Throughout the twenty-first century, robotic surgery has been used in multiple oral surgical procedures for the treatment of head and neck tumors and non-malignant diseases. With the assistance of robotic surgical systems, maxillofacial surgery is performed with less blood loss, fewer complications, shorter hospitalization and better cosmetic results than standard open surgery. However, the application of robotic surgery techniques to the treatment of head and neck diseases remains in an experimental stage, and the long-lasting effects on surgical morbidity, oncologic control and quality of life are yet to be established. More well-designed studies are needed before this approach can be recommended as a standard treatment paradigm. Nonetheless, robotic surgical systems will inevitably be extended to maxillofacial surgery. This article reviews the current clinical applications of robotic surgery in the head and neck region and highlights the benefits and limitations of current robotic surgical systems.

To investigate the changes of intestinal microcirculation in endotoxic shock and the effect of inducible nitric oxide synthase (iNOS) on intestinal microcirculation, endotoxic shock was induced by intravenous injection of lipopolysaccharide (LPS) in mice. Mean arterial pressure (MAP) was monitored throughout the experimental procedure. The velocity and flux of red blood cell (RBC) in villus tip arteriole and capillaries were measured by FITC-labeled erythrocytes and intravital microscopy. The effect of iNOS was determined by targeted disruption of mice iNOS-gene and administration of S-methylthiourea sulfate (SMT), a selective inhibitor of iNOS, before LPS injection. No significant differences in MAP, RBC velocity and flux at baseline were found among wild type mice, SMT pretreated mice and iNOS-gene knockout mice. LPS induced a dramatic fall of MAP in wild type mice. The decrease of MAP was significantly restored in iNOS-gene knockout mice and in wild type mice received SMT before LPS injection. The velocity and flux of RBC in villus tip arteriole and capillaries decreased markedly after LPS injection in wild type mice, while significantly higher velocity and flux of RBC were found in iNOS-gene knockout mice and SMT-pretreated mice both 60 and 120 min after LPS injection. The results demonstrate that iNOS plays an essential role in the intestinal microcirculation disturbance which occurs in endotoxic shock.
Animals ; Intestines ; blood supply ; Lipopolysaccharides ; Male ; Mice ; Mice, Knockout ; Microcirculation ; physiology ; Nitric Oxide Synthase Type II ; genetics ; physiology ; Shock, Septic ; chemically induced ; physiopathology

Objective: To investigate clinical outcomes of modified reattachment of superior peroneal retinaculum (SPR) for patients with recurrent peroneal tendon dislocation. Methods: A total of 24 cases with recurrent peroneal tendon dislocation from December 2012 to June 2017 were treated with modified reattachment of SPR. There were 20 males and 4 females. The average age was 24.9±9.3 years (14-48 years). The average BMI was 23.18±3.50 kg/m² (15.8-32.2 kg/m²). A 4-5 cm incision was made along the lateral margin of the fibula and curved distally around the fibular tip in line with the peroneal excursion. The superior peroneal retinaculum, peroneus longus and peroneus brevis were exposed. The periosteum and SPR were stripped from the fibula. The false pouch was formed. Two suture anchors were inserted into the postero-lateral ridge of the lateral malleolus without damaging the cartilaginous ridge, after which the SPR was reattached to the lateral malleolus with the anchored suture. The inner layer of the false pouch was incised, while the outer layer (periosteum) was sutured with the SPR in a pants-over-vest style. The following items, including American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), rate of return to previous sports level, time to return to sports activity, complication, and patients satisfaction were evaluated preoperatively and at the final follow-up. Results: The average operation duration was 36.1±8.8 min (20-51 min). The blood loss was 1-10 ml, average 4.1±2.7 ml. The follow-up was carried out in 22 cases for mean 33.9±15.7 months (13-61 months). AOFAS score was improved from 77.8±7.8 points to 95.5±4.3 points significantly (t=-11.89, P<0.001). VAS score was reduced from 4.2±2.4 to 0.3±0.8 significantly (t=7.69, P<0.001). Mean duration return to sports activity was 5.0±1.9 months (3-10 months). A total of 20 patients (91%) returned to their previous sports level. Only one patient (5%) was found with limitation of range of motion, while two patients (9%) reported pain at the scar site without recurrence. The satisfaction rate was 91%. Conclusion Clinical outcomes of modified reattachment of SPR for patients with recurrent peroneal tendon dislocation was safe and effective.

Objective： The current study was designed to investigate the relationship between cyclin A expression in non-small cell lung carcinoma (NSCLC) and the proliferative activity and the prognosis. Methods： Cyclin A expression in 60 non-small cell lung carcinoma specimens was detected by immunohistochemical method. DNA content was measured by flow cytometry. Results： Twenty-nine cases (48.3％ ) showed cyclin A expression. The median S-phase fraction of the cyclin A-positive 14.4± 3.9％ was higher than that of the cyclin A-negative 9.4± 3.5％ . The overall survival was significantly lower in patients with cyclin A expression than in those without cyclin A expression. Conclusion： Cyclin A expression contributed to the high proliferative activity in non-small cell lung carcinoma cells. Cyclin A might be a prognostic marker of non-small cell lung carcinoma.

