Do Regional Nerve Blocks During Bimaxillary Surgery Decrease Postoperative Pain and Vomiting Compared With Patient-Controlled Analgesia?

BACKGROUND: Postoperative pain after orthognathic surgery is commonly managed with opioids, which can cause nausea and vomiting. PURPOSE: The purpose of this study was to determine whether regional nerve blocks during bimaxillary surgery reduced postoperative pain and vomiting compared with patient-controlled analgesia (PCA). STUDY DESIGN, SETTING, AND SAMPLE: This retrospective cohort study recruited patients who underwent bimaxillary surgery between August 2018 and September 2020 at the Fourth Military Medical University Hospital. Participants whose procedures involved the cheekbone, temporomandibular joint, mandibular angle, or an autogenous iliac bone graft and those who were admitted to the intensive care unit after surgery were excluded. PREDICTOR VARIABLES: The primary predictor variables were postoperative analgesia management, regional maxillary and inferior alveolar nerve blocks, and PCA. OUTCOME VARIABLES: The primary outcome variables were moderate-to-severe postoperative pain and postoperative vomiting (POV) during the first 24 hours. Moderate-to-severe pain was defined as pain numerical rating scale ≥4, POV was defined as vomiting of gastrointestinal contents. COVARIATES: The study covariates included demographic, surgical, and anesthesia characteristics. ANALYSES: Statistical analyses were conducted using an unpaired t-test, χ2 test, or Fisher's exact test for the bivariate analysis. A multivariate logistic regression analysis was performed to assess the associations between the primary predictor variables and outcomes. Statistical significance was set at P < .05. RESULTS: 354 participants were included in the study (262 in the nerve block group, mean age 22.5 ± 4.0 years; 92 in the PCA group, mean age 22.6 ± 4.4 years; P = .81). There was no significant difference in sex between the groups (63.4 and 55.4% females in nerve block and PCA groups, respectively, P = .18). The multivariate regression analyses demonstrated that nerve blocks did not decrease moderate-to-severe postoperative pain (7.6 vs 10.9%, adjusted odds ratio = 0.67, 95% confidence interval: 0.22-2.01, P = .48), although they were associated with decreased POV (38.5 vs 65.2%, adjusted odds ratio = 0.34, 95% confidence interval: 0.18-0.65, P = .001). CONCLUSION AND RELEVANCE: For bimaxillary surgery, regional nerve blocks as opioid-free postoperative analgesia were not significantly associated with decreased postoperative pain but were associated with a lower POV risk.

Novel GNAI3 mutation in a Chinese family with auriculocondylar syndrome and treatment of severe dentofacial deformities: a 5-year follow-up case report.

BACKGROUND: Auriculocondylar syndrome (ARCND) is an extremely rare autosomal dominant or recessive condition that typically manifests as question mark ears (QMEs), mandibular condyle hypoplasia, and micrognathia. Severe dental and maxillofacial malformations present considerable challenges in patients' lives and clinical treatment. Currently, only a few ARCND cases have been reported worldwide, but most of them are related to genetic mutations, clinical symptoms, and ear correction; there are few reports concerning the treatment of dentofacial deformities. CASE PRESENTATION: Here, we report a rare case of ARCND in a Chinese family. A novel insertional mutation in the guanine nucleotide-binding protein alpha-inhibiting activity polypeptide 3 (GNAI3) was identified in the patient and their brother using whole-exome sequencing. After a multidisciplinary consultation and examination, sequential orthodontic treatment and craniofacial surgery, including distraction osteogenesis and orthognathic surgery, were performed using three-dimensional (3D) digital technology to treat the patient's dentofacial deformity. A good prognosis was achieved at the 5-year follow-up, and the patient returned to normal life. CONCLUSIONS: ARCND is a monogenic and rare condition that can be diagnosed based on its clinical triad of core features. Molecular diagnosis plays a crucial role in the diagnosis of patients with inconspicuous clinical features. We present a novel insertion variation in GNAI3, which was identified in exon 2 of chromosome 110116384 in a Chinese family. Sequential therapy with preoperative orthodontic treatment combined with distraction osteogenesis and orthognathic surgery guided by 3D digital technology may be a practical and effective method for treating ARCND.

