Unusual hard metal lung disease: bronchiolocentric interstitial pneumonia.

A 38-year-old woman experienced a persistent dry cough and progressively worsening dyspnoea for 2 years. Spirometry testing revealed a moderate-to-severe restrictive abnormality. High-resolution chest computed tomography showed diffuse reticulonodular opacities. A lung biopsy disclosed alveolar parenchymal inflammation and fibrosis with bronchiolocentric features, prompting consideration of interstitial pneumonia. Following a thorough investigation of her occupational history and an on-site inspection, it was discovered that the patient had been grinding drill bits designed for printed circuit boards for 8 years, exposing her to hard metals. Mineralogical analyses confirmed excessive tungsten in urine, serum and hair, leading to a diagnosis of hard metal lung disease due to tungsten carbide-cobalt exposure. After discontinuing exposure and commencing corticosteroid therapy, her symptoms, pulmonary function and imaging showed modest improvement. This case highlights the significance of assessing occupational history in patients with interstitial pneumonia and understanding industrial hazards for accurate diagnosis and care.

Five in one therapy for graded treatment of haemophilic arthritis.

INTRODUCTION: Haemophilic arthritis is the most universal clinical appearance of haemophilia. Treatment of this disease has become an important and difficult issue worldwide until recently. OBJECTIVE: To investigate the efficacy and safety of five in one therapy for graded treatment of haemophilic arthritis. METHODS: Haemophilic arthritis was classified into grades I-IV according to severity and the standards of De Palma and Cotler. Under no application of FVIII/FIX replacement therapy state, the effect of five in one therapy (intra-articular cavity drug injection, oral drug preparation, physiotherapy, and prevention of haemorrhage and infection evoked by puncture) was observed in 1527 affected joints of 750 cases of haemophilic arthritis. RESULTS: After 20 days treatment, all grade I and II, 94.98% of grade III and 56.16% of grade IV affected joints were completely relieved; 5.02% of grade III and 41.47% of grade IV affected joints were basically relieved; and 2.38% of grade IV were partially relieved. This resulted in short-term complete and basic relief of 98.56% (1505/1527) of all affected joints. After follow-up of 1-6 years, 86.97% of the affected joints were completely relieved, without any adverse reaction or complication. CONCLUSION: The results suggest that five in one therapy is safe and effective for treatment of haemophilic arthritis, and provides a convenient, cost-effective way of preventing and treating deformity caused by haemophilic arthritis.

Novel remodeling of the mouse heart mitochondrial proteome in response to acute insulin stimulation.

BACKGROUND AND AIM: Mitochondrial dysfunction contributes to the pathophysiology of diabetic cardiomyopathy. The aim of this study was to investigate the acute changes in the mitochondrial proteome in response to insulin stimulation. METHODS AND RESULTS: Cardiac mitochondria from C57BL/6 mice after insulin stimulation were analyzed using two-dimensional fluorescence difference gel electrophoresis. MALDI-TOF MS/MS was utilized to identify differences. Two enzymes involved in metabolism and four structural proteins were identified. Succinyl-CoA ligase [ADP forming] subunit beta was identified as one of the differentially regulated proteins. Upon insulin stimulation, a relatively more acidic isoform of this protein was increased by 53% and its functional activity was decreased by ∼32%. CONCLUSIONS: This proteomic remodeling in response to insulin stimulation may play an important role in the normal and diabetic heart.

Tumor-associated antigen/IL-21-transduced dendritic cell vaccines enhance immunity and inhibit immunosuppressive cells in metastatic melanoma.

