Orthodontic-surgical treatment for severe skeletal class Ⅱ malocclusion with vertical maxillary excess and four premolars extraction: A case report

BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatment plan for a patient initially treated with four-premolar-extraction camouflage, despite indications for orthognathic surgery.CASE SUMMARY A 23-year-old male sought treatment complaining about his unsatisfactory facial appearance. His maxillary first premolars and mandibular second premolars had been extracted, and a fixed appliance had been used to retract his anterior teeth for two years without improvement. He had a convex profile, a gummy smile, lip incompetence, inadequate maxillary incisor inclination, and almost a class I molar relationship. Cephalometric analysis showed severe skeletal class Ⅱ malocclusion(A point-nasion-B point = 11.5°) with a retrognathic mandible(sella-nasion-B point = 75.9°), a protruded maxilla(sella-nasion-A point = 87.4°), and vertical maxillary excess(upper incisor to palatal plane = 33.2 mm). The excessive lingual inclination of the maxillary incisors(upper incisor to nasion-A point line =-5.5°)was due to previous treatment attempts to compensate for the skeletal class Ⅱ malocclusion. The patient was successfully retreated with decompensating orthodontic treatment combined with orthognathic surgery. The maxillary incisors were repositioned and proclined in the alveolar bone, the overjet was increased, and a space was created for orthognathic surgery, including maxillary impaction, anterior maxillary back-setting, and bilateral sagittal split ramus osteotomy to correct his skeletal anteroposterior discrepancy. Gingival display was reduced, and lip competence was restored. In addition, the results remained stable after 2 years. The patient was satisfied with his new profile as well as with the functional malocclusion at the end of treatment.CONCLUSION This case report provides orthodontists a good example of how to treat an adult with severe skeletal class Ⅱ malocclusion with vertical maxillary excess after an unsatisfactory orthodontic camouflage treatment. Orthodontic and orthognathic treatment can significantly correct a patient’s facial appearance.

Hybrid treatment of varied orthodontic appliances for a patient with skeletal class II and temporomandibular joint disorders:A case report and review of literature

BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during orthodontic treatment,an immediate pause of orthodontic adjustments is recommended;the treatment can resume when the symptoms are managed and stabilized.CASE SUMMARY This case report presents a patient(26-year-old,female)with angle class I,skeletal class II and TMDs.The treatment was a hybrid of clear aligners,fixed appliances and temporary anchorage devices(TADs).After 3 mo resting and treatment on her TMD,the patient’s TMD symptom alleviated,but her anterior occlusion displayed deep overbite.Therefore,the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves.After the levelling,the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion.After careful examination of temporomandibular joints(TMJ)position,the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion.Eventually,the improved facial appearance and relatively stable occlusion were achieved.The 1-year follow-up records showed there was no obvious change in TMJ morphology,and her occlusion was stable.CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients.Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.

Simple and effective method for treating severe adult skeletal class II malocclusion: A case report

BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lips requested orthodontic camouflage.The treatment plan consisted of extracting the right upper third molar,right lower third molar,left lower second molar,and left upper third molar and moving the maxillary dentition distally using a convenient method involving microimplant nail anchors,push springs,long arm traction hooks,and elastic traction chains.After 52 months of treatment,her overbite and overjet were normal,and her facial profile was favorable.CONCLUSION This method can be used for distal movement of the maxillary dentition and to correct severe skeletal class II malocclusion in adults.

Improved super-elastic Ti–Ni alloy wire intrusion arch for skeletal class Ⅱ malocclusion combined with deep overbite:A case report

BACKGROUND Treatment for deep overbite cases can be difficult. This case report presents some techniques with improved super-elastic Ti–Ni alloy wire(ISW) for deep overbite correction.CASE SUMMARY A 21-year-old woman had a chief complaint of flaring maxillary teeth. Orthodontic evaluation revealed a skeletal class Ⅱ malocclusion and a convex profile appearance. A deep overbite with palatal impingement and large overjet were also noted. Bilateral maxillary first premolars were extracted, and spaces were closed using a closed-coil spring and elastic chain. The deep overbite was corrected by applying the ISW curve and ISW intrusion arch. Intermaxillary elastics was used to adjust the intermaxillary relationship. Active treatment took approximately 3 years, and the appearance and dentition alignment noticeably improved.CONCLUSION The use of the ISW technique in a case of skeletal class Ⅱ malocclusion with deep overbite achieved a desirable result, and the patient was satisfied with the treatment outcome.

