Determination of cotinine and 3-hydroxynicotinine in human serum by liquid chromatography-tandem mass spectrometry and its application.

In this study, we developed a method for determining cotinine and 3-hydroxycotinine in human serum and established a methodology for an in-depth study of tobacco exposure and health. After the proteins in the human serum samples were precipitated with acetonitrile, they were separated on a ZORBAX SB-Phenyl column with a mobile phase of methanol encompassing 0.3% formic acid-water encompassing 0.15% formic acid. The measurement was performed on an API5500 triple quadrupole mass spectrometer in the multiple reaction monitoring mode. Cotinine, 3-hydroxycotinine, and cotinine-d3 isotope internal standards were held for 2.56 minutes, 1.58 minutes, and 2.56 minutes, respectively. In serum, the linear range was 0.05 to 500 ng·mL-1 for cotinine and 0.50 to 1250 ng·mL-1 for 3-hydroxycotinine. The lower limit of quantification (LLOQ) was 0.05 ng·mL-1 and 0.5 ng·mL-1 for cotinine and 3-hydroxycotinine, respectively. The intra-day and inter-day relative standard deviations were <11%, and the relative errors were within ±â€…7%. Moreover, the mean extraction recoveries of cotinine and 3-hydroxycotinine were 98.54% and 100.24%, respectively. This method is suitable for the rapid determination of cotinine and 3-hydroxycotinine in human serum because of its rapidity, sensitivity, strong specificity, and high reproducibility. The detection of cotinine levels in human serum allows for the identification of the cutoff value, providing a basis for differentiation between smoking and nonsmoking populations.

[Effect of EPA on inflammatory response of human periodontal ligament fibroblasts induced by P. gingivalis LPS].

PURPOSE: To observe the effect of eicosapentaenoc acid (EPA) on the expression of inflammatory factors in human periodontal ligament fibroblasts (hPDLCs) induced by using lipopolysaccharides (LPS) of Porphyromonas gingivalis (P. gingivalis). METHODS: hPDLCs were cultured by using tissue block method, and the effects of different concentrations of EPA on the activity of hPDLCs cells were observed by MTT method. According to MTT results, the appropriate concentration of EPA was selected, and the expression of interleukin-6(IL-6), IL-8 and IL-1ß in hPDLCs induced by P.gingivalis LPS was detected by real time PCR and ELISA. The data were evaluated by SPSS 10.0 software package. RESULTS: 25-100 µmol/L EPA had no effect on the activity of hPDLCs cells, but could inhibit the expression of IL-6, IL-8 and IL-1ß induced by P. gingivalis LPS in a dose-dependent manner. CONCLUSIONS: EPA can inhibit the expression of inflammatory factors induced by P. gingivalis LPS without affecting cell activity, indicating that EPA has the possibility of anti-inflammatory treatment of periodontitis.

Two novel ectodysplasin A gene mutations and prenatal diagnosis of X-linked hypohidrotic ectodermal dysplasia.

BACKGROUND: Hypohidrotic ectodermal dysplasia (HED) is mainly caused by ectodysplasin A (EDA) gene mutation. Fetus with genetic deficiency of EDA can be prenatally corrected. This study aimed at revealing the pathogenesis of two HED families and making a prenatal diagnosis for one pregnant female carrier. DESIGNS: Genomic DNA was extracted from two HED patients and sequenced using whole exome sequencing (WES). The detected mutations were confirmed in patients and family members using Sanger sequencing. The expression of soluble ectodysplasin A1 (EDA1) protein was studied by western blot. The transcriptional activity of NF-κB pathway was tested by dual luciferase assay. The genomic DNA of fetus was extracted from shed chorion cells and EDA gene was screened through Sanger sequencing. RESULTS: We identified two novel EDA mutations: c.1136T>C (p.Phe379Ser) and c.[866G>C;868A>T] (p.[Arg289Pro;Ser290Cys]). Further examinations revealed that these two mutated EDA1 proteins showed completely impaired solubility, and the transcriptional NF-κB activation induced by these missense mutant-type EDA1 proteins was significantly reduced compared with wild-type EDA1. Furthermore, the analysis of amniotic fluid samples from a pregnant heterozygote indicated that the fetus was a c.1136T>C mutation female carrier. CONCLUSIONS: This study extended the mutation spectrum of X-linked hypohidrotic ectodermal dysplasia (XLHED) and applied prenatal diagnosis for the pregnant carrier, which can be helpful in genetic counseling, prenatal diagnosis, and intervention for the XLHED family.

