Analysis of factors influencing hospitalization cost of patients with distal radius fractures: an empirical study based on public traditional Chinese medicine hospitals in two cities, China.

BACKGROUND: Distal radius fractures (DRFs) have become a public health problem for all countries, bringing a heavier economic burden of disease globally, with China's disease economic burden being even more acute due to the trend of an aging population. This study aimed to explore the influencing factors of hospitalization cost of patients with DRFs in traditional Chinese medicine (TCMa) hospitals to provide a scientific basis for controlling hospitalization cost. METHODS: With 1306 cases of DRFs patients hospitalized in 15 public TCMa hospitals in two cities of Gansu Province in China from January 2017 to 2022 as the study object, the influencing factors of hospitalization cost were studied in depth gradually through univariate analysis, multiple linear regression, and path model. RESULTS: Hospitalization cost of patients with DRFs is mainly affected by the length of stay, surgery and operation, hospital levels, payment methods of medical insurance, use of TCMa preparations, complications and comorbidities, and clinical pathways. The length of stay is the most critical factor influencing the hospitalization cost, and the longer the length of stay, the higher the hospitalization cost. CONCLUSIONS: TCMa hospitals should actively take advantage of TCMb diagnostic modalities and therapeutic methods to ensure the efficacy of treatment and effectively reduce the length of stay at the same time, to lower hospitalization cost. It is also necessary to further deepen the reform of the medical insurance payment methods and strengthen the construction of the hierarchical diagnosis and treatment system, to make the patients receive reasonable reimbursement for medical expenses, thus effectively alleviating the economic burden of the disease in the patients with DRFs.

Endoscopic-Assisted Forehead Augmentation with Polyetheretherketone (PEEK) Patient-Specific Implant (PSI) for Aesthetic Considerations.

BACKGROUND: Forehead augmentation have become popular aesthetic procedures among Asians in recent years. However, the use of polyetheretherketone (PEEK) patient-specific implant (PSI) in the facial contouring surgery for aesthetic considerations is not well documented in the existing studies. The purpose of this study was to develop a novel method for forehead augmentation and assess the clinical outcomes and complications in patients who underwent forehead augmentation with PEEK PSI assisted by endoscopy. METHODS: The PEEK PSIs were fabricated using the virtual surgical planning (VSP) and the computer-aided manufacturing (CAM) for each patient, preoperatively. The implant pockets were dissected in the subperiosteal plane, and PEEK PSIs were placed in their designed position and fixed assisting by endoscopy via small incision within the hairline. All patients were asked to complete the FACE-Q questionnaire before and 6 months after the operation. Pre- and postoperative demographics, photographs, and other clinical data of patients were collected and analyzed. RESULTS: 11 patients underwent forehead augmentation were enrolled in this study. All procedures were completed successfully with the help of endoscope. The average patient age was 30.63 ± 2.54 years. The mean thickness and size of PEEK PSI were 4.44 ± 1.77 mm and 38.43 ± 22.66 cm2, respectively. The mean operative time was 83.00 ± 29.44 min, and the mean postoperative follow-up period was 11.00 ± 6.50 months. No implant exposure, extrusion or removal were reported. The FACE-Q scores of patients in satisfaction with the forehead increased from 47.64 ± 7.15 to 78.81 ± 6.35. CONCLUSIONS: PEEK PSIs can be prefabricated to achieve accurate remodeling of the frontal contour with good esthetic outcomes. The endoscope provides direct and magnified vision, which allow easy access to the supraorbital rim and lateral edge of the eyebrow arch and confirming the position of the implants without damaging nerves and vessels. Endoscopic-assisted forehead augmentation with PEEK PSI is safe and effective. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266 .

Characterization of a broad-spectrum endolysin rLysJNwz and its utility against Salmonella in foods.