Improved super-elastic Ti-Ni alloy wire for treating adult skeletal class III with facial asymmetry:A case report

BACKGROUND Correcting severe skeletal class III malocclusion with facial asymmetry in adults through orthodontic treatment alone is difficult.CASE SUMMARY In this case report,we describe orthodontic treatment and lower incisor extraction without orthognathic surgery for a 27-year-old man with a transverse discrepancy.The extraction sites were closed using an elastic chain.The use of intermaxillary elastics,improved super-elastic Ti-Ni alloy wire,and unilateral multibend edgewise arch wire was crucial for correcting facial asymmetry and the midline deviation.CONCLUSION After treatment,the patient had a more symmetrical facial appearance,acceptable overjet and overbite,and midline coincidence.The treatment results remained stable 3 years after treatment.This case report demonstrates that a minimally invasive treatment can successfully correct severe skeletal class III malocclusion with facial asymmetry.

肯氏Ⅰ、Ⅱ类牙列缺损数字化印模及模型在可摘局部义齿中的应用

目的评估肯氏Ⅰ、Ⅱ类牙列缺损数字化印模及树脂模型技术在可摘局部义齿(RPD)中的应用效果。方法选择肯氏Ⅰ、Ⅱ类牙列缺损患者,按照义齿制作流程分组:数字化印模/树脂模型/钴铬合金铸造支架组(A组)、数字化印模/树脂模型/激光打印钛支架组(B组)、藻酸盐印模/石膏模型/钴铬合金铸造支架组(C组)、藻酸盐印模/石膏模型/激光打印钛支架组(D组),每组40例。对最终完成的RPD在口内就位情况进行检查,评估指标包括卡环固位力、连接体和基托在口内的密合度、咬合准确度,各项指标评估分值使用Kruskal-Wallis秩和检验进行分析。结果4组RPD各项指标的评分值差异无统计学意义。结论利用数字化印模及树脂模型完成的铸造钴铬合金和激光打印钛支架式RPD能够满足肯氏Ⅰ、Ⅱ类牙列缺损患者的临床修复要求。

青少年骨性Ⅱ类错合畸形患者功能矫治前后3D面相变化的研究

目的 利用3D诊断技术对青少年骨性Ⅱ类患者面部软组织进行三维重建,分析治疗前后患者面部软组织变化。方法收集20例青少年骨性Ⅱ类下颌后缩的患者,采用功能矫治器导下颌向前促进下颌骨发育,纠正上下颌骨发育不调,每位患者治疗前后均采用3D相机获取患者面相资料,对比分析治疗前后患者软组织三维方向变化情况。结果 SNA,SNB,L1-MP增大,ANB,U1-SN减小,上唇厚度,下唇厚度,Pog-零子午线距离减小,口裂-颏下距,鼻唇角,唇齿角增大,差异均有统计学意义(P<0.05)。结论 青少年骨性Ⅱ类错合畸形患者功能矫治前后3D面相唇部厚度减小,凸度改善,颏部前伸,软组织侧貌更加协调美观。

Orthodontic camouflage versus orthognathic surgery: A comparative analysis of long-term stability and satisfaction in moderate skeletal Class III

Objective: The purpose of this study was to compare long-term stability and satisfaction between orthodontic camouflage and orthognathic surgery in treatment of moderate skeletal Class III adults. Materials and Methods: A total of 25 adults females who had been treated with orthodontic camouflage for Class III malocclusions were recalled at least 3 years post-treatment to evaluate stability and satisfaction with treatment outcomes. The data were compared with similar data for long-term outcomes in 21 patients with the same Class III problems who had bimaxillary surgical correction. Results: In the camouflage patients, small mean changes in skeletal landmark positions occurred over the long term, although the changes were generally much smaller than in the surgery patients. Dental changes in the surgery group were more severe than those in the camouflage group. The camouflage patients reported fewer functional or temporomandibular joint problems than did the surgery patients. Both groups reported similar levels of overall satisfaction with treatment. Conclusion: The results suggest that both camouflage and surgical treatment in moderate skeletal Class III adults can achieve satisfactory outcomes and provide long-term stability. If patients do not readily accept surgery because of potential surgical complications or financial difficulties, camouflage treatment may be an effective alternative treatment.

