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1.
Talanta ; 206: 120213, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31514887

RESUMO

Phthalate esters (PAEs) are an important kind of environmental endocrine disrupting chemicals, and have attracted great attention in environmental field. Present study described a new method for rapid and sensitive determination of PAEs including dibenzyl phthalate (DPhP), dibutyl phthalate (DnPP), and dicyclohexyl phthalate (DCHP) from aqueous matrices based on magnetic solid-phase extraction. Polyamidoamine (PAMAM) dendrimers-grafted magnetic-nanoparticles were synthesized and characterized, and the expected integration of more multifunctional sites of PAMAM dendrimers and rapid separation property was utilized for method development. To achieve the best extraction efficiency, several important parameters were optimized including the dosage of the adsorbent, sample pH, kind and volume of eluent, extraction time, desorption time, ionic strength. Under the optimal conditions, three phthalate esters were well enriched and simultaneously determined by high performance liquid chromatography with variable wavelength detector (VWD). Excellent linearities were observed in the range of 0.1-600 µg L-1 for DPhP and DnPP and 0.5-600 µg L-1 for DCHP, and all correlation coefficients (R2) were larger than 0.997. The limits of detection (LODs, S/N = 3) were ranged from 0.025 to 0.16 µg L-1. The spiked recoveries of PAEs in real water samples were in the range of 93.5-101.8% with satisfied relative standard deviations (RSDs) ranging from 0.9 to 4.1%. The prepared magnetic materials have shown good adsorption capability for PAEs and the developed method earned merits such as high sensitivity, simplicity, rapidness and environmental friendliness, which can be used as a robust alternative tool for monitoring PAEs in water samples.

2.
Ann Clin Lab Sci ; 49(4): 481-487, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31471337

RESUMO

BACKGROUND: Chemotherapy resistance reduces the effectiveness of chemotherapeutic drugs greatly, resulting in treatment failure. Therefore, exploring chemoresistance-related genes and the corresponding mechanism is extremely important. The central role of CD44v6 in colorectal cancer has been previously reported. However, the effects of CD44v6 gene knockdown on the chemosensitivity of colorectal cancer cells are not conclusive. MATERIAL AND METHODS: A stable CD44v6 knockdown cell model in HT29 cells (HT29-KD) was established via lentiviral transduction. A quantitative real-time polymerase chain reaction (PCR) was carried out to confirm the knockdown efficiency. The chemosensitivity of cells to 5-fluorouracil (5-FU) was determined by a cell counting kit (CCK)-8 assay. Cell apoptosis and the cell cycle were assessed by flow cytometry. RESULTS: The CD44v6 knockdown cell model was successfully constructed by using lentiviral transduction. Upon treatment with 5-FU, the inhibitory rate for cell activity of HT29-KD cells was significantly higher than that of the control group (HT29-NC). CD44v6 gene knockdown did not significantly affect HT-29 cell proliferation, according to the CCK-8 assay and cell cycle analysis. The cell apoptosis assay revealed that CD44v6 gene knockdown promoted HT-29 cell apoptosis. Without 5-FU treatment, there was no significant difference in terms of the relative expression level of the autophagy-related gene BECN1 between the two groups. However, with 5-FU treatment, the relative expression level of BECN1 in HT29-KD cells was much lower than that in HT29-NC cells. CONCLUSION: Our study confirms that CD44v6 gene knockdown can enhance chemosensitivity in HT29 cells by promoting apoptosis and inhibiting autophagy, thus affirming the effects of CD44v6 on the chemosensitivity of colorectal cancer.

