Sternal Pin Used to Close Sternum in Infants after Cardiac Surgery.

OBJECTIVE: A retrospective study was conducted to explore the efficacy of bioabsorbable poly-L-lactic acid sternal pins in sternal closure in infants after cardiac surgery. METHODS: A total of 170 infantile patients who underwent cardiac surgery were divided into the steel wire group (group A), the PDS cord group (group B), and the steel wire + sternal pin group (group C). The occurrence of the thoracic deformity was evaluated by vertebral index (VI), frontosagittal index (FSI), and Haller index (HI) values; the stability of the sternum was evaluated by detecting sternal dehiscence and displacement. RESULTS: By comparing the absolute values of the differences in VI, FSI, and HI in the three groups, it was found that the difference values of VI and HI in group C were significantly lower than those in group B (p = 0.028 and 0.005). For the highest deformation index, the deformation rate of infants in group C before discharge and during the 1-year follow-up was lower than that in group A and group B (p = 0.009 and 0.002, respectively). The incidence of sternal displacement in group C was also significantly lower than that in groups A and B (p = 0.009 and 0.009). During the 1-year follow-up, there was no sternal dehiscence, and the sternum healed completely in the three groups. CONCLUSION: The use of "steel wire + sternal pin" for sternal closure in infants after cardiac surgery can reduce the occurrence of sternal deformity, reduce anterior and posterior displacement of the sternum, and improve sternal stability.

Liposomal Curcumin Targeting Endometrial Cancer Through the NF-κB Pathway.

BACKGROUND/AIMS: Emerging evidence suggests that curcumin possesses chemopreventive properties against various cancers. However, its poor bioavailability limits its clinical application. In this study, we aimed to utilize encapsulation in liposomes (Lipo) as a strategy for the clinical administration of curcumin for endometrial carcinoma (EC). METHODS: Curcumin was encapsulated in a liposomal delivery system to prepare a formulation of liposomal curcumin (LC). EC cell lines Ishikawa and HEC-1 were treated with the compound and cell proliferation was measured using MTT assay. Hoechst 33258 staining assay and flow cytometry were used to detect apoptosis of the cells. Wound healing and cell invasion assays were employed to monitor cell motility. Underlying target signaling, such as NF-κB, caspases, and MMPs, were further studied via qRT-PCR and western blot. Thereafter, a zebrafish model was used to assess the toxicity of LC. Finally, a zebrafish transplantation tumor model of EC was grown and treated with LC. Tumors were monitored and harvested to study the expression of NF-κB. RESULTS: The formation of LC was successfully developed with excellent purity and physical properties. In vitro, LC resulted in dose-dependent inhibition of proliferation, induction of apoptosis, and suppression of Ishikawa and HEC-1 cell motility. LC treatment also suppressed the activation and/or expression of NF-κB, caspase-3, and MMP-9. No demonstrable toxicity was found in the zebrafish model and tumors were suppressed after treatment with LC. PCR analysis also showed down-regulated expression of NF-κB. CONCLUSIONS: LC was successfully prepared and played biological roles against EC probably through negative regulation of the NF-κB pathway in vitro and in vivo, which demonstrates its potential therapeutic effects in EC.

Varicella-associated disseminated intravascular coagulation secondary to Henoch-Schönlein purpura with renal and gastrointestinal system involvement in a child: A case report.

