1.Transpalatal modified Le Fort Ⅰ osteotomy for correction of maxillary hypoplasia in cleft lip and palate patients:a preliminary clinical application
Yu WU ; Zili LI ; Xing WANG ; Biao YI ; Lian MA
Journal of Peking University(Health Sciences) 2016;48(3):550-554
Objective:To evaluate the surgical corrective results of maxillary hypoplasia in patients with cleft lip and palate withtranspalatal modified Le Fort Ⅰ osteotomy.Methods:In the study,1 1 patients (4 women,and 7 men)with maxillary hypoplasia secondary to cleft lip and palate underwent transpalatal modified Le Fort Ⅰ osteotomy at Peking University School of Stomatology from Jan.201 2 to Dec.201 3, with the mean age of 21 years (from 1 8 to 27 years),Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty were performed simultaneously in 9 of them for better appearance and functional occlu-sion.Lateral cephalometric radiographs were taken and traced before surgery,immediately after surgery and 6 months after surgery.The position of subspinale (A)on horizontal direction,the angle of sella-na-sion-subsipmale (SNA)and the angle of sella-nasion-supramental (SNB)were collected and analyzed to evaluate the results.Results:All the patients were uneventful with transpalatal modified Le Fort Ⅰosteotomy.All of them had a better profile and a satisfactory occlusionafter operation.The position of A was moved forward (6.6 ±1 .1 )mm on average in horizontal direction when surgery was completed,and maintained (6.0 ±1 .2)mm on average 6 months after surgery.The average of SNA was 75.9°±2.8° before surgery,81 .6°±8.6°immediately after surgery,and maintained 81 .0°±2.6°6 months after sur-gery.The average of SNB was 82.6°±3.7°before surgery,78.0°±2.4°immediately after surgery,and maintained 78.5°±2.4°6 months after surgery.Conclusion:The maxillary hypoplasia in cleft lip and palate patients can be successfully corrected with transpalatal modified Le Fort Ⅰ osteotomy and the func-tional occlusion can be achieved simultaneously.The effect of deformity correction was satisfactory. Transpalatal modified Le Fort Ⅰ osteotomy can move maxilla more sufficiently,especially applicable for the patient with severe palatal scars preoperatively.
2.Feasibility of integrating 3D photos and cone-beam computed tomography images used to evaluate changes of soft and hard tissue after orthognathic surgery
Zhe WANG ; Liuning ZHU ; Lin ZHOU ; Biao YI
Journal of Peking University(Health Sciences) 2016;48(3):544-549
Objective:To evaluate the feasibility of integrating 3D photos and cone-beam computed tomography (CBCT)images and to assess the degree of error that may occur during the above process,and to analyze soft and hard tissue changes after orthognathic surgery using this new method.Methods:Ten patients with maxillofacial deformities were chosen.For each patient,CBCT scans and stereophotographic images were taken before and 3 months after surgery.3D photos were superimposed onto the CBCT skin im-ages using relatively immobile areas of the face as a reference.3D color maps and mean distances were used to evaluate the errors that might occur during the process.Two reference planes were set up using cer-tain points.The distances between Prn (pronasale),Sn (subnasale),Ls (labrale superior),ANS (anterior nasal spine),A (subspinale),UIE (upper incisor edge)to the coronal plane were calculated before and af-ter surgery.In order to verify the repeatability of this method,we examined the distances twice at two-week intervals.Paired t test was used to evaluate the reproducibility.Results:CBCT and 3D photos could be successfully fused with clinically acceptable errors.This new method could be used to evaluate soft and hard tissue changes after orthognathic surgery.The 3D color maps showed that the two images could be fused with minimal errors.The mean distances were within 0.3 mm,and the locations of landmarks on maxilla and mandible such as Ls,ANS,A,UIE changed significantly after orthognathic surgery (P <0.05). Landmarks on the nose such as Prn,Sn had little changes after surgery (P >0.1 ).The paired t test showed that the mean value and standard deviation were (0.08 ±0.98)mm.Conclusion:Fusing of CBCT and 3D stereophotographic images used as a new method in evaluating soft and hard tissue changes after orthognathic surgery was feasible and accurate.The virtual 3D composite craniofacial models permitted concurrent assess-ment of hard and soft tissues during diagnosis and treatment planning.Maxillary and mandibular locations had significant association with orthoganthic surgery while the nasal tissue was not simp affected by surgery.
