Chinese surgical robot-assisted surgery for parotid tumor: a case report.

Robotic surgery is known as the "third technological revolution" in the field of surgery, and is an important milestone in the development of modern surgery. However, our country's innovative surgical robot industry is still in its early stages, and it is only being utilized in certain surgical fields. To explore the effectiveness of the application of domestic surgical robot in oral and maxillofacial surgery, the author successfully completed a case of benign parotid tumor resection with the assistance of a domestic autonomous robot. The operation was successful, facial nerve function was preserved, and postoperative wound healing was good.

Curcumin and analogues in mitigating liver injury and disease consequences: From molecular mechanisms to clinical perspectives.

BACKGROUND: Liver injury is a prevalent global health concern, impacting a substantial number of individuals and leading to elevated mortality rates and socioeconomic burdens. Traditional primary treatment options encounter resource constraints and high costs, prompting exploration of alternative adjunct therapies, such as phytotherapy. Curcumin demonstrates significant therapeutic potential across various medical conditions, particularly emerging as a promising candidate for liver injury treatment. PURPOSE: This study aims to provide current evidence maps of curcumin and its analogs in the context of liver injury, covering aspects of biosafety, toxicology, and clinical trials. Importantly, it seeks to summarize the intricate mechanisms modulated by curcumin. METHODS: We conducted a comprehensive search of MEDLINE, Web of Science, and Embase up to July 2023. Titles and abstracts were reviewed to identify studies that met our eligibility criteria. The screening process involved three authors independently assessing the potential of curcumin mitigating liver injury and its disease consequences by reviewing titles, abstracts, and full texts. RESULTS: Curcumin and its analogs have demonstrated low toxicity in vitro and in vivo. However, the limited bioavailability has hindered their advanced use in liver injury. This limitation can potentially be addressed by nano-curcumin and emerging drug delivery systems. Curcumin plays a role in alleviating liver injury by modulating the antioxidant system, as well as cellular and molecular pathways. The specific mechanisms involve multiple pathways, such as NF-κB, p38/MAPK, and JAK2/STAT3, and the pro-apoptosis Bcl-2/Bax/caspase-3 axis in damaged cells. Additionally, curcumin targets nutritional metabolism, regulating the substance in liver cells and tissues. The microenvironment associated with liver injury, like extracellular matrix and immune cells and factors, is also regulated by curcumin. Initial evaluation of curcumin and its analogs through 12 clinical trials demonstrates their potential application in liver injury. CONCLUSION: Curcumin emerges as a promising phytomedicine for liver injury owing to its effectiveness in hepatoprotection and low toxicity profile. Nevertheless, in-depth investigations are warranted to unravel the complex mechanisms through which curcumin influences liver tissues and overall physiological milieu. Moreover, extensive clinical trials are essential to determine optimal curcumin dosage forms, maximizing its benefits and achieving favorable clinical outcomes.

Reconstruction of Total Maxillectomy Defects Using Coronoid-Temporalis Pedicled Flap, Titanium Mesh, and Free Flap.

The maxilla plays a crucial role in maintaining midfacial contour, supporting the globe and dentition and separating the oral and nasal cavity. Reconstruction of total maxillectomy defects has always been a challenge in head and neck surgery. In recent years, on the basis of existing methods, we have used the coronoid-temporalis pedicled flap combined with personalized titanium mesh and free flap to reconstruct total maxillectomy defects. This combination of multiple methods can restore the functional subunits of the maxilla. In this report, we introduce our surgical procedures in detail and assess the postoperative effects. Postoperative facial aesthetic outcomes were satisfactory in all 8 patients. None of the patients showed diplopia, oral-nasal reflux, hypernasality, titanium mesh exposure, or trismus. This new surgical procedure may be a simple and feasible option for the reconstruction of total maxillectomy defects.

Research on the effect of tire pattern design on noise and its reduction.

