Peripheral nerve defects are still a major challenge in clinical practice, and the most commonly used method of treatment for peripheral nerve defects is nerve transplantation, which has certain limitations and shortcomings, so new repair methods and techniques are needed. The peripheral nerve is elongated in limb lengthening surgery without injury, from which we got inspirations and proposed a new method to repair peripheral nerve defects: peripheral nerve elongation. The peripheral nerve could beelongated by a certain percent, but the physiological change and the maximum elongation range were still unknown. This study discussed the endurance, the physiological and pathological change of peripheral nerve elongation in detail, and got a lot of useful data. First, we developed peripheral nerve extender which could match the slow and even extension of peripheral nerve. Then, our animal experiment result confirmed that the peripheral nerve had better endurance for chronic elongation than that of acute elongation and cleared the extensibility of peripheral nerve and the range of repair for peripheral nerve defects. Our result also revealed the histological basis and changed the rule for pathological physiology of peri-pheral nerve elongation: the most important structure foundation of peripheral nerve elongation was Fontana band, which was the coiling of nerve fibers under the epineurium, so peripheral nerve could be stretched for 8.5%-10.0% without injury because of the Fontana band. We confirmed that peripheral nerve extending technology could have the same repair effect as traditional nerve transplantation through animal experiments. Finally, we compared the clinical outcomes between nerve elongation and perfor-mance of the conventional method in the repair of short-distance transection injuries in human elbows, and the post-operative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group. On the whole, all of these experimental results revealed the physiological phenomenon of peripheral nerve elongation, and described the physiological change and stretch range in detail. The systematic research results have filled the blank in this field, which is very helpful for clinical limb lengthening surgery, the design of elongation surgery and the evaluation of the peripheral nerve stretch injury. Peripheral nerve elongation will become an innovative treatment technology in repairing peripheral nerve defects.

Objective：To study the change of microRNA during the early stage of high phosphorus induced vascular smooth muscle cell (VSMC) calcification and its related mechanism.Methods:The in vitro calcification model was created through stimulating VSMC cell line A7r5 with high Pi (2.6 mmol/L) for 7 d. The calcification was validated through ocresolphthalein complexone colorimetry to detect the cellular calcium content, real-time PCR to measure the calcification-related gene expression and alizarin red staining to observe the formation of calcium nodules. Based on the cell calcification model, microRNA microarray array was applied to screen the profiles of microRNA expression in VSMC following high Pi stimulation for different periods (0, 3 and 12 h). The array data were analyzed by TAM tool to explore the activated signaling pathway.Results: The calcium content of A7r5 cells induced by high Pi was increased 9.6 times high as cells without Pi treatment (P<0.05). VSMC contractile phenotype genes (SM-α actin, SM22) were down-regulated (P<0.05), while calcification-related genes (BMP2, MSX2, Runx2) were up-regulated (P<0.05) in VSMC stimulated by high Pi. The calcium nodules were obviously formed in cells after 7 d high Pi treatment. In microarray experiment, 680 individual microRNAs were detected in high Pi-treated VSMCs at different time points (0, 3 and 12 h). Among these genes, miR-183, miR-664 and miR-9* were increased whereas miR-542-5P, let-7f and miR-29a were decreased in time-dependent manners. Twenty-six kinds of signaling pathways, including cell apoptosis, differentiation and proliferation, were significantly activated. All these activated pathways were associated with calcification. Conclusion:This study implies that microRNA changed in high Pi-induced VSMCs may involve in the process of calcification.

Objective： To establish a Mongolian gerbils model by long-term infection of Helicobacter pylori (Hp) with highly-expressed thioredoxin-1 (Trx1) gene and to investigate the histopathological findings of gastric mucosa in Mongolian gerbils. Methods: In this study, 75 healthy male Mongolian gerbils were randomly divided into 3 groups: Hp with highly-expressed Trx1 gene group (n=30), Hp with lowly-expressed Trx1 gene group (n=30), and control group (n=15). The animals underwent gastric perfusion of Hp suspension once a week for 5 weeks. The animals were sacrificed at the end of 4, 20, 34, 48, 70, and 90 weeks after inoculation for detecting Hp colonization by rapid urease test and Warthin-Starry silver staining and histological examination, respectively. Results: (1) The Mongolian gerbil model of long-term infection of Hp with highly-expressed Trx1 gene and lowly-expressed Trx1 gene were successfully established. (2) The macroscopic mucosal lesions, including erythema, uneven, erosion, nodules, etc. could be observed in experimental groups. The severity of lesions and the time when lesions occurred in Hp with highly-expressed Trx1 gene group were heavier/earlier than that in Hp with lowly-expressed Trx1 gene group. (3) Histopathologically, the gastric mucosa of Hp with highly-expressed Trx1 gene group showed the mild dysplastic hyperplasia of epithelial cells 34 weeks after the Hp inoculation, and the time was in the 48th week in Hp with lowly-expressed Trx1 gene group. At the end of the 90th week after Hp inoculation, the gastric adenocarcinoma could be detected in the two experimental groups (71.4% vs. 42.8%). The difference between the two experimental groups did not reach statistical significance (P=0.592), which might be due to the small sample capacity and/or short observation time. In addition, there were 2 cases with severe epithelial dysplastic hyperplasia in Hp with highly-expressed Trx1 gene group, and only 3 cases with moderate epithelial dysplastic hyperplasia in Hp with lowly-expressed Trx1 gene group. The uninfected control animals showed no abnormal findings throughout the entire observation period. Conclusion: Hp with highly-expressed/lowly-expressed Trx1 gene colonizes stably in the glandular gastric mucosa of Mongolian gerbils. The histological changes after infection are similar to those of the Hp infected human being, and Hp with highly-expressed Trx1 gene cause the injury of gastric mucosa and the occurrence of gastric adenocarcinoma. Trx1 maybe the virulence factor that participates in the pathogenesis of gastric cancer and Hp expressing high levels of Trx1 should be highly toxic for gastric diseases in China.

