[Category of facial symmetry perception after maxillary reconstruction using anterolateral thigh flap].

OBJECTIVE: To preliminarily establish a category of facial symmetry perception after maxillary reconstruction using anterolateral thigh flap (ALTF) by the methods of stereophotogrammetry and subjective assessment. METHODS: The patients underwent maxillectomy due to neoplasms invasion, and all the maxillary defects were reconstructed using ALTF.Three-dimensional (3D) photographs were captured from the patients with a stereophotogrammatrical camera set-up.In the Geomagic software, the mirror image was created by reflecting along an arbitrary plane outside of the face.After the registration, the postoperative side on the original 3D photograph was segmented into 6 areas.The 3D change of the facial soft-tissue was measured using surface-based color map.Twenty laypeople took part in the study as observers, and they were asked to rate the 3D photographs using 5 point Likert-type scale according to their own aesthetic standard.The soft tissue asymmetry was graded according to the score.The collected data were subjected to statistical analysis using the SPSS 24.0 software. RESULTS: In the study, 44 subjects were recruited (21 males and 23 females, age range from 19 to 79 years).The soft-tissue symmetry was graded into three levels according to the subjective scores.The grade Ⅰ was basically symmetrical.The grade Ⅱ was slightly asymmetrical.The grade Ⅲ was obviously asymmetrical.Statistically significant differences were found in the suborbital (P < 0.05) and zygomatic (P < 0.05) areas when comparing all grades of soft-tissue asymmetry, and in the buccal (P < 0.05) and superiolabial (P < 0.05) areas when comparing grades Ⅰ and Ⅲ.The extent of maxillary defect had significant impact on the symmetry of the midface soft-tissue after maxillary reconstruction. CONCLUSION: Varying extent maxillectomy would result in varying degrees of asymmetry, and cause different grades of symmetry perception even if they had been reconstructed using ALTF.The higher the grade, the worse the symmetry of facial soft-tissue.Suborbital and zygomatic areas were important aesthetic units that affected the facial symmetry perception, followed by buccal and superiolabial areas.The clinicians should pay attention to the soft-tissue support in these areas when reconstructing the maxillary defect, especially large defect with orbital floor involved.

[wareness and knowledge of oral cancer among 1 483 residents in Beijing].

OBJECTIVE: To investigate the oral cancer awareness, its related knowledge among residents in Beijing. METHODS: A questionnaire survey was conducted among Beijing residents (non-medical related personnel) on the knowledge of oral cancer and its prevention and treatment. RESULTS: A total of 1 483 questionnaires were completed, including 663 males (44.6%) and 820 females (55.3%), ranging from 15 to 91 years. Lung cancer was the most mentioned as heard of (94.3%), followed by liver cancer (92.5%) and gastric cancer (92.4%), while oral cancer was the least heard of (47.7%). Family account (P=0.015), residence (P=0.028), income (P=0.024), frequency of brushing teeth (P<0.001), frequency of mouth self-examination (P<0.001) and chew betel nut chewing (P=0.015) were significantly associated with oral cancer awareness. Most respondents learned about oral cancer from TV programs (24.3%), phone news (22.0%), WeChat (11.3%) and chatting with friends or people around (14.6%). Only 34.9% knew that smoking was a risk factor of oral cancer, and this knowledge was associated with age (P=0.011), education level (P=0.007), frequency of brushing teeth (P<0.001), and frequency of mouth self-examination (P=0.002). Only 23.5% knew that drinking was a risk factor of oral cancer, and this knowledge was associated with education level (P=0.002), residence (P=0.022), frequency of brushing teeth (P=0.009), and frequency of mouth self-examination (P=0.005). Only 35.1% knew that betel nut chewing was a risk factor for oral cancer, and this knowledge was associated with age (P=0.040), education level (P=0.002), family account (P=0.002), income (P=0.005), frequency of brushing teeth (P=0.001), frequency of mouth self-examination (P<0.001), and betel nut chewing (P=0.002). Only 35.7%, 21.6% and 16.9%, respectively, knew that long-term unhealed ulcers, white plaques and red plaques in the mouth were the early signs of oral cancer. CONCLUSION: This survey demonstrates a general lack of public awareness and knowledge about signs and symptoms of oral cancer, and its risk factors and treatment. Some residents have not formed good oral hygiene habits. Specific measures should be taken to improve the public awareness of oral cancer and related knowledge about prevention and treatment, such as the use of various new media for the public to promote their oral health knowledge, in order to reduce the incidence of oral cancer, improve early attendance rates and the patients' survival rates.

[The 464th case: sudden convulsion and coma in a patient with acute leukemia].

A 46-year-old female patient was diagnosed as mixed phenotype acute leukemia with chief complaints of intermittent gingival swelling and bleeding for 1 week. The induction chemotherapy was not effective. During the second course chemotherapy, the patient had sudden convulsion and coma. She was transferred to the intensive care unit with worsened condition after transient improvement. Her final diagnosis was secondary adrenocortical insufficiency, adrenal crisis, intractable hyponatremia and cerebral edema.

Pulmonary emboli from pulse-spray and mechanical thrombolysis: evaluation with an animal dialysis-graft model.

PURPOSE: To compare pulmonary emboli resulting from pulse-spray pharmacomechanical thrombolysis (PSPMT) and mechanical thrombolysis performed to declot dialysis-access grafts. MATERIALS AND METHODS: Polytetrafluoroethylene arteriovenous shunts were created in eight dogs and were deliberately clotted at monthly intervals. Animals were randomly assigned to treatment with pulse-spray urokinase thrombolysis or a low-speed rotational percutaneous thrombolytic device. Perfusion imaging, pulmonary-artery pressure measurements, and pulmonary arteriography were performed before and after each procedure. RESULTS: A total of 22 procedures were performed (11 PSPMT and 11 mechanical thrombolysis). Declotting was successful in all procedures, with 100% 30-day patency. Segmental defects were seen on perfusion images after 10 (91%) of 11 PSPMT procedures and two (18%) of 11 mechanical thrombolysis procedures (P < .002). Transient increases in pulmonary-artery pressure occurred in the PSPMT group. Complete resolution of emboli and return to baseline pressures were seen in all cases, even after multiple (up to four) procedures in the same animal. There was no histologic evidence of pulmonary infarction in either group. CONCLUSION: The percutaneous thrombolytic device is effective for declotting dialysis grafts in dogs and results in statistically significantly fewer pulmonary emboli compared with PSPMT.