N-cadherin cleavage: A critical function that induces diabetic retinopathy fibrosis via regulation of ß-catenin translocation.

Retinal fibrosis is a severe pathological change in the late stage of diabetic retinopathy and is also the leading cause of blindness. We have previously revealed that N-cadherin was significantly increased in type 1 and type 2 diabetic mice retinas and the fibrovascular membranes from proliferative diabetic retinopathy (PDR) patients. However, whether N-cadherin directly induces retinal fibrosis in DR and the related mechanism is unknown. Here, we investigated the pathogenic role of N-cadherin in mediating retinal fibrosis and further explored the relevant therapeutic targets. We found that the level of N-cadherin was significantly increased in PDR patients and STZ-induced diabetic mice and positively correlated with the fibrotic molecules Connective Tissue Growth Factor (CTGF) and fibronectin (FN). Moreover, intravitreal injection of N-cadherin adenovirus significantly increased the expression of FN and CTGF in normal mice retinas. Mechanistically, overexpression of N-cadherin promotes N-cadherin cleavage, and N-cadherin cleavage can further induce translocation of non-p-ß-catenin in the nucleus and upregulation of fibrotic molecules. Furthermore, we found a novel N-cadherin cleavage inhibitor, pigment epithelial-derived factor (PEDF), which ameliorated the N-cadherin cleavage and subsequent retinal fibrosis in diabetic mice. Thus, our findings provide novel evidence that elevated N-cadherin level not only acts as a classic EMT maker but also plays a causative role in diabetic retinal fibrosis, and targeting N-cadherin cleavage may provide a strategy to inhibit retinal fibrosis in DR patients.

Evaluation of modified clear Twin Block aligner in treating adolescents with skeletal class II malocclusion: A two-centre cephalometric study.

INTRODUCTION: The purpose of this study was to evaluate the therapeutic effect of modified clear Twin Block (CTB) aligner and traditional twin block (TB) appliance from skeletal, dentoalveolar and soft tissue changes in adolescents with skeletal class II malocclusion. METHODS: A total of 80 adolescents, included in this study from two medical centres, were distributed into CTB group, TB group and control group based on the treatment they received. Lateral cephalograms at pre-treatment (T1) and post-treatment (T2) were measured by modified Pancherz's cephalometric analysis, and dentoskeletal and soft tissue changes were analysed by independent-sample t-test, paired-sample t-test, ANOVA test and Scheffe's Post Hoc test. RESULTS: Seventy-five adolescents completed the study, including 32 in the CTB group, 32 in the TB group and 11 in the control group. Both CTB and TB treatment showed significant differences in most dentoskeletal and soft tissue measurements. Compared with the control group, improvements were observed in class II molar relationship through significant different in S Vert/Ms-S Vert/Mi in the CTB group (P < .01) and the TB group (P < .001), as well as deep overjet through significant different in S Vert/Is-S Vert/Ii in the CTB group (P < .001) and the TB group (P < .001). Besides, the CTB group also showed less protrusion of lower incisors and resulted in a more significant improvement in profile with fewer adverse effects on speaking, eating and social activities. CONCLUSIONS: For adolescents with skeletal class II malocclusion, CTB appliance was as effective as TB on improving dentoskeletal and soft tissue measurements, featuring more reliable teeth control and patient acceptance.

A label-free G-quadruplex aptamer fluorescent aptasensor for visual and real-time kanamycin detection in lake and human samples.

Antibiotic abuse is considered a serious problem affecting human health, necessitating that great attention be paid to explore robust, simple and sensitive methods for rapid evaluation. In this paper, we developed a fluorescent aptasensor for visual and real-time kanamycin detection by taking advantage of the label-free strategy based on H-aggregate disassembly of a chiral cyanine dye induced by a G-quadruplex aptamer. The good sensitivity and selectivity enabled this aptasensor to have a detection limit as low as 43 nM and have high specificity for kanamycin recognition. Furthermore, this assay was successfully applied for the detection of kanamycin in lake water and urine with excellent recoveries.

Unobtrusive monitoring of sedentary behaviors with fusion of bluetooth and ballistocardiogram signals.