肌激动器联合不同口外弓施力点治疗儿童骨性Ⅱ类错颌畸形的疗效研究

目的研究肌激动器配合不同口外弓施力点治疗儿童骨性II类错颌畸形的疗效差异。方法收集2019年1月—2020年12月绍兴市中医院口腔科治疗的骨性Ⅱ类错颌50例患儿作为研究对象,通过分发随机信封将其分为试验组与对照组,各25例。试验组使用改良头帽肌激动器(Vanbeek Activator),口外弓位置前移自上中切牙及侧切牙间伸出基托;对照组使用传统Vanbeek Activator,口外弓自上颌第一、二前磨牙间伸出基托。收集患儿治疗前后头颅定位侧位片进行头影测量。结果治疗后试验组下颌平面角、前后面高比和上颌牙合平面角的减小量显著高于对照组,差异有统计学意义(P<0.05);治疗后两组上颌矢状向位置(SNA角)、下颌矢状向位置(SNB角)、上下颌骨相对位置(ANB角)、Y轴角、下面高比例、上下中切牙角等比较,差异无统计学意义(P>0.05)。结论改良Vanbeek Activator的施力点位于上颌骨及上牙弓阻抗中心前部,可使上下颌骨发生一定程度逆时针旋转,有利于均角偏高角骨性II类错颌患儿的垂直向控制。

成人骨性Ⅱ类1分类患者侧貌美学评价指标及其影响因素的研究进展

骨性Ⅱ类1分类错(牙合)畸形不仅影响患者的咬合及咀嚼功能,而且严重影响患者的外貌甚至其心理健康,寻求侧貌的改善往往是患者就诊的主要动机。临床上对患者治疗前后的侧貌进行主客观评价分析,可帮助明确患者的诊疗意图和治疗后侧貌的变化。侧貌的美学分析结果常因主客观评价方法的不同及评价者的教育背景、地域、种族、年龄等影响而存在差异,因此,需了解不同主客观评价方法的优缺点及不同人群的审美差异,以在进行此类错(牙合)畸形矫治时指导临床,预测矫治的侧貌美学效果,有利于医患沟通,降低医疗风险及减少医患纠纷。

高角Ⅱ类开[牙合]患者上下颌前牙根长及中切牙冠根形态的锥形束CT研究

目的探讨高角Ⅱ类前牙开[牙合]患者的上下颌前牙牙根长度及中切牙冠根形态,为临床正畸治疗提供参考。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。对81例高角Ⅱ类患者(前牙开[牙合]40例、正常覆[牙合]41例)正畸治疗前的锥形束CT(cone-beam computed tomography,CBCT)图像进行分析,运用Dolphin软件对上下颌前牙的牙根长度以及中切牙冠根形态进行研究,并行统计学分析。结果高角Ⅱ类开患者(开[牙合]组)与高角Ⅱ类正常覆患者(正常覆[牙合]组)的上颌尖牙和侧切牙牙根长度差异无统计学意义,但开[牙合]组上颌中切牙(11.12±1.37)mm、下颌中切牙(10.15±1.09)mm、下颌侧切牙(11.27±1.15)mm和下颌尖牙(12.81±1.48)mm的牙根长度均较正常覆[牙合]组短且差异均具有统计学意义(P<0.05);另一方面,开[牙合]组的上颌中切牙冠根成角(1.10°±3.62°)显著小于正常覆[牙合]组(4.53°±2.30°)(P<0.01),而开[牙合]组的下颌中切牙冠根成角与正常覆[牙合]组的差异无统计学意义。结论高角Ⅱ类开[牙合]患者的上下颌中切牙、下颌侧切牙和下颌尖牙牙根均较高角Ⅱ类正常覆[牙合]患者短,高角Ⅱ类开[牙合]患者上颌中切牙牙冠长轴相对于牙根长轴偏唇侧,冠根成角较小,利于开[牙合]患者的前牙转矩控制或内收移动。

