Effect of Lipase and Phospholipase A1 on Foaming and Batter Properties of Yolk Contaminated Egg White.

Egg white (EW) is frequently used in bakery products because of its excellent foaming capabilities. However, egg yolk (EY) contamination often degrades the foaming characteristics of EW. The purpose of this study was to investigate the effect of different concentrations of phospholipase A1 (PLPA1) and lipase (LP) on EW. The changes in particle size distribution and potential before and after enzymatic digestion of EW with contaminated 0.5 wt% and 1.0%wt EY were tested. The foaming rate and foam stability were measured after the dispersions were digested with different concentrations of PLPA1 and LP. Additionally, the dispersion samples were used to prepare batter and angel cake, and the modulus, density, and microstructure of the batter were analyzed. Results showed that the potential absolute value increased when the EY was hydrolyzed by PLPA1. The distribution of yolk particle size showed a new aggregation and the average particle size decreased after LP hydrolysis. The dispersion samples hydrolyzed by PLPA1 and LP recovered all the properties of the samples at enzymatic concentrations of 500 U/g and 2500 U/g. This may be attributed to the changes in yolk particles resulting from the enzymatic digestion of EY and the production of amphiphilic lysophospholipids, fatty acids, and glycerol.

Variation of plantaris muscle: a case report with clinical significance / Variación del músculo plantar: reporte de un caso con significado clínico

SUMMARY: The plantaris muscle is located between the soleus and gastrocnemius muscles, within the posterior calf group. Due to degeneration and its loss of plantar-flexion function, the muscle is vestigial in human beings, but it retains clinical significance. Few cases of variation in the plantaris muscle have been reported, and this, therefore, appears to be rare. Nonetheless, absence of this muscle was identified via the dissection of a left lower limb (male), which also indicated the absence of an attachment in the usual position. The present report, which addresses such variation, may provide both inspiration and reference points for the clinical treatment of so-called "tennis leg", and for the use of plantaris muscle for the purposes of clinical, autologous graft repair.

RESUMEN: El músculo plantar se ubica entre los músculos sóleo y gastrocnemio, dentro del grupo posterior de la pierna. Debido a la degeneración y la pérdida de la función de flexión plantar, el músculo es un vestigio en los seres humanos, pero conserva su importancia clínica. Se han informado pocos casos de variación en el músculo plantar y, por lo tanto, esto parece ser raro. No obstante, se observó la ausencia de este músculo durante la disección de un miembro inferior izquierdo (masculino). El presente informe, que aborda dicha variación, puede proporcionar puntos de referencia para el tratamiento clínico de la llamada "pierna de tenista" y para el uso del músculo plantar con fines de reparación clínica con injerto autólogo.

The structure and stability analysis of the pea seed legumin glycosylated by oligochitosan.

BACKGROUND: The functionality of pea proteins is relatively weak relative to that of soybean proteins, which limits the application of pea proteins in food and nutritional applications. Glycosylation is a promising approach to influence the protein structure and in turn change the functional properties of pea proteins. RESULTS: In this study, the effect of transglutaminase-induced oligochitosan glycosylation on the structural and functional properties of pea seed legumin was studied. Different oligochitosan-modified legumin complexes (OLCs) were prepared by applying different molar ratios of legumin to oligochitosan (1:1 to 1:4) induced by transglutaminase (10 U g-1 protein). Results of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), glucosamine, and free amino analysis showed that the legumin could be covalently bonded with the oligochitosan and were influenced by the applying dose of the oligochitosan. Infrared spectroscopy, fluorescence, and scanning electron microscopy analysis indicated that the structure of the different OLC samples could be changed to different extents. Moreover, although the emulsifying activity decreased, the emulsification stability, thermal stability, and in vitro digestive stability of the OLCs were remarkably improved relative to that of the untreated legumin. CONCLUSION: Oligochitosan glycosylation could change the structure of the legumin and consequently improve its emulsification stability, thermal stability, and in vitro digestive stability. This study will facilitate the legumin functionalization by the glycosylation approach to fabricate protein-oligochitosan complex for potential food and nutritional applications. © 2020 Society of Chemical Industry.

