A molecular sheaf: doubly threaded [6]rotaxane.

We report that the use of a hydrogen-bonded pyrimidine-macrocycle complex can efficiently facilitate the threading of two bispyridinium ethylenes into four rings, as evidenced by X-ray crystallography of its precursor, offering a rare example of a doubly threaded [6]rotaxane in 91% yield. The unusual architecture is found to be stable with no dethreading despite the large ring size of the macrocycle with respect to the stopper.

Balanced transformer: efficient classification of glioblastoma and primary central nervous system lymphoma.

Objective.Primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM) are malignant primary brain tumors with different biological characteristics. Great differences exist between the treatment strategies of PCNSL and GBM. Thus, accurately distinguishing between PCNSL and GBM before surgery is very important for guiding neurosurgery. At present, the spinal fluid of patients is commonly extracted to find tumor markers for diagnosis. However, this method not only causes secondary injury to patients, but also easily delays treatment. Although diagnosis using radiology images is non-invasive, the morphological features and texture features of the two in magnetic resonance imaging (MRI) are quite similar, making distinction with human eyes and image diagnosis very difficult. In order to solve the problem of insufficient number of samples and sample imbalance, we used data augmentation and balanced sample sampling methods. Conventional Transformer networks use patch segmentation operations to divide images into small patches, but the lack of communication between patches leads to unbalanced data layers.Approach.To address this problem, we propose a balanced patch embedding approach that extracts high-level semantic information by reducing the feature dimensionality and maintaining the geometric variation invariance of the features. This approach balances the interactions between the information and improves the representativeness of the data. To further address the imbalance problem, the balanced patch partition method is proposed to increase the receptive field by sampling the four corners of the sliding window and introducing a linear encoding component without increasing the computational effort, and designed a new balanced loss function.Main results.Benefiting from the overall balance design, we conducted an experiment using Balanced Transformer and obtained an accuracy of 99.89%, sensitivity of 99.74%, specificity of 99.73% and AUC of 99.19%, which is far higher than the previous results (accuracy of 89.6% ∼ 96.8%, sensitivity of 74.3% ∼ 91.3%, specificity of 88.9% ∼ 96.02% and AUC of 87.8% ∼ 94.9%).Significance.This study can accurately distinguish PCNSL and GBM before surgery. Because GBM is a common type of malignant tumor, the 1% improvement in accuracy has saved many patients and reduced treatment times considerably. Thus, it can provide doctors with a good basis for auxiliary diagnosis.

BertNDA: A Model Based on Graph-Bert and Multi-Scale Information Fusion for ncRNA-Disease Association Prediction.

Non-coding RNAs (ncRNAs) are a class of RNA molecules that lack the ability to encode proteins in human cells, but play crucial roles in various biological process. Understanding the interactions between different ncRNAs and their impact on diseases can significantly contribute to diagnosis, prevention, and treatment of diseases. However, predicting tertiary interactions between ncRNAs and diseases based on structural information in multiple scales remains a challenging task. To address this challenge, we propose a method called BertNDA, aiming to predict potential relationships between miRNAs, lncRNAs, and diseases. The framework identifies the local information through connectionless subgraph, which aggregate neighbor nodes' feature. And global information is extracted by leveraging Laplace transform of graph structures and WL (Weisfeiler-Lehman) absolute role coding. Additionally, an EMLP (Element-wise MLP) structure is designed to fuse pairwise global information. The transformer-encoder is employed as the backbone of our approach, followed by a prediction-layer to output the final correlation score. Extensive experiments demonstrate that BertNDA outperforms state-of-the-art methods in prediction assignment and exhibits significant potential for various biological applications. Moreover, we develop an online prediction platform that incorporates the prediction model, providing users with an intuitive and interactive experience. Overall, our model offers an efficient, accurate, and comprehensive tool for predicting tertiary associations between ncRNAs and diseases.

Osteogenic differentiation of 3D-printed porous tantalum with nano-topographic modification for repairing craniofacial bone defects.