Dendritic cell (DC)-based vaccine approaches are being actively evaluated for developing immunotherapeutic agents against cancers. In this study, we investigated the use of engineered DCs expressing transgenic tumor-associated antigen hgp100 and the regulatory cytokine interleukin-21, namely DC-hgp100/mIL-21, as a therapeutic vaccine against melanoma. Tumor-bearing mice were injected intratumorally with transgenic DCs followed by three booster injections. Transgenic DC-hgp100/mIL-21 showed significant reduction in primary tumor growth and metastasis compared with DC-hgp100 alone and DC-mIL-21 alone. In vivo depletion of specific immune cell types (CD8(+) T, CD4(+) T and Natural killer (NK)-1.1(+) cells) effectively blocked the protective effect of this combinational vaccine. In adoptive transfer experiments, a survival rate of nearly 90% was observed at 60 days post-tumor inoculation for the combinational vaccine group. In contrast, all mice in the DC-hgp100 and DC-mIL-21-only groups died within 43-46 days after tumor challenge. Considerably increased levels of interferon (IFN)-γ, tumor necrosis factor (TNF)-α, granulocyte macrophage colony-stimulating factor (GM-CSF) and cytotoxic T lymphocytes (CTLs) were detected with the combination vaccine group compared with other individual treatment groups. In comparison with the DC-hgp100 or mIL-21 groups, the combinational DC-hgp100/mIL-21 vaccine also drastically suppressed the myeloid-derived suppressor cells (MDSCs) and T-regulatory (Treg) cell populations. Our findings suggest that a combinational DC- and gene-based hgp100 and mIL-21 vaccine therapy strategy warrants further evaluation as a clinically relevant cancer vaccine approach for human melanoma patients.

Outcomes of laryngectomy in elderly patients with laryngeal carcinoma.

Laryngeal carcinoma is a common tumor of the head and neck region. This study aimed to examine the outcomes of laryngectomy in elderly patients with laryngeal carcinoma. One-hundred twenty-two patients (male, 117; female, 5) aged 60 years or older (range, 60-94 years) who underwent laryngectomy between 1996 and 2010 were included. All patients were diagnosed with squamous cell carcinoma of the larynx, and 95 patients (77.9%) had additional concurrent diseases. Tumors were staged according to the TNM categories of the American Joint Committee on Cancer 2002 criteria; there were 16 stage-I, 24 stage-II, 52 stage-III, and 30 stage-IV cases. With regard to treatment modalities, 10 patients underwent transoral laser laryngectomy, 25 underwent partial laryngectomy, and 87 underwent total laryngectomy. When necessary, neck dissection was performed according to the Dalian criteria set in 2004 (a Chinese standard). Of the 122 cases, there were 114 cases of grade I (93.4%), 5 cases of grade II, and 3 cases of grade III (pharyngeal fistula in 2 cases recovered after 2 weeks of care) wound healing. No significant differences were observed in the occurrence or severity of comorbidities. The 1-, 3-, and 5-year actuarial survival rates were 97.5% (119/122), 84.4% (92/109), and 68.4% (67/98), respectively. Age alone should not be used to determine treatment options for elderly patients with squamous cell carcinoma. Presuming that careful pre-treatment evaluations are performed, laryngectomy is a key method for elderly patients with laryngeal carcinoma.

Polymorphisms in the promoter region of myostatin gene are associated with carcass traits in pigs.

Higher average daily gain, more lean meat yield and less fat yield of porcine carcass increase selling profits for animal producers. Myostatin (MSTN), previously called GDF8, is a member of transforming growth factor-ß (TGF-ß) superfamily. It is a negative regulator for both embryonic development and adult homeostasis of skeletal muscle. In this study, the genotypes of the previously described SNPs MSTN g.435G>A and g.447A>G SNPs in 66 Duroc pigs, 33 Landrace pigs, 180 Duroc × Landrace (DL) pigs and 155 Duroc × Yorkshire × Landrace (DYL) pigs were determined by Taqman SNP Genotyping Assays. For Duroc and Landrace pigs, MSTN g.435GG/g.447AA individual had greater backfat thickness (p < 0.05) than g.435AA/g.447GG individual, whereas MSTN g.435AA/g.447GG had greater meat (p < 0.05) and meat percentage (p < 0.05) than g.435GA/g.447AG individual. For DL and DYL pigs, the MSTN g.435GG/g.447AA animals were greater in backfat at ultrasound 10th rib (p < 0.05) and carcass 10th rib (p < 0.01) than g.435AA/g.447GG individual. The MSTN g.435AA/g.447GG individual also had higher values than g.435GG/g.447AA for anterior-end meat (p < 0.05), posterior-end meat (p < 0.01), total meat weight (p < 0.01) and meat percentage (p < 0.01). This study confirmed evidence that MSTN g.435G>A and g.447A>G affected carcass traits in pigs. The effects of the mutated alleles were additive with the maximal effects resulting from two copies of the mutated allele. Selection for MSTN g.435A/g.447G allele is expected to increase muscle of limb and total meat production and decrease backfat thickness.