无托槽隐形矫治联合牙周组织再生术治疗重度牙周炎伴Ⅱ类错颌畸形患者的临床疗效

目的:探讨无托槽隐形矫治联合牙周组织再生术(Guided tissue regeneration,GTR)在重度牙周炎伴Ⅱ类错颌畸形矫治患者中的应用价值。方法:选取浚县人民医院2018-09至2022-012022-12收治的130例重度牙周炎伴Ⅱ类错颌畸形患者,随机分为无托槽隐形矫治组和常规矫治组,各65例。常规矫治组在GTR术基础上进行金属直丝弓托槽矫治,无托槽隐形矫治组在GTR术基础上联合无托槽隐形矫治。矫治6m后,比较两组临床疗效、疼痛介质(P物质、前列腺素E_(2)(Prostaglandin E_(2),PGE_(2))、降钙素基因相关肽(Calcitonin gene-related peptide,CGRP))、龈沟液炎性因子(细胞间黏附因子-1(Intercellular cell adhesion molecule-1,ICAM-1)、白细胞介素-1β(Interleukin-1β,IL-1β)、基质金属蛋白酶8(Matrix metalloproteinase-8,MMP8))、牙周改善情况(牙周探诊深度(Periodontal depth,PD)、龈沟出血指数(Sulcus bleeding index,SBI)、牙菌斑指数(Plaque index,PLI)、牙龈指数(Gingivalindex,GI))、牙齿功能(咬合力、咀嚼效率)及不良反应情况。结果:矫治6m后,无托槽隐形矫治组总有效率高于常规矫治组(P<0.05);与矫治前相比,矫治6 m后,两组龈沟液P物质、PGE_(2)、CGRP、ICAM-1、IL-1β、MMP8水平、PD、SBI、PLI、GI均降低,咬合力、咀嚼效率均升高,且无托槽隐形矫治组改善程度更为显著(P<0.05);无托槽隐形矫治组不良反应发生率低于常规矫治组(P>0.05)。结论:无托槽隐形矫治联合GTR术用于重度牙周炎伴Ⅱ类错颌畸形患者可提高矫治效果,减轻龈沟液炎性程度,改善牙周状况,有助于减轻患者疼痛,增强牙齿功能,且具有较好安全性。

新城疫病毒ClassⅠ与ClassⅡ毒株交叉血凝抑制试验快速分类

ClassⅠ新城疫病毒(NDV)分离自健康家禽泄殖腔棉拭子,其基因序列与ClassⅡNDV存在很大差异,为了建立简单快速的NDV分类方法,用SPF鸡制备ClassⅠ和ClassⅡ毒株多价抗血清分别与选取的ClassⅠ和ClassⅡ代表毒株进行交叉血凝抑制反应。结果表明所有ClassⅠ毒株比同ClassⅡ毒株的交叉血凝抑制值高8～64(3～6log2)倍;而ClassⅡ毒株与ClassⅡ抗血清的HI效价比同ClassⅠ毒株的交叉血凝抑制值高2～8(1～3log2)倍,结果与基因分型高度一致,说明可以用交叉血凝抑制试验进行初步分类。本研究结果显示,NDVClassⅠ弱毒株血凝性与广泛应用的NDV弱毒疫苗株不同,基因序列分析可以部分解释这种差异,另外可能HN蛋白的空间结构也会影响其与血凝素结合的特性。

牙鲆MHC class ⅡB基因多态性及其与鱼体抗病力关系的分析

用fmhcN1和fmhcC1引物分别从42尾感病个体和42尾抗病个体的基因组DNA中扩增MHC基因片段,扩增产物长度为268/280 bp。在268/280 bp的核苷酸序列中,有32个(11.4%)核苷酸位点是多态的。在其编码的61个氨基酸位点中,有13个位点是多态的,其中有6个位点发生在多肽结合位点上。对核苷酸替代的类型及位点进行分析,发现非多肽结合位点的非同义碱基替代率与同义碱基替代率的比值(dN/dS)(0.523)远远小于多肽结合位点的非同义碱基替代率与同义碱基替代率的比值(dN/dS)(23.091),表明氨基酸替换集中出现在exon2多肽结合位点上。分析84个个体的411个阳性克隆的测序结果,发现有13个不同的MHC classⅡB等位基因,并且分别编码13个不同的氨基酸序列。其中大部分等位基因如a,b,c,d,e,f,j,k,i,m是两个群体共有的,等位基因d在感病群体中出现的频率(23.80%)显著高于在抗病群体中出现的频率(7.14%)。而等位基因g和h只出现在13个抗病个体中,其频率分别为21.4%和9.52%;等位基因l只出现在感病群体中,其频率为19.05%。