Salmonella is a common foodborne pathogen worldwide. The use of bacteriophage-encoded endolysins as antimicrobial agents is a promising approach for controlling pathogenic contamination. In this context, a recombinant endolysin named rLysJNwz, consisting of a single domain falling with the L-alanogyl-D-glutamate peptidase-like family, was cloned, expressed, and characterized. The yield of rLysJNwz was about 25 mg/L. Synergy between 7.5 µg/mL rLysJNwz and 0.5 mmol/L EDTA could decrease the viable counts of Salmonella NCTC 8271 by 93.28%. A synergistic effect between rLysJNwz and polymyxin B was demonstrated, exhibiting the MIC of polymyxin B decreased by twofold. Specifically, rlysJNwz had strong thermostability at temperatures (4-95 °C) and maintained high activity at pHs from 5.0 to 11.0. rlysJNwz was a metal ion-dependent peptidase, which activated by divalent metal ions such as Zn2+, Mn2+, or Ca2+. Moreover, it was also found that the synergism of rlysJNwz and EDTA had bactericidal activities against a broad range of Gram-negative bacteria, including several multidrug-resistant bacteria. The application of rLysJNwz combined with EDTA was evaluated on contaminated eggs and lettuce for 60 min, displaying more than 86.7% and 86.5% reduction of viable Salmonella, respectively. Hence, these results suggest that rLysJNwz is a potential antibacterial agent to control Salmonella, especially antibiotic-resistant pathogen contamination in the field of food safety. KEY POINTS: • rLysJNwz shows lytic activities against a broad range of Gram-negative bacteria. • Endolysin rLysJNwz is a stable metalloenzyme and has high thermostability. • rLysJNwz and 0.5 mmol/L EDTA synergistically inactivate Salmonella on eggs and lettuce.

Use of bentonite-coated activated carbon for improving the sensitivity of RT-qPCR detection of norovirus from vegetables and fruits: The ISO 15216-1:2017 standard method extension.

Produce-related foodborne outbreaks are becoming increasingly prevalent worldwide. In plant tissues, various compounds, including polysaccharides, phenolic compounds, and chlorophyll, can inhibit RT-PCR detection of viruses. In this study, we developed a highly sensitive RT-qPCR in combination with the bentonite-coated activated carbon (BCAC) assay for detection of norovirus from fruits and vegetables, which could be completed within 7 h and was about 10-100 fold more sensitive than the standard procedures (ISO 15216-1:2017). The extraction efficiencies of three surrogate viruses (MS2, MNV-1, and TV) from five fresh produce (lettuce, cherry tomato, blueberry, strawberry, and spinach) were higher with BCAC treatment than those of control groups, ranging from 17.82% to 98.60%. The average detection limit of these viruses using the BCAC-RT-qPCR method was stable at an average of 102 PFU/g or GC/g. Finally, this BCAC-RT-qPCR method was applied for detection of human norovirus GII.4 spiked onto lettuce and cherry tomato. The viral extraction efficiencies were up to 53.43% and 95.56%, respectively, which is almost four and seven times better than those without BCAC. Therefore, the BCAC-RT-qPCR method can be used to detect low levels of foodborne viruses from produce.

Soluble extracellular polymeric substance (SEPS) of histo-blood group antigen (HBGA) expressing bacterium Sphingobacterium sp. SC015 influences the survival and persistence of norovirus on lettuce.

Foodborne norovirus (NoV) outbreaks linked to leafy greens are common due to a lack of efficient strategies to prevent NoV spread from contaminated surfaces. We previously found that Sphingobacterium sp. SC015 in lettuce phyllosphere expresses histo-blood group antigen (HBGA)-like substances in soluble extracellular polymeric substances (SEPS) that contribute to NoV adherence on lettuce. Here, we extracted SEPS from bacterium SC015 (SEPS-SC015), analyzed their chemical composition, and examined their roles in the survival and protection of NoV and surrogates [murine norovirus (MNV-1) and Tulane virus (TuV)] on lettuce. Presence of SEPS-SC015 significantly increased survival and persistence of human NoV (HuNoV), MNV-1, and TuV at days 7 and 14, compared with virus alone. HuNoV, TuV, and MNV-1 seeded with SEPS-SC015 were more resistant to heat (70 °C, 2 min) than these viruses alone. SEPS-SC015 also increased viral resistance to sodium hypochlorite inactivation by treatment with 30 and 300 ppm bleach at 26 °C for 10 min. However, SEPS-SC015 was not effective at protecting these viruses under UV inactivation. Binding of TuV to SC015 bacteria and SEPS-SC015, visualized using transmission electron microscopy, suggests that protection might be related to direct interaction between SEPS-SC015 and viral particles. This study provides important insights that will help inform strategies to improve food safety.