This paper studies pattern noise in original equipment fitment through four approaches, including pitch arrangement optimization, pipe resonance experiment, orthogonal experimental design of tread transverse groove, and block shift simulation. An in-cab noise test is conducted to verify the effectiveness. Results show an 8.7% reduction in total harmonic energy and 12% decrease in the highest harmonic peak through pitch optimization. This paper introduces the 3-Sum concept to measure the difficulty of exciting a certain pitch harmonic. Meanwhile, the optimal width combination is found for central and shoulder longitudinal grooves. Transverse groove width, angle, and direction are studied using analysis of range and analysis of variance with the best match producing an indoor drum noise value of 76.09 dB. The simulation by the tread noise prediction system shows that the optimal misalignment of the central rib should be -7 mm, and its noise prediction value has a 2.21 dB(A) decrease from the original plan while the optimal misalignment of the shoulder rib is at its initial position. In the in-cab noise test, the sound pressure level of the optimized plan is reduced by 0.46 dB(A). Notably, the root mean square value within the frequency band 700-1300 Hz is reduced by 3.26 dB(A), which is a figure that fulfills the expected tread noise reduction.

Incidence of Unintentional Intraoperative Hypothermia and Its Risk Factors in Oral and Maxillofacial Surgery: A Prospective Study.

PURPOSE: Unintentional intraoperative hypothermia is a common complication in patients who undergo open surgery, increasing the risk of adverse outcomes. However, few studies have focused on intraoperative hypothermia during oral and maxillofacial surgery. Our study aimed to analyze the prevalence and risk factors of hypothermia in patients who underwent oral and maxillofacial surgery. DESIGN: A prospective cohort study was conducted on 128 patients who underwent oral and maxillofacial surgery. METHODS: This prospective study was conducted at West China Hospital of Stomatology between December 2020 and May 2021, and each patient was followed for at least 1-month postoperatively. Patients who underwent oral and maxillofacial surgery under general anesthesia, with at least 1-month follow-up were analyzed. The primary variable was intraoperative hypothermia, defined as core body temperature less than 36°C, measured using a tympanic thermometer during the surgery. We performed univariate and multivariate logistic regression analyses to identify the risk factors of unintentional intraoperative hypothermia. FINDINGS: The mean age of the 128 patients was 31.0 ± 20.9 years, and there was a male predominance (53.1%), with male to female ratio of 1.13:1. Thirty-one patients (24.2%) developed hypothermia intraoperatively. Older age (OR = 1.068, 95% CI: 1.028-1.110, P = .001), lower weight (OR = 0.878, 95% CI: 0.807-0.955, P = .002), greater blood loss (OR = 1.003, 95% CI: 1.000-1.006, P = .034), and undergoing cancer surgery (OR = 0.210, 95% CI: 0.067-0.656, P = .007) were associated with intraoperative hypothermia. CONCLUSIONS: Unintentional intraoperative hypothermia is common in patients who undergo surgery for oral cancer. Warming interventions to prevent intraoperative hypothermia for high-risk patients (older, lower weight, or more intraoperative bleeding) should be considered. Meanwhile, with careful nursing and rehabilitation instructions, intraoperative hypothermia does not lead to serious perioperative complications.

Prelamination of Anterolateral Thigh Osseocutaneous Flap With Fibula for the Reconstruction of Zygomatic Arch Defects After Facial Trauma.

Complex facial trauma usually results in significant physical, esthetical, functional, and psychological damage. Nowadays, tissue flap transfer is the most effective and common treatment for the reconstruction of facial defects. Among them, the prelaminated flap has a bigger role in reconstructing massive facial defects. In this report, the authors have described a case of a 48-year-old man who presented a complex defect of tissue and deformity in the oral and maxillofacial region because of traffic accident trauma. Given the complexity of this case, it was impossible to complete the reconstruction in a single operation. The authors used a vascularized fibula-free flap (VFFF) to reconstruct the right mandible during the first operation and implanted a segment of fibula into the subcutaneous tissue of the right anterolateral thigh, which was used during the second operation for the reconstruction of zygomatic arch. This individualized treatment plan achieved a final satisfactory surgical outcome.

II-Y-Shaped Vascular Anastomosis for Free Flap Transfer in Head and Neck Reconstruction in Vessel-Depleted Neck.

