Objective： To investigate the effect of silver nanoparticles (AgNPs) on hemichannel activity in human skin keratinocytes (HaCaT) and to explore the role of hemichannel in AgNP-induced anti-proliferative effect on HaCaT cells. Methods: HaCaT cells were exposed to 0, 0.1, 0.2, 1.0, 5.0, 10.0, 15.0 and 20.0 μg/cm2 of AgNPs for 24 h and cell viability was assessed by propidium iodide (PI) staining with flow cytometry. Hemichannel activity was examined by ethidium bromide (EB) uptake experiments in cells exposed to AgNPs with and without hemichannel inhibitor carbenoxolone (CBX). Afterward, HaCaT cells were seeded at a low density of 1×104cell /cm2 or a normal density of 4×104cell /cm2 and cultured for 24 h. Cell proliferation was measured by cell counting kit-8 (cck-8) in low-or normal-density cultured cells exposed to AgNPs for 24 h with and without 100 μmol/L CBX. Results: Cell viability showed no significant differences between the control and AgNP-exposed groups with the concentration less than 10 μg/cm2. Exposure to AgNPs increased EB uptake in a time- and dose-dependent manner in HaCaT cells and EB fluoresce density was increased to 116.67%, 124.85% and 139.53% of the control after exposure to 10 μg/cm2 AgNPs for 2 h, 12 h and 24 h. After being treated with 25, 50 and 100 μmol/L CBX, 10 μg/cm2 AgNP-induced increase in EB uptake was significantly reduced in HaCaT cells (P<0.01). The cellular proliferation rate was increased inlow-and normal-density cultured cells after AgNPs exposure with 100 μmol/L CBX. After being treated with 100 μmol/L CBX, 10 μg/cm2 AgNP-induced anti-proliferation in low-density cultured cells was significantly restrained (P<0.01). Conclusion: AgNPs could enhance hemichannel activity of HaCaT cells. Hemichannel activation was involved in AgNP-induced anti-proliferative effect.

Objective： To study the effect of titanium dioxide (TiO2) nanoparticles on intestinal glucose absorption in young rats and its size effect. Methods: In the study, 63 small intestine segments were isolated from 63 Sprague-Dawley rats (SD rats, 4-week-old) to prepare the everted gut sac model. In the first part of our work, the everted sacs were exposed to 0, 50 mg/L TiO2 nanoparticles (24 nm) for 2 h with the presence of a series of glucose concentrations (10, 25, 50, 100, 200, 400, and 800 mmol/L), and the glucose absorbing function of the everted sacs were assessed in the process. On the basis of the work, utilizing the same method, further study was carried out to compare the effects of TiO2 nanoparticles (24 nm) and fine-particles (120 nm) on intestinal glucose absorbing function with the presence of 400 mmol/L glucose and 0, 10, 50, 200 mg/L TiO2. 3 intestine segments were used in each group. Results: The cumulative glucose absorption increased with time extension and increased glucose concentration. In the first part of our work, with the presence of 400 mmol/L glucose, the group treated with 50 mg/L TiO2 nanoparticles showed significantly lower cumulative glucose absorption and glucose absorbing rate than the control group at the exposure time of  30 min (tcumulative absorption=3.254, P<0.05; tglucose absorbing rate=3.958, P<0.05), 90 min (tcumulative absorption=3.323, P<0.05; tglucose absorbing rate=3.063, P<0.05) and 120 min (tcumulative absorption=2.834, P<0.05; tglucose absorbing rate=3.002, P<0.05). At other glucose concentrations, statistically significant differences in cumulative glucose absorption or glucose absorbing rates were not found between the TiO2 nanoparticle exposed group and the control group. In the second part of our work, when compared with the control group, no significant downregulations in cumulative glucose absorption or glucose absorbing rates were observed in both TiO2 nano-particle treated group and TiO2 fine particle treated group. Differences between the TiO2 nanoparticle treated group and the TiO2 fine particle treated group were not statistically significant. Conclusion: Short-term exposure to TiO2 nanoparticles may downregulate the intestinal glucose absorbing function in young rats, and the difference with TiO2 fine particlesis is not obvious.

Objective：To investigate the effect of equol on the proliferation of colom cancer cells and to explore the mechanisms. Methods: Colon cancer cells (DLD1,HCT15,COLO205,LOVO,SW480) were incubated, the cell proliferation was identified by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide cell proliferation assay. Reverse transcription PCR and Western blot were used to measure the mRNA and the protein expression of estrogen receptor and nuclear factor (erythroid-derived 2)-like 2 (Nrf2)in the colon cancer cells, respectively. Moreover, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide cell proliferation assay was used to investigate the effect of estrogen receptor(ER) inhibitor,ERα agonist, and estrogen receptor ERβagonist on the cell proliferation. Results: ERα was faintly expressed in the DLD-1 and HCT-15 cells. However, ERβ expression in DLD1, HCT15, COLO205, LOVO, and SW480 colon cancer cells. Different concentrations of equol (0, 0.5, 1, 5, 10 μmol/L) significantly inhibited the growth of HCT-15 cell with the expression of ERα and ERβ.More-over, different concentrations of equol (0, 0.5, 1, 5, 10 μmol/L) significantly inhibited the growth of LOVO, and SW480 cells with the ERβ expression in a dosedependent manner as demonstrated with a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide cell proliferation assay. mRNA expressions of ERα and ERβ in HCT-15 were stimulated significantly. Western blotting proved that the protein expressions of ERα and ERβ increased with the increasing of equol dose. Moreover we found significant difference of Nrf2 protein expression in HCT-15 cell stimulated by different concentrationss of equol. After the similation of estrogen receptor inhibitor, ERα agonist, or ERβ agonist, we found that only dif-ferent concentrations of ERβ agonist(0, 1, 10, 100, 1 000, 10 000 nmol/L) significantly inhibited the growth of HCT-15, LOVO, and SW480 in adose-dependent manner. Estrogen receptor inhibitor and ERα agonistdid not present significant effect on the cell proliferation of HCT-15, LOVO, and SW480. Conclusion: Equol inhibited the colon cancer cell proliferation by its estrogenic activities and antioxidant activities.

Objective： To explore the antagonistic effect of quercetin on fine particulate matter (PM2.5)-induced embryonic developmental toxicity in vitro. Methods: PM2.5 was collected on glass fiber filters by PM2.5 samplers during the heating period of Dec. 2015 to Mar. 2016 in an area of Haidian District, Beijing City. The sampled filters were cut into 1 cm×3 cm pieces followed by sonication. The PM2.5 suspension was filtered into a 10 cm glass dish through 8 layers of sterile carbasus and stored at -80 ℃ until freeze drying. Frozen PM2.5 suspension was dried by vacuum freeze-drying. In vitro post-implantation whole embryo culture was used in this study. Pregnant rats with 9.5 gestation days (GD) were killed by cervical dislocation and the uteri were removed into sterile Hank’s solution. The embryos with intact yolk sacs and ecto placental cones were induced by PM2.5, and then subjected to intervention of quercetin at the doses of 0.1 μmol/L, 0.5 μmol/L, 1.0 μmol/L and 5.0 μmol/L, respectively. At the end of the 48 h culture period, the cultures were terminated, and all embryos were removed from the culture bottles and placed in prewarmed Hank’s solution for evaluation. Morphological evaluation of the embryos was conducted under a stereomicroscope using the morphologic scoring system by Brown and Fabro. The mitochondrial reactive oxygen species (ROS) level was detected by FACSCalibur flow cytometry using MitoSOXTM Red staining. Results: An obvious antagonistic effect was achieved through querce-tin at the dose of 1.0 μmol/L, which could result in an increase of visceral yolk sac (VYS) diameter, crown-rump length and head length, somite number, and the differentiation of visceral yolk sac vascular vessels. The scores of allantois, flexion, heart, hind brain, midbrain, forebrain, auditory system, visual system, olfactory system, branchialarch, maxillary process, forelimb bud and hindlimb bud also revealed a significant increase and the relative mitochondrial ROS level of embryonic cells was significantly decreased when compared with PM2.5 group. Although quercetin at the doses of 0.1 μmol/L, 0.5 μmol/L, 5.0 μmol/L also exhibited protective effects against PM2.5-induced embryonic developmental toxicity, the protective effect was weaker when compared with the dose of 1.0 μmol/L. Conclusion: Quercetin at proper dose may be of great benefit for the development of embryos exposed to PM2.5 in the uterus of the rats. Quercetin provides an effective strategy for the prevention of PM2.5-induced embryonic developmental toxicity. Clearance of mitochondrial ROS may be one of its mechanisms .

