[Factors influencing the quality of life of 104 children with phenylketonuria in Anhui Province, China].

OBJECTIVE: To investigate the factors influencing the quality of life (QOL) of children with phenylketonuria (PKU) in Anhui Province, China. METHODS: A total of 104 PKU children who were diagnosed and treated in three major maternal and child health hospitals in Anhui Province were enrolled as study subjects. The PedsQL™ 4.0 Generic Core Scales were used to evaluate the quality of life of these children. The multivariate logistic regression analysis was used to evaluate the factors influencing the QOL. RESULTS: The 104 PKU children had significantly lower overall QOL score and scores on the subscales of physiological functioning, emotional functioning, and social functioning than the general school-age children (P<0.01). They also had a significantly lower score on the physiological domain consisting of emotional functioning, social functioning, and role functioning than the general school-age children (P<0.01). The multivariate logistic regression analysis showed that an older age (≥4 years) of PKU children was the risk factor for poor QOL (OR=8.569, P<0.01), and guardians' engagement at enterprises or institutions was the protective factor for QOL (OR=0.206, P<0.05). CONCLUSIONS: PKU children have a low level of QOL, and age and guardians' occupation are factors influencing the QOL.

Clinical observation of docetaxel or gemcitabine combined with cisplatin in the chemotherapy after surgery for stage II-III non-small cell lung cancer.

AIM OF THE STUDY: This study aimed to compare the efficacy and toxicity of docetaxel combined with cisplatin (DP) and gemcitabine combined with cisplatin (GP) in postoperative chemotherapy after surgery of non-small cell lung cancer (NSCLC). MATERIAL AND METHODS: A total of 92 patients diagnosed with NSCLC after surgery were enrolled, and they were treated with DP (DP group) and GP (GP group). The efficacy and toxicity of the medications were then compared. RESULTS: Approximately 92.4% (85 out of 92) of the patients received chemotherapy for more than three weeks. In the DP and GP groups, the incidence rates of grade III-IV thrombocytopenia were 24.4% and 6.38%, respectively, whereas the incidence rates of alopecia were 88.9% and 25.5%, respectively. The difference between the two groups was statistically significant (p < 0.05). Disease-free survival rates in DP group in one and two years were 76.5% and 50.47%, respectively, whereas in the GP group they were 77.8% and 49.52%, respectively. No significant difference was observed between the two groups (p > 0.05). CONCLUSIONS: These results showed similar disease-free survival rates of DP and GP therapies in one and two years after surgery for NSCLC. However, the DP group exhibited higher incidence rates of grade III-IV thrombocytopenia and alopecia than the GP group. Therefore, we should select a specific treatment for each patient according to individual differences.

The Fertility Status of the Married People Living with HIV/AIDS in China.

In order to analyze the fertility status of the married people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLHA) of reproductive age in China, a sample of married PLHAs aged 22-45 in China is selected by using a stratified cluster sampling method. All participants are face-to-face interviewed with a structured questionnaire. Among them, the fertility status and its influencing factors of 366 PLHAs are statistically analyzed. Experimental results show that married PLHA of reproductive age in China has a high proportion of having children. The fertility status and fertility intention of females are higher than that of males. The proportion of unwanted pregnancies after the HIV + diagnosis of females is high.

[A retrospective cohort study on reduction of AIDS mortality among patients enrolled in national-free antiretroviral treatment programme in two cities in China].

