Navigation-based endoscopic enucleation (NBEE) of large mandibular cystic lesions involving the ramus.

OBJECTIVE: The aim of this study was to present an innovative surgical protocol, navigation-based endoscopic enucleation (NBEE) for the treatment of large mandibular cystic lesions involving the mandibular ramus. METHODS: Twelve patients who presented with a large mandibular cystic lesion involving the mandibular ramus were enrolled in this study. Preoperative planning and intraoperative navigation were performed in all 12 patients. RESULTS: All patients in this study were treated with navigation-based endoscopic enucleation successfully. The follow-up period ranged from 7 to 10 months. Bone regenerated was found in all patients postoperatively. Three patients experienced temporary mandibular nerve palsy, and all relieved within 2 months. No pathological bone fracture was found during surgery. CONCLUSIONS: The use of navigation-based endoscopic enucleation (NBEE) for the treatment of large mandibular cystic lesions involving the ramus proved to be an effective method for complete and precise enucleation of the cystic lesion that also preserved the surrounding tissue.

Biomechanical analysis of the maxillary sinus floor membrane during internal sinus floor elevation with implants at different angles of the maxillary sinus angles.

OBJECTIVE: This study analyzed and compared the biomechanical properties of maxillary sinus floor mucosa with implants at three different maxillary sinus angles during a modified internal sinus floor elevation procedure. METHODS: 3D reconstruction of the implant, maxillary sinus bone, and membrane were performed. The maxillary sinus model was set at three different angles. Two internal maxillary sinus elevation models were established, and finite element analysis was used to simulate the modified maxillary sinus elevation process. The implant was elevated to 10 mm at three maxillary sinus angles when the maxillary sinus floor membrane was separated by 0 and 4 mm. The stress of the maxillary sinus floor membrane was analyzed and compared. RESULTS: When the maxillary sinus floor membrane was separated by 0 mm and elevated to 10 mm, the peak stress values of the implant on the maxillary sinus floor membrane at three different angles were as follows: maxillary sinus I: 5.14-78.32 MPa; maxillary sinus II: 2.81-73.89 MPa; and maxillary sinus III: 2.82-51.87 MPa. When the maxillary sinus floor membrane was separated by 4 mm and elevated to 10 mm, the corresponding values were as follows: maxillary sinus I: 0.50-7.25 MPa; maxillary sinus II: 0.81-16.55 MPa; and maxillary sinus III: 0.49-22.74 MPa. CONCLUSION: The risk of sinus floor membrane rupture is greatly reduced after adequate dissection of the maxillary sinus floor membrane when performing modified internal sinus elevation in a narrow maxillary sinus. In a wide maxillary sinus, the risk of rupture or perforation of the wider maxillary sinus floor is reduced, regardless of whether traditional or modified internal sinus elevation is performed at the same height.

Machine Learning Model Based on Radiomics for Preoperative Differentiation of Jaw Cystic Lesions.

OBJECTIVE: This study aims to use machine learning techniques together with radiomics methods to build a preoperative predictive diagnostic model from spiral computed tomography (CT) images. The model is intended for the differential diagnosis of common jaw cystic lesions. STUDY DESIGN: Retrospective, case-control study. SETTING: This retrospective study was conducted at Sun Yat-sen Memorial Hospital of Sun Yat-sen University (Guangzhou, Guangdong, China). All the data used to build the predictive diagnostic model were collected from 160 patients, who were treated at the Department of Oral and Maxillofacial Surgery at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between 2019 and 2023. METHODS: We included a total of 160 patients in this study. We extracted 107 radiomic features from each patient's CT scan images. After a feature selection process, we chose 15 of these radiomic features to construct the predictive diagnostic model. RESULTS: Among the preoperative predictive diagnostic models built using 3 different machine learning methods (support vector machine, random forest [RF], and multivariate logistic regression), the RF model showed the best predictive performance. It demonstrated a sensitivity of 0.923, a specificity of 0.643, an accuracy of 0.825, and an area under the receiver operating characteristic curve of 0.810. CONCLUSION: The preoperative predictive model, based on spiral CT radiomics and machine learning algorithms, shows promising differential diagnostic capabilities. For common jaw cystic lesions, this predictive model has potential clinical application value, providing a scientific reference for treatment decisions.

Modified internal sinus elevation for patients with low residual bone height: A retrospective clinical study.