Objective：To investigate the effects of exposure to ambient particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs) on systemic oxidative stress biomarkers in chronic obstructive pulmonary disease (COPD) patients. Methods: A panel of forty-five diagnosed and stable COPD patients, whose residences were within 5 kilometers from Peking University Health Science Center (PKUHSC), were recruited and followed up twice between November 2014 and May 2015. The lung function index percentage of forced expiratory volume in 1 second (FEV1) to predicted value (FEV1%pred), was measured to reflect the severity of COPD patients. The systemic oxidative stress biomarkers malondialdehyde (MDA) and 8-hydroxyl-2′-deoxyguanosine (8-OHdG) in their urine samples were measured using high performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA), respectively. Concentrations of ambient air pollutants and levels of meteorological factors were measured continuously through the air pollution-monitoring station located in PKUHSC. PM2.5 samples, which were used for measuring the concentrations of PAHs, were collected by PM2.5 high volume air sampler. We constructed linear mixed-effects models, including single-pollutant model, 2-pollutant models and stratification analysis, to estimate the effects of air pollutants on urinary MDA and 8-OHdG after adjusting for confounding factors. Results: In our COPD-patient panel, the associations between ultrafine particles (UFP) and PAHs and urinary MDA were statistically significant at lag2 (P<0.05). For an interquartile range (IQR) increase in UFP and PAHs, respective increases of 28% (95%CI: 4%－57%) and 36% (95%CI: 4%－77%) in urinary MDA were observed, and the effects became stronger after adjusting for the concentration of black carbon (BC). The COPD patients were divided into 2 groups stratified by FEV1%pred. Most air pollutants had stronger effects of systemic oxidative stress in the COPD patients of FEV1%pred≥50%. In this group, we observed that an IQR increase in UFP was associated with a 98% (95%CI: 38%－186%) increase in urinary MDA, and an IQR increase in BC, UFP and PAHs were associated with respective increases of 87% (95%CI: 32%－166%), 69% (95%CI: 24%－130%) and 156% (95%CI: 66%－294%) in urinary 8-OHdG. We didn’t find significant associations between fine particulate matter (PM2.5) and urinary oxidative stress biomarkers. Conclusion: Our results suggested that exposure to air pollutants, especially UFP and PAHs, was responsible for exacerbation of systemic oxidative stress in COPD patients. Most air pollutants had stronger effects of systemic oxidative stress in mild to moderate COPD patients.

Objective：To assess the association between particulate air pollution and hospital admissions for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing, and to eva-luate the differences of association among different subgroups.Methods: Hospital admissions to intertiary hospitals for AECOPD from  January 1，2014, through  December 31, 2015 were obtained from the electronic hospitalization summary reports (HSRs).We obtained the data on air pollution during the study period from the national air pollution monitoring system. The data on meteorological variables were obtained from the Chinese meteorological bureau. A poison generalized additive model was used to assess the effects of particulate pollution on AECOPD with adjustment for the long term trend, day of week, holiday effect and meteorological variables. Subgroup analyses were also conducted by age and gender, which would help identify higher-risk groups. Results: A total of 7 884 hospitalizations from 15 tertiary hospitals were recorded during the study period, and 69.3% were male patients, 37.1% were ≥80 years of age, 45.5% were 65－79 years of age, and 17.4% were younger than 65. The mean (SD) daily concentrations of PM2.5, PM10 were 77.1 (66.6) μg/m3, 111.9 (75.8) μg/m3. Every 10 μg/m3 increase in particulate pollution concentration for a lag of 4 d was associated with an increase in hospital admissions for AECOPD as follows: 0.53% (95% CI: 0.01%－1.06%, P=0.0478) of PM2.5, 0.53% (95% CI: 0.07%－1.00%, P=0.0250) of PM10, respectively. We found differences in risk for AECOPD admissions among the different subgroups. For every 10 μg/m3 increase in PM2.5, PM10 exposure in the female group there was a 1.13% (95% CI: 0.19%－2.07%, P=0.018 3) increase, 1.06% (95% CI: 0.22%－1.91%, P=0.013 6) increase in admissions, respectively, while in the male group, the association was non-significant. The patients of 80 years of age and older demonstrated a hi-gher risk of AECOPD, 1.25% (95% CI: 0.40%－2.11%, P=0.004 0) increase of PM2.5, 1.18% (95% CI: 0.42%－1.95%, P=0.002 4) increase of PM10, respectively, while other subgroups didn’t find significant association. Conclusion: Our findings showed that particulate air pollution was significantly associated with hospital admissions for AECOPD in Beijing. The susceptibility to particulate pollution varied by gender and age.

Objective： To use vertical and humidity correcting method to calibrate aerosol optical depth (AOD), and to explore the feasibility of calibrated-AOD as exposure index to measure the level of air pollutants from the ground and to establish the exposure-response relationship between calibrated-AOD and people’s health outcomes. Methods: First of all, we interpolated AOD, PM2.5, relative humidity and planetary boundary layer height using Kriging method to obtain data at different locations and matched different data with respiratory death in Beijing by geographical coordinates. Then, the planetary boundary layer height and aerosol hygroscopic growth factor calculated based on relative humidity was used to calbrate the AOD. To compare the effects of calibrated-AOD and PM2.5, we used standardization method to get non dimensionless calibrated-AOD and PM2.5. At last, we used the generalized additive mixed model (GAMM) to estimate the acute effects of calibrated-AOD and PM2.5 on respiratory death and chronic obstructive pulmonary disease (COPD) death, after controlling the time trend, temperature and humidity effects, days of the week effect and holiday effects. Results: The correlation coefficient between calibrated-AOD and PM2.5 was 0.72. The effects of calibrated-AOD on respiratory death and COPD death was the strongest at lag 0-3, one unit of calibrated-AOD increases was associated with 3.64% (95%CI: 0.58%-6.78%) increase of respiratory death and 4.92% (95%CI: 1.81%-8.14%) increase of COPD death. As for PM2.5, the strongest effects appeared at lag 0-1, one unit of PM2.5 (about 155 μg/m3) increases was associated with excess risks of 3.96% (95%CI: 0.82%-7.19%) and 6.12% (95%CI: 1.44%-11.02%) for respiratory death and COPD death respectively. Compared with PM2.5, the effects of calibrated-AOD on respiratory death and COPD death had narrower confidence intervals. The calibrated-AOD was sensitive to capture the lag effects, and the cumulative lag effects of calibratedAOD were all significant on multiple lag days which indicated that the calibrated-AOD was sensitive to capture cumulative lag effects of air pollutants on respiratory death and COPD death as well. Conclusion: We believe that calibrated-AOD can be used as an index to reflect the effects of air pollutants on respiratory death in Beijing. In the absence of ground monitoring, calibrated-AOD can be used to mea-sure the relationship between air pollutants and some health outcomes.

