Establishment of three-dimensional measurement methods of nasolabial soft tissue for patients with maxillary protrusion / 北京大学学报(医学版)

OBJECTIVE@#To establish a series of three-dimensional measurement methods of nasolabial soft tissue for maxillary protrusion patients by using 3dMD camera, and to evaluate preoperative and postoperative changes of the nasolabial soft tissue.@*METHODS@#Three-dimensional facial photos of 30 female patients with maxillary protrusion [average age, (27.33±2.54) years] were taken by 3dMD camera preoperatively and at the end of postoperative 6 months or more. Then, 3dMD patient software was used to locate the selected landmarks at nasolabial region on the three-dimensional photos. Ten measurements, including soft tissue line distance, angle, curve distance and postoperative three-dimensional volume changes were measured twice with one week interval by 3 investigators, respectively. A standard consistency test calculated by the correlation coefficients (ICC) was performed between two sets of data (including all of the 10 measurements) for each investigator and among the three investigators to verify the repeatability.@*RESULTS@#The average maxillary incisor retraction distance of the 30 subjects was (5.13±0.99) mm, and the average follow-up time was (11.07±5.11) months. The standard consistency test was performed between the two sets of data for each investigator, and the correlation coefficients (ICC) of the 10 measurements were all over 0.8 for each investigator (P>0.05). The standard consistency test was performed among the three surveyors, with the result that the ICC of the width of the bilateral inner canthus, the height of the nose, the height of nasal tip, nasolabial angle, philtrum length, the curve height of upper vermilion and the height of upper lip were greater than 0.8 (P>0.05), and the ICC of the distance between SbalSbal, length of nasal dorsum and three-dimensional volume change of upper lip were 0.680, 0.627 and 0.528, respectively (P>0.05).@*CONCLUSION@#3dMD camera and 3dMD patient software can be used to measure and analyze the three-dimensional morphology of the nasolabial soft tissue for patients with maxillary protrusion preoperatively and postoperatively, and it is relatively accurate and reliable. However, the repeatability of three-dimensional positioning of the nasal tip point and the Sbal is slightly worse resulting in the lower value of the ICC of the distance between SbalSbal and length of nasal dorsum, as well as the upper lip three-dimensional volume change after the operation.

Accuracy analysis of computer assisted navigation for condylectomy via intraoral approach / 北京大学学报(医学版)

OBJECTIVE@#To explore the application accuracy of virtual preoperative plan after the condylectomy via intraoral approach under computer assisted surgical navigation, and to analyze the location and cause of the surgical deviation to provide reference for the surgical procedure improvement in the future.@*METHODS@#In the study, 23 cases with condylar hypertrophy (11 with condylar osteochondroma and 12 with condylar benign hypertrophy) in Department of Oral and Maxilloficial Surgery, Peking University School and Hospital of Atomatology from December 2012 to December 2016 were treated by condylectomy via intraoral approach under computer assisted surgical navigation. The patient's spiral CT data were imported into ProPlan software before operation, and the affected mandibular ramus was reconstructed three-dimensionally. The condylar osteotomy line was designed according to the lesion range, and the preoperative design model was generated and introduced into the BrainLab navigation system. Under the guidance of computer navigation, the intraoral approach was used to complete the condylar resection according to the preoperative design of the osteotomy line. Cranial spiral CT of the craniofacial region was taken within one week after operation. three-dimensional reconstruction of the mandibular ramus at the condylectomy side was performed, and the condylar section was divided into six segments (anterolateral, anterior, anteromedial, posteromedial, posterior, and posterolateral) and the corresponding regional measurement points P1 to P6 were defined. Then the preoperative virtual model and the postoperative actual model were matched by Geomagic studio 12.0 to compare the differences and to analyze the accuracy of the operation.@*RESULTS@#All the patients had successfully accomplished the operation and obtained satisfactory results. Postoperative CT showed that the condyle lesion was completely resected, and the condylar osteotomy line was basically consistent with the surgical design. No tumor recurrence or temporomandibular joint ankylosis during the follow-up period. The postoperative accuracy analysis of the condylar resection showed that the confidence intervals measured by the six groups of P1 to P6 were (-2.26 mm, -1.89 mm), (-2.30 mm, -1.45 mm), (-3.37 mm, -2.91 mm), (-2.83 mm, -1.75 mm), (-1.13 mm, 0.99 mm), and(-1.17 mm, 0.17 mm), where P3 group was different from the other 5 groups. There was no significant difference between the P5 and P6 groups and the difference between the other four groups was statistically significant.@*CONCLUSION@#Under the guidance of computer navigation, the intraoral approach can be performed more accurately. The surgical deviation of each part of the osteotomy surface is mainly due to excessive resection. The anterior medial area of the anterior medial condyle represents the most excessive resection. The posterior and posterior lateral measurement points represent the posterior condylar area. The average deviation is not large, but the fluctuation of the deviation value is larger than that of the other four groups. The accuracy of computer-assisted subtotal resection has yet to be improved.

