Conservative management of mandibular fractures in pediatric patients during the growing phase with splint fiber and ligature arch wire.

PURPOSE: The purpose of this article is to discuss the effective management of mandibular fractures in pediatric patients during the growing phase of the mandible using splint fiber and ligature wire. METHODS: A retrospective study examined pediatric patients with mandibular fractures who were treated using the splint (Quartz) fiber and ligature wire technique at the Stomatology Hospital of Xi'an Jiaotong University from August 2021 to January 2023. Data on gender, age, location or site of the fracture, and development of tooth stage were collected from the patient's medical records. Descriptive statistics were used to analyze the data and evaluate the effectiveness of the splint (Quartz) fiber technique for treating mandibular fractures in pediatric patients. RESULTS: Out of 256 subjects, 6 pediatric patients with mandibular fractures were selected, resulting in an incidence rate of 2.34% with an equal sex ratio. Mental or symphysis fracture was the most common site for fracture in children, accounting for 100% of cases. Right mandibular angle fracture was observed in 16.7% of patients, while 50% of the group (3 individuals) suffered from left condylar fracture and 16.7% had a bilateral condylar fracture. Treatment with Quartz splint fiber and circumdental arch wiring using ligature wire was successful with no observed post-treatment complications or malocclusion. The splint fiber was worn for 30 days and the circumdental arch wiring was for the same. Healing of bone fracture yields good results after 12 weeks. Follow-up care is crucial to monitor for complications, in this study, no post-treatment complications were observed. CONCLUSION: The treatment of pediatric mandibular fractures is complex and requires careful consideration of various factors. Conservative management should be the first choice, with open reduction and internal fixation reserved for specific cases. The use of quartz splint fiber and ligature wire is an effective treatment option for stabilizing the mandible and providing occlusal stability in growing children. A fiber splint along with ligature wire can also be used as an alternative treatment to avoid any adverse effects on the growth and development of the mandible and permanent teeth. A multidisciplinary approach is essential to achieving the best outcomes for pediatric patients with mandibular fractures.

980-nm diode laser excision of a giant pregnancy epulis.

The pure pregnancy epulis is mostly vascular, and generally shrinks or disappears with the drop in estrogen levels following delivery. However, the fibrous epulis or granulomatous epulis may enlarge rapidly in the early stages of pregnancy, necessitating surgical resection after pregnancy. This report described a 25-year-old patient with a post-term pregnancy. She had a lump on the buccal side of left mandibular molar region that was associated with intermittent hemorrhage and eating difficulty. Since the patient feared the conventional surgery, the 980-nm diode laser excision was performed to remove the epulis two weeks after delivery, with the involved teeth preserved. The new technique of 980-nm diode semiconductor laser may be a potential good option to treat pregnancy epulis, with less discomfort and involved teeth preserved.

Positional Changes of Mandibular Canal Before and After Decompression of Cystic Lesions in the Mandible.

PURPOSE: Significant displacement of the mandibular canal (MC), which occurs frequently in extensive mandibular cystic lesion cases, may raise the risk of inferior alveolar neurovascular bundle injury in surgery. The aim of the present study was to measure the association between positional changes of the MC and the direction (in the coronal plane) of bone expansion of cystic lesions in the mandible. PATIENTS AND METHODS: We performed a retrospective study of patients who had undergone decompression and enucleation surgery from January 2014 to December 2018. Based on coronal planes of cone-beam computerized tomography, the centroids of the expanded mandibles were calculated and considered markers for evaluation of the directions of bone expansion. In addition, the changes in the position of the MC before decompression and enucleation were measured and compared. A Cartesian coordinate system was introduced in this study to illustrate the relationship of positional changes between the displacement of the MC and expansion of the mandible in a straightforward manner. Statistical analysis was performed using the paired t test, unpaired t test, one-way analysis of variance or linear regression as appropriate. RESULTS: Thirty-six patients with an average age of 29.8 years (14 men, 22 women) who received treatment of decompression and enucleation for mandibular cystic lesions were included in this study. The MCs were displaced in the direction toward the lower edge of the mandible and opposite to the direction of mandibular expansion. In addition, the MCs were relocated close to their original location by 1.67 ± 1.45 mm (mean ± standard deviation) approximately 1 year after decompression, accounting for 22.66% of the total displacement. CONCLUSIONS: In mandibular cystic lesion cases, the MCs tend to displace opposite to the direction of mandibular expansion and relocate less after decompression.