[Effects of nasal valve on subjective nasal patency and nasal resistance: a correlation study on numerical simulation of nasal airflow].

Objective: To investigate the correlations between subjective nasal patency, nasal valve area size and aerodynamic parameters in normal nasal cavity by means of numerical simulation, and to explore the effect of nasal valve on nasal subjective sensation and nasal airflow regulation. Methods: A total of 52 healthy participants (31 males and 21 females) with the average age of 37.8 years, were recruited from the outpatient Department of Otorhinolaryngology Head and Neck Surgery, the Ninth People's Hospital Affiliated to the Medical College of Shanghai Jiao Tong University between January and August 2023. Visual Analog Scale (VAS) scores for unilateral nasal subjective sensation were obtained from all participants. Additionally, the aerodynamic characteristics of inspiratory airflow were simulated. A correlation matrix analysis was conducted to identify the correlation strength between these subjective and objective parameters. Results: VAS scores showed negative correlations with unilateral nasal valve cross-sectional area (r=-0.85, P<0.01) and unilateral intranasal airflow (r=-0.57, P<0.01), and was a positive correlation with unilateral nasal resistance (NR) at the front-end of inferior turbinate (r=0.61, P<0.01). The average cross-sectional area of unilateral nasal valve was (0.85±0.35) cm2. The cross-sectional area of unilateral nasal valve was negatively correlated with unilateral NR (r=-0.50, P<0.01), and positively correlated with unilateral nasal airflow (r=0.61, P<0.01). The NR at the nasal valve area accounted for (40.41±23.54)% of the total unilateral NR. Nearly half of the unilateral NR [(46.74±21.38)%] and air warming [(49.96±10.02)%] occurring before the front end of inferior turbinate were achieved. Conclusions: The nasal valve area plays a crucial role in influencing nasal NR, unilateral nasal airflow, and changes in nasal airflow temperature. Moreover, it is associated with subjective perception of nasal patency.

The timing of intravenous antibiotics and clinical outcomes of Mycobacterium abscessus complex lung diseases.

BACKGROUND: The importance of early intravenous (IV) antibiotic use for Mycobacterium abscessus complex lung diseases (MABC-LD) treatment remains unknown. METHODS: A retrospective multi-centre observational study was conducted in Taiwan. Patients who were diagnosed with and received treatment for MABC-LD from January 2007 to April 2021 were included. Treatment outcome was defined as modified microbiological cure of MABC-LD.RESULTS: Of the 89 enrolled patients, 34 (38.2%) received IV antibiotics as part of the treatment regimen. The median time to IV initiation was 1 day (IQR 1???49); 24 (70.6%) of these patients received IV agents within 4 weeks, defined as early-use. Forty-two (47.2%) patients achieved modified microbiological cure. In the multivariable logistic analysis, early IV antibiotic use was an independent factor associated with modified microbiological cure (aOR 5.32, 95% CI 1.66???17.00), whereas high radiological score (aOR 0.86, 95% CI 0.73???1.00) demonstrated negative association.CONCLUSIONS: In the present study, early use of effective IV antibiotic was prescribed in a low percentage (27%) for MABC-LD. By contrast, early IV antibiotic use was correlated with higher microbiological cure than were late or non-use. Future larger and prospective studies are needed to validate the association.

Comparing thermal welding instrument-assisted laparoscopic radical hysterectomy versus conventional radical hysterectomy in the management of FIGO IB1 squamous cell cervical carcinoma.