3.
Soft Robot ; 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31483202

RESUMO

Soft pneumatic actuators (SPAs) have existed for many years as one of the mainstream actuators. Along with the rise of soft robotics, the development in SPA designs in recent years was especially rapid and diverse. Particularly with innovations in SPA fabrication, there is an increasing variety of SPAs with different air chamber designs, varied scales, and distinctive motion modalities. Collectively, it can be seen that the majority of the SPAs come in the format of a finger-like one-dimensional actuator. To expand the SPA spectrum, this article gives a detailed and thorough introduction of a new class of SPA, called soft robotic pad (SRP). SRP is a silicone-based two-dimensional (2D) pad-like actuator that can be programmed to do a multiplicity of surface morphing without any change in thickness. We have previously reported a novel fabrication technique for SRP. However, it also came with a major issue-premature failure. Therefore, in this article, we present significant improvements in the fabrication that substantially strengthen the SRPs so that they can withstand higher pressure for future applications. In addition, shape and force modeling are also provided to predict the corresponding outputs upon different pressures. Motion tracking using Vicon system is proposed for the characterization of the 2D surface morphing. As a pioneering step, we also propose one SRP application, a soft wearable assistive pad for elbow flexion, to demonstrate its capabilities. As a new and unique member in the SPA family, SRP brings new dimension and more motion varieties to SPAs, a substantial boost to the application scope for SPAs and soft robots.

4.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 275-281, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496159

RESUMO

OBJECTIVE: To investigate the clinical features and implication of restless legs syndrome (RLS) in ischemic stroke patients. METHODS: A total of 199 ischemic stroke patients were enrolled and assessed by polysomnography (PSG). RLS was identified according to criteria of International Restless Legs Syndrome Study Group. Epworth Sleepiness Scale (ESS), Mini-mental State Examination (MMSE) and Patient Health Questionnaire (PHQ-9) were used to evaluate the sleep quality, cognitive function and post-stroke depression, respectively. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the neurological function 3 months after stroke onset. Gender-and age-matched non-ischemic stroke patients with RLS (primary PLS) were selected as controls. RESULTS: Twenty-two cases of RLS were identified among 199 ischemic stroke patients (11.1%). Generalized linear model and logistic regression showed that low serum ferritin level (ß=-133.3 mg/L, 95%CI:-200.4--0.1, P<0.01), subcortical infarction (OR=4.05, 95%CI:1.15-14.18, P<0.05) and female (OR=2.54, 95%CI:1.04-6.23, P<0.05) were identified as the risk factors of RLS in ischemic stroke patients. Compared with ischemic stroke patients without RLS, ESS increased by 4.37 (95%CI:2.33-6.41, P<0.01), PHQ-9 increased by 2.17 (95%CI:0.39--3.94, P<0.05), and reduced NIHSS from the baseline deceased by 0.97 (95%CI:-1.79--0.15, P<0.05) in ischemic stroke patients with RLS. In addition, the incidence of moderate-severe depression increased (OR=4.27, 95%CI:1.40-13.10, P<0.05) in ischemic stroke patients with RLS. The index of periodic leg movements of sleep (PLMS) with arousal in ischemic stroke patients with RLS was significantly higher than that in patients with primary RLS (ß=12.85, 95%CI:2.04-23.67, P<0.05). CONCLUSIONS: RLS is common in ischemic stroke patients and has adverse influences on patients.


Assuntos
Isquemia Encefálica , Síndrome das Pernas Inquietas , Acidente Vascular Cerebral , Isquemia Encefálica/complicações , Isquemia Encefálica/patologia , Depressão/complicações , Feminino , Humanos , Masculino , Polissonografia , Síndrome das Pernas Inquietas/complicações , Síndrome das Pernas Inquietas/patologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/patologia
5.
Chemosphere ; 239: 124715, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31499311

RESUMO

Electrodeposition is an economical and efficient way to prepare Ti/SnO2-Sb electrode for electrochemical oxidizing pollutants in wastewater. The solvent used for electrodeposition has a great effect on electrode performance. The conventional Ti/SnO2-Sb electrode electrodeposited using aqueous solvent has poor electrochemical activity and short service life. In this study, a Ti/SnO2-Sb electrode was prepared via electrodeposition using a deep eutectic solvent (DES). This new Ti/SnO2-Sb-DES electrode performed a rate constant of 0.571 h-1 for methylene blue decolorization and long accelerated service life of 12.9 h (100 mA cm-2; 0.5 M H2SO4), which were 1.7 times and 3.2 times as high as that of the electrode prepared in aqueous solvent, respectively. The enhanced properties were related to the 1.3 times increased electrochemically active surface area of Ti/SnO2-Sb-DES electrode which had a rough, multilayer and uniform surface structure packed with nano-sized coating particles. In conclusion, this study developed a facile, green and efficient pathway to prepare Ti/SnO2-Sb electrode with high performance.