Histone methyltransferase enzyme enhancer of zeste homolog 2 counteracts ischemic brain injury via H3K27me3-mediated regulation of PI3K/AKT/mTOR signaling pathway.

BACKGROUND: Epigenetic histone methylation plays a crucial role in cerebral ischemic injury, particularly in the context of ischemic stroke. However, the complete understanding of regulators involved in histone methylation, such as Enhancer of Zeste Homolog 2 (EZH2), along with their functional effects and underlying mechanisms, remains incomplete. METHODS: Here, we employed a rat model of MCAO (Middle cerebral artery occlusion) and an OGD (Oxygen-Glucose Deprivation) model of primary cortical neurons to study the role of EZH2 and H3K27me3 in cerebral ischemia-reperfusion injury. The infarct volume was measured through TTC staining, while cell apoptosis was detected using TUNEL staining. The mRNA expression levels were quantified through quantitative real-time polymerase chain reaction (qPCR), whereas protein expressions were evaluated via western blotting and immunofluorescence experiments. RESULTS: The expression levels of EZH2 and H3K27me3 were upregulated in OGD; these expression levels were further enhanced by GSK-J4 but reduced by EPZ-6438 and AKT inhibitor (LY294002) under OGD conditions. Similar trends were observed for mTOR, AKT, and PI3K while contrasting results were noted for UTX and JMJD3. The phosphorylation levels of mTOR, AKT, and PI3K were activated by OGD, further stimulated by GSK-J4, but inhibited by EPZ-6438 and AKT inhibitor. Inhibition of EZH2 or AKT effectively counteracted OGD-/MCAO-induced cell apoptosis. Additionally, inhibition of EZH2 or AKT mitigated MCAO-induced infarct size and neurological deficit in vivo. CONCLUSIONS: Collectively, our results demonstrate that EZH2 inhibition exerts a protective effect against ischemic brain injury by modulating the H3K27me3/PI3K/AKT/mTOR signaling pathway. The results provide novel insights into potential therapeutic mechanisms for stroke treatment.

Correcting the Broad, Flat and Short Chin Using Modified M-genioplasty.

BACKGROUND: Several genioplasty techniques can narrow the width of the chin. Nevertheless, patients with a broad and short chin who received these methods were unsatisfied with the outcomes. The goal of this study was to analyze the clinical outcomes of modified M-shaped genioplasty for broad, flat and short chin deformity. METHODS: Thirty-eight patients with broad, flat and short chins were included in this study from January 2019 to December 2021. The preoperative design was performed individually according to the data of the chin and the patient's desire of final chin shape. Narrowing and vertical elongating genioplasty was performed for all the patients with modified M-shaped genioplasty under general anesthesia according to the preoperative designs. All patients have completed the FACE-Q preoperatively and 3 months postoperatively. The results were evaluated by clinical appearances and FACE-Q scores. RESULTS: The vertical lengthening of the chin was 2-5 mm, with an average of 3.02 mm. The horizontal narrowing width was 3-6 mm, with an average of 5.6 mm. FACE-Q scores in satisfaction with the chin increased significantly from 35.34 ± 9.57 to 72.95 ± 6.81. There were no severe complications took place during the time frame of 3-24 months postoperatively. CONCLUSIONS: The modified M-shaped genioplasty preserved the bone structure in the midsymphyseal area and suprahyoid muscular attachments as far as possible, and the bone segments may be repositioned quickly. This technique produced reliable and esthetically satisfying results in correcting a short, flat and broad chin, with altered vertical length, slope, width and protrusion three-dimensionally. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A Retrospective Study of Transaxillary Endoscopic Breast Augmentation Using Ultrasonic Scalpel or Conventional Electrocautery for Implant Pocket Dissection.