Microbiota stratification and succession of amylase-producing Bacillus in traditional Chinese Jiuqu (fermentation starters).

BACKGROUND: Jiuqu are vital saccharifying and fermenting agents for Chinese fermented foods. Natural ventilation during Jiuqu fermentation causes changes in temperature, oxygen and moisture content, resulting in mass and heat gradients from the outer to inner areas of Jiuqu blocks. In the present study, microbiota stratification in Jiuqu was investigated by single molecule real-time sequencing and culture isolation. The contributors of Bacillus to amylase activity of Jiuqu and the dynamics of their biomass during Jiuqu fermentation were also analyzed. RESULTS: The dominant orders, genera and species between the inner and outer layers of Huangjiu qu (HJQ) were similar, although they displayed greater variance in two layers of Baijiu qu (BJQ). Bacillus possessed the highest diversity (including 27 species) in Jiuqu. Bacillus licheniformis, Bacillus altitudinis, Bacillus subtilis, Bacillus amyloliquefaciens and Bacillus megaterium were most prevalent in HJQ, whereas B. licheniformis, B. amyloliquefaciens and Bacillus cereus were dominant in BJQ. Isolates of B. amyloliquefaciens, B. subtilis and B. cereus exhibited high activities of amylase and glucoamylase. Quantification of Bacillus members possessing genes of α-amylase revealed that B. cereus and B. licheniformis were the most dominant microbes to secret α-amylase in Jiuqu and their biomass were increasing during Jiuqu fermentation. CONCLUSION: The present study demonstrates the microbial distribution in different layers of Jiuqu and clarifies the Bacillus species processing the activity of α-amylase. These results will help industries control the quality of Jiuqu by rationally selecting starters and optimizing their microbiota. © 2020 Society of Chemical Industry.

Isolation, characterization and antioxidant of polysaccharides from Stropharia rugosoannulata.

In this study, polysaccharides from Stropharia rugosoannulata were isolated and purified by macroporous adsorption resin and ion exchange chromatography to produce SRP-1 and SRP-2. Preliminary structural characteristics of SRP-1 and SRP-2 were also investigated. Our results showed that SRP-1 was neutral, while SRP-2 was acidic polysaccharides. The molar ratios of monosaccharides in SRP-1 and SRP-2 were different, but glucose was the main monosaccharide. Both α-type and ß-type glycosidic linkages were detected in SRP-1, whereas ß-constitution was dominant in SRP-2. Both SRP-1 and SRP-2 had a (1 → 6)-α-D-glucan backbone. Furthermore, the antioxidant activities of polysaccharides against ABTS+, DPPH and OH- radicals were determined in vitro. The results indicated that SRP-2 had a stronger antioxidant capacity than that of SRP-1. Our results may be valuable with regard to the utilization of polysaccharides from S. rugosoannulata as potential pharmaceuticals.

Association between Pretreatment Serum High-density Lipoprotein Cholesterol and Treatment Outcomes in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy: Findings from a Randomised Trial.

Background: To investigate the relationship between the pretreatment serum lipid concentrations and the clinical outcomes in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) who were treated with a combination of chemotherapy and radiotherapy. Methods: From August 2002 to April 2005, 400 patients with stage III or stage IVa nasopharyngeal carcinoma were recruited for a randomised clinical trial of induction chemotherapy combined with radiotherapy or concurrent chemoradiotherapy. Pretreatment serum lipid concentrations were examined in 342 patients. Both univariate and multivariate analyses were conducted to investigate the association of serum lipid levels with different treatment outcomes. Results: The 5-year failure-free survival rate for the low- high-density lipoprotein cholesterol (HDL-C) and high-HDL-C groups was 52.1% and 65.5%, respectively (p=0.017), and the 5-year overall survival rate was 64.7% and 72.5%, respectively (p=0.094). The pretreatment serum level of HDL-C was a favourable prognostic factor of overall survival and failure-free survival in a Cox regression model with HR 0.65 (95% CI 0.43-0.97; p=0.036) and 0.60 (95% CI 0.41-0.88; p =0.008). No significant correlation was observed between the prognosis of patients with NPC and serum levels of total cholesterol (TC), triglyceride (TG), or low-density lipoprotein cholesterol (LDL-C). Conclusions: The pretreatment serum level of HDL-C was an independent prognostic factor for patients with locoregionally advanced nasopharyngeal carcinoma who were treated with chemoradiotherapy.

