Metagenomic next-generation sequencing vs. conventional detection methods for detecting the pulmonary infections.

OBJECTIVE: The absence of proper pathogen treatment in the early stages can result in missing out on treatment chances or the overuse of antibiotics, both of which are the primary factors behind fatalities caused by lung infections. In this study, we aimed to investigate the efficacy of metagenomic next-generation sequencing (mNGS) in comparison to conventional detection methods in detecting infectious pathogens. PATIENTS AND METHODS: In this retrospective study, the infection pathogens of 104 patients were examined, and 86 bronchoalveolar lavage fluid (BALF), eight pleural effusions, and ten sputum samples were collected. The conventional detection approaches and mNGS analysis were used to determine the infection pathogen profiles and their detection rates were analyzed. RESULTS: Our study showed that mNGS was more sensitive (89.42%) than the conventional detection methods (56.73%) (p < 0.001), with a 32.69% improvement in sensitivity. The efficacy of mNGS in detecting mixed infections was significantly higher than that of conventional detection methods, with a detection rate of 85.29% compared to 17.65% (p < 0.001). The study demonstrated that mNGS had a higher sensitivity than the conventional detection methods when it came to diagnosing pulmonary infections, making it a potentially useful tool for clinical diagnosis. CONCLUSIONS: Combining mNGS with other pathogenic detection techniques can be an effective way to increase the rate of detecting pulmonary infections, as well as to provide guidance for treatment adjustments. Furthermore, the timing of sample collection and antibiotic administration can influence the effectiveness of mNGS when used on BALF specimens.

In children and adolescents with temporomandibular disorder assembled with juvenile idiopathic arthritis - no association were found between pain and TMJ deformities using CBCT.

BACKGROUND: Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer from temporomandibular disorder (TMD). Due to this, imaging diagnosis is crucial in JIA with non-symptomatic TM joint (TMJ) involvement. The aim of the study was to examine the association between clinical TMD signs/symptoms and cone-beam computed tomography (CBCT) findings of TMJ structural deformities in children and adolescents with JIA. METHODS: This cross-sectional study is part of a longitudinal prospective multi-centre study performed from 2015-2020, including 228 children and adolescents aged 4-16 years diagnosed with JIA, according to the International League of Associations for Rheumatology (ILAR). For this sub-study, we included the Bergen cohort of 72 patients (32 female, median age 13.1 years, median duration of JIA 4.5 years). Clinical TMD signs/symptoms were registered as pain on palpation, pain on jaw movement, and combined pain of those two. The severity of TMJ deformity was classified as sound (no deformity), mild, or moderate/severe according to the radiographic findings of CBCT. RESULTS: Of 72 patients, 21 (29.2%) had pain on palpation at and around the lateral pole, while 41 (56.9%) had TMJ pain upon jaw movement and 26 (36.1%) had pain from both. Of 141 TMJs, 18.4% had mild and 14.2% had moderate/severe structural deformities visible on CBCT. CBCT findings were not significantly associated with either the pain on palpation or the pain on jaw movement. A significant difference was found between structural deformities in CBCT and the combined pain outcome (pain at both palpation and movement) for both TMJs for the persistent oligoarticular subtype (p = 0.031). CONCLUSIONS: There was no association between painful TMD and CBCT imaging features of the TMJ in patients with JIA, but the oligoarticular subtype of JIA, there was a significant difference associated with TMJ pain and structural CBCT deformities.

[Studies on efficacy of a bioabsorbable steroid-eluting sinus stent in the frontal sinus opening of chronic rhinosinusitis with nasal polyps].