Objective：To observe the effect of CD40 siRNA on expression of IFN-γ, IL-17,  IL-4 and anti-dsDNA antibody of systemic lupus erythematosus (SLE) animal model MRL/Lpr mice and to discuss its therapy on MRL/Lpr mice. Methods: In the study, 16 female MRL/Lpr mice were randomly divided into control group (n=4), empty vector group (n=4), CD40siRNA1 group (n=4) and CD40-siRNA2 group (n=4). The vectors expressing siRNA against CD40 were injected by tail veil into MRL/Lpr mice, while MRL/Lpr mice in control group and empty vector group were injected with the same dose of PBS and pGFP-V-RS vector respectively.  The injection was given six times and every one day. The mice were sacrificed  14 d after injection, and the spleen tissue was weighed. The pGFP-V-RS was labeled by green fluorescent protein（GFP) and the tissue sections were observed whether siRNA expressed in the spleen. The expression levels of IFN-γ, IL-17, IL-4 and anti-dsDNA antibody in the sera were detected by ELISA method on the 1st day before the first time and the 2nd, 5th, 8th, 11th, and 14th days after last  injection, and the expression levels of CD40 mRNA in spleen tissue of MRL/Lpr mice were detected by RT-PCR and the expression levels of CD40 protein in spleen tissue of MRL/Lpr mice were detected by immunohistochemistry method. Results: The expression vector of CD40-siRNA could express in the spleen of MRL/Lpr. The spleens in CD40-siRNA1 group ［(78.85 ±5.61) mg］ and CD40-siRNA2 group ［(80.25±4.07) mg］ were lower than those in control  ［(141.88±7.81) mg］ and empty vector group ［(153.10±7.60) mg］. The levels of IL-17, IFN-γ and anti-dsDNA antibody were lower and the levels of IL-4 was higher in CD40-siRNA1 group and CD40-siRNA2 group on the 2nd, 5th and 8th days after last injection than on the 1st day before the first time (P<0.05). The levels of IFN-γ in CD40-siRNA1 group were (118.74±10.32) ng/L, (115.24±8.26) ng/L and (113.71±5.02) ng/L in turn, the levels of IFNγ in CD40siRNA2 group were (117.83±6.83) ng/L, (114.07±0.97) ng/L and (112.67±9.66) ng/L in turn. The levels of IL-17 in CD40-siRNA1 group were (7.05±0.41) ng/L, (6.34±0.76) ng/L and (5.83±0.43) ng/L in turn, the levels of IL-17 in CD40-siRNA2 group were (7.07±0.22) ng/L, (6.35±0.49) ng/L and (6.12±0.80) ng/L in turn. The levels of anti-dsDNA antibody in CD40-siRNA1 group were (7.51±0.29) ng/L, (6.74±0.45) ng/L and (6.32±0.39) ng/L  in turn, the levels of anti-dsDNA antibody in CD40-siRNA2 group were (8.19±0.38) ng/L, (7.14±0.50) ng/L and (6.48±0.29) ng/L in turn. The levels of IL-4 in CD40siRNA1 group were (26.51±1.81)ng/L  (27.80±1.72) ng/L  and (28.08±2.21) ng/L  in turn, the level of IL-4 in CD40-siRNA2 group were (26.28±2.03) ng/L, (28.15±2.95) ng/L and (28.37±1.71) ng/L in turn. The expression  levels of IL-17 and IFN-γ antibody increased gradually and the levels of IL-4 decreased gradually in CD40-siRNA1 group and CD40-siRNA2 group on the 11th and 14th days after last injection, then reached to the levels of control group and empty vector group (P>0.05). Though the levels of anti-dsDNA antibody in CD40-siRNA1 group and CD40-siRNA2 group on the 11th day was higher than on the 8th day, there was more significance than those in control group and empty vector group (P<0.05). There was no significance between the 4 groups on the 14th day. The levels of CD40 mRNA and protein were lower in CD40-siRNA1 group and CD40-siRNA2 group than in control group and empty vector group on the 14th day after last injection (P<0.05). Conclusion: CD-40 si-RNA can reduce the concentration of IL-17, IFN-γ and of anti-dsDNA antibody in serum, and at the same time, it can elevate the concentration of IL-4 and suppress CD40 mRNA and protein of spleen in MRL/Lpr. Meanwhile after suppressing CD40 mRNA and protein, it can reduce inflammatory response of the mice and the disease activity of MRL/Lpr, suggesting that CD-40 siRNA has therapy effect on SLE.

Objective：To investigate the anti-inflammation effects by activation of the cholinergic anti-inflammatory pathway and its mechanisms in non-alcoholic steatohepatitis (NASH) model mice. Me-thods: 6-week-old male C57BL/6J (B6) mice were randomly divided into four groups: the first group was normal mice, injected with saline; the second group was normal mice, injected with nicotine; the third group was NASH model mice, injected with saline; the fourth group was NASH model mice, injected with nicotine. The experimental mice were fed with either standard chow (SC) or high-fat and high-fructose (HFHF) for 17 weeks to generate an NASH model mice. The mice received injection once daily for 3 weeks ［nicotine dose, 400 μg/kg］. Then, their pathological characteristics and function of the liver were assessed. The expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum were analyzed by enzyme linked immunosorbent assay (ELISA). The expressions of alpha 7 nicotinic acetylcholine receptors (α7nAChR), Toll-like receptors-4 (TLR-4) and nuclear factor κB of phosphory-lation (p-NF-κB) in Kupffer cells were determined by Western blot and immunofluorescence assays. Results: We successfully generated NASH model mice by imitating the high-fat and high-fructose dietary style of NASH patients. The results of our investigation demonstrated that nicotine could reduce significantly the levels of IL-6, and TNF-α in serum (P<0.05). The expression of p-NF-κB protein in the group which was NASH model mice injected with nicotine declined significantly as compared with the group which was NASH model mice injected with saline (P<0.05). And the expression of α7nAChR protein elevated significantly conversely (P<0.05). Conclusion: Activation of the cholinergic anti-inflammatory pathway could inhibit the release of inflammatory factors as TNF-α and IL-6 in NASH model mice, and the mechanism for the inhibition of inflammatory was mediated by NF-κB pathway.

Objective：To analyze the risk and prognostic of patients with stage ⅠB1 cervical adenocarcinoma. Methods:  The clinical data of 139 patients with stage ⅠB1 cervical adenocarcinoma treated at Department of Gynecology and Obstetrics in Peking University First Hospital from August 1994 to April 2015 were retrospectively reviewed, which included 38 cases of cervical adenocarcinoma and 101 cases of cervical squamous cell carcinoma. A comparison was made between ovarian preserving group and bilateral oophorectomy group, in order to justify the risk and prognosis of ovarian preserving patients. Results:  The 5-year cumulative survival rate of stage ⅠB1 cervical adenocarcinoma and squamous cell carcinoma were 89.1% and 92.9% respectively with significant difference (P=0.034). One ovarian metastasis case was observed among the 32 cervical adenocarcinoma patients of bilateral oophorectomy, while another ovarian metastasis case was observed among 54 cervical squamous cell carcinoma patients of bila-teral oophorectomy. The ovarian metastasis rate was 3.1% (1/32) and 1.8 % (1/54) respectively with no statistical difference (P=0.574). The cumulative 5-year survival of 6 ovarian preserving patients with cervical adenocarcinoma was 80.1%, while that of 47 ovarian preserving patients with cervical squamous cell carcinoma was 94.6% (P=0.127). There was no statistical difference between the survival curve of the two groups. Conclusion:  The prognosis of stage Ⅰ B1 cervical adenocarcinomas was somewhat poorer than that of cervical squamous cell carcinoma. However it was still reasonable to perform ovarian preservation among young patients of stage Ⅰ B1 cervical adenocarcinoma with no high risk factors.

Objective： To determine the clinicopathological significance of the DNA methyltransferase 3B (DNMT3B) overexpression in endometrial carcinomas and to evaluate its correlation with hormone receptor status. Methods: Immunohistochemistry was performed to assess the expression of DNMT3B and hormone receptors in 104 endometrial carcinomas. Results:DNMT3B overexpression occurred frequently in endometrioid carcinoma (EC, 54.8%) more than in nonendometrioid carcinoma (NEC, 30.0%) with statistical significance (P=0.028). Furthermore, there was a trend that EC with worse clinico-pathological variables and shorter survival had a higher DNMT3B expression, and the correlation between DNMT3B and tumor grade reached statistical significance (P=0.019).A negative correlation between DNMT3B and estrogen receptor (ER) or progesterone receptor (PR) expression was found in EC. NMT3B overexpression occurred frequently in the ER or PR negative subgroups (78.9%, 86.7%) more than in the positive subgroups (47.7%, 47.8%) with statistical significance (P=0.016, P=0.006). In addition, the DNMT3B overexpression increased in tumors with both ER and PR negative expression (92.9%, P=0.002). However, no such correlation was found in NEC (P>0.05). Sequence analyses demonstrated multiple ER and PR binding sites in the promoter regions of DNMT3B gene. Conclusion: This study showed that the expression of DNMT3B in EC and NEC was different. DNMT3B overexpression in EC was associated with the worse clinicopathological variables and might have predictive value. The methylation status of EC and NEC maybe different. In addition, in EC, DNMT3B overexpression negatively correlated with ER or PR expression. In NEC, the correlation between DNMT3B and ER or PR status was not present.

