Objective：To explore the levels of TRAP1 and its roles in patients with ovarian tumor, and investigate the correlation between the expressions of TRAP1 in ovarian tumor tissues and related clinicopathological characteristics. Methods: 38 health women, 50 cases of benign ovarian tumors and 114 cases of epithelial ovarian cancers were examined by Real -time RT-PCR and immunohistochemical staining. Results: The immunohistochemical analysis demonstrated that TRAP1 protein was mainly located in the cytoplasm, the protein and mRNA expression of TRAP1 in ovarian cancer were significantly increased compared with those of normal control and benign tumor (P<0.05). The protein and mRNA expression of TRAP1 was related to histological grade and pathologic types (P<0.05), but not age, clinical stages, lymphnode metastasis or omental metastasis, and the amount of ascites (P>0.05). Conclusion: The high expression of TRAP1 may play potential role in epithelial ovarian cancer occurrence and progress.

Salivary gland tumors are a group of the most common tumors in the oral and maxillofacial region with obvious characteristics of clinical, histopathologic, and therapeutic aspects. During the past 50 years, our research group performed a systemic study on salivary gland tumors including imaging diagnosis, fine needle aspiration cytology, FT-mid-IR fiber optics spectroscopy, histopathologic features and biological behaviour of the tumors, functional parotid surgery, and ¹²⁵I seed implant branchytherapy. More reasonable principles of management for various types of the tumors were put forward based on the histopathologic features of the tumors. The surgical techniques were modified and the postoperative complications were reduced obviously. Thus, the quality of life of the patients was improved greatly.

To investigate the influence of duration of gonadotropin (Gn) administration on the clinical outcome of in vitro fertilization embryo transfer (IVF-ET). Methods: A total of 3 221 cycles of short protocol or antagonist protocol in our center from January 2012 to December 2012 were included in the retrospective study. According to the different duration of Gn administration, all patients were divided into group A (≤7 days, n=58) and group B (＞7 days, n=3 163). The different clinical parameters, such as age, duration of infertility, body mass index (BMI), basis estradiol (E ₂), folliclestimulating hormone (FSH), the number of antral follicle, the number of oocytes, endometrium thickness, fertility rate, good quality embryo rate, impatation rate and clinical pregnancy rate were compared between the two groups．Results: There was no significant difference in age, duration of infertility, BMI, basis E ₂, FSH, the number of antral follicle between the two groups. The number of oocytes in group A was fewer than that in group B ［（8.2±5.6）vs.（12.1±8.3），P=0.009］; endometrium thickness on the day of HCG in group A was thinner than that in group B ［（9.9±2.1） mm vs.（10.4±1.6） mm，P=0.002］. There was no significant difference in fertility rate, good quality embryo rate, impatation rate and clinical pregnancy rate (36.2% vs. 33.6%, P> 0.05). There was no significant difference in clinical pregnancy rate between the two groups in short protocol (33.3% vs. 27.2%, P> 0.05). In the same way, there was no significant difference in clinical pregnancy rate between the two groups in antagonist protocol (37.5% vs. 36.6%, P> 0.05). Conclusion: Although short duration of gonadotropin administration in short protocol and antagonist protocol has association with fewer number of oocytes, it may not affect the outcome of IVF- ET.

Objective：To construct a new human chemotactic cytokine PSMP eukaryotic expression vector to express PSMP in Chinese hamster ovary (CHO) cells and to obtain the purified recombinant PSMP protein for its functional mechanism study. Methods: PSMP-myc/His fragment, cut from pcDNA3.1-PSMP-myc/His, was inserted into pMH3 expression vector. This expression vector was transfected into CHO cells by electroporation. Stable clone strains were selected by Geneticin resistance screening. The expressions of PSMP protein in the cell culture supernatant were measured by Dot blot and Western blot analysis. The monoclone was prepared from resistance screening polyclone by limiting dilution method. A large number of the engineering cells were cultured with serum-free medium and the protein in the cell culture supernatant was purified by nickel affinity chromatography. The purity of the PSMP protein was analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). The functional activity of the protein was analyzed in vitro by Boyden chamber chemotaxis assay. Results:The eukaryotic expression vector pMH3-PSMP was successfully constructed by inserting PSMP-myc/His gene into pMH3 vector. After transfection of CHO cells, a stable expression of the PSMP gene engineering cell strain was obtained through twice cloning. The purity of the recombinant PSMP protein was 95% higher with bioactivity. Conclusion: The eukaryotic expression vector of PSMP protein is successfully constructed. The stable expression of PSMP is first obtained in CHO cell strain. The recombinant PSMP protein has higher purity and bioactivity, which provides a useful tool for further study of the functions and mechanisms of PSMP.