Intensive and lasting stress may induce severe damage to a human's physical and mental health. Successful stress management depends on the effective monitoring of people's everyday activities, in particular, their sedentary behaviors. Here, we propose an unobtrusive office sedentary behavior monitoring system that combines Bluetooth signals and ballistocardiogram (BCG) signals to classify an individual's sitting modes into four categories: off-seat, sedate, working, and in-motion. The proposed monitoring system simultaneously reads received signal strength indicators (RSSI) from several fixed Bluetooth Low Energy (BLE) beacons and BCG data from the piezoelectric sensor placed underneath the chair cushion, with distinct sampling frequencies. The raw signals are first denoised with local subspace projection. Then we extract the local spectral features from the reconstructed signal and the signal differences for a two-stage stacking learning algorithm. The temporally classified results establish a desk-based worker's sedentary profile and make possible the timely intervention of physical inactivity. We tested the prototype system for 15 subjects, and the preliminary results achieved 95% accuracy, demonstrating its potential in a real-world application.

Meckel's Diverticulum with Multiple Sprouts at the Tip in a Child.

Background: Meckel's diverticulum (MD) is usually a simple tubular-shaped diverticulum. Case report: We describe a MD with multiple complex terminal sprouts in a child found incidentally during an appendectomy for appendicitis. The MD was resected, and the child recovered well. Conclusion: MD may show multiple sprouts. There was no additional clinical consequence in this child with the malformed MD.

Application of artificial intelligence in a real-world research for predicting the risk of liver metastasis in T1 colorectal cancer.

BACKGROUND: Liver is the most common metastatic site of colorectal cancer (CRC) and liver metastasis (LM) determines subsequent treatment as well as prognosis of patients, especially in T1 patients. T1 CRC patients with LM are recommended to adopt surgery and systematic treatments rather than endoscopic therapy alone. Nevertheless, there is still no effective model to predict the risk of LM in T1 CRC patients. Hence, we aim to construct an accurate predictive model and an easy-to-use tool clinically. METHODS: We integrated two independent CRC cohorts from Surveillance Epidemiology and End Results database (SEER, training dataset) and Xijing hospital (testing dataset). Artificial intelligence (AI) and machine learning (ML) methods were adopted to establish the predictive model. RESULTS: A total of 16,785 and 326 T1 CRC patients from SEER database and Xijing hospital were incorporated respectively into the study. Every single ML model demonstrated great predictive capability, with an area under the curve (AUC) close to 0.95 and a stacking bagging model displaying the best performance (AUC = 0.9631). Expectedly, the stacking model exhibited a favorable discriminative ability and precisely screened out all eight LM cases from 326 T1 patients in the outer validation cohort. In the subgroup analysis, the stacking model also demonstrated a splendid predictive ability for patients with tumor size ranging from one to50mm (AUC = 0.956). CONCLUSION: We successfully established an innovative and convenient AI model for predicting LM in T1 CRC patients, which was further verified in the external dataset. Ultimately, we designed a novel and easy-to-use decision tree, which only incorporated four fundamental parameters and could be successfully applied in clinical practice.

Video-assisted thoracoscopic treatment as two-day surgery for lung neoplasms: a propensity-matched analysis.