BACKGROUND: Ultrasonic scalpel has been reported to be superior to conventional electrocautery in many studies. However, with respect to transaxillary endoscopic breast augmentation, few studies on the effect of ultrasonic scalpel are available in the literature. METHODS: The medical records of 173 female patients who underwent breast augmentation via endoscopic transaxillary approach from January 2018 to December 2020 were reviewed retrospectively. The patients were divided into two groups according to the implant pocket dissection instruments. In group A, the implant pockets were dissected with conventional electrocautery (EC group) on 81 patients, and in group B, ultrasonic scalpel (US group) was used for implant pockets on 92 patients. All operations were performed by the same senior plastic surgeon and the same surgical team. The operation time, intraoperative blood loss, postoperative total drainage volume, days of drainage, postoperative surgical site pain and hospital stay time of the two groups were compared and analyzed statistically. RESULTS: The average operation time of the US group (83.82 ± 11.57 min) was significantly shorter than that of the EC group (101.40 ± 14.36 min), intraoperative blood loss in the US group was significantly less than that of the EC group (18.67 ± 6.20 ml vs. 21.59 ± 6.44 ml), the mean hospital stay days (2.96 ± 0.69 vs. 4.30 ± 1.11), total drainage volume (122.24 ± 43.81 vs. 232.37 ± 99.15), and duration of drain (2.52 ± 0.54 vs. 3.77 ± 1.10), mean VAS score for surgical site pain on 3 postoperative days (5.08 ± 1.35 vs. 6.51 ± 1.36, 4.08 ± 1.16 vs. 5.40 ± 1.32, 3.04 ± 0.91 vs. 4.06 ± 1.11) were significantly lower in the US group compared to the EC group. CONCLUSIONS: The ultrasonic scalpel reduces operative time, intraoperative blood loss, postoperative drainage, postoperative pain, hospital stay time, and incidence of complications. The ultrasonic scalpel is safe and reliable for transaxillary endoscopic breast augmentation. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Leocarpinolide B Attenuates Collagen Type II-Induced Arthritis by Inhibiting DNA Binding Activity of NF-κB.

Rheumatoid arthritis (RA) is a chronic autoimmune disease triggered by a cascading inflammatory response. Sigesbeckia Herba (SH) has long been utilized as a traditional remedy to alleviate symptoms associated with rheumatism. Our previous study found that leocarpinolide B (LB), a sesquiterpene lactone isolated from the whole plant of SH, possesses potent a anti-inflammatory effect on macrophages. This study was designed to evaluate the therapeutic effects of LB on RA, and further investigate the underlying mechanisms. In collagen type II-induced arthritic mice, LB was demonstrated to decrease the production of autoimmune antibodies in serum and inflammatory cytokines in the joint muscles and recover the decreased regulatory T lymphocytes in spleen. Moreover, LB significantly suppressed the inflammatory infiltration, formation of pannus and bone erosion in the paw joints. In vitro testing showed that LB inhibited the proliferation, migration, invasion, and secretion of inflammatory cytokines in IL-1ß-induced human synovial SW982 cells. Network pharmacology and molecular docking suggested NF-κB p65 could be the potential target of LB on RA treatment, subsequent experimental investigation confirmed that LB directly interacted with NF-κB p65 and reduced the DNA binding activity of NF-κB in synovial cells. In conclusion, LB significantly attenuated the collagen type II-induced arthritis, which was at least involved in the inhibition of DNA binding activity of NF-κB through a direct binding to NF-κB p65. These findings suggest that LB could be a valuable lead compound for developing anti-RA drugs.

The Accuracy of a Patient-Specific Three-Dimensional Digital Ostectomy Template for Mandibular Angle Ostectomy.

BACKGROUND: Although three-dimensional (3D)-printed digital ostectomy templates (DOTs) can help surgeons perform mandibular angle ostectomy (MAO) more precisely and safely, the clinical application of such templates is problematic. OBJECTIVES: The aim of this study was to evaluate the accuracy of a novel DOT and improve the precision of MAO. METHODS: A total of 20 patients with a prominent mandibular angle (PMA) were allocated into 2 groups (10 patients per group). A conventional DOT and a novel DOT were applied to guide MAO in Groups A and B, respectively. The mean time taken for curved osteotomy and the volume of postoperative drainage on 1 side within 24 hours were recorded. The deviations between the simulated and postoperative lower border of the mandible were measured on both sides. RESULTS: All the patients were satisfied with the cosmetic outcomes. Statistical results showed that the mean time taken for curved osteotomy was shorter in Group B than in Group A, and that the volume of postoperative drainage on 1 side within 24 hours was similar between the 2 groups. The deviations at the anterior and posterior parts of the inferior border showed that the accuracy of osteotomy was higher in Group B than in Group A, and that there was no significant difference between the 2 groups in the middle part. CONCLUSIONS: The novel DOT is easy to locate and fix tightly, which reduced the operating time and increased the safety and precision of the procedures.

