Serious Condylar Head Absorption in Children With Intracapsular Condylar Fractures Treated Operatively With Long Screws.

OBJECTIVE: This study was performed to explore bone remodelling in children with intracapsular condylar fractures after the condylar fracture fragments were fixed using long screws and to offer possible explanations about the underlying mechanism. PATIENT AND METHODS: Records of children (less than 12 y old) who sustained intracapsular condylar fractures and fixed with long screws from May 2012 to January 2015 were retrieved. Age, gender, dates of injury, admission, and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fractures, treatment methods, and time of review were recorded and analyzed. Image dates of pretreatments and posttreatments, including the date of review, were also recorded. RESULTS: A total of 8 patients completed their follow-up, and all patients (n=5) who were followed up after more than 3 months showed serious resorption of the condylar head. The condylar head resorbed until the height (or articular surface) dropped and aligned with the surface of the screw. The shortest time of absorption, as shown by the computed tomography scan was 106 days, and the longest time was 171 days (average time of 141.8 d). CONCLUSIONS: Intracapsular condyle fractures in children should be managed conservatively as much as possible. However, if the height of the fracture fragments drops remarkably, open reduction and rigid internal fixation become possible choices.

Characteristics of Retained Foreign Bodies in the Tongue: A Retrospective Study of 35 Cases.

PURPOSE: There are only a few case reports of foreign bodies (FBs) in the tongue. Delayed diagnosis or misdiagnosis is commonly reported. The purpose of this study was to identify the demographic, clinical, and radiological features that might facilitate the diagnosis of retained FBs in the tongue. METHODS: A retrospective case series was performed. Clinical and imaging data of patients with FBs in the tongue at Wuhan University Hospital of Stomatology were reviewed. The outcome variable was a preliminary, radiological, intraoperative, or pathological diagnosis. Covariates included age, sex, FB-related history, symptoms and signs, duration, and computed tomography (CT) imaging features. Descriptive statistics were computed for each study variable. RESULTS: Thirty-five patients were included. The sample's mean age was 54.5 ± 11.2 years, included 19 males (54.3%). Eighty percent of the patients reported FB-related history with a mean duration of 4 weeks. More than 70% of the patients presented with tongue swelling. Approximately half of the 35 cases were preliminarily misdiagnosed, and 15 of them were initially suspected to be tumors. After CT examinations, 33 of the 35 cases were diagnosed as FB. Characteristic CT imaging feature of the FB was a radiopaque line. Most FBs were located at the anterior two-thirds and marginal area of the tongue and in an oblique direction. The depth of FB was 0.61 ± 0.42 cm. The superficial ends of most FBs were close to the surface of the dorsum and the tongue margin. CONCLUSIONS: The possibility of a retained FB should be included in the differential diagnosis of a nonhealing wound or tongue enlargement when a radiopaque line is present on CT images of patients presenting with or without FB-related history. It may be easier to detect a FB in the tongue when a CT imaging postprocessing protocol, including thin-slice reconstruction and multiplanar reformation visualization and careful interpretation, is used.

Removal of Fracture Fragments in Intracapsular Condylar Fractures: An Alternative Treatment Option.

OBJECTIVE: This study aimed to explore bone remodeling after condylar fracture fragments have been removed from patients with intracapsular condylar fractures. it also evaluated whether condyle fracture removal can be used alternatively when the authors treat patients with comminuted or small pieces of fracture or in extremely difficult operations. METHODS: Records of patients who sustained intracapsular condylar fractures and treated by removal of fragments for the period of February 2013 to September 2019 were retrieved. Data about age, gender, date of injury, dates of admission and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fracture, treatment methods and time of review were recorded and analyzed. Image dates of pre- and post-treatment (including the time of review) were also recorded. RESULTS: The data of a total of 103 patients ranging from 5 to 84 years old were retrieved during this study. A total of 135 sides of condylar fragments were removed. Almost all of the patients with comminuted condyle head fracture or type A fracture presented apparent shortening of the ramus height, and none of them showed osteogenesis (or new bone formation) during their follow-up. Present study only observed osteogenesis in few patients who sustained type B/C intracapsular condylar fractures during their follow-up. The younger the patient was, the longer the follow-up time was, and the higher the possibility of new bone formation was. No correlation was found between the amount of osteogenesis and follow-up time, the amount of osteogenesis was generally small, and no patient could form a new condyle head similar to the normal (or original) condyle head. Condylar hypertrophy only occurred in children. Four patients developed temporomandibular joint ankylosis. CONCLUSIONS: Removal of fracture fragments is an alternative treatment option for patients who sustained comminuted or small pieces of fracture or in extremely difficult operations.