Feasibility of integrating 3D photos and cone-beam computed tomography images used to evaluate changes of soft and hard tissue after orthognathic surgery / 北京大学学报(医学版)

Objective:To evaluate the feasibility of integrating 3D photos and cone-beam computed tomography (CBCT)images and to assess the degree of error that may occur during the above process,and to analyze soft and hard tissue changes after orthognathic surgery using this new method.Methods:Ten patients with maxillofacial deformities were chosen.For each patient,CBCT scans and stereophotographic images were taken before and 3 months after surgery.3D photos were superimposed onto the CBCT skin im-ages using relatively immobile areas of the face as a reference.3D color maps and mean distances were used to evaluate the errors that might occur during the process.Two reference planes were set up using cer-tain points.The distances between Prn (pronasale),Sn (subnasale),Ls (labrale superior),ANS (anterior nasal spine),A (subspinale),UIE (upper incisor edge)to the coronal plane were calculated before and af-ter surgery.In order to verify the repeatability of this method,we examined the distances twice at two-week intervals.Paired t test was used to evaluate the reproducibility.Results:CBCT and 3D photos could be successfully fused with clinically acceptable errors.This new method could be used to evaluate soft and hard tissue changes after orthognathic surgery.The 3D color maps showed that the two images could be fused with minimal errors.The mean distances were within 0.3 mm,and the locations of landmarks on maxilla and mandible such as Ls,ANS,A,UIE changed significantly after orthognathic surgery (P 0.1 ).The paired t test showed that the mean value and standard deviation were (0.08 ±0.98)mm.Conclusion:Fusing of CBCT and 3D stereophotographic images used as a new method in evaluating soft and hard tissue changes after orthognathic surgery was feasible and accurate.The virtual 3D composite craniofacial models permitted concurrent assess-ment of hard and soft tissues during diagnosis and treatment planning.Maxillary and mandibular locations had significant association with orthoganthic surgery while the nasal tissue was not simp affected by surgery.

Transpalatal modified Le Fort Ⅰ osteotomy for correction of maxillary hypoplasia in cleft lip and palate patients:a preliminary clinical application / 北京大学学报(医学版)

Objective:To evaluate the surgical corrective results of maxillary hypoplasia in patients with cleft lip and palate withtranspalatal modified Le Fort Ⅰ osteotomy.Methods:In the study,1 1 patients (4 women,and 7 men)with maxillary hypoplasia secondary to cleft lip and palate underwent transpalatal modified Le Fort Ⅰ osteotomy at Peking University School of Stomatology from Jan.201 2 to Dec.201 3, with the mean age of 21 years (from 1 8 to 27 years),Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty were performed simultaneously in 9 of them for better appearance and functional occlu-sion.Lateral cephalometric radiographs were taken and traced before surgery,immediately after surgery and 6 months after surgery.The position of subspinale (A)on horizontal direction,the angle of sella-na-sion-subsipmale (SNA)and the angle of sella-nasion-supramental (SNB)were collected and analyzed to evaluate the results.Results:All the patients were uneventful with transpalatal modified Le Fort Ⅰosteotomy.All of them had a better profile and a satisfactory occlusionafter operation.The position of A was moved forward (6.6 ±1 .1 )mm on average in horizontal direction when surgery was completed,and maintained (6.0 ±1 .2)mm on average 6 months after surgery.The average of SNA was 75.9°±2.8° before surgery,81 .6°±8.6°immediately after surgery,and maintained 81 .0°±2.6°6 months after sur-gery.The average of SNB was 82.6°±3.7°before surgery,78.0°±2.4°immediately after surgery,and maintained 78.5°±2.4°6 months after surgery.Conclusion:The maxillary hypoplasia in cleft lip and palate patients can be successfully corrected with transpalatal modified Le Fort Ⅰ osteotomy and the func-tional occlusion can be achieved simultaneously.The effect of deformity correction was satisfactory. Transpalatal modified Le Fort Ⅰ osteotomy can move maxilla more sufficiently,especially applicable for the patient with severe palatal scars preoperatively.