Objective：To evaluate the seven existing vaginal birth after cesarean (VBAC) screening tools and to identify additional factors that may predict VBAC or failed trial of labor in China. Methods: In the study, 53 patients with 1 previous cesarean delivery who then delivered between January 1, 2007 and Novenber 31, 2014 were recruited. The average age of the patients was (32.1±3.5) years，the average gestational age was (38.0±2.3) weeks. There was no significant difference of the successful group and the failed group in the maternal/neonatal mortality and morbidity, also in the incidence of the postpartum hemorrhage and the postpartum infection. The probability of VBAC was calculated for each participant using 7 prediction models created by Weinstein, Flamm, Grobman, Gonen, Troyer, Smith and Torri. The data were analyzed using t test, rank-sum test, and receiver operating curve analysis. Results: 44 trial of labor patients had a vaginal birth after cesarean delivery, and the successful rate was 83%. The scores between the successful group and the failed group had significant difference when eva-luated by Weinstein and Grobman scoring models only. After recalculating the successful rate of VBAC in different score levels according to the references, there was significant difference between the rates of different score levels when evaluated by the Weinstein model. The successful rates of different score levels were higher compared to the references (<50%) when evaluated by the Troyer (70%), Gonen (60%), Torri (85.7%) models. The area under the receiver operating characteristic curve of Weinstein prediction model (0.746) and Flamm prediction model (0.723) were more than 0.7, and there was no significant difference between the seven models. Conclusion: Among the seven scoring models, the Weinstein model is more applicable to the population of our country, but a new model more applying to Chinese women still needs to be created.

Objective： To assess the changing trends in Gleason score (GS) of Chinese prostate carcinoma (PCa) from January 1995 to December 2014. Methods: In the study, 875 patients admitted to hospital from January 1995 to December 2004 (1995-2004) and from January 2005 to December 2014 (2005-2014) were divided into two groups. The mean levels and proportions of GS, primary and se-condary grades were studied. The patients were divided into four groups according to age: ＜60, 60-69, 70-79 and ≥80 years.  Types of specimen included needle biopsy (NB), transurethral resection of the prostate (TURP) and radical prostatectomy (RP). Histological types were made up by acinar carcinoma and other types (including atrophic, pseudohyperplastic, foam, signet ring cell and ductal carcinoma, and so on). The total prostatespecific antigen (tPSA) involved groups of ＜20.0 μg/L and ≥20.0 μg/L. We observed the mean levels and proportions of GS in age, types of specimen, histological types and total prostate-specific antigen in different periods, and used SPSS 17.0 software for statistical analysis. Results: Compared with 1995-2004, the mean levels of GS, primary and secondary grades decreased 0.32 (P=0.003), 0.19 (P=0.001) and 0.12 (P=0.016) in 2005-2014, respectively. The proportions of ≤6 in GS increased 10.9% (P=0.003), and ≥8 decreased 14.0% (P<0.001). The difference of GS 7 was not statistically significant. In the primary grade,  the ratio of grades≤3 increased 12.8% (P=0.001), and grade 4 decreased 7.4% (P=0.037), grade 5 decreased 5.5% (P=0.007). The ratio of secondary grades≤3 increased 7.6% (P=0.037). The difference of grades 4 and 5 was not statistically significant. Conclusion: GS in Chinese patients with PCa showed a downward trend, which is one of the notable features in the past 20 years in China. The types of specimen and age are important factors in GS, while the histological types and tPSA have less impact on the GS.

Objective： To evaluate the impacts of clinical, pathological, and laboratory factors on oncological outcomes of patients with T3N0M0 renal cell carcinoma. Methods: The clinical data, laboratory exam results, and follow-up outcomes of 182 patients with T3N0M0 renal cell carcinoma who underwent nephrectomy from 2007 to 2012 in Peking University First Hospital were retrospectively collected. The 5-year cancer-specific survival and 5-year recurrence-free survival of all the patients were calculated using Kaplan-Meier method, and the statistical significance between the survival curves were compared using the Logrank test. Variables with significant differences in the univariate analysis were subjected to the multivariate analysis by Cox regression model. All the comparisons were conducted using two-tailed test and P<0.05 was considered statistically significant. Results: A total of 182 patients were included in this study. Of all the 182 patients, 126 were male (69.23%) and 56 were female (30.77%). The mean age was (56.75±12.45) years. The median follow-up time was 48 months (3-99 months). At the end of the follow-up, 50 patients (27.47%) died due to the disease after a median of 29.74 months and 59 patients (32.42%) had tumor recurrence after a median of 22.12 months. The 5-year cancer-specific survival of all patients was 68.30% (95% CI: 60.16%-75.84%); the 5-year recurrencefree survival was 60.70% (95% CI: 53.16%-68.84%). In the univariate analysis, diabetes mellitus, tumor invasion status, Fuhrman grade, serum album, serum cholestenone, anemia, and neutrophils percentage were associated with the cancer-specific survival and Fuhrman grade, serum album and anemia were associated with the recurrence-free survival. Variables with significant differences on univariate analysis were included in Cox multivariate regression analysis. Multivariate Logistic regression analysis showed that diabetes mellitus (HR=2.434, 95% CI: 1.243-4.769, P=0.010), hypoalbuminemia (HR=2.188, 95% CI: 1.074-1.074, P=0.031), and anemia (HR=3.320, 95% CI: 1.839-5.991, P<0.001) were independent risk factors significantly associated with cancerspecific survival; and higher Fuhrman grade (HR=2.552, 95% CI: 1.433-4.545, P=0.001), anemia (HR=2.535, 95% CI: 1.497-4.293, P=0.001) were independent factors significantly associated with recurrence-free survival. Conclusion: Diabetes mellitus, hypoalbuminemia, and anemia were independent risk factors significantly associated with cancer-specific survival of T3N0M0 renal cell carcinoma patients; higher Fuhrman grade and anemia were independent risk factors significantly associated with tumor recurrence of T3N0M0 renal cell carcinoma patients.

Objective：To explore the clinical pathological characteristics and improve the recognition in the diagnosis and treatment of incidental (stage T1a-T1b) prostate cancer. Methods:  Seven hundred and seventy-one patients who underwent TURP from May 2004 to September 2013 were analyzed retrospectively. In our institution, TURP specimens should be totally submitted in an extensive sampling method. The tumor area was outlined by estimation of an experienced genitourinary pathologist and calculated by the image analysis system software (Image J 1.47 h). The tumor area was then multiplied by the thickness of tissue. The total sum of all tumor volume was the estimated tumor volume. The clinical and pathological factors, follow-up results were obtained and we aimed to collect information about the period of watchful waiting (WW), PSA progression status, intervention status during the follow-up, the reason for intervention on WW and the type of intervention.Results:  The average age of 771 patients was (71.3±5.9) years old, and the average BMI was (23.9±3.1) kg/m2, preoperative average tPSA was (4.4±2.8) μg/L. Eighty-six (11.2%) cases of incidental prostate cancer were detected. The patients in T1a group (77 cases, 89.5%) had tumor volumes of (12.3±12.6) mm3, and the patients in T1b group had tumor volumes of (105.1±41.8) mm3.The range of tumor volume was 0.4－180.2 mm3. The volume of all the 86 cases was less than 500 mm3 as the threshold of insignificant cancer. All the patients were managed by WW. The mean followup time was 88.9 (27.9－150.1) months.The Gleason score was <7 in 79 patients, and ≥7 in 7 patients. There was no significant difference in age, preoperative tPSA, preoperative PSAD, postoperative tPSA, prostate volume and TURP resection between T1a group and T1b group (P>0.05). Among 84 patients without follow-up losts, PSA progression occurred in 5 patients. One T1a patient underwent radical prostatectomy (RP) as an intervention, and 3 patients underwent hormone therapy. One patient in T1b group underwent radiotherapy for PSA progression and one was treated because of patient preference without evidence of disease progression. There were no patients who died due to prostate cancer. Conclusion: Eighty-six (11.2%) cases of incidental prostate cancer were detected. The tumor volume of all the cases was insignificant cancer.The clinical outcomes of IPCa were satisfactory with the initial treatment of WW in the Chinese population.