A combined marker based on plasma D-dimer and serum albumin levels in patients with nasopharyngeal carcinoma is associated with poor survival outcomes in a retrospective cohort study.

Background: Activation of the clotting-fibrinolytic system in cancer patients is common and results in an unfavorable clinical outcome. This study aimed to investigate the role of pretreatment plasma D-dimer levels and the combination of D-dimer and albumin (DA) on the prediction of survival prognosis in patients with nasopharyngeal carcinoma (NPC). Methods: The study comprised 511 patients with NPC. Pretreatment plasma D-dimer and serum albumin levels were measured. DA was classified as a new biomarker where D-dimer and albumin levels were combined and was grouped by the cutoff value of both. The correlations of plasma D-dimer levels with clinicopathological features and survival outcome were calculated using the Chi-square test. Kaplan-Meier estimates were performed to analyze the survival functions and were compared using log-rank tests. Cox proportional hazard regression analysis was used to assess the effects of D-dimer and DA on distant overall survival (OS) and distant metastasis-free survival (DMFS). Results: The median follow-up period was 45.2 months (range 2.1-79.8). Elevated plasma D-dimer levels were positively associated with age at diagnosis (P = 0.034), platelet levels (P = 0.043), and Epstein Barr Virus (EBV) DNA copy number (P = 0.035). Additionally, multivariate analysis demonstrated that elevated plasma D-dimer levels were strongly associated with a poorer OS (HR 2.074, 95% CI 1.190-3.612, P = 0.010), but not DMFS. After adjustment for other variables, DA stratification acted as an independent prognostic marker for OS (P = 0.038) and DMFS (P = 0.031) in patients with NPC, when combined with albumin levels. Conclusions: Increased plasma D-dimer levels accurately predict poor OS and may be an effective independent prognostic factor in patients with NPC. Moreover, in conjunction with serum albumin, DA may serve as a factor in predicting OS and DMFS.

Development and external validation of a nomogram for predicting the overall survival of patients with stage II nasopharyngeal carcinoma after curative treatment.

Objective: To facilitate decision-making support for individual patients, development and external validation of a nomogram was undertaken to reveal prognostic factors and predict the value of concurrent chemoradiotherapy (CCRT) compared with radiotherapy (RT) for stage-II nasopharyngeal carcinoma (NPC) patients. Methods: Clinical data of 419 and 309 patients with American Joint Committee on Cancer (2017) stage-II NPC in two institutions in China were collected retrospectively. Overall survival (OS) and progression-free survival were compared using Kaplan-Meier estimates. Cox regression analysis was used to identify the prognostic factors for building the nomogram. Predictive accuracy and discriminative ability were measured using the Concordance Index. Results: Finally, there were 24 and 20 deaths in the development and validation group, respectively. Patients with stage T2N1, N1 stage, involvement of retropharyngeal and unilateral cervical lymph nodes, and who had RT alone had worse OS (P=0.019, 0.035, 0.003 and 0.010, respectively; log-rank test) than patients with stage T1N1 and T2N0, N0 stage, involvement of retropharyngeal or unilateral cervical lymph nodes, and CCRT, respectively. After multivariate analysis of the training set, age, neutrophil-to-lymphocyte ratio, therapy type, and pretreatment plasma concentration of Epstein-Barr virus DNA were independent prognostic factors of OS. A nomogram was established externally by involving all the factors stated above. The Concordance Index for the established nomogram to predict the OS of the training set was 0.793 (95% CI 0.689-0.897), and 0.803 (95% CI 0.696-0.910) in the validation set. Conclusion: These data suggest that the nomogram was validated externally, could predict long-term outcome accurately, and enable accurate stratification of risk groups for stage-II NPC. Our model facilitated individualized care of NPC patients.