A Study of Monocyte Excretion of TNF- α and IL-6 and Monocyte Expression of HLA Class Ⅱ Antigen In Genital Herpes

Objective: To study the role of monocytes in the pathogenesis of genital herpes. Methods: TNF- α and IL-6 levels in 27 cases of genital herpes were detected by enzyme linked immunosorbant assay (ELISA). HLA class Ⅱ antigen expression on monocytes were detected by an alkaline phosphatase anti-alkaline phosphatase method. Results: Compared with normal controls, levels of TNF- a and IL - 6 secreted by monocytes responding to LPS mitogen in vitro were significantly decreased [(3.13 ± 0.44ng/ml) vs (4.68 ± 0.54ng/ml), P<0.05 and (3.32 ± 1.06ng/ml) vs (6.46 ± 1.94ng/ ml), P<0.05, respectively]. HLA class Ⅱ antigen expression on monocytes in the genital herpes group was also significantly decreased [HLA-DR (67.48% ± 1.51%) vs (81.03% ± 1.32%), P<0.01 and HLA-DQ (29.54% ± 1.15%) vs (37.63% ± 1.79%), P <0.01 respectively]. Conclusion: These findings suggest that the decreased monocyte function may contribute to the pathogenesis of genital herpes. Augmenting or inducing monocyte function may be important in the prevention, treatment, and reduction of genital herpes cases.

ClassⅡ细菌素乳酸菌的筛选与定性及群体感应系统鉴定

筛选具有Class Ⅱ细菌素群体感应系统广谱抑菌作用的乳酸菌并进行鉴定,为产Class Ⅱ细菌素乳酸菌的研究应用奠定基础。将排除过氧化氢和有机酸干扰作用的10株乳酸菌,经胰蛋白酶、胃蛋白酶和蛋白酶K处理,采用牛津杯法筛选具有分泌细菌素广谱抑菌效果的乳酸菌和最小抑菌实验检测其最小抑菌浓度,通过16S rDNA同源性分析构建系统发育树,设计合成乳杆菌Class Ⅱ细菌素5个操纵子plnEFI、plnJKLR、plnGHSTUV、plnABCD和plnMNOP的特异性引物,PCR和电泳鉴定L-4分泌Class Ⅱ细菌素基因群体感应系统,通过UPLC和尿素-SDS-PAGE确定细菌素的分子质量。L-4为可能具有广谱抑菌作用革兰氏阳性植物乳杆菌,它对指示菌产生的抑菌圈分别为(18.83±0.39)mm和(19.96±0.49)mm,最小抑菌浓度分别为55μg/mL和57μg/mL;L-4具有分泌Class Ⅱ细菌素群体感应基因系统,能够分泌分子质量为10 ku蛋白类细菌素且符合Class Ⅱ细菌素分子量大小范围。L-4是1株具广谱抑菌作用且能分泌10 ku Class Ⅱ细菌素的植物乳杆菌。

两种评分方法在 G.V. Black Ⅱ类洞预备中的对比研究

目的:探讨Fair Grader 100三维评价系统和教师评分两种评分方法对G.V.Black Ⅱ类洞的评价有无差异,并评价教改前后学生预备Ⅱ类洞的质量。方法:选取广州医科大学口腔医学专业2017级本科生为研究对象,分别收集试验组和对照组预备的Ⅱ类洞样本,用上述两种评价方法对两组样本评分,并进行统计学分析。结果:试验组成绩优于对照组成绩,有统计学差异(P<0.01);两种评分方法的结果一致,无统计学差异(P>0.05)。结论:Fair Grader 100数字化评估系统可以在实验课教学中推广使用。

草药S抑制大鼠移植肾排斥反应中MHC Class Ⅱ分子表达的研究

为探索草药Ｓ抗大鼠同种异体肾移植急性排斥的作用机理，采用改进的Ｆａｂｒｅ和Ｋａ－ｍａｄａ大鼠原位肾移植模型，将ＳＤ大鼠肾移植给Ｗｉｓｔａｒ大鼠为同种异体移植，Ｗｉｓｔａｒ移植给Ｗｉｓｔａｒ大鼠为同品系移植（空白对照），共设五个实验组，观察移植后受体鼠存活、检测移植肾功能及定量测定移植肾内ＭＨＣＣｌａｓⅡ抗原分子的表达。结果表明，草药Ｓ能延长受体鼠存活时间，并抑制ＭＨＣＣｌａｓⅡ在移植肾内的表达（与不用药物组比较Ｐ＜０．０１），Ｓ药加小剂量环孢素Ａ（ｃｙｃｌｏｓｐｏｒｉｎｅＡ，ＣｓＡ）治疗组与同系组相比差异无显著性（Ｐ＞０．０５）。这些结果提示，移植肾内ＭＨＣＣｌａｓｓⅡ表达水平的高低与其排斥的强弱有相关性。