3.Analysis for serological diagnostic results of syphilis among entry personnel in Beijing port during 2012 -2014
Mengxian FENG ; Fujun SUN ; Fei WANG ; Kanglin WANG ; Min LIU
Journal of Peking University(Health Sciences) 2016;48(3):491-495
Objective:To analyze the results of syphilis specific serological tests among entry personnel in Beijing port during year 201 2 -201 4 in order to provide evidence for the prevention and control of syphilis.Methods:Demographics data and syphilis specific test results of entry personnel were obtained from the information system of Beijing International Travel Healthcare Center and input into Excel 201 6. Database for entry personnel was built up accordingly and was analyzed by IBMSPSS22.0.Results:The number of entry personnel in Beijing port during year 201 2 -201 4 was 1 06 302 person-time.According to the evaluation criteria,71 308 persons were recruited and analyzed,of whom 277 were tested serologi-cally positive and the total prevalence was 0.39% (95% CI:0.34% -0.43%).The prevalence was highest in the persons aged 40 -49 years (0.81 %)and was higher in males (0.50%)than in females (0.23%).The persons from Africa held higher prevalence (1 .27%)than from other five regions.As multivariate logical regression analysis indicated that the risk of syphilis infection was 1 0.38 times more in the persons aged 40 -49 years than in the persons <20 years (95%CI:5.59 -1 9.28),and 1 .85 times more in males than in females (95%CI:1 .40 -2.44).For the people from Africa,South America and Asia,the infection risks were respectively 4.89 times (95%CI:2.97 -8.06),4.82 times (95%CI:2.39 -9.74)and 1 .72 times (95%CI:1 .1 5 -2.59)more than that for the people from North Ameri-ca.Rising trend of the prevalence was observed in both genders by age groups (P value for trend χ2 <0.05).Except for Asia,the prevalences of the people from other five regions were rising slightly by years,however there were no obvious trends (P value for trend χ2 >0.05).Twenty-seven seropositive cases were found within 6 246 entry persons who were tested repeatedly during the research period,9 of which were seroconversion cases so that the cumulative conversion rate was 0.1 4% (9 /6 228).The average conversion time was (6.3 ±3.0)months.There was no statistical significance between the cu-mulative seroconversion rates of the persons with different genders and nationalities (P of Fisher’s exact test >0.05).Conclusion:Serological detection of syphilis for entry personnel in Beijing port and syphi-lis-related health education should be reinforced to reduce the risk of disease importing and spreading, protect susceptible subjects and promote health.
4.Effects of 1,3-diphenyl-1,3-propanedione on neurotransmitter contents of brain in mice administered with cocaine
Juan CHEN ; Yichao WANG ; Rong CUI ; Xiaoxiao LIU ; Baoxu ZHANG
Journal of Peking University(Health Sciences) 2016;48(3):398-402
Objective:To investigate the possible reversal effects of 1 ,3-diphenyl-1 ,3-propanedione (DPPD)for cocaine-induced content changes of neurotransmitters of brain in mice.Methods:In this study,36 healthy ICR male mice were randomly divided into control group,cocaine group,three DPPD pretreatment groups (200,400,and 800 mg/kg)and DPPD alone group (800 mg/kg).The mice in control group were administered intragastrically with 1 % Tween 80 for 3 d,and the mice in cocaine group were administered intragastrically with 1 % Tween 80 for 2 d before cocaine was injected subcutaneously on the 3rd day.The mice in the three DPPD pretreatment groups were administered intragastrically (DPPD 200,400,and 800 mg/kg)for 3 d before cocaine was injected subcutaneously 30 min after the administration on the 3rd day.The mice in DPPD alone group were administered intragastrically with DPPD at dose of 800 mg/kg for 3 d.The mice were sacrificed 20 minutes after cocaine injection.The contents of dopamine (DA)and 5-hydroxytryptamin (5-HT)in the mice brain were determined by high performance liquid chromatography (HPLC)-fluorescence detector,the contents of glutamic acid (Glu) and γ-aminobutyric acid (GABA)in the mice brain were determined by HPLC-ultraviolet detector,and the neurotransmitter levels were compared between the groups.Results:The results showed that as com-pared with the control group,DA and GABA contents in cocaine group increased significantly (P <0.01 and P <0.05),while Glu content decreased (P <0.05).As compared with cocaine group,the DA levels in the three DPPD pretreatment groups (200,400,and 800 mg/kg)all decreased significantly (P <0.01 ).In DPPD 200 mg/kg pre-administration group,GABA content decreased (P <0.05),and the contents of the four kinds of neurotransmitters had no statistical differences with those of the control group.Conclusion:DPPD may have potential reversal effects of the content changes of neurotransmitters in mice brain induced by cocaine at a lower dose.