Objective：To analyze associations of sedentary behavior and physical activity with dyslipidemia among residents in Wuhai city. Methods: Data about social demographic characteristics, life style, health status and other covariate required for analysis in this study was obtained from a cross-sectional study on a total of 11 497 18－79 years old residents in Wuhai City by questionnaire, body mea-surement and laboratory examination. In this study, sedentary behavior and physical activity were evaluated using international physical activity questionnaire long version (IPAQ). IPAQ is widely used all over the world, and its reliability and validity have been tested in Chinese population. 2016 Chinese Guideline for the Management of Dyslipidemia in Adults was used to define dyslipidemia in this study. Results: According to IPAQ scoring protocol, 124 participants were excluded as a result of reporting more than 960 min of physical activity per day. 50.58% of 11 373 participants included in the analysis reported more than 4 hours of sedentary behavior per day in this study, thus 49.42% participants reported no more than 4 hours of sedentary behavior per day; the proportions of these 11 373 participants who reached Low level physical activity, Moderate level physical activity and high level physical activity were 23.43%, 37.29% and 39.28% respectively; and the detection ratios of new cases and prevalent cases of dyslipidemia in Wuhai City were 20.46% and 16.13% respectively. After controlling for confounders in this study, we found out that sedentary behavior increased the risk of new cases of dyslipidemia in women (OR=1.17, 95% CI: 1.00－1.36), and increased the risk of prevalent cases of dyslipidemia in both men (OR=1.21, 95% CI: 1.02－1.44) and women (OR=1.24, 95% CI: 1.04－1.48); as for association of physical activity with dyslipidemia, association was found between high level physical activity and prevalent cases of dyslipidemia in men in this study (OR=0.78, 95% CI: 0.62－0.98), suggested that high level physical activity may help to reduce the risk of prevalent cases of dyslipidemia in men. Conclusion: Our results from this crosssectional study in Wuhai City suggested that sedentary behavior increased the risk of dyslipidemia; by contrast, physical activity may help to reduce the risk of dyslipidemia.

Objective： To understand and analyze the current situation and secular trends for prevalence of malnutrition among Chinese children and adolescents aged 7-18 years from 2005 to 2014, and to provide important scientific basis for students’ nutrition improvement. Methods: All the subjects aged 7-18 years in both sexes were sampled from 2005, 2010 and 2014 Chinese National Surveys on Students Constitution and Health. According to the new students’ health standard of “Screening Standard for Malnutrition of schoolage children and adolescents”(WS/T4562014) in 2014 of China, the nutritional status of children in 31 provinces (autonomous regions and municipalities, excluding Hong Kong, Macao and Taiwan province) were analyzed and compared in different ages, genders, regions and provinces from 2005 to 2014. The Tibetan students was used with the data of Tibetan minority and all the other students from 30 provinces (autonomous regions, municipalities) were Han minority. Results: The prevalence of malnutrition of children and adolescents of Han minority aged 7-18 years in 2014 was 10.0%. The prevalence of malnutrition components, including stunting, mild wasting and moderate severe wasting, were 0.8%, 3.7%, and 5.5%. Compared with 2005 and 2010, the prevalence of malnutrition of Han children and adolescents in 2014 had declined with 5.0 and 2.6 percentage points, respectively, and its components had declined with 1.0, 1.8, 2.2 and 0.4, 1.1, 1.2 percentage points, respectively. The prevalence of malnutrition of 2014 in boys was higher than in girls (11.1% vs.8.9%), the rural was higher than the urban (11.0% vs.9.1%) and the west (11.7%) was higher than the east (9.0%) and the middle (9.2%). Mild wasting of Chinese children and adolescents aged 7-18 years was the main component in malnutrition and the stunting in the Han and Tibetan children and adolescents only accounted for 8.0% and 7.5%, respectively. Compared with 2005 and 2010, the prevalence of malnutrition for Chinese children and adolescents aged 7-18 years in 2014 had declined with various extents constantly, and there was a statistically significant difference among three surveys (P<0.05). Provinces (autonomous regions, municipalities) with high prevalence of malnutrition mainly concentrated in the southwest of China from 2005 to 2014. Compared with 2005 and 2010, the prevalence of malnutrition declined in 31 provinces (autonomous regions, municipalities) of China in 2014. The number of provinces (autonomous regions, municipalities) with high prevalence of malnutrition decreased constantly and increased for the number of province (autonomous regions, municipalities) with low prevalence. Conclusion: The prevalence of malnutrition among Chinese children and adolescents aged 7-18 years had declined from 2005 to 2014, but the total prevalence of malnutrition was still high. Mild wasting was the main component in malnutrition and the prevalence of stunting was low. Provinces (autonomous regions, municipalities) with high prevalence of malnutrition mainly concentrated in the southwest of China.

Objective： To analyze the prevalence of reduced visual acuity (VA) and to examine the association between reduced visual acuity and influencing factors among Chinese Han students, so as to provide bases for the prevention and treatment of reduced visual acuity. Methods: Subjects were from 2014 Chinese National Surveys on Students’ Constitution and Health (CNSSCH). In this survey, 261 832 Han students aged 7-22 years participated. Unaided distance VA was measured using a retro-illuminated lgMAR chart with tumbling-E optotypes. Ametropia was determined by using serial bronchoscopy. Logistic regression was used to assess the association between reduced visual acuity and influencing factors. ArcMap 10 was used to map the regional distribution of reduced visual acuity. Results: Nationwide, the overall prevalence of reduced visual acuity was 66.6%, and was highest among the urban girls (73.5%). The prevalence of myopia was 60.8% and accounted for more than 90% among the students with reduced visual acuity. Compared with 2010 CNSSCH, the increments of reduced visual acuity were highest in the students aged 13-15 years (6.8 percentage points). The prevalence of reduced visual acuity ranged from 50.6% to 76.2% in each province (autonomous region, municipality) in 2014 CNSSCH. The top three of the prevalence of reduced visual acuity were Jiangsu (76.2%), Zhejiang (76.0%) and Shandong (75.9%), and the lowest three were Hainan (50.6%), Guizhou (53.9%) and Xinjiang (57.6%). Logistic regression showed that the girls, urban students, and students who spent ≥2 h per day in their after school homework were more likely to develop reduced visual acuity, but the students with physical activity time ≥2 h per day were less likely to develop reduced visual acuity. Conclusion: Although the situation was different in each province (autonomous region, municipality), reduced visual acuity has become a public concern affecting the health of students in China. Based on the intervention on the key populations, such as urban girls and pre adolescent students, we should also continue to strengthen the prevention and control for reduced visual acuity among all students.

