Incidence and risk factors of unplanned retreatment following dental general anesthesia in children with severe early childhood caries.

Objective: This study aimed to retrospectively describe the unplanned retreatment of dental general anesthesia (DGA) in children with severe early childhood caries (S-ECC) and explore potential factors that may influence the outcome of DGA treatment. Methods: Medical records of children with S-ECC who received DGA treatment were screened, and necessary data were extracted. The Kaplan-Meier method and Cox proportional hazards model were used to estimate the DGA survival rate and explore the potential factors affecting the success rate of DGA treatment. Results: Medical records of 852 children were included; 509 (59.7%) children with 1,212 (10.7%) teeth underwent unplanned retreatment. Restoration failure (30.12%) and new caries (29.46%) accounted for the most significant proportion of all failures. The median survival times were 510 and 1,911 days at the child and tooth levels, respectively. Unplanned retreatment risk was associated with the age of S-ECC children, frequency of follow-up, and fluoride application (hazard ratio = 0.97, 0.78, 0.69, P < 0.001). Conclusion: The treatment outcome of DGA administered to children with S-ECC was satisfactory at the tooth level from the perspective of the incidence of unplanned retreatment. Restoration failure was the main reason for the high unplanned retreatment rate. Strategies for a better outcome of DGA include improving the professional knowledge and skills of pediatric dentists and enhancing compliance of parents/patients. Health education and regular topical fluoride application may improve the success rate of DGA treatment.

Survival Analysis and Risk Factors of Pulpectomy among Children with Severe Early Childhood Caries Treated under General Anesthesia: A Retrospective Study.

OBJECTIVES: This study aims to retrospectively evaluate the survival rate of pulpectomy performed under dental general anesthesia (DGA) through long-term follow-up and to explore the risk factors associated with treatment failure. METHODS: The medical records of the children who were diagnosed with S-ECC and received pulpectomy treatment under general anesthesia (GA) from 1 August 2014 to 1 December 2019, in the Stomatological Hospital of Xi'an Jiaotong University, were collected. Two dentistry postgraduates extracted the necessary information and filled in a predesigned excel form. Survival analysis was performed using the Kaplan-Meier method. The shared frailty model was used to explore possible factors affecting the success rate of pulpectomy in primary teeth. RESULTS: A total of 381 children (mean age 3.49 ± 0.90) with S-ECC and 1220 teeth were included in the study, including 590 primary anterior teeth and 630 primary molars. The overall 35-month survival rate was 38.5%, which was 52.9% for anterior teeth and 31.1% for molars. The overall median survival time was 31 months, in which anterior teeth were 35 months and molars were 26 months. The older the children were, the greater the risk of treatment failure (HR 1.56, 95% CI 1.09, 2.24). The risk of pulpectomy failure of primary molars was 1.9 times that of primary anterior teeth (95% CI 1.36, 2.65) and the teeth with abnormal radiological findings before treatment was 1.41 times higher than that of teeth without imaging abnormalities (95% CI 1.74, 3.36). CONCLUSION: The survival rate of primary tooth pulpectomy is acceptable but decreased gradually with time. The failure rate of pulpectomy in primary molars is higher than that of primary anterior teeth. When the primary caries has extended to the pulp and resulted in a nonvital lesion, pulpectomy could be an option for maximum retention of the primary tooth.

Relationship Between Acyl and Desacyl Ghrelin Levels with Insulin Resistance and Body Fat Mass in Type 2 Diabetes Mellitus.

Purpose: Although strong evidence suggests that ghrelin plays an important role in regulating energy balance, the effects of acylated ghrelin (AG) and deacylated ghrelin (DAG) on fat mass are largely undefined. This study aimed to investigate the differential associations of both forms of ghrelin with insulin resistance and body fat mass in patients with type 2 diabetes mellitus (T2DM). Patients and Methods: A total of 162 patients with type 2 diabetes were recruited and classified based on BMI and visceral fat area (VFA) as VFA normal group (n = 78), normal-BMI VFA obesity group (n = 20) and high-BMI VFA obesity group (n = 64). VFA and subcutaneous fat area (SFA) were detected by bioelectrical impedance analysis. Blood samples were collected to measure fasting glucose, insulin, lipids, AG and DAG levels after clinical examination. Results: Compared with VFA normal group, DAG levels were significantly lower (421.7 ± 106.0 and 388.7 ± 96.5 pg/mL vs 524.4 ± 141.5 pg/mL, P < 0.01) in the two VFA obesity groups. No significant difference was found in AG levels within three groups. Among all subjects, BMI, VFA, SFA, fasting insulin and HOMA-IR were negatively correlated with DAG but positively with AG/DAG ratio (P < 0.01). In contrast, AG was positively correlated with HOMA-IR and fasting glucose (P < 0.01). Multiple stepwise regression analysis showed that fasting glucose was the independent factor of AG, VFA and HOMA-IR were the independent factors related to DAG. Conclusion: DAG levels have a strong negative association with excess body fat mass and insulin resistance, whereas AG levels are closely related to elevated blood glucose levels in T2DM patients.

