[Efficacy and safety of endovascular therapy after 24 h from ischemic stroke onset in patients with acute anterior circulation ischemic stroke].

Objective: To explore the effectiveness and safety of endovascular treatment (EVT) for patients with acute anterior circulation ischemic stroke with symptom onset exceeding 24 h. Methods: In this retrospective cohort study, data were extracted from patients who underwent endovascular treatment for acute anterior circulation ischemic stroke at the First Hospital of Jilin University from February 2019 to April 2022. A total of 569 patients were included, with a mean age of 63 (54-70) years. Among them, 398 (69.9%) were male. The patients were divided into two groups based on symptom onset time:>24 h group and≤24 h group. Propensity score matching (PSM) was used to match the patients in a 1︰1 ratio between the>24 h group and the≤24 h group. Logistic regression was used to evaluate the impact of symptom onset time on outcome events. Results: Before PSM, compared with≤24 h group, the>24 h group had a younger age [56 (48, 64) vs. 64 (55, 70), Z=-3. 60, P<0.001]; lower proportion of prior atrial fibrillation [1.8% (1/57) vs. 21.1% (108/512), χ2=12.39, P<0.001]; lower proportion of wake-up stroke [7.0% (4/57) vs. 27.7% (142/512), χ2=11.54, P<0.001]; lower baseline NIHSS score [11.0 (7.5, 14.0) vs. 13.0 (10.0, 16.0), Z=-3.22, P<0.001]; and a higher American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR) grading (P<0.001). After PSM, there were no significant differences in baseline characteristics between the two groups. There was no significant difference in the proportion of patients with a modified Rankin Scale (mRS) score≤2 at 90 days after surgery between the two groups (before matching: 42.0% vs. 40.4%, OR=0.745, 95%CI 0.407-1.362, P=0.339; after matching: 51.8% vs. 39.3%, OR=0.511, 95%CI 0.212-1.236, P=0.136). No significant differences were observed in the incidence of any safety outcomes between the>24 h group and the≤24 h group. Conclusion: For patients with acute anterior circulation ischemic stroke with symptom onset exceeding 24 h, EVT is feasible after strict radiological screening and has similar safety and effectiveness as for patients with symptom onset under 24 h.

[Diagnostic value of contrast-enhanced ultrasound in hepatic epithelioid hemangioendothelioma].

Objective: To investigate the features of contrast-enhanced ultrasound (CEUS) in hepatic epithelioid hemangioendothelioma (HEHE) in order to improve the preoperative diagnosis rate. Methods: CEUS images of 32 pathologically-proven cases of hepatic epithelioid hemangioendothelioma from January 2004 to August 2021 were collected. Lesions were analyzed to observe the features of enhancement mode, enhancement intensity, and distinct enhancement phases. Results: Among the 32 cases, one had a solitary lesion, 29 had multiple lesions, and two had diffuse-type lesions. Contrast-enhanced ultrasound revealed a total of 42 lesions in 32 cases. In terms of arterial phase enhancement, 18 lesions had overall enhancement, six lesions had uneven dendritic enhancement, 16 lesions had rim-like enhancement, and two lesions had just slight peripheral spot enhancement around the lesions. Among the three cases, there were multiple lesions that had overall enhancement and ring enhancement. In terms of the enhancement phase, 20 lesions showed "fast progression", 20 lesions showed "same progression", and two lesions showed "slow progression". During the late arterial or early portal venous phases with rapid washout, all lesions manifested as hypoechoic. With peaked enhanced intensity, 11 lesions had a lower enhancement intensity than the surrounding normal liver parenchyma; 11 lesions had the same enhancement degree as the surrounding normal liver parenchyma; and 20 lesions had a higher enhancement degree than the surrounding normal liver parenchyma. All 16 ring-enhancing lesions had marked hyperenhancement. In the typical enhancing lesions, four showed hyperenhancement, five showed low enhancement, and nine showed isoenhancement. In the dendrite-enhancing lesions, there were two isoenhancing and four hypoenhancing. Contrast-enhanced ultrasound delineated the boundaries of all lesions more clearly than two-dimensional ultrasound. Conclusion: Contrast-enhanced ultrasound has certain value in the diagnosis of hepatic epithelioid hemangioendothelioma.