Omega-3 Fatty Acids, Depressive Symptoms, and Cognitive Performance in Patients With Coronary Artery Disease: Analyses From a Randomized, Double-Blind, Placebo-Controlled Trial.

This trial investigated the efficacy of omega-3 polyunsaturated fatty acid (n-3 PUFA) treatment for improving depressive symptoms and cognitive performance in patients with coronary artery disease (CAD) participating in cardiac rehabilitation. Patients with CAD aged 45 to 80 years were randomized to receive either 1.9-g/d n-3 PUFA treatment or placebo for 12 weeks. Depressive symptoms were measured using the Hamilton Depression Rating Scale (HAM-D, primary outcome) and the Beck Depression Inventory II (BDI-II). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria were used to identify a depressive episode at baseline. Cognitive performance was measured using a standardized battery for vascular cognitive impairment. In 92 patients (age, 61.7 ± 8.7 y; 76% male, 40% depressed; HAM-D, 6.9 ± 5.9; BDI-II, 12.3 ± 10.9; n = 45 n-3 PUFA, n = 47 placebo), depression decreased (HAM-D, F3,91 = 2.71 and P = 0.049; BDI-II, F3,91 = 6.24 and P < 0.01), and cognitive performance improved (attention/processing speed, F1,91 = 5.57, P = 0.02; executive function, F1,91 = 14.64, P < 0.01; visuospatial memory, F1,91 = 4.01, P = 0.04) over cardiac rehabilitation. Omega-3 PUFA treatment increased plasma eicosapentaenoic acid (F1,29 = 33.29, P < 0.01) and docosahexaenoic acid (F1,29 = 15.29, P < 0.01) concentrations but did not reduce HAM-D (F3,91 = 1.59, P = 0.20) or BDI-II (F3,91 = 0.46, P = 0.50) scores compared with placebo. Treatment did not improve cognitive performance; however, n-3 PUFAs significantly increased verbal memory compared with placebo in a subgroup of nondepressed patients (F1,54 = 4.16, P = 0.04). This trial suggests that n-3 PUFAs do not improve depressive and associated cognitive symptoms in those with CAD. The possible benefits of n-3 PUFAs for verbal memory may warrant investigation in well-powered studies.

Deviation analysis of atlantoaxial pedicle screws assisted by a drill template.

Although C1-C2 pedicle screw fixation provides an excellent fusion rate and rigid fixation, this technique has a potential risk. It is essential to develop an accurate screwing method to avoid this neurovascular injury. To develop and validate the accuracy of a novel navigational template for C1-C2 pedicle screw placement in cadaveric specimens, computed tomography scans with 1-mm-wide cuts were obtained of 32 cadaveric cervical specimens. The authors developed 64 three-dimensional full-scale templates that were created by computer modeling with a rapid prototyping technique from the computed tomography data. Drill templates were constructed with a custom trajectory for each level and side. The drill templates were used to guide the establishment of a pilot hole for screw placement. The average distances between ideal and actual entry points of the C1 pedicle screws in the x, y, and z axes were 0.16±0.46 mm, 0.11±0.52 mm, and -0.01±0.54 mm, respectively, on the left side and 0.11±0.49 mm, 0.01±0.56 mm, and -0.09±0.59 mm, respectively, on the right side. The average distances between ideal and actual entry points of the C2 pedicle screws in the x, y, and z axes were 0.05±0.54 mm, 0.20±0.59 mm, and -0.06±0.58 mm, respectively, on the left side and 0.17±0.55 mm, 0.1±0.58 mm, and -0.01±0.49 mm, respectively, on the right side. Factors related to human error and imprecision are responsible for most malpositioning of instrumentation. The rapid prototyping drill template for C1-C2 screw placement is described to minimize human error, although it introduces error related to computer software and variation in manufacturing.

Deviation analysis of C1-C2 transarticular screw placement assisted by a novel rapid prototyping drill template: a cadaveric study.