OBJECTIVE: To determine the effect of national free highly active antiretroviral treatment (HAART) on reduction of mortality and relevant risk factors among adult Acquired immunodeficiency syndrome (AIDS) patients. METHODS: A retrospective cohort study was conducted and all AIDS patients diagnosed before Aug. 30th, 2008 in Zhumadian, Henan province, and Fuyang, Anhui province were enrolled in this study, where HAART initiated in early time. The data and information were collected such as AIDS progress, diagnosis, treatment, death and et al. RESULTS: Among 10,394 AIDS patients, the mean age was (41.7 +/- 9.3) year-old, 50.3% (5233/10,394) were male, 85.0% (8808/10,394) were married, 95.1% (9880/10,394) were farmers, and 81.2% (8438/10,394) were former plasma donors (FPDs). The coverage of HAART increased from 5.2% in 2002 to 66.5% in 2008. Conversely, the overall mortality declined from 35.4/100 person-years in 2002 to 5.9/100 person-years in 2008. In a multivariate Cox proportional hazards analysis, the greatest risk factor for mortality was non-HAART, with a hazard ratio (HR) 4.3 (95%CI: 4.0 - 4.7). Among treated patients, compared with higher CD(4)(+) T cell counts (> 200 cells/microl), those initiating therapy with lower CD(4)(+) T cell counts, were at greater risk to death (< 50 cells/microl, HR = 7.9; 50 - 199 cells/microl, HR = 2.8). Number of opportunistic infections (OIs) was risk to mortality (HR = 2.1). In addition, other risk factors included male, age (>or= 50 years old), and other infection way except FPDs (HR were 1.4, 1.6 and 1.8). CONCLUSION: The national free treatment program has significantly reduced the AIDS mortality rate among HIV-infected FPDs through the use of generic antiretroviral drugs in rural clinical settings. The effective reduction of AIDS mortality could be realized through increased coverage of therapy.

[The role and mechanism of endoplasmic reticulum stress key factor PREK in myoblast apoptosis under stress loading].

PURPOSE: This study was aimed to figure out the way that cyclic-stretch influenced the apoptosis of myoblasts and evaluate the importance of PERK and its possible mechanism involved. METHODS: L6 rat myoblasts were cultured in vitro and mechanical stimulation model was constructed successfully. The myoblasts were imposed tension for 0, 2, 6, 12 and 24 hours respectively by multi-channel cell stress loading system. The force value was 15% cell deformation and the frequency was 10 cycles/min. Each cycle was consisted of stretch for 3 seconds and relaxation for 3 seconds, and the group without tension was used as the control group. The apoptotic myoblasts were dyed by DAPI and observed through fluorescence microscopy to detect the apoptosis rate; the mRNA levels of PERK and CHOP in different groups were detected by real-time PCR and protein levels of PERK and p-PERK in different groups were detected by Western blot. PERK inhibitor was used to clear the role of PERK in apoptosis induced by cyclic-stretch and clarify the relationship between the endoplasmic reticulum stress and apoptosis induced by cyclic-stretch. SPSS 17.0 software package was used to analyze the data statistically. RESULTS: DAPI nuclear stain showed that cyclical tensile stress can induce apoptosis in vitro cultured myoblast. Apoptosis rate showed a trend of rising gradually over time, peaked at 24 h. After dealt with the inhibitor of PERK, the apoptosis rate of the 24 h group under the cyclic stretch showed no difference compared with the control. The results of real- time PCR showed that the mRNA of CHOP was increased with the extension loading time, while the mRNA of PERK showed no difference compared with the control. Western blot results showed that the protein level of p-PERK was increased with the extension of loading time, while the expression of PERK showed no difference compared with the control group. When PERK inhibitor added, the mRNA level of CHOP along with the protein expression level of p-PERK showed no significant difference compared to the control. CONCLUSIONS: PERK signaling pathway is involved in the apoptosis of myoblasts induced by cyclic stretch, and the possible mechanism may be closely related to the phosphorylation of PERK.

[A clinical study on effects of distalization of whole upper arch in borderline Class II malocclusion using microscrew anchorages in inferiozygomatic area].

