Biomechanical effects of a mandibular advancement device on the periodontal ligament: Based on different bone models.

Obstructive sleep apnea syndrome (OSAS) is recurrent apnoea caused by upper airway obstruction during sleep. In severe cases, OSAS might lead to sudden death. Currently, the mandibular advancement device (MAD) is the preferred product for the treatment of mild to moderate OSAS because of its compliance, portability and low cost. However, many clinical studies have suggested that long-term use of MAD might cause occlusal changes, periodontitis, muscle soreness, and joint damage. In view of the difficulties in the measurement of relevant mechanical factors in vivo, the present work aimed to quantitatively analyze biomechanical mechanisms that might lead to these side effects through computer numerical simulations and a nonhomogeneous alveolar bone model was established to approximate the actual bony features of the jaw in the simulations model. First, a 3D digital model of the teeth, periodontal ligament(PDL), and alveolar bone was created on the basis of computed tomography images and assembled with a 3D model of the MAD. A nonhomogeneous alveolar bone model was created based on computed tomographic images, and the stresses acting on the PDL were computed using the finite element method. The results showed that the nonhomogeneous model could more realistically reflect the mechanical properties of the alveolar bone and obtain the true stresses compared with the homogeneous model, which underestimated the adverse effects of PDL therapy. The numerical simulations in this paper can help doctors make more accurate judgements about MAD treatment from an oral health protection perspective.

Effect of puerarin injection on antioxidant capacity of patients with viral myocarditis / 中华实验和临床病毒学杂志

Objective@#To study the effect of puerarin injection on the antioxidant capacity of patients with viral myocarditis (VMC).@*Methods@#Seventy-four patients with VMC who were admitted during the period from January 2014 to March 2017 were randomly divided into the observation group and the control group, 37 cases in each group. The control group was given routine treatment, and on this basis, the observation group was additionally treated with intravenous infusion of puerarin injection. The curative effect and safety were evaluated after 14 days of intervention. Myocardial enzymes [creatine kinase isoenzyme (CK-MB), troponin T (cTnT)], inflammation [high-sensitivity C-reactive protein (hs-CRP), interleukin-35 (IL-35)] and antioxidant indexes [total antioxidant capacity (T-AOC), superoxide dismutase (SOD), reduced glutathione (GSH)] were determined before and after treatment.@*Results@#The total treatment response rate of the observation group was significantly higher than that of the control group (94.59% vs 72.97%) (χ2=6.366, P=0.012). The levels of serum CK-MB, cTnT and hs-CRP in the observation group were significantly lower than those in the control group after treatment (t=8.279, 21.907, 9.703, all P=0.000), while levels of IL-35, T-AOC, SOD and GSH were significantly higher than those in the control group (t=10.194, 11.128, 15.539, 11.390, all P=0.000). There were 2 cases of mild fever in the observation group and 1 case of transient abdominal distension.@*Conclusions@#Puerarin injection is safe and effective in the treatment of VMC. It can significantly inhibit inflammation and improve the antioxidant capacity.

Value of pelvic floor ultrasound in the perioperative evaluation of transvaginal modified patch repair and sacrospinous ligament fixation / 中华医学超声杂志（电子版）

Objective To investigate the value of evaluation of pelvic floor ultrasound in the transvaginal modified patch repair and sacrospinous ligament fixation in uterine prolapse patients. Methods Thirty-two patients with uterine prolapse were included in the retrospective study from March 2016 to January 2017 in Hangzhou maternity and child health care hospital. All patients were detected by pelvic floor ultrasound before operation and cured by vaginal patch bilateral sacral spine ligament fixation treatment after. Of them, 8 cases were complicated with cystocele and 3 cases with anorectal prolapse, and all the complications were treated at the same time. The observations of the change of position, shape and activity of the implant by transvaginal at rest, on maxium Valsalva and contraction, and the transperineal pelvic ultrasound were performed to evaluate the change of pelvic floor function and compare the distance from the lowest point of the bladder, uterus and the rectal ampulla to reference line (the horizontal line at the lower margin of the pubic bone), area of levator hiatus and the thickness of the puborectalis muscle before and after operation. Results The patches were observed 2D and 3D postoperatively by pelvic ultrasound. The U-shaped hyperecho could be clearly shown around the cervix and activity of patches were clearly shown. The observation of 32 cases of patients with pelvic viscera situation by the transperineal 2D and 4D pelvic ultrasound: the distance from the lowest point of the bladder, uterus and the rectal ampulla to reference line and the thickness of the puborectalis muscle enlarged after operation (0.65±1.85 vs 0.15±1.85, 2.80±1.10 vs -1.00±1.50, 0.60±1.90 vs-0.55±1.55,0.51±0.24 vs 0.37±0.19)onmaxium valsalva,the area of levator hiatus decreased after operation (20.15±7.20 vs 29.00±9.50).The differences were both statistically significant (all P < 0.05). Uterine prolapse were not found after operation. In the 8 cases with cystocele, 5 cases were cured and 3 cases were improved. And all the 3 cases of patients with anorectal prolapse were all cured. Conclusion Combined application of transvaginal and transperineal pelvic ultrasound can clearly show the suspension of the patch after the treatment of modified patch repair and Sacrospinous ligament fixation, which provide valuable imaging information in the evaluation of preoperative pelvic functionand postoperative therapeutic effect.