Endosymbionts of Metazoans Dwelling in the PACManus Hydrothermal Vent: Diversity and Potential Adaptive Features Revealed by Genome Analysis.

Deep-sea hydrothermal vent communities are dominated by invertebrates, namely, bathymodiolin mussels, siboglinid tubeworms, and provannid snails. Symbiosis is considered key to successful colonization by these sedentary species in such extreme environments. In the PACManus vent fields, snails, tubeworms, and mussels each colonized a niche with distinct geochemical characteristics. To better understand the metabolic potentials and genomic features contributing to host-environment adaptation, we compared the genomes of the symbionts of Bathymodiolus manusensis, Arcovestia ivanovi, and Alviniconcha boucheti sampled at PACManus, and we discuss their environmentally adaptive features. We found that B. manusensis and A. ivanovi are colonized by Gammaproteobacteria from distinct clades, whereas endosymbionts of B. manusensis feature high intraspecific heterogeneity with differing metabolic potentials. A. boucheti harbored three novel Epsilonproteobacteria symbionts, suggesting potential species-level diversity of snail symbionts. Genome comparisons revealed that the relative abundance of gene families related to low-pH homeostasis, metal resistance, oxidative stress resistance, environmental sensing/responses, and chemotaxis and motility was the highest in A. ivanovi's symbiont, followed by symbionts of the vent-mouth-dwelling snail A. boucheti, and was relatively low in the symbiont of the vent-periphery-dwelling mussel B. manusensis, which is consistent with their environmental adaptations and host-symbiont interactions. Gene families classified as encoding host interaction/attachment, virulence factors/toxins, and eukaryotic-like proteins were most abundant in symbionts of mussels and least abundant in those of snails, indicating that these symbionts may differ in their host colonization strategies. Comparison of Epsilonproteobacteria symbionts to nonsymbionts demonstrated that the expanded gene families in symbionts were related to vitamin B12 synthesis, toxin-antitoxin systems, methylation, and lipopolysaccharide biosynthesis, suggesting that these are vital to symbiont establishment and development in EpsilonproteobacteriaIMPORTANCE Deep-sea hydrothermal vents are dominated by several invertebrate species. The establishment of symbiosis has long been thought to be the key to successful colonization by these sedentary species in such harsh environments. However, the relationships between symbiotic bacteria and their hosts and their role in environmental adaptations generally remain unclear. In this paper, we show that the distribution of three host species showed characteristic niche partitioning in the Manus Basin, giving us the opportunity to understand how they adapt to their particular habitats. This study also revealed three novel genomes of symbionts from the snails of A. boucheti Combined with a data set on other ectosymbiont and free-living bacteria, genome comparisons for the snail endosymbionts pointed to several genetic traits that may have contributed to the lifestyle shift of Epsilonproteobacteria into the epithelial cells. These findings could increase our understanding of invertebrate-endosymbiont relationships in deep-sea ecosystems.

A multiplex one-step fluorescence quantitative differential diagnosis method for severe hand, foot and mouth disease caused by coxsackievirus A16.