Maxillofacial Injuries in Pediatric Patients.

OBJECTIVE: This study aimed to evaluate and analyse the demographic characteristics and changes in maxillofacial injuries during their development in pediatric patients. METHODS: A retrospective cohort and case-control study was conducted. The sample was composed of all children (less than 10.5 years) who presented with maxillofacial injuries within a 6.5-year period (from December 2012 to April 2019). Data about age, gender, hospitalization date, mechanism of trauma, location and pattern of injuries, associated general injuries or systemic diseases, admission methods (emergency admission or not), type of anesthesia, treatment methods and hospital costs (¥) were recorded and analyzed. Data analysis included Chi-square test, Fisher exact test, and t test. Univariate and multivariate analyses were also performed. Logistic regression analysis was used to control for confounding variables. Differences at P < 0.05 were considered significant. RESULTS: A total of 643 pediatric patients were included in this study, with a boy-to-girl ratio of 1.77:1 (411 boys and 232 girls). The age range was 0.18 to 10.5 years (average of 3.23 ±â€Š1.98 years). The largest age group was patients aged 1 to 2 years (200 patients, 31.1%), followed by 2 to 3 years (139 patients, 21.6%). In the majority of patients, fall at ground level was the most common mechanism of injury (391 patients, 60.8%). In addition, 613 patients (95.3%) sustained at least maxillofacial soft-tissue injuries, while 460 (71.5%) sustained only maxillofacial soft-tissue injuries and 183 (28.5%) sustained maxillofacial fractures. Lip was the most vulnerable soft tissue to be injured (283 patients, 44.0%). Patients who sustained maxillofacial soft-tissue injuries were less prone to maxillofacial fractures than those who did not. Maxillofacial fractures were highly presented in patients with dental injuries (OR = 6.783; 95% confidence interval, 3.147-14.620; P < 0.001). Older children (> 5 years old) were at higher risk of maxillofacial fractures than younger children (≤ 5 years old, P = 0.006). The risk of maxillofacial fractures (except symphysis fractures) increased with age, especially in patients aged between 5 and 10 years. Maxillofacial soft-tissue injuries were highly distributed amongst patients aged 1 to 5 years. The number of patients who sustained only maxillofacial soft-tissue injuries gradually decreased from 2013 to 2018. Patients in emergency admission (OR = 13.375; 95% confidence interval, 1.286-139.121; P = 0.030) and treated under general anesthesia (OR = 27015.375; 95% confidence interval, 1033.046-706484.218; P < 0.001) were more prone to be treated by surgery procedure. Patients with facial fractures were less frequent to be treated by surgery procedure (OR = 0.006; 95% confidence interval, 0.000-0.575; P = 0.028); however, the mandibular symphysis (OR = 18.141; 95% confidence interval, 2.860-115.069; P = 0.002) or body fractures (OR = 71.583; 95% confidence interval, 2.358-2172.879; P = 0.014) were highly treated by surgery procedure. CONCLUSIONS: Maxillofacial fractures in pediatric patients were significantly related to age, etiology, maxillofacial soft-tissue injury, dental injury and other general injuries. Older pediatric patients were at higher risk of maxillofacial fractures (except symphysis fractures) and lower risk of maxillofacial soft-tissue injuries than younger pediatric patients. Patients in emergency admission, fractures of the symphysis or body, and treated under general anesthesia were the main reasons for surgical management.

Restoration of Ramus Height in Child Patients With Extracapsular Condylar Fractures: Is This Mission Almost Impossible to Accomplish?