The relationship between maxillary sinus floor and the roots of maxillary third molar observed by CBCT / 实用口腔医学杂志

Cone-bine CT(CBCT)images of 2 130 maxillary third molars were divided into 3 groups according to the impaction position. The relationship between the floor of maxillary sinus and the roots of maxillary third molar was analyzed and compared.In low,median and high impaction groups the probability of the root tip of maxillary third molar higher than the floor of maxillary sinus was 4.5%,10.3% and 14.6% respectively.

Comparison of three surgical techniques for controlling nasal width after Le Fort Ⅰosteotomy / 北京大学学报(医学版)

Objective: To identify nasal width changes occurring after Le Fort Ⅰosteotomy and to compare prospectively the effect of three surgical techniques for controlling postoperative nasal width . Methods:In the study, 79 patients (22 male and 57 female, mean age 23.2 ±3.4 years), who re-ceived Le Fort Ⅰosteotomy at Peking University Hospital of Stomatology from 2011 to 2014, were ran-domly divided into three groups .Group 1 was treated with traditional intraoral alar base cinch suture ( ABCS);Group 2 with extraoral ABCS, and Group 3 with traditional ABCS plus an extra intraoral suture at points G.lat.All the patients had taken 3D photos using 3dMD camera before operation , and 3, and 6 months after operation.The nasal widths, which were indicated as distances between Sbal-Sbal, G.lat-G.lat and Al-Al, were measured by two examiners in the 3D photos three times with a time-interval of one week .SPSS 13 .0 was used to do the statistic analysis .Results: At the end of the postoperative 6 months, the nasal widths lessened as compared with the postoperative 3 months.No significant diffe-rences were found between the three groups 6 months after the operation .The degree of the postoperative nasal width widening had positive correlation with that of the intraoperative nasal width widening , and had negative correlation with the initial nasal width and the amount of post-suture narrowing .Conclusion:There is no difference between three suturing techniques for controlling nasal width widening after Le FortⅠosteotomy.The postoperative nasal width-widening can’t be totally avoided, and the alteration might last at least 6 months after the operation .For patients with narrow nasal width and need to move maxilla forward , more overcorrection of ABCS is needed to control the postoperative nasal base widening .

Clinical observation of the disto-lingual root of the impacted mandibular third molars / 实用口腔医学杂志

Cone beam CT(CBCT)data of 4 550 impacted mandibular third molars were divided into 6 groups by the direction of teeth im-paction.Analyzed by SPSS 19.0 statistical package and Pearson Chi-square Test,the incidence of disto-lingual roots was 5.38% and was various with different impation direction.

Clinical application of condylectomy via intraoral approach under computer assisted surgical navigation / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To assess the application of computer assisted surgical navigation in condylectomy via intraoral approach and its clinical results.</p><p><b>METHODS</b>Eight patients aged from 16 to 56 were treated by condylectomy via intraoral approach under computer assisted surgical navigation. There were 6 female and 2 male. The lesions were condyle osteoma in 3 patients, hemimandibular hyperplasia and condylar hyperplasia in 5 patients. Most patients had concomitant LeFortIosteotomy (6 cases), bilateral sagittal split ramus osteotomy (BSSRO) (5 cases),contralateral sagittal split ramus osteotomy (SSRO) (1 cases), genioplasty (4 cases) and mandible contouring (6 cases) to recover the facial symmetry.</p><p><b>RESULTS</b>All patients had good occlusion, oral function and facial symmetry after the operation. The average mouth opening was 38 mm before operation, and 41 mm one month after operation. The temporomandibular joint(TMJ) dysfunction syndrome alleviated or disappeared. The follow-up period was 3-12 months, and results were stable.</p><p><b>CONCLUSIONS</b>Computer assisted surgical navigation can precisely accomplish the condylectomy via intraoral approach.It causes less trauma to the patient than traditional condylectomy, and can better preserve the TMJ structure and function.</p>