[Clinicopathologic analysis of micro and mini parotid gland tumors].

OBJECTIVE: To investigate the clinicopathological characteristics of micro and mini parotid gland tumors and to provide reference for their clinical diagnosis and treatment. METHODS: Patients with parotid gland tumors treated in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from December 2012 to April 2020 were selected. Relevant clinical data of the patients with tumor diameter ≤20 mm detected by preoperative CT were collected to analyze the clinicopathological characteristics and prognosis of micro and mini parotid gland tumors. And the collected data were divided into two groups with diameter 11-20 mm and diameter ≤10 mm according to tumor diameter measured by preoperative CT. The clinicopathological differences between the two groups were statistically analyzed. RESULTS: A total of 2 067 patients with primary epithelial parotid gland tumors were collected, and 685 patients with tumor diameter ≤20 mm were examined by CT, accounting for 33.1%. The ratio of male to female patients with micro and mini parotid gland tumors was 1 ∶1.93, the average age was (45.3±13.8) years (12-83 years), and the median course of disease was 12 months (1 week to 30 years). Among them, 635 cases (92.7%) were benign tumors, 50 cases (7.3%) were malignant tumors, and the ratio of benign to malignant was 12.7 ∶1. The most common benign tumor was pleomorphic adenoma, and the most common malignant tumor was mucoepidermoid carcinoma. The micro and mini parotid gland tumors were divided into 11-20 mm group (n=611) and ≤10 mm group (n=74), the clinical characteristics comparison of the two groups of gender ratio, average age, course of di-sease had no statistical difference (P>0.05). In the 11-20 mm diameter group, the percentage of benign and malignant tumor was 92.8% (567/611) and 7.2% (44/611) respectively, and the ratio of benign to malignant tumors was 12.9 ∶1. In the ≤10 mm diameter group, the percentage of benign and malignant tumor was 91.9% (68/74) and 8.1% (6/74) respectively, and the ratio of benign to malignant tumors was 11.3 ∶1. There was no significant difference between the two groups (P>0.05). Fifty patients with malignant tumor were followed up for the median follow-up period of 39.5 months (1-91 months). Local recurrence occurred in 2 patients with one death. The overall 2-year survival rate was 93.7% and the 5-year survival rate was 89.3%. CONCLUSION: The majority of micro and mini parotid gland tumors was benign lesion. There was a good prognosis for micro and mini parotid gland carcinoma. Early surgical treatment was recommended for micro and mini parotid gland tumors.

[Clinical analysis of selective tracheostomy necessary for patients undergoing head and neck surgery with free flap reconstruction].

OBJECTIVE: To discover the factors that may affect the use of selective tracheostomy among patients who have undergone head and neck surgeries with free flap reconstruction, so that the patients will not need tracheostomy nor receive the unnecessary treatment. METHODS: Five hundred and thirty-three patients who had undergone head and neck surgery with free flap reconstruction operated by the same team of surgery at Department of Oral and Maxillofacial Surgery at Peking University School of Stomatology from 2015 to 2016 were reviewed. Three hundred and twenty-one (60.2%) of these patients underwent selective tracheostomy. All the patients' demographic information, operation-related information, prior treatments, comorbidities and complications were recorded and analyzed. RESULTS: The patients with defects of the tongue, mouth floor, oropharynx and bilateral mandible, who underwent neck dissection and with previous radiotherapy and smoking habit were more likely to get selective tracheostomy. Usage of bulky soft tissue flap might also add to the risk of airway obstruction and the need of selective tracheostomy, while other factors were not significantly related to the risk of postoperative airway obstruction and the patients could be kept safe without selective tracheostomy. Most cases without tracheostomy were kept safe except one case, while 8.39% of the patients with tracheostomy suffered from tracheostomy related complications, mainly pneumonia and hemorrhage of the tracheostomy wound, yet none led to serious consequences or even death. CONCLUSION: Selective tracheostomy is not necessary for patients who have undergone head and neck surgeries with free flap reconstruction except that there are defects at the tongue, oropharynx and mandible. Neck dissection, bulky soft tissue flap reconstruction, previous radiotherapy and smoking habit may also add to the risk of postoperative airway obstruction, while a favorable decision would involve a combination of all the above factors to assure the safety of the postoperative airway for the patients undergone head and neck surgeries with free flap reconstruction.