RATIONALE: Immunocompromised patients who developed varicella-zoster virus (VZV)-associated disseminated intravascular coagulation (DIC) previously included recipients of bone marrow, hematopoietic stem cell, or organ transplantations, patients with primary nephropathy receiving corticosteroid therapy, cancer patients receiving chemotherapy, and patients with human immune deficiency virus infection. The case reported here is novel because, to our knowledge, there has been no report of VZV-associated DIC after the onset of Henoch-Schönlein purpura (HSP). PURPOSE: To report the successful treatment of a novel pediatric case with VZV-associated DIC secondary to HSP. DIAGNOSIS AND INTERVENTION: An 8-year-old girl developed VZV-associated DIC 24 days after diagnosis of HSP with renal and gastrointestinal involvement. She was treated with methylprednisolone at a local hospital for 19 days, and suddenly developed fever starting from day 4 in our hospital. Her fever persisted with vesicular skin rashes on her back, strong abdominal and lower back pain, epistaxis, hematochezia, erosion and bleeding on her lips, in her mouth and at puncture sites on day 5. She was diagnosed with DIC with the laboratory evidence of dramatically decreased platelet count and fibrinogen, prolonged activated partial thromboplastin time and prothrombin time, and increased fibrin degradation products including d-dimers. She also developed multiple organ dysfunction syndrome. On day 7, the patient VZV nucleic acid result turned out to be positive. Methylprednisolone treatment was discontinued, and she was given a multi-modality therapy including medications of acyclovir and antibiotics, intravenous gamma-immunoglobulin, various blood product transfusions, continuous renal replacement therapy, plasma exchange, and administration of liver and gastrointestinal system protection drugs. OUTCOMES: The patient multi-organ function damage gradually recovered. After VZV control, the patient was treated with oral methylprednisolone again for HSP with nephritis. Urine analysis was normal 1 year later, and oral hormone was discontinued. No complication or relapse occurred during 2 years of follow-up. SIGNIFICANCE: This case report, for the first time, adds HSP treated with corticosteroids to the spectrum of clinical conditions that progressed to life-threatening secondary varicella-associated DIC. Early identification of varicella infection and DIC, combined with timely antiviral, immunoglobulin transfusion, plasma exchange, and other combined therapies are essential for saving patients' lives.

Forward osmosis membranes for high-efficiency desalination with Nano-MoS2 composite substrates.

Attractive membranes are critical for improving efficiencies of forward osmosis (FO) desalination process. In this study, a novel FO-PES-MoS2 thin film composite (TFC) membrane was assembled using the phase transfer method through merging MoS2 nanosheets into substrate casting solution. A sequence of characterization techniques was applied to test microstructures and physicochemical properties of the membranes and modification mechanisms based on MoS2 concentrations. Desalination efficiencies of the fabricated membranes were assessed by three NaCl draw solutions. Compared to the blank membrane, the MoS2-contained membranes had a thinner active layer, more upright and open pore structure, higher porosity, and lower surface roughness. 1 wt% MoS2 content was the optimal modification condition, and water flux increased by 35.01% under this condition. Simultaneously, reverse salt flux of the FO-PES-1-MoS2 membrane declined by 29.15% under 1 M NaCl draw solution, indicating increased salt ion rejection performance of the modified membranes. Moreover, Js/Jv ratio indicated that MoS2 nanosheets helped stabilize the desalination performance of the membranes. This study demonstrated that the novel FO-PES-MoS2 TFC membranes possessed improved performances and showed promising properties for saline water desalination.

[Clinical classification of 288 cases of bronchial tuberculosis based on an expert consensus].

OBJECTIVE: To study the clinical application and significance of the recently published expert consensus on endobronchial tuberculosis (EBTB). METHODS: A retrospective analysis of 288 cases of EBTB hospitalized in Tianjin Haihe Hospital from May 2005 to April 2010 was carried out. The classification and typing of the disease were based on a consensus report recently published by Chinese Journal of Tuberculosis and Respiratory Diseases. Chi-square test was performed to analyze the differences between groups. RESULTS: Of the 288 cases of EBTB, 47.9% (138/288) was classified as Type I (Inflammatory infiltrative), 33.3% (96/288) as Type II (ulcerous necrotic), 5.2% (15/288) as Type III (granulomatous hyperplastic), 7.3% (21/288) as Type IV (scar stricture) and 0.4% (1/288) as Type V (Bronchomalacia), respectively. There were 17 cases (5.9%) classified as a mixed type with a combination of Type IV or Type V disease with 1 or more of the other types. 37.5% (108/288) of the patients were young females, while young and middle-aged patients with type I and type II diseases accounted for 74.7% (215/288) of the cases, much more than old aged patients (6.6%, 19/288). 97.2% (n=280) of the cases suffered from secondary pulmonary tuberculosis. In 107 cases, the disease was located in the left, 162 cases in the right, while in 109 cases the right upper lobe bronchus was involved, and right main bronchus in 36 cases, 3 cases and 58 cases in left upper lobe with and without lingular segment, 10 cases in lingular segment only. Chest CT showed that local mucosal thickening of the trachea or bronchus was evident in 40.3% (116/288); toothed or spike protuberance in 30.9% (89/288), bronchial obstruction in 11.1% (32/288), and bronchial stenosis in 87.9% (253/288). The negative rate of sputum in the first month after interventional therapy was 60.2% (56/93), significantly higher than that in non-interventional therapy group (23.1%, 18/78). CONCLUSION: The new consensus report on EBTB was clinically useful for classification and typing of the disease, and for the selection of treatment modalities.

