with those in control group with the difference being statistically significant (P<0.01). VEGF staining of the rats in the 17-day old experimental group was significantly stronger, with an increasing positive rate, than that of the rats in the 17-day old control group (P<0.01). PEDF staining of the rats of 22 days old was weaker than that of the rats of 17 days old in the experimental groups (P<0.01). There was no significant difference in serum VEGF concentration among all groups (P>0.05). The serum PEDF concentration in the rats of 17 days old in experimental group was decreased significantly as compared with that in the rats of 17 days old in control group (P<0.01), and in experimental groups, the serum PEDF concentration of the rats of 22 days old was increased as compared with that of the rats of 17 days old (P<0.01). In conclusion, the obviously decreased serum PEDF concentration and the abnormal enhanced expression of VEGF density in local retinal tissue broke down the balance of PEDF/VEGF in whole-body or local tissues, which might play an important role in retinal vascular proliferation.