Comparison of clinical effects of two surgical approaches in the treatment of acetabular fractures.

Objective: To determine the clinical effect of lateral rectus abdominis approach and modified Stoppa approach for the surgical treatment of acetabular fractures. Methods: A retrospective analysis was performed on the case data of 30 patients with acetabular fractures admitted to the Department of Orthopaedics of Hengshui City People's Hospital from June 2017 to June 2021. According to the surgical methods, the enrolled patients were divided into the lateral rectus abdominis approach group (observation group) and the modified Stoppa approach group (control group), with 15 patients in each group. Further comparison was made on the incision length, operation time, intraoperative blood loss, length of stay in the hospital, fracture reduction, hip joint function, neurological recovery, and postoperative complications between the two groups. Results: There was no significant difference between the two groups in the length of stay in the hospital, hip joint function score, fracture reduction quality, and excellent-to-good rate of hip joint function (p>0.05). There were significant differences in incision length, intraoperative blood loss, operation time, postoperative motor and touch function scores, and postoperative complication rate between the observation group and the control group (p<0.05). Conclusion: The clinical effect of the lateral rectus abdominis approach is close to that of the modified Stoppa approach for the surgical treatment of acetabular fracture patients. However, and importantly, surgery through the lateral rectus abdominis approach has less trauma, shorter operation time, lower surgical complications, and good postoperative functional recovery.

Minimally Invasive Percutaneous Plate Osteosynthesis technique combined with locking compression plates guided by C-Arm X-Ray machine in treatment of tibial metaphyseal fractures: Curative effect and postoperative complications.

Objectives: To explore the curative effect of minimally invasive percutaneous plate osteosynthesis (MIPPO) technology combined with locking compression plates (LCP) guided by C-arm X-ray machine in the treatment of tibial metaphyseal fracture and its impact on the surgical indexes and postoperative complications. Methods: The present study was a retrospective analysis focusing on the clinical data of 104 cases of tibial metaphyseal fracture who were treated surgically in our hospital from February 2019 to February 2021. According to different surgical methods, patients who were treated by using MIPPO technology combined with LCP guided by C-arm X-ray machine were divided into the observation group (n=54), while those who underwent traditional open reduction and internal fixation were classified into the control group (n=50). Further comparison was made on the differences of the curative effect, surgical index (operation time, intraoperative blood loss, incision length, and healing time) and postoperative complications between the two groups. In addition, the differences in ankle function, knee function and quality of life [Medical Outcomes Study 36-item Short-Form Health Survey (MOS SF-36)] were evaluated between the two groups before treatment and 6 months after treatment. Results: The clinical curative effect and total efficacy of the observation group were better than those of the control group (All p<0.05). The operation time, intraoperative blood loss, incision length, and healing time were lower in the observation group when compared to those of the control group (All p<0.05). The total incidence of postoperative complications was also lower in the observation group than that in the control group (p<0.05). In addition, the scores of ankle function, knee function and MOS SF-36 in both groups were higher after 6 months of treatment than those before treatment; besides, the inter-group comparison showed that the scores of ankle function, knee function and MOS SF-36 in the observation group were higher than those in the control group (All p<0.05). Conclusion: MIPPO technology combined with LCP guided by C-arm X-ray machine has a significant curative effect on the treatment of tibial metaphyseal fracture. It can significantly improve the surgical index, reduce postoperative complications, and have an obvious effect on postoperative recovery of ankle function, knee joint function and quality of life.

Overexpression of Bone Morphogenetic Protein-1 Promotes Osteogenesis of Bone Marrow Mesenchymal Stem Cells In Vitro.