OBJECTIVE: This study aimed to assess whether ramus height is restored in children with extracapsular condylar fractures treated by conservative or surgery procedures. METHODS: The sample consisted of 35 children (collected consecutively) less than 12 years old who presented with extracapsular condylar fractures and treated within an 8-year period (June 2011 to April 2019). Data on the age, gender, date of injury, mechanism of trauma, location and pattern of mandibular condylar fracture, associated injuries and treatment methods were recorded and analyzed. Ramus height restoration is the main evaluation indicator during the follow-up period. RESULTS: Within the 8-year record retrieval, the 35 children sustained 41 extracapsular condylar fractures. For the sample size, 10 (24.4%) and 31 (75.6%) had condylar neck and base fractures, respectively. Deviation and green-stick fracture were the predominant types in condylar neck and base fractures, accounting for more than 3 quarters (31, 75.6%). The majority (33, 80.5%) of patients were treated with nonsurgical treatment, and 8 (19.5%) were treated by open reduction and internal fixation (ORIF). During the follow-up period (1-1419 days, average time of 110.6 days), only 1 patient (with bilateral extracapsular condylar fractures) had their ramus height restored (follow-up period, 256 days). Most members of the ORIF group (5 of 8, 62.5%) postoperatively showed bended ramus (deviated angularly/fragment angulation). CONCLUSION: Conservative treatment could hardly restore the ramus height of children with extracapsular condylar fractures. Anatomically or totally restoring the ramus height is difficult even with the surgical treatment of ORIF; however, surgical treatment of ORIF can substantially restore the ramus height for dislocated fractures or seriously displaced fractures.

Extracapsular Condylar Fractures Treated Conservatively in Children: Mechanism of Bone Remodelling.

OBJECTIVE: This study aims to reveal the reconstruction process in pediatric patients with extracapsular condylar fractures after conservative treatment. We clarify that the "upright" position (or "recontouring" or favorable prognosis) of condyles is not a result of the anatomical reduction of the deviated condylar processes but originates from the remodeling of the skeleton. We also explore the related mechanism. METHODS: The sample consisted of 27 pediatric patients aged less than 12 years who presented with extracapsular condylar fractures and were treated conservatively within an 8-year period (June 2011-April 2019). Data on the age, gender, date of injury, mechanism of trauma, location and pattern of mandibular condylar fracture and associated injuries and treatment methods of the patients were obtained. The process of bone remodeling in condyles was also recorded and analyzed. RESULTS: The 27 children in this study sustained 33 extracapsular condylar fractures over the 8-year period of record retrieval. Amongst these fractures, 8 (24.2%) and 25 (75.8%) were condylar neck and condylar base fractures, respectively. Deviation and green-stick fractures were the predominant types and accounted for over 3 quarters of the condylar neck and base fractures (28, 84.8%), followed by dislocation fracture (3, 9.1%), displacement fracture (1, 3.0%), and non-displaced fracture (1, 3.0%). The period of follow-up ranged from 2 days to 257 days (average, 58.78 days). Only 1 patient with bilateral extracapsular condylar fractures showed vertically reconstructed condyles, which indicates an upright position of the condylar processes. One patient showed less angulation after treatment than before treatment, 1 patient revealed greater angulation after treatment than before treatment and all other patients (20 patients) showed the same angulation pre- and post-treatment. Both patients with only extracapsular condylar fractures showed no obvious deviations in dentition and facial asymmetry after their injury and treatment. The shortest and longest times observed for bone remodeling were 33 and 256 days, respectively. Children whose condylar head remained completely or at least partly inside the glenoid fossa showed satisfactory remodeling results during follow-up. Computed tomography scan during follow-up generally showed bone regeneration in the lateral condyle articular surface and the medial portion of the ascending ramus and bone resorption in the displaced direction (ie, the medial condyle head became sharp). Condylar heads displaced completely outside of the glenoid fossa showed serious shortening of the ascending ramus, and no obvious bone remodeling was observed. Only 1 patient with bilateral extracapsular condylar fractures showed a normal contour (ie, a vertically reconstructed condyle reflecting the upright position of the condylar processes) after 8 months. CONCLUSION: Stress stimulation originating from the glenoid fossa and ascending ramus of the mandible is a prerequisite for good condylar reconstruction. Conservative treatment could be carried out if the condylar head remains completely or at least partly inside the glenoid fossa. When the condylar head is dislocated completely outside the glenoid fossa, the glenoid-condylar relationship ceases to exist, joint function is lost and the height of the ascending ramus is significantly reduced. In this case, open reduction may be suitable.

Comparison of Low Pre-Emptive Oral Doses of Celecoxib Versus Acetaminophen for Postoperative Pain Management After Third Molar Surgery: A Randomized Controlled Study.