Introduction: Congenital or acquired bone defects in the oral and cranio-maxillofacial (OCMF) regions can seriously affect the normal function and facial appearance of patients, and cause great harm to their physical and mental health. To achieve good bone defect repair results, the prosthesis requires good osteogenic ability, appropriate porosity, and precise three-dimensional shape. Tantalum (Ta) has better mechanical properties, osteogenic ability, and microstructure compared to Ti6Al4V, and has become a potential alternative material for bone repair. The bones in the OCMF region have unique shapes, and 3D printing technology is the preferred method for manufacturing personalized prosthesis with complex shapes and structures. The surface characteristics of materials, such as surface morphology, can affect the biological behavior of cells. Among them, nano-topographic surface modification can endow materials with unique surface properties such as wettability and large surface area, enhancing the adhesion of osteoblasts and thereby enhancing their osteogenic ability. Methods: This study used 3D-printed porous tantalum scaffolds, and constructed nano-topographic surface through hydrothermal treatment. Its osteogenic ability was verified through a series of in vitro and in vivo experiments. Results: The porous tantalum modified by nano-topographic surface can promote the proliferation and osteogenic differentiation of BMSCs, and accelerate the formation of new bone in the Angle of the mandible bone defect of rabbits. Discussion: It can be seen that 3D-printed nano-topographic surface modified porous tantalum has broad application prospects in the repair of OCMF bone defects.

KGETCDA: an efficient representation learning framework based on knowledge graph encoder from transformer for predicting circRNA-disease associations.

Recent studies have demonstrated the significant role that circRNA plays in the progression of human diseases. Identifying circRNA-disease associations (CDA) in an efficient manner can offer crucial insights into disease diagnosis. While traditional biological experiments can be time-consuming and labor-intensive, computational methods have emerged as a viable alternative in recent years. However, these methods are often limited by data sparsity and their inability to explore high-order information. In this paper, we introduce a novel method named Knowledge Graph Encoder from Transformer for predicting CDA (KGETCDA). Specifically, KGETCDA first integrates more than 10 databases to construct a large heterogeneous non-coding RNA dataset, which contains multiple relationships between circRNA, miRNA, lncRNA and disease. Then, a biological knowledge graph is created based on this dataset and Transformer-based knowledge representation learning and attentive propagation layers are applied to obtain high-quality embeddings with accurately captured high-order interaction information. Finally, multilayer perceptron is utilized to predict the matching scores of CDA based on their embeddings. Our empirical results demonstrate that KGETCDA significantly outperforms other state-of-the-art models. To enhance user experience, we have developed an interactive web-based platform named HNRBase that allows users to visualize, download data and make predictions using KGETCDA with ease. The code and datasets are publicly available at https://github.com/jinyangwu/KGETCDA.

Multi-Responsive Molecular Encapsulation and Release Based on Hydrogen-Bonded Azo-Macrocycle.

Research on stimuli-responsive host-guest systems is at the cutting edge of supramolecular chemistry, owing to their numerous potential applications such as catalysis, molecular machines, and drug delivery. Herein, we present a multi-responsive host-guest system comprising azo-macrocycle 1 and 4,4'-bipyridinium salt G1 for pH-, photo-, and cation- responsiveness. Previously, we reported a novel hydrogen-bonded azo-macrocycle 1. The size of this host can be controlled through light-induced E↔Z photo-isomerization of the constituent azo-benzenes. The host is found in this work to be capable of forming stable complexes with bipyridinium/pyridinium salts, and implementing guest capture and release with G1 under light in a controlled manner. The binding and release of the guest in the complexes can also be easily controlled reversibly by using acid and base. Moreover, the cation competition-induced dissociation of the complex 1a2⊃G1 is achieved. These findings are expected to be useful in regulating encapsulation for sophisticated supramolecular systems.

Real-time stealth optical transmission via dither-remodulation in a bias controller of a Mach-Zehnder modulator.

The physical layer transmission security is a promising technology against security threats. As an effective supplement to the encryption strategy, steganography has received widespread attention. We report a real-time 2 kbps stealth transmission in the 10 Gbps dual polarization QPSK public optical communication. The stealth data is embedded in dither signals via precise and stable bias control technique for a Mach-Zehnder modulator. In the receiver, the stealth data can be recovered from the normal transmission signals by low SNR signal processing and digital down conversion. The stealth transmission has been verified to pose almost no impact on the public channel over a 117 km distance. The proposed scheme is compatible with existing optical transmission systems, so that no new hardware needs to be employed. It can be accomplished and is exceeded economically by adding simple algorithms, which utilizes only a small amount of FPGA resources. The proposed method can cooperate with encryption strategies or cryptographic protocols at different network layers to reduce the communication overhead and improve the overall security of the system.

Enhanced kinetic behaviors of hollow MoO2/MoS2 nanospheres for sodium-ion-based energy storage.