Time in range, especially overnight time in range, is associated with sudomotor dysfunction in patients with type 1 diabetes.

BACKGROUND: Time in range (TIR) is advocated as key metric of glycemic control and is reported to be associated with microvascular complications of diabetes. Sudomotor dysfunction is among the earliest detectable diabetic peripheral neuropathy (DPN). We set about to research the relationship between TIR including overnight TIR and sudomotor function detected by SUDOSCAN with the intention of exploring the correlation of TIR including overnight TIR and early DPN in type 1 diabetes (T1D). METHODS: 95 patients with T1D were enrolled. TIR including nocturnal TIR of 3.9-10.0 mmol/L was evaluated with CGM. SUDOSCAN measured feet electrochemical skin conductance (FESC) and sudomotor dysfunction was defined as average FESC < 60µS. Logistic regressions were applied to examine the independent association of TIR and overnight TIR with sudomotor function. RESULTS: The overall prevalence of sudomotor dysfunction was 28.42%. Patients with sudomotor dysfunction had significantly lower TIR for the whole recorded phase and for nighttime. The sudomotor dysfunction prevalence progressively declined with the ascending tertiles of TIR and nocturnal TIR (P for trend < 0.05). Correlation analysis showed that the relationship between nocturnal TIR and FESC was stronger than that between TIR and FESC with correlation coefficients were respectively 0.362 and 0.356 (P < 0.001). Finally, logistic regression analysis indicated the independently negative relation between TIR and nocturnal TIR and sudomotor dysfunction (P < 0.05), and the correlation between nocturnal TIR and sudomotor dysfunction was more statistically significant. CONCLUSIONS: TIR is negatively correlated with sudomotor dysfunction in T1D independent of HbA1c. Furthermore, decreased nocturnal TIR is more closely related to the impaired function of sudomotor nerves in sweat glands.

Association between time in range, a novel measurement of glycemic control and islet secretory function in chinese patients with type 2 diabetes mellitus-An observational study.

AIMS: To explore the association between dynamic islet secretory function and TIR (time in range), a new valuable metric of glycemic control in type 2 diabetes (T2D). METHODS: In this observational study 256 patients with type 2 diabetes were included and continuous glucose monitoring system (CGMS) were applied to monitor blood glucose and also the calculation of TIR [the time spent in an individual's target glucose range (usually 3.9-10 mmol/L)]. The participants were divided into 3 groups according to the tertiles of TIR, 85 cases with TIR ≥ 65.05% (T1 group), 86 cases with 41.84 < TIR ≤ 65.05% (T2 group) and 85 cases with TIR < 41.84% (T3 group). Serum glucagon (GLA0h, GLA0.5h, GLA1h, GLA2h, GLA3h), C-peptide (Cp0h, Cp0.5h, Cp1h, Cp2h, Cp3h) concentration at different time points were measured after a 100 g standard steamed buns meal test to assess the pancreatic alpha cell and beta cell function. Spearman correlation analysis and multivariate linear stepwise regression analysis were adopted for statistical analysis. RESULTS: The average age and diabetes duration of all the participants were separately 56.09 ± 13.8 years and 8.0 (4.0,15.0) years. Compared with patients in T1 group, participants in group T2 and T3 tend to have a lower concentration of C-peptide at all time points, as well as GLA0h, GLA2h and GLA3h (p < 0.05). TIR was positively correlated with C-peptide at different time points, area under the curve of C-peptide in half an hour (AUCCp0.5h), GLA0h, GLA3h, area under the curve of glucagon in half an hour (AUCGLA0.5h)(rs = 0.263, 0.414, 0.510, 0.587, 0.528, 0.360, 0.259, 0.144 and 0.208, respectively, p < 0.05) and was negatively correlated with the increment of serum glucagon from baseline at 0.5 h, 1 h and 2 h after the standard energy loaded(△GLA0.5h, △GLA1h, △GLA2h)(rs = -0.152,-0.172 and -0.203, respectively, p < 0.05). Cp2h, Cp0h and GLA0h were independent factors for TIR (ß = 6.558,-6.930, 0.247, respectively, p < 0.01). CONCLUSION: Both islet alpha cell and beta cell secretory function have important influence on TIR, a novel vital index of glycemic fluctuation.