Objective： To compare various data of open pyeloplasty, laparoscopic pyeloplasty and endopyelotomy as a treatment of ureteropelvic junction obstruction（UPJO）, and to investigate and discuss the feasibility and effect of the three methods. Methods: In the study, 109 cases of UPJO treated by different surgical approaches in Peking University People’s Hospital from January 2004 to December 2014 were retrospectively investigated. The patients were divided into three groups according to the treatment they received: open peyloplasty group (32 cases), laparoscopic peyloplasty group (31 cases) and endopyelotomy group (46 cases).We compared the data of the operative time, intraoperative blood loss, perioperative complications and post-operative hospital stay among the three groups. The mean follow-up time was（51.9±40.1） months (6-132 months). Results: None of the laparoscopic peyloplties was converted to open peyloplasty. All endpyelotomies were successfully completed. The operative time was as follows: laparoscopic peyloplasty group (195.97±55.22) min, open peyloplasty group (121.19±33.95) min and endopyelotomy group (74.04±33.95) min，and there were significant differences among the three groups respectively（P<0.001）. There was no significant difference on the operative blood loss between open peyloplasty group and laparoscopic peyloplasty group (P=0.163). The operative blood loss of endopyelotomy group was 5（0,310）mL，which was lower than the other two groups, and this result had significant differences with the other two groups respectively（P<0.001）. There were significant differences on the postoperative hospital stay (days) among open peyloplasty group, laparoscopic peyloplasty group and endopeylotomy group (P<0.05，respectively).The success rate was comparable between open peyloplasty group and laparoscopic peyloplasty group( 93.8% vs. 90.3%, P=0.672), while the endopeylotomy group had a lower success rate compared with both open surgery group and laparoscopic group(69.6% vs. 93.8%, P=0.01； 69.6% vs. 90.3%, P=0.048, respectively). The complication rates of open peyloplasty group, laparoscopic peyloplasty group and endopeylotomy group were comparable(15.6%, 16.1% and 13.0%, respectively, P>0.05). Conclusion: The laparoscopic peyloplasty group had a longer operative time than open peyloplasty group, while its post-operative stay was shorter. There was no significant difference on the operative blood loss between open peyloplasty group and laparoscopic peyloplasty group. Although the success rate of endopyelotomy was lower than those of the other two groups, it had advantages over the aspect of operative time, operative blood loss and post operative stay.

Objective： To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function in patients after radical cystectomy with ileum urinary diversion. Methods: In the study, 60 patients who underwent radical cystectomy followed by ileum urinary diversions during Nov. 2014 and Nov. 2015 in Department of Urology of Peking University First Hospital were randomized into three groups: gum chewing group, placebo group treated with the abdomen physical therapy machine and control group treated with ordinary method. Time to flatus, time to bowel movement, incidence of postoperative distension of the abdomen and abdominal pain, and gut related complications (such as ileus, intestinal fistula, and volrulus) of all the patients were recorded and analysed. Results: In gum chewing group, the median time to flatus was 57 hours (49-72 hours), and the median time to bowel movement was 95 hours (88-109 hours), which were significantly shortened compared with the other two groups of patients (82 hours, 109 hours in placebo group and 81 hours, 108 hours in control group, respectively). No significant difference of the median time to flatus and to bowel movement was observed between placebo group and control group. There were no significant differences in the incidence of postoperative distension of the abdomen and abdominal pain, and gut related complications among the three groups. Conclusion: Chewing gum had stimulatory effect on bowel function recovery after cystectomy followed by ileum urinary diversion. Chewing gum was safe and simple, and could be routinely used for postoperative treatment after cystectomy and ileum urinary diversion.

Objective： To investigate age related changes in urodynamic parameters of women with urinary incontinence. Methods: From May 2008 to October 2015, a total of 214 patients diagnosed with urinary incontinence in Peking University People’s Hospital was involved in this study. Average age was (56.97±10.68) years, ranging from 30 to 82 years, and average history was (8.44±8.85) years, ranging from one month to 50 years. Urodynamic examinations of each patient were taken before operation routinely in Department of Urology, Peking University People’s Hospital. The urodynamic study was composed of noninvasive and invasive procedures. Analysis included maximal flow rate (Qmax), average flow rate, time to Qmax, voiding time, detrusor pressure at Qmax, maximal detrusor pressure, voided volume, post-void residual urine volume (PVR), the total capacity of bladder, first-, strong-, and urge-desire to void, cough leak point pressure (CLPP), and Valsalva leak point pressure (VLPP). Patients were divided into four groups according to age, Kolmogorov-Smirnov test and one-way ANOVA were used for data analysis. Results: A total of 214 patients were enrolled in this study. The data of Qmax, average flow rate, voided volume, and total capacity of bladder decreased with statistical significance. The value of residual urine volume and voiding time increased without statistical significance, while the value of maximal detrusor pressure decreased. Conclusion: Urodynamic examination data of females with urinary incontinence changes along with the elapse of age, which was mainly observed as age ascends, and the changes in urodynamic parameters of women with urinary incontinence suggest that the value of Qmax, average flow rate, voided volume, and total capacity of bladder decreased significantly, while the value of PVR and the voiding time increased and the value of maximal detrusor pressure decreased.

Objective：To describe a method based on analysis of the histogram of intensity values produced from the magnetic resonance imaging (MRI) for quantifying the degree of fatty infiltration. Methods: The study included 25 patients with dystrophinopathy. All the subjects underwent muscle MRI test at thigh level. The histogram M values of 250 muscles adjusted for subcutaneous fat, representing the degree of fatty infiltration, were compared with the expert visual reading using the modified Mercuri scale. Results: There was a significant positive correlation between the histogram M values and the scores of visual reading (r=0.854, P<0.001). The distinct pattern of muscle involvement detected in the patients with dystrophinopathy in our study of histogram M values was similar to that of visual reading and results in literature. The histogram M values had stronger correlations with the clinical data than the scores of visual reading as follows: the correlations with age (r=0.730, P<0.001) and (r=0.753, P<0.001); with strength of knee extensor (r=-0.468, P=0.024) and (r=-0.460, P=0.027) respectively. Meanwhile, the histogram M values analysis had better repeatability than visual reading with the interclass correlation coefficient was 0.998 (95% CI: 0.997-0.998, P<0.001) and 0.958 (95% CI: 0.946-0.967, P<0.001) respectively. Conclusion: Histogram M values analysis of MRI with the advantages of repeatability and objectivity can be used to evaluate the degree of muscle fatty infiltration.