Objective：To validate five-year risk prediction models for atherosclerotic cardiovascular di-sease (ASCVD) in a contemporary rural Northern Chinese population. Methods: Totally 6 489 rural adults aged 40 to 79 years without clinical ASCVD were enrolled at baseline between June and August 2010, and followed up through January 2017. Expected prediction risk using the China-PAR (prediction for ASCVD risk in China) model was compared with the pooled cohort equations (PCE) reported in the American College of Cardiology / American Heart Association guideline. Kaplan-Meier analysis was used to obtain the observed ASCVD event (including nonfatal myocardial infarction, coronary heart disease death, nonfatal or fatal stroke) rate at 5 years, and the expectedobserved ratios were calculated to eva-luate overestimation or underestimation in the cohort. The participants in the cohort were divided into 4 categories (<5.0%, 5.0%-7.4%, 7.5%-9.9%, and ≥10.0%) for comparisons based on ASCVD prediction risk. The models were assessed by discrimination C statistic, calibration χ2, and calibration charts and plots for illustration as well. Results: Over an average 5.82 years of follow-up in this validation cohort with 6 489 rural Chinese participants, 955 subjects developed a first ASCVD event. Recalibrated China-PAR model overestimated ASCVD events by 22.2% in men and 33.1% in women, while the overestimations were much higher for recalibrated PCE as 67.3% in men and 53.1% in women. Gender-specific China-PAR model had C statistics of 0.696 (95%CI, 0.669-0.723) for men and 0.709 (95%CI, 0.690-0.728) for women, which were similar to those of 0.702 (95%CI, 0.675-0.730) for men and 0.714 (95%CI, 0.695-0.733) for women in the PCE. Calibration χ2 values in China-PAR were 17.2 and 54.2 for men and women, respectively; however, the PCE showed poorer ca-libration (χ2=192.0 for men and χ2=181.2 for women). In addition, the calibration charts and plots illustrated good agreement between the observations and the predictions only in the China-PAR model, especially for men. Conclusion: In this validation cohort of rural Northern Chinese adults, the China-PAR model had better performance of five-year ASCVD risk prediction than the PCE, indicating that recalibrated China-PAR model might be an appropriate tool for risk assessment and primary prevention of ASCVD in China.

Objective： To explore the relationship between glycemic control and visceral adiposity index (VAI) among type 2 diabetes mellitus (T2DM) patients. Methods: A community-based epidemiological field study for patients with T2DM aged ≥ 40 years was conducted in China.Every participant underwent physical examinations, biochemical tests of fasting glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and so on, and a questionnaire, including anthropometric characteristics, lifestyle, disease history, family history, and medication use. Those participants with HbA1c ≥7.0% were classified as the poorly controlled in our analysis of relationship between glycemic control and VAI. Anthropometric characteristics, lifestyle, and biochemical indexes of the participants were compared among the groups of different VAI levels. Logistic models were applied in multiple analysis adjusting for possible confounders. Results: A total of 1 607 patients with T2DM were recruited in our analysis with a mean age of (59.4±8.1) years and an average T2DM duration of (7.0±6.4) years. Among them, 78.3% were on hypoglycemic therapy. The cutoff points of quartiles of VAI were calculated for the males and females, respectively. According to the ascending order of the quartiles of VAI, the participants were divided into four groups, i.e. Q1, Q2, Q3, and Q4. The poor glycemic control rate for these groups were 60.6%, 65.7%, 70.1%, and 71.0%, respectively (Trendχ2=12.20, P<0.001). After adjustment for age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL-C, smoking, cardio-cerebral vascular disease (CVD) history, hypoglycemic therapy, T2DM duration, and family history of diabetes, the Logistic regression models showed that the glycemic control rate was significantly associated with VAI levels among the patients with T2DM. Compared with the participants in group Q1, the ORs of poor glycemic control for those in groups Q2, Q3, and Q4 were 1.239 (95%CI 0.918 to 1.672), 1.513 (95%CI 1.117 to 2.050), and 1.535 (95%CI 1.128to 2.088), respectively (trend P=0.003). With each quartile increase in VAI, the OR of poor glycemic control was 1.162 (95%CI 1.054 to 1.282). Conclusion: The glycemic control among the patients with T2DM is significantly associated with VAI. High level of VAI is an indicator of poor glycemic control.

Objective： To explore the influence of awareness on the behaviors of Chinese adults with diabetes mellitus, so as to provide scientific evidence for developing relevant policies and strategies in the prevention and control of diabetes. Methods: Data from the 2013 China Chronic Disease Risk Factor Surveillance were used, covering 297 surveillance counties (districts). The variables involved in this crosssectional study included: the prevalence of diabetes, the awareness situation, demographic characteristics, behaviors, and other information. The study used descriptive analysis to analyze diabetes status and chi-square test to determine the difference in the distribution of behaviors between patients who were aware of their disease and those who were not. Logistic analysis was performed to examine the influence of diabetes awareness on patients’ behaviors with adjustment for potential confounders. Results: A total of 175 670 subjects were involved. The prevalence of self-reported diabetes in China in 2013 was 3.9%, while the awareness rate was 38.6%. The percentage of current smokers or current drinkers among the patients who were aware of their disease (20.2%, 25.0%) was less than that among the patients who were not aware (25.8%, 35.0%). The proportion of those who often exercised among the patients who were aware of their disease (83.4%) was higher than that among the patients who were not aware (79.0%). There was slightly higher proportion of the subjects who had insufficient intake of vegetables and fruits or over intake of red meat among the patients who were aware of their disease (49.4%, 28.0%) than that among the patients who were not aware (48.4%, 26.1%). After controlling urban and rural areas, regions, age, gender, nationality, marital status, educational level, occupation, and income factors, the possibility of current smoking (OR=0.79) or drinking (OR=0.58) among the patients who were aware of their disease was lower than among those who were not; the possibility of more than 150-minute physical activity per week (OR=1.30) among the patients who were aware of their disease was higher than among those who were not. Conclusion: The awareness rate of diabetes in China still remains low. Kno-wing whether they have diabetes or not has an effect on individual choice of behaviors, including smoking, drinking and physical activities. Therefore, health education and health examination for diabetes should be further expanded with wide cooperation from all relevant departments, thus forming an integrated environment involving individuals, health systems and socioeconomic policies to prevent and control diabetes.

Objective：To study the status quo of directive and nondirective support from family or friends among patients with diabetes in community and to explore the association between directive, nondirective support from family or friends and self-management behaviors. Methods: The data of the subjects were from the “Community Diagnosis in Tongzhou District, Beijing” survey. Questionnaire-based investigation, physical examination and glycated hemoglobin test were conducted on 474 eligible patients in community. The summary of diabetes self-care activities measure (SDSCA) was adopted to investigate the self-management behaviors, and directive and nondirective support scale among patients with diabetes (DNSS-PD) was adopted to measure the directive and nondirective support among patients with diabetes. Results: A total of 452 patients with diabetes were included in the analysis. The average score of directive support was 2.53±1.07, and only 27.6% patients had high level directive support. The average score of nondirective support was 3.13±1.12 and 50.8% patients had high level nondirective support. The average SDSCA total score was 35.38±14.21 and the corresponding scoring percentage was 45.95%. Only 20.6% patients had optimal self-management. The total score, score of diet and physical activity, general self-management situation, diet self-management situation and physical activity self-management situation of the patients in high level directive support group were significantly better than in low level directive support group. The total score, score of self-management behaviors in five aspects (diet, physical activity, blood glucose self-monitoring, foot care and smoking), general self-management situation, self-management situation of five aspects of patients in high level nondirective support group were significantly better than in low level nondirective support group. Gender (OR=2.729), nondirective support level (OR=4.890), age (OR=0.969) and body mass index (BMI) (OR=0.819) were important influencing factors of self-management behavior. Conclusion: The status quo of self-management among patients with diabetes is not optimistic. Patients obtain more nondirective support than directive support from family and friends. However, the support level of both nondirective and directive support should be improved in the future.Both high level directive support and high level nondirective support had positive correlation with better self-management behaviors. Nondirective support had positive correlation with five aspects of self-management behavior, while directive support had positive relation with selfmanagement behavior in aspects of diet and physical activity.In addition, more consideration and support of self-management should be provided for older obese male patients with diabetes in community, especially nondirective support.

