The Transformation of Neck Unicentric Castleman's Disease to Follicular Dendritic Cell Sarcoma.

A patient with a large neck mass underwent appropriate imaging, routine blood tests, and serological evaluations. The medical history revealed the patient had undergone a lymphadenectomy in the same region 8 years ago, and the pathological diagnosis was the hyaline-vascular subtype of unicentric Castleman's disease (UCD). The incisional biopsy and subsequent histopathological and immunohistochemical examination revealed the diagnosis of follicular dendritic cell sarcoma, consistent with the malignant transformation of UCD. UCD is uncommon and the malignant transformation of UCD is extremely rare in the head and neck region. Regional lymph node resection of one or more adjacent regions is the preferred treatment choice. Appropriate treatment procedures for UCD and regular follow-up are essential for a good prognosis. Laryngoscope, 2024.

Deficiency in SPOP-mediated ubiquitination and degradation of TIAM1 promotes gastric cancer progression.

It was well known that SPOP is highly mutated in various cancers especially the prostate cancer and SPOP mutation dramatically impaired its tumor suppressive function. However, the detailed role and underlying mechanisms of SPOP in regulating the growth of gastric cancer is not fully studied. Here, we found that Cullin3SPOP promoted the ubiquitination and degradation of TIAM1 protein in gastric cancer setting. Gastric cancer and prostate cancer derived SPOP mutation failed to suppress the proliferation, migration and invasion of gastric cancer cells partially due to the elevated level of TIAM1 protein. Notably, SPOP protein were negatively associated with TIAM1 protein in human gastric cancer tissue specimens. In conclusion, our results elucidate a molecular mechanism by which SPOP regulates the stability of TIAM1, and further demonstrate that SPOP inhibits the progression of gastric cancer by promoting the ubiquitination and degradation of TIAM1 protein.

Research progress on applications and mechanisms of osteogenesis effect of magnetic fields in oral field / 口腔疾病防治

@#Magnetic fields are safe and used in noninvasive physical therapies. Numerous studies have confirmed that magnetic fields have good osteogenic effects and certain value for clinical application in accelerating orthodontic tooth movement, promoting bone-implant integration, promoting fracture healing and improving the effects of distraction osteogenesis. Magnetic fields are expected to become applied as effective auxiliary methods for treating oral diseases. To support the clinical application of magnetic fields, this article reviews the applications of magnetic fields in the oral cavity, the biological effects on bone cells and the molecular mechanisms through which magnetic fields regulate bone metabolism. The biological effects of magnetic fields on bone cells include promoting osteogenesis by osteoblasts and mesenchymal stem cells and inhibiting bone resorption by osteoclasts. At the molecular level, bone cells sense and respond to magnetic stimulation, and through various mechanisms, such as displacement currents, Lorentz forces, and free radical pair effects, stimuli are transformed into biologically recognizable electrical signals that activate complex downstream signaling pathways, such as the P2 purinergic receptor signaling pathway, adenosine receptor signaling pathway, transforming growth factor-β receptor signaling pathway, mammalian target of rapamycin (mTOR) pathway, and Notch pathway. In addition, magnetic parameters, which are the factors affecting the osteogenic effects of magnetic fields, are discussed. However, the mechanisms of the osteogenic effects of magnetic fields are unclear, and further studies of these mechanisms could provide effective strategies for bone regeneration and periodontal tissue regeneration. In addition, considering the target of magnetic field therapies, combination with other drugs could lead to new strategies for the treatment of oral diseases.

The Diagnostic Value of Serum TGF-ß1, p2PSA Combined with PSA in Prostate Cancer.