Identification of Candidate Genes Associated with Charcot-Marie-Tooth Disease by Network and Pathway Analysis.

Charcot-Marie-Tooth Disease (CMT) is the most common clinical genetic disease of the peripheral nervous system. Although many studies have focused on elucidating the pathogenesis of CMT, few focuses on achieving a systematic analysis of biology to decode the underlying pathological molecular mechanisms and the mechanism of its disease remains to be elucidated. So our study may provide further useful insights into the molecular mechanisms of CMT based on a systematic bioinformatics analysis. In the current study, by reviewing the literatures deposited in PUBMED, we identified 100 genes genetically related to CMT. Then, the functional features of the CMT-related genes were examined by R software and KOBAS, and the selected biological process crosstalk was visualized with the software Cytoscape. Moreover, CMT specific molecular network analysis was conducted by the Molecular Complex Detection (MCODE) Algorithm. The biological function enrichment analysis suggested that myelin sheath, axon, peripheral nervous system, mitochondrial function, various metabolic processes, and autophagy played important roles in CMT development. Aminoacyl-tRNA biosynthesis, metabolic pathways, and vasopressin-regulated water reabsorption were significantly enriched in the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway network, suggesting that these pathways may play key roles in CMT occurrence and development. According to the crosstalk, the biological processes could be roughly divided into a correlative module and two separate modules. MCODE clusters showed that in top 3 clusters, 13 of CMT-related genes were included in the network and 30 candidate genes were discovered which might be potentially related to CMT. The study may help to update the new understanding of the pathogenesis of CMT and expand the potential genes of CMT for further exploration.

Surgery vs conservative treatment for type II and III odontoid fractures in a geriatric population: A meta-analysis.

BACKGROUND: It is unclear whether surgery or conservative treatment is more suitable for elderly patients with type II and type III odontoid fractures. We performed this meta-analysis to compare the efficacy of surgical and conservative treatments for type II and type III odontoid fractures. METHODS: A literature search was performed in PubMed, Embase, Web of Science, and Cochrane Library in January 2017. Only articles comparing surgery with conservative treatment in elderly patients with type II and type III odontoid fractures were selected. After 2 authors independently assessed the retrieved studies, 18 articles were included in this meta-analysis, and the primary endpoints were the nonunion rate and mortality rate. The secondary outcomes were patient satisfaction, complications, and the length of the hospital stay. The quality of the included studies was evaluated using the modified Newcastle-Ottawa scale. Sensitivity analyses were performed for high-quality studies, and the publication bias was evaluated using a funnel plot. RESULTS: Lower nonunion (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.18-0.40, P < .05) and mortality rates (OR: 0.52, 95% CI: 0.34-0.79, P < .05) confirmed the superiority of surgery in treating type II and type III fractures. The secondary outcomes differed. Patients in the surgery group felt more satisfied with the outcome (OR: 3.44, 95% CI: 1.19-9.95, P < .05), and the complications were similar in the 2 groups (OR: 1.14, 95% CI: 0.78-1.68, P = .5), whereas patients in conservative groups spent less time in the hospital (OR: 5.10, 95% CI: 2.73-7.47, P < .05). The results of the subgroup analyses and sensitivity analysis were similar to the original outcomes, and no obvious publication bias was observed in the funnel plot. CONCLUSION: Most elderly (younger than 70 years) patients with type II or type III odontoid fractures should be considered candidates for surgical treatment, due to the higher union rate and lower mortality rate, while statistically significant differences were not observed in the population with an advanced age (older than 70 years). Therefore, the selection of the therapeutic approach for elderly patients with odontoid fractures requires further exploration. Simultaneously, based on our meta-analysis, a posterior arthrodesis treatment was significantly superior to the anterior odontoid screw treatment.