7.
Mater Sci Eng C Mater Biol Appl ; 104: 109842, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31500042

RESUMO

Hydroxyapatite (HA) ceramics are well known for their biocompatibility, bioactivity, and osteoconductive nature. However, limited hierarchical structure and lack of ease in modularity hinder the widespread application of conventional HA ceramics. By using three-dimensional printing (3DP) techniques with multiple materials, including HA, complex biological and mechanical architecture of natural organisms can be achieved through biomimetics. In this study, we designed an osteoid, biomimetic, hierarchical, porous HA ceramic 3D printed scaffold (3DPs). Further incorporation of a covalent, modular, controlled release system (CMR), based on Watson-Crick's complementary oligonucleotides, and was added to carry a bone morphogenetic protein-2 (BMP2) peptide. The choice of a HA biomimetic scaffold housing BMP2 protein fragments was selected to successfully promote osteogenesis both in vitro and in vivo. Scanning electron microscopy, micro-computed tomography analysis and computer fluid dynamics simulations of the 3DPs showed a uniform biomimetic hierarchical structure and an effective interior permeability. Active molecules were found bound with high stability and modular to the scaffold surface via the CMR system. After 7 days of incubation under physiological conditions, approximately 90% of active factors remained bound. Compared to control groups, the 3DPs-CMR-BMP2 group significantly enhanced cell proliferation and adhesion. Moreover, the 3DPs-CMR-BMP2 group exhibited more extensive and sustained osteogenic effects through upregulated expression of osteogenic factors and enhanced calcium deposition, as compared to study and control groups. Furthermore, ectopic osteogenesis and a critical calvarial defect model confirmed that the 3DPs-CMR-BMP2 group significantly promoted in vivo bone healing versus control. Thus, our results showed that biomimetic hierarchical 3DPs with a CMR system successfully promote cell proliferation, adhesion, differentiation and osteogenesis, on a continuous cycle. The biomimetic hierarchical 3DPs with a CMR system offers a promising multi-functional, bone substitute material for treatment of patients with bone defects.

8.
Mater Sci Eng C Mater Biol Appl ; 104: 109944, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31500058

RESUMO

Anti-relapse therapy after surgery plays a critical role in cancer therapy. New strategies maximizing the delivery of drugs to tumor cells while reducing toxic side effects on normal tissues and organs are still urgently required. In order to solve the problems of the poor delivery and inadequate distribution of cytotoxic chemotherapeutic drugs in the clinical application, an ultrasound-controllable and implantable release-system that utilized waterborne polyurethane (WPU) and chitosan (CS) composite membrane as drug carrier with wide flexible loading capacity for doxorubicin (DOX) was described in present work. Benefiting from the hydrophilic segment in WPU and bioactivity of amino groups on side chains of CS, the resulting composite films exhibited fine biodegradability, favorable cytocompatibility and excellent blood compatibility. The in vitro release studies illustrated that the drug-loading membranes displayed a well sustained release effect manifested in slow release, stability and no sudden release, and the DOX was able to release in an ultrasound-controlled manner. Cellular uptake assay and CCK 8 assay showed that the DOX can be released efficiently from the drug-loading matrix and taken up by tumor cells. As a means of adjuvant local treatment, this work provided a facile approach to the design of ultrasound-regulated membrane matrix that is highly beneficial not only due to the higher and long-term therapeutic efficiency, and improvement of utilization efficiency of chemotherapeutic drugs but also the low toxicity to normal cells.