Objective： To determine the mechanism of sunitinib-induced autophagy in renal cell carcinoma cells. Methods: MTS assay was applied to detect the cell viability alteration under the treatment of sunitinib (2, 8 μmol/L). The sunitinib-induced autophagy as well as cell apoptosis was measured and compared after knocking down autophagy-related protein Beclin1 and microtubule associated protein 1 light chain 3 fusion protein (LC3) by RNA interference. The transmission electron microscope was used to observe the formation of autophagosomes in ACHN cells. The fluorescence microscope was used to monitor distribution and aggregation of endogenous LC3-Ⅱ. The expressions of protein such as LC3-Ⅱ, the autophagic regulation molecules protein kinase B/ mammalian target of rapamycin (Akt/mTOR) and the symbol of apoptosis poly ADP-ribose polymerase (PARP) were capable to be detected by immunoblotting assay. Results: Sunitinib was able to significantly trigger cell viability loss in the renal carcinoma cell ACHN, which was both in a concentration-dependent and time-dependent manner (P<0.05). After reducing the autophagy by knocking down Beclin1 and LC3, the number of cleavage of PARP was increased remarkably, whereas there was nearly not any cleavage in the mock group. By the transmission electron microscope, there were more autophagic vacuoles in ACHN cells after being administrated with sunitininb compared with the control. And the nuclear-to-cytosol translocation as well as aggregation of LC3-Ⅱ was presented after sunitinib treatment by the fluorescence microscope, which was the proof of the enhanced autophagy. According to the immunoblotting, sunitinib was able to increase the accumulation of LC3-Ⅱ. At the same time, the result of sunitinib combined with chloroquine, a drug which blocked the fusion of autophagosomes and lysosomes, demonstrated that the increasing amount of LC3-Ⅱ was due to the enhanced autophagy flux by sunitinib treatment in ACHN cells. However, phosphorylation of Akt as well as mTOR was decreased at the same time. The rapamycin (mTOR inhibitor) or knocking down Akt subunits could change the sunitinib-induced LC3-Ⅱ accumulation, whereas overexpression of Akt subunits decreased the autophagic flux, indicating that Akt/mTOR was the target of sunitinib in autophagy. Conclusion: Sunitinib induced autophagy via suppressing Akt/mTOR pathway, and the auto-phagy was involved in apopotosis.