Objective：To compare acquired immune deficiency syndrome (AIDS) related knowledge, attitudes, behaviors and their influencing factors among college students in different years in Beijing, and to provide evidence for targeted health education among college students in future. Methods: College students were selected by the stratified cluster sampling method, and a questionnaire survey was conducted among college students in year 2006 and 2016 in Beijing. The sample sizes were 1 800 and 3 001 college students, respectively. The contents of the questionnaire included: socio-demographic characteristics, AIDS related knowledge, AIDS related attitude, sex intercourse and its related risk behaviors, condom use intension, and AIDS related health education. Results: Compared with the  year 2006, the average AIDS knowledge scores of college students in year 2016 dropped from 12.78±1.95 to 11.90±2.56 (t=12.91, P<0.05), and the correct answer rates of questions in the knowledge part were decreased, too. Except for belief on condom use, the college students were more negative on AIDS related attitude and self-efficacy in year 2016 than in year 2006. Among the students who had sex experience, the rates of commercial sex ［17.65% (33/187) vs. 6.53% (16/245), χ2=13.003, P<0.001］ and the rates of homo-sexual intercourse ［15.43% (29/188) vs. 4.13% (10/242), χ2=16.356, P<0.001］ were higher in year 2016 than in year 2006. The main way for the students seeking pornographic information was changed from books to internet (41.15%) in 2016 compared with the year 2016. In 2016, the influencing factors of intention on condom use were male (OR=0.713), selfefficacy of condom purchase (OR=0.876), never received sex education before college (OR=0.752), selfefficacy of condom use (OR=1.135), belief of condom use (OR=1.775), and attitude towards AIDS patients (OR=1.136). Conclusion: AIDS related knowledge, attitudes and behaviors among college students have been changed, AIDS related health education should be designed and improved based on new characteristics of college students. AIDS health education in colleges should pay more attention to sex attitude and sex responsibility and selfprotection awareness among college students as well.

Objective： To investigate the awareness of acquired immune deficiency syndrome (AIDS) knowledge and AIDS-related behaviors among youth students in gay dating sites, and to provide evidences for AIDS prevention education through the internet. Methods： The students in gay dating sites, selected by a snowball sampling, were interviewed by questionnaires. Chi-square tests were used to analyze the awareness of AIDS knowledge among the students of different characteristics. The Logistic regression was used to analyze the factors associated with ever testing for HIV. Results: In the study, 469 youth students in gay dating sites filled in the questionnaires, and a total of 442 (94.2%) valid samples were collected. The awareness of HIV/AIDS knowledge for the public among the youth students in gay dating sites was 83.9% (371).The awareness of HIV/AIDS knowledge for the youth students was 77.1% (341), and the rate of ever testing for HIV was 52.0% (230). The awareness of HIV/AIDS knowledge for the public in the students were different in different age groups (P＝0.001), different marital statuses (P＜0.001), different sexual orientations (P＜0.001), and different genders of the first sexual partner (P＜0.001). The awareness of HIV/AIDS knowledge for the youth students were different in different age groups (P＝0.010), different marital status (P＝0.004), different sexual orientations (P＜0.001), and different genders of the first sexual partner (P＜0.001). The rate of ever having sexual intercourse among the youth students in gay dating sites was 75.1% (332), and the rate of multiple sexual partnerships among the youth students was 41.3% (137). Compared with homosexual orientation, sexual orientation as heterosexual (OR＝0.282，95%CI:0.151 to 0.528) and not sure (OR＝0.175，95%CI: 0.035 to 0.885) were risk factors of ever testing for HIV. Multiple sexual partnerships (OR＝2.103，95%CI:1.278 to 3.462) were promoting factors of ever testing for HIV. Conclusion: The rate of high-risk behaviors among the youth students in gay dating sites was high. The concern should be raised to heterosexual male students who had tendency to homosexual behavior.The AIDS prevention education should be developed in gay dating sites, to improve the self-protection awareness of the youth students.

Objective： To study the status and identify the determinants of outpatient service utilization of rural floating population in Beijing who have different accumulated residence time. Methods: The survey data of rural floating population health and health care services in Beijing in 2014 were used, and the migrant population aged 18 years and above were taken as the research object. Whether to use outpatient service within two weeks was taken as dependent variable, gender, age, education level, self-assessment score of socioeconomic status, accumulated residence time in Beijing, health insurance, average household income, suffering from high blood pressure or diabetes as independent variables. Logistic regression model was used to analyze the influencing factors. Results: The average age of the research object was 36.7 years, with mostly secondary education. The average accumulated residence time in Beijing was 8.4 years. The two-week prevalence rate was 10.3%, the two-week visiting rate calculated by person-time was 6.0%. The Logistic regression model suggested that, socioeconomic status, accumulated residence time and suffering from high blood pressure or diabetes were statistically significant determinants of outpatient service utilization. Conclusion: The research object is a younger and less educated population, their health status is better and outpatient service utilization is lower. It is found that people who have longer accumulated residence time in Beijing have lower outpatient service utilization. This is because people with longer residence time have lower age-adjusted two-week prevalence rate. This is also because people with longer residence time have larger proportion of taking continuous measures under doctor’s advice. It does not mean people with longer residence time have lower utilization of medical service. The residence time variable plays the role of proxy variable. It can solve the problem of variables’ endoge-neity. At the same time, it can reflect the influence to outpatient services utilization of some determinants，which are not included in the model but varies with residence time.

Objective：  To assess and analyze the operation efficiency of 8 commission general public hospitals managed directly by National Health and Family Planning Commission and 8 municipal general hospitals managed directly by Beijing Municipal Administration of Hospitals in Beijing and to provide suggestions on improving service capacity and designing relevant health policy. Methods: Input and output data of 8 commission hospitals and 8 municipal hospitals were obtained from Beijing Direct-Reported Health Statistics data from 2011 to 2014. Data envelopment analysis was used as the hospital operation efficiency measurement tool. The CCR and BCC models were built to calculate technical efficiency (TE), pure technical efficiency (PTE), scale efficiency (SE) and the status of scale efficiency of 16 hospitals in 2011 and 2014; the Malmquist index model was built to analyze the total factor productivity change (TFPC), technological change (TC), technical efficiency change, pure technical efficiency change and scale efficiency change of the 16 hospitals from 2011 to 2014.  Results: In 2011, the TE, PTE and SE of the commission hospitals were higher than those of the municipal hospitals, and the TEs of the commission hospitals and the municipal hospitals were 0.918 and 0.873 respectively. In 2014, the TE, PTE and SE of commission hospitals were lower than those of the municipal hospitals, and the TE of the commission hospitals and the municipal hospitals were 0.906 and 0.951, respectively, which was contrary to the results in 2011. According to the Malmquist index model, the average of TFPC of the municipal hospitals was larger than that of the commission hospitals, the former increased 5.9% and the latter increased 2.8% per year; the average of TC was greater than the one in both the municipal hospitals and the commission hospitals, with a growth of 3.2% and 2.9% per year, respectively; the average growth of PTE in the commission hospitals was lower than that of the municipal hospitals, and the average descent of SE in the commission hospitals was larger than that in the municipal hospitals. Conclusion: There are significant differences in the operation efficiency between different management systems and the main factors associated with operation efficiency are the technological and management level. Given scale efficiency status and macroeconomic medical policies, the commission hospitals and the municipal hospitals require further adjusting the distribution of medical resources, and it is of great significance for all the commission hospitals and the municipal hospitals to improve the management level and resource integration capability.