The treatment of mandibular micrognathia secondary to temporomandibular joint ankylosis with distraction osteogenesis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effect of distraction osteogenesis for patients with mandibular micrognathia secondary to temporomandibular joint (TMJ) ankylosis.</p><p><b>METHODS</b>43 patients (aged from 2 to 61 years old) with mandibular micrognathia were treated with mandibular distraction osteogenesis. Two types of mechanical distraction were utilized in this study. Ten patients (age ranged from 2 to 16-years-old, mean age 7.6 years old) with severe micrognathia underwent bilateral mandibular distraction with rigid external distraction (RED) device. Other 33 patients were treated with unilateral(6 cases) or bilateral (27 cases) mandibular distraction using internal distraction device. Distraction was started on the 4th to 8th day after operation and distraction rate was 0.25 mm every time, four times a day. Distractor was removed after 3 to 6 months of consolidation period.</p><p><b>RESULTS</b>Eighty sides of mandible in 43 patients were lengthened. The mean distraction distance was 23.2 mm (ranged from 14 to 35 mm). After distraction, the average posterior airway space (PAS) was enlarged from 4.9 mm to 10.4 mm and average angle of sella-nasion-point B (SNB) was increased from 64.2 degrees to 74.5 degrees. The apnea hypopnea index (AHI) was decrease significantly. The profile was improved and OSA was improved effectively in each patient. No complication occurred during treatment. No persistent numbness of lower lip was observed. All patients were satisfied with the results. After a mean follow-up period of 20.3 months(5 to 103 months) , the result was stable and no obvious relapse of micrognathia was observed.</p><p><b>CONCLUSIONS</b>Distraction osteogenesis is an effective way in correction of mandibular micrognathia secondary to TMJ ankylosis. RED is a new method for treatment of children and adolescence with severe mandibular micrognathia. The procedure is simple and safe with stable result.</p>

Preliminary study of condylectomy via intraoral approach / 中华口腔医学杂志

<p><b>OBJECTIVE</b>Condylectomy was performed to treat condylar osteoma or hyperplasia. Introduced two methods of condylectomy via intraoral approach and evaluated their clinical results.</p><p><b>METHODS</b>Thirty-five patients, aging from 22 to 57.21 years, were treated by condylectomy via intraoral approach, of which 21 were condyle osteoma, 14 hemimandibular hyperplasia and condylar hyperplasia. Intraoral vertical ramus osteotomy (IVRO) were used in 32 patients and intraoral condylectomy via coronoid process resection was used in 3 patients.</p><p><b>RESULTS</b>The treatment results including oral function and facial symmetry after the operation were good in all patients. The temporomandibular joint (TMJ) dysfunction syndrome alleviated or disappeared. The follow-up period was 6 months to 3 years, and no relapse of condylar osteoma or hyperplasia was found. The patients who had IVRO and TMJ reconstruction had some degree of transplanted bone resorption, and one patients had relapse of facial deformity. But the patients who had intraoral condylectomy via coronoid process resection only had mild condyle remodeling and no obvious bone resorption was noted.</p><p><b>CONCLUSIONS</b>The two methods of intraoral condylectomy introduced in this stugy can successfully correct the facial deformity and TMJ dysfunction caused by condylar osteoma or hyperplasia. But the surgeons need to have excellent surgical skills and careful selection of the indications.</p>