BACKGROUND: Enhanced recovery after surgery programs have reduced complications and shortened hospital stays after lung resection. This study aimed to determine whether video-assisted thoracoscopic surgery performed as a two-day surgery for lung neoplasms was safe and cost-effective. METHODS: This retrospective, propensity-matched, cohort analysis was conducted from January 2020 to August 2020. Among 959 patients who underwent video-assisted thoracoscopic surgery, 739 underwent inpatient surgery and 220 underwent two-day surgery. Propensity-matched analysis, incorporating preoperative variables, was used to compare postoperative complications, post-discharge follow-up results, and hospitalization costs between the groups. RESULTS: Propensity matching estimated 218 patients in each group. The mean length of hospital stay was shorter in the two-day surgery group (2.17 ± 0.89 days) than in the inpatient surgery group (6.31 ± 2.13 days) (P < 0.001). Delayed removal of chest tubes accounted for over half of the delayed discharges in the inpatient (17 [54.8%]) and two-day surgery (13 [65.0%]) groups. The postoperative pneumonia/atelectasis incidence was lower in the two-day surgery group than in the inpatient surgery group (P = 0.032). The two-day surgery group patients were readmitted to the hospital due to massive pleural effusion, pneumothorax, fever, severe chest pain, and physical weakness. The mean total hospitalization cost in the two-day surgery group was lower than that in the inpatient surgery group (¥ 33,926.1 versus ¥ 38,422.7, P < 0.001). Basic medical, nursing, drug, laboratory-related, and nonsurgical consumable costs in the two-day surgery group were significantly reduced. CONCLUSIONS: Two-day surgery is a safe, feasible, and cost-effective procedure for selected patients with lung neoplasms when combined with accurate preoperative evaluations, successful intraoperative assessments, and effective postoperative health care guidance.

A role for Snail-MnSOD axis in regulating epithelial-to-mesenchymal transition markers expression in RPE cells.

Age-related macular degeneration (AMD) is a common cause of vision loss. The epithelial-mesenchymal transition (EMT) of retinal pigment epithelial (RPE) cells, accompanied by oxidative damage, plays a crucial role in AMD. It is well known that manganese superoxide dismutase (MnSOD) encoded by SOD2 is a critical molecule in fighting against oxidative stress, and Snail encoded by SNAI1 is the essential transcription factor for EMT. However, the effect of MnSOD on EMT and the underlying mechanism in RPE cells remains unknown. In this study, we found that MnSOD knockdown triggered the EMT by upregulating Snail, while MnSOD overexpression reversed EMT even with TGFß treatment in RPE cells, and the anti-oxidative stress activity of MnSOD mediated this observation. In addition, Snail depletion increased both expression and activity of MnSOD while Snail overexpression decreased MnSOD expression and activity, and Dual-luciferase reporter and ChIP assays showed that Snail directly bound to E-box (CACCTG) in the SOD2 promoter. Moreover, MnSOD over-expression and Snail interference co-treatment strengthened the anti-oxidation and EMT reversing. Therefore, our findings demonstrate that MnSOD prevents EMT of RPE cells in AMD through inhibiting oxidative injury to RPE. Moreover, a critical EMT transcription factor, Snail, functions as a new negative transcriptional factor of SOD2. Herein, the Snail-MnSOD axis forms a mutual loop in the development of AMD, which may be a novel systemic treatment target for preventing AMD.

Study on the polymorphisms of HLA-ABCDQB1DRB1 alleles and haplotypes in Hubei Han population of China.

The present study aimed to analyse the frequencies of human leukocyte antigen HLA-ABCDQB1 and HLA-DRB1 alleles and haplotypes in a subset of 3,732 Han population from Hubei of China. All samples were typed in the HLA-ABCDQB1 and HLA-DRB1 loci using the sequence-based typing method; subsequently, the HLA polymorphisms were analysed. A total of 47 HLA-A, 89 HLA-B, 43 HLA-C, 49 HLA-DRB1 and 24 HLA-DQB1 alleles were identified in the Hubei Han population. The top three most frequent alleles in the HLA-ABCDQB1 and HLA-DRB1 were A*11:01 (0.2617), A*24:02 (0.1590), A*02:07 (0.1281); B*46:01 (0.1502), B*40:01 (0.1409) and B*58:01 (0.0616); C*01:02 (0.2023), C*07:02 (0.1691) and C*03:04 (0.1175); and DQB1*03:01 (0.2000), DQB1*03:03 (0.1900), DQB1*06:01 (0.1187); DRB1*09:01 (0.1790), DRB1*15:01 (0.1062) and DRB1*12:02 (0.0841), respectively. Meanwhile, the three most frequent two-loci haplotypes were A*02:07-C*01:02 (0.0929), B*46:01-C*01:02 (0.1366) and DQB1*03:03-DRB1*09:01 (0.1766). The three most frequent three-loci haplotypes were A*02:07-B*46:01-C*01:02 (0.0883), B*46:01-DQB1*03:03-DRB1*09:01 (0.0808) and C*01:02-DQB1*03:03-DRB1*09:01 (0.0837). The three most frequent four-loci haplotypes were A*02:07-B*46:01-C*01:02-DQB1*03:03 (0.0494), B*46:01-DRB1*09:01-C*01:02-DQB1*03:03 (0.0729) and A*02:07-B*46:01-DQB1*03:03-DRB1*09:01 (0.0501). The most frequent five-loci haplotype was A*02:07-B*46:01-C*01:02-DQB1*03:03-DRB1*09:01 (0.0487). Heat maps and multiple correspondence analysis based on the frequencies of HLA specificity indicated that the Hubei Han population might be described into Southern Chinese populations. Our results lay a certain foundation for future population studies, disease association studies and donor recruitment strategies.