[Application of diffusion-weighted magnetic resonance imaging in evaluating the efficacy of radiotherapy and chemotherapy for esophageal cancer].

This study was a prospective single arm trial conducted in Zhejiang Jinhua Guangfu hospital from February 2018 to June 2020. A total of 39 patients (32 males and 7 females) with esophageal cancer, aged from 44 to 82 (69±9) years were enrolled. Diffusion weighted magnetic resonance imaging(MR-DWI) was implemented to evaluate the changes of apparent diffusion coefficient(ADC) value before and after chemoradiotherapy. The results showed that the ADC value after chemoradiotherapy was higher than that before treatment[(2.03±0.42)×10⁻³ mm 2/s vs (1.60±0.28)×10⁻³ mm2/s], and there was a positive correlation between the increase of ADC value and the prognosis of patients.

[The study of the association between lung cancer screening and smoking behavior change].

The smoking cessation rate of 1 314 people at high risk of lung cancer in the area of lung cancer screening and early diagnosis and early treatment in Sichuan Province increased from 22.37% at baseline to 41.78% after screening (χ²=227.97, P<0.001), and the smoking amount of persistent smokers decreased from 20 cigarettes per day to 15 cigarettes per day (t=11.76, P<0.001). Those with positive results in lung cancer screening were more likely to quit smoking or continue to quit smoking. Male, younger age or lower education level would increase the risk of continuous smoking or relapse (P<0.05).

[Application of mixed reality technique for the surgery of oral and maxillofacial tumors].

OBJECTIVE: To explore the application of mixed reality technique for the surgery of oral and maxillofacial tumors. METHODS: In this study, patients with a diagnosis of an oral and maxillofacial tumor who were referred to Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from December 2018 to January 2020 were selected. The preoperative contrast-enhanced computed tomography data of the patients were imported into StarAtlas Holographic Medical Imaging System (Visual 3D Corp., Beijing, China). Three-dimensional (3D) model of tumor and key structures, such as skeleton and vessels were reconstructed to three-dimensionally present the spatial relationship between them, followed with the key structures delineation and preoperative virtual surgical planning. By using mixed reality technique, the real-time 3D model was displayed stereotactically in the surgical site. While keeping sterile during operation, the surgeon could use simple gestures to adjust the 3D model, and observed the location, range, and size of tumor and the key structures adjacent to the tumor. Mixed reality technique was used to assist the operation: 3D model registration was performed for guidance before tumor excision; intraoperative real-time verification was performed during tumor exposure and after excision of the tumor. The Likert scale was used to evaluate the application of mixed reality technique after the operation. RESULTS: Eight patients underwent mixed reality assisted tumor resection, and all of them successfully completed the operation. The average time of the 3D model registration was 12.0 minutes. In all the cases, the surgeon could intuitively and three-dimensionally observe the 3D model of the tumor and the surrounding anatomical structures, and could adjust the model during the operation. The results of the Likert scale showed that mixed reality technique got high scores in terms of perceptual accuracy, helping to locate the anatomical parts, the role of model guidance during surgery, and the potential for improving surgical safety (4.22, 4.19, 4.16, and 4.28 points respectively). Eight patients healed well without perioperative complications. CONCLUSION: By providing real-time stereotactic visualization of anatomy of surgical site and guiding the operation process through 3D model, mixed reality technique could improve the accuracy and safety of the excision of oral and maxillofacial tumors.

[Application of computer-assisted design for anterolateral thigh flap in oral and maxillofacial reconstruction].