Surgical management of hemifacial microsomia: a report of 24 cases / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of combined treatment for hemifacial microsomia (HFM).</p><p><b>METHODS</b>From July 1991 to August 2006, 24 consecutive patients with HFM were retrospectively analyzed. They underwent orthognathic surgery, free flap transplantation, Medpor implant, distraction osteogenesis. The patients age, deformity type, surgical timing, treatment methods and complications were analyzed.</p><p><b>RESULTS</b>The treatment was completed in all the patients. The facial symmetry was improved dramatically after operation. The occlusion relationship was improved also with good occlusion plane. 8 free flaps were survived with no necrosis.</p><p><b>CONCLUSIONS</b>The surgical treatment should be designed based on the age and deformity type in HFM. The occlusion relationship and appearance can be both improve markedly.</p>

Polymorphism of Human Cytomegalovirus （HCMV） UL146 Gene / 中国医科大学学报

Objective To investigate the polymorphism of human cytomegalovirus（HCMV）UL146 gene in clinical strains,and to evaluate its clinical diagnostic and therapeutic value of gene.Methods The UL146 gene of clinical strains was examined by quantitative polymerase chain reaction（Q-PCR）or general polymerase chain reaction（PCR）.Positive samples of PCR amplification were sequenced and analyzed.Results High variability of UL146 gene was found among 28 HCMV strains.According to phylogenetic analysis,all sequences of UL146 in clinical strains could be divided into three types and four subtypes.Chemokine ELRCXC region was highly conserved in all sequences.Conclusion HCMV-UL146 genes showed a high degree of polymorphism,and its encoded chemokine ELRCXC region was highly con-served.The relationship between HCMV-UL146 gene′s polymorphism and different clinical symptoms of HCMV infection was unclear.

Distraction osteogenesis of the mandibular ramus in hemifacial microsomia / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the application of distraction osteogenesis (DO) of the mandibular ramus in hemifacial microsomia.</p><p><b>METHODS</b>From 1999 to 2006, 15 patients with hemifacial microsomia were treated with DO of the ramus, including 12 cases of children and juveniles, 3 cases of grown-ups. Maxillary Le Fort I osteotomy, unilateral sagittal split ramus osteotomy, genioplasty and free scapular flaps were selected to perform on the first or secondary stage of treatment.</p><p><b>RESULTS</b>Successful distraction was achieved in all patients with an average distraction distance of 21.25 mm. The distractor was removed after consolidation proved by clinical examination and X-ray. Facial appearance and and occlusal relationship were improved greatly. The occlusal plane was almost normal. There was no infection, malunion or permanent injury of inferior alveolar nerve.</p><p><b>CONCLUSIONS</b>DO of the ramus is very effective for the correction of severe hemifacial microsomia. It has much better therapeutic effect than traditional orthognathic procedures.</p>

Effect of icariin on the mRNA expressions of Cbfαl, BMP2, BMP4 in rat osteoblasts / 北京大学学报(医学版)

Objective: To investigate the effect of icariin on the proliferation, differentiation, and the mRNA expressions of Cbfαl, BMP2, BMP4 of rat osteoblasts. Methods: Primary rat osteoblastic cells were obtained by sequentia collagenase/trypsin enzyme digestion from calvarial bones of new born ( within 24 h) SD rats and were identified by Alkaline phosphatase and alizarin red staining. The passage 3-5cells were treated with icariin at the concentration of 0 mol/L, 10~(-8)mol/L, 10~(-7)mol/L, 10~(-6)mol/L,10~(-5)mol/L, 10~(-4)mol/L for 24 h, 48 h, 72 h, and the proliferation of the cells was measured by CCK-8assay. The proliferation index was detected by Flow Cytometry and the activity of alkaline phosphatase was determined by p-Nitrophenyl phosphate (pNPP) method after being treated with icariin at the concentration mentioned above for 48 h. The total cellular RNA was extracted 48 h after being treated with icariin at the concentration of 10~(-6)mol/L, and the expressions of Cbfα1, BMP2, BMP4 mRNA were examined by real-time PCR. Results: Icariin showed no effect on the proliferation of osteoblasts, but improved ALP activity. The Cbfα1, BMP2, BMP4 mRNA were significantly upregulated after icariin treatment. Conclusion: Icariin could promote the differentiation ability of rat osteoblasts through upregulating the Cbfα1, BMP2, BMP4 mRNA expressions.