Mo-based heterostructures offer a new strategy to improve the electronics/ion transport and diffusion kinetics of the anode materials for sodium-ion batteries (SIBs). MoO2/MoS2 hollow nanospheres have been successfully designed via in-situ ion exchange technology with the spherical coordination compound Mo-glycerates (MoG). The structural evolution processes of pure MoO2, MoO2/MoS2, and pure MoS2 materials have been investigated, illustrating that the structureofthenanospherecan be maintained by introducing the S-Mo-S bond. Based on the high conductivity of MoO2, the layered structure of MoS2 and the synergistic effect between components, as-obtained MoO2/MoS2 hollow nanospheres display enhanced electrochemical kinetic behaviors for SIBs. The MoO2/MoS2 hollow nanospheres achieve a rate performance with 72% capacity retention at a current of 3200 mA g-1 compared to 100 mA g-1. The capacity can be restored to the initial capacity after a current returns to 100 mA g-1, while the capacity fading of pure MoS2 is up to 24%. Moreover, the MoO2/MoS2 hollow nanospheres also exhibit cycling stability, maintaining a stable capacity of 455.4 mAh g-1 after 100 cycles at a current of 100 mA g-1. In this work, the design strategy for the hollow composite structure provides insight into the preparation of energy storage materials.

Physiological analysis of severe chlamydia psittaci pneumonia and clinical diagnosis after doxycycline-based treatment.

Objective: To describe the clinical spectrum of severe Chlamydia psittaci pneumonia in order to understand the disease better. Methods: Retrospective analysis was made on 31 patients with severe Chlamydia psittaci pneumonia diagnosed in ICU by next-generation sequencing of metagenome Metagenomic next-generation sequencing(mNGS) from January 2019-November 2022, including clinical characteristics, laboratory examination results, imaging characteristics, treatment, and prognosis. Results: We included 31 patients with severe Chlamydia psittaci pneumonia, 15 of whom had a history of virus exposure. There were 12 cases with multiple bacterial infections, and the common symptoms included fever (31/31,100%), dyspnea (31/31, 100%), cough (22/31, 71.0%), and myalgia (20/31, 64.5%). Laboratory data showed that white blood cells were average or slightly increased, but the levels of C-reactive protein and neutrophils were high. CT findings of the lung were consolidation (19/31, 61.3%) and pleural effusion (11/31, 35.5%). Only one lobe was involved in 11 patients (35.5%). Before diagnosis, 22 patients (71.0%) did not have atypical pathogens in their antimicrobial regimen. After diagnosis, 19 patients (61.3%) received single drug treatment, of which doxycycline or moxifloxacin were the most commonly used drugs. Among 31 patients, three died, nine improved, and nineteen were cured. Conclusion: The clinical manifestations of severe Chlamydia psittaci pneumonia are non-specific. The application of mNGS can improve the diagnostic accuracy of Chlamydia psittaci pneumonia, reduce the unnecessary use of antibiotics, and shorten the course of the disease. Doxycycline-based treatment is effective for severe chlamydia psittaci pneumonia, but it is necessary to understand the secondary bacterial infection and other complications in the course of the disease.

Reconstruction of Dentomaxillofacial Deformity Secondary to Mandibular Defect Using Concomitant Orthognathic Surgery and Fibula Free Flap.

SUMMARY: The reconstruction of mandibular defects may be delayed or compromised for many reasons, especially in pediatric patients. With the growth of the remaining mandible and the maxilla in the malocclusion status, secondary dentomaxillofacial deformity is plausible. To treat the concomitant mandibular defect and secondary dentomaxillofacial deformity, a hierarchical algorithm using orthodontics, orthognathic surgery, and fibula free flap was developed. This retrospective case series included six patients with long-term mandibular defects caused by tumor resection without repair or with compromised costochondral reconstruction. All patients were treated using the same staged protocol, but with minor changes: (1) presurgical orthodontics, (2) virtual surgical planning, (3) fabrication of the guides and splints, (4) sequenced operations, and (5) postoperative care. The sequence of surgery included the Le Fort I osteotomy, mandibular sagittal split ramus osteotomy of the remaining ramus, final occlusion registration, repositioning of the distal segment of the mandible, segmented fibula reconstruction, and finally, the fixation of mandibular sagittal split ramus osteotomy. The operations and wound healing were uneventful in all patients, and no flap failure or severe complications were detected. Also, the patients exhibited no signs of temporomandibular joint ankylosis during the follow-up. The subspinale-nasion-supramental angle was significantly reduced after surgery. A significant improvement was detected in the facial contour symmetry measurements postoperatively. This proposed workflow of concomitant orthognathic surgery and the fibula free flap is effective and reliable for the reconstruction of dentomaxillofacial deformity secondary to the long-term mandibular defect.