OBJECTIVE: To investigate the feasibility and accuracy of using digital technology to design anterolateral thigh flap (ALTF) in oral and maxillofacial defect reconstruction. METHODS: Ten cases underwent oral and maxillofacial defects reconstruction with ALTFs in Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from June 2019 to Oct. 2019 were enrolled. There were 7 males and 3 females with the mean age of 47.1 years. Preoperative high frequency color Doppler ultrasound examination was performed to detect the perforators of ALTF. CT data of the thigh was imported in DICOM (digital imaging and communications in medicine) format to the Proplan CMF 3.0 software (Materalise, Belgium), then virtual harvest of ALTF was performed according to the points of perforators detected by high frequency color Doppler ultrasound and the virtual flap volume was calculated by Proplan CMF 3.0 software. ALTF was harvested followed by preoperative virtual design, and the actual flap volume of ALTF was measured by the draining method during the surgery. Finally, the accuracy rate of using high frequency color Doppler ultrasound to detect perforators of ALTFs was calculated, and the differences between the virtual flap volume measured by Propaln CMF 3.0 software and the actual volume of ALTF by the draining method were compared using paired samples T test. RESULTS: Fifteen perforators in the flaps area of 10 patients who underwent oral and maxillofacial defects reconstruction with ALTFs were detected by high frequency color Doppler ultrasound, and 16 perforators were identified during the surgery, with the accuracy rate of 87.5%. The flaps size ranged from 5 cm×7 cm to 8 cm×15 cm, all the 10 flaps survived. The donor sites were primarily closed without skin graft, and no surgery complication was found on the donor site. The mean flap volume measured by Propaln CMF 3.0 software was 71.4 cm³ (range: 36.1-188.4 cm³), and the mean volume measured by the draining method was 70.7 cm³ (range: 38.3-172.5 cm³). There was no significant difference between the virtual flap volume measured by Propaln CMF 3.0 software and the actual volume measured by draining method (t=0.318; P=0.758). CONCLUSION: Preoperative virtual design of ALTF has good feasibility and accuracy and can be used to guide the harvest of ALTF during operation.

Effect of pH on dissociation of casein micelles in yak skim milk.

The dissociation of yak casein (CN) micelles was evaluated by scanning electron microscopy, particle size, fluorescence properties, and soluble mineral and CN molecule content at pH 4.6 to 8.2. The results showed that the size of CN micelles remained constant with decreasing pH from 8.2 to 5.8 but sharply increased at pH ≤5.4. Casein micelles began to aggregate at pH 5.4, and the serum magnesium, potassium, iron, zinc, copper, and manganese levels had their minimum values at this pH level. During acidification, colloidal calcium phosphate dramatically disassociated from yak CN micelles, but the soluble CN monomer content decreased slightly. During alkalization, the soluble calcium and phosphorus content decreased below pH 6.8 but increased with pH increases from 6.8 to 8.2. However, the soluble CN content increased markedly during alkalization. The emission wavelength of 8-anilino-1-naphthalenesulfonic acid sodium salt fluorescence decreased during both acidification and alkalization from pH 6.6, whereas the opposite was found for intrinsic fluorescence.

[Physiological characteristics of Echinococcus and their association with interventions against echinococcosis].

Alveolar and cystic echinococcosis are important zoonotic diseases caused by the dog/fox tapeworms of Echinococcus granulosus and E. multilocularis, which are distributed in almost whole the world. The diseases remarkably impact on the people's health and economic development of communities. Echinococcus tapeworms need two mammalian animals to complete their lifecycle. The worms undergo different developmental stages (adult, egg/oncosphere, cyst, and protoscolex). Each stage has its own distinct physiological characteristics. We summarize the characteristics and emphasize that some features that strongly impact on design of control program. Based on the lifecycle of these worms, two stages are infectious, one is egg the only stage for primarily infecting humans and intermediate host, and another stage is protoscolex, the only stage for infecting the definite hosts of the worms. Eggs are produced by the adult worms parasitized in the intestine of definite hosts. It takes 45 days for eggs becoming mature in dogs. With this feature of the tapeworm, New Zealand and Tasmania in Australia designed control program for deworming 8 times annually with an interval between deworms at 45 days. E. multilocularis takes 28-30 days in dog/fox producing mature eggs. Given that co-existence of E. granulosus and E. multilocularis in western China, a control measure so called "prepatent deworming control measure" has been used in these endemic areas with dosing worms in dogs every month. It normally takes 12-15 months for producing protosocleces in E. granulosus cysts in sheep. If meat markets attract most lambs, that is an effective measure for controlling cystic echinococcosis given that there are no protoscoleces produced from those lambs. In addition, Echinococcus has its own unique biological characteristics, such as sexual reproduction and asexual reproduction, single-cell layer structure of cyst, bidirectional development of protoscoleces induced by bile salts, and long term of infection causing host asymptomatic reaction make the parasites a models for addressing some biological and biomedical issues. And more, hydatid cyst fluid is the antigen resource for identifying diagnostic reagents; the specific gene expressed in oncospheres has been developed as an effective vaccine used for control program. With the development and application of high-throughput omics, including genomics, transcriptomics and proteomics, we can use the physiological characteristics of Echinococcus for searching diagnostic reagents, developing preventive vaccines and identify new drug targets.

