Abstract:Bariatric and metabolic surgery has become one of the most important clinical innovations, in 2013 it was selected as top one innovation in medicine by the Cleveland Clinic. The clinical effect of metabolic surgery on the treatment of diabetes is far superior to the medical treatment, traditional diet control methods includes exercise, changing lifestyle and so on, which are almost invalid for severely obese patients, metabolic surgery has become an effective mean of weight loss and metabolic syndrome. In China about 95% of diabetes due to type 2 diabetes, and the ideal control rate is low, metabolic surgery to treat diabetes has become a clinical hot spot. With the bariatric and metabolic surgery guideline promoted in China, more and more problems are exposed gradually; many doctors were confused by the body mass index (BMI) constraints for various guidelines and consensus. So what is the relationship between BMI and bariatric and metabolic surgery-BMI is the most widely measurement index of obesity, but it cannot reflect of the intra fat content totally, so a variety of bariatric and metabolic surgery guidelines were created using BMI as foundation in different regions and countries, in Asia waist circumference was added as an indicator. In metabolic surgery guideline,Asian countries give the lower BMI standard than that in the West, and metabolic surgery indication is different from bariatric surgery, so from the prevention of diabetes complications, American association of clinical endocrinologists and American College of Endocrinology released a new consensus.

Abstract:Obesity, which results from dysregulated energy homeostasis due to excessive energy intake and/or reduced energy expenditure, has now become a rapidly increasing worldwide epidemic that seriously threatens people＇s health. How to prevent and treat obesity has become a major research focus for basic and clinic scientists in the metabolic research field. Recent studies have identified a new type of cells in the subcutaneous white adipose tissue that develop thermogenic functions under the conditions of cold stimulation. These brown fat-like cells, or beige cells, are different from classic white adipocytes that play a major role in the storage of lipids. Like brown adipocytes, beige adipocytes have thermogenic functions and are able to promote energy expenditure, suggesting they are an exciting target for the prevention and treatment of obesity and related metabolic diseases. In the current review, we will briefly summarize current findings on the functions of beige fat and the mechanisms regulating the beigeing process of white adipose tissue.

Abstract:Brown fat and beige fat are the so called thermogenic fat, thermogenisis and energy consumption are their physiological effect, activation of thermogenic fat is a new approach to the treatment of obesity and metabolic diseases, but they are different from the source, differentiation, biochemical characteristics, regulation of transcription factors and thermal effect. Physical exercise is associated with adipocyte and the thermogenisis process, researches indicated that it can affect differentiation and thermogenisis process via a variety of signal pathways and effects on brown fat and beige fat, and there has been debated on different modes of exercise affecting the differentiation and metabolism in thermogenic fat. This article reviews the advance and debate of brown fat and beige fat in physical exercise.

Abstract:Accumulating evidence showed that adipose inflammation plays an important role in obesity-associated metabolic disorders. As known, adipose tissue acts not only as an energy organ but also an endocrine organ, mainly consisting of fat cells, immune cells and other cells. Almost all of the immune cells participate in adipose inflammation, some of which are pro-inflammatory and others are anti-inflammatory. This review will summarize the participants in adipose inflammation, such as macrophages, T lymphocytes, dendritic cells, mast cells, eosinophils,and focus on the therapeutic potential of these adipose tissue immune cells in protecting from inflammation and obesity-related metabolic diseases will be discussed.