Objective: To investigate the diagnostic value of transforming growth factor-ß1 (TGF-ß1), prostate-specific antigen isomer 2 (p2PSA) combined with a prostate-specific antigen (PSA) in prostate cancer (PCa). Methods: From October 1, 2019 to September 1, 2022 we enrolled a total of 90 patients with PCa90 patients with PCa in the urology department of our hospital were selected as the PCa group, 90 patients with benign prostatic hyperplasia (BPH) were selected as the BPH group, and 90 healthy people were selected as a healthy control group. The levels of TGF-ß1, p2PSA and PSA in serum were detected, and the differences in TGF-ß1, p2PSA and PSA levels among the three groups and PCa patients with different pathological parameters were compared. Univariate and Logistic regression analyses were used to analyze the independent risk factors affecting the occurrence of PCa. With pathological results as the 'gold standard', the diagnostic efficacy of TGF-ß1, p2PSA and PSA alone and their combination for PCa was analyzed by the receiver operating characteristic (ROC) curve. Results: The levels of serum PSA, p2PSA, and TGF-ß1 in the PCa group were higher than those in the BPH group and control group (P < .001), and those in BPH group were higher than those in the control group (P < .001). The serum indexes of PCa group increased with the increase of Glerson grade and TNM stage (P < .001). The serum indexes of patients with lymph and bone metastasis were significantly higher than those without lymph and bone metastasis (P < .001). Logistic regression analysis showed that PSA, p2PSA and TGF-ß1 were independent risk factors for PCa (P < .001). The area under the ROC curve (AUC) of PSA, p2PSA, TGF-ß1 and combined detection were 0.738, 0.862, 0.821 and 0.932, respectively. The AUC of combined detection was greater than that of single detection (P < .001). Conclusion: The expression levels of serum TGF-ß1, p2PSA and PSA are related to PCa and are independent risk factors for PCa. The combined detection of the three groups can improve the diagnostic efficacy of PCa. Combined testing improves diagnostic accuracy for prostate cancer, allows for early intervention, and improves patient survival and confidence in treatment options. This will significantly improve the clinical management of prostate cancer. Future studies could explore other biomarkers or molecular indicators to further improve the accuracy of diagnosis and grading of prostate cancer. Additionally, differences between different populations and subtypes can be studied to better understand the heterogeneity of prostate cancer.

Harnessing the therapeutic potential of mesenchymal stem cell-derived exosomes in cardiac arrest: Current advances and future perspectives.

BACKGROUND: Cardiac arrest (CA), characterized by sudden onset and high mortality rates, is one of the leading causes of death globally, with a survival rate of approximately 6-24%. Studies suggest that the restoration of spontaneous circulation (ROSC) hardly improved the mortality rate and prognosis of patients diagnosed with CA, largely due to ischemia-reperfusion injury. MAIN BODY: Mesenchymal stem cells (MSCs) exhibit self-renewal and strong potential for multilineage differentiation. Their effects are largely mediated by extracellular vesicles (EVs). Exosomes are the most extensively studied subgroup of EVs. EVs mainly mediate intercellular communication by transferring vesicular proteins, lipids, nucleic acids, and other substances to regulate multiple processes, such as cytokine production, cell proliferation, apoptosis, and metabolism. Thus, exosomes exhibit significant potential for therapeutic application in wound repair, tissue reconstruction, inflammatory reaction, and ischemic diseases. CONCLUSION: Based on similar pathological mechanisms underlying post-cardiac arrest syndrome involving various tissues and organs in many diseases, the review summarizes the therapeutic effects of MSC-derived exosomes and explores the prospects for their application in the treatment of CA.

A Novel Technique for Resection and Reconstruction of the Temporomandibular Joint by Sliding Vertical Ramus Osteotomy using Only Submandibular Approach.

In this paper, an innovative technique for resection and reconstruction of the temporomandibular joint by sliding vertical ramus osteotomy using only a submandibular approach is presented. Before pulling the posterior mandibular border slightly downward to expose parts of the condyle, the vertical ramus osteotomy was performed. With the help of 3D simulation and surgical templates, the condylectomy was carried out using the ultrasonic osteotome through the submandibular approach. Our technique achieved the desired results while preventing complications of facial nerve paralysis, the occurrence of Frey syndrome, and the preauricular scar. Therefore, we suggest that this surgical method represents an alternative treatment option for temporomandibular joint lesions.

[Determination of polybrominated diphenyl ethers in marine sediments by composite chromatography column purification-gas chromatography-negative chemical ionization-mass spectrometry].