Diabetes mellitus and risk of anastomotic leakage after esophagectomy: a systematic review and meta-analysis.

Diabetes mellitus has the probability to impair the anastomotic healing and cause postesophagectomy anastomotic leakages but previous studies showed controversial results. This review aims to summary the impact of diabetes mellitus on the risk of anastomotic leakage after esophagectomy. We searched the PubMed and EMBASE databases to recognize English articles that met our eligibility criteria. Odds ratio with 95% confidence interval serves as the appropriate summarized statistic. Sensitivity analysis, meta-regression analysis, and publication bias tests were also performed to perceive potential bias risks. Finally, 16 observational studies with 12359 surgical patients were included. An overall analysis identified that diabetes mellitus was significantly associated with the risk of anastomotic leakage after esophagectomy (odds ratio = 1.63; 95% confidence interval = 1.25-2.12; P < 0.001). Further subgroup analysis showed a significant impact of diabetes mellitus in surgical populations from the Europe and America (odds ratio = 1.42; 95% confidence interval = 1.22-1.65; P < 0.001) but not in the Asian populations (odds ratio = 2.27; 95% confidence interval = 0.86-6.05; P = 0.1). The robustness of these estimates was confirmed by meta-regression analysis and sensitivity analysis. No significant publication bias exists between studies. In conclusion, this systematic review demonstrates that diabetes mellitus can be a significant risk factor of anastomotic leakage for patients undergoing esophagectomy. Our findings need to be further confirmed and modified by more well-designed worldwide multivariable analyses in the future.

Feeding different dietary protein to energy ratios to Holstein heifers: effects on growth performance, blood metabolites and rumen fermentation parameters.

Eighteen Chinese Holstein heifers average age 230 ± 14 days were allocated to 1 of 3 dietary crude protein (CP) to metabolizable energy (ME) ratios to examine the effects on growth performance, blood metabolites and rumen fermentation parameters with 90-days experiment. Three different dietary CP:ME ratios were targeted based on the formulation of dietary CP contents of 10.85%, 12.78% and 14.63% on dry matter (DM) basis with similar ME contents (10.42 MJ/kg DM), which were categorized as low, medium and high dietary CP:ME ratios. The actual CP:ME ratios obtained in this study significantly increased from low to high CP:ME ratio groups with a value of 10.59, 11.83 and 13.38 g/MJ respectively. Elevated CP:ME ratios significantly increased CP intake (kg/day) and feed efficiency (FE) which was defined as dry matter intake as a proportion of average daily gain (ADG), whereas little difference was observed in body weight (kg), ADG (kg/day), DM intake (kg/day) and ME intake (MJ/day) among the three different CP:ME ratio groups. Increasing dietary CP to ME ratios significantly increased CP digestibility, whereas digestibility of DM and gross energy remained constant in the current experiment. Blood urea nitrogen and insulin-like growth factor-1 linearly increased with increasing dietary CP:ME ratios. There was significantly dietary treatment effect on rumen fermentation parameters including acetate, propionate, butyrate and total volatile fatty acids. Therefore, this study indicated that increasing dietary CP levels with similar energy content contributed to increased protein intake and its digestibility, as well as FE. Holstein heifers between 200 and 341 kg subjected to 13.38 dietary CP:ME ratio showed improved feed efficiency, nutrient digestibility, some blood metabolites and rumen fermentation characteristics for 0.90 kg/day rate of gain.

[Application of three-dimensional reconstruction of the enhanced CT with iPlan CMF software in head and neck neoplasms].