9.
BMJ Open ; 9(9): e023162, 2019 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-31501092

RESUMO

INTRODUCTION: Starting dialysis early or late both result in a low quality of life and a poor prognosis in patients undergoing haemodialysis. However, there remains no consensus on the optimal timing of dialysis initiation, mainly because of a lack of suitable methods to assess variations in dialysis initiation time. We have established a novel equation named DIFE (Dialysis Initiation based on Fuzzy-mathematics Equation) through a retrospective, multicentre clinical cohort study in China to determine the most suitable timing of dialysis initiation. The predictors of the DIFE include nine biochemical markers and clinical variables that together influence dialysis initiation. To externally validate the clinical accuracy of DIFE, we designed the assessment of DIFE (ADIFE) study as a prospective, open-label, multicentre, randomised controlled trial to assess the clinical outcomes among patients who initiate dialysis in an optimal start dialysis group and a late-start dialysis group, based on DIFE. METHODS AND ANALYSIS: A total of 388 enrolled patients with end-stage renal disease will be randomised 1:1 to the optimal start dialysis group, with a DIFE value between 30 and 35, or the late-start dialysis group, with a DIFE value less than 30, using the Randomization and Trial Supply Management system. Participants will be assessed for changes in signs and symptoms, dialysis mode and parameters, biochemical and inflammatory markers, Subjective Global Assessment, Kidney Disease Quality of Life Short Form, Cognitive Assessment, medical costs, adverse events and concomitant medication at baseline, predialysis visiting stage and postdialysis visiting stage, every 12-24 weeks. The following data will be recorded on standardised online electronic case report forms. The primary endpoint is 3-year all-cause mortality. The secondary endpoints include non-fatal cerebrocardiovascular events, annual hospitalisation rate, quality of life, medical costs and haemodialysis related complications. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Ethics Committee of the First Affiliated Hospital of Dalian Medical University China (registration no: YJ-KY-2017-119) and the ethics committees of all participating centres. The final results of the ADIFE trial will be presented to the study sponsor, clinical researchers and the patient and public involvement reference group. Findings will be disseminated through peer-reviewed journals, Clinical Practice Guidelines and at scientific meetings. TRIAL REGISTRATION NUMBER: ClinicalTrial.gov. Registry (NCT03385902); pre-results.

10.
Nat Commun ; 10(1): 3543, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391469

RESUMO

As soluble catalysts, redox mediators can reduce the high charging overpotential of lithium-oxygen batteries by providing sufficient liquid-solid interface for lithium peroxide decomposition. However, the redox mediators usually introduce undesirable reactions. In particular, the so-called "shuttle effect" leads to the loss of both the redox mediators and electrical energy efficiency. In this study, an organic compound, triethylsulfonium iodide, is found to act bifunctionally as both a redox mediator and a solid electrolyte interphase-forming agent for lithium-oxygen batteries. During charging, the organic iodide exhibits comparable lithium peroxide-oxidizing capability with inorganic iodides. Meanwhile, it in situ generates an interfacial layer on lithium anode via reductive ethyl detaching and the subsequent oxidation. This layer prevents the lithium anode from reacting with the redox mediators and allows efficient lithium-ion transfer leading to dendrite-free lithium anode. Significantly improved cycling performance has been achieved by the bifunctional organic iodide redox mediator.

11.
J Cell Biochem ; 2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31452245

RESUMO

Increasing evidence demonstrates the crucial regulatory functions of circular RNAs in different cancer types. The major aim of the current study was to establish functions of circPIP5K1A during ovarian cancer. Our results showed an increased expression of circPIP5K1A in both ovarian cancers and cell lines, which was associated with poor prognosis. In functional analyses, downregulation of circPIP5K1A suppressed ovarian cancer cell migration, proliferation, and invasion in vitro. The miR-661 was indicated as a target of circPIP5K1A and insulin-like growth factor-binding protein 5 (IGFBP5) as a target of miR-661. circPIP5K1A silencing triggered downregulation of IGFBP5 through inducing an increase in miR-66 levels, as determined by the luciferase reporter assay. Data from cell counting kit-8, colony formation, wound healing, and Transwell assays showed that overexpression of IGFBP5 effectively reversed the circPIP5K1A depletion effects. The results collectively indicated that circPIP5K1A contributed to ovarian cancer progression via targeting the miR-661/IGFBP5 axis, supporting its utility as a candidate target for therapy of the disease.