PURPOSE: This study aimed to compare the pre-emptive analgesia of oral celecoxib with oral acetaminophen after surgical removal of the mandibular third molars. MATERIALS AND METHODS: A randomized, double-blinded, placebo-controlled clinical trial was conducted to examine patients presenting with a mandibular third molar for extraction under local anesthesia. The participants were randomized to receive a preoperative oral dose of celecoxib or acetaminophen as the predictor variable. The primary outcome variable was postoperative pain measured on a visual analog scale at different time points. The secondary outcome variable was the amount of postoperative analgesic medication taken in both groups. Statistical analyses included descriptive statistics, the t test, and the Pearson χ2 test. Significance was set at P < .05. The overall survival (interval to the first intake of ibuprofen) of the patients in each group was evaluated using Kaplan-Meier curves and log-rank analyses. RESULTS: Sixty participants were randomly divided into either the celecoxib group or acetaminophen group. The postoperative pain scores in the celecoxib group were significantly lower than those in the acetaminophen group at 4, 6, 8, and 12 hours (P = .008, P = .001, P = .021, and P = .011, respectively). The number of patients who did not require analgesics in the celecoxib group was less than that in the acetaminophen group (P = .018). The average amount of rescue analgesic medication in the celecoxib group (0.6 ± 0.8 dose) was significantly lower than that in the acetaminophen group (1.3 ± 1.0 doses) (P = .002). The Kaplan-Meier curve indicated that celecoxib resulted in long-term survival of the patients who did not receive rescue analgesic medication (P = .0055). CONCLUSIONS: Celecoxib exhibits a significant pre-emptive analgesic effect, thereby reducing the use of postoperative analgesics after removal of the third molar.

Maxillofacial Fractures in Women and Men: A 10-Year Retrospective Study.

PURPOSE: The purpose of this study was to evaluate and compare the demographic characteristics of maxillofacial fractures between women and men in China. PATIENTS AND METHODS: The sample was composed of all patients who sustained maxillofacial fractures during a 10-year period (2000 through 2009). Incidences, age distributions, etiologies, fracture patterns, associated injuries, and occupation distributions were recorded and analyzed. Data analysis included the χ(2) test, the Fisher exact test, and the t test. A P value less than .05 was considered significant. RESULTS: There were 1,131 patients (881 male and 250 female) who sustained maxillofacial fractures, with a male-to-female ratio of 3.5:1. Male patients sustained injuries most frequently during the autumn (P = .048), whereas female patients sustained more maxillofacial injuries during the summer (P = .006). Men sustained motorcycle (P = .023) and assault-related accidents (P = .036) more frequently than women, whereas women were more frequently injured in bicycle-related accidents (P < .001) or falling while at ground level (P = .001) than men. Women presented more frequently with condylar fracture than men (P = .028), whereas men were more prone to symphysis fractures than women (P = .037). For drivers, only men were involved (P = .001). Male workers sustained maxillofacial fractures more frequently than female workers (P < .001). Female children, students, and company staff were more prone to maxillofacial fractures than their male counterparts (P = .010, P = .004, and P = .044 respectively). CONCLUSIONS: The demographic characteristics of maxillofacial fractures in female patients considerably differ from those in male patients.

Resorbable plates for the fixation of isolated mandibular angle fracture.

PURPOSE: This study was designed to evaluate the results in isolated mandibular angle fractures treated with resorbable plates and to summarize experiences of the application of resorbable plates. PATIENTS AND METHODS: Ten patients (6 men and 4 women) with isolated displaced mandibular angle fracture were included in this case series. Open reduction by intraoral or extraoral approach was performed, and the fractures were fixed using single or dual resorbable plates. Postoperatively, follow-up was undertaken to evaluate the fracture healing and the degradation of resorbable plates. RESULTS: All the fractures healed without complications during the follow-up period. No screw or plate fractured during the surgery, no dislocation of the fracture segment after the fixation by resorbable plates, and no foreign body reaction related with resorbable plates were observed. CONCLUSIONS: With proper indication, resorbable plates are suitable for the fixation of isolated mandibular angle fractures. Single or dual resorbable plates by intraoral or extraoral approach can be individualized on the basis of the patients' condition.

Traumatic head injuries in patients with maxillofacial fractures: a retrospective case-control study.