OBJECTIVE: Three-dimensional reconstruction of the enhanced CT is increasingly becoming a valuable tool in head and neck neoplasms. The aim of this study is to reconstruct three-dimensional imaging of tumor and its surrounding important anatomical structure using iPlan CMF software, and to investigate the application of three-dimensional tumor mapping technique for the diagnosis and treatment of the head and neck neoplasms. METHODS: In the study, 13 cases with head and neck tumors in Department of Oral and Maxilloficial Surgery, Peking University School and Hospital of Stomatology from June 2014 to June 2015 were studied using spiral CT scanning technology based on the same scanning condition. iPlan CMF software was used to read the original CT data, and surface shaded technology was applied to reconstruct the spatial relationship of the tumor, vessel and skull. The distance between the tumor and its surrounding important anatomical structure could be measured. iPlan CMF software was also used to accomplish the virtual osteotomy to expose the tumor, vessel and skull. The preoperative preparation, operative situation and postoperative complication were reviewed. RESULTS: In this study 6 patients were male and 7 female. The age range was from 23 to 65 years, and the median patient age was 50 years. The three-dimensional reconstruction image clearly demonstrated the extent of the tumor size, location, and the relation to its surrounding important anatomical structure. According to the three-dimensional image, the surgical risk of the patients was evaluated. The preoperative preparation and surgeries were successfully performed for 10 patients. Blood transfusion for 3 patients was considered before the surgery and actually accomplished during the operation. The operations for 2 patients were performed with the help of doctors from other departments. Only one patient had hoarseness because the tumor resulted from the pneumogastric nerves. For 10 patients, the average operation time was (202±135) min, and the average operation bleeding was (235±252) mL. The other 3 patients were not suitable cases for surgery. CONCLUSION: The three-dimensional reconstruction of enhanced CT image with iPlan CMF software is very helpful to make the treatment plan to avoid damaging important anatomical structures and postoperative complications.

[Clinical analysis of cervical lymph node metastasis of cN0 maxillary malignant tumor].

OBJECTIVE: To investigate the cervical lymphatic metastasis rates of clinically negative neck lymph node (cN0) maxillary malignant tumors, to compare the cervical lymphatic metastasis rates of the various pathological types, and to provide the reference for the treatment of the neck of the patients with cN0 maxillary malignant tumor. METHODS: The clinical data of 277 cases with cN0 maxillary malignant tumor, treated in the department of oral and maxillofacial surgery of Peking University School and Hospital of Stomatology from 1990 to 2010, were reviewed. The cervical lymph node metastasis and the related clinical information were recorded. The clinical information including histopathology type of the tumors, tumor grade, primary site and TNM staging, as well as other demographic and clinical data, were retrieved from the electronic medical record system (EMRS) of the hospital. The pathogenesis of cervical lymph node metastasis in maxillary malignant tumors of different histopathological types, and the factors related to lymph node metastasis of upper cervical malignancy were analyzed by SPSS 19.0 statistical software. RESULTS: The overall cervical lymph node metastasis rate of the 277 patients with cN0 maxillary malignant tumor was 15.5% (43/277). Maxillary squamous cell carcinoma (SCC) had a strong cervical lymph node metastasis tendency and the rate was 33.0%. The overall metastatic rate of adenocarcinoma was 7.6% lower than that of SCC, and the occurrence of cervical lymph node metastasis time was relatively late, but the metastasis rate of highly malignant grade salivary gland carcinoma was significantly higher than that of intermediate and low grade carcinoma (P=0.037). The metastatic rates of some highly malignant cN0 salivary gland carcinomas including adenocarcinoma, not other specified, high-grade mucoepidermoid carcinoma (MEC), and salivary duct carcinoma were exceeded 15%, while the metastasis rates of adenoid cystic carcinoma and myoepithelial carcinoma were lower. The metastasis rate of the sarcomas was very low with the rate of 4.9%. CONCLUSION: Selective neck dissection (SND) is recommended for cN0 maxillary SCC and feasible for some highly malignant cN0 salivary gland carcinomas including adenocarcinoma, not other specified, high-grade MEC, salivary duct carcinoma. The neck can be closely observed for the patients with maxillary sarcoma.

[Surgical reconstruction of maxillary defects using a computer-assisted techniques].