H pylori receptor MHC classⅡcontributes to the dynamic gastric epithelial apoptotic response

AIM： To investigate the role of MHC class Ⅱ in the modulation of gastric epithelial cell apoptosis induced by H pylori infection. METHODS： After stimulating a human gastric epithelial cell line with bacteria or agonist antibodies specific for MHC class Ⅱ and CD95, the quantitation of apoptotic and anti-apoptotic events, including caspase activation, BCL-2 activation, and FADD recruitment, was performed with a fluorometric assay, a cytometric bead array, and confocal microscopy, respectively. RESULTS： Pretreatment of N87 cells with the anti-MHC class ⅡIgM antibody RFD1 resulted in a reduction in global caspase activation at 24 h of H pylori infection. When caspase 3 activation was specifically measured, crosslinking of MHC class Ⅱ resulted in markedly reduced caspase activation, while simple ligation of MHC class Ⅱ did not. Crosslinking of MHC class Ⅱ also resulted in an increased activation of the anti-apoptosis molecule BCL-2 compared to simple ligation. Confocal microscope analysis demonstrated that the pretreatment of gastric epithelial cells with a crosslinking anti-MHC class Ⅱ IgM blocked the recruitment of FADD to the cell surface. CONCLUSION： The ability of MHC class Ⅱ to modulate gastric epithelial apoptosis is at least partially dependent on its crosslinking. The crosslinking of this molecule has anti-apoptotic effects during the earlier time points of Hpylori infection. This effect is possibly mediated by the ability of MHC class Ⅱ to modulate the activation of the pro-apoptotic receptor Fas by blocking the recruitment of the accessory molecule FADD, and this delay in apoptosis induction could allow for prolonged cytokine secretion by Hpylori-infected gastric epithelial cells.

H pylori receptor MHC class Ⅱ contributes to the dynamic gastric epithelial apoptotic response

AIM： TO investigate the role of MHC class Ⅱ in the modulation of gastric epithelial cell apoptosis induced by H pylori infection. METHODS： After stimulating a human gastric epithelial cell line with bacteria or agonist antibodies specific for MHC class Ⅱ and CD95, the quantitation of apoptotic and anti-apoptotic events, including caspase activation, BCL-2 activation, and FADD recruitment, was performed with a fluorometric assay, a cytometric bead array, and confocal microscopy, respectively. RESULTS： Pretreatment of N87 cells with the anti-MHC class Ⅱ IgM antibody RFD1 resulted in a reduction in global caspase activation at 24 h of H pylori infection. When caspase 3 activation was specifically measured, crosslinking of MHC class Ⅱ resulted in a marked reduced caspase activation, while simple ligation of HHC class Ⅱ did not. Crosslinking of HHC class Ⅱ also resulted in an increased activation of the anti-apoptosis molecule BCL-2 compared to simple ligation. Confocal microscope analysis demonstrated that the pretreatment of gastric epithelial cells with a crosslinking anti-HHC class Ⅱ IgH blocked the recruitment of FADD to the cell surface. CONCLUSION： The results presented here demonstrate that the ability of MHC class Ⅱ to modulate gastric epithelial apoptosis is at least partially dependent on its crosslinking. Furthermore, while previous research has demonstrated that MHC class Ⅱ signaling can be proapoptotic during extended ligation, we have shown that the crosslinking of this molecule has anti-apoptotic ef-fects during the earlier time points of Hpylori infection. This effect is possibly mediated by the ability of MHC class Ⅱ to modulate the activation of the pro-apoptotic receptor Fas by blocking the recruitment of the accessory molecule FADD, and this delay in apoptosis induction could allow for prolonged cytokine secretion by Hpyloriinfected gastric epithelial cells.