Objective： To assess the consequences of switching aspirin dosage from 100 mg/d to 40 mg/d  on cardiovascular benefit, bleeding risk and platelet aggregation in very elderly patients. Methods: Arachidonic acid induced platelet aggregation(AA-Ag) was measured in 537 patients aged 80 or older treated with aspirin (100 mg/d). In the study, 100 patients with low on-treatment platelet aggregation and at high risk of bleeding and low risk of cardiovascular events, were switched to aspirin (40 mg/d) and their platelet aggregation was measured again 7 days later.Their bleeding and upper gastrointestinal symptoms were also recorded in following 3 months. Results: The study observed a heterogeneous distributed aspirin 100 mg/d AA-Ag (range: 0.42% to 28.78%)in the 537 very elderly patients.Aspirin 100 mg/d AA-Ag before the switch in aspirin 40 mg/d group was 5.00%±2.32% and the rate of the patients with low on-treatment platelet aggregation was 71.00%. The rates of melena or occult blood positive, other minimal bleeding,upper gastrointestinal symptoms and a history of gastrointestinal bleeding in 40 mg/d group were higher than those in 100 mg/d group. On a regimen of aspirin 40 mg/d, AA-Ag increased to 11.21%±4.95%(range: 2.12% to 28.84%) with 95.00%of the patients with AA-Ag<20%and the rate of the patients with low on-treatment platelet aggregation was 15.00%. Multiple variable analysis revealed that aspirin 40 mg/d AA-Ag was significantly influenced by aspirin 100 mg/d AA-Ag, BMI and platelet counts. The rate of gastrointestinal bleeding decreased from 12.00% to 5.00%,and upper gastrointestinal symptoms decreased from 59.00% to 21.00% after the switch in 40 mg/d group. Conclusion: Switching aspirin dosage from 100 mg/d to 40 mg/d reduces the bleeding events and improves upper gastrointestinal symptoms, thus inhibiting platelet aggregation effectively in very elderly patients.

Objective：To investigate prognostic factors of the T-cell non-Hodgkin’s lymphoma (T-NHL), and to study the clinical efficacy of CHOPE plus L-asparaginase(L-ASP) regimen for T-NHL. Methods:  Retrospective analyses were made of 61 T-NHL patients who were treated from July 2007 to August 2013. Randomly divided into two groups CHOPE and CHOPE+L group(Based on CHOPE, added with L-ASP on the 1st, 3rd, 5th, 7th, 9th and 11th day).Results:  Of the 61 patients evaluatd with the median survival was 22 (3-65) months，the complete remission rate was 52.50%, the partial remission rate 29.51%, and the response rate 80.01%. The complete remission rate was 57.89%, and the patial remission rate 84.21% in CHOPE+L and the complete remission rate 43.48%, the response rate 78.26% in CHOPE, respectively (both P>0.05). The 1-, 2-, and 5-year overall survival rates were 91.0%, 87.6% and 65.7% respectively (P>0.05). But the overall survival rate in CHOPE+L was significantly higher than that in CHOPE group in extranodal NK/T-cell lymphoma, nasal type(ENKTCL) (P<0.05). The analysis of the prognostic factors indicated that ENKTCL, the outside junction lesions, and the CR rate were poor factors with statistic significance in T-NHL. Conclusion:  CHOPE+L regimen has better efficacy for ENKTCL, but whether CHOPE+L regimen is used in the treatment of T-NHL, large prospective clinical trials are worth for further investigation.

Objective：To report thigh muscle magnetic resonance imaging (MRI) tests of four Chinese patients with dystrophinopathy with edema changes in adductor longus muscles that mimics adductor enthesopathy. Methods: Four boys, who were from four unrelated families and aged from 5 to 11 years, were investigated because of the clinical manifestations including myalgia or muscle weakness or the incidental findings of elevated serum creatine kinase levels, and were diagnosed with dystrophinopathy by gene test of Duchenne  muscular  dystrophy (DMD). Their creatine kinase levels were increased from 4 087 IU/L to 32 700 IU/L (Normal range: 75-175 IU/L). The muscle biopsy of three patients all demonstrated a dystrophic pattern including necrosis, regeneration, hypertrophy, atrophy and connective tissue proliferation, with different proportions of dystrophin-negative muscle fibers. The gene test of DMD showed an out-frame deletion of exons in three of the four patients, involving either exons 45 or exons 49-52 deletion or exon 62 duplication, and c.2665 C>T with nonsense mutation in the other one. Muscle MRI tests of the bilateral thighs were performed with T1 weighed sequence and slow tau inversion recovery sequence. The degree of fatty infiltration changes was scored. Results: MRI of the thigh muscles showed mild to severe fatty infiltration changes in T1 weighed sequence with the total scores from 2 to 13.The most severe fatty infiltration changes were in the long head of biceps femoris and adductor magnus. Obvious hyperintensities appeared mainly in the adductor longus muscles on slow tau inversion recovery (STIR) images in all the patients without any abnormal signals in the attachment of the ligament, indicating edema changes of the adductor longus muscles which mimiced adductor enthesopathy. Two of the four patients presented with edema changes in the bilateral adductor longus muscles, while the other two were with only unilateral changes. Furthermore, other thigh muscles, including adductor magnus, semitendinosus, sartorius and rectus femoris muscles, could also have mild edema changes in two of the four patients. Conclusion: Dystrophinopathy can manifest as edema changes in the adductor longus muscles in thigh muscle MRI tests, which is a typical lesion in adductor enthesopathy. The adductor longus muscles in the dystrophinopathy patients may be easy to be impaired due to traction injury during sports.

Objective：To compare total percutaneous access using preclose technique with femoral artery cut-down in endovascular aneurysm repair (EVAR) and assess the safety and feasibility of preclose technique. Methods: In the study, 81 cases undergoing EVAR from Dec. 2011 to Nov. 2014 in Peking University People’s Hospital were retrospectively reviewed. Preoperative CT angiography (CTA) showed presence of infrarenal abdominal aortic aneurysm or descending aortic aneurysm in all the cases. The maximum diameter of aneurysm >4.5 cm met the indications for surgical treatment. The conditions of bilateral femoral artery and iliac artery CTA showed were good, and there was no moderate or severe stenosis, nor was there any severe calcification in anterior wall of femoral artery. Not only were the cases fit for percutaneous endovascular aortic aneurysm repair (PEVAR), but also feasible with open endovascular aneurysm repair (OEVAR). According to the intention of the patients about the surgical incision, the cases were divided into group PEVAR and group OEVAR. The data of the general situation, operation time, blood loss, technical success rate, length of hospital stay after procedure and wound complications were analyzed statistically. Results: In the study, 44 cases (78 incisions) were enrolled in group PEVAR and 37 cases (65 incisions) in group OEVAR. There was no significant difference between the two groups in age, gender, body mass index (BMI), accompanying diseases, average number of stents and outer diameter of stent delivery system. Average operation time of group PEVAR was less than that of group OEVAR ［(119.1±102.0) min vs. (163.6±61.9) min, P=0.025］. The blood loss in group PEVAR was less than that in group OEVAR ［(64.7±97.0) mL vs. (98.6±88.3) mL］, but there was no significant difference (P=0.106). There was no difference in the technical success rate (94.9% vs.95.4%, P=1.000). The average length of hospital stay after procedure was significantly shorter in group PEVAR ［(7.8±2.8) d vs.(12.3±7.2) d, P<0.001］. There were 2 cases with subcutaneous hematoma of wound in group PEVAR and 7 cases of wound complications that occurred in group OEVAR including 3 cases with lymphatic leakage, 3 cases with lower limb ischemia and 1 case with subcutaneous hematoma. The analysis showed that PEVAR could reduce the wound complications (2.6%vs.10.8%), but there was no significant difference between the two groups (P=0.079).Conclusion: Using preclose technique in EVAR is safe and effective. It can shorten the operation time and length of hospital stay after procedure.