Objective: To assess the efficacy of a bioabsorbable steroid-eluting sinus stent in improving surgical outcomes when placed in the frontal sinus ostium (FSO) following full endoscopic sinus surgery (ESS) in patients with whole group chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: Patients with whole group CRSwNP who had similar lesions on bilateral sinus between September 2019 and March 2020 in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Changhai Hospital were chosen. Patients with CRSwNP who underwent extended ESS were randomly assigned to receive a steroid-eluting sinus stent in one FSO whereas the contralateral side received surgery alone. Endoscopic evaluations recorded at 30, 90 days postoperative were graded by an independent assessment panel to assess the need for interventions in the FSO. Semi-quantitative data with CT and endoscopic score were performed by rank sum test. The need for postoperative intervention and the patency rate of FSO were analyzed using the McNemar test. Results: Thirty-one patients with whole group CRSwNP met all eligible criteria, including 17 males and 14 females, with the age of (44.5±11.8) years(x¯±s). Stents were successfully placed in one FSO of all patients. At 30 days post-ESS, the assessment panel reported that steroid-eluting stents reduced the need for postoperative interventions by 41.0% (χ2=5.314,P=0.021), the need for oral steroid interventions by 40.0% (χ2=4.133,P=0.042) and the need for surgical interventions by 74.8% (χ2=4.292,P=0.038) compared to control sinuses with no stents. Clinical surgeons also reported greater diameter of FSO compared to control sinuses at 30 days post-ESS (74.2% vs 48.4%, χ2=4.351, P=0.037). These results at 90 days post-ESS were consistent with those at 30 days post-ESS. Conclusion: Bioabsorbable steroid-eluting sinus stents in the FSO can reduce polyp formation, adhesion, and the need for postoperative interventions in FSO of CRSwNP patients and improve the early postoperative outcomes.

Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis - a Norwegian cross- sectional multicentre study.

BACKGROUND: Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer pain from temporomandibular disorder (TMD). Still, routines for the assessment of temporomandibular joint (TMJ) pain in health and dental care are lacking. The aims of this study were to examine the prevalence of TMD in children and adolescents with JIA compared to their healthy peers and to investigate potential associations between JIA and TMD. METHODS: This comparative cross-sectional study is part of a longitudinal multicentre study performed during 2015-2020, including 228 children and adolescents aged 4-16 years with a diagnosis of JIA according to the ILAR criteria. This particular substudy draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Children and adolescents with JIA were matched with healthy controls according to gender, age, and centre site. Five calibrated examiners performed the clinical oral examinations according to a standardised protocol, including shortened versions of the diagnostic criteria for TMD (DC/TMD) and the TMJaw Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJs. RESULTS: In our cohort of 221 participants with JIA and 221 healthy controls, 88 (39.8%) participants with JIA and 25 (11.3%) healthy controls presented with TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p <  0.001). Vertical unassisted jaw movement was lower in participants with JIA than in controls, with means of 46.2 mm vs. 49.0 mm, respectively (p <  0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs and biologic disease-modifying antirheumatic-drugs presented with painful masticatory muscles and TMJs at palpation. CONCLUSION: Symptoms and clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in patients with JIA.

[Design and application of static progressive ankle foot orthosis].

The scar contracture of Achilles tendon in burn patients after operation is easy to cause " foot drop" , which leads to ankle dorsiflexion dysfunction. To solve this problem, the authors designed and made a static progressive ankle foot orthosis. The foot support part and the crus support part of the orthotic device are connected by rivets, and the distal end of the foot support part and the proximal end of the crus support part are pulled by the traction belt on both sides, gradually improving the ankle dorsiflexion function. This static progressive ankle foot orthosis is simple, practical, cost-effective, and worthy of clinical promotion.

[Nursing strategies for the facial skin injuries caused by wearing medical-grade protective equipment].

For effective resistance to virus attack and infection and reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. The paper summarizes the occurrence causes, common locations, and prevention ways about the device related pressure ulcers on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the prevention and nursing strategies for device related pressure ulcers and other related skin injuries during application of medical-grade protective equipment. The paper aims to provide reference for the prevention and nursing of device related pressure ulcers and related skin diseases for clinical medical staff, especially to the respectable personnel in front line of fighting against coronavirus disease 2019.

[Application of low temperature thermoplastic plate combined with special abdominal band in fixing abdominal pedicled flap for repairing 17 patients with deep electric burn wounds in hands].