Rapid Determination and Quality Control of Pharmacological Volatiles of Turmeric (Curcuma longa L.) by Fast Gas Chromatography-Surface Acoustic Wave Sensor.

INTRODUCTION: A novel analytical method using fast gas chromatography combined with surface acoustic wave sensor (GC-SAW) was developed for rapid determination of the pharmacological volatiles of turmeric (Curcuma longa L.). METHODS: The volatile compounds in 20 turmeric samples, collected from different parts and different origins, were assessed by the fast GC-SAW. In addition, gas chromatography-mass spectrometry (GC-MS) was employed to confirm the chemical composition of the main volatiles. The digital fingerprint of turmeric was established and analysed by principal component analysis and cluster analysis. RESULTS: Curcumene (9.1%), ß-sesquiphellandrene (5.1%) and ar-turmerone (69.63%) were confirmed as the main pharmacological volatiles of turmeric. The content of ar-turmerone in lateral rhizome turmeric was significantly higher than that of top rhizome and ungrouped turmeric. The contents of curcumene and ß-sesquiphellandrene in top rhizome turmeric were higher than those in lateral and ungrouped turmeric. The 20 turmeric samples were divided into four categories, which reflected the quality characteristics of the turmeric from different parts and origins. CONCLUSION: The GC-SAW method can rapidly and accurately detect pharmacologically volatiles of turmeric, and it can be used in the quality control of turmeric.

Correction to: Comparison of minimally invasive Ivor Lewis esophagectomy and left transthoracic esophagectomy in esophageal squamous cell carcinoma patients: a propensity score-matched analysis.

An amendment to this paper has been published and can be accessed via the original article.

Phosphorescent Tetradentate Platinum(II) Complexes Containing Fused 6/5/5 or 6/5/6 Metallocycles.

A series of phenylpyridine (ppy)-based 6/5/5 N*C^N^O and biphenyl (bp)-based 6/5/6 N*C^C*N Pt(II) complexes employing tetradentate ligands with nitrogen or oxygen atoms as bridging groups have been developed. Ligand structural modifications have great influences on the electrochemical, photophysical, and excited-state properties, as well as photostabilities of the Pt(II) complexes, which were systematically studied by experimental and theoretical investigations. The time-dependent density functional theory calculations and natural transition orbital analyses reveal that Pt(bp-6), Pt(bp-7), and Pt(bp-8) have dominant ligand-centered (3LC) mixed with small metal-to-ligand charge-transfer (3MLCT) characters in T1 states, resulting in relatively low quantum efficiencies (ΦPL) of 5-33% and 12-32% in dichloromethane solution and PMMA film, respectively. By contrast, Pt(ppy-1) possesses much more 3MLCT character in the T1 state, enabling a high ΦPL of 95% in dichloromethane and 90% in DPEPO film, and large radiative decay rates. The strength of the Pt-N1 coordination bond plays a critical role in the photostability. Pt(ppy-1)- and Pt(bp-6)-doped polystyrene films demonstrate long photostability lifetimes of 150 min for LT97 and LT98.5, respectively. A Pt(ppy-1)-based green OLED using 26mCPy as host realized a peak EQE of 18.5%, which still maintained an EQE of 10.4% at 1000 cd/m2, and an Lmax of over 40 000 cd/m2 was achieved. This study should provide a valuable reference for the further development of efficient and stable phosphorescent Pt(II) complexes.