Research progress concerning the sinus tarsal approach for treatment of calcaneal fractures / 中华创伤骨科杂志

Treatment of calcaneal fractures has always been the focus of many clinical researchers.The goals of traditional surgical treatment are not only to restore the integrity of calcaneal articular surface but also to reconstruct the anatomy of the calcaneus.More importantly,we need to reduce postoperative soft tissue swelling and incidence of postoperative complications.In recent years,scholars have reported satisfactory clinical efficacy and prognosis resulting from a sinus tarsal approach for treatment of calcaneal fractures.This paper reviews the latest research progress concerning the sinus tarsal approach for treatment of calcaneal fractures at home and abroad,intending to provide helpful information for the clinical surgeons.

Treatment research and new progress of early-onset scoliosis / 中国组织工程研究

BACKGROUND:Early-onset scoliosis is a kind of disease that seriously affects the growth of children’s spine and development of cardiorespiratory function. The treatment of the disease has always been the focus of many clinical researchers.OBJECTIVE:To analyze the therapy for early-onset scoliosis and explore the spinal fusion, spinal non-fusion, conventional growth rod technology and magnetic control ed growth rod technology of early-onset scoliosis. METHODS:We retrieved PubMed, CENTRAL, EMbase, the ISI Web of Knowledge Databases, VIP, CNKI, CBM and Wanfang Database for related studies published from inception of the database to March 2016. The key words were“scoliosis, growing rod, complications”. The included 54 studies were analyzed and discussed. RESULTS AND CONCLUSION:For these children of early-onset scoliosis, we should not only maintain the correction of spine deformities, but also protect the ability of spine growth, keeping the normal cardiopulmonary function. In addition to conventional (non-surgical) treatment, there are surgical treatment (such as spinal fusion and growing rod technique) and magnetical y control ed growing rod, a new technology for the treatment of early-onset scoliosis. A comprehensive understanding of the effect of surgical treatment on the spine growth and cardiopulmonary function of children with early-onset scoliosis wil help to prevent the occurrence of related complications, so as to obtain a better therapeutic effect.

Techniques of transperitoneal laparoscopic nephron -sparing surgery for renal tumors / 中华泌尿外科杂志

Objective To report on our experience with laparoscopic nephron-sparing surgery forthe treatment of renal tumors,and to seek the safe and effective techniques and methods. Methods FromJune 2003 to June 2005,16 patients (5 men and 11 women) with small exophytic solid renal masses weretreated by transperitoneal laparoscopic wedge resection in our hospital.The mean age was 46 years (range,29 -56 years).The mean tumor size of renal cell carcinoma (5 cases) and hamartoma (11 cases) was2.0 -3.5 cm and 3.0 -5.5 cm,respectively, in diameter. One case of hamartoma had secondary bleeding.Wedge resection of the tumors was performed quickly with scissor,and hemostasis was achieved by intra-ab-domen suturing and knotting. Results All the procedures were finished laparoscopically with no conver-sion to open surgery.The mean operative time was 104 min (range,70 -150 min);mean hot bloodless timewas 21 min(range,14 -32 min);mean blood loss was 158 ml (range,50 -700 ml).The pathologic exami-nation showed negative surgical margin in 5 cases of renal cell carcinoma.Postoperatively,no urinary leakageand secondary bleeding occurred,and the renal function was normal in all the 16 cases.The patients weredischarged 7 d after operation.Follow-up was 1 month to 1 year.Neither distant nor local recurrences wereobserved by the last follow-up date on B-ultrasound,IVUand CTat follow-up. Conclusions Laparoscopicnephron-sparing surgery for renal tumors is a minimally invasive procedure with less blood loss,less pain andfewer complications.Reliable non-traumatic kidney vessel control is the basic method of this operation.Sharpresection without smog and rapid renal incision suturing can reduce the renal hot bloodless time.