OBJECTIVES: To analyse and evaluate the correlation between traumatic head injuries (THIs) and maxillofacial fractures (MF). Age, gender and trauma mechanism correlated with THI were also investigated. PATIENTS AND METHODS: We conducted a hospital-based retrospective case-control study at Stomatology College and Hospital, Wuhan University. From January 2000 to December 2009, a total of 1131 patients with MF were enrolled in the statistical study to evaluate the association of THI and other risk factors with MF. Among these patients, 86 presented with THI. We utilized binary logistic regression and risk analysis to investigate the associations among MF and other risk factors with HI. RESULTS: Head injuries (103 injuries) were sustained by 86 patients (7.6%), with male-to-female ratio of 4.1:1.0. Most of the patients (52 patients, 50.5%) also exhibited cranial bone fractures. The age group with most patients was the 30-39 years age group (26 patients, 30.2%), followed by the 19-29 years age group (22 patients, 25.6%). Motor vehicle accident (MVA) was the most common mechanism of injury (49 patients, 74.1%). Patients older than 50 years showed the highest risk for head injury (OR, 2.0; 95% confidence interval, 1.1-3.7; P = 0.025). MVA had a sixfold risk of head injury (OR, 6.2; 95% confidence interval, 1.5-26.1; P = 0.013). Head injuries were more prone to occur in patients who had combined fracture of the mid-face and mandible (OR = 4.6, P < 0.001), and only a 0.3-fold risk of multimandible fractures (P < 0.001), 0.5-fold risk of single mandibular fracture (P = 0.017) and 0.3-fold risk of patients who sustained only single mandibular condylar fracture (P = 0.019). CONCLUSIONS: The occurrence of head injuries is significantly related to age, aetiology and the pattern and position of maxillofacial fractures.

Ocular trauma in patients with maxillofacial fractures.

PURPOSE: The purpose of this study was to analyze and evaluate ocular injuries in patients with maxillofacial fractures. Correlation of the ocular injury and patients' age, sex, trauma mechanism, and type of maxillofacial fracture was also investigated. MATERIALS AND METHODS: From January 2000 to December 2009, a total of 1131 patients with facial fractures were registered. The information and data collected and analyzed included the following: age, sex, mechanism of injury, type of facial fracture, type of ocular injury, and the relationship between ocular injury and facial fracture. RESULTS: Ocular injury (349 injuries) was sustained by 209 patients (18.5%), with a male/female ratio of 5.33:1 (176 males and 33 females). The age range of the patients associated with ocular trauma was 3 to 68 years (mean [SD], 32.40 [11.27] y). Patients aged 30 to 39 years showed the highest risk for ocular trauma (odds ratio [OR], 1.852; P < 0.001). Children showed the lowest risk for ocular injuries (OR, 0.162; P < 0.001). Motor vehicle accidents were the most common mechanism of injury (97 patients, 46.4%). Motor vehicle accidents also had a 2.243-fold risk for ocular trauma (OR, 2.243; P = 0.021). Ocular traumas were more prone to occur in patients who sustained midfacial fractures (OR, 10.232; P < 0.001), especially the patients with multiple midfacial fractures (OR, 12.389; P < 0.001). Fracture of the mandible had the lowest risk for ocular injuries (multimandibular fractures: OR, 0.035, P < 0.001; single mandibular fracture: OR, 0.151; P < 0.001). CONCLUSIONS: The occurrence of ocular injuries was significantly related to sex, age, etiology, as well as the pattern and position of the maxillofacial fractures.

Changing pattern in the characteristics of maxillofacial fractures.

PURPOSE: This study was designed to assess the changes in the etiology, incidence, and pattern of maxillofacial fractures during 2 different study periods in our department. PATIENTS AND METHODS: In this retrospective study, patients treated for maxillofacial fractures at our department from January 2000 to December 2009 were included. Data regarding patient's age, sex, etiology of fracture, time of injury, site of fracture, and pattern of fracture were collected and grouped chronologically into two 5-year periods: 2000 to 2004 (period 1) and 2005 to 2009 (period 2); the results of the study during these periods were analyzed and compared. RESULTS: A total of 1131 patients sustained maxillofacial fractures: 422 in the first period and 709 in the second period. During the second period, the male-female ratio increased from 3.35:1 to 3.63:1. Road traffic accidents remained the major etiologic factor, which increased remarkably from 49.3% to 54.6% (P = 0.085), whereas assault-related injuries decreased significantly from 16.8% to 12.4% (P = 0.039). The proportion of patients with mandibular fractures decreased from 59.6% to 55.3% (P = 0.037), whereas the proportion of patients with midfacial fractures increased from 40.4% to 44.7% (P = 0.037). CONCLUSIONS: The changing pattern of maxillofacial fractures in our center is correlated to the socioeconomic status, population mobility, and etiologic factors. Strict enforcement of traffic laws and regulations is still a focal factor in attaining appreciable reduction in maxillofacial fractures associated with road traffic accidents.