Climate change impact on photovoltaic power potential in China based on CMIP6 models.

China has the largest worldwide cumulative installed photovoltaic (PV) capacity, which is expected to be 1300 GW in 2050. Industrial production, population explosion and fossil fuel combustion would reduce the surface solar radiation that could be received by PV panels. However, it is still a problem to explore the integrated effects of socio-economic and air pollutant emissions on PV power potential in China. In this study, climate change impact on PV power potential in 2023-2100 were assessed using the Coupled Model Intercomparison Project Phase 6 (CMIP6) model, combining Shared Socio-economic Pathway (SSPs) and Representative Concentration Pathways (RCPs). The validation results with ground-based surface solar radiation measurements collected from 17 China Meteorological Administration (CMA) stations showed that the Meteorological Research Institute Earth System Model version 2-0 (MRI-ESM2-0) attained a better performance with mean correlation coefficients (R), Root Mean Square Error (RMSE), and Mean Absolute Error (MAE) of 0.85, 35.80 Wm-2 and 29.37 Wm-2, respectively. Then, the MRI-ESM2-0 model was selected to analyze the spatial and temporal variations in PV power potential. PV power potential decreased significantly in SSP585 ranging from 192.71 Wm-2 to 189.96 Wm-2 in 2023-2100 corresponding to the growing resource intensity and fossil fuel dependency. In contrast, if China continues on the path of sustainable and low-carbon development and keeps temperature rise to about 1.5 °C by 2100, PV power potential will increase by 1.36-5.90 Wm-2. Meanwhile, the effects of climatological factors on PV power potential were analyzed by Empirical Orthogonal Function (EOF) method. Results indicated that surface solar radiation had the highest contribution of >50 %, and the contribution of aerosols and cloud cover was about 20 %. This study is conducive to the full utilization of solar resources and has important implications for the future formulation of solar energy policy in China.

Preliminary Study of the Treatment Strategy for Retaining Traumatic Foreign Bodies Involving the Carotid Artery.

PURPOSE: Craniomaxillofacial trauma is usually accompanied by indwelling foreign bodies, and some of those are close to the carotid artery, which increases the risks and difficulties of surgical treatment. The introduction of interventional radiology combined with image-guided surgical navigation may be a good solution for precise surgery to remove foreign bodies. PATIENTS AND METHODS: Four patients were included in the study. All patients underwent digital subtraction angiography and enhanced computed tomography before surgery. The patients were divided into 3 categories (A, B, and C) according to the presence of carotid artery damage and its positional relationship with the foreign body, and 3 corresponding treatment strategies were developed. Treatments were completed using interventional radiology and surgical navigation systems. RESULTS: All foreign bodies were completely removed, except for 1 remaining in the jugular foramen in a patient. The prognosis of all patients was good, and no systemic complications occurred. CONCLUSION: The combined interventional radiology and surgical navigation method proposed in this study is an effective method to improve the accuracy and safety of foreign body removal surgery.

The Feasibility of Robot-Assisted Chin Osteotomy on Skull Models: Comparison with Surgical Guides Technique.

Surgical robotic technology is characterized by its high accuracy, good stability, and repeatability. The accuracy of mandibular osteotomy is important in tumor resection, function reconstruction, and abnormality correction. This study is designed to compare the operative accuracy between robot-assisted osteotomy and surgical guide technique in the skull model trials which simulated the genioplasty. In an experimental group, robot-assisted chin osteotomy was automatically performed in 12 models of 12 patients according to the preoperative virtual surgical planning (VSP). In a control group, with the assistance of a surgical guide, a surgeon performed the chin osteotomy in another 12 models of the same patients. All the mandibular osteotomies were successfully completed, and then the distance error and direction error of the osteotomy plane were measured and analyzed. The overall distance errors of the osteotomy plane were 1.57 ± 0.26 mm in the experimental group and 1.55 ± 0.23 mm in the control group, and the direction errors were 7.99 ± 1.10° in the experimental group and 8.61 ± 1.05° in the control group. The Bland-Altman analysis results revealed that the distance error of 91.7% (11/12) and the direction error of 100% (12/12) of the osteotomy plane were within the 95% limits of agreement, suggesting the consistency of differences in the osteotomy planes between the two groups. Robot-assisted chin osteotomy is a feasible auxiliary technology and achieves the accuracy level of surgical guide-assisted manual operation.