The Relationship Between ß-cell Function Indices and Sudomotor Function in Chinese Patients with Type 2 Diabetes.

PURPOSE: SUDOSCAN, a new non-invasive, quick, sensitive and quantitative technique, has been developed to detect diabetic peripheral neuropathy, and the latter is believed to be correlated with impaired ß-cell function. The purpose of the present study was to investigate the associations between ß-cell function indices and sudomotor function in Chinese type 2 diabetes. METHODS: A total of 266 Chinese patients with type 2 diabetes were enrolled. Sudomotor function was assessed using electrochemical skin conductance of hands and feet. Pancreatic ß-cell function was determined by homeostasis model assessment of ß-cell function index, early-phase ß-cell function indices and total ß-cell function indices. Pearson correlation analysis and multiple linear stepwise regression analysis were carried out to explore the associations between ß-cell function indices and sudomotor function. RESULTS: Patients with lower early-phase ß-cell function had lower electrochemical skin conductance levels of hands and feet and higher asymmetry ratio of hands and feet. Both Pearson correlation analysis and multiple linear stepwise regression analysis showed significantly positive relationships between early-phase ß-cell function and electrochemical skin conductance levels of hands and feet, after controlling for potential confounders (P<0.05). CONCLUSIONS: Impaired early-phase ß-cell function was positively associated with sudomotor dysfunction in Chinese patients with type 2 diabetes. We speculated that impaired early-phase ß-cell function may be associated with the incidence of sudomotor dysfunction in patients with T2DM.

A cross-sectional evaluation of knowledge among Chinese dentists regarding the treatment of traumatic injuries in primary teeth.

BACKGROUND/AIM: Injuries to the primary dentition affect children's esthetics, function, and mental health. They may also affect the development of the permanent teeth. The knowledge of dentists about deciduous tooth trauma is rarely evaluated. The aim of this study was to evaluate the knowledge and attitude of dentists in China regarding traumatic dental injuries to primary teeth. MATERIAL AND METHODS: A self-administered online questionnaire containing questions on demographic data and knowledge based on a clinical scenario was given to a purposive sample of dentists, recruited by a non-probability convenience sampling method. The chi-square test was used for statistical analysis, with the significance level set at P <.05. RESULTS: A total of 394 out of 409 dentists provided valid data. There was no significant difference in demographic data. Questions about the treatment of hard dental tissue injuries in primary teeth presented a correct-response rate of 66.4%, with the highest correct-response rate for enamel fracture (n = 368, 93.4%) and lowest for complicated crown-root fracture with pulp exposure (n = 104, 26.4%). Questions about treatment of luxation injuries in primary teeth presented a correct-response rate of 66.6%, with subluxation presenting the highest correct-response rate (n = 391, 99.2%). Factors associated with higher correct-response rates were specialist disciplines, educational qualifications, workplaces, experience of injured teeth treated, and educational experience about primary tooth trauma. No significant differences were found in the correct-response rates of dentists with different years of work experience. Lack of cooperation from children was considered a major obstacle for treatment. Special lectures and Internet courses were the most preferred methods of obtaining knowledge. CONCLUSION: The results suggest that it is necessary to enhance dental trauma education for dentists in China. More attention needs to be paid to trauma in primary dentition to ensure adequate treatment for traumatized primary teeth.

Continuous glucose monitoring defined time-in-range is associated with sudomotor dysfunction in type 2 diabetes.