Hand foot and mouth disease (HFMD) is a common childhood infectious disease which is caused by human enterovirus. The objective of this study was to develop a rapid, sensitive, and accurate method for detecting severe HFMD caused by coxsackievirus A16 (CV-A16). A closed-tube sensitive multiplex one-step reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was applied to detect CV-A16 in the early stage of severe HFMD. This assay targeted the CV-A16 structure protein VP1 to distinguish CV-A16 from other coxsackieviruses The 5'UTR region of enteric viruses was used for detecting the enterovirus and ribonuclease P (RNaseP) was adopted as the internal reference gene. The multiplex MGB probe assay system was used to detect PCR amplicons with different fluorescence reporters in the same system. The limit of detection (LOD) of the RT-qPCR assay for the CV-A16 VP1 gene was 125.893 copies/µl, for the 5' UTR was 50.1187 copies/µl and for the RNaseP gene was 158.49 copies/µl. Furthermore, specificity analysis showed that the multiplex RT-PCR had no cross-reactivity with the influenza virus, herpangina virus and SARS-COV-2. In correlation analysis, the sensitivity of the multiplex RT-qPCR assay for CV-A16 detection was 100 % (288/288) and the specificity of the multiplex RT-qPCR assay was 99.94 % (3395/3397). The overall agreement between the multiplex RT-qPCR and the results of clinical diagnosis was 99.95 % (3683/3685) and kappa value was 0.996 (p<0.001). The entire procedure, from specimen processing to result reporting, could be completed within 1.5 hours. The one-step multiplex RT-qPCR assay for detecting CV-A16 developed in this study is a good laboratory diagnostic tool for rapid and reliable distinguished detection of CV-A16, especially for severe HFMD patients at an early stage in the disease with low virus load of CV-A16.

Designing of molecularly imprinted polymer-based potentiometric sensor for the determination of heparin.

A novel potentiometric sensor with high selectivity and sensitivity has been developed for the determination of heparin, based on the modification of heparin-imprinted polymer film onto a glassy carbon. The performance of the developed heparin sensor was evaluated, and the results indicated that a sensitive potentiometric sensor could be fabricated. The obtained heparin sensor shows high-selectivity monitoring of heparin, shorter response time (<4 min), wider linear range (0.003-0.7 µM), lower detection limit (0.001 µM), and satisfactory long-term stability (>2 months). The potentiometric sensor was successfully applied to the determination of heparin in heparin sodium injection with recoveries between 97.1% and 110.0%.

Effects of inoculation with a binary mixture of Lactobacillus plantarum and Leuconostoc citreum on cell wall components of Chinese Dongbei suancai.

This study aimed to investigate the effects of inoculation with a starter culture consisting of Lactobacillus plantarum LNJ002 and Leuconostoc citreum BNCC 194779 on microbial community, cell wall polysaccharide characteristics, cell wall degrading enzymes, and microstructure during Chinese Dongbei suancai fermentation. The results showed that Lactobacillus (98.75%) was the dominant genus during fermentation of Dongbei suancai. The principal coordinates analysis (PCoA) suggested that inoculation with Lactobacillus promoted the stability of microbial community structure during Chinese Dongbei suancai fermentation. Besides, the lower content in cellulose (80.28 ± 2.61 ug/mg) and pectin (53.56 ± 2.67 ug/mg) observed in the inoculated fermented suancai. Simultaneously, the inoculated fermented suancai had the most decreases in SR 1 (70.35%) and SR 3 (72.06%) and the most increase in SR 2 (950%), which suggested that inoculation intensified the decrease of the linearity and the RG-1 branching degree of pectin. The contents of polygalacturonase (PG) and pectin methylesterase (PME) in inoculated fermented suancai were 21.06% and 21.86% higher than those in naturally fermented suancai. In addition, the surface of suancai leaves gradually changed from smooth to rough during fermentation, which was accelerated by inoculation. Moreover, Lactobacillus, Aspergillus, Wallemia and Mucor were all negatively correlated with cellulose and GalA. These results revealed that inoculation promoted the formation of dominant genus structure during suancai fermentation, changed the effects of enzymes on the degradation of cell wall components, thereby accelerated the formation of Chinese Dongbei suancai texture.

Maximal exposure of the parapharyngeal internal carotid artery via transnasal and transoral corridors.