12.
Artigo em Inglês | MEDLINE | ID: mdl-31453762

RESUMO

Background: To date, there have been few investigations on Candidatus Rickettsia tarasevichiae in rodents carried out in China. In this study, we conducted surveillance for Candidatus R. tarasevichiae infection in rodents. A total of 463 rodents were captured at five survey sites in Mudanjiang, Heilongjiang province, where Candidatus R. tarasevichiae patients have been reported. PCR targeting citrate synthase and outer membrane protein genes was performed and positive amplicons were sequenced. Result: Candidatus R. tarasevichiae was detected in 1.29% of the 463 rodents sampled from the five survey sites in Mudanjiang, Heilongjiang province. Only 2 out of 13 (15.38%) Rattus norvegicus and 4 out of 80 (5%) Clethrionomys rufocanus collected from Dashigou forestry were positive for the gltA and ompA genes of Candidatus R. tarasevichiae DNA. The detected Candidatus R. tarasevichiae was in the same clade of sequences from patients in Mudanjiang based on phylogenetic analysis. Conclusion: Rodents are major host of ticks and also serve as reservoirs of spotted fever group (SFG) Rickettsia. Although this is the first confirmation of Candidatus R. tarasevichiae detected in rodents in China, further investigations are needed to clarify the distribution of Candidatus R. tarasevichiae in rodents elsewhere and what role they play as reservoirs.

13.
Anal Chem ; 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31423770

RESUMO

Sulfur dioxide (SO2) plays significant roles in regulating cell apotosis and inflammation. However, there are complex interactions between small biomolecules in cells, and the identification of these coexisting biomarkers remains a challenge. Herein, we report an AND logic gate based fluorescent probe (NY-Lyso), operating by responding to pH differences between organelles in cell and selectively reacting with bisulfite (HSO3-). This approach allows the fluorescence of the probe to remain silent under neutral or alkaline conditions, notably, is activated by costimulation of lower pH and bisulfite. Furthermore, it was confirmed to be biocompatible and could be employed to monitor HSO3- in lysosomes of living cells. The proposed method demonstrated more practical and outstanding capabilities in targeted and real-time monitoring, providing an effective optical tool for biomarker sensing.

14.
Biomed Res Int ; 2019: 4693528, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428636

RESUMO

Background: Keloids are hard nodules or plaques formed by excessive proliferation of connective tissue. Radiotherapy, widely used in various benign and malignant skin diseases, is an effective treatment for keloids. This work evaluates Intrabeam photon radiotherapy in the management of keloids. Methods: Fourteen patients who have undergone Intrabeam radiotherapy for a total of 15 sites of keloids were followed up. Twelve cases were first onset and the other two had recurrent diseases. Thirteen patients underwent surgical resection of keloids before radiotherapy. One relapsing patient received only 2 rounds of radiation therapy as she could not be reoperated. Radiotherapy was divided into 2 sessions on days 0 and 3 after surgery. The dose was 4 or 5 Gy each time for 3 min 14 s to 12 min 1 s. In addition, we compared our data to the recurrence of keloids in fourteen patients who had previously been exposed to electron beam using conventional accelerators. Results: We analyzed the treatment for adverse reactions and recurrence. In the Intrabeam group, one patient developed superficial skin ulcers a month after treatment. No one experienced wound rupture, bleeding, infection, skin contractures, or obvious hyperpigmentation. None of the fourteen cases showed any recurrence so far after on median 22.5 months of follow-up. Five patients in the electron beam group relapsed 3 to 10 months after treatment. Conclusion: Here, Intrabeam photon radiotherapy was shown to be an effective treatment for keloid scars and it is therefore recommended for management of this disease.