Differential distribution of N- and O-Glycans and variable expression of sialyl-T antigen on HeLa cells-Revealed by direct fluorescent glycan imaging.

Cells are covered with glycans. The expression and distribution of specific glycans on the surface of a cell are important for various cellular functions. Imaging these glycans is essential to aid elucidation of their biological roles. Here, utilizing methods of direct fluorescent glycan imaging, in which fluorescent sialic acids are directly incorporated into substrate glycans via recombinant sialyltranferases, we report the differential distribution of N- and O-glycans and variable expression of sialyl-T antigen on HeLa cells. While the expression of N-glycans tends to be more peripheral at positions where cell-cell interaction occurs, O-glycan expression is more granular but relatively evenly distributed on positive cells. While N-glycans are expressed on all cells, sialyl-T antigen expression exhibits a wide spectrum of variation with some cells being strongly positive and some cells being almost completely negative. The differential distribution of N- and O-glycans on cell surface reflects their distinctive roles in cell biology.

An aggregation-induced emission luminogen combined with a cyanoacrylate fuming method for latent fingerprint analysis.

Fingerprints remain topologically unchanged in one's whole life, and therefore, have been used as a means to biometrically identify individuals in forensic investigations, law enforcement and access control. Appropriate methods are essential to obtain high-quality fingerprint images. In this contribution, an aggregation-induced emission luminogen tetraphenylethene-based dye FLA-2 was synthesized and characterized for the visualization of latent fingerprints (LFPs). LFPs can be directly visualized by incubating with the dye FLA-2 solution. And, after a cyanoacrylate fuming method pre-treatment stage, fine fingerprint structures can be obtained from level-1 to level-3 details. Two methods were compared using resolution, fluorescence intensity, and scanning electron microscopy imaging to investigate the influence of the cyanoacrylate fuming method pre-treatment stage. Furthermore, the visualization of old LFPs (7 d, 16 d and 30 d) on glass slides, aluminum foil and coin substrates also became effective after the pre-treatment step. The fluorescent LFP images mentioned above were all validated by using an automated fingerprint identification system obtaining positive matches. These results demonstrate the potential of this method to be applied to visualizing LFPs in the field of public security.

Direct fluorescent glycan labeling with recombinant sialyltransferases.

Glycosylation is a common modification found on numerous proteins and lipids. However, direct detection of glycans on these intact biomolecules has been challenge. Here, utilizing enzymatic incorporation of fluorophore-conjugated sialic acids, dubbed as direct fluorescent glycan labeling, we report the labeling and detection of N- and O-glycans on glycoproteins. The method allows detection of specific glycans without the laborious gel blotting and chemiluminescence reactions used in Western blotting. The method can also be used with a variety of fluorescent dyes.

VSIG-3 as a ligand of VISTA inhibits human T-cell function.

B7 family members and their receptors play a central role in the regulation of T-cell responses through T-cell co-stimulation and co-inhibition pathways that constitute attractive targets for the development of immunotherapeutic drugs. In this study, we report that VSIG-3/IGSF11 is a ligand of B7 family member VISTA/PD-1H and inhibits human T-cell functions through a novel VSIG-3/VISTA pathway. An extensive functional ELISA binding screening assay reveals that VSIG-3 binds to the new B7 family member VISTA but does not interact with other known members of the B7 family. Under the same experimental conditions, we did not observe any significant interaction between VSIG-8 and VISTA. In addition, VSIG-3 inhibits human T-cell proliferation in the presence of T-cell receptor signaling. Furthermore, VSIG-3 significantly reduces cytokine and chemokine production by human T cells including IFN-γ, IL-2, IL-17, CCL5/Rantes, CCL3/MIP-1α, and CXCL11/I-TAC. Anti-VISTA neutralization antibodies attenuate the binding of VSIG-3 and VISTA, as well as VSIG-3-induced T-cell inhibition. Hence, we have identified a novel ligand for VISTA that is able to inhibit human T-cell proliferation and cytokine production. This unique VSIG-3/VISTA co-inhibitory pathway may provide new strategies for the treatment of human cancers, autoimmune disorders, infection, and transplant rejection and may aid in the design of better vaccines.