Correction of progressive hemifacial atrophy by orthognathic surgical procedures combined distraction osteogenesis and scapular flap transplantation: 5 cases report / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and the therapeutic effect of orthognathic surgical procedures combined distraction osteogenesis and scapular flap for correction of progressive hemifacial atrophy.</p><p><b>METHODS</b>5 cases with progressive hemifacial atrophy were treated. 1 mild case was treated with microsurgical de-epithelia scapular flap (MDSF) and genioplasty in one stage. The 2 moderate cases were treated with Le Fort 1 osteotomy following by sagittal split ramus osteotomy and genioplasty at the first stage. 3 - 6 months later, the MDSFs were used for augmentation. 2 sever cases were treated with bimaxillary distraction osteogenesis on the affected side. 3 - 4 months later, the distraction devices were removed and MDSFs were transplanted.</p><p><b>RESULTS</b>The facial asymmetry was obviously improved. The orthognathic procedures and distraction osteogenesis achieved good therapeutic effect. All the MDSFs were survived.</p><p><b>CONCLUSIONS</b>The progressive hemifacial atrophy can result in very severe deformity when it occurs in very young age. The combined deformity of bone and soft tissue can be effectively corrected by orthognathic procedures combined with distraction osteogenesis and scapular flap transplantation.</p>

Prophylactic administration of Yunnan Baiyao capsule reduces intra-operative blood loss in orthognathic surgery / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the haemostatic efficacy and safety of prophylactic oral administration of Yunan Baiyao capsules on reduction of blood loss in bimaxillary orthognathic surgery.</p><p><b>METHODS</b>Eighty-seven patients scheduled for Le Fort I osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) were enrolled in the prospective, randomized, double-blind, placebo-controlled clinical study. Forty-three patients took prophylactic oral administration of Yunnan Baiyao capsules 3 days before operation, and 44 patients without Yunnan Baiyao administration served as control. The intraoperative blood loss during Le Fort I osteotomy and bilateral sagittal split ramus osteotomy was estimated and the safety of Yunnan Baiyao capsules was evaluated.</p><p><b>RESULTS</b>The total blood loss in the Yunnan Baiyao group (330.5 +/- 134.4) ml was significantly lower than that of the control group (420.3 +/- 175.9) ml. The blood loss of Le Fort I osteotomy in the Yunnan Baiyao group (154.9 +/- 84.3) ml was also significantly lower than that of the control group (203.8 +/- 98.1) ml. The mean blood loss of BSSRO in the Yunnan Baiyao group was also lower than that of the control group, but the differences was not significant. The post-operative fibrinolysis was in the same level in both groups. Thromboemblic events or other side effects were not observed in this clinical trial.</p><p><b>CONCLUSIONS</b>Prophylactic oral administration of Yunnan Baiyao capsules can effectively reduce the intra-operative blood loss in bimaxillary orthognathic surgery. Yunnan Baiyao capsule are an effective and safe haemostatic traditional Chinese medicine.</p>

Upper airway morphologic changes in obstructive sleep apnea hypopnea syndrome patients before and after orthognathic surgery and distraction osteogenesis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the morphologic changes of upper airway in obstructive sleep apnea and hypopnea syndrome (OSAHS) associated with micrognathism before and after orthognathic surgery and distraction osteogenesis, and subsequently to instruct clinical jobs effectively.</p><p><b>METHODS</b>Nine OSAHS patients associated with micrognathism (8 males, 1 female, mean age: 28.6 years) received orthognathic surgery and (or) distraction osteogenesis, and the curative effect was evaluated according to the subjective feelings and PSG. Upper airway structure before and after the treatment was measured by Somatom Sensation 16 CT scanner.</p><p><b>RESULTS</b>All 9 patients were clinically cured. The transverse length, the cross section area, and especially the sagittal length of the upper airway were obviously increased after the orthognathic surgery. The changes involved mainly in the velopharyngeal region and the laryngopharyngeal region, but not in the laryngopharyngeal region.</p><p><b>CONCLUSIONS</b>The orthognathic surgery and distraction osteogenesis can treat the OSAHS patients with microgonathism effectively by increasing their velopharyngeal and laryngopharyngeal sagittal length of upper airway.</p>