PURPOSE OF INVESTIGATION: The authors sought to evaluate the feasibility and acceptability of using the thermal welding technique with thermal ligating shear (TWT-TLS)-assisted laparoscopic radical hysterectomy (LRH) and systemic pelvic lymphadenectomy (SPL) in the management of Stage IB1 squamous cell carcinoma of the cervix. MATERIALS AND METHODS: The authors compared operating time, blood loss, and other intra- and postoperative parameters and outcomes in 53 patients between May 2003 and April 2007. RESULTS: Twenty-three patients were treated with TWT-TLS-assisted LRH and SPL (TWT-TLS group) and 30 patients with abdominal radical hysterectomy (ARH) and SPL (ARH group). The surgical time of the TWT-TLS group was significantly shorter than that of the ARH group (221.4 vs 264.6 min, p < 0.05). The blood loss of the TWT-TLS group was less than that of the ARH group (195.7 vs 1,214.7 ml, p < 0.001). The immediate postoperative recovery seemed to be rapid in the TWT-TLS group compared with the ARH group (1.4 vs 3.5 days for full diet, p < 0.001; 8.32 vs 12.14 days for hospital stay, p < 0.001). The recurrence rate between the two groups was similar during the median four-year follow-up (8.7% vs 13.3%). CONCLUSIONS: TWT-TLS is a safe and efficient method for laparoscopic RH and SPL with reduction of morbidity for early-stage cervical cancer. A further study is needed to confirm the above observation.

[Study on static parameters of internal nasal valve in 3-dimensional model of nasal cavity space].

Objective: To identify the internal nasal valve (INV) and to evaluate its key parameters in the established 3D models of nasal cavity space via Mimics from CT images, in order to provide evidence for quantitative diagnosis of nasal valve compromise. Methods: A total of 32 Han adults without nasal diseases who underwent maxillofacial CT test in Shanghai Ninth People's Hospital from January 2015 to December 2018 were retrospectively recruited, including 16 males and 16 females, with the age ranged from 20 to 80 years (50% age<50 years old). Maxillofacial CT images were used to create 3D model of nasal cavity space. The INV was identified and the following parameters were measured: the angle between the INV and the nasal bone (θINV-B), unilateral cross-sectional area of the INV (AINV-R, AINV-L), total cross-sectional area of the INV (AINV), unilateral height of the INV (HINV-R, HINV-L), unilateral nasal valve angle (αINV-R, αINV-L), and the sum of nasal valve angle (αINV). The AINV in our study was compared with the results of the previously adopted planes (PlaneC, perpendicular to the hard palate and PlaneB, plane perpendicular to the nasal bone). The parameters above were compared among genders, age and race groups. SPSS 26 and GraphPad Prism 9 software were used for statistical analysis and mapping of data. Results: The AINV in our study was (214.87±52.94) mm², which was significantly less than that of PlaneC (254.97±47.80) mm² and PlaneB (226.07±57.36) mm². The measured parameters were as follows: θINV-B was (82.07±7.06)°; AINV-R was (112.66±31.39) mm²; AINV-L was (102.21±27.14) mm²; AINV was (214.87±52.94) mm²; HINV-R was (24.87±4.62) mm; HINV-L was (24.35±4.86) mm; αINV-R was (20.48±2.99)°; αINV-L was (19.65±3.82)°; αINV was (40.13±6.24)°. The AINV-R was larger than AINV-L (t=2.33, P<0.05); The HINV, AINV-R, AINV-L and AINV of males were more than those of females (t value was 5.77, 3.21, 2.91 and 3.52, respectively, all P<0.01). The AINV of the young group (<50 years) was larger than that of the old group (t=2.83, P<0.01); The θINV-B was different between the Han people and the Caucasian (t=2.92,P<0.01). The αINV of the Han people was larger than that of Caucasians (Z=-6.92, P<0.01), but the HINV was smaller (Z=-3.89, P<0.01). Conclusion: The AINV carried out in 3D models of nasal cavity space is significantly smaller than that obtained by the previous methods of CT evaluation. INV static parameters differ among genders, age and race groups.

Polymorphism of HMGA1 is associated with increased risk of type 2 diabetes among Chinese individuals.