Acidity-Activated Charge-Convertible Silver Nanocomposites for Enhanced Bacteria-Specific Aggregation and Antibacterial Activity.

Bacterial infections has become an intractable problem to human health. To overcome this challenge, we developed an antimicrobial agent (AgNPs@PDPE) via the conjugation of a pH-responsive copolymer of PDMAEMA-b-PPEGMA onto AgNPs surface. The AgNPs@PDPE underwent an acidity-induced surface charge conversion that favored bacteria-specific aggregation and antibacterial activity improvement. The specific interaction between AgNPs@PDPE and bacteria under acidic conditions was confirmed via an electrochemical method using AgNPs@PDPE modified glassy carbon electrode as the working electrode. AgNPs@PDPE could efficiently aggregate and inhibit the growth of both Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) under acidic condition. The AgNPs@PDPE could also selectively distinguish pathogenic bacteria from host cells, and this characteristic is benefical for reducing the damage to surrounding tissues in the host. Moreover, AgNPs@PDPE could promote the healing of E. coli- and S. aureus-induced infection, as proven by the histological and TNF-α immunohistochemical analyses of rat dermal wounds. The proposed antimicrobial agent could to be an alternative treatment strategy for the safe treatment of treat bacteria-induced infections in clinics.

Personal exposure to fine particulate matter and benzo[a]pyrene from indoor air pollution and leukocyte mitochondrial DNA copy number in rural China.

Households in Xuanwei and Fuyuan, China, possess hazardous levels of fine particulate matter with an aerodynamic diameter <2.5 microns (PM2.5) and polycyclic aromatic hydrocarbons (PAHs) from coal combustion. Previous studies found that increased exposure to PM2.5 and benzo[a]pyrene (BaP; a PAH) were associated with decreased mitochondrial DNA copy number (mtDNAcn), a marker of oxidative stress. We further evaluated these associations in a cross-sectional study of 148 healthy non-smoking women from Xuanwei and Fuyuan. Personal exposure to PM2.5 and BaP was measured using portable devices. MtDNAcn was measured using qPCR amplification of leukocyte DNA that was collected after air measurements. Linear regression models were used to estimate the associations between personal exposure to PM2.5 and BaP, and mtDNAcn adjusted for age, body mass index (BMI) and fuel type. We found inverse associations between exposure to PM2.5 and BaP, and mtDNAcn. Each incremental log-µg/m3 increase in PM2.5 was associated with a significant decrease in mtDNAcn of -10.3 copies per cell [95% confidence interval (95% CI): -18.6, -2.0; P = 0.02]. Additionally, each log-ng/m3 increase in BaP was associated with a significant decrease in mtDNAcn of -5.4 copies per cell (95% CI: -9.9, -0.8, P = 0.02). Age, BMI, fuel type and coal mine type were not significantly associated with mtDNAcn. Exposure to PM2.5 and BaP may alter mitochondrial dynamics in non-smoking Chinese women. MtDNAcn may be a potential mediator of indoor air pollution on chronic disease development.

Cephalometric Analysis of Modifications of the Mandible Due to Reduction Mandibuloplasty in Patients With Prominent Mandibular Angle.