If the abdominal pedicled flaps are not well fixed after repair of deep electric burn wounds in hands, many problems such as poor blood supply may occur. In order to solve the above problems, we designed and manufactured the individualized low temperature thermoplastic plate combined with special abdominal band to fix abdominal pedicled flaps for repairing of 17 patients (12 males and 5 females, aged 2-35 years) with deep electric burn wounds in hands from February 2016 to August 2018, and achieved the desired results. The shoulder joint, elbow joint, and wrist joint were fixed by low temperature thermoplastic plate according to the 1/2 circumference of the patient's side chest and upper arm, and the braking of wrist joint and elbow joint was strengthened by special abdominal band. Application of the combined method of fixing abdominal pedicled flaps in repairing deep electric burn wounds in hands has high success rate of flap transplantation. It is simple to make and practical, and worthy of clinical promotion.

[Influences of follow-up methods on rehabilitation and compliance of patients with severe scar after burns].

Objective: To observe the influences of different follow-up methods on rehabilitation and compliance of patients with severe scar after burns. Methods: From January 2012 to May 2016, medical records of 116 patients with severe scar after burns who were admitted to our unit, discharged after wound healing and conforming to the criteria, were retrospectively analyzed. They were divided into face-to-face follow-up group [n=59, 45 males and 14 females, aged (36±9) years] and routine follow-up group [n=57, 44 males and 13 females, aged (35±9) years] based on different follow-up methods they received. On the day of discharge and in post discharge month (PDM) 1, 3, and 6, the Vancouver Scar Scale (VSS) was used to evaluate the hypertrophic scar in joints, Activities of Daily Living (ADL) scale was used to evaluate the disability of patients in the 2 groups. In PDM 1, 3, and 6, Medical Compliance Behavior Questionnaire was used to investigate the medical compliance behaviors of patients in the 2 groups. Data were processed with chi-square test, t test with Bonferroni correction, and analysis of variance for repeated measurement. Results: (1) The VSS score of patients in face-to-face follow-up group on the day of discharge was (11.1±0.7) points, which was close to (11.7±0.7) points of routine follow-up group (t=2.021, P>0.05). The VSS scores of patients in face-to-face follow-up group in PDM 1, 3, and 6 were (10.5±0.6), (8.6±0.7), and (4.7±0.5) points, which were significantly lower than (11.4±0.7), (10.9±1.0), and (9.4±0.8) points of routine follow-up group respectively (t=2.034, 2.033, 2.042, P<0.05 or P<0.01). (2) The ADL score of patients in face-to-face follow-up group on the day of discharge was close to that of routine follow-up group (t=1.781, P>0.05). The ADL scores of patients in face-to-face follow-up group in PDM 1, 3, and 6 were higher than those of routine follow-up group respectively (t=9.683, 8.584, 9.772, P<0.01). (3) The compliance rates of consisted rehabilitation, reasonable diet, and timing consultation of patients in face-to-face follow-up group were better than those of routine follow-up group respectively (χ(2)=19.015, 13.251, 8.652, P<0.01). Conclusions: Compared with routine follow-up by phone, face-to-face follow-up can do better in evaluating the scar condition and ADL of patients with severe scar after burns, and improve the medical compliance rates of patients, which is worthy of clinical promotion.

[Observation on the effects of multidisciplinary comprehensive intervention in integrated treatment of patients with extremely severe burns].