Abstract:Objective:To construct luciferase reporter plasmids of full-length and truncated promoters of growth arrest- and DNA-damage-inducible gene 45 (Gadd45) β/γ and detect their activity in rat GMCs in response to activating transcription factor 3 (ATF3) overexpression respectively, screening the possible binding sites for ATF3. Methods: Rat Gadd45β promoter (-110 5 ~ +236 nt) and Gadd45γ promoter (-913 ~ +72 nt) were amplified by PCR, and then cloned into the luciferase reporter plasmids (pGL3-basic) separately. The recombinant plasmids (pGL3-Gadd45β/γ-FL) were transfected into GMCs accompanied with rat ATF3 expression plasmid (pIRES2/ATF3) and the luciferase activity was detected to determine the role of ATF3 in Gadd45β/γ gene transcription. Meanwhile, the potential ATF3 binding sites within Gadd45β/γ promoter were predicted by bioinformatics software. Based on the predicted results, four truncated Gadd45β promoter luciferase reporters and three truncated Gadd45γ promoter luciferase reporters were constructed. Subsequently, the full-length as well as different truncated promoter luciferase reporters of Gadd45β/γ were transfected into GMCs accompanied with pIRES2/ATF3, and the luciferase activity was then detected to identify the ATF3 binding sites. Results: It was verified that different kinds of plasmids were all constructed correctly by PCR analysis and nucleotide sequencing. GMCs co-transfected with pGL3-Gadd45β/γ-FL and pIRES2/ATF3 displayed increased luciferase activity of Gadd45β and Gadd45γ promoter, respectively. In addition, pGL3-Gadd45β-4 co-transfected with pIRES2/ATF3 in GMCs showed notably reduced Gadd45β promoter activity than that of pGL3-Gadd45γ-FL, pGL3-Gadd45β-1, pGL3-Gadd45β-2, pGL3-Gadd45β-3 co-transfected with pIRES2/ATF3, indicating that the region of rat Gadd45β promoter (-146 ~ +23 nt) might contain ATF3 binding element. Likewise, pGL3-Gadd45γ-2 and pGL3-Gadd45γ-3 co-transfected with pIRES2/ATF3 in GMCs exhibited acute reduction of Gadd45γ promoter activity than that of pGL3-Gadd45γ-FL and pGL3-Gadd45γ-1, indicating that the region of rat Gadd45γ promoter (-456 ~ -61 nt) might contain more than one ATF3 binding element. Conclusion: The full-length and truncated Gadd45β/γ promoter luciferase reporter plasmids were constructed successfully, and the ATF3 binding regions within Gadd45β/γ promoters were identified.

Abstract:Objective:To investigate the changes of PERK-eIF2-ATF4 signaling pathway, pro-apoptosis CHOP, and JNK-c-Jun, as well as the effect of 17-estradiol (E2) following cerebral chronic hypoperfusion in the hippocampal CA1 region. Methods: Female rats were bilaterally ovariectomized, and 1 week later, chronic hypoperfusion was induced by occlusion bilateral common carotid arteries. The rats were randomly divided into the sham (14 d and 21 d)groups, the hypoperfusion (BCCAO 14 d, 21 d and 28 d) groups, the continuous physiological dose of E2 group, the JNK inhibitor SP600125 group and the solvent control group. GRP78, ATF4, CHOP, and phosphorylation levels of PERK, eIF2α, JNK and c-Jun were detected using Western blotting in the hippocampal CA1 region. Results: Compared to the sham 14 d group, phosphorylation levels of PERK and eIF2α, as well as ATF4 and CHOP expressions were significantly increased at 14 d, 21 d and 28 d after BCCAO, although there was no statistic difference in GRP78 protein expression. Furthermore, p-JNK and p-c-Jun significantly increased after BCCAO compared with the sham 14 d group. Either E2 or SP600125 not only significangly prevented the activation of JNK/c-Jun pathway, but also attenuated PERK-eIF2α-ATF4-CHOP stress signaling induced by BCCAO after 21 d in the hippocampal CA1 region. Conclusion: Chronic hypoperfusion induced by BCCAO could cause long term ER stress in the hippocampal CA1 region, which might include activation of JNK/c-Jun signaling pathway and CHOP transcriptional activity, and ultimately induce neuron damage. Continuously administration of physiological dose E2 could significantly prevent the damage.