Objective To analyze factors affecting outcomes of single-dose methotrexate(MTX)treatment in patients with ectopic pregnancy.Methods The data of 416 patients with ectopic pregnancy treated by single-dose MTX injection in Obstetrics and Gynecology Hospital,Fudan University from Jan 2019 to Dec 2022 were retrospectively analyzed.MTX was administered on day 1,and the serum β-human chorionic gonadotrophin(β-hCG)levels were measured on posttreatment day 4 and day 7.If serum β-hCG level decreased less than 15%,it was considered as treatment failure,thus the patient was included in the failure group.If serum β-hCG level decreased more than 15%,it was considered as effective initial treatment and β-hCG levels were measured weekly until back to nonpregnant level,thus the patient was included in the success group.Clinical data and treatment outcomes were collected and outcomes-related risk factors were analyzed.Results There were 70 patients in failure group and 346 patients in success group.The proportion of patients with increased β-humanchorionic gonadotrophin(β-hCG)level before MTX treatment in failure group was significantly higher than that of patients in success group(55.2%vs.35.8%,P=0.007)and the proportion of patients with decreased β-hCG level before MTX treatment in failure group was significantly lower than that of patients in success group(43.1%vs.63.6%,P=0.007).Monocyte counts in failure group was significantly lower than that in success group[(0.43±0.13)×109/L vs.(0.47±0.17)×109/L,t=-2.001,P=0.047)].The differences of basal β-hCG level,change speed of β-hCG level,serum albumin,serum creatinine,white blood cell,neutrocyte,mean platelet volume,neutrocyte-lymphocyte ratio,platelet-lymphocyte ratio and lymphocyte-monocyte ratio between the two groups were not significant.Logistic regression analysis suggested the changing patterns of serum β-hCG level and monocyte counts were associated with treatment outcomes.Decreased β-hCG level(OR=2.313,95%CI:1.222-4.379,P=0.010)and monocyte counts≥0.6×109/L(OR=4.018,95%CI:1.207-13.378,P=0.023)were positively correlated with treatment success.Conclusion Decreased β-hCG level MTX treatment and monocyte counts≥0.6×109/L were two independent risk factors for the successful treatment of ectopic pregnancy.

The sensor of the taste is the taste bud. The signals originated from the taste buds are transmitted to the central nervous system through the gustatory taste nerves. The chorda tympani nerve (innervating the taste buds of the anterior tongue) and glossopharyngeal nerve (innervating the taste buds of the posterior tongue) are the two primary gustatory nerves. The injuries of gustatory nerves cause their innervating taste buds atrophy, degenerate and disappear. The related taste function is also impaired. The impaired taste function can be restored after the gustatory nerves regeneration. The rat model of cross-regeneration of gustatory nerves is an important platform for research in the plasticity of the central nervous system. The animal behavioral responses and the electrophysiological properties of the gustatory nerves have changed a lot after the cross-regeneration of the gustatory nerves. The effects of the injury, regeneration and cross-regeneration of the gustatory nerves on the taste function in the animals will be discussed in this review. The prospective studies on the animal model of cross-regeneration of gustatory nerves are also discussed in this review. The study on the injury, regeneration and cross-regeneration of the gustatory nerves not only benefits the understanding of mechanism for neural plasticity in gustatory nervous system, but also will provide theoretical basis and new ideas for seeking methods and techniques to cure dysgeusia.
Animals ; Chorda Tympani Nerve ; physiology ; Glossopharyngeal Nerve ; physiology ; Nerve Regeneration ; Neuronal Plasticity ; Rats ; Taste ; physiology ; Taste Buds ; physiology ; Tongue ; innervation

Objective Toinvestigatethestatusoftick-borneRickettsiaeinfectionsamongmurine-likeanimalsin differentareasofZhejiangprovince.Methods Liverandspleensamplesofmurine-likeanimalscapturedthroughnight trapping method were collected from Anji,Jinhua and Tiantai County according to their geographic locations and historical detection of Rickettsiae .Nest-PCR tests were used to determine the presence of the 16S rRNA genes of Anaplasma and Ehrlichia ,and the heat shock protein genes (groEL)of Rickettsiae (including typhus and spotted fever group)and Orientiainthesesamples.Results Atotalof851murine-likeanimalsbelongingto14specieswerecaptured.The predominant species were Rattus confucianus (30.32%),Apodemus agrarius (18.80%) and Thallomys paedulcus (1 1.75%)and they were significantly different among three areas (P<0.05 ).48 Rickettsia positive were found in 562 tested samples with the positive rate of 8.54%,among which the percentage of Anaplasma,typhus group Rickettsia, Orientia,Ehrlichia and spotted fever group Rickettsia were 3.38%,1.78%,1.78%,1.07% and 0.53% respectively. The positive rates of Anaplasma in Jindong (4.76%)and Anji (4.27%)were significantly higher than that in Tiantai (P<0.05 )while the spotted fever group Rickettsia were found only in Tiantai County.Moreover,Rattus confucianus-the predominant species of Zhejiang Province-had the highest infection rate of tick-borne Rickettsiae up to 14.97%.Co-infections with several Rickettsiae were existed among the same species.Conclusion Rickettsiae infections exist widely among different areas of Zhejiang province and the positive rates are significantly different among species.