Diffuse-type tenosynovial giant cell tumor of the temporomandibular joint with skull base invasion: a report of 22 cases with literature review.

OBJECTIVES: The aim of this study was to retrospectively analyze the clinical characteristics, surgical treatment, and prognosis of patients with diffuse-type tenosynovial giant cell tumor (D-TGCT) involving the temporomandibular joint (TMJ) and the skull base. STUDY DESIGN: A retrospective study was performed in patients with D-TGCT involving the TMJ and the skull base at our institute from April 2009 to August 2018. Data on clinical characteristics, surgical treatment, and prognosis were collected and analyzed. A literature search on D-TGCT involving the TMJ was conducted and the data analyzed. RESULTS: The study included 22 patients (14 males and 8 females), with an average age of 44 years. The main symptoms were headache and hearing limitation, accompanied by a swelling in the TMJ area. Magnetic resonance imaging (MRI) showed low signals on T1- and T2-weighted images. All lesions were completely removed. Temporal bone flap, titanium mesh, and temporal muscle flap were used for reconstruction. The recurrence rate was 4.5%. In the literature, 115 cases were reported. Surgery alone was performed in 88 cases; postoperative radiotherapy was performed in 19 cases; the tumor recurrence rates were 9.1% and 15.8% for the 2 procedures, respectively. All patients were alive at the end of the follow-up period. CONCLUSIONS: D-TGCT involving the TMJ and the skull base is a locally aggressive but benign lesion necessitating complete resection and has a good prognosis.

[Mutation screening and functional analysis for 8 patients with ectodermal dysplasia].

PURPOSE: To identify the potentially pathogenic mutations in patients with ectodermal dysplasia (ED) and to investigate the pathogenicity of mutations by functional studies. METHODS: Eight Chinese ED patients were included in this study. Peripheral venous blood was taken from the patients and DNA was extracted. Whole-exome sequencing (WES) was performed using DNA samples. After quality control of the sequencing data, the potentially pathogenic mutations were screened. The pathogenicity of the mutations was predicted in silico. Immunofluorescence study and dual luciferase assays were performed to investigate the pathogenicity of the mutations. RESULTS: The effective rates of all sequencing samples were above 97.5% and the error rates were less than 0.03%. The proportions of Q20 were more than 97.0%. The average sequencing depths of the target region were more than 90×. The sequencing data were acceptable for further analysis. After data screening, three missense mutations of EDA were detected, including c.959A>G, c.1073A>G and c.1001G>A. The allele frequency was low in population database for all three mutations and in silico analysis indicated all three mutations were disease-causing. Immunofluorescence analysis showed that p65 protein nuclear translocation was compromised by EDA mutations, dual luciferase assays also showed that the activation of NF-κB pathway was decreased by EDA mutations. CONCLUSIONS: This study identified EDA mutations in Chinese ED patients and further verified the pathogenicity of the mutations by functional studies, contributing to the understanding of the pathogenesis of ED.

[Perioperative nursing of zygomatic implant surgery for patients with severe periodontitis].

PURPOSE: To analyze the perioperative nursing characteristics about severe periodontitis patients with immediate zygomatic implantation, and to summarize the clinical nursing experience. METHODS: Preoperatively, all patients received psychological counseling, oral hygiene instruction, and periodontal care with necessary means after physical examination. Cooperative procedures were preformed between nurses and surgeon during operation. After operation, nursing interventions were given including wound care, pain control, ice compression, appropriate diet and close follow-up. RESULTS: All patients were successfully operated without serious complications. Favorable implant primary stability was achieved in each patient. No patient developed wound dehiscence, one patient had wound pain and one patient had minor facial swelling. Temporary restoration was conducted to restore occlusal relationship and masticatory function within 48 hours. CONCLUSIONS: Comprehensive nursing intervention during perioperative period is necessary and deserves to be applied for patients with severe periodontitis who are treated with immediate zygomatic implant surgery.