[The symmetry of nasal maxillary complex of patients with unilateral complete cleft lip and palate at the stage of mixed dentition-A cone beam CT study].

PURPOSE: To investigate the symmetry of nasal maxillary complex in the three-dimensional directions of patients with unilateral complete cleft lip and palate(UCLP) at the stage of mixed dentition. METHODS: Craniofacial cone-beam CT(CBCT) images of 20 UCLP patients at the stage of mixed dentition were selected. Three-dimensional reconstruction of bone tissue was carried out by Mimics software, nasal root point and 32 markers with the same name of the healthy side and the cleft side of the nasal maxillary complex were traced, three-dimensional reference planes were set up, then the distances between the points to the three-dimensional planes were measured respectively. SPSS 22.0 software package was used to analyze the data. RESULTS: In the horizontal direction, compared with the non-cleft side, the width of the cleft side of the maxilla at INM and SPC was smaller, the width of maxilla at LPA and SPr was larger, the differences were statistically significant (P<0.05). In the sagittal direction, compared with the non-cleft side, the depth of LPA, Maz and SPr at the cleft side was larger, the depth of SPM and SPC was smaller, the differences were statistically significant (P<0.05).In the vertical direction, the positions of LPA, INM and Maz at the cleft side was lower than the non-cleft side, SPC and SPr were higher, the differences were statistically significant(P<0.05). The remaining points had no significant difference (P>0.05). CONCLUSIONS: The nasal maxillary complex of UCLP patients at the stage of mixed dentition is asymmetric in three directions. The asymmetric locations were mainly located in the nasal cavity and alveolar bone. No obvious asymmetry is found in the orbital region and the maxillary region far from the cleft.

Photoconductive method for measuring light transmission to the root of metal-ceramic and all-ceramic restorations.

OBJECTIVES: In this study, the authors attempted to develop a photoconductive method for measuring light transmission through a crown restoration to the root dentin; metal-ceramic crowns with four coping designs (metal collar, and metal framework ending 0, 1, and 2mm coronal to the axiogingival line angle) and two all-ceramic crowns (Empress II and In-Ceram Alumina) were compared. METHODS: According to pre-registered templates, 36 crowns were fabricated for an extracted central incisor. A cadmium sulfide (CdS) photoconductive cell was secured onto the root of a tooth, which was fixed in a light box. The validity and reliability of the experimental design were verified, and the impedance of the cell was recorded when the crowns were placed on the prepared tooth with or without try-in pastes under a constant luminance. RESULTS: A significant correlation (r= -0.99, p<0.001) was found between the light intensity and impedance of the CdS cell, and a 1.15% coefficient of variation between repeated measurements was observed. In this study, Empress II crowns had the smallest impedance, indicating that they provided the best light transmission. Conventional metal-ceramic crowns had the least light transmission, which was significantly improved by reducing the metal collar (p<0.05). The framework of metal-ceramic crowns which ended 2mm coronal to the axiogingival line angle showed as much light transmission as the In-Ceram crowns. The impedance increased when try-in pastes were employed in all test groups. SIGNIFICANCE: The photoconductive method was proven to be a reliable technique for measuring the light transmitted through restorations into the adjacent tissue.

Mortality in Children with Severe Hand, Foot and Mouth Disease in Guangxi, China.

OBJECTIVE: To analyze the clinical features of children with hand foot and mouth disease (HFMD) who died. METHODS: 331 deaths due to HFMD between 2010 and 2014 were included in this retrospective study; 15 autopsies were performed. RESULTS: Most deaths were seen in children aged below 3 y, and with enterovirus 71 infection (91%). The mean (SD) duration of HFMD from onset to death was 3.7(2.9) d. The mean (SD) age of fast progressors (from onset to death less than 4 days) was 17.4 (9.2) mo. Most of them were diagnosed as stage 3 and stage 4 of HFMD. Various pathological changes were observed in brain after autopsy, especially in brain stem and medulla. CONCLUSION: The brain stem encephalitis with the neurotropism of enteroviruses seems to be the main contributor to the death in HFMD.