Objective： To investigate the effect of macrophage-capping protein (CapG) on migration and proliferation of human gastric cancer cell line. Methods: Realtime PCR method was used to detect the expression of CapG gene in four gastric cancer cell lines, and AGS cells with low expression and transfection were selected as the research objects. Specific primers were designed for CapG and recombinant plasmids synthesized. A lentivirus packaging system which could express CapG was constructed, and a cell line stably expressing CapG was established by infecting human gastric cancer cell line AGS cells. The effect of overexpression of CapG gene on the growth and proliferation of AGS cells was analyzed by CCK8 assay. Cells cratch and Transwell assay were used to analyze the effect of overexpression of CapG gene on AGS cell migration. Results: After the overexpression of CapG, the growth rate of AGS cells was slightly lower than that of the control group, but there was no significant difference between the two groups (t=2.424, P=0.073). Scratch test showed that the average narrowing distance of the scratches in the CapG experimental group was significantly reduced compared with the control group, the average narrowing distance of the CapG experimental group and the control group was 336.99 μm and 45.54 μm, the difference was statistically significant (t=14.97, P=0.004). The average number of cell penetra-ting membrane in the CapG experimental group and the eGFP control group was 176 and 70, the number of the cells in the CapG experimental group was significantly higher than that of the control group (t=40.00, P<0.001). Conclusion: The overexpression of CapG gene has no significant effect on the growth and proliferation of AGS cells of gastric cancer cell line. Overexpression of CapG gene can promote the migration of AGS cells of gastric cancer cell lines.

Objective： To investigate the clinicopathological features, morphological characteristics, immunophenotypes of littoral cell angioma (LCA) in spleen, and to provide new evidence for making diagnosis and avoiding misdiagnosis. Methods: Clinicopathological data, histological characteristics of 13 cases of LCA were retrospectively studied and immunohistochemical staining was imposed on the paraffinembedded specimens, and 5 cases of cavernous hemangioma, 4 cases of normal littoral cells of spleens were used as control groups, simultaneously. Results: All the 13 LCA patients included 7 males and 6 females, aged from 39 to 70 years with an average of 54. 2 years and a median age of 55 years. Among these tumor patients, 6 cases were accompanied by malignances, benign tumors or inflammation states at abdominal cavities, and 7 cases were accidentally discovered by physical examinations. Grossly, spleens contained solitary or multiple gray red nodules ,which ranged from 0.5 to 6.2 cm in diameter. Histologically, tumors were composed by anastomosing vascular spaces which were lining by plump, rounded to cuboidal littoral cells that extended into vascular lumens. Usually, papillary frameworks that were covered by these cells were also seen extending into the lumens in some areas. Other types of histiocytoid cells were identified in lumens and the sizes were larger than the littoral cells. Both types of cells absented cytologic atypia. Immunohistochemical study demonstrated that the littoral cells in all cases were positive for vascular endothelial and histiocyte markers, such as CD21, CD31, CD68, polyclone FⅧRAg and ERG, while these cells were negative for CD8, CD34, and WT-1. These findings manifested that immunophenotype of littoral cell in LCA distinctive from that in controls. Conclusion: LCA is a benign lesion, which frequently occurs in the elderly. Its etiology remains confusion, however, immune dysregulation may associate with it because of the concomitance with other tumor or inflammation in some cases. The littoral cells in LCA show a hybrid endothelialhistiocytic phenotype on immunohistochemistry, therefore these cells may have features that intermediate between those of endotheliocytes and histiocytes. Emphasizing the histological findings and immunophenotypes is significant for diagnosis and differential diagnosis.

Objective： To observe the morphological changes on cochlear hair cells of rats in simulated weightlessness and inboard noise and to investigate the different changes in three turns of hair cells. Methods: Thirty-two healthy SD rats, all males, were randomly divided into four groups: control group, weightlessness group, noise group and weightlessness+noise groups (n=8). Then rats were exposed to -30° head down tilt as simulated weightlessness and inboard noise including steady-state noise which was (72±2) dB SPL and impulse noise up to 160 dB SPL in spaceship environment. The control group was kept in normal condition for 8 weeks. Bilateral auditory brainstem response (ABR) thresholds were tested before and after exposure respectively, and immunofluorescence staining and scanning electron microscopy (SEMs) of basilar membrane were applied after exposure. Results: ABR threshold shifts of each group were higher after exposure. There was difference between ABRs of the experiment groups before and after exposure (P<0.05). IF showed that the inner hair cells (IHCs) missing was the main damage in the basal turn of weightlessness group, the hair cells in the middle turn were swell and in the top turn, the hair cells were not clear. In noise group, the main loss happened in the outer hair cells (OHCs) of the outermost layer. In weightlessness+noise group, the nuclear missing in the basal turn was apparent, and mainly happened at the outermost layer. Meanwhile, the missing of hair cells in the middle turn and top turn was seen at the innermost layer. SEM showed that the cilia in the basal turn of weightlessness group were serious lodging, and occasional absence. Furthermore, the basal cilia in noise group became lodged and absent, and the other two turns were seriously missing. And in weightlessness+noise group, the cilia missing in the basal turn was apparently seen. The damage degree of the four groups: weightlessness+noise group>noise group>weightlessness group>control group and the damage degree of the four turns of hair cells: basal turn>mid turn>top turn. Conclusion: The rats exposed to the above environment for 2 weeks displayed obvious changes in cochlea morphology, and the weightlessness+noise group had the most obvious damage.

Objective： To compare the dosimetric data between the preoperative plans and postoperative verification in personalized 3D printed template-assisted and computed tomography (CT) image-guided 125-iodine seed implantation for supraclavicular metastatic tumor, and to evaluate the accuracy and feasibility at the dosimetry level. Methods: A total of 14 patients with supraclavicular metastatic tumor (including 15 lesions) who received 3D printed template assisted and CT image-guided 125-iodine seed implantation in Department of Radiation Oncology of Peking University Third Hospital from January to September 2016 were enrolled. There were 8 males and 6 females, aged from 46 to 79 years (mean age: 59.9 years). The Karnofsky performance score (KPS) was from 60 to 90 (median of 80). There were one patient who had not received radiotherapy before, and one patient had received radiotherapy, but the dose was unknown. The remaining 12 patients had received radiotherapy, with the median of 60 Gy (20-70 Gy), and one of them with the dose unknown. All the patients underwent preoperative enhanced CT scan, preoperative planning design, 3D printing template, puncture and particle implantation, the prescription dose from 110 Gy to 150 Gy. Comparisons of the dosimetric parameters between the postoperative verification and preoperative plans were made by paired t-test. The dose parameters inclu-ded D90, V100, V150, V200, matched peripheral dose (mPD), conformal index (CI), and external index (EI). The agreement was evaluated between the preoperative planning and postoperative actual dose parameters using BlandAltman analysis. BlandAltman plot showed the difference against the average of preoperative planning and postoperative actual dose parameters with limits of agreement (LoA) (broken lines). Results: The difference of all the data between pre-and postoperation, included D90, V100, V150, V200, mPD, and CI, which was not statistically significant (P>0.05). EI was statistically significant (P<0.05). There was poor consistency of D90, V100, V150, V200, and mPD, but better consistency of CI and EI. Conclusion: Personalized 3D printed template-assisted and CT image-guided 125-iodine seed implantation for supraclavicular metastatic tumor is accurate and feasible.