PURPOSE: To investigate the effect of distalization of upper dentition using microscrew anchorages placed in inferiozygomatic area to correct borderline Class II malocclusion. METHODS: Nine borderline Class II cases aged from 13-17 years old, with moderate convex profile were selected. All cases were designed to extract upper second molars or third molar germs to provide space for distalization of upper dentition using microscrew anchorages placed in inferiozygomatic area. Cephalometrics before and after treatment were compared to analyze the movement of upper morlars and incisors, as well as the position change of upper and lower lips. The data were analyzed by paired t test with SPSS17.0 Software package. RESULTS: After an average of 14 months of treatment, all cases got improved profiles with correction of Class II dental relationship. The upper molars and incisors were pulled back 3.1 mm and 2.8 mm, respectively. No adverse root resorption or sinus infection caused by the microscrews was observed. CONCLUSIONS: Microscrew anchorages placed in inferiozygomatic area can be used to correct borderline Class II malocclusion by distalization movement of upper dentition with a better profile and no adverse complication. Supported by Medical Guide Project of Science and Technology Committee of Shanghai Municipality (09411964900).

[Factors related to HIV-associated lipodystrophy among patients on antiretroviral therapy].

UNLABELLED: To describe the distribution and related risk factors of lipodystrophy (LD)among AIDS patients treated with antiretroviral drugs. METHODS: A cross-sectional study was performed on 261 AIDS patients treated with antiretroviral drugs. All the subjects were followed in the Center for Disease Control and Prevention of two counties in northern Anhui province from May 25 to 30, 2012. Data related to demography, physical examination, history of antiretroviral treatment, HIV plasma viral load, and CD4 + T cell count were collected. Clinical examination was based on an assessment of changes in face, legs, arms, buttocks(peripheral sites), back, chest, neck or abdomen or change in waist size (central sites)as quoted by the clinicians. RESULTS: LD was observed in 147 (56.3%) patients. The differences of age , gender, quality of sleep, weight and time of treatment between LD and non-lipodystrophy (NLD)groups were statistically significant (P < 0.05). Results from the Multivariate logistic regression analysis showed that the risk of women suffering from LD was 1.894 times of thd males (95%CI:1.075-3.338). The risk of those with LD showed an 1.448-fold increase regarding the time of treatment for each additional year (95%CI:1.267-1.654). Patients with poor quality of sleep were prone to LD with 11.901 times more than those with good quality of sleep (95%CI:2.701-52.441). CONCLUSION: LD was commonly observed in AIDS patients who were under antiretroviral therapy. Gender, tine of treatment and the quality of sleep appeared the main factors related to the results of observation.

The association between lower incisal inclination and morphology of the supporting alveolar bone--a cone-beam CT study.

AIM: To investigate the relationship between the positioning of the lower central incisor and physical morphology of the surrounding alveolar bone. METHODOLOGY: Thirty-eight patients (18 males, 20 females), with mean age of 13.4 years, were included in this study. As part of orthodontic treatment planning the patients were required to take dental Cone-beam CT (CBCT) covering the region of lower incisors, the surrounding alveolar bone and the mandibular symphysis. The cephalometric parameters were designed and measured to indicate the inclination of lower central incisor and physical morphology of the adjacent alveolar bone. Computer-aided descriptive statistical analysis was performed using SPSS 15.0 software package for Windows. A correlation analysis and a linear regression analysis between the incisor inclination and the alveolar bone morphology were performed. RESULTS: Significant positive correlations were found between the lower central incisor inclination and the morphological contour of the alveolar bone (P < 0.05). The lower central incisor root apex was closer to the lingual alveolar crest when it was buccally inclined. CONCLUSION: The morphology of the alveolar bone may be affected by incisal inclination.

[Arnett analysis of the correlation between midfacial soft and hard tissues].