BACKGROUND Osteogenesis of bone marrow mesenchymal stem cells (BMSCs) is an important research topic in the application of bone tissue engineering. Bone morphogenetic protein-1 (BMP-1) is important in bone formation and stability, but its effects on the osteogenesis of BMSCs are unclear. This study aimed to investigate the association of BMP-1 with the osteogenic capacity of BMSCs. MATERIAL AND METHODS Primary rabbit BMSCs were cultured and divided into a BMP-1-overexpressing group, a Green Fluorescent Protein-expressing (GFP) group, and a Control group. The transfection efficiency of BMP-1 was tested by Western blotting. Cell viabilities, alkaline phosphatase (ALP) activities, Ca2+ concentrations, and gross examinations of BMSC sheets were examined at different times. The osteogenic marker collagen I was assessed by immunohistochemical analysis. RESULTS The cell viability, ALP activity, and Ca2+ content of the BMP1-overexpressed group were significantly enhanced compared with the GFP group and Control group. Immunohistochemistry staining results showed that BMP-1 promoted the expression of type I collagen in BMSCs sheets. CONCLUSIONS Our results suggest that the overexpression of BMP-1 can promote the osteogenesis of BMSCs and provides an improved method of cell-based tissue engineering.

Human Indoor Exposome of Chemicals in Dust and Risk Prioritization Using EPA's ToxCast Database.

Humans spend most of their time indoors and thus have long-term exposure to chemicals. Dust is a sink for most indoor chemicals, and its ingestion is an important pathway for chemical uptake. Therefore, the chemical atlas from dust is an ideal environmental sample to investigate the indoor exposome and associated risk. In this study, we aimed to establish an indoor exposome database through comprehensive data mining on the occurrence of identified compounds in dust, and we prioritize chemicals of health concern. Through an extensive literature review (2849 articles), 355 chemicals and their concentrations were documented and analyzed for human exposure. Together with 81 compounds without concentration and 75 volatile organic compounds, we have established an indoor exposome database with 511 chemicals. Sixteen toxicological end points were selected for toxicity prioritization. Toxic equivalency factor (TEF)-based toxicity, calculated from EPA's ToxCast database, revealed a comprehensive atlas of the chemicals that had a primary contribution. Many of the prioritized compounds are currently neglected or are not actively studied. Overall, this investigation provides one of the most comprehensive analyses on chemical occurrence in indoor dust and prioritizes their chemical toxicity. Our findings can be used as a database for future exposome studies of the indoor environment and provide guidance for indoor risk assessments.

Assessing the Quality of Life in Patients With Dentofacial Deformities Before and After Orthognathic Surgery.

PURPOSE: This study aimed to assess the effect of health-related quality of life (QoL) among patients with dentofacial deformities who underwent orthognathic surgery compared with a control group without dentofacial deformities by use of generic oral health and condition-specific approaches. PATIENTS AND METHODS: In this prospective study, 2 questionnaires were administered to 85 patients (31 male and 54 female patients) who were evaluated before undergoing orthognathic surgery. The Short Form Oral Health Impact Profile Questionnaire (OHIP-14) and the Orthognathic Quality of Life Questionnaire (OQLQ) were administered before and 5 to 7 months after orthognathic surgery. The control group comprised 96 young university student volunteers without dentofacial deformities. RESULTS: The questionnaires were collected 5 to 7 months after surgery. The preoperative scores of the patients and the control group were contrasted separately. The respondents' postoperative OHIP-14 and OQLQ scores were significantly lower (P < .001 for total scores). The preoperative OQLQ scores for all domains were significantly higher among the patients than among the controls (P < .001 for total scores), whereas the total scores and 3 subscale scores of the OHIP-14 in the functional and psychological domains were significantly higher among the patients than among the controls (P < .05 for total scores). The preoperative and postoperative OQLQ total scores were remarkably different between male and female patients (P < .05). The postoperative OQLQ total scores were considerably higher in older patients than in younger patients (P < .05). All patients in the Class III group who underwent double-jaw surgery showed remarkable changes after surgery (P < .001 for total scores). CONCLUSIONS: Patients with dentofacial deformities had a poorer QoL compared with the healthy population, especially in functional and psychological aspects. Orthognathic surgery had a significant positive impact on QoL. Patients with Class III malocclusion who underwent double-jaw surgery seemingly benefitted the most after surgery.

Progress and challenges in the use of latent HIV-1 reactivating agents.