BACKGROUND: The parapharyngeal internal carotid artery (pICA) could be surgically exposed through the transnasal and transoral corridors. However, their potential degree of exposure has not been established sufficiently. This study aims to elucidate the maximal exposure of the pICA via the transnasal and transoral corridors. METHODS: An endonasal transpterygoid nasopharyngectomy for exposure of the pICA was performed on eight cadaveric specimens (16 sides), while a transoral approach for exposure of the pICA was performed on six additional specimens (12 sides). In addition, the CT angiography of 60 consecutive patients (120 sides) was analyzed to establish the potential maximal exposure of the pICA through each corridor. RESULTS: The hard palate becomes a restricting factor for the inferior exposure of the pICA via the transnasal approach, whereas the entire pICA segment could be adequately displayed through the transoral corridor. The maximal exposed length of the pICA for a transnasal and transoral approach was 3.08 ± 0.30 cm and 6.56 ± 0.57 cm, respectively. This difference was statistically significant (p < 0.001). CONCLUSION: An endonasal exposure of the pICA seems limited to its superior aspect, whereas the transoral corridor could provide adequate exposure of the entire length of pICA.

Clinical and imaging analysis of 22 cases of supernumerary teeth in the mandibular region.

PURPOSE: This study aimed to describe clinical and imaging analysis of supernumerary teeth in the mandibular region of 22 cases. STUDY DESIGN: Retrospective study METHODS: : This study enrolled patients diagnosed with supernumerary teeth who underwent cone beam computed tomography (CBCT) at Stomatology Hospital of Xi'an Jiaotong University from August 2016 to September 2022. Participants included individuals aged 7-29 years of both genders. The following variables were examined: number of supernumerary teeth, location, shape, direction, length, relationship with adjacent teeth and surrounding anatomical structures, and secondary effects RESULTS: : Out of 236 subjects, 22 (6.02%) were found to have supernumerary teeth in the mandibular region, with a total of 62 teeth identified. The male-to-female ratio was 5:6. Most supernumerary teeth were located in the lingual side of the mandibular region, particularly in the 34-35 tooth area (21.66%), followed by the 44-45 tooth region. The vast majority of supernumerary teeth (96.77%) were impacted, and more than half (51.67%) were located near the mental nerve canal. The average length of the supernumerary teeth was 10.5 mm. While no primary complications were observed, some secondary symptoms were noted, such as the ectopic eruption of adjacent teeth and crowding of permanent teeth. CONCLUSION: The supernumerary teeth in the mandibular area have regional characteristics, which can provide for clinical diagnosis and treatment. CBCT can accurately analyze the location of supernumerary teeth and their secondary effects, and provides the treatment plan on that basis.

Disease progression and pseudoprogression following partial response with rare gingiva metastasis upon IBI308 (sintilimab) immunotherapy reflects the complexity of metastatic lung cancer: a case report.

The differential diagnosis of progression and pseudoprogression is one difficulty in current immunotherapy. Since the time point and criteria for pseudoprogression diagnosis are not yet unified, current diagnosis and treatment rely on imaging and pathology. Here we report a 57-year-old Chinese male presented solitary left lower lung nodule with enlarged left hilar and mediastinal lymph nodes. Bilateral adrenal nodules and bilateral parietal lobe nodules were identified. The nodules were considered malignant by CT or MRI examinations. The patient was diagnosed left lower peripheral lung cancer with left hilar and mediastinal lymph node metastasis, bilateral adrenal metastasis, and bilateral parietal lobe metastasis. Progression was observed after the first-line pemetrexed + cisplatin (PP) standard chemotherapy. Due to the identification of strong positive PD-L1 expression (90%) in primary tissue immunohistochemistry, second-line IBI308 (sintilimab) immunotherapy was implemented. After the third cycle of immunotherapy, partial response was observed with the left lung lesion and the lung hilus and adrenal metastases, while pseudoprogression was found at the left lung and right hepatic lobe, and rare gingival progression was also identified. Palliative surgery was performed to remove the gingival metastatic lesion. The lesions of the lung, hilar and mediastinal lymph nodes and adrenal gland responded well, but the patient died due to uncontrollable progression of metastatic lesions in the brain. Whole-exome sequencing on gingival metastasis revealed pathogenic mutations in several important driver genes, including TP53, ErbB2, MET and PTEN. This study reported the coexistence of primary lesion response, pseudoprogression and progression in immunotherapy in lung cancer patient with rare gingival metastasis, and provided experience for handling mixed responses in immunotherapy.