Objective： To evaluate the clinical result of atlantoaxial reduction and fixation guided by the intraoperative CT. Methods: Sixteen cases were retrospectively studied, including seven males and nine females, with the mean age of 49.9 years. Twelve cases were diagnosed as chronic atlantoaxial instability or dislocation, while four cases as acute odontoid fracture and dislocation. Among the sixteen cases, fourteen underwent atlantoaxial fusion, while two underwent temporary atlantoaxial fixation without fusion. The intraoperative CT was used in the setting of: 1. Evaluating the atlantoaxial reduction before the screw insertion; 2. Guiding the C1 and C2 pedicle drilling (two cases using additional three-dimensional printing drilling template)；3. Evaluating the position of the screws and reduction after the atlantoaxial fixation. In addition, three-dimensional drilling template combined with intraoperative CT was used in two cases. CT scanning frequency was calculated. To evaluate the accuracy rate of screw fixation under the intraoperative CT, 19 cases without the intraoperative CT were studied as the control group. Results: Averaged CT scanning frequency was 1.4 times (Once in eleven cases, twice in four and three times in one). Among the sixteen cases, mal-positioned C1 screws were found and revised in two cases. No spinal cord injury or vertebral artery injury occurred. The follow-up ranged from three to ten months, with the mean of 6.7 months. Fourteen cases achieved solid osseous fusion, and two with temporary fixation had odontoid fracture union. Anatomic reduction was achieved in all the cases. Eleven cases with preoperative myelopathy had postoperative improvement and their mean JOA scores improved from 12.1 to 14.4. To the last follow-up, no hardware complications were found including screw broken, rod broken or fixation loosening. All the screws of intraoperative CT group had good positions. For 19 cases of the control group, there were two cases of mal-positioned screws (10.5%). Conclusion: Advantages of atlantoaxial reduction and fixation guided by the intraoperative CT included: improving the accuracy of the atlantoaxial screws, exactly evaluating the reduction of the atlantoaxial joint, immediately discovering the mal-positioned screws and avoiding the revision surgery. A good clinical result was found in the preliminary study.

Objective： To evaluate the role of the deep radioulnar ligament in the stability of the distal radioulnar joint (DRUJ). Methods: In the study, 14 fresh cadaver upper extremities were randomly divided into two groups. After exposuring the palmar and dorsal deep distal radioulnar ligament, one group was marked as palmar deep radioulnar ligament, and the other group was marked as dorsal deep radioulnar ligament. The pronator teres and the supinator were exposed. A Kirschner wire perpendicular to the bone on Lister tubercle of radius was inserted, then another Kirschner wire on the same level of ulnar inserted when the forearm was in neural position, which was kept parallel to the first Kirschner wire. These specimens were mounted on a specially designed jig which held the limb rigidly, keeping the elbow fle-xion and the ulnar fixation. The radius could freely rotate around the ulnar. Then 50 N force on the pronator teres was applied to simulate the active pronation, and 60 N force on the supinator to simulate the active supination. The active pronation was stimulated, and the displacement of the distal radius was measured with respect to the ulna. The active supination was atimulated, and the displacement of the distal radius was measured with respect to the ulna. The palmar deep radioulnar ligament in one group was cut, then the displacement of the distal radius measured with respect to the ulna when the forearm was in pronation and supination. The dorsal deep radioulnar ligament in the other group was cut, and the displacement of the distal radius measured with respect to the ulna when the forearm was in pronation and supination. Results: After resection of the palmar deep radioulnar ligament, the displacement of the distal radius with respect to the ulna was statistically significantly different when the forearm was in pronation (t=5.591, P=0.001), but there was no difference when the forearm was in supination (t=0.433, P=0.680). After resection of the dorsal deep radioulnar ligament, the displacement of the distal radius with respect to the ulna was not different when the forearm was in pronation (t=1.000, P=0.356), but there was statistically significant difference when the forearm was in supination (t=6.225, P=0.001). Conclusion: DRUJ is unstable when the forearm is in pronation after resection of the palmar deep ra-dioulnar ligament, and DRUJ is unstable when the forearm is in supination after resection of the dorsal deep radioulnar ligament.

Objective： To explore the relationship between the PTCH1 mutation and the expression of bcl-2, filaggrin, and loricrin in the keratocystic odontogenic tumour (KCOT), as well as the effects of the mutated PTCH1 on the epithelial proliferation and differentiation. Methods: The samples were collected from 20 cases of KCOT with mutated PTCH1, as well as 20 cases without mutation. All the samples were analyzed with immunohistochemical staining, for the purpose of investigating the expression of bcl-2, filaggrin, and loricrin. Results: In the samples with mutated PTCH1, the epithelia of 60% (12/20) cases expressed intensively positive bcl-2 staining, 20% (4/20) expressed moderate staining, and 20% (4/20) weak staining, but no negative bcl-2 staining samples were investigated; it was significantly different from the samples without PTCH1 mutation, in which 20% (4/20) expressed intensive staining, no moderate staining, 50% (10/20) weak staining, and 30% (6/20) negative staining were investigated (U=72, P=0.001). For the expression of filaggrin, 55% (11/20) of samples with PTCH1 mutations were stained weakly and 45% (9/20) showed negative staining, while in the samples not harboring PTCH1 mutations, 30% (6/20) cases showed moderate positive staining, 40% (8/20) weak staining and 30% (6/20) negative staining, no intensive staining was investigated (U=182, P=0.48). The loricrin expressed in all the layer of the epithelia in all the samples, while the filaggrin was mainly loca-lized within 1-4 layer cells of the epithelia. The differences of the expression of filaggrin and loricrin between the samples with mutated PTCH1 and without mutated PTCH1 displayed no significance. Conclusion: In the epithelia of KCOT, the bcl-2 expression was significantly associated with the PTCH1 mutation, which suggested that the mutated PTCH1 gene perhaps promotes the proliferation of KCOT epithelium.

Objective：To evaluate the feasibility of fine-needle aspiration cytology (FNAC) in diagnosing vascular abnormality in oral and maxillofacial region. Methods： The method of retrospective study was used. The data from the patients who underwent FNAC from 2011 to 2014 in Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology were collected. All the included patients were divided into surgery group and non-surgery group. The patients in surgery group underwent lesion resection and the postoperative pathological results were gained. The patients in non-surgery group underwent periodical sclerotherapy. The accuracy of FNAC was identified by histopathologic diagnosis in surgery group and the effect of sclerotherapy in non-surgery group. Results: In this study, 93 patients were involved, including 51 males and 42 females. The median age was 2.5 years. Among them, 67 cases were judged as vascular abnormality by FNAC, and 63 cases were in consistent with final diagnosis and 4 cases were not. Among the other 26 cases which were diagnosed as other diseases by FNAC, 5 cases were accorded with final diagnosis. Therefore, the sensitivity of FNAC on diagnosis of vascular abnormity was 93% and its specificity was 84%. Among them, there were 29 cases  in the surgery group and 64 cases in the non-surgery group. FNAC results were in consistent with the postoperative pathological results in 20 cases in surgery group (69%), and not consistent with pathological results in 9 cases . The pathological diagnoses included vascular malformations (3 cases), neurofibromas (2 cases), hamartoma (1 case), sebaceous cyst (1 case), adenolymphoma (1 case), and descriptive diagnosis (1 case). In non-surgery group, FNAC results were in consistent with the clinical effect of sclerotherapy in 61 cases (95%). There were 3 misdiagnosed cases. The coincident rate between the result of FNAC and that of pathological or clinical diagnosis was 86%. Conclusion: FNAC is a feasible and minimal invasive method to diagnose vascular abnormality in oral and maxillofacial region.