Application of mixed reality-based surgical navigation system in craniomaxillofacial trauma bone reconstruction.

OBJECTIVES: This study aimed to build a surgical navigation system based on mixed reality (MR) and optical positioning technique and evaluate its clinical applicability in craniomaxillofacial trauma bone reconstruction. Me-thods We first integrated the software and hardware platforms of the MR-based surgical navigation system and explored the system workflow. The systematic error, target registration error, and osteotomy application error of the system were then analyzed via 3D printed skull model experiment. The feasibility of the MR-based surgical navigation system in craniomaxillofacial trauma bone reconstruction was verified via zygomatico-maxillary complex (ZMC) reduction experiment of the skull model and preliminary clinical study. RESULTS: The system error of this MR-based surgical navigation system was 1.23 mm±0.52 mm, the target registration error was 2.83 mm±1.18 mm, and the osteotomy application error was 3.13 mm±1.66 mm. Virtual surgical planning and the reduction of the ZMC model were successfully conducted. In addition, with the guidance of the MR-based navigation system, the frontal bone defect was successfully reconstructed, and the clinical outcome was satisfactory. CONCLUSIONS: The MR-based surgical navigation system has its advantages in virtual reality fusion effect and dynamic navigation stability. It provides a new method for doctor-patient communications, education, preoperative planning, and intraoperative navigation in craniomaxillofacial surgery.

A host-guest interaction activated Bobbitt oxidant for highly efficient oxidation of alcohols.

Host-guest complexation using hydrogen-bonded macrocycles was found to enable activation of the Bobbitt oxidant reagent, which greatly facilitates the highly efficient oxidation of unactivated primary alcohols. This work provides a complementary approach to the activation of Bobbitt's salt with shape-persistent macrocycles in supramolecular catalysis.

Three-Dimensional Printed Customized Surgical Guides for the Precise Correction of Complex Midfacial Post-Traumatic Deformities.

PURPOSE: The introduction of intraoperative computed tomography and image-guided navigation have demonstrated some advantages for the correction of midfacial post-traumatic deformities. However, these methods still do not achieve satisfactory results. The authors sought to describe a novel method for the precise correction of complex midfacial post-traumatic deformities using three-dimensional printing customized surgical guides. METHODS: Ten patients with midfacial post-traumatic deformities admitted between January 15, 2018 and August 20, 2020 were included. To design the surgical guide for each patient, preoperative planning and simulation datasets were used as a virtual template. Each surgical guide comprised three-dimensional printing cutting guides and customized titanium plates to guide the osteotomy and repositioning of the fracture fragments intraoperatively. Reduction and fixation were confirmed by intraoperative navigation. Postoperative deviation chromatography analysis and clinical examination were conducted to evaluate the surgical outcome. All operations were successfully performed. RESULTS: The average difference between the virtual plans and postoperative results was less than 1.5 mm. The 3- to 6-month follow-up evaluation demonstrated that symptoms were alleviated, and postoperative function and esthetics improved considerably. CONCLUSIONS: Three-dimensional-printed customized surgical guides can accurately and effectively transfer the virtual surgical plan to the patient and could be considered an ideal and valuable option for this potentially complicated procedure.

Collaborative Control Method and Experimental Research on Robot-Assisted Craniomaxillofacial Osteotomy Based on the Force Feedback and Optical Navigation.

OBJECTIVE: Surgical robot has advantages in high accuracy and stability. But during the robot-assisted bone surgery, the lack of force information from surgical area and incapability of intervention from surgeons become the obstacle. The aim of the study is to introduce a collaborative control method based on the force feedback and optical navigation, which may optimally combine the excellent performance of surgical robot with clinical experiences of surgeons. MATERIALS AND METHODS: The CMF ROBOT system was integrated with the force feedback system to ensure the collaborative control. Force-velocity control algorithm based on force feedback was designed for this control method. In the preliminary experimental test, under the collaborative control mode based on force feedback and optical navigation, the craniomaxillofacial surgical robot entered the osteotomy line area according to the preoperative surgical plan, namely, right maxillary Le Fort I osteotomy, left maxillary Le Fort I osteotomy, and genioplasty. RESULTS: The force sensor was able to collect and record the resistance data of the cutting process of the robot-assisted craniomaxillofacial osteotomy assisted in real time. The statistical results showed that the repeatability of collaborative control mode was acceptable in bilateral maxillary Le Fort I osteotomies (right, P =0.124>0.05 and left, P =0.183>0.05) and unfavorable in genioplasty ( P =0.048<0.05). CONCLUSION: The feasibility of robot-assisted craniomaxillofacial osteotomy under the collaborative control method based on the force feedback and optical navigation was proved in some extent. The outcome of this research may improve the flexibility and safety of surgical robot to meet the demand of craniomaxillofacial osteotomy.