[Morphometric analysis of maxillofacial bone in 48 patients with ectodermal dysplasia].

PURPOSE: The study was performed to analyze the maxillofacial morphology of 48 patients with ectodermal dysplasia (ED) and to provide some reference for implant treatment of ED patients. METHODS: The study collected the clinical data and lateral cephalometric radiographs of 48 patients with ED treated between June 2013 and October 2016. The patients were grouped as follows: group 1, 23 patients, at least with two kinds of ectodermal disorder, besides hypodontia; group 2, 25 patients, only with one kind of ectodermal disorder, besides hypodontia. The number of missing teeth and maxillofacial cephalometric parameters were compared between 2 groups. SPSS 17.0 software package was performed for statistical analysis. RESULTS: The number of missing teeth was significantly larger in group 1(22.3±5.8) than group 2 (12±6.6) (P<0.05). The number of retained deciduous teeth was significantly larger in group 1 (8±4) than in group 2 (2.4±2.7) in females (P<0.05). Cephalometric analysis showed a reduced maxilla length (ANS-Ptm), retrusive maxilla (S-Ptm, SNA, NA-PA), a normal size (S-Co) and length (Co-Po) of mandible, a protruding mandible (NP-FH) and chin (Y axis), skeletal Angle Ⅲ malocclusion(ANB<0) and a reduced facial height (N-Me) in two groups. SNA, NA-PA, ANS-Ptm, S-Ptm and Y axis were significantly decreased and NP-FH was significantly increased in group 1 compared to group 2 in males (P<0.05). CONCLUSIONS: Maxillofacial morphology of ED patients typically presented a reduced maxilla length and retrusive maxilla, a normal size and length of mandible, a protruding mandible and chin, skeletal Angle Ⅲ malocclusion and a reduced facial height. The severity of abnormalities in maxillofacial bone morphology was correlated positively with absence of permanent teeth. Furthermore, retained deciduous teeth might have positive effect on the development of maxillofacial bone.

Accuracy of a real-time surgical navigation system for the placement of quad zygomatic implants in the severe atrophic maxilla: A pilot clinical study.

BACKGROUND: A real-time surgical navigation system potentially increases the accuracy when used for quad-zygomatic implant placement. PURPOSE: To evaluate the accuracy of a real-time surgical navigation system when used for quad zygomatic implant placement. MATERIALS AND METHODS: Patients with severely atrophic maxillae were prospectively recruited. Four trajectories for implants were planned, and zygomatic implants were placed using a real-time surgical navigation system. The planned-placed distance deviations at entry (entry deviation）points, exit (exit deviation) points, and angle deviation of axes (angle deviation) were measured on fused operation images. The differences of all the deviations between different groups, classified based on the lengths and locations of implants, were analysed. A P value of < 0.05 indicated statistical significance. RESULTS: Forty zygomatic implants were placed as planned in 10 patients. The entry deviation, exit deviation and angle deviation were 1.35 ± 0.75 mm, 2.15 mm ± 0.95 mm, and 2.05 ± 1.02 degrees, respectively. The differences of all deviations were not significant, irrespective of the lengths (P = .259, .158, and .914, respectively) or locations of the placed implants (P = .698, .072, and .602, respectively). CONCLUSION: A real-time surgical navigation system used for the placement of quad zygomatic implants demonstrated a high level of accuracy with only minimal planned-placed deviations, irrespective of the lengths or locations of the implants.

Profile and Correlates of Health-related Quality of Life in Chinese Patients with Coronary Heart Disease.