Objective：To evaluate the clinical effect of distalizing mandibular dentition with micro-implant in patients with skeletal classⅢmalocclusion. Methods: In the study, 20 patients with skeletal class Ⅲmalocclusion were selected. They are consist of 8 males and 12 female with an age range from 16 to 38 years old and an average age of (21.5±5.6) years.They were treated with straight wire technique and the implant were inserted into the mandibular external oblique line to distlize the lower dentition to a class Ⅰmolar relationships.Cephalometrics films were taken before and after treatment. The changes of hard tissue and soft tissue were analyzed by evaluating 26 measurement measurements. Results: ClassⅠmolar relationships were achieved, and the profile were improved after treatment. ANB increased by（0.80±1.02）°，Wits increased by （1.67±1.74） mm，after treatment（P<0.05）.The lower dentition were significantly retracted after treatment with L1-NB distance decreased by（2.64±1.50） mm, P<0.05; the mesial buccal cusp and mesial root of the lower first molars were retracted by （3.26±1.95） mm and （0.79±1.27） mm respectively （P<0.05）; the mesial buccal cusp of the lower second molars were retracted by （3.06±1.80） mm （P<0.05）. After treatment, mandibular teeth got uprighted distally. From incisors to molar, L1/MP, L5/MP, L6/MP, L7/MP angle decreased by(6.37±8.53)°, (10.59±8.50)°, (11.48±7.22)°, (15.72±7.16)°on average respectively （P<0.05）, all of those changes had the statically significant effects. Soft tissue change after treatment, the distance from lower lip to esthetic plane were decreased by (1.70±1.59) mm on average （P<0.05）. Conclusion: Distalizing mandibular dentition with micro-implant can get an satisfying result in patients with skeletal class Ⅲmalocclusion, the lower teeth were retracted by controlled tipping movement.

Objective： To detect the vascular paths in the lateral wall of maxillary sinus using cone beam computer tomography (CBCT), and to retrospect the surgical managements of avoiding bleeding complication during the lateral approach maxillary sinus elevation. Methods: The documents of 71 consecutive patients with 81 sides maxillary sinus elevation surgery were collected. The vascular paths in the lateral wall of maxillary sinus were detected by the preoperative CBCT, and the messages about the vascular in surgical records were analyzed. Results: The paths of the vascular could be detected in 77 (95.1%) sides maxillary sinus in the reconstruction panoramic images of CBCT. At the position of the first molar, the paths of the vascular of the lateral maxillary sinus walls could be detected in 54 sides (66.7%) in the reconstruction coronal images of CBCT, and the other 27 sides (33.3%) could not be detected. Two approximately parallel paths of the vascular were found in 3 sides (3.7%) of the lateral maxillary sinus walls. The different diagnoses occurred in 6 sinuses between two observers. The kappa of diagnostic consistency of the two observers was 0.842 (P<0.001). The mean distance between the lower border of the vascular path to the plane of the alveolar crest of 54 sides maxillary sinuses was about (13.0±4.7) mm. The mean distance between lower border of vascular path to the plane of the floor of the sinus was (9.3±4.8) mm. The vascular path was located in the floor wall in 1 sinus. During the lateral approach maxillary sinus elevation operation, intraosseous vessels were dissected in 4 sides sinus lateral wall, the vascular path was avoided consciously in 3 sides, and the sinus elevation surgery had to be given up in 1 side for the vessel was torn and bleeding. There were no vascular related messages in 73 sides of the lateral approach maxillary sinus elevation operation records. Conclusion: The vascular paths of maxillary sinus wall could be detected by CBCT in most cases. Preoperative CBCT examination was proved to be reliable. The vascular paths of maxillary sinus wall should be examined carefully. It was helpful to make the surgical design perfectible and reduce the risk of tearing the vessel in operation.

Objective： To investigate clinical features of distant metastases from malignant salivary gland carcinomas after treated by 125I internal brachy therapy alone. Methods: Between 2002 and 2010, 43 patients with locally advanced unresectable or recurrent malignant salivary gland carcinomas were treated by 125I internal brachy therapy alone at Peking University School and Hospital of Stomatology. All of them had been follow-up at least 2 years. The primary sites of malignant salivary gland carcinomas were the parotid for 12 patients, infratemporal fossa for 9 patients, tongue for 7 patients, maxilla for 6 patients, parapharyngeal for 4 patients, floor of months for 3 patients, submandibular gland for 1 patient, and lip for 1 patient. The overall survival rate, local control rate, and distant metastases were retrospectively reviewed. Results: Distant metastases occurred in 23 of the 43 patients (53.5%). Distant metastases developed from 5 to 96 months, with an average interval of (27.0±23.7) months from the time of initial diagnosis, the mean interval was 21 months. The commonest site of distant metastases overall was the lung 69.6%(16/23). The most common pathological types of distant metastases were adenoid cystic carcinoma (14/23, 60.9%) and nonspecific adenocarcinoma (7/23, 30.4%). At the time of the last follow-up, 26 patients died, and 18 of them due to distant metastases (69.2%, 18/26). In the study, 27 patients got complete remission(CR), 12 got partial remission(PR) more than 50%, 2 less than 50%, and 2 patients were invalid. The effective rate (CR+ PR) was 90.7%. The 3 year loco-regional control rate and survival rate were 60.1%, 82.6%, respectively, and the 5 year’s 53.4% and 56.0%. Conclusion: The 125I brachy therapy is a feasible and effective modality for the treatment of locally advanced unresectable or recurrent malignant salivary gland carcinomas. However, further studies are needed with larger numbers of patients and for a longer follow-up assessment. Distant metastasis was the main cause of treatment failure, and the lung was the most common site of distant metastases.

Objective： Some quantitative structure-activity relationship (QSAR) models have been developed to predict cardiac toxicity of drugs, which have limited predictive power due to based on hERG channel inhibition. The objective of this study was try to develop a QSAR model based on all kinds of cardiac adverse effects, and to predict the potential cardiotoxicity of chemical components in traditional Chinese medicines (TCM). Methods: In this study, the compounds data of all kinds of cardiac adverse reactions were selected as the training set. The QSAR models were constructed based on 1 109 compounds with cardiotoxicity and 789 compounds without cardiotoxicity, which were available from the Toxicity Reference Database (ToxRefDB) and Side Effect Resource (SIDER) database. The ADMET Predictor software was applied to calculate and to screen the molecular descriptors, and to construct the QSAR models using support vector machine (SVM) and artificial neural networks (ANN) algorithm, respectively. The models were optimized using compound-based 10-fold cross validation. Then, the predictive performance for the potential cardiotoxicity of chemical components in TCM were assessed using external validation by 19 components in TCM with cardiotoxicity and 10 components in TCM without cardiotoxicity. Results: A total of 220 molecular descriptors were selected for modeling, and the best model using SVM algorithm contained 87 molecular descriptors. The internal validation results showed that the predictive sensitivity, specificity, the Youden’s index (YI) and the Matthews correlation coefficient (MCC) were 71%, 70%, 0.41, and 0.41, respectively. The best model constructed using ANN algorithm contained 13 neurons and 87 molecular descriptors. The internal validation results showed that the predictive sensitivity, specificity, the YI and the MCC were 78%, 77%, 0.54, and 0.54, respectively. Both models were validated using external validation by the same set of 29 chemical components in TCM with or without cardiotoxicity, which were not included in the training set. The predictive performances of SVM or ANN model were as follows, respectively: sensitivity 95%, 95%; specificity 40%, 60%; and accuracy 76%, 83%. Conclusion: The predictive performance of the QSAR model using ANN algorithm was better than that of the model using SVM algorithm. The external validation study of 29 chemical components in TCM illustrated that the QSAR model was applicable for screening and predicting the potential cardiotoxicity of chemical components in TCM.