Polybrominated diphenyl ethers (PBDEs) are used as additive flame retardants. Because they lack the ability to form chemical bonds, PBDEs can easily enter the sediment environment. The accurate qualitative and quantitative analysis of PBDEs in sediments is of great importance for the accurate assessment of PBDE pollution in this environment. Sediments contain many impurities. Therefore, PBDEs in sediment should be purified before analysis to reduce the matrix effect. A method based on gas chromatography-negative chemical ionization-mass spectrometry (GC-NCI/MS) was developed to determine 13 PBDEs in marine sediment samples using a column packed with deactivated silica gel, acidified silica gel, Florisil, and anhydrous sodium sulfate. Sediment samples were extracted by ultrasonication with a mixed solvent of n-hexane-dichloromethane (3∶1, v/v). After two cycles of ultrasonic extraction, the extract was purified by a composite chromatographic column and eluted with n-hexane-dichloromethane (3∶1, v/v). Thirteen PBDEs were determined by GC-NCI/MS in selected-ion monitoring (SIM) mode. The effects of different fillers, eluents, and elution volumes on the purification of PBDEs in the composite column were compared and analyzed, and the GC-NCI/MS analysis conditions were optimized. Three different packing columns were used to purify the sample extract. The first column was packed with 3 g of deactivated silica, 6 g of acidic silica, 3 g of deactivated silica, 3 g of Florisil, and 6 g of anhydrous sodium sulfate; the second column was packed with 3 g of Florisil, 3 g of deactivated silica, 6 g of acidic silica, 3 g of deactivated silica, and 6 g of anhydrous sodium sulfate; and the third column was packed with 3 g of deactivated silica, 6 g of acidified silica, 3 g of deactivated silica, and 6 g of anhydrous sodium sulfate. Among these columns, that packed with 3 g of deactivated silica, 6 g of acidic silica, 3 g of deactivated silica, 3 g of Florisil, and 6 g of anhydrous sodium sulfate showed the best purification effect. The 13 PBDEs showed good linearity in the mass concentration range of 0.1-20 µg/L with correlation coefficients (r2) greater than 0.995 (decabromodiphenyl oxide (BDE-209), r2>0.99). The limits of quantification (S/N=10) was 0.002-0.126 µg/kg. The average recoveries of the 13 PBDEs at three spiked levels of 0.2, 1.0, and 4.0 µg/kg were 85.3%-101.3%, 84.8%-113.6%, and 86.3%-94.7% with relative standard deviations of 4.4%-14.0%, 0.4%-4.9%, and 1.9%-6.6%, respectively. These findings indicate that the method has high sensitivity and accuracy as well as good precision. Finally, the method was applied to the analysis and detection of PBDEs in actual marine sediment samples. The results revealed that the sediment samples contained different contents of the 13 PBDEs, and high detection rates were obtained for lower-brominated PBDE homologs. The detection rate of bis(4-bromophenyl) ether (BDE-15) was 100%, and the detected content of BDE-209 was as high as 60.49 µg/kg. These results demonstrate that the developed method is suitable for the accurate qualitative and quantitative analysis of PBDEs in marine sediment samples.

Three-dimensional Reconstruction and Comparison of Temporomandibular Joint Space Volume Before and After Orthognathic Surgery in Patients with Skeletal Class III Malocclusion With Mandibular Deviation.

OBJECTIVE: To look into the association between the degree of deviation and the changing trend in the temporomandibular joint (TMJ) space volume after orthognathic surgery in patients with skeletal Class III malocclusion. METHODS: Twenty patients having combined orthodontic-orthognathic treatment for skeletal Class III malocclusions with mandibular deviation were chosen, and craniofacial spiral CT was performed before (T0), two weeks after (T1), and six months after (T2) surgery. Using 3D volume reconstruction, further partitioning, and analysis of each domain's volume changes over time, the TMJ space volume is to be obtained. The differences in changes between groups A (mild deviation group) and B (severe deviation group) were examined to examine the impact of the degree of deviation on the TMJ space volume. RESULTS: A statistically significant difference ( P <0.05) existed between the postoperative TMJ space volume in group A and the preoperative overall, anterolateral, and anteroinferior space volume; the same difference also existed between the postoperative TMJ space volume in the NDS and the preoperative posterolateral, posteroinferior space volume. In group B, the postoperative TMJ space volume was statistically significant ( P <0.05) compared with the preoperative total and anteroinferior space volume in the DS; the difference between the total volume of the T1 stage on the NDS and the total volume of the T0 stage was statistically significant ( P <0.05). The two groups showed substantial differences in the space volume changes between the T1-T0 phase and the T2-T1 period. CONCLUSION: Patients with skeletal Class III malocclusion and mandibular deviation after orthognathic surgery see a change in the TMJ space volume. All patient types experience a largely consistent space volume change trend two weeks after surgery, and the degree of mandibular deviation is correlated with the intensity and longevity of the alteration.