Highly active antiretroviral therapy (HAART) can effectively suppress the replication of human immunodeficiency virus-1 (HIV-1) and block disease progression. However, chronic HIV-1 infection remains incurable due to the persistence of a viral reservoir, including the transcriptionally silent provirus in CD4(+) memory T cells and the sanctuary sites that are inaccessible to drugs. Reactivation and the subsequent elimination of latent virus through virus-specific cytotoxic effects or host immune responses are critical strategies for combating the disease. Indeed, a number of latency reactivating reagents have been identified through mechanism-directed approaches and large-scale screening, including: (1) histone deacetylase inhibitors (HDACi); (2) cytokines and chemokines; (3) DNA methyltransferase inhibitors (DNMTI); (4) histone methyltransferase inhibitors (HMTI); (5) protein kinase C (PKC) activators; (6) P-TEFb activators; and (7) unclassified agents, such as disulfram. They have proved to be efficacious in latent cell line models and CD4(+) T lymphocytes from HIV-1-infected patients. This review comprehensively summarizes the recent progress and relative challenges in this field.

Biomechanical analysis of a curvilinear distractor device for correcting mandibular symphyseal defects.

PURPOSE: The local mechanical environment is a determinant of successful transport disc distraction osteogenesis. This study assessed the biomechanics of a curvilinear distractor device for correcting mandibular symphyseal defects. MATERIALS AND METHODS: The finite element method was used to analyze an intact mandible, mandibular distractor bodies with different rail thicknesses (4, 6, 8, and 10 mm), and mandibular distractor bodies with rails and auxiliary lingual brackets. RESULTS: Rail thickness was positively correlated with maximum von Mises stress in the distractor and negatively correlated with maximum displacement of the mandibular distractor bodies. The maximum von Mises stress occurred at the junction of the rails and fixed arms. It also exceeded the yield strength of the titanium material. Compared with the maximum displacement of the intact mandible, that of the mandibular distractor bodies was visibly increased. CONCLUSION: An auxiliary lingual bracket can effectively decrease stress in such devices and displacement of mandibular distractor bodies. Rail fixation alone cannot achieve stability for distraction osteogenesis. Using an auxiliary lingual bracket effectively prevents distractor breakage and exposure.

Oregano essential oil-infused mucin microneedle patch for the treatment of hypertrophic scar.

Hypertrophic scar (HS) manifests as abnormal dermal myofibroblast proliferation and excessive collagen deposition, leading to raised scars and significant physical, psychological, and financial burdens for patients. HS is difficult to cure in the clinic and current therapies lead to recurrence, pain, and side effects. In this study, a natural amphiphilic polymer mucin is used to prepare a dissolving microneedle (muMN) that is loaded with oregano essential oil (OEO) for HS therapy. muMN exhibits sufficient skin/scar tissue penetration, quick skin recovery time after removal, good loading of natural essential oil, fast dissolution and detachment from the base layer, and good biocompatibility to applied skin. In the rabbit HS model, OEO@muMN shows a significant reduction in scar thickness, epidermal thickness index, and scar elevation index. OEO@muMN also attenuates the mean collagen area fraction and decreases the number of capillaries in scar tissues. Biochemical Assay reveals that OEO@muMN significantly inhibits the expression of transforming growth factor-ß1 (TGF-ß1) and hydroxyproline (HYP). In summary, this study demonstrates the feasibility and good efficacy of using the anti-proliferative and anti-oxidative OEO for HS treatment. OEO@muMN is an efficient formulation that holds the potential for clinical anti-HS application. muMN is an efficient platform to load and apply essential oils transdermally.

Assessment on the occupational exposure of manufacturing workers to Dechlorane Plus through blood and hair analysis.

Dechlorane Plus (DP), as a widely used flame retardant in different electrical and textile applications, has recently attracted great concern around the world. The present study investigated the DP levels and distribution in human samples from a DP manufacturing plant and a nearby area in east China. The DP concentrations ranged from 89.8 to 2958 ng/g lipid weight in whole blood and 4.08 to 2159 ng/g dry weight in hair. For the workers engaged in DP manufacturing process, their DP levels were significantly higher than those in most of the other two control groups from the nearby area. The values of anti-DP fractional abundance (fanti ratio) were commonly lower in the human samples from both the manufacturing plant and nearby area compared with those in the commercial products, and excretion as well as biotransformation are possible reasons for stereoselective accumulation of the syn-DP isomer in humans. Furthermore, a significantly positive relationship (p < 0.05) was obtained between (i) the concentrations (and fanti) in the paired blood and hair samples, indicating a similar distribution pattern of the two DP isomers in the paired samples; (ii) the DP levels in human body and the exposure time (p < 0.05), which suggests that further assessment could be needed to investigate potential long-term risks to the occupational population.