To evaluate the combined effect of premedication of parecoxib sodium and local infiltration of ropivocaine on postoperative shoulder pain and incisional pain in patients undergoing diagnostic hysteroscopy and laparoscopy. Methods: In the study, 60 patients undergoing elective diagnostic hysteroscopy and laparoscopy were randomly allocated to two groups (each with 30 patients). The patients in group 1 were premedicated with 40 mg parecoxib sodium (diluted with 2 mL normal saline), and 0.5% ropivacaine (20 mL) were infiltrated around the incision site before establishment of CO2 pneumoperitoneum. The patients in group 2 received 2 mL normal saline intraveniously before anesthesia induction, and infiltration of 0.5% ropivacaine 20 mL were also applied as group 1. After anesthetic withdrawal, the patients’ postoperative anesthesia recovery time and the time point of opening eyes on verbal command were noted. The intensities of postoperative shoulder pain and incisional pain were evaluated at 0, 2, 4, 8, 12, 24, and 48 h after surgery. The postoperative analgesic requirement was met by administration of tramadol. Results: Compared with group 2, the incidence of postoperative shoulder pain was less in group 1 (37% vs. 67%, P=0.020), and the occurence of severe pain was lower (4 vs. 11, P=0.037). The numerical rating scales (NRS) of right shoulder pain of group 1 were significantly reduced than those of group 2 at 12 h postoperatively ［0 (0, 2) vs. 0 (0, 8), P=0.012］. Left shoulder pain did not appear at 0 h and 2 h in both groups, while at 12 h and 24 h postoperatively, the NRS scores of group 1 were lower than those of group 2 ［0 (0, 1) vs. 0 (0, 8), P=0.026; 0 (0, 4) vs. 2 (0, 9), P=0.014］. The dynamic and static abdominal pain scores of group 1 were significantly decreased than those of group 2 in postanesthesia care unit (PACU) after surgery (P=0.001, P=0.005). The NRS scores of static abdominal pain of group 1 were significantly reduced than those of group 2 at 12 h and 24 h postoperatively (P=0.042, P=0.029). More patients in group 2 needed tramadol within 24 h postoperatively (8 vs. 0, P=0.002). Conclusion: Premedication of parecoxib sodium combined with local infiltration of ropinvocaine before incision could significantly reduce the postoperative shoulder pain and incisional pain as well as reduce opioid consumption in patients undergoing diagnostic hysteroscopy and laparoscopy.

Objective:To establish and validate a new model of health belief model(HBM) combined with theory of planned behavior(TPB). Methods: Path analysis was applied to set up a new model predicting ironfortified soy sauce consumption behavior using baseline survey data among women in rural and urban areas in Beijing, and the model was validated in followup survey. Results: It was proved that health values had powerful direct effect on behavior identity and had relatively strong direct effect on attitudes towards behavior; behavior identity had strong effect on behavior barriers, mostly in a direct way, and on behavior intention in a direct or indirect way; control belief was an important external factor influencing behavior intention; behavior intention was the most direct and most important one of factors influencing actual behavior; and convenience to buy was an important external factor influencing actual behavior. Conclusion: The integrated model of TPB and HBM explains behavior better and may be attempted in other similar researches.

Objective： To compare the clinical effects of direct anterior approach (DAA) and posterolateral piriformis-sparing approach (Mis-PLA) for minimally invasive surgery of total hip arthroplasty. Methods: The patients who had total hip arthroplasty from March 2015 to February 2016 were randomly divided into 2 groups: DAA group and Mis-PLA group. In the study, 43 patients (45 hips) were performed with total hip replacement via the direct anterior approach (DAA group). As comparison，39 patients (42 hips) were performed with total hip replacement via the posterolateral piriformis-sparing approach （Mis-PLAgroup） at the same period. DAA group：27 male patients (27 hips), and 16 female patients (18 hips)，with an average age of (57.4±7.3) years, preoperative Harris score (41.4±8.7), body mass index（BMI）(24.3±2.2) kg/m2; MisPLA group： 25 male patients (26 hips)，14 female patients (16 hips), with an average age of (59.2±7.3) years, preoperative Harris score (39.6±8.4), BMI (24.7±2.5) kg/m2. The length of incision， operation time， blood loss，postoperative Harris score were observed and specially the hip functional recovery was fully assessed. Results: (1) All the incisions healed by first intention. No complications were found in both groups. The length of incision：DAA group :（9.2±0.7） cm and Mis-PLA group :（9.5±0.6） cm. No statistical significant differences were found (P=0.053). The operation time：DAA group （74.3±10.1） min and Mis-PLA group（37.5±4.3） min, which showed statistically significant differences（P＜0.01）. Blood loss：DAA group（229.6±79.2） mL and Mis-PLA group (215.7±56.0) mL. Nostatistical significant differences were found （P=0.366）. (2) The patients in both groups were followed up for 6-12 months. The Harris hip scores for 6 weeks’ follow-up：(85.5±4.1) in DAA group and (79.0±4.4) in Mis-PLA group，which indicated statistically significant differences (P＜0.01).The Harris scores for the 6-month follow-up：(94.3±2.7) in DAA group and (95.2±1.9) in Mis-PLA group. No statistically significant differences were found (P=0.125). The basic daily hip function analysis for the 6-week follow-up：walking speed: no statistically significant differences were found between the two groups（P=0.298）; Climbing stairs: Mis-PLA group’ outcome was better than DAA group’s with statistical differences (P=0.047); Circling,sitting and wearing shoes and socks: outcomes in DAA group exceeded Mis-PLA group’s with statistically significant differences （P＜0.01，P=0.016，P＜0.01）. Conclusion: Total hip arthroplasty through either DAA or Mis-PLA approaches could result in very satisfactory clinical effect. Comparing with DAA, Mis-PLA requires less operation time, shorter learning curve，which indicates that it is a relatively safer approach. The advantages of total hip arthroplasty through direct anterior approach lie in less positional limitation in the early stage of postoperative period，as well as a faster recovery of hip function.