BACKGROUND: Although coronary heart disease (CHD) is one of the major cardiovascular diseases, risk factors associated with the health-related quality of life (HRQoL) of CHD patients remain unclear. The present study was designed to determine the profile and significant factors of the HRQoL in CHD patients. METHODS: A cross-sectional study was conducted in rural communities of Fangshan District, Beijing, China. Socio-demographic, lifestyle, and comorbidity information of CHD patients were collected by a structured questionnaire and medical records. HRQoL was measured using European Quality of Life 5-dimensions (EQ-5D) scale and EQ Visual Analog Scale (EQ-VAS). Multiple linear and logistic regressions were performed to explore the association of potential risk factors with HRQoL scores and each EQ-5D, respectively. RESULTS: Totally, 1928 CHD patients (mean age 61.64 ± 9.24 years; female:male = 2.4:1) were enrolled in the study. The mean score of EQ-5D index and EQ-VAS were 0.889 ± 0.172 and 71.56 ± 17.65, respectively. Multiple linear regression revealed that marital status, physical activity, moderate alcohol drinking, and family's population were positive independent correlates of EQ-VAS, whereas diabetes mellitus and stroke were negative independent correlates (all P < 0.05). Age and stroke were negatively while physical activity, moderate alcohol drinking, family's population and household income were positively correlated with EQ-5D index (all P < 0.05) independently. In addition, each of the five HRQoL dimensions had various specific determinants, including obesity, underweight, smoking or education. CONCLUSIONS: Findings of the study highlight certain socio-demographic, lifestyle factors, and comorbid stroke or diabetes mellitus as correlates of HRQoL in Chinese CHD patients. Large-scale cohort studies should be carried out to confirm our results in the future.

Eye-Lid approach for four zigomatic implant placement in the severely reabsorbed maxillae: technical note.

Up to date, zygomatic implants (ZIs) have been considered a predictable treatment modality for cases of atrophic maxilla. In some severe cases with severe vertical and/or horizontal bone resorption in the anterior maxilla, the placement of standard implants in the anterior area represents a challenge. In these arduous scenarios, performance of a zygomatic "quad-approach" might be advocated. Nevertheless, in limited zygomatic bone width, orbital cavity perforation constituted a potential risk that must be controlled during surgery. This paper focused at presenting a novel technique modification of conjunctival incision to expose the inferolateral orbital rim by an ophthalmologist, to assist the oral surgeon to have direct visualization of the orbital margin and to easily control the drilling direction. With this modification, the potential risk of orbital cavity penetration and its content damage could be diminished and ZIs might be well placed on accordance to prosthetically planned position.

Linkage and association between interleukin-6 gene polymorphisms and ischemic stroke: a family-based study in the northern Chinese Han population.

BACKGROUND: Numerous genetic risk factors of ischemic stroke (IS) have been reported from both candidate gene and genome-wide strategies with inconsistent results. The objective of this study was to confirm the relationship between 10 previously identified single-nucleotide polymorphisms (SNPs) and IS in the Chinese population. METHODS: A family-based study was conducted in a rural area of Beijing, with a total of 227 IS families with 622 participants recruited. Both linkage and association analyses were performed, with all the sibling pairs derived from the 227 families analyzed using the sib-pair test of model-free linkage to assess linkage between SNPs and IS, with association analyses including a family-based association test (FBAT) and generalized estimating equations (GEE). RESULTS: Nonparametric linkage analysis revealed that the rs1800796 polymorphism in the interleukin-6 (IL-6) gene is significantly linked to the small arterial occlusion (SAO) subtype (p=0.022), while the rs7193343 polymorphism in the ZFHX3 gene is linked to IS (p=0.002) under the dominant model. Significant allelic associations were identified between the G allele of rs1800796 and IS (p=0.042) and the SAO subtype (p=0.025) in the FBAT. The GEE method revealed that the G allele of rs1800796 increased IS risk by 1.55-fold (95% 95% confidence interval [CI]: 1.01, 2.37; p=0.043) and 2.43-fold (95% CI: 1.32, 4.45; p=0.004) in the SAO subtype in the dominant model, which correlated with the significant associations detected in the FBAT. CONCLUSIONS: In this study, we confirmed that the SNP of rs1800796 in the IL-6 gene is related to IS and the SAO subtype using different statistical approaches. These findings could contribute to identifying individuals with a high IS risk.