Levels and profiles of Dechlorane Plus in a major E-waste dismantling area in China.

Dechlorane Plus (DP) is a high-production volume, chlorinated flame retardant comprising two major isomers, syn- and anti-DP. In this study, levels of DP were measured in soil and earthworm samples in farmland from a typical E-waste dismantling area in China. The concentrations of total DP ranged from 0.17 to 1,990 ng g(-1) dw in soil samples and 3.43 to 89.2 ng g(-1) lw in earthworm samples. Higher DP levels were found in some main E-waste dismantling sites than those in other sites. The ratios of anti-DP to total DP (f anti) ranged from 0.57 to 0.80 in soil samples and 0.47 to 0.81 in earthworm samples, respectively. The f anti in most samples in this study was in the range of the reported technical DP values. These results showed that improper E-waste dismantling activities could result in the emission of DP. Most earthworm samples showed very low BSAFs (biota-to-soil accumulation factors) for total DP. The values of BSAF were in the range of 0.0007-1.85, with an average value of 0.23. This study presents the first report of the DP in earthworms, which would be useful for ecological risk assessment of DP in terrestrial ecosystem.

Occurrence and distribution of hexabromocyclododecane in sediments from seven major river drainage basins in China.

The concentrations and geographical distribution of hexabromocyclododecane (HBCD) were investigated in 37 composite surface sediments from seven major river drainage basins in China, including Yangtze River, Yellow River, Pearl River, Liaohe River, Haihe River, Tarim River and Ertix River. The detection frequency of HBCD was 54%, with the concentrations ranged from below limit of detection (LOD) to 206 ng/g dry weight. In general, the geographical distribution showed increasing trends from the upper reaches to the lower reaches of the rivers and from North China to Southeast China. Compared to other regions in the world, the average concentration of HBCD in sediments from Yangtze River drainage basin was at relatively high level, whereas those from other six river drainage basins were at lower or similar level. The highest HBCD concentration in sediment from Yangtze River Delta and the highest detection frequency of HBCD in Pearl River drainage basins suggested that the industrial and urban activities could evidently affect the HBCD distribution. HBCD diastereoisomer profiles showed that gamma-HBCD dominated in most of the sediment samples, followed by alpha- and beta-HBCD, which was consistent with those in the commercial HBCD mixtures. Further risk assessment reflected that the average inventories of HBCD were 18.3, 5.87, 3.92, 2.50, 1.77 ng/cm2 in sediments from Pearl River, Haihe River, Tarim River, Yellow River and Yangtze River, respectively.

A macrophage plasma membrane-coated and DNA structured nanomedicine targets to alleviate rheumatoid arthritis via dual inhibition to TNF-α and NF-κB.

High heterogenicity of rheumatoid arthritis (RA) leads to poor response in many patients. Combined therapies that simultaneously inhibit multiple proinflammatory targets may improve anti-RA efficacy. However, which monotherapies to combine and how to achieve the combination are critical issues. Here, we design a macrophage plasma membrane-coated and DNA structured nanomedicine to achieve a dual inhibitory therapy to Tumor necrosis factor alpha (TNF-α) and NF-κB. An anti-NF-κB decoy oligodeoxynucleotides (dODN) is first conjugated to a DNA cage with precise numbers and locations (Cage-dODN). Meanwhile, an anti-TNF-α siRNA is anchored to extracted macrophage plasma membrane (siRNA@M). Subsequently, siRNA@M is used to encapsulate Cage-dODN to fabricate siRNA@M(Cage-dODN) (siMCO). The size and zeta potential of siMCO are 63.1 ± 15.7 nm and -20.7 ± 3.8 mV respectively. siMCO shows increased intracellular uptake by inflamed macrophages and enhanced accumulation in inflamed mouse paws. siMCO also reduces pro-inflammatory factors at genetic and protein levels, alleviates arthritic symptoms, and shows no influence to major blood components. These results show that siMCO is a potential targeted, efficient, and safe dual inhibitory therapy for the treatment of inflammatory arthritis. The macrophage plasma membrane can be utilized to improve the targeting, stability, and efficacy of DNA structured nanomedicines.