Highly Efficient Phosphorescent Tetradentate Platinum(II) Complexes Containing Fused 6/5/6 Metallocycles.

A series of neutral tetradentate Pt(II) complexes with fused 6/5/6 metallocycles and biphenyl (bp)-containing ligands have been designed and synthesized. All bridging atoms adopt nitrogens designed as an acridinyl group (Ac), an aza acridinyl group (AAc), and an aza carbazolyl group (ACz), which can effectively tune their LUMO energy levels. Their HOMO energy levels can be well-controlled through molecular modifications on the bp moieties with electron-donating and electron-withdrawing groups. These molecular modifications also have profound effects on the electrochemical and photophysical properties and photostabilities of the Pt(II) complexes. The ground-states and excited states are systematically studied by density functional theory (DFT), time-dependent density functional theory (TD-DFT), and natural transition orbital (NTO) calculations. All the Pt(II) complexes exhibit admixed 3(LC/MLCT) characters in T1 states with various proportions, which are strongly structure-dependent. These 6/5/6 Pt(II) complexes demonstrate high quantum efficiencies in dichloromethane solutions (ΦPL = 27-51%) and in doped PMMA films (ΦPL = 36-52%) at room temperature with short luminescence lifetimes of 1.6-9.5 µs and 7.6-9.0 µs, respectively. They emit green light with dominant peaks of 512-529 nm in solutions and 512-524 nm in doped PMMA films, respectively. Importantly, Pt(bp-2) exhibits highly stable emission colors with the same dominant peaks at 512 nm in various matrixes and also demonstrates a long photostability lifetime, LT80, at 80% of initial luminance, of 190 min, which is doped in polystyrene films (5 wt %) excited by UV light of 375 nm at 500 W/m2. These studies indicate that these 6/5/6 Pt(II) complexes can act as good phosphorescent emitters for OLED applications and should provide a viable route for the development of efficient and stable Pt(II)-based phosphorescent emitters.

Cyclic tensile strain promotes the ECM synthesis of cranial base synchondrosis chondrocytes by upregulating miR-140-5p.

OBJECTIVE: This study aimed to explore the role of miR-140-5p in cranial base synchondrosis chondrocytes (CBSCs) under cyclic tensile strain (CTS). SETTING AND SAMPLE POPULATION: A total of 25 1-week-old Sprague Dawley rats from Shanghai Laboratory Animal Center, Chinese Academy of Sciences, were used. MATERIAL AND METHODS: The second passage of CBSCs was applied with CTS at 10% elongation (1 Hz) for 24 hours. MiR-140-5p levels in CBSCs were detected by qRT-PCR. The role of miR-140-5p in CBSCs was evaluated by transfection of mimics and inhibitor. RNA sequencing and online search of miRNA databases (TargetScan, miRDB and miRanda) were used in prediction of miR-140-5p targets. A luciferase reporter assay was applied to identify the target gene of miR-140-5p. RESULTS: Compared with the control, the expression of Col2a1 and Sox9 was significantly higher after CTS (P < .05). Also, CBSCs demonstrated higher expression of miR-140-5p after CTS loading for 24 hours (P < .05). Overexpression of miR-140-5p promoted ECM synthesis under CTS loading environment, while suppression of miR-140-5p inhibited the effect. Bloc1s2 was a putative target gene of miR-140-5p. CONCLUSIONS: The expression of ECM in CBSCs could be promoted by CTS and miR-140-5p might play a role in this process through targeting Bloc1s2.

Posttraumatic Growth in Tibetan Adolescent Survivors 6 Years After the 2010 Yushu Earthquake: Depression and PTSD as Predictors.