PURPOSE: To study the correlation between midfacial soft tissues and craniofacial hard structures of malocclusions with different skeletal patterns by Arnett analysis. METHODS: 60 children (26 males, 34 females), aged from 12 to 16 years, who had no orthodontic treatment, congenital craniofacial deformity and remarkable facial asymmetry, were divided into 3 groups according to ANB. Lateral cephalograms were taken when the patients' heads in natural positions and metal beads placed on right midface according to Arnett analysis. Statistical analysis was performed using SPSS10.0 software package and the values of midfacial soft tissues were compared among groups with one-way ANOVA. In addition, correlation analysis was conducted to determine the correlation between soft and hard tissues. RESULTS: The values were significantly varied with different ANB (P<0.01) such as overbite, overjet, orbital rim, cheek bone, Md1, lower lip anterior, throat length and facial angle. Mx occlusal plane, pogonion', subnasale'-pogonion', orbital rims, subpupil, alar base, cheek bone had significant correlation with SNB, while values like cheek bone and alar base had significant correlation with ANB. CONCLUSIONS: The soft tissues of midface are greatly correlative to craniofacial hard structures such as the sagital relationship of upper and lower jaws.

Condom use among married women at risk for sexually transmitted infections and HIV in rural China.

OBJECTIVE: To assess factors associated with condom use among married women in rural China, and provide evidence for implementing education strategies to prevent sexually transmitted infections and HIV. METHODS: A total of 737 sexually active married rural women who were aged between 18 and 49 years and had heard of AIDS were selected by cluster sampling and interviewed in 8 villages of Anhui province, China. RESULTS: The rate of condom use was only 5.4%.There were no significant differences in sexual behavior and condom use between married women whose husbands were away as migrant workers and the wives of nonmigrant men, except in knowledge of free condom sources. Significant factors associated with condom use included age, level of education, knowledge about condoms, training about condoms, sources of condoms, and husbands' attitude toward condoms. CONCLUSIONS: More educational interventions are needed to increase condom knowledge and promotion, especially among less educated women and married women left behind by migrant husbands.

Risk of sexual HIV transmission among wives left behind and wives of nonmigrant men in rural areas of China.

In rural areas of China where commercial plasma donation used to be common, little is known about sexual behaviors and condom use among wives left behind by migrating husbands and wives of nonmigrant men. This study investigated sexual behaviors and condom use among married women in rural areas of China. A cross-sectional survey was conducted with 1,873 participants recruited by a cluster-sampling method. Study results showed that wives left behind had a significantly lower mean frequency of sexual intercourse with their husbands in the previous month, a higher rate of multiple sexual partners, a higher rate of self-reported HIV infection, and a lower rate of condom use when compared with wives of nonmigrant men. Also, HIV-infected wives left behind who were infected by their husbands had multiple sex partners and did not use condoms consistently. This research provides additional insight that may be used to develop effective HIV prevention strategies in rural areas of China.

[The relationship between the stability of microimplants and factors of gender and age].

PURPOSE: To summarize the clinical failure rate of 286 self-drilling microimplant anchorages and to investigate the relationship between the stability of microimplant anchorages and the patient's gender and age. METHODS: The failure rate of 286 self-drilling microimplants placed in the maxillary posterior region for anterior teeth retraction was analyzed. All 143 cases were sorted into male group and female group by gender, as well as children group and adult group by age. The difference of failure rates was compared between male group and female group, as was done between children group and adult group. Besides, the incidence of failure in both sides of one patient was also compared between children group and adult group. The data were analyzed by Chi-square or U test with SPSS15.0 software package. RESULTS: Totally 50 microimplants failed and the average failure rate of 286 microimplants was 17.5%. The failure rates were 23.1% and 20.7% in children male group and children female group, and 10.0% and 12.1% in adult male group and adult female group. No significant difference was found between different gender groups. The total failure rate in children group was 21.8%, and 11.2% in adult group. The difference was significant (P<0.05, Chi-square test, two-tailed test). The incidence of failure in both sides in children group was 8.2%, while 1.7% in adult group. The difference was also significant (P<0.05, U test, one tailed test). CONCLUSIONS: In this study, the average failure rate of 286 self-drilling microimplants is 17.5%. There is no significant relationship between the stability of microimplants and gender. It seems more possible for microimplants placed in children to fail than those in adults.

[The effect of maxillary protraction in early permanent dentition].