Treatment of malignant triton tumor in zygomatic region.

Malignant triton tumor (MTT) is extremely rare and supposed to be highly aggressive because of high propensity for local recurrence and metastasis. To date, only about 170 cases were reported in various body locations including trunks, maxillary sinus, neck, extremities, retroperitoneal, and so on. We present a case of MTT in the zygoma with good outcome. A 27-year-old male patient with progressive swelling and pain in the right zygoma was proved to have an MTT by biopsy. Radical resection accompanying postoperative radiotherapy was adopted, and then the soft and hard tissue defects were repaired by prosthesis. The patient recovered well and was satisfied with the facial contour. At 45-month follow-up, there was no recurrence or metastasis that occurred. According to literature review, one third of MTTs appeared in the head and neck regions and seem to have a better prognosis. Radical resection is the most important remedy, and adjuvant radiotherapy could be helpful. With early finding and effective treatments, satisfactory outcome could be achieved.

Study on the Grading Model of Hepatic Steatosis Based on Improved DenseNet.

To achieve intelligent grading of hepatic steatosis, a deep learning-based method for grading hepatic steatosis was proposed by introducing migration learning in the DenseNet model, and the effectiveness of the method was verified by applying it to the practice of grading hepatic steatosis. The results show that the proposed method can significantly reduce the number of model iterations and improve the model convergence speed and prediction accuracy by introducing migration learning in the deep learning DenseNet model, with an accuracy of more than 85%, sensitivity of more than 94%, specificity of about 80%, and good prediction performance on the training and test sets. It can also detect hepatic steatosis grade 1 more accurately and reliably, and achieve automated and more accurate grading, which has some practical application value.

Recent advances on transdermal delivery systems for the treatment of arthritic injuries: From classical treatment to nanomedicines.

Arthritic injuries happen frequently during a lifetime due to accidents, sports, aging, diseases, etc. Such injuries can be cartilage/bone injuries, tendon injuries, ligament injuries, inflammation, pain, and/or synovitis. Oral and injective administration of therapeutics are typically used but cause many side effects. Transdermal administration is an alternative route for safe and efficient delivery. Transdermal formulations of non-steroidal anti-inflammatory drugs have been available on market for years and show promising efficacy in pain relieving, inflammation alleviation, infection control, and so on. Innovative transdermal patches, gels/films, and microneedles have also been widely explored as formulations to deliver therapeutics to combat arthritic injuries. However, transdermal formulations that halt disease progression and promote damage repair are translated slowly from lab bench to clinical applications. One major reason is that the skin barrier and synovial capsule barrier limit the efficacy of transdermal delivery. Recently, many nanocarriers, such as nanoparticles, nanolipids, nanoemulsions, nanocrystals, exosomes, etc., have been incorporated into transdermal formulations to advance drug delivery. The combined transdermal formulations show promising safety and efficacy. Therefore, this review will focus on stating the current development of nanomedicine-based transdermal formulations for the treatment of arthritic injuries. The advances, limitations, and future perspectives in this field will also be provided to inspire future studies and accelerate clinical translational studies. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement Biology-Inspired Nanomaterials > Lipid-Based Structures.

Network pharmacology analysis on mechanism of Jian Pi Qing Gan Yin decoction ameliorating high fat diet-induced non-alcoholic fatty liver disease and validated in vivo.