5.Immunomodulatory effect of oyster peptide on immunosuppressed mice
Dan XU ; Feng LIN ; Xiaoyu ZHU ; Wenying LIU ; Xiaowen CHEN ; Jinqiu FENG ; Aiqin FAN ; Muyi CAI ; Yajun XU
Journal of Peking University(Health Sciences) 2016;48(3):392-397
Objective:To evaluate the immunomodulating effect of oyster peptide on immunosup-pressed mice.Methods:ICR mice injected with cyclophosphamide (CTX)were adopted as the module group,with mice without treatment as the control group,and different dosages of oyster peptide (0.5 g/kg,1 .0 g/kg,and 2.0 g/kg)were given to the low,middle,and high groups for 1 5 days.The body weight,spleen,and thymus weight of the mice,structures under the microscope of the immune organs, numbers of white blood cells,ratios of T lymphocyte subsets,immune cytokines and numbers of nuclear cells,and DNA content in bone marrow were all assessed.Results:Compared with the control group, the structures of thymus and spleen of the mice in the CTX group appeared obscure and shrunk when ob-served under microscope,the number of their white blood cells declined (P =0.04),the proportion of their CD3 +T cells in peripheral blood declined (P =0.003),the proportion of their CD8 +T cells in pe-ripheral blood declined (P =0.002),the concentration of their IL-5 in peripheral blood significantly in-creased (P <0.01 ),the concentration of their nucleated cells and DNA density in bone marrow de-creased (P =0.04,P <0.01 ).Oyster could improve the structures of thymus and spleen of the immuno-suppressed mice.Compared with the CTX group,the number of white blood cells in 2.0 g/kg group in-creased (P =0.003),the proportion of CD3 +T cells in peripheral blood in 1 .0 g/kg group (P =0.04) and 2.0 g/kg group (P =0.02)increased,the proportion of CD8 +T cells in peripheral blood in 2.0 g/kg group increased (P =0.002),the concentration of IL-5 in peripheral blood in all the oyster treated groups increased (P <0.01 in 0.5 g/kg,1 .0 g/kg,and 2.0 g/kg groups),the concentration of IL-1 7 in peripheral blood in 2.0 g/kg group decreased (P =0.03),the concentration of nucleated cells in bone marrow of all the oyster treated groups increased (0.5 g/kg vs.CTX,P =0.04;1 .0 g/kg vs. CTX,P =0.02;2.0 g/kg vs.CTX P =0.01 ),the DNA content in bone marrow of all the oyster treated groups increased (P <0.01 in the 0.5 g/kg,1 .0 g/kg,and 2.0 g/kg groups).Conclusion:Oyster peptide could improve the structures of immune organs of the CTX-induced immunosuppressed mice,re-cover the imbalances of T lymphocyte subsets,improve the immune cytokines and increase numbers of nucleated cells and DNA content in bone marrow,thus improving the immunologic function.