PURPOSE: To evaluate the effect of maxillary protration in skeletal anterior crossbite patients in early permanent dentition and determine the optimal timing for orthopedic treatment. METHODS: 18 patients (11 males and 7 females with a mean age of 11.5 years) with concave profile were treated with protraction headgear. For each patient lateral cephalogram was taken before and after treatment. Cephalometric analysis was carried out by using linear and angular measurements. Statistical analysis was performed using SAS6.12 software package. RESULTS: All subjects were treated to normal overjet. SNA was increased by 2.06 degrees (P<0.001) ,A point was protruded by 3.94 mm(P<0.001), U1-SN was increased by 6.97 degrees (P<0.001).SNB was decreased by 1.39 degrees (P<0.01),SN-MP was increased by 2.64 degrees (P<0.001),Y axis was increased by 2.42 degrees (P<0.001), Pg point was decreased by 7.42 mm(P<0.001). Maxillary incisor was promoted by 6.86 mm,which was a result of 57.43% skeletal change and 42.57% dental change. CONCLUSIONS: Maxillary protraction can significantly promote maxillary growth, change mandibular growth direction and inhibit mandibular protrusion in early permanent dentition.

[Differences in serum retinol level between the breastfed and non-breastfed children aged 0 to 23 months].

OBJECTIVE: Some recent studies found that high prevalence of vitamin A deficiency in the breastfed children. This study aimed to understand the differences in serum retinol level between breastfed and bottle-fed children aged 0 to 23 months and the possible causes of low level of serum retinol for the breastfed children. METHODS: Data for children aged 0 to 23 months were extracted from a population-based cross sectional study for vitamin A nutrition status. Fluorescence method was used to measure the serum retinol. Mothers or caregivers were asked to answer a pre-designed questionnaire and socioeconomic status, peri-natal care, breastfeeding status, morbidity histories and other related factors were collected. Semi-quantitative food frequency questionnaire was used to investigate the child's dietary intake one week prior to the survey. Data were analyzed using SAS 8.1. RESULTS: Of 401 children aged 0 to 23 months, the breastfeeding rate was 50.37%. The means of the serum retinol level between bottle-fed (30.67 +/- 0.57) microg/dl and the breastfed children (27.60 +/- 0.56) microg/dl was significantly different (P < 0.01). The corresponding figures were (31.82 +/- 0.98) microg/dl and (29.46 +/- 0.96) microg/dl after adjustment for confounders, which also showed significant difference (P < 0.01). After stratified by age groups, the breastfeeding rates in the 0-, 6-, 12- and 18-months groups were 92.1%, 70.1%, 32.0% and 17.1%, respectively. We calculated the difference in means of the serum retinol level between the bottle-fed and breastfed children for each of four age groups, and the 95% confidence limits of the differences. The differences in means and the 95% confidence limits for 0-, 6-, 12- and 18-months group were 4.70 microg/dl (-2.52-1.92), 0.82 microg/dl (-2.32-3.95), 2.95 microg/dl (-0.68-6.58) and 6.05 microg/dl (2.34-9.77), respectively. After adjustment for confounders and covariates, the adjusted figures were 0.00 microg/dl (-7.18-7.19), 1.35 microg/dl (-1.76-4.45), 2.92 microg/dl (-0.82-6.65) and 4.26 microg/dl (0.71-7.81), respectively. The significant difference in means of serum retinol level was only found in the 18-months group before or after adjustments (P < 0.01 for both). The Cochrane-Atmitage chi square trend test showed that the breastfed children tended to have lower frequencies of complementary dietary intakes than that of the bottle-fed aged 12 months and above. CONCLUSIONS: The breastfed children aged 0 to 23 months had relative low serum retinol level while compared with the bottle-fed. However, the significant differences seemed to be only confined to those aged 18 months and above. Low level of vitamin A in breast milk and low frequent complimentary food supplements might have served as the potential for the differences.

[Analysis of the efficacy of Twin-block appliance on maxillofacial growth of six pairs of monozygotic twins].

