Design of surgical procedures for patients with special protrusion with digital technology / 中华医学美学美容杂志

Objective:To analyze the symmetry of different reference planes in the surgical simulation design of patients with protrusive jaw deformity with high and low eyes.Methods:Fifteen patients with partial jaw deformity were selected from January 2019 to June 2020, including 3 males and 12 females, aged 18-26 years, with average 23.78 years. Inclusion criteria were that the patients, aged more than 18 years, were diagnosed as protrusive jaw deformity with maxillary occlusal plane tilt and high and low eyes by clinical and imaging analysis. Three different 3D reference plane systems were established by different modeling methods. The distance between the landmarks of soft and hard tissues and the median sagittal plane was measured. The symmetry of skull was qualitatively analyzed by mirror image technique. The difference of three reference planes in surgical simulation symmetry of patients with protrusion jaw and high and low eyes was evaluated by one-way ANOVA.Results:Qualitative analysis showed that in the three measurement planes, the symmetry of the third reference plane was the best, and the symmetry of the second and the first was poor. Quantitative analysis showed that in measurement index of hard tissue, there was statistical difference between the distance of each landmark in the reference plane established by Method 3 and Method 1, Method 2 [(1.65±1.19) mm; (3.37±1.58) mm; (3.26±2.36) mm, P<0.05], but there was no statistical difference between Method 1 and Method 2 (P > 0.05). The measurement result of soft tissue was consistent with that of hard tissue, and the distance of each landmark in Method 3 from the median sagittal plane was very small, and the mean error was less than 0.5 mm, which was consistent with the clinical results. Conclusions:Digital model surgery technology can assist orthognathic surgeons in the design and prediction of surgical scheme, especially for patients with special partial jaw deformity.

Small-molecule anti-COVID-19 drugs and a focus on China's homegrown mindeudesivir (VV116) / 医学前沿

The coronavirus disease 2019 (COVID-19) pandemic has stimulated tremendous efforts to develop therapeutic agents that target severe acute respiratory syndrome coronavirus 2 to control viral infection. So far, a few small-molecule antiviral drugs, including nirmatrelvir-ritonavir (Paxlovid), remdesivir, and molnupiravir have been marketed for the treatment of COVID-19. Nirmatrelvir-ritonavir has been recommended by the World Health Organization as an early treatment for outpatients with mild-to-moderate COVID-19. However, the existing treatment options have limitations, and effective treatment strategies that are cost-effective and convenient for tackling COVID-19 are still needed. To date, four domestically developed oral anti-COVID-19 drugs have been granted conditional market approval in China. These drugs include azvudine, simnotrelvir-ritonavir (Xiannuoxin), leritrelvir, and mindeudesivir (VV116). Preclinical and clinical studies have explored the efficacy and tolerability of mindeudesivir and supported its early use in mild-to-moderate COVID-19 cases at high risk for progression. In this review, we discuss the most recent findings regarding the pharmacological mechanism and therapeutic effects focusing on mindeudesivir and other small-molecule antiviral agents for COVID-19. These findings will expand our understanding and highlight the potential widespread application of China's homegrown anti-COVID-19 drugs.

"Digital Simulation of Osteotomy Reduction of a Prominent Zygomatic Arch".

OBJECTIVE: To analyze the value of simulated surgery in predicting the outcome of individualized surgical reduction of a prominent zygomatic arch. METHODS: Computed tomography data were obtained from the electronic records of 15 patients who underwent surgery at Tianjin Stomatological Hospital for prominent zygoma. The data were imported into Mimics 23.0. Left and right three-dimensional (3D) zygoma models were created through standard procedures. In the 3D models, a wedge-shaped cut of the zygomatic bone was pushed inward, and the osteotomy position of the zygomatic arch was taken as a variable to simulate the reduction malarplasty. The reduction effect was calculated from the simulated movement of the fracture end of the zygomatic arch from internal pushing forces. Stable versus high-efficiency internal pushing areas were defined based on the amount of movement. Mean values with 95% confidence intervals (CI) were calculated for the areas data. RESULTS: The anterior edge of the stable internal pushing osteotomy area was located in front of the articular tubercle point (95% CI: 10.64-11.89 mm). The posterior edge of the stable internal pushing area was located in front of the articular tubercle point (95% CI: 7.8-9.13 mm). The posterior edge of the high-efficiency internal pushing area was located in front of the articular tubercle point (95% CI: 4.7-5.73 mm). CONCLUSION: Stable and high-efficiency internal pushing areas were detected above the zygomatic arch. The simulation showed that osteotomy in these areas can provide different degrees of zygomatic arch reduction.