BACKGROUND: Time in range (TIR), as a novel metric for glycemic control, has robust relevance with diabetic complications. Diabetic peripheral neuropathy (DPN) is characterized by sudomotor dysfunction. AIM: To explore the relationship between TIR obtained from continuous glucose monitoring (CGM) and sudomotor function detected by SUDOSCAN in subjects with type 2 diabetes. METHODS: The research enrolled 466 inpatients with type 2 diabetes. All subjects underwent 3-d CGM and SUDOSCAN. SUDOSCAN was assessed with electrochemical skin conductance in hands (HESC) and feet (FESC). Average feet ESC < 60 µS was defined as sudomotor dysfunction (+), otherwise it was sudomotor dysfunction (-). TIR refers to the percentage of time when blood glucose is between 3.9-10 mmol/L during 1 d period. RESULTS: Among the enrolled subjects, 135 (28.97%) presented with sudomotor dysfunction. Patients with sudomotor dysfunction (+) showed a decreased level of TIR (P < 0.001). Compared to the lowest tertile of TIR, the middle and the highest tertiles of TIR was associated with an obviously lower prevalence of sudomotor dysfunction (20.51% and 21.94% vs 44.52%) (P < 0.001). In addition, with the increase of TIR, HESC and FESC increased (P < 0.001). Regression analysis demonstrated that TIR was inversely and independently linked with the prevalence of sudomotor dysfunction after adjusting for confounding values (odds ratio = 0.979, 95%CI: 0.971-0.987, P < 0.001). CONCLUSION: The tight glycemic control assessed by TIR is of vitally protective value for sudomotor dysfunction in type 2 diabetes mellitus.

Step-by-step teaching method: improving learning outcomes of undergraduate dental students in layering techniques for direct composite resin restorations.

BACKGROUND: Layering techniques for direct composite resin restorations might be complicated for inexperienced learners, as a number of materials and instruments are required at each step. The present study aimed to compare and assess the teaching effect of step-by-step and all-in-one teaching methods in layering techniques for direct composite resin restorations among undergraduate dental students. METHODS: A total of 68 junior dental students participated in this study, which was a prospective and single-blind trial. The students were randomly divided into a step-by-step group (experimental group, n = 34) and all-in-one group (control group, n = 34). The same teacher taught the two groups, ensuring a comparable teaching effect. The final score of each student was an average of scores by two experts who were blinded to the grouping. The scoring system was consisted by five parts. Each part was assigned scores of 3.0, 1.5, or 0. The total maximum score was 15 and minimum was 0. The total time taken by each group was also calculated. RESULTS: The values of the quality of tooth restorations evaluated by experts for step-by-step and all-in-one groups were 11.29 ± 2.13 from 15 and 9.00 ± 2.71 from 15 (t = 3.88, P < 0.001), respectively. In addition, the time spent by the experimental group was significantly lesser than that spent by the control group, which was 122.47 ± 2.82 and 137.18 ± 6.75 min, respectively (t = 11.72, p < 0.001). CONCLUSION: With regard to the layering techniques for direct composite resin restorations, the outcomes were better in the step-by-step group than in the all-in-one group.

Worldwide tendency and perspectives in traumatic dental injuries: A bibliometric analysis over two decades (1999-2018).

BACKGROUND/AIMS: Traumatic dental injuries (TDIs) are considered to be a public dental health problem worldwide. The aim of the current study was to provide the worldwide tendency and perspectives in TDIs in the last two decades via bibliometric analysis. METHODS: ''Tooth injuries'' was searched as the Medical Subject Headings term within PubMed with the date range from 1999 to 2018. Two investigators perused information in the articles according to the inclusion and exclusion criteria. The articles were independently categorized according to the following aspects: (a) annual scholarly output; (b) leading countries or regions; (c) leading journals; (d) productive authors; (e) citations; (f) study design; (f) distribution of topics; and (g) the type of dentition and TDIs. VOSviewer 1.6.7 and Citespace 5.2 were used for analyzing and visualizing bibliometric networks. RESULTS: A total of 2627 articles about traumatic dental injuries were published and indexed in PubMed during the two decades, and the number of publications on traumatic dental injuries was rising in general. The research outputs were mainly concentrated in developed countries and affiliated hospitals of universities. Brazil was the most productive country. The journal Dental Traumatology had the most contributions to the scientific research of traumatic dental injuries. "Case report" was the most frequent type of article (36.50%), followed by cross-sectional studies (19.57%) and case-control studies (13.67%). Most studies focused on the treatment of TDIs (38.94%), especially for avulsion (21.01%), crown fracture (9.71%), and intrusion (5.25%). Permanent teeth (66%) were the dominant dentition. CONCLUSION: There is a lack of high-quality well-designed studies such as cohort studies. The number of publications on prevention and the primary dentition is disproportionate in relation to their significance.