PURPOSE: The purpose of this study was to investigate the efficacy of Twin-block appliance on maxillofacial growth by using monozygotic twins. METHODS: 6 pairs of non-high angle monozygotic twins aged 12.2 with class II division 1 malocclusion were selected from 32 pairs of twins. In the first year Twin A of each pair was functionally treated using Twin-block appliance; meanwhile, Twin B underwent non-extracted fixed treatment without any treatment procedure which might cause changes like functional appliances such as Class II elastics. The difference of the cephalometric changes of maxilla and mandible before and after treatment between Twin A and Twin B was compared using paired-t test. RESULTS: Compared with those of Twin A after one year treatment, SNA, Cd-A and Cd-Go of Twin B had little chang (P>0.05), but Cd-S' reduced (P<0.05), Cd-Gn and SNB increased (P=0.01), (Cd-Gn)-(Cd-A) and ANB increased (P<0.05) significantly. CONCLUSION: Twin-block appliance can stimulate forward mandibular growth and cause forward mandibular displacement, but has little effect on ramus height and maxillary growth.

[Study on perception of Shanghai population with labial profile].

OBJECTIVE: To investigate the perception of Shanghai population with labial profile and evaluate its effect on orthodontic treatment. METHODS: Four facial profiles with different labial convexity were drawn with computer aid on the basis of the pretty Chinese female cephalometric measurements. 650 panelists were selected from Shanghai area including 250 youth with normal profile and 200 adolescents under orthodontic treatment and their parents. Subjects were asked to rank the four facial profiles in descending order of attractiveness. RESULTS: The ranking was as follows: slightly straight style, standard style, straight style and slightly convex style. The normal male youth preferred more convex style than female. Patients with Class profile preferred standard style while Class and patients and the parents were fond of slightly straight style. CONCLUSION: People in Shanghai area tended to prefer straight profile. The perception with labial profile has sex and age difference. It also has difference between non-orthodontic and orthodontic patients and was influenced by the profiles themselves. It was suggested that consultation between orthodontist and patient was essential and more attention should be made on the patient's perception with labial profile.

[A Study On Dental and Craniofacial Structure of Normal Shanghai Adults Occlusion-III The Analysis of Dental Capacity and Craniofacial Structure]

OBJECTIVE:To examine the relationships between dental capacity and cranioficial structures.METHODS:Models, posterioanterior and lateral cephalometric films of 90 adults with normal occlusion in Shanghai area were measured and analyzed.RESULTS:The canine width of lower arch extended an important influence on the upper and lower arch. The dental capacity was highly correlated not only with the width and depth of cranioficial structure but with the height as well. The database of Coben analysis for normal Shanghai adults occlusion was established.CONCLUSION:The growth between dental and cranioficial structure was harmonized in three dimensions.

[Agenesis and the morphology and site of other teeth in the permanent dentition].

OBJECTIVE: To Investigate the relationship among anodontia, anomalously shaped teeth and reduction of teeth crown. METHODS: The position and the number of congenitally absent teeth of 79 patients were analysed, as well as the abnormal morphology of other teeth. The width of the remained teeth was measured and compared with that of normal on base of patients being divided into four groups by the number and the position of agenesis. RESULTS: (1)Most of the congenitally absent teeth were upper lateral incisors and lower central incisors. (2) The congenitally absent teeth of upper central incisors, upper and lower first molars were rare. While in several cases, the central incisors were lightly pet-shaped. (3) There was no significant difference in teeth size between mild hypodontia groups and normal. As the incremental degree of hypodontia, anterior teeth tended to reduce, while the size of posterior teeth was relatively stable. Upper lateral incisors, lower canines, upper second premolars, upper and lower second molars accounted most in the anomalously shaped teeth which could be often found in patients with hypodontia. CONCLUSION: (1) number during evolution. (2) The developmental anomaly of teeth size, teeth morphology and teeth number might be a procedure of continuous variation and it might be different manifestation of the same mechanism.