[The influence of age upon circadian rhythm of human pulp sensibility].

OBJECTIVE: To explore the influence of age on the circadian rhythm of pulp sensibility, guide the diagnosis and treatment of dental and endodontic diseases. METHODS: The first lower molars of young, middle-aged, and aged volunteers were inspected for the threshold of pulp sensitivity. Each inspection was implemented every 4 hours earlier, totally 7 times during 24 hours. All values of pulp sensibility threshold from each volunteer were analyzed by Halberg methods for cosinor-rhythmometry. The chronobiology characteristics of pulp sensibility were compared among young, middle-aged, and aged. RESULTS: The pulp sensibility threshold values of the young, middle-aged, and aged indicated to have the circadian rhythm alternation in period of 24 hours, with fitting well to a cosine curve. The trend of rhythm curve was similar to all three age groups. The acrophase and bathyphase appeared at 0:00 and 12:00 separately. The values and amplitudes of pulp threshold sensibility showed to be: young>aged> middle-aged. CONCLUSION: The circadian rhythm of pulp sensibility changes according with age. The pulp sensibility threshold value is lower in aged people than in the young, and the lowest sensibility threshold is in middle-aged people. Besides, the extent of rhythm fluctuation is the least in middle-aged people.

Liposomal curcumin alters chemosensitivity of breast cancer cells to Adriamycin via regulating microRNA expression.

BACKGROUND: Emerging evidence suggests that curcumin can overcome drug resistance to classical chemotherapies, but poor bioavailability and low absorption have limited its clinical use and the mechanisms remain unclear. Also, Adriamycin (Adr) is one of the most active cytotoxic agents in breast cancer; however, the high resistant rate of Adr leads to a poor prognosis. METHODS: We utilized encapsulation in liposomes as a strategy to improve the bioavailability of curcumin and demonstrated that liposomal curcumin altered chemosensitivity of Adr-resistant MCF-7 human breast cancer (MCF-7/Adr) by MTT assay. The miRNA and mRNA expression profiles of MCF-7/S, MCF-7/Adr and curcumin-treated MCF-7/Adr cells were analyzed by microarray and further confirmed by real-time PCR. We focused on differentially expressed miR-29b-1-5p to explore the involvement of miR-29b-1-5p in the resistance of Adr. Candidate genes of dysregulated miRNAs were identified by prediction algorithms based on gene expression profiles. Networks of KEGG pathways were organized by the selected dysregulated miRNAs. Moreover, protein-protein interaction (PPI) was utilized to map protein interaction networks of curcumin regulated proteins. RESULTS: We first demonstrated liposomal curcumin could rescue part of Adriamycin resistance in breast cancer and further identified 67 differentially expressed microRNAs among MCF-7/S, MCF-7/Adr and curcumin-treated MCF-7/Adr. The results showed that lower expressed miR-29b-1-5p decreased the IC50 of MCF-7/Adr cells and higher expressed miR-29b-1-5p, weaken the effects of liposomal curcumin to Adr-resistance. Besides, we found that 20 target genes (mRNAs) of each dysregulated miRNA were not only predicted by prediction algorithms, but also differentially expressed in the microarray. The results showed that MAPK, mTOR, PI3K-Akt, AMPK, TNF, Ras signaling pathways and several target genes such as PPARG, RRM2, SRSF1and EPAS1, may associate with drug resistance of breast cancer cells to Adr. CONCLUSIONS: We determined that an altered miRNA expression pattern is involved in acquiring resistance to Adr, and that liposomal curcumin could change the resistance to Adr through miRNA signaling pathways in breast cancer MCF-7 cells.

[Chronobiology of pulp sensibility in young people].