Quercetin-Coating Promotes Osteogenic Differentiation, Osseointegration and Anti-Inflammatory Properties of Nano-Topographic Modificated 3D-Printed Ti6Al4V Implant.

The capabilities of osseointegration and anti-inflammatory properties are of equal significance to the bio-inert titanium implant surface. Quercetin has proved its capacities of activating anti-inflammation through macrophage modulation and promoting osteogenic differentiation. Herein, we fabricated quercetin-coating on nano-topographic modificated 3D-printed Ti6Al4V implant surface. Subsequently the biological cells responses in vitro, anti-inflammatory and osseointegration performance in vivo were evaluated. In vitro studies indicated that quercetin-coating can enhance the adhesion and osteogenic differentiation of rBMSCs, while modulating the polarization of macrophages from M1 to M2 phase and improving the anti-inflammatory and vascular gene expression. Moreover, quercetin-loaded implants reduced the level of peri-implant inflammation and ameliorated new bone formation and rapid osseoinegration in vivo. Quercetin-coating might provide a feasible and favorable scheme for endowing 3D-printed titanium alloy implant surface with enhanced the rapid osseointegration and anti-inflammatory properties.

Learning from errors? The impact of erroneous example elaboration on learning outcomes of medical statistics in Chinese medical students.

BACKGROUND: Constructivism theory has suggested that constructing students' own meaning is essential to successful learning. The erroneous example can easily trigger learners' confusion and metacognition, which may "force" students to process the learning material and construct meaning deeply. However, some learners exhibit a low level of elaboration activity and spend little time on each example. Providing instructional scaffolding and elaboration training may be an efficient method for addressing this issue. The current study conducted a randomized controlled trial to examine the effectiveness of erroneous example elaboration training on learning outcomes and the mediating effects of metacognitive load for Chinese students in medical statistics during the COVID-19 pandemic. METHODS: Ninety-one third-year undergraduate medical students were randomly assigned to the training group (n = 47) and the control group (n = 44). Prerequisite course performance and learning motivation were collected as covariates. The mid-term exam and final exam were viewed as posttest and delayed-test to make sure the robustness of the training effect. The metacognitive load was measured as a mediating variable to explain the relationship between the training and academic performance. RESULTS: The training significantly improved both posttest and delayed-test performance compared with no training (Fposttest = 26.65, p < 0.001, Partial η2 = 0.23; Fdelayed test = 38.03, p < 0.001, Partial η2 = 0.30). The variation trend in metacognitive load in the two groups was significantly different (F = 2.24, p < 0.05, partial η2 = 0.20), but metacognitive load could not explain the positive association between the treatment and academic performance (ß = - 0.06, se = 0.24, 95% CI - 0.57 to 0.43). CONCLUSIONS: Erroneous example learning and metacognitive demonstrations are effective for academic performance in the domain of medical statistics, but their underlying mechanism merits further study.

Introduction of Digital-Assisted Multidisciplinary Treatment in the Functional and Morphological Reconstruction of Naso-Orbital-Ethmoid Fractures.

ABSTRACT: This study summarizes the process of digital-assisted multidisciplinary treatment (MDT) of naso-orbital-ethmoid (NOE) fractures and evaluates the treatment outcomes. From October 2018 to December 2020, 39 patients with NOE fractures were treated in our department, 21 of whom were diagnosed and treated by a multidisciplinary team. After preoperative multidisciplinary discussions and personalized virtual surgical planning, they received MDT with the assistance of a surgical navigation system. The other 18 patients received traditional single-disciplinary treatment, that is, no preoperative multidisciplinary discussions. Oral and maxil-lofacial surgeons performed surgical design and digitally-assisted surgery alone. After the operation, treatment outcomes were evaluated in terms of aesthetic appearance and function. The duration of preoperative preparation and postoperative aesthetic outcomes were not significantly different in patients who received single-disciplinary treatment and MDT ( P > 0.05). However, postoperative functional outcomes were significantly better in patients who received MDT ( P < 0.05). Furthermore, no significant complications were found. Digital-assisted MDT has a high application value in repair and appearance reconstruction, especially restoring functionality after NOE fracture; thus, it should be promoted in clinical practice.