Abstract:Objective:To investigate both mRNA and protein levels of B lymphoma Mo-MLV insertion region 1 (Bmi1) in a panel of tongue squamous cell carcinoma (TSCC) cell lines as compared with normal tongue mucosa, and then to study biological roles of Bmi1 in tongue tumorigenesis by loss-of-function assays using small interference RNA. Methods: RNA and protein expressions of Bmi1 in TSCC cell lines and normal tongue mucosa were detected by qRT-PCR and Western blot. Cellular immunofluorescence was performed to further characterize the subcellular distribution of Bmi1 in tongue cancer cell lines. Cell migration, invasion, proliferation and colony formation were assessed by wound-healing, Transwell, MTT and colony-forming experiments. To further reinforce the notion that Bmi1 is critical for tongue cancer growth in vivo, genetic approach was further utilized to inhibit Bmi1 in a tongue cancer xenograft model. Results: Bmi1 mRNA and protein levels in TSCC cell lines were significantly higher than that in normal tongue mucosa as assessed by real-time RT-PCR and Western blot assays (P < 0.05). Short-hairpin RNA-mediated Bmi1 knockdown inhibited cell proliferation, migration and invasion, reduced colony formation, presumably by modulation of p16, p14 and E-cadherin. Short-hairpin RNA-mediated Bmi1 knockdown significantly impaired tumor growth in a tongue cancer xenograft model. Conclusion:Bmi1 may serve as a key driver with multiple biological functions during tongue cancer progression and a novel therapeutic target against tongue cancers.

Abstract:Objective:To study the correlation between serum proprotein convertase subtilisin/kexin 9 (PCSK9) and the risk factors of atherosclerosis (AS) in patients with type 2 diabetes mellitus (T2DM). Methods:Fasting blood samples were obtained from 351 T2DM patients enrolled in the department of endocrinology and metabolism of Jiangsu Province Hospital between January 2011 to November 2011. History-taking, physical and biochemical examinations, and the severity of carotid artery and artery of lower extremity atherosclerosis assessment were examined. Serum PCSK9 was measured with a sensitive and specific sandwich ELISA. Results:The level of serum PCSK9 in patients with T2DM combined with AS was higher than that in T2DM patients without AS (P < 0.05). Besides,there was also a positive correlation between serum PCSK9 and varied carotid AS related-index,such as RCCA inside diameter,RCCA PI,RICA PI,LCCA PI,LICA PI,RICA RI,LCCA RI (all P < 0.05). Furthermore,a negative association was found between the serum PCSK9 and RCCA Vmax,RCCA Vmin,RCCA Tamx, in this population (all P < 0.05). Conclusion:The level of serum PCSK9 is strongly correlated with several risk factors of AS. In combination with traditional risk factors of AS,serum PCSK9 will provide more information for predicting the presence of AS-related cardiovascular diseases.

Abstract:Objective:To investigate the association between serum uric acid(SUA)and nonalcoholic fatty liver disease(NAFLD) in type 2 diabetic patients(T2DM). Methods:A total of 533 T2DM subjects were recruited to undergo anthropometric measurements and fasting blood sampling for biochemical assay such as blood glucose,lipid,uric acid and insulin. All subjects were divided into four groups according to the quartiles of SUA,and we compared the differences of metabolic indexes among them and analyzed the association between SUA level and NAFLD. Results:BMI,SBP,TG,fasting insulin and insulin resistance index(HOMA-IR)were significantly elevated with the increase of SUA concentration(P for trend < 0.05). Similarly,ALT and AST was increased with the elevation of SUA. The prevalence rates of NAFLD in participants with increasing SUA quartiles were 41.2%,54.9%,59.3% and 71.8%,respectively(P for trend < 0.001). Logistic regression analysis showed that the risk of NAFLD was increased by 239% in participants of the fourth SUA quartile as compared with participants in the first quartile. Conclusion:SUA was significantly and independently associated with NAFLD in T2DM patients.