Objective：To observe the effects of 0.4 μg/(kg·h) dose of dexmedetomidine on intra-operative wake-up test in children patients undergoing scoliosis surgery． Methods: Sixty patients for posterior scoliosis correction (ASA Ⅰ-Ⅱ， aged 5-16 years) from March 2013 to April 2015 were enrolled in this prospective, double-blinded, randomized, placebo-controlled study, The patients were randomly classified into two groups to receive dexmedetomidine (group RD, n=30) or saline solution (group R, n=30). In group RD, dexmedetomidine ［0.4 μg/(kg·h)］ was administered after tracheal intubation, while the equal volume saline solution was given instead in group R. Anesthesia was induced with midazolam, propofol, sufentanyl and cisatracurium, and anesthesia was maintained with sevoflurane inhalation and a continuous intravenous infusion of remifentanil in the both groups.BIS（bispectral index，BIS） value was maintained at 40－60,and mean arterial pressure (MAP) was maintained at ≥ 60 mmHg before the wake-up test.When the wake-up test was performed, immediately the dexmedetomidine and remifentanil infusion were stopped, and the end-tidal concentration of sevoflurane was adjusted to 0. Mean arterial pressure, and heart rate (HR) were recorded before anesthesia and at 5-minute intervals during the wake-up test. The wake-up test time, arousal quality and sedation scores were recorded also.In addition, the data were also gathered on the dosage of ephedrine and atropine were used, as well as the intraoperative awareness in the patients who were followed up on the first day after the operation．  Results: There were no differences between group RD and group R with regard to HR and MAP at getting into the operation room （t=-1.460，P=0.150;t =-1.015, P=0.315 ）. In group RD, no evidence was found for a difference in HR and MAP at awakening up versus at getting into the operation room （t=0.974,P=0.340；t=-1.449,P=0.161）, while in group R, an increase in HR and MAP occurred at awakening versus at getting into the operation room （t=-2.106，P=0.044；t=-2.352，P=0.026）.There were no significant differences in sedation scores and wake-up test time between the two groups（t=1.986，P=0.052；t=0.392，P=0.697）. The wake-up test quality was significantly better in group RD than in group R （t=-2.098，P=0.041）．HR in group RD was significantly lower than that in group R at any time point during the wakeup test (P<0．05)． Four patients had awareness occurrence during the operation in group R,and no awareness occurrence in group RD. Conclusion: Dexmedetomidine， when administered at a rate of 0.4 μg/(kg·h) as an adjuvant of sevoflurane inhalational anesthesia, could improve the wake-up test quality， and maintain hemodynamic stability during scoliosis surgery．

Objective：To investigate the distribution and content of transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) in concentrated growth factors (CGF) gel, and to clarify the difference among different layers of CGF. Methods: Venous blood samples were collected from 6 healthy volunteers to prepare CGF. The distribution, integrated optical density (IOD) and average optical density (AOD) of TGF-β1 and VEGF in CGF gel and red blood cell (RBC) layer were measured using immunohistochemistry. The concentrations of TGF-β1 and VEGF in the supernatant se-rum at baseline and the CGF releasate after 1 day were evaluated with enzyme-linked immunosorbent assays.Results:Abundant TGF-β1 and VEGF were concentrated in CGF gel. However, only a little could be found in polykaryocytes and sporadic platelets in RBC layer. Platelets and leukocytes were concentra-ted in between the two layers with high expression of TGF-β1. The concentrations of TGF-β1 and VEGF in the CGF releasate(55 236.78±3 686.34), (610.99±148.81) ng/L were significantly higher than those in the supernatant serum(20 710.20±4 523.14), (335.20±51.69)ng/L (P<0.001).Conclusion: CGF contains high quantities of TGF-β1 that can promote new bone formation and tissue healing. We suggest that CGF gel should be used right after being prepared. Supernatant serum and the area between CGF gel and RBC layer could also be mixed with bone substitute materials.

Objective：To explore a crown form classification method for upper central incisor which is more objective and scientific than traditional classification method based on the standardized photography technique. To analyze the relationship between crown form of upper central incisors and papilla filling in periodontally healthy Chinese Han-nationality youth. Methods: In the study, 180 periodontally healthy Chinese youth ( 75 males, and 105 females ) aged 20-30 (24.3±4.5) years were included. With the standardized upper central incisor photography technique, pictures of 360 upper central incisors were obtained. Each tooth was classified as triangular, ovoid or square by 13 experienced specialist majors in prothodontics independently and the final classification result was decided by most evaluators in order to ensure objectivity. The standardized digital photo was also used to evaluate the gingival papilla filling situation. The papilla filling result was recorded as present or absent according to naked eye observation. The papilla filling rates of different crown forms were analyzed. Statistical analyses were performed with SPSS 19.0.  Results: The proportions of triangle, ovoid and square forms of upper central incisor in Chinese Han-nationality youth were 31.4% (113/360), 37.2% (134/360) and 31.4% (113/360 ), respectively , and no statistical difference was found between the males and females.  Average κ value between each two evaluators was 0.381. Average κ value was raised up to 0.563 when compared with the final classification result. In the study, 24 upper central incisors without contact were excluded, and the papilla filling rates of triangle, ovoid and square crown were 56.4% (62/110), 69.6% (87/125), 76.2%  (77/101) separately. The papilla filling rate of square form was higher (P=0.007 ) . Conclusion: The proportion of clinical crown form of upper central incisor in Chinese Han-nationality youth is obtained. Compared with triangle form, square form is found to favor a gingival papilla that fills the interproximal embrasure space. The consistency of the present classification method for upper central incisor is not satisfying, which indicates that a new classification method, more scientific and objective than the present one, is to be found.

Objective：To compare the effects of three root canal sealers with respect to time on biocompatibility of human periodontal ligament cells (hPDLCs).The sealers included zinc oxide and eugenol based sealers (ZOE), epoxy resin sealers (ERS) and silicone based sealers (SBS). Methods: hPDLCs were primarily cultured,with the method combining of tissue explant and enzymatic digestion. The cells were then exposed to different extract fluids：（1）ZOE extracted for 24 h group ；（2）ZOE extracted for 1 week group；（3）ZOE extracted for 2 weeks group；（4）ERS extracted after 24 h group；（5）ERS extracted after 1 week group；（6）ERS extracted after 2 weeks group；（7）SBS extracted after 24 h group；（8）SBS extracted after 1 week group；（9）SBS extracted after 2 weeks group；（10）Dulbecco modified Eagle’s medium/F12（DMEM/F12）as negative control group. Cell morphology was observed under an inverted microscope.Cell proliferation was measured by methyl-thiazol-diphenyltetrazolium （MTT）assay.ALP assay kit was used for measuring alkaline phosphatase (ALP) activity. Sealers of 2 weeks’ setting time were then immersed in an osteogenic medium for examination of mineral nodules and calcium deposits. Results: Considering the relative growth rate(RGR),ZOE was severely to moderately cytotoxic（RGR:13.6%-39.9%）,while ERS was slightly or not cytotoxic (RGR: 87.6%-95.3%).Only SBS did not show any cytotoxicity after setting (RGR: 91.8%-106.7%). The setting time influenced the cytotoxicity of ERS which decreased after 1 week. Considering the ALP activity,there was no difference between SBS group and control group（F=3.397，P=0.053）. According to the results of calcium deposits, ZOE：D562 nm= 0.180±0.050,ERS：D562 nm= 2.968±0.201,SBS：D562 nm= 3.623±0.039,Control：D562 nm= 3.477±0.102,the ranking of ALP activity and calcium deposits was as follows: ZOE