Objective: To explore the effects of multidisciplinary comprehensive intervention in integrated treatment of patients with extremely severe burns. Methods: One hundred and ten patients hospitalized in our center from July 2013 to August 2017 met the criteria for inclusion in this study, and their medical records were retrospectively analyzed. According to the medical model at that time, 56 patients hospitalized from July 2013 to July 2015 received routine comprehensive treatment led by doctors, and they were included in the conventional intervention group. From August 2015 to August 2017, 54 patients were treated with integrated multidisciplinary interventions performed by a team consisting of physicians, intensive care nurses, burn nurses, intravenous infusion nurses, wound stoma nurses, and rehabilitation therapists, and they were included in the integrated intervention group. Acute Physiological and Chronic Health Assessment Ⅱ (APACHE Ⅱ) scores on admission and 4 weeks after treatment, incidences of pressure injury, wound sepsis, lung infection, and catheter-related infection during hospitalization, length of stay in intensive care unit (ICU) and total length of hospital stay, and Abbreviated Burn Specific Health Scale (BSHS-A) scores at discharge and 3 months after discharge were analyzed. Data were processed with t-test and chi-square test. Results: The APACHE Ⅱ scores of patients in the two groups were close on admission (t=0.573, P>0.05). Four weeks after treatment, the APACHE Ⅱ scores of patients in the two groups were obviously lower than those on admission within the same group (t=5.697, 4.853, P<0.01), and the score of the integrated intervention group was obviously lower than that of the conventional intervention group (t=2.170, P<0.05). No pressure injury was observed in patients of any group during hospitalization. The incidences of wound sepsis, lung infection, and catheter-related infection of patients in the integrated intervention group were 18.5% (10/54), 3.7% (2/54), and 9.3% (5/54), respectively, significantly lower than 42.9% (24/56), 21.4% (12/56), and 26.8% (15/56) of the conventional intervention group, χ2=4.073, 6.075, 3.962, P<0.05. The length of stay in ICU of patients in the integrated intervention group was (50±5) d, obviously shorter than (62±4) d of the conventional intervention group (t=2.852, P<0.01). The total length of hospital stay of patients in the integrated intervention group was (115±8) d, obviously shorter than (140±7) d of the conventional intervention group (t=16.885, P<0.01). At discharge and 3 months after discharge, the scores of BSHS-A, physical function, psychological function, and general health status of 50 patients in the integrated intervention group were significantly higher than those of 48 patients in the conventional intervention group (t=2.886, 3.126, 2.416, 2.544, 2.033, 3.471, 2.588, 2.210, P<0.05 or P<0.01), while the scores of social function of patients in the two groups were close (t=1.570, 1.350, P>0.05). Conclusions: Integrative treatment of patients with extremely severe burns by multidisciplinary comprehensive intervention can significantly alleviate the severity of burns, reduce the incidences of wound sepsis, lung infection, and catheter-related infection, shorten the length of stay in ICU and total length of hospital stay, and improve the quality of life.

Self-Propelled Particles with Velocity Reversals and Ferromagnetic Alignment: Active Matter Class with Second-Order Transition to Quasi-Long-Range Polar Order.

We introduce and study in two dimensions a new class of dry, aligning active matter that exhibits a direct transition to orientational order, without the phase-separation phenomenology usually observed in this context. Characterized by self-propelled particles with velocity reversals and a ferromagnetic alignment of polarities, systems in this class display quasi-long-range polar order with continuously varying scaling exponents, yet a numerical study of the transition leads to conclude that it does not belong to the Berezinskii-Kosterlitz-Thouless universality class but is best described as a standard critical point with an algebraic divergence of correlations. We rationalize these findings by showing that the interplay between order and density changes the role of defects.

Correlation between elastic parameters and collagen fibre features in breast lesions.

AIM: To correlate elastic parameters with collagen fibre shape and arrangement features in breast lesions. MATERIALS AND METHODS: Shear-wave elastography (SWE) was used to measure the stiffness of breast lesions in 54 patients before surgical removal. The value of stiffness was expressed as the mean and maximum elasticity (Emean and Emax). Lesions were sliced and stained with picric acid-sirius red to display the extracellular matrix (ECM) collagen fibre. The categories of the collagen fibres were based on the shape and arrangement features, i.e., category 0, wavy collagen fibres similar to normal breast tissue; category 1, taut parallel collagen fibres around tumour nests; category 2, straightened and aligned collagen fibres tending to be perpendicular to the tumour boundary; category 3, collagen fibre in a honeycomb arrangement. Bivariate correlation analysis was used to analyse the relationship between elastic parameters and collagen fibre category. RESULTS: For all 54 lesions, the correlation coefficient between Emean and category was 0.693 (p < 0.001), and between Emax and category was 0.794 (p < 0.001). For 36 malignant lesions, the correlation coefficient between Emean and category was 0.658 (p < 0.001), and between Emax and category was 0.771 (p < 0.001). CONCLUSION: Emean and Emax of breast lesions evaluated by SWE were positively correlated with ECM collagen fibre shape and arrangement category. Changes of ECM collagen fibre shape and arrangement may account for the stiffness variations of breast lesions.

