Objective:To assess the occurrence, prognosis and possible early risk factors of jaundice in polytrauma patients.Methods:This study was a single-center, prospective study. Polytrauma patients (age>18 years) admitted to Tongji Trauma Center from October 2020 to January 2023 were enrolled. The patients with liver, biliary tract or pancreatic traumatic injury, previously suffered from chronic liver disease were excluded. The clinical characteristics of patients, laboratory test results, imaging examination results, Injury Severity Score (ISS), Glasgow Coma Score and APACHEⅡ score were collected. The incidence of jaundice, the classification of jaundice or the severity of jaundice after multiple injuries, the mortality rate of polytrauma patients with jaundice, and the early independent risk factors of jaundice in polytrauma were analyzed. The differences between the groups were compared by Student’s t test or χ2 test. The independent risk factors of jaundice were analyzed by Logistic regression analyzed. Results:A total of 742 polytrauma patients were included, 34.09% polytrauma patients were accompanied by jaundice, and the ratio of both moderate and severe jaundice were as high as 32.41%. The main type of jaundice was intrahepatic cholestatic jaundice (47.03%). The mortality rate of polytrauma patients accompanied by jaundice was significantly higher than that of polytrauma patients without jaundice (12.25% vs. 3.47%, P<0.001). Logistic regression analysis showed that ISS score ( OR=3.405, 95% CI: 1.962-7.438, P=0.026), plasma lactate ( OR=2.216, 95% CI: 1.203-4.862, P=0.017), interleukin-6 levels ( OR=2.431, 95% CI: 1.424-3.793, P=0.007), the overall duration of parenteral nutrition ( OR=3.011, 95% CI: 1.624-5.041, P=0.022), and the total duration of mechanical ventilation ( OR=3.572, 95% CI: 1.497-4.601, P=0.031) were the early independent risk factors for jaundice in patients after polytrauma. Conclusions:Polytrauma patients are prone to developing jaundice after injury, which is more harmful, especially for intrahepatic cholestatic jaundice after injury. Early identification and early intervention of risk factors associated with jaundice after injury should be strengthened.

Objective To evaluate the results of the orthognathic surgery with computer aided simulation-three-dimensional(3D) printed surgical guide and dental model surgery in the treatmemt of patients with mandibular excess and facial asymmetries.Methods The coordinate system was built in ProPlan CMF 2.0 software,and the horizontal plane consisted of PoL,PoR,OrL,middle sagittal plane through nasion point and basion point and the plane perpendicular to the horizontal plane,coronoid plane through nasion point and the plane perpendicular to the horizontal plane and middle sagittal plane.The orientation of maxilla and mandibular distal segment was calculated by each triangle(U 1-U6L-U6R,L1-L6L-L6R,Me-M5L-M5R) before and after orthognathic surgery.A total of 60 mandibular excess patients with facial asymmetries were enrolled in this retrospective study.They were divided into two groups,group I with computer aided simulation,group Ⅱ with dental model surgery.The difference of maxillary occlusal plane roll and yaw angle,mandibular occlusal plane roll and yaw angle,and mandibular body plane roll and yaw angle were calculated.Statistical analysis was performed with SPSS 17.0 software.Results The yaw angle of mandibular occlusal plane of the dental model surgery and computer aided simulation was 0.36°± 0.48° and 0.84° ±0.36° (P=0.043),respectively.The roll angle of mandibular occlusal plane of the dental model surgery and computer aided simulation was 0.26°±0.79° and 0.54°±0.40°(P=0.032),respectively.The yaw angle of mandibular body plane of the dental model surgery and computer aided simulation was 0.60°± 1.04° and 0.23°±0.52°(P=0.008),respectively.The roll angle of mandibular body plane of the dental model surgery and computer aided simulation was 0.82°± 0.72° and 0.53°± 0.37° (P=0.028),respectively.The changes in computer aided simulation group were more obvious than that in the dental model surgery group,but the difference was not significant in the yaw angle of maxillary occlusal plane and the roll angle of maxillary occlusal plane between the two groups(P ＞ 0.05).Conclusions It was more effective to correct mnandibular asymmetry by computer aided simulation than dental model surgery.