OBJECTIVE: To explore the biological clock of pulp sensibility in young people so as to enrich the theory of pulp-chronobiology and conduce to clinical diagnosis and the treatment of pulposis. METHODS: 40 healthy young volunteers (20 males and 20 females) were examined. Pulp sensibility test was performed using the pulp sensibility tester produced in France. Pulp sensibility reading was obtained at each 4 hours from 8:00 a.m. till next 8:00 a.m., thus there were totally seven time-pints in 24 hours. And the readings were averaged. RESULTS: The pulp sensibility data of every volunteer were analyzed by methods for cosinor-rhythmometry, and significant difference (P<0.05) was found. The acrophase and bathyphase appeared at 0:00 and 12:00 separately. We did not find significant difference of the mesor, amplitude and phase between young males and females (P> 0.05). CONCLUSION: Circadian rhythm is demonstrated in thepulp sensibility data of young people; the highest pulp sensibility is at 12:00 while the lowest is at 0:00.

[Mapping QTLs for horizontal resistance to sheath blight in an elite rice restorer line, Minghui 63].

This study was conducted with a recombinant inbred line (RILs) population consisting of 240 recombination lines, derived from an elite combination, Zhenshan 97B x Minghui 63. The RILs and their parents were grown in a randomized complete design with two replications in the years of 1999 and 2000. Sheath blight response ratings for the population and their parents were identified by an improved method of inoculation, which was carried out with short woody toothpicks incubated with a Rhizoctonia solani strain, RH-9, and inserted the third sheath in the late tillering/green ring stage of growth. A linkage map was constructed from the RILs. The QTL mapping of sheath blight resistance was carried out by the method of interval QTL mapping. Two QTLs for sheath blight resistance were detected in each year, and were located on chromosome 5 and chromosome 9, respectively. The QTL for sheath blight resistance on chromosome 5 was flanked by markers C624 and C246 on the basis of 1999 data, and by markers C246 and RM26 using 2000 data. The 1-LOD-confidence intervals of QTLs for sheath blight resistance on chromosome 5 detected in two years greatly overlapped with each other, and the peak of the 1-LOD-confidence intervals were approximately the same site. This suggested that the QTL for resistance on chromosome 5 detected in 1999 was probably the same as the QTL detected in 2000. The QTL for sheath blight resistance on chromosome 9 was located on the marker interval of C472-R2638 in term of 1999 data, and on the interval of RM257-RM242 based on 2000 data, and the two intervals were 9.7 cM away from each other. Based on the effect analysis of QTLs for resistance, the genotype of MH63 had negative additive effects or reduced sheath blight rating.

Straw bio-degradation by acidogenic bacteria and composite fungi.

A composite microbial system, including a strain of Candida tropicalis (W3), a strain of Lactobacillus plantarm(WY3) and three strains of basidiomycete pL104, pL113 and C33, was chosen to degrade corn straw. The final pH was acid owing to the inoculation of acidogenic bacteria, and under this condition the composite fungi system could produce complex enzyme to destroy the compact structure of corn straw. The experimental results showed that the biomass of composite fungi could reach up to maximum when the pH value was 4.5. Through the bio-degradation by combining acidogenic bacteria with the composite fungi system, the cellulose, hemi-cellulose and lignin degradation rates of corn straw powder were 26.36%, 43.30% and 26.96%, respectively. And the gross crude protein content increased 60.41%. This study provided the evidence for the feasibility of developing a composite microbial system with high capability of degrading straw lignocelluloses in order to make reasonable use of straw resource and protect rural eco-environment.

Development of a multi-residue enantiomeric analysis method for 9 pesticides in soil and water by chiral liquid chromatography/tandem mass spectrometry.