[A case of schwannoma in cervical trachea].

Primary tracheal schwannoma is rare. It is easy to be misdiagnosed as bronchitis, asthma due to the lack of special symptom. Diagnosis of schwannoma depends on a comprehensive examination. Surgery is the only effective mean. Here we reported a 17-year-old male, who suffered from cough for 10 months. A variety of tests confirmed that he had schwannoma. There is no significant change after tumor resection via rigid bronchoscope since two years ago.

Phytoremediation of soils contaminated with phenanthrene and cadmium by growing willow (Salix × aureo-pendula CL 'j1011').

To assess the phytoremediation potential of an autochthonous willow (Salix × aureo-pendula CL 'J1011') for phenanthrene (PHE)-contaminated soils and PHE-cadmium (PHE-Cd) co-contaminated soils, we conducted field experiments in the lower reaches of the Yangtze River, China. Ethylenediaminetetraacetic acid (EDTA) and ethyl lactate were tested for individual and combined effects on the phytoremediation efficiency. For PHE-contaminated soils, willow plus ethyl lactate resulted in significant removal of PHE from soils after 45 days, and the PHE concentration in the shoots was significantly higher with than without ethyl lactate. For PHE-Cd co-contaminated soils, both willow plus EDTA and willow plus EDTA and ethyl lactate led to a significant decrease in the concentrations of PHE and Cd in the soils after 45 days, whereas willow alone did not. The PHE and Cd concentrations in the willow shoots were significantly enhanced in the presence of EDTA alone and with ethyl lactate, except for the PHE concentration in stems with EDTA alone. Under the same treatment, the presence of Cd had no significant influence on the PHE removal from soils. The results indicate the feasibility of using this willow together with both EDTA and ethyl lactate for the simultaneous removal of PHE and Cd from soils.

Evaluation of the effective dose of cone beam CT and multislice CT for temporomandibular joint examinations at optimized exposure levels.

OBJECTIVES: To compare the effective dose to patients from temporomandibular joint examinations using a dental CBCT device and a multislice CT (MSCT) device, both before and after dose optimization. METHODS: A Promax(®) 3D (Planmeca, Helsinki, Finland) dental CBCT and a LightSpeed VCT(®) (GE Healthcare, Little Chalfont, UK) multislice CT were used. Organ doses and effective doses were estimated from thermoluminescent dosemeters at 61 positions inside an anthropomorphic phantom at the exposure settings in clinical use. Optimized exposure protocols were obtained through an optimization study using a dry skull phantom, where four observers rated image quality taken at different exposure levels. The optimal exposure level was obtained when all included criteria were rated as acceptable or better by all observers. RESULTS: The effective dose from a bilateral examination was 184 µSv for Promax 3D and 113 µSv for LightSpeed VCT before optimization. Post optimization, the bilateral effective dose was 92 µSv for Promax 3D and 124 µSv for LightSpeed VCT. CONCLUSIONS: At optimized exposure levels, the effective dose from CBCT was comparable to MSCT.

Oxygen vacancy diffusion in bare ZnO nanowires.