Abstract:Objective: To detect the mRNA levels of genes of BMP/Samd signaling pathway in peripheral blood mononuclear cells of patients with systemic lupus erythematosus (SLE) and to determine their correlations with the ratio of OPG/RANKL, thus to further investigate the effect of BMP/Smad pathway on the bone metabolism of SLE patients. Methods: The mRNA levels of RANKL, OPG, BMP-2 and Smad1/5/8 gene in peripheral peripheral blood mononuclear cells from 26 SLE patients and 20 normal controls were detected by rea1-timePCR (RT-PCR), and the protein level of OPG and RANKL were measured by ELISA. The correlation analysis between these genes of BMP/Smad signaling and the ratio of OPG/RANKL or some indexes of disease activity were studied. Results: The mRNA levels of OPG decreased in SLE patients compared with normal controls (0.002 5 ± 0.000 7 vs. 0.017 6 ± 0.006 7, P < 0.05), and RANKL levels had no differences between the two groups (0.003 3 ± 0.001 0 vs. 0.002 4 ± 0.000 9, P > 0.05), which led to a decreased ratio of OPG/RANKL (0.229 6 ± 0.071 2 vs. 0.609 5 ± 0.165 1, P < 0.01). Both the mRNA levels of Smad1 and Smad8 were significantly decreased in SLE patients than those in controls (0.003 1 ± 0.000 4 vs. 0.006 6 ± 0.000 7; 0.003 3 ± 0.000 5 vs. 0.005 6 ± 0.000 6,P <0.01), and also the level of Smad5 was decreased (0.001 7 ± 0.000 3 vs. 0.004 2 ± 0.000 4, P < 0.05). There were no differences on the BMP-2 gene expression between the two groups (0.006 9 ± 0.002 0 vs. 0.010 5 ± 0.002 1,P > 0.05). Serum protein levels of RANKL were higher in SLE patients than those in controls (P < 0.01), while OPG levels had no differences between the two groups, which led to an decreased ratio of OPG/RANKL (P = 0.006) in SLE patients. Analysis showed that positive correlation between mRNA level of Smad8, ratio of OPG/RANKL and ESR levels of SLE patients (P < 0.05). Moreover, mRNA levels of Smad8 and OPG were found positively related (P < 0.01), while that of Smad1 and RANKL were negatively related (P < 0.01). Conclusion: The gene expressions of BMP/Smads signaling pathway were abnormal in SLE patients, which may be involved in the mechanism of unbalanced bone metabolism of patients.

Abstract:Objective:To elucidate the role of HMGB1 in the pathogenesis of diabetic nephropathy by detecting serum concentrations of HMGB1 and related inflammatory factors and oxidative stress makers in patients suffer with diabetic nephropathy. Methods:Collected clinical data and blood samples of 120 cases of diabetic nephropathy and 60 cases of simple diabetic patients. The patients with diabetic nephropathy were divided into two groups according to the 24 hours urinary albumin quantitative,microalbuminuria group (n=60) and macroalbuminuria group (n=60). HbA1c,TC,LDL-C,HDL-C,TG,creatinine of the samples were detected. Enzyme-linked immunosorbent (ELISA) was used to detect the concentration of HMGB1,RAGE,TNF-α and MDA of three groups. Results:①Compared with simple diabetes group,the serum concentration of HMGB1,RAGE,TNF-α and MDA significantly increased in two groups of diabetic nephropathy,and the difference is statistically significant (P < 0.01). ② The serum concentration of HMGB1,RAGE,TNF-α and MDA was highest in macroalbuminuria group of diabetic nephropathy. ③The expression of HMGB1 was positively correlated with RAGE,TNF-α and MDA. Conclusion:The serum concentration of HMGB1 was significantly increased in patients with clinical diabetic nephropathy.With the deterioration of albuminuria,the expression of HMGB1 gradually increased. HMGB1 may participate in the development of diabetic nephropathy by promoting inflammation and oxidative stress.