6.Therapeutic evaluation of the correction of the severe bi-maxillary protrusion cases by Tweed-Merrifield technique
Junqiang HUANG ; Shiyao LIU ; Jiuhui JIANG
Journal of Peking University(Health Sciences) 2016;48(3):555-561
Objective:To evaluate the influence of Tweed-Merrifield technique in correction of severe bimaxillary protrusion adult patients on the measurement of the dental and skeletal changes after orthodon-tic treatment by Johnston analysis and the regular cephalomatric analysis.Methods:Twelve adolescent patients with severe bimaxillary protrusion were included in this self-control retrospective study.Lateral cephalometric radiographs were taken before and after treatments.All the radiographs were traced and analyzed by the method of Johnston analysis.Other measurements were evaluated using a series of 1 3 li-near and angular measurements including SNA,SNB,ANB,U1 -SN,U1 -NA,U1 /NA,L1 -NB, U1 /NB,L1 /MP,U1 -L1 ,(U1 +L1 )/2-AB,MP/SN and MP/FH from regular cephalomatric analysis. These measurements were also applied to compare the differences between pre-and post-treatments,which clarify the dental and skeletal changes by Johnston analysis.The effect of orthodontic correction was de-termined using the non-parameters test.Results:The maxillary moved backforward by 1 .3 mm according to the stable skull base,while the mandible moved forward by 2.1 2 mm.The relative position between the maxillary and mandible (ABCH)changed 3.42 mm.The upper and lower incisors retracted signifi-cantly.The upper and lower molars moved slightly forward and the relative positions of upper and lower molars and anterior teeth after treatment were 3.44 mm and 4.23 mm respectively.After treatment,the parameters of ANB、U1 -NA、U1 /NA、U1 -SN、L1 -NB、L1 /NB and L1 -M were reduced by -(1 .98 ± 1 .55)°(P =0.01 2),-(5.08 ±4.6)mm (P =0.002),-(1 1 .79 ±1 .21 )°(P =0.004),-(1 3.55 ±6.32)°(P =0.047), -(3.1 7 ±3.07)mm (P =0.01 0), -(6.84 ±2.55)°(P =0.038)and-(4.1 3 ±2.24)°(P =0.048)on average,whose changes had the statistically significant effects.Con-clusion:Tweed-Merrifield technique (directional force technique)can stabilize anchorage molar,retract anterior teeth and significantly improve the hard and soft tissue profile for patients with bimaxillary protru-sion,and make a good vertical control which means this technique is applicable to the patients who need strong anchorage.Even for the severe bimaxillary protrusion adult patients,the Tweed-Merrifield tech-nique can control the anchoragewell and make the profiles improved greatly.
7.Comparison of periapical radiography and cone-beam computed tomography in en-dodontic treated teeth for assessment of periapical lesions
Mingming ZHANG ; Yuhong LIANG ; Xuejun GAO
Journal of Peking University(Health Sciences) 2016;48(3):539-543
Objective:To compare the assessments of the presence or absence and the changes of post-treatment periapical lesions using periapical radiographs versus cone-beam computed tomography (CBCT).Methods:Imaging records were selected from a sample of 233 radiographic examinations (in-cluding periapical radiographs and CBCT)of patients with chronic apical periododontitis who received treatment and review in Department of Cariology and Endodontology of Peking University School of Stoma-tology.After testing the inter-observer and intra-observer agreement,two observers determined the pre-sence or absence of a periapical lesion and classified the changes of lesions in 4 categories:absence,re-duction or enlargement of lesion,or uncertain.The differences between CBCT and periapical radiographs in detecting the presence or absence and the changes of periapical lesions were compared using McNemar test and Fisher’s exact test respectively.Results:In the study,233 teeth were assessed with both periapi-cal radiographs and CBCT images.Periapical lesions were detected in 178 teeth on CBCT scans and in 146 teeth on periapical radiographs.CBCT images revealed a significantly larger number of lesions than were revealed by periapical radiographs (P <0.01 ).There was disagreement on the changes of lesions between the two radiological technologies in 25% teeth,and the difference was statistically significant (P <0.01 ). Conclusion:Significant differences were observed between periapical radiographs and CBCT in detection of post-treatment periapical lesions and assessment of the changes of periapical lesions.
8.Separate vertical wiring combined with tension band and Kirschner-wire plus cer-clage wire in the treatment of displaced inferior pole fractures of the patella
Jian ZHANG ; Xieyuan JIANG ; Xiaowen HUANG
Journal of Peking University(Health Sciences) 2016;48(3):534-538
Objective:To investigate the clinical efficacy and outcomes of two separate vertical wiring combined with tension band and Kirschner-wire plus cerclage wire in the treatment of displaced inferior pole fractures of the patella.Methods:From January 201 3 to January 201 5,1 5 consecutive patients (mean age 54.5 years)with inferior pole fractures of the patella were retrospectively included in this study.All the patients underwent open reduction and internal fixation by separate vertical wiring com-bined with tension band and Kirschner-wire plus cerclage wire through longitudinal incision,4.5 d (range:3.1 -5.9 d)after initial injury.A safety check for early knee range of motion was performed before wound closure.The complications including infection,nonunion,loss of fixation and any wire breakage or irritation from implant were recorded.Anteroposterior and lateral views of the knee joint ob-tained during the follow-up were used to assess bony union based on the time when the fracture line disap-peared.At the time of the final outpatient follow up,functional evaluation of the knee joint was conduc-ted by B?stman system.Results:The follow-up time was 1 3.1 months (range:1 2 -1 9 months)after surgery on average,immediate motion without immobilization in all the cases was allowed and there was no case of reduction loss of the fracture and wire breakage.There was no case of irritation from the im-plant.At the final follow-up,the average range of motion (ROM)arc was 1 26.7°(range:1 1 5°-1 40°),the average ROMlag versus contralateral healthy leg was 1 0.3°(range:0°-35°).The mean B?stman score at the last follow-up was 28.9 (range:27 -30),and graded excellent in most cases. Conclusion:Two separate vertical wiring is an easy and effective method to reduce the displaced inferior pole fracture of patella.Augmentation of separate vertical wiring with tension band and Kirschner-wire plus cerclage wire in these patients provides enough strength to protected the early exercise of the knee joint and uneventful healing.By this surgical treatment,excellent results in knee function can be expec-ted for cases of displaced inferior pole fractures of the patella.