A novel and sensitive chiral liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) method was developed and validated for simultaneous measuring individual enantiomers of 9 pesticides including herbicides, insecticides, and fungicides in soil and water. The separation and determination were performed using reversed-phase chromatography on an amylose chiral stationary phase, a Chiralpak AD-RH column, under gradient elution using a mixture of ACN-2mM ammonium acetate in water as the mobile phase at 0.45 mL/min flow rate. The effects of three cellulose-based columns and three amylose-based columns on the separation were also investigated. The QuEChERS (acronym for Quick, Easy, Cheap, Effective, Rugged and Safe) method and solid-phase extraction (SPE) were used for the extraction and clean-up of the soil and water samples, respectively. Parameters including the matrix effect, linearity, precision, accuracy and stability were undertaken. Under optimal conditions, the mean recoveries for all enantiomers from the soil and water samples were ranged from 77.8% to 106.2% with the relative standard deviations (RSD) less than 14.2%. Good linearity (at least R(2) ≥ 0.9986) was obtained for all studied analytes in the soil and water matrix calibration curves over the range from 2.0 to 125 µg/L. The limits of detection (LOD) for all enantiomers in the soil and water were less than 1.8 µg/kg or µg/L, whereas the limit of quantification (LOQ) did not exceed 5.0 µg/kg or µg/L. The results of the method validation confirm that this proposed method is convenient and reliable for the enantioselective determination of the enantiomers of 9 chiral pesticides in soil and water.

[Comparative study on the apical root resorption between self-ligating and conventional brackets in extraction patients].

PURPOSE: To explore whether orthodontic light force with self-ligating brackets can reduce the amount of external apical root resorption (EARR). METHODS: Thirty patients with Class I or II crowding malocclusion were selected. Four first premolars of all patients were extracted in orthodontic treatment. 15 patients were treated with self-ligating brackets (Damon 3MX) and 15 patients with conventional ligation brackets, respectively. Patients in two groups were comparable in gender, age, crowded degree and malocclusion classification at the commencement of treatment. EARR of the maxillary and mandible incisors was evaluated on panoramic radiographs and models taken before and after treatment, and measured in millimeters. Student's t test was performed using SPSS19.0 software package. RESULTS: Overall, no difference was found in the amount of EARR between the two groups. The amount of EARR in maxillary central incisor was (2.05±1.51) mm in Damon group and (2.08±1.21) mm in conventional group(P=0.973>0.05); (1.77±1.01) mm in maxillary lateral incisor in Damon group and (1.91±1.59) mm in conventional group(P=0.848>0.05); (2.06±1.62) mm in mandibular central incisor in Damon group and (1.98±1.50) mm in conventional group(P=0.926>0.05); (1.94±1.45) mm in mandibular lateral incisor in Damon group and (1.84±1.17) mm in conventional group(P=0.888>0.05). CONCLUSION: No difference should be expected for root resorption between self-ligating and conventional brackets in orthodontic extraction treatment.

[Repairing of palatum durum defects following maxillectomy using nasal septum tissue flap].

OBJECTIVE: To discuss the effect of repairing of palatum durum defects following maxillectomy using nasal septum tissue flap. METHODS: Twenty-six patients underwent maxillectomy and the defects were repaired by using full (16 cases) and partial (10 cases) nasal septum tissue flaps. RESULTS: Twenty-one patients were healed by first intention, recovering swallowing and pronunciation function. Five patients suffered from fistula holes, and 2 healed after dressing while 2 of the other 3 patients healed after second suturing with 1 still got a small fistula hole. Facial deformity include 4 exterior cheek mild concave and 6 complained about unsuited false teeth and no dorsal subsidence was found. The 3, 5, 10 year survival rate was 46.2%, 30.8% and 11.5% respectively. CONCLUSIONS: Repairing defects with nasal septum tissue flap has advantages. Nasal septum can not be invaded easily, and the material can be got with ease, with rich blood supply, being resistant to infection, easy to heal and less chance of leading to fistula holes. With the cartilage of nasal septum as support, facial deformity can be reduced. And the method is worth spreading and exploiting.

[Endoscopic maxillary sinus surgery through anterior or posterior nasolacrimal duct approach].