Treatment of severe micrognathia accompanying obstructive sleep apnea hypopnea syndrome with rigid external distractor / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To approach the treatment of severe micrognathia accompanying obstructive sleep apnea hypopnea syndrome (OSAHS) with rigid external distractor (RED) in children.</p><p><b>METHODS</b>Six cases patients (4 males, 2 females) aged between 1.5 and 14 years, were diagnosed as ankylosis of temporomandibular joint severe micrognathia, and OSAHS. Under the nasal intubation and general anesthesia, the surgical procedures were performed by submandibular approach and osteotomy was done in mandible body. Mini plate was fixed and connected to RED. The distraction procedure was carried out</p><p><b>RESULTS</b>Patients' profile, posterior airway space, and the results of polysomnography were improved significantly. There were no complications. Four months after removing the RED, the new bone was well formed.</p><p><b>CONCLUSIONS</b>RED technique has advantages of uncomplicated procedures, high quality of new bone formation, and accurate regulation in the treatment of micrognathia. It is especially suitable for the treatment of children with severe micrognathia whose mandibular body is too small to insert the internal distractor.</p>

Combination of transpalatal advancement pharyngoplasty and uvulopalatopharyngoplasty for obstructive sleep apnea / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Investigate the response of the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) patients to combination of transpalatal advancement pharyngoplasty and uvulopalatopharyngoplasty.</p><p><b>METHODS</b>Thirty two patients with OSAHS, age ranged from 27 to 54, mean value (x +/- s) 39.1 +/- 7.8, male, body mass index (BMI) ranged from 22.9 to 36. 7 kg/m2, mean value (29.0 +/- 3.6) kg/m2, preoperative apnea and hypopnea index (AHI) was 11.7/h to 113.7/h, mean value (61.8 +/- 21.9)/h, the lowest blood oxygen saturation was 0.10 to 0.85, mean value 0.64 +/- 0. 13. With preoperative endoscopic technique, bony nasopharynx cavity narrowing were present, 14 patients had concomitant tonge-base obstruction. Cephalometric result, SNA ranged from 72.9 degrees to 87.0 degrees, mean value (80.7 +/- 4.1) degrees; SNB 69.50 to 85.0 degrees, mean value (76.8 +/- 4.5) degrees; PAS 0.5 cm to 2.1 cm, mean value (1.2 +/- 0.5) cm; MP-H: ranged from 1.2 cm to 3.5 cm, mean value (2.2 +/- 0.7) cm; PNS ranged from 2.4 cm to 3.5 cm, mean value (2.8 +/- 0.4) cm. All the patients had H-UPPP and concomitant transpalatal advancement pharyngoplasty. Fourteen patients with tonge-base obstruction had chin advancement. Results Six months after the operations, the patients were evaluated the response to the operations using Epworth sleep scale, OSAHS filtration questionnaire scale and polysomnography (PSG). There were 27 patients with the decrease percent of AHI reaching or more than 25% and 22 patients with the decrease percent of AHI reaching or more than 50% including 8 patients with AHI less than 5. The other 5 patients were ineffective. After operation, the Epworth sleep scale decreased from (9.2 +/- 4.5) to (4.7 +/- 2. 8) and OSAHS filtration questionnaire scale decreased form (56.0 +/- 15.3) to (17.5 +/- 11.5). Both of the differences were obvious (P < 0.01).</p><p><b>CONCLUSIONS</b>Combination of transpalatal advancement pharyngoplasty and H-UPPP can improve the efficacity and in some patients with pure retropalatal airway narrowing, the cure rate can be improved.</p>

Metabonomics and the modernization of traditional Chinese medicine / 中国医学科学院学报

The rapid development of systems biology and especially the advances in the high-throughput and comprehensive research technologies and research idea in metabonomics provide new strategies in the analysis of active components in the formula of traditional Chinese medicine (TCM) and pharmacokinetic analysis of their metabolites in vivo. Furthermore, the initiatives of metabonomics may pave a new way to explain the action mode of TCM in the light of modern sciences, while the metabonomic research achievements may contribute to the establishment of a new technique platform for evaluating the efficacy of the formula of TCM.