Objective： To evaluate the rate of basicervical fractures and document their diagnosis and treatment. Methods: From January 2005 to May 2016, 28 basicervical fractures of the 832 trochanteric fractures were collected and evaluated. The patients were treated with multiple screws, dynamic hip screw (DHS), intramedullary nail. Via the operation time, postoperative hospitalization, loss of blood duration the operation, hidden blood loss, total blood loss, mean union time and the final follow-up Harris hip score, the characteristics of different internal fixations were compared and analyzed. Results: The incidence of basicervical fractures was 3.37% (28/832) in our study. In the intramedullary nail group (16 patients), the operation time was 55 (20,120) min, the postoperative hospitalization was 3(2, 7) d, the intraoperative blood loss was 50(5,100) mL, the hidden blood loss was 533.37 (376.19, 987.15) mL, and the total blood loss 627.35 (406.19, 1037.16) mL . The union time and final follow-up Harris score were 6 (3, 9) months and 90.25 (74,100) min. In the DHS group (8 patients), the operation time was 87.5 (65,115) min, the postoperative hospitalization was 5.5 (2, 17) d, the intraoperative blood loss was 100 (50,300) mL, the hidden blood loss was 278.11 (202.43, 849.97) mL, and the total blood loss 580.19 (368.55, 899.97) mL . The union time and final followup Harris score were 5.5 (4, 12) months and 85.5 (84, 87) min. In the multiple screws group (4 patients), the operation time was 47.5 (35, 75) min, the postoperative hospitalization was 5 (2, 12) d, the intraope-rative blood loss was 20 (2, 70) mL, the hidden blood loss was 150 (100.00, 412.01) mL, and the total blood loss 195.00 (120.00, 414.01) mL. The union time and final follow-up Harris score were 4 (4, 6) months and 80 (61, 97) min. The patients treated with multiple screws and intramedullary nail had a shorter operation time than the DNS group, but no obvious difference was found between the other two groups (P=0.367). Postoperative hospitalization had no significant difference among the three groups. The intraoperative bleeding was more in the DHS group, the other two groups had no significant difference (P=0.100). However, the hidden blood loss was more in the intramedullary nail group, the other two groups had no significant difference (P=0.134). The total blood loss in the intramedullary nail group was more than multiple screw group, similar to the DHS group (P=0.483). One patient treated with multiple screws underwent internal fixation failure three months after operation. The mean union time and final follow-up Harris scores had no significant difference among the three groups (P>0.05). Conclusion: Through this study, we found that the incidence of basicervical fractures is low. Fractures with no shift can be confirmed by preoperative X-ray. For displaced fractures, preoperative CT + 3D reconstruction is recommended. Surgical treatment by closed reduction and internal fixation with DHS or intramedullary nail is shown to be very effective.