BACKGROUND: We have modified the internal sinus elevation by combining it with the sinus mucoperiosteum stripping procedure, which further increases the indications for the internal lift. Similar long-term clinical follow-up studies and three-dimensional finite element analyses are rare. OBJECTIVE: This study aimed to investigate the feasibility of the modified internal sinus floor elevation method in patients with low residual bone height using a three-dimensional (3D) finite element model and report on the long-term outcomes. MATERIALS AND METHODS: Overall, 99 implants were placed in 86 patients. All patients were followed-up for 3-24 months. The modified internal sinus floor elevation was dynamically simulated using a 3D finite element model, and the stress of the sinus membrane was measured. RESULTS: In trial group A (modified internal sinus floor elevation group), 57 implants were placed in 52 patients. The sinus floor height was lifted by 6.5 mm (95%confidence interval (CI): 6.2-6.8). The perforation rate was 8.8%, and the implant survival rate was 96.5%. In control group B (external sinus floor elevation group), 42 implants were placed in 34 patients. The sinus floor height was lifted by 8.8 mm (95%CI: 8.4-9.3). The perforation rate was 14.3%, and the implant survival rate was 100%. In trial group A, compared with the control group B, perforation decreased by 5.5% (odds ratio = 0.50 and 95%CI: 0.14-1.78; p = 0.282), and the sinus floor lift height was 2.3 mm lower (95%CI, 1.8-2.9; p < 0.001). The finite element analysis showed that the peak stress of the sinus membrane increased with an increase in height elevation and degree of membrane separation. CONCLUSION: Our findings indicate the positive clinical outcomes in patients with low RBH associated with the modified internal sinus elevation procedure.

Structural characterization of lignin and lignin-carbohydrate complex (LCC) of sesame hull.

In the present study, lignin and lignin-carbohydrate complex (LCC) constituting the cell wall structure of sesame hulls were investigated to explore novel techniques of dehulling. Milled wood lignin (MWL), Björkman LCC, and acid-soluble LCC (LCC-AcOH) were extracted from sesame hulls and characterized by carbohydrate composition analysis, molecular weight analysis, UV-vis spectroscopy, FT-IR, thermal analysis, Py-GC/MS, 2D HSQC NMR, and 31P NMR. The results showed that rhamnose accounted for the largest proportion of the lignin and LCC fractions, followed by glucose. Björkman LCC had the largest molecular weight, MWL had the smallest molecular weight, and LCC-AcOH had the largest polydispersity index. The lignin of sesame hulls consisted of syringyl (S), guaiacyl (G), p-hydroxyphenyl (H), and caffeyl alcohol (C) units. The most abundant monomer was guaiacyl (G), followed by caffeyl alcohol (C). C-type lignin is a new type of lignin that is different from the three traditional lignin monomers. The major lignin-linked bonds in the MWL and LCC-AcOH were ß-O-4' and ß-ß', and ß-5' bonds were present in the Björkman LCC. The major LCC chemical bonds in the three fractions were PhGly. These findings will provide the factual basis for exploring different dehulling methods to enhance the quality of sesame products.

[Analysis on detection of enterovirus nucleotides in feces samples of hand-foot-mouth disease patients after recovery].

OBJECTIVE: To explore the duration of enterovirus (EV) nucleotides positive in feces samples of hand-foot-mouth disease (HFMD) patients after recovery. METHODS: A consecutive 6-week follow up were carried out towards 49 cases of laboratory-diagnosed HFMD patients. A total of 5 - 8 g feces sample was collected from each patient once a week. The common EV nucleotides of HFMD were detected by RT-PCR method and analyzed by Kaplan-Meier Survival Analysis Method. RESULTS: The subtypes of the 49 HFMD patients included 16 enterovirus 71 (EV71), 15 coxsackievirus A16 (CoxA16) and 18 EV; a six-week follow up was carried out among all of them. In the first week, one EV71 patient and two EV patients were lost; in the fourth week, one CoxA16 were lost; and in the fifth week, one EV71 patient was lost. During the consecutive 6-week follow-up, the positive rates of EV nucleotides among EV71 patients were 81.3%, 60.9%, 47.4%, 33.9%, 27.1% and 18.1% separately; and the positive rates in CoxA16 group were 93.3%, 73.3%, 53.3%, 33.3%, 16.7% and 8.3% respectively. In EV group, the positive rates of EV nucleotides were 44.4% and 7.4% in the first two weeks and then turned to negative in the next 4 weeks. There was significant statistical difference in positive rates of EV nucleotides among different patients (χ(2) = 11.78, P = 0.001); however, each group of HFMD patients showed a declined trend with the extension of time. CONCLUSION: The duration of EV nucleotides positive in feces samples of HFMD patients lasted for a long period since their recovery; and the positive results in EV71 and CoxA16 patients might last for 6 weeks.