Cephalometry has been used to measure hard and soft facial tissues as well as to conduct the ostectomy to determine the characteristics of the prominent mandibular angles (PMA). The changes produced on the mandibles by reduction mandibuloplasty are not known. The objective of the present study was to identify by cephalometric analysis the anatomical changes of the mandibles that occur in patients with PMA after reduction mandibuloplasty. Forty-two patients with PMA were submitted to cephalometric analysis before, 1 week and 6 months after surgery to evaluate the changes of the mandibles produced by reduction mandibuloplasty. Cephalometry was standardized to obtain descriptive measurements of the dimensions of the mandibles. The modifications of the mandibles due to reduction mandibuloplasty showed a significant change obtained by cephalometry. At 1 week after surgery, the average distance between the gonions decreased 17.70 ±â€Š8.46 mm, the average length of the mandibular ramus reduced 5.84 ±â€Š3.26 mm, the average mandibular body length increased 4.61 ±â€Š2.74 mm, the average gonial angle increased 14.78 ±â€Š6.65°, the average mandibular plane angle increased 10.29 ±â€Š3.82°. At 6 months postoperatively, the first 3 linear measurements increased 3.68 ±â€Š2.91, 1.66 ±â€Š2.51, and 2.10 ±â€Š2.37 mm respectively; however, the last 2 angular measurements reduced 2.86 ±â€Š3.02° and 1.77 ±â€Š2.62° respectively. The results demonstrated that reduction mandibuloplasty can modificate mandibular contouring three-dimensionally. The data of 6 months postoperatively compare to those of the beauty people reported in the literature, there were statistically differences between the linear measurements, but no statistically differences between the angular measurements. Despite bone regeneration result in linear or angular measurements change, postoperative angular shape was predominantly maintained, and the preoperative angular prominence did not recur.

Gene-expression profiling of buccal epithelium among non-smoking women exposed to household air pollution from smoky coal.

In China's rural counties of Xuanwei and Fuyuan, lung cancer rates are among the highest in the world. While the elevated disease risk in this population has been linked to the usage of smoky (bituminous) coal as compared to smokeless (anthracite) coal, the underlying molecular changes associated with this exposure remains unclear. To understand the physiologic effects of smoky coal exposure, we analyzed the genome-wide gene-expression profiles in buccal epithelial cells collected from healthy, non-smoking female residents of Xuanwei and Fuyuan who burn smoky (n = 26) and smokeless (n = 9) coal. Gene-expression was profiled via microarrays, and changes associated with coal type were correlated to household levels of fine particulate matter (PM2.5) and polycyclic aromatic hydrocarbons (PAHs). Expression levels of 282 genes were altered with smoky versus smokeless coal exposure (P < 0.005), including the 2-fold increase of proinflammatory IL8 and decrease of proapoptotic CASP3. This signature was more correlated with carcinogenic PAHs (e.g. Benzo[a]pyrene; r = 0.41) than with non-carcinogenic PAHs (e.g. Fluorene; r = 0.08) or PM2.5 (r = 0.05). Genes altered with smoky coal exposure were concordantly enriched with tobacco exposure in previously profiled buccal biopsies of smokers and non-smokers (GSEA, q < 0.05). This is the first study to identify a signature of buccal epithelial gene-expression that is associated with smoky coal exposure, which in part is similar to the molecular response to tobacco smoke, thereby lending biologic plausibility to prior epidemiological studies that have linked this exposure to lung cancer risk.

Endoscopic-Assisted Intraoral Three-Dimensional Reduction Mandibuloplasty.

BACKGROUND: Oriental people have a square face with a prominent mandibular angle, which means masculine and coarse and is considered to be an unappealing feature. Reduction mandibuloplasty has become popular in the orient in the past 2 decades, and the operation was frequently performed through the intraoral approach. But an invisible mandibular angle forces the surgeon to perform blind ostectomy which leads to difficulty in performing an accurate ostectomy as planned, leaving unnatural mandibular contours and severe complications. METHODS: From January 2010 to January 2013, a total of 112 patients with prominent mandibular angles underwent one-stage long-curved ostectomy combined with splitting corticectomy through an intraoral approach with endoscopic assistance for reduction of the lower face. A retractor with an adjustable endoscope provides a clear operative field; the ostectomy line was marked. The one-stage long-curved ostectomy and corticectomy were performed following the marked ostectomy line using an oscillating saw with angles of various degrees and length under direct vision. RESULTS: Mandibular contouring was 3-dimensionally refined; the width of the lower face was reduced in the frontal view and the mandibular angle appeared natural and inconspicuous in the lateral view. The majority of patients were satisfied with both their frontal and lateral appearances. The gonial angle and the mandibular plane angle were increased effectively. No major complications such as fracture or facial nerve injury occurred. CONCLUSIONS: Intraoral approach of long-curved ostectomy combined with splitting corticectomy with endoscopic assistance allows surgeons to perform accurate, safe, and reproducible ostectomies and to recontour mandible 3-dimensionally, which can make the face look thinner from the frontal view and, in the lateral view, keeps it more natural looking with smooth ostectomized borders.