15.
Chem Commun (Camb) ; 55(68): 10088-10091, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31380863

RESUMO

Trace ethanol is applied as a cheap and effective electrolyte additive for reducing the activation voltage of Li2S cathodes in lithium-ion-sulfur batteries. Because Li2S can dissolve in ethanol, the solid-solid phase reaction in the first stage of the activation process converts into a liquid-solid phase reaction, which expedites the transport of electrons and lithium ions and reduces the activation voltage of Li2S. This strategy can be extended to other solvents that can dissolve Li2S.

16.
J Coll Physicians Surg Pak ; 29(9): 900-901, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31455493

RESUMO

The aim of this study was to compare the levels of erythropoietin (Epo), semaphorins 3A (Sema 3A) and pigment epithelium derived factors (PEDF) in serum and aqueous humor of those with neovascular glaucoma (NVG) and patients with cataract. It was an experimental study carried out from January 2016 to September 2018. Seventy-three NVG patients were selected as NVG group, and 73 cataract patients were selected as cataract group. The levels of Epo and sema 3A in serum and aqueous humor in NVG group were higher than those in cataract group (both p <0.001), and the level of PEDF in serum and aqueous humor in NVG group were lower than those in cataract group (p <0.001). Compared with cataract patients, NVG patients had higher levels of Epo and sema 3A in serum and aqueous humor and lower levels of PEDF.

17.
Int J Biol Macromol ; 140: 858-870, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31446105

RESUMO

One purified fraction from crude Fuzhuan brick tea polysaccharides (FBTPS), FBTPS-3, was obtained through column chromatography of DEAE Sepharose Fast Flow. The chemical properties and probiotic effects of FBTPS-3 were evaluated by fermentation in vitro. Moreover, the effects of FBTPS-3 on the function and metabolic pathway of gut microbiota were investigated by metagenomic sequencing. The results showed that FBTPS-3 was an heteropolysaccharide with molecular weight of 741 kDa, which was mainly composed of Man, Rha, GalA, Gal and Ara in molar ratio of 8.7:15.5:42.2:19.7:13.9. The contents of carbohydrates and uronic acid in FBTPS-3 were 44.78 ±â€¯2.85% and 40.4 ±â€¯2.11%, respectively. After fermentation, the molecular weight of FBTPS-3 and content of carbohydrates were significantly decreased, indicating that FBTPS-3 could be utilized by gut microbiota. Furthermore, the relative abundances of Bacteroides, Megasphaera and Prevotella were significantly increased by FBTPS-3. FBTPS-3 also significantly promoted the production of acetic, propionic and n-butyric acids. Based on the metagenomic sequencing, it was found that FBTPS-3 significantly enriched the metabolic pathway of starch and sucrose. All the results suggest that FBTPS-3 is expected to be developed as functional ingredients or foods to improve the host health through regulating the gut microbiota and physiological metabolic functions.

18.
Opt Lett ; 44(17): 4391-4394, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31465409

RESUMO

We present a detection method based on optical parametric amplification to amplify and detect near-infrared (NIR) optical imaging signals. A periodically poled lithium niobate crystal is employed as an optical parametric amplifier (OPA), which provides excellent quasi-phase-matching conditions for the optical parametric amplification process. A weak reflectance imaging signal at 1465 nm is amplified by the OPA with a high gain of up to 92 dB, and the amplified optical signal is detected with a low-cost photodetector under ambient light conditions. Such a high gain leads to a detection limit of 23 pW under a 5 MHz detection bandwidth, which is remarkably lower than the theoretical value of a NIR photomultiplier tube (PMT). By exploiting the advantages of the OPA, the incident power needed for microscopy or imaging is reduced by 40-60 dB. The high imaging gain of the OPA also significantly enhances the imaging penetration depth by selectively detecting the weak signal reflected from deep tissue structures. The successful implementation of the OPA enables a robust and sensitive detection method that offers the potential to replace PMTs in imaging applications within the NIR spectral range.