Update on the surgical management of temporomandibular joint-centered tendon sheath giant cell tumor with intradural extension: introducing a cost-effective method in using temporal bone for skull base reconstruction in preventing brain hernia.

Tendon sheath giant cell tumor is an idiopathic proliferative and destructive disease of the synovium. It is rare and tends to arise in large joints, for example, knee and ankle, but it can also arise in temporomandibular joints (TMJs). Because of its destructive nature, immediate treatment upon diagnosis is recommended. Radical resection proved to be an excellent choice for superior local control. However, the unfavorable anatomic location of TMJ and infratemporal fossa tumor with intradural extension make such a resection impractical. Hereby, we reported a case of resection of a TMJ tendon sheath giant cell tumor with intradural extension using a transcranial approach. This involves a complex radical resection with subsequent reconstruction. Transposition of temporal bone flap is a novel state-of-the-art technique in reconstructing the middle fossa floor defect by providing a three-dimensional rigid architecture to support the brain. Temporal bone flap is a reliable plug for rigid support in preventing brain hernia and cerebrospinal fluid leak. Despite its complexity, this cost-effective technique is relatively straightforward to learn and is applicable across all socioeconomic groups.

Artesunate exerts an anti-immunosuppressive effect on cervical cancer by inhibiting PGE2 production and Foxp3 expression.

Artesunate (ART), derived from a common traditional Chinese medicine, has beeen used an antimalarial for several years. In this study, the effect and mechanism of ART on anti-human cervical cancer cells was examined. The level of prostaglandin E2 (PGE2 ) and the population of CD4+CD25+Foxp3 regulatory T cells (Treg) in peripheral blood were detected by flow cytometry. In vivo antitumor activity was investigated in mice with cervical cancer by the subcutaneous injection of various concentrations of ART. The concentrations of PGE2 in the supernatants of CaSki cells were measured using an ELISA kit. Cyclooxygenase-2 (COX-2) and Foxp3 expression were determined using quantitative polymerase chain reaction (qPCR) and western blot analysis. The effect of ART on the viability of CaSki and Hela cells was evaluated with a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. It was identified that the level of PGE2 and the population of CD4+CD25+Foxp3 Treg cells in the peripheral blood were significantly higher in cervical cancer patients and mice with cervical cancer. ART was capable of inhibiting orthotopic tumor growth, which correlated with a decrease in the level of PGE2 and the percentage of Treg cells in mice with cervical cancer. Furthermore, ART decreased COX-2 expression and the production of PGE2 in CaSki and Hela cells. Notably, the supernatants of CaSki cells treated with ART lowered the expression of Foxp3 in Jurkat T cells, which was capable of being reversed by exogenous PGE2 . Our data revealed that ART may elicit an anti-tumor effect against cervical cancer by inhibition of PGE2 production in CaSki and Hela cells, which resulted in the decrease of Foxp3 expression in T cells. Therefore, ART may be an effective drug for immunotherapy of cervical cancer.

[Influence of chronic diseases on health related quality of life in middle-aged and elderly people from rural communities: application of EQ-5D scale on a Health Survey in Fangshan, Beijing].