A meta-analysis of emotional disorders as possible risk factors for chronic periodontitis.

The aim of the present meta-analysis was to evaluate scientific evidence on the association between emotional disorder (depression and anxiety) and chronic periodontitis. An overall electronic literature search in PubMed, ISI Web of Science, Cochrane Library, and China National Knowledge Infrastructure was undertaken up to November 2017. Newcastle-Ottawa scale was applied to ascertain the validity of each eligible study. Stata statistical software was used to perform meta-analysis. The strength of the association between periodontitis and emotional disorder was measured by odds ratios (ORs) with their 95% confidence intervals (95% CIs). Subgroup analysis and sensitivity analysis were performed. Publication bias was assessed through funnel plots and Begger's test. A total of 14 eligible articles were included in the meta-analysis, 6 of them were focused exclusively on depression, whereas 8 studies investigated both depression and anxiety. There was significant association between emotional disorder and chronic periodontitis (OR = 1.54, 95% CI = 1.27-1.86). Sensitivity analyses confirmed the stability of the present results. No evidence of asymmetry was observed in Begger's test. This meta-analysis demonstrates significant association between emotional disorder (including anxiety and depression) and chronic periodontitis. Nevertheless, the result should be interpreted with caution because of the potential bias and confounding in the included studies.

[Prevalence survey of immature permanent tooth trauma about the clinical visiting and prognosis in Xi'an schoolchildren].

OBJECTIVE: This study aims to investigate the clinical visiting and prognosis of schoolchildren in Xi'an after immature permanent tooth trauma and explore the prognostic factors associated with this type of trauma. METHODS: Through cluster and simple random sampling surveys, 4 013 pupils in schools from nine districts and four counties in Xi'an were sampled, respectively. All pupils and their parents were requested to complete a questionnaire, and children who had immature permanent tooth trauma answered a separate questionnaire and underwent oral examinations. The data of the survey were analyzed statistically. RESULTS: The amount of valid questionnaire was 3 641. Clinical visiting rate related to immature permanent tooth trauma of Xi'an schoolchildren was low (38.2%). Gender and trauma type were the factors related to clinical visiting for dental trauma concerns. The incidence of poor prognosis was 29.7%. The incidence of poor prognosis of patients with clinical visiting (35.4%) was higher than that of patients without clinical visiting (20.6%). CONCLUSIONS: Clinical visiting rate related to immature permanent tooth trauma in Xi'an schoolchildren is extremely low, and incidence of poor prognosis is high.

[Prevalence survey of dental trauma to immature permanent teeth in Xi'an schoolchildren].

OBJECTIVE: The prevalence rate, distribution, and reasons of immature permanent-tooth trauma in Xi'an were investigated and described, and a scientific basis was provided for the decision-making of health-administration departments. METHODS: Through cluster and simple random sampling survey, 4 013 pupils in schools from nine districts and four counties in Xi'an were sampled. All pupils and their parents were requested to complete a questionnaire. Oral examinations were conducted for children who had immature permanent teeth trauma. The number of trauma teeth and teeth were recorded. Survey data were analyzed statistically. RESULTS: The prevalence rate of immature permanent dental trauma was 10.5% in Xi'an. No significant differences were observed between districts and counties (P>0.05). The peak age of permanent dental trauma was at 7-9 years old, and the most was at 8 years old (31.5%). The first reason of trauma was falling down (50.9%), and the second reason was crash (36.0%). The most common trauma teeth were maxillary incisors (75.4%). CONCLUSIONS: The prevalence rate of immature permanent teeth trauma in Xi'an was in the middle of all international levels. Children, who are vulnerable to dental trauma at their age, should be provided with appropriate prevention measures to reduce the incidence of dental trauma.

DNA intercalating studies of [Ru(bpy)2dmt]2+ with two vacant nitrogen atoms by introducing copper(II) ions.