AIMS/HYPOTHESIS: Variants of the high-mobility group A1 (HMGA1) gene have been shown to be associated with insulin resistance and type 2 diabetes in individuals of European origin. We aimed to determine whether this locus confers significant susceptibility to type 2 diabetes in the Han Chinese population, and thus cross-race susceptibility to type 2 diabetes. METHODS: Polymorphisms in HMGA1 were identified by direct sequencing of genomic DNA derived from 192 Chinese participants (96 patients with type 2 diabetes and 96 controls). We then genotyped the common variant IVS5-13insC (c.136-14_136-13insC) in two other independent cohorts, including a total of 2,533 cases and 2,643 ethnically matched controls. RESULTS: We confirmed the association of the HMGA1 variant IVS5-13insC (c.136-14_136-13insC) with type 2 diabetes with an OR of 1.34 (95% CI 1.15, 1.56, p = 0.0002 under a dominant model, and 95% CI 1.16, 1.55, p = 0.0002 under an additive model) in the Han Chinese population, corresponding to a population attributable risk fraction of 5.0%. CONCLUSIONS/INTERPRETATION: HMGA1 is an important susceptibility locus that confers a high cross-race risk of the development of type 2 diabetes.

Investigation of genetic relationships among Taiwan black pigs and other pig breeds in Taiwan based on microsatellite markers.

The aim of this study was to investigate the genetic relationships between Taiwan black pigs (TBP) and other pig breeds by means of 15 fluorescent-labeled microsatellite markers. DNA from a total of 299 TBP from eight private farms and 234 purebred pigs representing six breeds and one synthetic line was used. Among the 15 microsatellite loci, polymorphism information content (PIC) values were all above 0.500; the numbers of observed alleles were all greater than the numbers of effective alleles (10.1 vs. 4.3 in averages). But 13 of the 15 microsatellite markers significantly deviated from the Hardy-Weinberg equilibrium (HWE); moreover, 13 of the 15 tested populations also deviated from the HWE. The inbreeding coefficient (F(IS)) indicated that two TBP populations (TBP-3 and TBP-4) had heterozygote deficiency (P < 0.01). The pair-wise F(ST), representing the genetic diversity between the two populations, ranged from 0.0332 to 0.3809. Meishan and Taoyuan breeds with black hair were previously considered closely related to TBP; however, the result of genetic relationship refuted this assumption. In conclusion, TBP is more similar to the European than Chinese breeds, and further investigations will need to clarify it more accurately.

Systemic steroids in acute exacerbation of COPD - from guidelines to bedside.

The optimal steroid dosages in AECOPD are still under debate. Admission records of patients in our hospital from January to December 2008 due to a diagnosis of AECOPD were reviewed. More wheezing and tachypnea were noted in the patients with a maximal daily prednisolone dose more than 60 mg. The steroid dose was higher in AECOPD without pneumonia than those concurrent with pneumonia. Those who had concurrent pneumonia had a higher risk of nosocomial infections. The study reflects the heterogeneity of AECOPD and that steroid dosages were determined by the clinical evaluation of the severity of illness and bacterial infections.

Urinary BLCA-4 is highly specific for detection of bladder cancer in Chinese Han population and is related to tumour invasiveness.

BLCA-4 is currently the most sensitive and specific urinary marker for bladder cancer. As the incidence of bladder cancer varies by ethnic and territory, we tended to evaluate the feasibility of bladder cancer detection using urinary BLCA-4 in Chinese Han nationality. Urines from 79 bladder cancer patients, 31 urinary tract infection patients and 29 normal controls were included. Tissue specimens of 53 bladder cancers, 24 pathologically normal tumour- adjacent urothelium and 15 healthy controls were involved. BLCA-4 antibody was produced and applied in an indirect ELISA assay for urine samples and immunohistochemistry study in tissue samples. Urinary BLCA-4 was significantly higher in the bladder cancer group (P=0.0001). The level was in no relation to age, gender, growth pattern, grade or stage. Discrepant to reported data, a cut-off value of 1.7×10⁻4 A was acquired here, which yields a sensitivity of 97.37% and specificity of 100%. Muscle invasiveness was related to a higher BLCA-4 level (P=0.0175). Tumour tissues were also scored higher in staining (P=0.0001), yet this was not related to invasiveness. In 41.67% of adjacent normal tissue we found positive BLCA-4 expression. Urinary BLCA-4 was also highly specific in bladder cancer detection in the Chinese, with additional indicative value in muscle invasiveness detection. A cut-off value of 1.7×10⁻4 A may be more adaptive to Chinese Han population.