OBJECTIVE: To explore the feasibility and effectiveness of the approaches and methodology of the endoscopic surgery for maxillary sinus lesions through the medial wall of the maxillary sinus. METHODS: From Jun. 2003 to Aug. 2010, endoscopic surgery through anterior or posterior nasolacrimal duct approaches to remove maxillary sinus lesions were conducted in 139 patients. Among them there were 43 cases with inverted papilloma, 63 cases with fungal maxillary sinusitis, 28 cases with maxillary sinus cyst, 3 cases with hemorrhagic necrotic polyps, and 2 cases with osteomas. All patients underwent preoperative CT scans, and patients with inverted papillomas also had MRI tests. Anterior-nasolacrimal canal paths included 3 ways: pyriform aperture, lacrimal bone recess (dissecting nasolacrimal duct or not were 2 subtypes), pyriform aperture-nasolacrimal duct approaches, and 97 patients were treated. Posterior-nasal lacrimal duct paths were also divided into 3 subtypes: the inferior turbinate flip flap, double pedicle inferior turbinate, single pedicle inferior turbinate, and 42 patients were treated. The postoperative effects were observed. RESULTS: All lesions were completely removed under endoscope, the nasolacrimal ducts and inferior turbinates were protected, no nasal lacrimal duct injury and inferior turbinate necrosis were found. Postoperative nasal congestion, headache, swelling discomfort, strange odor, dental pain and numbness and other symptoms gradually disappeared. Nine patients felt nasal dryness, and after nasal washing for about 1 month, the symptom gradually disappeared. Patients were followed up for 6 months to 79 months. In case of osteoma, and hemorrhagic and necrotic polyps, no recurrences were found. Apparent edema, hypertrophy of sinus mucosa could be seen during the surgery in all patients with fungal maxillary sinusitis, and the edema gradually disappeared after 3 months or so, with no relapse. Two cases of maxillary sinus cysts were found in other parts of the maxillary sinus 10 months and 18 months after the surgery, but the cysts were small and asymptomatic, so no further management needed, and they were still under follow-up. Three patients, recurred. In 1 case with inverted papilloma, a local lump on the opening were found 17 months after the surgery, and was removed in out-patient department and pathology showed papillary tumor recurrence, no relapse was found 1 year later; 1 patient had recurrence in anterior ethmoid sinus 15 months after operation, total ethmoidectomy was done and no relapse was found in 3 years. One patient had local recurrence in the posterolateral wall of the maxillary sinus 26 months after operation, and the secondary surgery was done via single pedicle inferior turbinate. The papilloma relapsed again after 1 year, an endoscopic Denker surgery was performed, with no recurrence after 18 months of follow-up. Three months after surgery, the maxillary sinus was scar-covered in all cases. Inferior turbinate maintained good shape, compared to those with inferior nasal meatus windowing surgery. Scars were significantly smaller, but no latch or obstruction of drainage were found. CONCLUSIONS: Endoscopic maxillary sinus surgery through anterior or posterior nasolacrimal duct approach can reduce the trauma, fully expose the sinuses, and facilitate postoperative treatment and review with a window. Retained inferior nasal turbinate is helpful to avoid dryness, crusting, headache and other complications due to too much removal of nasal exteral walls.

[Dynamic observation of applying repairing laryngeal mucosal defect with heterogeneous acellular dermal matrix].

OBJECTIVE: To study the clinical effect of heterogeneity (cattle) acellular dunal matrix in repairing mucosa defect in laryngeal surgery. METHODS: Eighteen cancer patients with mucosa defect in central vocal area accepted treatment with heterogeneity acellular dunal matrix after surgery. There were two methods to repair mucosa defect. One was simple use of acellular dunal matrix, the second was combined use of acellular dunal matrix and muscle lamella or muscle and tendon film lamella. 18 cases had cancer in central vocal area: T2N0M0 (8), T3N1M0 (5), T3N2M0 (4), T4N2M0 (1). All were squamous cell carcinoma. Ten cancer patients accepted radiation after surgery. The radiotherapy volume was 60-80 Gy. After the operation, the patients were checked by fibrolaryngoscope four or five times after half a year, observing the dynamic development. RESULTS: All 18 patients were healed, rechecked by endoscope after 0.5-6 months, heterogeneity acellular dunal matrix mingled with mucosa within 30-60 d, no allergy and irritation were found. The laryngeal function, including breathing, pronouncing and swallowing, was recovered. The survival rate (1 year) was 100%, and 10 patients survived after 2 years. After radiotherapy, the process of recovery was not affected. CONCLUSIONS: Heterogeneity acellular dunal matrix can be easily obtained and it is a new method to repair mucosa defect. The operative procedure is easy to perform and worthwhile to use clinically.