Abstract:Objective:To investigate the expression of SP70 in hunman ovarian cancer and its correlations with clinicopathological significance. Methods:A case-control study was conducted. Paraffin sections of tumor tissues from 65 patients with ovarian cancer and 30 patients with benign ovarian disease(15 benign ovarian tumor and 15 benign ovarian cyst) were collected. The expression of SP70 was examined by immunohistochemical staining. The results were scored by semiquantitative analysis. Statistical analysis was evaluated by chi-square test or Fisher exact test. The expression of SP70 in hunman ovarian cancer and their clinicopathological significance was analyzed. Relationship between SP70 and CA125 expression in ovarian cancer was analyzed by using Spearman rank correlation analysis. Results:The positive rate of SP70 in ovarian cancer was higher than that in benign ovarian disease (72.3% vs. 3.3%, P﹤0.05). The positive rate of SP70 in poor differentiation was also higher than that in well and moderate differentiation cancers(84.4% vs. 45.0%, P﹤0.05). Meanwhile,the high expression of SP70 in ovarian cancer between Ⅰ~Ⅱ stage and Ⅲ~Ⅳ stage was significantly different (94.1% vs. 64.6%, P﹤0.05). SP70 expression in patients with lymph node metastasis was very strong and there was significant difference between the former and that without lymph node metastasis (100% vs. 64.0%, P﹤0.05). The expression of SP70 and CA125 showed a complementary effect,but there was no significant correlation (r=0.039, P > 0.05). Conclusion:High expression of SP70 in ovarian cancer showed significant association with clinical stage,differentiation and lymph node metastasis. Therefore, it would be of some value in the evaluation of the diagnosis and prognosis of ovarian cancer. Joint detection of SP70 and CA125 can obviously improve the diagnostic sensitivity of ovarian cancer, having important clinical significance in early detection and diagnosis of ovarian cancer.

Abstract:Objective:To investigate the effect of YKL-40 and tidal lung function in infants with bronchiolitis by measuring the serumYKL-40, tidal volume, the level of time to peak tidal expiratory flow (TPTEF), ratio of TPTEF to total expiratory time (TPTEF/TE), volume to peak expiratory flow (VPEF), and ratio of VPEF to total expiratory volume (VPEF/VE). Methods: A total of 176 patients admitted to Wuxi Children＇s Hospital from September 2013 to May 2014 were enrolled. Eighty-five hospitalized infants with bronchiolitis (40 cases in the mild group and 45 cases in the severe group), 44 common pneumonia, and 47 normal children were enrolled in this study. The levels of serum YKL-40 and the tidal volume, TPTEF/TE, and VPEF/VE were determined by tidal breathing flow-volume loops and analyzed by statistical analysis. Results: YKL-40 was higher in the group of bronchiolitis compared to that in the pneumonia group and the control group (P < 0.05). There were no statistically significant differences in tidal volume (F=0.90, P=0.408). There was a significant difference of the ratio of TPTEF to TE (TPTEE/TE) in the three groups (H=74.844, P < 0.0001). The TPTEE/TE in the severe bronchiolitis group was lower than that in the mild bronchiolitis group (χ2=8.78, P < 0.05), which at the same time had the lower level than the pneumonia group (χ2=27.50, P < 0.05). In the three groups, the ratio of VPEF to VE (VPEF/VE) showed statistically different (H=76.392, P < 0.001). The VPEE/EE in the mild bronchiolitis group was statistically higher than that in the severe group (χ2=6.80, P < 0.05), which was lower than that in the pneumonia group (χ2=32.70, P < 0.05). YKL-40 was low negatively correlated with TPTEF/TE and VPEF/VE, (r=-0.278,P=0.001;r=-0.272,P=0.002), respectively. Conclusion: YKL-40 maybe an important inflammatory marker in bronchiolitis. The tidal lung function was a good monitoring and judgment index for bronchiolitis.