Lung inflammation is induced by renal ischemia and reperfusion injury as part of the systemic inflammatory syndrome.

INTRODUCTION: Ischemia and reperfusion injury (IRI) are mainly caused by leukocyte activation, endothelial dysfunction and production of reactive oxygen species. Moreover, IRI can lead to a systemic response affecting distant organs, such as the lungs. AIM: The objective was to study the pulmonary inflammatory systemic response after renal IRI. METHODS: Male C57Bl/6 mice were subjected to 45 min of bilateral renal ischemia, followed by 4, 6, 12, 24 and 48 h of reperfusion. Blood was collected to measure serum creatinine and cytokine concentrations. Bronchoalveolar lavage fluid (BALF) was collected to determine the number of cells and PGE(2) concentration. Expressions of iNOS and COX-2 in lung were determined by Western blot. Gene analyses were quantified by real time PCR. RESULTS: Serum creatinine increased in the IRI group compared to sham mainly at 24 h after IRI (2.57 +/- 0.16 vs. 0.43 +/- 0.07, p < 0.01). The total number of cells in BAL fluid was higher in the IRI group in comparison with sham, 12 h (100 x 10(4) +/- 15.63 vs. 18.1 x 10(4) +/- 10.5, p < 0.05) 24 h (124 x 10(4) +/- 8.94 vs. 23.2 x 10(4) +/- 3.5, p < 0.05) and 48 h (79 x 10(4) +/- 15.72 vs. 22.2 x 10(4) +/- 4.2, p < 0.05), mainly by mononuclear cells and neutrophils. Pulmonary COX-2 and iNOS were up-regulated in the IRI group. TNF-alpha, IL-1beta, MCP-1, KC and IL-6 mRNA expression were up-regulated in kidney and lungs 24 h after renal IRI. ICAM-1 mRNA was up-regulated in lungs 24 h after renal IRI. Serum TNF-alpha, IL-1beta and MCP-1 and BALF PGE(2) concentrations were increased 24 h after renal IRI. CONCLUSION: Renal IRI induces an increase of cellular infiltration, up-regulation of COX-2, iNOS and ICAM-1, enhanced chemokine expression and a Th1 cytokine profile in lung demonstrating that the inflammatory response is indeed systemic, possibly leading to an amplification of renal injury.

Anti-tumor activity of histone deacetylase inhibitors and the effect on ATP-binding cassette in ovarian carcinoma cells.

INTRODUCTION: Ovarian cancer is of worldwide importance, and has a significantly high mortality rate due to therapy failure. Drug resistance might be one of most importance factors. Histone deacetylase inhibitors (HDACi) have been reported to be a new class of promising anti-tumor agents, thus this study aimed to investigate the effect of HDAC on the chemo-resistance genes of human ovarian carcinoma cell lines. METHODS: The expressions of ATP binding cassette (ABC) transporter genes, multidrug-resistant protein (MDR1) and multidrug resistance-associated proteins (MRP1 and 2) of ovarian cancer cell lines OC-109 and SK-OV-3 after HDACi treatment were determined. RESULTS: HDACi, including sodium butyrate (NaB), suberoylanilide hydroxamic acid (SAHA) and trichostatin A (TSA) reduced ovarian cancer cell viability from 4.4% to 68.8%, in both dose- and time-dependent manners. The effect of HDACi on MDR1, MRP1, and MRP2 showed induced expression of MDR1 mRNA, but reduced mRNA expression of MRP1 and MRP2. CONCLUSIONS: The effect of HDACi on the reduced viability of ovarian cancer cell lines, concomitant with the induced expression of MDR1 and reduced expression of MRP1 and 2, might provide additional benefits in the management of ovarian cancers in the future.