19.
Oral Oncol ; 97: 69-75, 2019 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-31430641

RESUMO

OBJECTIVES: We evaluated the accuracy of computer-assisted mandibular reconstructions. PATIENTS AND METHODS: We retrospectively reviewed data for 26 patients who had mandibular reconstruction with a microvascular free fibula flap, January 2015 to June 2018. Postoperative mandible models were obtained from computed tomography scans. After registering the models to the corresponding preoperative plan, we performed comparative measurements. Patients were grouped by condylar involvement and subdivided based on number of fibular segments used for reconstruction. For each segment, we measured length and osteotomy angles. For the final postoperative outcome, we compared intercoronoid, intergonial, and anteroposterior distances and intersegmental plane shift. RESULTS: Means (SD) for deviation of each osteotomy angle and fibular segment length were 1.98° (2.98) and 1.78 mm (2.69), respectively, remaining constant across subgroups. Other mean values were as follows: intercoronoid distance deviation, 3.86 mm (range, 0.20-11.21 mm); intergonial distance deviation, 3.14 mm (range, 0.05-8.28 mm); anteroposterior distance deviation, 2.92 mm (range, 0.03-8.49 mm); and intersegmental plane shift, 11.00° (range, 2.76-24.15°). Where the condyle was preserved, the intercoronoid and intergonial deviation means differed significantly (respectively 5.02 mm and 4.88 mm, both P < 0.05) for one-segmented and three-segmented fibular reconstructions. Furthermore, reconstructions involving the condylar region compared with condyle preservation showed significantly different intersegmental plane shifts (7.18°; P < 0.05). CONCLUSION: Computer-assisted surgery provides cutting guides for obtaining accurate fibular segments, but current fixation methods lead to inaccuracies and reproducibility errors. In multisegmental transfer with condylar involvement, computer-assisted fixation is recommended to ensure accuracy of the preoperative plan.

20.
Medicine (Baltimore) ; 98(34): e16923, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441877

RESUMO

RATIONALE: There are already several reports concerning the occurrence of urethral diverticulum (UD) in female patients, but only rarely has a article describing UD combined with UD calculi or squamous carcinoma been published. Moreover, a case with squamous carcinoma and UD calculi at the same time has never been reported, making this the first case report about this condition. PATIENT CONCERNS: A 43-year-old woman presented to the gynaecology department with a complaint of a hard mass beneath the anterior vaginal wall. DIAGNOSES: Transvaginal ultrasound (TVU) revealed a UD. INTERVENTIONS: We performed a standard urethral diverticular excision. Intraoperatively, we identified and removed a stone from the diverticulum. The intraoperative finding of a stone challenged the diagnosis of UD, with subsequent histological examination of biopsy tissue from the mass demonstrating broadly squamous metaplasia. OUTCOMES: The broadly squamous metaplasia predominantly originated from the stone, and the stone was entirely removed. No complications occurred during the whole follow-up period. Moreover, after the 12-month follow-up, there was no diverticular recurrence or carcinoma metastasis. LESSONS: UD calculi may be considered a risk factor for female urethra squamous metaplasia, which with the potential of squamous carcinoma, so patients will be advised to treat this condition immediately.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Neoplasias Uretrais/diagnóstico , Adulto , Biópsia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Divertículo/complicações , Divertículo/diagnóstico por imagem , Divertículo/cirurgia , Feminino , Humanos , Imagem por Ressonância Magnética , Metaplasia , Neoplasias Uretrais/complicações , Neoplasias Uretrais/patologia , Neoplasias Uretrais/cirurgia , Cálculos Urinários/complicações , Cálculos Urinários/diagnóstico por imagem , Cálculos Urinários/cirurgia
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