Oxygen vacancies (VO) are known to be common native defects in zinc oxide (ZnO) and to play important roles in many applications. Based on density functional theory, we present a study for the migration of oxygen vacancies in ultra-thin ZnO nanowires (NWs). We find that under equilibrium growth conditions VO has a higher formation energy (Ef) inside the wire than that at shallow sites and surface sites, with different geometric relaxations and structural reconstructions. The migration of VO has lower barriers in the NW than in the bulk and is found to be energetically favorable in the direction from the bulk to the surface. These results imply a higher concentration of VO at surface sites and also a relative ease of diffusion in the NW structure. Our results support the previous experimental observations and are important for the development of ZnO-based devices in photocatalysis and optoelectronics.

The P450 enzyme Shade mediates the hydroxylation of ecdysone to 20-hydroxyecdysone in the Colorado potato beetle, Leptinotarsa decemlineata.

Ecdysone 20-monooxygenase (E20MO), a cytochrome P450 monooxygenase (CYP314A1), catalyses the conversion of ecdysone (E) to 20-hydroxyecdysone (20E). We report here the cloning and characterization of the Halloween gene Shade (Shd) encoding E20MO in the Colorado potato beetle, Leptinotarsa decemlineata. LdSHD has five conserved motifs typical of insect P450s, ie the Helix-C, Helix-I, Helix-K, PxxFxPE/DRF (PERF) and heme-binding motifs. LdShd was expressed in developing eggs, the first to fourth instars, wandering larvae, pupae and adults, with statistically significant fluctuations. Its mRNA was ubiquitously distributed in the head, thorax and abdomen. The recombinant LdSHD protein expressed in Spodoptera frugiperda 9 (Sf9) cells catalysed the conversion of E to 20E. Dietary introduction of double-stranded RNA (dsRNA) of LdShd into the second instar larvae successfully knocked down the LdShd expression level, decreased the mRNA level of the ecdysone receptor (LdEcR) gene, caused larval lethality, delayed development and affected pupation. Moreover, ingestion of LdShd-dsRNA by the fourth instars also down-regulated LdShd and LdEcR expression, reduced the 20E titre, and negatively influenced pupation. Introduction of 20E and a nonsteroidal ecdysteroid agonist halofenozide into the LdShd-dsRNA-ingested second instars, and of halofenozide into the LdShd-dsRNA-ingested fourth instars almost completely relieved the negative effects on larval performance. Thus, LdSHD functions to regulate metamorphotic processes by converting E to 20E in a coleopteran insect species Le. decemlineata.

Application of contrast-enhanced ultrasonography in the diagnosis of skeletal muscle crush injury in rabbits.

OBJECTIVE: To explore the diagnostic value of quantitative contrast-enhanced (CE) ultrasonography for crush injury in the hind limb muscles of rabbits. METHODS: A total of 120 New Zealand white rabbits were randomized to receive compression on the left hind limb for either 2 h (n = 56) or 4 h (n = 56) to induce muscle crush injury. Another eight animals were not injured and served as normal controls. CE ultrasonography parameters such as peak intensity (PI), ascending slop, descending slop and area under curve (AUC) were measured at 0.5, 2, 6 and 24 h and 3, 7 and 14 days after decompression. RESULTS: Compared with the uninjured muscles, reperfusion of the injured muscles showed early and high enhancement in CE ultrasonography images. The time-intensity curve showed a trend of rapid lift and gradual drop. The PI and AUC values differed significantly among the three groups and were positively correlated with serum and tissue biomarkers. Rabbits of the 4-h compression group showed significantly higher PI and AUC values, and serum and tissue parameters than the 2-h compression group at each time points. CONCLUSION: CE ultrasonography can effectively detect muscle crush injury and monitor dynamic changes of the injured muscles in rabbits. PI and AUC are promising diagnostic parameters for this disease. ADVANCES IN KNOWLEDGE: CE ultrasonography might play an important role in the pre-hospital and bedside settings for the diagnosis of muscle crush injury.

New insight into the spin-conserving excitation of the negatively charged nitrogen-vacancy center in diamond.