In order to analyze the temporal distribution characteristics of human rabies in China and explore the incidence forecasting,R3.3.2 software were used to establish the optimal ARIMA model of monthly incidences from 2004 to 2015 in Chi-na.Then the monthly incidences from January to November 2016 were forecasted with the model and the prediction accuracy was evaluated.The annual incidences of human rabies in China were decreasing tendency since 2007,and the monthly incidence reached highly during August to October.The optimal model was ARIMA(2,1,1)(2,0,0)12and the mean absolute error (MASE)was 0.755.The mean relative error was 15.61% when predicting the incidences from January to November 2016.In conclusion,there exists seasonal variation for human rabies in China and ARIMA model can be applied for the short-term fore-casting.

This study aimed to analyze the eluted components of syringe-type bis-acryl composites and to evaluate the effect of removing the oxygen-inhibited layer on cytotoxicity. Four different bis-acryl provisional composite materials-Protemp 4 (PT), Structur 2 SC (ST), Luxatemp Automix Plus (LT), and Hexa-Temp (HT)-were evaluated. Gas chromatography/mass spectrometry was used to analyze the composite eluate after 24 h of immersion in methanol. An agar overlay test and a live/dead assay were performed on the polymerized disc-shaped specimens after 24 h. To evaluate the effect of removing the oxygen-inhibited layer, samples were prepared with a surface oxygen-inhibited layer. The surface oxygen-inhibited layer of the disc-shaped specimens was removed with alcohol only (subgroup A) or with polishing and alcohol (subgroup PA), and their cytotoxicities were compared with those of “as received” (subgroup N) specimens using the WST-1 assay. Statistical significance was assessed using analyses of variance, followed by Bonferroni multiple comparison tests (α=0.05). Different components were detected by gas chromatography/mass spectrometry analysis among the groups. The agar overlay assay confirmed severe cytotoxicity in HT, LT, and ST groups, whereas PT showed moderate cytotoxicity. The effect of removing the oxygen-inhibited layer on cell viability was significantly higher in PA than in N in all composite groups. In HT and ST, the cell viability was significantly higher in PA than in A. Syringe-type bis-acryl composites for provisional restorations may elute various components into the oral cavity, which may cause cytotoxicity in adjacent structures. The cytotoxicity of the materials is reduced by the removal of the oxygen-inhibited layer.

Objective To analyze the effect and safety of profile pegylated interferon α-2a (PEG-IFN-α-2a) combined with ribavarin on hepatitis C virus (HCV)-related cirrhosis patients after splenic embolization.Methods Sixty-four HCV patients who underwent splenic embolization were randomly divided into treatment group and control group (32 cases in each group).Control group was given subcutaneous injection of recombinant human interferon α-2b (rhIFN α-2b) every other day,and oral administration of ribavarin 300 mg three times a day;Treatment group did not only receive the treatment above,but also received subcutaneous injection pegylated interferon α-2a 180 μg once a week.Both groups were treated for 12 weeks.HCV RNA positive rate,blood routine parameters,serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) levels,and adverse drug reactions were compared between the two groups.Results Before treatment,HCV RNA positive rate of the two groups were both 100％ (32/32 cases),after treatment,HCV RNA positive rate of treatment group was 53.13％ (17/32 cases) and that of and the control group was 78.12％ (25/32 cases),the difference was statistically significant (P ＜ 0.05).Mter treatment,the ANC of treatment group was (4.76 ± 0.33) × 109/L and that of the control group was (3.92 ±0.17) × 109/L,PLT levels of treatment group was (142.73 ± 17.04) × 109/L and that of and the control group was (128.72 ± 17.96) × 109/L,WBC levels of treatment group was (8.15 ± 1.84) × 109/L and that of and the control group was (6.57 ± 1.69 × 10)9/L,and the difference was statistically significant (P ＜ 0.05).After treatment,the ALT of the experimental group was 41.2 ± 22.4U · L-1 and that of and the control group was (60.1 ± 21.9) U · L-1,AST levels of the experimental group was 33.67 ± 18.46 U · L-1 and that of and the control group was (51.22 ± 16.95) U · L-1;The AST/ALT values were 0.78 ± 0.69,1.27 ± 0.73 in treatment group and in the control group,and the difference was statistically significant (P ＜ 0.05).Adverse drug reactions in treatment group was 40.63％ (13/32 cases),while it was 28.12％ (9/32 cases) in control group,thedifference was not statistically significant (P ＞ 0.05).Conclusion PEG-IFN-α-2a combined with riba virin could not only reduce HCV RNA positive rates,but also improve the serum AST and ALT levels in the treatment of hepatitis C virus-related cirrhosis underwent splenic embolization,which is safe.