Dental trauma in patients with single mandibular fractures.

PURPOSE: The purposes of this study were to investigate the occurrence and patterns of dental trauma in patients with single mandibular fracture and to evaluate the relationships between dental injury and fracture site of mandible. MATERIALS AND METHODS: From January 2000 to December 2009, 869 patients with mandibular fractures were registered. Only the patients with single mandibular fracture were included. The information and data collected included age, gender, mechanism of injury, type of mandibular fracture, and type of dental injury. RESULTS: Single mandibular fractures were sustained in 294 (33.8%) patients. Of these, 43.5% (128 patients) presented with associated dental injuries (509 injured teeth). The patients' male/female ratio was 2.46:1 (91 males and 37 females). Patients in 30-39 year age group possessed the highest risk of suffering dental trauma (odds ratio = 2.004, P = 0.014). Road traffic accidents were the most common mechanism of injury (54, 42.2%). Lower-anterior teeth were more often injured in patients with symphysis fracture (P < 0.001), and patients with condylar fracture more frequently sustained upper-posterior teeth injury (P < 0.001). Lower-posterior teeth injury was mostly found in patients with mandibular body fracture (P < 0.001) or angle fracture (P < 0.001). Dental injuries were more prone to occur in patients who sustained only symphysis fractures (odds ratio = 3.283, P < 0.001), and the risk was only 0.193-fold in patients who sustained only mandible angle fractures (odds ratio = 0.193, P < 0.001). CONCLUSIONS: The occurrence and type of dental injury were significantly related to the fracture site of mandible.

Dental trauma in patients with maxillofacial fractures.

PURPOSE: The purpose of this study was to analyze and evaluate the correlation between dental injuries and the pattern of maxillofacial fractures. The correlation with age, gender, trauma mechanism and type of maxillofacial fracture was also investigated. MATERIALS AND METHODS: From January 2000 to December 2009, 1131 patients with facial fractures were registered. Of these, 473 presented with associated dental trauma. The information and data collected and analyzed included: age, gender, mechanism of injury, type of facial fracture, type of dental injury, and the relationship between dental injury and facial fracture. RESULTS: Dental injury was sustained by 473 patients (41.8%), with a total of 2215 injured teeth. Of the 2215 injured teeth, 1191 (53.8%) were in the maxilla and 1024 (46.2%) in the mandible. Fall from a height had the highest risk of dental injuries (OR = 4.145, P = 0.002). The central incisor was the most injured tooth for both the maxilla (388, 36.2%) and mandible (284, 27.7%). The most common type of dental injury was avulsion (1070, 47.4%). More anterior teeth in the maxilla were of crown fracture, avulsion, and intrusion than that in the mandible, whereas more anterior teeth in the mandible were of subluxation and concussion than that in the maxilla. Dental injuries were more prone to occur in patients who sustained only symphysis fractures (OR = 2.817, P < 0.001), only 0.236-fold risk in patients who sustained only mandible angle fracture (P < 0.001). CONCLUSIONS: The occurrence of dental trauma is significantly related to the pattern and position of the maxillofacial fractures.

[Analysis of the efficacy of postoperative radiotherapy in gallbladder cancer].