The maxilla is the most important bony support of the mid-face skeleton and is critical for both esthetics and function. Maxillary defects, resulting from tumor resection, can cause severe functional and cosmetic deformities. Furthermore, maxillary reconstruction presents a great challenge for oral and maxillofacial surgeons. Nowadays, vascularized composite bone flap transfer has been widely used for functional maxillary reconstruction. In the last decade, we have performed a comprehensive research on functional maxillary reconstruction with free fibula flap and reported excellent functional and acceptable esthetic results. However, this experience based clinical procedure still remainssome problems in accuracy and efficiency. In recent years, computer assisted techniques are now widely used in oral and maxillofacial surgery. We have performed a series of study on maxillary reconstruction with computer assisted techniques. The computer assisted techniques used for maxillary reconstruction mainly include: (1) Three dimensional (3D) reconstruction and tumor mapping: providing a 3D view of maxillary tumor and adjacent structures and helping to make the diagnosis of maxillary tumor accurate and objective; (2) Virtual planning: simulating tumor resection and maxillectomy as well as fibula reconstruction on the computer, so that to make an ideal surgical plan; (3) 3D printing: producing a 3D stereo model for prebending individualized titanium mesh and also providing template or cutting guide for the surgery; (4) Surgical navigation: the bridge between virtual plan and real surgery, confirming the virtual plan during the surgery and guarantee the accuracy; (5) Computer assisted analyzing and evaluating: making a quantitative and objective of the final result and evaluating the outcome. We also performed a series of studies to evaluate the application of computer assisted techniques used for maxillary reconstruction, including: (1) 3D tumor mapping technique for accurate diagnosis and treatment of maxillary tumor; (2) Maxillary reconstruction with free fibula flap used computer assisted techniques; (3) Computer assisted orbital floor reconstruction after maxillectomy. The results suggested that computer assisted techniques could significantly improve the clinical outcome of maxillary reconstruction.

[Research of the effect of bone mineral density and fracture site of the vertebrae on low back pain in elderly patients with osteoporotic vertebral compression fractures].

OBJECTIVE: To investigate the effect of bone mineral density(BMD) and fracture site of the vertebrae on low back pain in elderly patients with osteoporotic vertebral compression fractures. METHODS: From August 2011 to August 2013, a total of 107 senile patients with osteoporotic vertebral compression fractures underwent percutaneous vertebroplasty were followed up for more than 2 ( average 2.5) years in Department of orthopedics, Xuanwu Hospital, Capital Medical University. The incidence of low back pain after vertebroplasty were analyzed on visual analog scale (VAS), and the relationship between BMD, vertebral fracture site were investigated. RESULTS: A total of 18 cases(16.8%)after vertebroplasty have significant low back pain. Along with BMD decreased [(-2.90±0.91) vs (-4.87±0.52)], the VAS of low back pain increasing, which showed statistical significance difference[(-3.12±0.91) vs (4.03±1.08), P<0.05]. The site of vertebral fracture was lower, the VAS was higher. CONCLUSIONS: About 16.8% patients show obvious low back pain after vertebroplasty. BMD and Vertebral fracture site were important factors of low back pain in elderly patients with osteoporotic vertebral compression fractures after vertebroplasty.

Chemical composition of yak colostrum and transient milk.

The objective of this study was to assess the changes in the chemical composition of yak colostrum and transient milk. Samples were collected from 12 yaks on days 1, 2, 3, 4, 5, 6 and 7 post-partum (PP). The gross composition, nitrogen fraction distribution, amino acid (AA) profile and fatty acid (FA) profile were analysed. All the components decreased rapidly during the first 3 days except lactose which increased. The ratio of whey protein to casein protein decreased from 46:54 to 17:83 during the first 7 days PP. The content of all the AAs decreased, while the percentages of eight essential AAs in protein of samples increased during the study period. Monounsaturated FAs and polyunsaturated FAs decreased in the first 7 days PP, whereas saturated FAs increased. In conclusion, the changes in chemical composition were remarkable during the first 3 days. The slight variations, happened during the transient period, are not negligible, which also should be taken into account in the development of yak colostrum supplements.

Intrinsic and interfacial effect of electrode metals on the resistive switching behaviors of zinc oxide films.