9.Effect of dexmedetomidine infusion on postoperative recovery for patients undergoing major spinal surgery during propofol anesthesia
Bingyan LI ; Zhiyu GENG ; Dongxin WANG
Journal of Peking University(Health Sciences) 2016;48(3):529-533
Objective:To evaluate the effect of intraoperative dexmedetomidine (DEX)infusion during propofol intravenous anesthesia on postoperative recovery after major spinal surgery.Methods:Sixty pa-tients aged 1 8 to 65 (American Society of Anesthesiologists,ASA Ⅰ -Ⅱ),scheduled for spinal surgery from January 201 4 to May 201 4 were randomized into two groups.The DEX group (n =30)received 0.5 μg/kg of DEX ten minutes before anesthesic induction,followed by an infusion of DEX at 0.2 μg/(kg·h)intraoperatively and the control group (n =30)was given identical amounts of normal saline. At the end of surgery,the patients of both groups received patient-controlled intravenous analgesia (PCIA)with morphine 0.5 mg/h (1 mg demand dose and 8 min lockout).Heart rate and mean arterial pressure (MAP) were continually monitored during operation and in the post-anesthesia care unit (PACU).The propofol and sufentanil consumptions during operation and the morphine consumption 48 h after surgery were recorded.The time for recovery and extubation were recorded.The followed-up evalua-tions were performed to assess Ramsay scores,visual analogue scale (VAS)pain scores as well as side effects in PACU and 48 h after surgery.Results:Heart rate of DEX group was lower than that of control group after intubation and extubation and in PACU 1 0 min (P <0.05).MAP was lower in DEX group than that in control group after extubation and in PACU (P <0.05).Compared with control group,the propofol consumption during anesthesic induction,the sufentanil consumption during operation and the cumulative consumption of morphine 2 h and 6 h after surgery were decreased (P <0.05).There were no differences between the two groups as to the time for recovery or extubation.Compared with control group,the VAS pain scores were significantly decreased (P <0.01 ),the incidence of postoperative nau-sea and vomiting in DEX group were significantly decreased (P <0.05)48 h after surgery.Conclusion:Intraoperative infusion of DEX improved quality of recovery,provided good analgesia,and decreased morphine use and the incidence of postoperative nausea and vomiting after major spinal surgery.
10.Study on the reliability of CardioChek PA for measuring lipid profile
Ying GAO ; Chenggang ZHU ; Naqiong WU ; Yuanlin GUO ; Geng LIU ; Qian DONG ; Jianjun LI
Journal of Peking University(Health Sciences) 2016;48(3):523-528
Objective:To evaluate the clinical correlation between the CardioChek PA analyzer (CCPA)and a clinical laboratory reference method to use for screening program purposes.Methods:Fasting blood samples were collected on 325 patients (age:23 -86 years).One venous sample was col-lected using a serum tube for the evaluation on a Beckman reference analyzer.A second venous sample was collected in a lithium heparin tube and was evaluated on the CCPA analyzer.Linear regression analy-ses and Bland-Altman method were performed for each measured analyte:total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),triglycerides (TG)and low density lipoprotein-cholesterol (LDL-C).Results:Our results demonstrated a good clinical agreement for TC,HDL-C,TG and LDL-C (97.0%,92.9%,92.4% and 83.7%)in comparison with the CCPA to the reference analyzer.The correlation coefficients were 0.875,0.81 3,0.91 0,0.864,respectively.P values all <0.001 .There was no significant difference in the detection rate of hyperlipidemia in TC,HDL-C and LDL-C.Conclu-sion:We have identified the pre-analytic phase as an important step to guarantee the quality of results and indicated that the CCPA is a reliable lipid point-of-care testing system that can be used for the appli-cation of clinical screening anywhere.