Abstract:Objective:To observe changes of the number and function of peripheral blood Vδ1 T cells in patients with sepsis, and preliminary study on the role of Vδ1 T cells in the pathogenesis of sepsis. Methods: A total of 40 patients with sepsis who underwent ICU treatment and 40 healthy controls (HC)who underwent physical examination in authors’ affiliated hospital from December, 2012 to December, 2014 were enrolled in this study. Peripheral venous blood samples (10 mL) were taken from both groups. The proportion of Vδ1 T cells and Foxp3 expression on Vδ1 T cells were detected by flow cytometry (FCM). The inhibition effect of Vδ1 T cells on CD4+ T cell proliferation was detected by CFSE staining. After coculture for 72 h, the inhibition effects of Vδ1 T cells on the IFN-γand TNF-α production ability of CD4+ T cell were detected by FCM. Results: The proportion of Vδ1 T cells in HC was(1.04 ± 0.22)%, and in sepsis was (3.35 ± 0.55)%, the proportion of Vδ1 T cells between HC and sepsis had statistical significance (P < 0.01). The proportion of Foxp3 expression on Vδ1 T was (10.02 ± 2.31) % in HC, and was (16.83 ± 3.63)% in sepsis, the proportion of Foxp3 expression on Vδ1 T between HC and sepsis had a statistical significance (P < 0.01). The inhibitory effect of Vδ1 T cells from HC on the proliferation, IFN-γ and TNF-α production ability of CD4 T cell were (44.26 ± 6.31)%,(34.84 ± 4.83)% and (39.31 ± 4.91)%, respectively; and the inhibitory effect of Vδ1 T cells from sepsis on the proliferation, IFN-γand TNF-α production ability of CD4 T cell were (62.35 ± 5.91)%,(50.37 ± 4.77)% and(54.94 ± 5.71)%, respectively. The inhibitory effect of Vδ1 T cells between HC and sepsis had a statistical significance (P < 0.01). Conclusion: Vδ1 T cells from sepsis have strong inhibitory function, resulting in immune function inhibition, finally resulting in sepsis.

Abstract:Objective:To compare the performance of predictive models which were established by support vector machine(SVM)and traditional logistic regression and to study the new method of early prognosis in the patients with ICH. Methods:Totally 339 patients with ICH were collected and followed up the clinical outcomes for 21 days. Using the random number method,the original sample was divided into two groups according to the proportion of 3∶1. One group(254 cases) was regarded as a training set for screening the variables and establishing the prediction model and the another group(85 cases) was used as validation set for evaluating the model effect. SVM and the conventional statistical methods of logistic regression were used to construct the predictive models. Results:Through the discriminant validation of the forecast of 85 patients with ICH,the predictive ability of SVM1 was the strongest in the four models. The accuracy and Youden index of four models were as follows,logistic regression:72.9%(62.0%~81.7%),0.441 (0.249~0.633);SVM1:82.4%(72.3%~89.5%),0.632(0.465~0.799);SVM2:78.8%(68.4%~86.6%),0.557 (0.379~0.735);SVM3:78.8%(68.4%~86.6%),0.563 (0.385~0.741). Conclusion:The model based on SVM could better predict the early prognosis of the patients with ICH. The efficacy of SVM model is superior to that of logistic regression model.

Abstract:Objective:To study the possible association between miR-196a2 gene polymorphisms and cervical cancer susceptibility among women in Jiangsu Province. Methods:The subjects included 509 cervical cancer cases and 562 cancer-free controls. We genotyped the functional polymorphism of miR-196a2 (rs11614913)by TaqMan-Probe assay method,and used a sample of 20 cervical cancer tissues to test the expression of mature miR-196a by real-time quantitative reverse transcription. Results:When compared with TT genotype,the variant homozygote CC genotype were associated with increased cervical cancer risk(OR=1.45,95%CI = 1.04~2.09) and cervical squamous cell carcinoma(CSCC) risk(OR=1.49,95%CI = 1.05~2.11); moreover,CC genotype was associated with high miRNA levels in CSCC tissues,whereas TT genotype showed a relatively low expression in comparison to both TC/CC (P=0.040) and CC patients(P=0.030). Conclusion:The natural genetic variation in pre-miR-196a2 may affect the amount of mature miR-196a in vivo,and contribute to the susceptibility to cervical cancer.