STUDY DESIGN: Cadaveric study. OBJECTIVE: The aim of this study was to develop and validate the accuracy of a novel navigational template for C1-C2 transarticular screw (C1C2TAS) placement in cadaveric specimens. SUMMARY OF BACKGROUND DATA: Currently, C1C2TASs are primarily positioned using a free-hand technique or under fluoroscopic guidance. Screw placement is challenging owing to the small size of the C2 isthmus, which places technical demands on the surgeon. Screw insertion carries a potential risk of neurovascular injury, magnifying the importance of using a precise technique for screw insertion. MATERIALS AND METHODS: Computed tomography (CT) scans with 0.625-mm wide cuts were obtained from the 32 cadaveric cervical specimens. The CT data were imported into a computer navigation system. We developed 32 three-dimensional drill templates, which were created by computer modeling using a rapid prototyping technique based on the CT data. We constructed drill templates using a custom trajectory for each level and side based on specimen anatomy. The drill templates were used to guide establishment of a pilot hole for screw placement. The entry point and angular direction of the intended screw positions and inserted screw positions were measured by comparing postoperative and preoperative images after the coordinate axes were synchronized. RESULTS: The average displacement of the entry point of the left and right C1C2TAS in the x-, y-, and z-axis was 0.13±0.90 mm, 0.50±1.50 mm, and -0.22±0.71 mm on the left, and 0.21±1.03 mm, 0.46±1.55 mm, and -0.29±0.58 mm on the right. There was no statistically significant difference in entry point and direction between the intended and actual screw trajectory. CONCLUSIONS: The small deviations seen are likely due to human error in the form of small variations in the surgical technique and use of software to design the prototype. This technology improves the safety profile of this fixation technique and should be further studied in clinical applications.

[A novel computer-assisted drill template for atlantoaxial pedicle screw placement:a cadaveric experimental study].

OBJECTIVE: To validate the accuracy of atlanto-axial pedicle screw placement with a rapid prototyping drill guide template and analyze the factors of screw deviations. METHODS: Computed tomography (CT) scan was performed in 16 cervical specimens. And three-dimension cervical vertebrae was reconstructed by Mimics software. The ideal trajectory for atlanto-axial pedicle screws was designed with a complementary basal template for posterior surface of atlanto-axial corresponding anatomical structure. Then drill guide template was materialized in a rapid prototyping machine. These templates were used during operation. The entry point and ideal and actual trajectories were measured after matching the positions of preoperative and postoperative specimens at designated coordinate axis. RESULTS: The average displacement of entry point of left and right C1 pedicle screw in x, y, z axis was (0.14 ± 0.59),(0.31 ± 1.32), (0.27 ± 0.68), (0.23 ± 0.55), (0.43 ± 1.21) and (0.30 ± 0.72) mm. And the average displacement of entry point of left and right C2 pedicle screw in m, n, p axis was (0.25 ± 0.85), (0.52 ± 1.52), (-0.27 ± 0.67), (0.44 ± 0.87), (0.38 ± 1.48), (-0.14 ± 0.62) mm.No statistically significant difference existed (P > 0.05) in deviation of entry point and between ideal and actual trajectories. CONCLUSION: Both human handling and inherent hardware and software factors are main reasons for a deviation of C1-C2 pedicle screw placement assisted by a rapid prototyping drill guide template.Ease of operation and individualized design are the advantages of drill guide template so as to greatly improve the precision of screw placement and reduce screw deviation.

Deviation analysis of C2 translaminar screw placement assisted by a novel rapid prototyping drill template: a cadaveric study.