Objective：To compare the proliferation and osteoblastic differentiation of dental pulp stem cell (DPSC) isolated from normal and inflamed pulps of different degrees in Beagle immature premolars, and provide evidence for the use of inflammatory DPSC (IDPSC). Methods: This study evaluated 14 Beagle’s young premolars (21 roots). In the experiment group, irreversible pulpitis was induced by pulp exposure and the inflamed pulps were extracted 2 weeks and 6 weeks after the pulp chamber opening.For the control group, normal pulps were extracted immediately after the exposure. HE staining and real-time PCR were performed to confirm the inflammation. The cells were isolated from the inflamed and normal pulps (IDPSC and DPSC). Cell proliferation and osteoblastic differentiation potentials of the two cells were compared. Results: Inflammation cells infiltration was observed in the inflamed pulps by HE staining. The expression of inflammatory factor was much higher in the 6 week inflamed pulp. IDPSC had higher potential of cell proliferation and osteoblastic differentiation potentials. Furthermore, the osteoblastic differentiation potentials of IDPSC from 2 week inflamed pulp were higher than those from 6 week inflamed pulp. Conclusion: The potential of cell proliferation and osteoblastic differentiation of DPSC was enhanced at early stage of irreversible pulpitis, and reduced at late stage in Beagle immature premolars.

Objective：To quantitatively evaluate the assembly precision of fabricating complete denture by computer numerical control (CNC) in manufacturing dentition and baseplate separately plus adhesive molding. Methods: The 3D surface data of a standard edentulous maxilla plaster cast model and the temporary base-plate were obtained using an Activity 880 3D scanner. The data (data1) of a complete denture were designed using a set of computer aided design (CAD) software developed by the research group of this study. The pins without undercut were designed as 3D shape of the joining area of the dentition and the baseplate by using the software of Imageware 13.2 and Geomagic Studio 2013. Zero in the top and 0.05 mm in the rest surfaces of the retention pins were set for adhesive clearance. Zenotec T1 (5-axis milling machine) was employed to manufacture polymethyl methacrylate (PMMA) dentition and baseplate. Double sides posterior and one anterior “union teeth” were got. The teeth were inserted into the retention pins in the baseplate and cemented with self-curing resin (Huge Dental Material Co., Ltd). The denture was scanned with the 3D scanner to obtain dataset Data4. Data2 and Data3 registration was set in Data4, Data2 and Data3 were united to gain Data 5. The adhesive clearance on the top of the retentional pins was measured, which was originally designed into 0 mm, and the assembly precision of dentition and baseplate obtained. Results: The average clearance measurements between the dentition and the baseplate: left molar teeth (0.44±0.04) mm, max 0.52 mm, min 0.29 mm; right molar teeth (0.52±0.07) mm, max 0.64 mm, min 0.28 mm; anterior teeth (0.60±0.10) mm, max 0.81 mm, min 0.40 mm; total average clearance (0.52±0.10) mm. Conclusion: The adhesive clearance can be controlled to the level of 0.5 mm when the joining part of the artificial teeth and the base was designed into the shape of retentional pins and the artificial dentition divided into 3 parts. We succeeded in using the CAD/ computer aided manufacturing (CAM) technology to fabricate the complete denture. Although the assembly precision of the dentition and the baseplate is not perfect, the results have proved that the technical routes are workable.

Objective： To compare the durability of resin-based root-surface coating material and all-in-one self-etching adhesive on root surface in vitro. Methods: Human extracted premolars or molars with intact roots were selected. The cementum was removed using a periodontal scaler to expose root dentin.The root surface was coated with an acid-resistant nail varnish, leaving a window of 3 mm×3 mm on the exposed dentin.The window was covered with either PRG Barrier Coat (PRG) or Clearfil S3 Bond (CS3). After water aging for 14 d, specimens were immersed in acid buffer at pH 4.5 for 4 d and the demineralization buffer was changed every 24 h. Then the specimen was split longitudinally through the center of the ‘window’ and the cross-sectional surface was observed with scanning electron microscope (SEM). After fixed and dehydrated, the prepared samples were coated with platinum. The coating material, root dentin and the interface was observed by scanning electron microscope (SEM). The thickness of the coating material was measured on the SEM images. Regarding toothbrush wear test, coronal dentindisks were prepared and covered with PRG and CS3, respectively. After storage in water for 24 h, the specimen was subjected to the toothbrush wear tester for 100, 200, 300, 500, 700, 1 500 brushing cycles. A slurry of fluoride toothpaste (1 ∶2 ratio of toothpaste and deionized water by weight) was used and the brushing load was 300 N. The surface microstructure of remaining coating material was analyzed using SEM. The wear depths were determined by a profilometer. Statistical analysis was performed with SPSS 20.0 by one-way ANOVA. The level of significance was at 0.05. Results: Application of PRG Barrier Coat produced a coating layer of (47.1±27.3) μm, while CS3 presented a thin film of (5.7±2.1) μm in thickness. The exposed dentin was hermetically sealed and no obvious gap was observed at the interface in both PRG and CS3 groups. There was no dentin demineralization observed in both groups after water aging. The wear depths of PRG and CS3 increased along with the numbers of brushing cycles. PRG wore at a significant lower pace than CS3 did (P<0.05). Conclusion: PRG coating resin had similar performances as CS3 on protecting root dentin from demineralization after water aging. What’s more, PRG demonstrated a higher toothbrush wear resistance than CS3. We concluded that PRG Barrier Coat contained S-PRG filler may be an effective coating material for protecting exposed root from both chemical and mechanical challenges. Further studies should be carried out to evaluate the longterm reliability of the rootsurface coating materials under the clinical setting.

Objective：To study the effect of nano hydroxyapatite on human adipose-derived mesenchymal stem cells(hASCs) mixture 3D bio-printing for cells’ proliferation and osteogenesis. Methods: P5 hASCs were used as seed cells, 10 g/L nano hydroxyapatite was added into the cell-sodium alginate-gelatin mixture (concentration: 20 g/L sodium alginate, 80 g/L gelatin; cell density: 1×106/mL), then the mixture was printed by 3D bio-printer as the experimental group. And the cell-sodium alginate-gelatin mixture without nano hydroxyapatite was printed as the control group. Respectively, both the experimental and control groups were detected by microscope, CCK-8, Western blot and PCR at certain time pointsafter being printed, whose cells’ proliferation and osteogenic differentiation were analyzed. Results:  The microscopic observation and CCK-8 results showed that the cells of the experimental group and the control group both had a good proliferation 24 h and 7 d after being printed. The Western blot results showed that 14 d after printing, the expression of Runtrelated transcription factor 2 (RUNX2) had no statistical difference between the experimental group and control group. The PCR results showed that 14 d after printing, the expression of osteogenesis-related genes (RUNX2, osterix, and osteocalcin) was significantly higher in the experimental group than in the control group. Conclusion:  Nano hydroxyapatite can increase osteogenic differentiation of the hASCs mixture after bio-printing, in which the cells still have a good proliferation.