Characterization of dissolved organic matter in biochar derived from various macroalgae (Phaeophyta, Rhodophyta, and Chlorophyta): Effects of pyrolysis temperature and extraction solution pH.

Characterization of biochar-derived dissolved organic matter (DOM) can provide deep insight into potential applications of biochar. Herein, biochar from six macroalgae (Phaeophyta-Sargassum fusiforme, Sargassum thunbergii, and Sargassum vachellianum; Rhodophyta-Grateloupia turuturu and Chondria crassicaulis; and Chlorophyta-Ulva pertusa) were subjected to pyrolysis at different temperatures (200 °C-500 °C). The effects of pyrolysis temperature and extraction solution pH on the characteristics of the macroalgal biochar-derived DOM (MBDOM) were investigated via fluorescence excitation-emission matrix spectroscopy with parallel factor (PARAFAC) analysis. Five humic-like substances and one protein-like substance were identified. The distributions of the six PARAFAC components depended on the macroalgae species, pyrolysis temperature, and extraction solution pH. The proportion of the protein-like substance (0 %-46.77 %) was less than that of the humic-like substances (100 %-53.23 %) in a given MBDOM regardless of the extraction solution pH values. Fluorescence spectral indicators show that DOM from macroalgal biochar is more autochthonous and humified than that from the corresponding biomass. Hierarchical cluster analysis and redundancy analysis results further show that the macroalgae species, pyrolysis temperature, and extraction solution pH jointly affect DOM characteristics with varying contribution levels.

Modified Le Fort I Arc Osteotomy Combined With Autologous Bone Grafts to Improve Midface Hypoplasia Combined With Skeletal Class III Malocclusion: A Technical Note.

Midface hypoplasia sometimes appears in patients with skeletal class III malocclusion in the Asian population, often requires additional surgical treatments. The technical note is intended to introduce a modified Le Fort I arc osteotomy combined with autologous bone grafts harvested from proximal segments after bilateral sagittal split ramus osteotomy to improve the profile for skeletal class III malocclusion patients with midface hypoplasia. The benefit of the modified technology is that the size and position of the arc can be adjusted according to the severity of the deformity to suit different patients. In addition, the application of autologous bone grafts increased the extra height of osteotomy line and enhanced the surgical effect, and maintained bone consolidation. More importantly, the osteotomy line of the modified Le Fort I arc osteotomy can be easily designed and this modification will not cause additional injuries. Therefore, we believe that for skeletal class III malocclusion patients with midface hypoplasia in Asia modified Le Fort I arc osteotomy combined with autologous bone grafts will be an efficient surgical method to improve midface hypoplasia.

Digital Economy and Environmental Quality: Insights from the Spatial Durbin Model.

Recent developments in attaining carbon peaks and achieving carbon neutrality have had enormous effects on the world economy. Digitalization has been considered a viable way to curtail carbon emissions (CE) and promote sustainable economic development, but scant empirical studies investigate the link between digitalization and CE. In this context, this study constructs the digitalization index using the entropy value method and spatial Markov chain, and the spatial Durbin model is employed to analyze its impact mechanism and influence on urban CE in 265 prefecture-level cities and municipalities in China from 2011 to 2017. The results indicate that: (1) The overall development level of the digital economy (DE) posed a significant spatial effect on urban environmental pollution. However, the effect varies according to the different neighborhood backgrounds. (2) The DE impedes urban environmental deterioration directly and indirectly through the channels of industrial structure, inclusive finance, and urbanization. (3) The development of the DE significantly reduces pollution in cities belonging to urban agglomerations, while the development of the DE escalates emissions in nonurban agglomeration cities. Finally, based on the results, important policy implications are put forward to improve the environmental quality of cities.