PURPOSE: The goal of this study is to evaluate the accuracy of patient-specific CT-based rapid prototype drill templates for C2 translaminar screw insertion. METHODS: Volumetric CT scanning was performed in 32 cadaveric cervical spines. Using computer software, the authors constructed drill templates that fit onto the posterior surface of the C2 vertebrae with drill guides to match the slope of the patient's lamina. Thirty-two physical templates were created from the computer models using a rapid prototyping machine. The drill templates were used to guide drilling of the lamina and post-operative CT images were obtained. The entry point and direction of the planned and inserted screws were measured and compared. RESULTS: Sixty-four C2 translaminar screws were placed without violating the cortical bone of a single lamina. The bilateral average transverse angle of intended and actual screw for C2TLS was 56.60 ± 2.22°, 56.38 ± 2.51°, 56.65 ± 2.24°, 56.39 ± 2.45°. The bilateral mean coronal angle of the planned and actual screw for C2TLS was 0°, 0°, -0.07 ± 0.32°, 0.12 ± 0.57°. The average displacement of the entry point of the superior and inferior C2TLS in the x, y, z axis was 0.27 ± 0.85, 0.49 ± 1.46, -0.28 ± 0.69, 0.43 ± 0.88, 0.38 ± 1.51, 0.23 ± 0.64 mm. CONCLUSION: The small deviations seen are likely due to human error in the form of small variations in the surgical technique and use of software to design the prototype. This technology improves the safety profile of this fixation technique and should be further studied in clinical applications.

Enantioselective synthesis of Amaryllidaceae alkaloids (+)-vittatine, (+)-epi-vittatine, and (+)-buphanisine.

Cat. on a hot tin roof: Enantioselective catalytic Michael addition of α-cyanoketones to acrylates under bifunctional organocatalysis was used to construct the unique arylic all-carbon quaternary stereocenter, which is synthetically crucial in the chemical synthesis of optically pure cis-aryl hydroindole alkaloids. The protocol offers an asymmetric route to (+)-vittatine, (+)-epi-vittatine, and (+)-buphanisine.

Pretreatment body mass index as an independent prognostic factor in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy: findings from a randomised trial.

OBJECTIVE: To investigate the relationship between the pretreatment body mass index (BMI) and the clinical outcomes in patients with locoregionally advanced nasopharyngeal carcinoma treated with combination of chemotherapy and radiotherapy. METHODS: From August 2002 to April 2005, 400 patients with stage III or stage IVa nasopharyngeal carcinoma were recruited for a randomised clinical trial of induction chemotherapy combined with radiotherapy or concurrent chemoradiotherapy. The patients were divided into four groups of underweight (BMI<18.5kg/m(2)), normal weight (BMI 18.5-22.9kg/m(2)), overweight (BMI 23.0-27.4kg/m(2)) or obese (BMI≥27.5kg/m(2)) according to the World Health Organization classifications for Asian populations. The differences in the long-term survival, of these four BMI groups were analysed. RESULTS: The 5-year failure-free survival rates for the underweight, normal weight, overweight and obese groups were 44%, 61%, 68% and 73%, respectively (p=0.014), and the 5-year overall survival rates were 51%, 68%, 80% and 72% (p=0.001), respectively. BMI was a strongly favoured prognostic factor of overall survival and failure-free survival in a Cox regression model. CONCLUSIONS: Pretreatment body mass index was a simple, reliable independent prognostic factor for patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.

Value of transrectal ultrasonography for tumor node metastasis restaging in patients with locally advanced rectal cancer after neoadjuvant chemoradiotherapy.

OBJECTIVE: To explore the value of transrectal ultrasonography (TRUS) for tumor node metastasis (TNM) restaging for patients with locally advanced rectal cancer after neoadjuvant chemoradiotherapy (neo-CRT). METHODS: One hundred and forty-nine patients with locally advanced rectal cancer (cT3-4 or cN+) who underwent TRUS after neo-CRT were retrospectively reviewed. TRUS restaging was compared with the results of post-operative pathological TNM findings. RESULTS: After neo-CRT, the accuracy of TRUS for diagnosing T-staging was 30.9%, with 60.4% (90/149) of cases overestimated. The sensitivity of TRUS for T-staging (T0 vs T1 vs T2 vs T3 vs T4) were 16.3%, 0%, 12.5%, 42.6% and 75.0%, respectively. The accuracy of TRUS for diagnosing N-staging after neo-CRT was 81.2%, with the sensitivities of N0 and N+ were 93.3% and 31.0%, respectively. After neo-CRT, 27.5% (41/149) of patients achieved pathologically complete response (pCR). The sensitivity, specificity, positive predictive value and negative predictive values of TRUS for pCR were 17.1%, 99.1%, 87.5% and 75.9%, respectively. CONCLUSIONS: TRUS can be applied for restaging T4 and N0, and has potential for screening out patients with pCR in those with locally advanced rectal cancer after neo-CRT, although some stages are overestimated for T-staging and its sensitivity for predicting pCR is low.