Abstract:Objective:The aim of this study was to compare cephalometric measurements obtained from conventional cephalograms with synthesized cone beam CT (CBCT) cephalograms. Methods:Cephalometric analyses of 65 patients were conducted on conventional and CBCT-synthesized cephalograms at the same time. The lateral cephalograms were manually analyzed through the Dolphin Imaging 11.0TM software. Measurement results were compared and analyzed by paired t-test and test of goodness of fit. Results:Significant differences between the conventional cephalograms and synthesized CBCT cephalograms were found in all measurements except N-ANS/N-Me,ANS-Me/N-Me,L1-AP,IMPA,U1-SN and SNA (P < 0.05). The test of goodness of fit showed that the fitting degree of linear distance in 7 items was high,in 3 items was medium;the fitting degree of angle in 10 items was high,in 3 items was medium,in 2 items was low. It can be considered that there was a correlation between two kinds of measurement results except NP-FH and SGn-FH. Conclusion:Most measurements show correlation between conventional cephalograms and synthesized CBCT cephalograms.

Abstract:Objective:To evaluate the role of quantitative measurements of orbital medial wall in the morphology of blow-out fracture based on CT imaging. Methods:Patients with periocular trauma who underwent CT scan from January 2012 to December 2014 were reviewed. A hundred patients without orbital fracture and 76 patients with pure orbital fracture (50 medial orbital wall fracture patients and 26 inferior orbital wall fracture patients) were identified. Quantitative measurements of orbital medial wall including anterior height,posterior height,anteroposterior diameter,area of lamina papyracea and number of ethmoid air cell septa,lamina papyracea area/ethmoid air cell septa were compared between groups by independent t-test. Results:There were no significant differences in all measurements between bilateral sides in patients without orbital fractures(P > 0.05),as well as in the anterior height,posterior height,anteroposterior length,and area of lamina papyracea between patients with isolated medial fractures and those with isolated inferior fractures. The number of ethmoid air cell septa was significantly fewer (P=0.013) and lamina papyracea area/ethmoid air cell septa significantly larger (P=0.011) in patients with medial wall fractures compared to those with inferior wall fractures. Conclusion:No significant differences were found in quantitative measurements of orbital medial wall between bilateral sides. Under the similar external force,the patients with fewer ethmoid air cell septa and larger lamina papyracea area/ethmoid air cell septa might be more likely to develop a medial wall fracture in similar external force.

Abstract:Objective: To investigate new aspects of the test-retest reliability of thermal quantitative sensory testing (QST) maxillofacial temperature in healthy young subjects, and differences between different parts and genders. Methods: Twenty-six healthy volunteers (14 women and 12 men) participated. Cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT) and heat pain threshold (HPT) were measured at three sites: the surface of left hand, and the left and right masseter. The testing was performed 3 times at 10 minutes intervals with each time of 3 stimulations at 4 seconds intervals, and repeated one week later. Data were analyzed with intraclass correlation coefficients (ICC) and four-way ANOVA for repeated measures of different genders, parts and time intervals. Results: Most variables showed acceptable to excellent reliability and non-significant difference across different test cycles (ICCCDT:0.642~0.869, ICCWDT:0.591~0.723, ICCCPT:0.672~0.967 and ICCHPT:0.757~0.917), and one-week intervals (ICCCDT: 0.508~0.772, ICCWDT: 0.560~0.885, ICCCPT: 0.629~0.872, and ICCHPT: 0.581~0.662). Bilateral contrast showed no statistical significance (PCDT=0.398, PWDT=0.223, PCPT=0.264 and PHPT=0.943). The CPT and HPT at the left hand were lower (lower sensitivity) than at the masseter (PCPT=0.003, PHPT=0.004). There were significant gender differences with higher sensitivity in women (PCPT=0.008 and PHPT=0.016). Conclusion: The reliability of most thermal threshold measures was acceptable for assessing somatosensory function. Facial skin is more sensitive to temperature-stimulated pain than the back of left hand skin, and female is more sensitive to temperature-stimulated pain than male.