This cross-sectional study explored the prevalence of posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) in Tibetan adolescent survivors (98% Tibetan and 2% Han) 6 years after the 2010 Yushu earthquake to identify the PTG predictors. In 2016, 850 high school students (from 11 to 20 years) in Yushu (N = 850) completed the self-rating depression scale, the PTSD Check List-Civilian version, the exposure degree scale, and the posttraumatic growth inventory. It was found that the PTG and probable PTSD prevalence rates were 49.7% and 8.9% 6 years after the earthquake, and that exposure level, depression level, and PTSD symptoms were all significant negative predictors for PTG in both the junior high school and senior high school students. Specifically, having a lower degree of exposure, a lower PTSD level, and no depression symptoms were associated with higher PTG. There was a significant PTG difference found between males and females; however, this gender difference was not found in the senior high school students. No significant PTG differences were found for the different ethnicities. The implications of the results and the limitations of this study are discussed.

Effects of Twin-block vs sagittal-guidance Twin-block appliance on alveolar bone around mandibular incisors in growing patients with Class II Division 1 malocclusion.

INTRODUCTION: The purpose of this study was to comparatively evaluate the effects of Twin-block (TB) appliance and sagittal-guidance Twin-block (SGTB) appliance on alveolar bone around mandibular incisors in growing patients with Class II Division 1 malocclusion, using cone-beam computed tomography. METHODS: The sample consisted of 25 growing patients with Class II Division 1 malocclusion (14 boys and 11 girls, mean age 11.92 ± 1.62 years) and was randomly distributed into the TB group (n = 13) and the SGTB group (n = 12). The treatment duration was 11.56 ± 1.73 months. Pretreatment (T1) and posttreatment (T2) cone-beam computed tomography scans were taken in both groups. Height, thickness at apex level, and volume of the alveolar bone around mandibular left central incisors were measured respectively on labial and lingual side, using Mimics software (version 19.0; Materialise, Leuven, Belgium). Based on the stable structures, 3-dimensional (3D) registrations of T1 and T2 models were taken to measure the sagittal displacement of incisors. Intragroup comparisons were evaluated by paired-samples t tests and Wilcoxon tests. Independent-samples t tests and Mann-Whitney U tests were used for intergroup comparisons. RESULTS: In both groups, alveolar bone height and volume on the labial side of the incisors significantly decreased after treatment (P <0.05). Lingual alveolar bone height, lingual and total alveolar bone volume, labial, lingual and total alveolar bone thickness showed no significant difference between T1 and T2 (P >0.05). In both groups the incisors tipped labially and drifted to the labial side. Compared with the TB group, less labial alveolar bone loss, less incisor proclination and crown edge drift were found in the SGTB group (P <0.05). CONCLUSIONS: Labial alveolar bone loss around mandibular incisors was observed after both types of appliances treatment in growing patients with Class II Division 1 malocclusion. Less labial alveolar bone loss, less incisor proclination, and crown edge drift were found in the SGTB group than in the TB group during treatment.

Imaging and Pathology Study of the Chemotherapy Regression Area of Hepatoblastoma - A Prospective Single-Center Study.

Objective: The objective of this study is to determine the frequency of no residual cancer tissue in the chemotherapy regression area (CRA) of hepatoblastoma after preoperative chemotherapy and to measure the distance between the tumor capsule and the residual cancer nests. Methods: All the tissues in the CRAs of the resected specimens were excised. HE staining and immunohistochemical staining were performed to determine the frequency of residual cancer tissue in the CRA, and the distances between the residual cancer nests and the tumor capsule were measured. Results: A total of 30 patients were included in the study. The tumor volume decreased after chemotherapy by an average of 619 ml. Of the 30 patients, the CRAs of 18 still had residual cancer nests. The longest distance between the residual cancer nest and tumor capsule was 11.2 mm. Conclusions: After chemotherapy, 60% of patients still had residual cancer nests in CRAs, the furthest distance was 11.2 mm.

Clinical features and factors leading to early recurrence of intussusception after saline reduction.