A novel, yet effective method for identifying DNA-binding modes of [Ru(bpy)(2)dmt](2+) (where bpy = 2,2'-bipyridine and dmt = 2,3-dimethyl-1,4,8,9-tetra-aza-triphenylene) on an indium tin oxide electrode has been successfully developed by introducing Cu(2+) ion and ethylenediaminetetraacetic acid. The results from emission spectra and fluorescence microscopic images suggested that [Ru(bpy)(2)dmt](2+) not only associates with Cu(2+) ion in both the absence and presence of DNA but also shows strong affinity with DNA in the presence of Cu(2+). Evidence for the strong binding of [Ru(bpy)(2)dmt](2+) to DNA was determined from the interface studies using electrochemical methods. The present study suggests that a combination of photoluminescence measurement with electrochemical methods identifies the DNA-binding behavior of luminescent molecules with redox activities. [Ru(bpy)(2)dmt](2+) binds to DNA via an intercalative mode.

[Detecting caries susceptible population in children with gtfB oligonucleotide probe].

OBJECTIVE: To establish a quick, exact and inexpensive method to detect caries susceptibility in children. METHODS: 125 caries free children, aged 3-4 years, were randomly sampled. A combination of polymerase chain reaction (PCR) and gtfB oligonucleotide probe hybridization method was used to detect Streptococcus mutans in saliva. The participants were followed up for a year and the clinical examination results were compared with the laboratory results. The perspective study was used to evaluate the detecting approach. RESULTS: When the combination of PCR and hybridization method was used to detect caries susceptibility of the sample, the predictive sensitivity, predictive specificity and predictive reliability were all increased to 69.2%, 46.8% and 54.3%, respectively as compared to only PCR, which were 56.4%, 44.2% and 48.3%, respectively. The samples with both the positive and negative results of hybridization detection had caries clinically, but the dmft index and prevalence were higher in the positive (dmft was 2.15 +/- 0.86, and the prevalence was 23.28%) than in the negative(dmft was 1.58 +/- 0.51, and the prevalence was 10.34%) which was statistically significant (P < 0.05). CONCLUSION: The probe was found to be quite potential in detecting caries susceptibility, but the predictive specificity and predictive reliability values were not significant.

Treatment of Streptococcus mutans with antisense oligodeoxyribonucleotides to gtfB mRNA inhibits GtfB expression and function.

We examined the effects of phosphorothioate-modified antisense oligodeoxyribonucleotides (PS-ODN) targeted to mRNA transcribed from gtfB, which encodes synthesis of water-insoluble glucans in Streptococcus mutans. Treatment of S. mutans with 10 muM antisense PS-ODNs inhibited gtfB mRNA transcription, GtfB expression and water-insoluble glucan synthesis. The architecture of biofilms formed by antisense PS-ODNs-treated S. mutans showed reduced biomass, more dispersed distribution with enlarged interspaces and fewer layers of attached cells. PS-ODN treatment had no effect on the growth of S. mutans. Our results indicated that it might be feasible to use antisense PS-ODN as a novel agent in caries prevention.

[Screening and identification of metastasis-related gene expression in tongue carcinoma with cDNA microarray assay].

OBJECTIVE: To identify metastasis-associated genes in tongue carcinoma and to better understand the mechanism underlying tongue carcinoma metastasis. To compared mRNA expression profiles of two tongue carcinoma cell strains with high and low metastatic potentials using microarray technology. METHODS: Tca8113 and Tb cells were used as model systems to study the molecular mechanism of tumor metastasis. Two fluorescent cDNA probes labeled with Cy3 and Cy5 dyes were prepared from the mRNA samples of Tca8113 and Tb cells by reverse transcription method. The two color probes were then mixed and hybridized to the cDNA chip constructed by double dots of 1 152 human genes, and scanned at two wave lengths. Differential expression genes from the above two cell lines were analyzed using computer. Then six of the different expression genes were further validated by RT-PCR technique. RESULTS: In the 1 152 clones of known genes and expressed sequence tags that were analyzed, 37 showed significantly different (minimum 2 folds) expression levels in two cell lines. Among the 37 genes, 15 were up regulated (with ratio more than 2) and 22 down regulated (with ratio less than 1/2). The results of RT-PCR analysis were coincident with those of microarray assay. CONCLUSION: Some of these genes are known to be involved in human tumor antigen, immune surveillance, adhesion, cell signaling pathway and growth control. It is suggested that the microarray in combination with a relevant analysis facilitates rapid and simultaneous identification of multiple genes of interests and in this study it provided a profound clue to screen candidate targets for early diagnosis and intervention.