Objective： To explore a new method of whole-process digital esthetic prosthodontic rehabilitation combined with periodontic surgery for complicated anterior teeth esthetic defects accompanied by soft tissue morphology, to provide an alternative choice for solving this problem under the guidance of threedimensional (3D) printing digital dental model and surgical guide, thus completing periodontic surgery and digital esthetic rehabilitation of anterior teeth. Methods: In this study, 12 patients with complicated esthetic problems accompanied by soft tissue morphology in their anterior teeth were included. The dentition and facial images were obtained by intra-oral scanning and three-dimensional (3D) facial scanning and then calibrated. Two esthetic designs and prosthodontic outcome predictions were created by computer aided design /computer aided manufacturing (CAD/CAM) software combined with digital photography, including consideration of white esthetics and comprehensive consideration of pink-white esthe-tics. The predictive design of prostheses and the facial appearances of the two designs were evaluated by the patients. If the patients chose the design of comprehensive consideration of pink-white esthetics, they would choose whether they would receive periodontic surgery before esthetic rehabilitation. The dentition design cast of those who chose periodontic surgery would be 3D printed for the guide of periodontic surgery accordingly. Results: In light of the two digital designs based on intra-oral scanning, facing scanning and digital photography, the satisfaction rate of the patients was significantly higher for the comprehensive consideration of pinkwhite esthetic design (P<0.05) and more patients tended to choose priodontic surgery before esthetic rehabilitation. The 3D printed digital dental model and surgical guide provided significant instructions for periodontic surgery, and achieved success transfer from digital design to clinical application. The prostheses were fabricated by CAD/CAM, thus realizing the whole-process digi-tal esthetic rehabilitation. Conclusion: The new method for esthetic rehabilitation of complicated anterior teeth esthetic defects accompanied by soft tissue morphology, including patient-involved digital esthetic analysis, design, esthetic outcome prediction, 3D printing surgical guide for periodontic surgery and di-gital fabrication is a practical technology. This method is useful for improvement of clinical communication efficiency between doctorpatient, doctor-technician and doctors from different departments, and is conducive to multidisciplinary treatment of this complicated anterior teeth esthetic problem.

Maxillary molar with three roots and 3 to 4 canals is a common occurrence. However, in addition to common root canal anatomy, there may be significant differences in the number, distribution, and morphological structure of root canals. The success of root canal treatment is dependent on ensuring that all the intricate details associated with it are meticulously followed. Failure to locate all canals could have a negative effect on the treatment as it may lead to initiation or continuation of periapical pathology. Missed canals were the main reason for patients reporting back for nonsurgical root canal retreatment. Moreover, the bacteria residing in such canals could also result in persistence of symptoms. Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This article presents three cases of endodontic management of maxillary molars with atypical canal morphology. In the three cases of this study, the patients underwent cone beam computed tomographic (CBCT) examination before root canal treatment. The CBCT images revealed that the maxillary molars in case 1 and case 2 had 5 canals. Case 1: 2 mesiobuccal (MB, MB2), two distobuccal (DB and DB2), and one palatal canal. Case 2: 2 mesiobuccal (MB, MB2), one distobuccal (DB), and two palatal canals (MP and DP). In case 3, CBCT scan slices showed that the maxillary first molar presented as a C-shaped root canal with a rare tooth anomaly of taurodontism. Although C-shaped root canals were most frequently seen in the mandibular second molar, they might also appear in maxillary molars. A literature search revealed only a few case reports of C-shaped root canal systems in maxillary molars. Case 3 described the fusion between mesiobuccal and palatal roots of the maxillary first molar, forming a C-shaped mesiopalatal root canal. The above cases suggest that endodontists should always be aware of aberrancies in root canal system apart from the knowledge of normal root canal anatomy. CBCT as a means of diagnosis can be helpful for identifying and managing these complex root canal systems. This case series also highlights the importance of magnification and illumination. Through using an endodontic microscope, clinicians can identify root canals that are difficult to locate or overlooked with normal vision. A correct access opening is a most important step to locate and negotiate the orifices of root canals. The use of ultrasonic tips can refine the access cavity and allow controlled and delicate removal of calcifications and other interferences to the canal orifices, thereby helping to locate the extra orifices.