A Novel Forceps for Preventing Mucosal Damage of the Hard Palate in Maxilla Mobilization During Le Fort I Osteotomy.

At present, the most effective and common strategy to mobilize the maxilla is to use Rowe disimpaction forceps. But because of the directed forces on the hard palate, the mucosa of the hard palate will have to receive an ineluctable mechanical injury. Therefore, we introduce a novel forceps (Patent No. 202110966069.X China), which can accurately and steadily clamp the maxilla on the premise of protecting the hard palate mucosa from loss of palatal vascularity and pressure necrosis, and then thoroughly mobilize the maxilla. Complaints and mucosal damage were not observed in the initial 3 patients.

Environmentally-relevant concentrations of the antipsychotic drugs sulpiride and clozapine induce abnormal dopamine and serotonin signaling in zebrafish brain.

The presence of drugs in surface and groundwaters adversely affects the physiological function of non-target organisms due special activities that can pose a serious threats to various forms of aquatic life. Psychotropic drugs are one of the most commonly used drugs in the world. Hence, the aim of this study was to investigate the effect of environmentally-relevant concentrations of the antipsychotic drugs, sulpiride and clozapine, on dopaminergic (DAergic) and serotonergic (5-HTergic) neurotransmitter systems in the brain of zebrafish. Adult zebrafish (AB strain) were exposed to the environmentally-relevant concentrations of sulpiride, clozapine, or a mixture of sulpiride and clozapine. The effects of the drugs on the mRNA and protein levels of major functional molecules in DAergic and 5-HTergic systems were then analyzed in the telencephalon and diencephalon. Both drugs induced abnormal mRNA and protein levels of important functional molecules of the DA and 5-HT signaling pathways in both telencephalon and diencephalon, as shown by the abnormal transcriptional levels of TH, DAT, DR D1, DR D2, MAO, TPH, serotonin transporter (SERT), 5-HTR 1AA, 5-HTR 1B, 5-THR 2AA, and 5-HTR 2B, and the abnormal translational levels of DAT, DR D2, SERT, 5-HTR 1A, 5-HTR 1B, and 5-HTR 2B. In addition, we observed a specificity in the adverse effects of these antipsychotic drugs, in terms of doses and brain parts. Compared to their effects alone, the drug mixture had a weaker effect on the DA and 5-HT systems, suggesting an antagonistic interaction between sulpiride and clozapine. Our findings suggest that sulpiride and clozapine interfere with DAergic and 5-HTergic neurotransmitter systems in the telencephalon and diencephalon of zebrafish, resulting in possible effects on brain functions and posing a serious threat to the health of zebrafish.

One-Stage Repair of Alveolar Cleft and Nasal Deformities Using Grafts From Nasal Septum: Application of Vomer, Ethmoid, and Septal Cartilage.

BACKGROUND: Patients with alveolar cleft unrepaired suffer from nasal deformities of different magnitude. Bone and cartilage grafts are harvested through several incisions. In this study, we present a method to simultaneously correct nasal deformities and repair alveolar cleft using grafts from the nasal septum. PATIENTS AND METHODS: All 6 patients with unilateral cleft lip and palate have alveolar cleft unrepaired combined with nasal deformity. Computed tomography scans and 3-dimensional-printed models of vomer and ethmoid bone were used for the purpose of preoperative design and for assessing the magnitude of deformity. Grafts of bone and cartilage from deviated septum were harvested by septoplasty through which dorsum deviation was corrected. Bone grafts from vomer and ethmoid were then fixed to the prepared alveolar cleft to repair the defect and elevate the alar base. Septal cartilage was adjusted into different shapes of grafts and deformities of nasal tip, nostrils, and columella were then corrected by rhinoplasty to restore the symmetry of the nose. RESULTS: Symmetry of nostrils was improved. The height of alar base on the cleft side was elevated to the level close to the noncleft side. Deviation of the septum, nasal dorsum, and columella was corrected. Projection of the nasal tip was adjusted to facial midline. Midface aesthetics was generally improved. CONCLUSION: Application of septal grafts reduce the number of incisions. One-stage repair of alveolar cleft and nasal deformities, with the aid of digital design, improves the postoperative experience and the general outcome of the surgery.