[Evaluation of histological changes of retrodisc attached tissue in patients with temporomandibular disorders by texture analysis: a pilot study].

Objective: To evaluate the histological changes of the retrodiscal tissue in the patients with temporomandibular disorders (TMD). Methods: Thirty-three TMD patients were performed with temporomandibular joint (TMJ) MRI examinations from April 2018 to April 2020 in TMD clinic, Hainan Hospital of General Hospital of Chinese PLA. The patients groups were classified according to the disc position as follows: normal position (NP) (29 TMJ), disk displacement with reduction (DDwR) (14 TMJ) and disk displacement without reduction (DDwoR) (23 TMJ). The gray-level co-occurrence matrix (GLCM) analysis was applied with the retrodiscal tissue on the open oblique sagittal proton weighted images. The texture parameters included as follows: angular second moment (ASM), contrast, correlation, inverse difference moment (IDM) and entropy. The statistical methods mainly included Kruskal-Wallis H test, one-way analysis of variance and receiver operating characteristic curve (ROC), to analyze the texture characteristic parameters of the retrodiscal tissue are statistically significant. Results: There was no significant difference of the retrodiscal tissue's ASM, contrast, correlation and IDM among 3 groups (P>0.05). The entropy in NP group (3.98±0.44) and DDwR group (4.20±0.52) presented significant higher than that in DDwoR group (3.70±0.38) (P<0.05). ROC analysis for the entropy demonstrated that the area under the curve was 0.70 when differentiating NP and DDwR (cut-off value 0.38, sensitivity 82.61%, specificity 55.17%), and was 0.79 when differentiating DDwR and DDwoR (cut-off value 0.47, sensitivity 82.61%, specificity 64.29%). Conclusions: Texture entropy could be primarily used to evaluate the histological and pathological changes of the retrodiscal tissue in the TMD patients.

[Application of 3D computer-assisted printing technique combined with plastic titanium mesh in the reconstruction of maxillary defect].

Objective: To investigate the application and clinical outcomes of using 3D computer-assisted printing technique combined with plastic titanium mesh in the reconstruction of maxillary defect. Methods: Clinical data of 14 patients in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital from January 2016 to June 2018, who were treated for partial or total removal of the maxilla due to benign or malignant tumors and those acquired maxillary defects caused by severe compound trauma were analyzed retrospectively. Twelve males and 2 females were included, with the age ranging from 16 to 51 years old. The sinonasal malignant tumors included squamous carcinoma (n=2) while benign tumors included hemangioma (n=1), maxillary fibrous dysplasia (n=3), maxillary cyst (n=2) and giant cell tumor of the maxilla (n=1). Five cases of post-traumatic maxillary defect were also included. According to preoperative thin-layer CT scanning data, computer modeling data was transmitted to a 3D printer to print out the original model and the reconstructed model. Preoperative simulation of tumor removal and maxillary reconstruction was done on the patient's original model, and the titanium mesh was shaped on the reconstructed model in order to properly reconstruct the area needed to be repaired. The pre-made titanium mesh was implanted into the defect area, the soft tissue flaps were reset, layered stitching and the local pressured bandage were used after surgery. Through postoperative clinical and CT examination, the patient's maxillofacial shape, nasal function and complications were evaluated. The results were analyzed by descriptive statistical method. Results: Lesions could be completely removed within the predicted range on the preoperative 3D-printed models of all cases. After debridement, titanium mesh could be implanted easily without re-shaping and trimming during surgery as in trauma cases. Titanium mesh could completely cover the missing bone surface closely, with titanium nails fixed smoothly, and the implanted titanium mesh was solid and stable. After the follow-up of 6 to 20 months, all patients were satisfied with the facial symmetry and the function was recovered well. Conclusion: Using 3D computer-assisted printing technique combined with plastic titanium mesh in the reconstruction of maxillary defect can accurately restore the maxillary structure for soft tissue support, and restore the facial shape and function.