Characterization and implications of the lingual process of the sphenoid bone: a cadaveric and radiographic study.

BACKGROUND: The surgical significance of the lingual process of the sphenoid bone (LPSB) has not been sufficiently addressed. The purpose of this study was to describe the anatomical details of the LPSB in relation to the quadrangular space. Moreover, the incidence of the LPSB and its correlation with the pneumatization of the sphenoid sinus and the development of the lateral recess of the sphenoid sinus (LRSS) were also evaluated. METHODS: A dissection and exposure of the LPSB and the quadrangular space was performed on 10 cadaveric specimens (20 sides). The incidence, length, and height of the LPSB were also assessed on computed tomography (CT) images (60 patients, 120 sides). The association between the presence of the LPSB with the pneumatization type of the sphenoid sinus and the presence of a LRSS was evaluated. RESULTS: In a cadaveric model, the LPSB, in association with the petrolingual ligament extending from the LPSB to the petrous apex, was identified on 7 sides (35%). The LPSB was continuous with the mandibular strut. The overall incidence of a LPSB was 48.33% on CT images, and the average length and height of the LPSB was (mean ± standard deviation) 5.30 ± 1.44 mm and 6.51 ± 1.32 mm, respectively. A significant correlation was identified between presence of the LPSB with the pneumatization type of the sphenoid sinus (p = 0.004) but no correlation was identified with the presence of the LRSS (p = 0.071). CONCLUSION: The LPSB and the petrolingual ligament are useful landmarks for procedures in the quadrangular space and Meckel's cave. However, the LPSB is not consistently present.

Age-associated microbiome shows the giant panda lives on hemicelluloses, not on cellulose.

The giant panda feeds almost exclusively on bamboo, a diet highly enriched in lignin and cellulose, but is characterized by a digestive tract similar to carnivores. It is still large unknown if and how the giant panda gut microbiota contributes to lignin and cellulose degradation. Here we show the giant pandas' gut microbiota does not significantly contribute to cellulose and lignin degradation. We found that no operational taxonomic unit had a nearest neighbor identified as a cellulolytic species or strain with a significant higher abundance in juvenile than cubs, a very low abundance of putative lignin and cellulose genes existed in part of analyzing samples but a significant higher abundance of genes involved in starch and hemicellulose degradation in juveniles than cubs. Moreover, a significant lower abundance of putative cellulolytic genes and a significant higher abundance of putative α-amylase and hemicellulase gene families were present in giant pandas than in omnivores or herbivores.

A blue emission polymer: synthesis, photophysical and electrochemical properties.

A novel π-conjugated polymer (PCPyrene) containing N-benzylcarbazole and pyrene units has been synthesized and characterized. The polymer possesses high thermal stability with the decomposition temperature of 440 °C. It shows higher fluorescence quantum yields of in solution and solid state, respectively. PCPyrene can emit bright blue-lights both in different organic solutions (440-460 nm) and in the solid state (492 nm). Compared the emission spectra of PCPyrene in solutions with in solid state, the solid state emission of PCPyrene is significantly red-shifted. Additionally, it is not obvious changes of the solid emission spectra even after being annealed at 150 °C under nitrogen for 24 h. The electrochemical properties and energy levels of PCPyrene were also investigated by cyclic voltammetry. Furthermore, in order to provide a basis forecasting the structure-physical property relationships, the photophysical properties of PCPyrene have been carefully investigated by fluorescence emission and UV-vis absorption spectra.