Winning the Blue Sky Defense War: Assessing Air Pollution Prevention and Control Action Based on Synthetic Control Method.

Undoubtedly, the rapid development of urbanization and industrialization in China has led to environmental problems, among which air pollution is particularly prominent. In response, the Chinese government has introduced a series of policies, including the Air Pollution Control and Prevention Action Plan (APPA), which is one of the most stringent environmental regulations in history. The scientific evaluation of the implementation of this regulation is important for China to win the battle of blue sky. Therefore, this study uses a synthetic control method to explore the effects of APPA on air pollution (AP) based on data of 30 provinces from 2000 to 2019. The study concludes that (1) APPA significantly reduces AP in the treatment provinces, and subsequent robustness tests validate our findings. However, the persistence of the policy effect is short in some provinces, and the rate of AP reduction slows down or even rebounds in the later stages of the policy. (2) The reduction effect of APPA varies significantly between regions and provinces. (3) The results of mechanism tests show that APPA reduces AP through high-quality economic development, population agglomeration, control of carbon emissions, and optimization of energy structure. Based on the above findings, targeted recommendations are proposed to promote AP control in China and win the blue sky defense war.

Can sustainable development policy reduce carbon emissions? Empirical evidence from resource-based cities in China.

Resource-based cities (RBCs) have made outstanding contributions to China's social and economic development over recent decades. Nevertheless, with the worsening climate change and the exhausted resources, how to curb carbon emissions of RBCs to deliver their low-carbon transformation is becoming a problem plaguing the world. To facilitate the low-carbon transformation of RBCs, the Chinese government has formulated many policies, including the Sustainable Development Policy of National Resource-based Cities, 2013-2020 (SDPRC). However, the implementation of SDPRC has not yielded a clear environmental influence. Therefore, this study employs the Propensity Score Matching-Difference in Difference to investigate this influence based on the panel data of 285 prefecture-level cities from 2006 to 2017 while exploring the related heterogeneity and impact mechanisms. It is found that: (1) the implementation of SDPRC has significantly reduced carbon emissions and intensities of RBCs, with this effect becoming more conspicuous with the advancement of the policy. A robust test also verifies these findings. (2) Results from the heterogeneity test demonstrate that the implementation of SDPRC has imposed a suppressive effect on CO2 emissions in eastern, central, and western Chinese regions, especially pronounced in the latter two regions. Except for the growing cities, which are not significantly affected by the policy, the other three types of cities have seen a catalytic effect on CO2 emission reduction from the implementation of the policy, with the most significant impact observed in the declining cities. (3) Analyses of related mechanisms reveal that thanks to the implementation of SDPRC, RBCs suppress CO2 emissions mainly by optimizing their industrial structures and relieving their energy intensities. Finally, some policy recommendations are proposed based on the findings of this study to facilitate the low-carbon transformation of RBCs.

Does green financial reform pilot policy promote green technology innovation? Empirical evidence from China.

As a new financial model that balances economic and ecological benefits, green finance (GF) plays an important role in promoting green economic development and ecological environmental protection. Based on the panel data set of 30 provinces in China from 2010 to 2020, this paper uses the synthetic control method (SCM) to explore the impact of the green financial reform pilot policy (GFRP) on the green technology innovation (GTI) capabilities of pilot areas and evaluate the policy effects. The specific research conclusions are as follows: (1) On the whole, the GFRP has a positive role in promoting the GTI capability of the pilot areas, but this role is different due to the different resources, environment, and economic development levels of each region. The areas with economic development levels in the middle and head are obviously affected by the policy, and the less developed areas are less affected by the policy or even have a restraining effect. (2) Although the pilot policy has improved the GTI capability of the pilot area, the promotion effect is unstable, that is, the implementation effect of the policy is unstable. In the early stage of policy implementation, the promotion effect of the policy on the regional GTI capacity is the most obvious, and this promotion effect begins to show a downward or stable trend in the 2-3 years after the policy is implemented. Based on the above conclusions, it can provide some reference for the revision and improvement of GFRP.