OBJECTIVE: To evaluate the health related quality of life (HRQoL) and to explore the influencing factors related to the prevalence of the essential hypertension, diabetes, coronary heart disease (CHD) and stroke in middle-aged and elderly people from rural communities. METHODS: A total of 5345 individuals were chosen from a 2010 Health Survey in Fangshan, Beijing. Self-designed questionnaire was applied to collect the information on general health-related behaviors, chronic conditions, self-rated health, blood pressure and HRQoL with the EuroQoL questionnaire (EQ-5D) were measured. Probit regression model was used to identify the influencing factors on HRQoL, adjusting age, marriage status, education level, smoking, alcohol intake, physical activity and control of blood pressure. Population Attributable Risk Proportion (PARP) for estimating the influence of chronic disease on HRQoL was also calculated. RESULTS: The average EQ-5D index was 0.923 ± 0.145, with 72.1% of the overall respondents in the status of having chronic diseases. Participants with chronic diseases had significantly lower EQ-5D index (0.907 ± 0.155) than those without (0.963 ± 0.105) (t = 15.082, P < 0.001). Significant relations were found between a lower HRQoL and chronic diseases. Relative risk (RR) and 95% confidence interval (95%CI) of poor HRQoL in populations with hypertension, diabetes, CHD and stroke were 1.686 (95%CI: 1.519 - 1.871), 1.725 (95%CI: 1.502 - 1.981), 1.869 (95%CI: 1.663 - 2.099), and 1.759 (95%CI: 1.474 - 2.089) respectively. The most influential disease appeared to be stroke in male (RR = 1.929, 95%CI: 1.462 - 2.546), whereas CHD in female individuals (RR = 1.926, 95%CI: 1.671 - 2.220). Rates of PARP (PAR%) for poor HRQoL in chronic disease subgroups were as follow: hypertension 31.05%, CHD 23.39%, diabetes 4.84% and stroke 4.44%, respectively. CONCLUSION: This study suggested that stroke, at individual level, was the major influential factor to HRQoL. However, hypertension remained the leading preventable influential factor to HRQoL at the population level.

Double-barrel fibula vascularized free flap with dental rehabilitation for mandibular reconstruction.

PURPOSE: The vascularized free fibula flap has become the most popular reconstruction method after mandibular resection because of adequate bone graft length and acceptance of dental implants. However, using 1 fibula bone may produce a height discrepancy between the native mandible and the grafted fibula that results in subsequent difficulty in wearing conventional dentures or osteointegrated implants. Several options can be used to resolve this problem such as delayed onlay bone graft, iliac bone reconstruction, fibula distraction, and double-barrel fibula flap graft. This article describes the reconstruction of segmental mandible defects with the double-barrel fibula flap and denture rehabilitation. MATERIALS AND METHODS: This procedure was used in 7 patients. A donor site fibula corresponding to at least twice the length of the mandibular defect was harvested. Double-barrel free fibula grafting was performed in 6 patients for primary reconstruction and 1 patient for secondary reconstruction, including 3 cases of osteocutaneous flap with skin islands in the reconstruction of a composite defect from a malignant tumor. Prosthodontic treatment was completed in all 7 patients. Four patients received secondary implant-supported dental reconstruction, and 3 patients who received radiation (6,000 cGy) after graft surgery had conventional removable partial dentures. RESULTS: Microvascular fibula transfers were completely successful, and all skin paddles survived without necrosis. The original mandibular contour was maintained by a reconstruction plate; the reconstruction mandibular length was 6.5 to 10 cm, the reconstruction height of the double-barrel fibula was 3.0 to 3.8 cm, and all patients were satisfied with the postoperative facial esthetics and chewing function from the implant-supported denture and removable partial prostheses. CONCLUSIONS: Mandibular segmental defects can be esthetically and functionally reconstructed by a double-barrel vascularized fibula flap that not only matches the height of the native mandible but also allows osteointegrated dental implantation for dental rehabilitation.

Clinical outcome of dental implants placed in fibula-free flaps for orofacial reconstruction.