Objective：To establish a digital method for production of custom trays for edentulous jaws using fused deposition modeling (FDM) based on threedimensional (3D) scans of primary jaw impressions, and to quantitatively evaluate the accuracy. Methods: A red modeling compound was used to make a primary impression of a standard maxillary edentulous plaster model. The plaster model data and the primary impression tissue surface data were obtained using a 3D scanner. In the Gemomagic 2012 software, several commands were used, such as interactive drawing curves, partial filling holes, local offset, bodily offset, bodily shell, to imitate clinical procedures of drawing tray boundary, filling undercut, buffer, and generating the tray body. A standard shape of tray handle was designed and attached to the tray body and the data saved as stereolithography (STL) format. The data were imported into a computer system connected to a 3D FDM printing device, and the custom tray for the edentulous jaw model was printed layer upon layer at 0.2 mm/layer, using polylactic acid (PLA) filament, the tissue surface of the tray was then scanned with a 3D scanner. The registration functions of Geomagic 2012 was used to register the 3dimentional surface data, and the point-cloud deviation analysis function of the Imageware 13.0 system was used to analyze the error. The CAD data of the custom tray was registered to the scan data, and the error between them was analyzed. The scanned plaster model surface was registered to the scanned impression surface and the scanned tray data to the CAD data, then the distance between the surface of plaster model and the scanned tissue surface of the custom tray was measured in Imageware 13.0. Results: The deviation between the computer aided design data and the scanned data of the custom tray was (0.17±0.20) mm, with (0.19±0.18) mm in the primary stress-bearing area, (0.17±0.22) mm in the secondary stress-bearing area, (0.30±0.29) mm in the border seal area, (0.08±0.06) mm in the buffer area; the space between the tissue faces of the plaster model and the scanned tissue surface of custom tray was (1.98±0.40) mm, with (1.85±0.24) mm in the primary stress-bearing area, (1.86±0.26) mm in the secondary stress-bearing area, (1.77±0.36) mm in the border seal area, (2.90±0.26) mm in the buffer area. Conclusion: With 3D scanning, computer aided design and FDM technology, an efficient means of custom tray production was established.

Objective：To compare two flexible embryo catheters and determine whether clinical outcome differs in the in vitro fertilization-embryo transfer (IVF-ET) cycles. Methods: This prospective control study was conducted by one doctor between July 2012 and November 2013. In the study, 2 064 patients undergoing fresh embryo transfer by using IVF-ET/intracytoplasmic sperm injection (ICSI)-ET in Reproductive Medical Center of Peking University Third Hospital were recruited. The subjects were divided into two groups. Cook Sydney IVF embryo transfer catheters (product model: K-JETS-7019-SIVF) were used for embryo transfer in group 1 (n=949), and Frydman-CCD catheters (product model: 131230301) were used in group 2 (n=1 115). Pregnancy outcomes were compared between these two groups. Results:There was no significant difference in age, diagnosis for infertility and stimulation protocol used between the two groups. In addition, there was no difference in the number of oocytes collected and in the number and score of embryos transferred. The significantly higher implantation rate, clinical pregnancy rate, and live birth rate (34.40% vs. 26.92%, 51.21% vs. 41.52%, 42.57% vs. 33.09%, P<0.05) were observed in group 1 compared with group 2. The abortion rate was not significantly different between the two groups (11.93% vs. 15.98%, P>0.05). The proportion of difficult transfer was higher in group 1 than that in group 2 (5.27% vs. 3.41%, P<0.05). There was no difference in the clinical pregnancy rate and live birth rate between the two difficult transfer cycles. Conclusion: The type of embryo transfer catheter affects the clinical outcome in IVF. Good clinical outcome can be obtained by using Cook Sydney IVF catheter, which is worthy of clinical promotion.

Here we reported two patients who presented with panuveitis and were transferred from ophthalmologists to rheumatologists, for both the patients had oral and genital ulcers. They were misdiagnosed with Behcet’s disease at first glance. Two young males presented with acute uveitis with history of recurrent oral and genital ulcers. They initially presented with symptoms and signs resembling Behcet’s disease and were treated with systemic steroids with suboptimal responses. Routine laboratory test revealed syphilis and human immunodeficiency virus (HIV) infection. After treatment of penicillin and anti HIV virus therapy, the panuveitis was relived. The other patient was lost in the follow up. Recently epidemiological data indicate that syphilis and HIV infection increase, which can mimic the manifestation of Behcet’s disease. Diagnosis of sexual transmitted diseases, such as HIV or syphilis needs to be ruled out in all cases that mimic the clinical feature of Behcet’s disease, especially for those who had a history of high risk behaviors. Every patient should have history analysis in detail. Screening of sexual transmitted diseases, such as HIV or syphilis is important especially in those rapid progressive panuveitis. Also, other virus infections, such as cytomegalovirus, epstein-barr virus or Herpes simplex virus can cause mucosa ulcers and uveitis. CD4 T cell count is a very important marker to indicate that the patient has immunodeficiency. Erythema nodosa and pseudofolliculitis are the third common clinical manifestation in Chinese Behcet’s disease patients. Rheumatologist should watch out for patients without skin involvement when making the diagnosis of Behcet’s disease. Syphilis-associated uveitis usually has a good prognosis. Treatment of antibiotics can get good response, 92% uveitis can be relieved, with 67% improved vision. Acute syphilitic posterior placoid chorioretinitis (ASPPC) is a clinically and angiographically distinct manifestation of ocular syphilis. Systemic glucocorticoid can be used in syphilis induced posterior uveitis, sleritis and optic neuritis, and it can also prevent the Hector’s reaction. However, for patients diagnosed with both HIV and syphilis, regular antibiotic can not prevent relapse. So doctors need to follow up them regularly. Patients who present with uveitis, oral and genital ulcers can be easily diagnosed with Behcet’s disease. Rheumatologists need to be aware of the reemergence of sexual transmitted disease. High degree of clinical suspicion can allow ophthalmologists and rheumatologists to diagnose and treat the disease early. Correct diagnoses timely can get the good treatment response, and rescue the vision. Treatment with regular antivirus and Penicillin can receive the good response, and moreover glucocorticoid can relieve the inflammation.

To investigate the effect and feasibility of total laparoscopy to treat hepatolithiasis using gallbladder-hepatic duct subcutaneous tunnel．Retrospective analysis was conducted of the case data of 11 patients with hepatolithiasis who underwent total laparoscopic treatment using gallbladder-hepatic duct subcutaneous tunnel from January 2010 to October 2014. The operation time, blood loss, postoperative complications and recurrence of stones were recorded．All the cases completed the operation．The average hospital-stay was 9.2 days (range: 3－29 d). The average operation time was 298 min (range: 225－480 min). The average blood loss was 253 mL (range: 50－700 mL), and the average blood loss of liver resection groups was 325 mL (range: 200－700 mL). The average discharge time was 3.3 days (range: 3-5 d). The rate of postoperative residual stones was 36.4% (4/11).We extracted stones with choledochofiberscope via T-tube sinus six weeks after operation. One case developed biliary leakage, and healed through adequate drainage and the T-tube was pulled out after one month. There was no perioperative mortality. All the cases were followed up and the mean follow-up was 22 months (range： 2－51 months). The anastomotic stenosis of gallbladder-hepatic duct was found in one case. But we got a good therapeutic result with performed gallbladder chemical ablation with 95% ethanol. No recurrence of hepatolithiasis was found. As a choice for minimally invasive method to hepatolithiasis using gallbladder-hepatic duct subcutaneous tunnel，total laparoscopy is a safe and feasible procedure.