OBJECTIVE: To summarize the experiences in gallbladder cancer treatment, evaluate the efficacy of postoperative radiotherapy, and investigate the method of improving the survival of gallbladder cancer patients. METHODS: One hundred and twenty-seven gallbladder cancer patients, treated in our center by radical resection (84 cases) and combined with postoperative radiotherapy (43 cases), between June 2003 to December 2009 were included in this study. Their clinical data and follow-up results were retrospectively analyzed. According to AJCC staging criteria, the survival time and 1-, 3- and 5-year survival rates of the surgery group and the postoperative radiotherapy group at the different pathological stages and resection margin status were compared. RESULTS: The median survival time of postoperative radiotherapy patients in stage III was 16.9 months, and the 1-year, 3-year, and 5-year survival rates were 55.7%, 23.5% and 18.2%, respectively, significantly higher than that of the simple operation group ( median survival time 14.3 months, and 1-year, 3-year, 5-year survival rates 42.7%, 22.6% and 16.7%, respectively) (P<0.05). The median survival time of postoperative radiotherapy patients in stage IV, the median survival time was 9.7 months in the postoperative radiotherapy group and 6.3 months in the simple surgery group, and the 1-year survival rates were 14.2% and 9.8%, the 3-year survival rates were 7.2% and 3.9%, the 5-year survival rates were 7.2% and 1.9%, respectively, all showing a statistically significant difference (P<0.05). Among the stage III and IVpatients, all the 1-, 3- and 5-year survival rates of the postoperative radiotherapy group were higher than that of the simple R0 and R1 surgical resection group (all P<0.05), but with a non-significant difference between the stageIandIIpatients (P>0.05). The main side effects in postoperative radiotherapy patients including nausea, vomiting and abdominal pain, all were successfully alleviated by symptomatic and supportive therapy, and the radiotherapy was successfully completed. CONCLUSIONS: With regard to the gallbladder cancer patients in stage III and IV, the survival rate can be obviously increased by postoperative radiotherapy. However, for patients in stageIand II, whether postoperative radiotherapy significantly improves the survival or not, needs to be further validated in larger scale studies.

[Pollution Characteristics and Risk Assessment of Antibiotics and Resistance Genes in Different Water Sources in the Wuhan Section of the Yangtze River].

The distribution characteristics, correlations, and potential ecological risks of 13 antibiotics and 10 antibiotic resistance genes (ARGs) in 16 water sources in Wuhan were analyzed using solid-phase extraction-ultra-high performance liquid chromatography-tandem mass spectrometry (SPE-UPLC-MS/MS) and real-time quantitative PCR technology. The distribution characteristics and correlations and potential ecological risks of antibiotics and resistance genes in this region were analyzed. The results showed that a total of nine antibiotics were detected in the 16 water source samples, and the concentration range was ND-177.36 ng·L-1. The concentration distribution presented as follows:Tributary Jushui River

Does trauma etiology affect the pattern of mandibular fracture?

PURPOSE: The purpose of the present study was to evaluate the relationship between trauma etiologies and anatomic sites of mandibular fractures. PATIENTS AND METHODS: The sample was composed of all patients who sustained mandibular fractures during a 10-year period (2000-2009). The patients' age and gender were recorded; the relationships between fracture etiology and pattern of mandibular fracture were also analyzed. Data analysis included the χ2 test, the Fisher exact test, the t test, and logistic regression analysis. P < 0.05 was considered significant. RESULTS: Fall at ground level had a 9.64-fold risk of mandibular condylar fractures (odds ratio, 9.64; P < 0.001). No significant relationship existed between different etiologies and symphysis fracture. All of the etiologies had a low risk to mandibular body fractures (odds radio, <1; P < 0.05). The occurrence of mandibular angle fractures was highly related to patients' age (P = 0.001). CONCLUSIONS: The pattern of mandibular fractures was highly related to patients' age and the different etiologies.

Fracture fragment of the condyle determines the ramus height of the mandible in children with intracapsular condylar fractures treated conservatively.

This study aimed to explore and impart understanding of bone remodelling in children with intracapsular fractures treated conservatively. Records of children (less than 12 years), who sustained intracapsular fractures and treated conservatively, were retrieved consecutively for the period of March 2011 to February 2016. Data about age, gender, date of injury, dates of admission and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fractures, treatment methods and time of review were recorded and analysed. Image dates of pre- and post-treatments, including date of review, were also recorded. A total of 22 patients complete their follow-up and show bone remodelling process. During their follow-up, all the displaced condylar fragments fused with the ramus stump at the displaced position. Regardless of the type of conservative procedure, both treatments cannot promote the spontaneous fracture reduction in patients with intracapsular condylar fractures. During follow-up, the absorption of the lateral process of the condyle after the closed treatment becomes close to the 'horizontal absorption', until the height (or articular surface) of the lateral condylar process dropped and aligned to the articular surface of the medial process. In children with intracapsular condylar fractures, the fracture fragment of the condyle determines the ramus height of the mandible. Closed treatment cannot restore the fracture fragment. If the height of the fracture fragments dropped remarkably, then open reduction and rigid internal fixation become more suitable.