Redox-triggered aggregation of ESIONPs with switchable T1 to T2 contrast effect for T2-weighted magnetic resonance imaging.

Magnetic resonance imaging (MRI) contrast agents (CAs) have drawn increasing attention in cancer diagnosis. However, since the signals they generate are always "on" and may bring interfering background signals to the region of interest, their selectivity and sensitivity need further improvement. Herein, extremely small iron oxide nanoparticles (ESIONPs) conjugated through a disulfide bond with polyethylene glycol (PEG) that is terminally modified with folic acid (FA), namely ESIONPs-s-s-PEG-FA, were designed and synthesized to target tumor tissues and selectively activate the T2 MRI contrast effect in the reducing environment of tumor cells. Due to the breakage of disulfide bonds by the high glutathione (GSH) concentration in tumor cells, the hydrophilic PEG chains detached from the surface of ESIONPs, which led to the aggregation of ESIONPs and the activation of the T2 contrast effect. In vitro results showed that ESIONPs-s-s-PEG-FA could effectively target tumors to assemble in the reductive environment and switch from a T1 contrast agent (CA) to a T2 one. Furthermore, MRI in tumor-bearing mice also indicated the obvious targeting capacity and the "turn on" of the T2 contrast effect. In addition, the results of the biosafety assay suggest that the tumor-targeted T1/T2 switchable CA is equipped with favorable biocompatibility for cancer diagnosis.

Extremely Small Iron Oxide Nanoparticle-Encapsulated Nanogels as a Glutathione-Responsive T1 Contrast Agent for Tumor-Targeted Magnetic Resonance Imaging.

Activatable magnetic resonance imaging (MRI) contrast agents that can be selectively stimulated at a tumor region are urgently demanded to realize the efficient and accurate diagnosis of cancers. Here, extremely small iron oxide nanoparticles (ESIONPs) modified with citric acid (ESIONPs-CA) are encapsulated in disulfide-cross-linked poly(carboxybetaine methacrylate) (poly(CBMA)) nanogels, and a cyclo[Arg-Gly-Asp-d-Tyr-Lys] (c(RGD)) ligand is further introduced to obtain ESIONP-packaged poly(CBMA) nanogels equipped with tumor-targeted c(RGD) (ICNs-RGD). On the basis of the transformation of the clustered ESIONPs into dispersed ones induced by the reducing glutathione (GSH), ICNs-RGD can complete the conversion from a T2 contrast agent to a T1 one, realizing the selective activation of the T1 contrasting effect. The GSH-dependent MRI signal conversion of ICNs-RGD is feasible in the tumor cell and tissue. Moreover, ICNs-RGD exhibits obvious targeting specificity and favorable biocompatibility. In the MRI experiments of tumor-bearing mice, benefiting from the stimuli-responsiveness toward GSH and targeting specificity, the T1 contrasting effect of tumor tissues can be selectively enhanced after the intravenous injection of ICNs-RGD. Therefore, tumor-targeted ICNs-RGD with a switchable MRI signal derived from the activation of GSH is a potential contrast agent for the efficient and precise tumor diagnosis in the clinic.

Risk factors for critical disease and death from hand, foot and mouth disease.

BACKGROUND: There has been a high mortality and morbidity rate of critical and fatal patients from hand, foot and mouth disease (HFMD) in China in recent. Causes for development of critical and fatal disease remain unclear. METHODS: We performed a case-control study to assess the association between use of drugs and development of critical disease and death from HFMD. RESULTS: We found that glucocorticoids treatment was associated with a greater incidence of severe HFMD, whereas andrographolides treatment was associated with a protective effect when they are used for treatment within 48 hours after onset or before being diagnosed as critical. CONCLUSIONS: We recommend that glucocorticoids should not be used for mild HFMD and andrographolides should undergo clinical trials for treatment of enterovirus 71 infections.