BACKGROUND: Functional reconstruction of the jaw defect due to tumor resection poses a challenging problem in maxillofacial surgery. The osteocutaneous fibula free flap in combination with simultaneous or second stage insertion of dental implants has exhibited growing popularity for such reconstructions. This study was aimed at evaluating the clinical status and the success rates of dental implants inserted in fibula-free flaps for orofacial reconstruction following ablation of tumors. METHODS: We conducted a clinical follow-up study based on 29 patients after oral tumor surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 5-year period. The follow-up protocol included clinical examination and radiological evaluation. The clinical records of the patients were reviewed retrospectively. Information on treatment modalities, dentition, implant parameters, and prostheses was collected and analyzed. RESULTS: In general, a high primary stability for implants placed into the free fibula grafts was achieved. The 1-year and 5-year cumulative survival rates of the implants were 96% and 91%, respectively, using the Kaplan-Meier method. The 1-year and 5-year cumulative success rates of implants placed into the fibula bone grafts were 95% and 87%, respectively. The main reasons for failure of the dental implants were infection, tumor recurrence and soft tissue proliferation. The fibula flap presents many advantages for implant placement, but its limited height sometimes makes implant-supported prosthetic rehabilitation difficult. CONCLUSIONS: Vascularized fibula bone grafts provide a firm basis for the placement of dental implants in jaw reconstruction. Implants placed in fibula bone grafts were shown to integrate normally. The double-barrel technique, or increasing the height of the fibula flap by vertical distraction osteogenesis before implant placement in the mandible, is desirable from a functional and esthetic point of view.

Endoscopic neurovascular perspective in microvascular decompression of trigeminal neuralgia.

PURPOSE: To evaluate the advantages of endoscopic assistance in microvascular decompression (MVD) for the treatment of trigeminal neuralgia (TGN). METHODS: One hundred and sixty-seven patients suffering from TGN were treated by MVD from October 2003 to December 2006. The operating microscope was used in conjunction with a 30 degrees effect endoscope to diagnose neurovascular compression (NVC). RESULTS: The type and grade of NVC were determined in all cases. 85.26% of neurovascular conflicts were diagnosed with the microscope alone. An additional 14.76% could be diagnosed with the assistance of the endoscope. 96.79% of patients experienced immediate relief of pain. CONCLUSIONS: MVD is a highly effective treatment for TGN. Endoscopes are very useful during the procedures. They increase the clarity of the surgical field and they enable panoramic visualization in areas that are blind to the direct field of view of the operating microscope. A significant percentage of neurovascular conflicts would be missed at surgery without endoscopic assistance.

Values of endoscopic ultrasonography for diagnosis and treatment of duodenal protruding lesions.

OBJECTIVE: The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography (CT) and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography (EUS) with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. METHODS: Patients with duodenal protruding lesions who were indicated for EUS were examined by EUS with 12 approximately 15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of EUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of EUS. Those patients without endoscopic resection or surgical excision were periodically followed up with EUS. RESULTS: A total of 169 patients with duodenal protruding lesions were examined by EUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner's gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After EUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of EUS, with 93.33% diagnostic accuracy. The results of follow-up with EUS indicated that duodenal cyst, Brunner's gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1 approximately 3 years. No related complications occurred among all patients that received EUS examinations. CONCLUSION: EUS is an effective and reliable diagnostic method for duodenal protruding lesions.

[Buccal soft tissue augmentation using acellular dermal matrix in implant therapy].

OBJECTIVE: To evaluate the use of acellular dermal matrix (ADM) to improve esthetic effects of alveolar ridge in dental implantology. METHODS: Fifty patients with similar single missing tooth in the anterior maxilla were randomly divided into two groups: the ADM group was treated with dental implant therapy plus ADM transplantation; the control group was treated with dental implant therapy alone. The periodontal parameters and the changes of horizontal width of alveolar crest at implant zones were evaluated before surgery and 12 weeks after surgery. RESULTS: All operated sites healed uneventfully. Mean horizontal width of alveolar crest in ADM group increased by (3.10 +/- 0.64) mm at 12 weeks and the control group increased by (0.30 +/- 0.50) mm, The volume increase showed a significant difference groups (P < 0.05). Mean horizontal width of alveolar crest in ADM group was (11.50 +/- 1.48) mm and the contralateral alveolar crest was (11.60 +/- 1.60) mm (P > 0.05). CONCLUSIONS: ADM is a suitable material for the treatment of soft tissue deformities due to its biocompatibility and horizontal gain of soft tissue.