Evaluation of biological properties of electron beam melted Ti6Al4V implant with biomimetic coating in vitro and in vivo.

BACKGROUND: High strength porous titanium implants are widely used for the reconstruction of craniofacial defects because of their similar mechanical properties to those of bone. The recent introduction of electron beam melting (EBM) technique allows a direct digitally enabled fabrication of patient specific porous titanium implants, whereas both their in vitro and in vivo biological performance need further investigation. METHODS: In the present study, we fabricated porous Ti6Al4V implants with controlled porous structure by EBM process, analyzed their mechanical properties, and conducted the surface modification with biomimetic approach. The bioactivities of EBM porous titanium in vitro and in vivo were evaluated between implants with and without biomimetic apatite coating. RESULTS: The physical property of the porous implants, containing the compressive strength being 163 - 286 MPa and the Young's modulus being 14.5-38.5 GPa, is similar to cortical bone. The in vitro culture of osteoblasts on the porous Ti6Al4V implants has shown a favorable circumstance for cell attachment and proliferation as well as cell morphology and spreading, which were comparable with the implants coating with bone-like apatite. In vivo, histological analysis has obtained a rapid ingrowth of bone tissue from calvarial margins toward the center of bone defect in 12 weeks. We observed similar increasing rate of bone ingrowth and percentage of bone formation within coated and uncoated implants, all of which achieved a successful bridging of the defect in 12 weeks after the implantation. CONCLUSIONS: This study demonstrated that the EBM porous Ti6Al4V implant not only reduced the stress-shielding but also exerted appropriate osteoconductive properties, as well as the apatite coated group. The results opened up the possibility of using purely porous titanium alloy scaffolds to reconstruct specific bone defects in the maxillofacial and orthopedic fields.

[Application of computer-assisted navigation in oral and maxillofacial surgery: retrospective analysis of 104 consecutive cases].

PURPOSE: To evaluate the application of computer-assisted navigation system (CANS) in Oral and Maxillofacial Surgery. METHODS: One hundred and four patients were included in this study, including 34 with zygomatic-orbital-maxillary fracture, 27 with unilateral TMJ ankylosis, 29 with fibrous dysplasia, 9 with mandibular angle hypertropia, 3 with cartilage and bone tumors and 2 with facial foreign bodies. CT scan was performed and the data was saved as Dicom (digital imaging and communications in medicine) format. With preoperative planning and 3-dimensional simulation, normal anatomic structures of the affected side were created by superimposing and mirroring the unaffected side. The osteotomy lines, amount and range of resection, the reduction position of bony segments and the reconstruction morphology was determined and displayed. All surgeries were performed under the guidance of navigation system. The accuracy of navigation was evaluated by comparing the postoperative CT three-dimensional model with preoperative surgical planning. RESULTS: Through registration, an accurate match between the intra-operative anatomy and the CT images was achieved. With the guidance of navigation, anatomic structures and the position of surgical instruments were shown real-time on the screen. No complications occurred in all patients and the systematic error was within 1 mm. Good coincidence with preoperative planning was achieved for osteotomy lines, the amount of resection and reduction of fractures. The mean error between virtual and real results was (1.46±0.24) mm. All patients healed uneventfully and facial symmetry was improved. CONCLUSIONS: With the ability of preoperative planning, surgical simulation and postoperative prediction, CANS shows its great value in improving the accuracy of oral and maxillofacial surgery, reducing trauma and restoring facial symmetry. It is regarded as a valuable and safe technique in this potentially complicated procedure.