Administration of growth hormone improves endometrial function in women undergoing in vitro fertilization: a systematic review and meta-analysis.

BACKGROUND: The positive effects of growth hormone (GH) on IVF are often attributed to improvements in oocyte and embryo quality. While emerging evidence emphasizes GH-induced improvements in the endometrium, these results are controversial. OBJECTIVE AND RATIONALE: This meta-analysis aimed to evaluate whether GH administration improved endometrial function and reproductive outcomes during IVF cycles and to thus guide clinical practice. SEARCH METHODS: A literature search in the Cochrane Central Register of Controlled Trials, PubMed and Embase was performed through to 30 November 2021, without language restrictions. Randomized controlled trials (RCTs) evaluating the effects of GH on IVF outcomes were included. Risk of bias and quality of evidence (QoE) were assessed according to the Cochrane Collaboration's tool and the Grading of Recommendations Assessment, Development and Evaluation system. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were assessed by random-effects models. OUTCOMES: A total of 25 trials with 2424 women were included. Seventeen RCTs with poor responders (n = 1723) showed that GH administration significantly increased endometrial thickness (EMT) (MD = 0.38, 95% CI: 0.18-0.59; moderate QoE), which contributed to an improved live birth rate (OR = 1.67, 95% CI: 1.13-2.49; very low QoE) and clinical pregnancy rate (CPR) (OR = 1.97, 95% CI: 1.43-2.72; low QoE). Subgroup analyses showed a dose- and time-dependent relationship between GH cotreatment and IVF outcomes; the optimal recommendation for improving CPR was consistent with that for EMT, rather than for oocytes and embryos. Hence, GH might improve fertility via effects on the endometrium. Administration of GH daily from the follicular phase of previous cycle until the hCG trigger with < 5 IU/day led to a thicker endometrium and a greater chance of becoming pregnant, while 5-10 IU/day or administration from the luteal phase of the previous cycle until the hCG trigger resulted in higher oocyte and embryo quality. Poor responders might benefit from cotreatment with the GnRH agonist long protocol more than other stimulation protocols. Pooled data from four trials (n = 354) on women with a thin endometrium indicated that improved endometrial function might be critical for improving reproductive outcomes during GH treatment, as no improvements in embryo quality were found. GH administration not only increased EMT (MD = 1.48, 95% CI: 1.21-1.75; moderate QoE) but also promoted endometrial morphology (OR = 2.67, 95% CI: 1.36-5.23; low QoE) and perfusion (OR = 5.84, 95% CI: 1.30-26.17; low QoE), thereby improving the CPR (OR = 2.71, 95% CI: 1.69-4.34; P < 0.0001; low QoE). There was insufficient evidence to reach a conclusion regarding the effects of GH in normal responders (n = 80). Due to obvious improvements in the CPR, women with a thin endometrium might be the most appropriate population to benefit from GH administration. WIDER IMPLICATIONS: Improving endometrial function might be another vital mechanism by which GH improves IVF outcomes. Optimal treatment should be offered to the target population according to their personal conditions and needs. The QoE was moderate to very low, due to limited sample sizes and methodological problems; thus, the results should be interpreted with caution. More rigorous RCTs with large sample sizes are needed to confirm the effects and determine optimal GH protocols.

Posterior Mandibular Segmental Split Osteotomy: A Novel Technique for Edentulous Space Reconstruction in Patients With Skeletal Class III Malocclusion.

ABSTRACT: This study presents an innovative surgery that successfully improved the facial profile and occlusal function of a patient with a skeletal Class III malocclusion and posterior hypodontia. The patient had chief complaints of missing teeth and a protrudedjaw. A novel 1-stage surgery referred to as posterior mandibular segmental split osteotomy combined with Le Fort i osteotomy and BSSRO was used because the patient wanted to save time and was worried about periodontal complications associated with other treatment methods. As a result, a satisfying facial profile and a Class I occlusion with a normal position of the posterior dentoalveolar segment of the mandible were achieved with no adverse effects. Thus, posterior mandibular segmental split osteotomy can be considered an effective treatment for skeletal Class III malocclusion with posterior hypodontia.