ETHNOPHARMACOLOGICAL RELEVANCE: Jian Pi Qing Gan Yin (JPQGY) has been used clinically to relieve non-alcoholic fatty liver disease (NAFLD) in China for decades; however, the underlying mechanisms of JPQGY remain unclear. AIM OF THE STUDY: We evaluated the effects and mechanisms of JPQGY and hepatic steatosis caused by the middle stage of 13-week-high-fat-diet-induced NAFLD in mice. MATERIALS AND METHODS: Different dosages of JPQGY (5.5, 11, and 22 g/kg/day) were administered to NAFLD mice simultaneously. Body weight, body mass index (BMI), and liver lipid- and inflammation-related serum indicators were measured enzymatically. Liver samples were stained with Oil Red O and hematoxylin and eosin (H&E). Next, we performed a network pharmacology analysis and verified eight target genes mapping to NAFLD-related lipid metabolism pathways. The mRNA/protein expression was analyzed by real-time polymerase chain reaction (PCR) and western blotting. RESULTS: JPQGY significantly relieved histological damage (steatosis-inflammation-fibrosis), prevented the downregulation of AMPK and Pparα, and upregulated LXRα, Srebp-1c, F4/80, Nf-κb, and Cyp2e1 in the HFD-induced NAFLD mouse model. CONCLUSIONS: The present results suggest that chronic treatment with JPQGY ameliorated HFD-induced NAFLD in mice by targeting the first and second phases of hepatic steatosis by stimulating the AMPK/PPARα pathway and inhibiting the LXRα/Srebp1/Nf-κb pathway. Our findings provide evidence that supports the clinical use of this formula for high-fat diet-induced fatty liver disease.

Facial changes in patients with skeletal class III deformity after bimaxillary surgery: an evaluation based on three-dimensional photographs registered with computed tomography.

The objective of this study was to evaluate facial soft and hard tissue changes, individually and relative to each other, in patients with skeletal class III deformity after bimaxillary surgery using three-dimensional (3D) photos obtained by white light scanning. Thirty patients with skeletal class III deformity who underwent bimaxillary surgery were selected. Each patient underwent white light scanning and spiral computed tomography (CT) within two weeks before (T0) and six months after surgery (T1). The 3D photos were registered with CT soft tissue models for T0 and T1, and the skeletal area unaffected by treatment (cranial base) was used to register T0 and T1. Then, the 3D colour-coded map was analysed to assess both skeletal and soft tissue changes between T0 and T1. Changes in the 3D coordinates of each anatomical landmark were analysed using the Student's t-test. Maxillary advancement by 2-3 mm and mandibular recession by 5-6 mm were observed; the mandible was shortened in the vertical direction. Compared with the preoperative values, the nasal columella was 0.51 mm shorter, the upper lip was 0.71 mm longer, the base of the alar cartilage was 1.38 mm wider, and the nasolabial angle became larger. The ratio of change in the position of soft tissue point Sn to hard tissue point A was 0.73:1, and that of soft tissue point Pg to hard tissue point Pog was 0.86:1. Images obtained by structured white light scanning registered with CT can be used as an alternative to study facial changes after orthognathic surgery.

Self-Assembling Anchorage of Hyaluronic Acid on the Nanoparticle Surface Confers Superiority of Triple Negative Breast Cancer Treatment.

Triple-negative breast cancer (TNBC) has been listed as one of the most fatal diseases, and no effective targeting treatment is clinically available. Although CD44-targeting hyaluronic acid (HA) has been utilized as targeting ligands in many studies, no facile ways have been developed through HA self-assembly at the nanoparticle surface. Herein, we reported N-isopropylacrylamide-grafted chitosan-based nanoparticles self-assembling with HA (HA-NPs) through electrostatic forces and loaded with curcumin (CUR). The HA-NPs displayed pH-responsive properties due to the chemical modification of chitosan, and the preparation process was optimized by central composite design-response surface methodology. HA anchorage confers the vehicle with tumor-targeting capability. HA-NPs displayed more robust effects of inhibiting TNBC primary tumor growth than free CUR and a plain counterpart but without increased systemic cytotoxicity. In addition, in vivo pharmacokinetic studies showed that HA-NPs significantly increased the in vivo residence time of free CUR and improved the bioavailability of CUR. These findings suggested that chitosan-based HA-NPs may provide a feasible and unique strategy to achieve CD44 targeting and enhance its efficacy in vivo for the treatment of advanced TNBC.