In vessel-depleted neck, salvage free flap transfer for head and neck reconstruction is challenging because the difficulty of selecting the recipient vessel and the discrepancy of vessel diameters. Here, the authors describe a novel technique for vascular anastomosis, which allows 2 thin donor veins end-to-end anastomosed with the larger recipient vein. This II-Y-shaped vascular anastomosis for free flap reconstruction were performed at Department of Head and Neck Surgery, Oral and Maxillofacial Oncology, West China Stomatology Hospital, Sichuan University. The patient received anterolateral thigh flap transfer after tumor excision. The ligated stump of external jugular vein was anastomosed to the enlarged accompanying veins of the anterolateral thigh flap. The flap survived completely without complications. The II-Y-shaped vascular anastomosis procedures were easy to perform and no complications were observed. Result suggests this novel technique could be useful in free flap transfer in vessel-depleted neck as an efficient way of adjusting the limited diameters.

Application of vascularized mucosal flap for early-medium-term tongue cancer and floor of mouth cancer defect repair: a preliminary study.

OBJECTIVES: This study aimed to assess the efficacy and safety of facial artery musculomucosal (FAMM) flap for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer. METHODS: A retrospective cohort study was conducted and included patients with early-medium stage tongue or floor of mouth cancer and reconstructed by FAMM flap or traditional free or axial flaps. Demographic data and surgery-related data were collected. Patients were followed up for 6 months and evaluated with satisfaction, maximal mouth opening, satisfactory contour and speech, and oral intake function at months 3 and 6. RESULTS: Forty-five patients were included, with 15 in the FAMM group and 30 in the flap group. All patients finished 3 months follow-up, and 1 in each group was lost to follow-up at month 6. All followed-up patients had no recurrence or metastasis. The FAMM group had a significantly shorter surgical time than the flap group (P<0.05). The flap group had significantly more donor sites that were uncomfortable compared with the FAMM group (P<0.05). There was no statistical significance on satisfaction, but the FAMM group had better outcomes on contour, speech, and oral intake function at month 6 than the flap group (P<0.05). The FAMM group had smaller maximal mouth opening than the flap group (P<0.05) at month 3 but equivalent maximal mouth opening at month 6 (P>0.05). CONCLUSIONS: FAMM flap has some advantages for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer, and it could be an ideal choice for clinical application.

Novel Visualization Methods Assisted Transurethral Resection for Bladder Cancer: An Updated Survival-Based Systematic Review and Meta-Analysis.

BACKGROUND: Photodynamic diagnosis and narrow-band imaging could help improve the detection rate in transurethral resection (TUR) of bladder cancer. It remained controversial that the novel visualization method assisted transurethral resection (VA-TUR) could elongate patients' survival compared to traditional TUR. METHODS: We performed electronic and manual searching until December 2020 to identify randomized controlled trials comparing VA-TUR with traditional TUR, which reported patients' survival data. Two reviewers independently selected eligible studies, extracted data, assessed the risk of bias. Meta-analysis was conducted according to subgroups of types of visualization methods (A) and clinical stage of participants. Publication bias was detected. RESULTS: We included 20 studies (reported in 28 articles) in this review. A total of 6,062 participants were randomized, and 5,217 participants were included in the analysis. Only two studies were assessed at low risk of bias. VA-TURB could significantly improve the recurrence-free survival (RFS) (HR = 0.72, 95% CI: 0.66 to 0.79, P <0.00001, I2 = 42%) and progression-free survival (PFS) (HR = 0.62, 95% CI: 0.46 to 0.82, P <0.0008, I2 = 0%) compared with TUR under white light. The results remain stable whatever the type of visualization method. The difference could be observed in the non-muscle-invasive bladder cancer (NMIBC) population (P <0.05) but not in the mixed population with muscle-invasive bladder cancer (MIBC) participants (P >0.05). CONCLUSION: VA-TUR could improve RFS and PFS in NMIBC patients. No significant difference is found among different types of VA-TUR. VA-TUR may be not indicated to MIBC patients.