OBJECTIVE: To investigate the clinical characteristics of early recurrent intussusception after ultrasound-guided saline reduction, and to explore the factors leading to early recurrence. METHODS: The retrospective observational case-control study was conducted at Weifang People's Hospital, Shandong, China, and comprised data from January 2015 to December 2017 related to paediatric intussusception patients aged 0-12 years who underwent ultrasound-guided saline enema reduction. The patients were divided into two recurrent and non-recurrent groups. Clinical characteristics of the patients with early recurrence were analysed. Factors compared between the groups were gender, age, onset season, onset-to-treatment time interval, blood in stool, fever, diarrhoea, abdominal pain and vomiting, weight and pathology. Data was analysed using SPSS 22. RESULTS: Of the 672 subjects, 86(13%) were patient with early recurrence while 586(87%) had no early recurrence and acted as controls. Among the patients, 70(81.4%) were aged 6-36 months. In 52(60.5%) patients, recurrence was once, and in 23(26.7%) twice. There were 141 episodes of intussusception; 24(17%) occurring in <12 hours, 85(60.2%) in 12-24 hours. Also, 5(6%) patients required surgery for reduction. Compared to the controls, the second quarter, heavier body weight and pathology were the factors leading to early recurrence of intussusceptions (p<0.05). CONCLUSIONS: The second quarter, heavier body weight and pathological leading points were found to be factors leading to early recurrent intussusception.

Comparison of minimally invasive Ivor Lewis esophagectomy and left transthoracic esophagectomy in esophageal squamous cell carcinoma patients: a propensity score-matched analysis.

BACKGROUND: To investigate the long-term efficacy of the minimally invasive Ivor Lewis esophagectomy (MIILE) in esophageal squamous cell carcinoma (ESCC) patients, a retrospective comparison of the quality of life (QOL) and survival between patients who underwent MIILE and left transthoracic esophagectomy (Sweet approach) was conducted. METHODS: A detailed database search identified 614 patients who underwent MIILE and 243 patients who underwent Sweet esophagectomy between January 2011 and December 2017. After propensity score matching, 216 paired cases were selected for statistical analysis. Survival was evaluated with Kaplan-Meier curves or Cox models. RESULTS: MIILE was associated with a longer duration, less blood loss and more lymph node dissected than Sweet esophagectomy. MIILE patients suffered from less pain, less frequently developed pneumonia, and had fewer postoperative complications. Additionally, MIILE patients began oral intake earlier and had a shorter postoperative hospital stay, and enhanced recovery of QOL. There was no significant difference between the approaches regarding the recurrence pattern, 2-year and 5-year overall survival (OS) or disease-free survival (DFS), except that patients with tumor-node-metastasis (TNM) stage I in the MIILE group demonstrated superior OS and DFS. Pathological TNM stage and postoperative complications were determined to be independent prognostic factors based on the multivariate analysis. CONCLUSION: MIILE is a safe and feasible approach for treating ESCC patients. MIILE approach may provide more postoperative advantages, enhanced QOL improvement, and more favorable long-term survival in early stage patients than the Sweet procedure.

A cone-beam computed tomography analysis of angulation and inclination of whole tooth and clinical crown in adults with normal occlusion.

OBJECTIVES: To identify the mesiodistal angulation and faciolingual inclination of whole tooth and clinical crown in Chinese young adults with normal occlusion, by examining CBCT digitalized images. SETTING AND SAMPLE POPULATION: Forty-two volunteers, who presented with normal occlusion and without previous orthodontic treatment, were selected for this study. MATERIALS AND METHODS: The subjects were advised to take dental CBCT and the digital images of the dentition were obtained. The widely recognized University of Southern California (USC) root vector analysis was adopted to detect the angulation and inclination of the whole tooth, as well as of the clinical crown. RESULTS: No statistically significant difference was detected between male and female subjects. The fluctuations of the angulation and the inclination of the whole tooth from anterior to posterior in both arches manifested distinctive trends. The changes in maxillary dentition seem relatively marked, whereas those in mandibular dentition show less obvious, demonstrating moderate fluctuation both in angulation or inclination. The angulation and inclination of clinical crown are obtained and are shown positively correlated with that of each whole tooth. CONCLUSIONS: The normal range of the mesiodistal angulation and faciolingual inclination of whole tooth and clinical crown in Chinese adults with normal occlusion are identified. This study could establish clinical standards for designing 3D dental data-based orthodontic appliances for Chinese, and for providing the guidance for orthodontic treatment.