The negatively charged nitrogen-vacancy (N-V(-)) color center in diamond is an important solid-state single photon source for applications to quantum communication and distributed quantum computation. Its full usefulness relies on sufficient radiative emission of the optical photons which requires realizable control to enhance emission into the zero-phonon line (ZPL) but until now is still a challenge. Detailed understanding of the associated excitation process would be of essential importance for such objective. Here we report a theoretical work that probes the spin-conserving optical excitation of the N-V(-) center. Using density-functional-theory (DFT) calculations, we find that the ZPL and the phonon-side band (PSB) depend sensitively on the axial strain of the system. Besides, we find a relatively small PSB appearing at about 100 GPa in the emission spectrum at low temperatures, which provides a means to enhance the coherent emission of the N-V(-) center in quantum optical networks.

Risk prognosis factors of chronic subdural hematoma evacuated by the novel YL-1 hollow needle aspiration drainage system.

AIM: The novel YL-1 hollow needle aspiration drainage system is an effective minimally invasive treatment in chronic subdural hematoma (CSDH). In order to find the risk prognosis factors of chronic subdural hematoma (CSDH) performed by the novel YL-1 hollow needle aspiration drainage system, a logistic analysis of postoperative results was performed. METHODS: One hundred ninety-four cases of chronic subdural hematoma in a period of 7 years since 2004 were collected. According to the postoperative rehabilitation effect of nerve function, the patients were divided into good prognosis group and poor prognosis group. The patients' indexes of the two groups with age, blood coagulation function, location of the hematoma, hematoma volume, admission Markwalder's grade, clinical symptoms were tested by the chi-square test, then the statistically significant factors were selected into the establishment of the Logistic regression model and further analysis of multiple factors were made on chronic subdural hematoma prognostic implications. RESULTS: Retrospective analysis was performed for differentiating good prognosis group (N.=174) and poor prognosis group (N.=20). Univariate analysis after the chi-square test showed that there were significant differences in gender, age, coagulation function, hematoma position, hematoma size, initial Markwalder's neurological grade, clinical symptoms and signs. Logistic regression analysis showed that chronic subdural hematoma prognostic factors sorted by odds ratio were as follows: high Markwalder's grade, male, coagulopathy, bilateral hematoma, senior citizens. CONCLUSION: We used logistic regression analysis to identify the risk prognosis factors of chronic subdural hematoma (CSDH) performed by a novel YL-1 hollow needle aspiration drainage systems, and found that high preoperative Markwalder's gradie, male, coagulopathy, bilateral hematoma, senior citizens will poorly affect prognosis in CSDH.

Detection accuracy of condylar defects in cone beam CT images scanned with different resolutions and units.

OBJECTIVES: To assess the impact of spatial resolution and cone beam CT (CBCT) unit on CBCT images for the detection accuracy of condylar defects. METHODS: 42 temporomandibular joints were scanned, respectively, with the CBCT units ProMax® 3D (Planmeca Oy, Helsinki, Finland) and DCT PRO (Vatech, Co., Ltd., Yongin-Si, Republic of Korea) at normal and high resolutions. Seven dentists evaluated all the test images with respect to the presence or the absence of condylar defects. Receiver operating characteristic curve analysis was employed to define the detection accuracy. Two-way analysis of variance was used to analyse the values under the receiver operating characteristic curves for the differences among imaging groups and observers. Intraobserver variation was analysed using the Wilcoxon test. RESULTS: Macroscopic anatomy examination revealed that, of the 42 temporomandibular joint condylar surfaces, 18 were normal and 24 had defects on the surface of condyles. No significant differences were found between the images scanned with normal and high resolutions for both CBCT units ProMax 3D (p = 0.119) and DCT PRO (p = 0.740). Significant differences exist between image groups of DCT PRO and ProMax 3D (p < 0.05). Neither the inter- nor the intraobserver variability were significant. CONCLUSIONS: The spatial resolution per se did not have an impact on the detection accuracy of condylar defects. The detection accuracy of condylar defects highly depends on the CBCT unit used for examination.