Exploring the role of electrode metals on the resistive switching properties of metal electrode/oxide/metal electrode sandwiched structures provides not only essential information to understand the underlying switching mechanism of the devices, but also useful guidelines for the optimization of the switching performance. A systematic study has been performed to investigate the influence of electrodes on the resistive switching characteristics of zinc oxide (ZnO) films in this contribution, in terms of both the intrinsic and interfacial effects. It has been found that the low-resistance state resistances (Ω(LRS)) of all the investigated devices are below 50 Ω, which can be attributed to the formation of highly conductive channels throughout the ZnO films. On the other hand, the high-resistance state resistances (Ω(HRS)) depend on the electronegativity and ionic size of the employed electrode metals. Devices with electrode metals of high electronegativity and large ionic size possess high Ω(HRS) values, while those with electrode metals of low electronegativity and small ionic size carry low Ω(HRS) values. A similar trend of the set voltages has also been observed, while the reset voltages are all distributed in a narrow range close to ±0.5 V. Moreover, the forming voltages of the switching devices strongly depend on the roughness of the metal/ZnO and/or ZnO/metal interface. The present work provides essential information for better understanding the switching mechanism of zinc oxide based devices, and benefits the rational selection of proper electrode metals for the device performance optimization.

MicroRNA-133a functions as a tumor suppressor in gastric cancer.

MicroRNAs (miRNAs) are small and highly conserved non-coding RNAs that regulate gene expression of target mRNAs through posttranscriptional inhibition involved in the tumorigenesis and progression of multiple malignancies. Although miR-133a has been shown to function as a tumor suppressor in some cancers, the clinical significance and function of miR-133a in gastric cancer remain unclear. Hence, we were focused on the expression and mechanisms of miR-133a in the development of gastric cancer in this study. It was found that the expression of miR-133a was downregulated (P<0.001), while transgelin-2 (TAGLN2) was upregulated (P<0.05) in primary gastric cancer tissues, compared to the adjacent non-cancerous tissues (ANCT). Furthermore, decreased expression of miR-133a and increased expression of TAGLN2 were both associated with lymph node metastases in patients with gastric cancer (P<0.001; P=0.011). Functional analysis studies revealed that ectopic expression of miR-133a reduced cell proliferation and invasion, and induced cell apoptosis and cycle arrest via suppressing the level of TAGLN2 from transcriptional and translational levels and downregulated the expression of proliferating cell nuclear antigen (PCNA) and matrix metalloproteinase-2 (MMP-2) in gastric cancer cells. In conclusion, these results demonstrate that decreased expression of miR-133a is associated with the lymph node metastases of patients with gastric cancer. Overexpression of miR-133a inhibits cell growth and invasion and induces cell apoptosis and cycle arrest through repressing TAGLN2 gene, suggesting that miR-133a might be used as a biomarker or therapeutic target for the treatment of gastric cancer.

Rett syndrome induced pluripotent stem cell-derived neurons reveal novel neurophysiological alterations.

Rett syndrome (RTT) is a neurodevelopmental autism spectrum disorder caused by mutations in the methyl-CpG-binding protein 2 (MECP2) gene. Here, we describe the first characterization and neuronal differentiation of induced pluripotent stem (iPS) cells derived from Mecp2-deficient mice. Fully reprogrammed wild-type (WT) and heterozygous female iPS cells express endogenous pluripotency markers, reactivate the X-chromosome and differentiate into the three germ layers. We directed iPS cells to produce glutamatergic neurons, which generated action potentials and formed functional excitatory synapses. iPS cell-derived neurons from heterozygous Mecp2(308) mice showed defects in the generation of evoked action potentials and glutamatergic synaptic transmission, as previously reported in brain slices. Further, we examined electrophysiology features not yet studied with the RTT iPS cell system and discovered that MeCP2-deficient neurons fired fewer action potentials, and displayed decreased action potential amplitude, diminished peak inward currents and higher input resistance relative to WT iPS-derived neurons. Deficiencies in action potential firing and inward currents suggest that disturbed Na(+) channel function may contribute to the dysfunctional RTT neuronal network. These phenotypes were additionally confirmed in neurons derived from independent WT and hemizygous mutant iPS cell lines, indicating that these reproducible deficits are attributable to MeCP2 deficiency. Taken together, these results demonstrate that neuronally differentiated MeCP2-deficient iPS cells recapitulate deficits observed previously in primary neurons, and these identified phenotypes further illustrate the requirement of MeCP2 in neuronal development and/or in the maintenance of normal function. By validating the use of iPS cells to delineate mechanisms underlying RTT pathogenesis, we identify deficiencies that can be targeted for in vitro translational screens.