Galectin­1 binds GRP78 to promote the proliferation and metastasis of gastric cancer.

The present study aimed to investigate the potential molecular mechanisms by which galectin­1 (Gal­1) and glucose­regulated protein 78 (GRP78) influence the development of malignant gastric cancer (GC). Immunohistochemistry and western blotting were used to map the expression and location of the Gal­1 gene in the 80 paraffin­embedded GC samples, 16 fresh samples and surrounding tissues. Gal­1 was overexpressed and knocked down using lentiviral vectors in the human GC cell lines HGC­27 and AGS. Through the use of the Cell Counting Kit­8 assay, clone formation assay, wound healing assay, invasion assay and tumor xenograft, the possible biological roles of Gal­1 were further evaluated. The downstream interacting proteins were predicted by the BioGRID database, and GRP78 was chosen for further investigation. Immunofluorescence labeling and Co­IP were used to confirm the connection. The statistical tests utilized were the two­tailed paired Student's t­test, χ2 test, Kaplan­Meier and Cox regression analysis, and Spearman's rank correlation coefficients. In GC, Gal­1 is extensively expressed and has the potential to interact with GRP78. Poor prognosis is linked to high levels of GRP78 and Gal­1 expression in patients with GC. According to the functional study, Gal­1 knockdown prevented cells from thriving and pushed Gal­1 expression, which aided in the proliferation, migration and invasion of GC. Gal­1 overexpression additionally aided the development of subcutaneous xenograft tumors. The mechanistic investigation proved that GRP78 and Gal­1 interacted, accelerating the course of GC. Gal­1 silencing had an inhibitory effect on the proliferation of HGC­27 cells that was removed by ectopic GRP78 expression, whereas the stimulating effects of Gal­1 overexpression in AGS cells were inhibited by GRP78 knockdown. In conclusion, Gal­1 interacts with GRP78 to facilitate the advancement of GC. The Gal­1/GRP78 axis is supported by the functional data of the present study as a possible GC treatment target.

[Preliminary study on mechanism of therapeutic effect of Huganjiexian decoction on hepatic fibrosis].

OBJECTIVE: To observe the effects of Huganjiexian decoction on rat hepatic fibrosis and the creation of cytokines. METHODS: Rat hepatic fibrosis was induced by intraperitoneally injection of carbon tetrachloride. At the same time, these rats were treated with different dosages of Huganjiexian decoction. Sho-saiko-to compound treating group and Fufangbiejiarangan Tablets treating group were used as positive controls. After twelve weeks, all rats were executed. Histopathologic changes were observed after H.E and Masson stainings. The expression of collagen type I, collagen type III, TGF-beta 1 and PDGF-BB in liver were detected by immunohistochemical staining. RESULTS: Compared with fibrotic group, hepatic fibrosis in decoction groups was significantly improved. In decoction groups, levels of collagen type I, collagen type III, TGFbeta1 and PDGF-BB were decreased, especially in the low-dose curcumin group. The TGF-beta 1 positive percentage were 7.56%+/-2.18%, 29.25%+/-7.84%, 13.54%+/-4.15%, 21.82%+/-6.64%, 20.06%+/-7.14%, 13.78%+/-4.35%, 12.75%+/-3.98% in liver tissues from normal group, model group, low, middle, high curcumin, Sho-saiko-to compound and Fufangbiejiarangan Tablets treating groups respectively (P less than 0.05); while the PDGF-BB positive percentage were 1.68%+/-0.41%, 11.70%+/-2.28%, 3.65%+/-0.76%, 5.24%+/-1.04%, 6.37%+/-1.12%, 4.16%+/-0.61%, 3.38%+/-0.56% in liver tissues from those groups respectively (P less than 0.05). CONCLUSION: Huganjiexian decoction can improve rat hepatic fibrosis, possibly via inhibiting the expression of collagen type I, collagen type III, TGFbeta1 and PDGF-BB.